Revista brasileira de epidemiologia = Brazilian journal of epidemiology最新文献

Objective: The aim of this study was to analyze temporal trends in malignant neoplasms of corpus uteri mortality in México from 2000 through 2022.

Methods: Certificates of death were analyzed. The age-standardized mortality rate (ASMR), the number of years of life lost, according to the federal state, was estimated. The changes in temporal trends were analyzed using joint point regression.

Results: The ASMR from malignant neoplasms of the corpus uteri was estimated at 2.5 (95% confidence interval [CI] 2.2-2.8), and the annual percentage change from 2000 to 2018 was 4.32. The age group of 60-65 years was most affected.

Conclusion: This report indicates an increase in the ASMR from malignant neoplasms of the corpus uteri. It also suggests the need for the development of public health laws focusing on the early diagnosis and prevention of uterine cancer.

Objective: Investigate changes in alcohol consumption and the association between maternal depression and anxiety, considering the moderating effect of social isolation during the COVID-19 pandemic, using a population-based cohort from Brazil.

Methods: Data were obtained from the WebCovid-19 study, a web-based follow-up of the 2019 Rio Grande (RS), Brazil, birth cohort, with 1,077 and 1,033 postpartum women participating in waves I and II, respectively. Changes in maternal alcohol consumption were self-reported, while depression and anxiety were assessed using the Edinburgh Postnatal Depression Scale and the Generalised Anxiety Scale. Crude and adjusted negative binomial regression was conducted, including tests for moderation by social isolation.

Results: Of the 781 mothers included, 57.3% reported staying home ≥5 days in the last week, and 5.0% increased alcohol consumption during the pandemic. Median depression and anxiety scores were 8.0 (interquartile range - IQR 3-13) and 6.0 (IQR 3-10), respectively. Mothers who increased alcohol consumption had a 5-point (95% confidence interval - 95%CI 3.0-7.0) and 4.2-point (95%CI 2.6-5.9) increase in depression and anxiety scores, respectively. Social isolation duration did not significantly modify the effect of alcohol consumption on mental health.

Conclusion: Increased alcohol consumption during the pandemic was associated with higher depression and anxiety scores. The hypothesised moderating effect of longer isolation on this association remains a possibility.

Objective: To describe the methodological procedures used to collect and analyze data from an online survey carried out from July to December 2023 and to verify whether the obtained sample is representative of the Brazilian population.

Methods: A cross-sectional epidemiological study was carried out through social media, using the Respondent-Driven Sampling methodology to collect information from the Brazilian adult population. For sample weighting, a post-stratification procedure was used based on sociodemographic data of the 2022 Continuous National Household Sample Survey (PNADC-2022). Prevalence estimates of chronic noncommunicable diseases, self-rated health, and health behaviors estimated in the ConVid-2 survey were compared with the estimates from the 2019 National Health Survey (PNS-2019).

Results: A total of 3,805 individuals participated in the ConVid-2 survey. When comparing sociodemographic variables from ConVid-2 with those from the PNADC, we verified very similar proportions in both surveys. Regarding chronic noncommunicable diseases, we found discrepancies only in prevalence of asthma and depression in comparison with PNS-2019. As for lifestyle habits, the percentages of current smoking, adequate leisure-time physical activity, and consumption of healthy and unhealthy foods were similar in both surveys. The greatest difference was observed in screen use after the COVID-19 pandemic.

Conclusion: The use of the Respondent-Driven Sampling method with the inclusion of recruiter-recruitee pairs enabled us to obtain more reliable estimates. Concerning lifestyle changes and the findings of this study, we highlight the need for actions aimed at promoting healthy behaviors and achieving greater advances in the control of chronic noncommunicable diseases.

Objective: To characterize the public health impacts resulting from the natural disaster caused by heavy rainfall and flooding in the state of Rio Grande do Sul (RS), Brazil, in 2024.

Methods: This was a descriptive ecological study covering the period between April 29 and May 31, 2024. The units of analysis were the municipalities and the nine functional planning regions. The following were analyzed: number and proportion of municipalities with an emergency declaration; deaths, ill individuals, and injured individuals per 100,000 inhabitants; and displaced and homeless people per thousand inhabitants.

Results: Of the 497 municipalities in RS, 91.3% declared an emergency, with emphasis on regions R2 and R5, where all municipalities were affected. Regions R1 and R2 were the most impacted in terms of human harm, particularly regarding homelessness, reaching 116 and 92.9 per thousand inhabitants, respectively. Emergencies were more frequent in regions R6, R7, and R5. The spatial distribution reveals that the most affected municipalities are geographically close, especially in regions R1, R2, and R8.

Conclusion: The unequal impacts across regions highlight the urgency of territorialized public policies, focused on prevention and emergency response. Strengthening risk governance and public health must occupy a central position in the climate agenda, promoting equity and resilience in the face of disasters.

In this essay, we discuss the challenges related to the interaction between epidemiology and health policies, programs, and services, with a particular focus on health surveillance. Although the scope of health surveillance encompasses knowledge beyond epidemiology, the use of epidemiological knowledge is paramount for enhancing the quality of its actions. We present the trajectory of the institutionalization process of health surveillance in Brazil, which culminated in the establishment of the National Health Surveillance Policy (PNVS) in 2018. The PNVS highlights a series of needs that can and should be addressed by epidemiology. These needs offer opportunities for greater interaction between epidemiology and health policies, programs, and services, but they require an update in epidemiology training models, both at the undergraduate and graduate levels, a greater appreciation for knowledge translation activities, and an improved alignment of the academic environment with advances in health surveillance policies in Brazil. Based on the analysis of Brazilian articles on health surveillance listed in the PubMed database, as well as data from research lines, projects, and theses and dissertations from graduate programs, we evaluate how the topic of health surveillance is integrated into research and graduate education in Collective Health in Brazil. We conclude this essay by discussing the contribution of the Fifth Strategic Plan for the Development of Epidemiology in Brazil (2025-2029) for strengthening health surveillance.

Objective: To analyze the temporal trend of the prevalence of abusive alcohol consumption in the Brazilian adult population residing in the country's capitals between 2006 and 2023, and to estimate projections for 2030.

Methods: Time-series study using data from the Surveillance System for Risk and Protective Factors for Chronic Diseases by Telephone Survey. Abusive alcohol consumption was defined as the intake of five or more drinks for men and four or more for women in a short period of time. The joinpoint regression model was used to identify trends, and exponential smoothing was applied to generate projections up to 2030.

Results: We observed an increasing trend in abusive alcohol consumption in the total population (from 15.6% in 2006 to 20.8% in 2023) and among women, across most age groups - except those aged 18-24 and 45-54 years -, among individuals with 12 or more years of education, and among racial groups identified as white, Black, and mixed-race. Among women, we observed an increase in 23 capitals. Considering the trends between 2015 and 2023, the 10% reduction target by 2030 is unlikely to be achieved.

Conclusion: The increase in alcohol consumption among women and the failure to meet the reduction target highlight the need to advance policies and programs to curb alcohol consumption.

Objective: To analyze COVID-19 morbidity according to sociodemographic characteristics and preexisting health conditions, based on data from a survey conducted in 2023 online called "ConVid-2 Behavior Survey".

Methods: This was a cross-sectional epidemiological study using the Respondent-Driven Sampling (RDS) method. Prevalence estimates and 95% confidence intervals were calculated for five COVID-19-related indicators. Logistic regression models were applied to test the hypothesis of associations between outcomes and sociodemographic characteristics.

Results: The sample included 3,805 individuals aged 18 years or older. Approximately 50% of participants had received four or more doses of the COVID-19 vaccine. The estimated prevalence of COVID-19 was 49.5%, with significant and increasing gradients by age and decreasing gradients by education level. Long COVID was identified in 32% of individuals with confirmed COVID-19, with the highest proportions among women (38.3%; OR=0.52; p=0.002), those with financial difficulties (38.9%; OR=1.68; p=0.02), and those with a chronic noncommunicable disease (36.3%; OR=1.58; p=0.03). The highest rate of hospitalization occurred among those with Long COVID (12.7%). Death of a household member due to COVID-19 was reported by 5.1% of participants.

Conclusion: The findings revealed major socioeconomic inequalities across all indicators related to COVID-19 morbidity. Older age, preexisting health conditions, and Long COVID contributed to greater disease severity and increased hospitalization. These findings are relevant to inform public policies aimed at supporting the diagnosis and management of COVID-19-related complications within the public health system.

Objective: To assess the prevalence and determinants of lifestyle habit changes in women during the COVID-19 pandemic.

Methods: This study analyzed data from the 2019 Rio Grande Birth Cohort, a population-based longitudinal study in Rio Grande, Brazil. We used data from the Perinatal Baseline Study (2019), before the COVID-19 pandemic, and the cohort's first follow-up (May-July 2020). We used standardized questionnaires to gather data on maternal sociodemographic characteristics, prenatal care, childbirth, care at birth and changes in habits during the COVID-19 pandemic, including sleep, physical activity, smoking, alcohol consumption, and diet. We used multinomial logistic regression, to calculate relative risk ratios (RR).

Results: In total (n=1,030), 52.5% maintained the same amount of sleep hours, 72.4% did not consume alcoholic beverages, 87.1% were non-smokers, 51.9% reported a decrease in physical activity, and 58.1% reported an increase in food intake. Older mothers, especially those older than 34, had lower risk of sleeping more hours (RR=0.53; 95% confidence interval - 95%CI 0.31-0.89), increasing their physical activity (RR 0.24; 95%CI 0.09-0.62), and were less likely to increase (RR=0.22; 95%CI 0.05-0.99) or decrease (RR=0.14; 95%CI 0.03-0.60) their alcohol consumption.

Conclusion: Social isolation during the pandemic led to changes in maternal habits, especially in physical activity and food intake. Older maternal age emerged as a key predictor, underscoring the need for targeted public health support for mothers during crises.

Objective: This study presents the accuracy of an algorithm with a mixed approach for linking the Mortality Information System (SIM) and the Influenza Epidemiological Surveillance Information System (SIVEP-Gripe) records, implemented in DuckDB.

Methods: The proposed algorithm was compared with a previously validated algorithm, in different prevalence scenarios. We employed a hybrid deterministic-probabilistic approach, using similarity metrics such as Jaro and Jaro-Winkler. The study highlights important advantages, including superior processing speed and scalability, maintaining high values in terms of sensitivity, specificity and predictive values.

Results: The DuckDB-based solution processed datasets significantly faster, with execution times up to one hundred times shorter, making it particularly suitable for large-scale, real-time applications.

Conclusions: This study underscores the potential of DuckDB as a high-performance analytical database for efficiently managing complex data integration tasks and highlights its suitability for resource-limited environments in public health, where timely and accurate record linkage is often essential.

Objective: In this essay, we discuss the belonging of Epidemiology to the Collective Health field, theories and contributions of Epidemiology to the health work process and to the impact assessment of Collective Health programs and actions, and the practical and theoretical tensions in the discipline and in the field.

Methods: The essay was conducted based on the theoretical contributions of various authors who reflected on Epidemiology throughout the 20th and early 21st centuries as well as the author's own experiences. It is organized into four thematic sections: the discipline's role within the field of Collective Health; the relations between Epidemiology and health practices; practical and theoretical tensions within the discipline itself and other disciplines within the field; and reflections on possible dialogues.

Results: We suggest resorting to transdisciplinarity, understanding the dynamics of scientific fields, overcoming false hierarchies between types of knowledge, defeating disciplinary limits, and decentralizing network connections as ways of coping with and overcoming difficulties.

Conclusions: The reward for this effort lies in the possibility of achieving effective responses to complex issues that, in addition to improving the health situation of populations, can be guided by the moral imperative of reducing inequalities and social injustices, respecting human rights, and building a more supportive and healthy society.