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BACKGROUND: The COVID-19 pandemic has significantly impacted global health, with diverse factors influencing the risk of death among reported cases. This study mainly analyzes the main characteristics that have contributed to the increase or decrease in the risk of death among Severe Acute Respiratory Syndrome (SARS) cases classified as COVID-19 reported in southeast Brazil from 2020 to 2023. METHODS: This cohort study utilized COVID-19 notification data from the Sistema de Vigilância Epidemiológica (SIVEP) information system in the southeast region of Brazil from 2020 to 2023. Data included demographics, comorbidities, vaccination status, residence area, and survival outcomes. Classical Cox, Cox mixed effects, Prentice, Williams & Peterson (PWP), and PWP fragility models were used to assess the risk of dying over time. RESULTS: Across 987,534 cases, 956,961 hospitalizations, and 330,343 deaths were recorded over the period. Mortality peaked in 2021. The elderly, males, black individuals, lower-educated, and urban residents faced elevated risks. Vaccination reduced death risk by around 20% and 13% in 2021 and 2022, respectively. Hospitalized individuals had lower death risks, while comorbidities increased risks by 20-26%. CONCLUSION: The study identified demographic and comorbidity factors influencing COVID-19 mortality. Rio de Janeiro exhibited the highest risk, while São Paulo had the lowest. Vaccination significantly reduces death risk. Findings contribute to understanding regional mortality variations and guide public health policies, emphasizing the importance of targeted interventions for vulnerable groups.
Assuntos
COVID-19 , Humanos , COVID-19/mortalidade , COVID-19/epidemiologia , Masculino , Feminino , Brasil/epidemiologia , Pessoa de Meia-Idade , Idoso , Adulto , Estudos Longitudinais , Adolescente , Adulto Jovem , Criança , Hospitalização/estatística & dados numéricos , Lactente , Pré-Escolar , SARS-CoV-2/isolamento & purificação , Comorbidade , Idoso de 80 Anos ou mais , Fatores de Risco , Síndrome Respiratória Aguda Grave/epidemiologia , Síndrome Respiratória Aguda Grave/mortalidade , Recém-NascidoRESUMO
ABSTRACT Objectives. The study aims to assess the trend of neonatal, post-neonatal, and infant mortality from 1996 to 2020 within the metropolitan region of the state of Rio de Janeiro and other regions. Methods. Ecological study using the region as analysis unity. Data were accessed from the Mortality Information System and Live Birth Information System in the capital Rio de Janeiro, in the neighboring areas of Niterói, São Gonçalo, Baixada Fluminense, and the remaining regions of the state of Rio de Janeiro State. We applied Poisson multilevel modeling, where the models' response variables were infant mortality and its neonatal and post neonatal components. Fixed effects of the adjusted models were region and death year variables. Results. During the 1996-2020 period, the Baixada Fluminense showed the highest infant mortality rate as to its neonatal and post neonatal components. All adjusted models showed that the more recent the year the lower the mortality risk. Niterói showed the lowest adjusted risk of infant mortality and its neonatal and post neonatal components. Conclusion. Baixada Fluminense showed the highest mortality risk for infant mortality and its neonatal and post-neonatal components in the metropolitan region. The stabilization in mortality rates in recent years was identified by the research.
RESUMO Objetivos. Avaliar a tendência da mortalidade neonatal, pós-neonatal e infantil de 1996 a 2020, na região metropolitana do estado do Rio de Janeiro e nas outras regiões. Métodos. Estudo ecológico utilizando regiões como unidade de análise. Os dados foram acessados no Sistema de Informações sobre Mortalidade e Sistema de Informações sobre Nascidos Vivos da Capital (Rio de Janeiro), dos territórios vizinhos (Niterói, São Gonçalo e Baixada Fluminense) e das outras regiões do Estado do Rio de Janeiro. Utilizamos a modelagem multinível de Poisson, onde as variáveis de resposta dos modelos foram mortalidade infantil e seus componentes neonatal e pós-neonatal. Os efeitos fixos dos modelos ajustados foram região e ano da morte. Resultados. No período 1996-2020, a Baixada Fluminense apresentou a maior taxa de mortalidade infantil de seus componentes neonatal e pós-natal na região metropolitana. Todos os modelos ajustados mostraram que quanto mais recente o ano, menor o risco de mortalidade. O risco ajustado da mortalidade infantil e seus componentes neonatal e pós-neonatal foi menor em Niterói. Conclusão. A Baixada Fluminense apresentou o maior risco de mortalidade infantil e de seus componentes neonatal e pós-neonatal na região metropolitana. Detectamos estabilização das taxas de mortalidade nos últimos anos.
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Objetivo: analisar o perfil sociodemográfico e comparar as diferenças das características de mulheres com alterações citológicas de alto grau em um serviço da atenção secundária. Método: estudo transversal retrospectivo de 2017 a 2021 realizado em 160 prontuários (CAAE 51800621.3.0000.5240). Resultados: predominaram mulheres com média de idade 40,7 anos, escolaridade abaixo do ensino médio, tiveram um a três filhos, não utilizavam preservativos e anticoncepcionais, não tabagistas e com alterações citopatológicas alto grau. As características com maiores percentuais para lesões citopatológicas de alto grau foram mulheres com quatro ou mais gestações, idade do parto menor ou igual a 18 anos, coitarca menor ou igual a 15 anos e tabagistas. Conclusão: serviços da rede de atenção, especialmente da atenção primária à saúde, devem capacitar permanentemente os profissionais visando cumprimento de fluxos assistenciais preconizadas pelas recomendações das diretrizes brasileiras de rastreamento da neoplasia cérvico-uterina atentando ao perfil encontrado de mulheres encaminhadas a atenção secundária.(AU)
Objective: analyzes the sociodemographic profile and compare the differences in the characteristics of women with high-grade cytological alterations in a secondary care service. Method: retrospective cross-sectional study from 2017 to 2021 carried out in 160 medical records (CAAE 51800621.3.0000.5240). Results: women predominated with a mean age of 40.7 years, education below high school, had one to three children, did not use condoms and contraceptives, non-smokers and with high-grade cytopathological alterations. The characteristics with the highest percentages for high-grade cytopathological lesions were women with four or more pregnancies, age at birth less than or equal to 18 years, coitarche less than or equal to 15 years, and smokers. Conclusion: services of the care network, especially primary health care, should permanently train professionals in order to comply with the care flows recommended by the recommendations of the Brazilian guidelines for screening cervical uterine neoplasia, paying attention to the profile found of women referred to secondary care.(AU)
Objetivo: analizar el perfil sociodemográfico y comparar las diferencias en las características de mujeres con alteraciones citológicas de alto grado en un servicio de segundo nivel de atención. Método: estudio transversal retrospectivo de 2017 a 2021 realizado en 160 historias clínicas (CAAE 51800621.3.0000.5240). Resultados: predominaron las mujeres con edad media de 40,7 años, escolaridad inferior a la secundaria, con uno a tres hijos, no usuarias de preservativo y anticonceptivos, no fumadoras y con alteraciones citopatológicas de alto grado. Las características con mayor porcentaje de lesiones citopatológicas de alto grado fueron mujeres con cuatro o más embarazos, edad al nacer menor o igual a 18 años, coitarquia menor o igual a 15 años y fumadoras. Conclusión: servicios de la red de atención, especialmente la atención primaria a la salud, deben capacitar permanentemente a los profesionales para cumplir con los flujos de atención recomendados por las recomendaciones de las directrices brasileñas para el tamizaje de la neoplasia cérvico-uterina, prestando atención al perfil encontrado de las mujeres referidas atención secundaria.(AU)
Assuntos
Feminino , Adulto , Pessoa de Meia-Idade , Neoplasias do Colo do Útero , Programas de Rastreamento , Saúde da Mulher , Continuidade da Assistência ao PacienteRESUMO
This study aimed to analyze the accuracy of two methods for detecting halitosis, the organoleptic assessment by a trained professional (OA) with volatile sulfur compounds (VSC) measurement via Halimeter® (Interscan Corporation) and information obtained from a close person (ICP). Participants were patients and companions who visited a university hospital over one year period to perform digestive endoscopy. A total of 138 participants were included in the VSC test, whose 115 were also included in the ICP test. ROC curves were constructed to establish the best VSC cut-off points. The prevalence of halitosis was 12% (95%CI: 7% to 18%) and 9% (95%CI 3% to 14%) for the OA and ICP, respectively. At the cut-off point >80 parts per billion (ppb) VSC, the prevalence of halitosis was 18% (95%CI: 12% to 25%). At the cut-off point >65 ppb VSC, sensitivity and specificity were 94% and 76%, respectively. At the cut-off point >140 ppb, sensitivity was 47% and specificity 96%. For the ICP, sensitivity was 14% and specificity 92%. VSC presents high sensitivity at the cut-off point of >65 ppb and high specificity at the cut-off point of >140 ppb. ICP had high specificity, but low sensitivity. The OA can express either occasional or chronic bad breath, whereas the ICP can be a potential instrument to detect chronic halitosis.
Assuntos
Halitose , Compostos de Enxofre , Humanos , Halitose/diagnóstico , Halitose/epidemiologia , Boca , Sensibilidade e EspecificidadeRESUMO
OBJECTIVE: The aim of this study was to assess the rate of repeated pregnancy in adolescence and its association with early marriage and education level. METHODS: This is a cross-sectional study conducted by searching the Live Births Data System. The study included all adolescents in the age group 10-19 years with live births from 2015 to 2019 (n=2,405,248), divided into three groups: G1: primiparas; G2: with 1 previous pregnancy; and G3: with two or more previous pregnancies. RESULTS: Total repeated pregnancies remained stable, along the years. In the age group 10-14 years, the decrease in the period was from 5.0 to 4.7%, whereas in the age group 15-19 years, it was from 27.8 to 27.3%. Being married or in a stable union increases by 96% the chance of repeated pregnancy in the age group 10-14 years (p<0.001; OR=1.96; 95% confidence interval [CI] 1.85-2.09). In the age group 15-19 years, the chance of repeated pregnancy among the married or in stable union increased 40% (p<0.001; OR=1.40; 95%CI 1.39-1.41)). Girls aged 10-14 years with an education level of<8 years had a 64% higher chance of repeated pregnancy (p<0.001; OR=1.64; 95%CI 1.53-1.75), and among those aged 15-19 years, there was a 137% higher chance of repeated pregnancy (p<0.001; OR=2.37; 95%CI 2.35-2.38). CONCLUSION: Repeated pregnancy in adolescence in Brazil remains very high over the years. There is an association between low education level and early marriage with repeated pregnancies in adolescence.
Assuntos
Gravidez na Adolescência , Adolescente , Feminino , Gravidez , Humanos , Lactente , Pré-Escolar , Brasil , Estudos Transversais , Escolaridade , Nascido VivoRESUMO
Halitosis affects all populations worldwide. The presence of chronic halitosis may be related to a health problem. Patients with bad breath usually seek a gastroenterologist and, in some cases, invasive and expensive exams, such as digestive endoscopy, are performed to investigate the etiology of halitosis. This study aimed to investigate whether the prevalence of bad breath in patients diagnosed with dyspepsia (any pain or discomfort in the upper abdomen) is higher than or equivalent to that in non-dyspeptic patients. This is a cross-sectional study that included 312 patients from university hospitals in the city of Rio de Janeiro (141 dyspeptic patients and 171 non-dyspeptic ones). The presence of halitosis was defined based on different cutoff points. Association analyses were performed using a log-binomial model and 95% confidence intervals were calculated for the coefficients, adjusting for sex and age. The equivalence test (Westlake) was used to test the hypothesis of equivalence between the proportions of patients with bad breath in the two groups (dyspeptic vs. non-dyspeptic), considering an equivalence band of ± 15%. The prevalence of bad breath ranged from 30% to 64% according to the definition of bad breath. Dyspepsia was not associated with bad breath in any of the three definitions of bad breath (two specific ones and a sensitive one). The proportion of patients with marked bad breath was equivalent in patients with and without dyspepsia.
Assuntos
Dispepsia , Halitose , Infecções por Helicobacter , Helicobacter pylori , Humanos , Halitose/etiologia , Halitose/complicações , Infecções por Helicobacter/complicações , Infecções por Helicobacter/diagnóstico , Infecções por Helicobacter/epidemiologia , Estudos Transversais , Brasil/epidemiologia , Dispepsia/complicações , Dispepsia/epidemiologiaAssuntos
COVID-19 , Gravidez na Adolescência , Gravidez , Feminino , Adolescente , Humanos , Brasil/epidemiologia , Pandemias , Fatores SocioeconômicosRESUMO
SUMMARY OBJECTIVE: This study aimed to describe the current situation of sexual aggression and assess the adhesion to ambulatory care follow-up. METHODS: This is a cross-sectional study involving female children and adolescents aged 0-19 years, treated at the Center for Multiprofessional Care of Sexual Violence of the General Hospital of Nova Iguaçu, from 2014 to 2018. RESULTS: Of the 453 children and adolescents, 264 (58.3%) were <14 years of age and 189 (41.7%) were 14-19 years of age. In both groups, 78% were black. School delay of >2 years was found in 15.6% of children in the age group <14 years and 40.5% of adolescents in the age group 14-19 years [p<0.001; OR=3.7 (2.1-65)]. In girls aged £13 years, abuse usually occurred at home (73.2%), which was perpetrated by one aggressor (91%) and known to the victim (91.2%). In adolescents aged ≥14 years, 84.1% of rapes occurred outside the home, practiced by one aggressor (74.8%), 57.8% were unknown, and in 91.2% of cases, there was use of physical force and/or verbal threats. The victims aged <14 years have 14 times more chance of experiencing aggression within the family setting [p<0.001; OR=14.3 (8.2-25.6)] and 16 times more chance of experiencing aggression from known persons [p<0.001; OR=16.2 (9.2-29.8)]. On the contrary, adolescents aged ≥14 years have three times more chance of being abused by more than one aggressor [p<0.001; OR=3.3 (1.8-6.1)]. CONCLUSION: Black girls, especially those aged <14 years, are in a situation of greater vulnerability for sexual violence, have less adhesion to follow-up, and often experience aggression in the household setting.
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OBJECTIVE: This study aimed to describe the current situation of sexual aggression and assess the adhesion to ambulatory care follow-up. METHODS: This is a cross-sectional study involving female children and adolescents aged 0-19 years, treated at the Center for Multiprofessional Care of Sexual Violence of the General Hospital of Nova Iguaçu, from 2014 to 2018. RESULTS: Of the 453 children and adolescents, 264 (58.3%) were <14 years of age and 189 (41.7%) were 14-19 years of age. In both groups, 78% were black. School delay of >2 years was found in 15.6% of children in the age group <14 years and 40.5% of adolescents in the age group 14-19 years [p<0.001; OR=3.7 (2.1-65)]. In girls aged £13 years, abuse usually occurred at home (73.2%), which was perpetrated by one aggressor (91%) and known to the victim (91.2%). In adolescents aged ≥14 years, 84.1% of rapes occurred outside the home, practiced by one aggressor (74.8%), 57.8% were unknown, and in 91.2% of cases, there was use of physical force and/or verbal threats. The victims aged <14 years have 14 times more chance of experiencing aggression within the family setting [p<0.001; OR=14.3 (8.2-25.6)] and 16 times more chance of experiencing aggression from known persons [p<0.001; OR=16.2 (9.2-29.8)]. On the contrary, adolescents aged ≥14 years have three times more chance of being abused by more than one aggressor [p<0.001; OR=3.3 (1.8-6.1)]. CONCLUSION: Black girls, especially those aged <14 years, are in a situation of greater vulnerability for sexual violence, have less adhesion to follow-up, and often experience aggression in the household setting.
Assuntos
Agressão , Vítimas de Crime , Adolescente , Criança , Feminino , Humanos , Adulto Jovem , População Negra , Estudos TransversaisRESUMO
Abstract This study aims to characterize the morbidity of COVID-19 in the year 2020 by identifying the most vulnerable areas and areas of clustering of cases in a favela from Rio de Janeiro/Brazil known as Manguinhos. This is a cross-sectional descriptive study performed from March 16, 2020, to August 12, 2020. We described the sociodemographic profile of the cases and performed spatial analysis using point and Kernel maps. Incidence rates were calculated by sex, age, and sub-regions. The incidence rate was 202/10,000. We detected clusters of cases west, central-north, and central-south of Manguinhos. High incidence rates were observed also in sub-regions of central-north, central-south, and southwest. In the sub-regions with high incidence, the percentage of people depending on financial governmental aid ranged between 13% and 21%. The sub-regions with the highest agglomeration of cases in the territory of Manguinhos coincide with the regions with the highest incidence rates, but not with the poorest regions of the territory.
Resumo O objetivo deste estudo é caracterizar a morbidade da COVID-19 no ano de 2020, identificando as áreas mais vulneráveis e áreas de aglomeração de casos em uma favela do Rio de Janeiro/Brasil conhecida como Manguinhos. Trata-se de um estudo descritivo transversal realizado de 16 de março a 12 de agosto de 2020. Descrevemos o perfil sociodemográfico dos casos e fizemos análise espacial por meio de mapas de pontos e Kernel. As taxas de incidência foram calculadas por sexo, idade e sub-regiões. A taxa de incidência foi de 202/10.000 habitantes. Detectamos aglomerados de casos a oeste, centro-norte e centro-sul de Manguinhos. Altas taxas de incidência foram observadas também nas sub-regiões centro-norte, centro-sul e sudoeste. Nas sub-regiões com alta incidência, o percentual de pessoas dependentes de ajuda financeira governamental variou entre 13% e 21%. As sub-regiões com maior aglomeração de casos no território de Manguinhos coincidem com as regiões com as maiores taxas de incidência, mas não com as regiões mais pobres do território.
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Abstract Halitosis affects all populations worldwide. The presence of chronic halitosis may be related to a health problem. Patients with bad breath usually seek a gastroenterologist and, in some cases, invasive and expensive exams, such as digestive endoscopy, are performed to investigate the etiology of halitosis. This study aimed to investigate whether the prevalence of bad breath in patients diagnosed with dyspepsia (any pain or discomfort in the upper abdomen) is higher than or equivalent to that in non-dyspeptic patients. This is a cross-sectional study that included 312 patients from university hospitals in the city of Rio de Janeiro (141 dyspeptic patients and 171 non-dyspeptic ones). The presence of halitosis was defined based on different cutoff points. Association analyses were performed using a log-binomial model and 95% confidence intervals were calculated for the coefficients, adjusting for sex and age. The equivalence test (Westlake) was used to test the hypothesis of equivalence between the proportions of patients with bad breath in the two groups (dyspeptic vs. non-dyspeptic), considering an equivalence band of ± 15%. The prevalence of bad breath ranged from 30% to 64% according to the definition of bad breath. Dyspepsia was not associated with bad breath in any of the three definitions of bad breath (two specific ones and a sensitive one). The proportion of patients with marked bad breath was equivalent in patients with and without dyspepsia.
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Abstract This study aimed to analyze the accuracy of two methods for detecting halitosis, the organoleptic assessment by a trained professional (OA) with volatile sulfur compounds (VSC) measurement via Halimeter® (Interscan Corporation) and information obtained from a close person (ICP). Methodolody Participants were patients and companions who visited a university hospital over one year period to perform digestive endoscopy. A total of 138 participants were included in the VSC test, whose 115 were also included in the ICP test. ROC curves were constructed to establish the best VSC cut-off points. Results The prevalence of halitosis was 12% (95%CI: 7% to 18%) and 9% (95%CI 3% to 14%) for the OA and ICP, respectively. At the cut-off point >80 parts per billion (ppb) VSC, the prevalence of halitosis was 18% (95%CI: 12% to 25%). At the cut-off point >65 ppb VSC, sensitivity and specificity were 94% and 76%, respectively. At the cut-off point >140 ppb, sensitivity was 47% and specificity 96%. For the ICP, sensitivity was 14% and specificity 92%. Conclusions VSC presents high sensitivity at the cut-off point of >65 ppb and high specificity at the cut-off point of >140 ppb. ICP had high specificity, but low sensitivity. The OA can express either occasional or chronic bad breath, whereas the ICP can be a potential instrument to detect chronic halitosis.
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SUMMARY OBJECTIVE: The aim of this study was to assess the rate of repeated pregnancy in adolescence and its association with early marriage and education level. METHODS: This is a cross-sectional study conducted by searching the Live Births Data System. The study included all adolescents in the age group 10-19 years with live births from 2015 to 2019 (n=2,405,248), divided into three groups: G1: primiparas; G2: with 1 previous pregnancy; and G3: with two or more previous pregnancies. RESULTS: Total repeated pregnancies remained stable, along the years. In the age group 10-14 years, the decrease in the period was from 5.0 to 4.7%, whereas in the age group 15-19 years, it was from 27.8 to 27.3%. Being married or in a stable union increases by 96% the chance of repeated pregnancy in the age group 10-14 years (p<0.001; OR=1.96; 95% confidence interval [CI] 1.85-2.09). In the age group 15-19 years, the chance of repeated pregnancy among the married or in stable union increased 40% (p<0.001; OR=1.40; 95%CI 1.39-1.41)). Girls aged 10-14 years with an education level of<8 years had a 64% higher chance of repeated pregnancy (p<0.001; OR=1.64; 95%CI 1.53-1.75), and among those aged 15-19 years, there was a 137% higher chance of repeated pregnancy (p<0.001; OR=2.37; 95%CI 2.35-2.38). CONCLUSION: Repeated pregnancy in adolescence in Brazil remains very high over the years. There is an association between low education level and early marriage with repeated pregnancies in adolescence.
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This study aims to identify a set of symptoms that could be predictive of SARS-CoV-2 cases in the triage of Primary Care services with the contribution of Qualitative Comparative Analysis (QCA) using Fuzzy Sets (fsQCA). A cross-sectional study was carried out in a Primary Health Care Unit/FIOCRUZ from 09/17/2020 to 05/05/2021. The study population was suspect cases that performed diagnostic tests for COVID-19. We collected information about the symptoms to identify which configurations are associated with positive and negative cases. For analysis, we used fsQCA to explain the outcomes "being a positive case" and "not being a positive case". The solution term "loss of taste or smell and no headache" showed the highest degree of association with the positive result (consistency = 0.81). The solution term "absence of loss of taste or smell combined with the absence of fever" showed the highest degree of association (consistency = 0,79) and is the one that proportionally best explains the negative result. Our results may be useful to the presumptive clinical diagnosis of COVID-19 in scenarios where access to diagnostic tests is not available. We used an innovative method used in complex problems in Public Health, the fsQCA.
Assuntos
Ageusia , COVID-19 , Humanos , COVID-19/diagnóstico , COVID-19/epidemiologia , SARS-CoV-2 , Brasil/epidemiologia , Estudos Transversais , Atenção Primária à SaúdeRESUMO
This study aimed to analyze the role of period, geographic and socio demographic factors in cancer-related mortality by prostate, breast, cervix, colon, lung and esophagus cancer in Brazilians capitals (2000-2015). Ecological study using data of Brazilian Mortality Information. Multilevel Poisson models were used to estimate the adjusted risk of cancer mortality. Mortality rate levels were higher in males for colon, lung and esophageal cancers. Mortality rates were highest in the older. Our results showed an increased risk of colon cancer mortality in both sexes from 2000 to 2015, which was also evidenced for breast and lung cancers in women. In both genders, the highest mortality risk for lung and esophageal cancers was observed in Southern capitals. Midwestern, Southern and Southeastern capitals showed the highest mortality risk for colon cancer both for males and females. Colon cancer mortality rate increased for both genders, while breast and lung cancers mortality increased only for women. The North region showed the lowest mortality rate for breast, cervical, colon and esophageal cancers. The Midwest and Northeast regions showed the highest mortality rates for prostate cancer.
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Neoplasias da Mama , Neoplasias da Mama/epidemiologia , Colo do Útero , Colo , Esôfago , Feminino , Humanos , Pulmão , Masculino , Análise Multinível , PróstataRESUMO
Abstract This study aimed to analyze the role of period, geographic and socio demographic factors in cancer-related mortality by prostate, breast, cervix, colon, lung and esophagus cancer in Brazilians capitals (2000-2015). Ecological study using data of Brazilian Mortality Information. Multilevel Poisson models were used to estimate the adjusted risk of cancer mortality. Mortality rate levels were higher in males for colon, lung and esophageal cancers. Mortality rates were highest in the older. Our results showed an increased risk of colon cancer mortality in both sexes from 2000 to 2015, which was also evidenced for breast and lung cancers in women. In both genders, the highest mortality risk for lung and esophageal cancers was observed in Southern capitals. Midwestern, Southern and Southeastern capitals showed the highest mortality risk for colon cancer both for males and females. Colon cancer mortality rate increased for both genders, while breast and lung cancers mortality increased only for women. The North region showed the lowest mortality rate for breast, cervical, colon and esophageal cancers. The Midwest and Northeast regions showed the highest mortality rates for prostate cancer.
Resumo Este estudo teve como objetivo analisar o papel de fatores temporais, geográficos e sociodemográficos na mortalidade por câncer de próstata, mama, colo do útero, cólon, pulmão e esôfago nas capitais brasileiras (2000-2015). Estudo ecológico utilizando informações brasileiras de mortalidade. Modelos de Poisson multinível foram usados para estimar o risco ajustado de mortalidade por câncer. Os níveis de mortalidade foram maiores em homens para câncer de cólon, pulmão e esôfago. As taxas de mortalidade foram mais altas nos idosos. Nossos resultados mostraram risco aumentado de mortalidade por câncer de cólon em ambos os sexos de 2000 a 2015, o que também foi evidenciado para câncer de mama e de pulmão em mulheres. Em ambos os sexos, o maior risco de mortalidade para câncer de pulmão e esôfago foi observado nas capitais do Sul. As capitais do Centro-Oeste, Sul e Sudeste apresentaram o maior risco de mortalidade por câncer de cólon tanto para homens quanto para mulheres. A taxa de mortalidade por câncer de cólon aumentou para ambos os sexos, enquanto a mortalidade por câncer de mama e de pulmão aumentou apenas para as mulheres. A região Norte apresentou a menor taxa de mortalidade por câncer de mama, colo do útero, cólon e esôfago. As regiões Centro-Oeste e Nordeste apresentaram as maiores taxas de mortalidade por câncer de próstata.
Assuntos
Neoplasias da Mama/epidemiologia , Próstata , Colo do Útero , Colo , Esôfago , Análise Multinível , PulmãoRESUMO
ABSTRACT: This study aims to evaluate the ratio of the number of cases of family violence and violence by a known person, over the four surveys that took place in 2006, 2007, 2009, and 2011, within the population treated in the Brazilian health services, according to demographic and socioeconomic characteristics. Data from the Vigilância de Violências e Acidentes survey was used. The variables age, victim sex, aggressor sex, race, and schooling level were considered in the analysis. This study pointed out decreasing trend in the number of violence-related care within the older age group. The number of familial violence-related care per victim sex was higher for male victims when the aggressor was female, and conversely, it was higher for female victims when the aggressor was male. The number of violence-related care was mostly higher in non-White people than in White. People with low schooling levels showed the highest ratio of the number of violence-related care.
Assuntos
Violência Doméstica , Idoso , Brasil/epidemiologia , Escolaridade , Feminino , Humanos , MasculinoRESUMO
OBJECTIVE: Compare official data on notifications of sexual violence against girls aged 10 to 13 years with data on pregnancy for the same age group between 2012 and 2018. METHODS: This is an epidemiological, descriptive, cross-sectional study with data from the Department of Informatics of the Unified Health System (DATASUS) on violence against and pregnancy of girls aged 10 to 13 years from 2012 to 2018. Data on sexual violence were accessed in the Health Information System (SINAN); on pregnancy, in the Live Births Information System (SINASC), on fetal deaths, in the Mortality Information System (SIM), and on abortions, in the Hospital Admission System (SIH). RESULTS: Between 2012 and 2018, out of 136,387 pregnancies, there were 120,185 live births and 15,402 interrupted pregnancies by abortions or fetal deaths of mothers who became pregnant aged 13 years or younger. In the same period, SINAN received 46,548 notifications of sexual abuse against girls aged 10 to 13 years. The number of girls who became pregnant before the age of 14, victims of statutory rape, was 2.9 times higher than the number of cases notified to SINAN. CONCLUSION: The lack of adequate notification of statutory rapes in Brazilian official statistics leads to the underestimation of its magnitude.
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Estupro , Delitos Sexuais , Brasil/epidemiologia , Estudos Transversais , Feminino , Humanos , Gravidez , ViolênciaRESUMO
OBJECTIVE: This study aimed to evaluate the frequency of late pregnancies in Brazil, the age-specific fertility rate (ASFR) in the regions, the rate of prematurity, and the rate of low birth weight (LBW) and their association with advanced maternal age compared with 20-34-year-old women. METHODS: This was a cross-sectional study conducted by searching the Information System on Live Births (Sistema de Informações Sobre Nascidos Vivos [SINASC]). Data from 1995 to 2018 were collected, and pregnant women were divided into three categories based on their age range: 35-39, 40-44, and ≥45 years. The study calculated the frequency of deliveries of mothers of advanced age in Brazil, the ASFR, and the rates of prematurity and LBW in each group. CONCLUSIONS: The frequency of deliveries and ASFR ≥35 years increased between 1995 and 2018. The chances of prematurity and LBW were higher with increased maternal age.