Prevalence and factors associated with driving under the influence of alcohol in Brazil.

OBJECTIVES: To estimate the prevalence and factors associated with Driving Under the Influence of Alcohol (DUIA) among car drivers and motorcyclists in Brazil and to evaluate the association between DUIA and self-reported Road Traffic Injuries (RTIs) in these groups. METHODS: A cross-sectional study was conducted using data from adults aged 18 or older who participated in the 2019 National Health Survey. Probability sampling was used to recruit participants, and data collection was carried out through home visits. Data from 31,246 car drivers and 21,896 motorcyclists were analyzed. Key indicators included the proportion (%) of car drivers who consumed alcohol and then drove in the past 12 months and the proportion (%) of motorcyclists who consumed alcohol and then drove in the past 12 months. Multiple Poisson regression was used to determine factors associated with DUIA and the association of this variable with RTIs in both groups. RESULTS: DUIA prevalence was 9.4% (95% Confidence Interval [95% CI] = 8.8-10.0) among car drivers and 11.2% (95% CI = 10.4-12.1) among motorcyclists. Among car drivers, DUIA prevalence was higher in men, young adults, those without a spouse/partner, and lower in individuals with lower income and education level. Among motorcyclists, DUIA prevalence was higher in men, young adults, those living outside the capitals and metropolitan regions, and lower in individuals with lower income. DUIA increased the prevalence of self-reported RTIs in the previous 12 months among car drivers and motorcyclists. CONCLUSIONS: A high prevalence of DUIA was evident among drivers, particularly motorcyclists. The DUIA was more prevalent among men and young adults. The DUIA was associated with an increased magnitude of self-reported RTIs among car drivers and motorcyclists. Despite the extensive legislation for zero tolerance toward DUIA in the country, actions need stricter enforcement.

Potentially inappropriate medications for the elderly: Incidence and impact on mortality in a cohort ten-year follow-up.

INTRODUCTION: Pharmacological therapy plays an important role in disease control in the elderly; unfortunately, this comes with a high prevalence in the use of medications classified as potentially inappropriate. OBJECTIVE: To analyze the incidence, risk factors, and survival of elderly people using potentially inappropriate medications (PIM). METHOD: A ten-year follow-up assessment of elderly participants residing in a capital of Central Brazil was conducted. The initial assessment (baseline) included 418 elderly people. Data were collected through home interviews guided by a questionnaire covering socioeconomic, demographic, living conditions, and health variables. The medication information obtained comprised active ingredient, dosage, route, and regimen for the medications. The PIMs were classified according to 2019 Beers Criteria. The analyses were performed using STATA 15.0. For survival analysis, a Cox Regression was performed with the respective Kaplan Meier curve. RESULTS: The incidence of PIM was 44.1 cases (95% CI: 35.2-54.7) per 1,000 people a year. The most used PIMs were nifedipine, glibenclamide, and sodium diclofenac. The risk factors were polypharmacy (aRR: 3.00; 95% CI: 1.31-6.88) and diabetes mellitus (aRR: 1.57; 95% CI: 1.03-2.39). We identified no statistically significant association between survival and the use of PIM. CONCLUSION: The study highlights the high consumption of PIM among the elderly causing polypharmacy risks. Health professionals working in drug treatment need to be alert to polypharmacy risks to ensure the rational use of medications to prevent adverse reactions and other health problems.

Prevalence and Risk Factors for Self-Report Diabetes Mellitus: A Population-Based Study.

The aim of this study was to estimate the prevalence and risk factors for self-reported diabetes mellitus (DM) in the adult population of the Central-West region of Brazil. In 2013, a cross-sectional study using the data from the National Health Survey and comprising 7519 individuals aged ≥18 years from the Central-West region was conducted. Participants were interviewed at their homes about sociodemographic data and risk factors for DM. To verify the risk factors with DM, the Poisson regression model was used. The analyses were performed for the total sample and stratified according to sex. The prevalence of DM was 6.5% (95% confidence interval [95% CI], 5.7-7.3). The diagnosis of self-reported DM was 4.3% in men and 7.5% in women. In the global sample, it was found that age between 40-59 years and ≥60 years, previous smoking (former smoker), self-reported hypertension, self-reported dyslipidemia, overweight, and obesity were independently associated with self-reported DM. In men, risk factors were: Age ≥ 60 years, self-reported hypertension, self-reported dyslipidemia, and obesity. In women, risk factors were: Age 30-39 years, 40-59 years, and ≥60 years, previous smoking (former smoker), self-reported hypertension, self-reported dyslipidemia, overweight, and obesity. Conclusion: The prevalence of DM was 6.5%. DM was associated with advanced age; previous smoking (former smoker), hypertension, dyslipidemia, overweight, and obesity. Some differences in risk factors between men and women were noted.

Reproductive desire among women living with HIV/AIDS in Central Brazil: Prevalence and associated factors.

BACKGROUND: The purpose of this study was to estimate the prevalence and examine the factors associated with reproductive desire among women living with HIV/AIDS (WLWHA) in Central Brazil. METHODS: A cross-sectional study involving 274 WLWHA, aged 18 to 49 years, was conducted with the support of treatment services and non-governmental organizations that assist people living with HIV/AIDS. Data regarding sociodemographic characteristics, substance use, sexual behavior, and reproductive variables were collected through interviews. Poisson regression with robust variance was used to analyze the factors associated with reproductive desire. RESULTS: The prevalence of reproductive desire was 25.9% (95.0% confidence interval [CI]: 21.1-31.4%). This outcome was associated with age < 30 years (adjusted prevalence ratio [APR]: 2.93; p < 0.001), black skin color or race (APR: 2.28; p = 0.017), partner's reproductive desire (APR: 7.55; p < 0.001), absence of children (APR: 2.13; p = 0.003), history of abortion (APR: 1.65; p = 0.045) and undetectable viral load at the time of data collection (APR: 1.92; p = 0.043). CONCLUSION: The prevalence of reproductive desire among WLWHA was relatively high. It is necessary to include fertility issues as part of assistance and counseling for women in referral services to support them with their feelings, goals, and needs regarding reproductive choices.

HIV Testing in Non-Injection Drug Users: Prevalence and Associated Factors.

The objective of this study was to estimate the prevalence of and identify factors associated with lifetime testing for the human immunodeficiency virus (HIV) in non-injection drug users (NIDU). A cross-sectional study was conducted with 323 individuals in clinics for chemical dependency in the state of Goiás in the Central-West region of Brazil. Logistic regression analysis was used to identify factors associated with lifetime HIV testing. Testing for HIV was associated with age, female gender, crack use, history of sexually transmitted infections, acquaintance with people living with HIV/AIDS and/or who had died from AIDS, and history of having received some instruction on HIV/AIDS prevention methods. It was found that only 26.6% reported having access to the HIV rapid test. We concluded determinants for HIV testing must be taken into account when planning prevention and programming strategies. These include the widening of testing coverage among NIDU, educational health actions, establishment of links between sexually transmitted infection prevention services and addiction treatment services, and the use of rapid tests to help people who are in contact with the virus learn about their HIV status, enter treatment, and improve their quality of life.