Quality, opportunity, and treatment of data of tuberculosis and human immunodeficiency virus co-infection / Calidad, oportunidad y manejo de los datos de coinfección tuberculosis y virus de la inmunodeficiencia humana / Qualidade, oportunidade e tratamento de dados de tuberculose e coinfecção com vírus da imunodeficiência humana

Background and Objectives: The identification, evaluation, and use of methodological resources for data quality analysis is important to support planning actions of public policies for the control of tuberculosis (TB) and the co-infection TB and human immunodeficiency virus (HIV). The objective was to analyze the quality and timeliness of notification of TB and TB-HIV co-infection cases from the Notifiable Diseases Information System (SINAN - Sistema de Informação de Agravos de Notificação) in Espírito Santo State, from 2016 to 2018. Methods: This is a cross-sectional study of the quality of SINAN data using the Centers for Disease Control and Prevention (CDC) guidelines to analyze the quality and timeliness of SINAN-TB notification, with emphasis on the description of TB-HIV co-infection in Espírito Santo State, from 2016 to 2018. It considered five methodological steps that included quality analysis, standardization of records, duplicity analysis, the completeness of data through linkage with the SINAN-HIV database and anonymization of data. It obtained ethical approval under the number 4022892 on 12/05/2020. Results: The study showed that 89% of mandatory variables and 91% of essential variables showed satisfactory completeness. In TB-HIV co-infection 73% of the variables were completed, but essential variables related to TB treatment follow-up showed unsatisfactory completeness. The timeliness of reporting was considered regular. Conclusion: Improvements in work processes and the development of a specific methodological process for data treatment are necessary to qualify the information available in SINAN-TB.(AU)

Justificativa e Objetivos: A identificação, avaliação e emprego de recursos metodológicos para análise da qualidade dos dados é importante para fundamentar ações de planejamento das políticas públicas no controle da tuberculose (TB) e da coinfecção TB e o vírus da imunodeficiência humana (HIV). O objetivo é analisar a qualidade e a oportunidade de notificação dos casos de TB e coinfecção TB-HIV do Sistema de Informação de Agravos de Notificação (SINAN) no Espírito Santo, de 2016 a 2018. Métodos: Trata-se de um estudo transversal da qualidade dos dados do SINAN com uso do Guia do Centers for Disease Control and Prevention (CDC) de análise da qualidade e oportunidade de notificação do SINAN-TB, com ênfase na descrição da coinfecção TB-HIV no Espírito Santo, de 2016 a 2018. Considerou-se cinco etapas metodológicas que incluíram análise da qualidade, padronização dos registros, análise de duplicidade, a completitude dos dados por meio de linkage com o banco de dados do SINAN-HIV e anonimização dos dados. Obteve aprovação ética sob parecer de nº 4022892 em 12/05/2020. Resultados: O estudo mostrou que 89% das variáveis obrigatórias e 91% das variáveis essenciais apresentaram completitude satisfatória. Na coinfecção TB-HIV 73% das variáveis foram preenchidas, porém variáveis essenciais relacionadas ao acompanhamento do tratamento para TB apresentaram completitude insatisfatória. A oportunidade de notificação foi considerada regular. Conclusão: Melhorias nos processos de trabalho e elaboração de processo metodológico específico para o tratamento dos dados são necessárias para qualificar as informações disponíveis no SINAN-TB.(AU)

Justificación y Objetivos: La identificación, evaluación y utilización de recursos metodológicos de análisis de la calidad de los datos es importante para apoyar la planificación de políticas públicas de control de la tuberculosis (TB) y la coinfección con el virus de la inmunodeficiencia humana (VIH). El objetivo es analizar la calidad y oportunidad de la notificación de casos de TB y coinfección TB-VIH del Sistema de Informação de Agravos de Notificação (SINAN), en el Estado del Espírito Santo, desde el año 2016 hasta 2018. Métodos: Este es un estudio transversal utilizando el análisis de la Guía de los Centros para el Control y Prevención de Enfermedades (CDC) de la calidad y oportunidad de la notificación en SINAN-TB, con énfasis en la descripción de la coinfección TB-VIH, en el Estado del Espírito Santo, desde el año 2016 hasta 2018. Fueran considerados cinco pasos metodológicos que incluyeron análisis de calidad, estandarización de registros, análisis de duplicidad, vinculación con la base de datos SINAN-VIH y anonimización de datos. Obtuvo aprobación ética bajo dictamen nº 4022892 el 12/05/2020. Resultados: El 89% de las variables obligatorias y el 91% de las variables esenciales se completaron satisfactoriamente. En la coinfección TB-VIH el 73% de las variables fueron completadas, mientras que las variables esenciales relacionadas con el acompañamiento del tratamiento para la TB presentaron una completitud insatisfactoria. La oportunidad de notificación fue considerada regular. Conclusión: Las mejoras en los procesos de trabajo y la elaboración de un proceso metodológico específico para el tratamiento de los datos son necesarias para cualificar la información disponible en el SINAN-TB.(AU)

Compulsorily notifiable diseases and health problems and socio-environmental conditions: an ecological study, Espírito Santo, Brazil, 2011-2015. / Doenças e agravos de notificação compulsória e condições socioambientais: estudo ecológico, Espírito Santo, 2011-2015.

OBJECTIVE: To analyze association between climatic-environmental conditions and occurrence of compulsorily notifiable diseases and health problems, in the state of Espírito Santo, Brazil, 2011-2015. METHODS: This was an ecological study of municipality clusters calculated based on cases confirmed on the Notifiable Health Conditions Information System for the period 2011-2015. RESULTS: Notifications were more frequent among females (51.1%); people of brown race/skin color (31.7%); in the 20-49 year age group (48.1%) and in the Metropolitan Health Region (60.3%). The factors associated with health problems were ambulatory care sensitive conditions (p-value<0.001); education development index (p-value<0.001); temperature (p-value=0.019) and degree of urbanization (p-value=0.004). Diseases were associated with population density (p-value<0.001); temperature (p-value<0.001), humidity (p-value<0.001) and altitude (p-value=0.005). CONCLUSION: Health problems were positively associated with ambulatory care sensitive conditions, the education development index and temperature; but negatively associated with degree of urbanization. Diseases were positively associated with the factors mentioned.

Doenças e agravos de notificação compulsória e condições socioambientais: estudo ecológico, Espírito Santo, 2011-2015 / Enfermedades y trastornos de notificación obligatoria y condiciones socioambientales: estudio ecológico, Espírito Santo, Brasil, 2011-2015 / Compulsorily notifiable diseases and health problems and socio-environmental conditions: an ecological study, Espírito Santo, Brazil, 2011-2015

Objetivo: Analisar a associação das condições climático-ambientais e a ocorrência das doenças e agravos de notificação compulsória no estado do Espírito Santo, Brasil. Métodos: Estudo ecológico dos agregados municipais calculados a partir de casos confirmados no Sistema de Informação de Agravos de Notificação (Sinan) para o período 2011-2015. Resultados: As notificações foram mais frequentes no sexo feminino (51,1%), raça/cor da pele parda (31,7%), faixa etária de 20-49 anos (48,1%) e região metropolitana de saúde (60,3%). Os fatores associados aos agravos foram as condições sensíveis à Atenção Básica (p-valor<0,001), o índice de desenvolvimento de educação (p-valor<0,001), a temperatura (p-valor=0,019) e o grau de urbanização (p-valor=0,004). As doenças estiveram associadas a densidade populacional (p-valor<0,001), temperatura (p-valor<0,001), umidade (p-valor<0,001) e altitude (p-valor=0,005). Conclusão: Os agravos associaram-se positivamente às condições sensíveis à Atenção Básica, índice de desenvolvimento da educação e temperatura; e negativamente ao grau de urbanização. As doenças associaram-se positivamente aos fatores citados.

Objetivo: Analizar la asociación de las condiciones climáticas-ambientales y la ocurrencia de enfermedades y trastornos de notificación obligatoria en el estado de Espírito Santo, Brasil. Métodos: Estudio ecológico de los agregados municipales, a partir de casos confirmados en el Sistema de Información de Agravamientos de Notificación, período 2011-2015. Resultados: Las notificaciones fueron más frecuentes en el sexo femenino (51,1%); raza/ color de piel parda (31,7%); de 20-49 años (48,1%) y región metropolitana de salud (60,3%). Los factores asociados a los agravamientos fueron sensibles a la atención primaria (p<0,001); los índices de desarrollo educativo (p<0,001); la temperatura (p=0,019) y el grado de urbanización (p=0,004). Los agravamientos estuvieron asociados con la densidad de población (p<0,001); la temperatura (p<0,001), la humedad (p <0,001) y la altitud (p=0,005). Conclusión: Los agravamientos se asociaron positivamente con las condiciones sensibles a la atención primaria, con el índice de desarrollo educativo y la temperatura; y negativamente con el grado de urbanización. Las enfermedades se asociaron positivamente con los factores mencionados.

Objective: To analyze association between climatic-environmental conditions and occurrence of compulsorily notifiable diseases and health problems, in the state of Espírito Santo, Brazil, 2011-2015. Methods: This was an ecological study of municipality clusters calculated based on cases confirmed on the Notifiable Health Conditions Information System for the period 2011-2015. Results: Notifications were more frequent among females (51.1%); people of brown race/skin color (31.7%); in the 20-49 year age group (48.1%) and in the Metropolitan Health Region (60.3%). The factors associated with health problems were ambulatory care sensitive conditions (p-value<0.001); education development index (p-value<0.001); temperature (p-value=0.019) and degree of urbanization (p-value=0.004). Diseases were associated with population density (p-value<0.001); temperature (p-value<0.001), humidity (p-value<0.001) and altitude (p-value=0.005). Conclusion: Health problems were positively associated with ambulatory care sensitive conditions, the education development index and temperature; but negatively associated with degree of urbanization. Diseases were positively associated with the factors mentioned.

[C-peptide and cardiovascular mortality: systematic review and meta-analysisPéptido C y mortalidad cardiovascular: revisión sistemática y metanálisis]. / Peptídeo C e mortalidade cardiovascular: revisão sistemática e metanálise.

OBJECTIVE: To analyze the available evidence regarding the association between C-peptide and cardiovascular and overall mortality. METHODS: A systematic review of MEDLINE and EMBASE was performed. Articles published in English, Portuguese, or Spanish, reporting observational studies investigating the association between C-peptide and cardiovascular or overall mortality were included. The association between C-peptide and cardiometabolic risk factors, hemodynamic factors, and anthropometric measures was also investigated. The methodological quality of studies was assessed using the Newcastle-Ottawa Scale. RESULTS: The literature search revealed 107 articles on the topic of interest. Following the screening step, 18 articles presenting data on the association between C-peptide and cardiovascular risk were included. Five studies provided data on the relationship between C-peptide and cardiovascular or overall mortality. C-peptide was positively associated with body mass index in Chinese individuals, and inversely associated with HDL cholesterol in population samples from Asia, Middle East, and the United Stated. Nevertheless, meta-analysis of cardiovascular risk components was not possible. In the meantime, C-peptide was associated with cardiovascular mortality (RR = 1.62; 95%CI: 0.99-2.66) and overall mortality (RR = 1.39; 95%CI: 1.04-1.84). CONCLUSIONS: The present systematic review and meta-analysis showed that serum levels of C-peptide were positively associated with overall mortality in all individuals and with cardiovascular mortality in individuals without comorbidities. Based on these results, it is possible to recommend the use of C-peptide in clinical practice as a proxy of insulin resistance associated with cardiovascular mortality.

OBJETIVO: Analizar las evidencias sobre la asociación entre el péptido C y la mortalidad cardiovascular y general disponibles en la bibliografía. MÉTODOS: Se realizó una revisión sistemática en las bases de datos MEDLINE y EMBASE. Se incluyeron artículos publicados en inglés, portugues o español con estudios observacionales que investigaron la asociación entre el péptido C y la mortalidad cardiovascular y general. Se buscó también evaluar la asociación entre el péptido C y factores de riesgo cardiometabólicos, factores hemodinámicos y medidas antropométricas. Se evaluó la calidad metodológica de los estudios según los criterios de la escala de Newcastle-Ottawa. RESULTADOS: Se identificaron 107 estudios. Al final del proceso de clasificación se incluyeron 18 artículos que presentaban datos sobre la asociación entre el péptido C y el riesgo cardiovascular. Cinco estudios proporcionaron datos sobre la relación entre el péptido C y la mortalidad cardiovascular y general. El péptido C presentó una asociación positiva con el índice de masa corporal en población china, y una asociación inversa con el colesterol HDL en muestras poblacionales de Asia, Oriente Medio y Estados Unidos. Sin embargo, no fue posible realizar un metanálisis para los componentes de riesgo cardiovascular. Por otro lado, el péptido C se asoció con la mortalidad cardiovascular (RR = 1,62, IC95%: 0,99 a 2,66) y general (RR = 1,39, IC95%: 1,04 a 1,84). CONCLUSIONES: En la revisión sistemática y el metanálisis realizados los niveles séricos de péptido C se asociaron positivamente con la mortalidad general en todos los individuos y con la mortalidad cardiovascular en personas sin comorbilidades. Con base en estos resultados, es posible recomendar el empleo del péptido C en la práctica clínica como proxy de la resistencia a la insulina asociada a la mortalidad cardiovascular.

C-Peptide and cardiovascular risk factors among young adults in a southern Brazilian cohort.

BACKGROUND: Proinsulin connecting peptide (C-Peptide) is a marker of the beta-cell function and has been considered a marker of insulin resistance whose evidence suggests were associated with cardiovascular mortality. Our study aims to evaluate the association of C-Peptide with metabolic cardiovascular risk factors among young adults followed since birth in southern Brazil. METHODS: In 1982, maternity hospital in Pelotas, a southern Brazilian city, were visited daily and all births were identified. Live births whose family lived in the urban area of the city were identified, their mothers interviewed, and these subjects have been prospectively followed. Casual hyperglycemia patients were excluded from analysis. C-Peptide was assessed at 23 years, when transversely analyzed its association with cardiometabolic and hemodynamic risk factors, and longitudinally 30 years of age. RESULTS: At age 23, 4297 individuals were evaluated, and C-Peptide was measured in 3.807. In a cross-sectional analysis at 23 years of age, C-Peptide was positively associated with waist circumference, body mass index, glycaemia, triglycerides, and C-reactive protein. The association with HDL cholesterol was negative. In the longitudinal analysis at 30 years, C-Peptide remained associated with BMI, waist circumference, glycated hemoglobin, triglycerides, and C-reactive protein, whereas the association was negative for HDL. CONCLUSION: In the Pelotas birth cohort, the C-Peptide was associated with obesity indicators (waist circumference and BMI) cross-sectional (23 years) and longitudinal (30 years). We also observed cross-sectional and longitudinal associations of C-Peptide with cardiometabolic and inflammatory risk factors.

Conditions of gestation, childbirth and childhood associated with C-peptide in young adults in the 1982 Birth Cohort in Pelotas-RS; Brazil.

BACKGROUND: The connecting peptide in insulin has been associated with cardiovascular risk and overall mortality in the adult population. However, its early determinants are unknown. Assess the association of exposures during pregnancy, delivery, and childhood with C-peptide among 22-23 years old individuals prospectively followed since birth, in a southern Brazilian city. METHODS: In 1982, all hospital births in the city were identified and those livebirths whose families lived in the urban area were evaluated (n = 5914). The 1982 Pelotas Birth Cohort has prospectively followed these subjects at different moments. In this study, we evaluated the association of C-peptide with exposures occurring during pregnancy, delivery and childhood. In the 22-23 years follow-up visit, we tried to follow the whole cohort and the subjects were interviewed, examined and donated a blood sample. C-peptide was measured using the chemiluminescence immunoassay technique (Immulite®-Siemens, Germany). RESULTS: In the 22-23 years visit, 4297 subjects were interviewed and the C-peptide was measured in 3807. The geometric mean of C-peptide was 0.83 ng/mL and the mean was higher among women. In the adjusted analysis, C-peptide was positively associated with family income at birth, lower among children of non-white mothers (0.90; CI95% 0.84-0.96), higher among females (1.22; CI95% 1.16-1.28), and positively associated with rapid weight gain between two and four years of age (1.18; CI95% 1.05-1.32). CONCLUSION: Family income at birth, non-white maternal skin color, and rapid weight gain between two and four years of age were associated with high levels of C-peptide.

Vigilância de fatores de risco e proteção para doenças e agravos não transmissíveis em município de pequeno porte, Brasil, 2010 / Surveillance of risk and protective factors for non-communicable diseases and Injuries in a small municipality, Brazil, 2010

Objetivo: apresentar a metodologia e resultados da implantação da vigilância de fatores de risco e proteção para doenças e agravos não transmissíveis (DANT) em município de pequeno porte, Anchieta, no estado do Espírito Santo, Brasil, em 2010. Métodos: estudo transversal de base populacional com realização de exames bioquímicos, aferição da pressão arterial, avaliação antropométrica e eletrocardiograma da população-alvo. Resultados: aproximadamente 25,0 por cento dos entrevistados relataram consumo regular de refrigerante, 45,2 por cento, carne com gordura, e 22,5 por cento, abuso de bebida alcoólica; 14,1 por cento referiram ser inativos, 16,2 por cento, fumantes, 52,1 por cento apresentaram excesso de peso auto-referido, e 16,9 por cento, obesidade; sobre fatores de proteção, 5,0 por cento da população referiu consumir frutas e hortaliças conforme recomendado, e 3,6 por cento, atividade física no lazer; a prevalência de uso de cinto de segurança no banco da frente foi de 74,0 por cento, e 83,5 por cento dos motociclistas referiram utilizar capacete; entre os indivíduos que realizaram exames, 49,2 por cento apresentaram hipercolesterolemia, 46,0 por cento, lesão renal, 19,0 por cento, alteração em eletrocardiograma e 5,8 por cento, diabetes. Conclusão: a metodologia utilizada permitiu conhecer a prevalência dos fatores de risco e proteção para DANT em município de pequeno porte; ações de promoção da saúde, vigilância, prevenção e atenção estão sendo elaboradas com base nos resultados encontrados.

Objective: to present the methodology and results of the implementation of surveillance for risk and protective factors for non-communicable diseases (NCD) and injuries in a small city, Anchieta, in the State of Espírito Santo, Brazil, in 2010. Methods: a population-based cross sectional study with blood sample collection, blood pressure, anthropometric measurements and electrocardiogram of the target-population. Results: approximately 25.0 per cent adults interviewed reported drinking soft drinks regularly, 45.2 per cent, eat meat with visible fat, and 22.5 per cent, harmful use of alcohol; 14.1 per cent reported physical inactivity, 16.2 per cent, tobacco smoking, 52.1 per cent, self-reported overweight, and 16.9 per cent, obesity; among protective factors, 5.0 per cent reported fruit and vegetable intake as recommended, and 3.6 per cent, leisure time physical activity; prevalence of seat belt use in front seat was 74.0 per cent; helmet use was reported by 83.5 per cent of motorcyclists; among individuals who performed blood tests, 49.2 per cent had hypercholesterolemia, 46.0 per cent presented some stage of chronic kidney disease, 19.0 per cent, cardiovascular dysfunction according to electrocardiogram, and 5.8 per cent, diabetes. Conclusion: the methodology allowed to know the risk and protective factors for NCD in a small city of Brazil; actions on health promotion, surveillance, prevention and health care are being developed, based on the results of this study.