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OBJECTIVE: To estimate the time trend of cardiovascular mortality from 1980 to 2012. METHODS: We performed an ecological time series study of cardiovascular mortality in Brazil. Data regarding deaths were obtained from the Mortality Information System and divided into two groups: deaths from ischemic heart disease (IHD) and deaths from cerebrovascular disorders (CBVD). RESULTS: A -34.73% variation in IHD standardized mortality rates was recorded for Brazil. Concerning specific regions, an increase was observed in the Northeast (117.98%%) and the Midwest (10.26%). IHD mortality rates fell in the Southeast (-53.08%), South (-44.56%) and North (-4.39%). For CBVD, the overall variation was -48.10%. Mortality rates were reduced in most regions: -61.99% in the Southeast, -55.49% in the South, -26.91% in the Midwest, and -20.78% in the North. Only the Northeast recorded an increase in CBVD mortality (13.77%). CONCLUSIONS: We observed an overall declining trend for IHD and CBVD mortality in Brazil from 1980 to 2012, with strong regional variation. Mortality rates were highest in the Southeast and South for both groups of disorders, and lowest in the North and Northeast. Surveillance efforts should take into account the regional differences in epidemiological profile.
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Enfermedades Cardiovasculares/mortalidad , Brasil/epidemiología , Trastornos Cerebrovasculares/mortalidad , Geografía Médica , Humanos , Mortalidad/tendencias , Estudios RetrospectivosRESUMEN
OBJECTIVE: To estimate the prevalence of exposure to violence, characterizing its magnitude, types and occurrence in the adult population in Brazil. METHODS: Cross-sectional study with data from the National Health Survey conducted in 2019. The prevalence of violence in the last 12 months and respective 95% confidence intervals (95%CI) were estimated according to sociodemographic variables. Crude prevalence ratios were estimated by Poisson regression. RESULTS: The prevalence of exposure to violence among adults in Brazil was 18.3% (95%CI 17.8-18.8), with a significantly higher frequency among women (19.4%; 95%CI 18.7-20.0), in the 18-29 age group (27.0%; 95%CI 25.7-28.4), in self-declared black people (20.6%; 95%CI 19.3-21.9) and mixed race (19.3%; 95%CI 18.6-20.1) and among inhabitants of the Northeast region (18.7%; 95%CI 18.0-19.5). Among the victims of violence, 15.6% (95%CI 14.2-17.0) sought health care, of which (91.2%; 95%CI 88.1-93.6) were attended. The most reported types of violence were: psychological (17.4%; 95%CI 16.9-17.9), physical (4.1%; 95%CI 3.9-4.4) and sexual (0.8%; 95%CI 0.7-0.9). Men were more exposed to violence with the use of firearms or sharp targets, while women were the predominant victims for all other types and mechanisms of violence. The aggressor most cited was the intimate partner, the most frequent place of occurrence of violence being the residence and public streets/places. CONCLUSION: In Brazil, violence affected one in five adults. Women, young people and people with black skin were the population segments most exposed to violence, which should be a priority in prevention actions.
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Exposición a la Violencia , Violencia de Pareja , Adolescente , Adulto , Brasil/epidemiología , Estudios Transversales , Femenino , Humanos , Masculino , Prevalencia , ViolenciaRESUMEN
OBJECTIVE: to describe the profile of case notifications and hospitalizations of intentional self-harm involving adolescents in Brazil. METHODS: this was a descriptive study with data from the Notifiable Health Conditions Information System (SINAN) (2011-2014) and the Brazilian National Health System Hospital Information System (SIH/SUS) (2007-2016) about intentional self-harm. RESULTS: there were 15,702 notifications, with predominance of the 15-19 years age group (76.4%), females (71.6%) and White race/skin color (58.3%); the home was the most frequent place of occurrence (88.5% among those 10-14 years old and 89.9% among those 15-19 years old); poisoning/intoxication was the most used method (76.6% and 78% in the 10-14 and 15-19 age groups, respectively); there were 12,060 hospitalizations, with a predominance of females (58.1%) and greater occurrence in Southeast Region (2.7 and 7.0 notifications/100,000 inhabitants in the 10-14 and 15-19 age groups, respectively). CONCLUSION: the results reinforce the need for health services to be sensitive to recording cases and providing care to these adolescents.
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Hospitalización/estadística & datos numéricos , Conducta Autodestructiva/epidemiología , Intento de Suicidio/estadística & datos numéricos , Adolescente , Brasil/epidemiología , Niño , Femenino , Sistemas de Información en Hospital , Humanos , Masculino , Adulto JovenRESUMEN
Resumo Objetivo Analisar a tendência da mortalidade por suicídio no estado do Espírito Santo e em sua Região Serrana no período de 1996 a 2020. Métodos Estudo descritivo e analítico de série temporal com dados consolidados dos óbitos por suicídio na população acima de 15 anos de idade obtidos no Sistema de Informações sobre Mortalidade. As unidades de análise foram o estado do Espírito Santo e sua Região Serrana. A análise da tendência foi verificada pela regressão de Prais-Winsten e pelo cálculo da variação percentual anual. Resultados Foram notificados 3.922 óbitos por suicídio no Espírito Santo e, destes, 525 na Região Serrana. A tendência da mortalidade por suicídio no estado foi crescente na população geral acima de 15 anos (APC= 5,1; IC95%= 0,28-9,92; p=0,039). A tendência da mortalidade se manteve crescente entre a população feminina, tanto em relação ao estado (APC= 6;5; IC95%= 1,55-14,46; p=0,012) como na região serrana (APC= 15,2; IC95%= 1,21-29,20; p=0,035). A mortalidade foi crescente na faixa etária de 30 a 59 anos no estado (APC= 3,4; IC95%= 0,62-6,10; p=0,018) e na Região Serrana (APC= 2,9; IC95%= 2,02-3,86; p <0,001). Conclusão A tendência foi crescente na população geral do estado do Espírito Santo e em sua Região Serrana entre adultos jovens e do sexo feminino. A relevância da violência autoprovocada verificada nas taxas analisadas neste estudo aponta para a necessidade do emprego de estratégias preventivas, especialmente entre as mulheres.
Resumen Objetivo Analizar la tendencia de la mortalidad por suicidio en el estado de Espírito Santo y en su Región Serrana en el período de 1996 a 2020. Métodos Estudio descriptivo y analítico de serie temporal con datos consolidados de las muertes por suicidio en la población mayor de 15 años obtenidos del Sistema de Información sobre Mortalidad. Las unidades de análisis fueron el estado de Espírito Santo y su Región Serrana. El análisis de la tendencia se verificó por regresión de Prais-Winsten y por cálculo de la variación porcentual anual. Resultados Se notificaron 3.922 muertes por suicidio en Espírito Santo, de las cuales 525 fueron en la Región Serrana. La tendencia de la mortalidad por suicidio en el estado fue creciente en la población general mayor de 15 años (APC= 5,1; IC95 %= 0,28-9,92; p=0,039). La tendencia de la mortalidad se mantuvo creciente en la población femenina, tanto con relación al estado (APC= 6;5; IC95 %= 1,55-14,46; p=0,012) como en la Región Serrana (APC= 15,2; IC95 %= 1,21-29,20; p=0,035). La mortalidad fue creciente en el grupo de edad de 30 a 59 años en el estado (APC= 3,4; IC95 %= 0,62-6,10; p=0,018) y en la Región Serrana (APC= 2,9; IC95 %= 2,02-3,86; p <0,001). Conclusión La tendencia fue creciente en la población general del estado de Espírito Santo y en su Región Serrana en adultos jóvenes y de sexo femenino. La relevancia de la violencia autoprovocada verificada en los índices analizados en este estudio indica la necesidad de emplear estrategias preventivas, específicamente en mujeres.
Abstract Objective To analyze the trend of suicide mortality in the state of Espirito Santo and its Mountain Region from 1996 to 2020. Methods Descriptive and analytical time series study with consolidated data on deaths by suicide in the population over 15 years old obtained from the Mortality Information System. The units of analysis were the state of Espirito Santo and its Mountain Region. The trend analysis was verified by Prais-Winsten regression and by calculating the annual percentage change. Results A total of 3922 deaths by suicide were reported in Espirito Santo and of these, 525 in the mountain Region. The trend of suicide mortality in the state was increasing in the general population over 15 years old (APC= 5.1; 95%CI= 0.28-9.92; p=0.039). The mortality rate continued to grow among the female population, both in relation to the state (APC= 6.5; 95%CI= 1.55-14.46; p=0.012) and in the mountain region (APC= 15.2; 95%CI= 1.21-29.20; p=0.035). Mortality increased in the age group from 30 to 59 years old in the state (APC= 3.4; 95%CI= 0.62-6.10; p=0.018) and in the Mountain Region (APC= 2.9; 95%CI= 2.02-3.86; p<0.001). Conclusion The suicide trend was growing in the general population of the state of Espirito Santo and its Mountain Region among young and female adults. The relevance of self-inflicted violence verified in the rates analyzed in this study points to the need to use preventive strategies, especially among women.
RESUMEN
The aim of the study was to characterize the profile of victims of self-inflicted injuries, who were attended at urgent and emergency care services in Brazilian state capitals, by using the "Viva Survey" database of 2014. Descriptive statistics of the self-inflicted injuries by gender, as well as logistic regression analysis, were performed. The evaluated characteristics were age, gender, race/skin color, education, area of residence, characteristics of the event, alcohol use and the outcome of the case. The results showed that almost 10% of the surveyed cases that were treated by emergency medical services in relation to violence were due to self-inflicted injuries: of particular note were the cases involving females and adults. Gender differences were found, including some that were related to the method chosen to commit suicide. It was not possible to evaluate some factors that are generally associated with suicide attempts because the necessary information was not within the scope of the instrument used for data collection. It was concluded that emergency medical services are very important in terms of studies regarding suicide because they are the gateway to such cases. However, given its sensitive nature, the information issued by emergency medical services is very restricted. Consequently, patients need appropriate follow-up to prevent further suicide attempts.
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Conducta Autodestructiva/epidemiología , Intento de Suicidio/estadística & datos numéricos , Suicidio/estadística & datos numéricos , Violencia/estadística & datos numéricos , Adolescente , Adulto , Brasil/epidemiología , Niño , Preescolar , Estudios Transversales , Bases de Datos Factuales , Servicios Médicos de Urgencia/estadística & datos numéricos , Femenino , Humanos , Lactante , Recién Nacido , Modelos Logísticos , Masculino , Persona de Mediana Edad , Factores de Riesgo , Factores Sexuales , Adulto JovenRESUMEN
The Violence and Accidents Survey Conducted in Sentinel Emergency Departments (VIVA Survey) is the sentinel surveillance component of the Violence and Accidents Surveillance System (VIVA). It was conducted for the first time in 2006 and again in 2007, 2009, 2011 and 2014. The sample is comprised of victims of accidents and violence treated in Emergency Departments linked to the Brazilian National Health System (SUS). The services are selected intentionally. This isfollowed by probability sampling of 12-hour shifts by conglomerates in single-stage selection. Data is collected by trained interviewers using a standard form. The variables include data about the service site, the victim, the event, injury and case development. The VIVA Survey provides key information for the implementation of policies for addressing violence and accidents as well as for health and peace promotion policies.
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Accidentes/estadística & datos numéricos , Servicio de Urgencia en Hospital/estadística & datos numéricos , Violencia/estadística & datos numéricos , Brasil/epidemiología , Humanos , Programas Nacionales de Salud/organización & administración , Vigilancia de Guardia , Encuestas y CuestionariosRESUMEN
INTRODUCTION:: Brazil has the sixth largest bicycles fleet in the world and bicycle is the most used individual transport vehicle in the country. Few studies address the issue of cyclists' accidents and factors that contribute to or prevent this event. METHODOLOGY:: VIVA is a cross-sectional survey and is part of the Violence and Accidents Surveillance System, Brazilian Ministry of Health. We used complex sampling and subsequent data review through multivariate logistic regression and calculation of the respective odds ratios. RESULTS:: Odds ratios showed greater likelihood of cyclists' accidents in males, people with less schooling and living in urban and periurban areas. People who were not using the bike to go to work were more likely to suffer an accident. DISCUSSION:: The profile found in this study corroborates findings of other studies. They claim that the coexistence of cyclists and other means of transportation in the same urban space increases the likelihood of accidents. CONCLUSION:: The construction of bicycle-exclusive spaces and educational campaigns are required.
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Accidentes de Tránsito/estadística & datos numéricos , Ciclismo/estadística & datos numéricos , Población Urbana/estadística & datos numéricos , Adolescente , Adulto , Brasil/epidemiología , Niño , Preescolar , Estudios Transversales , Escolaridad , Femenino , Humanos , Lactante , Recién Nacido , Modelos Logísticos , Masculino , Análisis Multivariante , Factores de Riesgo , Factores Sexuales , Adulto JovenRESUMEN
This paper aimed to describe the epidemiological profile of pedestrians injured in traffic accidents treated at urgent and emergency facilities participating in the 2014VIVA Survey and the characterization of these events and consequences for these victims. This is a cross-sectional study conducted in the period from September to November 2014 in 24 Brazilian state capitals and the Federal District. We analyzed variables that characterize the victim, the accident and its severity and case outcome. We calculated simple and relative frequencies and performed a bivariate analysis by gender and age group. We used the Rao-Scott test with a 5% significance level in order to verify the independence of variables. Results show that 34.3% of attendances were for individuals aged 20-39 years, 54.2% had brown skin and 35.9% of individuals had up to 4 years of schooling. Run-overs occurred mainly at night (33.6%) and in the afternoon (31.3%). Most cases resulted in discharge in all age groups, but 41.6% of the elderly (60 years and over) required hospitalization. We stress the need for public investment, prioritizing pedestrian circulation in traffic and road infrastructure planning.
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Accidentes de Tránsito/estadística & datos numéricos , Servicio de Urgencia en Hospital/estadística & datos numéricos , Peatones/estadística & datos numéricos , Heridas y Lesiones/epidemiología , Adolescente , Adulto , Factores de Edad , Brasil/epidemiología , Niño , Preescolar , Estudios Transversales , Femenino , Hospitalización/estadística & datos numéricos , Humanos , Lactante , Recién Nacido , Masculino , Persona de Mediana Edad , Factores de Tiempo , Heridas y Lesiones/terapia , Adulto JovenRESUMEN
ABSTRACT: Objective: To estimate the prevalence of exposure to violence, characterizing its magnitude, types and occurrence in the adult population in Brazil. Methods: Cross-sectional study with data from the National Health Survey conducted in 2019. The prevalence of violence in the last 12 months and respective 95% confidence intervals (95%CI) were estimated according to sociodemographic variables. Crude prevalence ratios were estimated by Poisson regression. Results: The prevalence of exposure to violence among adults in Brazil was 18.3% (95%CI 17.8-18.8), with a significantly higher frequency among women (19.4%; 95%CI 18.7-20.0), in the 18-29 age group (27.0%; 95%CI 25.7-28.4), in self-declared black people (20.6%; 95%CI 19.3-21.9) and mixed race (19.3%; 95%CI 18.6-20.1) and among inhabitants of the Northeast region (18.7%; 95%CI 18.0-19.5). Among the victims of violence, 15.6% (95%CI 14.2-17.0) sought health care, of which (91.2%; 95%CI 88.1-93.6) were attended. The most reported types of violence were: psychological (17.4%; 95%CI 16.9-17.9), physical (4.1%; 95%CI 3.9-4.4) and sexual (0.8%; 95%CI 0.7-0.9). Men were more exposed to violence with the use of firearms or sharp targets, while women were the predominant victims for all other types and mechanisms of violence. The aggressor most cited was the intimate partner, the most frequent place of occurrence of violence being the residence and public streets/places. Conclusion: In Brazil, violence affected one in five adults. Women, young people and people with black skin were the population segments most exposed to violence, which should be a priority in prevention actions.
RESUMO: Objetivo: Estimar a prevalência de exposição à violência, caracterizando sua magnitude, tipos e ocorrência na população adulta do Brasil. Métodos: Estudo transversal com dados da Pesquisa Nacional de Saúde realizada em 2019. Estimou-se a prevalência de violência nos últimos 12 meses e respectivos intervalos de confiança de 95% (IC95%) segundo variáveis sociodemográficas. Razões de prevalência bruta foram estimadas por regressão de Poisson. Resultados: A prevalência de exposição à violência entre adultos no Brasil foi de 18,3% (IC95% 17,8-18,8), com frequência significativamente maior entre as mulheres (19,4%; IC95% 18,7-20,0), no grupo de 18-29 anos (27,0%; IC95% 25,7-28,4), nas pessoas autodeclaradas pretas (20,6%; IC95% 19,3-21,9) e pardas (19,3%; IC95% 18,6-20,1) e entre habitantes da região Nordeste (18,7%; IC95% 18,0-19,5). Entre as vítimas de violência, 15,6% (IC95% 14,2-17,0) procuraram atendimento de saúde, das quais 91,2% (IC95% 88,1-93,6) o receberam. Os tipos de violência mais relatados foram: psicológica (17,4%; IC95% 16,9-17,9), física (4,1%; IC95% 3,9-4,4) e sexual (0,8%; IC95% 0,7-0,9). Os homens foram mais expostos à violência com uso de arma de fogo ou objetivos cortantes, enquanto as mulheres foram as vítimas predominantes para todos os demais tipos e mecanismos de violência. O agressor mais citado foi o/a parceiro/a íntimo/a, e os locais mais frequentes de ocorrência da violência foram residência, vias e locais públicos. Conclusão: No Brasil, a violência afetou um a cada cinco adultos. Mulheres, jovens e pessoas de pele negra foram os segmentos populacionais mais expostos à violência e devem ser prioritários nas ações de prevenção.
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Humanos , Masculino , Femenino , Adolescente , Adulto , Violencia de Pareja , Exposición a la Violencia , Violencia , Brasil/epidemiología , Prevalencia , Estudios TransversalesRESUMEN
Resumo Objetivo: descrever o perfil das notificações e internações de lesões autoprovocadas envolvendo adolescentes no Brasil. Métodos: estudo descritivo, com dados do Sistema de Informação de Agravos de Notificação (Sinan) (2011-2014) e do Sistema de Informações Hospitalares do Sistema Único de Saúde (SIH/SUS) (2007-2016) sobre lesões autoprovocadas. Resultados: houve 15.702 notificações, predominando o grupo etário de 15-19 anos (76,4%) do sexo feminino (71,6%), e raça/cor da pele branca (58,3%); a residência foi o local mais frequente dessas ocorrências (88,5% de 10-14 anos; 89,9% de 15-19 anos); o meio mais utilizado foi envenenamento/intoxicação (76,6% e 78,0%, respectivamente nas idades de 10-14 e 15-19); houve 12.060 internações, com predominância do sexo feminino (58,1%) e maior ocorrência na região Sudeste (2,7 e 7,0 notificações/100 mil habitantes, nos grupos de 10-14 e 15-19 anos, respectivamente). Conclusão: os resultados reforçam a necessidade de os serviços de saúde estarem sensíveis ao registro, atenção e cuidado desses adolescentes.
Resumen Objetivo: describir el perfil de las notificaciones y hospitalizaciones por lesiones autoprovocadas en adolescentes en Brasil. Métodos: estudio descriptivo con datos de los Sistemas de Información de Agravamiento de Notificación (2011 a 2014) y de Informaciones Hospitalarias del Sistema Único de Salud (SIH/SUS) (2007 a 2016) sobre lesiones autoprovocadas. Resultados: hubo 15.702 notificaciones, con predominio del grupo de 15-19 años (76,4%), mujeres (71,6%) y raza/color de piel blanca (58,3%); la residencia fue el lugar más frecuente (88,5% entre 10 y 14 años y 89,9% entre 15 y 19 años); envenenamiento/intoxicación fue el medio más utilizado (76,6% y 78,0% respectivamente en las edades de10-14 y 15-19 ); hubo 12,060 hospitalizaciones, con predominio de mujeres (58,1%) y mayor ocurrencia en la Región Sudeste (2,7 y 7,0 notificaciones/100 mil habitantes entre 10 y 14 y entre 15 y 19 años). Conclusión: los resultados refuerzan la necesidad de que los servicios de salud sean sensibles al registro y la atención y cuidado de estos adolescentes.
Abstract Objective: to describe the profile of case notifications and hospitalizations of intentional self-harm involving adolescents in Brazil. Methods: this was a descriptive study with data from the Notifiable Health Conditions Information System (SINAN) (2011-2014) and the Brazilian National Health System Hospital Information System (SIH/SUS) (2007-2016) about intentional self-harm. Results: there were 15,702 notifications, with predominance of the 15-19 years age group (76.4%), females (71.6%) and White race/skin color (58.3%); the home was the most frequent place of occurrence (88.5% among those 10-14 years old and 89.9% among those 15-19 years old); poisoning/intoxication was the most used method (76.6% and 78% in the 10-14 and 15-19 age groups, respectively); there were 12,060 hospitalizations, with a predominance of females (58.1%) and greater occurrence in Southeast Region (2.7 and 7.0 notifications/100,000 inhabitants in the 10-14 and 15-19 age groups, respectively). Conclusion: the results reinforce the need for health services to be sensitive to recording cases and providing care to these adolescents.
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Adolescente , Intento de Suicidio , Heridas y Lesiones , Sistemas de Información , Adolescente , Hospitalización , Epidemiología DescriptivaRESUMEN
The scope of this article is to describe hospitalizations resulting from intentionally self-inflicted injuries attended by the Unified Health System (SUS) for the 2002-2013 period. It is an observational, descriptive study of hospital admissions in the SUS arising from intentionally self-inflicted injuries in Brazil between 2002 and 2013. A decreasing trend was observed for the rate of hospitalization in individuals aged 10 and above. Hospitalizations were concentrated between 30 to 49 years of age for men, while for women it was between 20 to 29 years of age. The highest rates of hospitalization and hospital deaths were in the Southeast. The main cause of hospitalization was intentional intoxication with medication and unspecified biological substances. Studies of this type provide input for defining prevention strategies taking into consideration the most vulnerable groups and the complexity of factors associated with suicidal behavior.
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Hospitalización/estadística & datos numéricos , Conducta Autodestructiva/epidemiología , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Brasil/epidemiología , Niño , Femenino , Humanos , Masculino , Persona de Mediana Edad , Factores de Tiempo , Adulto JovenRESUMEN
Resumo Caracteriza-se o perfil das vítimas de lesão autoprovocada que procuraram atendimento em serviços de urgência e emergência nas capitais brasileiras, utilizando-se a base de dados do Viva Inquérito 2014. Foi realizada estatística descritiva das lesões autoprovocadas por sexo e análise por regressão logística. As características avaliadas foram: faixa etária, sexo, raça/cor de pele, escolaridade, zona de residência, características do evento, uso de álcool e evolução do atendimento. Os resultados mostram que quase 10% dos atendimentos por violências nos serviços de urgência e emergência pesquisados decorrem de lesões autoprovocadas, com destaque para casos que envolvem mulheres e adultos. Há diferenças entre gêneros, inclusive as relacionadas à escolha do método para cometer suicídio. Alguns fatores geralmente associados às tentativas de suicídio não puderam ser avaliados, porque as informações não estavam contidas no escopo do instrumento de coleta. Conclui-se que o serviço de emergência é muito importante para os estudos de suicídio porque constituem a porta de entrada dos casos que chegam aos serviços. No entanto, dado seu caráter pontual, as informações que emite são muito restritas. Assim, os pacientes necessitam de acompanhamento posterior para prevenção das reincidências.
Abstract The aim of the study was to characterize the profile of victims of self-inflicted injuries, who were attended at urgent and emergency care services in Brazilian state capitals, by using the "Viva Survey" database of 2014. Descriptive statistics of the self-inflicted injuries by gender, as well as logistic regression analysis, were performed. The evaluated characteristics were age, gender, race/skin color, education, area of residence, characteristics of the event, alcohol use and the outcome of the case. The results showed that almost 10% of the surveyed cases that were treated by emergency medical services in relation to violence were due to self-inflicted injuries: of particular note were the cases involving females and adults. Gender differences were found, including some that were related to the method chosen to commit suicide. It was not possible to evaluate some factors that are generally associated with suicide attempts because the necessary information was not within the scope of the instrument used for data collection. It was concluded that emergency medical services are very important in terms of studies regarding suicide because they are the gateway to such cases. However, given its sensitive nature, the information issued by emergency medical services is very restricted. Consequently, patients need appropriate follow-up to prevent further suicide attempts.
Asunto(s)
Humanos , Masculino , Femenino , Recién Nacido , Lactante , Preescolar , Niño , Adolescente , Adulto , Adulto Joven , Suicidio/estadística & datos numéricos , Intento de Suicidio/estadística & datos numéricos , Violencia/estadística & datos numéricos , Conducta Autodestructiva/epidemiología , Brasil/epidemiología , Modelos Logísticos , Factores Sexuales , Estudios Transversales , Factores de Riesgo , Bases de Datos Factuales , Servicios Médicos de Urgencia/estadística & datos numéricos , Persona de Mediana EdadRESUMEN
O Inquérito de Violências e Acidentes em Serviços Sentinela de Urgência e Emergência (VIVA Inquérito) é o componente de vigilância sentinela do Sistema de Vigilância de Violências e Acidentes (VIVA). Sua primeira edição foi realizada em 2006; outras foram realizadas em 2007, 2009, 2011 e 2014. A amostra é composta por vítimas de acidentes e violências atendidas em serviços de urgência e emergência vinculados ao Sistema Único de Saúde (SUS). Os serviços são selecionados de forma intencional, e posteriormente é realizada uma etapa de amostragem probabilística de turnos de 12 horas, por conglomerados em único estágio de seleção. Os dados são coletados por entrevistadores treinados, com formulário padronizado. As variáveis incluem dados sobre o estabelecimento, a vítima, a ocorrência, a lesão e a evolução do caso. O VIVA Inquérito disponibiliza informações fundamentais para a implementação de políticas de enfrentamento das violências e acidentes e promoção da saúde e da paz.
La Encuesta de Violencia y Accidentes en los Servicios de Emergencia y Urgencia Centinelas es el componente de vigilancia centinela del Sistema de Vigilancia de Violencia y Accidentes (VIVA). Su primera edición se celebró en 2006, otras ediciones se llevaron a cabo en 2007, 2009, 2011 y 2014. La muestra se compone de víctimas de accidentes y violencia atendidas en los servicios de urgencia y emergencia del Sistema Único de Salud. Los servicios fueron seleccionados intencionalmente, a continuación, se lleva a cabo una etapa de muestreo probabilístico de los turnos de 12 horas, por conglomerados en una sola etapa de selección. Los datos se recogen mediante um formulario estandarizado, por entrevistadores entrenados. Las variables incluyen datos sobre el establecimiento, la víctima, la ocurrencia de lesiones, y evolución del caso. La Encuesta VIVA proporciona informaciones clave para la implementación de políticas para hacer frente a la violencia, accidentes y promoción de la paz.
The Violence and Accidents Survey Conducted in Sentinel Emergency Departments (VIVA Survey) is the sentinel surveillance component of the Violence and Accidents Surveillance System (VIVA). It was conducted for the first time in 2006 and again in 2007, 2009, 2011 and 2014. The sample is comprised of victims of accidents and violence treated in Emergency Departments linked to the Brazilian National Health System (SUS). The services are selected intentionally. This isfollowed by probability sampling of 12-hour shifts by conglomerates in single-stage selection. Data is collected by trained interviewers using a standard form. The variables include data about the service site, the victim, the event, injury and case development. The VIVA Survey provides key information for the implementation of policies for addressing violence and accidents as well as for health and peace promotion policies.
Asunto(s)
Humanos , Masculino , Femenino , Violencia , Accidentes , Encuestas Epidemiológicas , Vigilancia de Guardia , Causas Externas , Monitoreo Epidemiológico , Sistema Único de SaludRESUMEN
Resumo O Brasil possui a sexta maior frota de bicicletas do mundo, sendo esta o veículo de transporte individual mais utilizado no país. Porém, poucos estudos abordam a temática envolvendo os acidentes com ciclistas, bem como os fatores que colaboram ou evitam essa ocorrência. Utilizou-se amostragem complexa e posterior análise de dados por regressão logística multivariada e cálculo das respectivas razões de chance para estudar o Inquérito de delineamento transversal (VIVA), o qual compõe o Sistema de Vigilância de Violências e Acidentes do Ministério da Saúde. As razões de chance apontaram maiores chances de ocorrência de acidentes envolvendo ciclistas em indivíduos do sexo masculino, de menor escolaridade e que residem em área urbana e periurbana. Pessoas que não estavam utilizando a bicicleta para ir ao trabalho apresentaram maior chance de acidente. O perfil encontrado no presente estudo corrobora os achados de outros estudos, os quais consideram que a coexistência de ciclistas com os demais meios de transporte, no mesmo espaço urbano, acarreta em maior chance de acidentes. A construção de espaços exclusivos à circulação de bicicletas e a realização de campanhas educativas são preconizadas.
Abstract Introduction: Brazil has the sixth largest bicycles fleet in the world and bicycle is the most used individual transport vehicle in the country. Few studies address the issue of cyclists' accidents and factors that contribute to or prevent this event. Methodology: VIVA is a cross-sectional survey and is part of the Violence and Accidents Surveillance System, Brazilian Ministry of Health. We used complex sampling and subsequent data review through multivariate logistic regression and calculation of the respective odds ratios. Results: Odds ratios showed greater likelihood of cyclists' accidents in males, people with less schooling and living in urban and periurban areas. People who were not using the bike to go to work were more likely to suffer an accident. Discussion: The profile found in this study corroborates findings of other studies. They claim that the coexistence of cyclists and other means of transportation in the same urban space increases the likelihood of accidents. Conclusion: The construction of bicycle-exclusive spaces and educational campaigns are required.
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Humanos , Masculino , Femenino , Recién Nacido , Lactante , Preescolar , Niño , Adolescente , Adulto , Adulto Joven , Población Urbana/estadística & datos numéricos , Ciclismo/estadística & datos numéricos , Accidentes de Tránsito/estadística & datos numéricos , Brasil/epidemiología , Modelos Logísticos , Factores Sexuales , Estudios Transversales , Análisis Multivariante , Factores de Riesgo , EscolaridadRESUMEN
Resumo O objetivo do artigo foi descrever o perfil epidemiológico de pedestres que sofreram lesões no trânsito, atendidos em unidades de urgência e emergência participantes do VIVA Inquérito de 2014 e a caracterização desses eventos e de suas consequências para essas vítimas. Trata-se de um estudo transversal realizado no período de setembro a novembro de 2014 em 24 capitais brasileiras e no Distrito Federal. Foram analisadas variáveis que caracterizam a vítima, o acidente e sua gravidade e a evolução do caso. Foram calculadas frequências simples e relativas. Realizou-se análise bivariada segundo sexo e faixa etária. Para verificar a independência entre as variáveis, empregou-se o teste de Rao-Scott, com um nível de significância de 5%. Os resultados mostram que 34,3% dos atendimentos foi de indivíduos na faixa etária de 20 a 39 anos, 54,2% de pessoas de cor parda, 35,9% de indivíduos com até 4 anos de escolaridade. Os atropelamentos ocorreram principalmente à noite (33,6%) e à tarde (31,3%). Em todos os grupos etários a maior parte dos casos evoluiu para a alta, mas 41,6% dos idosos (60 anos ou mais) necessitaram de internação hospitalar. Destaca-se a necessidade de investimentos públicos priorizando a circulação de pedestres no planejamento do trânsito e da infraestrutura das vias.
Abstract This paper aimed to describe the epidemiological profile of pedestrians injured in traffic accidents treated at urgent and emergency facilities participating in the 2014VIVA Survey and the characterization of these events and consequences for these victims. This is a cross-sectional study conducted in the period from September to November 2014 in 24 Brazilian state capitals and the Federal District. We analyzed variables that characterize the victim, the accident and its severity and case outcome. We calculated simple and relative frequencies and performed a bivariate analysis by gender and age group. We used the Rao-Scott test with a 5% significance level in order to verify the independence of variables. Results show that 34.3% of attendances were for individuals aged 20–39 years, 54.2% had brown skin and 35.9% of individuals had up to 4 years of schooling. Run-overs occurred mainly at night (33.6%) and in the afternoon (31.3%). Most cases resulted in discharge in all age groups, but 41.6% of the elderly (60 years and over) required hospitalization. We stress the need for public investment, prioritizing pedestrian circulation in traffic and road infrastructure planning.
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Humanos , Masculino , Femenino , Recién Nacido , Lactante , Preescolar , Niño , Adolescente , Adulto , Persona de Mediana Edad , Adulto Joven , Heridas y Lesiones/epidemiología , Accidentes de Tránsito/estadística & datos numéricos , Servicio de Urgencia en Hospital/estadística & datos numéricos , Peatones/estadística & datos numéricos , Factores de Tiempo , Heridas y Lesiones/terapia , Brasil/epidemiología , Estudios Transversales , Factores de Edad , Hospitalización/estadística & datos numéricosRESUMEN
The scope of this article is to describe hospitalizations resulting from intentionally self-inflicted injuries attended by the Unified Health System (SUS) for the 2002-2013 period. It is an observational, descriptive study of hospital admissions in the SUS arising from intentionally self-inflicted injuries in Brazil between 2002 and 2013. A decreasing trend was observed for the rate of hospitalization in individuals aged 10 and above. Hospitalizations were concentrated between 30 to 49 years of age for men, while for women it was between 20 to 29 years of age. The highest rates of hospitalization and hospital deaths were in the Southeast. The main cause of hospitalization was intentional intoxication with medication and unspecified biological substances. Studies of this type provide input for defining prevention strategies taking into consideration the most vulnerable groups and the complexity of factors associated with suicidal behavior.
Este artigo tem por objetivo descrever as internações hospitalares decorrentes de lesões autoprovocadas intencionalmente, atendidas no Sistema Único Saúde, no período de 2002 a 2013. Trata-se de estudo observacional, descritivo. Foi observada tendência decrescente para a taxa de internação em indivíduos com 10 ou mais anos de idade. As internações concentraram-se entre 30 a 49 anos de idade para os homens, enquanto para as mulheres entre 20 a 29 anos. As maiores taxas de internação e de óbitos hospitalares foram na região Sudeste. A principal causa de internação foi a autointoxicação intencional por medicamentos e substâncias biológicas não especificadas. Estudos desta natureza fornecem subsídios para a definição de estratégias de prevenção considerando os grupos mais vulneráveis e a complexidade dos fatores associados aos comportamentos suicidas.
Asunto(s)
Humanos , Masculino , Femenino , Adolescente , Adulto , Persona de Mediana Edad , Anciano , Anciano de 80 o más Años , Adulto Joven , Conducta Autodestructiva/epidemiología , Hospitalización/estadística & datos numéricos , Factores de Tiempo , Brasil/epidemiologíaRESUMEN
Objetivo. Estimar a tendência temporal da mortalidade por doenças cardiovasculares no Brasil no período de 1980 a 2012. Método. Realizamos um estudo ecológico de série temporal das taxas de mortalidade por doenças cardiovasculares no Brasil. Os dados sobre óbitos foram provenientes do Sistema de Informações de Mortalidade e divididos em dois grupos: óbitos por doenças isquêmicas do coração (DIC) e por doenças cerebrovasculares (DCBV). Resultados. No Brasil, houve variação de -34,73% dos coeficientes padronizados de mortalidade para as DIC; aumento de 117,98% no Nordeste e de 10,26% no Centro-Oeste; e redução no Sudeste (-53,08%), Sul (-44,56%) e Norte (-4,39%). As DCBV apresentaram uma variação de -48,05%. A maioria das regiões apresentou redução nas taxas de mortalidade: -61,99% no Sudeste, -55,49% no Sul, -26,91% no Centro-Oeste e -20,78% no Norte. Só o Nordeste apresentou aumento (13,77%). Conclusões. Observamos uma tendência geral de queda dos coeficientes de mortalidade por DIC e DCBV no Brasil de 1980 a 2012, com marcadas variações regionais, sendo que as regiões Sudeste e Sul apresentaram os maiores coeficientes para os dois grupos de doenças e as regiões Norte e Nordeste, os menores. É importante considerar, nos planos de vigilância, as desigualdades no perfil epidemiológico entre as regiões do país.
Objective. To estimate the time trend of cardiovascular mortality from 1980 to 2012. Methods. We performed an ecological time series study of cardiovascular mortality in Brazil. Data regarding deaths were obtained from the Mortality Information System and divided into two groups: deaths from ischemic heart disease (IHD) and deaths from cerebrovascular disorders (CBVD). Results. A -34.73% variation in IHD standardized mortality rates was recorded for Brazil. Concerning specific regions, an increase was observed in the Northeast (117.98%%) and the Midwest (10.26%). IHD mortality rates fell in the Southeast (-53.08%), South (-44.56%) and North (-4.39%). For CBVD, the overall variation was -48.10%. Mortality rates were reduced in most regions: -61.99% in the Southeast, -55.49% in the South, -26.91% in the Midwest, and -20.78% in the North. Only the Northeast recorded an increase in CBVD mortality (13.77%). Conclusions. We observed an overall declining trend for IHD and CBVD mortality in Brazil from 1980 to 2012, with strong regional variation. Mortality rates were highest in the Southeast and South for both groups of disorders, and lowest in the North and Northeast. Surveillance efforts should take into account the regional differences in epidemiological profile.
Asunto(s)
Regionalización , Anomalías Cardiovasculares/prevención & control , Cardiopatías/mortalidad , BrasilRESUMEN
Objetivos: Estimar a magnitude da associação entre a exposição a resíduos de pesticidas organoclorados (OC) e alterações de marcadores hepáticos. Método: Estudo seccional conduzido em população exposta a OC residente em Cidade dos Meninos, Duque de Caxias (RJ), Brasil (n=354). Foram calculadas as taxas de alterações dos marcadores hepáticos (Alanina aminotransferase (ALT), Aspartato aminotransferase (AST), fosfatase alcalina, gama glutamil transpeptidase (GGT) e albumina) e, em seguida, por meio de regressão logística binária não condicional, foi estimada a associação entre a presença ou não de alterações e os grupos de exposição, criados com base na exposição a alimentos, solo e água contaminados no local. Razões de chance (Odds ratio - OR) brutas e ajustadas para os grupos de exposição e para os fatores de confusão e seus respectivos intervalos de confiança (IC95%) foram obtidos. Resultados: Após ajuste pela regressão logística, os resultados do presente estudo apontam para nenhuma associação entre alterações em enzimas hepáticas e a exposição a OC. Conclusão: O achado sugere que o metabolismo que envolve a distribuição e a biotransformação de OC no organismo não envolve toxicidade direta ao fígado. .
Objectives: To estimate the magnitude of the association between exposure to organochlorine pesticide residues and alterations of liver markers. Methods: Cross-sectional study conducted in a population exposed to organochlorines resident of Cidade dos Meninos, Duque de Caxias (RJ), Brazil (n=354). Rates were calculated from changes in hepatic markers (Alanine aminotransferase (AST), Aspartate aminotransferase (AST), alkaline phosphatase, gamma glutamyl transpeptidade (GGT) and albumin) and then, using binary logistic regression non-conditional, was estimated the association between the presence or absence of changes and exposure groups, created based on the exposure to food contaminated soil and water on site. Odds ratios unadjusted and adjusted for exposure groups and for confounding factors and their confidence interval (95%CI) were obtained. Results: After adjustment by logistic regression, the results of this study indicate no association between changes in liver enzyme abnormalities and exposure to organochlorines. Conclusion: Finding suggests that the metabolism involving the distribution and biotransformation of organochlorine compounds in the body involves no direct toxicity to the liver. .
RESUMEN
Analisar a tendência de mortalidade entre homens no Município do Rio de Janeiro, por grupo de causas, entre 1996 e 2011. Métodos: Estudo descritivo de série temporal, utilizando dados de óbitos masculinos de residentes no Município do Rio de Janeiro, no período de 1996 a 2011, para grandes grupos de causas. Os dados foram analisados com os softwares Excel 2010 e Statistical Package for the Social Sciences (SPSS) versão 22.0. Resultados: A tendência da mortalidade por grandes grupos de causas entre homens no Município do Rio de Janeiro está decrescendo, com diferença entre os grupos de causas. Porém, estes homens seguem adoecidos com o passar dos anos. Conclusão: A Política Nacional de Atenção à Saúde do Homem deve estar mais sensível a esta realidade, ofertando uma atenção em saúde capaz de reconhecer mais integralmente as necessidades de saúde desse público...