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1.
Sci Total Environ ; 803: 149744, 2022 Jan 10.
Artigo em Inglês | MEDLINE | ID: mdl-34482147

RESUMO

Pharmaceuticals (PhACs) are considered emerging contaminants with potential accumulation in aquatic organisms. Thus, seafood consumption may cause long-term effects and health risk for consumers. In the present study, the occurrence of PhACs in seafood from two Brazilian coastal areas, Sepetiba Bay (n = 43) and Parnaiba Delta River (n = 48), was determined for the first time, and their potential risk for human health was assessed. An eco-friendly multi-analytes method was used, after being validated for the different types of matrices (mussels, fatty and lean fish). All compounds under study were detected at least in four seafood species, including chloramphenicol, an antibiotic prohibited in animal foods. Most PhACs had mean concentrations below limit of quantification. Ibuprofen and other nonsteroidal anti-inflammatory drugs (NSAIDs), as well as simvastatin and carbamazepine were the main PhACs bioaccumulated in edible parts of seafood species from Brazil. The high trophic level carnivorous species, snook, was the most contaminated by NSAIDs, while bivalves were the seafood more contaminated by lipid regulators. The profile of contamination did not vary among different types of matrix, except in relation to carbamazepine and ketoprofen. These PhACs were more abundant in species from Sepetiba Bay, an area highly impacted by human influence. The estimated daily exposure for Brazilian population that consumes the studied species was up to 20.3 ng/kg bw/day via carib pointed-venus and 25.7 ng/kg bw/day via snooks, lower than acceptable daily intake. Thus, consumption of seafood species from Sepetiba Bay and Parnaiba Delta River seems to be safe to the population in what concerns the PhACs studied.


Assuntos
Preparações Farmacêuticas , Poluentes Químicos da Água , Animais , Brasil , Monitoramento Ambiental , Humanos , Medição de Risco , Alimentos Marinhos/análise , Poluentes Químicos da Água/análise
2.
Sci Total Environ ; 803: 149747, 2022 Jan 10.
Artigo em Inglês | MEDLINE | ID: mdl-34487895

RESUMO

This study estimates exposure and inhaled dose to air pollutants of children residing in a tropical coastal-urban area in Southeast Brazil. For that, twenty-one children filled their time-activities diaries and wore the passive samplers to monitor NO2. The personal exposure was also estimated using data provided by the combination of WRF-Urban/GEOS-Chem/CMAQ models, and the nearby monitoring station. Indoor/outdoor ratios were used to consider the amount of time spent indoors by children in homes and schools. The model's performance was assessed by comparing the modelled data with concentrations measured by urban monitoring stations. A sensitivity analyses was also performed to evaluate the impact of the model's height on the air pollutant concentrations. The results showed that the mean children's personal exposure to NO2 predicted by the model (22.3 µg/m3) was nearly twice to those measured by the passive samplers (12.3 µg/m3). In contrast, the nearest urban monitoring station did not represent the personal exposure to NO2 (9.3 µg/m3), suggesting a bias in the quantification of previous epidemiological studies. The building effect parameterisation (BEP) together with the lowering of the model height enhanced the air pollutant concentrations and the exposure of children to air pollutants. With the use of the CMAQ model, exposure to O3, PM10, PM2.5, and PM1 was also estimated and revealed that the daily children's personal exposure was 13.4, 38.9, 32.9, and 9.6 µg/m3, respectively. Meanwhile, the potential inhalation daily dose was 570-667 µg for PM2.5, 684-789 µg for PM10, and 163-194 µg for PM1, showing to be favourable to cause adverse health effects. The exposure of children to air pollutants estimated by the numerical model in this work was comparable to other studies found in the literature, showing one of the advantages of using the modelling approach since some air pollutants are poorly spatially represented and/or are not routinely monitored by environmental agencies in many regions.


Assuntos
Poluentes Atmosféricos , Poluição do Ar em Ambientes Fechados , Poluição do Ar , Poluentes Atmosféricos/análise , Poluição do Ar/análise , Poluição do Ar em Ambientes Fechados/análise , Brasil , Criança , Exposição Ambiental/análise , Monitoramento Ambiental , Humanos , Material Particulado/análise , Instituições Acadêmicas
3.
Rev Lat Am Enfermagem ; 29: e3490, 2021.
Artigo em Inglês, Espanhol, Português | MEDLINE | ID: mdl-34730766

RESUMO

OBJECTIVE: to translate and culturally adapt the Risk assessment and management of exposure of health care workers in the context of covid-19 questionnaire to the Brazilian context and to develop and evaluate a sociodemographic and occupational characterization questionnaire to compose the adapted questionnaire. METHOD: five stages were conducted to adapt the Risk assessment and management of exposure of health care workers in the context of covid-19 questionnaire, namely: translation, synthesis of the translations, evaluation by a committee of judges, back translation and pre-test. As for the complementary questionnaire, it was elaborated and evaluated by a committee of judges and a pre-test was carried out. RESULTS: the questionnaires were validated and the pre-test stage was conducted with health workers and students. CONCLUSION: the final version adapted to the Brazilian context was called Questionário de avaliação de risco e gestão da exposição de trabalhadores e estudantes de saúde no contexto da covid-19 and is available for use, together with the final version of the Sociodemographic and occupational questionnaire: Risk assessment and management of exposure of health care workers and students in the context of covid-19. These questionnaires may assist in mitigating the risks of infection, illness and death of health workers and students due to covid-19.


Assuntos
COVID-19 , Brasil , Comparação Transcultural , Pessoal de Saúde , Humanos , Medição de Risco , SARS-CoV-2 , Inquéritos e Questionários , Traduções
4.
BMC Health Serv Res ; 21(1): 1221, 2021 Nov 11.
Artigo em Inglês | MEDLINE | ID: mdl-34763679

RESUMO

BACKGROUND: Immunopreventable diseases are a public health reality in Brazil and worldwide, a reality that is not exclusive to children, but affects the adult population. OBJECTIVES: Discriminating the total costs of hospitalizations from immunopreventable diseases in the population aged 20 to 59 years. METHODS: A population, observational, descriptive, retrospective study was conducted with secondary information from DATASUS to discriminate the hospitalizations associated with immunopreventable diseases in Brazil and their care costs, within the Scope of the SUS, between 2008 and 2018, in the economically active population (20 to 59 years). RESULTS: It was analyzed 127,746 hospitalizations for immunopreventable diseases, (27.92% of all hospitalizations) were observed in the adult population, totaled R$115,682,097.54 (29.72% of the total costs). Of this population studied, 51.48% were registered as male; 66.74% were associated with influenza disease; 16.05% to chickenpox/herpes zoster infection and 7.55% to acute hepatitis B infections. The trend analysis of the time series of hospitalizations in this population showed a stationary trend. CONCLUSIONS: The 127,746 hospitalizations could be avoided with immunization, and 127,746 workers who could be working and not hospitalized. There were also R$115,682,097.54 that could be invested in other public health needs, which became necessary for the treatment of preventable diseases.


Assuntos
Herpes Zoster , Custos Hospitalares , Adulto , Brasil/epidemiologia , Feminino , Hospitalização , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Adulto Jovem
5.
Int J Public Health ; 66: 584308, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34744556

RESUMO

Objectives: The concept of vulnerability has been used more frequently in several studies, in an attempt to better understand the specificities and needs of different population groups, both in environmental and socio-economical terms. The aim of this study is to identify, characterize and analyze populations in situations of socio-environmental vulnerability in the city of Rio de Janeiro, based on social, economic, environmental and public health indicators organized into a summary index - the Socio-Environmental Vulnerability Index. Methods: The methodology integrated 15 indicators in a Multi-Criteria Decision Analysis into a Geographic Information System. Results: According to our results, socio-environmental vulnerability in Rio de Janeiro is aggravated by at-risk situations and environmental degradation. These aspects are jeopardized by the population density in slum areas, where the most disadvantaged groups live in a process of environmental and urban exclusion. Conclusion: The study concludes about the importance of these tools in guiding resource allocation and their contribution to formulating and implementing more effective public policies.


Assuntos
Meio Ambiente , Populações Vulneráveis , Brasil , Cidades , Sistemas de Informação Geográfica , Humanos , Áreas de Pobreza , Fatores Socioeconômicos
6.
Int J Public Health ; 66: 609179, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34744575

RESUMO

Objective: To describe the inequalities in the double burden of malnutrition (DBM) in the adult population. Methods: Study carried out with data from the VIGITEL study, conducted in 2019 in all Brazilian capitals. Underweight and excess weight were evaluated on the basis of years of schooling and age. Multi-level analysis was performed including Human Development Index of each capital and individual-level variables. The inequality slope index was used to assess the magnitude of the inequalities found. All analyses considered the svy command owing to the complexity of the sampling process. Results: 47.119 individuals were studied. Men with no education had 6 percentage points more underweight compared to those with higher education. Higher prevalence of excess weight was found among men with higher education and women with no education. In women, the difference was 18 percentage points between extreme categories. Elderly people with no education had 10 percentage points more excess weight than those with higher education. Conclusions: The findings suggest the need for intersectoral actions that can cope with the social inequalities and help confronting with the DBM in Brazil.


Assuntos
Disparidades nos Níveis de Saúde , Desnutrição , Adulto , Brasil/epidemiologia , Feminino , Humanos , Masculino , Desnutrição/epidemiologia , Fatores Socioeconômicos
7.
Cien Saude Colet ; 26(suppl 3): 3397-3408, 2021.
Artigo em Português, Inglês | MEDLINE | ID: mdl-34787175

RESUMO

The paper presents the relationship between the allocation of financial resources and the type of local basic health infrastructure in an initial sample of 5,570 Brazilian municipalities. This is an explanatory research using multiple correspondence analysis and quantile regression between expenditure/control variables and the type of structure of PHC Units. The correspondence between the type and the representative variables of expenditure shows that inferior typologies are related to lower per capita expenditure in these variables, and vice versa. Quantile regression showed a positive relationship with the type of infrastructure in the two cycles evaluated. There is evidence that expenditure variables are positively related to infrastructure, which allows us to understand that allocating more resources leads to better infrastructure. Results point to the need to improve the governance of financial resources for health, as municipalities with lower socioeconomic indicators have an infrastructure in the lower categories. We can conclude that there are multiple actors, and the various criteria for allocating and decentralizing resources bring about difficulties of coordination and integration between the entities, restricting the appropriate prioritization in the distribution of resources.


Assuntos
Gastos em Saúde , Atenção Primária à Saúde , Brasil , Cidades , Humanos , Fatores Socioeconômicos
8.
Rev Gaucha Enferm ; 42: e20200488, 2021.
Artigo em Inglês, Português | MEDLINE | ID: mdl-34755806

RESUMO

OBJECTIVE: To carry out the cultural adaptation of the Special Needs Kids Questionnaire into Brazilian Portuguese and assess its reliability. METHODS: Methodological study conducted between September 2019 and June 2020 from the stages of translation, back-translation, content validation, semantic validation and pilot test. Content Validation Index, Cronbach's Alpha Coefficient and Intraclass Correlation Coefficient were calculated. RESULTS: After the second round, the adapted version had a Content Validation Index greater than 0.80 in all items and was considered understandable by the mothers. The pilot test included 89 mothers of children born prematurely from the Neonatal Intensive Care Unit in the test and 44 in the retest. All items had Cronbach's Alpha greater than 0.70. Of the 20 items, 15 showed moderate reliability, three high and two weak. CONCLUSION: The instrument proved to be reliable and has the potential to identify the fragmentation and discontinuity of the care received.


Assuntos
Comparação Transcultural , Traduções , Brasil , Psicometria , Reprodutibilidade dos Testes , Inquéritos e Questionários
9.
Cien Saude Colet ; 26(10): 4397-4409, 2021 Oct.
Artigo em Português, Inglês | MEDLINE | ID: mdl-34730631

RESUMO

This article aims to analyze if it is possible for Brazil to meet the Sustainable Development Goals (SDG) 3.1, based on a diagnosis of the situation of maternal mortality in the Health Regions (HRs) of Brazil, in 2018, and the main characteristics of this mortality between 1996 and 2018 in the country. The study consists of two articulated phases: (i) bibliographical analysis of maternal mortality in Brazil; (ii) study in the Mortality Information System (SIM, in Portuguese). In 2018, from the 450 HRs, 159 showed a maternal mortality rate (MMR) of above 70 per 100,000 live births (LBs). Between 1996 and 2018, in Brazil, there was a reduction among women 30 to 49 years of age. However, in the age group of 10 to 29 years, there was no change during the time studied. The dissemination of the Maternal Mortality Committees, the PHPN, the PNAISM, and the "Stork Network" have all contributed to improvements in late pregnancies; however, they were inefficient at preventing deaths among young mothers. Compliance with SDG 3.1 requires: prioritization of CIR with MMR greater than 70.0/100,000 LB; qualification of prenatal services, focusing on care among women aged 10 to 29 years and hypertensive complications; and legalization of abortion.


Assuntos
Aborto Induzido , Aborto Espontâneo , Adolescente , Adulto , Brasil/epidemiologia , Criança , Feminino , Humanos , Mortalidade Materna , Gravidez , Desenvolvimento Sustentável , Adulto Jovem
10.
Cien Saude Colet ; 26(10): 4453-4469, 2021 Oct.
Artigo em Português, Inglês | MEDLINE | ID: mdl-34730635

RESUMO

Brazil is undergoing a demographic transition characterized by regional inequalities. It is reasonable to assume that aspects related to poverty, development and inequality might reverse the sign of the association of indicators of demographic transition, exemplifying a phenomenon known as Simpson's Paradox. The aim of this study was to analyze the effect of inequality, poverty and social development on population dynamics in Brazil, verifying the occurrence of Simpson's paradox in demographic transition. We used population data from the 1991, 2000 and 2010 national censuses, broken down by age and federative unit (FU). The correlation between demographic indicators was assessed by stratifying the FUs into groups according to their median social indicators. The findings show that all FUs have progressed against social indicators and are undergoing demographic transition; however, despite reductions in disparities over the study period, persistent gaps exist between regions. Simpson's paradox was present when the analysis was carried out by census year and social indicators, and was particularly pronounced in 1991. The main challenge is to define how to analyze demographic dynamics in Brazil and understand how contextual factors alter the pace, quantum, and pattern of demographic transition.


Assuntos
Pobreza , Brasil/epidemiologia , Humanos , Dinâmica Populacional
11.
Cien Saude Colet ; 26(10): 4715-4726, 2021 Oct.
Artigo em Português | MEDLINE | ID: mdl-34730657

RESUMO

The scope of this article is to present and analyze the institutional governance profile of the 434 regional interagency committees operating in 25 states of the Brazilian Federation. The data were taken from the National Survey of Regional Interagency Committees (CIR), a census conducted in the years 2017 and 2018, and were collected through a questionnaire applied to the coordinators/directors/presidents of the CIR. The composition of the CIR profile was carried out using an analysis matrix specifically developed for this study, which combines 23 variables organized in five dimensions of institutional governance: institutional legitimacy, compliance and consistency of operation, quality of structure and operating conditions, federative equilibrium and quality of decision-making. The results show, on the one hand, an interagency institutional governance system consolidated throughout the national territory, with significant acceptance by the state and municipal spheres and clearly defined and publicized operating rules. On the other hand, it reveals a complex of levels characterized by marked limitations in financial and human resources and management infrastructure, in addition to action concentrated on emergency problems in the management of the network of health care and services.


Assuntos
Política de Saúde , Programas Nacionais de Saúde , Brasil , Atenção à Saúde , Instalações de Saúde , Humanos
12.
Cien Saude Colet ; 26(10): 4737-4748, 2021 Oct.
Artigo em Português, Inglês | MEDLINE | ID: mdl-34730659

RESUMO

This cross-sectional study investigated the association between self-reported race/skin color and two outcomes - psychosocial demand and physical demand at work - in 1,032 workers in an urban cleaning services company and two footwear manufacturers, located in the State of Bahia, Brazil. Psychosocial demand was measured through the Job Content Questionnaire and physical demand was measured through questions about postures and cargo handling. A Cox regression analysis provided prevalence ratios (PR) adjusted by age, gender, and educational level. Among blacks, there is a higher proportion of garbage collectors and a lower proportion of supervisory positions. Black workers are more subject to high psychological demand and low job control and, consequently, to high strain (PR=1.65). Also, they are more exposed to work with arms above shoulder level (PR=1.93), and material handling (PR=1.62), compared to white workers. Brown workers are more exposed to low job control (PR=1.36), work with arms above shoulder level (PR=1.48), and material handling (PR=1.25), also compared with whites. Social support is lower among blacks and brown. The study demonstrated inequities in psychosocial and physical exposures at work that are in line with the structural conception of racism. This evidence can contribute to the adoption of practices that increase equity in the world of work.


Assuntos
Pigmentação da Pele , Brasil , Estudos Transversais , Humanos , Prevalência , Inquéritos e Questionários
13.
BMJ Open ; 11(11): e052971, 2021 11 01.
Artigo em Inglês | MEDLINE | ID: mdl-34725080

RESUMO

INTRODUCTION: Asthma is a common long-term disorder and strategies to improve asthma control are still a challenge. Integrated delivery of health systems is critical for effective asthma care: there is limited information on experiences of care coordination for asthma from Latin America, especially on perspectives of health personnel and in the context of the COVID-19 pandemic. METHODS AND ANALYSIS: This protocol details a qualitative approach to analyse health workers' perspectives of healthcare coordination for asthma control during COVID-19 pandemic in Ecuador and Brazil, at primary and specialised levels, through in-depth semistructured interviews using a video communications platform. The analysis will identify knowledge and perspectives based on coordination of clinical information, clinical management and administrative coordination. Theoretical sampling will be used to obtain approximately equal numbers of women and men within each level of healthcare; data saturation will be used to determine sample size. Transcripts will be analysed using content-coding procedures to mark quotations related to major topics and subthemes included in the interview guide, and narrative analysis will be based on a theoretical framework for healthcare coordination to identify new themes and subthemes. ETHICS AND DISSEMINATION: Ethical approval was obtained from the ethics committees of Hospital General Docente Calderón, Quito, Ecuador; and Universidade Federal da Bahia, Salvador, Brazil. The findings of this study will be disseminated through peer-reviewed articles, conference presentations and condensed summaries for key stakeholders and partners.


Assuntos
Asma , COVID-19 , Asma/epidemiologia , Asma/terapia , Brasil/epidemiologia , Atenção à Saúde , Equador/epidemiologia , Feminino , Pessoal de Saúde , Humanos , Masculino , Pandemias , Pesquisa Qualitativa , SARS-CoV-2
14.
Environ Monit Assess ; 193(12): 816, 2021 Nov 17.
Artigo em Inglês | MEDLINE | ID: mdl-34791540

RESUMO

Indicators are important tools to improve the efficiency of water supply systems. Considering that the performance could vary according to the systems' sizes, this research proposed financial, operational, and water quality indicators for water supply systems of municipalities with different populations in Minas Gerais, Brazil. The organisation and selection of the sample were based on available information in the National Sanitation Data System of 2014. We selected 363 municipalities of Minas Gerais and 56 predictors. Through multiple linear regression (MLR), we found that the commitment of revenues with expenditures and the ratio among revenues and expenses are the most relevant variables to describe the financial performance. Furthermore, water loss per connection and water-billing index were the most important to describe the operational performance. Finally, models related to water quality performance could not be established due to the low value of the coefficient of determination. We observed that supply systems have distinct variables to describe their financial and operational performance, according to their sizes. Small municipalities have a strong relationship with financial performance and expenses. Large counterparts have their performance related to the collection, which can be explained by the economy of scale. Considering the operational performance, we observed that larger municipalities have a strong relationship between their operational performance and water loss. These models are potential tools in the decision-making processes, which can be used to promote improvements in water supply systems.


Assuntos
Monitoramento Ambiental , Saneamento , Brasil , Cidades , Abastecimento de Água
16.
BMC Public Health ; 21(1): 1825, 2021 10 09.
Artigo em Inglês | MEDLINE | ID: mdl-34627182

RESUMO

BACKGROUND: There is a growing body of literature that recognizes the importance of public engagement in health technology assessment. However, there is still uncertainty regarding how the results should be recorded, analyzed, and used by decision makers. OBJECTIVE: Synthesize the contributions of the Brazilian public (women, health professionals, managers, educational institutions, and companies) about the implementation of the National Clinical Guidelines for Care in Normal Birth from the public consultation carried out in Brazil. METHOD: IRaMuTeQ software was used to organize and summarize the corpus based on three types of analysis: descriptive statistics; descending hierarchical classification; and specificities analysis. The public consultation was conducted in 2016 by the National Committee for Health Technology Incorporation (CONITEC) in the Brazilian public health system as part of the guideline development process. RESULTS: The corpus consisted of 303 texts, separated into 1233 text segments, 1081 of which were used, corresponding to retention of 87.67%. Five classes emerged from our analyses: mandatory presence of an obstetrician during labor and delivery in hospital settings; barriers and facilitators for guideline implementation; use of evidence-based practices by health professionals; progression of labor and delivery and women's rights; and mobilization to promote the guideline For each class, the most frequent words and sentences with the highest chi-squared scores were presented. Barriers were associated with lack of financial resources, training and professional motivation, and facilitators with training to change the practices of health professionals. Obstetric nurses emerged as an alternative for supervising normal births as well as the mandatory presence of an obstetrician during childbirth in hospital settings. CONCLUSION: Our findings summarize the contributions provided by the Brazilian public and shed some light on the barriers and facilitators of clinical guidelines for care in normal birth. These topics are not typically explored by quantitative studies. Including this information in the decision-making process would not only increase public engagement, but provide greater evidence for implementing the clinical guidelines nationwide.


Assuntos
Parto Obstétrico , Avaliação da Tecnologia Biomédica , Brasil , Feminino , Humanos , Parto , Gravidez , Encaminhamento e Consulta
17.
BMC Public Health ; 21(1): 1842, 2021 10 12.
Artigo em Inglês | MEDLINE | ID: mdl-34641846

RESUMO

BACKGROUND: Public health recognizes that health conditions depend on factors related to the development patterns income distribution, degree of poverty, working conditions, among other social determinants. The objective of this study was to analyze the association of maternal mortality with the Human Development Index (HDI), Gini Index, Income per capita, and the Social Vulnerability. METHOD: The study analyzed the relationship between MMR and socioeconomic indicators in the 26 federative units and the Federal District of Brazil, in 2017. The socioeconomic indicators used in the study were: HDI, Gini Index, Income per capita, and SVI. Crude and adjusted linear regression were performed between maternal mortality and socioeconomic indicators. RESULTS: When analyzing which socioeconomic determinants that are related to maternal mortality ratio rates, a higher per capita income positive effect was observed for lower MMR (ß = - 150.8; CI 95% -289.9 to - 11.7; r2 = 0.17; p = 0.035), as well as a trend of higher MMR in relation to the SVI (ß = 97.7; CI 95% -12.2 to 207.6; r2 = 0.12; p = 0.079). In model found by the stepwise forward selections, only the per capita income was um index related to less RMM (ß = - 0.02; CI 95% -0.05 to - 0.002; r2 = 0.15; p = 0.028). CONCLUSION: The findings showed that the per capita income has a negative association MMR in the different states of Brazil, but seems canceled because of the other socioeconomic determinants related to the poor live conditions.


Assuntos
Renda , Mortalidade Materna , Brasil/epidemiologia , Humanos , Saúde Pública , Fatores Socioeconômicos
18.
BMC Public Health ; 21(1): 1841, 2021 10 12.
Artigo em Inglês | MEDLINE | ID: mdl-34641849

RESUMO

BACKGROUND: Tuberculosis (TB) presents a high burden of disease and is considered a global emergency by the World Health Organization (WHO), as the leading cause of death from infectious disease in adults. TB incidence is related directly to access to health services and socioeconomic determinants and inequality. Providing primary care settings can lead to improved access, shorter waiting times for patients, and enhanced TB case detection. The article aims to identify the spatial and temporal risk areas for TB and the relationship between TB cure and primary healthcare coverage from 2012 to 2014 in Rio de Janeiro, Brazil. METHODS: A cross-sectional study was conducted in Rio de Janeiro, Brazil. All cases of TB reported to the Information System on Diseases of Notification (SINAN) from 2012 to 2014 were included. Socioeconomic variables from the 2010 Brazilian national census were also added. Socioeconomic variables were selected from multivariate analysis using principal factors analysis. Spatial association was verified with generalized additive model (GAM). It was possible to identify areas at higher risk of failure to cure TB. RESULTS: TB rates showed strong positive spatial autocorrelation. TB cure rate varied according to schooling (individuals with complete secondary schooling had higher cure rates than illiterate individuals; OR 1.72, 95% CI 1.30-2.29), alcohol consumption (OR 0.47, 95% CI 0.35-0.64), contact investigation (OR 2.00, 95% CI 1.56-2.57), positive HIV serology (OR 0.31, 95% CI 0.23-0.42), and census tracts with higher elderly rates (OR 9.39, 95% CI 1.03-85.26). Individuals who had been covered by primary healthcare (PHC) for 35 to 41 months had 1.64 higher odds of cure, compared to those with no PHC coverage (95% CI 1.07-2.51). CONCLUSION: A comprehensive risk map was developed, allowing public health interventions. Spatial analysis allowed identifying areas with lower odds of TB cure in the city of Rio de Janeiro. TB cure was associated statistically with time of coverage by primary healthcare. TB cure rate also varied according to sociodemographic factors like schooling, alcohol abuse, and population density. This methodology can be generalized to other areas and/or other public health problems. HIGHLIGHTS: We studied standardized municipal TB cure rates in an area of social inequality in Brazil. TB rates showed strong positive spatial autocorrelation. Higher rates were associated with population density and socioeconomic conditions. Illiterate individuals were less likely to achieve TB cure. TB cure was less likely in individuals with HIV and alcohol abuse. TB cure was greater in areas with high primary healthcare coverage.


Assuntos
Tuberculose , Adulto , Brasil/epidemiologia , Estudos Transversais , Humanos , Atenção Primária à Saúde , Fatores Socioeconômicos , Análise Espacial , Tuberculose/epidemiologia , Tuberculose/terapia
19.
Artigo em Inglês | MEDLINE | ID: mdl-34682711

RESUMO

Cervical cancer is the second most common form of cancer in the world among women, and it is estimated to be the third most frequent cancer in Brazil, as well as the fourth leading cause of death from cancer. There is a difference in cervical cancer mortality rates among different administrative regions in Brazil along with an inadequate distribution of cancer centers in certain Brazilian regions. Herein, we analyze the trends in hospital admission and mortality rates for CC between 2000 and 2012. This population-based ecological study evaluated the temporal trend in cervical cancer between the years 2000 and 2012, stratifying by Brazilian administrative regions. The North and Northeast regions had no reduction in mortality in all age groups studied (25 to 64 years); when analyzing hospitalization rates, only the age group of 50 to 64 years from the North Region did not present a reduction. During the years studied, in the South Region, the age group ranging from 50 to 54 years had the greatest reduction in mortality rates (ß = -0.59, p = 0.001, r2 = 0.63), and the group ranging from 45 to 49 years had the greatest reduction in hospital admission rates (ß = -8.87, p = 0.025, r2 = 0.37). Between the years 2000 and 2012, the greatest reduction in the incidence of UCC was in the South Region (ß = -1.43, p = 0.236, r2 = 0.12) followed by the Central-West (ß = -1, p < 0.001, r2 = 0.84), the Southeast (ß = -0.95, p < 0.001, r2 = 0.88), the Northeast (ß = -0.67, p = 0.080, r2 = 0.25), and, finally, by the North (ß = -0.42, p = 0.157, r2 = 0.17). There was a greater reduction in mortality rates and global hospitalization rates for CC in Brazil than in the United States during the same period with exceptions only in Brazil's North and Northeast regions.


Assuntos
Neoplasias do Colo do Útero , Adulto , Brasil/epidemiologia , Feminino , Hospitais , Humanos , Incidência , Pessoa de Meia-Idade , Mortalidade , Neoplasias do Colo do Útero/epidemiologia
20.
Front Public Health ; 9: 687110, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34631640

RESUMO

Professionals throughout the world have been working to assess the interdisciplinary interaction and interdependence between health and wellbeing in a constantly changing environment. The One Health concept was developed to encourage sustainable collaborative partnerships and to promote optimal health for people, animals, plants, the environment, and the whole planet. The dissemination of scientific discoveries and policies, by working directly with diverse communities, has been one of the main goals for Global One Health. The One Health concept has also been referred or related to as "One Medicine, One Medicine-One Health, One World-One Health, EcoHealth," and Planetary Health," depending on each fundamental view and approach. In Latin America, despite the concept still being discussed among health professionals and educators, several One Health initiatives have been used daily for more than decades. One Health action has been applied especially in rural and underserved urban areas where low socioeconomic status, lack of health professionals, and scarcity of medical resources may require professionals to work together. Local communities from diverse social and economic statuses, including indigenous populations have been working with institutions and social organizations for many years, accomplishing results through grassroots movements. These "bottom-up" socio-community approaches have also been tools for the prevention and control of diseases, such practice has preceded the One Health concepts in Latin American countries. It is strongly believed that collaborative, multidisciplinary, political, and economic initiatives with prosocial focus may become investments toward obtaining significant results in the face of global, economic and health challenges; working for a healthier world with inclusivity, equity, and equality. In this study, it is briefly presented how the One Health approach has been initiated and developed in Latin America, highlighting the events and actions taken in Brazil, Chile, and Colombia.


Assuntos
Saúde Única , Brasil/epidemiologia , Chile , Colômbia , Humanos , América Latina/epidemiologia
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