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The objective of this study is to evaluate the association between the consumption of ultra-processed foods (UPF) and the mental health of pregnant women from the South of Brazil. This is a cross-sectional study carried out in Criciúma, Brazil, through face-to-face interviews, from April to December 2022. Pregnant women aged 18 or older who underwent prenatal care in the forty-eight basic health care units of the municipality and who were in their third trimester of pregnancy were included. High consumption of UPF was considered as six or more items or subgroups of UPF consumed on the day before the interview, using the Nova-UPF screener. The mental health variables were depressive symptoms, stress, sadness and anxiety. Crude and adjusted analyses were conducted using the Fisher's exact test and the Poisson regression with robust variance. In total, 428 pregnant women were studied; most of them were aged between 20 and 25 years and were white. Pregnant women who presented high consumption of UPF were 1·42-fold (95 % CI 1·06, 1·92) more likely to experience anxiety and presented a prevalence 56 % (95 % CI 1·18, 2·07) higher of stress when compared with those who did not present high consumption of UPF. The prevalence of depressive symptoms and feelings of sadness was 1·31-fold (95 % CI 1·08, 1·60) and 3·41-fold (95 % CI 1·77, 6·58) higher among those with high consumption of UPF, respectively. The results suggest that diet quality is associated with the mental health of pregnant women. Promoting joint actions focused on food and nutritional education, and mental health, for pregnant women, is necessary.
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OBJECTIVE: To assess the association between household food insecurity (FI) and major depressive episodes (MDE) amid Covid-19 pandemic in Brazil. DESIGN: Cross-sectional study carried out with data from four consecutive population-based studies. SETTING: The study was conducted between May and June 2020, in Bagé, a Brazilian southern city. Household FI was measured using the short-form version of the Brazilian Food Insecurity Scale. Utilising the Patient Health Questionnaire-9, we used two different approaches to define MDE: the cut-off point of ≥ 9 and the diagnostic criteria proposed by the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR). Association between FI and MDE was analysed using crude and adjusted Poisson regression models. PARTICIPANTS: 1550 adults (≥ 20 years old). RESULTS: The prevalence of household FI was 29·4 % (95 % CI 25·0, 34·4). MDE prevalence varied from 4·4 % (95 % CI 3·1, 6·0), when we used the DSM-IV-TR criteria to define this condition, to 9·6 % (95 % CI 7·3, 12·5) of the sample, when we used the cut-off point of ≥ 9 as definition. The prevalence of MDE was more than two times higher in those individuals living with FI, independent of the criteria adopted to define the outcome. Adjustment for potential confounders did not change the association's magnitude. CONCLUSIONS: Household FI has been positively associated with MDE amid Covid-19 pandemic, independent of socio-demographic characteristics of participants. Actions are needed to warrant basic living conditions to avoid FI and hunger and its consequences for the Brazilian population, especially those consequences linked to mental health disorders.
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COVID-19 , Trastorno Depresivo Mayor , Adulto , Brasil/epidemiología , COVID-19/epidemiología , Estudios Transversales , Trastorno Depresivo Mayor/epidemiología , Inseguridad Alimentaria , Abastecimiento de Alimentos , Humanos , Pandemias , Prevalencia , Adulto JovenRESUMEN
The Covid-19 pandemic is related to increased alcohol consumption and smoking. These behaviors may be related to several sociodemographic, behavioral and mental health factors. Thus, the aim of this study was to assess the association between alcohol consumption and cigarette smoking with sociodemographic, behavioral and mental health characteristics. This study used data from two population-based studies conducted in two cities from Southern Brazil amid the Covid-19 pandemic. Individuals aged 18 years or older were included and selected using a multistage sampling procedure. Alcohol consumption and smoking and changes in such consumption during the Covid-19 pandemic were evaluated. Sociodemographic, behavioral, pandemic-related, and mental health variables were also included. A hierarchical model was used to conduct the adjusted analyses, and Poisson regression with robust adjustment was used for variance. A total of 2170 individuals were studied. The prevalence of alcohol consumption and smoking were 9.3% and 14.2%, respectively. The rates of increase in alcohol consumption and smoking during the Covid-pandemic were about 20% and 30%, respectively. They were higher among those with depressive symptoms, feeling of sadness and self-reported stress. Those with poor diet quality had higher prevalence of alcohol consumption (PR: 1.82) and were 1.58 times more likely to smoke. The findings may help stakeholders in health and political systems to better understand the consequences of the Covid-19 pandemic and develop strategies to mitigate these consequences in Brazil and elsewhere.
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COVID-19 , Consumo de Bebidas Alcohólicas/epidemiología , Consumo de Bebidas Alcohólicas/psicología , COVID-19/epidemiología , Humanos , Salud Mental , Pandemias , Fumar/epidemiologíaRESUMEN
BACKGROUND: With the COVID-19 pandemic, social isolation, and information search have increased dramatically. This increased search for information about the Coronavirus, called infodemic, was greatly affected by fake news and information without scientific evidence. This article aimed to assess the infodemic amid the COVID-19 pandemic and its association with sociodemographic and pandemic-related variables, as well as describe the main sources from which people obtained information about COVID-19. METHODS: A cross-sectional population-based study was performed in Criciúma, Brazil. All individuals aged 18 years or older, residing in the 607 households systematically selected, were invited to answer the questionnaire. Infodemic and sources to seek information about COVID-19 were evaluated, as well as sociodemographic and pandemic-related variables. Adjusted Poisson regression with robust variance was used to evaluate associations. RESULTS: A total of 863 individuals participated in the study. The prevalence of infodemic was 22.1%, and television was the main source of information (58.9%). Three groups presented a higher prevalence of infodemic: older adults (PR: 1.65), individuals with low income (PR: 2.97), and those who had had contact with someone infected (PR: 2.20). CONCLUSIONS: The findings reflect how some groups are more exposed to infodemic, and underline the responsibility and importance of intersectoral actions for dissemination of information about COVID-19.
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OBJECTIVE: We aimed to analyze the frequency of adherence to social distancing and individual protection measures of adult and older populations in two cities in southern Brazil and to characterize the sociodemographic aspects of these individuals. METHODS: This cross-sectional, population-based study was conducted in the cities of Rio Grande, RS, and Criciúma, SC, Brazil. The outcome measure was the frequency of adherence to social distancing measures. Fisher's exact test (5% significance) was used to calculate the differences in prevalence according to exposure variables. RESULTS: Among the 2,170 participants over the age of 18, the prevalence of adherence to social distancing was 18.5%. Adherence was significantly higher among women; older adults; single, divorced, or widowed people with a low educational level; people of lower socioeconomic status; and people affected by multiple chronic diseases. CONCLUSION: Approximately one in five respondents adhered to measures of social distancing, and adherence was more prevalent among the risk groups.
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COVID-19 , Distanciamiento Físico , Humanos , Brasil , Estudios Transversales , Femenino , Masculino , Persona de Mediana Edad , COVID-19/prevención & control , COVID-19/epidemiología , Adulto , Anciano , Adulto Joven , Factores Socioeconómicos , Adolescente , Factores Sociodemográficos , SARS-CoV-2RESUMEN
Good sleep quality is a well-known indicator of physical and mental health, well-being, and overall vitality. This study aimed to verify the association between the practice of physical activity and sleep duration and quality in adults and older adults in southern Brazil. A cross-sectional population-based study was carried out with 820 individuals of both sexes aged 18 years or more, where sociodemographic variables were collected and also health-related variables. This study included 523 (63.8%) women and 297 (36.2%) men, and the prevalence of adequate sleep hours was 41.5% (95%CI: 39.1; 44.9). People who performed leisure walking were 34% more likely to present adequate sleep duration (PR: 1.34; 95%CI: 1.10; 1.64) compared to those who did not perform leisure walking. Individuals who met the recommendations for moderate or vigorous physical activity were more likely to have good sleep quality (PR: 1.16; 95%CI: 1.01; 1.34). Future health behavior modification strategies to improve sleep quality at the population level should consider encouraging lifestyle improvements, thus increasing the practice of physical activities.
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Ejercicio Físico , Actividades Recreativas , Masculino , Humanos , Femenino , Anciano , Brasil/epidemiología , Estudios Transversales , Factores Socioeconómicos , SueñoRESUMEN
OBJECTIVE: This study aimed to evaluate the association between sleep duration and quality and mental health before and amid the COVID-19 pandemic. METHODS: Data from two population-based cross-sectional studies conducted in 2019 and 2020 with adults in Criciúma, Southern Brazil. The Patient Health Questionnaire-9 (PHQ-9) was used to screen major depressive episodes, while the perceived stress scale was used to assess perceived stress. Sleep was evaluated through self-reported duration and quality. Crude and adjusted Poisson regression models were used to assess the association between sleep and mental health disorders. RESULTS: A total of 820 (in 2019) and 863 subjects (in 2020) were assessed. Sleep quality presented significant associations with depression and stress in both years, and the magnitude of the association with depression increased amid COVID-19 pandemic. In individuals with poor/very poor sleep quality, the risk of depression in 2019 was 2.14 (95%IC 1.48;3.09) higher when compared to those with good/very good sleep quality. This risk increased to 2.26 (95%IC 1.49;3.40) in 2020. The risk of stress was 1.90 (95%IC 1.42;2.55) in 2019 and 1.66 (95%IC1.34;2.07) in 2020. The sleep duration was not associated with mental health disorders in the adjusted analyses. CONCLUSION: The results provide important evidence that sleep quality can influence mental health of adults. The COVID-19 pandemic seems to have had a considerable impact on this association.
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COVID-19 , Trastorno Depresivo Mayor , Trastornos del Inicio y del Mantenimiento del Sueño , Adulto , Ansiedad , Brasil/epidemiología , COVID-19/epidemiología , Estudios Transversales , Depresión/epidemiología , Humanos , Salud Mental , Pandemias , Sueño , Trastornos del Inicio y del Mantenimiento del Sueño/epidemiologíaRESUMEN
Aim: To compare the physical activity pattern before and during the COVID-19 pandemic and verify the association with contextual, behavioral, and health variables related to the pandemic in adults and older adults from southern Brazil. Subject and methods: This is a panel-type, population-based study in Rio Grande-RS and Criciúma-SC, with 4290 individuals. The physical activity pattern (dependent variable) was measured using the International Physical Activity Questionnaire-IPAQ. In addition, contextual, behavioral, and health aspects related to the pandemic (independent variables) were assessed by questionnaires. Fisher's exact test was used for bivariate analyses and Poisson regression with robust variance to calculate crude and adjusted prevalence, with their respective 95% confidence intervals. Results: There was a 72% reduction in commuting physical activity and a 145% increase in physical inactivity when compared before and during the pandemic. Social distancing, excessive search for information about COVID-19, fear of the pandemic, and COVID-19 infection were all factors that contributed to the decline in physical activity during the pandemic. The home office was a protective factor for physical inactivity. Conclusion: The COVID-19 pandemic has negatively affected the pattern of physical activity in the general population, except for those who switched to working from home. Supplementary Information: The online version contains supplementary material available at 10.1007/s10389-022-01789-x.
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Fear is a reaction that can influence multiple aspects of health and life. During the Covid-19 pandemic, there have been serious pathophysiological, social, behavioral and mental consequences that can be related to fear. This study aimed to assess the fear of Covid-19 and its association with sociodemographic, behavioral and health variables. Data were gathered from two cross-sectional population-based studies conducted in 2020 with adults from two cities from Southern Brazil. The Fear of Covid-19 scale was used to evaluate fear of Covid. Exposure variables were socioeconomic, demographic, health and pandemic-related factors. Adjusted Poisson regression was performed to assess the association between fear of Covid-19 and the exposure variables. A total of 2,152 subjects were assessed. Higher fear of Covid-19 was found among women and in individuals with symptoms of Covid-19. Living alone, being richer, and testing positive for Covid-19 were associated with lower prevalence of fear. Higher prevalence of fear of Covid-19 was related to worse sleep quality, worse health perception, sadness, higher stress, depressive symptoms, and suicidal ideation. There was a linear association between fear of Covid-19 and health outcomes. The results provide evidence that fear of Covid-19 seems to be associated with socioeconomic, demographic, health and pandemic-related factors.
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COVID-19 , Adulto , Ansiedad/epidemiología , Brasil/epidemiología , Estudios Transversales , Depresión/epidemiología , Miedo , Femenino , Humanos , Pandemias , SARS-CoV-2RESUMEN
OBJECTIVE: To assess regional and social inequalities in mammography and Papanicolaou tests. METHODS: This was a cross-sectional study with data from the 2019 Chronic Disease Risk and Protective Factors Surveillance Telephone Survey (Vigitel). The outcome variables were mammography and cytopathology test. The exposure variables were race/skin color, schooling and region of residence in Brazil. Absolute inequality measurements were presented using the slope index of inequality (SII) and equiplots. RESULTS: 23,339 women were included in this study. Having a mammography was 5.2 percentage points higher in women with higher levels of education, while having a cytopathology test was 5.3 percentage points lower in women of Black race/skin color.Having mammography and cytopathology tests was 3.9 and 11.2 percentage points higher, respectively, in the Southern region. CONCLUSION: Social and regional inequalities persist in Brazil and affect mainly women of Black race/skin color, with low education levels and living in the Northeast region of the country.
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Mamografía , Prueba de Papanicolaou , Brasil/epidemiología , Estudios Transversales , Femenino , Humanos , Factores SocioeconómicosRESUMEN
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.
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Disparidades en el Estado de Salud , Desnutrición , Adulto , Brasil/epidemiología , Femenino , Humanos , Masculino , Desnutrición/epidemiología , Factores SocioeconómicosRESUMEN
O objetivo deste trabalho é avaliar condições de vida, trabalho e saúde dos pescadores artesanais em um município do Sul do Brasil. É um estudo descritivo que incluiu trabalhadores de pesca com 18 anos ou mais. A entrevista foi realizada face a face e o questionário aplicado era único e padronizado. Continha informações sociodemográficas, condições de pesca, hábitos de vida e saúde. A qualidade de vida foi avaliada pelo WHOQOL-BREF. Foram entrevistados 160 pescadores, com média de idade de 48,9 (± 12,4) anos. A maioria era do sexo masculino (64,4%), com ensino fundamental completo (65,6%) e praticavam arrasto de rede (55,0%). Cerca de um terço deles fazia uso de álcool (38,7%) e 46,8% referiram consumo abusivo nos últimos 30 dias. Um quarto dos pescadores fumava (26,9%) e quase a totalidade tinha prática insuficiente de atividade física (93,1%). Doenças osteomusculares acometeram 65,6% deles e 52,5% sofreram acidente de trabalho. Referente à qualidade de vida, o domínio ambiente apresentou a menor média de escore. Fomentar estudos com esse público-alvo é essencial para implementar ações de prevenção e promoção da saúde, além de políticas de assistência aos pescadores para diminuir vulnerabilidades e garantir qualidade de vida.
This descriptive study evaluates the living, working and health conditions of artisanal fishing workers in a Southern Brazilian city. Fishing workers aged 18 and over were interviewed in person and answered a unique and standardized questionnaire, which covered sociodemographic information, fishing conditions, life habits and health. Quality of life was evaluated by the WHOQOL-bref. A total of 160 fishing workers were interviewed, with a mean age of 48.9 (± 12.4 years). Most were male (64.4%), with complete elementary school (65.6%) and practiced fishing net trawling (55.0%). About a third of them drank alcohol (38.7%), and 46.8% reported abusive consumption in the last 30 days. About a quarter reported smoking (26.9%) and most declared insufficient physical activity (93.1%). Musculoskeletal diseases affected 65.6% of the sample and 52.5% suffered occupational accidents. Regarding quality of life, the environment domain showed the lowest score. Conducting studies with this target population is essential to implement prevention and health promotion actions, as well as aid policies to reduce vulnerabilities and ensure quality of life.
El objetivo de este estudio es evaluar las condiciones de vida, trabajo y salud de los pescadores artesanales de un municipio del Sur de Brasil. Se trata de un estudio descriptivo que incluyó a trabajadores de la pesca con edad igual o superior a 18 años. La entrevista se realizó cara a cara, y el cuestionario aplicado fue único y estandarizado. Y estaba compuesto por información sociodemográfica, condiciones de pesca, hábitos de vida y salud. La calidad de vida se evaluó mediante WHOQOL-BREF. Se realizó entrevistas a 160 pescadores, cuya edad promedio fue de 48,9 (± 12,4) años. La mayoría de ellos eran del sexo masculino (64,4%), tenían estudios primarios completos (65,6%) y practicaban la pesca de arrastre (55,0%). Cerca de un tercio de ellos consumía alcohol (38,7%) y el 46,8% reportó un consumo abusivo en los últimos treinta días. Una cuarta parte de los pescadores reportó fumar (26,9%) y casi todos tenían actividad física insuficiente (93,1%). Las enfermedades musculoesqueléticas afectaron al 65,6% de ellos, y el 52,5% sufrió un accidente de trabajo. En cuanto a la calidad de vida, el dominio ambiente tuvo un puntaje promedio más bajo. Fomentar estudios con este público objetivo es fundamental para implementar acciones de prevención y promoción de la salud, así como políticas de asistencia a los pescadores para reducir vulnerabilidades y asegurarles calidad de vida.
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ABSTRACT Objective: We aimed to analyze the frequency of adherence to social distancing and individual protection measures of adult and older populations in two cities in southern Brazil and to characterize the sociodemographic aspects of these individuals. Methods: This cross-sectional, population-based study was conducted in the cities of Rio Grande, RS, and Criciúma, SC, Brazil. The outcome measure was the frequency of adherence to social distancing measures. Fisher's exact test (5% significance) was used to calculate the differences in prevalence according to exposure variables. Results: Among the 2,170 participants over the age of 18, the prevalence of adherence to social distancing was 18.5%. Adherence was significantly higher among women; older adults; single, divorced, or widowed people with a low educational level; people of lower socioeconomic status; and people affected by multiple chronic diseases. Conclusion: Approximately one in five respondents adhered to measures of social distancing, and adherence was more prevalent among the risk groups.
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Identificar a prevalência de aleitamento materno exclusivo e fatores relacionados durante os seis primeiros meses de vida do lactente. Trata-se de um estudo transversal realizado com 102 nutrizes residentes no município de Balneário Gaivota(SC) que efetivaram o pré-natal na rede pública ou privada e tiveram parto no ano de 2018. Os dados foram coletados por aplicação de questionário contemplando as variáveis sociodemográficas, gestacionais e pós-gestacionais. A prevalência de aleitamento materno exclusivo foi de 43,1%. Aqueles bebês que usavam mamadeira tiveram 45% menos probabilidade de ter recebido aleitamento materno exclusivo até os 6 meses de idade, e aqueles que receberam prescrição de fórmula infantil na alta hospitalar apresentaram 54% menos chance comparados aos seus pares. Os fatores relacionados ao aleitamento materno exclusivo são comportamentais e modificáveis, sendo necessária a orientação pelos profissionais de saúde durante a consulta pré-natal, puericultura e no acompanhamento do desenvolvimento infantil.
To identify the prevalence of exclusive breastfeeding and its related factors during the first six months of the infant's life. This is a cross-sectional study carried out with 102 nursing mothers residing in the city of Balneário Gaivota( SC) who performed prenatal care in the public or private network and gave birth in 2018. Data were collected by application of a questionnaire and included sociodemographic, gestational and post-gestational variables. The prevalence of exclusive breastfeeding was 43.1%. Those babies who used a bottle were 45% less likely to have been exclusively breastfed up to six months of age, and those who were prescribed infant formula at hospital discharge were 54% less likely compared to their peers. Factors related to exclusive breastfeeding are behavioral and modifiable, thus, guidance by health professionals is necessary during prenatal and childcare consultations and in the monitoring of child development.
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Identificar as prevalências de HIV/AIDS em uma cidade da região metropolitana de Porto Alegre (RS) e descrever características dos indivíduos infectados. Estudo descritivo em Sapucaia do Sul com dados do Sistema de Informação de Agravos de Notificação (SINAN) de 2009 a 2018. Foram incluídas notificações de indivíduos com idade igual ou superior a 13 anos, e excluídas aquelas com preenchimento inadequado e gestantes. Tendência temporal dos casos de HIV/AIDS foi apresentada por frequência absoluta e características sociodemográficas por frequências absoluta e relativa. Foram notificados 832 casos de HIV/AIDS no município, dos quais 43,4% correspondentes à AIDS. Durante o período avaliado, a notificação de HIV aumentou 4.000%, e a de AIDS, 230%, com predominância no sexo masculino, adultos jovens, brancos e com ensino fundamental incompleto. Os resultados são relevantes no âmbito da saúde coletiva, pois contribuem para nortear e fortalecer estratégias de combate e controle da doença.
To identify HIV/AIDS prevalences in a city from the metropolitan region of Porto Alegre (RS) and describe the infected individuals' characteristics. Descriptive study in Sapucaia do Sul with data from Notifiable Diseases Information System between 2009 and 2018. Notifications from individuals aged 13 years and over were included, and observations with inadequate completion and pregnant women were excluded. Temporal trend from HIV/AIDS cases was presented through absolute frequency and sociodemographic characteristics through absolute and relative frequencies.832 cases of HIV/AIDS cases were reported in the city and 43.4% of which corresponded to AIDS. During the evaluated period, an increase of 4.000% in the notification of HIV, and of 230% of AIDS was identified, with a predominance of males, young adults, white, and with incomplete primary education. These results are extremely relevant in the public health field as they can help to guide and strengthen strategies to combat and control the disease.
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Objective Purpose: To assess the influence of sleep disorders on temporal and jaw pain in the morning in adults and elderly people. Methods: Population-based study with representative individuals aged 18 years or over. Individuals were selected using a multistage sampling procedure. The outcomes of morning jaw pain and morning temporal pain were assessed. Sleep bruxism, obstructive sleep apnea, and sleep quality were evaluated as exposure variables. Adjusted analysis was conducted using Poisson regression. All analysis was sex stratified. Results: 820 individuals were studied. Female with sleep bruxism were 1.37 times more likely to have morning temporal pain (p=0.041). Male and female with bruxism had a prevalence 160% and 97%, respectively, higher of morning jaw pain (male: p=0.003; female: p<0.001). Women with obstructive sleep apnea were 1.52 times more likely to have morning temporal pain (p=0.023). Men with poor sleep quality had a prevalence 190% higher of morning temporal pain (p=0.005). Conclusion: Morning craniofacial pain is more frequent in individuals with sleep disorders, and there are differences between sexes. Since more than one sleep disorder can be present in the same individual, studies that adjust the analyses for possible confounders are important to avoiding possible overlap between them.
RESUMO Objetivo: Avaliar a influência dos distúrbios do sono nas dores temporais e mandibulares pela manhã em adultos e idosos. Métodos: Estudo de base populacional realizado com uma amostra representativa de indivíduos com 18 anos ou mais. Os participantes foram selecionados por meio de um processo amostral com múltiplos estágios. Os desfechos avaliados foram a dor matinal na mandíbula e a dor temporal matinal. Apneia obstrutiva do sono, bruxismo do sono e qualidade do sono foram as variáveis de exposição avaliadas. Análise ajustada foi realizada através da Regressão de Poisson e todas as análises foram estratificadas por sexo. Resultados: Foram estudados 820 indivíduos. Mulheres com bruxismo do sono tiveram 1,37 vezes mais chance de ter dor temporal matinal (p=0,041). Homens e mulheres com bruxismo tiveram uma prevalência 160% e 97%, respectivamente, maior de dor matinal na mandíbula (homens: p=0,003; mulheres: p<0,001). Mulheres com apneia obstrutiva do sono tiveram 1,52 vezes mais chance de ter dor temporal matinal (p=0,023). Homens com má qualidade do sono tiveram prevalência 190% maior de dor temporal matinal (p=0,005). Conclusão: Dor craniofacial matinal é mais frequente em indivíduos com distúrbios do sono e há diferenças entre os sexos. Uma vez que mais de um distúrbio do sono pode estar presente no mesmo indivíduo, estudos que ajustem as análises para possíveis confundidores são importantes para evitar uma possível sobreposição entre eles.
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A hipertensão arterial sistêmica (HAS) e o diabetes mellitus (DM) foram as doenças crônicas não transmissíveis mais prevalentes no Brasil em 2019. Dentre os fatores que podem contribuir para o descontrole dessas doenças está o uso inadequado de medicamentos. O objetivo deste estudo foi verificar a prevalência e os fatores associados à não adesão ao tratamento medicamentoso para HAS e DM entre adultos residentes nas capitais brasileiras e no Distrito Federal. Trata-se de um estudo transversal de base populacional com dados da Vigilância de Fatores de Risco e Proteção para Doenças Crônicas por Inquérito Telefônico (VIGITEL) de 2019. Foram incluídos indivíduos (≥ 18 anos) com diagnóstico de HAS e/ou DM. Não adesão ao tratamento medicamento para HAS e para DM foram os desfechos. As variáveis macrorregião de moradia, sexo, cor da pele, faixa etária, escolaridade, estado civil, autopercepção de saúde e posse de plano de saúde foram as exposições. Foram realizadas análises descritivas de todas as variáveis. Análises brutas utilizando o teste Qui-quadrado de Pearson e análises ajustadas utilizando Regressão de Poisson foram conduzidas para avaliar as associações. Foram estudados 52.443 indivíduos. As prevalências da não adesão para o tratamento medicamentoso para HAS e DM foram de 10,1% e 6,0%, respectivamente. Após análise ajustada, indivíduos do sexo feminino apresentaram uma menor probabilidade (RP: 0,67; IC95% 0,53-0,85) de não aderir ao tratamento medicamento para HAS, em comparação ao sexo masculino. A variável faixa-etária apresentou uma associação linear inversa com esse desfecho, ou seja, quanto maior a faixa etária, menor a probabilidade de não adesão ao tratamento medicamento para HAS (p<0,001). Não foram encontradas associações entre as variáveis independentes e a não adesão ao tratamento medicamentoso para DM. Em conclusão, destaca-se a necessidade de iniciativas e projetos governamentais que foquem nos grupos mais propensos à não adesão dos tratamentos medicamentosos.
Systemic arterial hypertension (SAH) and diabetes mellitus (DM) were the most prevalent non-communicable chronic diseases in Brazil in 2019. Among the factors that may contribute to the lack of control of these diseases is the inappropriate use of medications. The aim of this study was to verify the prevalence and factors associated with non-adherence to drug treatment for SAH and DM among adults residing in Brazilian capitals and the Federal District. This is a population-based cross-sectional study with data from the 2019 Surveillance of Risk and Protective Factors for Chronic Diseases by Telephone Survey (VIGITEL). Individuals (≥ 18 years old) diagnosed with SAH and/or DM were included. Non-adherence to drug treatment for SAH and DM were the outcomes. The variables macro-region of residence, sex, skin color, age, education, marital status, self-perception of health and ownership of health insurance were the exposures. Descriptive analyzes of all variables were performed. Crude analyzes using Pearson's chi-square test and adjusted analyzes using Poisson regression were conducted to evaluate the associations. A total of 52,443 individuals were studied. The prevalence of non-adherence to drug treatment for SAH and DM was 10.1% and 6.0%, respectively. After adjusted analysis, female subjects were less likely (PR: 0.67; 95%CI 0.53-0.85) of not adhering to drug treatment for SAH, compared to males. The age variable showed an inverse linear association with this outcome, that is, the higher the age, the lower the probability of non-adherence to the drug treatment for SAH (p<0.001). No associations were found between the independent variables and non-adherence to drug treatment for DM. In conclusion, there is a need for government initiatives and projects that focus on the groups most likely to not adhere to drug treatments.
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Context: The effect of both birth order and number of siblings on overweight and/or obesity has not been determined. Birth order and sibsize have been mathematically coupled to overweight and/or obesity, but thus far their respective effects have been estimated separately. Objective: The aim of this systematic review was to evaluate the effects of both birth order and number of siblings on the risk of overweight/obesity. Data Sources: The electronic databases MEDLINE, Social Science, SocINDEX, PsycINFO, CINAHL Plus, and Academic Search Complete were searched systematically. Study Selection: Titles and abstracts of 1698 records were examined. After 1504 records were excluded, 2 authors independently assessed the full text of all remaining papers (n = 194); disagreements were resolved by discussion. Data Extraction: A standardized form for assessment of study quality and evidence synthesis was used to extract data from the included studies. Results: Twenty studies were included in the systematic review, 14 of which were included in the meta-analysis. Meta-analyses showed that lower (vs higher) birth order and smaller (vs greater) number of siblings were associated with overweight and/or obesity, with ORs of 1.47 (95%CI, 1.12-1.93) and 1.46 (95%CI, 1.17-1.84), respectively. However, among the 9 studies that attempted to separate the effects of birth order and number of siblings in the same analysis, a higher risk of overweight/obesity was consistently found among individuals without siblings than among those with 1 or more siblings, rather than among firstborns more generally. Conclusion: The results show that both lower birth order and lower number of siblings are associated with risk of overweight/obesity, which suggests that only children are at a slightly increased risk of overweight/obesity. Systematic Review Registration: PROSPERO registration number CRD42014015135.
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Orden de Nacimiento , Sobrepeso/epidemiología , Hermanos , Humanos , RiesgoRESUMEN
A systematic review with meta-analysis was performed to estimate the accuracy of IgM ELISA for Leptospirosis diagnosis. A search of Medline, Lilacs, Embase, Cochrane Central Register of Controlled Trials and Grey literature (Google Scholar and British Library) was conducted. The medical subject headings (MeSHs) and the words "leptospirosis", "human leptospirosis" and "IgM ELISA" were used. Fifty-two studies were analyzed, which included 10,775 samples. The pooled sensitivity of all the studies was 86% (CI 95%, 85%-87%) and specificity was 90% (CI 95%, 89%-91%). In studies of the acute phase, the sensitivity and specificity were 84% (CI 95%, 82%-85%) and 91% (CI 95%, 90%-91%), respectively. In conclusion, IgM ELISA is sensitive for use as an initial screen for leptospiral infections.
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Ensayo de Inmunoadsorción Enzimática/métodos , Inmunoglobulina M/inmunología , Leptospirosis/diagnóstico , Humanos , Leptospirosis/inmunología , Sensibilidad y EspecificidadRESUMEN
A diabetes mellitus pode afetar negativamente a qualidade de vida. Esse fato é ainda mais agravado com a presença de complicações macro e microvasculares decorrentes da patologia, como a lesão diabética. Este artigo tem como objetivo avaliar a qualidade de vida e as características epidemiológicas das pessoas com lesão diabética, por meio do estudo descritivo realizado com todos os diabéticos que apresentavam lesão diabética e que foram atendidos no ambulatório de feridas de Criciúma (SC) (n = 54). A qualidade de vida foi avaliada em quatro domínios (físico, psicológico, ambiente e relações sociais) por meio do questionário WHOQOL-bref. Além disso, foram estudadas variáveis sociodemográficas e de saúde relacionadas com a lesão diabética. As análises descritivas foram apresentadas utilizando o programa Stata, versão 12.1. As principais causas da lesão foram trauma e neuropatia diabética (40,7%), grande parte das lesões estava localizada nos dedos dos pés (31,5%) e quase metade do número das pessoas referiu que a causa da lesão iniciou de forma desconhecida (47,9%). Os domínios de qualidade de vida apresentaram baixos escores (físico: 59,5; psicológico: 56,0; relações sociais: 56,0; ambiente: 69,0), sendo os domínios psicológico e de relações sociais os que apresentaram as menores médias. Pode-se observar como a lesão diabética pode afetar a saúde e a qualidade de vida desses indivíduos, o que sugere maior necessidade do cuidado por parte dos profissionais de saúde, a fim de melhorar esses aspectos referentes à saúde desses indivíduos.
Diabetes mellitus can negatively affect quality of life, a picture further aggravated by the presence of micro and macrovascular complications resulting from the pathology, such as diabetic wounds. Hence, this descriptive study evaluates the quality of life and epidemiological characteristics of all diabetics (n = 54) who presented diabetic ulcers and were treated in the wound outpatient clinic in Criciúma, Santa Catarina, Brazil. Quality of life was assessed in four domains (physical, psychological, environmental, and social relationships) using the WHOQOL-bref questionnaire. The sociodemographic and health variables related to diabetic injuries were also studied. Descriptive analyses were presented using Stata version 12.1. Trauma and diabetic neuropathy (40.7%) were the leading causes, with most injuries located on toes (31.5%). Almost half of the participants reported the cause of injury as 'unknown' (47.9%). The quality of life domains had low scores (physical: 59.5; psychological: 56.0; social relationships: 56.0; environment: 69.0), with the psychological and social relationships presenting the lowest averages. In conclusion, diabetic wounds can affect the health and quality of life of these individuals, which suggests a need for greater care by health professionals to improve these health-related aspects.
La diabetes mellitus puede afectar negativamente la calidad de vida de las personas. Este hecho se ve agravado por la presencia de complicaciones macro- y microvasculares derivadas de la patología, como la lesión diabética. Este artículo pretende evaluar la calidad de vida y las características epidemiológicas de las personas con lesiones diabéticas a partir de un estudio descriptivo, realizado con todos los diabéticos que tenían una lesión diabética y que fueron atendidos en la clínica de heridas en Criciúma, en Santa Catarina, Brasil (n = 54). La calidad de vida se evaluó en cuatro dominios (físico, psicológico, ambiente y relaciones sociales) utilizando el cuestionario WHOQOL-Bref. Además, se estudiaron variables sociodemográficas y de salud relacionadas con la lesión diabética. Los análisis descriptivos se presentaron utilizando el programa Stata, versión 12.1. La principal causa de la lesión fue el traumatismo y la neuropatía diabética (40,7%), la mayoría de las lesiones se localizaron en los dedos de los pies (31,5%) y casi la mitad de las personas refirió que la causa de la lesión se inició de forma desconocida (47,9%). Los dominios de calidad de vida tuvieron bajas puntuaciones (físico: 59,5; psicológico: 56,0; relaciones sociales: 56,0; ambiente: 69,0), mientras los dominios psicológico y de relaciones sociales tuvieron los más bajos promedios. Se puede observar cómo la lesión diabética puede afectar la salud y la calidad de vida de estos individuos, lo que sugiere una mayor necesidad de atención por parte de los profesionales de la salud, con el fin de mejorar estos aspectos relacionados con la salud de esta población.