Analysis of cervical cancer mortality rate trends in Natal-RN, Brazil, between 2000 and 2012 / Análisis de las tendencias de la tasa de mortalidad por cáncer de cuello uterino en Natal-RN, Brasil, entre 2000 y 2012

ABSTRACT Objective To describe cervical cancer mortality rates and their corresponding trends, and to analyze the spatial correlations of this type of cancer in Natal-RN, Brazil, between 2000 and 2012. Materials and Methods The simple linear regression model, the empirical Bayes method and the Global Moran's index were used for the statistical analysis. Results The mortality coefficient of cervical cancer in Natal, standardized by age range, was 5.5 per 100 000 women. All historical series for the coefficients studied were classified as stable. The Global Moran's index obtained was 0.048, with a p-value for the spatial test correlation between neighborhoods of 0.300. The average family income by neighborhood showed no significant correlation to cervical cancer mortality rates. Conclusion This study found a temporal stabilization and spatial independence trend of cervical cancer mortality rates in women from Natal, as well as the absence of correlation between these rates and the average family income of the of the participating women distributed by neighborhoods. In view of this, changes in the public policies should be made aimed at preventing the disease; adopting these measures could positively impact the screening program, improving the coverage of Pap smears and immunization campaigns against HPV, in order to reverse this trend and achieve a reduction of mortality rates.(AU)

RESUMEN Objetivo Describir las tasas de mortalidad por cáncer de cuello uterino y sus tendencias, así como analizar las correlaciones espaciales de este tipo de cáncer en Natal-RN, Brasil, entre 2000 y 2012. Materiales y Métodos Para el análisis estadístico se utilizaron el modelo de regresión lineal simple, la estimación empírica de Bayes y el índice Moran Global. Resultados La tasa de mortalidad por cáncer de cuello uterino en Natal, estandarizado por rango de edad, fue 5.5 por cada 100 000 mujeres. Todas las series históricas para los coeficientes estudiados se clasificaron como estables. El índice Moran Global obtenido fue 0.048, con un valor p de 0.300 para la correlación de prueba espacial entre vecindarios. El ingreso familiar promedio por vecindario no mostró correlación significativa con las tasas de mortalidad por cáncer de cuello uterino. Conclusión En este estudio se observó una tendencia temporal de estabilización e independencia espacial de la tasa de mortalidad por cáncer cervical en mujeres de Natal, así como la ausencia de correlación entre estas tasas y el ingreso familiar promedio de las mujeres participantes, distribuidas por vecindarios de la ciudad. En vista de esto, se sugiere que se adopten cambios en las políticas públicas dirigidas a la prevención de la enfermedad que apunten a medidas que puedan tener un impacto positivo en el programa de monitoreo, mejorando la cobertura de la prueba de Papanicolaou, así como de las campañas de vacunación contra el VPH, con el objetivo de revertir esta tendencia y lograr una reducción en las tasas de mortalidad de la enfermedad.(AU)

Analysis of cervical cancer mortality rate trends in Natal-RN, Brazil, between 2000 and 2012.

OBJECTIVE: To describe cervical cancer mortality rates and their corresponding trends, and to analyze the spatial correlations of this type of cancer in Natal-RN, Brazil, between 2000 and 2012. MATERIALS AND METHODS: The simple linear regression model, the empirical Bayes method and the Global Moran's index were used for the statistical analysis. RESULTS: The mortality coefficient of cervical cancer in Natal, standardized by age range, was 5.5 per 100 000 women. All historical series for the coefficients studied were classified as stable. The Global Moran's index obtained was 0.048, with a p-value for the spatial test correlation between neighborhoods of 0.300. The average family income by neighborhood showed no significant correlation to cervical cancer mortality rates. CONCLUSION: This study found a temporal stabilization and spatial independence trend of cervical cancer mortality rates in women from Natal, as well as the absence of correlation between these rates and the average family income of the of the participating women distributed by neighborhoods. In view of this, changes in the public policies should be made aimed at preventing the disease; adopting these measures could positively impact the screening program, improving the coverage of Pap smears and immunization campaigns against HPV, in order to reverse this trend and achieve a reduction of mortality rates.

Rationality of Antimicrobial Prescriptions in Community Pharmacy Users.

BACKGROUND: Although there is a conflict between the treatment benefits for a single individual and society, restrictions on antibiotic use are needed to reduce the prevalence of resistance to these drugs, which is the main result of irrational use. Brazil, cataloged as a pharmemerging market, has implemented restrictive measures for the consumption of antibiotics. The objective of this study was to investigate the quality of antimicrobial prescriptions and user knowledge of their treatment with these drugs. METHODS AND FINDINGS: A two-stage cross-sectional, combined and stratified survey of pharmacy users holding an antimicrobial prescription was conducted in the community between May and November 2014. A pharmacist analyzed each prescription for legibility and completeness, and applied a structured questionnaire to the users or their caregivers on their knowledge regarding treatment and user sociodemographic data. An estimated 29.3% of prescriptions had one or more illegible items, 91.3% had one or more missing items, and 29.0% had both illegible and missing items. Dosing schedule and patient identification were the most commonly unreadable items in prescriptions, 18.81% and 12.14%, respectively. The lack of complete patient identification occurred in 90.53% of the prescriptions. It is estimated that 40.3% of users have used antimicrobials without prescription and that 46.49% did not receive any guidance on the administration of the drug. CONCLUSIONS: Despite the measures taken by health authorities to restrict the misuse of antimicrobials, it was observed that prescribers still do not follow the criteria of current legislation, particularly relating to items needed for completion of the prescription. Moreover, users receive little information about their antimicrobial treatment.

Seasonal variation of potential flavivirus vectors in an urban biological reserve in northeastern Brazil.

Although yellow fever (YF) has not been reported on the eastern coast of Brazil since 1942, there was a reemergence of dengue fever in Brazil in 1987 due to the reintroduction of Aedes aegypti (L.). To assess areas of potential risk for transmission of vector-borne diseases, a surveillance system was placed in a large Atlantic Forest reserve in Natal, Rio Grande do Norte, Brazil, where in 2004 unexplained epizootics were reported among marmosets. The etiologic agent causing the mortality in marmosets has not been identified. Wyeomyia bourrouli Lutz, Haemagogus leucocelaenus Dyar & Shannon, Ae. aegypti, Aedes albopictus (Skuse), Ochlerotatus scapularis Rondani, Ochlerotatus serratus Theobald, Ochlerotatus taeniorhynchus Wiedemann, Culex quinquefasciatus Say, and Limatus durhami Theobald were collected in the park and in the proximity of the households adjacent to the park. Seasonal abundance fluctuation was significant for Ae. aegypti, Ae. albopictus, Ochlerotatus scapularis (Rondani), and Hg. leucocelaenus. Eggs of Ae. aegypti, Ae. albopictus, and Hg. leucocelaenus were more frequently found at the conclusion of the rainy season. A significant negative correlation between the number ofAe. albopictus collected and temperature was observed (r = -0.50), i.e., for each 10C increase in temperature, the number of specimens collected decreased eight-fold. The findings reported herein reinforce the need for a sustainable arboviral surveillance program in this area to decrease the potential risk of emergence of vector borne diseases as YF.

Estudo comparativo do período de aleitamento materno de crianças em creches internas e externas / Comparative study of breastfeeeding period among children from internal and external day-care centers

Um estudo transversal de 137 mäaes com crianças com idade entre 0 e 35,9 meses em creches nas cidades de Parobé e Três Coroas, RS, analisou o tempo de amamentaçäo e sua associaçäo com creches junto ao local de trablaho (creches internas) e com creches conveniadas, distantes do local de trabalho (creches externas). A prevalência de amamentaçäo aos 3,6 e 12 meses foi de 60 por cento, 26 por cento e 7 por cento, respectivamente. Houve uma associaçäo estatística muito significativa entre presença das crianças em creches internas e amamentaçäo superior a 3 meses (X2=18,65; p = 0,00001). As mäes com crianças em creches internas tinham duas vezes mais chance de amamentar além do 3§ mês do que as mäes de crianças em creches externas. A proximidade das creches internas com o local de trabalho proporciona maior tranqüilidade e segurança às mäes. Existem também uma maior disponibilidade de tempo para amamentar no trabalho, mantendo o estímulo à produçäo de leite, dispensando assim a introduçäo de complemento