ABSTRACT
Living with extremely low-income is an important risk factor for HIV/AIDS and can be mitigated by conditional cash transfers. Using a cohort of 22.7 million low-income individuals during 9 years, we evaluated the effects of the world's largest conditional cash transfer, the Programa Bolsa Família, on HIV/AIDS-related outcomes. Exposure to Programa Bolsa Família was associated with reduced AIDS incidence by 41% (RR:0.59; 95%CI:0.57-0.61), mortality by 39% (RR:0.61; 95%CI:0.57-0.64), and case fatality rates by 25% (RR:0.75; 95%CI:0.66-0.85) in the cohort, and Programa Bolsa Família effects were considerably stronger among individuals of extremely low-income [reduction of 55% for incidence (RR:0.45, 95% CI:0.42-0.47), 54% mortality (RR:0.46, 95% CI:0.42-0.49), and 37% case-fatality (RR:0.63, 95% CI:0.51 -0.76)], decreasing gradually until having no effect in individuals with higher incomes. Similar effects were observed on HIV notification. Programa Bolsa Família impact was also stronger among women and adolescents. Several sensitivity and triangulation analyses demonstrated the robustness of the results. Conditional cash transfers can significantly reduce AIDS morbidity and mortality in extremely vulnerable populations and should be considered an essential intervention to achieve AIDS-related sustainable development goals by 2030.
Subject(s)
Acquired Immunodeficiency Syndrome , South American People , Adolescent , Humans , Female , Cohort Studies , Acquired Immunodeficiency Syndrome/epidemiology , Acquired Immunodeficiency Syndrome/prevention & control , Income , Poverty , Brazil/epidemiologyABSTRACT
BACKGROUND: Rotavirus has been the leading cause of severe cases of acute diarrhoea (AD) among children worldwide; however, in the same areas, a large reduction in AD related to rotavirus has been observed after the introduction of the rotavirus vaccine. In Brazil, where there is a high rotavirus vaccine coverage, AD caused by pathogens other than rotavirus is still a frequent cause of outpatient visits and hospitalisations among children under 5 years. METHODS: A hospital-based case-control study enrolled children aged 4 to 24 months admitted to 10 hospitals from all five Brazilian Regions. Cases (n=1178) were children admitted with diarrhoea who tested negative for rotavirus in a stool sample. Controls (n=2515) were children admitted without diarrhoea, frequency matched to cases by sex and age group. We estimated odds ratios using logistic regression, in a hierarchical approach according to a previously defined conceptual framework. Population-attributable fractions (PAF) were estimated for each variable, each block and for all significant variables in the latter model adjusted. RESULTS: The factors studied accounted for 41% of the non-rotavirus AD hospital admissions and the main risk factors included lack of adequate excreta disposal (PAF=12%), untreated drinking water (PAF=11%) and a history of previous hospitalization due to AD (PAF=21%). Low socio-economic conditions, no public water supply, crowding and low weight-for-age made smaller contributions. CONCLUSIONS: These findings further our knowledge of risk factors associated with severe AD in the post-rotavirus vaccination era. We recommend further increase in coverage of basic sanitation, improvements in water quality and further expansion of primary healthcare coverage to reduce the occurrence of non-rotavirus severe diarrhoea and subsequent hospitalization of Brazilian children.
Subject(s)
Diarrhea , Hospitalization , Brazil/epidemiology , Case-Control Studies , Child , Child, Preschool , Diarrhea/epidemiology , Diarrhea/etiology , Female , Hospitalization/statistics & numerical data , Humans , Infant , Logistic Models , Male , Odds Ratio , Risk Factors , Sanitation/standards , Vaccination , Water Supply/standardsABSTRACT
A cross-sectional study was conducted on dietary patterns and their influence on the occurrence of wheezing and atopic and non-atopic asthma in a sample of 1,168 children and adolescents in Salvador, Bahia State, Brazil. Wheezing and asthma symptoms in the previous 12 months were obtained using the ISAAC questionnaire. The presence of aeroallergen-specific IgE was identified. A food frequency questionnaire was used to define dietary patterns. The study applied logistic regression and multinomial polytomous logistic regression. Fish consumption was associated with a 27% reduction in wheezing (95%CI: 0.56-0.94), 37% in asthma (95%CI: 0.47-0.83), 51% in non-atopic asthma (95%CI: 0.31-0.79), and 38% in non-atopic wheezing (95%CI: 0.46-0.83). The highest tertile of dietary patterns reduced wheezing by 27% (95%CI: 0.57-0.95), atopic wheezing by 46% (95%CI: 0.30-0.98), asthma by 36% (95%CI: 0.49-0.83), and atopic asthma by 50% (95%CI: 0.28-0.89). Fish consumption may thus have a protective effect against wheezing and non-atopic asthma and dietary pattern against atopic asthma and wheezing.
Subject(s)
Asthma/physiopathology , Feeding Behavior/physiology , Respiratory Sounds/physiopathology , Asthma/immunology , Brazil , Child , Child, Preschool , Cross-Sectional Studies , Female , Humans , Hypersensitivity, Immediate/immunology , Hypersensitivity, Immediate/physiopathology , Immunoglobulin E/blood , Male , Respiratory Sounds/immunology , Risk Factors , Surveys and Questionnaires , Urban PopulationABSTRACT
Avaliou-se, em estudo transversal, a influência do padrão alimentar sobre a ocorrência de sibilo e asma atópica e não atópica em 1.168 crianças e adolescentes em Salvador, Bahia, Brasil. Sibilo e sintomas de asma nos últimos 12 meses foram obtidos por meio do questionário ISAAC. Atopia foi definida pela presença de IgE específica a aerolérgenos. Questionário de frequência alimentar foi usado para definir padrões alimentares. Empregou-se regressões logística e logística politômica multivariadas. O consumo de pescados reduziu a ocorrência de sibilo em 27% (IC95%: 0,56-0,94) e asma em 37% (IC95%: 0,47-0,83); asma não atópica em 51% (IC95%: 0,31-0,79) e sibilo não atópico em 38% (IC95%: 0,46-0,83). O maior tercil do padrão alimentar reduziu o sibilo em 27% (IC95%: 0,57-0,95), sibilo atópico em 46% (IC95%: 0,30-0,98), asma em 36% (IC95%: 0,49-0,83) e asma atópica em 50% (IC95%: 0,28-0,89). O consumo de pescados pode conferir efeito protetor para sibilo e asma não atópica e o padrão alimentar para sibilo e asma atópica.
A cross-sectional study was conducted on dietary patterns and their influence on the occurrence of wheezing and atopic and non-atopic asthma in a sample of 1,168 children and adolescents in Salvador, Bahia State, Brazil. Wheezing and asthma symptoms in the previous 12 months were obtained using the ISAAC questionnaire. The presence of aeroallergen-specific IgE was identified. A food frequency questionnaire was used to define dietary patterns. The study applied logistic regression and multinomial polytomous logistic regression. Fish consumption was associated with a 27% reduction in wheezing (95%CI: 0.56-0.94), 37% in asthma (95%CI: 0.47-0.83), 51% in non-atopic asthma (95%CI: 0.31-0.79), and 38% in non-atopic wheezing (95%CI: 0.46-0.83). The highest tertile of dietary patterns reduced wheezing by 27% (95%CI: 0.57-0.95), atopic wheezing by 46% (95%CI: 0.30-0.98), asthma by 36% (95%CI: 0.49-0.83), and atopic asthma by 50% (95%CI: 0.28-0.89). Fish consumption may thus have a protective effect against wheezing and non-atopic asthma and dietary pattern against atopic asthma and wheezing.
Este estudio transversal se llevó a cabo para estudiar la influencia de los hábitos alimentarios en la aparición del asma y sibilancias atópicas y no atópicas en una muestra de 1.168 niños y adolescentes en Salvador, Bahía, Brasil. Las sibilancias y síntomas de asma en los últimos 12 meses se han obtenido a partir del cuestionario ISAAC. Se identificó la presencia de IgE específica de alérgeno aéreo. Se utilizó un cuestionario de frecuencia de alimentos para definir hábitos alimentarios. Se aplicó la regresión logística y el modelo logístico multinomial. El consumo de pescado redujo las sibilancias en un 27% (IC95%: 0,56-0,94) y el asma en un 37% (IC95%: 0,47-0,83), las sibilancias atópicas en un 51% (IC95%: 0,31-0,79) y no atópicas en un 38% (IC95%: 0,46-0,83). El tercil más alto de los hábitos alimentarios reduce sibilancias en un 27% (IC95%: 0,57-0,95), sibilancias atópicas en un 46% (IC95%: 0,30-0,98), el asma en un 36% (IC95%: 0,49-0,83) y un 50% en el asma atópico (IC95%: 0,28-0,89). El consumo de pescado puede promover un efecto protector, dentro el patrón de dieta, contra sibilancias atópicas y no atópicas y asma.
Subject(s)
Child , Child, Preschool , Female , Humans , Male , Asthma/physiopathology , Feeding Behavior/physiology , Respiratory Sounds/physiopathology , Asthma/immunology , Brazil , Cross-Sectional Studies , Hypersensitivity, Immediate/immunology , Hypersensitivity, Immediate/physiopathology , Immunoglobulin E/blood , Risk Factors , Respiratory Sounds/immunology , Surveys and Questionnaires , Urban PopulationABSTRACT
OBJECTIVE: This intervention study aimed to investigate the effect of osteoporosis on periodontal condition among 48 post-menopausal women undergoing periodontal therapy. MATERIAL AND METHODS: The experimental group, which underwent non-surgical periodontal therapy, was composed of 16 women with periodontitis to be treated, and the control group was formed by 32 women without periodontitis. Oral condition was assessed on three occasions: at the start of the treatment (first examination), 1 month (first re-examination) and 4 months after the end of the therapy (second re-examination). In the second re-examination, recurrence of periodontal disease was evaluated by comparing the clinical measurements obtained pre- and post-treatment. The diagnosis of osteoporosis was made by investigating densitometry reports obtained previously. Descriptive analysis, analysis of variance and the Bonferroni post hoc test were applied to the data gathered, with statistical significance level of 5%. RESULTS: The frequency of periodontitis was 50% in the treated group and 25% in the group without periodontitis. In both groups, this recurrence was greater in subjects with osteoporosis (37.5 and 18.75%, respectively) than in the individuals without osteoporosis (12.5 and 6.25%, respectively). CONCLUSIONS: The preliminary results indicate that osteoporosis possibly has an influence on periodontal condition among individuals undergoing non-surgical periodontal treatment.
