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[RESUMO]. Objetivo. Calcular o indicador de consumo de álcool per capita (APC) para o Brasil utilizando dados nacio nais (APC Brasil), com vistas a estabelecê-lo como padrão ouro para o país em substituição ao indicador anteriormente calculado pela Organização Mundial da Saúde (OMS) com base em dados internacionais. Métodos. Foram selecionadas, no Brasil, as fontes públicas de dados necessárias para a composição do cálculo do APC registrado e definida a concentração alcoólica por categoria de bebida. Para as variáveis APC turista e APC não registrado, indisponíveis no Brasil, foram usadas as estimativas da Organização das Nações Unidas (ONU) e da OMS. O indicador APC Brasil foi calculado e comparado ao indicador produzido pela OMS por meio de análise das medianas para o período de 2005 a 2020. Resultados. O indicador de consumo de álcool nacional foi de 9,2 litros per capita em 2005, chegando a 9,8 em 2020. Já o indicador da OMS mostrou, para 2005, um consumo de 8,4 litros per capita, com queda até 2016 e leve aumento para 7,8 em 2020. Conclusão. O APC Brasil foi calculado com base em fontes nacionais e mostrou tendência distinta em relação ao indicador da OMS, que se mostrou em queda. A disponibilização transparente e regular desse indicador por canais governamentais permitirá o seu monitoramento, possibilitando a elaboração de políticas para o enfrentamento do consumo do álcool no país.
[ABSTRACT]. Objective. To calculate the alcohol per capita consumption (APC) in Brazil (Brazil APC) using national data and to establish the Brazil APC as gold standard for the country, replacing the indicator previously calculated by the World Health Organization (WHO) based on international data. Method. The Brazilian public data sources necessary for calculating the recorded APC were selected, and the alcohol concentration was defined by beverage category. For the variables of tourist APC and unrecorded APC, which are unavailable in Brazil, estimates from the United Nations (UN) and the WHO were used. The Brazil APC indicator was calculated and compared to the indicator produced by the WHO through analysis of the medians obtained for the period from 2005 to 2020. Results. The national alcohol consumption indicator was 9.2 liters per capita in 2005, reaching 9.8 in 2020. The WHO indicator showed a consumption of 8.4 liters per capita in 2005, decreasing until 2016 and slightly increasing to 7.8 in 2020. Conclusion. The Brazil APC was calculated based on national sources and showed a distinct trend compared to the WHO indicator, which showed a decrease. The regular and transparent provision of this indicator through government channels will support the development of policies to address alcohol consumption in the country.
[RESUMEN]. Objetivo. Calcular el indicador del consumo de alcohol per cápita en Brasil a partir de datos nacionales, con miras a establecerlo como patrón de referencia para el país en sustitución del indicador calculado anteriormente por la Organización Mundial de la Salud a partir de datos internacionales. Métodos. Se seleccionaron las fuentes públicas de datos de Brasil necesarias para estructurar el cálculo del consumo de alcohol per cápita registrado y se definió la concentración de alcohol por clase de bebida. Para las variables de consumo de alcohol per cápita por parte de turistas y consumo per cápita no registrado, que no están disponibles en Brasil, se utilizaron estimaciones de las Naciones Unidas y de la Organización Mundial de la Salud. Se calculó el indicador del consumo de alcohol per cápita en Brasil y se comparó con el indicador elaborado por la OMS mediante un análisis de las medianas correspondientes al período 2005-2020. Resultados. El indicador nacional del consumo de alcohol fue de 9,2 litros per cápita en el 2005, con un aumento a 9,8 en el 2020. El indicador de la Organización Mundial de la Salud mostró un consumo de 8,4 litros per cápita en el 2005, con una reducción hasta el 2016 y un leve aumento a 7,8 en el 2020. Conclusión. Se calculó el consumo de alcohol per cápita en Brasil a partir de fuentes nacionales, lo que mostró una tendencia distinta de la tendencia descendente del indicador de la Organización Mundial de la Salud. La disponibilidad transparente y regular de este indicador por medio de los canales gubernamentales permitirá su seguimiento, con lo cual se podrán formular políticas para enfrentar el consumo de alcohol en el país.
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Bebidas Alcohólicas , Desarrollo Sostenible , Indicadores de Salud , Vigilancia en Salud Pública , Brasil , Bebidas Alcohólicas , Desarrollo Sostenible , Indicadores de Salud , Vigilancia en Salud Pública , Brasil , Bebidas Alcohólicas , Desarrollo Sostenible , Indicadores de Salud , Vigilancia en Salud PúblicaRESUMEN
Objective: To calculate the alcohol per capita consumption (APC) in Brazil (Brazil APC) using national data and to establish the Brazil APC as gold standard for the country, replacing the indicator previously calculated by the World Health Organization (WHO) based on international data. Method: The Brazilian public data sources necessary for calculating the recorded APC were selected, and the alcohol concentration was defined by beverage category. For the variables of tourist APC and unrecorded APC, which are unavailable in Brazil, estimates from the United Nations (UN) and the WHO were used. The Brazil APC indicator was calculated and compared to the indicator produced by the WHO through analysis of the medians obtained for the period from 2005 to 2020. Results: The national alcohol consumption indicator was 9.2 liters per capita in 2005, reaching 9.8 in 2020. The WHO indicator showed a consumption of 8.4 liters per capita in 2005, decreasing until 2016 and slightly increasing to 7.8 in 2020. Conclusion: The Brazil APC was calculated based on national sources and showed a distinct trend compared to the WHO indicator, which showed a decrease. The regular and transparent provision of this indicator through government channels will support the development of policies to address alcohol consumption in the country.
Objetivo: Calcular el indicador del consumo de alcohol per cápita en Brasil a partir de datos nacionales, con miras a establecerlo como patrón de referencia para el país en sustitución del indicador calculado anteriormente por la Organización Mundial de la Salud a partir de datos internacionales. Métodos: Se seleccionaron las fuentes públicas de datos de Brasil necesarias para estructurar el cálculo del consumo de alcohol per cápita registrado y se definió la concentración de alcohol por clase de bebida. Para las variables de consumo de alcohol per cápita por parte de turistas y consumo per cápita no registrado, que no están disponibles en Brasil, se utilizaron estimaciones de las Naciones Unidas y de la Organización Mundial de la Salud. Se calculó el indicador del consumo de alcohol per cápita en Brasil y se comparó con el indicador elaborado por la OMS mediante un análisis de las medianas correspondientes al período 2005-2020. Resultados: El indicador nacional del consumo de alcohol fue de 9,2 litros per cápita en el 2005, con un aumento a 9,8 en el 2020. El indicador de la Organización Mundial de la Salud mostró un consumo de 8,4 litros per cápita en el 2005, con una reducción hasta el 2016 y un leve aumento a 7,8 en el 2020. Conclusión: Se calculó el consumo de alcohol per cápita en Brasil a partir de fuentes nacionales, lo que mostró una tendencia distinta de la tendencia descendente del indicador de la Organización Mundial de la Salud. La disponibilidad transparente y regular de este indicador por medio de los canales gubernamentales permitirá su seguimiento, con lo cual se podrán formular políticas para enfrentar el consumo de alcohol en el país.
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OBJECTIVE: To estimate the disability and costs of the Brazilian Unified Health System for IHD attributable to trans-fatty acid (TFA) consumption in 2019. DESIGN: This ecological study used secondary data from the Global Burden of Disease (GBD) Study 2019 to estimate the years lived with disability from IHD attributable to TFA in Brazil in 2019. Data on direct costs (purchasing power parity: 1 Int$ = R$ 2·280) were obtained from the Hospital and Ambulatory Information Systems of the Brazilian Unified Health System. Moreover, the total costs in each state were divided by the resident population in 2019 and multiplied by 10 000 inhabitants. The relationship between the socio-demographic index, disease and economic burden was investigated. SETTING: Brazil and its twenty-seven states. PARTICIPANTS: Adults aged ≥ 25 years of both sexes. RESULTS: IHD attributable to TFA consumption resulted in 11 165 years lived with disability (95 % uncertainty interval 93218 462) in 2019 in Brazil. A total of Int$ 54 546 227 (95 % uncertainty interval 4 505 79285 561 810) was spent in the Brazilian Unified Health System in 2019 due to IHD attributable to TFA, with the highest costs of hospitalisations, for males and individuals aged ≥ 50 years or over. The highest costs were observed in Sergipe (Int$ 6508/10 000; 95 % uncertainty interval 57610 265), followed by the two states from the South. Overall, as the socio-demographic index increases, expenditures increase. CONCLUSIONS: TFA consumption results in a high disease and economic IHD burden in Brazil, reinforcing the need for more effective health policies, such as industrial TFA elimination, following the international agenda.
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Ácidos Grasos trans , Humanos , Brasil/epidemiología , Ácidos Grasos trans/efectos adversos , Masculino , Femenino , Persona de Mediana Edad , Adulto , Anciano , Costo de Enfermedad , Personas con Discapacidad/estadística & datos numéricos , Costos de la Atención en Salud/estadística & datos numéricos , Carga Global de EnfermedadesRESUMEN
Background: There is a lack of up-to-date estimates about the prevalence of Chagas disease (ChD) clinical presentations and, therefore, we aimed to assess the prevalence of clinical forms of ChD among seropositive adults, pooling available data. Methods: A systematic review was conducted in Medline, Embase, Biblioteca Virtual em Saúde and Cochrane databases looking for studies published from 1990 to August 2023, which investigated the prevalence of ChD clinical forms among seropositive adults, including: (i) indeterminate phase, (ii) chronic Chagas cardiomyopathy (CCM), (iii) digestive and (iv) mixed (CCM + digestive) forms. Pooled estimates and 95% confidence intervals (CI) were calculated using random-effects models. Studies quality and risk of bias was assessed with the Leboeuf-Yde and Lauritsen tool. Heterogeneity was assessed with the I2 statistic. The study was registered in the PROSPERO database (CRD42022354237). Findings: 1246 articles were selected for screening and 73 studies were included in the final analysis (17,132 patients, 44% men). Most studies were conducted with outpatients (n = 50), followed by population-based studies (n = 15). The pooled prevalence of the ChD clinical forms was: indeterminate 42.6% (95% CI: 36.9-48.6), CCM 42.7% (95% CI: 37.3-48.3), digestive 17.7% (95% CI: 14.9-20.9), and mixed 10.2% (95% CI: 7.9-13.2). In population-based studies, prevalence was lower for CCM (31.2%, 95% CI: 24.4-38.9) and higher for indeterminate (47.2%, 95% CI: 39.0-55.5) form. In meta-regression, age was inversely associated with the prevalence of indeterminate (ß = -0.05, P < 0.001) form, and directly associated with CCM (ß = 0.06, P < 0.001) and digestive (ß = 0.02, P < 0.001) forms. Heterogeneity was overall high. Interpretation: Compared to previous publications, our pooled estimates show a higher prevalence of CCM among ChD seropositive patients, but similar rates of the digestive form. Funding: This study was funded by the World Heart Federation, through a research collaboration with Novartis Pharma AG.
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[This corrects the article DOI: 10.3389/fnut.2023.1283108.].
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BACKGROUND: Chagas disease (CD) is a neglected disease affecting millions worldwide, yet little is known about its economic burden. This systematic review is part of RAISE project, a broader study that aims to estimate the global prevalence, mortality, and health and economic burden attributable to chronic CD and Chronic Chagas cardiomyopathy. The objective of this study was to assess the main costs associated with the treatment of CD in both endemic and non-endemic countries. METHODS: An electronic search of the Medline, Lilacs, and Embase databases was conducted until 31st, 2022, to identify and select economic studies that evaluated treatment costs of CD. No restrictions on place or language were made. Complete or partial economic analyses were included. RESULTS: Fifteen studies were included, with two-thirds referring to endemic countries. The most commonly investigated cost components were inpatient care, exams, surgeries, consultation, drugs, and pacemakers. However, significant heterogeneity in the estimation methods and presentation of data was observed, highlighting the absence of standardization in the measurement methods and cost components. The most common component analyzed using the same metric was hospitalization. The mean annual hospital cost per patient ranges from $25.47 purchasing power parity US dollars (PPP-USD) to $18,823.74 PPP-USD, and the median value was $324.44 PPP-USD. The lifetime hospital cost per patient varies from $209,44 PPP-USD for general care to $14,351.68 PPP-USD for patients with heart failure. DISCUSSION: Despite the limitations of the included studies, this study is the first systematic review of the costs of CD treatment. The findings underscore the importance of standardizing the measurement methods and cost components for estimating the economic burden of CD and improving the comparability of cost components magnitude and cost composition analysis. Finally, assessing the economic burden is essential for public policies designed to eliminate CD, given the continued neglect of this disease.
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Cardiomiopatía Chagásica , Enfermedad de Chagas , Insuficiencia Cardíaca , Humanos , Costo de Enfermedad , Estrés Financiero , Enfermedad de Chagas/epidemiologíaRESUMEN
BACKGROUND & AIM: The impact of cardiovascular disease attributable to trans fatty acids (TFAs) in the Brazilian population has not been systematically evaluated. This study aims to analyze the burden of ischemic heart disease (IHD) attributable to TFAs in Brazil between 1990 and 2019. METHODS: Data from the Global Burden of Disease Study 2019 were used to investigate the attributable burden in Brazil and its 27 federative units, for both sexes-pooled adults aged ≥25 years. Mortality and disability-adjusted life years (DALYs) from IHD attributable to TFAs were expressed as crude and age-standardized rates and differences from 1990 to 2019 by percentage and annualized rate of change. Linear regression was used to investigate trends. National voluntary and regulatory policies for industrial TFAs (iTFAs) implemented until 2019, summary exposure value (SEV) and sociodemographic index (SDI) were examined. RESULTS: Between 1990 and 2019, crude and age-standardized mortality rates from IHD attributable to TFAs decreased by -15.9% and -58.0%, respectively, in Brazil. A decrease in crude (-23.3%) and age-standardized (-56.4%) DALY rates of IHD attributable to TFAs was also noticed in the country. States of the South, Southeast, and the Federal District had the largest declines of IHD attributable to TFAs, while states of the Northeast and North had the smallest or even an increase. The policies already adopted had little effect on the IHD burden. A lower SEV and higher SDI value seemed to reduce the burden of IHD. CONCLUSIONS: Although a downward trend in IHD attributable to TFAs and a reduction in exposure to TFAs were observed, this burden is still relevant in Brazil, reinforcing the importance of diet policies, such as banning iTFAs.
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Enfermedades Cardiovasculares , Isquemia Miocárdica , Ácidos Grasos trans , Adulto , Femenino , Masculino , Humanos , Ácidos Grasos trans/efectos adversos , Isquemia Miocárdica/epidemiología , Brasil/epidemiología , Modelos LinealesRESUMEN
BACKGROUND: Dietary risk factors have an important impact on premature deaths and disabilities due to non-communicable diseases. In this study, we perform diet optimization to design different dietary scenarios taking into account food prices and preferences and evaluate the number of deaths that would be prevented as well as the economic burden and costs from the health system that would be saved in Brazil. METHODS: We used dietary intake and food prices data from the nationwide Household Budget Survey (HBS) and the National Dietary Survey (NDS) 2017-2018. Linear programming models were performed to design five scenarios which different sets of key diet modifications at the least deviation from the baseline consumption. Comparative risk assessment models were used to estimate the health impacts of optimized dietary changes on mortality and the economic impacts on morbidity (hospitalizations) and premature deaths. RESULTS: The optimized diets were, on average, more expensive than the baseline diets, varying from Int$ (international dollar) 0.02/day to 0.52/day/adult. The number of deaths prevented or postponed varied from 12,750 (10,178-15,225) to 57,341 (48,573-66,298) according to the different scenarios. The diet modifications would save from 50 to 219 million in hospitalizations and from 239 to 804 million yearly in productivity losses with the reduction of premature deaths. CONCLUSION: A substantial number of deaths and costs due to hospitalization and productivity losses would be avoidable even with small changes in diets. However, even the cheapest intervention might be prohibitive for deprived families, yet subsidies and social policies could contribute to improving diets.
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Dieta , Alimentos , Adulto , Humanos , Brasil/epidemiología , Factores de Riesgo , PresupuestosRESUMEN
Background: The consumption of processed meat causes negative impacts on health; however, this burden for the population living in developing countries is less explored. This study aimed to describe the burden of chronic noncommunicable diseases (NCDs) attributed to a diet rich in processed meat between 1990 and 2019 in Brazil and its federative units and the financial burden on the Unified Health System (SUS) in 2019. Methods: Secondary data from the Global Burden of Disease (GBD) and SUS Information Systems were used in this ecological study. The metrics to assess the burden of NCDs attributable to processed meat consumption were disability-adjusted life years (DALYs) and deaths. The age-standardized rates were presented per 100,000 inhabitants with 95% uncertainty intervals (95% UI). The cost of hospitalizations and outpatient procedures covered by SUS for the treatment of NCDs attributable to processed meat consumption was estimated using the population-attributable fraction. Both burdens were estimated for both sex and stratified by sex, specific cause, and federative units. Results: The age-standardized DALY rates attributable to a diet rich in processed meat increased between 1990 (75.31/100,000 [95% UI: 34.92-139.65]) and 2019 (79.35/100,000 [95% UI: 42.84-126.25]); while mortality rates remained stable between 1990 (2.64/100,000 [95% UI: 1.17-5.21) and 2019 (2.36/100,000 [95% UI: 1.22-4.09]). The cost of hospitalization and outpatient procedures in Brazil for NCDs attributable to the consumption of processed meat was approximately US$ 9,4 million, of which US$ 6,1 million was spent on ischemic heart disease, US$ 3,1 million on colorectal cancer, and US$ 200 thousand on type 2 diabetes mellitus. Conclusion: The NCD burden did not decrease during the years evaluated, while the financial burden was high in 2019, with higher treatment costs for ischemic heart disease. These results can guide political, economic, and health education interventions to advance the fight against NCDs.
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This study aimed to describe the characteristics of elderly people abuse notifications by gender and to assess notification patterns according to gender. We analyzed data from the Brazilian Information System for Notificable Diseases (SINAN) in 2017. We carried out a descriptive analysis of victim characteristics, violence, and the probable perpetrator according to gender. Pearson's χ2 test was used to assess the significance between groups. Then, we verified the main relationships between the studied characteristics and the victim's gender by simple correspondence analysis (SCA). Thus, 17,311 cases/suspicions of elderly people abuse were notified, corresponding to 7.2% of the total number of violence notifications. Of these victims, 50.4% were white, 42.3% were married, and 17.2% had a disability/disorder; 76.9% occurred at home, 62.8% included physical violence, and 49.5% were cases of repeated violence. Most perpetrators were men (62%), and violence by two or more perpetrators was observed in 62.8% of the cases. SCA evidenced inequalities in older adults' gender, which proved to be higher among women. Physical violence was the most common among younger and old individuals, whereas neglect/abandonment tended to occur more frequently among the oldest individuals, and was most often committed by daughters. In sum, this study demonstrated evidence of gender-based violence, especially among older adults. Disability proved to be an essential characteristic for neglect/abandonment in older adults. In this context, policies are needed to reduce gender inequalities and implement a care network for older adults who are victims of violence.
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Violencia de Género , Violencia , Masculino , Humanos , Femenino , Anciano , Brasil/epidemiología , Abuso Físico , Grupo SocialRESUMEN
ABSTRACT Objective: to evaluate the association between parental supervision and sexual behaviors among Brazilian adolescents. Methods: Cross-sectional study with data from 102,072 adolescents who responded to the National Adolescent School-based Health Survey. We estimated the prevalence of sexual behaviors (initiation, use of condoms, contraception, and number of partners). Parental supervision was evaluated using a score considering five indicators. We calculated prevalence ratios (PR) adjusted by age and sex in order to estimate the association between parental supervision score and sexual behaviors of adolescents. Results: Prevalence of risky sexual behavior for adolescents with minimum and maximum parental supervision were: sexual initiation (min.: 58.0%; max.: 20.1%), condom use in the last sexual intercourse (min.: 50.9%; max.: 80.2%), use of contraceptives (min.: 40.8; max.: 49.1%), and mean number of partners (min.: 3.25; max.: 2.88). Parental supervision was greater among girls. Those with higher supervision scores had higher prevalence of condom use in the first and last sexual intercourse and of contraceptive methods, and a smaller mean number of partners, even after adjustments for sex and age. Conclusion: The greater the parental supervision, the better the sexual behavior for both sexes, although supervision seems to occur differently between girls and boys. These findings point to the role of the family in providing adolescents with monitoring, along with dialogue and affection, conditions that encourage healthy and risk-free sexual behavior.
RESUMO Objetivo: Avaliar a associação entre a supervisão dos pais e comportamentos sexuais entre os adolescentes brasileiros. Métodos: Estudo transversal com dados de 102.072 estudantes do 9º ano que responderam à Pesquisa Nacional de Saúde do Escolar de 2015. Estimou-se a prevalência dos comportamentos sexuais (iniciação, uso de preservativo, contracepção e número de parcerias). A supervisão dos pais foi avaliada por meio de escore formado por cinco indicadores. Foram calculadas razões de prevalência ajustadas por sexo e idade para a análise das relações existentes entre o escore de supervisão dos pais e os comportamentos sexuais de adolescentes. Resultados: As prevalências de comportamentos sexuais em adolescentes com mínima e máxima supervisão parental foram: iniciação sexual (mín.: 58,0%; máx.: 20,1%), uso do preservativo na última relação sexual (mín.: 50,9%; máx.: 80,2%), de contraceptivos (mín.: 40,8; máx.: 49,1%) e número de parceiros (mín.: 3,25; máx.: 2,88). A supervisão parental apresentou maior magnitude no sexo feminino. Aqueles com maior escore de supervisão apresentaram maiores prevalências do uso de preservativos na primeira e última relação sexual, de métodos contraceptivos e menor média do número de parceiros, mesmo após ajustes por sexo e idade. Conclusão: Quanto maior a supervisão dos pais, melhores os comportamentos sexuais, para ambos os sexos, apesar de a supervisão ocorrer de forma diferenciada entre os sexos. Esses achados apontam o papel da família em proporcionar aos adolescentes monitoramento simultâneo ao diálogo e ao afeto, condição estimuladora do comportamento sexual saudável e livre de riscos.
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This study aimed to describe the characteristics of elderly people abuse notifications by gender and to assess notification patterns according to gender. We analyzed data from the Brazilian Information System for Notificable Diseases (SINAN) in 2017. We carried out a descriptive analysis of victim characteristics, violence, and the probable perpetrator according to gender. Pearson's χ2 test was used to assess the significance between groups. Then, we verified the main relationships between the studied characteristics and the victim's gender by simple correspondence analysis (SCA). Thus, 17,311 cases/suspicions of elderly people abuse were notified, corresponding to 7.2% of the total number of violence notifications. Of these victims, 50.4% were white, 42.3% were married, and 17.2% had a disability/disorder; 76.9% occurred at home, 62.8% included physical violence, and 49.5% were cases of repeated violence. Most perpetrators were men (62%), and violence by two or more perpetrators was observed in 62.8% of the cases. SCA evidenced inequalities in older adults' gender, which proved to be higher among women. Physical violence was the most common among younger and old individuals, whereas neglect/abandonment tended to occur more frequently among the oldest individuals, and was most often committed by daughters. In sum, this study demonstrated evidence of gender-based violence, especially among older adults. Disability proved to be an essential characteristic for neglect/abandonment in older adults. In this context, policies are needed to reduce gender inequalities and implement a care network for older adults who are victims of violence.
Este estudo teve como objetivo descrever as características das notificações de abuso de idosos por sexo e avaliar os padrões de notificação de acordo com o sexo. Foram analisados dados do Sistema de Informação de Agravos de Notificação de 2017. A análise descritiva das características da vítima, da violência e do provável agressor foi feita de acordo com o sexo. O teste do χ2 de Pearson foi utilizado para avaliar a significância entre os grupos. Em seguida, as principais relações entre as características estudadas e o sexo da vítima foram verificadas por meio da análise de correspondência simples (ACS). Assim, 17.311 casos ou suspeitas de abuso de idosos foram notificados, correspondendo a 7,2% do total de notificações de violência. Dessas vítimas, 50,4% são brancas, 42,3% casadas e 17,2% têm uma deficiência ou um transtorno. Dos casos, 76,9% ocorreram em casa, sendo 62,8% por violência física e 49,5% por violência recorrente. A maioria dos perpetradores é do sexo masculino (62%), e observamos violência por dois ou mais perpetradores em 62,8%. A ACS evidenciou desigualdades no sexo dos idosos, em que o número de mulheres era maior. A violência física mais comum entre adultos, mais jovens e mais velhos, é a negligência ou o abandono dos mais frágeis e mais idosos, mais frequentemente praticada pela filha. Em suma, o estudo evidenciou a violência de gênero, especialmente entre os idosos, e a debilidade como característica essencial para a negligência ou abandono dessa população. Nesse contexto, são necessárias políticas para reduzir as desigualdades, especialmente as de gênero, e implementar uma rede de cuidado aos idosos vítimas de violência.
El objetivo del presente estudio es describir las características de las notificaciones de malos tratos a personas mayores por sexo y evaluar los patrones de notificación en función del sexo. Se analizaron los datos del Sistema Brasileño de Información de Enfermedades de Notificación (SINAN) de 2017. Se realizó un análisis descriptivo de las características de la víctima, la violencia y el probable agresor según el sexo. Se utilizó la prueba χ2 de Pearson para evaluar la significación entre grupos. A continuación, se verificaron las principales relaciones entre las características estudiadas y el sexo de la víctima mediante análisis de correspondencias simples (ACS). Así, se notificaron 17.311 casos/sospechas de malos tratos a personas mayores, lo que corresponde al 7,2% del número total de notificaciones de violencia. De estas víctimas, el 50,4% son de raza blanca, el 42,3% están casadas y el 17,2% tienen una discapacidad/trastorno. El 76,9% ocurrieron en el hogar, el 62,8% se debieron a violencia física y el 49,5% fueron violencia reincidente. La mayoría de los agresores son hombres (62%), y la violencia ejercida por dos o más agresores se observó en el 62,8%. El ACS evidenció desigualdades en el sexo de los adultos mayores, observándose una mayor incidencia entre las mujeres. La violencia física más común entre los adultos más jóvenes y mayores, es la negligencia/abandono entre los adultos más frágiles y mayores, cometida con mayor frecuencia por la hija. En resumen, el estudio evidenció la violencia basada en el sexo, especialmente entre adultos mayores, y la fragilidad como característica esencial para la ocurrencia de negligencia/abandono en adultos mayores. En este contexto, son necesarias políticas que reduzcan las desigualdades, especialmente las de sexo, e implementen una red de atención a los adultos mayores víctimas de violencia.
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Objective: to evaluate the association between parental supervision and sexual behaviors among Brazilian adolescents. Methods: Cross-sectional study with data from 102,072 adolescents who responded to the National Adolescent Health Survey. We estimated the prevalence of sexual behaviors (initiation, use of condoms, contraception, and number of partners). Parental supervision was evaluated using a score considering five indicators. We calculated prevalence ratios (PR) adjusted by age and sex in order to estimate the association between the parental supervision score and the sexual behaviors of the adolescents. Results: Prevalence of risky sexual behavior for adolescents with minimum and maximum parental supervision were: sexual initiation (min.: 58.0%; max.: 20.1%), condom use in the last sexual intercourse (min.: 50.9%; max.: 80.2%), use of contraceptives (min.: 40.8; max.: 49.1%), and mean number of partners (min.: 3.25; max.: 2.88). Parental supervision was greater among girls. Those with greater supervision score had higher prevalence of condom use in the first and last sexual intercourse, use of contraceptive methods and a lower mean number of partners, even after adjustments for sex and age. Conclusion: The greater parental supervision, the better the sexual behavior for both sexes, although supervision seems to occur differently between girls and boys. These findings point to the role of the family in providing adolescents with monitoring, along with dialogue and affection, conditions that encourage healthy and risk-free sexual behavior.
Objetivo: Avaliar a associação entre a supervisão dos pais e comportamentos sexuais entre os adolescentes brasileiros. Métodos: Estudo transversal com dados de 102.072 estudantes do 9° ano que responderam à Pesquisa Nacional de Saúde do Escolar de 2015. Estimou-se a prevalência dos comportamentos sexuais (iniciação, uso de preservativo, contracepção e número de parcerias). A supervisão dos pais foi avaliada por meio de escore formado por cinco indicadores. Foram calculadas razões de prevalência (RP) ajustadas por sexo e idade para análise das relações existentes entre o escore de supervisão dos pais e os comportamentos sexuais de adolescentes. Resultados: As prevalências de comportamentos sexuais em adolescentes com mínima e máxima supervisão parental foram: iniciação sexual (min.: 58,0%; máx.: 20,1%), uso do preservativo na última relação sexual (mín.: 50,9%; máx.: 80,2%), de contraceptivos (min.: 40,8; máx.: 49,1%), e número de parceiros (mín.: 3,25; máx.: 2,88). Supervisão parental apresentaram maior magnitude no sexo feminino. Aqueles com maior escore de supervisão, apresentaram maiores prevalências do uso de preservativos na primeira e última relação sexual, de métodos contraceptivos e menor média do número de parceiros, mesmo após ajustes por sexo e idade. Conclusão: Quanto maior a supervisão dos pais melhores os comportamentos sexuais, para ambos os sexos, apesar da supervisão ocorrer de forma diferenciada entre os sexos. Esses achados apontam o papel da família em proporcionar aos adolescentes monitoramento, simultâneo ao diálogo e ao afeto, condições estimuladoras ao comportamento sexual saudável e livre de riscos.
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BACKGROUND AND OBJECTIVE: The consumption of sugar-sweetened beverages (SSBs) is one of the main risk factors for chronic noncommunicable diseases (NCDs). This study aimed to estimate the burden of NCDs attributable to the consumption of SSBs in 2019, and the changes that occurred from 1990 to 2019 in Brazil and its five macro-regions. METHODS: This descriptive study used data from the Global Burden of Disease 2019. The metrics used were years lived with disability (YLD), years of life lost (YLL), disability-adjusted life-years (DALYs), and deaths. The estimates of crude and age-standardized rates and their respective 95% uncertainty intervals (IIs) were presented per 100,000 inhabitants in 2019, in addition to the changes observed in 1990-2019. RESULTS: Over the last three decades, the age-standardized rate decreased in the Central-West, South, and Southeast regions, while it remained stabled in the Northeast and North regions; meanwhile, the gross DALY rates increased due to the consumption of SSB in all five Brazilian macro-regions. Type 2 diabetes mellitus (DM-2) and ischemic heart disease (IHD) were the main outcomes related to the consumption of SSB, with IHDs showing higher mortality rates and YLL in 1990 and 2019 compared with DM-2, which revealed higher YLD rates. CONCLUSION: No significant decrease was observed in the burden of disease attributed to the consumption of SSBs between 1990 and 2019, thus revealing the need to implement and strengthen the articulated actions to reduce the consumption of SSBs, while also considering the country's realities and regional inequalities.
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Diabetes Mellitus Tipo 2 , Enfermedades no Transmisibles , Bebidas Azucaradas , Enfermedad Crónica , Humanos , Enfermedades no Transmisibles/epidemiología , Factores de RiesgoRESUMEN
Objetivo: estimar a prevalência de doenças e agravos não transmissíveis e seus fatores de risco em industriários de Minas Gerais, Brasil. Materiais e método: estudo transversal com dados secundários cedidos pelo Serviço Social da Indústria. As variáveis estudadas foram tabagismo, uso de álcool, inatividade física, alimentação inadequada, excesso de peso, doenças e agravos não transmissíveis referidos e autoavaliação da saúde. Calcularam-se as prevalências e as diferenças segundo sexo, faixa etária e escolaridade pelo teste x2 de Pearson. Na sequência, calcularam-se as razões de prevalência ajustadas pelas covariáveis por meio de regressão de Poisson. Resultados: foram estudados 34.072 trabalhadores. A prevalência de prática insuficiente de atividade física foi 75 %, consumo inade-quado de frutas 66 % e consumo regular de refrigerante ou suco artificial 42 %. O tabagismo foi relatado por 10 %, fumo passivo no ambiente de trabalho por 14 % e uso abusivo de álcool por 30 %. Dos trabalhadores, 55 % estavam acima do peso, 2 % referiram diabetes, 10 % hipertensão e 10 % colesterol elevado. Homens apresentaram maiores prevalências de alimentação inadequada e colesterol elevado, enquanto as mulheres apresentaram maior prevalência de sedenta-rismo, obesidade, hipertensão e colesterol elevado. Conclusões: os resultados mostram baixa prevalência de atividade física, alto consumo de alimentos não saudáveis e de sobrepeso, além de elevada prevalência de consumo abusivo de álcool entre trabalhadores das indústrias de Minas Gerais.
Objetivo: estimar la prevalencia de enfermedades no transmisibles y sus factores de riesgo en trabajadores industriales de Minas Gerais, Brasil. Materiales y método: estudio transversal con datos secundarios del Servicio Social de la Industria. Las variables estudiadas fueron tabaquismo, consumo de alcohol, sedentarismo, dieta inadecuada, sobrepeso, dolencias y enfermedades no transmisibles referidas y autoevaluación de la salud. La prevalencia y las diferencias según el sexo, la edad y la educación se calcularon mediante la prueba x2 de Pearson. Posteriormente, se calcularon las razones de prevalencia ajustadas por covariables mediante regresión de Poisson. Resultados: se estudió un total de 34.072 trabajadores. La prevalencia de actividad física insuficiente fue de 75 %, el consumo inadecuado de fruta de 66 % y el consumo regular de refrescos o jugos artificiales alcanzó un 42 %. Además, 10 % de los participantes reportó el consumo de tabaco, 14 % afirmó ser fumador pasivo en el lugar de trabajo y 30 % reportó la ingesta excesiva de alcohol. De los trabajadores en la muestra, 55 % tenía sobrepeso, 2 % informó padecer de diabetes, 10 % de hipertensión y un 10 % adicional presentar colesterol alto. La población masculina reportó una mayor prevalencia de dieta inadecuada y colesterol alto, mientras que las mujeres presentaron mayor prevalencia de sedentarismo, obesidad, hipertensión y colesterol alto. Conclusiones: los resultados muestran baja prevalencia de la actividad física, elevado consumo de alimentos poco saludables y altas cifras de sobrepeso, así como una alta prevalencia del abuso de alcohol en los trabajadores del sector industrial de Minas Gerais.
Objective: To estimate the prevalence of non-communicable diseases and their associated risk factors among industrial sector workers of Minas Gerais, Brazil. Materials and method: Cross-sectional study with secondary data provided by the Industry Social Service. The variables examined were tobacco use, alcohol use, physical inactivity, inadequate diet, overweight, non-communicable diseases referred, and self-assessment of health. Prevalence figures and differences were calculated using Pearson's chi-square test, according to sex, age group, and level of schooling. Following this, the prevalence ratio adjusted by all covariates was calculated using Poisson regression. Results: A total of 34,072 workers were studied. The prevalence of insufficient physical activity was 75 %, inadequate consumption of fruits reached 66 %, and the regular consumption of soft drinks or artificial juice was 42 %. Smoking was reported by 10 % of the participants, passive smoking in the workplace by 14 %, and alcohol abuse by 30 %. Of the workers in the sample, 55 % were overweight, 2 % reported diabetes, 10 % hypertension, and 10 % high cholesterol. Men presented a higher prevalence of inadequate diet, tobacco use, alcohol use, and overweight. Women presented greater physical inactivity, obesity, hypertension, and high cholesterol. Conclusions: Findings show a low prevalence of physical activity, high consumption of unhealthy foods, and high prevalence of obesity and alcohol abuse among the industrial workers of Minas Gerais.
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Humanos , Factores de Riesgo , Encuestas Epidemiológicas , Salud Laboral , Enfermedades no Transmisibles , Enfermería del TrabajoRESUMEN
RESUMO Objetivo: analisar os indicadores de consumo e exposição a bebidas alcoólicas entre escolares brasileiros em 2019 e compará-los aos de 2015. Método: estudo transversal com dados da Pesquisa Nacional de Saúde do Escolar (PeNSE), realizadas em 2015 e 2019. Em 2019, analisaram-se os indicadores referentes ao consumo e à exposição a bebidas alcoólicas, estratificadas por sexo, faixa etária, dependência administrativa, unidades da federação e região geográfica. Estimou-se as prevalências e os respectivos intervalos de 95% de confiança (IC 95%). Resultados: houve aumento na experimentação de bebidas alcoólicas antes de 13 anos (30,6% em 2015 para 34,6% em 2019); sofrer embriaguez na vida (27,2% em 2015 para 47,0% em 2019) e ter problemas com amigos devido ao consumo de bebidas alcóolicas (9,3% em 2015 para 15,7% em 2019). Todos os indicadores foram mais prevalentes entre meninas, exceto beber em binge e episódios de embriagues, que não tiveram diferenças entre os sexos, bem como foram mais elevadas entre estudantes mais velhos. Os episódios de embriaguez e ter amigos que ingerem bebida alcoólica foram mais prevalentes entre escolares de escolas públicas, enquanto o consumo de bebidas alcoólicas pelos pais e ter tido problemas com suas famílias ou amigos devido ao consumo de bebidas alcoólicas foram mais elevados em estudantes de escolas privadas. Conclusão: evidenciaram-se elevadas prevalências de experimentação, consumo e exposição a bebidas alcoólicas, mostrando que grande parcela dos adolescentes brasileiros se encontra exposta a uma carga evitável de morbimortalidade decorrente do consumo e exposição ao álcool.
RESUMEN Objetivo: analizar los indicadores de consumo y exposición a bebidas alcohólicas entre los estudiantes brasileños en 2019 y compararlos con los de 2015. Método: estudio transversal con datos de la Encuesta Nacional de Salud Escolar (PeNSE), realizada en 2015 y 2019. En 2019 se analizaron los indicadores referidos al consumo y exposición a bebidas alcohólicas estratificados por sexo, grupo de edad, dependencia administrativa, unidades federativas y región geográfica. Se estimó la prevalencia y los respectivos intervalos de confianza del 95% (IC 95%). Resultados: aumenta la experimentación con bebidas alcohólicas antes de los 13 años (30,6% en 2015 a 34,6% en 2019); sufrir borracheras en la vida (27,2% en 2015 a 47,0% en 2019) y tener problemas con los amigos por el consumo de alcohol (9,3% en 2015 a 15,7% en 2019). Todos los indicadores eran más frecuentes entre las chicas, excepto el consumo compulsivo de alcohol y los episodios de embriaguez, que no presentaban diferencias de género, además de ser más elevados entre los estudiantes de mayor edad. Los episodios de consumo de alcohol y el hecho de tener amigos que beben bebidas alcohólicas fueron más frecuentes entre los estudiantes de la escuela pública, mientras que el consumo de alcohol por parte de los padres y el hecho de haber tenido problemas con sus familias o amigos debido al consumo de alcohol fueron mayores en los estudiantes de las escuelas privadas. Conclusión: se evidenció una alta prevalencia de experimentación, consumo y exposición a bebidas alcohólicas, mostrando que una gran parte de los adolescentes brasileños está expuesta a una carga evitable de morbilidad y mortalidad resultante del consumo y exposición al alcohol.
ABSTRACT Objective: to analyze the indicators regarding consumption of and exposure to alcoholic beverages among Brazilian schoolchildren in 2018 and compare them to those from 2015. Method: a cross-sectional study conducted with data from the 2015 and 2019 National School Health Survey (Pesquisa Nacional de Saúde do Escolar, PeNSE). In 2019, the indicators referring to consumption of and exposure to alcoholic beverages were analyzed, stratified by gender, age group, administrative system, Federation Unit, and geographical region. The prevalence values and their respective 95 confidence intervals (95% CIs) were estimated. Results: there was an increase in trying alcoholic beverages before the age of 13 (from 30.6% in 2015 to 34.6% in 2019); being drunk in their lifetime (from 27.2% in 2015 to 47.0% in 2019) and having problems with friends due to alcohol consumption (from 9.3% in 2015 to 15.7% in 2019). All the indicators were more prevalent among the girls, except for binge drinking and drunkenness episodes, which presented no differences between the genders and were also higher among older students Episodes of drunkenness and having friends who drink alcohol were more prevalent among students from public schools, while consumption of alcoholic beverages by parents and having had problems with their families or friends due to alcohol consumption were higher in students from private schools. Conclusion: high prevalence of experimentation, consumption and exposure to alcoholic beverages was evidenced, showing that a large number of Brazilian adolescents are exposed to an avoidable burden of morbidity and mortality resulting from consumption of and exposure to alcohol.
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Humanos , Adolescente , Consumo de Bebidas Alcohólicas/prevención & control , Salud del Adolescente , Bebidas Alcohólicas/efectos adversos , Consumo de Alcohol en Menores/estadística & datos numéricos , Factores Socioeconómicos , Brasil , Estudios Transversales , Encuestas EpidemiológicasRESUMEN
INTRODUCTION: Excessive sodium consumption is associated with increased blood pressure, which is an important risk factor for non-communicable diseases (NCDs). This study therefore aimed to describe the burden of NCDs attributable to excessive sodium consumption among Brazilians. METHODS: This observational study used mortality and Disability Adjusted Life Years (DALY) rates, and their respective uncertainty intervals (UI), from the Global Burden of Disease Study 2019 (GBD 2019). The burden was obtained by the population attributable fraction of each NCD, considering the minimum theoretical value of risk (intake of 0-3g of sodium/day); the excessive consumption proportion in the population, obtained through population inquiries; and the relative risks obtained through meta-analyses. RESULTS: Excessive sodium consumption was the third highest dietary risk contributing to deaths (30,814; 95% UI = 2,034 - 84,130) and DALYs (699,119; 95% UI= 43,130 - 1,914,066) in 2019. States from the Northeast region had the highest age-standardized rates of deaths and DALYs, and the male population was more affected by NCDs caused by excessive sodium consumption. Cardiovascular diseases were the main contributing factors in the burden attributable to excessive sodium consumption. CONCLUSIONS: Regardless of the progress in addressing NCDs related to this risk factor, the impact remains high, especially among men and in the Northeast region. More effective measures are needed to reduce sodium in industrialized products, such as health promotion actions to combat sodium consumption, in order to prevent and control NCDs in Brazil.
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Carga Global de Enfermedades , Enfermedades no Transmisibles , Brasil/epidemiología , Humanos , Masculino , Años de Vida Ajustados por Calidad de Vida , SodioRESUMEN
INTRODUCTION: Monitoring trends in risk factors (RFs) and the burden of diseases attributable to exposure to RFs is an important measure to identify public health advances and current inadequate efforts. Objective: Analyze the global burden of disease attributable to exposure RFs in Brazil, and its changes from 1990 to 2019, according to the sex and age group. METHODS: This study used data from the Global Burden of Disease study. The Summary Exposure Value, which represents weighted prevalence by risk, was used to estimate exposure to RFs. The mortality and DALYs (Disability Adjusted Life Years) measurements were used to estimate the burden of diseases. For comparisons by year and between Brazilian states, age-standardized rates were used. RESULTS: Arterial hypertension was the factor responsible for most deaths in both sexes. For DALYs, the most important RF was the high body mass index (BMI) for women and alcohol consumption for men. Smoking had a substantial reduction in the attributable burden of deaths in the period. An important reduction was identified in the exposure to RFs related to socioeconomic development, such as unsafe water, lack of sanitation, and child malnutrition. Metabolic RFs, such as high BMI, hypertension, and alcohol consumption showed an increase in the attributable burden. CONCLUSIONS: Our findings point to an increase in metabolic RFs, which are the main RFs for mortality and DALYs. These results can help to consolidate and strengthen public policies that promote healthy lifestyles, thus reducing disease and death.
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Carga Global de Enfermedades , Saneamiento , Consumo de Bebidas Alcohólicas , Brasil/epidemiología , Niño , Femenino , Humanos , Masculino , Factores de RiesgoRESUMEN
INTRODUCTION: An unhealthy diet is a modifiable risk factor for non-communicable diseases (NCDs), one of the most important public health problems in Brazil. This study aimed to analyze the burden of NCDs attributable to dietary risks in Brazil between 1990-2019. METHODS: Secondary data from the Global Burden of Disease Study were used to estimate the burden attributable to fifteen dietary risks in Brazil. The main sources of data for Brazil were national surveys and international databases. A comparative risk assessment was used to obtain the population attributable fraction. We described the intake of each dietary risk and the distribution of number and rates of deaths and Disability-adjusted life years (DALYs) attributable to diet by sex, age, state, and year from 1990-2019. RESULTS: Cardiovascular diseases, diabetes mellitus, and neoplasms were the main NCDs attributable to an unhealthy diet. Age-standardized mortality and DALYs rates attributable to unhealthy diet decreased between 1990-2019 (-51.5% and -48.8, respectively). Diet high in red meat and sodium, and low in whole grains were the three main risk factors contributing to the burden of NCDs both in 1990 and 2019. The burden of NCDs was higher among males in the middle-aged population (around 50 years), as well as in the states of Maranhão, Rio de Janeiro, and Alagoas. CONCLUSIONS: The present study found a suboptimum diet among the Brazilian population. The major contributors to this burden were diet high in red meat and sodium and low in whole grains. This study supports priorities in public policies on food and nutrition to reduce the burden of NCDs.