Self-rated health according to sex and associated factors in Manaus, Brazil, 2019: a population-based cross-sectional study.

OBJECTIVE: To assess the prevalence and factors associated with poor self-rated health according to respondents' sex in Manaus, Brazil. METHODS: This was a cross-sectional population-based study with adults in Manaus in 2019. Adjusted prevalence ratios and 95% confidence intervals (95%CI) were calculated using Poisson regression following a hierarchical model. RESULTS: Poor self-rated health occurred in 35.2% (95%CI 33.3;37.2) of the 2,321 participants and was higher in females (PR = 1.27; 95%CI 1.13;1.43). In the general population, among both sexes, poor self-rated health was higher among the oldest, those with moderate and severe food insecurity and with chronic diseases (p-value < 0.05). Among females, poor health was also higher among the evangelical and those with mild food insecurity. Among males, self-rated health was also poorer among the retired and those with education below elementary level (p-value < 0.001). CONCLUSION: The female sex had the poorest health rating, influenced by morbidity and access to food.

Self-rated health according to sex and associated factors in Manaus, Brazil, 2019: a population-based cross-sectional study / Autoevaluación de la salud según sexo y factores asociados en Manaus, Brasil, 2019: estudio transversal de base poblacional / Autoavaliação de saúde de acordo com sexo e fatores associados em Manaus, 2019: estudo transversal de base populacional

Abstract Objective: To assess the prevalence and factors associated with poor self-rated health according to respondents' sex in Manaus, Brazil. Methods: This was a cross-sectional population-based study with adults in Manaus in 2019. Adjusted prevalence ratios and 95% confidence intervals (95%CI) were calculated using Poisson regression following a hierarchical model. Results: Poor self-rated health occurred in 35.2% (95%CI 33.3;37.2) of the 2,321 participants and was higher in females (PR = 1.27; 95%CI 1.13;1.43). In the general population, among both sexes, poor self-rated health was higher among the oldest, those with moderate and severe food insecurity and with chronic diseases (p-value < 0.05). Among females, poor health was also higher among the evangelical and those with mild food insecurity. Among males, self-rated health was also poorer among the retired and those with education below elementary level (p-value < 0.001). Conclusion: The female sex had the poorest health rating, influenced by morbidity and access to food.

Resumen Objetivo: Analizar la prevalencia y los factores asociados a la mala autoevaluación de salud según sexo en Manaus, Brasil. Métodos: Se trata de un estudio poblacional transversal con adultos residentes en Manaus en 2019. Las razones de prevalencia ajustadas (RP) y los intervalos de confianza del 95% (IC95%) se calcularon mediante regresión jerárquica de Poisson. Resultados: Autoevaluación mala de salud ocurrió en 35,2% (IC95% 33,3;37,2) de los 2.321 participantes y fue mayor en el sexo femenino (RP = 1,27; IC95%1,13;1,43). En la población general, femenina y masculina, la mala autoevaluación de salud fue mayor entre ancianos, con inseguridad alimentaria moderada y grave y con enfermedades crónicas (p-valor < 0,05). En el sexo femenino, la mala salud fue mayor en evangélicas y con inseguridad alimentaria leve. En el sexo masculino, jubilados y con educación inferior al nivel básico también tuvieron una peor autoevaluación (p-valor < 0,001). Conclusión: Personas de sexo femenino tuvieron una peor valoración de salud, influenciada por la morbilidad y el acceso a la alimentación.

Resumo Objetivo: Analisar a prevalência e fatores associados à autoavaliação de saúde ruim segundo o sexo em Manaus. Métodos: Trata-se de estudo transversal de base populacional com adultos residentes em Manaus em 2019. Razões de prevalências (RP) ajustadas e intervalos de confiança de 95% (IC95%) foram calculadas por regressão de Poisson hierarquizada. Resultados: Saúde autoavaliada como ruim ocorreu em 35,2% (IC95% 33,3;37,2) dos 2.321 participantes e foi maior no sexo feminino (RP = 1,27; IC95% 1,13;1,43). Na população geral, em ambos os sexos, saúde autoavaliada como ruim foi maior entre os mais velhos, com insegurança alimentar moderada e grave e com presença de doenças crônicas (p-valor < 0,05). No sexo feminino, saúde ruim foi maior em evangélicas e com insegurança alimentar leve. No masculino, aposentados e com nível de ensino inferior ao fundamental também apresentaram pior autoavaliação (p-valor < 0,001). Conclusão: Pessoas do sexo feminino apresentaram pior avaliação de saúde, influenciada por morbidade e acesso a alimentação.

Prevalence of Physical Violence Against Brazilian Women: Systematic Review and Meta-Analysis.

Violence against women is a major problem in Brazil, but data on its prevalence are scarce. We aimed to estimate the prevalence of physical violence against women in Brazil. We conducted a systematic review and meta-analysis of the prevalence of physical violence against women. Population-based researches that assessed physical violence in Brazilian women were searched on MEDLINE, Embase, Scopus, and VHL/BIREME. The last search update was carried out in March 2020. Two researchers selected the studies, extracted the data, and assessed the quality of the eligible studies. Summary of prevalence and 95% confidence interval (CI) was calculated using Freeman-Tukey double arccosine transformation, weighted by the official local population size. Heterogeneity was estimated by I 2 and investigated by meta-regression analyses. Of 3,408 reports, 13 studies carried out from 1999 to 2016 (n = 25,781 women) were included. Most studies had limitations on sample size (5/13) and response rate (7/13). The prevalence of physical violence was 22.4% in lifetime (95% CI [21.6, 23.2%]; I 2 = 99.0%), and 11.5% in previous year (95% CI [11.1, 11.9%]; I 2 = 99.5%). Assuring privacy during interview significantly increased the prevalence (p = .028; residual I 2 = 80.0%). Higher prevalence was also observed in studies with adequate sample source, validated questionnaire, and privacy (in both recall periods), potentially due to lower risk of nonresponse bias. Over two in 10 Brazilian women suffered physical violence during their lives, and over one tenth, in the previous year. Measurement of outcome affected the prevalence; privacy should be assured for the interviewee for future reliable estimates in the country.

Biological characterization of Trypanosoma cruzi epimastigotes derived from trypomastigotes isolated from Brazilian chagasic patients.

Chagas disease (CD), caused by Trypanosoma cruzi, occurs in several countries in Latin America and non-endemic countries. Heterogeneity among T. cruzi population has been the Achilles' heel to find a better treatment for CD. In this study, we characterized the biochemical parameters and mitochondrial bioenergetics of epimastigotes differentiated from eight T. cruzi isolates (I1-I8) obtained from Brazilian CD patients. Molecular analysis of parasites DTUs grouped all of them as TcII. The profile of the growth curves in axenic cultures was distinct among them, except for I1 and I3 and I2 and I4. Doubling times, growth rates, cell body length, and resistance to benznidazole were also significantly different among them. All the isolates were more glucose-dependent than other T. cruzi strains adapted to grow in axenic culture. Mitochondrial bioenergetics analysis showed that each isolate behaved differently regarding oxygen consumption rates in non-permeabilized and in digitonin-permeabilized cells in the presence of a complex II-linked substrate. When complex IV-linked respiratory chain substrate was used to provide electrons to the mitochondrial respiratory chain (MRC), similarity among the isolates was higher. Our findings show that TcII epimastigotes derived from patients' trypomastigotes displayed their own characteristics in vitro, highlighting the intra-TcII diversity, especially regarding the functionality of mitochondrial respiratory complexes II and IV. Understanding T. cruzi intraspecific biological features help us to move a step further on our comprehension regarding parasite's survival and adaptability offering clues to improve the development of new therapies for CD.