RESUMEN
We carried out the health situation analysis in the Legal Amazon through morbidity and mortality indicators and the comparison between intra and inter-state federation of the region and Brazil. Analysis of the health situation, trends, and identification of clusters in the Brazilian Amazon, for the period from 2010 to 2021, using secondary data available in official health information systems. Circulatory diseases were the main cause of death, representing 23% of deaths. External causes and respiratory diseases contributed 16% and 9% of deaths, respectively; 52.6% of infant deaths occurred in the early neonatal period, and the infant mortality rate remained above the national average. The ratio of maternal mortality was also high and above the national average between 2010 and 2021. The dengue incidence rate remained below the national average with a drop trend of -59.50%. However, rates of Chagas disease, AIDS, Hansen's disease, American cutaneous leishmaniasis and tuberculosis remained above average rates in the country. It was concluded that the population of the Brazilian Amazon faces health challenges. The findings facilitate the identification of territorial priorities for the implementation of actions that impact morbidity and mortality reduction in the region.
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Causas de Muerte , Mortalidad Infantil , Brasil/epidemiología , Humanos , Lactante , Mortalidad Infantil/tendencias , Causas de Muerte/tendencias , Femenino , Recién Nacido , Niño , Preescolar , Morbilidad/tendencias , Adulto , Adolescente , Masculino , Sistemas de Información en Salud , Persona de Mediana Edad , Adulto Joven , Mortalidad Materna/tendencias , Anciano , Mortalidad/tendenciasRESUMEN
The aim was to map evidence on the quality of records in the Mortality Information System (SIM) through a national scoping review of articles published up to April 2023 across five databases (PubMed, Embase, Scopus, LILACS, and SciELO). Studies focused on specific causes of death were excluded. Dimensions evaluated included accessibility, methodological clarity, coverage, completeness, reliability, consistency, non-duplication, timeliness, validity, and studies on ill-defined causes/garbage codes. Among the 33 included articles, a general improvement in SIM quality was observed, with a 68.5% reduction in garbage codes (2000-2015). However, regional inequalities in SIM persist, with coverage below 90% in Acre and Maranhão and poorer performance in the North and Northeast regions. A robust SIM is essential for public health strategies aimed at preventing avoidable deaths.
O objetivo foi mapear evidências sobre a qualidade dos registros do Sistema de Informação sobre Mortalidade (SIM) por meio de revisão de escopo nacional com artigos publicados até abril de 2023 em cinco bases (PubMed, Embase, scopus, LILACS e SciELO). Excluíram-se estudos focados em causas específicas de óbito. Foram avaliadas dimensões como acessibilidade, clareza metodologica, cobertura, completitude, confiabilidade, consistencia, nao-duplicidade, oportunidade, validade e estudos de causas mal definidas/garbage codes.. Dos 33 artigos incluídos, observou-se melhoria geral da qualidade do SIM, com redução de 68,5% nos garbage codes (2000-2015). Contudo, persistem desigualdades regionais no SIM, com cobertura abaixo de 90% no Acre e Maranhão e pior desempenho nas regiões Norte e Nordeste. Um SIM robusto é essencial para estratégias de saúde pública voltadas à prevenção de mortes evitáveis.
El objetivo fue mapear evidencias sobre la calidad de los registros del Sistema de Información sobre Mortalidad (SIM) a través de una revisión de alcance nacional con artículos publicados hasta abril de 2023 en cinco bases de datos (PubMed, Embase, Scopus, LILACS y SciELO). Se excluyeron estudios centrados en causas específicas de muerte. Se evaluaron dimensiones como accesibilidad, claridad metodológica, cobertura, completitud, fiabilidad, consistencia, no duplicación, oportunidad, validez y estudios sobre causas mal definidas/códigos basura. Entre los 33 artículos incluidos, se observó una mejora general en la calidad del SIM, con una reducción del 68,5% en los códigos basura (2000-2015). Sin embargo, persisten desigualdades regionales en el SIM, con una cobertura inferior al 90% en Acre y Maranhão y un peor desempeño en las regiones Norte y Nordeste. Un SIM robusto es esencial para estrategias de salud pública dirigidas a prevenir muertes evitables.
Asunto(s)
Sistemas de Información , Mortalidad , Brasil/epidemiología , Humanos , Sistemas de Información/normas , Mortalidad/tendencias , Reproducibilidad de los Resultados , Salud Pública , Exactitud de los Datos , Causas de MuerteRESUMEN
This study aimed to evaluate the overall excess mortality and COVID-19 mortality in the regions of Brazil, in 2020, by sex and age group. An ecological study was carried out to calculate the overall excess mortality, by sex and age group, using the expected number of deaths in a non-pandemic context and the deaths observed in 2020. Data on deaths were extracted from the Brazilian Mortality Information System, in addition to population data from the Brazilian Institute of Geography and Statistics. Excess mortality was calculated considering: the difference between the mortality rates observed in 2020 and the average of the rates from 2015 to 2019, standardized by age; and the difference between observed deaths obtained via a quasi-Poisson model and the deaths expected for 2020. In Brazil, the standardized overall mortality rate in 2020 was 590 deaths per 100,000 inhabitants, with excess mortality of 44 deaths per 100,000 inhabitants, while the mortality rate from COVID-19 was 79 deaths per 100,000 inhabitants. The highest overall mortality rates were observed in the North and Northeast regions. The excess deaths estimated by the ratio between observed and expected deaths nationwide in 2020 was 16%; of which 17% were males, 16% were females, 7% were individuals from 0 to 59 years old, and 20% were individuals aged 60 years or older. These outcomes enabled a better understanding on the impact of the COVID-19 pandemic on the mortality in Brazil in 2020, indicating a more pronounced excess mortality in the North, Northeast and Central-West regions and among men older than 60 years.
O objetivo deste estudo foi avaliar o excesso de mortalidade geral e a mortalidade por COVID-19 nas regiões do Brasil, no ano de 2020, segundo sexo e faixa etária. Realizou-se estudo ecológico que calculou o excesso de mortalidade geral, por sexo e faixa etária, utilizando os quantitativos esperados de óbitos em um contexto sem a pandemia e os óbitos observados em 2020. Dados sobre óbitos foram extraídos do Sistema de Informações sobre Mortalidade e dados populacionais do Instituto Brasileiro de Geografia e Estatística. O excesso de mortalidade foi calculado considerando a diferença entre as taxas de mortalidade observadas em 2020 e a média das taxas de 2015 a 2019, padronizadas por idade, e a diferença entre os óbitos observados obtido por meio de uma modelagem quasi-Poisson e aqueles esperados para 2020. No Brasil, a taxa de mortalidade geral padronizada, no ano de 2020, foi de 590 óbitos por 100 mil habitantes, sendo o excesso de mortalidade de 44 óbitos por 100 mil habitantes, enquanto a taxa de mortalidade por COVID-19 foi de 79 óbitos por 100 mil habitantes. As maiores taxas de mortalidade geral foram observadas nas regiões Norte e Nordeste. O excesso de óbitos estimado pela razão entre os óbitos observados e esperados, em todo o país em 2020, foi de 16%; sendo 17% para o sexo masculino, 16% para o feminino, 7% para indivíduos entre 0 e 59 anos, e 20% para aqueles com idade igual ou superior a 60 anos. Os dados permitiram um entendimento mais direcionado do impacto da pandemia de COVID-19 na mortalidade do Brasil em 2020, apontando um excesso de óbitos mais expressivo nas regiões Norte, Nordeste e Centro-oeste e entre os grupos de homens e com idade superior a 60 anos.
El objetivo fue evaluar el exceso de mortalidad general y la mortalidad por COVID-19 en las regiones de Brasil, en el año 2020, según el sexo y el rango de edad. Se realizó un estudio ecológico que calculó el exceso de mortalidad general, por sexo y rango de edad, utilizando las cifras de muertes esperadas en un contexto sin pandemia y las muertes observadas en el 2020. Los datos sobre defunciones se extrajeron del Sistema de Informaciones sobre la Mortalidad brasileño y de los datos poblacionales del Instituto Brasileño de Geografía y Estadística. El exceso de mortalidad se calculó teniendo en cuenta: la diferencia entre las tasas de mortalidad observadas en el 2020 y las tasas promedio del 2015 al 2019, estandarizadas por edad; y la diferencia entre las muertes observadas obtenidas mediante modelos cuasi-Poisson y las esperadas para el 2020. En Brasil, la tasa de mortalidad general estandarizada en el 2020 fue de 590 muertes por 100.000 habitantes, con un exceso de mortalidad de 44 muertes por 100.000 habitantes, mientras que la tasa de mortalidad por COVID-19 fue de 79 muertes por 100.000. Las tasas de mortalidad general más altas se observaron en las regiones Norte y Nordeste. El exceso de muertes estimado por la relación entre muertes observadas y esperadas, en todo el país en el 2020, fue del 16%; 17% para hombres, 16% para mujeres, 7% para personas entre 0 y 59 años, y 20% para personas de 60 años o más. Los datos permitieron comprender mejor el impacto de la pandemia de COVID-19 en la mortalidad en Brasil en el 2020, señalando un exceso más significativo de muertes en las regiones Norte, Nordeste y Centro-Oeste y entre grupos de hombres y personas mayores de 60 años.
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COVID-19 , Humanos , Brasil/epidemiología , COVID-19/mortalidad , Masculino , Femenino , Persona de Mediana Edad , Lactante , Adulto , Adolescente , Preescolar , Niño , Adulto Joven , Distribución por Edad , Recién Nacido , Anciano , Distribución por Sexo , Mortalidad/tendencias , Pandemias , SARS-CoV-2 , Factores SexualesRESUMEN
Importance: The Walter Index is a widely used prognostic tool for assessing 12-month mortality risk among hospitalized older adults. Developed in the US in 2001, its accuracy in contemporary non-US contexts is unclear. Objective: To evaluate the external validity of the Walter Index in predicting posthospitalization mortality risk in Brazilian older adult inpatients. Design, Setting, and Participants: This prognostic study used data from a cohort of adults aged 70 years or older admitted to the geriatric unit of a university hospital in Brazil from January 1, 2009, to February 28, 2020. Participants underwent comprehensive geriatric assessments at admission, were reevaluated at discharge, and were subsequently followed up for 48 months. Data were analyzed from March to July 2024. Main Outcomes and Measures: The Walter Index, a score based on 6 risk factors (male sex, dependent activities of daily living at discharge, heart failure, cancer, high creatinine level, and low albumin level), was calculated to assess its predictive accuracy for 12-month mortality as well as 6-, 24-, and 48-month mortality. The study investigated whether incorporating delirium, frailty, or C-reactive protein level enhanced accuracy. Performance was assessed using discrimination, calibration, and clinical utility measures. Results: In total, 2780 participants (mean [SD] age, 81 [7] years; 1795 [65%] female) were included, with 89 (3%) lost to follow-up. The 12-month posthospitalization mortality rate was 23% (646 participants). Mortality was 7% (47 of 634) in the lowest-risk group (0-1 point), 17% (111 of 668) for 2 to 3 points, 25% (198 of 803) for 4 to 6 points, and 43% (290 of 675) in the highest-risk group (≥7 points). The index demonstrated an area under the receiver operating characteristic curve (AUC) of 0.714 (95% CI, 0.691-0.736) for predicting 12-month posthospitalization mortality (AUCs were 0.75 and 0.80 in the original derivation and validation cohorts, respectively). Comparable results were observed for mortality at 6 months (AUC, 0.726; 95% CI, 0.700-0.752), 24 months (AUC, 0.711; 95% CI, 0.691-0.730), and 48 months (AUC, 0.719; 95% CI, 0.700-0.738). Adding delirium modestly increased the index's discrimination (AUC, 0.723; 95% CI, 0.702-0.749); additionally including frailty and C-reactive protein level did not improve discrimination further (AUC, 0.723; 95% CI, 0.701-0.744). Conclusions and Relevance: In this prognostic study of hospitalized older adults in Brazil, the Walter Index showed similar discrimination in predicting postdischarge mortality as it did 2 decades ago in the US. These findings highlight the need for continuous validation and potential modification of established prognostic tools to improve their applicability across settings.
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Evaluación Geriátrica , Humanos , Masculino , Femenino , Anciano , Anciano de 80 o más Años , Brasil/epidemiología , Evaluación Geriátrica/métodos , Factores de Riesgo , Pronóstico , Medición de Riesgo/métodos , Hospitalización/estadística & datos numéricos , Mortalidad/tendencias , Valor Predictivo de las Pruebas , Actividades Cotidianas , Mortalidad Hospitalaria , Reproducibilidad de los Resultados , Delirio/mortalidad , Delirio/diagnóstico , Fragilidad/mortalidad , Fragilidad/diagnósticoRESUMEN
OBJECTIVE: To describe the epidemiological profile and analyze the temporal trend of deaths due to Parkinson's disease among the elderly in Brazil from 2002 to 2021. METHODS: Descriptive and temporal trend study using data from the Mortality Information System. Annual percent change (APC) and 95% confidence intervals (95% CI) were estimated using the Prais-Winsten regression model. RESULTS: Among the 57,723 deaths, there was a higher frequency in males (54.7%), individuals aged ≥ 80 years (57.7%), and White individuals (75.0%). Mortality trends increased in both males (APC = 3.32; 95%CI 2.49; 4.16) and females (APC = 2.81; 95%CI 1.80; 3.82); across all age groups, particularly ages 70-79 (APC = 4.93; 95%CI 2.98; 6.91); and in all Brazilian regions, especially the Northeast (APC = 6.79; 95%CI 4.35; 9.30). CONCLUSION: Deaths due to Parkinson's disease were more frequent among males and the oldest age groups, with an increasing mortality trend observed over the period. MAIN RESULTS: An increasing trend in mortality due to Parkinson's disease was found among elderly people of both sexes, of all age groups and in all Brazilian regions in the period. IMPLICATIONS FOR SERVICES: The increase in mortality due to Parkinson's disease implies greater demand for health care services and, consequently, contributes to the financial burden related to diagnosis and treatment of people with the disease. PERSPECTIVES: Investing in research and technologies for timely diagnosis, treatment and health recovery are crucial. Furthermore, the need exists to promote health policies that guarantee equitable access to specialized services.
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Enfermedad de Parkinson , Humanos , Brasil/epidemiología , Masculino , Femenino , Anciano , Enfermedad de Parkinson/mortalidad , Enfermedad de Parkinson/epidemiología , Anciano de 80 o más Años , Persona de Mediana Edad , Distribución por Sexo , Factores de Tiempo , Distribución por Edad , Factores de Edad , Factores Sexuales , Mortalidad/tendenciasRESUMEN
Recent studies project that temperature-related mortality will be the largest source of damage from climate change, with particular concern for the elderly whom it is believed bear the largest heat-related mortality risk. We study heat and mortality in Mexico, a country that exhibits a unique combination of universal mortality microdata and among the most extreme levels of humid heat. Combining detailed measurements of wet-bulb temperature with age-specific mortality data, we find that younger people who are particularly vulnerable to heat: People under 35 years old account for 75% of recent heat-related deaths and 87% of heat-related lost life years, while those 50 and older account for 96% of cold-related deaths and 80% of cold-related lost life years. We develop high-resolution projections of humid heat and associated mortality and find that under the end-of-century SSP 3-7.0 emissions scenario, temperature-related deaths shift from older to younger people. Deaths among under-35-year-olds increase 32% while decreasing by 33% among other age groups.
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Calor , México/epidemiología , Humanos , Adulto , Persona de Mediana Edad , Anciano , Adolescente , Adulto Joven , Cambio Climático , Niño , Mortalidad , Preescolar , Factores de Edad , Masculino , Femenino , HumedadRESUMEN
Los empiemas fúngicos representan una entidad potencialmente fatal, con tasas de mortalidad elevadas en la mayoría de las series. Se presenta el caso de un empiema por Candida albicans tratado exitosamente en un paciente diabético. Se demuestra la importancia del inicio precoz y agresivo del tratamiento.
Fungal empyemas represent a potentially fatal entity, with high mortality rates in most series. A case of empyema due to Candida albicans successfully treated in a diabetic patient is presented, demonstrating the importance of early and aggressive initiation of treatment.
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Humanos , Masculino , Adulto , Derrame Pleural , Candida albicans/aislamiento & purificación , Enfermedad Celíaca , Diabetes Mellitus , Empiema/tratamiento farmacológico , Toracoscopía , Heridas y Lesiones , Incidencia , Mortalidad , Fiebre , Laparotomía , Leucocitosis , Antifúngicos/uso terapéuticoRESUMEN
Resumen Introducción: El desarrollo y expansión urbana han generado la pérdida y transformación de los ecosistemas andinos. Sin embargo, alrededor de las grandes ciudades colombianas aún se encuentran relictos boscosos que mantienen gran riqueza de biodiversidad, la cual es amenazada por la infraestructura vial. El énfasis de los trabajos de Ecología de Carreteras en el Neotrópico ha estado centrado en el efecto del atropellamiento de fauna desde el punto de vista taxonómico. Objetivo: Evaluar, ecológica y espacialmente, el atropellamiento de la fauna en carreteras ubicadas en zonas de interés para la expansión urbana del norte de los Andes colombianos. Métodos: Se evaluaron la tasa de mortalidad de vertebrados, las zonas críticas de atropellamientos por grupo taxonómico y grupos funcionales. Esto se realizó por medio de análisis de ecología espacial, específicamente análisis de densidad de Kernel y análisis de estadística espacial de puntos calientes. Adicionalmente, se identificó las características del paisaje asociadas al atropellamiento y se evaluó el papel de las vías como factor de resistencia y permeabilidad. Resultados: Se encontraron 279 animales atropellados de 64 especies que representan el 28 % de las 273 especies vertebradas presentes en las áreas protegidas en inmediaciones de las carreteras estudiadas. Se estimó una tasa promedio entre 42 y 170 individuos atropellados por año. Se detectaron patrones diferenciales en la densidad de atropellamiento por grupos taxonómicos y funcionales, donde las especies nocturnas y el tipo de gremio trófico son los más vulnerables. Asimismo, se encontró que los tramos de las vías en cercanía a coberturas boscosas presentan mayor riqueza de especies atropelladas y con mayores requerimientos ecológicos. Estos tramos representan una resistencia importante al movimiento de las especies de la zona. Conclusiones: El atropellamiento presenta patrones espaciales heterogéneos, no solo a nivel taxonómico, sino también a nivel funcional, lo cual representa un deterioro para los ecosistemas protegidos en zonas periurbanas.
Abstract Introduction: Urban development and expansion have led to the loss and transformation of Andean ecosystems. However, remnant forests that maintain biodiversity still exist around Colombia's major cities, but these forests are threatened by the road infrastructure. Road ecology in the Neotropics has been focused specifically in documenting the effects of roadkill from a taxonomic point of view, mainly in rural areas. Objective: To evaluate ecologically and spatially, the collision of fauna on roads located in areas of urban expansion in the Northern Colombian Andes. Methods: We assessed vertebrate mortality rate and identified the critical areas of roadkill by taxonomic and functional groups. This was achieved through spatial ecology analysis, specifically Kernel density analysis and hotspot spatial statistical analysis. Additionally, we identified landscape features associated with road mortality and assessed the role of roads as resistance and permeability factors. Results: A total of 279 roadkilled animals belonging to 64 species were found, accounting for 28 % of the 273 vertebrate species recorded in the reserve near the studied roads. The average mortality rate for vertebrates was estimated from 42 to 170 individuals annually. Differential patterns were detected in roadkill density across taxonomic and functional groups, where nocturnal species and the trophic guilds are the most vulnerable. Likewise, it was found that the sections of the roads close to the forest have a greater roadkill species richness with greater ecological requirements. These sections constitute an important resistance to species movement in the area. Conclusions: Road mortality in the study area exhibits heterogeneous spatial patterns not only at a taxonomic but also at a functional level, suggesting the deterioration of protected ecosystems in adjacent peri-urban areas.
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Animales , Vertebrados , Mamíferos/clasificación , Mortalidad , Colombia , Ecosistema Andino , Áreas ProtegidasRESUMEN
Coletânea de boletins dos Núcleos de epidemiologia das unidades de saúde do estado de Goiás que notificam os casos suspeitos ou confirmados de óbitos e realizam a análise e interpretação desses dados para que sejam transformados em informação para a comunicação aos demais níveis de vigilância epidemiológica para subsidiar a tomada de decisão dos gestores de saúde. Trata-se de um estudo descritivo, realizado com dados secundários com informações provenientes das declarações de óbitos e prontuário eletrônico do paciente via Sistema de Prontuário Eletrônico do Paciente MVPEP
Collection of bulletins from the Epidemiology Centers of the health units of the state of Goiás that report suspected or confirmed cases of death and perform the analysis and interpretation of this data so that it can be transformed into information for communication to other levels of epidemiological surveillance to support the decision-making of health managers. This is a descriptive study, carried out with secondary data with information from death certificates and electronic patient records via the Electronic Patient Record System MVPEP
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Humanos , Epidemiología , Donantes de Sangre/estadística & datos numéricos , Mortalidad , Accidentes de Trabajo/estadística & datos numéricos , Síndrome Respiratorio Agudo Grave/epidemiología , Dengue/epidemiología , Publicaciones Electrónicas , Hepatitis Viral Humana/epidemiologíaRESUMEN
[RESUMEN]. Objetivo. Evaluar las diferencias en la letalidad del dengue entre las distintas subregiones de las Américas en el período 2014-2023 y explorar su relación con el índice de desarrollo humano (IDH) de cada región. Método. Estudio ecológico longitudinal realizado a partir de datos de acceso libre de cada país, que se agruparon en las subregiones correspondientes para calcular los distintos indicadores. Además, se realizó una regresión lineal entre la letalidad media en cada región y el IDH regional ponderado. Resultados. Existen grandes diferencias en la letalidad por dengue según la subregión y una variabilidad considerable según el año. Estas diferencias de letalidad no están directamente correlacionadas con la incidencia registrada en cada región. El IDH regional muestra una estrecha relación con la letalidad: un mayor IDH se asocia generalmente a una menor letalidad. Conclusiones. Las diferencias subregionales de letalidad y su relación con el nivel de desarrollo señalan que la estrategia de control del dengue debe ser diseñada desde una perspectiva amplia y multifactorial.
[ABSTRACT]. Objective. Evaluate the differences in the dengue case fatality rate among the different subregions of the Americas in the period 2014-2023 and explore their relationship with the human development index (HDI) in each subregion. Methods. Longitudinal ecological study based on open-access data from each country, grouped into the corresponding subregions to calculate the different indicators. In addition, a linear regression was performed between the mean case fatality rate in each region and the weighted regional HDI. Results. There are large differences in dengue lethality by subregion and considerable variability by year. These differences in lethality are not directly correlated with the incidence recorded in each region. The regional HDI shows a close relationship with lethality: a higher HDI is generally associated with a lower case fatality rate. Conclusions. The observed differences in lethality and their relationship with subregional development levels indicate that a broad and multifactorial perspective should be taken when designing a dengue control strategy.
[RESUMO]. Objetivo. Avaliar as diferenças na letalidade da dengue entre as diversas sub-regiões da Região das Américas no período de 2014 a 2023 e explorar sua relação com o índice de desenvolvimento humano (IDH) de cada sub-região. Método. Estudo ecológico longitudinal baseado em dados de acesso aberto de cada país. Os dados foram agrupados pelas sub-regiões correspondentes para calcular diversos indicadores. Além disso, foi feita uma regressão linear entre a letalidade média em cada sub-região e o IDH sub-regional ponderado. Resultados. Há grandes diferenças na letalidade da dengue entre sub-regiões, com uma variabilidade considerável conforme o ano. Essas diferenças na letalidade não estão correlacionadas diretamente à incidência registrada em cada sub-região. O IDH sub-regional teve uma relação estreita com a letalidade: um IDH mais alto geralmente está associado a uma letalidade menor. Conclusões. As diferenças sub-regionais na letalidade e sua relação com o nível de desenvolvimento indicam que a estratégia de controle da dengue deve ser elaborada a partir de uma perspectiva abrangente e multifatorial.
Asunto(s)
Dengue , Mortalidad , Desarrollo Humano , Inequidades en Salud , Américas , Mortalidad , Desarrollo Humano , Inequidades en Salud , Américas , Mortalidad , Desarrollo Humano , Inequidades en SaludRESUMEN
BACKGROUND: Human immunodeficiency virus (HIV) infection is a health problem in Brazil and worldwide. Without treatment, the infection can progress to Acquired Immunodeficiency Syndrome (AIDS), with a high mortality potential. The objective of this study was to analyze the time trend of AIDS mortality in Brazil, macro-regions, federal units and their respective capitals, from 2012 to 2022. METHODS: This is a time-series study of all AIDS deaths in Brazil from 2012 to 2022. The study included the annual number of deaths and the crude and standardized mortality rates. The Joinpoint regression model was used for the time analysis of the standardized rates. Annual percentage change (APC) and average annual percentage change (AAPC) were calculated. A 95% confidence interval (CI) and a 5% significance level were used. RESULTS: During the period analyzed, 128,678 AIDS deaths were recorded in Brazil, with a crude mortality rate of 6.3/100,000 and a standardized mortality rate of 5.3/100,000. From 2012 to 2020, three regions showed a declining trend in AIDS mortality: Central-West (AAPC - 2.3%; 95%CI -4.3 to -0.21; p = 0.03), Southeast (AAPC - 5.6%; 95%CI -6.8 to -4.0; p < 0.001), and South (AAPC - 4.4%; 95%CI -5.27 to -3.6; p < 0.001). There was also a downward trend in 10 states and 10 capitals. There was an increase in the number of deaths from 2020 onwards in the North, Northeast and Southeast regions compared to 2019. CONCLUSION: There was a downward trend in AIDS mortality from 2012 to 2020 and an upward trend from 2020 to 2022. The regional differences observed could reflect the social disparities that exist in Brazil. In addition, the Covid-19 pandemic has had an impact on the process of dealing with HIV in Brazil.
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Síndrome de Inmunodeficiencia Adquirida , Brasil/epidemiología , Humanos , Síndrome de Inmunodeficiencia Adquirida/mortalidad , Síndrome de Inmunodeficiencia Adquirida/epidemiología , Masculino , Femenino , Mortalidad/tendencias , Adulto , Infecciones por VIH/mortalidad , Infecciones por VIH/epidemiología , Persona de Mediana EdadRESUMEN
Background: About 39 million people are living with HIV worldwide, 62% of people living with HIV receive antiretroviral therapy. The combination of ART has allowed suppression of viral replication and disease progression, decreasing mortality. Objective: To analyze HIV trends in Mexico during the period 2000-2022. Material and methods: An ecological study of deaths due to HIV during the period 2000 to 2022 was carried out. Mortality rates were adjusted by the direct method and joinpoint regression was used to analyze trends and estimate the annual percentage change. Results: The national HIV mortality rate was 0.05 per 100,000 population while in 2022 it decreased to 0.04 per 100,000 population. Trend analysis identified two points of change, with a significant reduction in mortality rates at the national level in the period 2007-2022 and a subsequent decrease in mortality. At the state level, there were variations in trends with some states showing significant increases at the end of the study period, such as Jalisco, Campeche, and Quintana Roo. Changes by sex were heterogeneous. Conclusions: Reductions in HIV mortality rates are limited to some states of the country, so it is necessary to implement health strategies according to social, economic, and cultural characteristics and with a gender perspective.
Introducción: alrededor de 39 millones de personas viven con VIH a nivel mundial, el 62% de las personas que viven con VIH reciben terapia antirretroviral (TAR). La combinación de TAR ha permitido suprimir la replicación viral y progresión de la enfermedad, disminuyendo la mortalidad por VIH. Objetivo: analizar las tendencias de VIH en México durante el período 2000-2022. Material y métodos: se realizó un estudio ecológico de las defunciones por VIH ocurridas en el periodo 2000 a 2022. Se realizó el ajuste de tasas de mortalidad por el método directo y se utilizó la regresión de joinpoint para analizar las tendencias y estimar el cambio porcentual anual. Resultados: la tasa de mortalidad nacional por VIH fue de 0.05 por 100,000 habitantes, mientras que en 2022 se redujo a 0.04 por 100,000 habitantes. El análisis de tendencias permitió identificar dos puntos de cambio con una reducción significativa en las tasas de mortalidad a nivel nacional en el periodo 2007-2022, para posteriormente presentar un descenso en la mortalidad. A nivel estatal, se presentaron variaciones en las tendencias en algunos estados que mostraron incrementos significativos al final del periodo de estudio (Jalisco, Campeche y Quintana Roo). Los cambios por sexo fueron heterogéneos. Conclusiones: las reducciones en las tasas de mortalidad por VIH se limitan a algunas entidades del país, por lo que es necesario implementar estrategias de salud acordes a las características sociales, económicas, culturales y con perspectiva de género.
Asunto(s)
Infecciones por VIH , Humanos , México/epidemiología , Femenino , Masculino , Infecciones por VIH/mortalidad , Infecciones por VIH/tratamiento farmacológico , Mortalidad/tendencias , Adulto , Persona de Mediana EdadRESUMEN
This paper analyzed the scientific production on natural mortality (M) in fish, in order to understand the existing methods and identify the most commonly used ones. Research was carried out in the Web of Science database (WoS), using bibliometric and systematic analysis methods to evaluate scientific production using the following indicators: relevance of scientific journals, scientific recognition of papers, relevance of authors and co-occurrence of keywords. The bibliographic portfolio was composed of the hundred most cited papers of the WoS. The most relevant papers are reviews on the topic studied, which justifies the number of citations. The most cited researchers were the authors of the main estimators of M. The keywords of greatest occurrence were: natural mortality, growth and age. Of the total papers, only 19 estimated M for 28 species. Of these papers, 58% studied population dynamics and 42% made assessments of fish stocks. The most commonly used estimators were Hoenig (1983) and Pauly (1980b). Given the results obtained, it is important to develop more sophisticated methods, taking into account new approaches, such as temperature variation within this estimator, which was not observed in any of the methods.
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Bibliometría , Peces , Animales , Peces/clasificación , Dinámica Poblacional , MortalidadRESUMEN
Insufficient quality of the underlying cause of death in the Brazilian Mortality Information System (SIM), acronym in Portuguese underlists violence and it is necessary to redistribute garbage causes (GC) into valid causes in public health prevention. This study estimated mortality from external causes using the GC redistribution method (GBD-Brazil) and compared it with SIM and estimated data from the GBD-IHME study from 2010 to 2019 in Brazil and its states. The GBD-Brazil GC redistribution algorithm applies previous steps of the GBD-IHME with modifications, using two criteria: proportion of target causes (valid) or reclassification of investigated causes. The SIM data were not adjusted. Standardized rates by direct method, local regression in the time series, and the ratio of the GBD-Brazil and SIM rates are used as correction factors for traffic injuries, falls, suicides, and homicides. Brazil recorded 1.34 million deaths with valid external causes and 171,700 CG in ten years. The redistribution of GC from GBD-Brazil increased valid causes by 12.2%, and the trend curve of the rates was similar to that found with SIM data, but diverged from each other and from the GBD-IHME in states in the North and Northeast regions. The GBD-Brazil estimates changed the pattern of external causes in the states, applying greater corrections to falls in the states of the North and Northeast and homicides in the other states. The GBD-Brazil method can be used in the analysis of violent deaths because it seeks greater methodological simplicity, which guarantees both replication by public managers and consistency of the estimated data, considering the local composition of the data in the redistribution process.
A qualidade insuficiente da causa básica de óbito no Sistema de Informações sobre Mortalidade (SIM) subenumera as violências, e se faz necessária a redistribuição das causas garbage (CG) em causas válidas na prevenção em saúde pública. Este estudo estimou a mortalidade de causas externas usando método de redistribuição de CG (GBD-Brasil), e comparou com dados do SIM e estimados do estudo GBD-IHME de 2010 a 2019 no Brasil e Unidades Federativas (UF). O algoritmo de redistribuição das CG do GBD-Brasil aplica etapas prévias do GBD-IHME com modificações, usando dois critérios: proporção das causas-alvo (válidas) ou reclassificação de causas investigadas. Os dados do SIM estão sem correção. Utiliza-se taxas padronizadas por método direto, regressão local na série temporal e razão das taxas GBD-Brasil e SIM como fator de correção para lesões de trânsito, quedas, suicídios e homicídios. O Brasil registrou 1,34 milhão de óbitos com causas externas válidas e 171.700 CG em 10 anos. A redistribuição de CG do GBD-Brasil aumentou em 12,2% as causas válidas, e a curva de tendência das taxas foi semelhante à encontrada com dados do SIM, mas divergem entre si e com o GBD-IHME em UFs do Norte e do Nordeste. As estimativas do GBD-Brasil mudaram o padrão das causas externas nas UFs, aplicando maiores correções em quedas nas UFs do Norte e do Nordeste e homicídios nas demais UFs. O método GBD-Brasil pode ser utilizado na análise de mortes violentas por buscar maior simplicidade metodológica, que garante tanto replicação por gestores públicos como consistência do dado estimado, considerando a composição local do dado no processo de redistribuição.
La calidad insuficiente de la causa de muerte en el Sistema de Información de Mortalidad brasileño (SIM) subestima la violencia, por lo cual es necesario redistribuir las causas garbage (CG) en causas válidas en la prevención de la salud pública. Este estudio estimó la mortalidad por causas externas por el método de redistribución de CG (GBD-Brasil) y la comparó con los datos de SIM y con los datos estimados del estudio GBD-IHME de 2010 a 2019 por el país (Brasil) y sus estados. El algoritmo de redistribución de CG del GBD-Brasil aplica los pasos anteriores de GBD-IHME con modificaciones, utilizando dos criterios: proporción de causas objetivo (válidas) o reclasificación de las causas investigadas. Los datos del SIM no están corregidos. Las tasas estandarizadas se utilizan método directo, regresión local en las series de tiempo y relación de tasas GBD-Brasil y SIM como factor de corrección para lesiones de tráfico, caídas, suicidios y homicidios. Brasil registró 1,34 millones de muertes por causas externas válidas y 171.700 CG en diez años. La redistribución de CG de GBD-Brasil aumentó las causas válidas en un 12,2%, y la curva de tendencia de las tasas fue similar a la encontrada con los datos SIM, pero divergieron entre sí y con el GBD-IHME en los estados del Norte y Nordeste. Las estimaciones del GBD-Brasil cambiaron el patrón de causas externas en los estados mediante la aplicación de mayores correcciones a las caídas en los estados del Norte y Nordeste y a los homicidios en los otros estados. El método GBD-Brasil se puede utilizar en el análisis de muertes violentas porque es una metodología más simple, lo que garantiza tanto la replicación por parte de los gestores públicos como la consistencia de los datos estimados, teniendo en cuenta la composición local de los datos en el proceso de redistribución.
Asunto(s)
Causas de Muerte , Brasil/epidemiología , Humanos , Femenino , Masculino , Adulto , Persona de Mediana Edad , Adolescente , Niño , Adulto Joven , Preescolar , Lactante , Anciano , Sistemas de Información , Mortalidad/tendencias , Suicidio/estadística & datos numéricos , Homicidio/estadística & datos numéricos , Algoritmos , Recién NacidoRESUMEN
Hypertrophic cardiomyopathy (HCM) is a relatively prevalent disease, primarily of a genetic etiology, affecting both sexes and characterized by left ventricular hypertrophy. However, limitations within healthcare systems, socioracial factors, and the issue of underdiagnosis hinder accurate mortality assessments in our region. This study, therefore, aimed to assess the mortality trends associated with HCM in Brazil from 2010 to 2020, with a focus on socioracial factors and healthcare disparities. This ecological, time-series study employed a quantitative approach based on secondary data from the Mortality System (SIM) developed by the Brazilian Ministry of Health. Mortality incidence and trend analyses were conducted using the average annual percent change (AAPC) and the annual percent change (APC). The results indicated a predominance of HCM-related deaths among white males aged 40 years and older. Additionally, an increasing trend in HCM-related mortality was observed among white and brown males and females aged 40 years and above from 2010 to 2018. Throughout the entire period covered in the study, the incidence of deaths due to HCM increased by 18.3% and 69.8% in the northeastern and southeastern regions. The findings suggest that health system managers should consider addressing the factors influencing HCM mortality and encourage the development and implementation of clinical protocols across healthcare institutions nationwide. Such protocols are recommended to facilitate early diagnosis and establish effective treatment strategies, ultimately aiming to improve the survival rates and quality of life for individuals affected by HCM.
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Cardiomiopatía Hipertrófica , Humanos , Brasil/epidemiología , Masculino , Cardiomiopatía Hipertrófica/mortalidad , Cardiomiopatía Hipertrófica/epidemiología , Femenino , Adulto , Persona de Mediana Edad , Anciano , Adulto Joven , Incidencia , Adolescente , Niño , Preescolar , Mortalidad/tendenciasRESUMEN
O câncer de boca é o sexto câncer mais comum em todo o mundo e representa um problema global crescente. Apesar disso, 70% desses cânceres são diagnosticados em estágios avançados, reforçando a importância de estratégias para prevenção e detecção precoce do câncer. Este trabalho tem como objetivo investigar a aplicabilidade de estratégias para detecção precoce do câncer de boca. Como existem diversas revisões sistemáticas já publicadas sobre o tema, a proposta é realizar uma revisão guarda-chuva das revisões sistemáticas. As buscas realizadas nas bases de dados resultaram em 2145 artigos, e outras fontes de informações acrescentaram mais 114 artigos. Após a detecção de artigos duplicados eletrônica e manualmente, em conjunto com a primeira fase da revisão, 83 artigos foram selecionados para a segunda fase da revisão. Por fim, 46 revisões sistemáticas foram incluídas neste estudo, tendo 9 artigos sido considerados confiáveis para sumarização da evidência atual. Artigos cuja estratégia foi de exame clínico convencional realizado por profissionais treinados e estudos em que houve um maior acesso dos indivíduos à saúde bucal, apresentaram um resultado mais preciso, confiável e custo-efetivo na avaliação dos grupos de indivíduos de alto risco. Em geral, os métodos auxiliares que apresentaram resultados promissores foram aqueles à base de autofluorescência e citopatologia. As estratégias de rastreamento não devem ser descartadas, uma vez que ainda há uma carência de estudos de alta qualidade nesse tema.
Asunto(s)
Neoplasias de la Boca , Tamizaje Masivo , Morbilidad , Mortalidad , Diagnóstico Precoz , DiagnósticoRESUMEN
La sepsis neonatal temprana es un desafío de salud pública en Ecuador, con altas tasas de morbilidad-mortalidad. El diagnóstico precoz es crucial, pero los métodos actuales tienen limita-ciones. El índice neutrófilo linfocito se presenta como un biomarcador prometedor para detec-ción y manejo de la sepsis neonatal temprana. Este estudio busca establecer su punto de corte y evaluar su eficacia en el Hospital de Especialidades Carlos Andrade Marín. MATERIALES Y MÉTODOS: Se realizó un estudio retrospectivo y descriptivo en este hospital, recopilando datos clínicos neonatales de enero de 2017 a diciembre de 2021. Se incluyeron expedientes de pacientes con sospecha de sepsis neonatal temprana nacidos desde la semana 26, excluyendo historias clínicas incompletas o con sepsis tardía. Se analizaron variables como edad, sexo y biomarcadores, utilizando el software SPSS versión 27. El estudio fue aprobado por el Comité de Ética de Investigación en Seres Humanos del Hospital de Especialidades Carlos Andrade Marín. RESULTADOS: Se analizaron 102 expedientes de recién nacidos con sepsis neonatal en 5 años. La mayoría eran neonatos muy prematuros y nacidos por cesárea. Con punto de cor-te de 0.86 para el índice neutrófilo linfocito, con una sensibilidad del 98.1% y especificidad del 85.4%. DISCUSIÓN: No se encontró una relación significativa entre el sexo y la sepsis. Aunque el índice neutrófilo linfocito mostró alta sensibilidad y especificidad, su baja área bajo la curva indica que no es un marcador fiable para diagnosticar de sepsis neonatal. CONCLUSIÓN: Se requieren estudios adicionales con muestras más grandes y otros marcadores biológicos para mejorar la capacidad diagnóstica de la sepsis neonatal.
Early neonatal sepsis is a public health challenge in Ecuador, with high morbidity and mortality rates. Early diagnosis is crucial, but current methods have limitations. The neutrophil-lympho-cyte ratio, emerges as a promising biomarker for the detection and management of early neo-natal sepsis. This study aims to establish its cutoff point and evaluate its efficacy at the Carlos Andrade Marín Specialty Hospital. MATERIALS AND METHODS: A retrospective and descrip-tive study was conducted at this hospital, collecting neonatal clinical data from January 2017 to December 2021. Records of patients with suspected early neonatal sepsis born from week 26 were included, excluding incomplete medical records or those with late-onset sepsis. Variables such as age, sex, and biomarkers were analyzed using SPSS version 27 software. The study was approved by the hospital's ethics committee. RESULTS: A total of 102 medical records of newborns with neonatal sepsis over 5 years were analyzed. Most were very premature and born by cesarean section. A cutoff point of 0.86 for the neutrophil-lymphocyte ratio was determined, with a sensitivity of 98.1% and a specificity of 85.4%. DISCUSSION: No significant relationship was found between sex and sepsis. Although the neutrophil-lymphocyte ratio showed high sen-sitivity and specificity, its low area under the curve indicates that it is not a reliable marker for diagnosing neonatal sepsis. CONCLUSION: Additional studies with larger samples and other biological markers are needed to improve the diagnostic capacity for neonatal sepsis.
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Humanos , Masculino , Femenino , Recién Nacido , Recién Nacido , Biomarcadores , Biomarcadores/análisis , Sensibilidad y Especificidad , Sepsis Neonatal/diagnóstico , Cultivo de Sangre , Morbilidad , Mortalidad , Ecuador , Mortalidad Neonatal Precoz , NeutrófilosRESUMEN
OBJECTIVE: This descriptive study aimed to measure the excess all-cause mortality potential years of working life lost (PYWLL) in the working-age population of six Ibero-American countries in 2020 and 2021. METHODS: This study was based on all-cause deaths for the age group 15-69 years for men and women in six countries: Colombia, Costa Rica, México, Peru, Portugal and Spain. The expected PYWLL was the average value determined from the previous 5 years (2015-2019). To estimate the excess of PYWLL, the expected PYWLL was subtracted from the observed PYWLL values for 2020 and 2021, separately. RESULTS: In the four Latin American countries, the excess PYWLL per death was approximately double (between 12 and 16 years) that of the two European countries (between 3 and 9 years). CONCLUSIONS: The loss of working-age individuals will probably have a profound social and economic recovery impact, affecting families and communities. The informal employment and labour market structures may be contributing to the adverse effects of the pandemic in the region. Investing in universal, comprehensive and sustainable health and social protection systems in the Latin American countries is crucial to build resilience against current and future crises.
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Empleo , Humanos , Persona de Mediana Edad , Masculino , Adulto , Femenino , Adolescente , Anciano , Adulto Joven , América Latina/epidemiología , Europa (Continente)/epidemiología , Empleo/estadística & datos numéricos , Esperanza de Vida/tendencias , COVID-19/epidemiología , COVID-19/mortalidad , Portugal/epidemiología , Mortalidad/tendencias , España/epidemiología , Causas de Muerte/tendencias , Perú/epidemiologíaRESUMEN
OBJECTIVES: In Northeast Brazil, the poorest region of the country, indigenous communities face critical health care challenges. Despite legal entitlements to the Unified Health System (SUS), systemic barriers persist, exacerbating health disparities and mortality. This ecological study analyzed mortality trends and causes of death within the Special Indigenous Sanitary District (DSEI) Alagoas-Sergipe over a decade. METHODS: Data on deaths from 2012 to 2022 were obtained from the Indigenous Health Secretariat. Causes of death were classified into 13 categories. Mortality rates per 1,000 indigenous inhabitants were calculated, and trends were analyzed using the Mann-Kendall test. The study also compared causes of death by age group. RESULTS: Mortality rates ranged from 3.3 to 5.2 per 1,000, showing a moderate upward trend over time (τ = 0.5, p = 0.042). Predominant causes included heart and vascular disorders (24.3%), external causes (12.4%), respiratory issues (11.1%), and infections (10.9%). About one-third of pediatric deaths were associated with general neonatal complications. CONCLUSIONS: This study highlights increasing mortality in indigenous communities in Northeast Brazil. The predominant causes of death reflect broader public health concerns. These trends emphasize the urgency for more effective, culturally sensitive public health policies and improved health care access.
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Causas de Muerte , Pueblos Indígenas , Mortalidad , Adolescente , Adulto , Anciano , Niño , Preescolar , Femenino , Humanos , Lactante , Recién Nacido , Masculino , Persona de Mediana Edad , Brasil/epidemiología , Causas de Muerte/tendencias , Mortalidad/tendencias , Mortalidad/etnologíaRESUMEN
BACKGROUND: Chagas disease is a silent illness with high mortality burden in many Latin American countries, such as Brazil. Bahia has the fourth highest mortality rate in Brazil. This study analyzed the temporal trends and regional differences in the mortality rate of Chagas disease in Bahia State from 2008 to 2018. METHODS: A time-series analysis of Chagas disease-related deaths was conducted using data from the Mortality Information System of Brazil. We compared the mortality rate due to Chagas disease as the primary cause and mention of the disease in the death certificate, standardized by age and health macroregion/residence municipality, and mapped hot and coldspots. RESULTS: The Chagas Disease Mortality Rate in Bahia during the study period revealed a stationary trend, ranging from 5.34 (2008) to 5.33 (2018) deaths per 100,000 inhabitants. However, the four health macroregions showed an upward trend in mortality rates. The mortality rate (age-adjusted) ranged from 4.3 to 5.1 deaths per 100,000 inhabitants between 2008 and 2018. We observed a upward trend in the mortality rate among individuals aged ≥70 years and a higher incidence of death among men than among women. Of the total number of deaths (8,834), 79.3% had Chagas disease as the primary cause and the death certificates of 20.7% mentioned the disease. Cardiac complications were reported in 85.1% of the deaths due to Chagas disease. CONCLUSIONS: The regional and individual differences in the mortality rate of Chagas disease highlighted in this study may support health planning that considers the peculiarities of the territory.