Awareness of the diagnosis, treatment, and control of diabetes mellitus in Brazil.

OBJECTIVE: To estimate the proportions of awareness, treatment, and control of diabetes mellitus (DM) in the Brazilian adult population. METHOD: This is a cross-sectional study, with data from a representative sample of the Brazilian population, taken from the National Health Survey(PNS 2014/2015). Outcomes were defined based on glycated hemoglobin (HbA1c) measurements, self-reported DM diagnosis, and use of hypoglycemic agents or insulin. The proportion of DM awareness, treatment, and control was estimated according to sociodemographic characteristics, health conditions, and access to health services, and their respective 95% confidence intervals. RESULTS: DM prevalence in the Brazilian population was of 8.6% (95%CI: 7.8-9.3): 68.2% (95%CI: 63.9-72.3) were aware of their diagnosis, 92.2% (95%CI: 88.6-94.7) of those who were aware were undergoing drug treatments, and, of these, 35.8% (95%CI: 30.5-41.6) had controlled HbA1c levels. The proportions of DM awareness, control, and treatment were lower in men aged 18 to 39 years, individuals with low education, without health insurance, and beneficiaries of the Bolsa Família program. CONCLUSION: Approximately one in ten Brazilians has DM. A little more than half of this population is aware of their diagnosis, a condition measured by HbA1c dosage and clinical diagnosis. Among those who know, the vast majority are undergoing drug treatments. However, less than half of these have their HbA1c levels controlled. Worse scenarios were found in subgroups with high social vulnerability.

Investigation of cancer incidence in ELSA-Brasil.

Low- and middle-income countries have high cancer-related mortality rates, and Brazil has one of the highest incidences of all cancers in South America. Since 2008, the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil) follows up 15,105 civil adult servants of college education and research institutions in six Brazilian capitals, collecting relevant information on risk factors for the incidence of cancer and other noncommunicable diseases. This study aimed to describe the methodology for surveillance and investigation of the incidence of primary cancers in ELSA-Brasil. The surveillance and investigation involve annual telephone interviews, data collection of medical registries (biopsy records, chemotherapy/radiotherapy reports, hospital records or death certificates/autopsy statements), eligibility and final classification, date and basis of diagnosis, tumor topography and histological type. The cumulative incidence of all types of cancer in ELSA-Brasil during the first five years of follow-up (2009-2013) was 2.27 %. The challenges encountered in the investigation process are related to the lack of data on the occurrence of distant metastasis and essential details regarding diagnoses. However, the quality control and the adequacy of the methods adopted enables the construction of a solid and pioneering database in the country, which will contribute to advance in research on the natural history of the most frequent types of cancer.

Influence of the COVID-19 pandemic on labor and childbirth care practices in Brazil: a cross-sectional study.

BACKGROUND: It has been hypothesized that the coronavirus disease 2019 (COVID-19) pandemic may have changed the conduct of obstetric practices at the time of labor, delivery, and birth. In Brazil, many practices lacking scientific evidence are implemented in this care, which is charcaterized by excessive use of unnecessary interventions. This scenario may have been worsened by the pandemic. Thus, we analyzed the effects of the pandemic on care during prenatal care and delivery by comparing the results of two surveys (one was administered before the pandemic and the other during the pandemic) in public hospitals in Belo Horizonte - Minas Gerais (MG), Brazil. METHODS: This cross-sectional and comparative study analyzed preliminary data from the study "Childbirth and breastfeeding in children of mothers infected with SARS-CoV-2", which was conducted in three referral maternity hospitals in Belo Horizonte - MG during the pandemic in the first half of 2020 in Brazil. The final sample consisted of 1532 eligible women. These results were compared with data from 390 puerperae who gave birth in the three public hospitals in the study "Birth in Belo Horizonte: labor and birth survey", conducted before the pandemic to investigate the changes in practices of labor and delivery care for the mother and her newborn, with or without COVID-19 infection, before and during the pandemic. In this research, "Birth in Belo Horizonte: labor and birth survey", data collection was performed between November 2011 and March 2013 by previously trained nurses. Between study comparisons were performed using Pearson's chi-square test, with a confidence level of 95%, and using Stata statistical program. RESULTS: We found a significant increase in practices recommended by the World Health Organization during the pandemic including the following: diet offering (48.90 to 98.65%), non-pharmacological pain relief (43.84 to 67.57%), and breastfeeding in the newborn´s first hour of life (60.31 to 77.98%) (p < 0.001). We found a significant reduction of non-recommended interventions, such as routine use of episiotomy (15.73 to 2.09%), the Kristeller maneuver (16.55 to 0.94%), oxytocin infusion misused (45.55 to 28.07%), amniotomy (30.81 to 15.08%), and lithotomy position during labor (71.23 to 6.54%) (p < 0.001). CONCLUSION: Our study revealed a statistically significant increase in the proportion of use of recommended practices and a reduction in non-recommended practices during labor and delivery. However, despite advances in the establishment of World Health Organization recommended practices in labor, delivery, and birth, the predominance of interventionist and medicalized practices persists, which is worsened by events, such as the pandemic.

Arterial hypertension and associated factors: National Health Survey, 2019.

OBJECTIVE: To analyze the factors associated with self-reported arterial hypertension, as well as its prevalence in the Brazilian adult population. METHODS: Data from 88,531 individuals aged 18 years or older who responded to the 2019 National Health Survey were analyzed. The outcome studied was self-reported arterial hypertension. Sociodemographic variables and clinical and lifestyle conditions were considered as exposures. The prevalence ratio (PR), crude and adjusted for sex, age, and schooling was used as a measure of association to verify the factors related to its prevalence, obtained by Poisson regression with robust variance. RESULTS: The prevalence of self-reported arterial hypertension was of 23.9% (95%CI: 23.4-24.4). When adjusting for age, sex, and schooling, the adjusted Prevalence Ratios (APR) were higher among: regular health self-assessment (APR = 1.6; 95%CI: 1.5-1.6) and bad health self-assessment (APR = 1.7; 95%CI: 1.6-1.8); self-reference to heart disease (APR = 1.7; 95%CI: 1.6-1.7), diabetes (APR = 1.7; 95%CI: 1.6-1.8), high cholesterol (APR = 1.6; 95%CI: 1.6-1.7), overweight (APR = 1.4; 95%CI: 1.4-1.5), and obesity (APR = 2.0; 95%CI: 1.9-2.1); high salt intake (APR = 1.1; 95%CI: 1.0-1.1); higher among former smokers (APR = 1.1; 95%CI: 1.1-1.2) and lower among smokers (APR = 0.9; 95%CI: 0.8-0.9); and consumption of ultra-processed foods (APR = 0.9; 95%CI: 0.8-0.9). CONCLUSION: A quarter of the Brazilian adult population claims to have arterial hypertension, more prevalent among women and associated with older age groups, Black, mixed-race, and others, low schooling, high salt intake, former smoking, presence of comorbidities, and worse health self-assessment.

Tradução, adaptação cultural e validação do Instrumento de Autoavaliação em Diabetes / Translation, cultural adaptation and validation of the diabetes self-report tool / Traducción, adaptación cultural y validación de la herramienta de autoevaluación de la diabetes

Objetivo: realizar tradução, adaptação cultural e validação do Instrumento de Autoavaliação em Diabetes para aplicação no contexto brasileiro. Métodos: estudo metodológico realizado com 132 profissionais, entre os anos de 2016 e 2018, em seis etapas: 1 - Tradução inicial; 2 - Síntese da tradução; 3 - Retrotradução (back translation); 4 - Avaliação pelo comitê de juízes; 5 - Adequação cultural (pré teste); e 6 - Reprodutibilidade. Houve participação de profissionais de equipes multiprofissionais envolvidas no tratamento do diabetes por meio da plataforma e-surv. Resultados: entre os participantes, predominaram o sexo feminino (73,5%), profissionais com especialização (pós-graduação Lato Sensu) (51,5%) e com experiência na assistência a pessoas com diabetes (84,4%). O Índice de Validade de Conteúdo (IVC) foi satisfatório (0,850). O instrumento apresentou boa consistência interna (Alfa de Cronbach = 0,878). A análise de confiabilidade do instrumento, realizada pelo cálculo do coeficiente de correlação intraclasse (CCI), indicou concordância adequada em todas as medidas, 0,878 (IC 95%: 0,864 - 0,891), com Kappa Ponderado médio de 0,714 e índices acima de 0,60 em 85% os itens, mostrando boa concordância teste e reteste. Conclusão: a versão traduzida e culturalmente adaptada do Instrumento d e Autoavaliação em Diabetes apresentou boa confiabilidade, aceitabilidade e estabilidade temporal satisfatórias conforme os parâmetros internacionais, podendo ser utilizada, pelos profissionais da saúde, para autoavaliação em diabetes.(AU)

Objective: to carry out translation, cultural adaptation, and validation of the Diabetes Self-Report Instrument for application in the Brazilian context. Methods: methodological study carried out with 132 professionals, between 2016 and 2018, in six steps: 1 - Initial translation; 2 - Synthesis of the translation; 3 - Back translation; 4 - Evaluation by the judging committee; 5 - Cultural adequacy (pre-test); and 6 - Reability. There was participation of professionals from multidisciplinary teams involved in the treatment of diabetes through the e-surv platform. Results: among the participants, there was a predominance of females (73.5%), professionals with specialization (Lato sensu postgraduate degree) (51.5%) and with experience in caring for people with diabetes (84.4%). The Content Validity Index (CVI) was satisfactory (0.850). The instrument showed good internal consistency (Cronbach's alpha=0.878). The instrument's reliability analysis, carried out by calculating the intraclass correlation coefficient (ICC), indicated adequate agreement in all measurements, 0.878 (95% CI: 0.864 - 0.891), with mean weighted Kappa of 0.714 and indices above 0. 60 out of 85% of the items, showing good test-retest agreement. Conclusion: the translated and culturally adapted version of the Diabetes Self-report Instrument showed good reliability, acceptability, and satisfactory temporal stability according to international parameters, and can be used by healthcare professionals for self-report of diabetes.(AU)

Objetivo: realizar la traducción, adaptación cultural y validación de la Herramienta de Autoevaluación de Diabetes para aplicación en el contexto brasileño. Métodos: estudio metodológico realizado con 132 profesionales, entre 2016 y 2018, en seis etapas: 1 ­ Traducción inicial; 2 ­ Síntesis de la traducción; 3 ­ Traducción inversa; 4 ­ Evaluación por el comité de jueces; 5 ­ Adecuación cultural (pre-test); y 6 ­ Reproducibilidad. Se contó con la participación de profesionales de equipos multidisciplinarios...(AU)

Awareness of the diagnosis, treatment, and control of diabetes mellitus in Brazil / Conhecimento do diagnóstico, tratamento e controle do diabetes mellitus no Brasil

ABSTRACT OBJECTIVE To estimate the proportions of awareness, treatment, and control of diabetes mellitus (DM) in the Brazilian adult population. METHOD This is a cross-sectional study, with data from a representative sample of the Brazilian population, taken from the National Health Survey(PNS 2014/2015). Outcomes were defined based on glycated hemoglobin (HbA1c) measurements, self-reported DM diagnosis, and use of hypoglycemic agents or insulin. The proportion of DM awareness, treatment, and control was estimated according to sociodemographic characteristics, health conditions, and access to health services, and their respective 95% confidence intervals. RESULTS DM prevalence in the Brazilian population was of 8.6% (95%CI: 7.8-9.3): 68.2% (95%CI: 63.9-72.3) were aware of their diagnosis, 92.2% (95%CI: 88.6-94.7) of those who were aware were undergoing drug treatments, and, of these, 35.8% (95%CI: 30.5-41.6) had controlled HbA1c levels. The proportions of DM awareness, control, and treatment were lower in men aged 18 to 39 years, individuals with low education, without health insurance, and beneficiaries of the Bolsa Família program. CONCLUSION Approximately one in ten Brazilians has DM. A little more than half of this population is aware of their diagnosis, a condition measured by HbA1c dosage and clinical diagnosis. Among those who know, the vast majority are undergoing drug treatments. However, less than half of these have their HbA1c levels controlled. Worse scenarios were found in subgroups with high social vulnerability.

RESUMO OBJETIVO Estimar as proporções dos indivíduos que têm conhecimento do diagnóstico, tratamento e controle do diabetes mellitus (DM) na população adulta brasileira. MÉTODO Este é um estudo transversal, com dados de amostra representativa da população brasileira, provenientes da Pesquisa Nacional de Saúde (PNS 2014/2015). Os desfechos foram definidos com base na medida de hemoglobina glicada (HbA1c), no diagnóstico autorreferido de DM e no uso de hipoglicemiantes ou de insulina. Estimou-se a proporção do conhecimento, tratamento e controle do DM de acordo com as características sociodemográficas, condição de saúde e de acesso aos serviços de saúde, e seus respectivos intervalos de 95% de confiança (IC95%). RESULTADOS A prevalência de DM na população brasileira foi 8,6% (IC95% 7,8-9,3), 68,2% (IC95% 63,9-72,3) tinham conhecimento do seu diagnóstico, 92,2% (IC95% 88,6-94,7) dos que tinham conhecimento realizam tratamento medicamentoso, e desses, 35,8% (IC95% 30,5-41,6) tinham os níveis de HbA1c controlados. As proporções de conhecimento, controle e tratamento foram menores nos homens, com idade de 18 a 39 anos, indivíduos que possuem baixa escolaridade, sem plano de saúde e beneficiários do Programa Bolsa Família. CONCLUSÃO Aproximadamente um em cada dez brasileiros apresenta DM. Um pouco mais da metade desta população tem conhecimento do seu diagnóstico, condição aferida por dosagem de HbA1c e diagnóstico clínico. Entre os que sabem, a grande maioria está sob tratamento medicamentoso. Porém, menos da metade destes tem seus níveis de HbA1c controlados. Cenários piores foram encontrados em subgrupos com alta vulnerabilidade social.

Prevalence and factors associated with self-reported diagnosis of high cholesterol in the Brazilian adult population: National Health Survey 2019. / Prevalência e fatores associados ao diagnóstico autorreferido de colesterol alto na população adulta brasileira: Pesquisa Nacional de Saúde 2019.

OBJECTIVE: To estimate the prevalence of self-reported high cholesterol diagnosis and to analyze the factors associated with the prevalence in the Brazilian adult population. METHODS: Cross-sectional study, using data from the 2019 National Health Survey. The diagnosis of high cholesterol was self-reported. Poisson regression models yielded prevalence ratios (PR) and 95% confidence intervals (95%CI). RESULTS: In the 88,531 adults, the prevalence of high cholesterol was 14.6%. Positively associated: female sex (PR = 1.44; 95%CI 1.40;1.52), age ≥ 60 years (PR = 3.80; 95%CI 3.06;4.71), health insurance (PR = 1.33; 95%CI 1.24;1.42), poor or very poor self-rated health (PR = 1.75; 95%CI 1.60;1.90), hypertension (PR = 1.78; 95%CI 1.68;-1.89), diabetes (RP = 1.54; 95%CI 1.45;1.65), renal failure (PR = 1.33; 95%CI 1.15;1.53), obesity (PR = 1.27; 95%CI 1.18;1.36), former smoker (PR = 1.13; 95%CI 1.07;1.20), alcohol abuse (PR = 1.11; 95%CI 1.01;1.21), physically active during leisure time (PR = 1.22; 95%CI 1.15;1.30). CONCLUSION: High cholesterol was associated with sociodemographic characteristics, health condition and lifestyle.

Tendências temporais de internações de crianças por condições sensíveis à atenção primária em Minas Gerais, Brasil / Tendencias temporales de admisión infantil por condiciones sensibles a la atención primaria en Minas Gerais, Brasil / Temporal tendencies in hospitalization of children for primary care-sensitive conditions in Minas Gerais, Brazil

RESUMO Objetivo: analisar a tendência das internações por condições sensíveis à atenção primária em crianças menores de cinco anos de idade, no estado de Minas Gerais. Métodos: estudo ecológico de séries temporais utilizou registros do Sistema de Informação Hospitalar, período de 2008 a 2018. As análises de tendência foram realizadas pelo método de Prais-Winsten para verificar tendências: estacionárias (p > 0,05), decrescentes (p < 0,05 e coeficiente de regressão negativo) ou ascendentes (p < 0,05 e coeficiente de regressão positivo) por região de saúde e por grupo etário (até um ano e de um a quatro anos). Resultados: houve tendência decrescente de internações entre crianças no estado (variação percentual anual = -4,96%; p < 0,05), com redução de internações por gastroenterites infecciosas e complicações, pneumonias bacterianas e asma. Observou-se aumento de internações por anemia; doenças pulmonares e infecções de ouvido, nariz e garganta. Para crianças menores de um ano, foi observado que as internações por doenças preveníveis por imunização e condições sensíveis apresentaram tendência ascendente (ß=5,69 e p < 0,05), com destaque para a sífilis congênita. Conclusões: o cenário de Minas Gerais é similar ao de outros estados brasileiros, nos quais se observa redução de internação de crianças de até cinco anos, com aumento de internações por anemia, doenças pulmonares e infecção de ouvido, nariz e garganta. Ainda que existam melhorias nas práticas e políticas voltadas para a saúde da criança, os achados reforçam o planejamento de ações para o cuidado a agravos preveníveis na atenção primária.

RESUMEN Objetivo: analizar la tendencia de las hospitalizaciones por condiciones sensibles a la atención primaria en niños menores de cinco años, en el estado de Minas Gerais. Métodos: se realizó un estudio ecológico de series de tiempo con registros del Sistema de Información Hospitalaria, de 2008 a 2018. Se realizaron análisis de tendencias mediante el método de Prais-Winsten para verificar las tendencias: estacionaria (p> 0.05), decreciente (p <0.05 y coeficiente de regresión negativo) o ascendente (p <0,05 y coeficiente de regresión positivo) por región sanitaria y por grupo de edad (hasta un año y de uno a cuatro años). Resultados: hubo una tendencia decreciente de hospitalizaciones entre los niños del estado (variación porcentual anual = -4,96%; p <0,05), con una reducción de las hospitalizaciones por gastroenteritis infecciosa y complicaciones, neumonía bacteriana y asma. Hubo un aumento de las hospitalizaciones por anemia; enfermedades pulmonares e infecciones de oído, nariz y garganta. Para los menores de un año, se observó que las hospitalizaciones por enfermedades prevenibles por inmunización y condiciones sensibles mostraron una tendencia ascendente (ß = 5,69 yp <0,05), con énfasis en la sífilis congénita. Conclusiones: el escenario en Minas Gerais es similar al de otros estados brasileños, en los que hay una reducción en el número de hospitalizaciones de niños hasta los cinco años, con un aumento de las hospitalizaciones por anemia, enfermedades pulmonares y de oído, nariz e infecciones de garganta. Si bien existen mejoras en las prácticas y políticas orientadas a la salud infantil, los hallazgos refuerzan la planificación de acciones para la atención de enfermedades prevenibles en atención primaria.

ABSTRACT Objective: to analyze the tendency of hospitalizations for primary care-sensitive conditions in children under five years of age in the state of Minas Gerais. Methods: an ecological time series study used records from the Hospital Information System, from 2008 to 2018. Tendency analyzes were performed using the Prais-Winsten method to verify tendencies: stationary (p > 0.05), decreasing (p < 0.05 and negative regression coefficient) or increasing (p < 0.05 and positive regression coefficient) by health region and by age group (up to one year and from one to four years). Results: there was a downward tendency in hospitalizations among children in the state (annual percentage variation = -4.96%; p < 0.05), with a reduction in hospitalizations for infectious gastroenteritis and complications, bacterial pneumonia, and asthma. An increase in hospitalizations due to anemia was observed, lung diseases and ear, nose, and throat infections. For children under one year old, it was observed that hospitalizations for diseases preventable by immunization and sensitive conditions showed an upward tendency (ß=5.69 and p < 0.05), with emphasis on congenital syphilis. Conclusions: the scenario of Minas Gerais is similar to that of other Brazilian states, in which there is a reduction in hospitalization of children up to five years old, with an increase in hospitalizations for anemia, lung diseases and ear, nose and throat infections. Although there are improvements in practices and policies aimed at children's health, the findings reinforce the planning of actions for the care of preventable diseases in primary care.

Intervalos de referência de parâmetros de creatinina e hemoglobina glicosilada para a população adulta brasileira: pesquisa nacional de saúde / Intervalos de referencia de los parámetros creatinina y hemoglobina glicosilada para la población adulta brasileña: pesquisa nacional de saúde / Reference intervals of creatinine and glycated hemoglobin parameters for the brazilian adult population: national health survey

RESUMO Objetivo: estimar intervalos de referência (IR) de creatinina e hemoglobina glicosilada (HbA1c) na população adulta brasileira. Métodos: estudo transversal, utilizando na base de dados Pesquisa Nacional de Saúde (PNS), entre 2014-2015, composta por 8.952 adultos. Para estabelecer IR, aplicaram-se critérios de exclusão, removeram-se outliers e foi feita estratificação. Após esses procedimentos, a amostra constitui-se de 2.723 adultos para HbA1c e de 2.738 adultos para creatinina. Avaliaram-se diferenças pelos testes Mann Withney e Kruskal Wallis (p≤0,05). Resultados: homens (IR 0,69-1,25; mediana 0,95 mg/dL) apresentaram maiores IR para creatinina que mulheres (IR 0,53-1,05; mediana 0,74 mg/dL) e tiveram maiores valores de limites inferiores (LI) e mediana de HbA1c (sexo masculino: IR: 4,55-5,97; mediana 5,3%; sexo feminino: IR 4,49-5,97; mediana 5,20%) (p≤0,05). Nas mulheres, IR para creatinina foram mais elevados entre 45 a 59 anos (IR: 0,55-1,04; mediana 0,77 mg/dL) e a partir dos 60 anos (IR: 0,54-0,98; mediana 0,77 mg/dL (p≤0,05). Para HbA1c, homens apresentaram IR mais elevados a partir de 60 anos (IR 4,65-6,07; mediana 5,44%) e mulheres a partir de 45 anos (45 a 59 anos: IR 4,61-6,05; mediana 5,40%; e 60 anos ou mais: IR 4,82-6,03; mediana 5,50%) (p≤0,05). Para creatina, foram observados menores LI dos IR e mediana mais proeminente nos adultos de raça/cor branca (IR: 0,56-1,19; mediana 0,85%) em comparação com a parda (IR: 0,55-1,19; mediana 0,84%) (p≤0,05). Conclusão: IR próprios possibilitam desvelar as condições de saúde dos adultos brasileiros e podem subsidiar a identificação adequada de doença renal crônica e diabetes.

RESUMEN Objetivo: estimar los intervalos de referencia (IR) de creatinina y hemoglobina glicosilada (HbA1c) en la población adulta brasileña. Métodos: estudio transversal, utilizando la base de datos Pesquisa Nacional de Saúde (PNS), entre 2014-2015, compuesto por 8.952 adultos. Para establecer la IR, se aplicaron criterios de exclusión, se eliminaron los valores atípicos y se realizó una estratificación. Tras estos procedimientos, la muestra estaba formada por 2.723 adultos para la HbA1c y 2.738 adultos para la creatinina. Las diferencias se evaluaron mediante las pruebas de Mann Withney y Kruskal Wallis (p≤0,05). Resultados: los hombres (IR 0,69-1,25; mediana 0,95 mg/dL) tenían un IR de creatinina más alto que las mujeres (IR 0,53-1,05; mediana 0,74 mg/dL) y presentaban valores de límite inferior (LI) y mediana de HbA1c más altos (hombre: IR: 4,55-5,97; mediana 5,3%; mujer: IR 4,49-5,97; mediana 5,20%) (p≤0,05). En las mujeres, los IR para la creatinina fueron mayores entre los 45 y los 59 años (IR: 0,55-1,04; mediana 0,77 mg/dL) y a partir de los 60 años (IR: 0,54-0,98; mediana 0,77 mg/dL (p≤0,05). En cuanto a la HbA1c, los hombres mostraron una IR más alta a partir de los 60 años (IR 4,65-6,07; mediana 5,44%) y las mujeres a partir de los 45 años (45 a 59 años: IR 4,61-6,05; mediana 5,40%; y 60 años o más: IR 4,82-6,03; mediana 5,50%) (p≤0,05). En el caso de la creatina, observamos un menor LI de los IR y una mediana más prominente en los adultos blancos (IR: 0,56-1,19; mediana 0,85%) en comparación con los adultos morenos (IR: 0,55-1,19; mediana 0,84%) (p≤0,05). Conclusión: las IR propias permiten desvelar las condiciones de salud de los adultos brasileños y pueden subsidiar la correcta identificación de la enfermedad renal crónica y la diabetes.

ABSTRACT Objective : to estimate reference intervals (RIs) of creatinine and glycated hemoglobin (HbA1c) in the Brazilian adult population. Methods : a cross-sectional study, using the National Health Survey (Pesquisa Nacional de Saúde, PNS) database, between 2014-2015, consisting of 8,952 adults. To establish RIs, exclusion criteria were applied, outliers were removed and stratification was performed. After these procedures, the sample consisted of 2,723 adults for HbA1c and 2,738 adults for creatinine. Differences were evaluated by means of the Mann Whitney and Kruskal Wallis tests (p≤0.05). Results : men (RI: 0.69-1.25; median: 0.95 mg/dL) had higher RIs for creatinine than women (RI: 0.53-1.05; median: 0.74 mg/dL) and higher lower limit (LL) values and median HbA1c (male: RI: 4.55-5.97; median: 5.3%; female: RI: 4.49-5.97; median: 5.20%) (p≤0.05). In women, the RIs for creatinine were higher in the age groups between 45 and 59 years old (RI: 0.55-1.04; median: 0.77 mg/dL) and from 60 years old (RI: 0.54-0.98; median: 0.77 mg/dL (p≤0.05). For HbA1c, men had higher RIs from age 60 (RI: 4.65-6.07; median: 5.44%) and women from 45 years old (45-59: RI: 4.61-6.05; median: 5.40%; and 60 years old or more: RI: 4.82-6.03; median: 5.50%) (p≤0.05). For creatinine, lower RI LLs and more prominent medians were observed in white-skinned adults (RI: 0.56-1.19; median: 0.85%) when compared to brown-skinned (RI: 0.55-1.19; median: 0.84%) (p≤0.05). Conclusion : appropriate RIs make it possible to unveil the health conditions of Brazilian adults and can support proper identification of chronic kidney disease and diabetes.

Association between Adiposity Indexes and Kidney Disease: Findings from the Longitudinal Study of Adult Health (Elsa-Brazil).

INTRODUCTION: Chronic kidney disease (CKD) is a public health problem and it is associated with a high risk of mortality. Overweight and obesity are known as independent risk factors for CKD. OBJECTIVE: To investigate the association between adiposity indexes and kidney disease. METHODS: This study included 14,636 adults from ELSA-Brazil. Outcome variables: altered glomerular filtration rate (GFR), categorized as yes (GFR <60 mL/min/1.73 m2) and no (GFR ≥60 mL/min/1.73 m2), albuminuria, estimated by albumin-creatinine ratio and categorized as yes (≥30 mg/g) and no (<30 mg/g), and presence of chronic kidney disease (CKD) (altered GFR and/or albuminuria). Exposure variables: obesity and overweight (body mass index (BMI)≥30 and ≥25 kg/m2, respectively), high waist circumference (WC) (≥102 cm in men and ≥88 cm in women), high waist-to-hip ratio (WHR) (≥0.90 in men and ≥0.85 in women), and high waist-to-height ratio (WHtR) (≥0.5). To estimate the association between main exposures and outcomes, logistic regression analyses were performed using models adjusted for sociodemographic variables (age, gender, race/skin color, education), behavioral (smoking, physical activity, alcohol consumption), components of the metabolic syndrome (HDL cholesterol, triglycerides, hypertension, diabetes mellitus) and history of cardiovascular disease (myocardial infarction, angina or heart failure). RESULTS: Individuals with obesity, high WC, WHR and WHtR were more prone to albuminuria when compared to individuals with normal values for these measures. It was also observed that these altered measures were positively associated with the presence of CKD. CONCLUSION: Adiposity indexes have a direct and significant association with albuminuria and CKD.

Prevalência e fatores associados ao diagnóstico autorreferido de colesterol alto na população adulta brasileira: Pesquisa Nacional de Saúde 2019 / Prevalencia y factores asociados con el diagnóstico autoinformado de colesterol alto en la población adulta brasileña: Investigación Nacional de Salud 2019 / Prevalence and factors associated with self-reported diagnosis of high cholesterol in the Brazilian adult population: National Health Survey 2019

Objetivo: Estimar a prevalência de diagnóstico autorreferido de colesterol alto e analisar os fatores associados à prevalência na população adulta brasileira. Métodos: Estudo transversal utilizando a Pesquisa Nacional de Saúde 2019. O diagnóstico de colesterol alto foi autorreferido. Modelos de regressão de Poisson originaram as razões de prevalência (RP) e intervalos de confiança de 95% (IC95%). Resultados: Nos 88.531 adultos, a prevalência de colesterol alto foi de 14,6%. Associaram-se positivamente: sexo feminino (RP = 1,44; IC95% 1,40;1,52), idade ≥ 60 anos (RP = 3,80; IC95% 3,06;4,71), ter plano de saúde (RP = 1,33; IC95% 1,24;1,42), autoavaliação de saúde ruim ou muito ruim (RP = 1,75; IC95% 1,60;1,90), ter hipertensão (RP = 1,78; IC95% 1,68;1,89), ter diabetes (RP = 1,54; IC95% 1,45;1,65), ter insuficiência renal (RP = 1,33; IC95% 1,15;1,53), ter obesidade (RP = 1,27; IC95% 1,18;1,36), ser ex-fumante (RP = 1,13; IC95% 1,07;1,20), consumir álcool abusivamente (RP = 1,11; IC95% 1,01;1,21), ser ativo no lazer (RP = 1,22; IC95% 1,15;1,30). Conclusão: O colesterol alto associou-se a condições sociodemográficas, de saúde e estilo de vida.

Objetivo: Estimar la prevalencia de colesterol alto autodeclarado y analizar factores asociados la prevalencia en adultos brasileños. Métodos: Estudio transversal utilizando la Encuesta Nacional de Salud de 2019. El diagnóstico de colesterol alto fue autodeclarado. Los modelos de regresión de Poisson produjeron razón de prevalencia (RP) e intervalos de confianza del 95% (IC95%). Resultados: En 88.531 adultos, la prevalencia fue 14,6%. Asociaron positivamente: sexo feminino (RP = 1,44; IC95% 1,40;1,52), edad ≥ 60 años (RP = 3,80; IC95% 3,06;4,71), seguro salud (RP = 1,33; IC95% 1,24;1,42), autoevaluación de salud mala o muy mala (RP = 1,75; IC95% 1,60;1,90), hipertensión (RP = 1,78; IC95% 1,68;1,89), diabetes (RP = 1,54; IC95% 1,45;1,65), insuficiencia renal (RP = 1,33; IC95% 1,15;1,53), obesidad (RP = 1,27; IC95% 1,18;1,36), exfumador (RP = 1,13; IC95% 1,07;1,20), abuso de alcohol (RP = 1,11; IC95% 1,01;1,21), estar activo en el tiempo libre (RP = 1,22; IC95% 1,15;1,30). Conclusión: Colesterol alto se asoció con condiciones sociodemográficas, de salud y estilo de vida.

Objective: To estimate the prevalence of self-reported high cholesterol diagnosis and to analyze the factors associated with the prevalence in the Brazilian adult population. Methods: Cross-sectional study, using data from the 2019 National Health Survey. The diagnosis of high cholesterol was self-reported. Poisson regression models yielded prevalence ratios (PR) and 95% confidence intervals (95%CI). Results: In the 88,531 adults, the prevalence of high cholesterol was 14.6%. Positively associated: female sex (PR = 1.44; 95%CI 1.40;1.52), age ≥ 60 years (PR = 3.80; 95%CI 3.06;4.71), health insurance (PR = 1.33; 95%CI 1.24;1.42), poor or very poor self-rated health (PR = 1.75; 95%CI 1.60;1.90), hypertension (PR = 1.78; 95%CI 1.68;-1.89), diabetes (RP = 1.54; 95%CI 1.45;1.65), renal failure (PR = 1.33; 95%CI 1.15;1.53), obesity (PR = 1.27; 95%CI 1.18;1.36), former smoker (PR = 1.13; 95%CI 1.07;1.20), alcohol abuse (PR = 1.11; 95%CI 1.01;1.21), physically active during leisure time (PR = 1.22; 95%CI 1.15;1.30). Conclusion: High cholesterol was associated with sociodemographic characteristics, health condition and lifestyle.

Elaboration and validation of an e-book with the laws about diabetes in schools / Elaboração e validação de um e-book com as leis sobre o diabetes nas escolas

ABSTRACT Objectives: to elaborate an e-book about children and adolescents' rights and duties concerning diabetes in schools. Methods: we developed this methodological study in nine steps: Creation process definition, bibliographic survey, e-book elaboration, readability and apprehensibility examination, illustration, committee of judges and targeted audience validation (students' moms with diabetes and school staff), experts' meetings and final discussion. We have considered acceptable the Content Validity Coefficient minimum of 0.80. Results: we obtained an average Content Validity Coefficient of 0,97 for clarity and relevance, and the images had 94% approval. In the face-to-face test, the targeted audience have considered the material clear and adequate to the intended purpose. Conclusions: the e-book was elaborated and validated regarding the content and relevance, and may be used to instruct the population about diabetes' laws in schools.

RESUMEN Objetivos: elaborar y validar un libro electrónico sobre los derechos y deberes de niños y adolescentes con diabetes en las escuelas. Métodos: es un estudio metodológico desarrollado en nueve etapas: definición del proceso de creación, levantamiento bibliográfico, elaboración del libro digital, cálculo de la legibilidad y percepción, ilustración, validación por el comité de jueces y público objeto (madres de alumnos con diabetes y equipo escolar), reuniones de especialistas y discusión final. Se consideró aceptable el Coeficiente de Validez de Contenido mínimo de 0,80. Resultados: se obtuvo el Coeficiente de Validez de Contenido promedio de 0,97 para claridad y relevancia y las imágenes obtuvieron un 94% de aprobación. En la prueba presencial, el público objeto consideró el material claro y adecuado para la finalidad propuesta. Conclusiones: el libro electrónico fue elaborado y validado según contenido y relevancia, pudiendo utilizarse para instruir a la población sobre las leyes de la diabetes en las escuelas.

RESUMO Objetivos: elaborar e validar um e-book sobre os direitos e deveres de crianças e adolescentes com diabetes nas escolas. Métodos: estudo metodológico, desenvolvido em nove etapas: definição do processo de criação, levantamento bibliográfico, elaboração do e-book, cálculo da legibilidade e apreensibilidade, ilustração, validação pelo comitê de juízes e público-alvo (mães de alunos com diabetes e equipe escolar), reuniões de especialistas e discussão final. Considerou-se aceitável o Coeficiente de Validade de Conteúdo mínimo de 0,80. Resultados: obteve-se o Coeficiente de Validade de Conteúdo médio de 0,97 para clareza e relevância, e as imagens tiveram 94% de aprovação. No teste face a face, o público-alvo considerou o material claro e adequado à finalidade proposta. Conclusões: o e-book foi elaborado e validado quanto a conteúdo e relevância, podendo ser utilizado para instruir a população acerca das leis sobre o diabetes nas escolas.

Arterial hypertension and associated factors: National Health Survey, 2019 / Hipertensão arterial e fatores associados: Pesquisa Nacional de Saúde, 2019

ABSTRACT OBJECTIVE To analyze the factors associated with self-reported arterial hypertension, as well as its prevalence in the Brazilian adult population. METHODS Data from 88,531 individuals aged 18 years or older who responded to the 2019 National Health Survey were analyzed. The outcome studied was self-reported arterial hypertension. Sociodemographic variables and clinical and lifestyle conditions were considered as exposures. The prevalence ratio (PR), crude and adjusted for sex, age, and schooling was used as a measure of association to verify the factors related to its prevalence, obtained by Poisson regression with robust variance. RESULTS The prevalence of self-reported arterial hypertension was of 23.9% (95%CI: 23.4-24.4). When adjusting for age, sex, and schooling, the adjusted Prevalence Ratios (APR) were higher among: regular health self-assessment (APR = 1.6; 95%CI: 1.5-1.6) and bad health self-assessment (APR = 1.7; 95%CI: 1.6-1.8); self-reference to heart disease (APR = 1.7; 95%CI: 1.6-1.7), diabetes (APR = 1.7; 95%CI: 1.6-1.8), high cholesterol (APR = 1.6; 95%CI: 1.6-1.7), overweight (APR = 1.4; 95%CI: 1.4-1.5), and obesity (APR = 2.0; 95%CI: 1.9-2.1); high salt intake (APR = 1.1; 95%CI: 1.0-1.1); higher among former smokers (APR = 1.1; 95%CI: 1.1-1.2) and lower among smokers (APR = 0.9; 95%CI: 0.8-0.9); and consumption of ultra-processed foods (APR = 0.9; 95%CI: 0.8-0.9). CONCLUSION A quarter of the Brazilian adult population claims to have arterial hypertension, more prevalent among women and associated with older age groups, Black, mixed-race, and others, low schooling, high salt intake, former smoking, presence of comorbidities, and worse health self-assessment.

RESUMO OBJETIVO Analisar os fatores associados à hipertensão arterial autorreferida, bem como sua prevalência, na população de adultos brasileiros. MÉTODOS Foram analisados dados de 88.531 indivíduos de 18 anos ou mais que responderam à Pesquisa Nacional de Saúde de 2019. O desfecho estudado foi a hipertensão arterial autorreferida. Como exposições, foram consideradas variáveis sociodemográficas, condições clínicas e de estilo de vida. Para verificar os fatores associados à prevalência, usou-se como medida de associação a razão de prevalência (RP) bruta e ajustada por sexo, idade e escolaridade, obtidas por meio da Regressão de Poisson com variância robusta. RESULTADOS A prevalência da hipertensão arterial autorreferida foi de 23,9% (IC95% 23,4-24,4). Ao ajustar por idade, sexo e escolaridade, as Razões de Prevalência ajustadas (RPaj) foram mais elevadas entre: auto avaliação de saúde regular (RPaj = 1,6; IC95% 1,5-1,6) e ruim (RPaj = 1,7; IC95% 1,6-1,8); autorreferência a doença do coração (RPaj = 1,7; IC95% 1,6-1,7), diabetes (RPaj = 1,7; IC95% 1,6-1,8), colesterol elevado (RPaj = 1,6; IC95% 1,6-1,7), sobrepeso (RPaj = 1,4; IC95% 1,4-1,5) e obesidade (RPaj = 2,0; IC95% 1,9-2,1); consumo elevado de sal (RPaj = 1,1; IC95% 1,0-1,1); entre ex-fumantes (RPaj = 1,1; IC95% 1,1-1,2) e menor entre fumantes (RPaj = 0,9; IC95% 0,8-0,9) e consumo de alimentos ultraprocessados (RPaj = 0,9; IC95% 0,8-0,9). CONCLUSÃO Um quarto da população adulta brasileira afirma ter hipertensão arterial, de forma mais prevalente entre as mulheres e associada às maiores faixas etárias, cor da pele/raça preta, parda e outras, baixa escolaridade, consumo elevado de sal, ex-tabagismo, presença de comorbidades e pior autoavaliação de saúde.

Elaboration and validation of an e-book with the laws about diabetes in schools.

OBJECTIVES: to elaborate an e-book about children and adolescents' rights and duties concerning diabetes in schools. METHODS: we developed this methodological study in nine steps: Creation process definition, bibliographic survey, e-book elaboration, readability and apprehensibility examination, illustration, committee of judges and targeted audience validation (students' moms with diabetes and school staff), experts' meetings and final discussion. We have considered acceptable the Content Validity Coefficient minimum of 0.80. RESULTS: we obtained an average Content Validity Coefficient of 0,97 for clarity and relevance, and the images had 94% approval. In the face-to-face test, the targeted audience have considered the material clear and adequate to the intended purpose. Conclusions: the e-book was elaborated and validated regarding the content and relevance, and may be used to instruct the population about diabetes' laws in schools.

Consumption of alcoholic and non-alcoholic beverages: ELSA-Brasil results. / Consumo de bebidas alcoólicas e não alcoólicas: Resultados do ELSA-Brasil.

The study aims to describe the consumption of alcoholic and non-alcoholic beverages according to sociodemographic, health and location variables. Cross-sectional study with ELSA-Brasil data (2008-2010). A questionnaire was used to collect sociodemographic, food, health data and anthropometry. Descriptive analysis and association with variables of interest were carried out. In the sample, 8% of the total caloric value comes from non-alcoholic beverages (5.6%: sugary drinks), and 4% from alcoholic beverages (2.7%: beer). Consumers of unsweetened and artificially sweetened beverages reported moderate/strong physical activity, former smokers and higher education. The opposite was true for sugary drinks. Eutrophic people reported higher consumption of sugary drinks and those obese, artificially sweetened and beer. Alcohol consumption varied with age (young: beer; elderly: wine/spirits) and education (low education: beer/spirits; higher education: wine). Coffee, natural juice and soda were the most consumed non-alcoholic beverages and beer was the most prevalent alcoholic beverage. Consumption variation was observed according to geographic location. The consumption of sugary and alcoholic beverages is high in Brazil and public health strategies are required.

Objetiva-se descrever o consumo de bebidas alcoólicas e não alcoólicas segundo variáveis sociodemográficas, de saúde e localização. Estudo transversal com dados do ELSA-Brasil (2008-2010). Aplicou-se questionário para coleta de dados sociodemográficos, de alimentação, saúde, além de antropometria. Realizou-se análise descritiva e associação com variáveis de interesse. Na amostra, 8% do valor calórico total é proveniente de bebidas não alcoólicas (5,6%: bebidas açucaradas), e 4% de bebidas alcoólicas (2,7%: cerveja). Os consumidores de bebidas não adoçadas e adoçadas artificialmente realizam atividade física moderada/forte, são ex-fumantes e apresentam escolaridade alta. O oposto foi verificado para as bebidas açucaradas. Indivíduos eutróficos relataram maior consumo de bebidas açucaradas e os obesos, as adoçadas artificialmente e cerveja. O consumo de bebidas alcoólicas variou com a idade (jovens: cerveja; idosos: vinho/destiladas) e escolaridade (baixa: cerveja/destiladas; alta: vinho). Café, suco natural e refrigerante foram as bebidas não alcoólicas mais consumidas e a cerveja a alcoólica mais prevalente. Observou-se variação de consumo segundo a localização geográfica. O consumo de bebidas açucaradas e alcoólicas é alto no Brasil e estratégias de saúde pública são necessárias.

Association of self-reported sleep disturbances with ideal cardiovascular health in Brazilian adults: A cross-sectional population-based study.

OBJECTIVE: To examine the association between sleep disturbances and cardiovascular health in Brazilian adults. METHODS: We analyzed cross-sectional data from a nationally representative sample of 36,480 Brazilian adults ages 18 and over. Multivariate Poisson regression models were used to assess the association between sleep disturbances (difficulty falling asleep, frequent interruptions in sleep, or sleeping more than usual) and Life's Simple 7 (LS7) cardiovascular health (CVH) scores through consideration of four behaviors (smoking, physical activity, body mass index, and diet) and three biological factors (hypercholesterolemia, hypertension, and diabetes). RESULTS: Adults with no sleep disturbances had better CVH, with higher mean LS7 CVH scores (4.2, 95% confidence interval [CI]: 4.1; 4.2) when compared to those experiencing some level of sleep disturbance within a 2-week timespan (3.8, 95% CI: 3.7; 3.8). Specifically, compared to those with no sleep disturbance, adults reporting sleep disturbances for half of the weekdays had significantly lower LS7 CVH mean scores (ß = -0.02, 95% CI: -0.04; 0.01). Adults who had disturbances more than half of the weekdays had even lower scores (ß = -0.06, 95% CI: -0.09; -0.02), followed by those who reported disturbances almost every day (ß = -0.08, 95% CI: -0.11; -0.04), even after adjusting for age, sex, education status, depressive symptoms, and night shift work. CONCLUSION: Brazilian adults with sleep disturbances are less likely to achieve ideal CVH. Given that sleep disturbances seem to be increasingly common in Brazil, recent gains in CVH mortality may be affected.

Fruit and vegetable consumption, leisure-time physical activity and binge drinking in Belo Horizonte, Brazil, according to the Health Vulnerability Index.

OBJECTIVE: To estimate the prevalence of fruit and vegetable consumption, practice of leisure time physical activity (LTPA) and binge drinking for small areas of Belo Horizonte, Minas Gerais. METHODS: Ecological study conducted with data from the Surveillance System for Risk and Protection Factors for Noncommunicable Diseases by Telephone Survey (Sistema de Vigilância de Fatores de Risco e Proteção para Doenças Crônicas por Inquérito Telefônico - Vigitel). The prevalence of risk and protection factors from 2006 to 2013 were estimated and the 95% confidence intervals calculated. "Small areas" corresponded to the municipality division into four strata of health risk classification given by the Health Vulnerability Index 2012 (Índice de Vulnerabilidade à Saúde - IVS). RESULTS: The mean prevalences for the period were: about 42% of regular intake of fruit and vegetable, 34.7% of leisure time activity and 20.4% of binge drinking. The prevalence of fruit and vegetable consumption was higher in low-risk areas (58.5%; 95%CI 56.8 - 60.2) and lower in very high-risk areas (32.3%; 95%CI 27.7 - 36.9). The practice of LTPA was higher in low-risk areas (40.8%; 95%CI 38.9 - 42.8) and lower in very high risk (25.2%; 95%CI 20.6 - 29.9). Binge drinking was higher in low-risk areas (22.9%; 95%CI 21.7 - 24.2) compared to very high-risk areas (14.3%; 95%CI 11.4 - 17.3). CONCLUSION: It was identified a gradient in the distribution of risk and protection factors for noncommunicable diseases in Belo Horizonte according to the risk classification. This information can support programs aimed at reducing health inequalities, especially in the most vulnerable areas.

Estimates of hypertension and diabetes mellitus prevalence according to Health Vulnerability Index in Belo Horizonte, MG, Brazil.

OBJECTIVE: To estimate the prevalences of hypertension and diabetes for small areas in Belo Horizonte, according to the Health Vulnerability Index (HVI). METHODS: Ecological study with data from the Surveillance of Risk and Protection Factors for Chronic Diseases by Telephone Survey (Vigitel) conducted in Belo Horizonte, from 2006 to 2013. The self-reported diagnosis of diabetes and hypertension were evaluated. The estimates of prevalence and the 95% confidence interval (95%CI) were calculated using the direct and indirect method by HVI grouped into four categories: low, medium, high and very high health risk. RESULTS: During the period evaluated, 26% (95%CI 25.2 - 26.8) and 6.1% (95%CI 6.7 - 6.5) of the adult population from Belo Horizonte reported being hypertensive and diabetic, respectively. According to the indirect method to obtain estimates of hypertension and diabetes prevalences per HVI, it was found that areas of very high risk had a higher prevalence of adults with hypertension (38.6%; 95%CI 34.8 - 42.4) and diabetes (16.2%; 95%CI 13.1 - 19.3) when compared to the low risk (28.2%; 95%CI 27.0 - 29.4 and 6%; 95%CI 5.4 - 6.7, respectively). CONCLUSION: The adult population living in areas at high risk for health had a higher prevalence of hypertension and diabetes compared to those with a lower risk.

Tendência temporal de internações por sífilis congênita entre 2008 e 2018, em Minas Gerais / Temporal trend of congenital syphilis hospitalizations between 2008 and 2018 in Minas Gerais

Objetivou-se analisar a tendência temporal de internações por sífilis congênita entre 2008 e 2018 em Minas Gerais. Método: estudo ecológico de série temporal. Para a análise de tendência, realizou-se modelo de Prais-Winsten. Calculou-se a Variação Percentual Anual para apresentar a intensidade da tendência. Resultados: foi observada tendência ascendente de internações por sífilis congênita em 12 macrorregiões de Minas Gerais. As maiores Variações Percentuais Anuais foram observadas nas regiões: Leste do Sul, Oeste e Leste. A macrorregião Leste do Sul apresentou a maior variação do estado (84,34%; IC95% 50,30; 126,09) e a Triângulo Norte apresentou menor variação percentual anual (19,62; IC95% 6,48; 34,38). Conclusão: a tendência de aumento de internações por sífilis congênita, observada em 12 das 13 macrorregiões de saúde, caracteriza uma tendência ascendente no estado e reforça a necessidade de formulação ou revisão de ações que priorizem a prevenção desse agravo.

The objective was to analyze the temporal trend of congenital syphilis hospitalizations between 2008 and 2018 in Minas Gerais. Method: ecological time-series study. Prais-Winsten estimation was used for trend analysis. The Annual Percentage Variation was calculated to show the trend intensity. Results: an ascending trend of congenital syphilis hospitalizations was observed in 12 macro-regions of Minas Gerais. The greater Annual Percentage Variations were observed in the Leste do Sul, West and East regions. The Leste do Sul macro-region showed the highest variation in the state (84.34%; CI95% 50.30; 126.09) while Triângulo Norte showed the lowest annual percentage variation (19.62; CI95% 6.48; 34.38). Conclusion: the ascending trend of congenital syphilis hospitalizations observed in 12 out of the 13 health macro-regions characterizes an ascending trend in the state and reinforces the need to develop or review actions that prioritize the prevention of this disease

Estimates of prevalence of hypertension and diabetes mellitus according to Health Vulnerability Index in Belo Horizonte, Brazil / Estimativas de prevalência de hipertensão e diabetes mellitus segundo Índice de Vulnerabilidade da Saúde em Belo Horizonte, Brasil

Objective: To estimate the prevalence of hypertension and diabetes for small areas in Belo Horizonte, using the Health Vulnerability Index (HVI). Methods: Ecological study with data from the Surveillance of Risk and Protection Factors for Chronic Diseases by Telephone Survey (Vigitel) conducted in Belo Horizonte, from 2006 to 2013. The self-reported diagnosis of diabetes and hypertension were evaluated. The estimates of prevalence and the 95% confidence interval (95% CI) were calculated using the direct and indirect method by HVI grouped into four categories: low, medium, high and very high health risk. Results: During the period evaluated, 26.0% (95% CI 25.2 - 26.8) and 6.1% (95% CI 6.7% - 6.5%) of the adult population in Belo Horizonte reported being hypertensive and diabetic, respectively. According to the indirect method to obtain estimates of hypertension and diabetes due to HVI, it was found that areas of very high risk had a higher prevalence of adults with hypertension (38.6; 95% CI: 34.8 - 42.4) and diabetes (16.2%; 95% CI: 13.1 - 19.3) when compared to the low risk (28.2; 95% CI: 27.0­ 29.4) and (6.0%; 95% CI: 5.4 - 6.7), respectively. Conclusions: The adult population living in areas at high risk for health had a higher prevalence of hypertension and diabetes compared to those with a lower risk.

Objetivo: Estimar as prevalências de hipertensão e diabetes para pequenas áreas em Belo Horizonte, utilizando o índice de vulnerabilidade à Saúde (IVS). Métodos:  Estudo ecológico com dados do sistema de Vigilância de Fatores de Risco e Proteção para Doenças Crônicas por Inquérito Telefônico realizado em Belo Horizonte, nos anos de 2006 a 2013. Foram avaliados o diagnóstico autorreferido de diabetes e hipertensão. As estimativas de prevalências e o intervalo de 95% de confiança (IC95%) foram calculadas usando o método de estimação direto e indireto por IVS agrupado em quatro categorias: baixo, médio, alto e muito alto risco à saúde. Resultados:  Durante o período avaliado, 26,0 % (IC95% 25,2 ­ 26,8) e 6,1 % (IC95% 6,7% ­ 6,5%) da população adulta de Belo Horizonte reportaram ser hipertensos e diabéticos, respectivamente. Segundo o método indireto para obtenção das estimativas de hipertensão e diabetes por IVS, verificou-se que as áreas de risco muito elevado apresentaram maior prevalência de adultos com hipertensão (38,6; IC95%: 34,8 - 42,4) e diabetes (16,2%; IC95%:13,1 ­ 19,3) quando comparados com o de baixo risco  (28,2; IC95%: 27,0­ 29,4) e (6,0%; IC95%: 5,4 ­ 6,7), respectivamente. Conclusões: A população de adultos residentes em áreas com risco elevado à saúde apresentou maiores prevalências de hipertensão e diabetes em comparação àquelas com menor risco.