ABSTRACT
Abstract Objective: To determine the incidence of MIS-C in Brazil, describe the clinical and sociodemographic characteristics of the pediatric population affected by MIS-C and compare mortality and lethality outcomes with isolated Covid-19 and MIS-C cases. Methods: Observational and retrospective cohort study of cases of MIS-C associated with Covid-19 in the Brazilian population between 04/01/2020 and 04/17/2021. Data from the Ministry of Health's epidemiological bulletin up to the 15th epidemiological week of 2021, were used. The analyzes were descriptive through absolute and relative frequencies. The significance level is 5% in Stata 16.0 package. Results: Between 04/01/2020 and 04/07/2021, 903 cases of MIS-C associated with Covid-19 were notified in Brazil, of which, the largest part (55.26%) were male, between 0 and 4 years old (45.29%), from the Southeast region (38.76%). The deaths (61; 6.7%) were higher in the female gender, between 0 and 4 years old (47.54%) and in the Southeast region (34.43%). It was identified that the risk of death by MIS-C related to Covid-19 is 5.29 (CI = 2.83; 9.87 and P-value = <0.001) times higher in adolescents from 15-19 years old than in other age groups when compared to 0-4 years old children. Also, the residency in North region was as risk factor to death (RR = 3.72, IC = 1.29; 10.74 e P-value = 0.008). Conclusion: In this study, despite the numbers showing more deaths from zero to 4 years old, the risk for teenagers is notably higher. In addition, Brazil's Northern region is a risk factor that reaffirms social inequality and poor access to health.
ABSTRACT
INTRODUÇÃO: Idosos com 80 anos ou mais representam o segmento populacional com o maior crescimento proporcional em países emergentes. Investigações abordando a tendência de mortalidade por neoplasias malignas na população muito idosa no Brasil são escassas e incomuns. OBJETIVO: Descrever a tendência de óbitos por câncer na população muito idosa, por sexo e tipo, entre 2000 e 2017 no Brasil. METODOLOGIA: Estudo descritivo, tipo tendência, com uso de dados secundários do Sistema de Informações sobre Mortalidade (do Departamento de Informática do Sistema Único de Saúde). As variáveis foram ano de óbito, sexo e sítio da neoplasia. Os cinco principais tipos de neoplasia foram determinados, e foram calculadas as taxas de mortalidade e tendência específicas. A tendência foi determinada por modelo de regressão joinpoint Nos casos em que se identificaram um ou mais joinpoints, calculou-se a variação percentual anual média, do inglês average annual percent change (AAPC), por meio da média geométrica ponderada das variações percentuais anuais (APCs, do inglês annual percent change) na qual os pesos foram equivalentes aos comprimentos dos segmentos. Estimou-se a significância estatística a da APC/AAPC pelo cálculo dos seus respectivos intervalos de confiança de 95% (IC95%), considerando alfa de 0,05. RESULTADOS: Foi observada uma tendência crescente da taxa de mortalidade (AAPC = 1,50; IC95% 1,20 - 1,70), no sexo masculino (AAPC = 1,90; IC95% 1,70 - 2,10) e feminino (AAPC = 1,30; IC95% 1,00 - 1,50). Maiores taxas de mortalidade concentraram-se em homens. Os sítios de câncer que mais causaram mortes foram próstata (AAPC = 1,70; IC95% 1,10 - 2,30), em homens, e mama (AAPC = 1,90; IC95% 1,50 - 2,20), em mulheres, seguidos por bronquios e pulmões, estômago e cólon, todos com taxas crescentes exceto estômago. CONCLUSÕES: Observaram-se taxas crescentes de neoplasias rastreáveis e/ou preveníveis, alertando sobre necessidade de medidas preventivas.
INTRODUCTION: Adults aged 80 and over represent the fastest growing segment of the population in emerging countries. Studies of cancer mortality trends in the oldest old population are scarce in Brazil. OBJECTIVE: To describe trends in cancer mortality in the Brazilian oldest old, by gender and cancer type, from 2000 to 2017. METHODS: This was a descriptive study with a time trend design, based on data from the Mortality Information System (of the Informatics Department of the Unified Health System). The variables analyzed were year of death, sex and cancer site. The five most common types of cancer were identified, and mortality rates and trends were calculated for each one. Trends were determined using joinpoint regression. In all cases where one or more joinpoints were statistically significant the average annual percent change (AAPC) was calculated based on the arithmetic mean of the annual percent change (APC), weighted by the length of each segment. The statistical significance of the APC and AAPC was estimated by calculating 95% confidence intervals (CI) with an alpha level of 0.05. RESULTS: Mortality rates increased over time (AAPC = 1.50; 95%CI, 1.20 - 1.70) in both males (AAPC = 1.90; 95%CI, 1.70 - 2.10) and females (AAPC = 1.30; 95%CI, 1.00 - 1.50). Men had higher mortality rates than women. The most common causes of cancer-related death were prostate cancer (AAPC = 1.70; 95%CI, 1.10 - 2.30) in men, and breast cancer (AAPC = 1.90; 95%CI, 1.50 - 2.20) in women, followed by cancers of the lung and bronchus, stomach and colon. All rates increased over time, except in the case of stomach cancer. CONCLUSION: The study revealed increasing mortality rates for screenable and/or preventable cancers, alerting to the need for preventive measures.