Your browser doesn't support javascript.
Show: 20 | 50 | 100
Results 1 - 20 de 33
Säo Paulo med. j ; 140(3): 412-421, May-June 2022. tab, graf
Article in English | LILACS | ID: biblio-1377378


ABSTRACT BACKGROUND: Workplaces can be sources of mental distress. In healthcare services, this can also affect patients. OBJECTIVE: To assess the prevalence of and factors associated with depressive symptoms, burnout, job satisfaction and patient safety culture and the relationships between these constructs, among healthcare workers. DESIGN AND SETTING: Cross-sectional study in a university hospital in Manaus, Brazil. METHODS: Randomly selected workers were interviewed based on Brazilian-validated tools. We calculated the prevalence ratio (PR) and 95% confidence interval (CI) of depressive symptoms and burnout using Poisson regression with robust variance; and the β-coefficient of safety culture and job satisfaction using linear regression. Outcome relationships were assessed using partial least-squares structural equation modeling. RESULTS: 300 professionals were included; 67.3% were women. The prevalence of depressive symptom was 19.0% (95% CI: 14.5; 23.5%) and burnout, 8.7% (95% CI: 5.2; 12.3%). Lack of work stability increased depression (PR = 1.88; 95% CI: 1.17; 3.01) and burnout (PR = 2.17; 95% CI: 1.03; 4.57); and reduced job satisfaction (β = -11.93; 95% CI: -18.79; -5.07). Depressive symptoms and burnout were positively correlated, as also were job satisfaction and safety culture (P < 0.001); job satisfaction was negatively correlated with burnout (P < 0.001) and depression (P = 0.035). CONCLUSION: Impermanent employment contracts increased depression and burnout and reduced job satisfaction. Job satisfaction reduced poor mental health outcomes and increased safety culture. Job satisfaction and safety culture were directly proportional (one construct increased the other and vice versa), as also were depression and burnout. Better working conditions can provide a virtuous cycle of patient safety and occupational health.

Humans , Male , Female , Burnout, Professional/epidemiology , Job Satisfaction , Brazil/epidemiology , Cross-Sectional Studies , Surveys and Questionnaires , Patient Satisfaction , Safety Management , Depression/epidemiology , Patient Safety , Latent Class Analysis , Hospitals, University
Epidemiol. serv. saúde ; 31(2): e2021653, 2022. tab, graf
Article in Portuguese | LILACS-Express | LILACS | ID: biblio-1384899


Resumo Objetivo: Analisar a prevalência e fatores associados à polifarmácia e a presença de potenciais interações medicamentosas em Manaus, estado do Amazonas, Brasil, em 2019. Métodos: Estudo transversal de base populacional, com adultos de ≥ 18 anos. Entre pessoas em polifarmácia (≥ 5 medicamentos), pesquisou-se a presença de interações medicamentosas na base Micromedex. Razões de prevalências (RP) com intervalos de confiança de 95% (IC95%) foram calculadas por regressão de Poisson com variância robusta, seguindo análise hierárquica e considerando o delineamento amostral complexo. Resultados: Dos 2.321 participantes, 2,8% (IC95% 2,1;3,6) estavam em polifarmácia e, destes, 74,0% apresentaram interações, sendo mais frequentes quatro ou mais interações por pessoa (40,4%) e gravidade alta (59,5%). Polifarmácia foi maior entre idosos (RP = 3,24; IC95% 1,25;8,42), pessoas com saúde ruim (RP = 2,54; IC95% 1,14;5,67), hospitalização prévia (RP = 1,90; IC95% 1,09;3,32) e multimorbidade (RP = 3,20; IC95% 1,53;6,67). Conclusão: A polifarmácia foi mais frequente entre idosos e pessoas com problemas de saúde, que tiveram mais interações medicamentosas.

Resumen Objetivo: Analizar la prevalencia y factores asociados a la polifarmacia y la presencia de posibles interacciones farmacológicas en Manaus, estado de Amazonas, Brasil, en 2019. Métodos: Estudio poblacional transversal realizado con adultos con edad ≥ 18 años. Entre personas en polifarmacia (≥ 5 medicamentos), se investigó la presencia de interacciones farmacológicas en Micromedex. Las razones de prevalencia (RP) con intervalos de confianza de 95% (IC95%) se calcularon mediante la regresión de Poisson con varianza robusta, siguiendo análisis jerárquico y considerando el diseño de muestra complejo. Resultados: De los 2.321 participantes, 2,8% (IC95% 2,1;3,6) se encontraban en polifarmacia, de los cuales 74,0% presentaban interacciones, siendo más frecuentes cuatro o más interacciones por persona (40,4%) y de alta gravedad (59,5%). La polifarmacia fue mayor entre los ancianos (RP = 3,24; IC95% 1,25;8,42), personas con mala salud (RP = 2,54; IC95% 1,14;5,67), hospitalización previa (RP = 1,90; IC95% 1,09;3,32) y multimorbilidade (RP = 3,20; IC95% 1,53;6,67). Conclusión: La polifarmacia fue más frecuente entre los ancianos y personas con problemas de salud, que potencialmente tenían más interacciones farmacológicas.

Abstract Objective: To assess the prevalence and factors associated with polypharmacy and the presence of potential drug interactions in Manaus, Amazonas state, Brazil, in 2019. Methods: This was a population-based cross-sectional study conducted with adults aged ≥ 18 years. The presence of drug interactions among people on a polypharmacy regimen (≥ 5 drugs) was investigated on the Micromedex database. Prevalence ratios (PR) with 95% confidence intervals (95%CI) were calculated using Poisson regression model with robust variance, following hierarchical analysis and considering the complex sample design. Results: Of the 2,321 participants, 2.8% (95%CI 2.1;3.6) were on polypharmacy regimen, of whom, 74.0% presented drug interactions, usually with four or more drug interactions per person (40.4%) and high severity (59.5%). Polypharmacy was higher among older adults (PR = 3.24; 95%CI 1.25;8.42), people with poor health (PR = 2.54; 95%CI 1.14;5.67), previous hospitalization (PR = 1.90; 95%CI 1.09;3.32) and multimorbidity (PR = 3.20; 95%CI 1.53;6.67). Conclusion: Polypharmacy was more frequent among older adults and people with medical problems, who presented more drug interactions.

Rev. saúde pública (Online) ; 56: 2, 2022. tab, graf
Article in English | LILACS-Express | LILACS, BBO | ID: biblio-1361135


ABSTRACT OBJECTIVE To investigate the use of health services among adults living in Manaus, Amazonas. METHODS This was a panel of two cross-sectional studies conducted in Manaus in 2015 and 2019. Individuals aged ≥ 18 years were selected by probabilistic sampling and interviewed at home. The study outcomes were doctor visits and hospitalizations in the previous 12 months, and unmet surgical needs. Variations between 2015 and 2019 were tested using chi-squared goodness-of-fit test. Poisson regression with robust variance was employed to calculate the prevalence ratios (PR) of the outcomes with 95% confidence intervals (95%CI). RESULTS The surveys included 5,800 participants in total. Visits to the doctor decreased from 2015 (78.7%) to 2019 (76.3%; p < 0.001), hospital admissions increased from 2015 (7.9%) to 2019 (11.5%; p < 0.001), and unmet surgical needs decreased in the period (15.9% to 12.1%; p < 0.001). These variations were particularly observed in vulnerable individuals - sicker; poorer; non-whites; and those belonging to lower social classes, with less access to education, formal jobs, and health insurance (p < 0.05). Doctor visits were higher in people with fair health status (PR = 1.09; 95%CI 1.06-1.12), health insurance (PR = 1.13; 95%CI 1.09-1.17), and chronic diseases (p < 0.001) but lower in men (PR = 0.87; 95%CI 0.84-0.90) and informal workers (PR = 0.89; 95%CI 0.84-0.94). Hospitalizations were higher in people with worse health statuses (p < 0.001), without partners (PR = 1.27; 95%CI 1.05-1.53), and with multimorbidity (PR = 1.68; 95%CI 1.33-2.12) but lower in men (PR = 0.55; 95%CI 0.44-0.68), older adults (p < 0.001), informal workers (PR = 0.67; 95%CI 0.51-0.89), and unemployed (PR = 0.72; 95%CI 0.53-0.97). Unmet surgical needs were higher in older adults (p < 0.001), middle-class people (PR = 1.24; 95%CI 1.01-1.55), worse health statuses (p < 0.001), and chronic diseases (p < 0.001) but lower in men (PR = 0.76; 95%CI 0.65-0.86). CONCLUSIONS From 2015 to 2019, less people visited the doctor, more were admitted to hospitals, and less were in need of surgery or aware of that need, potentially indicating poorer access to health services.

J. pediatr. (Rio J.) ; 97(5): 490-499, Sept.-Oct. 2021. tab, graf
Article in English | LILACS | ID: biblio-1340153


Abstract Objective: To estimate the prevalence of childhood obesity in Brazil by means of a systematic review of representative studies. Sources: We searched for population-based studies that assessed obesity in Brazilian children aged < 10 years in MEDLINE, EMBASE, Scopus and other sources up to September, 2019. Paired researchers selected studies, extracted data and assessed the quality of these studies. Meta-analysis of prevalence and confidence interval (95% CI) was calculated, weighted by the population sizes using Freeman-Tukey double-arccosine transformation. Heterogeneity (I2) and publication bias were investigated by meta-regression and Egger's test, respectively. Summary of the findings: 53 studies were included (n = 122,395), which were held from 1986 to 2015 and limited mainly due to inadequate response rates. Prevalence of obesity in the threedecade period was of 8.2% ([95% CI]: 8.1-8.4%, I2 = 98.5%). Higher prevalence was observed in boys (9.7% [9.4-9.9%], I2 = 97.4%) than girls (7.3% [7.1 7.5%], I2 = 96.1%). Prevalence increased according to the decade (1990: 6.5% [6.0-7.0 %], I2 = 96.8%; 2000: 7.9% [7.7-8.0 %], I2 = 98.8%; 2010: 12.0% [11.5-12.6 %], I2 = 95.8%), and Brazilian region (Northeast: 6.4% [6.2−6.7%], I2 = 98.1%; North: 6.7% [6.3−7.2%], I2 = 98.8%; Southeast:10.6% [10.2−11.0%], I2 = 98.2%; South: 10.1 [9.7−10.4%], I2 = 97.7%). Heterogeneity was affected by age and region (p < 0.05) and publication bias was discarded (p = 0.746). Conclusion: For every 100 Brazilian children, over eight had obesity in the three-decade period and 12 in each 100 had childhood obesity in more recent estimates. Higher prevalence occurred in boys, recent decades and more developed Brazilian regions.

Humans , Male , Female , Child , Pediatric Obesity/epidemiology , Brazil/epidemiology , Prevalence
Article in English, Portuguese | LILACS | ID: biblio-1155472


ABSTRACT Objective: The availability of hazardous products in households increases the risks of poisoning. The present study aimed to assess the frequency and associated factors of the availability and storage of hazardous products in residences in the metropolitan region of Manaus. Methods: Population-based and cross-sectional study conducted in 2015 with adults selected with three-stage probabilistic sampling. Participants were interviewed face-to-face. Prevalence ratio (PR) of the presence of hazardous products (presence of chumbinho [illegal anti-cholinesterase rodenticide], artisanal cleaning products, and unsafe storage of these products and medications) and 95% confidence intervals (95%CI) were calculated with Poisson regression with robust variance, weighted by the complex sampling method adopted. Results: A total of 4,001 participants was included, of which 53.0% (95%CI 51.5-54.6) reported presence of hazardous products in their households, 36.3% (95%CI 34.8-37.8) had unsafe storage, 16.2% (95%CI 15.1-17.4) had artisanal cleaning products, and 8.2% (95%CI 7.4-9.1) had chumbinho. Households with children ≤5 years old had safer storage (PR=0.78; 95%CI 0.71-0.86) and more artisanal products (PR=1.30; 95%CI 1.11-1.51). Presence of artisanal products was higher in lower educational levels (PR=2.20; 95%CI 1.36-3.57) and lower economic classifications (PR=1.63; 95%CI 1.25-2.13). Conclusions: Over half of the households in the metropolitan region of Manaus kept hazardous products; one-third stored them unsafely. Artisanal cleaning products and chumbinho were frequently present. Households with children had safer storage of products, and socioeconomic factors affected the availability of such hazardous products.

RESUMO Objetivo: A disponibilidade de produtos perigosos em domicílios aumenta os riscos de intoxicações. Este estudo objetivou avaliar a frequência e os fatores associados à disponibilidade e armazenamento de produtos perigosos em residências da Região Metropolitana de Manaus. Métodos: Estudo transversal de base populacional realizado em 2015 com adultos selecionados por amostragem probabilística em três estágios. Os participantes foram entrevistados pessoalmente. A razão de prevalência (RP) da presença de produtos perigosos (presença de chumbinho [rodenticida anticolinesterase ilegal], produtos de limpeza artesanais e armazenamento inseguro desses produtos e de medicamentos) e intervalos de confiança de 95% (IC95%) foram calculados por regressão de Poisson com variância robusta, ponderada pela amostragem complexa adotada. Resultados: 4.001 participantes foram incluídos, dos quais 53,0% (IC95% 51,5-54,6) reportaram a presença de produtos perigosos em seus domicílios, 36,3% (IC95% 34,8-37,8) apresentaram armazenamento inseguro, 16,2% (IC95% 15,1-17,4) possuíam produtos de limpeza artesanais e 8,2% (IC95% 7,4-9,1) possuíam chumbinho. Os domicílios com crianças menores de 5 anos apresentaram armazenamento mais seguro (RP=0,78; IC95% 0,71-0,86) e mais produtos artesanais (RP=1,30; IC95% 1,11-1,51). Presença de produtos artesanais foi maior em menores níveis de escolaridade (RP=2,20; IC95% 1,36-3,57) e menores classificações econômicas (RP=1,63; IC95% 1,25-2,13). Conclusões: Mais da metade dos domicílios da Região Metropolitana de Manaus possuía produtos perigosos; um terço os armazenava sem segurança. Produtos de limpeza artesanais e chumbinho estavam frequentemente presentes. Os domicílios com crianças apresentaram armazenamento mais seguro de produtos e fatores socioeconômicos afetaram a disponibilidade de tais produtos perigosos.

Humans , Male , Female , Adolescent , Adult , Poisoning/epidemiology , Urban Population/statistics & numerical data , Hazardous Substances/poisoning , Health Surveys/statistics & numerical data , Household Products/poisoning , Poisoning/mortality , Poisoning/prevention & control , Socioeconomic Factors , Awareness/ethics , Brazil/epidemiology , Residence Characteristics , Family Characteristics , Prevalence , Cross-Sectional Studies , Health Surveys/trends , Educational Status , Household Products/statistics & numerical data
Cad. Saúde Pública (Online) ; 36(12): e00074520, 2020. tab
Article in English | LILACS, SES-SP | ID: biblio-1142636


Abstract: We aimed to investigate the association between occupational exposures and health-related quality of life among both informal and formal workers in the Brazilian Amazon. We conducted a cross-sectional study with working adults in the Manaus Metropolitan Region, Amazonas State, in 2015. Participants were selected through a three-step probabilistic sampling. The primary outcome was the health-related quality of life indicator, measured by the Brazilian validated version of the European Quality of Life 5-Dimensions 3-Levels (EQ-5D-3L) tool. Adjusted multivariate analysis was performed by Tobit regression and considered the complex sampling design. Results were converted to odds ratio (OR). Out of the 1,910 working individuals from the sample, 60.2% were formal workers. Informal workers were significantly more exposed to occupational risks than formal workers (p ≤ 0.05). Mean utility score for informal and formal workers was 0.886 (95%CI: 0.881; 0.890). Quality of life of informal workers was negatively impacted by exposure to noise (OR = 1.28; 95%CI: 1.13; 1.52), occupational stress (OR = 1.95; 95%CI: 1.65; 2.21), and industrial dust (OR = 1.46; 95%CI: 1.28; 1.72), while formal workers were negatively associated with exposure to chemical substances (OR = 1.58; 95%CI: 1.28; 1.87), noise (OR = 1.40; 95%CI: 1.23; 1.65), sun (OR = 1.65; 95%CI: 1.09; 1.40), occupational stress (OR = 1.65; 95%CI: 1.46; 1.87), biological material (OR = 2.61; 95%CI: 1.72; 3.97), and industrial dust (OR = 1.46; 95%CI: 1.28; 1.65). Exposure to occupational risks among workers from the Manaus Metropolitan Region was high, affecting both informal and formal workers. Brazilian policies need to be enforced to reduce the impacts on quality of life among workers in this region.

Resumo: O estudo buscou investigar a associação entre exposições ocupacionais e qualidade de vida relacionada à saúde entre trabalhadores informais e formais na Amazônia brasileira. Realizamos um estudo transversal com trabalhadores adultos na Região Metropolitana de Manaus, Amazonas, em 2015. Os participantes foram selecionados por amostragem probabilística em três estágios. O desfecho primário foi a qualidade de vida relacionada à saúde, medida pela versão brasileira validada do instrumento European Quality of Life 5-Dimensions 3-Levels (EQ-5D-3L). Foi realizada a análise multivariada ajustada por regressão de Tobit, considerando o desenho complexo da amostra. Os resultados foram convertidos em razão de chances (OR). Entre os 1.910 indivíduos na amostra que estavam trabalhando, 60,2% eram trabalhadores formais. Os trabalhadores informais foram mais expostos aos riscos ocupacionais (p ≤ 0,05). A média de utilidade para trabalhadores informais e formais foi 0,886 (IC95%: 0,881; 0,890). A qualidade de vida dos trabalhadores informais foi impactada negativamente pela exposição ao ruído (OR = 1,28; IC95%: 1,13; 1,52), estresse ocupacional (OR = 1,95; IC95%: 1,65; 2,21) e poeiras industriais (OR = 1,46; IC95%: 1,28; 1,72), enquanto trabalhadores formais mostraram uma associação negativa com exposição a substâncias químicas (OR = 1,58; IC95%: 1,28; 1,87), ruído (OR = 1,40; IC95%: 1,23; 1,65), luz solar (OR = 1,65; IC95%: 1,09; 1,40), estresse ocupacional (OR = 1,65; IC95%: 1,46; 1,87), material biológico (OR = 2,61; IC95%: 1,72; 3,97) e poeiras industriais (OR = 1,46; IC95%: 1,28; 1,65). A exposição a riscos ocupacionais entre trabalhadores na Região Metropolitana de Manaus é alta, afetando trabalhadores informais e formais. Políticas brasileiras devem ser implementadas para reduzir os impactos sobre a qualidade de vida dos trabalhadores nessa região do país.

Resumen: El objetivo era investigar la asociación entre exposiciones ocupacionales y calidad de vida relacionada con la salud entre trabajadores formales e informales en la Amazonia Brasileña. Realizamos un estudio transversal con trabajadores adultos en la región metropolitana de Manaus, estado del Amazonas, en 2015. Los participantes fueron seleccionados a través de una muestra probabilística en tres pasos. El resultado primario fue la calidad de vida relacionada con la salud, medida por la versión brasileña validada de la herramienta European Quality of Life 5-Dimensions 3-Levels (EQ-5D-3L). Se realizó un análisis ajustado multivariado mediante la regresión Tobit y se consideró el diseño complejo de la muestra. Los resultados se convertieron en odds ratio (OR). De los 1.910 trabajadores procedentes de la muestra, un 60,2% fueron trabajadores formales. Los trabajadores informales estuvieron significativamente más expuestos a los riesgos ocupacionales que los trabajadores formales (p ≤ 0,05). La puntuación media de utilidad para los trabajadores informales y formales fue 0,886 (IC95%: 0,881; 0,890). La calidad de vida de los trabajadores informales estuvo negativamente impactada por la exposición al ruido (OR = 1,28; IC95%: 1,13; 1,52), estrés ocupacional (OR = 1,95; IC95%: 1,65; 2,21), y polvos industriales OR = 1,46; IC95%: 1,28; 1,72), mientras que los trabajadores formales estuvieron negativamente asociados con la exposición a sustancias químicas (OR = 1,58; IC95%: 1,28; 1,87), ruido (OR = 1,40; IC95%: 1,23; 1,65), sol (OR = 1,65; IC95%: 1,09; 1,40), estrés ocupacional (OR = 1,65; IC95%: 1,46; 1,87), material biológico (OR = 2,61; IC95%: 1,72; 3,97), y polvos industriales (OR = 1,46; IC95%: 1,28; 1,65). La exposición a riesgos ocupacionales entre trabajadores en la región metropolitana de Manaus es alta, afectando tanto a trabajadores informales como formales. Se necesitan imponer políticas brasileñas para reducir los impactos en la calidad de vida entre trabajadores en esta región.

Humans , Adult , Quality of Life , Occupational Exposure/adverse effects , Brazil/epidemiology , Odds Ratio , Cross-Sectional Studies
Braz. J. Pharm. Sci. (Online) ; 56: e18756, 2020. tab, graf
Article in English | LILACS | ID: biblio-1249166


The use of medicines can be an indicator of healthcare access. Our aim was to evaluate the consumption of medicine and associated factors among adults in Manaus Metropolitan Region, located in the north of Brazil. A cross-sectional population-based study was conducted with adults, ≥18 years old, selected by probabilistic sampling. The outcome was the use of medicine in the previous 15 days. Poisson regression with robust variance was used to calculate the prevalence ratio (PR) of medicine consumption, with 95% confidence interval (CI). Use of medicines was reported by 29% (95% CI: 28-31%) of the participants. People with good (PR: 0.82, 95% CI: 0.72-0.94) and fair (PR: 0.77, 95% CI: 0.65-0.90) health status were shown to use less medication than those with very good health. People with partners (PR: 1.19, 95% CI: 1.08-1.31), and people who had sought healthcare service in the fortnight (PR: 2.16, 95% CI: 1.97-2.37) showed higher medicine consumption. Medical prescription (80.1%) was the main inductor of consumption; purchasing at a drug store (46.4%), and acquiring through the Brazilian Unified Health System (39.6%) were the main ways to obtain medicines. About one-third of adults in the Metropolitan Region of Manaus used medicines regularly, mainly people with very good health, living with partners, and with recent use of a health service.

Humans , Male , Female , Adolescent , Adult , Middle Aged , Aged , Aged, 80 and over , Population , Unified Health System , Cross-Sectional Studies/methods , Adult , Drug Utilization/statistics & numerical data , Prescriptions , World Health Organization/organization & administration , Pharmaceutical Preparations/supply & distribution , Health Status , Delivery of Health Care/classification , Economics
Epidemiol. serv. saúde ; 29(4): e2020026, 2020. tab, graf
Article in English, Portuguese | LILACS | ID: biblio-1124748


Objetivo; Analisar o tempo de espera e a duração de consulta médica na região metropolitana de Manaus, Brasil. Métodos: Estudo transversal, realizado com adultos residentes na região em 2015. O tempo de espera para consulta e a duração da consulta, em minutos, foram referidos pelos participantes. A análise foi realizada por regressão de Tobit e ponderada pelo desenho amostral. Resultados: Foram entrevistados 4.001 indivíduos. O tempo médio de espera foi de 125,4 minutos (IC95% 120,2;130,5), enquanto a consulta durou, em média, 52,5 minutos (IC95% 48,0;57,0). Mulheres, pessoas pobres, pessoas com baixa escolaridade, indígenas, residentes em municípios do interior, sem seguro de saúde e atendidos por ginecologistas esperaram mais pela consulta (p<0,05). O tempo de consulta foi menor em pessoas não brancas, com estado de saúde ruim e com plano de saúde (p<0,05). Conclusão: A consulta médica durou, em média, metade do tempo de espera. Observaram-se iniquidades sociais nesses períodos de tempo.

Objetivo: Analizar el tiempo de espera y la duración de la consulta médica en la región metropolitana de Manaus, Brasil. Métodos: Estudio transversal realizado con adultos que viven en la región en 2015. El tiempo de espera y la duración de la consulta en minutos fueron informados por los participantes. El análisis se realizó mediante regresión de Tobit y ponderado por el diseño amostral. Resultados: 4,001 personas fueron entrevistadas. El tiempo de espera promedio fue de 125,4 minutos (IC95% 120,2;130,5) y la consulta duró un promedio de 52,5 minutos (IC95% 48.0;57.0). Mujeres, personas pobres, con baja educación, indígenas, residentes del interior, sin seguro médico y atendidas por ginecólogos esperaron más tiempo para la consulta (p<0.05). El tiempo de consulta fue más corto con personas no blancas, con mala salud y con seguro de salud (p<0.05). Conclusión: La duración de la consulta médica fue, en promedio, la mitad del tiempo de espera. Se observaron desigualdades sociales en estes tiempos.

Objective: To assess waiting times and length of medical consultations in the Manaus metropolitan region, Brazil. Methods:This was a cross-sectional study conducted with adults living in the region in 2015. Waiting time for consultation and length of consultation in minutes were reported by the participants. Analysis was performed using Tobit regression and weighted by the sample design. Results: 4,001 individuals were interviewed. Average waiting time was 125.4 minutes (95%CI 120.2;130.5), while consultations lasted an average of 52.5 minutes (95%CI 48.0;57.0). Women, poor people, people with less education, indigenous people, people resident in the state interior, people without health insurance, and individuals seen by gynecologists waited longer for their consultation (p <0.05). Consultation time was shorter for non-White people, those with poor health status and those who had health insurance (p <0.05). Conclusion: On average length of medical consultations was half the waiting time. Social inequalities were observed in these lengths of time.

Humans , Male , Female , Adult , Middle Aged , Aged , Quality of Health Care , Waiting Lists , Health Services Accessibility , Urban Population , Physicians' Offices , Brazil , Cross-Sectional Studies
Rev. Soc. Bras. Med. Trop ; 53: e20190363, 2020. tab, graf
Article in English | LILACS | ID: biblio-1057278


Abstract INTRODUCTION: This study assessed the seroprevalence of cytomegalovirus, associated factors, and Epstein-Barr virus coinfection among adult residents of Manaus. METHODS: Using a cross-sectional study design, we collected blood samples from 136 individuals in a household survey in 2016. Prevalence ratios were calculated using Poisson regression. RESULTS: Cytomegalovirus and Epstein-Barr virus seroprevalences were 67.6% (95% CI: 9.7-75.6%) and 97.8% (95% CI: 95.3-100.0%), respectively. Coinfection was observed in 66.2% (95% CI: 58.1-74.2%) of participants. Bivariate analysis showed no statistical association. CONCLUSIONS: Seroprevalences were high among participants and approximately 7 out of 10 individuals had cytomegalovirus and Epstein-Barr virus coinfection.

Humans , Male , Female , Adolescent , Young Adult , Cytomegalovirus Infections/epidemiology , Herpesvirus 4, Human/immunology , Epstein-Barr Virus Infections/epidemiology , Cytomegalovirus/immunology , Antibodies, Viral/blood , Socioeconomic Factors , Brazil/epidemiology , Seroepidemiologic Studies , Prevalence , Cross-Sectional Studies , Risk Factors , Cytomegalovirus Infections/diagnosis , Epstein-Barr Virus Infections/diagnosis , Coinfection , Middle Aged
Rev. bras. epidemiol ; 23: e200024, 2020. tab, graf
Article in Portuguese | LILACS | ID: biblio-1101598


Resumo: Introdução: As intoxicações por agrotóxicos causam elevada morbimortalidade. A vigilância é necessária da produção até o uso desses produtos. Objetivo: Analisar as intoxicações e os fatores associados à letalidade por agrotóxicos. Método: Trata-se de estudo caso controle baseado nos atendimentos de intoxicação por agrotóxicos realizados em 2017 por centros de informação e assistência toxicológica do Brasil. Pacientes que evoluíram a óbito compuseram o grupo caso, e os sobreviventes, o grupo controle. Calculou-se odds ratio (OR) dos fatores de risco para óbito, com intervalo de confiança (IC) de 95%. Com base no modelo de regressão, desenvolveu-se um modelo preditivo de morte, estratificado por faixa etária, sexo e contexto ocupacional, para investigação do risco dos trabalhadores agropecuários intoxicados por agentes extremamente tóxicos. Resultados: Identificaram-se 3.826 pacientes intoxicados por agrotóxicos, dos quais 146 evoluíram para óbito. Idosos (OR = 4,94; IC95% 2,49 - 9,80), homens (OR = 1,68; IC95% 1,15 - 2,46), trabalhadores do setor agropecuário (OR = 2,20; IC95% 1,15 - 4,24), tentativas de suicídio (OR = 13,27; IC95% 6,48 - 27,19) e exposição a produtos extremamente tóxicos (OR = 2,77; IC95% 1,84 - 4,16) apresentaram mais chances de óbito nas intoxicações por agrotóxicos. Conclusão: Em cada 100 intoxicações por agrotóxicos, quatro evoluíram para óbito. Idosos, homens, trabalho no setor agropecuário, tentativas de suicídio e produtos extremamente tóxicos apresentaram mais chances de óbito.

ABSTRACT: Background: Pesticide poisoning causes high morbidity and mortality. Surveillance is required for post-marketing monitoring of these products. Aim: To assess poisonings and associated factors with lethality by pesticides. Method: This is a case-control study based on the cases of pesticide poisoning assisted in 2017 by Brazilian Poison Control Centers. Patients who died were the cases and the survivors, the control. The odds ratio (OR) of death and 95% confidence interval (CI) were calculated. From the regression model, a predictive model of death was developed, stratified by age, gender and occupational context to investigate the risk of agricultural workers poisoned by extremely hazardous agents. Results: 3,826 patients poisoned by pesticides were identified, of which 146 died. Older people (OR = 4.94; 95%CI 2.49 - 9.80), males (OR = 1.68; 95%CI 1.15 - 2.46), agricultural workers (OR = 2.20; 95%CI 1.15 - 4.24), suicide attempts (OR = 13.27; 95%CI 6.48 - 27.19) and exposure to extremely hazardous products (OR = 2.77; 95%CI 1.84 - 4.16) odds of death from pesticide poisoning. Conclusion: Out of 100 pesticides poisoning, four died. Elderly, males, working in the agricultural sector, suicide attempts and extremely hazardous products had a higher risk of death.

Humans , Male , Female , Infant , Child, Preschool , Child , Adolescent , Adult , Young Adult , Pesticides/poisoning , Poisoning/mortality , Suicide, Attempted/statistics & numerical data , Brazil/epidemiology , Case-Control Studies , Logistic Models , Sex Factors , Risk Factors , Occupational Exposure/adverse effects , Occupational Exposure/statistics & numerical data , Age Factors , Sex Distribution , Age Distribution , Agricultural Workers' Diseases/mortality , Farmers/statistics & numerical data , Middle Aged
Epidemiol. serv. saúde ; 29(1): e2018414, 2020. tab
Article in Portuguese | LILACS | ID: biblio-1090245


Objetivo: analisar a frequência e fatores associados à cobertura por planos privados de saúde na região metropolitana de Manaus, AM, Brasil. Métodos: estudo transversal de base populacional realizado em 2015, por meio de entrevista domiciliar; as razões de prevalência (RP) e intervalos de confiança (IC95%) foram calculadas pela regressão de Poisson, com variância robusta ajustada por sexo e faixa etária. Resultados: foram entrevistados 4.001 indivíduos, dos quais 13% (IC95% 12,0 a 14,1%) tinham plano de saúde; maior cobertura por planos foi observada entre militares (RP=3,18 - IC95% 1,64;6,15), empregados dos setores privado (RP=1,91 - IC95% 1,46;2,52) e público (RP=1,75 - IC95% 1,23;2,49); a cobertura por planos de saúde foi menor entre pessoas mais pobres (RP=0,21 - IC95% 0,13;0,33) e de menor escolaridade (RP=0,66 - IC95% 0,46;0,99). Conclusão: a frequência de planos de saúde foi baixa e associou-se a melhor poder aquisitivo, escolaridade e situação de trabalho.

Objetivo: analizar la frecuencia y los factores asociados a la cobertura por planes de salud en la región metropolitana de Manaus, AM, Brasil. Métodos: estudio transversal de base poblacional por entrevista domiciliar. Las razones de prevalencia (RP) e intervalo de confianza (IC95%) fueron calculadas por regresión de Poisson con varianza robusta, ajustadas por sexo y edad. Resultados: se entrevistaron 4.001 individuos; 13% (IC95%: 12,0 a 14,1%) tenían plan de salud; la mayor cobertura por planes fue observada entre militares (RP=3,18 - IC95% 1,64;6,15), empleados del sector privado (RP=1,91 - IC95% 1,46;2,52) y del sector público (RP=1,75 - IC95% 1,23;2,49); la cobertura fue menor en personas más pobres (RP=0,21 - IC95% 0,13;0,33) y de menor escolaridad (RP=0,66 - IC95% 0,46;0,99). Conclusión: la frecuencia de planes de salud fue baja y se asoció con mejor poder adquisitivo, escolaridad y situación de trabajo.

Objective: to analyze the frequency and factors associated with coverage by health insurance in the metropolitan region of Manaus, AM, Brazil. Method: a cross-sectional population-based study was conducted in 2015, with data collected through household interviews; prevalence ratios (PR) and confidence intervals (95%CI) were calculated using Poisson regression with robust variance adjusted for sex and age. Results: we interviewed 4,001 individuals; 13% (95%CI - 12.0;14.1%) had health insurance; greater insurance coverage was observed among military personnel (PR=3.18 - 95%CI 1.64;6.15), private sector employees (PR=1.91 - 95%CI 1.46;2.52) and public sector employees (PR=1.75 - 95%CI 1.23;2.49); health insurance was lower among poorer people (PR=0.21 - 95%CI 0.13;0.33), and those with less schooling (PR=0.66 - 95%CI 0.46;0.99). Conclusion: frequency of health insurance was low and was associated with better purchasing power, schooling, and employment.

Humans , Male , Female , Adult , Middle Aged , Aged , Aged, 80 and over , Young Adult , Quality of Health Care , Prepaid Health Plans/statistics & numerical data , Health Status Disparities , Health Services Accessibility/statistics & numerical data , Socioeconomic Factors , Brazil , Cross-Sectional Studies
Säo Paulo med. j ; 137(3): 216-222, May-June 2019. tab
Article in English | LILACS | ID: biblio-1020966


ABSTRACT BACKGROUND: Patient safety culture is part of the organizational profile of healthcare institutions and is associated with better quality of care. OBJECTIVE: To assess patient safety culture in a university hospital. DESIGN AND SETTING: Hospital-based cross-sectional study conducted in a public university hospital in São Paulo, Brazil, between September and December 2015. METHODS: We randomly selected 68 sectors of the hospital, to include up to 5 employees from each sector, regardless of length of experience. We used the validated Brazilian version of the Hospital Survey on Patient Safety Culture (HSOPS) via an electronic interface. We calculated the percentage of positive responses for each dimension of the HSOPS and explored the differences in age, experience, occupation and educational level of respondents using the chi-square test. RESULTS: Out of 324 invited respondents, 314 (97%) accepted the invitation and were surveyed. The sample presented predominance of women (72%), nursing staff (45%) and employees with less than six years' experience at the hospital (60%). Nine out of the 12 dimensions showed percentages of positive responses below 50%. The worst results related to "nonpunitive response to errors" (16%). A better safety culture was observed among more experienced staff, nurses and employees with a lower educational level. In the previous year, no events were reported by 65% of the participants. CONCLUSIONS: The patient safety culture presented weaknesses and most of professionals had not reported any event in the previous year. A policy for improvement and cyclical assessment is needed to ensure safe care.

Humans , Male , Female , Adolescent , Adult , Middle Aged , Aged , Young Adult , Health Personnel , Safety Management , Patient Safety , Brazil , Cross-Sectional Studies , Hospitals, University
Rev. saúde pública (Online) ; 53: 05, jan. 2019. tab
Article in English | LILACS | ID: biblio-979050


ABSTRACT OBJECTIVE To determine the prevalence of current depressive symptoms in people with diabetes mellitus and their association with the disease. METHODS Data were collected from the Brazilian National Health Survey (Pesquisa Nacional de Saúde - PNS), a cross-sectional, population-based study conducted in 2013. Study participants were selected by simple random cluster sampling in three stages: census tracts, households, and residents aged ≥ 18 years. The presence of diabetes was self-reported, whereas the presence of current depressive symptoms was determined by the Patient Health Questionnaire-9 (PHQ-9) and mean scores of this questionnaire were calculated for the variables assessed. Tobit regression was used to evaluate variation in these individuals. RESULTS Of the 60,202 interviewees, 6.03% (n = 3,636) reported diabetes mellitus. The disease was more frequent in female, older, widowed, obese and with incomplete elementary education. Depression symptoms were mild-to-moderately severe in 22% of the diabetics. The severity of current depressive symptoms was higher in individuals that were female (PHQ-9 mean = 3.35), older adults (PHQ-9 mean = 3.01), indigenous (PHQ-9 mean = 3.46), separated/divorced (PHQ-9 mean = 3.13), widowed (PHQ-9 mean = 3.39), obese (PHQ-9 mean = 3.13) and with incomplete primary education (PHQ-9 mean = 3.21). Higher severity of depressive symptoms was associated with the use of insulin and with coma (PHQ-9 mean = 8.32), limb amputation (PHQ-9 mean = 7.55), circulatory problems (PHQ-9 mean = 6.94), infarction (PHQ-9 mean = 6.83), diabetic foot (PHQ-9 mean = 6.62), and kidney problems (PHQ-9 mean = 6.68). The severity of current depressive symptoms was associated with diabetes severity and degree of limitation in activities of daily living (PHQ-9 mean = 10.62). CONCLUSIONS Interventions to improve depressive symptoms should be prioritized in people with diabetes are female, older adults, indigenous, widowed, separated/divorced, obese and with incomplete elementary education.

Humans , Male , Female , Adolescent , Adult , Young Adult , Depression/epidemiology , Diabetes Mellitus/psychology , Diabetes Mellitus/epidemiology , Socioeconomic Factors , Severity of Illness Index , Brazil/epidemiology , Prevalence , Cross-Sectional Studies , Surveys and Questionnaires , Sex Distribution , Age Distribution , Diabetes Complications/psychology , Depression/etiology
Rev. Soc. Bras. Med. Trop ; 52: e20190232, 2019. tab
Article in English | LILACS | ID: biblio-1020445


Abstract INTRODUCTION: Dengue is an endemic and epidemic disease in Brazil, with a high burden of disease. Amazonas State has a high risk of transmission. This study aimed to assess the self-reported prevalence of dengue in adults living in Manaus Metropolitan Region. METHODS: A cross-sectional study was conducted with adults living in Manaus Metropolitan Region in 2015. We performed a three-phase probabilistic sampling to collect participants' clinical and sociodemographic data. Self-reported dengue infection in the previous year was the primary outcome. Descriptive statistics and Poisson regression analysis with robust variance were used to calculate the prevalence ratio (PR) of dengue infections with 95% confidence intervals (95% CIs). Multilevel analysis including city and neighborhood variables was calculated. All analyses considered the complex sampling. RESULTS: Among the 4,001 participants, dengue in the previous year was self-reported by 7.0% (95% CI 6.3%-7.8%). Dengue was more frequent in women(PR 1.51; 95% CI 1.06-2.13), elderly participants (≥60 years old, PR 2.54; 95% CI 1.19-5.45), White and Asian participants (PR, 1.57; 95% CI, 1.11-2.23), and individuals who had not received endemic agent visits (PR, 2.28; 95% CI, 1.31-3.99). After multilevel analysis, sex was no longer a significant variable, with the remaining associations still significant. CONCLUSIONS: Seven out of 100 inhabitants of Manaus Metropolitan Region reported dengue in the previous year. Dengue was predominantly observed in women, elderly individuals, White and Asian individuals, and individuals who did not receive endemic agent visits. The setting plays an important role in dengue infections.

Humans , Male , Female , Adolescent , Adult , Young Adult , Dengue/epidemiology , Self Report/statistics & numerical data , Socioeconomic Factors , Urban Population , Brazil/epidemiology , Prevalence , Cross-Sectional Studies , Middle Aged
Säo Paulo med. j ; 136(5): 407-413, Sept.-Oct. 2018. tab
Article in English | LILACS | ID: biblio-979384


ABSTRACT BACKGROUND: The consumption of antibiotics has been widely discussed, mainly because of antibacterial resistance, which has become a worldwide concern. In Brazil, sale of antibiotics is currently ruled by Agência Nacional de Vigilância Sanitária (ANVISA) regulation RDC 20/2011, which restricts sales to those made under medical prescription. The aims of this study were to evaluate antibiotic use and associated factors among adults in the Metropolitan Region of Manaus, Amazonas, Brazil, and to assess the proportion of self-medication from this use. DESIGN AND SETTING: Population-based cross-sectional study conducted in the Metropolitan Region of Manaus between May and August 2015. METHODS: Adults aged ≥ 18 years were selected through probabilistic sampling in three stages. Trained interviewers collected data from the participants in their homes. Antibiotic consumption over the last 15 days was reported. Bivariate analysis was used to calculate the prevalence ratio (PR) of antibiotic usage, with 95% confidence interval (95% CI). A multivariate model adjusted according to significant variables at P ≤ 0.20 using Poisson regression with robust variance was constructed. RESULTS: The prevalence of antibiotic use was 3.4% (95% CI 2.8-4.0%). Adjusted analysis showed that consumption was higher among women than among men (PR 1.58; 95% CI 1.11-2.24) and among people with fair health status than among those with good health (PR 1.52; 95% CI 1.08-2.15). The prevalence of self-medication was 19.0%; amoxicillin was the most self-medicated antibiotic (10/26). CONCLUSION: Antibiotic use was associated with women and individuals with fair health status. One fifth of the antibiotics were consumed through self-medication, contrary to the current Brazilian legislation.

Humans , Male , Female , Adult , Middle Aged , Young Adult , Self Medication/statistics & numerical data , Anti-Bacterial Agents/therapeutic use , Socioeconomic Factors , Brazil , Poisson Distribution , Cross-Sectional Studies , Surveys and Questionnaires , Sex Distribution , Age Distribution , Drug Misuse/statistics & numerical data
Rev. latinoam. enferm. (Online) ; 26: e3014, 2018. tab, graf
Article in English | LILACS, BDENF | ID: biblio-961160


ABSTRACT Objective: to assess patient safety culture in a university hospital. Method: cross-sectional study with data collection through the Hospital Survey on Patient Safety Culture applied in electronic device. A total of 381 employees were interviewed, corresponding to 46% of the sum of eligible professionals. Data were analyzed descriptively. the Cronbach's alpha was used to calculate the frequency and reliability. Results: most were women (73%) from the nursing area (50%) and with direct contact with patients (82%). The composites related to "teamwork within units" (58%, α=0.68), "organizational learning - continuous improvement" (58%, α=0.63), "supervisor/manager expectations and actions promoting patient safety" (56%, α=0.73) had higher positive responses. Nine composites had low positive responses, with emphasis on "nonpunitive response to error" (18%, α=0.40). Only the item "in this unit, people treat each other with respect" had positive response above 70%. The patient safety assessment in the work unit was positive for 36% of employees, however only 22% reported events in past year. Conclusion: the findings revealed weaknesses in the safety culture at the hospital, with emphasis on culpability.

RESUMO Objetivo: avaliar a cultura de segurança do paciente em hospital universitário. Método: estudo transversal com coleta de dados por meio do Hospital Survey on Patient Safety Culture aplicado em dispositivo eletrônico. Entrevistaram-se 381 funcionários, correspondendo a 46% do total de profissionais elegíveis. Os dados foram analisados descritivamente, com cálculo de frequências e da confiabilidade pelo alfa de Cronbach. Resultados: a maior parte eram mulheres (73%), da área de enfermagem (50%) e com contato direto com pacientes (82%). As dimensões "trabalho em equipe no âmbito das unidades" (58%, α=0,68), "aprendizado organizacional" (58%, α=0,63), "expectativas e ações dos supervisores e gerentes para promoção da segurança do paciente" (56%, α=0,73) apresentaram maior positividade. Nove dimensões tiveram positividade baixa, com destaque para "respostas não punitivas aos erros" (18%, α=0,40). Somente o item "nesta unidade, as pessoas se tratam com respeito" obteve positividade acima de 70%. A avaliação da segurança do paciente na unidade de trabalho foi positiva para 36% dos funcionários, porém somente 22% informaram ter notificado eventos no último ano. Conclusão: os achados revelam fragilidades na cultura de segurança no hospital, com destaque à culpabilização.

RESUMEN Objetivo: evaluar la cultura de seguridad del paciente en un hospital universitario. Método: estudio transversal con recogimiento de datos por medio del Hospital Surveyon Patient Safety Culture aplicado en dispositivo electrónico. Se entrevistaron 381 funcionarios, correspondiendo a 46% del total de profesionales elegibles. Los datos fueron analizados descriptivamente; fueron calculadas las frecuencias y la confiabilidad con el alfa de Cronbach. Resultados: la mayor parte eran mujeres (73%) del área de enfermería (50%), con contacto directo con pacientes (82%). Las dimensiones "trabajando en equipo dentro de las unidades" (58%, α=0,68), "aprendizaje organizativo - mejorías continuas" (58%, α=0,63), "expectativas y acciones del supervisor para promover la seguridad de los pacientes" (56%, α=0,73), presentaron mayor positividad. Nueve dimensiones tuvieron positividad baja, con destaque para respuesta no punitivas a los errores (18%, α=0,40). Solamente el ítem "en esta unidad, el personal se trata con respeto" obtuvo positividad arriba de 70%. La evaluación de la seguridad del paciente en la unidad de trabajo fue positiva para 36% de los funcionarios; sin embargo, solamente 22% reportaran incidentes en el último año. Conclusión: los hallazgos revelan fragilidades en la cultura de seguridad en el hospital, entre los cuales se destaca la culpabilización.

Humans , Male , Female , Middle Aged , Aged , Universities/organization & administration , Safety Management/organization & administration , Patient Safety/standards , Hospital Administration/standards , Switzerland , Attitude of Health Personnel , Surveys and Questionnaires
Epidemiol. serv. saúde ; 26(4): 725-734, out.-dez. 2017. tab, graf
Article in Portuguese | LILACS | ID: biblio-953354


OBJETIVO: descrever o uso de serviços de saúde entre adultos residentes na Região Metropolitana de Manaus, Amazonas, Brasil. MÉTODOS: estudo descritivo, com dados de inquérito de base populacional realizado com adultos (≥18 anos) residentes na Região Metropolitana de Manaus em 2015; foi empregada amostragem probabilística por conglomerados em três estágios; os dados foram coletados nos domicílios dos participantes. RESULTADOS: participaram 4.001 adultos, 52,8% mulheres, 49,7% entre 18-34 anos; 80% avaliaram seu estado de saúde como bom/regular; nas duas semanas anteriores à entrevista, 20,9% (IC95% 19,7;22,2%) utilizaram serviço de saúde, 44,4% deles uma unidade básica de saúde; 2,9% (IC95% 2,4;3,4%) nunca consultaram um serviço de saúde; entre aqueles que consultaram médico na vida (n=3.886), a maioria avaliou positivamente a última consulta. CONCLUSÃO: a situação de saúde e última consulta foram avaliados positivamente; um quinto da população acessou algum serviço de saúde na quinzena anterior, sendo a unidade básica o principal serviço.

OBJETIVO: describir el uso de servicios de salud en adultos de la Región Metropolitana de Manaus, Amazonas, Brasil. MÉTODOS: estudio descriptivo transversal de base poblacional realizado con adultos de la Región Metropolitana de Manaus en 2015; utilizamos muestreo probabilístico en tres etapas; los datos fueron colectados en los domicilios. RESULTADOS: se incluyeron 4.001 individuos, 52,8% mujeres, 49,7% entre 18-34 años; 80% clasificó su estado de salud como bueno/regular; en las última quincena, 20,9% (IC95% 19,7;22,2%) utilizaron servicios de salud, 44,4% de estos en unidades básicas; 2.9% (IC95% 2,4;3,4%) nunca consultaron un médico; entre los que ya visitaron a un médico, la mayoría evaluó positivamente la última consulta. CONCLUSIÓN: la situación de salud y última consulta fueron evaluadas positivamente; un quinto utilizó un servicio en la quincena anterior, las unidades básicas fueron el principal servicio utilizado.

OBJECTIVE: to describe the use of health services in adults living in Manaus Metropolitan Region, Amazonas, Brazil. METHODS: a population-based cross-sectional study was carried out with adults (≥18 years) living in Manaus Metropolitan Region in 2015; probabilistic sampling with three-stage clusters was used; data were collected at the participants' households. RESULTS: 4,001 adults participated, 52.8% were women, 49.7% aged 18-34 years; 80% rated their health status as good/regular; in the fortnight previous to the survey, 20.9% (95%CI 19.7;22.2%) had used a health service, 44.4% of those visited a primary health care unit; 2.9% (95%CI 2.4;3.4%) never used a health service; among those who already visited a doctor (n=3,886), most gave positive feedback about the last visit. CONCLUSION: health situation and last medical visit were positively assessed; one fifth of the population had used a health service in the two weeks prior to the interview, primary health care units were the main services used.

Humans , Male , Female , Adult , Population , Diagnosis of Health Situation , Surveys and Questionnaires , Health Services , Epidemiology, Descriptive
Epidemiol. serv. saúde ; 26(3): 589-604, jul.-set. 2017. tab, graf
Article in Portuguese | LILACS | ID: biblio-953334


OBJETIVO: estimar a prevalência da utilização de serviços de saúde no Brasil. MÉTODOS: revisão sistemática e meta-análise de estudos transversais de base populacional; foram pesquisadas MEDLINE, EMBASE, outras fontes e microdados de inquéritos; duas pesquisadoras selecionaram os estudos, extraíram os dados e avaliaram a qualidade metodológica para inclusão na meta-análise. RESULTADOS: localizaram-se 1.979 referências, foram incluídos 27 estudos; a prevalência de consulta médica no último ano foi de 71% (intervalo de confiança de 95% [IC95%]= 69; 73%; I2= 99%); diferenças na proporção de mulheres nas amostras (p=0,001; R2=25%) e no tempo recordatório dos estudos (p>0,001; R2=72%) contribuíram para a alta heterogeneidade; a prevalência de consultas odontológicas foi de 37% (IC95% = 32; 42%; I2=100%), e de hospitalização, 10% (IC95% = 9; 11%; I2=98%), no último ano. CONCLUSÃO: mais da metade da população realizou uma consulta médica, cerca de um terço foi ao dentista e um décimo hospitalizou-se no último ano.

OBJETIVO: analizar la prevalencia de uso de servicios de salud en Brasil. MÉTODOS: revisión sistemática de estudios transversales. Se buscó en MEDLINE, EMBASE, otras fuentes y microdatos de encuestas, indexados hasta enero/2017; dos investigadores seleccionaron, extrajeron datos y evaluaron la calidad metodológica de los estudios; combinamos los estudios en una meta-análisis. RESULTADOS: obtuvimos 1.979 referencias e incluimos 27; la prevalencia de visita médica en el último año fue 71% (intervalo de confianza al 95% [IC95% ] = 69 a 73%; I2=99%); la proporción de mujeres (p=0,001; R2=25%) y período de recuerdo (p>0,001; R2=72%) contribuyeron para la heterogeneidad; la prevalencia de consulta a un dentista fue de 37% (IC95% = 32 a 42%; I2=100%), y de hospitalización, 10% (IC95% = 9 a 11%; I2=98%), en el último año. CONCLUSIÓN: más de la mitad de la población hizo una visita médica, cerca de un tercio consultó con el dentista y una décima parte fueron hospitalizadas en el último año.

OBJECTIVE: to analyze the prevalence of use of health services in Brazil. METHODS: systematic review and meta-analysis of population-based cross-sectional studies; MEDLINE, EMBASE, other sources, and microdata of surveys were searched; two researchers selected the studies, extracted the data and assessed methodological quality to include in the meta-analysis. RESULTS: from 1,979 retrieved references, 27 studies were included; the prevalence of medical visits in the previous year was 71% (confidence interval of 95% [95%CI] = 69; 73%; I2=99%); the proportion of women in each study (p=0.001; R2=25%) and the recall period (p>0.001; R2= 72%) contributed to the heterogeneity; prevalence of dental consultation was 37% (95%CI = 32; 42%; I2=100%), and of hospitalization, 10% (95%CI = 9; 11%; I2=98%), in the last year. CONCLUSION: more than half of the population had at least one medical visit, about one-third had a dental consultation and a tenth was hospitalized in the previous year.

Humans , Prevalence , Ambulatory Care , Review , Meta-Analysis
Ciênc. Saúde Colet ; 22(8): 2615-2626, Ago. 2017. tab, graf
Article in Portuguese | LILACS | ID: biblio-890428


Resumo O uso de medicamentos em adultos foi avaliado por alguns estudos de base populacional no Brasil, mas não há estimativa geral da prevalência desse consumo disponível. Nosso objetivo foi estimar a prevalência do uso de medicamentos avaliada em estudos transversais entre adultos brasileiros. Realizou-se uma revisão sistemática da literatura por meio de busca no Medline, Embase, Scopus, Lilacs, SciELO, banco de teses da Capes até janeiro de 2017. Duas revisoras selecionaram as pesquisas, extraíram os dados e avaliaram a qualidade metodológica daquelas incluídas. As prevalências de consumo foram combinadas em meta-análises, a heterogeneidade foi medida pelo I2 e investigada por análises de subgrupo e metarregressão. A busca identificou 4.005 publicações, das quais 14 foram incluídas no estudo. A maioria dos estudos (12/14) mediu o consumo nos últimos 15 dias, encontrando prevalência de consumo de 49,1% (IC95%: 48,5-49,6%; I2 =100%). O período recordatório explica parte da heterogeneidade encontrada (R2= 23%; p = 0,048), mas a análise de subgrupos não possibilitou encontrar resultados mais homogêneos. O uso de medicamentos é realizado por quase metade dos adultos brasileiros. Ações adequadas de assistência e atenção farmacêutica são necessárias para assegurar o uso racional dessas tecnologias.

Abstract The use of medicine in adults has been assessed by some population-based studies in Brazil, but to date there has been no overall estimate of the prevalence of drug consumption. We therefore aimed to estimate the prevalence of medicine use as measured in previously reported cross-sectional studies among Brazilian adults. We conducted a systematic review of the literature, searching in MEDLINE, Embase among others to a date ending January 2017. Two researchers selected the studies, extracted data and assessed methodological quality of those chosen for inclusion. The consumption prevalence were combined in meta-analyses, the heterogeneity measured by I2 and investigated by subgroup analyses and meta-regression. The search identified 4,005 publications, of which 14 were ultimately included in the study. Most studies (12/14) measured the consumption over the previous 15 days, finding a consumption prevalence of 49.1% (95% CI: 48.5-49.6%, I2 = 100%). The recall period explains part of the heterogeneity found (R2 = 23%, p = 0.048), however the subgroup analysis did not allow for more homogeneous results. The use of medications occurs among almost half of all Brazilian adults. Appropriate pharmaceutical assistance and care are necessary to ensure the rational use of these technologies.

Humans , Adult , Research Design , Pharmaceutical Preparations/administration & dosage , Drug Therapy/statistics & numerical data , Brazil , Prevalence , Cross-Sectional Studies