Prevalência de saúde cardiovascular ideal na população adulta brasileira - Pesquisa Nacional de Saúde 2019 / Prevalencia de salud cardiovascular ideal en la población adulta brasileña - Encuesta Nacional de Salud 2019 / Prevalence of ideal cardiovascular health in the Brazilian adult population - National Health Survey 2019

Objective: to analyze the prevalence of ideal cardiovascular health (CVH) in the Brazilian adult population based on the 2019 National Health Survey. Methods: this was a population-based cross-sectional study (n = 77,494); prevalence and respective 95% confidence intervals (95%CI) of ideal CVH (seven metrics achieved simultaneously) and by individual metrics (four behavioral and three biological metrics), as defined by the American Heart Association, were estimated. Results: only 0.5% (95%CI 0.4;0.6) of the study population presented ideal CVH, with higher prevalence among those with higher level of education (1.3%; 95%CI 0.9;1.6) and residents in urban areas (0.6%; 95%CI 0.5;0.7); the prevalence of behavioral and biological metrics was 0.7% (95%CI 0.6;0.8) and 63.3% (95%CI 62.7;63.9) respectively. Conclusion: the prevalence of ideal CVH was very low, highlighting the need for public policies aimed at promotion, surveillance and CVH care in the Brazilian adult population.

Objetivo: analizar la prevalencia de salud cardiovascular (SCV) ideal en la población adulta brasileña con base en la Encuesta Nacional de Salud de 2019. Métodos: estudio transversal de base poblacional (n = 77.495). Según lo propuesto por la Asociación Americana del Corazón, la prevalencia y los intervalos de confianza del 95% (IC95%) del SCV ideal se estimaron globalmente (siete metas alcanzadas simultáneamente) y por metas individuales (cuatro metas de comportamiento y tres metas). Se calculó la prevalencia de las metas por variables sociodemográficas. Resultados: sólo el 0,5% (IC95% 0,4;0,6) de la población presentó SCV ideal, siendo más frecuente en aquellos con educación superior (1,3%; IC95% 0,9;1,6) y entre los residentes de áreas urbanas (0,6%; IC95%0,5;0,7). La prevalencia de las metas de comportamiento y biológicas fue de 0,7% (IC95% 0,6;0,8) y 63,3% (IC95% 62,7;63,9), respectivamente. Conclusión: la prevalencia de SCV ideal en adultos brasileños es muy baja, destacando la necesidad de políticas públicas para la promoción, vigilancia y atención a la SCV en la población adulta brasileña.

Objetivo: analisar a prevalência de saúde cardiovascular (SCV) ideal na população adulta brasileira. Métodos: estudo transversal com base na Pesquisa Nacional de Saúde de 2019 (n = 77.494); foram estimadas as prevalências e respectivos intervalos de confiança de 95% (IC95%) de SCV ideal (sete metas alcançadas simultaneamente) e por metas individuais (quatro metas comportamentais; três biológicas), conforme propõe a Associação Americana do Coração. Resultados: apenas 0,5% (IC95% 0,4;0,6) da população estudada apresentou SCV ideal, observando-se maior prevalência entre aqueles com maior escolaridade (1,3%; IC95% 0,9;1,6) e os residentes em áreas urbanas (0,6%; IC95% 0,5;0,7); as prevalências das metas comportamentais e biológicas foram de 0,7% (IC95% 0,6;0,8) e 63,3% (IC95% 62,7;63,9) respectivamente. Conclusão: a prevalência de SCV ideal foi muito baixa, evidenciando a necessidade de políticas públicas para promoção, vigilância e atenção à SCV na população adulta brasileira.

A Population-based Screening of Type 2 Diabetes in High-risk Population of Yasuj, Iran.

Complications associated with diabetes can be prevented by early diagnostics. A high-risk population was screened for diabetes, and the prevalence of undiagnosed diabetes mellitus (DM) and impaired fasting glucose (IFG) were used for examining the impacts of lifestyle, social and anthropometric features, and other risk factors. The target population comprised 30-65 years old residents from the western suburbs of Yasuj. Homes were approached, and a standard questionnaire was used for collecting information on sex, blood pressure, weight, height, and BMI for each participant. The high-risk participants were recognized according to the National Diabetes Prevention and Control Committee criteria and were introduced to an assigned laboratory. Blood samples were collected after 12-hour fasting for the measurement of total cholesterol, triglycerides and fasting glucose levels. The statistical analysis was performed with the SPSS statistical package, using a logistic regression model. Out of 2,569 individuals, 1,336 (52%) were with highrisk diabetes, 71.5% were female, and 28.5% were male. Of 191 (7.4%) individuals with known diabetes, 5 (2.6%) had type 1 diabetes; 881 (66.9%) out of 1,336 high-risk individuals were referred to assigned laboratory. Of 881 high-risk individuals, 157 (17.8%) had fasting blood sugar (FBS) ≥126 mg/dL and 118 (13.4%) had FBS between110 and 125 mg/dL. Percentages of participants with triglyceride ≥150 mg/dL and cholesterol ≥200 mg/dL were 298 (33.8%) and 207 (23.5%) respectively. Diabetes was associated with ageing, dyslipidaemia, family history of diabetes, lower physical activity on occupation, intake of lower dietary fibre, and non-literacy in the sampled population. This study suggests that diabetes is a common health problem in this area. Furthermore, considerable rate of newly-diagnosed diabetes signifies the importance of the screening programme.

Lifetime Prevalence, age and gender distribution and age-of-onset of psychiatric disorders in the São Paulo Metropolitan Area, Brazil: results from the São Paulo Megacity Mental Health Survey / Prevalência em toda a vida, distribuição por idade e sexo e idade de início de transtornos psiquiátricos na área metropolitana de São Paulo, Brasil: resultados do Estudo Epidemiológico de Transtornos Mentais São Paulo Megacity

OBJECTIVES: To estimate prevalence, age-of-onset, gender distribution and identify correlates of lifetime psychiatric disorders in the São Paulo Metropolitan Area (SPMA). METHODS: The São Paulo Megacity Mental Health Survey assessed psychiatric disorders on a probabilistic sample of 5,037 adult residents in the SPMA, using the World Mental Health Survey Version of the Composite International Diagnostic Interview. Response rate was 81.3%. RESULTS: Lifetime prevalence for any disorder was 44.8%; estimated risk at age 75 was 57.7%; comorbidity was frequent. Major depression, specific phobias and alcohol abuse were the most prevalent across disorders; anxiety disorders were the most frequent class. Early age-of-onset for phobic and impulse-control disorders and later age-of-onset for mood disorders were observed. Women were more likely to have anxiety and mood disorders, whereas men, substance use disorders. Apart from conduct disorders, more frequent in men, there were no gender differences in impulse-control disorders. There was a consistent trend of higher prevalence in the youngest cohorts. Low education level was associated to substance use disorders. CONCLUSIONS: Psychiatric disorders are highly prevalent among the general adult population in the SPMA, with frequent comorbidity, early age-of-onset for most disorders, and younger cohorts presenting higher rates of morbidity. Such scenario calls for vigorous public health action.

OBJETIVOS: Estimar a prevalência, idade de início, distribuição por sexo e idade e identifica fatores correlacionados à morbidade psiquiátrica na Região Metropolitana de São Paulo (RMSP). MÉTODOS: O Estudo Epidemiológico de Transtornos Mentais São Paulo Megacity avaliou transtornos psiquiátricos em uma amostra probabilística composta por 5.037 adultos (18+) residentes na RMSP, utilizando o Composite International Diagnostic Interview, versão World Mental Health Survey. A taxa global de resposta foi de 81,3%. RESULTADOS: A prevalência de pelo menos um transtorno mental ao longo da vida foi de 44,8% e o risco estimado aos 75 anos de idade foi de 57,7%; comorbidade ocorreu com frequência. Depressão maior, fobias específicas e abuso de álcool foram os transtornos mais prevalentes; transtornos de ansiedade foi a classe de transtornos mais frequente. Fobias específicas e transtornos do controle de impulsos tiveram idade de início precoce, enquanto transtornos do humor tiveram início mais tardiamente. Mulheres apresentaram maior risco para transtornos do humor e de ansiedade, e homens para transtornos decorrentes do uso de álcool e drogas. Com exceção de transtornos da conduta, que foram mais frequentes em homens, não se observou diferenças de gênero na distribuição de transtornos do controle de impulso. Observou-se uma tendência consistente entre os diferentes transtornos de maiores taxas de morbidade nas coortes mais jovens. Baixa escolaridade mostrou-se associada a transtornos decorrentes do uso de álcool e drogas. CONCLUSÃO: Transtornos psiquiátricos na população geral adulta da RMSP são altamente prevalentes, com comorbidade frequente, idade de início precoce na maior parte dos transtornos avaliados, e taxas mais elevadas nas coortes mais jovens. Tal cenário suscita ações vigorosas de saúde pública.

Estado nutricional e fatores sociodemográficos em adultos residentes em Ribeirão Preto, SP, 2006: projeto OBEDIARP / Nutritional and socioeconomic status in adults living in Ribeirão Preto, SP, 2006: OBEDIARP Project

OBJETIVO: Estimar as prevalências de sobrepeso e obesidade e identificar fatores sociodemográficos associados a estes desfechos, em residentes de Ribeirão Preto - SP, Brasil, em 2006. MÉTODOS: Estudo epidemiológico transversal, de base populacional, conduzido em adultos de ambos os sexos com 30 anos e mais. O processo de amostragem foi desenvolvido em três estágios, sorteando-se inicialmente 81 setores censitários e, subsequentemente, 1.671 domicílios e 1.205 elegíveis. A variabilidade introduzida na terceira fração de amostragem (sorteio de elegíveis) foi corrigida pela atribuição de pesos, originando amostra ponderada de 2.197 participantes. O estado nutricional foi classificado em três categorias (eutróficos, sobrepeso e obesos), utilizando-se os pontos de corte para o Índice de Massa Corporal (IMC), recomendados pela Organização Mundial da Saúde-2000. Para a investigação de fatores associados ao sobrepeso e à obesidade, utilizou-se a regressão de Poisson, obtendo-se razões de prevalência que foram estimadas por pontos e por intervalos com 95 por cento de confiança. RESULTADOS: A prevalência de sobrepeso foi mais elevada entre os homens (49,7 por cento) que entre as mulheres (33,7 por cento), ocorrendo o inverso em relação à obesidade, nas mulheres, cuja prevalência (27,5 por cento) ultrapassou a dos homens (19,1 por cento). Nos modelos finais, ao se considerar o "sobrepeso", permaneceram como fatores positivamente associados: as faixas etárias de "50 a 59 anos" e "60 anos e mais"; o "1º terço" de renda e "viver com companheiro(a)". Em relação ao sexo, ser do sexo feminino constituiu-se em fator de proteção para este desfecho. Para a "obesidade", todas as categorias de idade e o estado marital permaneceram positivamente associados a este desfecho. CONCLUSÃO: Além da elevada prevalência de sobrepeso e obesidade no município, a detecção de diferentes conjuntos de variáveis sociodemográficas associadas aos componentes do excesso de peso indica a necessidade de estratégias específicas de intervenção sobre estes grupos, tendo em vista a promoção da saúde e a prevenção de doenças crônico-degenerativas, na população.

OBJECTIVE: To estimate overweight and obesity prevalence, and socioeconomic correlates in adults living in Ribeirão Preto city - SP, Brazil, in 2006. METHODS: A cross-sectional population-based epidemiological study was carried out in adults aged 30 years and older using three-stage cluster sampling: 81 census tracts were firstly selected, followed by 1,671 households and 1,205 individuals. The variability introduced in the third sampling fraction (individuals assortment) was corrected, resulting in a weighted sample of 2,197 participants. The nutritional status was classified in three categories (normal, overweight and obesity) according the Body Mass Index (BMI) cut-offs recommended by World Health Organization-2000 criteria. To investigate the nutritional status correlates, prevalence ratios were estimated by points and 95 percent confidence intervals, using Poisson regression. RESULTS: Overweight prevalence was higher in male (49.7 percent) than female (33.7 percent), whereas the obesity prevalence was higher in female (27.5 percent) than male (19.1 percent). In the final model, considering "overweight" as the outcome, the following variables were positively associated: the last two strata of age: "50-59" and "60 and older"; the "1st tertile" of income, and living "with partner". Females presented a protective effect compared to males. Considering "obesity", all the "age categories" and "marital status" were positively associated to the outcome. CONCLUSION: Along with the high overweight and obesity prevalences in Ribeirão Preto, the detection of different sets of socioeconomic correlates pointed out the need of specific intervention strategies, focused on health promotion and chronic-degenerative diseases prevention in the population.

Challenge of Reducing Perinatal Mortality in Rural Congo: Findings of a Prospective, Population-based Study.

Each year, an estimated six million perinatal deaths occur worldwide, and 98% of these deaths occur in low- and middle-income countries. These estimates are based on surveys in both urban and rural areas, and they may underrepresent the problem in rural areas. This study was conducted to quantify perinatal mortality, to identify the associated risk factors, and to determine the most common causes of early neonatal death in a rural area of the Democratic Republic of the Congo (DRC). Data were collected on 1,892 births. Risk factors associated with perinatal deaths were identified using multivariate analysis with logistic regression models. Causes of early neonatal deaths were determined by physician-review of information describing death. The perinatal mortality rate was 61 per 1,000 births; the stillbirth rate was 30 per 1,000 births; and the early neonatal death rate was 32 per 1,000 livebirths. Clinically-relevant factors independently associated with perinatal death included: low birthweight [odds ratio (OR)=13.51, 95% confidence interval (CI) 7.82-23.35], breech presentation (OR)=12.41; 95% CI 4.62-33.33), lack of prenatal care (OR=2.70, 95% CI 1.81-4.02), and parity greater than 4 (OR=1.93 95% CI 1.11-3.37). Over one-half of early neonatal deaths (n=37) occurred during the first two postnatal days, and the most common causes were low birthweight/prematurity (47%), asphyxia (34%), and infection (8%). The high perinatal mortality rate in rural communities in the DRC, approximately one-half of which is attributable to early neonatal death, may be modifiable. Specifically, deaths due to breech presentation, the second most common risk factor, may be reduced by making available emergency obstetric care. Most neonatal deaths occur soon after birth, and nearly three-quarters are caused by low birthweight/prematurity or asphyxia. Neonatal mortality might be reduced by targeting interventions to improve neonatal resuscitation and care of larger preterm infants.