Prevalence of adult smokers in Brazilian capitals according to socioeconomic deprivation / Prevalência de fumantes adultos nas capitais brasileiras, segundo privação socioeconômica

ABSTRACT Objective: To estimate the prevalence of adult smokers in the 26 capitals and the Federal District according to the Brazilian Deprivation Index (Índice Brasileiro de Privação - IBP). Methods: Dataset on smoking were obtained from the Surveillance of Risk and Protective Factors for Noncommunicable Diseases by Survey (Vigitel) system for the 26 capitals and the Federal District, in the period from 2010 to 2013. The IBP classifies the census sectors according to indicators such as: income less than ½ minimum wage, illiterate population and without sanitary sewage. In the North and Northeast regions, the census sectors were grouped into four categories (low, medium, high and very high deprivation) and in the South, Southeast and Midwest regions into three (low, medium and high deprivation). Prevalence estimates of adult smokers were obtained using the indirect estimation method in small areas. To calculate the prevalence ratios, Poisson models are used. Results: The positive association between prevalence and deprivation of census sector categories was found in 16 (59.3%) of the 27 cities. In nine (33.3%) cities, the sectors with the greatest deprivation had a higher prevalence of smokers when compared to those with the least deprivation, and in two (7.4%) there were no differences. In Aracaju, Belém, Fortaleza, João Pessoa, Macapá and Salvador, the prevalence of adult smokers was three times higher in the group of sectors with greater deprivation compared to those with less deprivation. Conclusion: Sectors with greater social deprivation had a higher prevalence of smoking, compared with less deprivation, pointing to social inequalities.

RESUMO Objetivo: Estimar as prevalências de adultos fumante nas 26 capitais e no Distrito Federal segundo o Índice Brasileiro de Privação. Métodos: Os dados sobre tabagismo foram obtidos junto ao sistema de Vigilância de Fatores de Risco e Proteção para Doenças Crônicas por Inquérito (Vigitel) para as 26 capitais e o Distrito Federal, no período de 2010 a 2013. O Índice Brasileiro de Privação classifica os setores censitários segundo indicadores como: renda menor que meio salário mínimo, população não alfabetizada e sem esgotamento sanitário. Nas regiões Norte e Nordeste, os setores censitários foram agrupados em quatro categorias (baixa, média, alta e muito alta privação) e, nas regiões Sul, Sudeste e Centro-Oeste, em três (baixa, média e alta privação). As estimativas de prevalências de adultos fumantes foram obtidas pelo método indireto de estimação em pequenas áreas. Para o cálculo das razões de prevalências, empregram-se modelos de Poisson. Resultados: A associação positiva entre a prevalência e a privação das categorias de setores censitários foi encontrada em 16 (59,3%) das 27 cidades. Em nove (33,3%) cidades, os setores de maior privação apresentaram maior prevalência de fumantes quando comparados aos de menor privação e, em duas (7,4%), não apresentaram diferenças. Em Aracaju, Belém, Fortaleza, João Pessoa, Macapá e Salvador, as prevalências de adultos fumantes foram três vezes maiores no grupo de setores com maior privação em relação aos de menor privação. Conclusão: Setores de maior privação social apresentaram maiores prevalências de tabagismo, comparados com menor privação, apontando desigualdades sociais.

Association between multimorbidity, intensive care unit admission, and death in patients with COVID-19 in Brazil: a cross-section study, 2020

ABSTRACT BACKGROUND: Multimorbidity can influence intensive care unit (ICU) admissions and deaths due to coronavirus disease (COVID-19). OBJECTIVE: To analyze the association between multimorbidity, ICU admissions, and deaths due to COVID-19 in Brazil. DESIGN AND SETTING: This cross-sectional study was conducted using data from patients with severe acute respiratory syndrome (SARS) due to COVID-19 recorded in the Influenza Epidemiological Surveillance Information System (SIVEP-Gripe) in 2020. METHODS: Descriptive and stratified analyses of multimorbidity were performed based on sociodemographic, ventilatory support, and diagnostic variables. Poisson regression was used to estimate the prevalence ratios. RESULTS: We identified 671,593 cases of SARS caused by COVID-19, of which 62.4% had at least one morbidity. Multimorbidity was associated with male sex, age 60-70 and ≥ 80 years, brown and black skin color, elementary education and high school, ventilatory support, and altered radiologic exams. Moreover, all regions of the country and altered computed tomography due to COVID-19 or other diseases were associated with death; only the northeast region and higher education were associated with ICU admission. CONCLUSION: Our results showed an association between multimorbidity, ICU admission, and death in COVID-19 patients in Brazil.

Impacto da pandemia por COVID-19 na prevalência de casos de prematuridade / Impacto de la pandemia de COVID-19 en la prevalencia de casos de prematuridad / Impact of the COVID-19 pandemic on the prevalence of prematurity cases

Objetivo: analisar a prevalência da prematuridade no contexto da pandemia. Método: estudo transversal, retrospectivo e descritivo, desenvolvido na maternidade de referência do estado do Piauí. Resultados: 46,7% dos prontuários foram do ano de 2020 e 53,3% do ano de 2021. Houve 79% para gravidez única, parto cesáreo 59,1% e líquido amniótico claro 53%. O perfil clínico do RN em relação ao sexo, 47% eram do sexo feminino e 35 % do masculino. Médias: peso de 2462g, perímetro cefálico 34.36cm, torácico 32.58 cm, e comprimento de 48.02 cm. Considerando essa análise no ano de 2020 e 2021 foram contabilizados 21,1% RN com idade gestacional identificando uma prematuridade ao nascer e, 78,9% com idade gestacional dentro dos valores para pós termo. Conclusão: Os índices de prematuridade estão acima do esperado (21,1%), novas pesquisas com amostras mais importantes e melhor delineamento de métodos são necessárias para ampliar o escopo da discussão.(AU)

Objective: to analyze the prevalence of prematurity in the context of the pandemic. Method: a cross-sectional, retrospective and descriptive study, carried out at a reference maternity hospital in the state of Piauí. Results: 46.7% of the medical records were from 2020 and 53.3% from 2021. There were 79% for singleton pregnancy, cesarean delivery 59.1% and clear amniotic fluid 53%. The clinical profile of the NB in relation to sex, 47% were female and 35% male. Averages: weight of 2462g, head circumference 34.36cm, thoracic circumference 32.58cm, and length of 48.02cm. Considering this analysis, in 2020 and 2021, 21.1% of newborns with gestational age were identified as prematurity at birth, and 78.9% with gestational age within the values for post-term. Conclusion: Prematurity rates are higher than expected (21.1%), new research with more important samples and better method design are necessary to broaden the scope of the discussion (AU)

Objetivo: analizar la prevalencia de la prematuridad en el contexto de la pandemia. Método: estudio transversal, retrospectivo y descriptivo, desarrollado en la maternidad de referencia del estado de Piauí. Resultados: El 46,7% de los registros fueron del año 2020 y el 53,3% del año 2021. Hubo un 79% por embarazo único, parto por cesárea un 59,1% y líquido amniótico claro un 53%. El perfil clínico del RN en relación al sexo, el 47% eran del sexo femenino y el 35% del masculino. Promedios: peso de 2462 g, perímetro cefálico 34,36 cm, perímetro torácico 32,58 cm y longitud de 48,02 cm. Considerando este análisis, en 2020 y 2021, el 21,1% de los recién nacidos con edad gestacional fueron identificados como prematuros al nacer, y el 78,9% con edad gestacional dentro de los valores para postérmino. Conclusión: Las tasas de prematuridad son más altas de lo esperado (21,1 %), se necesitan nuevas investigaciones con muestras más importantes y un mejor diseño de métodos para ampliar el alcance de la discusión(AU)

Exploración de la presión arterial en pobladores del área de salud 27 de Noviembre del municipio Marianao / Blood Pressure Exploration in the November 27th Health Area Population from Marianao Municipality

RESUMEN Fundamento: las enfermedades del corazón fueron la primera causa de defunciones en Cuba en el 2018, dentro de ellas, en segundo lugar, las enfermedades hipertensivas. La hipertensión arterial puede ser una causa directa de muerte, pero además, es el factor de riesgo cardiovascular que más muertes provoca. Objetivo: explorar el comportamiento de la presión arterial en una población de un área de salud, para determinar la prevalencia de pacientes hipertensos, el control de la enfermedad en ellos y la existencia o no, de nuevos casos. Método: se realizó un estudio transversal, descriptivo, para explorar la presión arterial en una población con edades entre 40 y 70 años, de los consultorios uno y tres del área de salud 27 de Noviembre del municipio Marianao, La Habana, en 2018. La selección de la muestra se realizó por factibilidad y estuvo constituida por 152 individuos, que firmaron su consentimiento informado. Se realizaron entrevistas personalizadas, examen físico con mediciones de la presión arterial, del peso y la talla y se calculó el índice de masa corporal. Los datos se procesaron con el programa estadístico SPSS 15.0. Se utilizó estadística descriptiva: frecuencias, porcentajes y el coeficiente de correlación Rho de Spearman. Resultados: predominaron las personas del grupo de edades de 50 a 59 años. Se encontraron 68 personas con el diagnóstico de hipertensión arterial para el 44,7 % y presuntos hipertensos fue el 4,6 %, al consolidarlos, se alcanzó una prevalencia de 49,3 %. Conclusión: la medición de la presión arterial a la población, es fundamental para su control.

ABSTRACT Background: heart diseases were the first cause of deaths in Cuba in 2018, within them, secondly, hypertensive diseases. High blood pressure can be a direct cause of death, but it is also the cardiovascular risk factor that causes the most deaths. Objective: to explore the behavior of blood pressure in a population of a health area, to determine the prevalence of hypertensive patients, the control of the disease in them and the existence or not of new cases. Method: a cross-sectional, descriptive study was carried out to explore blood pressure in a population aged between 40 and 70 years, in clinics one and three of the November 27 health area of the Marianao municipality, Havana, in 2018. The Selection of the sample was carried out by feasibility and consisted of 152 individuals, who signed their informed consent. Personalized interviews, physical examination with measurements of blood pressure, weight and height were carried out, and the body mass index was calculated. The data were processed with the statistical program SPSS 15.0. Descriptive statistics were used: frequencies, percentages and Spearman's Rho correlation coefficient. Results: people from the age group 50 to 59 years predominated. There were 68 people with a diagnosis of hypertension the 44.7 % and suspected hypertensive the 4.6 %, upon consolidation, a prevalence of 49.3 % was reached. Conclusion: the measurement of blood pressure in the population is essential for its control.

Prevalência autorreferida de hipertensão e fatores associados em comunidades quilombolas do Rio Grande do Sul, Brasil / Self-reported prevalence of hypertension and associated factors in quilombola communities in the State of Rio Grande do Sul, Brazil

Resumo Este estudo teve como objetivo identificar a prevalência e fatores associados à hipertensão arterial (HA) em adultos quilombolas do Rio Grande do Sul (RS). Trata-se de um estudo transversal de base populacional, realizado em 2011, com 589 adultos responsáveis por domicílios e amostragem proporcional ao tamanho. O desfecho foi obtido com a pergunta: "Algum médico já lhe disse que você tem hipertensão?". Foi empregada regressão de Poisson, com variância robusta e entrada hierarquizada das variáveis. Por fim, foram calculadas as frações atribuíveis populacionais por componente (FAPC) para fatores modificáveis associados à HA. A prevalência autorreferida de HA foi de 38,3% (IC95% 31,4%-45,1%). A análise ajustada revelou associação do desfecho com faixa etária, escolaridade, consumo excessivo de álcool, circunferência da cintura acima do adequado e presença de diabetes. A análise dos FAPC revelou que, se os indivíduos tivessem maior escolaridade, a prevalência de HA seria reduzida. Diante da elevada prevalência de HA e da extrema vulnerabilidade social dessa população, políticas públicas que garantam seu acesso a direitos fundamentais (saúde, renda e escolaridade) poderiam ter impacto importante na diminuição desse desfecho.

Abstract The study sought to identify the prevalence of arterial hypertension (AH) and possible associated factors in adults residing in quilombola communities in the State of Rio Grande do Sul (RS). A transversal population-based study, carried out in 2011, included 589 adult households in quilombola communities in the State of RS, by sampling proportional to the size. The outcome was obtained by the question: "Has a doctor ever told you that you have hypertension?" Poisson regression with robust variance and hierarchical input variables were used. Finally, the population attributable fractions per component (PAFC) were calculated for modifiable factors associated to AH. The self-reported prevalence of AH was 38.3% (CI95% 31.4%-45.1%). Adjusted analysis revealed an association of the outcome with age group, education, excessive alcohol consumption, waist circumference and the presence of diabetes. PAFC analysis revealed that if the individuals had greater schooling, the prevalence of AH would be reduced. Given the high prevalence of AH and the extreme social vulnerability of this population, public policies that guarantee their access to fundamental rights (health, income and schooling) could have a significant impact in reducing this outcome.

Prevalence of anemia in schools of the metropolitan region of Curitiba, Brazil

ABSTRACT Background: Anemia during childhood is one of the biggest public health problems worldwide, including Brazil. Insufficient or abnormal production of hemoglobin, loss of iron and excessive destruction of red blood cells are the most common causes of anemia. Among the reasons of anemia, iron deficiency accounts for 50% of anemia cases in developing countries. Affected individuals present a wide range of clinical problems, including delayed neuropsychomotor progression, impaired cellular immunity and reduction of intellectual capacity. This study aimed to evaluate the prevalence of anemia in children attending public schools in the metropolitan region of Curitiba, Paraná, Brazil. Method: A retrospective study was conducted of 409 children aged 8-12 years old included in an extension project of the Universidade Federal do Paraná. The results of complete blood count and hemoglobin electrophoresis of all children were evaluated. Anemia was considered when the hemoglobin levels were <11.5 g/dL. Results: The prevalence of anemia was found to be 2.2% of the population studied, with hypochromic microcytic anemia being the most common type. Seven children had sickle cell trait and one had β-thalassemia. Conclusion: The prevalence of anemia in this study was considered normal according the World Health Organization classification, which is different from the data found in other Brazilian regions.

Revisión crítica de las fuentes de variabilidad en la medición de la prevalencia de esquizofrenia / Critical review of the sources of variability in the measurement of the prevalence of schizophrenia

Conocer la prevalencia de la esquizofrenia y trastornos afines tiene una importancia relevante en la investigación epidemiológica y en la planificación de servicios. Sin embargo, existe una gran variabilidad en los resultados obtenidos en las diferentes investigaciones. El objetivo de este artículo es hacer una revisión crítica de los aspectos metodológicos de los estudios epidemiológicos que pueden influir en la medición de la prevalencia de esquizofrenia y trastornos afines y ofrecer una serie de recomendaciones generales para su medición. Se revisan 53 estudios epidemiológicos que relatan 76 tasas de prevalencia que oscilan entre 1 y 45 por 1000 habitantes. Se han encontrado seis factores metodológicos que creemos que están influyendo en la variabilidad de la medida de prevalencia de la esquizofrenia: 1. el tipo de prevalencia según el periodo de tiempo, siendo la más utilizada la prevalencia puntual; 2. el rango de edad de la población de estudio, siendo lo más frecuente incluir a personas mayores de 18 años; 3. el ámbito de detección de los casos más frecuentemente utilizado es la población general; 4. las clasificaciones de enfermedades utilizadas son la CIE y la DSM en similar proporción; 5. la categoría diagnóstica incluida frecuentemente en los estudios es el grupo de psicosis no afectivas; 6. el método de valoración diagnóstica más utilizado es la entrevista CIDI. Conclusión Consideramos que llegar a un consenso internacional para homogeneizar los aspectos metodológicos en los estudios epidemiológicos para calcular cifras de prevalencia de esquizofrenia nos facilitará la comparación de sus resultados.

Epidemiologic research plays a very relevant role to know the prevalence of schizophrenia. However, sometimes data from different studies are compared without taking into account some methodological questions that influence the results. This paper reviews different methodological factors that influence variability of rates in schizophrenia prevalence. Also, we provide some generic recommendations for measuring prevalence. We have revised 52 studies which offer prevalence rates of schizophrenia. A big difference appears in the prevalence rates of schizophrenia which range between 1 to 45 per 1000 inhabitants. The factors founded can be summarized as follows: 1. type of prevalence; 2. denominator population; 3. place of selection of cases; 4. classification issue; 5. diagnoses categories and 6. methods of diagnoses. In conclusion, in the epidemiological studies about schizophrenia prevalence we have to take into account the methodological factors involved in order to interprete and compare results from different studies.

Parafunctional oral habits and itsrelationship with family structure in a Mexican preschoolers group, 2013 / Hábitos orales parafuncionales y su relación con la estructura familiar en un grupo de preescolares mexicanos, 2013

Introduction. Habit is any act acquired through experience and performed regularly and unconsciously. Parafunctional habits are resulting from the perversion of a normal function, acquired by repeated practice of an act that is not functional or necessary, may be signs of adjustment problems or inappropriate emotional expression. Its importance lies in the fact that they can interfere with the development of dental occlusion. Objective. To evaluate the prevalence of parafunctional oral habits and their possible association with the type of family, in a group of preschool children from eastern Mexico City. Methodology. Observational, descriptive and cross-sectional study was carrying on. Preschool children group and their parents were surveyed before an examiner calibration (k =0.87, p=0.001). The detection of different parafunctional habits was conducted in two stages: 1) application of a parent questionnaire and 2) clinical assessment of the child. Results and discussion. 57.7 percent of the studied population had at least one parafunctional oral habit. Onycophagia habit was the most prevalent. The relationship between prevalence of parafunctional habits with family type was significant (X2=87.439, p=0.0001). Conclusions. The prevalence of parafunctional habits was high which was associated with family type also the most frequent parafunctional habit onycophagia.

Introducción. Un hábito es cualquier acto adquirido mediante la experiencia y realizado regular e inconscientemente. Los hábitos bucales parafuncionales son los que resultan de la alteración de una función normal, o los que se adquieren por la práctica repetida de un acto que no es funcional ni necesario, pudiendo ser signos de problemas de adaptación o de expresión emocional inadecuada. Su importancia radica en el hecho de que pueden interferir con el desarrollo de la oclusión dental, razón por la cual el objetivo del presente estudio fue evaluar la prevalencia de hábitos bucales parafuncionales y su posible relación con la estructura familiar, en un grupo de preescolares de un Centro de Desarrollo Infantil del oriente de la Ciudad de México. Metodología. El estudio fue de carácter observacional, descriptivo y transversal, en el que 111 preescolares y sus padres fueron encuestados previa calibración de una examinadora (k=0.87, p=0.001). La detección de los diferentes hábitos bucales parafuncionales se realizó en dos etapas: 1) aplicación de un cuestionario al padre de familia y 2) valoración clínica del niño. Resultados y discusión. El 57.7 por ciento de la población estudiada presentó, al menos un hábito bucal parafuncional. La onicofagia fue el hábito de mayor prevalencia. La relación entre la prevalencia de hábitos parafuncionales con la estructura familiar resultó ser significativa (X2=87.439, p=0.0001). Conclusiones. La prevalencia de hábitos bucales parafuncionales fue alta la cual estuvo relacionada con la estructura familiar, asimismo, el hábito parafuncional más frecuente fue la onicofagia.

Prevalencia de queilitis actínica en trabajadores expuestos a radiación ultravioleta en Talca, Chile / Prevalence of actinic cheilitis in chilean workers exposed to ultraviolet radiation

El objetivo de esta investigación es determinar la prevalencia de queilitis actínica (QA) y factores asociados en trabajadores expuestos a radiación UV solar en la ciudad de Talca, Chile. Se examinaron 151 trabajadores, donde un 16.6 por ciento presentó QA. Todas las lesiones se presentaron en el labio inferior. El 40 por ciento de los casos poseía una edad entre 50 y 59 años y el 96 por ciento de los pacientes diagnosticados trabajaba más de 6 horas diarias expuestos al sol. El 56 por ciento de los diagnósticos de QA presentaron un historial 20 o más años totales de exposición a radiación UV por motivos laborales. El 56 por ciento de los casos de QA presentaron antecedentes de hábito de fumar. Los principales signos presentes en los casos de QA fueron la sequedad (100 por ciento), esfumación del margen del bermellón (88 por ciento) y el edema labial (84 por ciento). La mayoría de las lesiones fueron asintomáticas (60 por ciento).

The objective of this research is to determine the prevalence of actinic cheilitis (AC) and associated factors in workers exposed to solar UV radiation in the city of Talca (Chile). A total of 151 workers, of which 16.6 percent exhibited AC, were examined. All lesions appeared on the lower lip. The 40 percent of cases aged between 50-59 years and 96 percent of patients diagnosed worked up to 6 hours daily exposed to the sun. 56 percent of the diagnoses of AC had a history of 20 or more years of exposure to UV radiation for work. 56 percent of cases of AC had a history of smoking. Major signs present in the AC cases were the dryness (100 percent), blurred demarcation between the lip vermilion border and the skin (88 percent) and labial edema (84 percent). Most lesions were asymptomatic (60 percent).

Hábitos de sucção não nutritiva em crianças pré-escolares / Nonnutritive sucking habits among preschool-aged children

OBJETIVO: Verificar a prevalência e os fatores associados aos hábitos de sucção não nutritiva em crianças pré-escolares matriculadas em creches e pré-escolas de Natal (RN). MÉTODOS: Foi conduzido um estudo transversal com 1.190 crianças de ambos os sexos na faixa etária de 3 a 5 anos, matriculadas em creches e pré-escolas de Natal. Não foram incluídas no estudo crianças com fendas labiopalatinas, desordens temporomandibulares, ou aquelas submetidas a tratamento ortodôntico e/ou ortopédico; também não fizeram parte da amostra instituições de ensino especializadas em crianças portadoras de deficiência. Utilizou-se um questionário estruturado, respondido pelos pais ou responsável, com dados sobre a instituição, sexo e idade das crianças, escolaridade dos pais e questões relacionadas aos hábitos. A análise dos dados foi realizada através do teste do qui-quadrado e a regressão logística. RESULTADOS: Obteve-se prevalência de 40,2 por cento de hábitos de sucção não nutritiva, dos quais 27,7 por cento eram de sucção de chupeta e 12,5 por cento de dedo. Os hábitos de sucção apresentaram maior percentual para o sexo feminino, destacando-se a sucção de dedo (p = 0,02); em crianças com menos idade destacou-se a sucção de chupeta (p = 0,0006). Observou-se maior frequência de sucção de chupeta e de dedo, respectivamente, para o nível superior (p < 0,05) e fundamental (p < 0,05) de escolaridade dos pais. A regressão logística demonstrou que a menor idade dos indivíduos (p = 0,033) e o nível médio de escolaridade dos pais (p = 0,035) são fatores independentes para a persistência dos hábitos. CONCLUSÃO: Verificou-se uma alta prevalência de realização dos hábitos de sucção não nutritiva, apresentando como fatores de destaque a menor idade das crianças e o nível médio de escolaridade dos pais.

OBJECTIVE: To verify the prevalence and factors associated with nonnutritive sucking habits in preschool-aged children attending daycare centers and preschools in Natal, Brazil. METHODS: A cross-sectional study was conducted with 1,190 children of both sexes, aged 3 to 5 years, enrolled in daycare centers and preschools in Natal, Brazil. Exclusion criteria were: children with cleft lip and palate, temporomandibular joint disorders, or submitted to orthodontic and/or orthopedic treatment; as well as institutions specialized in children with disabilities. Parents or guardians answered a structured questionnaire providing information on the institution, children's sex and age, parents' educational level, and habit-related questions. Data analysis was performed using the chi-square test and logistic regression. RESULTS: A prevalence of 40.2 percent of nonnutritive sucking habits was obtained; of these, 27.7 percent were pacifier-sucking and 12.5 percent were finger-sucking habits. Girls showed a higher percentage of sucking habits, especially finger sucking (p = 0.02); younger children showed a higher prevalence of pacifier-sucking habits (p = 0.0006). A higher frequency of pacifier- and finger-sucking habits was associated, respectively, with parents' higher education (p < 0.05) and elementary education (p < 0.05). Logistic regression revealed that younger individuals (p = 0.033) and secondary education level of parents (p = 0.035) are independent factors for habit persistence. CONCLUSION: A high prevalence of nonnutritive sucking habits was verified, highlighting younger age groups and secondary education level of parents as important associated factors.