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Abstract Introduction In 2020, suicide was the third leading cause of death in Mexico among young people ages 15 and 29, accounting for 43.0% of all suicides in the country, making it a major public health issue. Objective To explore changes in the geographic distribution of suicide rates by state and to analyze the magnitude, distribution, and pattern of suicide mortality in young Mexicans ages 15 to 29 between 1990 and 2020. Method Descriptive, ecological time-series study, based on official information. Standardized mortality rates were calculated using information on deaths (INEGI) and population estimates (CONAPO). The magnitude, distribution, and patterns of suicide mortality at the national level and by state were analyzed using the Joinpoint segmented regression model. Results From 1990 to 2020, suicide mortality in young people increased by 198% and was higher in women (285%) than men (178%). The states with the highest suicide mortality rates from 2016 to 2020 were Chihuahua (18.5 suicides/100,000 young people ages 15-29), Aguascalientes (16.6), Yucatán (14.4), Guanajuato (14.1), and San Luis Potosí (12.9), accounting for 23.0% of total suicide deaths. Discussion and conclusion The study of mortality trends could contribute to the management of a national suicide prevention strategy in young Mexicans, providing support for public health decision-making, such as the identification of the states and regions that should be prioritized.
Resumen Introducción En 2020, el suicidio fue la tercera causa de muerte en México en los jóvenes de 15 a 29 años y concentró el 43.0% del total de suicidios del país. Por lo tanto, es un problema de salud pública muy relevante. Objetivo Explorar los cambios en la distribución geográfica de las tasas de suicidio por entidad federativa, así como analizar la magnitud, distribución y tendencia de la mortalidad por suicidio, en los jóvenes mexicanos de 15 a 29 años entre 1990 y 2020. Método Estudio ecológico descriptivo de series de tiempo, a partir de la información de fuentes oficiales. Se calcularon las tasas estandarizadas de mortalidad utilizando la información sobre defunciones (INEGI) y las estimaciones de población (CONAPO). Se analizó la magnitud, distribución y tendencias de la mortalidad por suicidio a nivel nacional y por entidad federativa, utilizando el modelo de regresión segmentada Joinpoint. Resultados De 1990 a 2020, la mortalidad por suicidio en jóvenes creció 198%, siendo mayor en las mujeres (285%) que en los hombres (178%). Las entidades con mayor mortalidad por suicidio, de 2016 a 2020, fueron Chihuahua (18.5 suicidios/100 mil jóvenes 15-29 años), Aguascalientes (16.6), Yucatán (14.4), Guanajuato (14.1) y San Luis Potosí (12.9), las cuales concentraron el 23.0% del total de muertes por suicidios. Discusión y conclusión El estudio de las tendencias de la mortalidad podría contribuir a la gestión de una estrategia nacional para la prevención del suicidio en jóvenes mexicanos, proporcionando sustento para la toma de decisiones en salud pública, como la identificación de las entidades federativas y regiones del país que deben recibir la máxima prioridad.
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Abstract Objective: To develop a convolutional neural network (CNN) model, trained with the Brazilian "Estudo Longitudinal de Saúde do Adulto Musculoesquelético" (ELSA-Brasil MSK, Longitudinal Study of Adult Health, Musculoskeletal) baseline radiographic examinations, for the automated classification of knee osteoarthritis. Materials and Methods: This was a cross-sectional study carried out with 5,660 baseline posteroanterior knee radiographs from the ELSA-Brasil MSK database (5,660 baseline posteroanterior knee radiographs). The examinations were interpreted by a radiologist with specific training, and the calibration was as established previously. Results: The CNN presented an area under the receiver operating characteristic curve of 0.866 (95% CI: 0.842-0.882). The model can be optimized to achieve, not simultaneously, maximum values of 0.907 for accuracy, 0.938 for sensitivity, and 0.994 for specificity. Conclusion: The proposed CNN can be used as a screening tool, reducing the total number of examinations evaluated by the radiologists of the study, and as a double-reading tool, contributing to the reduction of possible interpretation errors.
Resumo Objetivo: Desenvolver um modelo computacional - rede neural convolucional (RNC) - treinado com radiografias da linha de base do Estudo Longitudinal de Saúde do Adulto Musculoesquelético (ELSA-Brasil Musculoesquelético), para a classificação automática de osteoartrite dos joelhos. Materiais e Métodos: Trata-se de um estudo transversal abrangendo todos os exames da linha de base do ELSA-Brasil Musculoesquelético (5.660 radiografias dos joelhos em incidência posteroanterior). Os exames foram interpretados por médico radiologista com treinamento específico e calibração previamente publicada. Resultados: A RNC desenvolvida apresentou área sob a curva característica de operação do receptor de 0,866 (IC 95%: 0,842-0,882). O modelo pode ser calibrado para alcançar, não simultaneamente, valores máximos de 0,907 para acurácia, 0,938 para sensibilidade e 0,994 para especificidade. Conclusão: A RNC desenvolvida pode ser utilizada como ferramenta de triagem, reduzindo o número total de exames avaliados pelos radiologistas do estudo, e/ou como ferramenta de segunda leitura, contribuindo com a redução de possíveis erros de interpretação.
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A sífilis persiste como um problema de saúde pública, sobretudo pelos entraves existentes no enfrentamento da sífilis gestacional e congênita. Considerando que a ocorrência dessas infecções se relaciona a fatores maternos e programáticos, este estudo buscou analisar as características epidemiológicas do binômio mãe-filho exposto à sífilis e sua distribuição espacial no Paraná entre 2012 e 2020. Trata-se de estudo descritivo e ecológico, com dados dos sistemas nacionais de informação do Brasil. Foram considerados os casos de gestantes e de crianças registrados entre 2012 e 2020 no estado do Paraná. Foram apresentadas as frequências absolutas e relativas para a caracterização, calculando-se a variação percentual entre o primeiro e o último triênio. Ainda, foi empregado o índice de Moran para a geoespacialização segundo regiões de saúde. Houve predomínio em mulheres de 20 a 39 anos (71,24%), brancas (67,22%) e com até oito anos de estudo (80,76%), com diagnóstico nas fases primária e latente (76,42%). Os casos concentraram-se em crianças do sexo masculino (48,72%), diagnosticadas na fase recente (96,42%), e naquelas cujas mães aderiram ao pré-natal (88,88%), mas os parceiros, por sua vez, não foram tratados (69,46%). Houve aumento do diagnóstico materno durante o pré-natal (16,61%) e redução dos óbitos infantis por sífilis (31,25%). Observou-se concentração das notificações nas regiões Metropolitana e de Pato Branco. Em suma, as gestantes apresentaram idade reprodutiva e baixa escolaridade e foram tratadas durante o pré-natal, contudo, sem a inclusão dos parceiros. Ademais, evidenciou-se comportamento espacial aleatório nas regiões de saúde, com disparidade entre a sífilis gestacional e a congênita.
Syphilis remains as serious public health issue due to existing obstacles in combating gestational and congenital syphilis. Since the onset of these infections is related to maternal and programmatic factors, this study analyzed the epidemiological profile of the mother-child binomial exposed to syphilis and its spatial distribution in Paraná from 2012 to 2020. This is a descriptive, ecological study with data from Brazilian national information systems. Cases of pregnant women and children recorded between 2012 and 2020 in the state of Paraná were considered. Absolute and relative frequencies were estimated for characterization, calculating the percentage variation between the first and last three years. The Moran index was also used for geospacialization according to health regions. Most women were aged 20 to 39 years (71.24%), white (67.22%), and had up to 8 years of schooling (80.76%), with diagnosis in the primary and latent stages (76.42%). Most cases concerned male children (48.72%), diagnosed in the recent phase (96.42%), and from mothers who adhered to prenatal care (88.88%), but the partners were untreated (69.46%). Maternal diagnosis increased during prenatal care (16.61%) and infant deaths by syphilis decreased (31.25%). Most cases were notified in the Metropolitan and Pato Branco regions. In short, the pregnant women were of reproductive age, had low education, and were treated during prenatal care, but their partners were not included. The health regions showed random spatial behavior, with disparity between gestational and congenital syphilis.
La sífilis persiste como un problema de salud pública, principalmente por los obstáculos en hacer frente la sífilis gestacional y congénita. Teniendo en cuenta que la ocurrencia de estas infecciones está relacionada con los factores maternos y programáticos, este estudio tuvo como objetivo analizar las características epidemiológicas del binomio madre-hijo expuestos a la sífilis y la distribución espacial en Paraná (Brasil) entre 2012 y 2020. Se trata de un estudio descriptivo y ecológico, con datos de los sistemas de información nacionales de Brasil. Se consideraron los casos de mujeres embarazadas y niños registrados entre 2012 y 2020 en Paraná. Se presentaron las frecuencias absolutas y relativas, calculando la variación porcentual entre el primer y el último trienio. Asimismo, se utilizó el índice de Moran, según regiones de salud. Predominaron las mujeres de entre 20 y 39 años de edad (71,24%), blancas (67,22%), con hasta ocho años de estudio (80,76%), con diagnóstico en estadio primario y latente (76,42%). Los casos se concentraron en hijos varones (48,72%), diagnosticados en fase reciente (96,42%), y en aquellos cuyas madres tuvieron acceso a los cuidados prenatales (88,88%), pero su pareja no recibió el tratamiento (69,46%). Hubo un aumento en el diagnóstico materno durante la atención prenatal (16,61%) y una reducción en las muertes de niños por sífilis (31,25%). Se observó una concentración de casos en las regiones Metropolitana y de Pato Branco. En resumen, las mujeres embarazadas se encontraban en edad reproductiva, tenían bajo nivel de estudios y eran atendidas durante el prenatal, sin incluir su pareja. Además, se evidenció un comportamiento espacial aleatorio en las regiones de salud, con disparidad entre sífilis gestacional y congénita.
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Humans , Female , Pregnancy , Pregnancy Complications, Infectious , Syphilis, CongenitalABSTRACT
Introdução: no Brasil, é possível identificar mudanças nas práticas alimentares nas últimas décadas, alimentos tradicionais como arroz e feijão perderam a importância e foram substituídos por alimentos prontos para o consumo. Objetivo: diante disso, o objetivo do estudo foi avaliar as práticas alimentares de professores da rede municipal de educação de Passo Fundo, RS. Metodologia: foi realizado um estudo transversal com professores de ambos os sexos da rede municipal de educação. Os professores foram convidados a participar do estudo por meio de correio eletrônico da prefeitura municipal. A coleta de dados foi mediante formulário eletrônico com questões sobre condições sociodemográficas, saúde e práticas alimentares Resultados: foram avaliados 108 professores, a média de idade foi de 42,81 anos (DP=8,85) e 95,4% eram mulheres. Em relação às práticas alimentares, observou-se que 68,7% (n=71) apresentaram práticas alimentares satisfatórias, sendo que a média de pontuação foi de 45,46 (DP=8,33). Conclusão: apesar do elevado percentual de práticas alimentares excelentes, observa-se práticas alimentares inadequadas que podem contribuir para a ocorrência de excesso de peso ao longo do tempo.
Introduction: in Brazil, it is possible to identify changes in eating practices in recent decades, traditional foods such as rice and beans have lost importance and have been replaced by ready-to-eat foods. Objective: therefore, the objective of the study was to evaluate the eating habits of teachers from the public education system of Passo Fundo, RS. Methodology: a cross-sectional study was carried out with male and female teachers from the municipal public education system. Teachers were invited to participate in the study via e-mail from the municipal government. Data were collected using an electronic form with questions about sociodemographic conditions, health and eating practices. Results: 108 teachers were evaluated; the average age was 42.81 years (SD=8.85) and 95.4% were women. Regarding eating practices, it was observed that 68.7% (n=71) had satisfactory eating practices, with an average score of 45.46 (SD=8.33). Conclusion: despite the high percentage of excellent eating practices, it was be observed that inadequate eating practices can contribute to the occurrence of excess weight over time.
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Humans , Male , Female , Adult , Middle Aged , Aged , Diet , Feeding Behavior , Epidemiologic Studies , Cross-Sectional StudiesABSTRACT
Fundamento un elevado porcentaje de personas que han padecido COVID-19, refieren tras la recuperación de la fase aguda, manifestaciones que se prolongan por más de tres semanas, e incluso, durante tres meses después del cuadro clínico original. Objetivo caracterizar desde el punto clínico y epidemiológico a pacientes confirmados al SARS-CoV-2 en la etapa post-COVID-19. Métodos se realizó un estudio descriptivo transversal, en pacientes confirmados al SARS-CoV-2 en etapa post-COVID-19, pertenecientes al Policlínico Hermanos Martínez Tamayo, en el periodo octubre-noviembre de 2021. Se estudiaron todos los pacientes (N=400) atendidos en consulta post-COVID-19 en el periodo declarado. La información se obtuvo mediante encuestas epidemiológicas realizadas. Resultados predominaron los pacientes con edades entre 50 y 59 años, del sexo femenino. Las manifestaciones clínicas más frecuente fueron tos, pérdida del gusto y del olfato. El esquema de vacunación incompleto fue el más frecuente. El lugar de ingreso más utilizado fueron los centros de aislamiento, así como el uso del Nasalferon como tratamiento. Las complicaciones predominaron en pacientes no vacunados, y con edad de 60 años y más. Conclusiones un elevado porcentaje de pacientes presentó manifestaciones clínicas tras el periodo agudo de la enfermedad. La COVID-19, a mediano plazo, tuvo mayores implicaciones en el sistema respiratorio, nervioso y osteomioarticular. Las campañas de vacunación ayudan a prevenir los síntomas graves del virus y a contrarrestar las complicaciones.
Background a high percentage of people who have suffered from COVID-19 report, after recovery from the acute phase, manifestations that last for more than three weeks, and even for three months after the original clinical picture. Objective to characterize, from the clinical and epidemiological point of view, patients confirmed to SARS-CoV-2 in the post-COVID-19 stage. Methods a descriptive cross-sectional study was carried out in patients confirmed to SARS-CoV-2 in the post-COVID-19 stage, belonging to the Hermanos Martínez Tamayo Polyclinic, from October to November 2021. All patients were studied (N= 400) attended in post-COVID-19 consultation in the declared period. The information was obtained through epidemiological surveys carried out. Results there was a predominance of patients aged between 50 and 59 years old, female. The most frequent clinical manifestations were cough, loss of taste and smell. The incomplete vaccination scheme was the most frequent. The most used place of admission were isolation centers, as well as the use of Nasalferon as a treatment. Complications predominated in unvaccinated patients, and aged 60 years and over. Conclusions a high percentage of patients presented clinical manifestations after the acute period of the disease. COVID-19, in the medium term, had greater implications in the respiratory, nervous and osteomyoarticular systems. Vaccination campaigns help prevent serious symptoms of the virus and counteract complications.
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Introducción: Los trastornos emocionales y del comportamiento que se inician en la infancia llevan a cambios que se extienden hasta la edad adulta, con consecuencias sociales. Objetivo: Determinar la asociación de la depresión en la adultez con trastornos mentales de inicio en la infancia y otras condiciones, en Envigado, 2017. Materiales y métodos: Estudio con enfoque cuantitativo, tipo observacional, transversal con intención analítica. El tamaño de la muestra fue de 737 individuos, entre 18 y 65 años. Se aplicó el instrumento CIDI - CAPI de la OMS. El procesamiento y análisis se llevó a cabo en SPSS v. 21 de la Universidad CES y Epidat 4.2. Resultados: La proporción de depresión en la adultez es de 10,8%, en la población de estudio que tuvo antecedente de trastorno por déficit de atención e hiperactividad (TDAH) fue aproximadamente 5,6 veces más que en aquellos que no tenían este antecedente (OR= 6,62; IC95% 1,92-22,7). Conclusiones: El TDAH en la infancia incrementa la probabilidad de presentar depresión en la adultez en la población de Envigado, lo cual soporta la importancia de promover acciones de salud mental en la niñez, para prevenir la depresión en la edad adulta.
Introduction: Emotional and behavioral disorders that begin in childhood lead to adult changes, which have social consequences. Objective: To determine the association of adult depression with childhood onset of mental disorders and other factors in Envigado (Colombia). Materials and methods: A quantitative observational and cross-sectional study was carried out. The sample size was 737 individuals aged between 18 to 65 years. The CIDI-CAPI instrument of the WHO was used. Data processing and analysis was conducted through SPSS v. 21 software from the CES University and Epidat 4.2. Results: The percentage of depression in adults was 10.8%. This figure was 5.6 times greater in the study population that had history of attention deficit hyperactivity disorder (ADHD) compared to individuals who did not have this disorder (OR= 6.62; 95% CI 1.92-22.7). Conclusions: Childhood ADHD increases the probability of depression in the adult population of Envigado, which supports the importance of promoting mental health programs in children in order to prevent adulthood depression.
Introdução: Os transtornos emocionais e comportamentais que se iniciam na infância levam a alterações que se estendem até a idade adulta, com consequências sociais. Objetivo: Determinar a associação da depressão na idade adulta com transtornos mentais de início na infância e outras condições, em Envigado, 2017. Materiais e métodos: um estudo foi realizado com abordagem quantitativa, observacional, transversal e com intenção analítica. O tamanho da amostra foi de 737 indivíduos, entre 18 e 65 anos de idade. Foi aplicado o instrumento CIDI - CAPI da OMS. O processamento e análise foram realizados no SPSS v. 21 da Universidad CES e Epidat 4.2. Resultados: A proporção de depressão na idade adulta é de 10,8%, na população estudada que tinha histórico de transtorno de déficit de atenção e hiperatividade (TDAH) foi aproximadamente 5,6 vezes maior do que naquelas sem esse histórico (OR= 6,62; 95 % CI 1,92-22,7). Conclusões: O TDAH na infância aumenta a probabilidade de apresentar depressão na idade adulta na população de Envigado, o que reforça a importância de promover ações de saúde mental na infância, para prevenir a depressão na idade adulta.
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Humans , Male , Female , Child, Preschool , Child , Adult , Middle Aged , Aged , Behavior , Mental Disorders , Attention Deficit Disorder with Hyperactivity , Behavioral Symptoms , Child Behavior Disorders , DepressionABSTRACT
Cancer incidence reported by The Global Cancer Observatory (GLOBOCAN) is an estimate based on the registries available in each country. Their validity in regions such as Latin America is affected by the lack of reliable data and less access to healthcare among the population. Studying the geographic distribution of the incidence of malignant tumors facilitates the search for risk factors and allows prioritizing health resources. Aim: To estimate the incidence of the main malignant tumors in Chilean people with access to a private healthcare insurance at an oncological institute, and to know its geographical distribution. Material and Methods: Incident cancer cases during 2017 and 2018 were obtained from the institution's Tumor Registry. The incidence was adjusted by age and sex of the Chilean population obtained from the 2017 Census. Cancer rates were calculatedfor each of the 16 administrative regions in Chile. Results: Overall, the incidence of breast, lung, colon and thyroid cancers in the studied population was significantly higher than estimates for Chile reported by GLOBOCANfor 2020, especiallyfor thyroid cancer. There is a higher incidence of breast cancer in Greater Santiago and of lung cancer in men in the Antofagasta Region. Conclusions: The regional differences observed are explained by known risk factors. However the high incidence of lung and colon cancer in the Los Ríos Region requires further studies.
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O objetivo deste estudo é descrever o mix contraceptivo e analisar os fatores associados ao tipo de contraceptivo usado pelas mulheres brasileiras em idade reprodutiva. Trata-se de estudo transversal, de base populacional, com dados de 19.962 mulheres de 15 a 49 anos. Os desfechos foram uso e tipo de contraceptivo, classificados em: contraceptivos reversíveis de curta duração (SARC), longa duração (LARC) e permanentes. As variáveis explicativas foram: características da história reprodutiva, sociodemográficas e de acesso aos serviços de saúde. Utilizou-se a regressão logística multinomial para estimativas da odds ratio (OR), tendo os SARC como categoria de referência. As análises foram realizadas no módulo survey do software Stata, que considerou o efeito do plano amostral complexo da Pesquisa Nacional de Saúde de 2019. A prevalência do uso de contraceptivos foi de 83,7%. Do total de usuárias, 72% usavam SARC, 23,2% métodos permanentes e 4,8%, LARC. Mulheres com maior escolaridade, plano de saúde, que tiveram partos e participaram de grupos de planejamento reprodutivo tiveram maior chance de usar LARC na comparação com o uso de SARC, enquanto o cadastro na unidade básica de saúde se associou a menor chance de uso. Ainda, quanto maior a idade e paridade, além de viver com o companheiro, maior a chance de usar métodos permanentes em relação ao uso de SARC. Apesar da elevada cobertura de contracepção, o mix contraceptivo permanece obsoleto, com predomínio do uso de SARC. Além disso, observou-se importante desigualdade de acesso, sendo os LARC acessíveis apenas por mulheres com melhores condições socioeconômicas, enquanto os métodos permanentes foram associados a um perfil de maior vulnerabilidade social.
This study aims to describe the contraceptive mix and analyze the factors associated with the type of contraceptive used by Brazilian women of reproductive age. This is a cross-sectional, population-based study with data from 19,962 women aged 15 to 49 years. The outcomes were use and type of contraceptive, classified as: short-acting reversible contraceptives (SARC), long-acting (LARC), and permanent. The explanatory variables were characteristics of reproductive history, sociodemographic history, and access to health services. Multinomial logistic regression was used for odds ratio (OR) estimates, with SARC being the reference category. The analyses were performed in the Survey module of the Stata software, which considered the effect of the complex sampling plan of the 2019 Brazilian National Health Survey. The prevalence of contraceptive use was 83.7%. Of the total number of users, 72% used SARC, 23.2% permanent methods, and 4.8% LARC. Women with higher education, health insurance, who had deliveries, and who participated in reproductive planning groups had a higher chance of using LARC when compared with the use of SARC, while registration at the basic health unit was associated with a lower chance of use. Still, the higher the age and parity, in addition to living with the partner, the greater the chance of using permanent methods in relation to the use of SARC. Despite the high coverage of contraception, the contraceptive mix remains obsolete, with a predominance of the use of SARC. In addition, important inequalities in access were observed, with LARC being accessible only to women with better socioeconomic conditions, while permanent methods were associated with a profile of greater social vulnerability.
El objetivo fue describir la combinación anticonceptiva y analizar los factores asociados al tipo de anticonceptivo usado por las mujeres brasileñas en edad reproductiva. Estudio transversal, de base poblacional, con datos de 19.962 mujeres de 15 a 49 años. Los resultados fueron el uso y el tipo de anticonceptivo, clasificados en: anticonceptivos reversibles de corta duración (SARC), de larga duración (LARC) y permanentes. Las variables explicativas fueron características de la historia reproductiva, sociodemográficas y de acceso a los servicios de salud. Se utilizó la regresión logística multinomial para las estimaciones de la odds ratio (OR), siendo los SARC la categoría de referencia. Los análisis fueron realizados en el módulo survey, del software Stata, que consideró el efecto del sistema de muestreo complejo de la Encuesta Nacional de Salud de 2019. La prevalencia del uso de anticonceptivos fue del 83,7%. Del total de usuarias, 72% usaban SARC, el 23,2% métodos permanentes y el 4,8% LARC. Las mujeres con mayor educación, plan de salud, que tuvieron partos y participaron de grupos de planificación reproductiva tuvieron mayor posibilidad de usar LARC cuando comparados al uso de SARC, mientras que el registro en la unidad básica de salud se asoció con una menor posibilidad de uso. Además, cuanto mayor sea la edad y la paridad, además de vivir con el compañero, mayor será la posibilidad de utilizar métodos permanentes en relación con el uso de SARC. A pesar de la alta cobertura de anticoncepción, la combinación anticonceptiva sigue siendo obsoleta, con un uso predominante de SARC. Además, se observaron importantes desigualdades en el acceso, siendo los LARC accesibles solo para mujeres con mejores condiciones socioeconómicas, mientras que los métodos permanentes se asociaron con un perfil de mayor vulnerabilidad social.
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ABSTRACT Objective This work aimed to report values regarding oral hygiene habits at home during the pandemic and compare the difference with previous oral hygiene habits. Methods This study was performed anonymously and had patients answer an online questionnaire. The questionnaire consisted of 11 closed-answer questions (except 1) concerning oral hygiene habits at home at the time of COVID-19 and participant characteristics, including gender and age. A total of 1,136 questionnaires were filled in via a link sent by email to the patients. Results Among the 1,136 patients examined, 32.4% (372) were male and 67.6% (775) were female, and almost half (47.9%) of the patients who answered the questionnaire were aged 18-40 years. Patients who participated in our survey were asked questions related to dental and tongue hygiene. The answers showed that although they had more time during the pandemic, they brushed their teeth less and did not brush their tongues regularly. Conclusion Patients with periodontal problems usually have less time for brushing and do not have good plaque control. The questionnaire showed the opposite, such that the patient's compliance and motivation matters more than time. Thus, dentists and dental hygienists must encourage and make patients understand the importance of oral hygiene at home.
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Special Article Introduction Hematopoietic stem cell transplantation is the only curative treatment for many disorders and international data shows a growing trend. Method We aimed to evaluate the temporal trends in HSCT transplant rates in Argentina. A time-series analysis was performed for the period 2009 to 2018 using the national database from the National Central Coordinating Institute for Ablations and Implants. Crude and standardized transplant rates were calculated. A permutation joinpoint regression model analysis was used to identify significant changes over time. Results Altogether, 8,474 transplants were reported to INCUCAI by 28 centers (autologous 67.5%); the main indication was multiple myeloma (30%). The WHO age-sex standardized HSCT rates for the entire country were 153.3 HSCT/10 million inhabitants (95% CI 141.7-165.8) in 2009 and 260.1 HSCT/10 million inhabitants (95% CI 245.5-275.5) in 2018. There was a large gap in HSCT rates among the states and regions. The transplant rate was higher for autologous transplants throughout the years. Within the allogeneic group, the related donor transplant rate was higher than the unrelated donor transplant rate. The joinpoint regression analysis of HSCT rates for the whole country over time showed an observed annual percentage change of 6.3% (95% CI 5.4-7.3; p< 0.01). No changes were observed for unrelated donors during the study period. Conclusions Age-sex standardized HSCT rates in Argentina are increasing, mainly due to autologous and family donor allogeneic transplants. A wide variation across the country was found, demonstrating differences in the access to transplantation among Argentine regions.
Subject(s)
Humans , Transplantation, Autologous , Stem Cell Transplantation , Argentina , Epidemiologic StudiesABSTRACT
Introduction: Hematopoietic stem cell transplantation is the only curative treatment for many disorders and international data shows a growing trend. Method: We aimed to evaluate the temporal trends in HSCT transplant rates in Argentina. A time-series analysis was performed for the period 2009 to 2018 using the national database from the National Central Coordinating Institute for Ablations and Implants. Crude and standardized transplant rates were calculated. A permutation joinpoint regression model analysis was used to identify significant changes over time. Results: Altogether, 8,474 transplants were reported to INCUCAI by 28 centers (autologous 67.5%); the main indication was multiple myeloma (30%). The WHO age-sex standardized HSCT rates for the entire country were 153.3 HSCT/10 million inhabitants (95% CI 141.7 −165.8) in 2009 and 260.1 HSCT/10 million inhabitants (95% CI 245.5−275.5) in 2018. There was a large gap in HSCT rates among the states and regions. The transplant rate was higher for autologous transplants throughout the years. Within the allogeneic group, the related donor transplant rate was higher than the unrelated donor transplant rate. The joinpoint regression analysis of HSCT rates for the whole country over time showed an observed annual percentage change of 6.3% (95% CI 5.4-7.3; p < 0.01). No changes were observed for unrelated donors during the study period. Conclusions: Age-sex standardized HSCT rates in Argentina are increasing, mainly due to autologous and family donor allogeneic transplants. A wide variation across the country was found, demonstrating differences in the access to transplantation among Argentine regions
Subject(s)
Hematopoietic Stem Cell Transplantation , Argentina , Transplantation, Autologous , Transplantation, Homologous , Epidemiologic StudiesABSTRACT
Objective: A cross-sectional study that estimated the prevalence of Internet Addiction and associated factors among High School and College students in Montes Claros - Minas Gerais, Brazil. Methods: Internet Addiction was evaluated through the Internet Addiction Test, and demographic, socioeconomic, and lifestyle factors, as well as internet usage profile characteristics, were examined. Descriptive analysis and the Poisson regression model were applied. Results: Of the 2,519 participants, 52.3% were considered with Internet Addiction Problems. In High School, the following factors were identified: are women and girls, age over >16, class C, alcohol consumption, impaired sleep, frequent use of social networks, and time spent connected. In Higher Education, the following factors: are women and girls, age over >23, paid activity, class C and D/E, alcohol consumption, impaired sleep, imbalanced diet, frequent use of social networks, and time spent connected. Conclusion: There was an expressive prevalence of Internet Addiction Problems, an outcome associated with the demographic, socioeconomic, lifestyle, and internet use characteristics.
Objetivo: Estudo transversal que estimou prevalência de Adicção em Internet e fatores associados entre estudantes do Ensino Médio e Superior em Montes Claros - Minas Gerais, Brasil. Métodos: A Adicção em Internet foi avaliada pelo Internet Addiction Test e se investigaram fatores demográficos, socioeconômicos, estilo de vida e perfil de uso de internet. Foram realizadas análises descritivas e modelo de regressão de Poisson. Resultados: Dos 2.519 participantes, 52,3% apresentaram problemas de Adicção em Internet. No grupo de estudantes de Ensino Médio examinado, identificaram-se os seguintes fatores: sexo feminino, idade >16, classe C, consumo de álcool, sono prejudicado, uso frequente das redes sociais e tempo de conexão. No Ensino Superior, foram constatados: sexo feminino, idade >23, atividade remunerada, classe C e D/E, consumo de álcool, sono prejudicado, alimentação não balanceada, uso frequente das redes sociais e tempo de conexão. Conclusão: Houve expressiva prevalência de Problemas com Adicção em Internet, desfecho associado a características demográficas, socioeconômicas, ao estilo de vida e ao uso da internet.
Subject(s)
Epidemiologic Studies , Student Health , Behavior, Addictive , InternetABSTRACT
Objective@#To analyze the epidemiological and etiological characteristics of hand-foot-mouth disease (HFMD) in Tongren City during 2018 to 2022, so as to provide the reference for HFMD effective prevention and control.@*Methods@#Monitoring data on HFMD in Tongren City from 2018 to 2022 was collected from National Infectious Disease Reporting Information Management System. Descriptive epidemiological method was conducted on the data analysis.@*Results@#A total of 14 376 cases of HFMD were reported in Tongren City during 2018 to 2022, the average annual incidence rate of HFMD was 89.43/100 000. Totally 47 severe cases were reported, accounting for 0.33% of the total cases. The incidence rates of HFMD were generally declining trend during 2018 to 2022 (124.68/100 000, 95.37/100 000, 78.50/100 000, 61.63/100 000, 87.80/100 000) ( χ 2 trend =393.05, P <0.01), mainly occurred during April to July (48.13%), among children under 5 years old (95.72%). During 2018 to 2022, a total of 967 laboratory diagnosed cases reported in different years, regions, age groups showed significant differences in pathogen composition ratio ( χ 2=169.62, 456.65 , 167.96, P <0.05). From 2018 to 2022, the dominant pathogen of HFMD was constantly changing. Other enteroviruses were the dominant epidemic strains in 2018 and 2022 (33.04%, 37.62%), CoxA 6 was the dominant epidemic strain in 2019 to 2020 ( 68.75 %, 50.78%), and CoxA16 was the dominant epidemic strain in 2021(43.30%).In 2018, one case was infected with CoxA16 and EV71.The difference of pathogen composition ratio varied in different years ( χ 2=169.62, P <0.01).@*Conclusions@#The prevalence of HFMD in Tongren City has showed a declining trend during 2018 to 2022, and the dominant strain of HFMD has changed in recent years. The pathogen monitoring of HFMD should be strengthened to timely grasp the distribution and changes of pathogens, so as to provide a basis for the precise prevention and control of HFMD.
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Objective@#To analyze the spatial temporal distribution characteristics of tuberculosis among high school students at county levels in Gansu Province from 2018 to 2022,so as to provide a scientific basis for tuberculosis prevention and control in schools.@*Methods@#Tuberculosis data from high school students in counties (districts) reported in Gansu Province from 2018 to 2022 was collected from the Tuberculosis Information Management System and Infectious Disease Information Reporting System of the Chinese Disease Prevention and Control Information Management System. Demographic data of high school students in counties (districts) came from the General Management System of the Chinese Disease Prevention and Control Information Management System, and the spatial clustering of the reported incidence rate of pulmonary tuberculosis among high school students in Gansu Province in the past five years was analyzed using the methods of global spatial autocorrelation (Moran s I) and local indicators of spatial audocorrelation(LISA).@*Results@#A total of 41 885 pulmonary tuberculosis cases were reported in various counties of Gansu Province From 2018 to 2022, with an average reported incidence rate of 32.81/100 000. During the same period, 1 170 high school students cases were reported, with an average reported incidence rate of 13.72/100 000. With the exception of 2020, the reported incidence rate of pulmonary tuberculosis among high school students was non random distribution in other 4 years, showed a moderate intensity of spatial clustering. From 2018 to 2022, most counties in Gansu Province reported that the incidence rate of pulmonary tuberculosis among high school students was 10.00/100 000 or below, the counties with reported incidence rate >40.00/100 000 were mainly distributed in Luqu County, Maqu County, Diebu County, Hezuo City, Xiahe County of Gannan Prefecture, Gangu County and Wushan County of Tianshui Prefecture, Wenxian County and Kangxian County of Longnan Prefecture, Huachi County of Pingliang Prefecture, Huanxian County of Qingyang Prefecture. The number of counties where the reported incidence rate of tuberculosis among high school students more than 30.00/100 000 gradually decreased from 2018 to 2022. In the past five years, the reported incidence rate of tuberculosis among high school students in all counties of Gannan Prefecture remained above 40.00/ 100 000 . The LISA analysis results showed that the high incidence areas were mainly concentrated in Gannan Prefecture.@*Conclusions@#The epidemic situation of pulmonary tuberculosis among high school students in Gansu province from 2018 to 2022 is still a serious condition, showing the characteristics of unbalanced regional distribution. The reported incidence rate shows a strong spatial clustering, and the hot spots are concentrated in the counties (districts) of Gannan prefecture in Gansu Province.
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Objective@#To analyze the epidemiological characteristics and trends of chronic disease mortality among children aged 0-14 in China during 2012-2021, so as to provide scientific basis for the formulation of prevention strategies for chronic diseases in children.@*Methods@#The descriptive epidemiological analysis was conducted for chronic disease mortality among children aged 0-14 during 2012 to 2021 from China Cause of Death Surveillance Data Set, and the Joinpoint regression models were used to analyze the average annual percentage change (AAPC) of child chronic disease mortality.@*Results@#From 2012 to 2021, the mortality rates of chronic diseases among children aged 0-14 years in China (23.33/100 000, 19.54/100 000, 19.27/100 000, 17.69/ 100 000 , 16.87/100 000, 16.44/100 000, 14.49/100 000, 13.79/100 000, 11.61/100 000, 9.43/100 000)showed a decreasing trend (AAPC=-7.94%, P <0.01). The overall mortality rates for boys and girls and for chronic diseases were decreasing in both urban and rural areas (AAPC=-8.44%, -7.05%, -8.42%, -6.77%, P <0.05). The average annual mortality rate of chronic diseases was higher in boys (16.81/100 000) than in girls (13.96/100 000) ( χ 2=526.44, P <0.01). The average annual mortality rate from chronic diseases among children was higher in urban (15.98/100 000) than in rural areas (13.46/100 000) in the central region, and higher in rural (19.75/100 000) than in urban areas (15.96/100 000) in the western region ( χ 2=117.63, 190.25, P < 0.01 ). Except for malignant tumors, the trend of overall mortality rates of congenital abnormalities, neurological and mental disorders, cardiovascular diseases, and digestive system diseases were all decreasing (AAPC=-11.48%, -2.92%, -7.82%, -12.51 %, P <0.05).@*Conclusions@#The overall mortality rate of chronic diseases in children in China shows a downward trend during 2012-2021, but the situation of chronic disease prevention and control is still severe. Targeted prevention strategies should be adopted, focusing on the prevention and health care of males, children under 5 years old.
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Objective:To analyze the changing trend of intracerebral hemorrhage (ICH) incidence among residents with different characteristics during 9 years of comprehensive hypertension prevention and control (hypertension prevention and control) in Tengzhou from 2013 to 2021.Methods:From January 1, 2013 to December 31, 2021, the new ICH cases collected by the Center for Disease Control and Prevention in Tengzhou City were analyzed to calculate the incidence of ICH, and the trend of its distribution was analyzed among residents with different ages, sexes, and between urban and rural areas. The registered population information came from Tengzhou Public Security Bureau. Age and sex standardized incidence was calculated based on the 7th National Population Census in 2020. The Cochran-Armitage test was used to analyze the time and age trends of the incidence.Results:The overall ICH crude and standardized incidence in Tengzhou City decreased from 97.30/100 000 to 52.13/100 000 ( Z=-9.93, P<0.001) and 119.30/100 000 to 50.69/100 000 ( Z=-15.40, P<0.001) from 2013 to 2021, and both elevated to form a single peak in 2020, with 22.58% ( χ 2=24.02, P<0.001) and 18.09% ( χ 2=17.08, P<0.001) higher than in 2019, respectively. The trends in male and female incidence over the same period were similar to the overall trends, and the incidence was higher in males than in females in all years. The incidence of ICH increased with age in all years. The difference of increase in male incidence rate in 2020 was statistically significant in three age groups ≥45 years compared with 2019 (36.29%, 23.57% and 16.18%, respectively, χ 2=6.73, 4.65, 4.00, P<0.001). The incidence of ICH decreased by 70.07% and 36.23% ( Z=18.44, 5.22, P<0.001) in urban and rural areas respectively from 2013 to 2021, whereas increased by 34.15% ( χ 2=10.88, P<0.01) and 22.08% ( χ 2=18.63, P<0.001) in 2020 compared with 2019 separately. Conclusions:The incidence of ICH in Tengzhou from 2013 to 2021 showed a significant downward trend, with the decrease in the incidence of ICH in women exceeding that in men. The decrease in the incidence of ICH in urban areas exceeded that in rural areas, and male morbidity seemingly had a younger trend.
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Objective:To investigate clinical features of patients with chronic spontaneous urticaria (CSU) in China.Methods:A questionnaire survey was carried out in CSU patients at the first visit and 4 follow-up visits in Departments of Dermatology of 12 third-grade hospitals in northern and southern China from January to December 2019. The survey content included demographic characteristics, pruritus intensity, the number of wheals, concomitant symptoms (such as pain in skin lesions, arthralgia, fever) during the last week prior to the admission, classification and subtypes of urticaria, and previous and current treatment regimens, etc., and the 7-day urticaria activity score (UAS7) was used to evaluate the therapeutic effect. Patients from 9 hospitals in Sichuan, Hubei and Fujian provinces were enrolled into the southern China group, and patients from 3 hospitals in Beijing municipality and Liaoning province were enrolled into the northern China group. Differences between groups were analyzed by two-independent-sample t-test, Mann-Whitney U test or chi-square test. Results:Overall, 1 396 CSU outpatients were enrolled, including 592 males and 804 females; their age was 38.32 ± 16.13 years, 1 109 (79.5%) were aged between 20 and 60 years, and 660 (47.3%) were aged between 20 and 40 years. Their age at onset was 35.85 ± 16.03 years, and the disease duration was 0.50 (0.25, 2.00) years. Allergic diseases were the most common concomitant diseases, 269 (19.3%) patients were diagnosed with accompanied allergic rhinitis or conjunctivitis, 169 (14%) with accompanied eczema/dermatitis, 39 (2.8%) with accompanied asthma; only 19 (1.4%) CSU patients had a history of thyroid diseases, but 133 (9.5%) were positive for anti-thyroid peroxidase (TPO) or anti-thyroglobulin (Tg) antibodies at the visit; elevated serum total IgE levels were observed in 437 (31.3%) patients, and 104 (7.4%) were positive for autoantibodies. There were 1 078 (77.2%) patients in the southern China group and 318 (22.8%) in the northern China group, and the southern China group showed significantly longer disease duration (2.16 ± 4.76 years vs. 1.53 ± 2.80 years, P < 0.001) , and significantly higher proportions of patients with family history (10.7% vs. 3.5%) , with painful lesions (5.8% vs. 0.9%) , and those with arthralgia (10.7% vs. 0) compared with the northern China group (all P < 0.05) . The three most prevalent urticaria subtypes were CSU (835 cases, 49.9%) , symptomatic dermographism (437 cases, 31.3%) , and angioedema (138 cases, 9.9%) , and the proportion of patients with the single diagnosis of CSU was significantly higher in the southern China group (53%) than in the northern China group (38.9%, P < 0.001) . In terms of treatment, 1 365 (97.8%) patients received conventional-dose second-generation H1 antihistamines alone or in combination, and only 31 (2.2%) were treated with antihistamines at high doses; other medicines were mostly administered in combination, and compound glycyrrhizin was most frequently prescribed (36.6%) , while omalizumab was only administered in 7 patients (0.5%) . Conclusions:Significant differences in the clinical features of CSU were observed between northern and southern China. Nowadays traditional modalities are inadequate for the treatment of CSU, and new therapeutic drugs are somewhat promising.
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Objective@#To analyze the trend and characteristics of school tuberculosis epidemic in Shijiazhuang from 2011 to 2020, and to provide reference for school tuberculosis prevention and control.@*Methods@#Descriptive methods were used to analyze the epidemiological characteristics of tuberculosis among students and the epidemic situation of tuberculosis in schools in Shijiazhuang from 2011 to 2020. The χ 2 test and χ 2 trend test were used to analyze the characteristics and trend of school tuberculosis.@*Results@#A total of 4 896 cases of tuberculosis were registered among students in Shijiazhuang from 2011 to 2020. The average annual registered incidence rate of students was 24.69/100 000, and the difference in incidence rate was statistically significant ( χ 2=318.50, P <0.01) the overall registered incidence rate of tuberculosis among students in the past 10 years was on the rise ( χ 2 trend =87.79, P <0.01). Among the student cases, male accounted for 53.89%, female accounted for 46.11%. The age group of students aged >18 and above accounted for the largest proportion(50.35%), followed by the age group aged 16-18( 35.80 %). Most students cases occurred in April and September-November, with September the highest(12.03%). A total of 22 clustered outbreaks (174 cases) and the aggregate epidemic accounted for 3.55% of the total number of students with tuberculosis.@*Conclusion@#The prevention and control of tuberculosis epidemic in schools in Shijiazhuang should not be underestimated, and strengthen the supervision, management, publicity and education of students in key age groups to avoid clusters of outbreaks.
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Objective@#To investigate the characteristics of HIV/AIDS cases among 15-24 year old population reported in Hefei from 2004 to 2022, so as to provide insights into AIDS control among adolescents.@*Methods@#The epidemiological data regarding HIV/AIDS cases between 15 and 24 years old reported in Hefei from 2004 to 2022 were captured from the AIDS comprehensive prevention and control information system of Chinese disease prevention and control information system, and data regarding temporal distribution, population distribution, and routes of infections and detection were descriptively analyzed by descriptive epidemiological methods.@*Results@#From 2004 to 2022, 865 cases of HIV/AIDS were reported in Hefei among 15-24 years old youth, accounting for 21.80% of the total reported cases. Among the HIV/AIDS patients, males accounted for 92.60%(801 cases), the unmarried ones accounted for 93.41% (808 cases)，those with college degree or above accounted for 60.12% (520 cases)，and 25.78%(223 cases) of them were students. The proportion of student cases increased annually( χ 2 trends =47.67, P <0.01). Homosexual transmission accounted for 81.39%, both showed an increasing trend( χ 2 trends =51.23, P <0.01)．Totally 55.49% of cases were found through testing and consultation, and the proportion of cases increased by year( χ 2 trends =112.18, P <0.01). In 2004-2022，the number of newly reported cases among people aged 15-24 showed a rising trend at an average rate of 24.46% by year( Z=4.92, P <0.01), which was higher than the average rate of 21.54% for the entire population( Z=12.75, P <0.01).@*Conclusion@#The epidemic of HIV/AIDS among population aged 15-24 years is serious in Hefei. Comprehensive measures for HIV education and prevention intervention are desperately needed to be reinforced among targeted students.
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Objective To investigate the status and molecular epidemiology of hepatitis D virus (HDV) infection in the gathering area of Mongolian population in Inner Mongolia Autonomous Region of China. Methods A total of 230 patients with positive hepatitis B surface antigen (HBsAg) who attended Inner Mongolia International Mongolian Hospital from April 2019 to October 2020 were enrolled, and according to related information, they were divided into hepatitis B+liver cirrhosis group( n =18) and hepatitis B group( n =212). According to HBsAg quantification with a cut-off value of 250 IU/mL, the patients were divided into HBsAg < 250 IU/mL group( n =104) and HBsAg ≥250 IU/mL group( n =126). ELISA was used to detect HDV antibody, and quantitative real-time PCR was used to measure HDV RNA in patients with positive HDV antibody. Genotyping was performed for HDV RNA-positive samples. The chi-square test was used for comparison of categorical data between two groups. Results The positive rate of HDV antibody was 16.09%, and among the patients with positive HDV antibody, the positive rate of HDV RNA was 91.89%. Among the 18 patients with hepatitis B and liver cirrhosis, the positive rate of HDV antibody was 44.44%, and among the patients with positive HDV antibody, the positive rate of HDV RNA was 100%. There were 104 patients with HBsAg < 250 IU/mL, among whom only 3 patients (2.88%) were positive for hepatitis D antibody, and there were 126 patients with HBsAg ≥250 IU/mL, with a positive rate of HDV antibody of 26.98%. Genotype 1 was observed in all the samples that could be genotyped. Conclusion There is a relatively high infection rate of HDV in Inner Mongolia Autonomous Region, especially in patients with HBsAg ≥250 IU/mL or those with liver cirrhosis. It is necessary to strengthen the detection of hepatitis D in HBsAg-positive patients and perform early diagnosis and treatment to prevent the further progression of hepatitis.