Self-injurious behavior and related mortality in children under 10 years of age: a retrospective health record study in Brazil

Objective: To describe and analyze data on self-injurious behavior (SIB) and related mortality in children under 10 years old in Brazil. Methods: A descriptive study was performed using secondary public health care data extracted from the Hospital Information System (Sistema de Informações Hospitalares, SIH) and Mortality Information System (Sistema de Informações sobre Mortalidade, SIM) in Brazil. The databases are available for online access at http://datasus.saude.gov.br/. Results: In Brazil, according to SIH data, 11,312 hospitalizations of patients under 10 years of age were recorded from 1998 to 2018 as resulting from SIB (ICD-10 X60-X84 codes). Of these, 65 resulted in death. According to the SIM, from 1996 to 2016, 91 deaths related to SIB were recorded, 81 (89%) in children aged 5 to 9 years, nine (9.9%) in children aged 1 to 4 years, and one (1.1%) in a child below 1 year of age. Conclusion: These results highlight the relevance of creating measures to better understand SIB and related mortality in this age group. They also reveal the vulnerability of children in Brazil and warrant further studies to address these issues.

Mortalidade por causas externas: revisão dos dados do Sistema de Informação de Mortalidade / Mortality from external causes: a review of the data of the Mortality Information System (SIM)

Objetivo: Traçar o perfil epidemiológico da mortalidade por causas externas. Métodos: Estudo retrospectivo, descritivo, de abordagem quantitativa. A população estudada correspondeu a vítimas que foram a óbito por causas externas, por local de ocorrência, no Estado do Tocantins, de 2010 a 2015. Os dados foram extraídos do banco de dados do Sistema de Informação de Mortalidade do Ministério da Saúde. As variáveis analisadas foram faixa etária, sexo, municípios de ocorrência e categorias da décima edição da Classificação Internacional de Doenças e Problemas Relacionados à Saúde. Resultados: Nos anos de 2010 a 2015, foram registrados 7.691 óbitos por causas externas no Tocantins. Destes, 7.142 corresponderam apenas às categorias consideradas por este estudo, dentre as quais acidentes de transporte e agressões obtiveram maior número de casos, com 43,92% e 29,98%, respectivamente. Da mortalidade por acidentes de transporte, 33,5% corresponderam a motociclistas. Os homens representaram a maioria das ocorrências (82,46%). A faixa etária de 20 a 29 anos foi a mais acometida (24,85%), mas óbitos por quedas e por afogamentos ocorreram mais nas faixas etárias de 80 anos ou mais (207 óbitos) e 30 a 39 anos (72 óbitos), respectivamente. As cidades com maiores resultados foram Palmas (20,71%) e Araguaína (16,5%). Conclusão: Os dados demonstram a magnitude do problema a nível estadual e os impactos causados à saúde pública e à sociedade como um todo. Revelam, ainda, a necessidade de políticas públicas de valorização da vida e da promoção de oportunidades, que visem à igualdade entre os cidadãos. (AU)

OBJECTIVE: To describe the epidemiological profile of mortality from external causes. METHODS: This is a retrospective, descriptive and quantitative study. The population studied consists of victims who died from external causes, by place of occurrence, in the state of Tocantins from 2010 to 2015. Data were extracted from the Mortality Information System database of the Brazilian Ministry of Health. The analyzed variables were age, gender, municipalities of occurrence, and categories of the 10th edition of the International Classification of Diseases. RESULTS : Between the years 2010 and 2015, there were 7691 deaths due to external causes in Tocantins. Of these, 7142 corresponded only to the categories considered by this study, such as transportation accidents and assaults that obtained the highest number of cases, with 43.92% and 29.98%, respectively. The mortality due to transportation accidents had 33.5% consisting of motorcyclists. Besides, men represent the majority of occurrences (82.46%). The age range of 20-29 years was the most affected (24.85%), but deaths from falls and drowning occurred more frequently in the age range of 80 years or more (207 deaths), and 30-39 years (72 deaths), respectively. The cities with the highest results were Palmas (20.71%), and Araguaína (16.5%). CONCLUSI ON: Data demonstrate the magnitude of the problem at the state level, and the impacts caused to the public health and society as a whole. They also reveal the need for public policies to value life and promote opportunities for equality among citizens. (AU)

Carga de enfermedad de los adolescentes en Uruguay y su comparación con la de América Latina y el Caribe / Global burden of disease among teenagers in Uruguay and its comparison with Latin America and the Caribbean

Resumen Introducción. La adolescencia es considerada una etapa de buena salud y por tanto poco estudiada. El objetivo de este estudio es describir la evolución de la mortalidad en adolescentes en Uruguay y analizar la carga de enfermedad en esta etapa de la vida, a través de la medida de los Años de Vida Perdidos por Muerte Prematura en Uruguay y su comparación con los de América Latina y el Caribe según sexo, causa y subregión. Metodología. Se utilizaron fuentes de datos secundarias: el registro nacional de defunciones del Uruguay, el primer estudio de Carga Global de Enfermedad en Uruguay y la información presentada por la página de visualización de datos del Instituto de Métricas y Evaluación en Salud. Resultados. La mortalidad en los adolescentes se ha mantenidos aproximadamente estable entre 1997 y 2015. Loa años perdidos por muerte prematura para el Uruguay son más en los hombres y sus principales causas son los accidentes de tránsito, heridas auto infringidas y violencia. El mismo comportamiento se presenta en la región. Conclusiones. Los determinantes sociales de la salud vinculados a la pobreza e inequidad tienen un rol en el desarrollo de depresión, conductas riesgosas y violentas que posiblemente expliquen la perdida de años por muerte prematura en esta etapa de la vida.

Abstract Introduction. Adolescence is considered a healthy stage of life and therefore little studied. This study described mortality over time in teenagers in Uruguay and analysed the burden of disease at this stage of life by the measure of Years of Life Lost by Premature Death in Uruguay and by comparison with rates in Latin America and the Caribbean by sex, cause and sub-region. Methodology. Secondary data sources used were the national registry of deaths in Uruguay, the first Global Burden of Disease study in Uruguay and the information on the data visualisation page of the Institute of Metrics and Health Evaluation. Data were extracted by the authors and displayed in tables and graphs. Results. Teenager mortality held roughly stable between 1997 and 2015. More years were lost to premature death among Uruguayan men, the main causes being traffic accidents, self-inflicted injuries and violence. The same behaviour occurs throughout the region. Conclusions. The social determinants of health connected with poverty and inequality play a role in the development of depression, risky and violent behaviour, which possibly explain the loss of years due to premature death in adolescence.

Perfil de mortalidade por causas externas entre Adventistas do Sétimo Dia e a população geral / Profile of mortality from external causes among Seventh-day Adventists and the general populations

Resumo Este estudo teve por objetivo comparar o perfil de mortalidade por causas externas entre Adventistas do Sétimo Dia e população geral do Espírito Santo no período de 2003 a 2009. Realizou-se busca dos Adventistas no banco nominal do Sistema de Informação sobre Mortalidade de posse das informações dos Adventistas fornecidas pelas sedes administrativas da instituição. Os óbitos por causas externas ocorridos no período estudado foram então separados em dois grupos: Adventistas e população geral. Os Adventistas apresentaram menor mortalidade proporcional por causas externas (10%) que a população geral (19%), sendo o sexo masculino o principal responsável por essa diferença. Em ambos os grupos os óbitos predominaram na faixa de 20 a 29 anos. As mortes por causas acidentais foram mais expressivas entre os Adventistas (68,08%) enquanto as mortes por causas intencionais relacionadas às agressões e lesões autoprovocadas foram mais significativas na população geral (53,67% de todas as mortes). A razão de mortalidade padronizada para as causas externas foi 41,3, sendo assim ser Adventista reduziu a mortalidade em 58,7%. Acredita-se que o benefício dos Adventistas verificado em relação à mortalidade por causas externas possa estar relacionado à recomendação de abstinência do consumo de álcool por esse grupo.

Abstract This paper aimed to compare the profile of mortality from external causes among Seventh-day Adventists and the general population of Espírito Santo from 2003 to 2009. A search of Adventists was performed in the nominal database of the Mortality Information System containing data on Adventists provided by the administrative offices of the institution. Deaths from external causes occurred during the study period were then divided into two groups: Adventists and the general population. Adventists had lower proportional mortality from external causes (10%) than the general population (19%), and males were the main reason for this difference. In both groups, deaths prevailed in the 20-29 years age group. Deaths from accidental causes were most significant among Adventists (68.08%), while deaths from intentional causes related to assault and self-inflicted injuries were more significant in the general population (53.67% of all deaths). The standardized mortality ratio for external causes was 41.3, thus, being Adventist reduced mortality by 58.7%. It is believed that the benefit of Adventists observed for mortality from external causes is related to this group's abstinence from alcohol consumption.