Résumé
ABSTRACT Introduction: burns represent a pivotal component of trauma in Brazil, accounting for 2 million incidents and 2,500 deaths annually. Self-intentional burns are associated with a worse prognosis, larger burned surface area, higher infection rates, and death. The lack of studies on the issue of self-immolation raises epidemiological questions regarding Brazilian victims. This study aimed to investigate the profile of burn events associated with self-injurious behavior among Brazilian victims. Methods: this systematic review was performed according to PRISMA 2020 guidelines and evaluated the correlation between self-injurious behavior as a cause of burns in Brazilian victims and its epidemiological implications in the last 20 years (2003-2023). The MeSH terms "Burns", "Self-Injurious Behavior", "Epidemiology" and "Brazil" were queried in the PubMed/MEDLINE, SciELO, and Cochrane Library databases, and, after selection by inclusion/exclusion criteria, the most relevant studies were critically analyzed. Results: From 1,077 pre-selected studies, 92 were potentially eligible, resulting in 7 manuscripts incorporated in this review. From 3,510 burned victims assembled in the pool of selected studies, 311 cases displayed self-injurious behavior. Burned patients who attempted to burn their lives have a higher risk of death (p<0.05; RR=5.1 [3.2-8.1]) and larger burned surface area (p<0.05; MD=19.2 [10-28.2]), compared to accidental cases. Moreover, the female gender was at a higher risk of attempting self-immolation (p<0.05; RR=4.01 [2.9-5.5]). Conclusion: our results show that self-inflicted burn cases were associated with a larger burned surface area and a higher risk of death, and the female gender was identified as a relevant risk factor in Brazil.
RESUMO Introdução: Queimaduras representam um componente fundamental do trauma no Brasil, sendo responsáveis por 2 milhões de incidentes e 2.500 mortes anualmente. Queimaduras autointencionais estão associadas a pior prognóstico, maior superfície corporal queimada, maiores taxas de infecção e morte. A falta de estudos sobre a problemática da autoimolação levanta questões epidemiológicas em relação às vítimas brasileiras. O estudo se objetivou investigar o perfil das queimaduras associados ao comportamento autolesivo entre vítimas brasileiras. Métodos: Esta revisão sistemática foi realizada de acordo com as diretrizes PRISMA 2020 e avaliou a correlação entre comportamento autolesivo como causa de queimaduras em vítimas brasileiras e suas implicações epidemiológicas nos últimos 20 anos (2003-2023). Os termos MeSH "Burns", "Self-Injurious Behavior", "Epidemiology" e "Brazil" foram elencados no PubMed/MEDLINE, SciELO e Cochrane Library e, após seleção por critérios de inclusão/exclusão, os estudos mais relevantes foram analisados criticamente. Resultados: Dos 1.077 estudos pré-selecionados, 92 foram potencialmente elegíveis, resultando em 7 manuscritos incorporados nesta revisão. Das 3.510 vítimas queimadas reunidas no conjunto de estudos selecionados, 311 casos apresentaram comportamento autolesivo. Pacientes que tentaram autoimolação apresentam maior risco de morte (p<0,05; RR=5,1 [3,2-8,1]) e maior superfície corporal queimada (p<0,05; MD=19,2 [10-28,2]), em comparação com casos acidentais. Ademais, o sexo feminino apresentou maior risco para tentativa de autoimolação (p<0,05; RR=4,01 [2,9-5,5]). Conclusão: Nossos resultados mostram que os casos de queimaduras autoprovocadas foram associados a uma maior área de superfície corporal queimada e a um maior risco de morte, e o sexo feminino foi identificado como um fator de risco relevante no Brasil.
Résumé
Abstract INTRODUCTION: Chagas disease (CD) affects 5.7-7.0 million individuals worldwide, and its prevalence reached 25.1% in the state of Bahia, Brazil. There is an association between the prevalence of CD, the socioeconomic status of the population, and the risk of re-emergence due to non-vectorial transmission, such as blood transfusion. This study determined the seroprevalence of T. cruzi infection among blood donors in the state of Bahia, located in northeastern Brazil, and their epidemiological profile during a 10-year period. METHODS: We performed a descriptive cross-sectional study involving a database review. Data were collected from patients with non-negative results for T. cruzi infection during a 10-year period. RESULTS: A total of 3,084 (0.62%) samples were non-negative for T. cruzi infection in an initial serological screening, and 810 (0.16%) samples were non-negative in the second screening. The correlation between infection and age (30 years or older) and between infection and lower educational level (12 years or less) in the first and second screening was statistically significant. The seroprevalence of T. cruzi infection was higher in men in the first screening. In addition, 99.52% of the municipalities of Bahia had at least one case of CD. Livramento de Nossa Senhora and Salvador presented the highest disease prevalence and recurrence, respectively. CONCLUSIONS: The seroprevalence of T. cruzi infection in these populations was lower than that found in other studies in Brazil but was comparatively higher in densely-populated areas. The demographic characteristics of our population agreed with previous studies.