Covid-19 in health workers: an ecological study from sinan data, 2020-2021 / Covid-19 en personal de salud: un estudio ecológico a partir de datos del sinan, 2020-2021 / Covid-19 em trabalhadores da saúde: um estudo ecológico a partir de dados do sinan, 2020-2021

ABSTRACT Objective: to analyze the epidemiological and occupational profile of health workers notified for COVID-19 in Brazil, in the years 2020 and 2021. Method: this is an ecological study, which used data from the Information System of Notifiable Diseases (SINAN) and the Annual Social Information List (RAIS), from the years 2020 and 2021. Sociodemographic and occupational variables were analyzed. The prevalence rates of COVID-19 in health workers were calculated, modeled by Poisson regression in the Stata 14 software. Results: in 2020 and 2021, 35,545 health workers were affected by COVID-19. A higher prevalence of the disease was observed in females (79.0%), between 30 and 49 years (65.5%) and in blacks and browns (41.4%). Higher rates were observed in women (793.9/100,000 in 2020), young workers (839.9/100,000 in 2020), non-whites (1,497.4/100,000 in 2020) and in northern Brazil, with 1,688.1 cases per 100,000 workers in 2020. Nursing professionals, physicians and physical therapists had the highest rates of the disease in 2020 and 2021. Conclusion: there was a difference between the sexes, as well as social, racial and occupational inequities that reflect the need to expand health surveillance measures in order to ensure greater prevention, protection and assistance to health workers.

RESUMEN Objetivo: analizar el perfil epidemiológico y ocupacional de los trabajadores de la salud notificados por COVID-19 en Brasil, en los años 2020 y 2021. Método: se trata de un estudio ecológico, que utilizó datos del Sistema de Información de Enfermedades de Declaración Obligatoria (SINAN) y del Registro Anual de Información Social (RAIS), de los años 2020 y 2021. Se analizaron variables sociodemográficas y ocupacionales. Se calcularon las tasas de prevalencia de COVID-19 en trabajadores de la salud, modeladas por regresión de Poisson en el software Stata 14. Resultados: En 2020 y 2021, 35.545 trabajadores de la salud se vieron afectados por COVID-19. Se observó una mayor prevalencia de la enfermedad en el sexo femenino (79,0%), entre 30 y 49 años (65,5%) y en negros y pardos (41,4%). Se observaron tasas más altas en mujeres (793,9/100.000 en 2020), trabajadores jóvenes (839,9/100.000 en 2020), no blancos (1.497,4/100.000 en 2020) y en el norte de Brasil, con 1.688,1 casos por 100.000 trabajadores en 2020. Profesionales de enfermería, médicos y fisioterapeutas tuvieron las tasas más altas de la enfermedad en 2020 y 2021. Conclusión: hubo diferencia entre los sexos, así como desigualdades sociales, raciales y ocupacionales que reflejan la necesidad de ampliar las medidas de vigilancia de la salud para garantizar una mayor prevención, protección y asistencia a los trabajadores de la salud.

RESUMO Objetivo: analisar o perfil epidemiológico e ocupacional dos trabalhadores da saúde notificados para COVID-19 no Brasil, nos anos de 2020 e 2021. Método: trata-se de um estudo ecológico, que utilizou dados do Sistema de Informação de Agravos de Notificação (SINAN) e da Relação Anual de Informações Sociais (RAIS), dos anos de 2020 e 2021. Analisaram-se variáveis sociodemográficas e ocupacionais. Foram calculadas as taxas de prevalência de COVID-19 em trabalhadores da saúde, modeladas por Regressão de Poisson no software Stata 14. Resultados: em 2020 e 2021, 35.545 trabalhadores da saúde foram acometidos pela COVID-19. Observou-se maior prevalência da doença no sexo feminino (79,0%), entre 30 e 49 anos (65,5%) e em pretos e pardos (41,4%). Foram observadas maiores taxas em mulheres (793,9/100.000 em 2020), trabalhadores jovens (839,9/100.000 em 2020), não brancos (1.497,4/100.000 em 2020) e no Norte do Brasil, com 1.688,1 casos a cada 100.000 trabalhadores em 2020. Profissionais da enfermagem, médicos e fisioterapeutas apresentaram as maiores taxas da doença em 2020 e 2021. Conclusão: observou-se diferença entre os sexos, bem como iniquidades sociais, raciais e ocupacionais que traduzem a necessidade de ampliar medidas de vigilância em saúde, a fim de garantir maior prevenção, proteção e assistência aos trabalhadores de saúde.

Prevalence of unprotected sexual activity in the Brazilian population and associated factors: National Health Survey, 2019. / Prevalência de atividade sexual desprotegida na população brasileira e fatores associados: Pesquisa Nacional de Saúde, 2019.

OBJECTIVE: To estimate prevalence of unprotected sexual activity and associated factors in the Brazilian population. METHODS: This was a cross-sectional study with 61,523 adults aged 18 years or older who took part in the 2019 National Health Survey. We estimated prevalence of unprotected sexual activity in the last year. We analyzed association of socioeconomic and demographic variables with the outcome using Poisson regression, estimating prevalence ratios (PR) and 95% confidence intervals (95%CI). RESULTS: Prevalence of unprotected sexual activity was 76.9% (95%CI 76.3;77.6), being higher in all the country's regions in comparison to the Northern region, as well as being higher among people living in rural areas (PR = 1.04; 95%CI 1.03;1.06), females (PR = 1.06; 95%CI 1.05;1.08), participants aged 60 years or older (PR = 1.33; 95%CI 1.27;1.38), married individuals (PR = 1.25; 95%CI 1.23;1.27) and those with less education (PR = 1.05; 95%CI 1.03;1.06). CONCLUSION: Strategies aimed at groups with higher prevalence of unprotected sexual activity are necessary.

Tuberculosis incidence rate time series in the state of Santa Catarina, Brazil: analysis of a decade, 2010-2019. / Série histórica da taxa de incidência de tuberculose em Santa Catarina: análise de uma década, 2010-2019.

OBJECTIVE: To describe the profile of tuberculosis cases and analyze the temporal trend of tuberculosis incidence rate in Santa Catarina, by sex, from 2010 to 2019. METHODS: This was a time series study conducted using data from the Notifiable Health Conditions Information System (SINAN). The Prais-Winsten regression model was used. RESULTS: There were 16,446 new cases of tuberculosis. Most cases occurred in males (68.5%), people aged 20 to 49 years (70.3%), in Greater Florianópolis (25.1%) and in individuals with incomplete elementary education (40.0%). A falling trend in tuberculosis incidence rates was found for males (APC: -1.86%; 95%CI -2.68;-1.03), females (APC: -1.92%; 95%CI -2.63;-1.20) and both sexes (APC: -1.77%; 95%CI -2.37;-1.17). CONCLUSION: In the decade analyzed, there was a significant reduction in the tuberculosis incidence rate in Santa Catarina, in both sexes. There was a predominance of males, people of economically active age and with low schooling.

Prevalence of unprotected sexual activity in the Brazilian population and associated factors: National Health Survey, 2019 / Prevalencia de actividad sexual sin protección en la población brasileña y factores asociados: Encuesta Nacional de Salud, 2019 / Prevalência de atividade sexual desprotegida na população brasileira e fatores associados: Pesquisa Nacional de Saúde, 2019

Objective: To estimate the prevalence and factors associated with unprotected sexual activity in the Brazilian population. Methods: Cross-sectional study with 61.523 adults aged 18 years or older, participating in the 2019 National Health Survey. The prevalence of unprotected sexual activity in the last year was estimated. The association of socioeconomic and demographic variables with the outcome was analyzed using Poisson regression, with estimation of prevalence ratios (PR) and 95%CI. Results: The prevalence of unprotected sexual activity was 76.9% (95%CI 76.3;77.6), being higher in all regions compared to the North region, rural residents (PR=1.04 ­ 95%CI 1.03;1.06), female participants (PR=1.06 ­ 95%CI 1.05;1.08), participants aged 60 years or older (PR=1,33 ­ 95%CI 1,27;1,38), married (PR=1.25 ­ 95%CI 1.23;1.27), and less educated (PR=1.05 ­ 95%CI 1.03;1.06). Conclusion: Strategies aimed at groups with a higher prevalence of unprotected sexual activity are necessary.

Objetivo: Estimar la prevalencia y los factores asociados a la actividad sexual sin protección en la población brasileña. Métodos: Estudio transversal con 61.523 adultos mayores de 18 años participantes de la Encuesta Nacional de Salud 2019. Se estimó la prevalencia de actividad sexualsin protección en el último año. La asociación de variables socioeconómicas y demográficas con el desenlace se analizó mediante regresión de Poisson, con estimación de razones de prevalencia (RP) e IC95%. Resultados: La prevalencia de actividad sexual sin protección fue del 76,9% (IC95% 76,3; 77,6), siendo mayor en todas las regiones en comparación con el Norte, residentes rurales (RP=1,04 ­ IC95% 1,03;1,06), mujeres (RP=1,06 ­ IC95% 1,05;1,08), mayores de 60 años (RP=1,33 ­ IC95% 1,27;1,38), casados (RP=1,25 ­ IC95% 1,23;1,27) y menos educados (RP=1,05 ­ IC95% 1,03;1,06). Conclusión: Se necesitan estrategias dirigidas a los grupos con mayor prevalencia de actividad sexual sin protección.

Objetivo: Estimar a prevalência e fatores associados à atividade sexual desprotegida na população brasileira. Métodos: Estudo transversal com 61.523 adultos, na idade de 18 anos ou mais, participantes da Pesquisa Nacional de Saúde 2019. Foram estimadas as prevalências de atividade sexual desprotegida no último ano. A associação das variáveis socioeconômicas e demográficas com o desfecho foi analisada pela regressão de Poisson, com estimação das razões de prevalências (RPs) e intervalo de confiaça de 95% (IC95%). Resultados: A prevalência de atividade sexual desprotegida foi de 76,9% (IC95% 76,3;77,6), maior em todas as macrorregiões nacionais quando comparadas região Norte, em moradores da zona rural (RP=1,04 ­ IC95% 1,03;1,06), sexo feminino (RP=1,06 ­ IC95% 1,05;1,08), idade de 60 anos ou mais (RP=1,33 ­ IC95% 1,27;1,38), casados (RP=1,25 ­ IC95% 1,23;1,27) e menos escolarizados (RP=1,05 ­ IC95% 1,03;1,06). Conclusão: Estratégias direcionadas aos grupos com maior prevalência de atividade sexual desprotegida são necessárias.

Historical series of tuberculosis incidence in the state of Santa Catarina, Brazil: analysis of a decade, 2010-2019 / Serie histórica de incidencia de tuberculosis en el estado de Santa Catarina, Brasil: análisis de una década, 2010-2019 / Série histórica da incidência de tuberculose em Santa Catarina: análise de uma década, 2010-2019

Objective: To describe the profile of tuberculosis cases and analyze the temporal trend of the disease incidence in Santa Catarina, according to sex, from 2010 to 2019. Methods: Time series study carried out with data from the Notifiable Diseases Information System (Sinan). The Prais-Winsten regression model was used. Results: There were 16,446 new cases of tuberculosis. Most cases occurred in men (68.5%), people aged 20 to 49 years (70.3%), in Greater Florianópolis (25.1%) and in individuals with incomplete elementary school (40.0%). A decreasing trend was observed in the incidence rates of tuberculosis for men (VPA: -1.86% ­ 95%CI -2.68;-1.03), women (VPA: -1.92% ­ 95%CI -2.63;- 1.20) and both sexes (VPA: -1.77% ­ 95%CI -2.37;-1.17). Conclusion: In the decade analyzed, there was a significant reduction in the incidence rate of tuberculosis in Santa Catarina, in both sexes. A predominantly male profile was observed, of an economically active age and with low education.

Objetivo: Describir el perfil de los casos de tuberculosis y analizar la tendencia temporal de la incidencia de la enfermedad en Santa Catarina, según sexo, de 2010 a 2019. Métodos: Estudio de series de tiempo realizado con datos del Sistema de Información de Enfermedades Notificables (Sinan). Se utilizó el modelo de regresión de Prais-Winsten. Resultados: Se registraron 16.446 nuevos casos de tuberculosis. La mayoría de los casos ocurrieron en hombres (68,5%), personas de 20 a 49 años (70,3%), Gran Florianópolis (25,1%) y en individuos con primaria incompleta (40,0%). Se observó una tendencia decreciente en las tasas de incidencia de tuberculosis para hombres (VPA: -1,86% ­ IC95% -2,68;-1,03), mujeres (VPA: -1,92% ­ IC95% -2,63;-1,20) y ambos sexos (VPA: -1,77% ­ IC95% -2,37;-1,17). Conclusión: En la década analizada, hubo una reducción significativa en la tasa de incidencia de tuberculosis en Santa Catarina, en ambos sexos. Se observó un perfil predominantemente masculino, en edad económicamente activa y con baja escolaridad.

Objetivo: Descrever o perfil dos casos de tuberculose e analisar a tendência temporal da incidência da doença em Santa Catarina, Brasil, segundo sexo, no período de 2010 a 2019. Métodos: Estudo de série temporal, realizado com dados do Sistema de Informação de Agravos de Notificação (Sinan). Utilizou-se o modelo de regressão de Prais-Winsten. Resultados: Ocorreram 16.446 casos novos de tuberculose, em sua maioria homens (68,5%), pessoas de 20 a 49 anos de idade (70,3%), na Grande Florianópolis (25,1%) e em indivíduos com ensino fundamental incompleto (40,0%). Observou-se tendência de decréscimo nas taxas de incidência de tuberculose para homens (VPA: -1,86% ­ IC95% - 2,68;-1,03), mulheres (VPA: -1,92% ­ IC95% -2,63;-1,20) e ambos os sexos (VPA: -1,77%­ IC95% -2,37;-1,17). Conclusão: Na década analisada, ocorreu redução significativa na taxa de incidência de tuberculose em Santa Catarina, em ambos os sexos. Observou-se perfil predominantemente masculino, em idade economicamente ativa e com baixa escolaridade.

Prevalência de atividade sexual desprotegida na população brasileira e fatores associados: Pesquisa Nacional de Saúde, 2019 / Prevalencia de actividad sexual sin protección en la población brasileña y factores asociados: Encuesta Nacional de Salud, 2019 / Prevalence of unprotected sexual activity in the Brazilian population and associated factors: National Health Survey, 2019

Objetivo: Estimar a prevalência e fatores associados à atividade sexual desprotegida na população brasileira. Métodos: Estudo transversal com 61.523 adultos, na idade de 18 anos ou mais, participantes da Pesquisa Nacional de Saúde 2019. Foram estimadas as prevalências de atividade sexual desprotegida no último ano. A associação das variáveis socioeconômicas e demográficas com o desfecho foi analisada pela regressão de Poisson, com estimação das razões de prevalência (RPs) e intervalo de confiança de 95% (IC95%). Resultados: A prevalência de atividade sexual desprotegida foi de 76,9% (IC95% 76,3;77,6), maior em todas as macrorregiões nacionais quando comparadas à região Norte, em moradores da zona rural (RP = 1,04; IC95% 1,03;1,06), sexo feminino (RP = 1,06; IC95% 1,05;1,08), idade de 60 anos ou mais (RP = 1,33; IC95% 1,27;1,38), casados (RP = 1,25; IC95% 1,23;1,27) e menos escolarizados (RP = 1,05; IC95% 1,03;1,06). Conclusão: Estratégias direcionadas aos grupos com maior prevalência de atividade sexual desprotegida são necessárias.

Objetivo: Estimar la prevalencia y los factores asociados a la actividad sexual sin protección en la población brasileña. Métodos: Estudio transversal con 61.523 adultos mayores de 18 años participantes de la Encuesta Nacional de Salud 2019. Se estimó la prevalencia de actividad sexual sin protección en el último año. La asociación de variables socioeconómicas y demográficas con el desenlace se analizó mediante regresión de Poisson, con estimación de razones de prevalencia (RP) e IC95%. Resultados: La prevalencia de actividad sexual sin protección fue del 76,9% (IC95% 76,3;77,6), siendo mayor en todas las regiones en comparación con el Norte, residentes rurales (RP = 1,04; IC95% 1,03;1,06), sexo femenino (RP = 1,06; IC95% 1,05;1,08), mayores de 60 años (RP = 1,33; IC95% 1,27;1,38), casados (RP = 1,25; IC95% 1,23;1,27) y menos educados (RP = 1,05; IC95% 1,03;1,06). Conclusión: Se necesitan estrategias dirigidas a los grupos con mayor prevalencia de actividad sexual sin protección.

Objective: To estimate prevalence of unprotected sexual activity and associated factors in the Brazilian population. Methods: This was a cross-sectional study with 61,523 adults aged 18 years or older who took part in the 2019 National Health Survey. We estimated prevalence of unprotected sexual activity in the last year. We analyzed association of socioeconomic and demographic variables with the outcome using Poisson regression, estimating prevalence ratios (PR) and 95% confidence intervals (95%CI). Results: Prevalence of unprotected sexual activity was 76.9% (95%CI 76.3;77.6), being higher in all the country's regions in comparison to the Northern region, as well as being higher among people living in rural areas (PR = 1.04; 95%CI 1.03;1.06), females (PR = 1.06; 95%CI 1.05;1.08), participants aged 60 years or older (PR = 1.33; 95%CI 1.27;1.38), married individuals (PR = 1.25; 95%CI 1.23;1.27) and those with less education (PR = 1.05; 95%CI 1.03;1.06). Conclusion: Strategies aimed at groups with higher prevalence of unprotected sexual activity are necessary.

Série histórica da taxa de incidência de tuberculose em Santa Catarina: análise de uma década, 2010-2019 / Serie histórica de la tasa de incidencia de tuberculosis en el estado de Santa Catarina, Brasil: análisis de una década, 2010-2019 / Tuberculosis incidence rate time series in the state of Santa Catarina, Brazil: analysis of a decade, 2010-2019

Objetivo: Descrever o perfil dos casos de tuberculose e analisar a tendência temporal da taxa de incidência da doença em Santa Catarina, Brasil, segundo sexo, no período de 2010 a 2019. Métodos: Estudo de série temporal, realizado com dados do Sistema de Informação de Agravos de Notificação (Sinan). Utilizou-se o modelo de regressão de Prais-Winsten. Resultados: Ocorreram 16.446 casos novos de tuberculose, em sua maioria entre o sexo masculino (68,5%), pessoas de 20 a 49 anos de idade (70,3%), na Grande Florianópolis (25,1%) e em indivíduos com ensino fundamental incompleto (40,0%). Observou-se tendência de decréscimo nas taxas de incidência de tuberculose para o sexo masculino (VPA: -1,86%; IC95% -2,68;-1,03), feminino (VPA: -1,92%; IC95% -2,63;-1,20) e ambos os sexos (VPA: -1,77%; IC95% -2,37;-1,17). Conclusão: Na década analisada, ocorreu redução significativa na taxa de incidência de tuberculose em Santa Catarina, em ambos os sexos. Observou-se perfil predominantemente masculino, em idade economicamente ativa e com baixa escolaridade.

Objetivo: Describir el perfil de los casos de tuberculosis y analizar la tendencia temporal de la tasa de incidencia de la enfermedad en Santa Catarina, según sexo, de 2010 a 2019. Métodos: Estudio de series de tiempo realizado con datos del Sistema de Información de Enfermedades Notificables (Sinan). Se utilizó el modelo de regresión de Prais-Winsten. Resultados: Se registraron 16.446 nuevos casos de tuberculosis. La mayoría de los casos ocurrieron entre las personas de sexo masculino (68,5%), de 20 a 49 años (70,3%), Gran Florianópolis (25,1%) y en individuos con primaria incompleta (40,0%). Se observó una tendencia decreciente en las tasas de incidencia de tuberculosis para el sexo masculino (VPA: -1,86%; IC95% -2,68;-1,03), el sexo feminino (VPA: -1,92%; IC95% -2,63;-1,20) y ambos sexos (VPA: -1,77%; IC95% -2,37;-1,17). Conclusión: En la década analizada, hubo una reducción significativa en la tasa de incidencia de tuberculosis en Santa Catarina, en ambos sexos. Se observó un perfil predominantemente masculino, en edad económicamente activa y con baja escolaridad.

Objective: To describe the profile of tuberculosis cases and analyze the temporal trend of tuberculosis incidence rate in Santa Catarina, by sex, from 2010 to 2019. Methods: This was a time series study conducted using data from the Notifiable Health Conditions Information System (SINAN). The Prais-Winsten regression model was used. Results: There were 16,446 new cases of tuberculosis. Most cases occurred in males (68.5%), people aged 20 to 49 years (70.3%), in Greater Florianópolis (25.1%) and in individuals with incomplete elementary education (40.0%). A falling trend in tuberculosis incidence rates was found for males (APC: -1.86%; 95%CI -2.68;-1.03), females (APC: -1.92%; 95%CI -2.63;-1.20) and both sexes (APC: -1.77%; 95%CI -2.37;-1.17). Conclusion: In the decade analyzed, there was a significant reduction in the tuberculosis incidence rate in Santa Catarina, in both sexes. There was a predominance of males, people of economically active age and with low schooling.

Evolution of COVID-19 in Santa Catarina, Brazil: state decrees and epidemiological indicators up until August 2020. / Evolução da COVID-19 em Santa Catarina: decretos estaduais e indicadores epidemiológicos até agosto de 2020.

OBJECTIVE: To describe the evolution of decrees and indicators related to COVID-19 in Santa Catarina, Brazil, up until August 2020. METHODS: This was an ecological study that analyzed epidemiological indicators and state decrees on social distancing. The decrees were grouped into restriction, maintenance and relaxation. The indicators were mortality, incidence and transmissibility. RESULTS: 179,443 cases and 2,183 deaths were recorded in the period. The incidence rate went from 20.4 cases per 100,000 inhabitants in March to 642.2 in August. Fifteen state decrees were issued. In August, when the highest mortality rate was observed (13.1 per 100,000 inhabitants), it was found that all decree categories, except one, had been relaxed. CONCLUSION: The decrees that relaxed social distancing measures were issued early and in disagreement with the epidemiological context in the state.

Estimating underdiagnosis of COVID-19 with nowcasting and machine learning.

OBJECTIVE: To analyze the underdiagnosis of COVID-19 through nowcasting with machine learning in a Southern Brazilian capital city. METHODS: Observational ecological design and data from 3916 notified cases of COVID-19 from April 14th to June 2nd, 2020 in Florianópolis, Brazil. A machine-learning algorithm was used to classify cases that had no diagnosis, producing the nowcast. To analyze the underdiagnosis, the difference between data without nowcasting and the median of the nowcasted projections for the entire period and for the six days from the date of onset of symptoms were compared. RESULTS: The number of new cases throughout the entire period without nowcasting was 389. With nowcasting, it was 694 (95%CI 496-897). During the six-day period, the number without nowcasting was 19 and 104 (95%CI 60-142) with nowcasting. The underdiagnosis was 37.29% in the entire period and 81.73% in the six-day period. The underdiagnosis was more critical in the six days from the date of onset of symptoms to diagnosis before the data collection than in the entire period. CONCLUSION: The use of nowcasting with machine learning techniques can help to estimate the number of new disease cases.

Correlation of overweight condition and obesity with mortality by COVID-19 in Brazil's state capitals

ABSTRACT Objective: To evaluate the correlation between the prevalence of overweight condition and obesity with mortality rates due to COVID-19 in Brazil's state capitals. Materials and methods: This is an ecological study, whose units of analysis were the 26 state capitals and the Federal District of Brazil. Prevalence was estimated by the results of the Vigilância de Fatores de Risco e Proteção para Doenças Crônicas por Inquérito Telefônico 2019 (VIGITEL). The general mortality rates due to COVID-19 were collected on the official website of the Brazilian Ministry of Health (MH) and stratified by the same Brazilian capitals evaluated in the VIGITEL survey. The rates included the period between the 1st and 29th Epidemiological Weeks of 2020. The Partial Correlation Test (r) was used, controlled for confounding factors, to evaluate the correlation between the prevalence of overweight/obesity and the overall mortality rates due to COVID-19. Results: The mean mortality rate for COVID-19 in the period was 65.1 deaths per 100,000 inhabitants. Regarding the prevalence of obesity and overweight, 20.2% and 54.7% were the mean values observed in the state capitals, respectively. The prevalence of obesity was positively correlated with the overall mortality rate due to COVID-19, with mean positive correlation (r=0.380) and statistically significant correlation (p=0.034). Conclusion: This study pointed out that, at the aggregate level, there is a concomitant and correlated increase in mortality rates due to COVID-19 and prevalence of obesity in Brazilian capitals. The data found may contribute to actions to cope with the pandemic aimed at this population.

Correlation of overweight condition and obesity with mortality by COVID-19 in Brazil's state capitals.

OBJECTIVE: To evaluate the correlation between the prevalence of overweight condition and obesity with mortality rates due to COVID-19 in Brazil's state capitals. METHODS: This is an ecological study, whose units of analysis were the 26 state capitals and the Federal District of Brazil. Prevalence was estimated by the results of the Vigilância de Fatores de Risco e Proteção para Doenças Crônicas por Inquérito Telefônico 2019 (VIGITEL). The general mortality rates due to COVID-19 were collected on the official website of the Brazilian Ministry of Health (MH) and stratified by the same Brazilian capitals evaluated in the VIGITEL survey. The rates included the period between the 1st and 29th Epidemiological Weeks of 2020. The Partial Correlation Test (r) was used, controlled for confounding factors, to evaluate the correlation between the prevalence of overweight/obesity and the overall mortality rates due to COVID-19. RESULTS: The mean mortality rate for COVID-19 in the period was 65.1 deaths per 100,000 inhabitants. Regarding the prevalence of obesity and overweight, 20.2% and 54.7% were the mean values observed in the state capitals, respectively. The prevalence of obesity was positively correlated with the overall mortality rate due to COVID-19, with mean positive correlation (r=0.380) and statistically significant correlation (p=0.034). CONCLUSION: This study pointed out that, at the aggregate level, there is a concomitant and correlated increase in mortality rates due to COVID-19 and prevalence of obesity in Brazilian capitals. The data found may contribute to actions to cope with the pandemic aimed at this population.

Association between obstructive sleep apnea and health-related quality of life in untreated adults: a systematic review.

PURPOSE: The objective of this systematic review was to answer the question: "Is there association between obstructive sleep apnea (OSA) and health-related quality of life (HRQoL) in untreated adults?" METHODS: We included observational studies that evaluated the health-related quality of life of patients with OSA vs control groups, through generic and disease-specific questionnaires. The searches were conducted in six databases: Embase, Lilacs, PsycINFO, PubMed, Scopus, and Web of Science. Additional search in the grey literature and hand search were performed, and also experts were consulted. Risk of bias was performed by using Joanna Briggs Institute Critical Appraisal Checklist for cross-sectional, cohort, and case-control studies. We analyzed the data using a narrative synthesis. The Grading of Recommendations Assessment, Development, and Evaluation evidence profile was used to verify the overall certainty of the assessed evidence. RESULTS: Nineteen studies were included for qualitative analysis. Generic questionnaires showed worse HRQoL in the OSA group compared to the control group in at least one domain of the HRQoL questionnaires. The affected domains that showed statistical and clinically relevant differences were physical functioning, physical role, pain, general health, vitality, emotional role, and mental health. The certainty of evidence assessment was very low. CONCLUSION: The available literature suggests that OSA in untreated adults is associated with worse HRQoL. However, this association seems to disappear when we consider only studies adjusted for related covariates. REGISTRATION: CRD42018114746.

Evolução da COVID-19 em Santa Catarina: decretos estaduais e indicadores epidemiológicos até agosto de 2020 / Evolución de la COVID-19 en Santa Catarina, Brasil: decretos estatales e indicadores epidemiológicos hasta agosto de 2020 / Evolution of COVID-19 in Santa Catarina, Brazil: state decrees and epidemiological indicators up until August 2020

Objetivo: Descrever a evolução dos decretos e indicadores relacionados à COVID-19 em Santa Catarina, Brasil, até agosto de 2020. Métodos: Estudo ecológico que analisou indicadores epidemiológicos e decretos estaduais sobre o distanciamento social. Os decretos foram agrupados em medidas de restrição, manutenção ou flexibilização. Mortalidade, incidência e transmissibilidade constituíram os indicadores. Resultados: Foram registrados 179.443 casos e 2.183 óbitos no período selecionado. A taxa de incidência passou de 20,4 casos a cada 100 mil habitantes no mês de março para 642,2/100 mil hab. em agosto. Foram emitidos 15 decretos estaduais. Em agosto, quando se observou a maior taxa de mortalidade (13,1/100 mil hab.), verificou-se que todas as categorias, à exceção de uma, haviam sido flexibilizadas. Conclusão: Os decretos que flexibilizaram as medidas de distanciamento social foram emitidos precocemente, em desacordo com o contexto epidemiológico no estado.

Objetivo: Describir la evolución de los decretos e indicadores relacionados con la COVID-19 en Santa Catarina, Brasil, hasta agosto de 2020. Métodos: Estudio ecológico que analizó indicadores epidemiológicos y decretos estatales sobre distanciamiento social. Los decretos se agruparon en: restricción; mantenimiento y flexibilización. Mortalidad, incidencia y transmisibilidad fueron los indicadores. Resultados:Se registraron 179.443 casos y 2.183 defunciones. La tasa de incidencia pasó de 20,4 casos por 100.000 habitantes en marzo a 642,2 en agosto. Se emitieron 15 decretos estatales. En agosto, cuando se observó la tasa de mortalidad más alta (13,1 por 100.000 habitantes), parecía que todas las categorías, con excepción de una, se habían flexibilizado por decretos anteriores. Conclusión: Los decretos que flexibilizaron las medidas de distancia social se emitieron precozmente y en desacuerdo con el momento epidemiológico en el estado.

Objective: To describe the evolution of decrees and indicators related to COVID-19 in Santa Catarina, Brazil, up until August 2020. Methods: This was an ecological study that analyzed epidemiological indicators and state decrees on social distancing. The decrees were grouped into restriction, maintenance and relaxation. The indicators were mortality, incidence and transmissibility. Results: 179,443 cases and 2,183 deaths were recorded in the period. The incidence rate went from 20.4 cases per 100,000 inhabitants in March to 642.2 in August. Fifteen state decrees were issued. In August, when the highest mortality rate was observed (13.1 per 100,000 inhabitants), it was found that all decree categories, except one, had been relaxed. Conclusion: The decrees that relaxed social distancing measures were issued early and in disagreement with the epidemiological context in the state.

Estimating underdiagnosis of COVID-19 with nowcasting and machine learning / Estimativa do subdiagnóstico de COVID-19 utilizando machine learning e nowcasting

ABSTRACT: Objective: To analyze the underdiagnosis of COVID-19 through nowcasting with machine learning in a Southern Brazilian capital city. Methods: Observational ecological design and data from 3916 notified cases of COVID-19 from April 14th to June 2nd, 2020 in Florianópolis, Brazil. A machine-learning algorithm was used to classify cases that had no diagnosis, producing the nowcast. To analyze the underdiagnosis, the difference between data without nowcasting and the median of the nowcasted projections for the entire period and for the six days from the date of onset of symptoms were compared. Results: The number of new cases throughout the entire period without nowcasting was 389. With nowcasting, it was 694 (95%CI 496-897). During the six-day period, the number without nowcasting was 19 and 104 (95%CI 60-142) with nowcasting. The underdiagnosis was 37.29% in the entire period and 81.73% in the six-day period. The underdiagnosis was more critical in the six days from the date of onset of symptoms to diagnosis before the data collection than in the entire period. Conclusion: The use of nowcasting with machine learning techniques can help to estimate the number of new disease cases.

RESUMO: Objetivo: Analisar o subdiagnóstico da COVID-19 por meio de nowcasting com machine learning em uma capital do sul do Brasil. Métodos: Estudo ecológico observacional utilizando dados de 3.916 casos notificados de COVID-19 de 14 de abril a 2 de junho de 2020 em Florianópolis, Brasil. O algoritmo de machine learning foi usado para classificar os casos que ainda não tinham diagnóstico, produzindo o nowcasting. Para analisar o subdiagnóstico, foi comparada a diferença entre os dados sem nowcasting e a mediana das projeções com nowcasting para todo o período e para os seis dias a partir da data de início dos sintomas. Resultados: O número de novos casos sem nowcasting durante todo o período foi de 389, com nowcasting foi de 694 (IC95% 496-897). No período de seis dias, o número sem nowcasting foi de 19 e 104 (IC95% 60-142) com nowcasting. O subdiagnóstico foi de 37,29% em todo o período e 81,73% no período de seis dias. O subdiagnóstico foi mais crítico em seis dias, desde a data do início dos sintomas até o diagnóstico antes da coleta de dados, do que em todo o período. Conclusão: O uso de nowcasting com técnicas de machine learning pode ajudar a estimar o número de novos casos da doença.

Association Between Sleep Bruxism and Quality of Life: A Systematic Review.

AIMS: To evaluate the association between sleep bruxism (SB) and quality of life (QoL) in the general population. METHODS: A systematic review was conducted, and studies were included with no restrictions regarding age, gender, or language. SB and general health-related QoL and/or oral health-related QoL (OHRQoL) measures in the included studies needed to be based on validated tools. The databases searched were Google Scholar, LILACS, OpenGrey, ProQuest, PubMed, Science Direct, Scopus, and Web of Science. Quality of evidence was evaluated using the Joanna Briggs Institute critical appraisal checklists and GRADE (Grading of Recommendations Assessment, Development, and Evaluation) criteria. RESULTS: Fourteen studies met the inclusion criteria. Ten studies were published in English, and four in Portuguese. All studies evaluating the association of SB with health-related QoL showed no statistical significance when overall scores were considered. The overall quality of evidence was considered very low due to high heterogeneity among the studies. SB seemed not to be associated with health-related QoL, but did have a negative impact on some characteristics of OHRQoL. CONCLUSION: There is insufficient scientific evidence to support or disprove the association between SB and QoL/OHRQoL in the general population.

Consumption of fruits and vegetables and association with life habits and nutritional status: a prospective study in a cohort of the elderly. / Consumo de frutas, legumes e verduras e associação com hábitos de vida e estado nutricional: um estudo prospectivo em uma coorte de idosos.

The aim of this study was to estimate the association between life habits and adequate consumption of fruits and vegetables (F&V) after four years of follow-up among elderly of a cohort in Florianópolis, Santa Catarina. This is a longitudinal population-based study, the sample being composed of individuals 60 years of age or older living in the urban area of the city of Florianópolis-SC. The baseline study took place in 2009-2010 and the second wave in 2013-2014. Adequate consumption was assessed by considering the frequency of ingestion of F&V at least five times a day at least five times a week. Life habits (smoking, alcohol consumption, physical activity and Internet use) and a biological variable (nutritional status) were associated. Multilevel logistic regression was used for the statistical analysis. There was a 5.23% increase in F&V consumption between evaluations. In the adjusted final models, internet use was associated with a greater chance of regular consumption of F&V (OR = 1.48, 95% CI: 1.09 - 2.01), while overweight was associated with a lower chance of outcome (OR = 0.76, 95% CI: 0.61 - 0.95). In conclusion, using the internet has proven to contribute significantly to a more adequate diet in F&V, as well as being overweight has shown to be a risk factor.

O objetivo foi estimar a associação entre hábitos de vida e o consumo adequado de frutas, legumes e verduras (FLV) após quatro anos de seguimento entre os idosos de uma coorte em Florianópolis, Santa Catarina. Trata-se de um estudo longitudinal de base populacional sendo a amostra constituída por indivíduos de 60 anos ou mais, moradores da zona urbana da cidade de Florianópolis-SC. A linha de base do estudo ocorreu em 2009-2010 e a segunda onda em 2013-2014. O consumo adequado foi avaliado considerando a frequência de ingestão de FLV ao menos cinco vezes ao dia em pelo menos cinco vezes na semana. Foi realizada associação com hábitos de vida (tabagismo, consumo de álcool, atividade física e uso de internet) e uma variável biológica (estado nutricional). Nas análises estatísticas utilizou-se regressão logística multinível. Observou-se um aumento de 5,23 % no consumo de FLV de uma onda para outra. Na análise ajustada, o uso de internet foi associado à maior chance de consumo regular de FLV (OR = 1,48 IC95% 1,09 - 2,01), enquanto o excesso de peso foi associado à menor chance do desfecho (OR = 0,76 IC95% 0,61-0,95). Conclui-se que utilizar a internet demonstrou ser um hábito de vida que contribui significativamente para uma dieta mais adequada em FLV, bem como o excesso de peso um fator de risco.

Consumo de frutas, legumes e verduras e associação com hábitos de vida e estado nutricional: um estudo prospectivo em uma coorte de idosos / Consumption of fruits and vegetables and association with life habits and nutritional status: a prospective study in a cohort of the elderly

Resumo O objetivo foi estimar a associação entre hábitos de vida e o consumo adequado de frutas, legumes e verduras (FLV) após quatro anos de seguimento entre os idosos de uma coorte em Florianópolis, Santa Catarina. Trata-se de um estudo longitudinal de base populacional sendo a amostra constituída por indivíduos de 60 anos ou mais, moradores da zona urbana da cidade de Florianópolis-SC. A linha de base do estudo ocorreu em 2009-2010 e a segunda onda em 2013-2014. O consumo adequado foi avaliado considerando a frequência de ingestão de FLV ao menos cinco vezes ao dia em pelo menos cinco vezes na semana. Foi realizada associação com hábitos de vida (tabagismo, consumo de álcool, atividade física e uso de internet) e uma variável biológica (estado nutricional). Nas análises estatísticas utilizou-se regressão logística multinível. Observou-se um aumento de 5,23 % no consumo de FLV de uma onda para outra. Na análise ajustada, o uso de internet foi associado à maior chance de consumo regular de FLV (OR = 1,48 IC95% 1,09 - 2,01), enquanto o excesso de peso foi associado à menor chance do desfecho (OR = 0,76 IC95% 0,61-0,95). Conclui-se que utilizar a internet demonstrou ser um hábito de vida que contribui significativamente para uma dieta mais adequada em FLV, bem como o excesso de peso um fator de risco.

Abstract The aim of this study was to estimate the association between life habits and adequate consumption of fruits and vegetables (F&V) after four years of follow-up among elderly of a cohort in Florianópolis, Santa Catarina. This is a longitudinal population-based study, the sample being composed of individuals 60 years of age or older living in the urban area of the city of Florianópolis-SC. The baseline study took place in 2009-2010 and the second wave in 2013-2014. Adequate consumption was assessed by considering the frequency of ingestion of F&V at least five times a day at least five times a week. Life habits (smoking, alcohol consumption, physical activity and Internet use) and a biological variable (nutritional status) were associated. Multilevel logistic regression was used for the statistical analysis. There was a 5.23% increase in F&V consumption between evaluations. In the adjusted final models, internet use was associated with a greater chance of regular consumption of F&V (OR = 1.48, 95% CI: 1.09 - 2.01), while overweight was associated with a lower chance of outcome (OR = 0.76, 95% CI: 0.61 - 0.95). In conclusion, using the internet has proven to contribute significantly to a more adequate diet in F&V, as well as being overweight has shown to be a risk factor.

Factors associated with the use of waterpipe and other tobacco products among students, Brazil, 2015. / Fatores associados ao uso de narguilé e outros produtos do tabaco entre escolares, Brasil, 2015.

OBJECTIVE: To identify the frequency and factors associated with the use of waterpipe and other tobacco products among Brazilian students. METHODS: This is a cross-sectional study based on data from the National Adolescent Student Health Survey. The sample consisted of 9th-grade students from elementary school. We conducted a descriptive analysis of the use of tobacco products in 2012 and 2015. To explore the relationship between the use of other tobacco products and factors such as sociodemographic characteristics, family, mental health, and life habits, we calculated the adjusted odds ratio. RESULTS: The use of other tobacco products increased from 4.8% (95%CI 4.6 - 5.0) in 2012 to 6.1% (95%CI 5.7 - 6.4) in 2015, with a higher proportion among boys. Waterpipe was the most commonly used product in 2015 (71.6%; 95%CI 68.8 - 74.2), especially among girls. Factors positively associated with the use of other tobacco products were: attending private school, living with father/mother, working, not having friends, suffering domestic violence, skipping classes, consuming cigarettes and alcohol, experimenting drug, having had sex, having smoker parents or guardians, and seeing people smoking. The protective factors were: female gender, increasing age, multiracial or indigenous people, having meals with a guardian, family supervision, and practicing physical activity. CONCLUSION: The use of other tobacco products was high and has been increasing in recent years, particularly waterpipe. It is important to raise awareness of the risks and monitor the use of these products, as well as improve public policies of tobacco control in the country.

OBJETIVO: Identificar a frequência e os fatores associados ao uso de narguilé e outros produtos do tabaco entre os escolares brasileiros. MÉTODOS: Estudo transversal com dados da Pesquisa Nacional de Saúde do Escolar. A amostra foi composta por alunos do 9º ano do Ensino Fundamental. Foi realizada análise descritiva do uso de produtos do tabaco em 2012 e 2015. Para explorar a relação de fatores como características sociodemográficas, familiares, saúde mental e hábitos de vida com o uso de outros produtos do tabaco, foram calculados odds ratio ajustados. RESULTADOS: O uso de outros produtos do tabaco aumentou de 4,8% (IC95% 4,6 - 5,0), em 2012, para 6,1% (IC95% 5,7 - 6,4), em 2015, com maior proporção em meninos. O narguilé foi o produto mais usado em 2015 (71,6%; IC95% 68,8 - 74,2), sendo mais frequente em meninas. Foram positivamente associados ao uso de outros produtos do tabaco: escola privada, morar com pai/mãe, trabalhar, não ter amigos, sofrer violência familiar, faltar às aulas, fazer uso de cigarros e álcool, ter experimentado drogas, já ter tido relação sexual, ter pais ou responsáveis fumantes e presenciar pessoas fumando. Os fatores de proteção foram: sexo feminino, incremento da idade, cor da pele parda ou indígena, fazer refeições com responsável, ter supervisão familiar e praticar atividade física. CONCLUSÃO: Conclui-se que o uso de outros produtos do tabaco foi elevado, com aumento nos últimos anos, destacando-se o narguilé. Torna-se importante a conscientização dos riscos e a vigilância do uso desses produtos, bem como o avanço das políticas públicas de controle do tabagismo no país.

Association between the display of cigarette packs at the point of sale and smoking susceptibility among adolescents in Brazil.

This was a cross-sectional study aimed at determining the association between exposure to tobacco displays at the point of sale and susceptibility to smoking in schoolchildren in the 14- to 17-year age bracket. Of the participating students, 69.0%, 21.3%, and 9.7% were classified as never smokers, experimenters, and smokers, respectively. Of the participants who were classified as being exposed to smoking, 18.9% were susceptible to smoking. Of the participants who were classified as being unexposed to smoking, 12.9% were susceptible to smoking (OR = 1.56; 95% CI: 1.04 -2.35; p = 0.029). Exposure to point-of-sale tobacco displays is associated with smoking susceptibility in Brazilian adolescents.

Association between the display of cigarette packs at the point of sale and smoking susceptibility among adolescents in Brazil / Associação entre a exposição a maços de cigarros em pontos de venda e susceptibilidade ao tabagismo entre adolescentes brasileiros

ABSTRACT This was a cross-sectional study aimed at determining the association between exposure to tobacco displays at the point of sale and susceptibility to smoking in schoolchildren in the 14- to 17-year age bracket. Of the participating students, 69.0%, 21.3%, and 9.7% were classified as never smokers, experimenters, and smokers, respectively. Of the participants who were classified as being exposed to smoking, 18.9% were susceptible to smoking. Of the participants who were classified as being unexposed to smoking, 12.9% were susceptible to smoking (OR = 1.56; 95% CI: 1.04 -2.35; p = 0.029). Exposure to point-of-sale tobacco displays is associated with smoking susceptibility in Brazilian adolescents.

RESUMO Com o objetivo de verificar a associação entre a exposição a maços de cigarros em pontos de venda e a susceptibilidade ao tabagismo, foi realizado um estudo transversal com escolares entre 14 e 17 anos. Destes, 69,0% eram nunca fumantes, 21,3% eram experimentadores, e 9,7% eram fumantes. Entre os escolares expostos a maços de cigarros nos pontos de venda, 18,9% eram susceptíveis ao tabagismo, enquanto entre os estudantes não expostos, 12,9% eram susceptíveis a fumar (OR = 1,56; IC95%: 1,04-2,35; p = 0,029). Conclui-se que a exposição a maços de cigarros em pontos de venda está associada à susceptibilidade ao tabagismo entre adolescentes brasileiros.