Lethality and mortality of COVID-19 in an important industrial center in Latin America, region of Grande ABC, São Paulo, Brazil / Letalidade e mortalidade da COVID-19 em importante pólo industrial da américa latina, região do Grande ABC, São Paulo

INTRODUCTION: the new coronavirus (COVID-19) disease has been causing economic and health system impacts worldwide, triggering humanitarian crises in vulnerable regions, marked by high mortality rates of the disease. Brazil has been suffering an increase in the number of cases, characteristic of the formation of a second wave, with great epidemiological differences observed in the most diverse regions of the country. Many studies illustrate the behaviour of COVID-19 in the state of São Paulo, but there are gaps in the scientific literature on the epidemiology of COVID-19 in municipalities of the São Paulo metropolitan region that constitute an important industrial pole in Latin America, such as the region of Grande ABC. OBJECTIVE: to evaluate mortality and lethality trends of COVID-19 during the period March 2020 to July 2021, in municipalities on region of Grande ABC, metropolitan region of São Paulo, Brazil, divided into two periods (March to November 2020 and December to July 2021. METHODS: we conducted an ecological time series study with population data from the Brazilian Ministry of Health. We collected the number of cases and deaths confirmed for COVID-19 in the municipalities that make up the region of Grande ABC (Diadema, Mauá, Rio Grande da Serra, Ribeirão Pires, Santo André, São Bernardo do Campo, and São Caetano do Sul) from March 2020 to July 2021. Prais-Winsten linear regression was performed, and the percentage of daily change was calculated. Differences were considered significant when p<0.05. RESULTS: in region of Grande ABC, in the period analysed, 217,264 cases and 10,004 deaths of COVID-19 were recorded. Although the mortality rate remained stationary during the first wave (March to November 2020) and the second wave (December 2020 to July 2021); lethality transitioned from decreasing during the first wave to increasing during the second wave, with rates varying according to municipality. CONCLUSION: trend analyses in incidence, mortality, and lethality rates assist in understanding the behaviour of the COVID-19 Pandemic in the region known as Grande ABC. Efforts must be maintained throughout the region to control the Pandemic.

INTRODUÇÃO: a doença do novo coronavírus (COVID-19) vem ocasionando impactos econômicos e nos sistemas de saúde mundiais, desencadeando crises humanitárias em regiões vulneráveis, marcadas por elevadas taxas de mortalidade da doença. O Brasil vem sofrendo por um aumento no número de casos, característicos da formação de uma segunda onda, com grandes diferenças epidemiológicas observadas nas mais diversas regiões do país. Muitos estudos ilustram o comportamento da COVID-19 no estado de São Paulo, mas há lacunas na literatura científica sobre a epidemiologia da COVID-19 em municípios da região metropolitana de São Paulo que constituem importante polo industrial da América latina, como por exemplo a região do Grande ABC. OBJETIVO: avaliar as tendências de mortalidade e letalidade da COVID-19 durante o período de março de 2020 a julho de 2021, em municípios do Grande ABC, região metropolitana de São Paulo, Brasil, dividindo em dois períodos (março a novembro de 2020 a dezembro a julho de 2021. MÉTODO: foi realizado um estudo ecológico de series temporais com dados populacionais oriundo do Ministério da Saúde do Brasil. Foram coletados o número de casos e óbitos confirmados para COVID-19 nos municípios que compõe a região do Grande ABC (Diadema, Mauá, Rio Grande da Serra, Ribeirão Pires, Santo André, São Bernardo do Campo e São Caetano do Sul) no período de março de 2020 a julho de 2021. Foi realizado a regressão linear de Prais-Winsten, e calculado o percentual de mudança diária. Foram consideradas diferenças significativas, quando p<0,05. RESULTADOS: na região do Grande ABC, no período analisado, foram registrados 217.264 casos e 10.004 óbitos de COVID-19. Apesar da taxa de mortalidade ter se mantido estacionária durante a primeira onda (março a novembro de 2020) e a segunda onda (dezembro de 2020 a julho de 2021); a letalidade transitou de decrescente durante a primeira onda para crescente durante a segunda onda, com índices variando segundo o município. CONCLUSÃO: as análises de tendência nas taxas de incidência, mortalidade e letalidade auxiliam na compreensão do comportamento da Pandemia da COVID-19 na região conhecida como Grande ABC. Esforços devem ser mantidos em toda à região para o controle da Pandemia.

Analysis of Diabetes Mellitus-Related Amputations in the State of Espírito Santo, Brazil.

Background and objectives: Diabetes mellitus (DM) stands out among the most important public health problems worldwide since it represents a high burden on health systems and is associated with higher hospitalization rates, and a higher incidence of cardiovascular diseases. Amputations are among the most common complications, leading to disability and increasing care costs. This research aims to analyze the prevalence of DM-related amputations, comorbidities and associated risk factors in the diabetic population residing in the State of Espírito Santo, Brazil. Materials and Methods: This is a quantitative, exploratory, cross-sectional study with a time series design and the use of secondary data registered and followed by the system of Registration and Monitoring of Hypertension and Diabetes-SisHiperdia. Results: The sample consisted of 64,196 diabetic patients, out of them, 3.9% had type 1 DM, 10.9% with type 2 DM, and 85.2% with DM coexisting with hypertension. Most were female (66.6%), aged 40 to 59 years (45.6%), and 60 years and older (45.2%). The prevalence of DM-related amputations in the analyzed sample was 1.2% in type 1 DM, 1.5% in type 2 DM, and 2.2% in concomitant DM and hypertension. Higher amputation rates were observed in males in the age group above 60 years in type 1 DM and type 2 DM and were slightly higher in the age groups up to 29 years in DM with hypertension. A higher prevalence of amputation was related to smoking, physical inactivity, acute myocardial infarction (AMI), stroke, chronic kidney disease (CKD), and diabetic foot (DF) in all types of DM. Conclusions: The present study showed a significant prevalence of DM-related amputations. An increased prevalence was evidenced when correlated with smoking, physical inactivity, AMI, stroke, CKD, and DF with significant statistical associations, except for a sedentary lifestyle in type 1 DM.

Knowledge and acceptability of the human papillomavirus vaccine among health professionals in Acre state, western Amazon.

OBJECTIVE: To evaluate the knowledge and acceptability of the human papillomavirus (HPV) vaccine among health professionals from western Amazonia. METHODS: A cross-sectional study was conducted in the Sistema Assistencial è Saúde da Mulher e da Criança (Health Care System for Women and Children; SASMC) in Acre, Brazil, in 2017. The participants comprised 196 health professionals. The data collection instrument contained 31 questions about HPV, its clinical repercussions for women, and the HPV vaccine. Quantitative variables were presented as medians and 95% confidence intervals (CIs), and p<0.05 was considered statistically significant. For the analyses, chi-square tests and Mann-Whitney tests were used. The collected data were analyzed using Stata®11.0. RESULTS: Of the 196 health professionals, 39.8% (n=76) were physicians and 61.2% (n=120) were other health professionals. The interviewees were mostly female (n=143, 73%, 95% CI 66.1 to 78.9%) who worked in the medical field (n=81, 41.3%, 95% CI 34.4 to 48.6%), and the median age was 38 years (95% CI 36.0 to 39.7). Physicians had increased knowledge regarding only the statement "cervical cancer is one of the main causes of cancer in women", with a proportion ratio of 0.88 (0.80; 0.97) and p<0.001. Regarding clinical knowledge of the HPV vaccine, a low proportion of correct answers was obtained for all the questions, and no significant differences were found between the groups. CONCLUSION: Acceptability and knowledge of HPV and its vaccine were similar among health professionals, with knowledge gaps in questions about the relation between smoking and cervical cancer and specific clinical knowledge.

Knowledge and acceptability of the human papillomavirus vaccine among health professionals in Acre state, western Amazon

OBJECTIVE: To evaluate the knowledge and acceptability of the human papillomavirus (HPV) vaccine among health professionals from western Amazonia. METHODS: A cross-sectional study was conducted in the Sistema Assistencial è Saúde da Mulher e da Criança (Health Care System for Women and Children; SASMC) in Acre, Brazil, in 2017. The participants comprised 196 health professionals. The data collection instrument contained 31 questions about HPV, its clinical repercussions for women, and the HPV vaccine. Quantitative variables were presented as medians and 95% confidence intervals (CIs), and p<0.05 was considered statistically significant. For the analyses, chi-square tests and Mann-Whitney tests were used. The collected data were analyzed using Stata®11.0. RESULTS: Of the 196 health professionals, 39.8% (n=76) were physicians and 61.2% (n=120) were other health professionals. The interviewees were mostly female (n=143, 73%, 95% CI 66.1 to 78.9%) who worked in the medical field (n=81, 41.3%, 95% CI 34.4 to 48.6%), and the median age was 38 years (95% CI 36.0 to 39.7). Physicians had increased knowledge regarding only the statement "cervical cancer is one of the main causes of cancer in women", with a proportion ratio of 0.88 (0.80; 0.97) and p<0.001. Regarding clinical knowledge of the HPV vaccine, a low proportion of correct answers was obtained for all the questions, and no significant differences were found between the groups. CONCLUSION: Acceptability and knowledge of HPV and its vaccine were similar among health professionals, with knowledge gaps in questions about the relation between smoking and cervical cancer and specific clinical knowledge.