Depressive symptoms as an independent risk factor for mortality

Objective: To evaluate the relationship between presence of depressive symptoms and risk of death in older adults residing in a municipality in Southern Brazil. Methods: Between 2009 and 2014, 1,391 people participated in the EpiFloripa Aging Cohort Study, a population-based longitudinal study. Depressive symptoms were assessed through the Geriatric Depression Scale. The initial time was considered the age at the first interview, and the end time, the age at the last contact or death. Cox regression models were used to estimate the mortality risk associated with depressive symptoms, adjusted by sex, education, income, paid work, smoking status, alcohol consumption, morbidities, medication use, physical activity, disability, cognitive impairment, and body mass index. Results: The prevalence of depressive symptoms was 23.5% (95%CI 20.4-26.9). On crude analysis, the risk of mortality was 1.86 (95%CI 1.35-2.55) for individuals with depressive symptoms; in adjusted models, the risk of mortality was 1.67 (95%CI 1.15-2.40). Conclusion: Depressive symptoms are an independent risk factor for mortality in older Brazilian adults. Our findings highlight the importance of screening this population for depression and the practice of preventive actions.

Depressive symptoms as an independent risk factor for mortality.

OBJECTIVE: To evaluate the relationship between presence of depressive symptoms and risk of death in older adults residing in a municipality in Southern Brazil. METHODS: Between 2009 and 2014, 1,391 people participated in the EpiFloripa Aging Cohort Study, a population-based longitudinal study. Depressive symptoms were assessed through the Geriatric Depression Scale. The initial time was considered the age at the first interview, and the end time, the age at the last contact or death. Cox regression models were used to estimate the mortality risk associated with depressive symptoms, adjusted by sex, education, income, paid work, smoking status, alcohol consumption, morbidities, medication use, physical activity, disability, cognitive impairment, and body mass index. RESULTS: The prevalence of depressive symptoms was 23.5% (95%CI 20.4-26.9). On crude analysis, the risk of mortality was 1.86 (95%CI 1.35-2.55) for individuals with depressive symptoms; in adjusted models, the risk of mortality was 1.67 (95%CI 1.15-2.40). CONCLUSION: Depressive symptoms are an independent risk factor for mortality in older Brazilian adults. Our findings highlight the importance of screening this population for depression and the practice of preventive actions.

The burden of infectious diseases in the Brazilian Southern state of Santa Catarina.

Infectious diseases are still significant causes of deaths in Brazil. The objective of this study was to estimate the burden of selected infectious diseases in the Brazilian Southern state of Santa Catarina in 2011. An ecological study was conducted. The infectious diseases included were HIV/AIDS, tuberculosis, hepatitis B, hepatitis C, Chagas disease, diarrheal diseases and other infectious diseases. Data were collected from official health information systems. Disability Adjusted Life Years (DALY) were estimated by the sum of Years of Life Lost (YLL) and Years Lived with Disability (YLD). 45,237.33 DALYs were estimated, with a rate of 685.46 DALYs per 100,000 population. 92.9% was due to YLL and 7.1% to YLD. Men and the age range of 0-4 years presented higher burden. The highest burden was attributed to HIV/AIDS. There was a high concentration of burden rates in the coast regions of the state. It could be concluded that more than 90% of the burden was attributed to the early mortality component. The highest burden was observed among men, children under 5 years of age and at the coast regions of the state. The highest levels of burden were due to HIV/AIDS.

Factors associated with hepatitis C seropositivity in people living with HIV.

OBJECTIVE: To identify risk factors associated with hepatitis C virus (HCV) seropositivity in human immunodeficiency virus (HIV)-infected patients. METHODS: A paired case-control study adjusted by age and gender was conducted. It included adults coinfected with HIV and HCV (cases) and HIV mono-infected subjects (controls) using non-probability sampling. Data were collected through interviews and review of medical records. The chi-square test was used for comparing categorical variables and the Student's t-test or Wilcoxon (Mann-Whitney U) test for continuous variables. Confidence intervals (95%) were estimated along with crude and adjusted odds ratios using conditional logistic regression. RESULTS: A total of 165 patients were surveyed, including 55 cases and 110 controls. The mean age was 43.6 ± 8.4 years, ranging from 19 to 64 years; 70.9% were male. Independent risk factors for HIV/HCV coinfection were education (up to eight years of schooling); age at first intercourse < 15 years; having undergone tattooing; blood transfusion; and use of injecting drugs. CONCLUSIONS: Low level of education, early age at first sexual intercourse, tattooing, blood transfusions, and sharing needles and other drug injection equipment were factors that increased the risk of HIV/HCV coinfection. The results from this research can be compared with similar data from other regions to help direct preventive and educational efforts targeting people living with HIV.

Factors associated with hepatitis C seropositivity in people living with HIV / Factores asociados con la seropositividad al virus de la hepatitis C en personas con infección por el VIH

OBJECTIVE: To identify risk factors associated with hepatitis C virus (HCV) seropositivity in human immunodeficiency virus (HIV)-infected patients. METHODS: A paired case-control study adjusted by age and gender was conducted. It included adults coinfected with HIV and HCV (cases) and HIV mono-infected subjects (controls) using non-probability sampling. Data were collected through interviews and review of medical records. The chi-square test was used for comparing categorical variables and the Student’s t-test or Wilcoxon (Mann-Whitney U) test for continuous variables. Confidence intervals (95%) were estimated along with crude and adjusted odds ratios using conditional logistic regression. RESULTS: A total of 165 patients were surveyed, including 55 cases and 110 controls. The mean age was 43.6 ± 8.4 years, ranging from 19 to 64 years; 70.9% were male. Independent risk factors for HIV/HCV coinfection were education (up to eight years of schooling); age at first intercourse < 15 years; having undergone tattooing; blood transfusion; and use of injecting drugs. CONCLUSIONS: Low level of education, early age at first sexual intercourse, tattooing, blood transfusions, and sharing needles and other drug injection equipment were factors that increased the risk of HIV/HCV coinfection. The results from this research can be compared with similar data from other regions to help direct preventive and educational efforts targeting people living with HIV.

OBJETIVO: Determinar los factores de riesgo asociados con la seropositividad al virus de la hepatitis C (VHC) en pacientes infectados por el virus de la inmunodeficiencia humana (VIH) MÉTODOS: Se llevó a cabo un estudio de casos y testigos apareados, ajustados por edad y sexo. Este estudio, realizado mediante muestreo no probabilístico, incluyó a adultos coinfectados por el VIH y el VHC (casos) y a otros infectados únicamente por el VIH (testigos). Se recopilaron datos mediante entrevistas y revisiones de expedientes médicos. Se utilizó la prueba de ji al cuadrado para comparar las variables categóricas, y la prueba t de Student o la prueba de Wilcoxon (U de Mann-Whitney) para las variables continuas. Se calcularon los intervalos de confianza (95%) junto con las razones de posibilidades brutas y ajustadas mediante el empleo de un modelo de regresión logística condicional. RESULTADOS: Fueron estudiados 165 pacientes (55 casos y 110 testigos). La media de edad fue de 43,6 ± 8,4 años, con edades comprendidas entre los 19 y los 64 años; 70,9% eran hombres. Los factores de riesgo independientes de coinfección por el VIH y el VHC fueron la educación (hasta ocho años de escolarización); la primera relación sexual a una edad inferior a los 15 años; los tatuajes; la transfusión de sangre; y el consumo de drogas inyectables. CONCLUSIONES: El escaso nivel de formación, la primera relación sexual a una edad temprana, los tatuajes, las transfusiones de sangre y el compartir agujas y otros materiales de inyección de drogas fueron factores que aumentaron el riesgo de coinfección por el VIH y el VHC. Se pueden comparar los resultados de esta investigación con datos similares de otras regiones para orientar las iniciativas preventivas y educativas dirigidas a las personas infectadas por el VIH.