Background Brazil is the world’s fifth most populous nation, and is currently experimenting a fast demographic aging process in a context of scarce resources and social inequalities. To understand the health profile of older adults in Brazil is fundamental for planning public policies. Methods The estimates were derived from data obtained through the collaboration between the Brazilian Ministry of Health and the Institute of Health Metrics and Evaluation of the University of Washington. The Brazilian Institute of Geography and Statistics provided the population estimates. Data on causes of death came from the Mortality Information System. To calculate morbidity, population-based studies on the prevalence of diseases in Brazil were comprehensively searched, in addition to information obtained from national databases such as the Hospital Information System, the Outpatient Information System, and the Injury Information System. We presented the Global Burden of Disease (GBD) 2017 estimates among Brazilian older adults (60+ years old) for life expectancy at birth (LE), healthy life expectancy (HALE), cause-specific mortality, years of life lost (YLLs), years lived with disability (YLDs), and disability-adjusted life years (DALYs), from 2000 to 2017. Results LE at birth significantly increased from 71.3 years (95% UI to 70.9-71.8) to 75.2 years (95% UI 74.7-75.7). There was a trend of increasing HALE, from 62.2 years (95% UI 59.54-64.5) to 65.5 years (95% UI 62.6-68.0). The proportion of DALYs among older adults increased from 7.3 to 10.3%. Chronic noncommunicable diseases are the leading cause of death among middle aged and older adults, while Alzheimer’s disease is a leading cause only among older adults. Mood disorders, musculoskeletal pain, and hearing or vision losses are among the leading causes of disability. Conclusions The increase in LE and the decrease of the DALYs rates are probably results of the improvement of social conditions and health policies. However, the smaller increase of HALE than LE means that despite living more, people spend a substantial time of their old age with disability and illness. Preventable or potentially controllable diseases are responsible for most of the burden of disease among Brazilian older adults. Health investments are necessary to obtain longevity with quality of life in Brazil.
A vigilância entomológica da doença de Chagas em Mambaí e Buritinópolis, no Estado de Goiás, Brasil, tem sido mantida com participação da população, notificando a presença de vetores nas habitações. Passado longo tempo após instituídas as ações de controle e tendo-se já certificado a interrupção da transmissão vetorial, buscou-se avaliar o conhecimento e as práticas da população nessa situação. Os resultados apontam progressivo desinteresse pelo tema doença de Chagas, atribuível à redução da magnitude do problema representado pela enfermidade, a pouca participação das escolas na vigilância, à pequena importância dos vetores secundários e nativos e, em conseqüência, às limitadas intervenções dos serviços de controle em resposta às notificações. Propõe-se, que atividades de busca direta por amostragem sejam periodicamente realizadas e maior envolvimento das instituições de ensino.Palavras-chaves: Doença de Chagas. Vigilância entomológica. Participação comunitária. ABSTRACTEntomological surveillance of Chagas disease in Mambaí and Buritinópolis, in the State of Goiás, Brazil, has been kept up through the local population's participation, consisting of reporting the presence of vectors inside their homes. A long time has elapsed since instituting these control measures and it has now been certified that vector transmission has been halted. Thus, this study sought to evaluate the population's knowledge and practices in this situation. The results show that there has been progressive indifference towards the topic of "Chagas disease", which can be attributed to the reduction in the magnitude of the problem that this disease represented, little participation in surveillance among schools, low epidemiological importance of secondary and native vectors and, consequently, limited control interventions from health services in response to notifications. It is proposed that direct search activities by means of sampling should be carried out periodically, and that there should be greater involvement among teaching institutions.
Background Brazil is the world’s fifth most populous nation, and is currently experimenting a fast demographic ageing process in a context of scarce resources and social inequalities. To understand the health profile of older adults in Brazil is fundamental for planning public policies. Methods The estimates were derived from data obtained through the collaboration between Brazilian Ministry of Health with the Institute of Health Metrics and Evaluation of the University of Washington. The Brazilian Institute of Geography and Statistics provided the population estimates. Data on causes of death came from the Mortality Information System. To calculate morbidity, population-based studies on the prevalence of diseases in Brazil were comprehensively searched, in addition to information obtained from national databases such as the Hospital Information System, the Outpatient Information System, and the Injury Information System. We presented the Global Burden of Disease (GBD) 2017 estimates among Brazilian older adults (60 + years old) for life expectancy at birth (LE), healthy life expectancy (HALE), cause-specific mortality, years of life lost (YLLs), years lived with disability (YLDs), and disability-adjusted life-years (DALYs), from 2000 to 2017. Results LE at birth significantly increased from 71.3 years (95%UI to 70.9–71.8) to 75.2 years (95%UI 74.7–75.7). There was a trend of increasing HALE, from 62.2 years (95%UI 59.54–64.5) to 65.5 years (95%UI 62.6–68.0). The proportion of DALYs among older adults increased from 7.3–10.3%. Chronic noncommunicable diseases are the leading cause of death among middle-aged and older adults, while Alzheimer's disease is a leading cause only among older adults. Mood disorders, musculoskeletal pain and hearing or vision losses are among the leading causes of disability. Conclusions The increase in LE and the decrease of the DALYs rates are probably results of the improvement of social conditions and health policies. However, the smaller increase of HALE than LE means that despite living more, people spend a substantial time of their old age with disability and illness. Preventable or potentially controllable diseases are responsible for most of the burden of disease among Brazilian older adults. Health investments are necessary to obtain longevity with quality of life in Brazil.
Objectives The aim of this study is to evaluate the differences in knowledge about TB among prison workers and workers of the basic health services (administrative and health professionals). Method It was designed a cross-sectional study with 115 guards and health professionals of a prison, 121 administrative workers of the health services and 125 health professionals of the health services. Knowledge about diagnosis symptoms, prevention and treatment was sought using a questionnaire based on KAP (knowledge, attitude and practice) survey. Differences among the proportion of affirmative answers were estimated using c 2 test with significance level of 0.05. Results Although the most important symptom for all three groups was cough for more than 2 weeks, administrative and health professionals mentioned it in a higher proportion (84 and 85%) than prison workers (66%) (p<0.05). Weight lost (60%) and fever of unknown cause (32%) did not show statistical difference (p¼0.07 and p¼0.59). Airborne transmission was correctly informed by 88.4% to 94.4% with no statistical differences (p¼0.19) and sharing plates (41%) and shaking hands (5%) were incorrectly mentioned as forms of transmission, also without differences among groups. Supervised treatment (74%e80%) also did not have statistical difference. Conclusions Although health professionals showed a higher knowledge, 15% gave incorrect answers, thus continued education is needed to improve TB diagnosis and prevention. Introduction The physiopathology of dengue hemorrhagic fever (DHF), severe form of Dengue Fever, is poorly understood. We are unable to identify patients likely to progress to DHF for closer monitoring and early intervention during epidemics, so most cases are sent home. This study explored whether patients with selected co-morbidities are at higher risk of developing DHF. Methods A matched case-control study conducted in a dengue seropositive population in two Brazilian cities. For each case of DHF, 7 sero-positive controls were selected. Cases and controls were interviewed and information collected on demographic and socioeconomic status, reported co-morbidities (diabetes, hypertension, allergy) and use of medication. Conditional logistic regression was used to calculate the strength of the association between the comorbidities and occurrence of DHF. Results 170 cases of DHF and 1175 controls were included. Significant associations were found between DHF and white ethnicity (OR¼4.7; 2.1e10.2), high income (OR¼6.8; 4.0e11.4), high education (OR¼4.7; 2.35e9.27), reported diabetes (OR¼2.7; 1.1e6.7) and reported allergy treated with steroids (OR¼2.9.0; 1.0e8.5). Black individuals who reported being treated for hypertension had 13 times higher risk of DHF then black individuals reporting no hypertension. Conclusion This is the first study to find an association between DHF and diabetes, allergy and hypertension. Given the high case fatality rate of DHF (1%e5%), we believe that the evidence produced in this study, suggests that screening criteria might be used ...
Estimates of completeness of death registration are crucial to produce estimates of life tables, population projections and to the global burden of diseases study. They are an imperative step in quality of data analysis. In the case of state level data in Brazil, it is important to consider spatial and temporal variation in the quality of mortality data. In this paper, we compare and discuss alternative estimates of completeness of death registration, adult mortality (45q15) and life expectancy estimates produced by the National Statistics Office (IBGE), Institute for Health Metrics and Evaluation (IHME) and estimates presented in Queiroz, et.al (2017) and Schmertmann and Gonzaga (2018), for 1980 and 2010. We find significant differences in estimates that affect both levels and trends of completeness of adult mortality in Brazil and states. IHME and Queiroz, et.al (2017) estimates converge in 2010, but there are large differences when compared to estimates from the National Statistics Office (IBGE). Larger differences are observed for less developed states.
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