Navegando por Autor "Souza, Maria de Fátima Marinho de"
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Item Association between firearms and mortality in Brazil, 1990 to 2017 : a global burden of disease Brazil study.(2020) Malta, Deborah Carvalho; Soares Filho, Adauto Martins; Pinto, Isabella Vitral; Minayo, Maria Cecília de Souza; Lima, Cheila Marina de; Machado, Ísis Eloah; Teixeira, Renato Azeredo; Morais Neto, Otaliba Libânio; Ladeira, Roberto Marini; Merchan-Hamann, Edgar; Souza, Maria de Fátima Marinho de; Vasconcelos, Cíntia Honório; Vidotti, Carlos Cezar Flores; Cousin, Ewerton; Glenn, Scott; Bisignano, Catherine; Chew, Adrienne; Ribeiro, Antônio Luiz Pinho; Naghavi, MohsenBackground: Brazil leads the world in number of firearm deaths and ranks sixth by country in rate of firearm deaths per 100,000 people. This study aims to analyze trends in and burden of mortality by firearms, according to age and sex, for Brazil, and the association between these deaths and indicators of possession and carrying of weapons using data from the global burden of diseases, injuries, and risk factors study (GBD) 2017. Methods: We used GBD 2017 estimates of mortality due to physical violence and self-harm from firearms for Brazil to analyze the association between deaths by firearms and explanatory variables. Results: Deaths from firearms increased in Brazil from 25,819 in 1990 to 48,493 in 2017. Firearm mortality rates were higher among men and in the 20–24 age group; the rate was 20 times higher than for women in the same age group. Homicide rates increased during the study period, while mortality rates for suicides and accidental deaths decreased. The group of Brazilian federation units with the highest firearm collection rate (median = 7.5) showed reductions in the rate of total violent deaths by firearms. In contrast, the group with the lowest firearm collection rate (median = 2.0) showed an increase in firearm deaths from 2000 to 2017. An increase in the rate of voluntary return of firearms was associated with a reduction in mortality rates of unintentional firearm deaths (r = −0.364, p < 0.001). An increase in socio-demographic index (SDI) was associated with a reduction in all firearm death rates (r = −0.266, p = 0.008). An increase in the composite index of firearms seized or collected was associated with a reduction in rates of deaths by firearm in the subgroup of females, children, and the elderly (r = −0.269, p = 0.005). Conclusions: There was a change in the trend of firearms deaths after the beginning of the collection of weapons in 2004. Federation units that collected more guns have reduced rates of violent firearm deaths.Item Avaliação da função renal na população adulta brasileira, segundo critérios laboratoriais da Pesquisa Nacional de Saúde.(2019) Malta, Deborah Carvalho; Machado, Ísis Eloah; Pereira, Cimar Azeredo; Figueiredo, André William; Aguiar, Lilian Kelen de; Almeida, Wanessa da Silva de; Souza, Maria de Fátima Marinho de; Rosenfeld, Luiz Gastão Mange; Szwarcwald, Célia LandmannObjetivo: O presente estudo avaliou a função renal da população adulta brasileira, segundo critérios laboratoriais da Pesquisa Nacional de Saúde (PNS). Metodologia: Estudo descritivo realizado com os dados laboratoriais da PNS, coletados entre os anos de 2014 e 2015. Com base nos dados laboratoriais foram analisadas prevalências populacionais de creatinina sérica (CR) e estimativa da taxa de filtração glomerular (TFG), segundo variáveis sociodemográficas. Resultados: A amostra foi de 8.535 indivíduos com idade de 18 anos ou mais para o estudo da CR e de 7.457 indivíduos para o estudo de TFG. A prevalência TFG < 60 mL/ min/1,73 m2 foi de 6,7% (IC95% 6,0 – 7,4), foi mais elevada em mulheres (8,2% IC95% 7,2 – 9,2) do que em homens (5,0% IC95% 4,2 – 6,0) p < 0,001 e em idosos ≥ 60 anos foi de 21,4%. Os valores de CR ≥ 1,3 mg/dL em homens foram 5,5% (IC95% 4,6 – 6,5) e em mulheres foram de CR ≥ 1,1 mg/dL, de 4,6% (IC95% 4,0 – 5,4), sem diferença estatística significativa nos valores de CR entre sexo, p = 0,140. Conclusão: Resultados laboratoriais da PNS identificaram prevalências mais elevadas da doença renal crônica na população brasileira do que o estimado em estudos autorreferidos. A TFG < 60 mL/min/1,73 m2 é mais elevada em mulheres e atinge um quinto dos idosos. Esses exames podem ser úteis no propósito de identificar precocemente a doença e, dessa forma, prevenir a progressão da lesão renal e reduzir o risco de eventos cardiovasculares e de mortalidade.Item Cardiovascular mortality during the COVID-19 pandemics in a large Brazilian city : a comprehensive analysis.(2022) Brant, Luisa Campos Caldeira; Pinheiro, Pedro Cisalpino; Ribeiro, Antônio Luiz Pinho; Machado, Ísis Eloah; Correa, Paulo Roberto Lopes; Santos, Mayara Rocha dos; Souza, Maria de Fátima Marinho de; Malta, Deborah Carvalho; Passos, Valéria Maria de AzeredoIntroduction: The impact of COVID-19 pandemics on cardiovascular diseases (CVD) may be caused by health system reorganization and/or collapse, or from changes in the behaviour of individuals. In Brazil, municipalities were empowered to define regulatory measures, potentially resulting in diverse effects on CVD morbimortality. Objective: To analyse the impact of COVID-19 pandemics on CVD outcomes in Belo Horizonte (BH), the sixth greater capital city in Brazil, including: mortality, mortality at home, hospitalizations, intensive care unit utilization, and in-hospital mortality; and the differential effect according to sex, age range, social vulnerability, and pandemic’s phase. Methods: Ecological study analysing data from the Mortality and Hospital Information System of BH residents aged ≥30 years. CVD was defined as in Chapter IX from ICD- 10. Social vulnerability was classified by a composite socioeconomic index as high, medium and low. The observed age-standardized rates for epidemiological weeks 10–48, 2020, were compared to the expected rates (mean of 2015–2019). Risk ratios (RiR) were analysed and 95% confidence intervals were calculated for all estimates. Population projected to 2020 for BH and its census tracts were used to calculate rates. Results: We found no changes in CVD mortality rates (RiR 1.01, 95%CI 0.96–1.06). However, CVD deaths occurred more at homes (RiR 1.32, 95%CI 1.20–1.46) than in hospitals (RiR 0.89, 95%CI 0.79–0.99), as a result of a substantial decline in hospitalization rates, even though proportional in-hospital deaths increased. The rise in home deaths was greater in older adults and in had an increasing gradient in those more socially vulnerable (RiR 1.45); for high (RiR 1.45), medium (RiR 1.32) and low vulnerability (RiR 1.21). Conclusion: The greater occurrence of CVD deaths at home, in parallel with lower hospitalization rates, suggests that CVD care was disrupted during the COVID-19 pandemics, which more adversely affected older and more socially vulnerable individuals, exacerbating health inequities in BH.Item Maior mortalidade durante a pandemia de COVID-19 em áreas socialmente vulneráveis em Belo Horizonte : implicações para a priorização da vacinação.(2021) Passos, Valéria Maria de Azeredo; Brant, Luisa Campos Caldeira; Pinheiro, Pedro Cisalpino; Correa, Paulo Roberto Lopes; Machado, Ísis Eloah; Santos, Mayara Rocha dos; Ribeiro, Antônio Luiz Pinho; Paixão, Lucia Maria Miana; Pimenta Junior, Fabiano Geraldo; Souza, Maria de Fátima Marinho de; Malta, Deborah CarvalhoObjetivo: Avaliar a mortalidade por áreas de Belo Horizonte (BH) durante a pandemia de COVID- 19 conforme a vulnerabilidade social, visando a uma estratégia de vacinação. Métodos: Estudo ecológico com análise de mortalidade, segundo setores censitários classificados pelo índice de vulnerabilidade da saúde, composto de indicadores de saneamento e socioeconômicos. Óbitos por causas naturais e COVID-19 foram obtidos do Sistema de Informação sobre Mortalidade, entre a 10a e a 43a semanas epidemiológicas (SE) de 2020. Calculou-se o excesso de mortalidade por modelo de série temporal, considerando-se as mortes observadas por SE entre 2015 e 2019, por setor censitário. Taxas de mortalidade (TM) foram calculadas e padronizadas por idade com base em estimativas populacionais do Instituto Brasileiro de Geografia e Estatística (IBGE). Resultados: Houve 16,1% (n = 1.524) de excesso de mortalidade em BH: 11, 18,8 e 17,3% nas áreas de baixa, média e elevada vulnerabilidade, respectivamente. As diferenças entre TM observadas e esperadas por causas naturais, padronizadas por idade, foi igual a 59/100 mil habitantes em BH, aumentando de 31 para 77 e 95/100 mil, nas áreas de baixa, média e elevada vulnerabilidade, respectivamente. Houve gradiente de aumento com a idade nas TM por COVID-19, variando de 4 a 611/100 mil habitantes entre as idades de 20–39 anos e 75+ anos. A TM por COVID-19 por 100 mil idosos (60+ anos) foi igual a 292, aumentando de 179 para 354 e 476 nos setores de baixa, média e elevada vulnerabilidade, respectivamente. Conclusão: Desigualdades na mortalidade, mesmo entre idosos, aliadas à baixa oferta de doses, demonstram a importância de priorizar áreas socialmente vulneráveis durante a vacinação contra COVID-19.Item Patterns of abuse of elderly people in Brazil : analysis of notifications.(2023) Andrade, Fabiana Martins Dias de; Machado, Ísis Eloah; Freitas, Maria Imaculada de Fátima; Souza, Maria de Fátima Marinho de; Malta, Deborah CarvalhoThis study aimed to describe the characteristics of elderly people abuse notifications by gender and to assess notification patterns according to gender. We analyzed data from the Brazilian Information System for Notificable Diseases (SINAN) in 2017. We carried out a descriptive analysis of victim characteristics, violence, and the probable perpetrator according to gender. Pearson’s χ2 test was used to assess the significance between groups. Then, we verified the main relationships between the studied characteristics and the victim’s gender by simple correspondence analysis (SCA). Thus, 17,311 cases/suspicions of elderly people abuse were notified, corresponding to 7.2% of the total number of violence notifications. Of these victims, 50.4% were white, 42.3% were married, and 17.2% had a disability/disorder; 76.9% occurred at home, 62.8% included physical violence, and 49.5% were cases of repeated violence. Most perpetrators were men (62%), and violence by two or more perpetrators was observed in 62.8% of the cases. SCA evidenced inequalities in older adults’ gender, which proved to be higher among women. Physical violence was the most common among younger and old individuals, whereas neglect/abandonment tended to occur more frequently among the oldest individuals, and was most often committed by daughters. In sum, this study demonstrated evidence of gender-based violence, especially among older adults. Disability proved to be an essential characteristic for neglect/abandonment in older adults. In this context, policies are needed to reduce gender inequalities and implement a care network for older adults who are victims of violence.Item Prevalência de hemoglobinopatias na população adulta brasileira : Pesquisa Nacional de Saúde 2014–2015.(2019) Rosenfeld, Luiz Gastão Mange; Bacal, Nydia Strachman; Cuder, Maria Alice Martins; Silva, Alanna Gomes da; Machado, Ísis Eloah; Pereira, Cimar Azeredo; Souza, Maria de Fátima Marinho de; Malta, Deborah CarvalhoObjetivo:Descrever a prevalência das hemoglobinopatias da população adulta brasileira, segundo exames laboratoriais da Pesquisa Nacional de Saúde. Métodos: Estudo descritivo realizado com os dados laboratoriais da Pesquisa Nacional de Saúde coletados entre os anos de 2014 e 2015. A pesquisa de hemoglobinopatias foi feita pelo método da cromatografia líquida de alto desempenho. Os resultados dos exames individuais foram interpretados fornecendo os parâmetros normais, homozigotos ou heterozigotos para hemoglobina S, C e D, além de outras eventuais hemoglobinopatias. Foram estimadas prevalências das hemoglobinopatias segundo sexo, cor da pele, região, idade e escolaridade. Resultados: Houve presença de hemoglobinopatias em 3,7% da população. As principais foram o traço falciforme (2,49%), a talassemia menor (0,30%) e a suspeita de talassemia maior (0,80%). Em relação ao traço falciforme e à suspeita de talassemia maior, houve diferença estatisticamente significativa para a variável cor da pele (p < 0,05). As prevalências encontradas para traço falciforme segundo cor de pele foram: preta (4,1%), parda (3,6%), branca (1,2%) e outras (1,7%). Conclusão: As hemoglobinopatias mais prevalentes foram o traço falciforme e a talassemia menor, predominando entre pretos e pardos. O estudo ajuda na identificação das hemoglobinopatias e no aconselhamento genético na preconcepção.Item The GBD Brazil network : better information for health policy decision-making in Brazil.(2020) Malta, Deborah Carvalho; Passos, Valéria Maria de Azeredo; Machado, Ísis Eloah; Souza, Maria de Fátima Marinho de; Ribeiro, Antônio Luiz PinhoItem The impact of COVID-19 pandemic course in the number and severity of hospitalizations for other natural causes in a large urban center in Brazil.(2021) Brant, Luisa Campos Caldeira; Pinheiro, Pedro Cisalpino; Machado, Ísis Eloah; Correa, Paulo Roberto Lopes; Santos, Mayara Rocha dos; Ribeiro, Antônio Luiz Pinho; Tupinambás, Unaí; Santiago, Christine Ferretti; Souza, Maria de Fátima Marinho de; Malta, Deborah Carvalho; Passos, Valéria Maria de AzeredoThe COVID-19 pandemic may indirectly impact hospitalizations for other natural causes. Belo Horizonte is a city with 2.5 million inhabitants in Brazil, one of the most hardly-hit coun- tries by the pandemic, where local authorities monitored hospitalizations daily to guide regu- latory measures. In an ecological, time-series study, we investigated how the pandemic impacted the number and severity of public hospitalizations by other natural causes in the city, during 2020. We assessed the number and proportion of intensive care unit (ICU) admissions and in-hospital deaths for all-natural causes, COVID-19, non-COVID-19 natural causes, and four disease groups: infectious, respiratory, cardiovascular, and neoplasms. Observed data from epidemiological week (EW) 9 (first diagnosis of COVID-19) to EW 48, 2020, was compared to the mean for the same EW of 2015–2019 and differences were tested by Wilcoxon rank-sum test. The five-week moving averages of the studied variables in 2020 were compared to that of 2015–2019 to describe the influence of regulatory mea- sures on the indicators. During the studied period, there was 54,722 hospitalizations by non- COVID-19 natural causes, representing a 28% decline compared to the previous five years (p<0.001). There was a concurrent significant increase in the proportion of ICU admissions and deaths. The greater reductions were simultaneous to the first social distancing decree or occurred in the peak of COVID-19 hospitalizations, suggesting different drivers. Hospitali- zations by specific causes decreased significantly, with greater increase in ICU admissions and deaths for infectious, cardiovascular, and respiratory diseases than for neoplasms. While the first reduction may have resulted from avoidance of contact with healthcare facili- ties, the second reduction may represent competing causes for hospital beds with COVID- 19 after reopening of activities. Health policies must include protocols to address hospitali- zations by other causes during this or future pandemics, and a plan to face the rebound effect for elective deferred procedures.