DEMSC - Artigos publicados em periódicos
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Item Diminishing benefits of urban living for children and adolescents’ growth and development.(2023) Coelho, George Luiz Lins Machado; NCD Risk Factor CollaborationOptimal growth and development in childhood and adolescence is crucial for lifelong health and well-being1,2,3,4,5,6. Here we used data from 2,325 population-based studies, with measurements of height and weight from 71 million participants, to report the height and body-mass index (BMI) of children and adolescents aged 5–19 years on the basis of rural and urban place of residence in 200 countries and territories from 1990 to 2020. In 1990, children and adolescents residing in cities were taller than their rural counterparts in all but a few high-income countries. By 2020, the urban height advantage became smaller in most countries, and in many high-income western countries it reversed into a small urban-based disadvantage. The exception was for boys in most countries in sub-Saharan Africa and in some countries in Oceania, south Asia and the region of central Asia, Middle East and north Africa. In these countries, successive cohorts of boys from rural places either did not gain height or possibly became shorter, and hence fell further behind their urban peers. The difference between the age-standardized mean BMI of children in urban and rural areas was <1.1 kg m–2 in the vast majority of countries. Within this small range, BMI increased slightly more in cities than in rural areas, except in south Asia, sub-Saharan Africa and some countries in central and eastern Europe. Our results show that in much of the world, the growth and developmental advantages of living in cities have diminished in the twenty-first century, whereas in much of sub-Saharan Africa they have amplified.Item COVID-Inconfidentes - SARS-CoV-2 seroprevalence in two Brazilian urban areas in the fourth quarter 2020 : study protocol and initial results.(2023) Meireles, Adriana Lúcia; Lourenção, Luciano Garcia; Menezes Junior, Luiz Antonio Alves de; Coletro, Hillary Nascimento; Justiniano, Irene Carolina Sousa; Moura, Samara Silva de; Diniz, Amanda Popolino; Sabião, Thaís da Silva; Rocha, Ana Maria Sampaio; Batista, Aline Priscila; Lage, Nara Nunes; Simões, Bárbara dos Santos; Santos, Carolina Ali; Mendonça, Raquel de Deus; Andrade, Amanda Cristina de Souza; Barbosa, Keila Furbino; Masioli, Cássio Zumerle; Carraro, Júlia Cristina Cardoso; Menezes, Mariana Carvalho de; Nascimento, Renata Cristina Rezende Macedo do; Roever, Leonardo; Caiaffa, Waleska Teixeira; Coelho, George Luiz Lins MachadoObjective: To describe study protocol and initial results of research project COVID-Inconfidentes. Method: This paper described the methodological procedures adopted and the prevalence of the SARS-CoV-2 infection in the population. A household survey was conducted between October and December 2020, in two historic cities of Brazil's mining region. Anti-SARS-CoV-2 antibody was detected using the Wondfo® rapid test. The face-to- face interview consisted of administration of a questionnaire containing registration data, sociodemographic and economic variables, living habits, general health condition, mental health, sleep habits, and eating and nutrition. Results: We evaluated 1,762 residents, of which 764 (43.4 %) were in Mariana and 998 (56.6 %) in Ouro Preto. For both cities, 51.9 % of the interviewees were female, with a predominance of the age range 35 to 59 years old (47.2 %). The prevalence of the SARS-CoV-2 infection was 5.5 % in both cities, 6.2 % in Ouro Preto, and 4.7 % in Mariana (p-value > 0.05). Conclusion: The study was effective to estimate the seroprevalence of infection by the virus and its findings will enable further analyses of the health conditions of the population related to social isolation and the risk of infection with SARS-CoV-2.Item Profile of natural Trypanosoma cruzi infection among dogs from rural areas of southern Espírito Santo, Brazil.(2022) Pontes, Beathriz Giostri; Kuster, Marieta Cristina Couto; Freitas, Letícia Azeredo de; Barbosa, Wagner Miranda; Coelho, George Luiz Lins Machado; Zanini, Marcos Santos; Bahia, Maria Terezinha; Santos, Fabiane Matos dosBackground: The emergence of Trypanosoma cruzi infection via oral transmission has a habitual character in its primitive endemic cycle. Recent findings revealed the first death by oral transmission of T. cruzi in the state of Espírito Santo, Brazil, in 2012, which was recorded in the rural area of Guarapari. This study evaluated the characteristics related to the occurrence of natural T. cruzi infection among dogs from the rural areas of Alegre and Iconha, municipalities of Espírito Santo. Methods: Logistic regression analysis of factors contributing to serological detection of T. cruzi in dogs was performed in environments where Espírito Santo’s Department of Health Surveillance had previously notified triatomines positive for Trypanosoma spp. from 2014 to 2017. Results: A total of 36 dogs were analyzed, of which 10 (27.77%) tested positive, one was borderline (2.79%), and 25 tested negative (69.44%) for T. cruzi infection. São Caetano, a district from the Iconha municipality, presented a 25 times greater chance for the detection of positive tests (OR:25; 95% CI; 2.37->100). Dogs with updated mandatory vaccination presented with a lower risk of positive serodiagnosis (OR:0.12; 95% CI: 0.02-0.63). Conclusions: Our results highlight for the first time the occurrence of natural T. cruzi canine infection, detected in the municipality of Iconha, mainly among dogs with un-updated mandatory vaccines in the district of São Caetano.Item Adductor pollicis muscle thickness in Brazilian adolescents and associations with nutritional status, sexual maturation and physical activity (EVA-JF Study).(2022) Pereira, Priscila Moreira de Lima; Neves, Felipe Silva; Fontes, Vanessa Sequeira; Campos, Angélica Atala Lombelo; Coelho, George Luiz Lins Machado; Faria, Eliane Rodrigues de; Netto, Michele Pereira; Oliveira, Renata Maria Souza; Cândido, Ana Paula CarlosObjective: The present study aims to assess the associations of adductor pollicis muscle thickness (APMT) with age, skin color, sexual maturation, anthropometric indicators and physical activity in Brazilian adolescents. Materials and methods: Cross-sectional study of adolescents aged 14-19 years. Weight, height, body mass index (BMI), arm circumference (AC), APMT, body fat, fat-free mass (FFM), fat-free mass index (FFMI), sexual maturation, time of physical activity and skin color were evaluated. APMT was associated with categorical variables using Mann-Whitney or Kruskal-Wallis tests and correlated with anthropometric variables using Spearman’s correlation. Linear regression was used with APMT as a dependent and the other variables as predictors. Data analysis was carried out in SPSS® software (version 17.0) with a 5% significance level. Results: 828 adolescents were evaluated, 57.6% female, with a mean age of 16.13 ± 1.20 years. APMT had an average value of 18.0 mm in females and 21.0 mm in males. The measure was greater in males, in more advanced stages of sexual maturation, overweight and physical activity. It presented a moderate correlation with FFM, FFMI, body fat and AC. In the final model of multiple linear regression for females, the variables AC and body fat explain 20.1% of the APMT variability. For men, the variables AC and FFMI explain 30.5% of the APMT variability. Conclusion: It is recommended that APMT be used in a complementary manner in the nutritional assessment of adolescents.Item Rotating shift workers with vitamin D defciency have a higher risk of obstructive sleep apnea.(2022) Menezes Júnior, Luiz Antônio Alves de; Fajardo, Virgínia Capistrano; Freitas, Silvia Nascimento de; Coelho, George Luiz Lins Machado; Oliveira, Fernando Luiz Pereira de; Nascimento Neto, Raimundo Marques do; Meireles, Adriana LúciaObjectives The study aimed to evaluate the association between obstructive sleep apnea (OSA) and vitamin D defciency (VDD) in shift workers. Methods This cross-sectional study included male rotating shift workers in an iron ore extraction company. Participants were classified as VDD when 25(OH)D < 20 ng/mL for a healthy population and 25(OH)D < 30 ng/ mL for groups at risk for VDD. Risk of developing OSA was classified by Berlin questionnaire (BQ) and NoSAS score. Data were compared using chi-square analysis with Cramer’s V as effect size, and Bonferroni correction. Multivariate logistic regression analysis was performed to investigate whether or not VDD was associated with OSA risk assessment. Results Among 1423 male workers, mostly younger, aged 30 to 39 years (53%), worked shifts for more than 5 years (76%). The prevalence of high risk of OSA by BQ was 16%, and 33% by NoSAS score. Additionally, 29% had VDD. In multivariate analysis, controlled for confounding factors, workers with VDD had a 52% increased chance of OSA by BQ (OR 1.52; CI95% 1.06–2.18) and a 64% increased chance of OSA by NoSAS score (OR 1.64; CI95% 1.09–2.48). After subgroup analyses, similar results were not observed in workers aged 20–29 and 30–39 years. Conclusion Rotating shift workers with vitamin D defciency are more likely to have obstructive sleep apnea, assessed by the Berlin questionnaire and NoSAS score.Item Lung function six months after severe COVID-19 : does time, in fact, heal all wounds?(2022) Bretas, Daniel Cruz; Leite, Arnaldo Santos; Mancuzo, Eliane Viana; Prata, Tarciane Aline; Andrade, Bruno Horta; Oliveira, Jacqueline das Graças Ferreira; Batista, Aline Priscila; Coelho, George Luiz Lins Machado; Augusto, Valéria Maria; Marinho, Carolina CoimbraBackground COVID-19 has been associated with persistent symptoms and functional changes, especially in those surviving severe disease. Methods We conducted a prospective multicenter study in patients with severe COVID-19 to determine respiratory sequelae. Patients were stratified into two groups: ward admission (WA) and intensive care unit (ICU) admission. In each follow-up visit, the patients where inquired about cough and dyspnea, and performed spirometry, lung volumes, carbon monoxide diffusion capacity (DLCO), 6-minute walk test (6MWT), and respiratory muscle strength (MIP and MEP). Results of pulmonary function tests at 45 days and 6 months after hospital admission were compared using paired analysis. Results 211 patients were included, 112 in WA and 99 in ICU. Dyspnea persisted in 64.7% in the WA and 66.7% in the ICU group after 6 months. Lung function measures showed significant improvement between 45 days and 6 months, both in WA and ICU groups in VC, FVC, FEV1, total lung capacity, and 6MW distance measures. The improvement in the proportions of the altered functional parameters was significant in the ICU group for VC (44.2% 45 d; 20.8% 6 m; p = 0,014), FVC (47.6% 45 d; 28% 6 m; p = 0,003), FEV1 (45.1% 45 d; 28% 6 m; p = 0,044), DLCO (33.8% 45 d; 7.7% 6 m; p < 0,0001). Conclusion Six months follow-up of patients with the severe forms of COVID-19 showed significant improvement in the lung function measures compared to 45 days post hospital discharge. The difference was more evident in those requiring ICU admission.Item Food insecurity and symptoms of anxiety and depression disorder during the COVID- 19 pandemic : COVID-Inconfidentes, a population-based survey.(2022) Sabião, Thaís da Silva; Mendonça, Raquel de Deus; Meireles, Adriana Lúcia; Coelho, George Luiz Lins Machado; Carraro, Júlia Cristina CardosoThis study aimed to investigate the association between adult food insecurity (FI) and symptoms of generalized anxiety disorder (GAD) and major depressive disorder (MDD) in two Brazilian cities during the coronavirus disease (COVID-19) pandemic. This study used data derived from a cross-sectional survey of 1693 adults. Interviews were conducted using an electronic questionnaire. The FI was measured using the Brazilian Food Insecurity Scale. The Generalized Anxiety Disorder-7 was used to measure the symptoms of GAD. The Patient Health Questionnaire-9 was used for MDD symptoms. The association between FI, GAD, and MDD symptoms was investigated using a Poisson regression model with robust variance to estimate the prevalence ratio and 95% confidence interval (95% CI). In regression models, a linear association between FI levels and outcomes was observed, with severe food insecurity having a 3.56 higher prevalence of GAD symptoms (95% CI: 2.23, 5.68) and a 3.03 higher prevalence of MDD (95% CI: 1.55, 5.90). In the stratified analyses, worse results were observed for females and males, individuals with non-white race/skin color, those without children, and those with lower monthly family income. In conclusion, the FI was associated with symptoms of GAD and MDD, and the sociodemographic characteristics interfered in this association. Therefore, we recommend the improvement of public health and social protection policies for food-insecure people.Item Percentage of energy contribution according to the degree of industrial food processing and associated factors in adolescents (EVA-JF study, Brazil).(2021) Melo, Adriana Soares Torres; Neves, Felipe Silva; Batista, Aline Priscila; Coelho, George Luiz Lins Machado; Sartorelli, Daniela Sales; Faria, Eliane Rodrigues de; Netto, Michele Pereira; Oliveira, Renata Maria Souza; Fontes, Vanessa Sequeira; Cândido, Ana Paula CarlosObjective: To evaluate energetic contribution according to the degree of industrial food processing and its association with sociodemographic, anthropometric, biochemical, clinical and behavioural characteristics in adolescents. Design: Cross-sectional study (Adolescent Lifestyle Study). Food consumption was assessed using 24-h dietary recalls, with foods classified by degree of industrial progressing. The usual diet was estimated using the Multiple Source Method. In a linear regression model, the energy percentage (E %) was associated with sociodemographic, anthropometric, biochemical, clinical and behavioural characteristics, after adjustment for sex and age. Setting: Juiz de Fora, Brazil. Participants: Eight hundred and four adolescents, of both sexes, 14–19 years of age, enrolled in public schools. Results: The E % of unprocessed or minimally processed foods corresponded to 43·1 %, processed foods to 11·0 % and the ultraprocessed foods to 45·9 %. E % of unprocessed foods was associated with socio-economic stratum (adjusted β = −0·093; P = 0·032), neck circumference (adjusted β = 0·017; P = 0·049), screen time (adjusted β = −0·247; P = 0·036) and HDL-cholesterol (adjusted β = −0·156; P = 0·003). E % of ultraprocessed foods was associated with socio-economic stratum (adjusted β = 0·118; P = 0·011), screen time (adjusted β = 0·375; P = 0·003), BMI (adjusted β = −0·029; P = 0·025), neck circumference (adjusted β = −0·017; P = 0·028) and HDL-cholesterol (adjusted β = 0·150; P = 0·002). Conclusions: There was a high E % of ultraprocessed foods in the diet of the adolescents. Actions are needed to raise the awareness of adopting healthy eating habits.Item Hypertension is associated with a variant in the RARRES2 gene in populations of Ouro Preto, Minas Gerais, Brazil : a cross-sectional study.(2021) Batista, Aline Priscila; Barbosa, Keila Furbino; Azevedo, Rafael Júnior de; Vianna, Valeska Natiely; Queiroz, Erica Maria de; Marinho, Carolina Coimbra; Coelho, George Luiz Lins MachadoBackground: Arterial hypertension (AH) is implicated in vascular health and contributes significantly to cardiovascular morbidity and mortality. In addition to the contribution of usual risk factors for AH, elucidating the influence of genetic factors is a promising area of investigation. Therefore, we evaluated the association between AH and cardiovascular risk factors (CVRFs) and genetic polymorphisms in communities in Southeast Brazil. Methods: A total of 515 adults aged 18-91 years, who were cross-sectionally assessed between 2015-2016, were included. Demographic, clinical, behavioral, anthropometric characteristics, and laboratory parameters and 12 single nucleotide polymorphisms in seven candidate genes involved in cardiovascular risk (RARRES2, AGT, NOS3, GNB3, APOE, APOB, APOC3, LDLR, and PPARG) were evaluated, with AH as the outcome. Sex, age, and laboratory parameters were considered the main confounding factors. Results: There was a significant association between age >60 years (odds ratio [OR] =6.74), alcohol dependence (OR=3.84), smoking (OR=1.74), overweight (OR=1.74), high plasma triglyceride (TG) levels (OR=1.98) and low high-density lipoprotein (HDL-c) (OR=6.22), diabetes (OR=3.68), and insulin resistance (OR=2.40) and AH. A significant association was observed between rs4721 in RARRES2 and AH. The T allele in homozygosis was a potent chance modifier for AH. The highest chance gradients for AH were characterized by the presence of the TT genotype and DMT2 (OR=9.70), high TG (OR=6.26), low HDL-c (OR=8.20), and age more than 60 years (OR=9.96). Conclusion: The interaction of the T allele of the rs4721 polymorphism in RARRES2 with CVRFs may predispose carriers to a higher cardiovascular risk.Item Worldwide trends in hypertension prevalence and progress in treatment and control from 1990 to 2019 : a pooled analysis of 1201 population-representative studies with 104 million participants.(2021) Coelho, George Luiz Lins Machado; NCD Risk Factor CollaborationBackground Hypertension can be detected at the primary health-care level and low-cost treatments can effectively control hypertension. We aimed to measure the prevalence of hypertension and progress in its detection, treatment, and control from 1990 to 2019 for 200 countries and territories. Methods We used data from 1990 to 2019 on people aged 30–79 years from population-representative studies with measurement of blood pressure and data on blood pressure treatment. We defined hypertension as having systolic blood pressure 140 mm Hg or greater, diastolic blood pressure 90 mm Hg or greater, or taking medication for hypertension. We applied a Bayesian hierarchical model to estimate the prevalence of hypertension and the proportion of people with hypertension who had a previous diagnosis (detection), who were taking medication for hypertension (treatment), and whose hypertension was controlled to below 140/90 mm Hg (control). The model allowed for trends over time to be non-linear and to vary by age. Findings The number of people aged 30–79 years with hypertension doubled from 1990 to 2019, from 331 (95% credible interval 306–359) million women and 317 (292–344) million men in 1990 to 626 (584–668) million women and 652 (604–698) million men in 2019, despite stable global age-standardised prevalence. In 2019, age-standardised hypertension prevalence was lowest in Canada and Peru for both men and women; in Taiwan, South Korea, Japan, and some countries in western Europe including Switzerland, Spain, and the UK for women; and in several low-income and middle-income countries such as Eritrea, Bangladesh, Ethiopia, and Solomon Islands for men. Hypertension prevalence surpassed 50% for women in two countries and men in nine countries, in central and eastern Europe, central Asia, Oceania, and Latin America. Globally, 59% (55–62) of women and 49% (46–52) of men with hypertension reported a previous diagnosis of hypertension in 2019, and 47% (43–51) of women and 38% (35–41) of men were treated. Control rates among people with hypertension in 2019 were 23% (20–27) for women and 18% (16–21) for men. In 2019, treatment and control rates were highest in South Korea, Canada, and Iceland (treatment >70%; control >50%), followed by the USA, Costa Rica, Germany, Portugal, and Taiwan. Treatment rates were less than 25% for women and less than 20% for men in Nepal, Indonesia, and some countries in sub-Saharan Africa and Oceania. Control rates were below 10% for women and men in these countries and for men in some countries in north Africa, central and south Asia, and eastern Europe. Treatment and control rates have improved in most countries since 1990, but we found little change in most countries in sub-Saharan Africa and Oceania. Improvements were largest in high-income countries, central Europe, and some upper-middle-income and recently high-income countries including Costa Rica, Taiwan, Kazakhstan, South Africa, Brazil, Chile, Turkey, and Iran. Interpretation Improvements in the detection, treatment, and control of hypertension have varied substantially across countries, with some middle-income countries now outperforming most high-income nations. The dual approach of reducing hypertension prevalence through primary prevention and enhancing its treatment and control is achievable not only in high-income countries but also in low-income and middle-income settings.