DEMSC - Artigos publicados em periódicos
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Item Parental supervision and sexual behavior among Brazilian adolescents.(2023) Reis, Gleice Barbosa; Sousa, Marco Aurélio de; Andrade, Gisele Nepomuceno de; Malta, Deborah Carvalho; Machado, Ísis Eloah; Mendes, Mariana Santos FelisbinoObjective: to evaluate the association between parental supervision and sexual behaviors among Brazilian adolescents. Methods: Cross-sectional study with data from 102,072 adolescents who responded to the National Adolescent School-based Health Survey. We estimated the prevalence of sexual behaviors (initiation, use of condoms, contraception, and number of partners). Parental supervision was evaluated using a score considering five indicators. We calculated prevalence ratios (PR) adjusted by age and sex in order to estimate the association between parental supervision score and sexual behaviors of adolescents. Results: Prevalence of risky sexual behavior for adolescents with minimum and maximum parental supervision were: sexual initiation (min.: 58.0%; max.: 20.1%), condom use in the last sexual intercourse (min.: 50.9%; max.: 80.2%), use of contraceptives (min.: 40.8; max.: 49.1%), and mean number of partners (min.: 3.25; max.: 2.88). Parental supervision was greater among girls. Those with higher supervision scores had higher prevalence of condom use in the first and last sexual intercourse and of contraceptive methods, and a smaller mean number of partners, even after adjustments for sex and age. Conclusion: The greater the parental supervision, the better the sexual behavior for both sexes, although supervision seems to occur differently between girls and boys. These findings point to the role of the family in providing adolescents with monitoring, along with dialogue and affection, conditions that encourage healthy and risk-free sexual behavior.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 Consumo e exposição a bebidas alcoólicas entre adolescentes brasileiros : evidências das pesquisas nacionais de saúde do escolar de 2015 e 2019.(2022) Malta, Deborah Carvalho; Prates, Elton Junio Sady; Ferreira, Alan Cristian Marinho; Freitas, Paula Carvalho de; Oliveira, Patrícia Pereira Vasconcelos de; Gomes, Crizian Saar; Machado, Ísis Eloah; Rios Neto, Eduardo Luiz GonçalvesObjetivo: analisar os indicadores de consumo e exposição a bebidas alcoólicas entre escolares brasileiros em 2019 e compará-los aos de 2015. Método: estudo transversal com dados da Pesquisa Nacional de Saúde do Escolar (PeNSE), realizadas em 2015 e 2019. Em 2019, analisaram-se os indicadores referentes ao consumo e à exposição a bebidas alcoólicas, estratificadas por sexo, faixa etária, dependência administrativa, unidades da federação e região geográfica. Estimou-se as prevalências e os respectivos intervalos de 95% de confiança (IC 95%). Resultados: houve aumento na experimentação de bebidas alcoólicas antes de 13 anos (30,6% em 2015 para 34,6% em 2019); sofrer embriaguez na vida (27,2% em 2015 para 47,0% em 2019) e ter problemas com amigos devido ao consumo de bebidas alcóolicas (9,3% em 2015 para 15,7% em 2019). Todos os indicadores foram mais prevalentes entre meninas, exceto beber em binge e episódios de embriagues, que não tiveram diferenças entre os sexos, bem como foram mais elevadas entre estudantes mais velhos. Os episódios de embriaguez e ter amigos que ingerem bebida alcoólica foram mais prevalentes entre escolares de escolas públicas, enquanto o consumo de bebidas alcoólicas pelos pais e ter tido problemas com suas famílias ou amigos devido ao consumo de bebidas alcoólicas foram mais elevados em estudantes de escolas privadas. Conclusão: evidenciaram-se elevadas prevalências de experimentação, consumo e exposição a bebidas alcoólicas, mostrando que grande parcela dos adolescentes brasileiros se encontra exposta a uma carga evitável de morbimortalidade decorrente do consumo e exposição ao álcool.Item Burden of disease attributable to risk factors in Brazil : an analysis of national and subnational estimates from the 2019 Global Burden of Disease study.(2022) Malta, Deborah Carvalho; Mendes, Mariana Santos Felisbino; Machado, Ísis Eloah; Veloso, Guilherme Augusto; Gomes, Crizian Saar; Brant, Luisa Campos Caldeira; Ribeiro, Antônio Luiz Pinho; Oliveira, Patrícia Pereira Vasconcelos de; Flor, Luisa Sorio; Gakidou, EmmanuelaIntroduction: Monitoring trends in risk factors (RFs) and the burden of diseases attributable to exposure to RFs is an important measure to identify public health advances and current inadequate efforts. Objective: Analyze the global burden of disease attributable to exposure RFs in Brazil, and its changes from 1990 to 2019, according to the sex and age group. Methods: This study used data from the Global Burden of Disease study. The Summary Exposure Value, which represents weighted prevalence by risk, was used to estimate exposure to RFs. The mortality and DALYs (Disability Adjusted Life Years) measurements were used to estimate the burden of diseases. For comparisons by year and between Brazilian states, age-standardized rates were used. Results: Arterial hypertension was the factor responsible for most deaths in both sexes. For DALYs, the most important RF was the high body mass index (BMI) for women and alcohol consumption for men. Smoking had a substantial reduction in the attributable burden of deaths in the period. An important reduction was identified in the exposure to RFs related to socioeconomic development, such as unsafe water, lack of sanitation, and child malnutrition. Metabolic RFs, such as high BMI, hypertension, and alcohol consumption showed an increase in the attributable burden. Conclusions: Our findings point to an increase in metabolic RFs, which are the main RFs for mortality and DALYs. These results can help to consolidate and strengthen public policies that promote healthy lifestyles, thus reducing disease and death.Item ConVid – Pesquisa de Comportamentos pela Internet durante a pandemia de COVID-19 no Brasil : concepção e metodologia de aplicação.(2021) Szwarcwald, Célia Landmann; Souza Junior, Paulo Roberto Borges de; Damacena, Giseli Nogueira; Malta, Deborah Carvalho; Barros, Marilisa Berti de Azevedo; Romero, Dália Elena; Almeida, Wanessa da Silva de; Azevedo, Luiz Otávio; Machado, Ísis Eloah; Lima, Margareth Guimarães; Werneck, André Oliveira; Silva, Danilo Rodrigues Pereira da; Gomes, Crizian Saar; Ferreira, Arthur Pate de Souza; Gracie Carrijo, Renata de Saldanha da Gama; Pina, Maria de Fátima deA ConVid – Pesquisa de Comportamentos foi realizada no Brasil de 24 de abril a 24 de maio de 2020, com o objetivo de investigar as mudanças nos estilos de vida e nas condições de saúde durante a pandemia de COVID-19. Neste artigo, apresentamos a concepção e metodologia da pesquisa. Estudo de corte transversal com a utilização de um questionário pela Internet, com ques- tões validadas em inquéritos de saúde anteriores. O método de amostragem foi o “bola de neve virtual” e foram usados os procedimentos de pós-estratificação. Os resultados relativos às doenças crônicas não transmissíveis e estilos de vi- da pré-pandemia foram comparados às estimativas da Pesquisa Nacional de Saúde de 2013 e da Vigilância de Fatores de Risco e Proteção para Doenças Crônicas por Inquérito Telefônico de 2019. A amostra total foi de 45.161 pessoas. Após a ponderação dos dados, as distribuições amostrais das variáveis demográficas foram semelhantes às populacionais. Apenas as pessoas de baixo nível de instrução foram sub-representadas. A comparação com os resultados anteriores mostrou similaridade na maioria das estimati- vas: consumo recomendado de frutas e legumes (22,1%), atividade física reco- mendada (35,2%), fumo de cigarros (12,3%), consumo frequente e abusivo de álcool (6,7%), obesidade (21,2%), prevalências autorreferidas de hipertensão (18,6%), diabetes (7,1%) e doença do coração (4,4%). O inquérito online pos- sibilitou conhecer as condições de saúde da população durante a pandemia. A similaridade dos indicadores com os obtidos em pesquisas tradicionais per- mitiu validar as estimativas médias. Estudos são necessários para investigar como os efeitos endógenos das redes sociais virtuais podem ser levados em con- sideração na estimação da variância.Item Factors affecting Brazilians’ self-rated health during the COVID-19 pandemic.(2021) Szwarcwald, Célia Landmann; Damacena, Giseli Nogueira; Barros, Marilisa Berti de Azevedo; Malta, Deborah Carvalho; Souza Junior, Paulo Roberto Borges de; Azevedo, Luiz Otávio; Machado, Ísis Eloah; Lima, Margareth Guimaraes; Romero, Dália Elena; Gomes, Crizian Saar; Werneck, André Oliveira; Silva, Danilo Rodrigues Pereira da; Gracie Carrijo, Renata de Saldanha da Gama; Pina, Maria de Fátima deThis is a cross-sectional study investigating the factors affecting brazilians’ self-rated health during the COVID-19 pandemic, based on data from the web-based behavior survey. Carried out from April 24 to May 24, 2020, the survey recruited participants by a chain sampling procedure. Its outcome was the worsening of self-rated health during the pandemic. Statistical analysis was based on a hierarchical model of determination. Logistic regression mod- els were used to test the associations between sociodemographic characteristics, pre-existing health conditions, lifestyle indicators and intensity of social re- straint measures, and biological and psychological issues during the pandemic. From the total sample of 45,161 participants, 29.4% reported worsening of health state during this period. After adjusting for hierarchical distal factors, the health problems mostly associated with worsening health state were: bad self-rated health (adjusted OR = 4.35, p < 0.001), health care seeking for men- tal health problem (adjusted OR = 3.95, p < 0.001), and for COVID-19 (ad- justed OR = 3.60, p < 0.001). People who experienced sleep problems, worsen- ing of back pain, depression and at least one flu symptom during the pandemic were twice as likely to report worsening of health status. Sedentary and eat- ing behaviors and adherence to social distancing measures showed significant correlation with the outcome. There exists a relation between social, biologi- cal, and psychological factors, mediated by lifestyles and variables pertaining to confinement. Altogether, these factors have negatively affected self-rated health during the COVID-19 pandemic in Brazil.Item Mental health of Brazilian adolescents during the COVID-19 pandemic.(2022) Barros, Marilisa Berti de Azevedo; Lima, Margareth Guimaraes; Malta, Deborah Carvalho; Azevedo, Renata Cruz Soares de; Fehlberg, Bruna Kelly; Souza Junior, Paulo Roberto Borges de; Azevedo, Luiz Otávio; Machado, Ísis Eloah; Gomes, Crizian Saar; Romero, Dália Elena; Damacena, Giseli Nogueira; Werneck, André Oliveira; Silva, Danilo Rodrigues Pereira da; Almeida, Wanessa da Silva de; Szwarcwald, Célia LandmannWe aimed to assess the factors associated with frequent sadness and nervousness in Brazilian adolescents, during the Covid-19 pandemic, in 9470 adolescents (aged 12–17 years), interviewed from June 27 to September 17, 2020. Prevalences and prevalence ratios were estimated according to socio-demographic variables and factors related to family, school, friends, and health. Brazilian adolescents often felt sad (32.4%) and nervous (48.7%). Higher prevalences of these feelings were related to: being female; aged 15–17 year; from families with financial difficulties; having learned little or nothing with remote education; missing friends; having few friends; family disagreements; having regular/bad health before the pandemic; and worsened health and sleep during the pandemic. Higher prevalence of nervousness was also found in adolescents who worked before the pandemic and those who reported lack of concentration and not knowing if they had COVID-19. Sadness and nervousness in Brazilian adolescents is high and the need for action by the government, schools, health services, and parents to mitigate the impact of the pandemic on the physical and mental health of adolescents. Special attention must be paid to adolescents with previous health problems and those belonging to the most socially vulnerable population.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 Estimativas do risco cardiovascular em dez anos na população brasileira : um estudo de base populacional.(2021) Malta, Deborah Carvalho; Pinheiro, Pedro Cisalpino; Teixeira, Renato Azeredo; Machado, Ísis Eloah; Santos, Filipe Malta dos; Ribeiro, Antônio Luiz PinhoFundamentos: As doenças cardiovasculares são a principal causa de morbimortalidade, altos custos com saúde e perdas econômicas importantes. O escore de Framingham tem sido amplamente utilizado para estratificar o risco dos indivíduos avaliados, identificando aqueles com risco maior para que sejam implementadas medidas de prevenção direcionadas para esse grupo. Objetivo: Estimar o risco cardiovascular em 10 anos da população brasileira adulta. Métodos: Estudo transversal, utilizando dados laboratoriais de uma subamostra da Pesquisa Nacional de Saúde. Para calcular o risco cardiovascular, utilizou-se o escore de Framingham, estratificado por sexo. Resultados: A maioria das mulheres (58,4%) apresentou baixo risco cardiovascular, 32,9%, risco médio e 8,7%, risco elevado. Entre homens, 36,5% apresentaram risco cardiovascular baixo, 41,9%, risco médio e 21,6%, risco elevado. O risco aumentou com a idade e foi elevado na população com baixa escolaridade. A proporção dos componentes do modelo de Framingham, por grupos de risco e sexo, mostra que, no risco elevado entre mulheres, os indicadores que mais contribuíram para o risco cardiovascular foram: a pressão arterial sistólica, colesterol total, HDL, diabetes e tabagismo. Entre homens, pressão arterial sistólica, colesterol total, HDL, tabagismo e diabetes. Conclusão: Trata-se do primeiro estudo nacional com dados laboratoriais a estimar o risco de doença cardiovascular em dez anos. Os escores de risco são úteis para subsidiar as práticas de prevenção dessas doenças, considerando o contexto clínico e epidemiológico.Item Convergence in alcohol abuse in Brazilian capitals between genders, 2006 to 2019 : what population surveys show.(2021) Malta, Deborah Carvalho; Silva, Alanna Gomes da; Prates, Elton Junio Sady; Alves, Francielle Thalita Almeida; Cristo, Elier Broche; Machado, Ísis EloahObjective: To analyze the temporal trend of the prevalence of alcohol abuse among adults in Brazilian capitals, between 2006 and 2019. Methods: Time series study, based on data from the Surveillance System for Risk and Protective Factors for Chronic Diseases by Telephone Survey (Vigitel), between 2006 and 2019. The population consisted of adults (≥ 18 years old) with landline telephone residing in Brazilian capitals. The trend analysis was performed by linear regression. Results: Between 2006 and 2019 there was a significant increase (p = 0.03) in the abusive consumption of alcoholic beverages in the total adult population, from 15.6 to 18.8%. Among men, there was a stability trend (p = 0.96), and among women, there was an increase from 7.7 to 13.3% (p < 0.001; β = 0.295). In the male gender stratified by capitals , from 2006 to 2019 there was a reduction in Belém, Fortaleza, João Pessoa, Macapá, Manaus, Natal, Recife, São Luis, and Teresina. On the other hand, there was growth in the Federal District. Among women, the trend was upward in: Aracaju, Belo Horizonte, Cuiabá, Curitiba, Florianópolis, Goiânia, Palmas, Porto Alegre, Rio de Janeiro, Salvador, São Paulo, Vitória, and the Federal District. Conclusion: The results indicate that more adult women are currently drinking in excess compared to previous years, suggesting an increased risk of alcohol-related harm in this portion of the population in Brazilian capitals, bringing about a convergence effect with the prevalence among men and women.