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Fernandes QHRF, Paixão ES, Costa MDCN, Teixeira MG, Rios JDC, Santo KDSGD, Barreto ML, Acosta AX. Temporal trends in prevalence and infant mortality of birth defects in Brazil, from 2001 to 2018. CIENCIA & SAUDE COLETIVA 2023; 28:969-979. [PMID: 37042906 DOI: 10.1590/1413-81232023284.13912022] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Accepted: 11/19/2022] [Indexed: 04/13/2023] Open
Abstract
Congenital anomalies (CA) are a relevant problem for global public health, affecting about 3% to 6% of newborns worldwide. In Brazil, these are the second main cause of infant mortality. Thus, extensive studies are needed to demonstrate the impact of these anomalies on births and deaths. The present study describes the temporal trends of prevalence and infant mortality due to CA among live births in Brazil and regions, from 2001 to 2018, using the related data between the Live Birth Information System (SINASC, acronym in Portuguese) and the Mortality Information System (SIM, acronym in Portuguese). The prevalence and infant mortality due to CA has increased in Brazil and in most regions, especially in the Northeast and North. CAs in the musculoskeletal system were the most frequent at birth (29.8/10,000 live births), followed by those in the circulatory system (12.7/10,000 live births), which represented the primary cause of death in this group. The applied linkage technique made it possible to correct the national prevalence of CA by 17.9% during the analyzed period, after retrieving the anomalies reported in SIM, thereby proving to be a good tool to improve the quality of information on anomalies in Brazil.
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Affiliation(s)
- Qeren Hapuk R Ferreira Fernandes
- Programa de Pós-Graduação em Biotecnologia em Saúde e Medicina Investigativa, Centro de Integração de Dados e Conhecimentos para Saúde, Instituto Gonçalo Moniz - Fiocruz-BA. R. Waldemar Falcão 121, Candeal. 40.296-710 Salvador BA Brasil.
| | - Enny S Paixão
- London School of Hygiene and Tropical Medicine. London UK
| | - Maria da Conceição N Costa
- Centro de Integração de Dados e Conhecimentos para Saúde, Centro de Pesquisas Gonçalo Muniz, Instituto Gonçalo Moniz - Fiocruz-BA. Instituto de Saúde Coletiva, Universidade Federal da Bahia. Salvador BA Brasil
| | - Maria Glória Teixeira
- Centro de Integração de Dados e Conhecimentos para Saúde, Centro de Pesquisas Gonçalo Muniz, Instituto Gonçalo Moniz - Fiocruz-BA. Instituto de Saúde Coletiva, Universidade Federal da Bahia. Salvador BA Brasil
| | | | | | - Mauricio L Barreto
- Centro de Integração de Dados e Conhecimentos para Saúde, Centro de Pesquisas Gonçalo Muniz, Instituto Gonçalo Moniz - Fiocruz-BA. Instituto de Saúde Coletiva, Universidade Federal da Bahia. Salvador BA Brasil
| | - Angelina Xavier Acosta
- Programa de Pós-Graduação em Biotecnologia em Saúde e Medicina Investigativa, Centro de Integração de Dados e Conhecimentos para Saúde, Instituto Gonçalo Moniz - Fiocruz-BA. R. Waldemar Falcão 121, Candeal. 40.296-710 Salvador BA Brasil.
- Faculdade de Medicina da Bahia, Universidade Federal da Bahia. Salvador BA Brasil
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Geographic distribution of live births and infant mortality from congenital anomalies in Brazil, 2012-2017. J Community Genet 2021; 12:377-386. [PMID: 33496933 DOI: 10.1007/s12687-021-00509-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2020] [Accepted: 01/19/2021] [Indexed: 10/22/2022] Open
Abstract
In the 2010-2014 period, the mean prevalence of congenital anomalies (CA) in the world was estimated at 398/10,000 births. CA are an important cause of mortality, disability, and comorbidity. Thus, the present study aims to describe the geographical and temporal distributions of live births and infant mortality (IM) due CA (IM-CA) in Brazil, from 2012 to 2017. The data used in this study is available at the Department of Informatics of the Unified Health System (DATASUS). The prevalence of CA at birth was 81.67/10,000 (95% CI 80.46-82.88), and the IM-CA rate was 27.97/10,000 (95% CI 27.95-28.00) in the studied period. The five CA with the highest rates were polydactyly (9.66/10,000, 95% CI 6.10-9.82), Down syndrome (3.40/10,000, 95% CI 3.41-5.99), microcephaly (2.92/10,000, 95% CI 2.91-3.12), hydrocephalus (2.72/10,000, 95% CI 2.65-2.90), and spina bifida (2.44/10,000, 95% CI 2.43-2.64). São Paulo was the Brazilian state with the highest CA birth rate (119.3/10,000), and Amazonas was the state with the highest IM-CA rate (33.8/10,000). The description and data analyses such as those performed in this work are relevant for healthcare systems and can be very useful in the formulation of public health campaigns and policies, as well as informing and educating professionals and the population. The management of clinical actions should consider all social, economic, geographic, and epidemiological factors.
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Sebastião YV, Metzger GA, Chisolm DJ, Xiang H, Cooper JN. Impact of ICD-9-CM to ICD-10-CM coding transition on trauma hospitalization trends among young adults in 12 states. Inj Epidemiol 2021; 8:4. [PMID: 33487175 PMCID: PMC7830822 DOI: 10.1186/s40621-021-00298-x] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2020] [Accepted: 01/05/2021] [Indexed: 01/26/2023] Open
Abstract
BACKGROUND We aimed to estimate the impact of the International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) coding transition on traumatic injury-related hospitalization trends among young adults across a geographically and demographically diverse group of U.S. states. METHODS Interrupted time series analyses were conducted using statewide inpatient databases from 12 states and including traumatic injury-related hospitalizations in adults aged 19-44 years in 2011-2017. Segmented regression models were used to estimate the impact of the October 2015 coding transition on external cause of injury (ECOI) completeness (percentage of hospitalizations with a documented ECOI code) and on population-level rates of injury-related hospitalizations by nature, intent, mechanism, and severity of injury. RESULTS The transition to ICD-10-CM was associated with a drop in ECOI completion in the transition month (- 3.7%; P < .0001), but there was no significant change in the positive trend in ECOI completion from the pre- to post-transition periods. There were significant increases post-transition in the measured rates of hospitalization for traumatic brain injury (TBI), unintentional injury, mild injury (injury severity score (ISS) < 9), and injuries caused by drowning, firearms, machinery, other pedestrian, suffocation, and unspecified mechanism. Conversely, there were significant decreases in October 2015 in the rates of hospitalization for assault, injuries of undetermined intent, injuries of moderate severity (ISS 9-15), and injuries caused by fire/burn, other pedal cyclist, other transportation, natural/environmental, and other specified mechanism. A significant increase in the percentage of hospitalizations classified as resulting from severe injury (ISS > 15) was observed when the general equivalence mapping maximum severity method for converting ICD-10-CM codes to ICD-9-CM codes was used. State-specific results for the outcomes of ECOI completion and TBI-related hospitalization rates are provided in an online supplement. CONCLUSIONS The U.S. transition from ICD-9-CM to ICD-10-CM coding led to a significant decrease in ECOI completion and several significant changes in measured rates of injury-related hospitalizations by injury intent, mechanism, nature, and severity. The results of this study can inform the design and analysis of future traumatic injury-related health services research studies that use both ICD-9-CM and ICD-10-CM coded data. LEVEL OF EVIDENCE II (Interrupted Time Series).
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Affiliation(s)
- Yuri V. Sebastião
- grid.240344.50000 0004 0392 3476Center for Surgical Outcomes Research and Center for Innovation in Pediatric Practice, Abigail Wexner Research Institute at Nationwide Children’s Hospital, Columbus, OH USA ,grid.410711.20000 0001 1034 1720Present address: Division of Global Women’s Health, School of Medicine, University of North Carolina, Chapel Hill, NC USA
| | - Gregory A. Metzger
- grid.240344.50000 0004 0392 3476Center for Surgical Outcomes Research and Center for Innovation in Pediatric Practice, Abigail Wexner Research Institute at Nationwide Children’s Hospital, Columbus, OH USA ,grid.261331.40000 0001 2285 7943Department of Surgery, College of Medicine, The Ohio State University, Columbus, OH USA
| | - Deena J. Chisolm
- grid.240344.50000 0004 0392 3476Center for Surgical Outcomes Research and Center for Innovation in Pediatric Practice, Abigail Wexner Research Institute at Nationwide Children’s Hospital, Columbus, OH USA ,grid.240344.50000 0004 0392 3476Center for Population Health and Equity Research and Center for Innovation in Pediatric Practice, Abigail Wexner Research Institute at Nationwide Children’s Hospital, Columbus, OH USA ,grid.261331.40000 0001 2285 7943Department of Pediatrics, College of Medicine, The Ohio State University, Columbus, OH USA ,grid.261331.40000 0001 2285 7943Division of Health Services Management & Policy, College of Public Health, The Ohio State University, Columbus, OH USA
| | - Henry Xiang
- grid.261331.40000 0001 2285 7943Department of Pediatrics, College of Medicine, The Ohio State University, Columbus, OH USA ,grid.240344.50000 0004 0392 3476Center for Pediatric Trauma Research and Center for Injury Research and Policy, Abigail Wexner Research Institute at Nationwide Children’s Hospital, Columbus, OH USA ,grid.261331.40000 0001 2285 7943Division of Epidemiology, College of Public Health, The Ohio State University, Columbus, OH USA
| | - Jennifer N. Cooper
- grid.240344.50000 0004 0392 3476Center for Surgical Outcomes Research and Center for Innovation in Pediatric Practice, Abigail Wexner Research Institute at Nationwide Children’s Hospital, Columbus, OH USA ,grid.261331.40000 0001 2285 7943Department of Pediatrics, College of Medicine, The Ohio State University, Columbus, OH USA ,grid.261331.40000 0001 2285 7943Division of Epidemiology, College of Public Health, The Ohio State University, Columbus, OH USA
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Coutinho CM, Negrini SFBM, Araujo DCA, Teixeira SR, Amaral FR, Moro MCR, Fernandes JDCP, Motta MSF, Negrini BVM, Caldas CACT, Anastasio ART, Furtado JM, Bárbaro AAT, Yamamoto AY, Duarte G, Mussi‐Pinhata MM. Early maternal Zika infection predicts severe neonatal neurological damage: results from the prospective Natural History of Zika Virus Infection in Gestation cohort study. BJOG 2020; 128:317-326. [DOI: 10.1111/1471-0528.16490] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/03/2020] [Indexed: 01/31/2023]
Affiliation(s)
- CM Coutinho
- Department of Gynaecology and Obstetrics Ribeirão Preto Medical School University of São Paulo Ribeirão Preto Brazil
| | - SFBM Negrini
- Department of Paediatrics Ribeirão Preto Medical School University of São Paulo Ribeirão Preto Brazil
| | - DCA Araujo
- Epidemiology and Disease Control Division Department of Public Health and Surveillance Secretary of Health Ribeirão Preto Brazil
| | - SR Teixeira
- Department of Imaging, Haematology and Oncology Ribeirão Preto Medical SchoolUniversity of São Paulo Ribeirão Preto Brazil
| | - FR Amaral
- Department of Paediatrics Ribeirão Preto Medical School University of São Paulo Ribeirão Preto Brazil
| | - MCR Moro
- Department of Gynaecology and Obstetrics Ribeirão Preto Medical School University of São Paulo Ribeirão Preto Brazil
| | - JDCP Fernandes
- Department of Paediatrics Ribeirão Preto Medical School University of São Paulo Ribeirão Preto Brazil
| | - MSF Motta
- Department of Paediatrics Ribeirão Preto Medical School University of São Paulo Ribeirão Preto Brazil
| | - BVM Negrini
- Department of Paediatrics Ribeirão Preto Medical School University of São Paulo Ribeirão Preto Brazil
| | - CACT Caldas
- Rehabilitation Centre of Clinics Hospital at the Ribeirão Preto School of Medicine Ribeirão Preto Brazil
| | - ART Anastasio
- Department of Health Sciences Ribeirão Preto Medical School University of São Paulo Ribeirão Preto Brazil
| | - JM Furtado
- Division of Ophthalmology Ribeirão Preto Medical School University of São Paulo Ribeirão Preto Brazil
| | - AAT Bárbaro
- Department of Paediatrics Ribeirão Preto Medical School University of São Paulo Ribeirão Preto Brazil
| | - AY Yamamoto
- Department of Paediatrics Ribeirão Preto Medical School University of São Paulo Ribeirão Preto Brazil
| | - G Duarte
- Department of Gynaecology and Obstetrics Ribeirão Preto Medical School University of São Paulo Ribeirão Preto Brazil
| | - MM Mussi‐Pinhata
- Department of Paediatrics Ribeirão Preto Medical School University of São Paulo Ribeirão Preto Brazil
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Anderson D, Neri JICF, Souza CRM, Valverde JG, De Araújo JMG, Nascimento MDSB, Branco RCC, Arrais NMR, Lassmann T, Blackwell JM, Jeronimo SMB. Zika Virus Changes Methylation of Genes Involved in Immune Response and Neural Development in Brazilian Babies Born With Congenital Microcephaly. J Infect Dis 2020; 223:435-440. [PMID: 32614431 DOI: 10.1093/infdis/jiaa383] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2020] [Accepted: 06/25/2020] [Indexed: 11/14/2022] Open
Abstract
The recent increase in babies born with brain and eye malformations in Brazil is associated with Zika virus (ZIKV) infection in utero. ZIKV alters host DNA methylation in vitro. Using genome-wide DNA methylation profiling we compared 18 babies born with congenital ZIKV microcephaly with 20 controls. We found ZIKV-associated alteration of host methylation patterns, notably at RABGAP1L which is important in brain development, at viral host immunity genes MX1 and ISG15, and in an epigenetic module containing the causal microcephaly gene MCPH1. Our data support the hypothesis that clinical signs of congenital ZIKV are associated with changes in DNA methylation.
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Affiliation(s)
- Denise Anderson
- Telethon Kids Institute, University of Western Australia, Perth Children's Hospital, Perth, Western Australia, Australia
| | - João I C F Neri
- Institute of Tropical Medicine of Rio Grande do Norte, Department of Biochemistry, Universidade Federal do Rio Grande do Norte, Natal, Rio de Grande do Norte, Brazil
| | - Cássio R M Souza
- Institute of Tropical Medicine of Rio Grande do Norte, Department of Biochemistry, Universidade Federal do Rio Grande do Norte, Natal, Rio de Grande do Norte, Brazil
| | - Joanna G Valverde
- Institute of Tropical Medicine of Rio Grande do Norte, Department of Biochemistry, Universidade Federal do Rio Grande do Norte, Natal, Rio de Grande do Norte, Brazil
| | - Josélio M G De Araújo
- Institute of Tropical Medicine of Rio Grande do Norte, Department of Biochemistry, Universidade Federal do Rio Grande do Norte, Natal, Rio de Grande do Norte, Brazil
| | | | - Rebeca C C Branco
- Department of Pathology, Federal University of Maranhão, São Luis, Maranhão, Brazil
| | - Nivia M R Arrais
- Department of Pediatrics, Federal University of Rio Grande do Norte, Empresa Brasileira de Servicos Hospitalares, Natal, Rio de Grande do Norte, Brazil
| | - Timo Lassmann
- Telethon Kids Institute, University of Western Australia, Perth Children's Hospital, Perth, Western Australia, Australia
| | - Jenefer M Blackwell
- Telethon Kids Institute, University of Western Australia, Perth Children's Hospital, Perth, Western Australia, Australia
| | - Selma M B Jeronimo
- Institute of Tropical Medicine of Rio Grande do Norte, Department of Biochemistry, Universidade Federal do Rio Grande do Norte, Natal, Rio de Grande do Norte, Brazil.,National Institute of Science and Technology of Tropical Diseases, Natal, Rio de Grande do Norte, Brazil
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Spatiotemporal Analysis of the Population Risk of Congenital Microcephaly in Pernambuco State, Brazil. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17030700. [PMID: 31973162 PMCID: PMC7037094 DOI: 10.3390/ijerph17030700] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/23/2019] [Revised: 01/10/2020] [Accepted: 01/15/2020] [Indexed: 11/17/2022]
Abstract
Since an outbreak in Brazil, which started in 2015, Zika has been recognized as an important cause of microcephaly. The highest burden of this outbreak was in northeast Brazil, including the state of Pernambuco. The prevalence of congenital microcephaly in Pernambuco state was estimated from the RESP (Registro de Eventos em Saúde Pública) surveillance system, from August 2015 to August 2016 inclusive. The denominators were estimated at the municipality level from official demographic data. Microcephaly was defined as a neonatal head circumference below the 3rd percentile of the Intergrowth standards. Smoothed maps of the prevalence of microcephaly were obtained from a Bayesian model which was conditional autoregressive (CAR) in space, and first order autoregressive in time. A total of 742 cases were identified. Additionally, high and early occurrences were identified in the Recife Metropolitan Region, on the coast, and in a north–south band about 300 km inland. Over a substantial part of the state, the overall prevalence, aggregating over the study period, was above 0.5%. The reasons for the high occurrence in the inland area remain unclear.
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