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Figueirôa BDQ, Lira PICD, Vanderlei LCDM, Vidal SA, Frias PGD. [Evaluation of the effectiveness of the intervention to improve the Brazilian Mortality Information System in Pernambuco, Brazil: a quasi-experimental study]. CAD SAUDE PUBLICA 2024; 40:e00077523. [PMID: 38198385 PMCID: PMC10775963 DOI: 10.1590/0102-311xpt077523] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Revised: 08/12/2023] [Accepted: 09/01/2023] [Indexed: 01/12/2024] Open
Abstract
This study evaluated the influence of the variation in the implementation of the Brazilian Mortality Information System (SIM) on the results, before and after the intervention to improve the system in Pernambuco, Brazil. The SIM logical model and matrix of indicators and assessment were described, primary data were collected from the 184 municipalities and secondary data were collected from the system database. The degree of implementation (DI) was obtained from the indicators of structure and process, and then related to result indicators, based on the model. The intervention was directed at the shortcomings identified, and developed using strategic stages. The percentage of annual variation of the DI and the results before and after the intervention were calculated. The SIM was classified as partially implemented in the pre- (70.6%) and post-intervention (73.1%) evaluations, with increments in all components. The Health Regions followed the same classification of the state level, except for XII (80.3%), regarding implemented score after the intervention. The coverage of the system; deaths with a defined underlying cause; monthly transfer; and timely submission of data were above 90% in both evaluations. There was an improvement in the completeness of infant Death Certificates and in the timely recording of notifiable events. Strengthening the management and operationalization of the SIM with interventions applied to data registration can improve the system's results.
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Affiliation(s)
- Barbara de Queiroz Figueirôa
- Programa de Pós-graduação em Saúde da Criança e do Adolescente, Universidade Federal de Pernambuco, Recife, Brasil
- Secretaria Estadual de Saúde de Pernambuco, Recife, Brasil
| | - Pedro Israel Cabral de Lira
- Programa de Pós-graduação em Saúde da Criança e do Adolescente, Universidade Federal de Pernambuco, Recife, Brasil
| | | | - Suely Arruda Vidal
- Programa de Pós-graduação em Avaliação em Saúde, Instituto de Medicina Integral Prof. Fernando Figueira, Recife, Brasil
| | - Paulo Germano de Frias
- Programa de Pós-graduação em Avaliação em Saúde, Instituto de Medicina Integral Prof. Fernando Figueira, Recife, Brasil
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2
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Orellana J, Jacques N, Leventhal DGP, Marrero L, Morón-Duarte LS. Excess maternal mortality in Brazil: Regional inequalities and trajectories during the COVID-19 epidemic. PLoS One 2022; 17:e0275333. [PMID: 36264994 PMCID: PMC9584504 DOI: 10.1371/journal.pone.0275333] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Accepted: 09/14/2022] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND The COVID-19 pandemic has exceeded 6 million known disease-related deaths and there is evidence of an increase in maternal deaths, especially in low- and middle-income countries. We aimed to estimate excess maternal deaths in Brazil and its macroregions as well as their trajectories in the first 15 months of the COVID-19 epidemic. METHODS This study evaluated maternal deaths from the Mortality Information System of the Ministry of Health, with excess deaths being assessed between March 2020 and May 2021 by quasi-Poisson generalized additive models adjusted for overdispersion. Observed deaths were compared to deaths expected without the pandemic, accompanied by 95% confidence intervals according to region, age group, and trimester of occurrence. Analyses were conducted in R version 3.6.1 and RStudio version 1.2.1335. RESULTS There were 3,291 notified maternal deaths during the study period, resulting in a 70% excess of deaths regardless of region, while in the North, Northeast, South and Southeast regions, excess deaths occurred regardless of age group. Excess deaths occurred in the March-May 2021 trimester regardless of region and age group. Excess deaths were observed in the Southeast region for the 25-36-year-old age group regardless of the trimester assessed, and in the North, Central-West and South regions, the only period in which excess deaths were not observed was September-November 2020. Excess deaths regardless of trimester were observed in the 37-49-year-old age group in the North region, and the South region displayed explosive behavior from March-May 2021, with a 375% excess of deaths. CONCLUSIONS Excess maternal deaths, with geographically heterogenous trajectories and consistently high patterns at the time of the epidemic's greatest impact, reflect not only the previous effect of socioeconomic inequalities and of limited access to maternal health services, but most of all the precarious management of Brazil's health crisis.
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Affiliation(s)
- Jesem Orellana
- Leônidas and Maria Deane Institute, Oswaldo Cruz Foundation, Manaus, Amazonas, Brazil
- * E-mail:
| | - Nadège Jacques
- Postgraduate Program in Epidemiology, Department of Social Medicine, Federal University of Pelotas, Pelotas, Rio Grande do Sul, Brazil
| | | | - Lihsieh Marrero
- Department of Nursing, Amazonas State University, Manaus, Amazonas, Brazil
| | - Lina Sofía Morón-Duarte
- Global Institute of Clinical Excellence, Keralty, Bogotá, Distrito Capital, Colombia
- Translational Research Group, Sanitas University Foundation, Bogotá, Distrito Capital, Colombia
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3
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Oliveira GMMD, Brant LCC, Polanczyk CA, Malta DC, Biolo A, Nascimento BR, Souza MDFMD, Lorenzo ARD, Fagundes AADP, Schaan BD, Castilho FMD, Cesena FHY, Soares GP, Xavier GF, Barreto JAS, Passaglia LG, Pinto MM, Machline-Carrion MJ, Bittencourt MS, Pontes OM, Villela PB, Teixeira RA, Sampaio RO, Gaziano TA, Perel P, Roth GA, Ribeiro ALP. Estatística Cardiovascular – Brasil 2021. Arq Bras Cardiol 2022; 118:115-373. [PMID: 35195219 PMCID: PMC8959063 DOI: 10.36660/abc.20211012] [Citation(s) in RCA: 57] [Impact Index Per Article: 28.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Accepted: 11/10/2021] [Indexed: 02/07/2023] Open
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4
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Teixeira RA, Ishitani LH, Marinho F, Pinto Junior EP, Katikireddi SV, Malta DC. Methodological proposal for the redistribution of deaths due to garbage codes in mortality estimates for Noncommunicable Chronic Diseases. REVISTA BRASILEIRA DE EPIDEMIOLOGIA 2021; 24:e210004. [PMID: 33886877 DOI: 10.1590/1980-549720210004.supl.1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Accepted: 12/10/2021] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE To propose a method for improving mortality estimates from noncommunicable diseases (NCD), including the redistribution of garbage codes in Brazilian municipalities. METHODS Brazilian Mortality Information System (MIS) was used as a data source to estimate age standardized mortality rates, before and after correction, for NCD (cardiovascular, chronic respiratory, diabetes, and neoplasms). The treatment for the correction of data addressed missing data, under-registration, and redistribution of garbage codes (GCs). Three-year periods 2010-2012 and 2015-2017, and the Bayesian method were used to estimate mortality rates, reducing the effect of fluctuation caused by small numbers at the municipal level. RESULTS GCs redistribution step showed greater weight in corrections, about 40% in 2000 and roughly 20% as from 2007, with stabilization starting in this year. Throughout the historical series, the quality of information on causes of death has improved in Brazil, with heterogeneous results being observed among municipalities. CONCLUSION Methodological studies that propose correction and improvement of the MIS are essential for monitoring mortality rates due to NCD at regional levels. The methodological proposal applied, for the first time in real data from Brazilian municipalities, is challenging and deserves further improvements. Improving the quality of the data is essential in order to build more accurate estimates based on the raw data from the SIM.
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Affiliation(s)
- Renato Azeredo Teixeira
- Postgraduate Program in Public Health, School of Medicine, Universidade Federal de Minas Gerais - Belo Horizonte (MG), Brazil
| | - Lenice Harumi Ishitani
- Research Group on Epidemiology and Health Evaluation, Universidade Federal de Minas Gerais - Belo Horizonte (MG), Brazil
| | - Fátima Marinho
- Institute of Advanced Studies, Universidade de São Paulo - São Paulo (SP), Brazil
| | | | | | - Deborah Carvalho Malta
- Postgraduate Program in Public Health, School of Medicine, Universidade Federal de Minas Gerais - Belo Horizonte (MG), Brazil
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5
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Teixeira RA, Ishitani LH, França E, Pinheiro PC, Lobato MM, Malta DC. Mortality due to garbage codes in Brazilian municipalities: differences in rate estimates by the direct and Bayesian methods from 2015 to 2017. REVISTA BRASILEIRA DE EPIDEMIOLOGIA 2021; 24:e210003. [PMID: 33886876 DOI: 10.1590/1980-549720210003.supl.1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Accepted: 11/30/2020] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVE To generate estimates of mortality rates due to garbage codes (GC) for Brazilian municipalities by comparing the direct and the Bayesian methods, based on deaths registered in the Mortality Information System (SIM) between 2015 and 2017. METHODS Data from the SIM were used. The analysis was performed in groups of GC levels 1 and 2, levels 3 and 4, and total GC. Mortality rates were estimated directly and also according to the Bayesian method by applying the Empirical Bayesian Estimator. RESULTS About 38% of GC were estimated and regional differences in mortality rates were observed, higher in the Northeast and Southeast and lower in the South and Midwest regions. The Southeast presented similar rates for the two analyzed groups of GC. The smallest differences between direct and Bayesian method estimates were observed in large cities with a population over 500 thousand inhabitants. Municipalities in the north of the state of Minas Gerais and those in the states of Rio de Janeiro, São Paulo, and Bahia presented high rates at levels 1 and 2. CONCLUSION There are differences in the quality of the definition of the underlying causes of death, even with the use of Bayesian methodology, which assists in smoothing the rates. The quality of the definition of causes of death is important, as they are associated with the access to and quality of healthcare services and support health planning.
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Affiliation(s)
- Renato Azeredo Teixeira
- Graduate Program in Public Health, School of Medicine, Universidade Federal de Minas Gerais - Belo Horizonte (MG), Brazil
| | - Lenice Harumi Ishitani
- Epidemiology and Health Assessment Research Group, Universidade Federal de Minas Gerais - Belo Horizonte (MG), Brazil
| | - Elisabeth França
- Graduate Program in Public Health, School of Medicine, Universidade Federal de Minas Gerais - Belo Horizonte (MG), Brazil
| | | | | | - Deborah Carvalho Malta
- Graduate Program in Public Health, School of Medicine, Universidade Federal de Minas Gerais - Belo Horizonte (MG), Brazil
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6
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Silva GAE, Jardim BC, Ferreira VDM, Junger WL, Girianelli VR. Cancer mortality in the Capitals and in the interior of Brazil: a four-decade analysis. Rev Saude Publica 2020; 54:126. [PMID: 33295593 PMCID: PMC7688260 DOI: 10.11606/s1518-8787.2020054002255] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2019] [Accepted: 03/17/2020] [Indexed: 12/29/2022] Open
Abstract
OBJECTIVE: to describe the trend of mortality from general cancer and more frequent types among men and women living in the Capitals and other municipalities of the five macro-regions of Brazil between 1978 and 2017. METHODS: Time series study with mortality data corrected by redistribution of ill-defined causes. Proportional cancer mortality was calculated for Brazil and regions. The annual percentage change in rates for total cancer and specific types in each segment and in the selected unit of analysis was calculated by generalized linear regression with Gaussian binding. RESULTS: the proportion of cancer increased progressively for both sexes from 1978 to 2017. Important differences between the Capitals and the interior of the macro-regions were seen with disaggregated data. The greatest declines occurred for stomach cancer, except in the northern and interior regions of the Northeast, and for the cervix cancer, with a generalized fall, with the exception of the interior of the northern region. Lung cancer decreased among men in the Southeast and South regions and had a generalized increase among women. Breast and prostate cancers tended to decrease in the Southeast and South regions and among residents of the Capitals but showing an increase in the interior of the North and Northeast regions. Colorectal cancer had a general tendency to increase; with stability among men in the Capitals of the South region and among women of the Southeast and Midwest regions and, since 2007, a decrease among women in the South region. CONCLUSIONS: Cancer mortality showed great variation among residents of capitals and the interior of the country's major regions. Clear decrease in mortality was seen for the main types in the Southeast and South regions. The North and Northeast regions have patterns compatible with cancers associated with poverty, while the large increase of the cancers related to sedentary lifestyle stand out.
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Affiliation(s)
- Gulnar Azevedo E Silva
- Universidade do Estado do Rio de Janeiro. Instituto de Medicina Social. Departamento de Epidemiologia. Rio de Janeiro, RJ, Brasil
| | - Beatriz Cordeiro Jardim
- Universidade do Estado do Rio de Janeiro. Instituto de Medicina Social. Departamento de Epidemiologia. Rio de Janeiro, RJ, Brasil.,Instituto Nacional de Câncer José Alencar Gomes da Silva. Rio de Janeiro, RJ, Brasil
| | - Vanessa de Melo Ferreira
- Universidade do Estado do Rio de Janeiro. Instituto de Medicina Social. Departamento de Epidemiologia. Rio de Janeiro, RJ, Brasil
| | - Washington Leite Junger
- Universidade do Estado do Rio de Janeiro. Instituto de Medicina Social. Departamento de Epidemiologia. Rio de Janeiro, RJ, Brasil
| | - Vania Reis Girianelli
- Fundação Oswaldo Cruz. Escola Nacional de Saúde Pública Sérgio Arouca. Rio de Janeiro, RJ, Brasil
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7
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Inequalities in infant mortality in Brazil at subnational levels in Brazil, 1990 to 2015. Popul Health Metr 2020; 18:4. [PMID: 32993802 PMCID: PMC7526088 DOI: 10.1186/s12963-020-00208-1] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Accepted: 06/19/2020] [Indexed: 01/13/2023] Open
Abstract
Background In this study, infant mortality rate (IMR) inequalities are analyzed from 1990 to 2015 in different geographic scales. Methods The Ministry of Health (MoH) IMR estimates by Federative Units (FU) were compared to those obtained by the Global Burden of Disease (GBD) group. In order to measure the inequalities of the IMR by FU, the ratios from highest to lowest from 1990 to 2015 were calculated. Maps were elaborated in 2000, 2010, and 2015 at the municipality level. To analyze the effect of income, IMR inequalities by GDP per capita were analyzed, comparing Brazil and the FU to other same-income level countries in 2015, and the IMR municipal estimates were analyzed by income deciles, in 2000 and 2010. Results IMR decreased from 47.1 to 13.4 per 1000 live births (LB) from 1990 to 2015, with an annual decrease rate of 4.9%. The decline was less pronounced for the early neonatal annual rate (3.5%). The Northeast region showed the most significant annual decline (6.2%). The IMR estimates carried out by the GBD were about 20% higher than those obtained by the MoH, but in terms of their inequalities, the ratio from the highest to the lowest IMR among the 27 FU decreased from 4 to 2, for both methods. The percentage of municipalities with IMR higher than 40 per 1000 LB decreased from 23% to 2%, between 2000 and 2015. Comparing the IMR distribution by income deciles, all inequality measures of the IMR decreased markedly from 2000 to 2010. Conclusion The results showed a marked decrease in the IMR inequalities in Brazil, regardless of the geographic breakdown and the calculation method. Despite clear signs of progress in curbing infant mortality, there are still challenges in reducing its level, such as the concentration of deaths in the early neonatal period, and the specific increases of post neonatal mortality in 2016, after the recent cuts in social investments.
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8
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de Oliveira GMM, Brant LCC, Polanczyk CA, Biolo A, Nascimento BR, Malta DC, de Souza MDFM, Soares GP, Xavier GF, Machline-Carrion MJ, Bittencourt MS, Pontes OM, Silvestre OM, Teixeira RA, Sampaio RO, Gaziano TA, Roth GA, Ribeiro ALP. Cardiovascular Statistics - Brazil 2020. Arq Bras Cardiol 2020; 115:308-439. [PMID: 33027364 PMCID: PMC9363085 DOI: 10.36660/abc.20200812] [Citation(s) in RCA: 83] [Impact Index Per Article: 20.8] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2020] [Revised: 09/09/2020] [Accepted: 09/09/2020] [Indexed: 02/06/2023] Open
Affiliation(s)
- Gláucia Maria Moraes de Oliveira
- Instituto do Coração Edson SaadUniversidade Federal do Rio de JaneiroRio de JaneiroRJBrasil Instituto do Coração Edson Saad
da
Universidade Federal do Rio de Janeiro
(UFRJ),
Rio de Janeiro
,
RJ
–
Brasil
- Departamento de Clínica MédicaFaculdade de MedicinaUniversidade Federal do Rio de JaneiroRio de JaneiroRJBrasil Disciplina de Cardiologia,
Departamento de Clínica Médica
da
Faculdade de Medicina
da
Universidade Federal do Rio de Janeiro
(UFRJ),
Rio de Janeiro
,
RJ
–
Brasil
| | - Luisa Campos Caldeira Brant
- Departamento de Clínica MédicaFaculdade de MedicinaUniversidade Federal de Minas GeraisBelo HorizonteMGBrasil Departamento de Clínica Médica
da
Faculdade de Medicina
da
Universidade Federal de Minas Gerais
(UFMG),
Belo Horizonte
,
MG
–
Brasil
- Centro de TelessaúdeHospital das ClínicasUniversidade Federal de Minas GeraisBelo HorizonteMGBrasil Serviço de Cardiologia e Cirurgia Cardiovascular e
Centro de Telessaúde
do
Hospital das Clínicas
da
Universidade Federal de Minas Gerais
(UFMG),
Belo Horizonte
,
MG
–
Brasil
| | - Carisi Anne Polanczyk
- Faculdade de MedicinaUniversidade Federal do Rio Grande do SulPorto AlegreRSBrasil Faculdade de Medicina
da
Universidade Federal do Rio Grande do Sul
(UFRS),
Porto Alegre
,
RS
–
Brasil
- Serviço de CardiologiaHospital Moinhos de VentoPorto AlegreRSBrasil Serviço de Cardiologia
do
Hospital Moinhos de Vento
,
Porto Alegre
,
RS
–
Brasil
- Hospital de Clínicas de Porto AlegrePorto AlegreRSBrasil Hospital de Clínicas de Porto Alegre
(HCPA),
Porto Alegre
,
RS
–
Brasil
| | - Andreia Biolo
- Faculdade de MedicinaUniversidade Federal do Rio Grande do SulPorto AlegreRSBrasil Faculdade de Medicina
da
Universidade Federal do Rio Grande do Sul
(UFRS),
Porto Alegre
,
RS
–
Brasil
- Serviço de CardiologiaHospital Moinhos de VentoPorto AlegreRSBrasil Serviço de Cardiologia
do
Hospital Moinhos de Vento
,
Porto Alegre
,
RS
–
Brasil
- Hospital de Clínicas de Porto AlegrePorto AlegreRSBrasil Hospital de Clínicas de Porto Alegre
(HCPA),
Porto Alegre
,
RS
–
Brasil
| | - Bruno Ramos Nascimento
- Departamento de Clínica MédicaFaculdade de MedicinaUniversidade Federal de Minas GeraisBelo HorizonteMGBrasil Departamento de Clínica Médica
da
Faculdade de Medicina
da
Universidade Federal de Minas Gerais
(UFMG),
Belo Horizonte
,
MG
–
Brasil
- Centro de TelessaúdeHospital das ClínicasUniversidade Federal de Minas GeraisBelo HorizonteMGBrasil Serviço de Cardiologia e Cirurgia Cardiovascular e
Centro de Telessaúde
do
Hospital das Clínicas
da
Universidade Federal de Minas Gerais
(UFMG),
Belo Horizonte
,
MG
–
Brasil
| | - Deborah Carvalho Malta
- Programa de Pós-Graduação em Saúde PúblicaUniversidade Federal de Minas GeraisBelo HorizonteMGBrasil Programa de Pós-Graduação em Saúde Pública
da
Universidade Federal de Minas Gerais
(UFMG),
Belo Horizonte
,
MG
–
Brasil
| | - Maria de Fatima Marinho de Souza
- Programa de Pós-Graduação em Saúde PúblicaUniversidade Federal de Minas GeraisBelo HorizonteMGBrasil Programa de Pós-Graduação em Saúde Pública
da
Universidade Federal de Minas Gerais
(UFMG),
Belo Horizonte
,
MG
–
Brasil
- Organização Vital StrategiesNova YorkEUA Organização Vital Strategies
,
Nova York
–
EUA
| | - Gabriel Porto Soares
- Instituto do Coração Edson SaadUniversidade Federal do Rio de JaneiroRio de JaneiroRJBrasil Instituto do Coração Edson Saad
da
Universidade Federal do Rio de Janeiro
(UFRJ),
Rio de Janeiro
,
RJ
–
Brasil
- Universidade de VassourasVassourasRJBrasil Curso de Medicina da
Universidade de Vassouras
,
Vassouras
,
RJ
–
Brasil
| | - Gesner Francisco Xavier
- Faculdade de MedicinaUniversidade Federal de Minas GeraisBelo HorizonteMGBrasil Biblioteca da
Faculdade de Medicina
Universidade Federal de Minas Gerais
(UFMG),
Belo Horizonte
,
MG
–
Brasil
| | - M. Julia Machline-Carrion
- ePHealth Primary Care SolutionsSanto Antônio SCBrasil ePHealth Primary Care Solutions
,
Santo Antônio
,
SC
–
Brasil
| | - Marcio Sommer Bittencourt
- Divisão de Clínica MédicaHospital UniversitárioUniversidade de São PauloSão PauloSPBrasil Divisão de Clínica Médica
do
Hospital Universitário
da
Universidade de São Paulo
,
São Paulo
,
SP
–
Brasil
- Faculdade Israelita de Ciências da Saúde Albert Einstein São PauloSPBrasil Faculdade Israelita de Ciências da Saúde Albert Einstein
,
São Paulo
,
SP
–
Brasil
| | - Octavio M. Pontes
- Departamento de Neurociências e Ciências do Comportamento Faculdade de Medicina de Ribeirão PretoUniversidade de São PauloSão PauloSPBrasil Serviço de Neurologia Vascular e Emergências Neurológicas, Divisão de Neurologia,
Departamento de Neurociências e Ciências do Comportamento
,
Faculdade de Medicina de Ribeirão Preto
da
Universidade de São Paulo
(USP),
São Paulo
,
SP
–
Brasil
| | - Odilson Marcos Silvestre
- Universidade Federal do AcreRio BrancoACBrasil Universidade Federal do Acre
(UFAC),
Rio Branco
,
AC
–
Brasil
| | - Renato Azeredo Teixeira
- Programa de Pós-Graduação em Saúde PúblicaUniversidade Federal de Minas GeraisBelo HorizonteMGBrasil Programa de Pós-Graduação em Saúde Pública
da
Universidade Federal de Minas Gerais
(UFMG),
Belo Horizonte
,
MG
–
Brasil
| | - Roney Orismar Sampaio
- Departamento de CardiopneumologiaFaculdade de MedicinaUniversidade de São PauloSão PauloSPBrasil Departamento de Cardiopneumologia
da
Faculdade de Medicina
da
Universidade de São Paulo
(USP),
São Paulo
,
SP
–
Brasil
- Programa de Pós-GraduaçãoFaculdade de MedicinaUniversidade de São PauloSão PauloSPBrasil Programa de Pós-Graduação
da
Faculdade de Medicina
da
Universidade de São Paulo
(USP),
São Paulo
,
SP
–
Brasil
- Hospital das ClínicasFaculdade de MedicinaUniversidade de São PauloSão PauloSPBrasil Unidade Clínica de Cardiopatias Valvares do Instituto do Coração (Incor) do
Hospital das Clínicas
da
Faculdade de Medicina
da
Universidade de São Paulo
(HCFMUSP),
São Paulo
,
SP
–
Brasil
| | - Thomaz A. Gaziano
- Brigham and Women’s HospitalBostonEUA Brigham and Women’s Hospital
,
Boston
–
EUA
- Department of MedicineHarvard Medical SchoolBostonEUA Department of Medicine
, Cardiovascular,
Harvard Medical School
,
Boston
–
EUA
| | - Gregory A. Roth
- Global Health and Health Metrics SciencesInstitute for Health Metrics and EvaluationWashingtonEUA Global Health and Health Metrics Sciences
at the
Institute for Health Metrics and Evaluation
(IHME),
Washington
–
EUA
- Division of CardiologyUniversity of WashingtonSchool of MedicineWashingtonEUA Division of Cardiology
at the
University of Washington
School of Medicine
,
Washington
–
EUA
| | - Antonio Luiz Pinho Ribeiro
- Departamento de Clínica MédicaFaculdade de MedicinaUniversidade Federal de Minas GeraisBelo HorizonteMGBrasil Departamento de Clínica Médica
da
Faculdade de Medicina
da
Universidade Federal de Minas Gerais
(UFMG),
Belo Horizonte
,
MG
–
Brasil
- Centro de TelessaúdeHospital das ClínicasUniversidade Federal de Minas GeraisBelo HorizonteMGBrasil Serviço de Cardiologia e Cirurgia Cardiovascular e
Centro de Telessaúde
do
Hospital das Clínicas
da
Universidade Federal de Minas Gerais
(UFMG),
Belo Horizonte
,
MG
–
Brasil
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9
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Malta DC, Teixeira R, Oliveira GMMD, Ribeiro ALP. Cardiovascular Disease Mortality According to the Brazilian Information System on Mortality and the Global Burden of Disease Study Estimates in Brazil, 2000-2017. Arq Bras Cardiol 2020; 115:152-160. [PMID: 32696855 PMCID: PMC8384283 DOI: 10.36660/abc.20190867] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2019] [Revised: 02/21/2020] [Accepted: 03/16/2020] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND The Brazilian Information System on Mortality (SIM) is of vital importance in monitoring the trends of cardiovascular diseases (CVDs) and is aimed at supporting public policies. OBJECTIVE To compare historical series of CVD mortality based on data from the SIM, with and without correction, and from the Brazil Global Burden of Disease (GBD) Study 2017, in the 2000-2017 period. METHODS Analysis of CVD mortality in Brazil between 2000 and 2017. Three CVD mortality estimates were compared: Crude SIM, Corrected SIM, and GBD 2017. Absolute numbers and age-standardized rates were used to compare the estimates for Brazil, its states and the Federal District. RESULTS In the SIM, the total of deaths ranged from 261,000, in 2000, to 359,000, in 2017. In the GBD 2017, the total of deaths ranged from 292,000 to 388,000, for the same years, respectively. A high proportion of the causes of death from CVD corresponded to garbage codes, classified according to the GBD 2017, reaching 42% in 2017. The rates estimated by GBD ranged from 248.8 (1990) to 178.0 (2017) deaths per 100,000 inhabitants. The rates of the Crude SIM and Corrected SIM also showed a reduction for the whole series analyzed, the Crude SIM showing lower rates: 204.9 (1990) and 155.1 (2017) deaths per 100 thousand inhabitants. When analyzing by the states and Federal District, the Crude SIM trends reversed, with an increase in mortality rates in the Northern and Northeastern states. CONCLUSION This study shows the decrease in CVD mortality rates in Brazil in the period analyzed. Conversely, when analyzing by the states and Federal District, the Crude SIM showed an increase in those rates for the Northern and Northeastern states. The use of crude data from the SIM can result in interpretation errors, indicating an increase in rates, due to the increase in death data capture and the improvement in the definition of the underlying causes of death in the past decade, especially in the Northern and Northeastern regions, justifying the use of corrected data in mortality analyses. (Arq Bras Cardiol. 2020; 115(2):152-160).
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Affiliation(s)
- Deborah Carvalho Malta
- Universidade Federal de Minas Gerais - Escola de Enfermagem, Programa de Pós-Graduação em Saúde Pública.,Belo Horizonte, MG - Brasil
| | - Renato Teixeira
- Universidade Federal de Minas Gerais Programa de Pós-Graduação em Saúde Pública, Faculdade de Medicina,Belo Horizonte, MG - Brasil
| | | | - Antonio Luiz Pinho Ribeiro
- Universidade Federal de Minas Gerais - Centro de Telessaúde - Hospital das Clínicas/Departamento de Clínica Médica - Faculdade de Medicina, UFMG,Belo Horizonte, MG - Brasil
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10
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Soares Filho AM, Vasconcelos CH, Nóbrega AAD, Pinto IV, Merchan-Hamann E, Ishitani LH, França EB. Improvement of the unspecified external causes classification based on the investigation of death in Brazil in 2017. REVISTA BRASILEIRA DE EPIDEMIOLOGIA 2019; 22Suppl 3:e190011.supl.3. [PMID: 31800850 DOI: 10.1590/1980-549720190011.supl.3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2019] [Accepted: 07/26/2019] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND Unspecified causes of death are among the traditional indicators of quality of information. OBJECTIVE To verify the performance of the 60 cities in the Data for Health Initiative project and to analyze the reclassification of unspecified external causes of death (UEC). METHODS Using the 2017 records from the Mortality Information System, the proportion and percent change in UEC were compared after investigation between project cities and other cities, and the percent of reclassification to specific external causes was calculated. RESULTS The project cities comprised 52% (n = 11,759) of the total UEC in Brazil, of which 64.5% were reclassified after investigation, whereas the other cities reclassified 31% of UEC. Results were similar for men, youth, blacks, metropolitan cities, the Southeast region, and deaths attested by forensic institutes. In the project cities, pedestrian traffic accidents were external causes with greater reclassification. In men, the UEC was reclassified to homicides (23.8%) and accident of terrestrial transportation (ATT) (11.1%), with motorcyclists (4.4%) and pedestrians (4.3%) being the most prominent. In women, these causes were changed to other accident causes (20.8%), ATT (10.6%) and homicides (7.9%). UEC changed to ATT (18.3%) in the age groups of 0-14 years old and to homicides (32.5%) in the age groups of 15-44 years. CONCLUSION The project cities obtained better results after investigation of UEC, enabling analysis of the reclassification to specific causes by sex and age groups.
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Affiliation(s)
- Adauto Martins Soares Filho
- Grupo de Pesquisa em Epidemiologia e Avaliação de Serviços, Universidade Federal de Minas Gerais, Belo Horizonte (MG), Brasil
| | | | | | | | - Edgar Merchan-Hamann
- Programa de Pós-Graduação em Saúde Coletiva, Universidade de Brasília, Brasília (DF), Brasil
| | - Lenice Harumi Ishitani
- Grupo de Pesquisa em Epidemiologia e Avaliação de Serviços, Universidade Federal de Minas Gerais, Belo Horizonte (MG), Brasil
| | - Elisabeth Barboza França
- Programa de Pós-Graduação em Saúde Pública, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte (MG) - Brasil
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11
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Vidor AC, Conceição MBM, Luhm KR, Alves MDFT, Arceno A, França EB, Abreu DMXD. Quality of data on causes of death in southern Brazil: the importance of garbage causes. REVISTA BRASILEIRA DE EPIDEMIOLOGIA 2019; 22Suppl 3:e19003.supl.3. [PMID: 31800855 DOI: 10.1590/1980-549720190003.supl.3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2019] [Accepted: 08/02/2019] [Indexed: 11/22/2022] Open
Abstract
INTRODUCTION The study objective was to analyze the quality of data on causes of death in southern Brazil. METHODS Mortality Information System (SIM - Sistema de Informações sobre Mortalidade) data were used to evaluate the occurrence of Garbage Causes (GC) in death certificates (DCs) of residents of South states and their capitals between 2015 and 2016. The GC of each state were compared to the other states and grouped by severity level (N1 to N4, according to decreasing potential impact on mortality profile). We evaluated the N1 and N2 GC in the 0-74 years, in accordance with local of occurrence and attesting professional. RESULTS The occurrence of GC ranged from 29 to 31% among the three states, below the national average (34%). The GC of levels N1 and N2 were similar between states and heterogeneous between capitals. Most deaths were in-hospital, between 55%-64% of N1 and N2 GC occurred in the states and 39%-55% in the capitals. As for home deaths, this number ranged between 25%-31% and 25%-40%, respectively. More than 30% of the attesting professionals (except in Florianópolis) were declared as "others" in the corresponding DC field. Physicians from the Forensic Medical Institute (IML) and Death Verification Service (SVO) attested 15 to 24% of N1 and N2 GC in the states and 33 to 66% in the state capitals. CONCLUSION The improvement of mortality data should involve strategies aimed at hospital physicians, in accordance with the volume of deaths and the IML and SVO services in addition to support for the emission of home DC, due to the importance in generating more severe GC.
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Affiliation(s)
- Ana Cristina Vidor
- Secretaria Municipal de Saúde de Florianópolis - Florianópolis (SC), Brasil
| | | | - Karin Regina Luhm
- Departamento de Saúde Coletiva, Universidade Federal do Paraná - Curitiba (PR), Brasil
| | | | - Aline Arceno
- Secretaria de Estado da Saúde de Santa Catarina - Florianópolis (SC), Brasil
| | - Elisabeth Barboza França
- Programa de Pós-Graduação de Saúde Pública, Faculdade de Medicina, Universidade Federal de Minas Gerais - Belo Horizonte (MG), Brasil
| | - Daisy Maria Xavier de Abreu
- Núcleo de Educação em Saúde Coletiva, Faculdade de Medicina, Universidade Federal de Minas Gerais - Belo Horizonte (MG), Brasil
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12
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Souza MLPD. [Mortality from suicide in indigenous children in Brazil]. CAD SAUDE PUBLICA 2019; 35Suppl 3:e00019219. [PMID: 31433029 DOI: 10.1590/0102-311x00019219] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2019] [Accepted: 04/17/2019] [Indexed: 11/22/2022] Open
Abstract
This study aimed to describe the characteristics, distribution, and mortality rates from suicide in indigenous children in Brazil compared to non-indigenous children. This descriptive study covered the years from 2010 to 2014, using national databases. The study collected deaths in individuals 10 to 14 years of age whose underlying cause was "inentional self-inflicted injury". Hanging was the most frequently used means in both indigenous and non-indigenous children, although it was more frequent in the former. Among indigenous children, suicides in hospitals or other healthcare establishments were less common than in non-indigenous. Approximately three-fourths of suicides in indigenous children occurred in just 17 municipalities. The mortality rate from suicide among indigenous children was 11.0/100,000 (8.4-14.3), or 18.5 times higher (10.9-31.6) than in non-indigenous, which was 0.6/100,000 (0.5-0.6), with no differences between boys and girls. This study showed for the first time on a national scale the specific characteristics of suicide in indigenous children, with high rates, and also identified priority areas for interventions.
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13
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Varela AR, Schneider BC, Bubach S, Silveira MF, Bertoldi AD, Duarte LSM, Menezes AMB, Domingues MR, Bassani DG. Fetal, neonatal, and post-neonatal mortality in the 2015 Pelotas (Brazil) birth cohort and associated factors. CAD SAUDE PUBLICA 2019; 35:e00072918. [PMID: 31411283 DOI: 10.1590/0102-311x00072918] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2018] [Accepted: 02/06/2019] [Indexed: 11/22/2022] Open
Abstract
This study aimed to describe fetal, neonatal, and post-neonatal mortality and associated factors in participants of the 2015 Pelotas (Brazil) birth cohort. The child mortality sub-study followed up all deaths in the first year of life. Data were collected on intrauterine fetal deaths (weight ≥ 500g and/or gestational age ≥ 20 weeks), neonatal deaths (< 28 days of life), and post-neonatal deaths (from 28 days to the end of the first year of life). Descriptive analyses using the Pearson chi-square test and a multinomial logistic regression to estimate the risk of fetal, neonatal, and post-neonatal deaths compared to live infants in the cohort (reference group) were performed. Data from 4,329 eligible births were collected, of which 54 died during the fetal period. Of the 4,275 eligible live births, 59 died in the first year of life. An association between fetal, neonatal, and post-neonatal deaths (OR = 15.60, 7.63, and 5.51 respectively) was found, as well as less than six prenatal consultations. Compared to live infants, fetal deaths were more likely to occur in non-white mothers, and neonatal deaths were 14.09 times more likely to occur in a preterm gestational age (< 37 weeks). Compared to live infants, infants that were born in a C-section delivery had 3.71 increased odds of post-neonatal death. Additionally, neonatal deaths were 102.37 times more likely to have a low Apgar score on the fifth minute after birth. These findings show the need for early interventions during pregnancy, ensuring access to adequate prenatal care.
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Affiliation(s)
- Andrea Ramirez Varela
- Programa de Pós-graduação em Epidemiologia, Universidade Federal de Pelotas, Pelotas, Brasil
| | | | - Susana Bubach
- Programa de Pós-graduação em Epidemiologia, Universidade Federal de Pelotas, Pelotas, Brasil.,Universidade Federal do Espírito Santo, São Matheus, Brasil
| | | | - Andréa Dâmaso Bertoldi
- Programa de Pós-graduação em Epidemiologia, Universidade Federal de Pelotas, Pelotas, Brasil
| | - Lina Sofia Moron Duarte
- Programa de Pós-graduação em Epidemiologia, Universidade Federal de Pelotas, Pelotas, Brasil
| | - Ana Maria B Menezes
- Programa de Pós-graduação em Epidemiologia, Universidade Federal de Pelotas, Pelotas, Brasil
| | - Marlos R Domingues
- Programa de Pós-graduação em Epidemiologia, Universidade Federal de Pelotas, Pelotas, Brasil
| | - Diego G Bassani
- Programa de Pós-graduação em Epidemiologia, Universidade Federal de Pelotas, Pelotas, Brasil
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