Post-COVID-19 syndrome among hospitalized COVID-19 patients: a cohort study assessing patients 6 and 12 months after hospital discharge

Post-COVID-19 syndrome involves a variety of symptoms that last more than 12 weeks after COVID diagnosis. This study aimed to analyze post-COVID-19 syndrome among hospitalized COVID-19 patients 6 and 12 months after hospital discharge. This is an ambidirectional cohort study conducted with individuals who were discharged from three main hospitals in the capital of Mato Grosso State, Brazil, between October and December 2021 and January and March 2022. After data collection from medical records, the individuals were interviewed by telephone 6 and 12 months after hospital discharge, when they were asked about the presence of ongoing or new symptoms and when symptom frequency was evaluated according to sociodemographic and economic characteristics hospitalization, and health conditions. Of all 277 medical records evaluated, 259 patients were eligible to participate in the study, 190 patients six months after discharge and 160 patients 12 months after hospital discharge. At six months, 59% were female patients, 40% were aged 60 years or older, and 87.4% reported at least one symptom. At 12 months, 58.7% were female patients, 37.5% were aged 30 to 49 years, and 67.5% reported at least one symptom. Fatigue was the most common symptom 6 and 12 months after hospital discharge (55.3% and 40.6%, respectively), followed by memory problems (36.8%; 20%), and hair loss (26.8%; 11.2%). The prevalence of post-COVID-19 syndrome was higher among patients of older age, lower income, with hypertension, diabetes, and more severe infection during hospitalization. The risk factors for post-COVID-19 syndrome help understand the long-term effects and the importance of monitoring after the acute phase of the disease.

Physical activity of adolescents and the urban environment of Brazilian capitals: National School Health Survey, 2015

This study aimed to evaluate the practice of physical activity (PA) among adolescents and its association with characteristics of the urban environment of Brazilian capitals. Study with adolescents from the 26 Brazilian capitals and the Federal District participating in the National School Health Survey, 2015 edition. The association between regular practice of PA (≥300 minutes/week) and the dimensions of urban well-being (urban mobility, urban environmental conditions, urban housing conditions, urban collective services, and urban infrastructure) was examined using multilevel logistic regression. A total of 50,904 adolescents were evaluated, among which 20.7% were active. It was observed in the multiple model that adolescents who live in capitals with better urban environmental conditions, such as the presence of tree coverage, less open sewage, and less accumulated garbage around the houses, are more likely to be active (OR = 1.06; 95% CI:1.01;1.12). Adolescents who live in cities with less urban disorder are more likely to be active.

Association of household composition with dietary patterns among adolescents in Brazil

The present study identified dietary patterns (DP) and analyse their association with household composition. This is a cross-sectional school-based study, with a nationally representative sample of Brazilian adolescent students, aged 11-19 years, with data from National School Health Survey (n 102 072). Food consumption was obtained through the weekly frequency of consumption of food markers, and the confirmatory factor analysis was applied to examine the latent variables 'Healthy' (beans, legumes/vegetables and fresh fruit/fruit salad) and 'Unhealthy' (ultra-processed foods, sweets, soft drinks and snacks) DP. The association between household composition and DP was estimated considering lives with both parents as reference category. Among adolescents aged 11-14 years, adherence to healthy DP was lower for boys who lived only with mother (β = -2·1), and boys (β = -4·9) and girls (β = -4·5) who lived without any parents. Adherence to unhealthy DP was higher among boys (β = 7·6) and girls (β = 6·0) who lived only with mother, and boys (β = 4·6) and girls (β = 5·3) who lived only with father. For older adolescents (aged 15-19 years), adherence to the unhealthy DP was higher among boys who lived only with mother (β = 3·9) or only with father (β = 5·3) and girls who lived only with mother (β = 6·3). Adherence to healthy DP was lower among girls who lived only with father (β = -9·0). Thus, adolescents who lived in single-parent households had lower adherence to healthy DP and greater adherence to unhealthy DP. Among younger adolescents of both sexes, living without any parent contributed to lower adherence to healthy DP.

Adherence to school meals and co-occurrence of the healthy and unhealthy food markers among Brazilian adolescents

The aim of this study was to analyze the association between adherence to school meals and the co-occurrence of the regular consumption of healthy and unhealthy eating markers among Brazilian adolescents. Data from 67,881 adolescents in Brazilian public schools who participated in the 2015 National School Health Survey, were used. From the 7-day FFQ, the dependent variable was constructed, co-occurrence of regular consumption (≥ 5x/week) of healthy and unhealthy food markers, which was categorized as regular consumption of none, one or two, or three eating markers. We performed an ordinal logistic regression with adjustment for sociodemographic, eating habits outside of school, and school characteristics variables. The prevalence of the co-occurrence of the regular consumption of three healthy eating markers was 14.5%, and that of three unhealthy markers was 4.9%. High adherence to school meals (every day) was positively associated with regular consumption of healthy eating markers and inversely associated with regular consumption of unhealthy eating markers. The school meals provided by PNAE contribute to the promotion of healthy eating habits among Brazilian adolescents.

Effect of the dietary inflammatory potential on the trajectory of body adiposity in a Brazilian cohort of university students

OBJECTIVES

University students are vulnerable to unhealthy eating habits that characterize a proinflammatory diet. This study aimed to estimate the dietary inflammatory index (DII) and its association with the trajectory of body adiposity markers in university students.

METHODS

The study analyzed data from 685 students entering a Brazilian public university in 2016 and 2017 and followed until 2018. DII was estimated from 39 dietary parameters obtained by 24-h dietary recall. Body adiposity was assessed by anthropometric markers and the percentage of body fat. Linear mixed-effects models were used to estimate the trajectory of adiposity markers according to DII tertiles.

RESULTS

After adjustment for confounding variables, at baseline, DII showed a positive association with increased percentage of body fat among men (β = 0.52; 95% CI: 0.01; 1.03) and waist-to-height ratio (WHtR; β = 0.15; 95% CI: 0.12; 0.18) and among women with all body adiposity markers: BMI (β = 0.68; 95% CI: 0.30; 1.05), percentage of body fat (β = 1.43; 95% CI: 0.74; 2.11), WC (β = 1.15; 95% CI: 0.41; 1.89) and WHtR (β = 0.13; 95% CI:0,10; 0.16). The rate of change of the outcome variables over time was not associated with DII at baseline.

CONCLUSIONS

The diet of university students in this Brazilian cohort study was characterized as proinflammatory and it was associated with body adiposity markers.

Food Insecurity Among Haitian Migrants Living In Brazil

OBJECTIVE

To analyze the situation of food insecurity among Haitians living in Midwest of Brazil, based on questions of the Brazilian Scale of Food Insecurity (BSFI).

METHODS

A survey was carried out with a probabilistic sampling proportional to sex of Haitians aged over 18 years who lived in Cuiabá and Várzea Grande, Mato Grosso. Haitian migrants were interviewed by bilingual (Haitian Creole/Portuguese) individuals, and for the analysis of the BSFI questions. Because the BSFI is not validated for Haitians, the first eight questions of the scale were assessed separately, according to sex, debts incurred for the migration project and time of residence in Brazil. Chi-square was calculated to test the differences between groups.

RESULTS

A total of 404 Haitians were evaluated, 81.9% male individuals, 60.9% aged between 18 and 36 years. Among the respondents, 64.4% were worried about running out of food before having money to buy more food, and 62.6% answered that they ran out of food before having money to buy it. Higher proportions of positive answers were observed for women and those who reported having debts to finance the migration costs to Brazil.

CONCLUSION

The high proportion of positive answers to the BSFS questions by Haitians seems to indicate a situation of social vulnerability and food insecurity, especially among Haitian women, as well as among those who had debts to migrate to Brazil and those who have lived in the country for more than a year.

Deaths from post-COVID conditions in Brazil

This paper aims to assess the magnitude and profile of deaths from post-COVID conditions in Brazil. Descriptive study based on preliminary data from the 2021 Mortality Information System. Records with ICD code B94.8 as the Basic Cause and with code U09 in some lines of part I or II of the declaration were considered for analysis. The distribution of deaths by geographic region, semester of occurrence, sex, age group, ethnicity/skin color, schooling, and place of occurrence was evaluated. We identified 2,948 deaths from conditions subsequent to COVID-19 were recorded, ranging from 0.5 deaths per 1,000 records in the Northeast Region to 3.6/1,000 in the Midwest Region. More than half occurred among males (58.0%), those aged 60 years or older (66.9%), and whites (51.8%). Conclusion: Deaths from post-COVID conditions had distinct sociodemographic characteristics between regions.

Deaths from post-COVID conditions in Brazil

Abstract This paper aims to assess the magnitude and profile of deaths from post-COVID conditions in Brazil. Descriptive study based on preliminary data from the 2021 Mortality Information System. Records with ICD code B94.8 as the Basic Cause and with code U09 in some lines of part I or II of the declaration were considered for analysis. The distribution of deaths by geographic region, semester of occurrence, sex, age group, ethnicity/skin color, schooling, and place of occurrence was evaluated. We identified 2,948 deaths from conditions subsequent to COVID-19 were recorded, ranging from 0.5 deaths per 1,000 records in the Northeast Region to 3.6/1,000 in the Midwest Region. More than half occurred among males (58.0%), those aged 60 years or older (66.9%), and whites (51.8%). Conclusion: Deaths from post-COVID conditions had distinct sociodemographic characteristics between regions.

Prevalence of Ivermectin use to prevent COVID-19 during the pandemic in Mato Grosso: cross-sectional home-based study

OBJECTIVE

To analyze the use of ivermectin as COVID-19 prevention method by the population of Mato Grosso in 2020.

METHODS

This is a home-based survey, carried out between September and October 2020, in 10 pole cities of the socioeconomic regions of State. The use of ivermectin was evaluated through the question: "Did you take ivermectin to prevent COVID-19?". Sociodemographic variables (sex, age group, education, family income), current work situation, being benefitted by government financial programs, as well as symptoms, seroprevalence of antibodies against SARS-CoV-2, and previous diagnosis of COVID-19 were evaluated. Prevalence and their associations were estimated using the chi-square test.

RESULTS

4.206 individuals were evaluated for prevalence of ivermectin use; 58.3% of the individuals responded positively, this rate being higher in the municipalities of the western region of the state (66.6%). There was no significant difference between sexes, but the prevalence was higher among people aged 50-59 years (69.7%), who were white (66.5%), with complete higher education or more (68.8%) and higher family income (≥3 minimum wages-64.2%). The use of this drug was even higher among participants who considered their knowledge of the disease good or very good (65.0%), who reported having symptoms of COVID-19 (75.3%), and who had been previously diagnosed with the disease (91.2%).

CONCLUSION

There was a high prevalence of use of ivermectin as a method to prevent covid-19 by the population of Mato Grosso, indicating the need for strategies to inform the population about the risks of off-label use of drugs and to combat the advertising of drugs that are ineffective against COVID-19.

Trend of incompleteness of maternal schooling and race/skin color variables held on the Brazilian Live Birth Information System, 2012-2020

OBJECTIVE

to analyze the trend of incompleteness of the maternal schooling and race/skin color variables held on the Brazilian Live Birth Information System (SINASC) between 2012 and 2020.

METHODS

this was an ecological time series study of the incompleteness of maternal schooling and race/skin color data for Brazil, its regions and Federative Units, by means of joinpoint regression and calculation of annual percentage change (APC) and average annual percentage change.

RESULTS

a total of 26,112,301 births were registered in Brazil in the period; incompleteness of maternal schooling data decreased for Brazil (APC = -8.1%) and the Southeast (APC = -19.5%) and Midwest (APC = -17.6%) regions; as for race/skin color, there was a downward trend for Brazil (APC = -8.2%) and all regions, except the Northeast region, while nine Federative Units and the Federal District showed a stationary trend.

CONCLUSION

there was an improvement in filling out these variables on the SINASC, but with regional disparities, mainly for race/skin color.

Cesarean birth and risk of obesity from birth to adolescence: A cohort study

BACKGROUND

Recent studies have shown associations between cesarean birth and overweight. However, very few studies have evaluated weight gain or adiposity throughout life, and the majority are restricted to analysis during childhood. The purpose of this study was to analyze the effect of cesarean birth on obesity risk from birth to adolescence.

METHODS

The study sample was drawn from live births that occurred in 1999 and 2000 in Mato Grosso-Brazil. Participants were evaluated once when they were between 0 and 5 years of age and again after approximately 10 years (2009-2011). To measure the association between cesarean birth and obesity (Body Mass Index/age >+2 z-scores), we used generalized estimation equations (GEE) with binomial distribution and log-binomial models for repeated measures, controlled by the following confounding factors: weight and length at birth, sex, gestational age, breastfeeding, maternal age and schooling, economic class in childhood, and maternal smoking during pregnancy. The exposure-time interaction term was evaluated to verify differences in the change in the risk of obesity over time.

RESULTS

56.8% of children in the sample were born by cesarean birth. Children born by cesarean had a higher risk of obesity from birth through adolescence (RR = 1.22, 95% CI = 1.02; 1.46), even after adjusting for covariates, when compared with those born vaginally. However, the time-exposure interaction term was not significant, which indicates that there was no increased risk of obesity over time.

CONCLUSION

Cesarean birth was positively associated with obesity from birth to adolescence, with a persistent risk in the period evaluated.

Ideal Cardiovascular Health in adolescents: Findings from Study of Cardiovascular Risks in Adolescents

BACKGROUND AND AIM

We assessed the Ideal Cardiovascular Health (CVH) in Brazilian adolescents according to demographics and socioeconomic characteristics.

METHODS AND RESULTS

This is a cross-sectional study with data from the Study of Cardiovascular Risks in Adolescents (ERICA), with a nationwide representative sample of 36,956 Brazilian adolescents, aged 12-17 years, enrolled in public and private schools. The CVH metrics considered were body mass index (BMI), physical activity, smoking, healthy diet score, blood pressure, fasting plasma glucose, and total cholesterol. The demographics and socioeconomic characteristics analyzed were sex, age, race/skin color, and type of school attended. The study design was considered, and the significant difference determined by the non-overlapping of 95% Confidence Interval. The mean ideal CVH score was 4.0, higher for females, adolescents aged 15-17 years, and students from private schools. The prevalence of ideal fasting plasma glucose was 96%, of non-smoking 95.6%, of ideal blood pressure 75.5%, of ideal BMI 73.2%, of ideal total cholesterol 55.4%, of ideal physical activity 45.2%, and only 0.5% had an ideal diet. The prevalence of ideal CVH metrics varied according to demographics and socioeconomic characteristics.

CONCLUSION

Females, older adolescents, and students who attended private school had a better CVH. Demographics and socioeconomic characteristics were associated with CVH metrics. The low ideal proportions found for diet and physical activity are of concern and reinforce the need for food and nutritional educational actions designed to promote healthy behaviors in adolescence to prevent the development of cardiovascular diseases.

Skipping breakfast associated with socioeconomic and lifestyle factors in Brazilian adolescents

The aim is to estimate the prevalence and evaluate the association of socioeconomic and lifestyle factors with skipping breakfast among Brazilian adolescent students. A cross-sectional study carried out with adolescent ninth-graders from Brazilian public and private schools participating in the 2015 National School Health Survey. The prevalence of skipping breakfast (less than five days/week) and its respective 95% confidence intervals were estimated and stratified by gender according to demographic, socioeconomic, and lifestyle factors, self-perceived body image, and attitudes towards weight. A three-block hierarchical Poisson regression, considering the complex sample design. The prevalence of skipping breakfast was 35.6%, higher among girls than boys. In both genders, skipping breakfast was positively associated with the highest socioeconomic level, morning school shift, paid work, regular consumption of alcoholic beverages, living only with the mother, the father or neither, the irregular consumption of school food and meals with parents, considering oneself too fat/fat and trying to lose weight. In general, skipping breakfast was associated with socioeconomic factors and lifestyle behaviors harmful to health among adolescent students.

Factors associated with suicidal ideation during the COVID-19 pandemic in a population in the Brazilian Legal Amazon

This article aims to analyze the factors associated with suicidal ideation in the COVID-19 pandemic. A cross-sectional home-based survey, with three-stage cluster sampling, was conducted with 4,203 adults from ten municipalities in the Mato Grosso, Brazil. The data collection was carried households to assessment of sociodemographic characteristics, substance use and behavior in the pandemic. The Level 1 Symptom Cross Scale was used to identify suicidal ideation and aspects of mental health (somatic symptoms, sleep disturbances, dissociation, depression, anger, mania, anxiety, thoughts, substance use and memory). Chemiluminescence was used to detect IgG anti-SARS-CoV-2 antibodies. The prevalence of suicidal ideation was 19.2%, and the associated with increased consumption of alcohol (RP=1.16), smoking (RP=1.30), COVID-19 symptoms (RP=1.03), having one's life affected (RP=1.04), mental illness (RP=1.09) somatic symptoms (RP=1.15), sleep disturbance (RP=1.30), dissociation (RP=1.24), depression (RP=1.24), anger (RP=1.11), anxiety (RP=1.26), substance use (RP=1.19), drug prescription use (RP=1.18) and memory (RP=1.87). Highlights the high prevalence of suicidal ideation related to COVID-19 symptoms, changes in behavior post-pandemic and mental health factors.

Factors associated with death among cancer patients hospitalized for COVID-19 in Mato Grosso, Brazil

OBJECTIVE

To analyze the prognostic factors for death from COVID-19 among cancer patients.

METHODS

This is a retrospective study based on data recorded in the reporting system for COVID-19 hospitalizations in Mato Grosso. We assessed cases of cancer patients reported between April 2020 and June 2021. We calculated absolute and relative frequencies of sociodemographic variables, hospital care variables, and comorbidities, as well as mean, median, and standard deviation of age and length of stay. Odds ratios and their respective 95% confidence intervals (95%CI) - crude and adjusted - were estimated using the logistic regression model.

RESULTS

We analyzed 948 cancer patients hospitalized for COVID-19 in Mato Grosso, with a mean age of 59.7 years. The proportion of deaths was 34.5%, the mortality rate was 3.73 deaths/day (95%CI 3.35-4.16), and the median time between admission and death was 18 days. The likelihood of death was greater among patients aged 60 years or older, with chronic lung disease, who were admitted directly to intensive care units, and required mechanical ventilation at the time of admission. Patients hospitalized from April to December 2020 and January to March 2021 had a greater chance of death than those hospitalized between April and June 2021.

CONCLUSION

The likelihood of death from COVID-19 was greater in cancer patients hospitalized before their vaccination period in the state, as well as among older individuals and those admitted in worse clinical conditions.

Self-reported symptoms and seroprevalence against SARS-CoV-2 in the population of Mato Grosso: a household-based survey in 2020

OBJECTIVE:

This study aimed to analyze the association between self-reported symptoms and seroprevalence against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in the population of Mato Grosso.

METHODS:

A household-based survey was conducted on 4,206 adults from 10 municipalities of Mato Grosso, in the Brazilian Midwest, who were selected by cluster sampling in three stages. Questionnaires were applied between September and October 2020, and chemiluminescence was used for the quantitative determination of immunoglobulin G (IgG) antibodies against the S1 and S2 proteins of SARS-CoV-2.

RESULTS:

Approximately half (47.0%) of individuals with SARS-CoV-2 antibodies (12.5%) reported having no symptoms. The most prevalent symptoms among individuals with antibodies were body pain (37.0%), fever (32.9%), and smell and taste change (28.7%). The search for a basic health unit was predominant (45.0%) as the first service, and only 5.3% reported being hospitalized.

CONCLUSION:

A high proportion of asymptomatic cases of coronavirus disease 2019 (COVID-19) was identified in the general population, even among older adults and individuals with comorbidities.

[Prevalence of SARS-CoV-2 antibodies in the State of Mato Grosso, Brazil: a population-based survey]

Seroprevalence data provide relevant information on the development and progression of the COVID-19 pandemic. The study aimed to estimate the prevalence of SARS-CoV-2 antibodies in Mato Grosso State, Brazil, and its distribution according to sociodemographic and economic characteristics. This population-based serological survey was conducted in September-October 2020 in individuals 18 years or older in ten municipalities (counties) in the state of Mato Grosso. Interviews and collection of biological samples were conducted in the households, and determination of IgG antibodies to SARS-CoV-2 was performed with chemiluminescence. A total of 4,306 individuals were evaluated, and COVID-19 prevalence was estimated at 12.5% (95%CI: 10.5; 14.7), ranging from 7.4% to 24.3% between municipalities. No significant differences were found in prevalence of infection according to race/color, schooling, or family income, but lower prevalence was seen in individuals with a pensioner living in the same household, who did not receive emergency financial aid, and whose family income had not decreased after social distancing measures during the epidemic. Estimated prevalence of SARS-CoV-2 antibodies in this population-based survey is essential to measure the magnitude of the disease and will back measures to confront and control the pandemic.

Restricted dietary pattern may contribute to lowering blood pressure in adolescents with obesity: Study of Cardiovascular Risk in Adolescents

OBJECTIVE

Dieting is one of the main target factors for interventions that seek to control and prevent rising blood pressure. This study identified dietary patterns and analyzed their association with adolescents' blood pressure.

METHODS

This is a cross-sectional study with a probabilistic and nationally representative sample of adolescents aged 12-17 years, who participated in the Study of Cardiovascular Risk in Adolescents (ERICA), carried out in 2013-2014 with Brazilian adolescents (N = 36 956). Food consumption was assessed by 24 h recall. Dietary patterns were identified using the Reduced Rank Regression method, and considering waist circumference, fasting insulin, and dietary polyunsaturated fat/saturated fat ratio as intermediate variables. Multiple linear regression models stratified by weight were developed; SBP and DBP were the dependent variables, and dietary pattern scores were the independent ones, with adjustment for potential confounding factors.

RESULTS

The following patterns were identified: 'Brazilian common', 'Restricted' and 'Added sugar'. The 'Restricted' pattern, which included diet/light foods, chicken and chicken-based dishes, leafy greens, vegetables and spices, red meats and dishes based on red meats and tubers, was inversely associated with SBP (β = -1.55; 95% CI = -2.26 to -0.83) and DBP (β = -1.19; 95% CI = -1.70 to -0.68) in adolescents with obesity.

CONCLUSION

In adolescents with obesity, a low-energy density diet was associated with reduced blood pressure. These findings are consistent with international recommendations for preventing elevated blood pressure.

Fatores associados ao óbito entre pacientes com câncer internados por COVID-19 em Mato Grosso, Brasil

RESUMO: Objetivo: Analisar os fatores prognósticos para o óbito por COVID-19 em pacientes com câncer. Métodos: Estudo retrospectivo com base nos dados registrados no sistema de notificação de casos de internações por COVID-19 de Mato Grosso. Foram avaliados casos notificados entre abril de 2020 e junho de 2021 com câncer. Calcularam-se as frequências absolutas e relativas das variáveis sociodemográficas, de assistência hospitalar e comorbidades, assim como média, mediana e desvio padrão da idade e do tempo de internação. Estimaram-se o odds ratio e seu respectivo intervalo de confiança de 95%, bruto e ajustados, por meio do modelo de regressão logística. Resultados: Foram considerados 948 pacientes com câncer internados por COVID-19 em Mato Grosso, com média de idade de 59,7 anos. A proporção de óbitos foi de 34,5%, e a taxa de mortalidade, de 3,73 pessoas/dia (intervalo de confiança de 95% — IC95% 3,35–4,16), com mediana de tempo entre admissão e óbito de 18 dias. Foi maior a chance de óbito entre os pacientes com 60 anos ou mais de idade, com doença pulmonar crônica, que internaram em leitos de unidade de terapia intensiva e necessitaram de ventilação mecânica no momento da internação. Os pacientes internados no período de abril a dezembro de 2020 e janeiro a março de 2021 apresentaram maior chance de óbito quando comparados aos internados entre abril e junho de 2021. Conclusão: Foi maior a chance de óbitos por COVID-19 entre pacientes com câncer internados antes do período de vacinação desse grupo no estado e entre aqueles mais velhos e admitidos em piores condições clínicas.

Lifestyle-related behaviors and depressive symptoms in college students

This study sought to examine the association between lifestyle-related behaviors and depressive symptoms among college students. This cross-sectional study analyzed baseline data of a dynamic-cohort study from a public university in Central-Western Brazil, in all 21 undergraduate full-time courses. Students up to 25 years old who were enrolled for the first time in a university were included in the study, except pregnant and/or nursing women. All students who met the eligibility criteria were invited to participate in the study. From a total of 1,212 eligible students, 1,038 were included (85.6%). All participants answered a self-administered questionnaire on smoking, alcohol consumption, screen time, sleep duration, and meal patterns. Depressive symptoms were assessed using the Patient Health Questionnaire-9 (PHQ-9). Multivariate Poisson regression models stratified by sex were used to estimate the associations. Depressive symptoms was observed in 31.6% (males 23.6%; females 39.9%; p-value chi-square test = 0.01) of the students. Smoking, drinking spirits, and having irregular meal habits were directly associated with depressive symptoms in both males and females. The co-occurrence of two risk behaviors (men: aPR = 2.23, 95%CI: 1.25; 3.99; women: aPR = 1.54, 95%CI: 1.03; 2.30) and three or more risk behaviors (men: aPR = 3.42, 95%CI: 1.90; 6.16; women: aPR = 2.09, 95%CI: 1.39; 3.15) increased the occurrence of depressive symptoms among the students. Lifestyle-related unhealthy behaviors were associated with an increased occurrence of depressive symptoms among college students. These findings suggest the need of interventions encouraging changes in lifestyle to promote mental health and to improve the quality of life in this group.

Poor sleep quality, excessive daytime sleepiness and association with mental health in college students

AIM

To estimate the prevalence of poor sleep quality and excessive daytime sleepiness (EDS) among college students and to analyse their association with aspects of mental health.

SUBJECTS AND METHODS

A cross-sectional study carried out with 1113 college students, enrolled in full-time courses at a public university in the Mid-West region of Brazil. Data were collected through a self-administered questionnaire with questions about demographics, socioeconomics, mental health, sleep quality, and EDS. Measurements of weight and height were taken to assess weight status using the body mass index. Multivariate logistic regression models were used to estimate the associations between perceived stress (classified as light, moderate, and high) and presence of depressive symptoms with poor sleep quality and presence of EDS.

RESULTS

High prevalence of poor sleep quality (65.5%) and EDS (55%) was observed. In the adjusted models, poor sleep quality was significantly associated with moderate and high perceived stress and presence of depressive symptoms. For EDS, there was also a significant association with moderate and high perceived stress and presence of depressive symptoms.

CONCLUSIONS

High prevalence of poor sleep quality and EDS was found among college students. Perceived stress and presence of depressive symptoms were significantly associated with both evaluated outcomes.

[Infant mortality in Mato Grosso, Brazil: trend and causes of death between 2007 and 2016]

Geographical and temporal variations in infant mortality subsidize the process of planning and assessing maternal and child health. This is a time-series study that set out to analyze the trend of infant mortality in Mato Grosso and its health regions from 2007 to 2016 and to identify the distribution of causes of death according to age group and birth weight. For the trend analysis, the infant mortality rates stratified by causes of death between 2007 and 2016 were evaluated using polynomial regression models. There was a decreasing linear trend in infant mortality rates in the state, but individually only four of the 16 health regions followed this trend. Half of the deaths occurred in the early neonatal period. Causes avoidable by adequate attention to women during pregnancy and childbirth and to the newborn represented 51.1% of the deaths. There was an increasing tendency of proportional mortality for causes not manifestly avoidable. It is acknowledged that it is important to know the trend of rates in order to define priority population groups for early interventions that increase survival and reduce infant mortality. In addition, the investigation of deaths in the state should be implemented to establish the underlying cause.

[Nutritional status of children of Haitian descent and their demographic, socioeconomic and health characteristics in Cuiabá, State of Mato Grosso (MT), Brazil]

The scope of this study was to analyze the distribution of anthropometric variables according to demographic, socioeconomic, and health characteristics among children of Haitian descent between 0 and 5 years of age living in Cuiabá-MT. It consists of a cross-sectional and census-based study with data collected between August 2016 and February 2017. The dependent variables were body mass index (BMI) and height-for-age z-score, using Student's t-Test and ANOVA in the statistical analysis. A total of 67 children, 73.2% to 24 months of age and 34.3% being male, were evaluated. There was a significant proportion of families with per capita income of less than 1/4 of the minimum wage (65.6%), with no home monitoring for the family health strategy (88.1%), and long working hours for mothers (43.3%). The onset of prenatal care until the third month of pregnancy and female sex were associated with higher BMI averages. For height-for-age, an association with lower mean values was found for households with more than one resident per room, higher age range of the child, and child-care in daycare centers. Thus, although few factors have an association with the anthropometric indications evaluated, it is necessary to consider the precarious socioeconomic conditions in which these children find themselves.

[Sleep-related problems and associated factors among the Brazilian population: National Health Survey, 2013]

The scope of this study was to estimate the frequency of sleep-related problems and associated factors. It was a study based on data from the National Health Survey conducted in Brazil in 2013. Sleep-related problems were assessed with the question "How often have you had sleep problems in the last two weeks, such as difficulty falling asleep, waking up frequently during the night or sleeping more than usual?" The answers were grouped into: none of the days, less than half of the days and more than half of the days. Of the individuals evaluated, 71.1% reported having no problems with sleep on any day, 14.0% on at least half of the days and 14.9% on more than half of the days. The highest frequencies of sleep-related problems were reported by women and more advanced age. For men and women, smoking, alcohol abuse, physical inactivity, sedentary behavior, and high blood pressure were significantly associated with the frequency of sleep problems on more than half of the days, and also excess weight for women. Thus, the frequency of sleep-related problems in the Brazilian population was high. Women, older individuals with lifestyle-related risk behaviors, high blood pressure, and overweight were the highest risk subgroups.

Incidence of depressive symptoms and its association with sociodemographic factors and lifestyle-related behaviors among Brazilian university students

Entering university brings on changes in lifestyle and psychological stress and has been associated with increased risk of 1988 in college students. This study aimed to investigate the incidence of depressive symptoms and associated sociodemographic and lifestyle factors among university students. A dynamic cohort of freshmen was followed up for three years, starting at their entry to university (baseline) and then annually. A structured auto administered questionnaire was applied to obtain information on age, sex, economic class, living situation, smoking and drinking, sedentary and sleep behaviors, and change in physical activity after university admission. Depressive symptoms were assessed using the Patient Health Questionaire-9. Incidence and incidence rate of depressive symptoms were calculated. Poisson Regression with robust variance was used to identify risk factors associated to these disorders. A total of 1,034 students without depressive symptoms at baseline were investigated. The overall incidence of depressive symptoms was 28.3% and the incidence rate (IR) was 2.12, being greater for females (2.75) than males (1.65). The IR decreased over time for both males (from 2.61 to 0.41) and females (from 4.25 to 0.54). A greater risk of depressive symptoms was observed for younger male students compared to those ≥20 years old (IRR_adj = 1.64) and for women who reported concomitant use of alcohol and tobacco compared to those that reported no smoking and no alcohol consumption. For both males (IRR_adj = 2.80) and females (IRR_adj = 1.91), severe stress level was associated with greater risk of depressive symptoms when compared to mild stress level. Depressive Symptoms occurred more significantly in females, in the early years of undergraduate course, in males <20 years old, and among those with high stress level. Understanding the possible causes of depression is essential to promote mental health and well-being among college student.

Prevalence of disordered eating behaviors and associated factors in Brazilian university students

BACKGROUND

University students may be a vulnerable group to adopt unhealthy behaviors, including changes in eating behavior. Assessment of factors associated with the prevalence of disordered eating behaviors in this population may facilitate the early identification of their predictors, thus allowing fast interventions.

AIM

To analyze the prevalence of disordered eating behaviors (DEB) and associated factors in Brazilian university students.

METHODS

Cross-sectional study of male and female students aged 16-25 years, enrolled in full-time degree program at a public university in the mid-west of Brazil. Disordered eating behaviors in the last three months (binge eating, purging, and food restriction), through an adapted version of the instrument developed by Hay, was evaluated and the association with demographic and socioeconomic characteristics, including lifestyle, body image, perceived stress, depressive symptoms, and excess weight, was analyzed. A hierarchical analysis model was performed to determine the relative importance of factors on the prevalence of DEB.

RESULTS

A total of 1608 university students were evaluated (50.7% male). Prevalence of DEB was 4.4% for binge eating, 2.5% for purging and 9.1% for food restriction, all of which were higher among women (7.0%, 4.4%, and 13.5%) compared with men (1.8%, 0,6%, and 4.9%, respectively). The factors that remained significantly associated with these behaviors were female sex, smoking, consumption of alcoholic beverages, dissatisfaction with body image, excess weight, high perceived stress, and presence of self-reported depressive symptoms.

CONCLUSION

Factors associated with DEB signal that intervention is required to create synergy between individual and population-level interventions in lifestyle behaviors.

Influence of sociodemographic and economic factors on physical activity among university students

Objective: To estimate the influence of socioeconomic factors on the variation in time spent by university students on physical activity after the first academic year. Methods: Quantitative longitudinal study of 348 full-time university students aged 16-25 years from the capital of Mato Grosso, Brazil. Change in time spent on moderate and vigorous physical activity was assessed in minutes per week through the short version of the International Physical Activity Questionnaire (IPAQ). The following independent variables were analyzed: gender, age, race/skin color, economic class, students’ housemates and field of study. Multinomial regression analysis was used to check for associations between physical activity time variation in tertiles and the independent variables. Results: The overall change in median physical activity time in one year was -90.0 minutes/week. Students of higher socioeconomic status maintained the same physical activity time, while those in other socioeconomic classes showed a decrease in such time after the first year at university. After adjustments, lower economic class (OR=2.85; 95%CI= 1.26-6.43) and living in a shared house (OR=2.84; 95%CI= 1.26-6.38) were associated with decrease in time spent on physical activity. Conclusion: There was a decrease in time spent on physical activity among students belonging to the lower economic classes who lived in a shared house after the first year at university.

Socio-economic and demographic characteristics associated with risk behaviour patterns for chronic non-communicable diseases in Brazil: data from the National Health Survey, 2013

OBJECTIVE

To identify risk behaviour patterns for chronic non-communicable diseases (NCD) in the Brazilian population and to investigate associated socio-economic and demographic factors.

DESIGN

Factor analysis was used to identify patterns considering the following risk behaviours: consumption of soft drinks/artificial juice, sweet foods, red meat with apparent fat, chicken skin; inadequate consumption of fruits and vegetables; alcohol abuse; smoking; absence of physical activity during leisure time; and time spent watching television. The χ 2 test was used to compare ratios. All analyses accounted for weighting factors and the study's complex sampling design effect. The socio-economic and demographic variables evaluated were gender, age, schooling level and macro region of residence.

SETTING

National Health Survey, a household survey with national representation, conducted in 2013 in Brazil.ParticipantsIndividuals (n 60202) aged 18 years or over.

RESULTS

Four risk behaviour patterns were identified: 'Physical inactivity in leisure time and Inadequate consumption of fruits and vegetables', 'Saturated fat', 'Alcohol and Smoking' and 'Sedentary behaviour and Sugar', explaining 52·01 % of the total variance. Overall, greater adherence to 'Saturated fat' and 'Alcohol and Smoking' patterns was observed among men and those with lower education level. The 'Sedentary behaviour and Sugar' and 'Physical inactivity in leisure time and Inadequate consumption of fruits and vegetables' patterns had greater adherence among younger individuals, and the first was associated with higher education whereas the second with less education among individuals residing in the North and Northeast regions.

CONCLUSIONS

Risk behaviour patterns for NCD were heterogeneous, reflecting the socio-economic and demographic differences in Brazil.

Prenatal follow-up of Haitian and Brazilian women in Mato Grosso

Abstract Objectives: to analyze the prenatal follow-up performed by pregnant women in Haiti and Brazil in the state of Mato Grosso. Methods: a cross-sectional study of secondary database, with analysis of SINASC birth records in Mato Grosso between 2013 and 2015, of Brazilian children, born from both Brazilian and Haitian mothers. Variables related to the identification of the newborn and the woman, maternal data on gestational history, including information on prenatal follow-up of the last gestation were evaluated, besides the birth characteristics. Results: 167,820 live births were registered in the state in the period, of which 139 (0.08%) were children of Haitian women. Haitian mothers were older, however with lower schooling when compared to Brazilian mothers. The proportion of mothers of Haitian nationality who had at least 6 prenatal consultations was lower, and the proportion of vaginal births was higher, when compared to Brazilian women. The prevalence of low birth weight among live births of Haitian mothers was also higher. Conclusions: the results of this study point to the need to understand these differences, since some indicators have distanced from those advocated by WHO. These findings may contribute to the public policies development aimed at this population.

Self-reported weight and height are valid measures to determine weight status: results from the Brazilian National Health Survey (PNS 2013)

Self-reported measures have been used to obtain weight and height information in some epidemiological surveys. The validation of such information is necessary to guarantee data quality. This study assessed the validity of self-reported weight and height to determine weight status. Data were obtained in the Brazilian National Health Survey, a Brazilian household-based nationwide survey carried out in 2013. In this survey, 40,366 individuals (aged ≥ 18 years) provided self-reported and measured information about weight and height. Student’s paired t-test was used to verify the differences between self-reported and measured data. The agreement between measurements was obtained using the intraclass correlation coefficient (ICC) and Bland-Altman method. To evaluate variations in weight status categorizations, the weighted kappa coefficient and exact agreement were used. Sensitivity and specificity were estimated for the self-reported information to classify overweight and obese individuals. There was high agreement between self-reported and measured weight, height, and body mass index (ICC > 0.88). The mean agreements estimated by the Bland-Altman method were 99.6% for weight and 100.6% for height. The weighted kappa coefficient showed substantial agreement among the weight status categories (> 0.66); the exact agreement was 77%. Sensibility and specificity for overweight (83% and 87.5%, respectively) and obesity (73.4% and 96.7%, respectively) were considered high for the sociodemographic characteristics evaluated. According to our results, self-reported measurements of weight and height can be used cautiously as valid alternatives to determine weight status.

Use of health services by Haitian immigrants in Cuiabá-Mato Grosso, Brazil

This paper aims to analyze the use of health services by Haitian immigrants in Cuiabá, Mato Grosso. This is a cross-sectional study with a random sample of 452 Haitian immigrants in Cuiabá and Várzea Grande, interviewed between December 2014 and February 2015. Sociodemographic and health characteristics, lifestyle factors, and the use of health services were evaluated. Data analysis included Chi-square test and Poisson regression to investigate the factors associated with the use of health services. We found that 45.6% of respondents used some health service in Brazil, with a higher prevalence of use among women, those with higher income, longer residence time in Brazil, better understanding of the Portuguese language, and with poor self-reported health. The PHC Unit (UBS) and public urgent and emergency care were the primary services used. We conclude by saying that the SUS assisted the immigrants under the Brazilian constitutional principle of the right to health.

Longitudinal Study on the Lifestyle and Health of University Students (ELESEU): design, methodological procedures, and preliminary results

Admission to a university may cause significant changes in the pattern of exposure to health risks. The aim of this paper is to describe the study design and methodological procedures adopted in the Longitudinal Study on the Lifestyle and Health of University Students (ELESEU). This study examines a dynamic cohort of full-time students at a public university in the State of Mato Grosso, Brazil. This research, which started in 2015, will have four years of follow-up and is scheduled to end in 2018. A self-administered questionnaire is applied, containing questions regarding demographic and socioeconomic characteristics, and information on health conditions and risk factors such as lifestyle, perceived stress, symptoms of depression, body image, risk behaviors for eating disorders, self-assessment of health and diet quality, and other issues related to nutrition and health. Anthropometric and blood pressure measurements are also recorded. Two 24-hour dietary recalls and cholesterol, triglycerides, and glucose capillary measurements are collected in 50% of the students. In 2015, 495 participants (82.6% of the eligible students) were assessed in the baseline study. Of these, 348 (70.3%) were followed up in 2016. In 2016, 566 participants were included in the cohort (81% of the eligible students). This study will help to identify the factors that might influence changes in the nutritional, health, and metabolic status of young adults during college life.

[International migration, health, and work: an analysis of Haitians in Mato Grosso State, Brazil]

This article addresses the relations between immigration, health, and work in Haitian immigrants in Cuiabá and Várzea Grande, Mato Grosso State, Brazil, emphasizing their work conditions. This was an exploratory study based on primary data collected through a survey of the Haitian population in Cuiabá in 2014-2015. A total of 452 Haitians were interviewed, living in Cuiabá and Várzea Grande (373 men and 79 women), and the findings point to the precarious social situation of Haitian immigrants in Mato Grosso State, marked by high unemployment. Of the immigrants interviewed, 52.7% were currently working and 26.5% reported a workweek greater than 48 hours. The two main occupations for Haitian immigrants in Cuiabá were construction and services, and most were working below their original level of training, skills sets, and job experience in Haiti. The main risks identified in these two sectors were physical (53.2% and 63.4%, respectively) and accidents (23.4% and 17.1%, respectively), in addition to reports of physical and psychosocial distress. The study points to the precarious social, economic, and labor conditions of the Haitian population in the capital of Mato Grosso.

Effects of socioeconomic position and social mobility on linear growth from early childhood until adolescence

OBJECTIVE

To assess the effect of socioeconomic position (SEP) in childhood and social mobility on linear growth through adolescence in a population-based cohort.

METHODS

Children born in Cuiabá-MT, central-western Brazil, were evaluated during 1994 - 1999. They were first assessed during 1999 - 2000 (0 - 5 years) and again during 2009 - 2011 (10 - 17 years), and their height-for-age was evaluated during these two periods.Awealth index was used to classify the SEP of each child's family as low, medium, or high. Social mobility was categorized as upward mobility or no upward mobility. Linear mixed models were used.

RESULTS

We evaluated 1,716 children (71.4% of baseline) after 10 years, and 60.6% of the families showed upward mobility, with a higher percentage among the lowest economic classes. A higher height-for-age was also observed among those from families with a high SEP both in childhood (low SEP= -0.35 z-score; high SEP= 0.15 z-score, p < 0.01) and adolescence (low SEP= -0.01 z-score; high SEP= 0.45 z-score, p < 0.01), whereas upward mobility did not affect their linear growth.

CONCLUSION

Expressive social mobility was observed, but SEP in childhood and social mobility did not greatly influence linear growth through childhood in this central-western Brazilian cohort.

Familial aggregation and dietary patterns in the Brazilian population

The aim of the study was to identify dietary patterns in Brazil and verify aggregation among members of the same family based on the Brazilian National Dietary Survey, a nationwide dietary survey conducted in 2008-2009 in individuals over 10 years of age. Dietary intake was estimated with a food record. Dietary patterns were identified by factor analysis, and familial aggregation was verified by linear regression. Three major dietary patterns were identified: (1) a traditional snack featuring coffee, rolls, oils and fats, and cheese; (2) traditional main meal, based on rice, beans and other legumes, and meat; and (3) fast food type snacks, namely sandwiches, processed meats, soft drinks, snacks, and pizza. Pattern 2 showed the strongest association (β = 0.37-0.64). Patterns 1 and 3 showed positive associations for all pairs of family members, with β ranging from 0.27 to 0.44 and 0.32 to 0.42, respectively. The study showed familial aggregation of dietary patterns in the Brazilian population.

Effect of the exposure to maternal smoking during pregnancy and childhood on the body mass index until adolescence

OBJECTIVE

Investigate the effect of exposure to smoking during pregnancy and early childhood on changes in the body mass index (BMI) from birth to adolescence.

METHODS

A population-based cohort of children (0-5 years old) from Cuiabá, Midwest Brazil, was assessed in 1999-2000 (n = 2,405). Between 2009 and 2011, the cohort was re-evaluated. Information about birth weight was obtained from medical records, and exposure to smoking during pregnancy and childhood was assessed at the first interview. Linear mixed effects models were used to estimate the association between exposure to maternal smoking during pregnancy and preschool age, and the body mass index of children at birth, childhood and adolescence.

RESULTS

Only 11.3% of the mothers reported smoking during pregnancy, but most of them (78.2%) also smoked during early childhood. Among mothers who smoked only during pregnancy (n = 59), 97.7% had smoked only in the first trimester. The changes in body mass index at birth and in childhood were similar for children exposed and those not exposed to maternal smoking. However, from childhood to adolescence the rate of change in the body mass index was higher among those exposed only during pregnancy than among those who were not exposed.

CONCLUSIONS

Exposure to smoking only during pregnancy, especially in the first trimester, seems to affect changes in the body mass index until adolescence, supporting guidelines that recommend women of childbearing age to stop smoking.

Prevalence and factors associated with sedentary behavior in adolescents

OBJECTIVE

To analyze the prevalence of sedentary behavior and associated factors in adolescents.

METHODS

A cross-sectional study with adolescents aged 10 to 17 years, of both sexes, belonging to a 1994-1999 birth cohort in the city of Cuiabá, MT, Central Western Brazil. Data were collected using a questionnaire containing sociodemographic, economic, lifestyle and anthropometric variables. Sedentary behavior was determined as using television and/or computer/video games for a time greater than or equal to 4 hours/day. Associations with sedentary behavior were evaluated using body mass index in childhood and adolescence and sociodemographic and behavioral variables using hierarchical logistic regression.

RESULTS

The overall prevalence of sedentary behavior was 58.1%. Of the 1,716 adolescents evaluated, 50.7% (n = 870) were male. In multivariate analysis, after adjustment for confounding factors, the variables that remained associated with sedentary behavior were: age (14 and over) (OR = 3.51, 95%CI 2.19;5.60); higher socioeconomic class (OR = 3.83, 95%CI 2.10;7.01), higher level of maternal education (OR = 1.81, 95%CI 1.09;3.01); living in the country (OR = 0.49, 95%CI 0.30;0.81); insufficient physical activity (OR = 1.25, 95%CI 1.02;1.53); experimentation with alcoholic beverages (OR = 1.34, 95%CI 1.08;1.66) and being overweight in adolescence (OR = 1.33, 95%CI 1.06;1.68).

CONCLUSIONS

The high proportion of adolescents in sedentary activities and the lack of association with being overweight in childhood, indicates the need for educational initiatives to reduce multiple risk behaviors. Encouraging physical activity in young people as a way of reducing sedentary behavior and, consequently, being overweight is fundamental.

[Obesity: main risk factor for systemic arterial hypertension in Brazilian adolescents from a cohort study]

OBJECTIVE

To identify the prevalence and factors associated with hypertension in adolescents.

SUBJECTS AND METHODS

Cross-sectional study of 1,716 adolescents of a cohort study, aged from 10 to 16 years old sociodemographic, economic, and lifestyle characteristics were obtained from an interview, and birth weight from hospital records. Hypertension was defined as systolic or diastolic blood pressure above the 95th percentile according to the classification recommended by the Second Task Force High Blood Pressure in Children and Adolescents. Nutritional status was diagnosed by body mass index (BMI), according to the z score from curves published by the World Health Organization. Waist circumference was measured at the natural waist. The association between hypertension and the explanatory variables was measured using logistic regression.

RESULTS

The adolescents interviewed represent 71.4% of the baseline, and 50.7% of them were males. The prevalence of hypertension was 11.7%. In the multivariate analysis, after adjustment for age sex and skin color, hypertension was associated with obesity [OR = 2.27, (95%) CI = 1.64 to 3.14] but not associated with waist circumference after adjusting for BMI. Early life factors were not associated with hypertension in adolescence.

CONCLUSION

The results show an association between obesity and hypertension among adolescents.

Effect of tobacco smoke exposure during pregnancy and preschool age on growth from birth to adolescence: a cohort study

BACKGROUND

There is strong evidence of an association between maternal smoking during pregnancy and restriction of intrauterine growth, but the effects of this exposure on postnatal linear growth are not well defined. Furthermore, few studies have investigated the role of tobacco smoke exposure also after pregnancy on linear growth until adolescence. In this study we investigated the effect of maternal smoking exposure during pregnancy and preschool age on linear growth from birth to adolescence.

METHODS

We evaluated a cohort of children born between 1994 and 1999 in Cuiabá, Brazil, who attended primary health clinics for vaccination between the years 1999 and 2000 (at preschool age) and followed-up after approximately ten years. Individuals were located in public and private schools throughout the country using the national school census. Height/length was measured, and length at birth was collected at maternity departments. Stature in childhood and adolescence was assessed using the height-for-age index sex-specific expressed as z-score from curves published by the World Health Organization. Linear mixed effects models were used to estimate the association between exposure to maternal smoking, during pregnancy and preschool age, and height of children assessed at birth, preschool and school age, adjusted for age of the children.

RESULTS

We evaluated 2405 children in 1999-2000, length at birth was obtained from 2394 (99.5%), and 1716 at follow-up (71.4% of baseline), 50.7% of the adolescents were male. The z-score of height-for-age was lower among adolescents exposed to maternal smoking both during pregnancy and childhood (p < 0.01). Adjusting for age, sex, maternal height, maternal schooling, socioeconomic position at preschool age, and breastfeeding, children exposed to maternal smoking both during pregnancy and preschool age showed persistent lower height-for-age since birth to adolescence (coefficient: -0.32, p < 0.001) compared to non-exposed. Paternal smoking at preschool age was not associated with growth after adjustment for confounders.

CONCLUSION

Exposure to maternal smoking not only during pregnancy, but also at early childhood, showed long-term negative effect on height of children until adolescence.

Mobilidade social, estilo de vida e índice de massa corporal de adolescentes

OBJETIVO Analisar a associação entre mobilidade social, estilo de vida e índice de massa corporal de adolescentes. MÉTODOS Estudo de coorte com 1.716 adolescentes de dez a 17 anos de idade, de ambos os sexos. Os adolescentes eram participantes de um estudo de coorte e nasceram entre 1994 e 1999. Os adolescentes foram avaliados em escolas públicas e privadas entre 2009 e 2011. O estilo de vida foi avaliado por meio de entrevista e a antropometria foi utilizada para o cálculo do índice de massa corporal. Para a classificação econômica na infância e na adolescência foram utilizados critérios preconizados pela Associação Brasileira de Empresas de Pesquisa. Mobilidade social ascendente foi considerada como aumento em pelo menos uma classe econômica no período de dez anos. Utilizou-se regressão de Poisson para estimar a associação entre a mobilidade social ascendente e os desfechos avaliados. RESULTADOS Dos adolescentes (71,4% de seguimento da coorte), 60,6% apresentaram mobilidade social ascendente. Destes, 93,6% pertenciam à classe econômica D e 99,9% à E. Maior prevalência de ascensão social foi observada para escolares de cor da pele preta (71,4%) e parda (61,9%), matriculados na escola pública (64,3%) e cujas mães apresentaram menor escolaridade na primeira avaliação (67,2%) e na reavaliação (68,7%). A mobilidade social ascendente mostrou-se associada apenas aos comportamentos sedentários (p = 0,02) após ajuste para variáveis de confusão. A classe econômica na infância mostrou-se mais associada aos desfechos avaliados do que a mobilidade social ascendente. CONCLUSÕES A mobilidade social ascendente não mostrou associação com a maioria dos desfechos avaliados, possivelmente por ter sido discreta e porque o período considerado no estudo pode não ter sido suficiente para refletir mudanças substanciais no estilo de vida e no índice de massa corporal dos adolescentes.

[Factors associated with self-reported systemic arterial hypertension according to VIGITEL in 26 Brazilian capitals and the Federal District in 2008]

The scope of this article is to study the association between lifestyle, nutritional status and the prevalence of self-reported systemic arterial hypertension, weighted by the system of risk and protective factors for Chronic Non-Communicable Diseases (CNCD) by telephone surveys and standardized by age and sex, in adults from 26 Brazilian state capitals and the Federal District in 2008. For each city the prevalence of hypertension was standardized by the direct method. Multiple linear regression analysis was performed between the factors of interest and the prevalence of hypertension, weighted and standardized by gender and age. After standardization, the prevalence of hypertension tended to increase in capitals with a younger population and decrease in those with a higher proportion of elderly individuals. In regression models, the prevalence of weighted and standardized hypertension remained associated with the prevalence of excess weight and the consumption of fruit and vegetables (FV). However, physical activity was only negatively associated with the weighted prevalence of hypertension. A positive association with weighted and standardized prevalence of hypertension was observed with excess weight and regular consumption of FV.

Fatores associados à Hipertensão Arterial Sistêmica autorreferida segundo VIGITEL nas 26 capitais brasileiras e no Distrito Federal em 2008

O objetivo deste artigo é estudar a associação entre estilo de vida e estado nutricional e prevalência de Hipertensão Arterial Sistêmica (HAS) autorreferida, ponderada pelo sistema de Vigilância de Fatores de Risco e Proteção para Doenças Crônicas por Inquérito Telefônico (VIGITEL) e padronizada por idade e sexo, em indivíduos adultos das 26 capitais brasileiras e Distrito Federal em 2008. Calculou-se para cada capital a prevalência de HAS padronizada pelo método direto. Realizou-se regressão linear múltipla dos fatores de interesse em relação à prevalência de HAS ponderada e padronizada por sexo e idade. Após a padronização, a prevalência de HAS tendeu a aumentar nas capitais com população mais jovem e a diminuir naquelas com mais idosos. Nos modelos de regressão, mantiveram-se associados à prevalência de HAS, ponderada e padronizada, o excesso de peso e o consumo de frutas e hortaliças. Porém, a atividade física associou-se negativamente apenas à prevalência de HAS ponderada. Observou-se, com a prevalência ponderada e padronizada de HAS, associação positiva com excesso de peso e consumo regular de frutas e hortaliças e apenas com a prevalência ponderada observou-se associação inversa dessa morbidade com a prática de atividade física.

O censo escolar como estratégia de busca de crianças e adolescentes em estudos epidemiológicos

Alternativas de baixo custo que possibilitem o acompanhamento de grupos populacionais constituem estratégias importantes na condução de estudos de coorte. Este trabalho apresenta os procedimentos para o uso do censo escolar como instrumento de busca de crianças e adolescentes em estudos de seguimento. O estudo foi realizado entre os estudantes adolescentes que frequentaram os postos de saúde de Cuiabá, Estado de Mato Grosso, Brasil, para vacinação em 1999. Foram localizados 86,8% de adolescentes com o uso do censo escolar e 0,2% pelo Sistema de Informações sobre Mortalidade. Dentre os adolescentes localizados, foram entrevistados 1.716, representando uma taxa de seguimento de 71,4%. Neste estudo, o censo escolar mostrou ser um método efetivo na busca de estudantes.