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Rosa RJ, de Araújo JST, Berra TZ, Ramos ACV, Moura HSD, do Nascimento MC, Tártaro AF, Silva RVDS, Delpino FM, Fiorati RC, Teibo TKA, Alves YM, de Paiva JQR, Arcoverde MAM, Scholze AR, Arcêncio RA. Factors associated with status and self-perceived mental health changes in the face of the COVID-19 pandemic in Brazil. PLOS Glob Public Health 2023; 3:e0001636. [PMID: 37594925 PMCID: PMC10437945 DOI: 10.1371/journal.pgph.0001636] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/26/2022] [Accepted: 07/19/2023] [Indexed: 08/20/2023]
Abstract
The SARS-CoV-2-triggered Public Health Emergency of International Importance has significantly contributed to emotional and mental health issues. The aim of this study was to identify factors associated with self-perceived mental health changes while facing the COVID-19 pandemic in Brazil. This was a cross-sectional, descriptive, and analytical study that collected data via a web survey using a validated instrument. The study included individuals over 18 years old residing in the 26 federal units and the Federal District from August 2020 to November 2022. The sample was recruited using the snowball technique. Two logistic regression analyses were conducted to identify factors associated with the outcomes of interest. The first analysis considered individuals who rated their mental health condition as poor as the dependent variable, while the second analysis considered individuals who reported changes in their mental health during the pandemic as the dependent variable. The study found that individuals with complete college education and those using tranquilizers or antidepressants were more likely to perceive their mental health as poor (1.97 and 2.04 times higher likelihood, respectively). Increased consumption of ultra-processed foods during the pandemic was associated with a 2.49 higher likelihood of reporting mental health changes. Participants also reported more difficulty sleeping. The negative self-perception of mental health varied across Brazil's regions and changed over time, with different patterns observed before and after the vaccination period. In 2022, most regions of Brazil classified their mental health as "poor." The study highlights the impact of the COVID-19 pandemic on mental health, with increased prevalence of mental disorders and emotional problems among the population. The results highlight the presence of mental disorders and increased reporting of emotional problems among the population due to the impact of the COVID-19 pandemic.
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Affiliation(s)
- Rander Junior Rosa
- Department of Maternal-Infant Nursing and Public Health, University of São Paulo at Ribeirão Preto College of Nursing, Ribeirão Preto, São Paulo, Brazil
| | - Juliana Soares Tenório de Araújo
- Department of Maternal-Infant Nursing and Public Health, University of São Paulo at Ribeirão Preto College of Nursing, Ribeirão Preto, São Paulo, Brazil
| | - Thaís Zamboni Berra
- Department of Maternal-Infant Nursing and Public Health, University of São Paulo at Ribeirão Preto College of Nursing, Ribeirão Preto, São Paulo, Brazil
| | - Antônio Carlos Vieira Ramos
- Department of Maternal-Infant Nursing and Public Health, University of São Paulo at Ribeirão Preto College of Nursing, Ribeirão Preto, São Paulo, Brazil
| | - Heriederson Sávio Dias Moura
- Department of Maternal-Infant Nursing and Public Health, University of São Paulo at Ribeirão Preto College of Nursing, Ribeirão Preto, São Paulo, Brazil
| | - Murilo César do Nascimento
- Department of Maternal-Infant Nursing and Public Health, University of São Paulo at Ribeirão Preto College of Nursing, Ribeirão Preto, São Paulo, Brazil
| | - Ariela Fehr Tártaro
- Department of Maternal-Infant Nursing and Public Health, University of São Paulo at Ribeirão Preto College of Nursing, Ribeirão Preto, São Paulo, Brazil
| | - Ruan Victor dos Santos Silva
- Department of Maternal-Infant Nursing and Public Health, University of São Paulo at Ribeirão Preto College of Nursing, Ribeirão Preto, São Paulo, Brazil
| | - Felipe Mendes Delpino
- Department of Maternal-Infant Nursing and Public Health, University of São Paulo at Ribeirão Preto College of Nursing, Ribeirão Preto, São Paulo, Brazil
| | - Regina Célia Fiorati
- Department of Neurosciences and Behavioral Sciences, Ribeirão Preto Medical School of the University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Titilade Kehinde Ayandeyi Teibo
- Department of Maternal-Infant Nursing and Public Health, University of São Paulo at Ribeirão Preto College of Nursing, Ribeirão Preto, São Paulo, Brazil
| | - Yan Mathias Alves
- Department of Maternal-Infant Nursing and Public Health, University of São Paulo at Ribeirão Preto College of Nursing, Ribeirão Preto, São Paulo, Brazil
| | - Juliana Queiroz Rocha de Paiva
- Department of Maternal-Infant Nursing and Public Health, University of São Paulo at Ribeirão Preto College of Nursing, Ribeirão Preto, São Paulo, Brazil
| | - Marcos Augusto Moraes Arcoverde
- Center for Education, Letters and Health, Western Paraná State University, Campus Foz do Iguaçu, Foz do Iguaçu, Paraná, Brazil
| | | | - Ricardo Alexandre Arcêncio
- Department of Maternal-Infant Nursing and Public Health, University of São Paulo at Ribeirão Preto College of Nursing, Ribeirão Preto, São Paulo, Brazil
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Orfão NH, Andrade RLDP, Ruffino-Netto A, da Silva LWF, Villa TCS, Seifert ML, Zilly A, Arcoverde MAM, Hoare I, Izurieta R, da Silva-Sobrinho RA. Influence of COVID-19 on the notification of drug-resistant pulmonary tuberculosis cases. BMC Infect Dis 2023; 23:497. [PMID: 37507668 PMCID: PMC10375729 DOI: 10.1186/s12879-023-08463-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Accepted: 07/15/2023] [Indexed: 07/30/2023] Open
Abstract
BACKGROUND To analyze the influence of the COVID-19 pandemic on the process of diagnosis and monitoring of drug-resistant pulmonary tuberculosis (TB) cases reported in the state of Paraná, Brazil, from 2015 to 2020. METHODS Ecological study with quantitative approach. This study was based on diagnosed cases of pulmonary TB reported in the Notifiable Disease Information System in residents of Paraná; as well as through the number of confirmed cases of COVID-19 in the state epidemiological bulletin for the year 2020. The study data were analyzed using descriptive statistics. RESULTS It was found that, although the number of reported pulmonary TB cases (drug-resistant and general) increased between 2015 and 2019, there was a drop in notification in 2020, the first year of the COVID-19 pandemic. The notification of TB cases was also influenced monthly during the year according to the increase in the number of COVID-19 cases. For cases of drug-resistant pulmonary TB, the provision of diagnostic tests and Directly Observed Treatment decreased by more than half in 2020, especially when compared to 2019. CONCLUSIONS In view of these findings, the influence of COVID-19 on the diagnosis and monitoring of drug-resistant and general pulmonary TB cases is evident, showing that the pandemic has compromised the advances of recent decades in achieving the goals established for its eradication by 2035.
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Affiliation(s)
| | | | | | | | | | | | - Adriana Zilly
- Universidade Estadual do Oeste do Paraná, Foz do Iguaçu, Brazil
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Silva-Sobrinho RA, Oliveira KS, Deschutter EJ, Arcoverde MAM, Hoare I, Izurieta R, Zilly A, Topanotti ML, de Almeida AM, Meira MCR, da Luz LDP, Cicchelero LM, Zimermann F. Risk areas for the occurrence of leprosy in border countries of South America - Brazil and Argentina. PLoS One 2022; 17:e0276977. [PMID: 36417347 PMCID: PMC9683543 DOI: 10.1371/journal.pone.0276977] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Accepted: 10/17/2022] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE The aim was to analyze the spatial association and relative risk (RR) of leprosy cases diagnosed in southern Brazil and in the Argentinean province of Misiones during 2010 to 2016. METHODS This ecological-type epidemiological study analyzed data from the Health Ministries of both countries. The analysis included frequency measures, spatial autocorrelation, RR cluster analysis and map construction. RESULTS A hyperendemic occurrence was identified in all study regions, in the state of Paraná 71.2% of the municipalities were hyperendemic and in Misiones, Argentina 41.2%. The GI* statistical analysis showed clusters of high incidence rates in the state of Paraná and low-risk clusters in much of the state of Rio Grande do Sul, both in Brazil. The analysis indicated an area with RR equal to 3.87 - (p < .0001) when considering the entire territory and an RR of 2.80 - (p < .0001) excluding the state of Paraná, with the number of departments of Misiones, Argentina included in the risk clusters increasing significantly. CONCLUSIONS The findings indicate a high probability of similar illness in adjacent areas, according to their relative position in space, as the occurrence of the disease is influenced by neighboring clusters.
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Affiliation(s)
- Reinaldo Antonio Silva-Sobrinho
- Program in Public Health in Border Region—Master’s Degree, Western Paraná State University, Foz do Iguaçu, Paraná, Brazil
- * E-mail:
| | - Keurilene Sutil Oliveira
- Program in Public Health in Border Region—Master’s Degree, Western Paraná State University, Foz do Iguaçu, Paraná, Brazil
| | - Enrique Jorge Deschutter
- Master’s Degree in Public Health and Communicable Diseases, College of Pharmacy and Biochemistry, National University of Misiones, Posadas, Misiones, Argentina
| | | | - Ismael Hoare
- Public Health Doctoral Program, College of Public Health, University of South Florida, Tampa, Florida, United States of America
| | - Ricardo Izurieta
- Public Health Doctoral Program, College of Public Health, University of South Florida, Tampa, Florida, United States of America
| | - Adriana Zilly
- Program in Public Health in Border Region—Master’s Degree, Western Paraná State University, Foz do Iguaçu, Paraná, Brazil
| | - Maria Luzia Topanotti
- Master’s Degree in Public Health and Communicable Diseases, College of Pharmacy and Biochemistry, National University of Misiones, Posadas, Misiones, Argentina
| | - Ana Maria de Almeida
- Department of Maternal-Infant Nursing and Public Health, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Mara Cristina Ripoli Meira
- Program in Public Health in Border Region—Master’s Degree, Western Paraná State University, Foz do Iguaçu, Paraná, Brazil
| | | | - Laiz Mangini Cicchelero
- Program in Public Health in Border Region—Master’s Degree, Western Paraná State University, Foz do Iguaçu, Paraná, Brazil
| | - Fatima Zimermann
- Department of Epidemiological Surveillance, Hospital Samic of Puerto Iguazú, Puerto Iguazú, Misiones, Argentina
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Scholze AR, Dália Alves J, Berra TZ, Santos FLD, Ramos ACV, Lima de Freitas G, José Quina Galdino M, Meneguetti Pieri F, Augusto Moraes Arcoverde M, Cristina Pillon S, Monroe AA, Fronteira I, Gomes D, Alexandre Arcêncio R. The burden of alcohol, tobacco and others drugs among incarcerated population diagnosed with tuberculosis: time trends and spatial determinants in Southern Brazil. BMC Public Health 2022; 22:999. [PMID: 35581564 PMCID: PMC9112653 DOI: 10.1186/s12889-022-13408-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Accepted: 05/12/2022] [Indexed: 12/05/2022] Open
Abstract
BACKGROUND Tuberculosis (TB) is an infectious disease caused by Mycobacterium tuberculosis and is a public health problem worldwide. It is estimated that 90% of the patients diagnosed with TB live in vulnerable environments with limited health resources, such as individuals living in correctional facilities. This study aimed to identify the consumption of alcohol, tobacco, and other drugs among prisoners diagnosed with TB and the spatial determinants and time trends of the phenomenon in southern Brazil. METHODS A cross-sectional study using data from the Brazilian Notifiable Diseases Information System was carried out. TB cases confirmed from 2014 to 2018 in prisons located in Paraná, Brazil, were selected. The Prais-Winsten procedure was performed to identify time trends by calculating monthly rates and the percentage of monthly variation. The Seasonal-Trend by Loess decomposition method was used to verify the time series and trends. The spatial association was verified with the Getis-Ord Gi* technique, and the risk areas were identified using spatial scan statistics. RESULTS A total of 1,099 TB cases were found in the studied population. The consumption of tobacco (n = 460; 41.9%), illegal drugs (n = 451; 41.0%), and alcohol (n = 179; 16.3%) stood out. An ascending trend was found for the consumption of alcohol (+ 19.4%/mo. (95%CI: 12.20-23.03)), tobacco (+ 20.2%/mo. (95%CI: 12.20-28.82)), and illegal drugs (+ 62.2%/mo. (95%CI: 44.54-81.97)). Spatial analysis revealed clusters for the use of alcohol, tobacco, and illegal drugs. CONCLUSIONS This study advances knowledge presenting the burden of drug use and its typology among individuals diagnosed with TB in the prison system. There is a growing trend among patients to use drugs, especially illegal drugs. The clusters show differences between the places where the prisons are located.
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Affiliation(s)
- Alessandro Rolim Scholze
- Department of Maternal-Infant and Public Health Nursing, Ribeirão Preto College of Nursing, University of São Paulo, São Paulo, Ribeirão Preto, Brazil.
| | - Josilene Dália Alves
- Institute of Biological Sciences and Health, Federal University of Mato Grosso, Barra do Garças, Mato Grosso, Brazil
| | - Thaís Zamboni Berra
- Department of Maternal-Infant and Public Health Nursing, Ribeirão Preto College of Nursing, University of São Paulo, São Paulo, Ribeirão Preto, Brazil
| | - Felipe Lima Dos Santos
- Department of Maternal-Infant and Public Health Nursing, Ribeirão Preto College of Nursing, University of São Paulo, São Paulo, Ribeirão Preto, Brazil
| | - Antônio Carlos Vieira Ramos
- Department of Maternal-Infant and Public Health Nursing, Ribeirão Preto College of Nursing, University of São Paulo, São Paulo, Ribeirão Preto, Brazil
| | - Giselle Lima de Freitas
- Department of Maternal-Infant and Public Health Nursing, College of Nursing, Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | | | | | | | - Sandra Cristina Pillon
- Department of Psychiatric Nursing and Human Sciences, Ribeirão Preto College of Nursing, University of São Paulo, São Paulo, Ribeirão Preto, Brazil
| | - Aline Aparecida Monroe
- Department of Maternal-Infant and Public Health Nursing, Ribeirão Preto College of Nursing, University of São Paulo, São Paulo, Ribeirão Preto, Brazil
| | - Inês Fronteira
- Global Health and Tropical Medicine, Instituto de Higiene E Medicina Tropical, Universidade Nova de Lisboa, Lisbon, Portugal
| | - Dulce Gomes
- School of Science and Technology, Research Center in Mathematics and Application, University of Évora, Évora, Portugal
| | - Ricardo Alexandre Arcêncio
- Department of Maternal-Infant and Public Health Nursing, Ribeirão Preto College of Nursing, University of São Paulo, São Paulo, Ribeirão Preto, Brazil
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Mendes Oliveira F, Arcêncio R, Moraes Arcoverde MA, Fronteira I. Are the neglected tropical diseases under control in the tri-border region between Brazil, Argentina, and Paraguay? J Infect Dev Ctries 2022; 16:547-556. [DOI: 10.3855/jidc.13613] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Accepted: 06/05/2021] [Indexed: 10/31/2022] Open
Abstract
Introduction: Implementation of prevention and control measures for communicable diseases in border regions can be challenging and lead to inefficient attempts to control them. We describe evidences on the strengths, weaknesses, opportunities and challenges regarding implementation of health interventions for control, prevention and treatment of selected neglected tropical diseases (NTD), a group of transmissible diseases typically prevalent in tropical countries and vulnerable populations, in the tri-border between Brazil, Argentina, and Paraguay.
Methodology: A systematic literature review of observational and experimental studies was conducted, using PubMed and Bireme databases. Eligibility criteria were location (tri-border area) and subject (health interventions).
Results: Of a total of 595 references identified, 34 studies were included (18 pertaining to leishmaniasis, 11 to dengue, 2 to leprosy, 2 to soil-transmitted helminthiases and 1 to Chagas’ disease), with an inclusion rate of 6.4%. The main strengths were the similarity of health interventions between countries and easiness of mobility and communication flows. The main weaknesses were access to rural areas and discrepancies in the number of studies between countries. As for opportunities, we identified increased tourism, economic development and recent increasing research in this field. The main challenges were the absence of studies regarding other prevalent NTD in the region and movement of goods, animals and people across borders.
Conclusions: Although epidemiological studies are still needed to better understand and assess the prevalence of NTD in the area, mainly in Paraguay, these findings can inform decision-makers and health managers to plan a common strategy to address NTD.
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Giacomet CL, Santos MS, Berra TZ, Alves YM, Alves LS, da Costa FBP, Ramos ACV, Crispim JDA, Monroe AA, Pinto IC, Fiorati RC, Arcoverde MAM, Gomes D, de Freitas GL, Yamamura M, Arcêncio RA. Temporal trend of tuberculosis incidence and its spatial distribution in Macapá - Amapá. Rev Saude Publica 2021; 55:96. [PMID: 34878090 PMCID: PMC8647990 DOI: 10.11606/s1518-8787.2021055003431] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Accepted: 03/19/2021] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE To evaluate the temporal trend of tuberculosis incidence after the implementation of the rapid molecular test (RMT-TB), to identify whether tuberculosis presents seasonal variation and to classify the territory according to case density and risk areas in Macapá, Amapá. METHODS Ecological study of tuberculosis cases registered in the Sistema de Informação de Agravos de Notificação (SINAN - Information System for Notifiable Diseases) between 2001 and 2017. We used the Prais-Winsten test to classify the temporal trend of incidence and the interrupted time series to identify changes in the temporal trend before and after the implementation of the rapid molecular test, and to verify seasonality in the municipality. The Kernel estimator was used to classify case density and scan statistics to identify areas of tuberculosis risk. RESULTS A total of 1,730 cases were identified, with a decreasing temporal trend of tuberculosis incidence (-0.27% per month, 95%CI -0.13 to -0.41). The time series showed no change in level after the implementation of the GeneXpert®MTB/RIF molecular test; however, the incidence increased in the post-test period (+2.09% per month, 95%CI 0.92 to 3.27). Regarding the seasonal variation, it showed growth (+13.7%/month, 95%CI 4.71 to 23.87) from December to June, the rainy season - called amazon winter season -, and decrease (-9.21% per month, CI95% -1.37 to -16.63) in the other periods. We classified areas with high density of cases in the Central and Northern districts using Kernel and identified three protection clusters, SC1 (RR = 0.07), SC2 (RR = 0.23) and SC3 (RR = 0.36), and a high-risk cluster, SC4 (RR = 1.47), with the scan statistics. CONCLUSION The temporal trend of tuberculosis incidence was decreasing in the time series; however, detection increased after the introduction of RMT-TB, and tuberculosis showed seasonal behavior. The case distribution was heterogeneous, with a tendency to concentrate in vulnerable and risk territories, evidencing a pattern of disease inequality in the territory.
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Affiliation(s)
- Clóvis Luciano Giacomet
- Universidade de São PauloEscola de Enfermagem de Ribeirão PretoRibeirão PretoSPBrasilUniversidade de São Paulo. Escola de Enfermagem de Ribeirão Preto. Ribeirão Preto, SP, Brasil
| | - Marcio Souza Santos
- Universidade de São PauloEscola de Enfermagem de Ribeirão PretoRibeirão PretoSPBrasilUniversidade de São Paulo. Escola de Enfermagem de Ribeirão Preto. Ribeirão Preto, SP, Brasil
| | - Thaís Zamboni Berra
- Universidade de São PauloEscola de Enfermagem de Ribeirão PretoRibeirão PretoSPBrasilUniversidade de São Paulo. Escola de Enfermagem de Ribeirão Preto. Ribeirão Preto, SP, Brasil
| | - Yan Mathias Alves
- Universidade de São PauloEscola de Enfermagem de Ribeirão PretoRibeirão PretoSPBrasilUniversidade de São Paulo. Escola de Enfermagem de Ribeirão Preto. Ribeirão Preto, SP, Brasil
| | - Luana Seles Alves
- Universidade de São PauloEscola de Enfermagem de Ribeirão PretoRibeirão PretoSPBrasilUniversidade de São Paulo. Escola de Enfermagem de Ribeirão Preto. Ribeirão Preto, SP, Brasil
| | - Fernanda Bruzadelli Paulino da Costa
- Universidade de São PauloEscola de Enfermagem de Ribeirão PretoRibeirão PretoSPBrasilUniversidade de São Paulo. Escola de Enfermagem de Ribeirão Preto. Ribeirão Preto, SP, Brasil
| | - Antonio Carlos Vieira Ramos
- Universidade de São PauloEscola de Enfermagem de Ribeirão PretoRibeirão PretoSPBrasilUniversidade de São Paulo. Escola de Enfermagem de Ribeirão Preto. Ribeirão Preto, SP, Brasil
| | - Juliane de Almeida Crispim
- Universidade de São PauloEscola de Enfermagem de Ribeirão PretoRibeirão PretoSPBrasilUniversidade de São Paulo. Escola de Enfermagem de Ribeirão Preto. Ribeirão Preto, SP, Brasil
| | - Aline Aparecida Monroe
- Universidade de São PauloEscola de Enfermagem de Ribeirão PretoRibeirão PretoSPBrasilUniversidade de São Paulo. Escola de Enfermagem de Ribeirão Preto. Ribeirão Preto, SP, Brasil
| | - Ione Carvalho Pinto
- Universidade de São PauloEscola de Enfermagem de Ribeirão PretoRibeirão PretoSPBrasilUniversidade de São Paulo. Escola de Enfermagem de Ribeirão Preto. Ribeirão Preto, SP, Brasil
| | - Regina Célia Fiorati
- Universidade de São PauloEscola de Enfermagem de Ribeirão PretoRibeirão PretoSPBrasilUniversidade de São Paulo. Escola de Enfermagem de Ribeirão Preto. Ribeirão Preto, SP, Brasil
| | - Marcos Augusto Moraes Arcoverde
- Universidade do Oeste do ParanáEscola de EnfermagemFoz do IguaçuPRBrasilUniversidade do Oeste do Paraná, Escola de Enfermagem. Foz do Iguaçu, PR, Brasil
| | - Dulce Gomes
- Universidade de ÉvoraDepartamento de MatemáticaÉvoraPortugalUniversidade de Évora. Departamento de Matemática. Évora, Portugal
| | - Giselle Lima de Freitas
- Universidades Federal de Minas GeraisFaculdades de EnfermagemBelo HorizonteMGBrasilUniversidades Federal de Minas Gerais. Faculdades de Enfermagem. Belo Horizonte, MG, Brasil
| | - Mellina Yamamura
- Universidades Federal de São CarlosFaculdades de EnfermagemSão CarlosSPBrasilUniversidades Federal de São Carlos. Faculdades de Enfermagem. São Carlos, SP, Brasil
| | - Ricardo Alexandre Arcêncio
- Universidade de São PauloEscola de Enfermagem de Ribeirão PretoRibeirão PretoSPBrasilUniversidade de São Paulo. Escola de Enfermagem de Ribeirão Preto. Ribeirão Preto, SP, Brasil
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7
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Martoreli Júnior JF, Ramos ACV, Alves JD, Crispim JDA, Alves LS, Berra TZ, Barbosa TP, da Costa FBP, Alves YM, dos Santos MS, Gomes D, Yamamura M, Pinto IC, Fuentealba-Torres MA, Nunes C, Pieri FM, Arcoverde MAM, dos Santos FL, Arcêncio RA. Inequality of gender, age and disabilities due to leprosy and trends in a hyperendemic metropolis: Evidence from an eleven-year time series study in Central-West Brazil. PLoS Negl Trop Dis 2021; 15:e0009941. [PMID: 34784350 PMCID: PMC8631739 DOI: 10.1371/journal.pntd.0009941] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2021] [Revised: 11/30/2021] [Accepted: 10/21/2021] [Indexed: 11/22/2022] Open
Abstract
The present study aimed to investigate the epidemiological situation of leprosy
(Hansen’s Disease), in a hyperendemic metropolis in the Central-West region of
Brazil. We studied trends over eleven years, both in the detection of the
disease and in disabilities, analyzing disparities and/or differences regarding
gender and age. This is an ecological time series study conducted in Cuiabá,
capital of the state of Mato Grosso. The population consisted of patients
diagnosed with leprosy between the years 2008 and 2018. The time series of
leprosy cases was used, stratifying it according to gender (male and female),
disability grade (G0D, G1D, G2D, and not evaluated) and age. The calendar
adjustment technique was applied. For modeling the trends, the Seasonal-Trend
decomposition procedure based on Loess (STL) was used. We identified 9.739
diagnosed cases, in which 58.37% were male and 87.55% aged between 15 and 59
years. Regarding detection according to gender, there was a decrease among women
and an increase in men. The study shows an increasing trend in disabilities in
both genders, which may be related to the delay in diagnosis. There was also an
increasing number of cases that were not assessed for disability at the time of
diagnosis, which denotes the quality of the services. In the 2019 report, Brazil had a detection rate of 13.23 per 100.000 inhabitants
far from the goal of less than 1 leprosy (Hansen’s Disease) case per 10,000
inhabitants describe by the World Health Organization. The present study aimed
to investigate the epidemiological situation of leprosy and its trend between
2008 and 2018 in a hyperendemic metropolis in the Central-West region of Brazil.
A total of 9.739 leprosy cases were reported between 2008 and 2018. The majority
of cases were male (58.37%), with a predominant age of 15 to 59 years (87.55%).
The predominant level of education was incomplete elementary school (43.96%).
The disability grade at diagnosis showed that 40.19% had G0D and for the G2D was
8,.06%.There was a predominance in operational classification of multibacillary
cases (72.85%). While detection rate trends in females and the majority of the
age groups are decreasing, increases are seen in the detection of male patients
and patients already suffering from disabilities. Although declining trends were
presented, the metropolis is still not close to elimination showing the need
prioritize leprosy actions and to improve care for this disease.
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Affiliation(s)
- José Francisco Martoreli Júnior
- Department of Maternal-Infant Nursing and Public Health, University of
São Paulo at Ribeirão Preto College of Nursing, Ribeirão Preto, São Paulo,
Brazil
- * E-mail:
| | - Antônio Carlos Vieira Ramos
- Department of Maternal-Infant Nursing and Public Health, University of
São Paulo at Ribeirão Preto College of Nursing, Ribeirão Preto, São Paulo,
Brazil
| | - Josilene Dalia Alves
- Departament of Epidemiology, Federal University of Mato Grosso, Cuiába,
Mato Grosso, Brazil
| | - Juliane de Almeida Crispim
- Department of Maternal-Infant Nursing and Public Health, University of
São Paulo at Ribeirão Preto College of Nursing, Ribeirão Preto, São Paulo,
Brazil
| | - Luana Seles Alves
- Department of Maternal-Infant Nursing and Public Health, University of
São Paulo at Ribeirão Preto College of Nursing, Ribeirão Preto, São Paulo,
Brazil
| | - Thaís Zamboni Berra
- Department of Maternal-Infant Nursing and Public Health, University of
São Paulo at Ribeirão Preto College of Nursing, Ribeirão Preto, São Paulo,
Brazil
| | - Tatiana Pestana Barbosa
- Department of Maternal-Infant Nursing and Public Health, University of
São Paulo at Ribeirão Preto College of Nursing, Ribeirão Preto, São Paulo,
Brazil
| | - Fernanda Bruzadelli Paulino da Costa
- Department of Maternal-Infant Nursing and Public Health, University of
São Paulo at Ribeirão Preto College of Nursing, Ribeirão Preto, São Paulo,
Brazil
| | - Yan Mathias Alves
- Department of Maternal-Infant Nursing and Public Health, University of
São Paulo at Ribeirão Preto College of Nursing, Ribeirão Preto, São Paulo,
Brazil
| | - Márcio Souza dos Santos
- Department of Maternal-Infant Nursing and Public Health, University of
São Paulo at Ribeirão Preto College of Nursing, Ribeirão Preto, São Paulo,
Brazil
| | - Dulce Gomes
- Department of Mathematics, University of Évora, Évora,
Portugal
| | - Mellina Yamamura
- Departament of Nursing, Federal University of São Carlos, São Carlos, São
Paulo, Brazil
| | - Ione Carvalho Pinto
- Department of Maternal-Infant Nursing and Public Health, University of
São Paulo at Ribeirão Preto College of Nursing, Ribeirão Preto, São Paulo,
Brazil
| | | | - Carla Nunes
- Department of Public Health, New University of Lisbon, Lisbon,
Portugal
| | | | - Marcos Augusto Moraes Arcoverde
- Center for Education, Letters and Health, Western Paraná State
University, Campus Foz do Iguaçu, Foz do Iguaçu, Paraná,
Brazil
| | - Felipe Lima dos Santos
- Department of Maternal-Infant Nursing and Public Health, University of
São Paulo at Ribeirão Preto College of Nursing, Ribeirão Preto, São Paulo,
Brazil
| | - Ricardo Alexandre Arcêncio
- Department of Maternal-Infant Nursing and Public Health, University of
São Paulo at Ribeirão Preto College of Nursing, Ribeirão Preto, São Paulo,
Brazil
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Meira MCR, Nihei OK, Moschini LE, Arcoverde MAM, Britto ADS, Sobrinho RADS, Muñoz SS. INFLUÊNCIA DO CLIMA NA OCORRÊNCIA DE DENGUE EM UM MUNICÍPIO BRASILEIRO DE TRÍPLICE FRONTEIRA. Cogit Enferm 2021. [DOI: 10.5380/ce.v26i0.76974] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Objetivo: analisar a evolução temporal da incidência da dengue e sua correlação com variáveis climáticas em Foz do Iguaçu, um município brasileiro de tríplice fronteira, no período de agosto de 2006 a julho de 2016. Método: estudo descritivo e analítico, realizado em 2018. Foram utilizados dados secundários obtidos dos sistemas de informações em saúde. Utilizou-se análise temporal e foi aplicado teste de regressão linear simples para avaliar a correlação entre as taxas de incidência da dengue e as variáveis climáticas. Resultados: os anos epidêmicos representaram 60% do período estudado. Ocorreu correlação positiva da incidência de dengue com a média da umidade relativa do ar (r=0,276; p=0,025), média da temperatura (até dois meses antes r=0,288; p=0,014) e pluviosidade (até três meses antes r=0,308; p=0,008). Conclusões: as variáveis climáticas identificadas com relação positiva podem subsidiar aprevisão e controle da epidemia de dengue.
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Silva MSD, Arcoverde MAM, Andrade RLDP, Zilly A, Villa TCS, Silva-Sobrinho RA. Information system on tuberculosis: data completeness spatial analysis in the state of Paraná, Brazil. Rev Esc Enferm USP 2021; 55:e20200538. [PMID: 34464433 DOI: 10.1590/1980-220x-reeusp-2020-0538] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2020] [Accepted: 04/22/2021] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE To analyze the spatiality of completeness of the Information System on Diseases of Compulsory Declaration of tuberculosis in Paraná state, focusing on the border region. METHOD A study composed by the notified cases of the disease treated in Paraná between 2008 and 2017. The variable completeness was classified as excellent (<5% of incompleteness), good (5 to <10%), regular (10 to <20%), poor (20% to 50%), and very poor (>50%). Moran global was used for the spatial correlation and local association was analyzed. Logistic regression was employed to assess the spatial association of the variables with the border and, for the significant variables, multiple logistic regression was used. The study abides by the resolution 510/2016 of the National Health Council. RESULTS There was a "high-high" correlation for education level, 2- and 6-month sputum smear in the Eastern health macroregional and "high-high" correlation in the Northwestern macroregional for 2-month sputum smear and antibiotic sensitivity testing. There was no spatial association with the border. CONCLUSION Unsatisfactory completeness was identified in the database and conglomerates, indicating spatial association of incompleteness of some variables, but with no relation with the border. There was no worsening of completeness nor of the case outcomes related to these regions.
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Affiliation(s)
- Marcelle Saldanha da Silva
- Universidade Estadual do Oeste do Paraná, Programa de Pós-Graduação em Saúde em Região de Fronteira, Foz do Iguaçu, PR, Brazil
| | | | | | - Adriana Zilly
- Universidade Estadual do Oeste do Paraná, Foz do Iguaçu, PR, Brazil
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Silva-Sobrinho RA, Zilly A, Silva RMMD, Arcoverde MAM, Deschutter EJ, Palha PF, Bernardi AS. Coping with COVID-19 in an international border region: health and economy. Rev Lat Am Enfermagem 2021; 29:e3398. [PMID: 33439950 PMCID: PMC7798397 DOI: 10.1590/1518-8345.4659.3398] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2020] [Accepted: 08/21/2020] [Indexed: 12/23/2022] Open
Abstract
OBJECTIVE to analyze how the social isolation measures and closed borders affected the health and economy in an international border region. METHOD descriptive cross-sectional study conducted in the western region of Paraná, Brazil, using an electronic form created using Google® forms. A sample of 2,510 people was addressed. Descriptive analysis and the Chi-square test were performed, with a level of significance established at 5%. This public opinion survey, addressing unidentified participants, is in accordance with Resolutions 466/2012 and 510/2016. RESULTS the participants were 41.5 years old on average, most were women and worked in the education sector; 41.9% reported that the closing of borders/commercial businesses negatively influenced income; 17.7% reported the possibility of losing their jobs; 89.0% consider that a larger number of people would be sick if the borders/commercial had not been closed; 63.7% believe the health services are not prepared to deal with the pandemic; 74.9% realize that the Brazilian Unified Health System may not have sufficient service capacity; 63.4% reported anxiety; and 75.6% of commercial workers will experience changes in their income level. CONCLUSION the closing of international borders and commercial businesses was related to a perception of physical and mental changes, job loss, and decreased income.
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Affiliation(s)
| | - Adriana Zilly
- Universidade Estadual do Oeste do Paraná, Campus de Foz do Iguaçu, Foz do Iguaçu, PR, Brazil
| | | | | | | | - Pedro Fredemir Palha
- Universidade de São Paulo, Escola de Enfermagem de Ribeirão Preto, PAHO/WHO Collaborating Centre for Nursing Research Development, Ribeirão Preto, SP, Brazil
| | - Angela Sobral Bernardi
- Universidade Estadual do Oeste do Paraná, Campus de Foz do Iguaçu, Foz do Iguaçu, PR, Brazil
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Pereira MC, Stranburger da Silva J, Venialgo Silva T, Moraes Arcoverde MA, Carrijo AR. Telessaúde e Covid-19: experiências da enfermagem e psicologia em Foz do Iguaçu. R Saúde Públ Paraná 2020. [DOI: 10.32811/25954482-2020v3sup1p198] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Introdução: A pandemia do novo coronavírus, mostrou a necessidade da utilização de meios tecnológicos no exercício das atividades que envolvem atenção à saúde. Nesse sentido, o objetivo é relatar o desenvolvimento e a aplicabilidade de uma Central de Telessaúde com intervenções de Enfermagem e Psicologia. Método: Estudo descritivo do tipo relato de experiência desenvolvido pelo projeto de extensão intitulado Contribuição das ações de extensão da Unioeste no combate a pandemia do Covid-19 nas Regiões Oeste e Sudeste do Paraná, no município de Foz do Iguaçu. Resultados e Discussão: As intervenções realizadas, permitiram o acompanhamento dos pacientes mediante atendimento telefônico, momento em que eram realizadas as orientações para manutenção dos cuidados de prevenção e promoção à saúde, bem como encaminhamento para outros serviços de referência. Conclusão: A experiência vivenciada nos possibilitou perceber que é possível prestar atendimento multiprofissional mediante uso de tecnologias diversas, para evitar maiores agravos na saúde da população.
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Alves YM, Berra TZ, Alves LS, de Assis IS, Arcoverde MAM, Ramos ACV, Arroyo LH, Campoy LT, Bruce ATI, Dos Santos FL, Souza LLL, de Almeida Crispim J, Arcêncio RA. Risk areas for tuberculosis among children and their inequalities in a city from Southeast Brazil. BMC Pediatr 2020; 20:462. [PMID: 33023517 PMCID: PMC7541251 DOI: 10.1186/s12887-020-02364-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Accepted: 09/28/2020] [Indexed: 11/14/2022] Open
Abstract
Background The objective of the study was to identify areas of risk for the appearance of tuberculosis in children and their association with social inequalities in a municipality in southeastern Brazil. Methods Ecological study conducted in Ribeirão Preto, Brazil. To identify areas of spatial risk for tuberculosis in children, we used spatial scanning statistics. To analyze the association of cases of childhood tuberculosis with social vulnerability, we used the Social Vulnerability Index of São Paulo, and four explanatory statistical models were listed. Results There were 96 cases of childhood tuberculosis, of which 90 were geocoded through a process of converting addresses to geographic coordinates. A risk area was identified in the municipality, where children under 15 years old have 3.14 times greater risk of contracting tuberculosis than those living outside this area. The variables identified as risk factors were: number of private and collective households, proportion of children aged 0 to 5 years in the population, proportion of households without per capita income, and the proportion of private households with monthly nominal incomes of up to one quarter of wage minimums. The variables identified as protection factors were the proportion of women under the age of 30 years responsible for the household under and women responsible for the household with an average income over BRL 2344. Conclusion The study showed areas of risk for the occurrence of tuberculosis in children. The study is in line with the End TB Strategy and the 2030 Agenda, which aim to support strategic actions and, therefore, save the lives of children through the systematic, intensified, and comprehensive identification of children with tuberculosis respiratory symptoms in the community.
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Affiliation(s)
- Yan Mathias Alves
- Public Health Nursing Graduate Program, University of São Paulo at Ribeirão Preto College of Nursing, Avenida dos Bandeirantes, 3900, Monte Alegre, Ribeirão Preto, São Paulo, 14040-902, Brazil.
| | - Thaís Zamboni Berra
- Public Health Nursing Graduate Program, University of São Paulo at Ribeirão Preto College of Nursing, Avenida dos Bandeirantes, 3900, Monte Alegre, Ribeirão Preto, São Paulo, 14040-902, Brazil
| | - Luana Seles Alves
- Public Health Nursing Graduate Program, University of São Paulo at Ribeirão Preto College of Nursing, Avenida dos Bandeirantes, 3900, Monte Alegre, Ribeirão Preto, São Paulo, 14040-902, Brazil
| | | | | | - Antonio Carlos Vieira Ramos
- Public Health Nursing Graduate Program, University of São Paulo at Ribeirão Preto College of Nursing, Avenida dos Bandeirantes, 3900, Monte Alegre, Ribeirão Preto, São Paulo, 14040-902, Brazil
| | - Luiz Henrique Arroyo
- Public Health Nursing Graduate Program, University of São Paulo at Ribeirão Preto College of Nursing, Avenida dos Bandeirantes, 3900, Monte Alegre, Ribeirão Preto, São Paulo, 14040-902, Brazil
| | - Laura Terenciani Campoy
- Public Health Nursing Graduate Program, University of São Paulo at Ribeirão Preto College of Nursing, Avenida dos Bandeirantes, 3900, Monte Alegre, Ribeirão Preto, São Paulo, 14040-902, Brazil
| | - Alexandre Tadashi Inomata Bruce
- Public Health Nursing Graduate Program, University of São Paulo at Ribeirão Preto College of Nursing, Avenida dos Bandeirantes, 3900, Monte Alegre, Ribeirão Preto, São Paulo, 14040-902, Brazil
| | - Felipe Lima Dos Santos
- Public Health Nursing Graduate Program, University of São Paulo at Ribeirão Preto College of Nursing, Avenida dos Bandeirantes, 3900, Monte Alegre, Ribeirão Preto, São Paulo, 14040-902, Brazil
| | - Ludmilla Leidianne Limirio Souza
- Public Health Nursing Graduate Program, University of São Paulo at Ribeirão Preto College of Nursing, Avenida dos Bandeirantes, 3900, Monte Alegre, Ribeirão Preto, São Paulo, 14040-902, Brazil
| | - Juliane de Almeida Crispim
- Inter-institutional Doctoral Program in Nursing, University of São Paulo at Ribeirão Preto College of Nursing, Ribeirão Preto, São Paulo, Brazil
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Rêgo Queiroz AA, Zamboni Berra T, Inomata Bruce AT, da Cunha Garcia MC, Dos Santos DT, Moraes Arcoverde MA, Seles Alves L, Yamamura M, Scatena Villa TC, Fredemir Palha P, Chiaravalloti-Neto F, Arcêncio RA. Effect of social development in reducing tuberculosis mortality In northeastern Brazil areas. J Infect Dev Ctries 2020; 14:869-877. [PMID: 32903231 DOI: 10.3855/jidc.12196] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2019] [Accepted: 06/14/2020] [Indexed: 10/31/2022] Open
Abstract
INTRODUCTION Tuberculosis (TB) is the primary cause of death among infectious diseases affecting groups in extreme poverty. Social improvements could reverse this situation in Brazil. This study aims to demonstrate the spatial relationship between social development (SD) and TB mortality in Natal, a city in northeastern Brazil. METHODOLOGY Ecological study. The study population comprised TB deaths recorded in the Mortality Information System between 2008 and 2014. The units of analysis were 59 human development units (HDUs). Raw and smoothed mortality rates were calculated using the global empirical Bayes method. Primary components analysis was used to develop the SD indicators. An association between TB mortality and SD was verified using multiple linear regression analysis. Spatial autocorrelation was verified using models with global spatial effects. Analyses were performed using Statistica version 12.0, ArcGIS version 10.2, Statistical Package for the Social Sciences version 20.0, and OpenGeoDa 1.0.1. The significance level was established at 5% (p < 0.05). RESULTS The TB mortality rate with non-random spatial distribution ranged between 0.52 and 8.90 per 100,000 inhabitants. The spatial lag model was chosen because it presented the highest log-likelihood value, lowest AIC, and highest R2. A negative association was found between TB mortality and SD (R2 = 0.207; p = 0.03). CONCLUSIONS The results show a negative association between TB mortality and the high SD indicator. This study can support decision-making in terms of collective projects within public health in order to link the health field to other sectors, aiming for social well-being and human development.
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Affiliation(s)
| | - Thaís Zamboni Berra
- College Nursing at Ribeirão Preto, University of Sao Paulo. Ribeirão Preto, Sao Paulo, Brazil.
| | | | | | | | | | - Luana Seles Alves
- College Nursing at Ribeirão Preto, University of Sao Paulo. Ribeirão Preto, Sao Paulo, Brazil.
| | - Mellina Yamamura
- College Nursing at Ribeirão Preto, University of Sao Paulo. Ribeirão Preto, Sao Paulo, Brazil.
| | | | - Pedro Fredemir Palha
- College Nursing at Ribeirão Preto, University of Sao Paulo. Ribeirão Preto, Sao Paulo, Brazil.
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14
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Berra TZ, Assis ISD, Arroyo LH, Arcoverde MAM, Alves JD, Campoy LT, Alves LS, Crispim JDA, Bruce ATI, Alves YM, Lima Dos Santos F, da Costa Uchôa SA, Fiorati RC, Lapão L, Arcêncio RA. Social determinants of deaths from pneumonia and tuberculosis in children in Brazil: an ecological study. BMJ Open 2020; 10:e034074. [PMID: 32819980 PMCID: PMC7443304 DOI: 10.1136/bmjopen-2019-034074] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
OBJECTIVE To identify the risk areas of deaths due to unspecified pneumonia and tuberculosis (TB) in children, and to identify if there is a relationship between these events with higher TB incidence and social determinants. METHODS Ecological study carried out in Brazil. All cases of TB or unspecified pneumonia deaths in children under 5 years of age reported between 2006 and 2016 were included and collected through Department of Informatics of the Unified Health System (Brazil's electronic database). The Spatial Scan Statistics was used to identify areas at higher risk of dying from this event. The spatial association was verified through the Getis-Ord techniques. The Bivariate Moran Global Index was used to verify the spatial autocorrelation between the two events. To identify the association of TB and pneumonia deaths with endemic areas of pulmonary TB and social determinants, four explanatory statistical models were identified. RESULTS A total of 21 391 cases of pneumonia and 238 cases of TB were identified. Spatial scanning analysis enabled the detection of four clusters of risk for TB (relative risk, RR, between 3.30 and 18.18) and 22 clusters for pneumonia (RR between 1.38 and 5.24). The spatial association of the events was confirmed (z-score 3.74 and 64.34) and spatial autocorrelation between events (Moran Index:0.031 (p=0.001)). The zero-inflated negative binomial distribution was chosen, and an association for both events was identified with the TB incidence rate (OR 5.3, 95% CI 2.85 to 9.84; OR 6.63, 95% CI 5.62 to 7.81), with the Gini Index (OR 1.78, 95% CI 1.12 to 2.82; OR 4.22, 95% CI 3.63 to4.92). Primary care coverage showed an inverse association for both events (OR 0.10, 95% CI 0.67 to 0.17; OR 0.18, 95% CI 0.15 to 0.21) for pneumonia). Finally, a family that benefited from the Bolsa Família Programme had an inverse association for deaths from pneumonia (OR 0.81, 95% CI 0.52 to 1.25). CONCLUSIONS The results do not just contribute to reduce mortality in children, but mainly contribute to prevent premature deaths through identification of critical areas in Brazil, which is crucial to qualify health surveillance services.
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Affiliation(s)
- Thaís Zamboni Berra
- Department of Maternal-Infant and Public Health, Universidade de Sao Paulo, Ribeirão Preto, Brazil
| | | | - Luiz Henrique Arroyo
- Department of Maternal-Infant and Public Health, Universidade de Sao Paulo, Ribeirão Preto, Brazil
| | | | - Josilene Dália Alves
- Department of Maternal-Infant and Public Health, Universidade de Sao Paulo, Ribeirão Preto, Brazil
| | - Laura Terenciani Campoy
- Department of Maternal-Infant and Public Health, Universidade de Sao Paulo, Ribeirão Preto, Brazil
| | - Luana Seles Alves
- Department of Maternal-Infant and Public Health, Universidade de Sao Paulo, Ribeirão Preto, Brazil
| | | | | | - Yan Mathias Alves
- Department of Maternal-Infant and Public Health, Universidade de Sao Paulo, Ribeirão Preto, Brazil
| | - Felipe Lima Dos Santos
- Department of Maternal-Infant and Public Health, Universidade de Sao Paulo, Ribeirão Preto, Brazil
| | | | - Regina Celia Fiorati
- Department of Maternal-Infant and Public Health, Universidade de Sao Paulo, Ribeirão Preto, Brazil
| | - Luis Lapão
- International Public Health and Biostatistics, Universidade Nova de Lisboa, Lisboa, Portugal
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Ramos ACV, Gomes D, Santos Neto M, Berra TZ, de Assis IS, Yamamura M, Crispim JDA, Martoreli Júnior JF, Bruce ATI, dos Santos FL, Souza LLL, Alves YM, de Andrade HLP, Arcoverde MAM, Pieri FM, Arcêncio RA. Trends and forecasts of leprosy for a hyperendemic city from Brazil's northeast: Evidence from an eleven-year time-series analysis. PLoS One 2020; 15:e0237165. [PMID: 32764785 PMCID: PMC7413479 DOI: 10.1371/journal.pone.0237165] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2020] [Accepted: 07/21/2020] [Indexed: 11/23/2022] Open
Abstract
This study’s objective was to estimate the temporal trends of leprosy according to sex and age groups, as well as to estimate and predict the progression of the disease in a hyperendemic city located in the northeast of Brazil. This ecological time-series study was conducted in Imperatriz, Maranhão, Brazil. Leprosy cases diagnosed between 2006 and 2016 were included. Detection rates stratified by sex and age groups were estimated. The study of temporal trends was accomplished using the Seasonal-Trend Decomposition method and temporal modeling of detection rates using linear seasonal autoregressive integrated moving average model according to Box and Jenkins method. Trend forecasts were performed for the 2017–2020 period. A total of 3,212 cases of leprosy were identified, the average incidence among men aged between 30 and 59 years old was 201.55/100,000 inhabitants and among women in the same age group was 135.28/100,000 inhabitants. Detection rates in total and by sex presented a downward trend, though rates stratified according to sex and age presented a growing trend among men aged less than 15 years old and among women aged 60 years old or over. The final models selected in the time-series analysis show the forecasts of total detection rates and rates for men and women presented a downward trend for the 2017–2020 period. Even though the forecasts show a downward trend in Imperatriz, the city is unlikely to meet a significant decrease of the disease burden by 2020.
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Affiliation(s)
- Antônio Carlos Vieira Ramos
- Department of Maternal-Infant Nursing and Public Health, University of São Paulo at Ribeirão Preto College of Nursing, Ribeirão Preto, São Paulo, Brazil
- * E-mail:
| | - Dulce Gomes
- Department of Mathematics, University of Évora, Évora, Portugal
| | - Marcelino Santos Neto
- Center for Social Sciences, Health and Technology, Federal University of Maranhão, Imperatriz, Maranhão, Brazil
| | - Thaís Zamboni Berra
- Department of Maternal-Infant Nursing and Public Health, University of São Paulo at Ribeirão Preto College of Nursing, Ribeirão Preto, São Paulo, Brazil
| | | | - Mellina Yamamura
- Nursing Department, Federal University of São Carlos, São Carlos, São Paulo, Brazil
| | - Juliane de Almeida Crispim
- Department of Maternal-Infant Nursing and Public Health, University of São Paulo at Ribeirão Preto College of Nursing, Ribeirão Preto, São Paulo, Brazil
| | - José Francisco Martoreli Júnior
- Department of Maternal-Infant Nursing and Public Health, University of São Paulo at Ribeirão Preto College of Nursing, Ribeirão Preto, São Paulo, Brazil
| | - Alexandre Tadashi Inomata Bruce
- Department of Maternal-Infant Nursing and Public Health, University of São Paulo at Ribeirão Preto College of Nursing, Ribeirão Preto, São Paulo, Brazil
| | - Felipe Lima dos Santos
- Department of Maternal-Infant Nursing and Public Health, University of São Paulo at Ribeirão Preto College of Nursing, Ribeirão Preto, São Paulo, Brazil
| | - Ludmilla Leidianne Limirio Souza
- Department of Maternal-Infant Nursing and Public Health, University of São Paulo at Ribeirão Preto College of Nursing, Ribeirão Preto, São Paulo, Brazil
| | - Yan Mathias Alves
- Department of Maternal-Infant Nursing and Public Health, University of São Paulo at Ribeirão Preto College of Nursing, Ribeirão Preto, São Paulo, Brazil
| | - Hamilton Leandro Pinto de Andrade
- Department of Maternal-Infant Nursing and Public Health, University of São Paulo at Ribeirão Preto College of Nursing, Ribeirão Preto, São Paulo, Brazil
| | - Marcos Augusto Moraes Arcoverde
- Center for Education, Letters and Health, Western Paraná State University, Campus Foz do Iguaçu, Foz do Iguaçu, Paraná, Brazil
| | | | - Ricardo Alexandre Arcêncio
- Department of Maternal-Infant Nursing and Public Health, University of São Paulo at Ribeirão Preto College of Nursing, Ribeirão Preto, São Paulo, Brazil
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Campoy LT, Ramos ACV, Souza LLL, Alves LS, Arcoverde MAM, Berra TZ, Arroyo LH, Santos DTD, Arcêncio RA. Spatial distribution and temporal trend of National Health System and Supplemental Health Sector human resources, Brazil, 2005-2016. Epidemiol Serv Saude 2020; 29:e2018376. [PMID: 32401878 DOI: 10.5123/s1679-49742020000200020] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2019] [Accepted: 02/28/2020] [Indexed: 11/02/2022] Open
Abstract
OBJECTIVE to analyze the spatial distribution and temporal trend of human resources for the Brazilian National Health System (SUS) and the Supplemental Health sector. METHODS an ecological study was conducted in the country's 27 Federative Units (FUs); SUS Information Technology Department (DATASUS) data were used relating to the doctor, dental surgeon, nurse and nursing technician personnel categories for the period 2005-2016; Prais-Winsten regression was used to assess the time trend. RESULTS there was an rising trend of Supplemental Health Sector human resources in all personnel categories, with an mean annual increase of 0.054 (95%CI: 0.031;0.076); with regard to SUS, there was an increase in dental surgeons and nursing technicians, with annual increases of 0.008 (95%CI: 0.003;0.011), and 0.066 (95%CI 0.022; 0.087), respectively, while in most FU, nurses showed a stationary trend and doctors showed a stationary or falling trend. CONCLUSION inequalities were found in human resource distribution, reflecting the health system crisis.
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Affiliation(s)
- Laura Terenciani Campoy
- Escola de Enfermagem de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brazil
| | | | | | - Luana Seles Alves
- Escola de Enfermagem de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brazil
| | | | - Thaís Zamboni Berra
- Escola de Enfermagem de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brazil
| | - Luiz Henrique Arroyo
- Escola de Enfermagem de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brazil
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Ramos ACV, Santos Neto M, Arroyo LH, Yamamura M, Assis IS, Alves JD, Arcoverde MAM, Alves LS, Berra TZ, Martoreli Júnior JF, Pieri FM, Arcêncio RA. Magnitude of social determinants in high risk areas of leprosy in a hyperendemic city of northeastern Brazil: An ecological study. LEPROSY REV 2020. [DOI: 10.47276/lr.91.1.41] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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de Assis IS, Berra TZ, Alves LS, Ramos ACV, Arroyo LH, Dos Santos DT, Arcoverde MAM, Alves JD, de Almeida Crispim J, Pieri FM, Frade MAC, Pinto IC, Nunes C, Arcêncio RA. Leprosy in urban space, areas of risk for disability and worsening of this health condition in Foz Do Iguaçu, the border region between Brazil, Paraguay and Argentina. BMC Public Health 2020; 20:119. [PMID: 31996183 PMCID: PMC6988226 DOI: 10.1186/s12889-020-8236-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2019] [Accepted: 01/16/2020] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND Leprosy is a public health problem and a challenge for endemic countries, especially in their border regions where there are intense migration flows. The study aimed to analyse the dynamics of leprosy, in order to identify areas of risk for the occurrence of the disease and disability and places where this health condition is worsening. METHOD This ecological study considered the new cases of leprosy reported in the municipality of Foz do Iguaçu from 2003 to 2015. Spatial and spatial-temporal scan statistics were used to identify the risk areas for the occurrence of leprosy, as well as the Getis-Ord Gi and Getis-Ord Gi* methods. Areas of risk for disabilities were identified by the scan statistic and kernel density estimation. RESULTS A total of 840 cases were reported, of which 179 (21.3%) presented Grade 1 or 2 disabilities at the time of diagnosis. Leprosy risk areas were concentrated in the Southern, Eastern and Northeastern Health Districts of the municipality. The cases of Grade 2 disability were observed with higher intensity in regions characterized by high population density and poverty. CONCLUSION The results of the study have revealed changes in the pattern of areas at risk of leprosy according to the investigated periods. In addition, it was possible to verify disabilities as a condition present in the investigated cases, or that may be related to the late diagnosis of the disease. In the areas of risk identified, patients have reported worse physical disability after diagnostic confirmation, or indicate inadequate clinical examination, reinforcing the need for structuring leprosy control services in a qualified manner.
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Affiliation(s)
- Ivaneliza Simionato de Assis
- Nursing College of Ribeirão Preto, University of São Paulo, Ribeirão Preto, São Paulo, Brazil.
- University Center Dinâmica of Cataratas, Foz do Iguaçu, Paraná, Brazil.
| | - Thais Zamboni Berra
- Nursing College of Ribeirão Preto, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Luana Seles Alves
- Nursing College of Ribeirão Preto, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | | | - Luiz Henrique Arroyo
- Nursing College of Ribeirão Preto, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | | | | | | | | | | | | | - Ione Carvalho Pinto
- Nursing College of Ribeirão Preto, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Carla Nunes
- Escola Nacional de Saúde Pública, Universidade Nova de Lisboa, Lisbon, Portugal
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Oliveira KSD, Arcoverde MAM, Deschutter EJ, Silva AJD, Zilly A, Silva Sobrinho RAD. HANSENÍASE EM PAÍSES FRONTEIRIÇOS NA AMÉRICA DO SUL: UM ESTUDO ECOLÓGICO. Cogitare Enferm 2019. [DOI: 10.5380/ce.v24i0.64917] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Objetivo: caracterizar o perfil clínico epidemiológico e a distribuição espacial da incidência dahanseníase em territórios fronteiriços da América do Sul.Método: trata-se de um estudo ecológico. O estudo compreendeu a Província de Misiones naArgentina e a Região Sul do Brasil. A população foi composta por 10.319 casos novos de hanseníase,diagnosticados entre 2010 e 2016.Resultados: o estado do Paraná foi o mais endêmico, representando 70,2% (n=7,247) doscasos. Houve predomínio da classificação operacional multibacilar (79,8%, n=8.233) e Grau 0de incapacidade física (50,6%, n=5.223). Em Misiones 18,9% utilizaram esquema de tratamentosubstitutivo. No período, notou-se uma situação hiperendêmica em 780 (65,5%) dos municípios/departamentos estudados.Conclusão: o estudo mostrou que as regiões estudadas apresentam alta endemicidade, transmissãoativa e diagnóstico tardio da hanseníase. Essas tendências entrelaçadas à força de morbidade e detransmissão recente e persistente da doença, ampliam a relevância da hanseníase como problemade saúde pública na região.
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Campoy LT, Arroyo LH, Ramos ACV, Andrade RLDP, Arcoverde MAM, Alves JD, Arcêncio RA. COBERTURA DE TRATAMENTO DIRETAMENTE OBSERVADO SEGUNDO O RISCO DE COINFECÇÃO TB/HIV E DESFECHOS DESFAVORÁVEIS. Cogitare Enferm 2019. [DOI: 10.5380/ce.v24i0.66775] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Objetivo: analisar a cobertura do tratamento diretamente observado segundo o risco de coinfecçãotuberculose/vírus da imunodeficiência humana e desfechos desfavoráveis.Método: estudo ecológico com dados secundários relacionados aos 10.389 casos novos decoinfecção notificados no estado de São Paulo de 2010 a 2015. Dados analisados pelo Índice Localde Moran, estatística de varredura espacial e Modelos Bayesianos Hierárquicos.Resultados: região metropolitana de São Paulo e Baixada Santista concentraram maior incidênciade coinfecção e abandono ao tratamento. Baixa cobertura de tratamento diretamente observadoesteve associada aos territórios em risco para a coinfecção e maior risco de abandono. Municípiode São Paulo, região litorânea e região de Ribeirão Preto apresentaram maior incidência de óbito,o qual não apresentou relação com a cobertura do tratamento diretamente observado.Conclusão: baixa cobertura de tratamento diretamente observado apresentou associação commaior risco de coinfecção e abandono do tratamento.
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Arroyo LH, Ramos ACV, Yamamura M, Berra TZ, Alves LS, Belchior ADS, Santos DT, Alves JD, Campoy LT, Arcoverde MAM, Bollela VR, Bombarda S, Nunes C, Arcêncio RA. Predictive model of unfavorable outcomes for multidrug-resistant tuberculosis. Rev Saude Publica 2019; 53:77. [PMID: 31553380 PMCID: PMC6752648 DOI: 10.11606/s1518-8787.2019053001151] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2018] [Accepted: 11/26/2018] [Indexed: 12/29/2022] Open
Abstract
OBJECTIVE to analyze the temporal trend, identify the factors related and elaborate a predictive model for unfavorable treatment outcomes for multidrug-resistant tuberculosis (MDR-TB). METHODS Retrospective cohort study with all cases diagnosed with MDR-TB between the years 2006 and 2015 in the state of São Paulo. The data were collected from the state system of TB cases notifications (TB-WEB). The temporal trend analyzes of treatment outcomes was performed through the Prais-Winsten analysis. In order to verify the factors related to the unfavorable outcomes, abandonment, death with basic cause TB and treatment failure, the binary logistic regression was used. Pictorial representations of the factors related to treatment outcome and their prognostic capacity through the nomogram were elaborated. RESULTS Both abandonment and death have a constant temporal tendency, whereas the failure showed it as decreasing. Regarding the risk factors for such outcomes, using illicit drugs doubled the odds for abandonment and death. Besides that, being diagnosed in emergency units or during hospitalizations was a risk factor for death. On the contrary, having previous multidrug-resistant treatments reduced the odds for the analyzed outcomes by 33%. The nomogram presented a predictive model with 65% accuracy for dropouts, 70% for deaths and 80% for failure. CONCLUSIONS The modification of the current model of care is an essential factor for the prevention of unfavorable outcomes. Through predictive models, as presented in this study, it is possible to develop patient-centered actions, considering their risk factors and increasing the chances for cure.
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Affiliation(s)
- Luiz Henrique Arroyo
- Universidade de São Paulo. Escola de Enfermagem de Ribeirão Preto. Ribeirão Preto, SP, Brasil
| | | | - Mellina Yamamura
- Universidade de São Paulo. Escola de Enfermagem de Ribeirão Preto. Ribeirão Preto, SP, Brasil
| | - Thais Zamboni Berra
- Universidade de São Paulo. Escola de Enfermagem de Ribeirão Preto. Ribeirão Preto, SP, Brasil
| | - Luana Seles Alves
- Universidade de São Paulo. Escola de Enfermagem de Ribeirão Preto. Ribeirão Preto, SP, Brasil
| | | | - Danielle Talita Santos
- Universidade de São Paulo. Escola de Enfermagem de Ribeirão Preto. Ribeirão Preto, SP, Brasil
| | - Josilene Dália Alves
- Universidade de São Paulo. Escola de Enfermagem de Ribeirão Preto. Ribeirão Preto, SP, Brasil
| | - Laura Terenciani Campoy
- Universidade de São Paulo. Escola de Enfermagem de Ribeirão Preto. Ribeirão Preto, SP, Brasil
| | | | - Valdes Roberto Bollela
- Universidade de São Paulo. Faculdade de Medicina de Ribeirão Preto. Ribeirão Preto, SP, Brasil
| | - Sidney Bombarda
- Secretaria de Estado da Saúde de São Paulo. São Paulo, SP, Brasil
| | - Carla Nunes
- Universidade NOVA de Lisboa. Escola Nacional de Saúde Pública. Lisboa, Portugal
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Alves LS, Dos Santos DT, Arcoverde MAM, Berra TZ, Arroyo LH, Ramos ACV, de Assis IS, de Queiroz AAR, Alonso JB, Alves JD, Popolin MP, Yamamura M, de Almeida Crispim J, Dessunti EM, Palha PF, Chiaraval-Neto F, Nunes C, Arcêncio RA. Detection of risk clusters for deaths due to tuberculosis specifically in areas of southern Brazil where the disease was supposedly a non-problem. BMC Infect Dis 2019; 19:628. [PMID: 31315568 PMCID: PMC6637579 DOI: 10.1186/s12879-019-4263-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2019] [Accepted: 07/04/2019] [Indexed: 01/06/2023] Open
Abstract
Background Tuberculosis (TB) is the infectious disease that kills the most people worldwide. The use of geoepidemiological techniques to demonstrate the dynamics of the disease in vulnerable communities is essential for its control. Thus, this study aimed to identify risk clusters for TB deaths and their variation over time. Methods This ecological study considered cases of TB deaths in residents of Londrina, Brazil between 2008 and 2015. We used standard, isotonic scan statistics for the detection of spatial risk clusters. The Poisson discrete model was adopted with the high and low rates option used for 10, 30 and 50% of the population at risk, with circular format windows and 999 replications considered the maximum cluster size. Getis-Ord Gi* (Gi*) statistics were used to diagnose hotspot areas for TB mortality. Kernel density was used to identify whether the clusters changed over time. Results For the standard version, spatial risk clusters for 10, 30 and 50% of the exposed population were 4.9 (95% CI 2.6–9.4), 3.2 (95% CI: 2.1–5.7) and 3.2 (95% CI: 2.1–5.7), respectively. For the isotonic spatial statistics, the risk clusters for 10, 30 and 50% of the exposed population were 2.8 (95% CI: 1.5–5.1), 2.7 (95% CI: 1.6–4.4), 2.2 (95% CI: 1.4–3.9), respectively. All risk clusters were located in the eastern and northern regions of the municipality. Additionally, through Gi*, hotspot areas were identified in the eastern and western regions. Conclusions There were important risk areas for tuberculosis mortality in the eastern and northern regions of the municipality. Risk clusters for tuberculosis deaths were observed in areas where TB mortality was supposedly a non-problem. The isotonic and Gi* statistics were more sensitive for the detection of clusters in areas with a low number of cases; however, their applicability in public health is still restricted.
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Affiliation(s)
- Luana Seles Alves
- Nursing Graduate Program in Public Health Nursing, University of São Paulo at Ribeirão Preto Nursing College, 3900 Avenida dos Bandeirantes, São Paulo, Brazil. .,Maternal-Infant and Public Health Nursing Department, University of São Paulo at Ribeirão Preto College of Nursing, Av dos Bandeirantes 3900, Ribeirão Preto, São Paulo, 14040-902, Brazil.
| | - Danielle Talita Dos Santos
- Inter-institutions Doctoral Program in Nursing, University of São Paulo at Ribeirão Preto Nursing College, São Paulo, Brazil
| | - Marcos Augusto Moraes Arcoverde
- Nursing Graduate Program in Public Health Nursing, University of São Paulo at Ribeirão Preto Nursing College, 3900 Avenida dos Bandeirantes, São Paulo, Brazil
| | - Thais Zamboni Berra
- Nursing Graduate Program in Public Health Nursing, University of São Paulo at Ribeirão Preto Nursing College, 3900 Avenida dos Bandeirantes, São Paulo, Brazil
| | - Luiz Henrique Arroyo
- Inter-institutions Doctoral Program in Nursing, University of São Paulo at Ribeirão Preto Nursing College, São Paulo, Brazil
| | - Antônio Carlos Vieira Ramos
- Nursing Graduate Program in Public Health Nursing, University of São Paulo at Ribeirão Preto Nursing College, 3900 Avenida dos Bandeirantes, São Paulo, Brazil
| | - Ivaneliza Simionato de Assis
- Nursing Graduate Program in Public Health Nursing, University of São Paulo at Ribeirão Preto Nursing College, 3900 Avenida dos Bandeirantes, São Paulo, Brazil
| | | | | | - Josilene Dália Alves
- Inter-institutions Doctoral Program in Nursing, University of São Paulo at Ribeirão Preto Nursing College, São Paulo, Brazil
| | | | - Mellina Yamamura
- Inter-institutions Doctoral Program in Nursing, University of São Paulo at Ribeirão Preto Nursing College, São Paulo, Brazil
| | - Juliane de Almeida Crispim
- Inter-institutions Doctoral Program in Nursing, University of São Paulo at Ribeirão Preto Nursing College, São Paulo, Brazil
| | | | | | - Francisco Chiaraval-Neto
- Department of Epidemiology, School of Public Health, University of São Paulo, São Paulo, São Paulo, Brazil
| | - Carla Nunes
- National School of Public Health, Nova University of Lisbon, Lisboa, Portugal
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Arroyo LAH, Arcoverde MAM, Alves JD, Fuentealba-Torres M, Cartagena-Ramos D, Scholze AR, Ramos ACV, Arcêncio RA. Spatial analysis of cases of Tuberculosis with Mental Disorders in São Paulo. Rev Bras Enferm 2019; 72:654-662. [DOI: 10.1590/0034-7167-2017-0949] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2018] [Accepted: 06/16/2018] [Indexed: 11/22/2022] Open
Abstract
ABSTRACT Objective: To analyze the spatial distribution of Tuberculosis cases with Mental Disorders, identifying factors that determine its occurrence. Method: Ecological study, conducted in the municipalities of São Paulo State. Secondary data were used, with the incidence of Tuberculosis and Mental Disorders as dependent variables in the years 2012 to 2015 and independent variables, socioeconomic, health and income transfer data. The Geographically Weighted Regression was applied in this study. Results: It was observed a distinct distribution between cases of Tuberculosis and Mental Disorders in the municipalities of São Paulo State. Among the explanatory factors, the Primary Care Coverage, population of freedom and income inequality were spatially associated with Mental Illness (R2= 0.12); Alcoholism (R2= 0.12) Illicit Drugs (R2= 0.50) and Smoking (R2= 0.50). Conclusion / Final considerations: The study advances in knowledge by evidencing the spatial distribution of cases of Tuberculosis and Mental Disorders, evidencing the determining factors for its occurrence in São Paulo State.
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Fuentealba-Torres M, Cartagena-Ramos D, Fronteira I, Lara LA, Arroyo LH, Arcoverde MAM, Yamamura M, Nascimento LC, Arcêncio RA. What are the prevalence and factors associated with sexual dysfunction in breastfeeding women? A Brazilian cross-sectional analytical study. BMJ Open 2019; 9:e025833. [PMID: 31028040 PMCID: PMC6502039 DOI: 10.1136/bmjopen-2018-025833] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
OBJECTIVE This study determined the prevalence and factors associated with sexual dysfunction in breastfeeding women. DESIGN Cross-sectional analytical study. SETTING Population-based study of individuals living in the northeast region of São Paulo state, Brazil. PARTICIPANTS From May to August 2017, 372 women aged ≥18 years were selected who gave exclusive, predominant or complementary breast feeding up to 23 months postpartum, and who did not have contraindications for the resumption of intercourse. Pregnant women, those diagnosed with mental health problems, users of medications that affect sexual function (antihypertensives, antidepressants or antipsychotics) and women unable to read or understand the instructions for the study were excluded. PRIMARY AND SECONDARY OUTCOME MEASURES The breastfeeding women completed the Female Sexual Function Index, the EUROHIS-QOL 8-item index and a questionnaire to collect participants' sociodemographic, clinical and interpersonal data. A bivariate analysis was performed, and variables with p values<0.20 were analysed by multivariate logistic regression. RESULTS Sexual dysfunction was present in 58.3% of the study population. Factors significantly associated with female sexual dysfunction (FSD) included placing a low importance on sexual intercourse (adjusted OR [AOR]=2.49, 95% CI=1.22 to 5.09), limited communication with the partner (AOR=2.64, 95% CI=1.43 to 4.86), decreased frequency of sexual intercourse (AOR=2.17, 95% CI=1.30 to 3.61) and low quality of life (AOR=2.23, 95% CI=1.33 to 3.74). CONCLUSIONS The prevalence of FSD appears with a great magnitude in breastfeeding women. The risk factors for sexual dysfunction are biopsychosocial and these findings may lead to improved counselling for prenatal and postnatal care.
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Affiliation(s)
| | - Denisse Cartagena-Ramos
- Maternal-Infant and Public Health, University of Sao Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Inês Fronteira
- Department of International Public Health and Biostatistics, Universidade Nova de Lisboa Escola Nacional de Saude Publica, Lisboa, Lisboa, Portugal
| | - Lúcia Alves Lara
- Departament of Gynecology and Obstetrics, University of Sao Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Luiz Henrique Arroyo
- Maternal-Infant and Public Health, University of Sao Paulo, Sao Paulo, São Paulo, Brazil
| | | | - Mellina Yamamura
- Maternal-Infant and Public Health, University of Sao Paulo, Ribeirão Preto, São Paulo, Brazil
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Alves JD, Arroyo LH, Moraes Arcoverde MA, Cartagena-Ramos D, Zamboni Berra T, Seles Alves L, Vieira Ramos AC, Fuentealba-Torres M, Simionato de Assis I, Fiorati RC, Nunes C, Arcêncio RA. [Magnitude of social determinants in the risk of death from tuberculosis in Central-west Brazil]. Gac Sanit 2019; 34:171-178. [PMID: 30878245 DOI: 10.1016/j.gaceta.2019.01.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/03/2018] [Revised: 11/08/2018] [Accepted: 01/03/2019] [Indexed: 10/27/2022]
Abstract
OBJECTIVE To evaluate the magnitude of social determinants in areas of risk of mortality due to tuberculosis in a high incidence city. METHOD Ecological study, which recruited the cases of tuberculosis deaths registered between 2006 and 2016 in the capital of Mato Grosso-Brazil. The social determinants were obtained from the Human Development Units. Sweep statistics were used to identify areas of risk of mortality due to tuberculosis. Principal component analysis was carried out to identify dimensions of social determinants. Multiple logistic regression was applied to verify associations between the dimensions of social determinants and the risk of mortality from tuberculosis. A 5% error was fixed. The standard error was established at 5% for all statistical tests. RESULTS A total of 225 deaths due to tuberculosis were registered in the period, distributed heterogeneously in the space. A cluster of risk for tuberculosis mortality was identified, with RR=2.09 (95%CI: 1.48-2.94; p=0.04). Social determinants, low educational level and poverty were associated with the risk of mortality due to tuberculosis (OR: 2.92; 95%CI: 1.17-7.28). Income had a negative association with the risk of mortality due to tuberculosis (OR: 0.05; 95%CI: 0.00-0.70). The value of the ROC curve of the model was 92.1%. CONCLUSIONS The results confirmed that the risk of mortality due to tuberculosis is a problem associated with social determinants. Health policies and social protection programmes can collaborate to address this problem.
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Affiliation(s)
- Josilene Dália Alves
- Departamento Materno-Infantil y Salud Pública, Escuela de Enfermería de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, Brasil.
| | - Luiz Henrique Arroyo
- Departamento Materno-Infantil y Salud Pública, Escuela de Enfermería de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, Brasil
| | - Marcos Augusto Moraes Arcoverde
- Departamento Materno-Infantil y Salud Pública, Escuela de Enfermería de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, Brasil
| | - Denisse Cartagena-Ramos
- Departamento Materno-Infantil y Salud Pública, Escuela de Enfermería de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, Brasil
| | - Thais Zamboni Berra
- Departamento Materno-Infantil y Salud Pública, Escuela de Enfermería de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, Brasil
| | - Luana Seles Alves
- Departamento Materno-Infantil y Salud Pública, Escuela de Enfermería de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, Brasil
| | - Antônio Carlos Vieira Ramos
- Departamento Materno-Infantil y Salud Pública, Escuela de Enfermería de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, Brasil
| | - Miguel Fuentealba-Torres
- Departamento Materno-Infantil y Salud Pública, Escuela de Enfermería de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, Brasil
| | - Ivaneliza Simionato de Assis
- Departamento Materno-Infantil y Salud Pública, Escuela de Enfermería de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, Brasil
| | - Regina Célia Fiorati
- Departamento de Ciencias de la Salud, Facultad de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, Brasil
| | - Carla Nunes
- Escola Nacional de Salud Pública, Universidade Nova de Lisboa, Lisboa, Portugal
| | - Ricardo Alexandre Arcêncio
- Departamento Materno-Infantil y Salud Pública, Escuela de Enfermería de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, Brasil
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Ramos ACV, Alves LS, Berra TZ, Popolin MP, Arcoverde MAM, Campoy LT, Martoreli JF, Lapão LV, Palha PF, Arcêncio RA. [Family Health Strategy, private health care, and inequalities in access to mammography in BrazilEstrategia de Salud Familiar, salud suplementaria y desigualdad en el acceso a la mamografía en Brasil]. Rev Panam Salud Publica 2018; 42:e166. [PMID: 31093194 PMCID: PMC6398316 DOI: 10.26633/rpsp.2018.166] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2017] [Accepted: 08/15/2018] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE To evaluate the association between access to mammography and coverage by private health insurance or by the public healthcare system through the Family Health Strategy (FHS). METHOD An ecological study was performed with data obtained from the Unified Health System Data Processing Department (DATASUS). Time trends were analyzed using the Prais-Winsten method, having the Brazilian federal units as units of analysis. Multiple linear regression was used to investigate the relationship between the dependent variable - women aged 50 to 69 years who never had a mammogram - and the independent variables (coverage by the FHS or private health care and socioeconomic aspects). RESULTS Acre was the only Brazilian state for which an increasing growth trend in private health care was not observed. Roraima, Tocantins, Maranhão, Piauí, Rio Grande do Norte, and Paraíba showed a stable trend for FHS coverage, whereas all other federal units had increasing coverage. A significant association was observed between never having had a mammogram at 50 to 69 years of age and the variables mean per capita income and FHS and private health care coverage (R2 = 0.77; P < 0.001). CONCLUSION Unequal access to mammography is a reality in Brazil. Both private health care and the FHS have contributed to improve health care accessibility for Brazilian women.
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Affiliation(s)
- Antônio Carlos Vieira Ramos
- Universidade de São Paulo (USP), Escola de Enfermagem de Ribeirão Preto, Ribeirão Preto (SP), Brasil,Correspondência: Antônio Carlos Vieira Ramos,
| | - Luana Seles Alves
- Universidade de São Paulo (USP), Escola de Enfermagem de Ribeirão Preto, Ribeirão Preto (SP), Brasil
| | - Thaís Zamboni Berra
- Universidade de São Paulo (USP), Escola de Enfermagem de Ribeirão Preto, Ribeirão Preto (SP), Brasil
| | - Marcela Paschoal Popolin
- Universidade Federal de Mato Grosso (UFMT), Instituto de Ciências da Saúde, Campus de Sinop, Sinop, (MT), Brasil
| | - Marcos Augusto Moraes Arcoverde
- Universidade Estadual do Oeste do Paraná (UNIOESTE), Campus de Foz do Iguaçu, Centro de Educação, Letras e Saúde, Foz do Iguaçu (PR), Brasil
| | - Laura Terenciani Campoy
- Universidade de São Paulo (USP), Escola de Enfermagem de Ribeirão Preto, Ribeirão Preto (SP), Brasil
| | - José Francisco Martoreli
- Universidade de São Paulo (USP), Escola de Enfermagem de Ribeirão Preto, Ribeirão Preto (SP), Brasil
| | - Luís Velez Lapão
- Universidade Nova de Lisboa, Instituto de Higiene e Medicina Tropical, Lisboa, Portugal
| | - Pedro Fredemir Palha
- Universidade de São Paulo (USP), Escola de Enfermagem de Ribeirão Preto, Ribeirão Preto (SP), Brasil
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Arcoverde MAM, Berra TZ, Alves LS, Santos DTD, Belchior ADS, Ramos ACV, Arroyo LH, Assis ISD, Alves JD, Queiroz AARD, Yamamura M, Palha PF, Neto FC, Silva-Sobrinho RA, Nihei OK, Arcêncio RA. How do social-economic differences in urban areas affect tuberculosis mortality in a city in the tri-border region of Brazil, Paraguay and Argentina. BMC Public Health 2018; 18:795. [PMID: 29940908 PMCID: PMC6019811 DOI: 10.1186/s12889-018-5623-2] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2017] [Accepted: 05/29/2018] [Indexed: 11/18/2022] Open
Abstract
Background The World Health Organization (WHO) launched the “End TB Strategy”, which aims to reduce tuberculosis (TB) mortality by 95% by 2035, Brazil has made a commitment to this, however, one challenge is achieving the goal in the border region, where the TB situation is more critical. The proposal was to analyse the spatial mortality due to TB and its socio-economic determinants in the general population, around the border areas of Brazil, Paraguay and Argentina, as well as the temporal trend in this region. Method This ecological study considered the cases of TB deaths of residents of Foz do Iguaçu (BR), with its units of analysis being the census sectors. The standardized mortality rate was calculated for each area. Socioeconomic variables data were obtained from the 2010 Demographic Census of the Brazilian Institute of Geography and Statistics (IBGE). The scan statistic was applied to calculate the spatial relative risk (RR), considering a 95% confidence interval (CI). Spatial dependence was analysed using the Global Bivariate Moran I and Local Bivariate Moran I (LISA) to test the relationship between the socioeconomic conditions of the urban areas and mortality from TB. Analysis of the temporal trend was also performed using the Prais-Winsten test. Results A total of 74 cases of TB death were identified, of which 53 (71.6%) were male and 51 (68.9%) people of white skin colour. The mortality rate ranged from 0.28 to 22.75 cases per 100,000 inhabitants. A spatial relative risk area was identified, RR = 5.07 (95% CI 1.79–14.30). Mortality was associated with: proportion of people of brown skin colour (I: 0.0440, p = 0.033), income (low income I: − 0.0611, p = 0.002; high income I: − 0.0449, p = 0.026) and density of residents (3 and 4 residents, I: 0.0537, p = 0.007; 10 or more residents, I: − 0.0390, p = 0.035). There was an increase in the mortality rate in people of brown skin colour (6.1%; 95% CI = 0.029, 0.093). Conclusion Death due to TB was associated with income, race resident density and social conditions. Although the TB mortality rate is stationary in the general population, it is increasing among people of brown skin colour.
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Affiliation(s)
- Marcos Augusto Moraes Arcoverde
- Nursing College of Ribeirão Preto, University of São Paulo, São Paulo, Brazil. .,State University of West Paraná, Avenida Paraná, 1610, Foz do Iguaçu, Paraná, 85863-720, Brazil.
| | - Thais Zamboni Berra
- Nursing College of Ribeirão Preto, University of São Paulo, São Paulo, Brazil
| | - Luana Seles Alves
- Nursing College of Ribeirão Preto, University of São Paulo, São Paulo, Brazil
| | | | | | | | | | | | | | | | - Mellina Yamamura
- Nursing College of Ribeirão Preto, University of São Paulo, São Paulo, Brazil
| | | | | | | | - Oscar Kenji Nihei
- State University of West Paraná, Avenida Paraná, 1610, Foz do Iguaçu, Paraná, 85863-720, Brazil
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Simionato de Assis I, Arcoverde MAM, Ramos ACV, Alves LS, Berra TZ, Arroyo LH, de Queiroz AAR, dos Santos DT, Belchior ADS, Alves JD, Pieri FM, Silva-Sobrinho RA, Pinto IC, Tavares CM, Yamamura M, Frade MAC, Palha PF, Chiaravalloti-Neto F, Arcêncio RA. Social determinants, their relationship with leprosy risk and temporal trends in a tri-border region in Latin America. PLoS Negl Trop Dis 2018; 12:e0006407. [PMID: 29624595 PMCID: PMC5906021 DOI: 10.1371/journal.pntd.0006407] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2017] [Revised: 04/18/2018] [Accepted: 03/24/2018] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Brazil is the only country in Latin America that has adopted a national health system. This causes differences in access to health among Latin American countries and induces noticeable migration to Brazilian regions to seek healthcare. This phenomenon has led to difficulties in the control and elimination of diseases related to poverty, such as leprosy. The aim of this study was to evaluate social determinants and their relationship with the risk of leprosy, as well as to examine the temporal trend of its occurrence in a Brazilian municipality located on the tri-border area between Brazil, Paraguay and Argentina. METHODS This ecological study investigated newly-diagnosed cases of leprosy between 2003 and 2015. Exploratory analysis of the data was performed through descriptive statistics. For spatial analysis, geocoding of the data was performed using spatial scan statistic techniques to obtain the Relative Risk (RR) for each census tract, with their respective 95% confidence intervals calculated. The Bivariate Moran I test, Ordinary Least Squares (OLS) and Geographically Weighted Regression (GWR) models were applied to analyze the spatial relationships of social determinants and leprosy risk. The temporal trend of the annual coefficient of new cases was obtained through the Prais-Winsten regression. A standard error of 5% was considered statistically significant (p < 0.05). RESULTS Of the 840 new cases identified in the study, there was a predominance of females (n = 427, 50.8%), of white race/color (n = 685, 81.6%), age range 15 to 59 years (n = 624, 74.3%), and incomplete elementary education (n = 504, 60.0%). The results obtained from multivariate analysis revealed that the proportion of households with monthly nominal household income per capita greater than 1 minimum wage (β = 0.025, p = 0.036) and people of brown race (β = -0.101, p = 0.024) were statistically-significantly associated with risk of illness due to leprosy. These results also confirmed that social determinants and risk of leprosy were significantly spatially non-stationary. Regarding the temporal trend, a decrease of 4% (95% CI [-0.053, -0.033], p = 0.000) per year was observed in the rate of detection of new cases of leprosy. CONCLUSION The social determinants income and race/color were associated with the risk of leprosy. The study's highlighting of these social determinants can contribute to the development of public policies directed toward the elimination of leprosy in the border region.
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Affiliation(s)
- Ivaneliza Simionato de Assis
- Graduate Program in Public Health Nursing, Nursing College of Ribeirão Preto, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
- * E-mail:
| | - Marcos Augusto Moraes Arcoverde
- Graduate Program in Public Health Nursing, Nursing College of Ribeirão Preto, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Antônio Carlos Viera Ramos
- Graduate Program in Public Health Nursing, Nursing College of Ribeirão Preto, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Luana Seles Alves
- Graduate Program in Public Health Nursing, Nursing College of Ribeirão Preto, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Thais Zamboni Berra
- Graduate Program in Public Health Nursing, Nursing College of Ribeirão Preto, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Luiz Henrique Arroyo
- Graduate Program Interunit Doctoral Program in Nursing, University of São Paulo at Ribeirão Preto College of Nursing, Ribeirão Preto, São Paulo, Brazil
| | | | - Danielle Talita dos Santos
- Graduate Program Interunit Doctoral Program in Nursing, University of São Paulo at Ribeirão Preto College of Nursing, Ribeirão Preto, São Paulo, Brazil
| | - Aylana de Souza Belchior
- Graduate Program Interunit Doctoral Program in Nursing, University of São Paulo at Ribeirão Preto College of Nursing, Ribeirão Preto, São Paulo, Brazil
| | - Josilene Dália Alves
- Graduate Program Interunit Doctoral Program in Nursing, University of São Paulo at Ribeirão Preto College of Nursing, Ribeirão Preto, São Paulo, Brazil
| | | | | | - Ione Carvalho Pinto
- Graduate Program in Public Health Nursing, Nursing College of Ribeirão Preto, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Clodis Maria Tavares
- Department of School of Nursing and Pharmacy, Federal University of Alagoas, Maceió, Alagoas, Brazil
| | - Mellina Yamamura
- Graduate Program Interunit Doctoral Program in Nursing, University of São Paulo at Ribeirão Preto College of Nursing, Ribeirão Preto, São Paulo, Brazil
| | - Marco Andrey Cipriani Frade
- Division of Dermatology of the Department of Internal Medicine of the Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Pedro Fredemir Palha
- Graduate Program in Public Health Nursing, Nursing College of Ribeirão Preto, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | | | - Ricardo Alexandre Arcêncio
- Graduate Program in Public Health Nursing, Nursing College of Ribeirão Preto, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
- Graduate Program Interunit Doctoral Program in Nursing, University of São Paulo at Ribeirão Preto College of Nursing, Ribeirão Preto, São Paulo, Brazil
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Arcoverde MAM, Conter RS, Silva RMMD, Santos MFD. FEELINGS AND EXPECTATIONS OF PREGNANT WOMEN LIVING WITH HIV: A PHENOMENOLOGICAL STUDY. REME: Revista Mineira de Enfermagem 2015. [DOI: 10.5935/1415-2762.20150043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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