Revista de saude publica最新文献

{"title":"Psychometric study of the Hospital Anxiety and Depression Scale with health professionals.","authors":"Priscila Pereira da Silva Lopes, Rafaela Schaefer, Juliana Nichterwitz Scherer","doi":"10.11606/s1518-8787.2025059006420","DOIUrl":"10.11606/s1518-8787.2025059006420","url":null,"abstract":"<p><strong>Objective: </strong>To assess the validity of the internal structure and reliability of the Brazilian version of the Hospital Anxiety and Depression Scale (HADS) for screening depressive and anxious symptoms in primary care health professionals.</p><p><strong>Methods: </strong>A psychometric study carried out with health professionals from primary health care services in a municipality in Rio Grande do Sul, Brazil, in 2023. The quality of the HADS instrument was assessed by internal structural validity, using Exploratory Factor Analysis (EFA), Confirmatory Factor Analysis (CFA), and internal consistency, using Cronbach's Alpha and McDonald's Omega coefficients.</p><p><strong>Results: </strong>217 health professionals took part in the study, of both sexes and from different professional categories, such as doctors, nurses, nursing technicians and assistants, dentists and oral health assistants, and community health workers. The EFA showed the two-factor model, anxiety and depression, as originally proposed. The CFA confirmed that the two-dimensional model was a good fit for the sample investigated. The Alpha and Omega values were 0.833 and 0.838 for anxiety and 0.763 and 0.766 for depression, respectively. Both indicated acceptable reliability.</p><p><strong>Conclusions: </strong>The HADS is a valid and reliable instrument for screening symptoms of anxiety and depression in primary care professionals in Rio Grande do Sul, Brazil.</p>","PeriodicalId":21230,"journal":{"name":"Revista de saude publica","volume":"59 ","pages":"e9"},"PeriodicalIF":2.1,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12211771/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144561019","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Spatial clusters of risk and cartography of care for drug-resistant tuberculosis.","authors":"Jaqueline Garcia de Almeida Ballestero, José Nildo de Barros Silva Júnior, Luiz Henrique Arroyo, Daniele Maria Pelissari, Isabela Zaccaro Rigolin, Pedro Fredemir Palha, Aline Aparecida Monroe, Quézia Rosa Ferreira, Gilberto da Cruz Leal, Leonora de Oliveira Teixeira, Yury Bitencourt da Costa, Ione Carvalho Pinto, Rubia Laine de Paula Andrade, Ricardo Alexandre Arcêncio","doi":"10.11606/s1518-8787.2025059006489","DOIUrl":"10.11606/s1518-8787.2025059006489","url":null,"abstract":"<p><strong>Objective: </strong>To identify spatial clusters of risk and map the care network for people with drug-resistant tuberculosis in the state of São Paulo.</p><p><strong>Methods: </strong>This is an ecological study, carried out by collecting data from the Special Tuberculosis Treatment Information System (Site-TB) of people treated for drug-resistant tuberculosis from 2013 to 2020, in the state of São Paulo. Mapping was carried out using Kernel and scan statistic techniques.</p><p><strong>Results: </strong>1,084 cases were reported in the period analyzed. São Paulo, Ribeirão Preto, Santos, Guarulhos, and Campinas were the municipalities with the highest number of cases. The spatial pattern of agglomeration of cases and referral centers for treatment were similar, with gaps in coverage in the southwest and northwest of the state. Six spatial clusters were identified: four low-risk and two high-risk, located in São Paulo, Diadema, Santos, and Guarujá.</p><p><strong>Conclusions: </strong>The concentration of cases and tertiary referral centers in metropolitan areas highlights inequalities in access to treatment for drug-resistant tuberculosis. These findings indicate the need for health policies to expand diagnosis and treatment, improving the control of drug-resistant tuberculosis in the state of São Paulo.</p>","PeriodicalId":21230,"journal":{"name":"Revista de saude publica","volume":"59 ","pages":"e11"},"PeriodicalIF":2.1,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12211794/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144561021","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Munduruku Indigenous children: health situation in an area with high mercury exposure.","authors":"Cristina Barroso Hofer, André Reynaldo Santos Périssé, Ana Cláudia Santiago de Vasconcellos, Paulo Victor de Sousa Viana, Joseph W Kempton, Marcelo de Oliveira Lima, Iracina Maura de Jesus, Sandra de Souza Hacon, Paulo Cesar Basta","doi":"10.11606/s1518-8787.2025059006403","DOIUrl":"10.11606/s1518-8787.2025059006403","url":null,"abstract":"<p><strong>Objective: </strong>The Munduruku indigenous people are among those most severely impacted by mercury (Hg) contamination in the Amazon region. Mercury exposure can have severe consequences for the physical and cognitive development of children. We aimed to describe the health assessment in indigenous Munduruku children in the Tapajós River basin, possibly exposed chronically to Hg.</p><p><strong>Methods: </strong>A cross-sectional study with children <12 years old living in the Sawré Muybu (SM), Poxo Muybu (PM), and Sawré Aboy (SA) villages. We collected data between October 29th and November 9th, 2019, through interviews and clinical evaluation (child neurodevelopment tests and anthropometric measurements), and measured blood hemoglobin levels and Hg in hair samples. The history of immunization and other health issues were collected from the Brazilian health booklets. We investigated the prevalence of Hg exposure ≥ 6.0 µg/g. The measure of association used was the Prevalence Ratio (PR), with a 95% CI.</p><p><strong>Results: </strong>We examined 83 children, 40 in SM, 15 in SA, and 28 in PM. 51.8% were girls, 45.7% had completed the vaccination schedule, 16.0% had changes in the neurodevelopment test, and 13.9% had anemia. Their weight and height/length averages were (Z-scores) -0.86 and -1.59, respectively. 45.1% of children had Hg-levels ≥ 6.0 µg/g. The prevalence of mercury contamination in children in SA was almost four times greater (PR:3.66; 95%CI 2.17-6.18) than that in children in SM, and girls were almost twice as likely (PR:1.67; 95%CI 1.07-2.62) to have mercury levels ≥ 6.0 µg/g, when compared with boys in the study villages.</p><p><strong>Conclusions: </strong>The higher concentration of hair Hg-levels occurred in SA, where Hg exposure is higher. Although we cannot prove causality, we believe that understanding the possible health impacts of mercury exposure among the Munduruku children is vital for developing strategies to mitigate these effects and for supporting the fight for their rights and the protection of their territories.</p>","PeriodicalId":21230,"journal":{"name":"Revista de saude publica","volume":"59 ","pages":"e19"},"PeriodicalIF":2.1,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12211787/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144561018","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sex-specific public health data: analyzing the arboviral impact on women in Brazil.","authors":"Brena F Sena, Danyelly Bruneska Gondim Martins, Carmen Simone Grilo Diniz, José Luiz Lima Filho","doi":"10.11606/s1518-8787.2025059006235","DOIUrl":"10.11606/s1518-8787.2025059006235","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the differential impact of arboviral infections, specifically dengue virus, chikungunya virus, and Zika virus, on women in Brazil, with a focus on sex- and age-disaggregated analyses.</p><p><strong>Methods: </strong>A comprehensive epidemiological and geospatial data analysis was conducted utilizing data from Brazil's national health data system, including the disease notification system (Sistema de Informação de Agravos de Notificação) and mortality information system (Sistema de Informação sobre Mortalidade), covering national and municipal level data. Arboviral case notification rates were analyzed using generalized linear mixed models with negative binomial regression, stratified by sex, age group, and year. Geospatial visualizations mapped the case rate distribution highlighting the top municipalities with the most female case rate and hospitalizations rate. All analyses were implemented in the statistical software R.</p><p><strong>Results: </strong>Significant sex- and age-stratified differences were observed in the arbovirus notification rates for dengue virus, chikungunya virus, and Zika virus over the past seven years, with consistently higher rates among women compared to men. Stratified analyses revealed that females aged 20-59 years, particularly those of reproductive age, bore a disproportionately higher burden across all three viruses. The low serotyping resolution for the dengue virus constrained further granular analysis, particularly for severe outcomes such as hospitalizations and mortality based on dengue serotype.</p><p><strong>Conclusion: </strong>Sex- and age-disaggregated epidemiological surveillance is critical to inform public health policies and interventions targeting arboviral diseases. This study underscores the necessity of incorporating sex-specific data analyses to optimize responses for vulnerable female populations. Geospatial visualizations reveal infection hotspots, providing actionable insights for region-specific interventions to improve health outcomes in Brazil.</p>","PeriodicalId":21230,"journal":{"name":"Revista de saude publica","volume":"59 ","pages":"e17"},"PeriodicalIF":2.1,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12211769/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144561020","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Time trend of Vigitel Brasil operation indicators (2006 to 2023).","authors":"Taciana Maia de Sousa, Luiza Eunice Sá da Silva, Laura Cordeiro Rodrigues, Thaís Cristina Marquezine Caldeira, Letícia de Oliveira Cardoso, Rafael Moreira Claro","doi":"10.11606/s1518-8787.2025059006369","DOIUrl":"10.11606/s1518-8787.2025059006369","url":null,"abstract":"<p><strong>Objective: </strong>To analyze the time trend of indicators from the Vigitel data collection operation between 2006 and 2023.</p><p><strong>Methods: </strong>A methodological study that analyzed the temporal trend of three Vigitel operation indicators: eligibility rate, response rate and refusal rate, as well as the number of contacts answered according to days of the week and times of day. A series of linear regressions was used to identify temporal variations for the entire period (2006 to 2023) and for the final five years of this period (2018 to 2023).</p><p><strong>Results: </strong>During the 17 editions analyzed, there was a decrease in the eligibility rate (-3.26 pp/year; p < 0.001) with the greatest magnitude in the most recent period (-12.23 pp/year; p = 0.010). Although the inclusion of mobile phones in the register in 2023 has mitigated the drop in eligibility, especially in recent years, the reduction has remained high (-10.43 pp/year; p = 0.020). The response rate also fell over the entire period (-0.78; p < 0.001) and, together with the fall in eligibility, represents an obstacle to the sustainability of the survey. On the other hand, the refusal rate also fell (-0.23 pp/year; p = 0.030), indicating the consistent quality of the system's operation. The number of contacts answered was concentrated on weekdays and between 9am and 8pm.</p><p><strong>Conclusions: </strong>An analysis of the data from the Vigitel survey suggests that the methodology used has become fatigued, with reductions in eligibility and response rates over the years. Only the refusal rate, despite being far from its lowest levels, remains at satisfactory levels. The search for alternatives that make participation more convenient for the respondent is an important path for surveys of this nature, with a view to maintaining the quality of health surveillance in the country.</p>","PeriodicalId":21230,"journal":{"name":"Revista de saude publica","volume":"59 ","pages":"e20"},"PeriodicalIF":2.1,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12211791/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144561023","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Erratum.","authors":"","doi":"10.11606/s1518-8787.2025059005816err","DOIUrl":"10.11606/s1518-8787.2025059005816err","url":null,"abstract":"<p><p>[This corrects the article doi: 10.11606/s1518-8787.2025059005816].</p>","PeriodicalId":21230,"journal":{"name":"Revista de saude publica","volume":"59 ","pages":"e5err"},"PeriodicalIF":2.1,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12211765/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144561016","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Congenital Zika syndrome: geographical access to the health care network.","authors":"Danielle Amaral de Freitas, Mayumi Duarte Wakimoto, Reinaldo Souza-Santos","doi":"10.11606/s1518-8787.2025059006562","DOIUrl":"10.11606/s1518-8787.2025059006562","url":null,"abstract":"<p><strong>Objectives: </strong>To analyze the geographic access of children with congenital Zika syndrome (CZS), residing in the city of Rio de Janeiro between 2015 and 2017, to rehabilitation services.</p><p><strong>Methods: </strong>Ecological study, based on spatial analysis. Commute maps were constructed using QGis 3.36.3 and the distances, time and cost between rehabilitation services and the homes of children with CZS, in the city of Rio de Janeiro, reported between 2015 and 2017 in the Registry System of Public Health Events.</p><p><strong>Results: </strong>47 children were identified, 6 died. Among the 41 survivors, 17 were followed up in primary and secondary health care (PHC and SHC), 10 only in PHC, 7 only in SHC, and 7 had no follow-up record. CZS cases were more frequent in the north and west zones of the city. 143 trajectories followed by the 36 children between home and a rehabilitation service were identified; 147 commutes, followed 1 to 106 times; the majority destined for 3 units (n = 17 - 47.0%). The largest number of trajectories and commutes were among residents in the north and west zones of the city, poorer regions, with greater distances, cost, and time spent traveling between home and the health unit.</p><p><strong>Conclusions: </strong>The variation in trajectories, the number of recorded commutes, and the number of units included in the trajectories suggest the complexity of the children's clinical condition, from basic care in PHC to procedures with greater technological density in specialized care.</p>","PeriodicalId":21230,"journal":{"name":"Revista de saude publica","volume":"59 ","pages":"e10"},"PeriodicalIF":2.1,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12211770/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144561009","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Estimating the share of ultra-processed foods in Brazilian municipalities.","authors":"Leandro Teixeira Cacau, Maria Helena D'Aquino Benicio, Renata Bertazzi Levy, Maria Laura da Costa Louzada","doi":"10.11606/s1518-8787.2025059006615","DOIUrl":"10.11606/s1518-8787.2025059006615","url":null,"abstract":"<p><strong>Objective: </strong>To estimate the caloric share of ultra-processed foods (% UPF) in the 5,570 Brazilian municipalities.</p><p><strong>Methods: </strong>The estimation of % UPF in municipalities was performed using a statistical prediction model based on data from 46,164 individuals aged over >10 years who participated in the Household Budget Survey (HBS 2017-2018). Multiple linear regression was used to estimate the average % UPF (measured through two 24-hour dietary recalls) based on predictor variables (sex, age, income, education, race/color, urbanity, federative units, and geographic location). The model's adequacy was assessed through residual analysis and by comparing predicted values with those directly measured in POF 2017-2018 using Lin's concordance correlation coefficient (CCC). The linear coefficients obtained from the multiple linear regression model were applied to the sociodemographic data from the 2010 Census (measured similarly to POF) to estimate the % UPF for each municipality.</p><p><strong>Results: </strong>The statistical model proved adequate, showing normally distributed residuals and a CCC of 0.87, indicating almost perfect agreement. There was heterogeneity in the distribution of % UPF estimates, ranging from 5.75% in Aroeiras do Itaim (PI) to 30.5% in Florianópolis (SC). % UPF estimates were higher (>20%) in municipalities from the South region and the state of São Paulo. Capitals had higher estimates of caloric contribution from ultra-processed foods compared to other municipalities in their states.</p><p><strong>Conclusions: </strong>The predictive model revealed differences in % UPF among Brazilian municipalities. The generated estimates can contribute to monitoring ultra-processed food consumption at the municipal level and support the development of public policies focused on promoting healthy eating.</p>","PeriodicalId":21230,"journal":{"name":"Revista de saude publica","volume":"59 ","pages":"e22"},"PeriodicalIF":2.1,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12207894/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144561017","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Erratum.","authors":"","doi":"10.11606/s1518-8787.2025059005728err","DOIUrl":"10.11606/s1518-8787.2025059005728err","url":null,"abstract":"<p><p>[This corrects the article doi: 10.11606/s1518-8787.2020054005728] [This corrects the article doi: 10.11606/s1518-8787.2024058005728].</p>","PeriodicalId":21230,"journal":{"name":"Revista de saude publica","volume":"59 ","pages":"e5serr"},"PeriodicalIF":2.1,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12207888/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144561013","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Erratum.","authors":"","doi":"10.11606/s1518-8787.2025059005729err","DOIUrl":"10.11606/s1518-8787.2025059005729err","url":null,"abstract":"<p><p>[This corrects the article doi: 10.11606/s1518-8787.2024058005729] [This corrects the article doi: 10.11606/s1518-8787.2024058005729].</p>","PeriodicalId":21230,"journal":{"name":"Revista de saude publica","volume":"59 ","pages":"e13serr"},"PeriodicalIF":2.1,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12207893/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144561014","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}