Epidemiologia e servicos de saude : revista do Sistema Unico de Saude do Brasil最新文献

{"title":"A multicenter study on the mental health of Brazilian adolescent mothers, 2024.","authors":"Amanda Ferreira de Carvalho, Daniela Dal Forno Kinalski Guaranha, Bruna Marmett, Júlia Mathias Reis, Bruna Silveira da Rosa, Carmem Lisiane Escouto de Souza, Tiago Chagas Dalcin, Sérgio Luís Amantéa, Frederico Viana Machado","doi":"10.1590/S2237-96222025v34e20240226.en","DOIUrl":"10.1590/S2237-96222025v34e20240226.en","url":null,"abstract":"<p><strong>Objective: </strong>To analyze the mental health of Brazilian adolescent mothers who use the Unified Health System (Sistema Único de Saúde, SUS).</p><p><strong>Methods: </strong>This is a multicenter study conducted with 583 adolescent mothers (10-19 years old). The participants responded to a questionnaire on sociodemographic variables, mental health and family support. The results were presented as absolute and relative frequencies. The association between outcome and variables was investigated using Poisson regression.</p><p><strong>Results: </strong>Some level of depression (61.9%) and anxiety (63.8%) was present in the adolescents. These symptoms were associated with a lack of family support (p-value<0.001), the loss of school friends (p-value<0.001), the diagnosis of postpartum depression (p-value<0.001), and the diagnosis of depression or anxiety before or during pregnancy (p-value<0.001). 15.9% of the adolescents diagnosed with mental health conditions were being treated. The main barriers identified were difficulties in access to psychological support, lack of interest and lack of encouragement.</p><p><strong>Conclusion: </strong>The study revealed worrying rates of depression and anxiety among teenage girls. The importance of family support was emphasized, the absence of which is linked to increased symptoms of mental distress. The impact of the loss of social ties and a history of mental health problems, such as postpartum depression, is highlighted. 15% of the adolescents had psychological monitoring, which makes evident the barriers to access to mental health. The results underline an urgent need for interventions and public policies to improve access to psychological support and to promote the mental health of this population.</p>","PeriodicalId":520611,"journal":{"name":"Epidemiologia e servicos de saude : revista do Sistema Unico de Saude do Brasil","volume":"34 ","pages":"e20240226"},"PeriodicalIF":2.0,"publicationDate":"2025-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12435885/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145034919","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Drugs incorporated into the Brazilian Unified Health System: document analysis of methodological decisions in budget impact analyses between 2012 and 2024.","authors":"Daniel da Silva Pereira Curado, Everton Nunes da Silva","doi":"10.1590/S2237-96222025v34e20250122.en","DOIUrl":"10.1590/S2237-96222025v34e20250122.en","url":null,"abstract":"<p><strong>Objective: </strong>Systematize the methodological decisions adopted in the budget impact analyses of the recommendation reports of the National Commission for the Incorporation of Technologies into the Unified Health System (Conitec) regarding drugs incorporated into the SUS (Brazilian Unified Health System) in the period from 2012 to 2024.</p><p><strong>Methods: </strong>This is an exploratory, descriptive, retrospective study, based on document analysis of Conitec's technical recommendation reports with decisions on the incorporation of drugs published up to 2024. Information from the Budget Impact Analyses (BIA) was extracted and presented in terms of percentage, median and interquartile range.</p><p><strong>Results: </strong>291 analyses for the incorporation of drugs were identified. More than half of these were requested by the public sector (65.3%). Chronic non-communicable diseases were most frequent (39.2%), followed by infectious diseases (22.3%) and rare conditions (21.0%). The majority of the drugs included represented new additions (55.3%). The presence of BIA in the analyses was quite gradual, reaching 100% only from 2019 onwards. 64.5% used claims data-based and 84.0% conducted sensitivity analyses in the BIAs analysed. The total median of the incorporation diffusion (market share) ranged from 30.0% (1st year) to 72.0% (5th year). The cost analyses were essentially focused on the acquisition cost of drugs. However, the quantity of pharmaceutical units was not clearly reported in 55.5% of the analyses.</p><p><strong>Conclusion: </strong>The findings indicate that methodological inconsistencies persist in BIAs, such as the absence of sensitivity analyses and cost analyses limited to the acquisition cost of drugs. Therefore, it is suggested that there may be weaknesses in the estimates of the real budget impacts of technologies on the SUS.</p>","PeriodicalId":520611,"journal":{"name":"Epidemiologia e servicos de saude : revista do Sistema Unico de Saude do Brasil","volume":"34 ","pages":"e20250122"},"PeriodicalIF":2.0,"publicationDate":"2025-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12435967/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145034912","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Trends in dengue incidence and lethality: interrupted time series analysis, Brazil, 2001-2022.","authors":"Tatiane Fernandes Portal de Lima Alves da Silva, Henry Maia Peixoto, Lúcia Rolim Santana de Freitas, Emerson Luiz Lima Araújo, Walter Massa Ramalho","doi":"10.1590/S2237-96222025v34e20240424.en","DOIUrl":"10.1590/S2237-96222025v34e20240424.en","url":null,"abstract":"<p><strong>Objective: </strong>To analyze the temporal trend of dengue incidence and lethality rates and the proportions of its serotypes, in the different macro-regions of Brazil, between 2001 and 2022. In particular, the immediate and gradual effects of these indicators were verified in the periods before and after the publication of the National Guidelines for the Prevention and Control of Dengue Epidemics.</p><p><strong>Methods: </strong>This was an interrupted time series analysis. Prais-Winsten generalized linear regression was used and the annual percentage variation was determined with a 95% confidence interval (95%CI). The data were extracted from the Notifiable Diseases Information System and the Mortality Information System.</p><p><strong>Results: </strong>The incidence of dengue in Brazil was stationary from 2001 to 2009, and the effects of the National Guidelines were not detectable between 2010 and 2022. The dengue fatality rate showed an increasing trend in the period 2001-2009. Between 2010 and 2022, there were gradual reductions of 30.0% in the North (95%CI -36.8; -22.5), 27.9% in the Northeast (95%CI -33.3; -22.2), 20.1% in the Southeast (95%CI -30.0; -8.8), and 17.8% in the Center-West (95%CI -22.5; -12.7). For the South, the dengue fatality rate remained stationary between 2001 and 2009 and undetectable between 2010 and 2022.</p><p><strong>Conclusion: </strong>The trend in the dengue incidence rate in Brazil was stationary in the period 2001-2009. Between 2010 and 2022, it was not possible to detect immediate and gradual effects on incidence rates. The trend in dengue fatality rates in Brazil (except in the South region) was increasing between 2001 and 2009. After 2010, gradual reductions were identified.</p>","PeriodicalId":520611,"journal":{"name":"Epidemiologia e servicos de saude : revista do Sistema Unico de Saude do Brasil","volume":"34 ","pages":"e20240424"},"PeriodicalIF":2.0,"publicationDate":"2025-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12435890/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145035019","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mortality and potential years of life lost due to COVID-19 among healthcare workers in Bahia, 2020-2022.","authors":"Renata Barbosa Vilaça Marques de Carvalho, Kionna Oliveira Bernardes Santos, Rita de Cássia Pereira Fernandes, Verônica Maria Cadena Lima, Luciane Gabriele Pereira Gomes Lopes, Rafaela Cordeiro Freire","doi":"10.1590/S2237-96222025v34e20240315.en","DOIUrl":"10.1590/S2237-96222025v34e20240315.en","url":null,"abstract":"<p><strong>Objective: </strong>Estimate mortality indicators and impact of COVID-19 on healthcare workers in Bahia in the period 2020-2022.</p><p><strong>Methods: </strong>This is a descriptive study, with death data extracted from the Brazilian Mortality Information System. Population data were obtained from professional councils, the National Registry of Health Establishments and the Brazilian National Immunization Program Information System. The mortality rate was calculated and presented per 1,000 workers. Potential years of life lost and productive years of life lost due to COVID-19 were estimated. An analysis was carried out between mortality rates and the proportion of people vaccinated against COVID-19.</p><p><strong>Results: </strong>Of the total number of deaths (n=403), the majority were female (63.3%), aged 40 or over (85.4%), of brown race/skin color (52.1%) and with secondary or technical education (48.1%). The highest mortality rates were observed among elderly/healthcare caregivers, health agents, veterinarians/zootechnicians, biologists and pharmacy/office attendants. Regarding the evolution of mortality, three waves were observed, with a reduction in deaths after the start of vaccination. In total, 6,771 potential years of life lost and 6,778 productive years of life lost were estimated, with a greater impact on women, in the 40-49 age group and in occupations that involved direct care.</p><p><strong>Conclusion: </strong>The results showed the potential impact generated by COVID-19 on the healthcare workers in Bahia.</p>","PeriodicalId":520611,"journal":{"name":"Epidemiologia e servicos de saude : revista do Sistema Unico de Saude do Brasil","volume":"34 ","pages":"e20240315"},"PeriodicalIF":2.0,"publicationDate":"2025-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12435958/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145034948","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of the performance of biological drugs in the treatment of ankylosing spondylitis: cohort study, Minas Gerais, 2018-2023.","authors":"Bárbara Rodrigues Alvernaz Dos Santos, Gerusa Araújo de Oliveira, Grazielle Dias Silva, Jessica Barreto Ribeiro Dos Santos, Marina Morgado Garcia, Augusto Afonso Guerra Junior, Francisco de Assis Acurcio, Juliana Alvares-Teodoro","doi":"10.1590/S2237-96222025v34e20240116.en","DOIUrl":"10.1590/S2237-96222025v34e20240116.en","url":null,"abstract":"<p><strong>Objectives: </strong>To assess the persistence and time until discontinuation of biological drugs used by people with ankylosing spondylitis treated in the Brazilian Unified Health System and to investigate the factors associated with them.</p><p><strong>Methods: </strong>Data were collected from an open historical cohort between 2018 and 2023 on the administrative processes required for requesting medicines from the specialized component of pharmaceutical assistance in Minas Gerais, Brazil. Sociodemographic and clinical data and treatment history were collected. A descriptive analysis of the variables was performed. The Cox proportional hazards model was used to identify factors associated with time to discontinuation of the first biological drug. The logistic regression model was used to evaluate the factors associated with persistence at 12 and 24 months of treatment.</p><p><strong>Results: </strong>A total of 530 participants were included, with an average age of 46 years, of which 50.0% were male. Adalimumab and golimumab were the most prescribed drugs. The mean follow-up time was 26.4 months, and the median time to discontinuation was 34 months. Persistence at 12 and 24 months was 82.0% and 63.0%. No significant differences were observed between biological drugs.</p><p><strong>Conclusion: </strong>The analysis of persistence and time to discontinuation showed no differences between the drugs, which justified their maintenance in the first line of treatment of the protocol. Factors associated with the clinical profile of users may be related to differences in effectiveness, but more in-depth studies are needed to confirm these results, given the limitations of using administrative data in epidemiological research.</p>","PeriodicalId":520611,"journal":{"name":"Epidemiologia e servicos de saude : revista do Sistema Unico de Saude do Brasil","volume":"34 ","pages":"e20240116"},"PeriodicalIF":2.0,"publicationDate":"2025-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12435891/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145034956","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reinfection and post-vaccination infection by SARS-CoV-2 in nursing professionals: a prospective cohort study, Recife, 2020-2023.","authors":"Thaís Milena da Silva Mesquita Verissimo, Ulisses Ramos Montarroyos, Demetrius Montenegro, Cláudio Luiz França Neto, Carolline Araújo Mariz","doi":"10.1590/S2237-96222025v34e20240162.en","DOIUrl":"10.1590/S2237-96222025v34e20240162.en","url":null,"abstract":"<p><strong>Objective: </strong>To estimate the incidence and factors associated with SARS-CoV-2 reinfection and post-vaccination infection in nursing professionals.</p><p><strong>Methods: </strong>This was a prospective, descriptive, and analytical cohort study conducted in Recife from March 2020 to January 2023, following 399 nursing professionals. The cumulative incidences of COVID-19 infection and reinfection were estimated with a 95% confidence interval (95%CI).</p><p><strong>Results: </strong>Among the participants, 71.9% (95%CI 67.3; 76.1) had SARS-CoV-2 infection; of these, 26.6% (95%CI 22.5; 31.1) were reinfected. Regarding the timing of infection, 46.4% (95%CI 41.5; 51.3) of participants were infected before the first dose of the vaccine. After the first dose, the incidence of infection decreased to 25.6% (95%CI 21.5; 30.1), highlighting the importance of vaccination. Nursing technicians were the category with the highest risk of infection. Women were at higher risk of infection and reinfection.</p><p><strong>Conclusion: </strong>This finding of a reduced occurrence of infections among individuals vaccinated with at least one dose and with a history of prior SARS-CoV-2 infection reinforces the evidence base for hybrid immunity. However, despite the number of infections and reinfections among these professionals, further research is needed to systematize information on primary and recurrent infection cases in this population group, in order to enhance understanding of the phenomenon and improve surveillance processes, as well as prevention, control, and care measures targeting this professional category.</p>","PeriodicalId":520611,"journal":{"name":"Epidemiologia e servicos de saude : revista do Sistema Unico de Saude do Brasil","volume":"34 ","pages":"e20240162"},"PeriodicalIF":2.0,"publicationDate":"2025-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12435892/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145034920","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reviewed article: Alencar JVA, Carvalho DPC, Umeno HG, França MASA, Azevedo MN. Intersectional analysis of the social vulnerability of individuals with differences in the time between oral cancer diagnosis and treatment: a cross-sectional study, Brazil, 2011-2020. Epidemiol Serv Saude. 2025:34;e20240849.","authors":"Arn Migowski","doi":"10.1590/S2237-96222025v34e20240849.b","DOIUrl":"10.1590/S2237-96222025v34e20240849.b","url":null,"abstract":"","PeriodicalId":520611,"journal":{"name":"Epidemiologia e servicos de saude : revista do Sistema Unico de Saude do Brasil","volume":"34 ","pages":"e20240849.b"},"PeriodicalIF":2.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12404596/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144986173","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Factors associated with complications related to the use of peripherally inserted central venous catheter in hospitalized children: a case-control study, Sorocaba, Brazil, 2018-2022.","authors":"Mayara Amancio de Souza, Luciane Cruz Lopes, Marcus Tolentino Silva","doi":"10.1590/S2237-96222025v34e20240134.en","DOIUrl":"10.1590/S2237-96222025v34e20240134.en","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate factors associated with complications related to the use of peripherally inserted central venous catheters in children undergoing surgical procedures.</p><p><strong>Methods: </strong>This was a case-control study, conducted in a public hospital in Sorocaba, with an emphasis on surgical procedures, between 2018 and 2022. Electronic medical records were used as a source of information. Odds ratio (OR) and 95% confidence intervals (95%CI) were calculated.</p><p><strong>Results: </strong>The study included 109 children aged up to 2 years 11 months and 29 days of age, of which 62 were cases and 47 were controls. The frequency of complications related to the use of peripherally inserted central venous catheters was 56.9% (95%CI 47.3; 66.0), and the most frequent complications were obstruction (30.3%) (95%CI 22.3; 39.7), accidental removal (10.1%) and hyperemia (9.2%). There was a greater chance of complications when the child remained in the neonatal pediatric intensive care unit (OR 5.45; 95%CI 1.20; 24.8) and when maintaining intravenous hydration (OR 3.71; 95%CI 1.02; 13.52). Female children (OR 2.93; 95%CI 1.24; 6.91), using total parenteral nutrition (OR 2.97; 95%CI 1.11; 7.94) and with Down syndrome (OR 19.19; 95%CI 2.23; ∞) had a higher chance of obstruction.</p><p><strong>Conclusion: </strong>Children in intensive care and receiving intravenous hydration had a higher chance of complications. Understanding the factors associated with complications benefits patients, healthcare institutions and the Brazilian Unified Health System (SUS).</p>","PeriodicalId":520611,"journal":{"name":"Epidemiologia e servicos de saude : revista do Sistema Unico de Saude do Brasil","volume":"34 ","pages":"e20240134"},"PeriodicalIF":2.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12435953/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144985837","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reviewed article: Campos HL, Fernandes GJA, Sousa DG, Conrado PLM, Campos EO, Santos Filho RAB, Costa PFF, Silva CM, Conrado GAM, Galvão PVM. Impacts of the COVID-19 pandemic on excess deaths: descriptive study, Pernambuco, 2020-2022. Epidemiol Serv Saude. 2025:34;e20240286.","authors":"Arthur Cruz","doi":"10.1590/S2237-96222025v34e20240286.a","DOIUrl":"10.1590/S2237-96222025v34e20240286.a","url":null,"abstract":"","PeriodicalId":520611,"journal":{"name":"Epidemiologia e servicos de saude : revista do Sistema Unico de Saude do Brasil","volume":"34 ","pages":"e20240286.a"},"PeriodicalIF":2.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12404599/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144986143","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reviewed article: Moraes LP, Raposo LM. Impact of Vaccination and SARS-CoV-2 Variants on Severe COVID-19 Outcomes: A Cross-Sectional Study, Brazil, 2021-2022. Epidemiol Serv Saude. 2025:34;e20240613.","authors":"Michelle Fernanda Borges da Silva","doi":"10.1590/S2237-96222025v34e20240613.b","DOIUrl":"10.1590/S2237-96222025v34e20240613.b","url":null,"abstract":"","PeriodicalId":520611,"journal":{"name":"Epidemiologia e servicos de saude : revista do Sistema Unico de Saude do Brasil","volume":"34 ","pages":"e20240613.b"},"PeriodicalIF":2.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12404606/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144986176","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}