Revista brasileira de epidemiologia = Brazilian journal of epidemiology最新文献

{"title":"Mapping the spatial and temporal frequency of systemic lupus erythematosus in Brazil.","authors":"Andreza Martyres, Alice Ramos-Silva, Fabiana Rabe Carvalho, Rodrigo Cutrim Gaudio, Katia Lino Baptista, Elisangela Costa Lima, Thalia Medeiros, Andrea Alice Silva","doi":"10.1590/1980-549720250030","DOIUrl":"10.1590/1980-549720250030","url":null,"abstract":"<p><strong>Objective: </strong>The aim of this study was to analyze the spatial and temporal distribution of systemic lupus erythematosus (SLE) cases in Brazil from 2008 to 2022.</p><p><strong>Methods: </strong>We conducted an ecological study based on data from patients treated in the Unified Health System. SLE cases were identified using International Classification of Diseases-10 codes and analyzed by geographic region, age, and color/race. Spatial distribution was assessed to identify high and low prevalence, while temporal trends were evaluated through annual percentage change (APC).</p><p><strong>Results: </strong>In 2022, the national prevalence was 52.3/100,000 inhabitants, with marked geographical disparities. Southeast (68.14/100,000) and South (66.37/100,000) regions showed the highest reporting rates. Spatial analysis identified significant clustering, particularly in São Paulo and Paraná, accounting for 95.4% of the high-prevalence municipalities. Temporal analysis of the adult population revealed a consistent increase in SLE prevalence from 2008 to 2022 (APC=15.5%, p<0.001), which was most pronounced in the Northeast and South, while a slower increase was observed in the North. A correlation was observed between the number of rheumatologists and the number of cases/100,000 inhabitants (R=0.567, p=0.002).</p><p><strong>Conclusion: </strong>This study reveals significant geographic disparities and a rising trend in SLE prevalence across Brazil. The clustering of cases in specific municipalities and the correlation between rheumatologist availability and prevalence underscore the need for targeted healthcare resources. These findings highlight the importance of investigating how healthcare access impacts regional disparities in SLE prevalence and advancing equitable care nationwide.</p>","PeriodicalId":74697,"journal":{"name":"Revista brasileira de epidemiologia = Brazilian journal of epidemiology","volume":"28 ","pages":"e250030"},"PeriodicalIF":0.0,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12129240/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144227891","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":"Temporal analysis of gestational and congenital syphilis indicators in Brazil: toward the elimination of vertical transmission by 2030?","authors":"Gabriel Pavinati, Lucas Vinícius de Lima, Marjorie Fairuzy Stolarz, Melissa Ferrari Gomes, Sidnei Nathan Soares Turquino, Gabriela Tavares Magnabosco","doi":"10.1590/1980-549720250028","DOIUrl":"10.1590/1980-549720250028","url":null,"abstract":"<p><strong>Objective: </strong>To analyze, at national and regional levels, the trend of proxy indicators for the progress toward the elimination of the vertical transmission of syphilis in Brazil.</p><p><strong>Methods: </strong>This is an ecological study that assessed the annual percent change (APC) of indicators related to gestational and congenital syphilis.</p><p><strong>Results: </strong>An APC of 11.15% was observed in the detection rate of gestational syphilis (95% confidence interval - 95%CI 2.78-23.19), with stability in congenital syphilis across all regions. There was a reduction of prenatal care coverage among pregnant women with syphilis (APC=-7.34%; 95%CI -10.15; -5.33), and also a decrease in late diagnosis of the infection (APC=-10.77%; 95%CI -14.29; -8.79).</p><p><strong>Conclusions: </strong>We evidenced challenges in achieving the 2030 elimination targets, highlighting the need for adjustments in current public policies on syphilis prevention and control.</p>","PeriodicalId":74697,"journal":{"name":"Revista brasileira de epidemiologia = Brazilian journal of epidemiology","volume":"28 ","pages":"e250028"},"PeriodicalIF":0.0,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12129237/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144227805","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":"Nova food classification system: a contribution from Brazilian epidemiology.","authors":"Maria Laura da Costa Louzada, Kamila Tiemann Gabe","doi":"10.1590/1980-549720250027","DOIUrl":"10.1590/1980-549720250027","url":null,"abstract":"<p><p>This essay presents the Nova food classification, a conceptual innovation of Brazilian epidemiology, describing its genesis, the scientific evidence derived from its application, and its implications for public health. Created in 2010, Nova classifies foods into four groups based on the degree of processing: unprocessed or minimally processed foods, processed culinary ingredients, processed foods, and ultra-processed foods. Since its development, several epidemiological studies have demonstrated the negative impacts of high consumption of ultra-processed foods on health, such as associations with various non-communicable diseases, including obesity, diabetes, cardiovascular diseases and mental health outcomes. In Brazil, the consumption of these foods has increased significantly in recent decades, with the caloric share of ultra-processed foods rising from 12.6 to 18.4% between 2002-2003 and 2017-2018, with this increase being more pronounced among more vulnerable socioeconomic groups. Nova underpins the recommendations of the Brazilian Dietary Guidelines and has played a crucial role in informing public policies, such as the update of the National basic food basket and the guidelines of the National School Feeding Program, which aim to limit the access to ultra-processed foods. Finally, the essay addresses the political and scientific challenges, including the need for more experimental studies to strengthen the evidence and the potential of fiscal and marketing regulation strategies that take into account the impact of food processing on health.</p>","PeriodicalId":74697,"journal":{"name":"Revista brasileira de epidemiologia = Brazilian journal of epidemiology","volume":"28 ","pages":"e250027"},"PeriodicalIF":0.0,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12129239/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144227803","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":"What are the characteristics and where is the highest risk of snakebite accidents in the state of São Paulo?","authors":"Gisele Dias de Freitas, Alec Brian Lacerda, Thiago Salomão de Azevedo, Anderson de Oliveira, Roberta Maria Fernandes Spinola, Flávio Santos Dourado, Fan Hui Wen, Francisco Chiaravalloti-Neto","doi":"10.1590/1980-549720250026","DOIUrl":"10.1590/1980-549720250026","url":null,"abstract":"<p><strong>Objectives: </strong>To understand the pattern of snakebite envenomation, the objective was to describe accidents and deaths by snake genus, age group, sex, race/ethnicity, education level, place of residence and occurrence, seasonality, vegetation cover, and to identify spatial clusters with a higher risk of accidents in the state of São Paulo.</p><p><strong>Methods: </strong>A descriptive study using data from the Notifiable Diseases Information System (SINAN) on snakebite accidents between 2010 and 2022. The Getis-Ord Gi* index was applied to identify high- and low-risk clusters.</p><p><strong>Results: </strong>Bothropic accidents predominated (61.5%), affecting men (78.7%), whites (64.7%), adults aged 20-59 years (67.1%), and individuals with low education levels (63.4%). Most accidents occurred in urban areas (55.7%), while deaths were more frequent in rural areas (68.1%), with longer treatment delays. Incidence remained stable, increasing during hot and rainy periods. Many cases were not autochthonous, and vegetation type influenced accident patterns: Bothrops in dense and humid areas, Crotalus in dry and open regions, and Micrurus in both. Spatial analysis highlighted areas of higher and lower risk, varying by accident type.</p><p><strong>Conclusions: </strong>Identifying the most affected population, seasonality, and high-risk areas provides essential support for preventive actions and effective management. The findings can guide efforts towards vulnerable populations, anticipate preventive strategies during high-incidence periods, and optimize resources, such as professional training and antivenom serum distribution in high-risk regions.</p>","PeriodicalId":74697,"journal":{"name":"Revista brasileira de epidemiologia = Brazilian journal of epidemiology","volume":"28 ","pages":"e250026"},"PeriodicalIF":0.0,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12129242/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144227806","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":"Higher tendency of undertreatment in older patients with laryngeal cancer in Brazil.","authors":"Ana Luiza Fassizoli da Fonte, Guilherme Jorge Costa, Adilis Stepple da Fonte Neto, Rodrigo Alves Pinto, Maria Júlia Gonçalves de Mello","doi":"10.1590/1980-549720250031","DOIUrl":"10.1590/1980-549720250031","url":null,"abstract":"<p><strong>Objective: </strong>This study compared treatments and outcomes between patients younger than 70 years and those aged 70 years or older (elderly) with laryngeal cancer (LC).</p><p><strong>Methods: </strong>Data were collected from Brazilian hospital records between 2000 and 2017.</p><p><strong>Results: </strong>A total of 38,978 patients were analysed, of whom 8,803 (22.6%) were ≥70 years old. Elderly patients were more frequently diagnosed at early stages (39.3% vs. 28.9%; p<0.001). However, these patients were 15% less likely to undergo surgery, 46% less likely to receive chemotherapy, and 33% less likely to receive combined treatments. In addition, elderly patients were 35% more likely to receive supportive care only.</p><p><strong>Conclusions: </strong>Despite early diagnosis, elderly patients received fewer oncological treatments and more palliative care.</p>","PeriodicalId":74697,"journal":{"name":"Revista brasileira de epidemiologia = Brazilian journal of epidemiology","volume":"28 ","pages":"e250031"},"PeriodicalIF":0.0,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12129238/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144227890","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":"Prevalence of psychological violence in the employed Brazilian population and its occurrence in the workplace: National Survey of Health 2019.","authors":"Priscila Maria Stolses Bergamo Francisco, Daniela de Assumpção, Marcia Bandini, Sergio Roberto de Lucca","doi":"10.1590/1980-549720250025","DOIUrl":"10.1590/1980-549720250025","url":null,"abstract":"<p><strong>Objective: </strong>To estimate the prevalence of psychological violence among employed adults aged 18-69 years; to verify the distribution of sociodemographic and lifestyle characteristics within those who have reported psychological violence in the workplace; and to estimate the number of individuals who have reported this type of violence perpetrated by the employer/boss in the workplace.</p><p><strong>Methods: </strong>This is a descriptive study with data from the National Survey of Health (2019). Employed people were selected in relation to the workforce. Psychological violence was defined as follows: in the last 12 months, \"has anyone offended, humiliated, or mocked you in front of other people?\". For those who reported violence, the location of the incident and who the aggressor was were verified. The prevalence of psychological violence was estimated and the characteristics of those who suffered this type of violence were described by absolute and relative frequencies.</p><p><strong>Results: </strong>The prevalence of psychological violence reached 11% (95% confidence interval [CI]: 10.5-11.6) of the employed adult population, was higher among women, individuals between 18-29 years old, Black people, single, and among those with income up to 0.5 minimum wage. Of the individuals who suffered psychological violence in the workplace, 57.6% were men, 31.9% were between 30-39 years old, 47% were mixed-race, 44.4% completed high school, 39.8% had an income between one and two minimum wages, 13.5% were smokers, 37.6% consumed alcoholic beverages, and 23.8% consumed alcohol excessively. As for the aggressor, 28.8% (around two million people) reported that psychological violence in the workplace was committed by the employer/boss.</p><p><strong>Conclusion: </strong>According to the study results, among the employed Brazilian population, 11% reported psychological violence in the last year; we identified the segments most affected by psychological violence in the workplace and measured this violence having the boss/employer as the aggressor.</p>","PeriodicalId":74697,"journal":{"name":"Revista brasileira de epidemiologia = Brazilian journal of epidemiology","volume":"28 ","pages":"e250025"},"PeriodicalIF":0.0,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12129241/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144227804","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":"Assessment of inequalities in women's and children's health: Why, how, and for whom? Analyses of the Brazilian Live Birth Information System.","authors":"Fernando César Wehrmeister, Janaína Calu Costa, Luiza Eunice Sá da Silva, Natalia Peixoto Lima, Francine Dos Santos Costa, Aluísio Jardim Dornellas de Barros","doi":"10.1590/1980-5497202500XX","DOIUrl":"10.1590/1980-5497202500XX","url":null,"abstract":"<p><p>In this manuscript we discuss the importance of monitoring the analyses on health inequalities in women's and children's health. Data from the Brazilian Live Birth Information System were used to introduce the main inequality measures. The years from 2020 to 2022 were combined and at least one and eight or more antenatal care visits were considered as outcomes. As inequality measures, simple (ratios and differences) and complex measures for ordered (slope index of inequality and concentration index) and unordered (weighted and unweighted mean absolute difference from the mean) outcomes were presented. We discuss the strengths, limitations, and importance of inequality monitoring for researchers and policymakers.</p>","PeriodicalId":74697,"journal":{"name":"Revista brasileira de epidemiologia = Brazilian journal of epidemiology","volume":"28 ","pages":"e250029"},"PeriodicalIF":0.0,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12124669/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144227889","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":"Depressive symptoms of school-aged adolescents: cumulative effect of adverse events and mediation of social support.","authors":"Célia Regina de Andrade, Raquel de Vasconcellos Carvalhaes de Oliveira, Joviana Quintes Avanci","doi":"10.1590/1980-549720250019","DOIUrl":"https://doi.org/10.1590/1980-549720250019","url":null,"abstract":"<p><strong>Objective: </strong>To analyze the effect of cumulative adverse childhood experiences and depressive symptoms on adolescence and to identify direct and indirect relationships between the variables and the mediating role of social support.</p><p><strong>Methods: </strong>This is a cross-sectional study with a sample of 1,117 school-aged adolescents aged 13 to 19 years. The Children's Depression Inventory and Adverse Childhood Experiences scales were used, organized into socioeconomic, family, community, and total dimensions. Descriptive analysis was carried out and the structural equation model was used, with probit estimation, applying social support as mediator.</p><p><strong>Results: </strong>The prevalence of depressive symptoms among school-aged adolescents was 8.2%. We observed that the accumulation of socioeconomic, family, and community factors increases the occurrence of depressive symptoms, adjusted for sex, skin color, and social support. Mediation by social support explains 16.7% of the total effect of exposure to the analyzed factors. In the socioeconomic dimension, the depression probit increases by 0.033 for each category, with 21.2% mediated by social support. In the family dimension, the increase is 0.020 (25% mediated); in the community, 0.018 (16.7% mediated); and in the total dimension, 0.012 (17% mediated).</p><p><strong>Conclusion: </strong>The observation of the effect of the accumulation of Adverse Childhood Experiences on depressive symptoms in adolescence requires actions in vulnerable groups, with social support helping to mitigate the risk of depression.</p>","PeriodicalId":74697,"journal":{"name":"Revista brasileira de epidemiologia = Brazilian journal of epidemiology","volume":"28 ","pages":"e250019"},"PeriodicalIF":0.0,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12068810/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144082725","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":"Spatial analysis of neonatal near miss and socioeconomic and healthcare indicators in the state of Paraná.","authors":"Maria Luiza Melo da Silva, Natan Nascimento de Oliveira, Andreia Ferdin, Maria José Quina Galdino, Emiliana Cristina Melo, Rosana Rosseto de Oliveira","doi":"10.1590/1980-549720250023","DOIUrl":"https://doi.org/10.1590/1980-549720250023","url":null,"abstract":"<p><strong>Objective: </strong>To analyze the spatial distribution of neonatal near miss and socioeconomic and healthcare indicators in the state of Paraná.</p><p><strong>Methods: </strong>Ecological, cross-sectional study of neonatal near miss rates in municipalities in the state of Paraná, from 2020 to 2022, obtained through data from the Live Birth Information System (SINASC) and the Mortality Information System (SIM), connected through deterministic linkage. The spatial distribution of neonatal near miss rates, socioeconomic indicators (maternal age and race/ethnicity), and healthcare indicators (type of delivery and number of prenatal consultations) were performed. Global and Local Moran's Index were used for spatial analysis.</p><p><strong>Results: </strong>The neonatal near miss rate in Paraná was 28.46 per thousand live births. Health regions (HR) 4th HR - Irati, 3rd HR - Ponta Grossa, 6th HR - União da Vitória, and 17th HR - Londrina stood out with high rates of neonatal near miss. Concerning the indicators, significant rates were evident among women of black, yellow, and indigenous race/color, as well as inadequacies in prenatal.</p><p><strong>Conclusions: </strong>The results highlight priorities in the Eastern and Northern macro-regions, where high-high clusters indicate an urgent need to assess access and quality of care. Additionally, there is a need to investigate neonatal near miss in Black, Yellow, and Indigenous women, as well as low prenatal adherence or coverage.</p>","PeriodicalId":74697,"journal":{"name":"Revista brasileira de epidemiologia = Brazilian journal of epidemiology","volume":"28 ","pages":"e250023"},"PeriodicalIF":0.0,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12068812/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144082729","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":"Therapeutic modalities in the first cancer treatment: percentage variation before and during the pandemic, in Ceará, a state in the Northeast region of Brazil.","authors":"Stefane Vieira Nobre, Miren Maite Uribe Arregi, Thereza Maria Magalhães Moreira, Antonio Germane Alves Pinto, Marcelo Gurgel Carlos da Silva","doi":"10.1590/1980-549720250024","DOIUrl":"https://doi.org/10.1590/1980-549720250024","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the percentage variation of the different therapeutic modalities used in new cases of cancer, before and during the pandemic, in Ceará.</p><p><strong>Methods: </strong>Descriptive study with information from records of the Hospital Information System and Authorization of Highly Complex Procedures, and Cancer Information Systems in the state of Ceará, Brazil.</p><p><strong>Results: </strong>There was a reduction of 2,575 (-30.85%) new cases in 2020 and 2,368 (-28.37%) in 2021. Regarding the therapeutic modalities, it was possible to observe that there were decreases in the numbers of all institutions in the first cancer treatment, except for isolated radiotherapy and for combined surgery+iodine therapy+radiotherapy. Surgery was the modality most often performed in a timely manner (<30 days) and chemotherapy in an untimely manner (>60 days). The impact on the initiation of timely treatment (<30 days after diagnosis) was greater in 2021 than in 2020. In general, late treatments (>60 days) were lower than in 2019. The period of 31-60 days was shown to be above 2019 almost the entire year, in 2020 and 2021.</p><p><strong>Conclusion: </strong>The number of new cancer cases in Ceará may occur during the pandemic. This situation impacted the reduction of all therapeutic modalities, except for radiotherapy alone and associated with surgery+iodine therapy. However, it did not harm the number of new cases treated in a timely manner.</p>","PeriodicalId":74697,"journal":{"name":"Revista brasileira de epidemiologia = Brazilian journal of epidemiology","volume":"28 ","pages":"e250024"},"PeriodicalIF":0.0,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12068809/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144082691","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}