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

{"title":"Socioeconomic and labor characterization and prevalence of chronic disease in the Colombian population in the periods 2010, 2013, and 2016: A multiple correspondence analysis.","authors":"Francisco Palencia-Sánchez, Gustavo Antonio Bruges Morales, Martha Riaño-Casallas","doi":"10.1590/1980-549720250036","DOIUrl":"10.1590/1980-549720250036","url":null,"abstract":"<p><strong>Objective: </strong>To analyze the relationship between the prevalence of chronic diseases and socioeconomic, demographic and occupational determinants in the Colombian population in 2010, 2013 and 2016. We sought to identify patterns of association between these variables and evaluate how they have evolved over time, with a particular emphasis on the implications for public health, especially in informal work contexts.</p><p><strong>Methods: </strong>We used longitudinal data from the Colombian Longitudinal Urban Survey, which covers socioeconomic strata 1 to 4. The sample includes both men and women and heads of households and spouses, aged 18 to 65 years. The variables of interest are classified into three categories: health, labor and sociodemographic factors. The main methodology used was Multiple Correspondence Analysis (MCA).</p><p><strong>Results: </strong>Three different labor groups were identified in the sample: formal, semi-formal and informal. The informal workers group showed a higher prevalence of chronic diseases compared to the other two groups. Labor category was the social determinant of greatest relevance in health variability.</p><p><strong>Conclusion: </strong>The study's findings indicate that labor informality is associated with an elevated risk of developing chronic diseases in Colombia. These results highlight the necessity for policy interventions that prioritize enhancing working conditions as a strategy to achieve improved public health outcomes.</p>","PeriodicalId":74697,"journal":{"name":"Revista brasileira de epidemiologia = Brazilian journal of epidemiology","volume":"28 ","pages":"e250036"},"PeriodicalIF":0.0,"publicationDate":"2025-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12227103/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144610488","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":"Analysis of mortality by cardiovascular disease subgroups in Brazil before and during the COVID-19 pandemic (2000-2022) by sex and age group.","authors":"Cicero Emanoel Alves Leite, Raphael Mendonça Guimarães, Andréa Sobral","doi":"10.1590/1980-549720250033","DOIUrl":"10.1590/1980-549720250033","url":null,"abstract":"<p><strong>Objective: </strong>To analyze the effect of the COVID-19 pandemic on mortality by cardiovascular disease (CVD) subgroups in Brazil, considering sex and age group.</p><p><strong>Methods: </strong>Ecological time-series study with secondary data from the Mortality Information System for the period 2000-2022. Age-adjusted mortality rates per 100,000 inhabitants were calculated and joinpoint regression models were used to estimate rate trends.</p><p><strong>Results: </strong>Mortality from CVD in Brazil between 2000 and 2022 showed a decrease in ischemic heart disease (IHD) and cerebrovascular disease (CBVD), while other CVD showed an unstable behavior, increasing after 2020. The reduction in IHD was more pronounced until 2020, decelerating thereafter. CBVD continued to decline but at a slower pace. Other CVD, after a downward trend, showed a significant increase (+3.8% per year), possibly because of the pandemic. Women had a greater reduction in mortality, especially due to IHD. Intermediate age groups (40-59 years) showed a decrease until 2020 but recorded increases after this period, reinforcing the impact of the pandemic. In 2021, all subgroups showed excess mortality: 8% for CBVD and IHD, and 15% for other CVD. In 2022, this pattern intensified, with values of 16% (CBVD), 18% (IHD) and 23% (other CVD).</p><p><strong>Conclusion: </strong>The COVID-19 pandemic significantly impacted CVD mortality in Brazil, changing trends according to age group, sex and disease subgroup. The study points to an inflection in mortality rates during the pandemic, highlighting the need for further investigations to understand the mechanisms involved.</p>","PeriodicalId":74697,"journal":{"name":"Revista brasileira de epidemiologia = Brazilian journal of epidemiology","volume":"28 ","pages":"e250033"},"PeriodicalIF":0.0,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12204235/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144562315","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 bias attributable to composite outcome in clinical trials published in 2019-2020: a systematic review.","authors":"José Mário Nunes da Silva, Juliana Ferreira Souza Conceição, Paula Camila Ramírez, Christian Leonardo Diaz-León, Fredi Alexander Diaz-Quijano","doi":"10.1590/1980-549720250035","DOIUrl":"10.1590/1980-549720250035","url":null,"abstract":"<p><strong>Objective: </strong>The aim of this study was to investigate the prevalence of bias attributable to composite outcome (BACO) in clinical trials.</p><p><strong>Methods: </strong>We searched PubMed for randomized clinical trials where the primary outcome was a binary composite that included all-cause mortality among its components from January 1, 2019, to December 31, 2020. For each trial, the BACO index was calculated to assess the correspondence between effects on the composite outcome and mortality. This systematic review was registered in PROSPERO (CRD42021229554).</p><p><strong>Results: </strong>After screening 1,076 citations and 171 full-text articles, 91 studies were included from 13 different medical areas. The prevalence of significant or suggestive BACO among the 91 included articles was 25.2% (n=23), including 12 with p<0.005 and 11 with p between 0.005 and <0.05. We observed that in 17 (73.9%) of these 23 studies, the BACO index value was between 0 and <1, indicating an underestimation of the effect. The other six studies showed negative values (26.1%), indicating an inversion of the association with mortality. None of the studies showed significant overestimation of the association attributable to the composite outcome.</p><p><strong>Conclusion: </strong>These findings highlight the need to predefine guidelines for interpreting effects on composite endpoints based on objective criteria such as the BACO index.</p>","PeriodicalId":74697,"journal":{"name":"Revista brasileira de epidemiologia = Brazilian journal of epidemiology","volume":"28 ","pages":"e250035"},"PeriodicalIF":0.0,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12204237/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144562318","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 sociodemographic, clinical and behavioral characteristics of people living with the human immunodeficiency virus and its association with quality of life.","authors":"Ehideé Gómez La-Rotta, Leidy Janeth Erazo Chavez, Harold Gomez-Larrota, Pedro Henrique de Faria, Armindo Augusto da Nobrega Albuquerque, Felipe Thiele Cecílio, Max da Silva Maciel, José Antonio Enciso Domínguez, Maria Rita Donalisio","doi":"10.1590/1980-549720250034","DOIUrl":"10.1590/1980-549720250034","url":null,"abstract":"<p><strong>Objective: </strong>To investigate inequalities of race/skin color and sex in relation to quality of life of people living with the human immunodeficiency virus (HIV) in a Brazilian university hospital between 2017 and 2018.</p><p><strong>Methods: </strong>This is a cross-sectional study conducted between 2017 and 2018 with 350 people living with HIV, applying the HIV-specific Quality of Life (QoL) scale. The groups were compared using the χ2 test and Student's t-test or Kruskal-Wallis test. To evaluate the factors associated with the nine domains of QoL, Tweedie Regression, an application of the Generalized Linear Model, was performed.</p><p><strong>Results: </strong>Of the 350 participants, 55.7% self-reported to be white and 44.3%, Black/mixed-race; with a mean age (standard deviation - SD) of 45.2 (±12.6). We verified that 46.3% reported having suffered some type of prejudice, 34.8% due to the disease, 12% due to skin color, and 11.4% due to sexual orientation. The overall mean quality of life was 78.85 (±11.61). The domain with the lowest mean was Confidentiality Concerns (M: 43.45±29.46). Among the factors associated with several domains were sex (woman), level of education, per capita income, having suffered some prejudice, or hospitalizations in the last year.</p><p><strong>Conclusion: </strong>Differences in level of education, per capita income, and work status by self-reported race/skin color of the participants were evidenced, showing inequalities in the study population. Sex (woman) is the factor associated with most of the QoL domains, among them Life Satisfaction, Confidentiality Concerns, Health Concerns, Financial Concerns, Medication Concerns, Acceptance of HIV, and Sexual Function.</p>","PeriodicalId":74697,"journal":{"name":"Revista brasileira de epidemiologia = Brazilian journal of epidemiology","volume":"28 ","pages":"e250034"},"PeriodicalIF":0.0,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12204236/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144562317","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":"ERRATUM.","authors":"","doi":"10.1590/1980-549720250022erratum","DOIUrl":"10.1590/1980-549720250022erratum","url":null,"abstract":"<p><p>[This corrects the article doi: 10.1590/1980-549720250022].</p>","PeriodicalId":74697,"journal":{"name":"Revista brasileira de epidemiologia = Brazilian journal of epidemiology","volume":"28 ","pages":"e20250022erratum"},"PeriodicalIF":0.0,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12204234/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144562316","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":"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}