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

{"title":"Record linkage in tuberculosis epidemiological surveillance in Brazil: systematic methodological literature review.","authors":"Klauss K S Garcia, Amanda Amaral Abrahão, Henry Maia Peixoto, Elisabeth Carmen Duarte, Wildo Navegantes de Araújo, Walter Massa Ramalho","doi":"10.1590/1980-549720260045","DOIUrl":"10.1590/1980-549720260045","url":null,"abstract":"<p><strong>Objective: </strong>To describe the literature on the methodological characteristics and use of record linkage techniques applied to tuberculosis surveillance in Brazil.</p><p><strong>Methods: </strong>A systematic methodological review (PROSPERO: CRD42024623969) was conducted following the 2020 guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). Searches were performed on the following databases: PubMed, Embase, Scopus, Virtual Health Library (VHL), Scientific Electronic Library Online (Scielo), and Latin American and Caribbean Literature on Health Sciences (LILACS) on February 5, 2025. Scientific articles produced in Brazil and whose authors applied record linkage between health information systems for epidemiological surveillance purposes were included. Grey literature, studies without a focus on tuberculosis, studies without application of linkage, and studies conducted outside Brazil were excluded. Descriptive synthesis was used, reporting frequencies, proportions, and measures of central tendency. Risk of bias or methodological quality were not assessed due to the heterogeneity of study designs and objectives, and because this review aimed to describe the methodological characteristics of the studies rather than synthesize effect estimates or epidemiological associations.</p><p><strong>Results: </strong>The search retrieved 1,549 records; 49 studies were included. Most studies used the tuberculosis module of the Notifiable Diseases Information System (SINAN-TB, 98.0%) and the Mortality Information System (SIM, 67.3%); the most frequently used software was OpenRecLink (57.1%). The most common key variables were \"name,\" \"date of birth,\" and \"mother's name.\" The linkage percentage ranged from 0.1 to 97.3%. The most frequent objectives were the description of epidemiological scenarios (24.5%), analysis of associated factors (20.4%), and investigation of underreporting (16.3%). Cohort (49.0%) and descriptive (34.7%) study designs predominated.</p><p><strong>Conclusion: </strong>Record linkage integrates complementary databases and may strengthen tuberculosis surveillance. The findings suggest the potential usefulness of record linkage to support epidemiological analyses, improve records, and inform surveillance actions.</p>","PeriodicalId":74697,"journal":{"name":"Revista brasileira de epidemiologia = Brazilian journal of epidemiology","volume":"29 ","pages":"e260045"},"PeriodicalIF":2.0,"publicationDate":"2026-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13506216/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148841977","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 tooth loss among adults and older adults in municipalities participating in oral national surveys 2003, 2010 and 2023.","authors":"Sônia Cristina Lima Chaves, Jony Arrais Pinto Júnior, Thais Regis Aranha Rossi, Thamyres Pereira Lima, Ana Tereza Ribeiro da Silva, Ana Maria Freire de Souza Lima, Joana Danielle Brandão Carneiro, Doralice Severo da Cruz Teixeira, Sandra Garrido de Barros, Leonardo Marchini, Monira Samann Kallás","doi":"10.1590/1980-549720260030.supl.1","DOIUrl":"10.1590/1980-549720260030.supl.1","url":null,"abstract":"<p><strong>Objective: </strong>This study analyzed trends in tooth loss and caries severity among adults and older adults from 2003 to 2023.</p><p><strong>Methods: </strong>An ecological study using secondary data from the three national oral health Surveys (SB Brasil 2003, 2010, and 2023) in 43 municipalities that participated in all editions. The analysis of trends in caries severity and tooth loss among adults (35-44 years) and older adults (65-74 years) was performed using structural equation modeling.</p><p><strong>Results: </strong>Among adults, a significant association was observed between higher illiteracy rates and increased the decayed, missing, and filled teeth index (DMFT) (β=+0.309; p<0.001). On the other hand, greater coverage by oral health teams and private dental plans were associated with a reduction in these outcomes (β=-0.040 p<0.001 and β=-5.527 p<0.001, respectively). The associations were less evident but pointed in the same direction among older adults regarding illiteracy rates and private dental plan coverage, where the estimated coefficients showed lower magnitude and significance, indicating moderation of contextual effects and stability of the indicators over time.</p><p><strong>Conclusion: </strong>The study confirmed a downward trend in tooth loss and DMFT between 2003 and 2023, pronounced in adults and to a lesser extent in older adults in Brazil. The latter are particularly vulnerable to rapid deterioration in oral health, requiring individualized analyses in future studies and the targeting of efforts by policymakers and implementers.</p>","PeriodicalId":74697,"journal":{"name":"Revista brasileira de epidemiologia = Brazilian journal of epidemiology","volume":"29 suppl 1","pages":"e260030supl1"},"PeriodicalIF":2.0,"publicationDate":"2026-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13516018/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148842237","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":"COVID-19 vaccine effectiveness against in-hospital mortality in immunocompromised older adults: a Brazilian hospital surveillance study, 2024.","authors":"Rodrigo Poubel Vieira de Rezende, João Felipe Nicolaci Pimentel, Bruno Santos Caxias, Caio Moreira Salgueiro, Lucas Tanikawa de Oliveira, Luís Fernando de Araújo Santos, Caroline Pimentel Pessanha, Vitoria Xavier Tracierra, Michael Gunter Simão, Mario Gustavo de Aranda Pacheco, Vitor Alves Cruz, Luiz Eduardo da Costa Oliveira","doi":"10.1590/1980-549720260041","DOIUrl":"https://doi.org/10.1590/1980-549720260041","url":null,"abstract":"<p><strong>Objective: </strong>The study evaluated the association between COVID-19 vaccination and in-hospital mortality among immunocompromised older adults hospitalized for COVID-19 in Brazil during the 2024 epidemiologic year.</p><p><strong>Methods: </strong>This retrospective hospital-based surveillance study used data from the Brazilian SIVEP-Gripe database. All hospitalized cases of COVID-19-related severe acute respiratory syndrome in immunocompromised individuals aged ≥60 years reported during epidemiological weeks 1-52 of 2024 were included. Multivariable logistic regression was used to estimate odds ratio (OR) and 95% confidence interval (95%CI) for the association between COVID-19 vaccination (number of doses) and in-hospital mortality, adjusting for clinical and sociodemographic covariates.</p><p><strong>Results: </strong>Among 474 patients, in-hospital mortality was 36% (171/474). Only 56 (12%) were unvaccinated. Compared with unvaccinated individuals, adjusted ORs for mortality were 0.67 (95%CI 0.32-1.39) for 1-2 doses, 0.67 (95%CI 0.31-1.42) for 3 doses, 0.54 (95%CI 0.26-1.15) for 4 doses, and 0.56 (95%CI 0.26-1.17) for 5-6 doses. Mechanical ventilation (OR 12.55; 95%CI 6.39-26.33) and lower educational attainment (elementary education: OR 2.94; 95%CI 1.39-6.44) were independent predictors of death. COVID-19 vaccination was not significantly associated with reduced in-hospital mortality among immunocompromised older adults hospitalized for the disease in Brazil in 2024. However, all adjusted ORs were below unity, suggesting a trend toward protection with increasing doses.</p><p><strong>Conclusions: </strong>The strong association of mortality with mechanical ventilation and social determinants highlights the need for timely boosters and comprehensive preventive strategies for this vulnerable population.</p>","PeriodicalId":74697,"journal":{"name":"Revista brasileira de epidemiologia = Brazilian journal of epidemiology","volume":"29 ","pages":"e260041"},"PeriodicalIF":2.0,"publicationDate":"2026-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13480620/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148802764","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":"A return to the environment in epidemiology: multilevel analysis of diabetes mellitus in a large urban agglomeration of Argentina.","authors":"María Jimena Marro, Maria de Jesus Mendes da Fonseca, Iuri da Costa Leite, Christian Ballejo, Marcio Alazraqui","doi":"10.1590/1980-549720260043","DOIUrl":"https://doi.org/10.1590/1980-549720260043","url":null,"abstract":"<p><strong>Objective: </strong>The burden of disease due to diabetes mellitus has shown an increasing trend worldwide. Given the potential of physical structures to create opportunities for the adoption of individual behaviors, this study aimed to analyze the relationship between neighborhood food environments and green spaces and the prevalence of diabetes mellitus in the Mar del Plata-Batán urban agglomeration in Argentina, while also considering individual characteristics, from 2013 to 2018.</p><p><strong>Methods: </strong>A cross-sectional design with a multilevel approach was used. Individual data from the National Risk Factor Survey were linked to data on food environments and green spaces aggregated at the census tract level. Multilevel logistic regression models were used, with individuals nested within census tracts; odds ratios were estimated for independent variables with 95% confidence intervals.</p><p><strong>Results: </strong>A total of 946 observations distributed across 81 census tracts were analyzed. After adjustment for individual variables, living in census tracts with a high density of healthy food outlets was associated with a 43% reduction in the odds of having diabetes [OR 0.57 (0.35-0.93)]. Public green space area per inhabitant in the neighborhood was not significantly associated with the odds of diabetes. The proportion of variability attributable to the contextual level ranged from 2.35 to 1.20%.</p><p><strong>Conclusions: </strong>The neighborhood food environment was associated with diabetes mellitus in the studied agglomeration. These results may encourage the development of longitudinal studies with greater power to demonstrate the causal role of the food environment in the occurrence of diabetes.</p>","PeriodicalId":74697,"journal":{"name":"Revista brasileira de epidemiologia = Brazilian journal of epidemiology","volume":"29 ","pages":"e260043"},"PeriodicalIF":2.0,"publicationDate":"2026-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13480625/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148802790","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":"Patterns of behaviors related to modifiable health risk factors among Brazilian older adults: Data from the 2013 and 2019 National Health Surveys.","authors":"Mariana Sousa de Abreu Menezes, Zayanna Christine Lopes Lindôso, Ana Karina Teixeira da Cunha França, Poliana Cristina de Almeida Fonseca Viola, Bruno Luciano Carneiro Alves de Oliveira","doi":"10.1590/1980-549720260042","DOIUrl":"https://doi.org/10.1590/1980-549720260042","url":null,"abstract":"<p><strong>Objective: </strong>To analyze patterns of modifiable health risk behaviors among Brazilian older adults (≥60 years) using data from the 2013 and 2019 National Health Surveys.</p><p><strong>Methods: </strong>A cross-sectional study was conducted based on secondary data from the 2013 and 2019 National Health Surveys. Behavior patterns were defined using Latent Class Analysis according to four main domains: smoking, alcohol consumption, physical activity, and diet. Relative frequencies and their 95% confidence intervals (95%CI) were calculated for lifestyle variables, as well as for independent variables associated with socioeconomic and demographic factors.</p><p><strong>Results: </strong>Five behavior patterns were identified for each year. In 2013, patterns related to unhealthy habits (smoking), physical inactivity, and dietary patterns (including bean, vegetable, legume, and fish consumption) were identified. In 2019, the findings also involved the same patterns found in 2013, with the difference that fish consumption showed greater relevance in differentiating between classes, although its population prevalence decreased over the period. Physical inactivity was associated with harmful habits, including inadequate diet, smoking, and alcohol consumption. Age, sex, education level, and race significantly influenced these patterns.</p><p><strong>Conclusion: </strong>In Brazil, unhealthy aging overlaps with multiple modifiable risk factors. Understanding these patterns and their determinants enables the development of strategies to reduce health inequalities and promote quality of life and well-being among older adults. A combined approach to risk factors contributes to more effective public policies.</p>","PeriodicalId":74697,"journal":{"name":"Revista brasileira de epidemiologia = Brazilian journal of epidemiology","volume":"29 ","pages":"e260042"},"PeriodicalIF":2.0,"publicationDate":"2026-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13480969/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148802817","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":"Water fluoridation, functional dentition and tooth loss in Brazilian adults: a multilevel analysis of SB Brasil 2023.","authors":"Paulo Roberto Barbato, José Leopoldo Ferreira Antunes, Paulo Frazao, Marco Aurélio Peres","doi":"10.1590/1980-549720260031.supl.1","DOIUrl":"https://doi.org/10.1590/1980-549720260031.supl.1","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the association between water fluoridation and the maintenance of functional dentition (≥20 teeth) and tooth loss in Brazilian adults aged 35 to 44, considering individual and contextual factors.</p><p><strong>Methods: </strong>This study employed a cross-sectional design using data from SB Brasil 2023 (n=9,019). The main exposure was the availability of fluoridated water in municipalities, obtained from national sanitation information systems. The outcomes analyzed were (i) functional dentition (binary) and (ii) number of missing teeth (count). To reduce confounding bias, inverse probability weighting was used to balance individual (age, sex, education, and income) and contextual (municipal development index and dental service coverage) covariates. The analysis was performed using multilevel Poisson models for functional dentition and multilevel negative binomial models for missing teeth. The robustness of the results was assessed using E-values, estimating sensitivity to potential unmeasured confounders.</p><p><strong>Results: </strong>After adjustment, fluoridation showed no significant association with functional dentition (PR 1.24; 95%CI 0.91-1.68). However, it was significantly associated with a lower rate of missing teeth (RR 1.30; 95%CI 1.01-1.67). Sensitivity analysis (E-value) indicated high susceptibility to unmeasured confounders for the count outcome.</p><p><strong>Conclusion: </strong>In the context of widespread use of fluoridated dentifrice, water fluoridation demonstrated a significant protective effect against tooth loss in adults, although it was totally or partially confounded by socioeconomic variables. These findings reinforce the importance of universal fluoridation policies, which should be combined with strategies targeting vulnerable groups, aiming to reduce inequalities and promote oral health in the adult population.</p>","PeriodicalId":74697,"journal":{"name":"Revista brasileira de epidemiologia = Brazilian journal of epidemiology","volume":"29Suppl 1 Suppl 1","pages":"e260031supl1"},"PeriodicalIF":2.0,"publicationDate":"2026-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13483508/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148802533","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 mortality and disease burden from diabetes mellitus in Argentina between 1990 and 2022.","authors":"Camila Soledad Dominguez, Guillermo Raúl Macias","doi":"10.1590/1980-549720260039","DOIUrl":"https://doi.org/10.1590/1980-549720260039","url":null,"abstract":"<p><strong>Objective: </strong>The study aimed to analyze the trends in mortality and disease burden due to Diabetes Mellitus in Argentina from 1990 to 2022.</p><p><strong>Methods: </strong>A longitudinal descriptive time-series study was conducted. Age-standardized mortality rates (ASMRs) and age-adjusted potential years of life lost (AAYPLL) were calculated. Trend analysis was performed using segmented regression (Joinpoint).</p><p><strong>Results: </strong>Between 1990 and 2022, a total of 270,394 deaths from diabetes mellitus were recorded in Argentina, of which 52.1% occurred among men and 48.8% among women. ASMRs and AAYPLL analyses consistently showed higher values among men than among women. The average annual percent change (AAPC) for both ASMRs and AAYPLL indicated a plateau among men and a significant decrease among women.</p><p><strong>Conclusion: </strong>The findings suggest a slight trend toward a decrease in the age at death among men, whereas the opposite pattern was observed among women. These findings have important implications for public health and policymaking. The high number of DM-related deaths among older age groups underscores the need for healthcare services tailored to the aging population. Furthermore, gender differences in mortality, with women tending to die at older ages than men, suggest that healthcare strategies should address gender-specific needs and risks.</p>","PeriodicalId":74697,"journal":{"name":"Revista brasileira de epidemiologia = Brazilian journal of epidemiology","volume":"29 ","pages":"e260039"},"PeriodicalIF":2.0,"publicationDate":"2026-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13480621/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148802407","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":"Territorial inequalities in the food environment of Brazilian metropolitan regions.","authors":"Laura Luciano Scaciota, Claudio Makoto Kanai, Marcos Anderson Lucas da Silva, Renata Bertazzi Levy","doi":"10.1590/1980-549720260040","DOIUrl":"https://doi.org/10.1590/1980-549720260040","url":null,"abstract":"<p><strong>Objective: </strong>To describe the retail food environment of Brazilian metropolitan regions using intramunicipal socioeconomic indicators, applying the Locais-NOVA classification.</p><p><strong>Methods: </strong>Data from the 2023 Annual Social Information Report were used, with Human Development Units (HDUs) as the unit of analysis. Food establishments were geocoded and assigned to HDUs. The Locais-NOVA methodology was applied, which classifies food acquisition outlets according to the degree of food processing and proposes five food environment indicators. The percentage of each indicator was calculated for HDUs and stratified into tertiles of the Municipal Human Development Index (MHDI), considering the distribution of HDUs, Brazilian macroregions, and capitals versus non-capitals. A food environment healthiness indicator was created to measure the competition between healthy and unhealthy outlets and was used for spatial description through maps.</p><p><strong>Results: </strong>A total of 8,977 HDUs across 24 metropolitan regions were assessed, with a mean MHDI of 0.76 and an average of 42.8 food establishments per HDU. Most food outlets were classified as sources of ultra-processed foods (64.9%), with a higher proportion in the first MHDI tertile (67.5%) compared with the third tertile (63.1%). A lower presence of outlets sourcing fresh and minimally processed foods was observed in the first MHDI tertile compared with the third (25.8 vs. 32.3%). The Southeast showed the highest percentage of outlets sourcing processed foods (17.3%). Non-capital concentrated a higher proportion of outlets sourcing processed foods compared with capitals.</p><p><strong>Conclusion: </strong>A high prevalence of outlets sourcing ultra-processed foods was observed, particularly in territories with worse socioeconomic conditions.</p>","PeriodicalId":74697,"journal":{"name":"Revista brasileira de epidemiologia = Brazilian journal of epidemiology","volume":"29 ","pages":"e260040"},"PeriodicalIF":2.0,"publicationDate":"2026-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13480622/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148802774","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":"Clinical profile and pattern of second primary tumors in HPV-positive and HPV-negative oropharyngeal cancer.","authors":"Matheus de Abreu, Dandara Menezes de Araujo Oliveira, Janaina Naiara Germano, Luiz Paulo Kowalski, Maria Paula Curado","doi":"10.1590/1980-549720260046","DOIUrl":"https://doi.org/10.1590/1980-549720260046","url":null,"abstract":"<p><strong>Objectives: </strong>To evaluate the clinical-epidemiological profile of patients with oropharyngeal cancer (OPC) positive for human papillomavirus (HPV+) and negative for human papillomavirus (HPV-), and to compare differences in the development of second primary tumors (SPT).</p><p><strong>Methods: </strong>Retrospective cohort with patients diagnosed with OPC. Sociodemographic/clinical data, p16-status, alcohol/tobacco consumption were extracted. Absolute/relative frequencies, odds ratios (OR), prevalence of HPV and SPT were calculated.</p><p><strong>Results: </strong>Of 538 patients with OPC, 59.8% (n=322) were HPV+; 40.2% (n=216) HPV-. The prevalence of SPTs was higher among HPV- (21.8%; n=47) than HPV+ (13.0%; n=42). Non-smokers were 4.5 times more likely to have HPV+ OPC (OR 4.58; confidence interval - CI 2.48-8.67), and non-drinkers were 2.06 times more likely (OR=2.06; CI 1.15-3.72). Nodal involvement was associated with a 2.77-fold higher likelihood of HPV+ (OR 2.77; CI 1.70-4.56); lymphoepithelial topographies with a 2.13-fold higher likelihood (OR 2.13; CI 1.37-3.31). SPTs occurred most in the skin (17.3%, n=9) and penis/prostate (15.4%, n=8) in HPV+, whereas in HPV- in head and neck (36.2%, n=22) and respiratory tract (18.0%, n=11). The interval between OPC diagnosis and SPT diagnosis was shorter in the HPV+ (median: 40 months).</p><p><strong>Conclusion: </strong>SPT pattern in OPC is not equal across HPV-groups. HPV- showed a higher prevalence of SPTs, more often involving the head and neck/respiratory tract, which may reflect the cumulative effect of tobacco/alcohol exposure. In HPV+, the lower SPT prevalence and different tumor distribution may indicate a more limited field cancerization effect. The shorter time to SPT diagnosis in HPV+ suggests that surveillance strategies may need to consider distinct risk profiles according to HPV-status.</p>","PeriodicalId":74697,"journal":{"name":"Revista brasileira de epidemiologia = Brazilian journal of epidemiology","volume":"29 ","pages":"e260046"},"PeriodicalIF":2.0,"publicationDate":"2026-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13480623/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148802761","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":"Classification of the risk of transmission of vaccine-preventable diseases among children under 2 years of age in the municipality of São Paulo, Brazil.","authors":"Mariana de Souza Araújo, José Elisomar Silva de Santana, Melissa Palmieri, Luciana Ursini Nunes, Thaís Moreira Oliveira, Maria Eduarda Viana Oliveira, Guilherme Augusto Veloso, Thales Philipe Rodrigues da Silva, Fernanda Penido Matozinhos","doi":"10.1590/1980-549720260035","DOIUrl":"10.1590/1980-549720260035","url":null,"abstract":"<p><strong>Objective: </strong>To analyze the classification of the risk of transmission of vaccine-preventable diseases among children under 2 years of age in a large Brazilian municipality in 2022 and 2023.</p><p><strong>Method: </strong>Ecological epidemiological study using secondary data on vaccination coverage (VC) for nine immunobiologicals recommended in the vaccination schedule for children under 2 years of age. Immunobiological dose data were obtained from the National Immunization Program Information System (Sistema de Informações do Programa Nacional de Imunizações - SI-PNI), while data were collected from the Ministry of Health website and filtered by place of residence. Data were analyzed using the R software package.</p><p><strong>Results: </strong>In 2022, 100% of the Health Surveillance Units (Unidades de Vigilância em Saúde - UVIS) showed low VC for the second dose of the measles-mumps-rubella (MMR) vaccine. In the same year, 61% and 54% of the UVIS achieved adequate VC for the hepatitis A and human rotavirus vaccines, respectively. In 2023, improvements in VC were observed for most vaccines, except for the meningococcal C and varicella vaccines, which showed a reduction in the number of UVIS achieving adequate VC. Regarding the classification of the risk of reintroduction of vaccine-preventable diseases, the proportion classified as \"low and very low\" increased from 0% in 2022 to 10.7% in 2023.</p><p><strong>Conclusion: </strong>VC improved in 2023 for most vaccines analyzed across the UVIS. However, variations in VC were observed according to vaccine type and year. These findings reinforce the need to maintain regional actions aimed at achieving vaccination targets, given the indications of a recovery in VC.</p>","PeriodicalId":74697,"journal":{"name":"Revista brasileira de epidemiologia = Brazilian journal of epidemiology","volume":"29 ","pages":"e260035"},"PeriodicalIF":2.0,"publicationDate":"2026-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13449748/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148725896","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}