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PubMed1993

[Profile of the elderly in a metropolitan area of southeastern Brazil: results of a domiciliary survey].

A multicentre study concerned with the health needs of the elderly population living in urban areas and coordinated by the Panamerican Health Organization was undertaken in 6 Latin-American countries. In Brazil, 1,602 elderly residents (of 60 years of age and over) in the District of S. Paulo, constituting a multistage random sample stratified by socioeconomic status, participated in a household survey using a multidemensional functional assessment questionnaire. The results showed a highly deprived population (70% had a per capita income of less than US $ 100 per month), living mostly in multigenerational households (59% were living with children and/or grandchildren), with a high prevalence of chronic physical illnesses (only 14% referred no illness) and psychiatric disorders (27% were considered psychiatric cases), a high proportion of them showing a loss of autonomy (47% needed help in performing at least one of the activities of daily living). The results are put into perspective concerning future needs in terms of specialized health services and social support for the growing population of elderly people in Brazil.

Age Factors↗
PubMed1993

[Urban focus of schistosomiasis in a metropolitan area in a southeastern region of Brazil].

Urban focus of schistosomiasis in an urban area of South-eastern, Brazil. An active, urban focus of schistosomiasis in Belo Horizonte, MG, Brazil is described. It is located in the "Julien Rien" Park, a leisure area of 48,500 m2 created by the local administration in 1980 on the south side of city. Snail captures were made over 10 years (1983-1992) resulting in the collection of 3,361 Biomphalaria glabrata, ranging from 6.4 to 12.8 mm in diameter (mean = 9.3); 23 (0.7%) of these were found to be infected with Schistosoma mansoni. The finding of S. mansoni intermediate hosts in urban areas (ponds, small artificial lakes, etc) may be related to the introduction of fish and ornamental aquatic plants coming from specialized shops or areas in which they occur. It is suggested that the introduction of fish aquatic plants into urban water collections without a quarantine period should be avoided, as a prophylactic measure.

Animals↗
PubMed1994

[Dengue in a urban locality of southeastern Brazil: epidemiological aspects].

A dengue fever epidemic which occurred in Ribeirão Preto County, S. Paulo State, Brazil, during the period November, 1990 to March, 1991 has been analysed elsewhere. The general aspects of dengue epidemiology and control have been reviewed in this article. Emphasis is given to the analysis of some factors involved in the risk of dengue haemorrhagic fever and ecological aspects of the vector, as well as to the appropriateness of strategies for dengue eradication or control. Epidemiological characteristics of dengue, mainly those related to its occurrence in different geographical areas and periods of time are described. The Ribeirão Preto epidemic has thus, been set within the context of the spread of the disease at global level, in the Americas, and particularly in Brazil and S. Paulo State.

Brazil↗
PubMed1994

[Reliability of the declaration of underlying cause of infant deaths in the metropolitan region of southeastern Brazil].

The quality of official information on underlying causes of infant deaths was studied on the basis of data collected for a population-based study of the surveillance of infant mortality in the metropolitan region of Belo Horizonte, Brazil in 1989. The survey included the analysis of a sample of infant deaths carried out by comparing the underlying causes of death as coded on death certificates to those recorded by a group of doctors who abstracted information from hospital records. We verified that 11.7% of neonatal deaths did not have the underlying cause of death confirmed by the investigation (kappa = 0.61), and neither did 44.0% of post-neonatal deaths (kappa = 0.47). It is believed that this major disagreement among post-neonatal deaths is due to the close correlation observed among the major causes of death within this group (pneumonia, diarrhoea and malnutrition). For example, associated malnutrition was observed in 76.9% of those cases in which diarrhoea was coded as the underlying cause of death. It was concluded that the quality of the death certificates is not satisfactory. However, the composition of the main groups of causes presented no significant alteration after investigation and may be used in public health surveillance, especially if we regard pneumonia, diarrhoea and malnutrition as a group with the same determinants. Unfortunately, this group still accounts for a great number of otherwise avoidable deaths in Brazil.

Brazil↗
PubMed1995

Mortality from asthma in the state of S. Paulo, Brazil (1970-1992).

Mortality from asthma has shown important variations over time in several countries. In Brazil, a mortality study performed in the 60s, covering the cities of S. Paulo and Ribeirão Preto, and other ten cities showed that S. Paulo presented the lowest death rate from asthma among of them all. It was decided to study the time trends of deaths from asthma and from the whole set of respiratory diseases from 1970 to 1992, in the population aged 15-34 yrs. old in the State of S. Paulo, as well as to compare them with those of other countries. Asthma mortality rates during the 23 years of observation since 1975, showed an oscillatory declining pattern with a peak of deaths in the initial years. The linearization of the curve allows the calculation of Pearson's correlation coefficient that was significantly negative, suggesting a decline in the mortality over this period, mainly in the 5-9 yrs. old and 30-34 yrs. old strata. The segmentation of data between the period of ICD-9, 1970 to 1978, and of ICD-9, 1979 and subsequent years, shows that there is stability within each period, in all age-groups, except for that of 5-9 yr. olds between 1970-1978. Comparing the rates of the population aged 15-34 yrs. old for the State of S. Paulo, Brazil, with trends observed in 14 other countries, an intermediate pattern for the first triennial period (1970-1972) as well as for the subsequent triennial periods, emerges. A prevalence study of asthma, a follow up program meant for using emergency rooms and a surveillance of deaths due to all respiratory diseases and specifically to asthma are strongly recommended.

Adolescent↗
PubMed1996

[Identification of food sources of Anopheles aquasalis (Diptera: Culicidae) by precipitin test in the State of Rio de Janeiro, Brazil].

Anopheles aquasalis has shown local variations in blood-host preference in Brazil: it seems to be anthropophilic in the northeast and zoophilic or opportunistic in the Amazon and other regions. A study was carried out in Guapimirim county, State of Rio de Janeiro, from May to November 1992, for the purpose of identifying the blood meal source of this anopheline by capillary tube precipitin test. A total of 1,366 females were captured at natural resting-places, 725 of which were blood-fed. The gut content of 473 blood fed females reacted to the antisera used (human, cow, horse, pig, dog and chicken). The majority of the females-356 (75.3%)-had blood from only one source. A substantial bovine preference was observed-52.2% had fed on cows, 29.8% on horses, 10.7% on pigs, 4.5% on chickens and 1.7% on dogs, but only few had fed on man (1.1%) and none on rats. On the other hand, 24.7% of the females had fed on more than one host, mainly on cows and horses. It was assumed that An. aquasalis is zoophilic in southeastern Brazil, feeding on a wide variety of animals, the cow being the primary host.

Animals↗
PubMed1996

Mortality among patients with non-affective functional psychoses in a metropolitan area of south-eastern Brazil.

High mortality rates among those suffering from schizophrenia and related psychoses have been consistently described in developed societies. However, to date there is a lack of data on this matter in Brazil. In order to examine this issue, a prospective 2-year follow-up study was carried out in S. Paulo. The sample consisted of 120 consecutive admissions to psychiatric hospitals in a defined catchment area, aged 18 to 44 years old, with clinical diagnoses of non-affective functional psychoses according to the ICD-9. After 2 years, 116 (96.7%) subjects were traced. During the study period there were 7 deaths (6.0% of those traced), 5 (4.3%) due to suicide. All but one of the suicides occurred in the first year after discharge from hospital. Age and sex Standardised Mortality Ratios (relative to rates for the population of the city of Sao Paulo) were 8.4 for overall mortality (95% confidence interval: 4.0-15.9) and 317.9 for deaths due to suicide (95% confidence interval: 125.2-668.3). These results are in agreement with previous studies, and show that in Brazil non-affective functional psychoses are life-threatening illnesses, which need adequate care, particularly when patients go back to live in the community after hospital discharge.

Adolescent↗
PubMed1996

[Distribution of Biomphalaria straminae in the southern neotropical region of Brazil].

A careful anatomical revision of 10,616 preserved specimens of snails from 76 localities of the State of S. Paulo, Brazil, was made with a view better to determining the geographical distribution of Biomphalaria straminea in the Neotropical Region of Southern Brazil. The analysis has shown that previous determinations were correct. The study was then complemented with a survey of information from the literature about distribution of the species. The distribution pattern of the species has expanded greatly over the last few years, perhaps an account of the construction of new dams, and the navigation system in the upper Paraná Basin. Epidemiological data have shown that B. straminea is a good host to S. mansoni. Continuous schistosomiasis control must be exercised so as to prevent the further expansion of the disease.

Animals↗
PubMed1997

[Profile of self-medication in Brazil].

INTRODUCTION: The data presented are part of a World Health Organization (WHO) multicenter study of self-medication in Latin America. Brazilian sites included: Belo Horizonte, Fortaleza, the city of S. Paulo and outlying locations. The objective was to characterize self-medication practices by analyzing drugs sought by consumers in pharmacies without a physician's prescription. MATERIAL AND METHOD: Drugs were classified according to the Anatomic Therapeutic Classification codes, and analyzed with respect to 1) intrinsic value; 2) recognition as an essential drug (by either WHO or Brazil); 3) number of active ingredients; and 4) requirement for prescription. RESULTS: Five thousand, three hundred and thirty-two (5,332) different drugs, with 785 distinct active ingredients were sought. Of these, 49.5% were fixed dose combinations, 53.0% were of little intrinsic value, 44.1% required a physician's prescription, 71.0% were not essential drugs, and 40.0% of requests were based on prior prescriptions from the physician. The drugs most requested were analgesics (17.3%), nasal descongestants (7.0%), antirheumatic anti-inflammatory drugs (5.6%), and systemic anti-infective drugs (5.6%). CONCLUSIONS: Self-medication in Brazil reflects the needs and habits of the population. It is strongly influenced by physician's-prescribing habits and by the inadequate selectivity of the Brazilian pharmaceutical market.

Adult↗
PubMed1997

[Tuberculosis associated with AIDS: the situation in a Northeastern region of Brazil].

INTRODUCTION: The main aspects of the HIV and Mycobacterium tuberculosis coinfection in the adult patients attended by the main reference hospital for infectious diseases in the State of Ceará, Brazil, responsible for the notification of 89.3% of the cases registered in the state between 1986 and 1992 were investigated. METHODOLOGY: Data were collected from the case histories of patients of more than 15 years of age with a diagnosis of AIDS, attended in a state reference hospital in Northeastern Brazil. The analysis of the data obeys the criteria of the Ministry of Health for the definition of this disease. RESULTS: Tuberculosis had been present in 30.6% of the patients studied (151/493) and it was diagnosed by the first year after the AIDS diagnosis in 76.8% of the cases. The proportion of AIDS cases with tuberculosis is significantly greater (p = 0.032) among men (94.7%) than among women (88.3%). An increased linear trend in the proportion of cases with tuberculosis was noticed in the AIDS cases according to the decrease in level of schooling (p < 0.001). The direct baciloscopy of the sputum although considered a high priority exam, was made in only 72.9% of the patients, presenting positive results in 28.3% of these. The extrapulmonary form was detected in 23.9% of the cases and, among those, the miliary form in 25% and the meningitis in 16.7%. These results differ in a significant way (p < 0.001 for all) from the cases with tuberculosis without HIV infection in adults registered in the state in 1992 (9.8% extrapulmonary, 7.2% miliary and 3.3% meningitis). In most cases, death occurred in the presence of tuberculosis (52.3%), and only 10.6% managed to recover from the tuberculosis. CONCLUSIONS: The premature development of tuberculosis in AIDS patients, the presence of a high percentage of extrapulmonary forms and the high lethality are indicator that the prevention and control measures of these two pathologies cannot be considered separately in this State.

AIDS-Related Opportunistic Infections↗
PubMed1997

Factors affecting nutrition behavior among middle-class adolescents in urban area of Northern region of Brazil.

INTRODUCTION: Brazil has been called a nation in nutrition transitional because of recent increases in the prevalence of obesity and related chronic diseases. With overweight conditions already prevalent among middle-income populations, there exists a need to identify factors that influence nutrition behavior within this group. OBJECTIVE: To address this subject, a research study was implemented among middle-class adolescents attending a large private secondary school in Manaus, Amazonas, Brazil. The study determined the availability and accessibility of snack foods as well as subjects' attitudes and preferences towards, and the influence of family and friends on healthy (high-nutrient density) snack choices. METHODS: The 4-stage process included: (a) a nutrition expert focus group discussion that reported local nutrition problems in general and factors related to adolescent nutrition, (b) an adolescent pilot survey (n = 63) that solicited information about snacking preferences and habits as well as resources for nutrition information and snack money: (c) a survey of various area food market sources to determine the availability and accessibility of high nutrient density snacks; and (d) a follow-up adolescent survey (n = 55) that measured snack food preferences and perceptions about their cost and availability. RESULTS: Results included the finding that, although affordable high nutrient density snacks were available, preferences for low nutrient density snacks prevailed. The adolescents were reportedly more likely to be influenced by and obtain nutrition information from family members than friends. CONCLUSION: From study results it is apparent that a focus on food availability will not automatically result in proper nutritional practices among adolescents. This fact and the parental influence detected are evidence of a need to involve adolescents and their parents in nutrition education campaigns to improve adolescent snack food choices.

Adolescent↗
PubMed1997

[Women's opinion on abortion legalization in a middle size county in southern Brazil].

INTRODUCTION: Induced abortion is the main cause of maternal death in Brazil. Question of its legalization has been the subject of frequent discussion. MATERIAL AND METHOD: In order to assess the influence of the variables affecting the opinion of women of reproductive age, a population-based systematic sample in the county of Rio Grande (Southern Brazil) was examined. RESULTS: Of a total of 1,456 interviews 30% endorsed the legalization, whatever the circumstances; this percentage was directly associated with age, schooling, family income and previous induced abortion (p < 0.01). Adjusted analysis using logistic regression showed a significant effect of schooling and previous induced abortion on favourable opinion. CONCLUSION: Schooling and previous induced abortion were the main determinants of women's favorable opinions regarding abortion legalization.

Abortion, Induced↗
PubMed1998

[Bancroftian filariasis in Brazil].

The past and present distribution of Bancroftian filariasis in Brazil is reviewed. Parasitological and entomological surveys were conducted between 1951 and 1958, the autochthonous transmission of Wuchereria bancrofti having been found only in 11 places in the country as follows, with the corresponding prevalences; Ponta Grossa (SC), 14.5% Belém (PA), 9.8%; Barra de Laguna (SC), 9.4%; Recife (PE), 6.9%; Castro Alves (BA), 5.9%; Florianópolis (SC), 1.4%; São Luis (MA), 0.6%; Salvador (BA), 0.4%; Maceió (AL), 0.3%; Manaus (AM). 0.2% and Porto Alegre (RS), 0.1%. The distribution of infection was urban and focal, occurring mainly along the coast. Control measures carried out against filariasis achieved considerable success, reducing infection and transmission, only Belém and Recife being considered endemic areas. Recent studies show the active transmission of filariasis with higher prevalences than those observed in the past, in Maceió, considered to be free from infection, and in Recife. The knowledge of the present status of Bancroftian filariasis in Brazil is important as baseline information, because it will allow for the establishment of control measures by Public Health organizations.

Animals↗
PubMed1998

Two-year follow-up study of elderly residents in S. Paulo, Brazil: methodology and preliminary results.

INTRODUCTION: Previous cross-sectional studies have shown a high prevalence of chronic disease and disability among the elderly. Given Brazil's rapid aging process and the obvious consequences of the growing number of old people with chronic diseases and associated disabilities for the provision of health services, a need was felt for a study that would overcome the limitations of cross-sectional data and shed some light on the main factors determining whether a person will live longer and free of disabling diseases, the so-called successful aging. The methodology of the first follow-up study of elderly residents in Brazil is presented. METHOD: The profile of the initial cohort is compared with previous cross-sectional data and an in-depth analysis of nonresponse is carried out in order to assess the validity of future longitudinal analysis. The EPIDOSO ('Epidemiologia do Idoso') Study conducted a two-year follow-up of 1,667 elderly people (65+), living in S. Paulo. The study consisted of two waves, each consisting of household, clinical, and biochemical surveys. RESULTS AND CONCLUSIONS: In general, the initial cohort showed a similar profile to previous cross-sectional samples in S. Paulo. There was a majority of women, mostly widows, living in multigenerational households, and a high prevalence of chronic illnesses, psychiatric disturbances, and physical disabilities. Despite all the difficulties inherent in follow-up studies, there was a fairly low rate of nonresponse to the household survey after two years, which did not actually affect the representation of the cohort at the final household assessment, making unbiased longitudinal analysis possible. Concerning the clinical and blood sampling surveys, the respondents tended to be younger and less disabled than the nonrespondents, limiting the use of the clinical and laboratory data to longitudinal analysis aimed at a healthier cohort. It is worth mentioning that gender, education, family support, and socioeconomic status were not important determinants of nonresponse, as is often the case.

Aged↗
PubMed1999

[Aedes albopictus in rural zone of Brazil and its implication in the wild yellow fever transmission].

Larvae and adult forms of Aedes albopictus were found during ecological study of anopheline mosquitos in the rural zone of the state of Mato Grosso do Sul in Brazil. This occurrence was registered, for the first time in Brazil, in an enzoootic area if sylvatic yellow fever virus. This implies a potential risk of the transfer of this virus to an urban area infested with Aedes aegypti.

Aedes↗
PubMed1999

[Mortality among Japanese migrants living in the State of Parana, Brazil].

INTRODUCTION: Taking as a premise that the study concerning the morbimortality of migrant populations may make a contribution to a better understanding of the epidemiology of diseases, mainly the chronic-degenerative ones and their related risk factors, the aim of this study is an analysis of the mortality experience of a population of migrants born in Japan, but living in the State of Paraná, Brazil, and a comparison of their pattern of mortality with those of Japan and Paraná. METHODS: The population studied was composed of the Japanese migrants - Issei - living in the State of Parana, Brazil, of more than 50 years of age, identified in the X General Brazilian Census of 1st September, 1991. Information on deaths which occurred between 1st March 1990 and 28th February, 1993, was obtained through the Ministry of Health data base. The main causes of death were analysed after the calculation of the age-adjusted death rates, using the world standard population older than 50 years old, for each sex, for the Issei, the inhabitants in Japan and in Paraná. Standardized Risk Ratio - SRR - and respective 95% confidence interval were estimated for selected causes among Issei versus the population living in Japan and Issei versus persons living in Paraná. RESULTS: Among the main results, it was observed that the female Issei mortality rate was in an intermediary position when compared to Japan's and Paraná's rates, while men showed figures quite close to the Japanese rates. Concerning the specific causes, it was observed that among male Issei, when compared to the Japanese population, the rates were significantly lower for stomach, but higher for diabetes and ischaemic heart diseases. Regarding the female Issei aged 50 or more years old, only the death rate for lung cancer was itself significantly lower than that of Japanese women. When compared to the Paraná pattern, the male Issei rates were lower regarding ischaemic heart and cerebrovascular diseases. Concerning stomach and lung cancer, there was no statistical difference. The female Issei rates were lower for lung cancer and ischaemic heart diseases. Regarding diabetes and cerebrovascular diseases, no significant difference among rates was detected. CONCLUSIONS: The results obtained make it possible to assert a deviation in the Issei pattern of mortality from that of their country of origin (Japan) and a perseptible approximation to the pattern of their new homeland (Paraná). Such observations suggest the influence of socio-cultural factors, mainly dietary habits, on their morbi-mortality.

Age Distribution↗
PubMed1999

[Mosquitoes potential vectors of canine heartworm in the Northeast Region from Brazil].

INTRODUCTION: In some coastal districts of São Luís, capital of the state of Maranhão, Brazil, the prevalence of Dirofilaria immitis is more than 40% in house dogs. Natural potential vectors, as found in other areas of Northeastern Brazil, are unknown. The aim of this study was to identify probable vectors of the disease. METHODS: Mosquito catches were performed at a coastal, district Olho d'Agua, in S. Luís, to look for local potential vectors. Captures were carried out monthly, from March 1996 to May 1997, outdoors, having a man and a dog as baits. Mosquitoes were dissected for D. immitis larvae. RESULTS: A total of 1,738 mosquitoes belonging to 11 species were collected. Culex quinquefasciatus, the only species collected every month, was more frequently in the dry season. It accounted for 54.5% of the total, followed by Aedes albopictus (20. 3%), Ae. scapularis (11%) and Ae. taeniorhynchus (11%). D. immitis larvae were detected in 0.1% of the Cx. quinquefasciatus dissected (L3 in the Malpighian tubules) and 0.5% of the Ae. taeniorhynchus (L2 in the Malpighian tubules). CONCLUSION: Ae. taeniorhynchus and Cx. quinquefasciatus are considered natural potential vectors of the canine heartworm in São Luís. The role of Cx. quinquefasciatus as primary vector of D. immitis, however, needs further evaluation.

Animals↗