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At least 1,099 records · Page 61Linked to original sources
PubMed2003

Epidemiological aspects of retrovirus (HTLV) infection among Indian populations in the Amazon Region of Brazil.

HTLV was initially described in association with a form of leukemia in Japan and a neurological disease in the Caribbean. It was soon shown that HTLV-II was endemic among Amerindians and particularly among Brazilian Indians. The Amazon Region of Brazil is presently the largest endemic area for this virus and has allowed several studies concerning virus biology, the search for overt disease, epidemiological data including detailed demographic data on infected individuals, clear-cut geographic distribution, definition of modes of transmission and maintenance within small, epidemiologically-closed groups, and advances in laboratory diagnosis of the infection. A new molecular subtype named HTLV-IIc was further described on the basis of genome sequencing and phylogenetic analysis. This subtype is present in other areas of Brazil, indicating that the virus is additionally both a valuable marker for tracing past human migration routes in the Americas and a probable marker for social habits of the present human population. HIV, the other human retrovirus, is still not prevalent among indigenous communities in the Brazilian Amazon, but these groups are also easy targets for the virus.

Adolescent↗
PubMed2003

[Brain tumors mortality in Brazil, 1980-1998].

Brain tumors are rare, but their incidence and mortality have increased in different countries, including Brazil, especially among the elderly. This paper presents the mortality pattern of brain tumors in Brazil, including distribution of mortality rates by gender, age, topography, and tumor staging, from 1980 to 1998. Age-adjusted (by world population) brain cancer mortality rates increased from 2.24/100,000 to 3.35/100,000 inhabitants among the overall population during this period (an increase of 50%). Observed rates were higher during childhood than adolescence and increased with age, reaching the highest levels among the elderly. Among individuals 70 years of age and older, an average annual increase of 6% was observed in the series. Brain and meningeal tumor rates are presented for the entire country and selected State capitals. Further study is needed to elucidate the role of both new diagnostic technologies and environmental exposures potentially associated with the observed changes in brain cancer mortality rates.

Adolescent↗
PubMed2003

Prevalence of having a regular doctor, associated factors, and the effect on health services utilization: a population-based study in Southern Brazil.

In order to assess the prevalence of having a regular doctor, associated factors, and the effects on health services utilization, a cross-sectional study was performed in Rio Grande, Brazil, from January to May 2000. A total of 1,260 individuals 15 years or over were interviewed. Adjusted prevalence ratios and 95% confidence intervals were calculated, using a Poisson regression model. Some 37% of the sample had a regular doctor. Adjusted analysis revealed a direct and linear association with income. Female gender, age, private health insurance coverage, and chronic health problems were also associated with the outcome. Having a regular physician was associated with a 51% increase in clinical breast examination and a 62% increase in cervical cancer screening during the previous year, as well as a 98% increase in prostate cancer screening in the previous year in men 40 years or over. The study concluded that the prevalence of having a regular doctor in Brazil is low and is directly associated with socioeconomic factors. Individuals with a regular physician tend to have better access to health services. The promotion of consultation with a regular doctor among the population may improve health care quality and health services access, particularly in the poorest groups.

Adolescent↗
PubMed2003

[The private vaccines market in Brazil: privatization of public health].

The main objective of this article is to analyze the vaccines market in Brazil, which is characterized as consisting of two segments with distinct practices and logics: the public segment, focused on supply within the Unified National Health System (SUS) and the private segment, organized around private clinics, physicians' offices, and similar private health facilities. The private vaccines market segment, studied here for the first time, is characterized in relation to the supply and demand structure. Historical aspects of its structure are analyzed, based on the creation of one of the first immunization clinics in the country. The attempt was to analyze this segment in relation to its economic dimensions (imports and sales), principal manufacturers, and products marketed. It economic size proved much greater than initially hypothesized. The figures allow one to view it as one of the main segments in the pharmaceutical industry in Brazil as measured by sales volume. One detects the penetration of a privatizing logic in a sphere that has always been essentially public, thereby introducing into the SUS a new space for disregarding the principles of equity and universality.

Brazil↗
PubMed2003

[Comments on studies of industrial and non-industrial environments in Brazil: a comparative approach].

Air quality in industrial environments has been studied since the second half of the 20th century. Well-documented results show that exposure to chemical pollutants through their consumption, production, and storage can damage workers' health. New research focusing on non-industrial environments has shown unexpected correlations between air quality and health effects. Artificial ventilation systems have been related to health-related complaints and a high rate of absenteeism. Symptoms related to air quality in non-industrial environments are recognized by the World Health Organization and encompassed under the so-called sick building syndrome (SBS). In Brazil there are few studies comparing indoor air quality and health. The present study is intended to map the studies already conducted in Brazil in order to encourage further research in this area, due to its importance for public health.

Air Conditioning↗
PubMed2003

[Overweight and obesity prevalences in male adolescents in Northeast Brazil, 1980-2000].

This study aimed to determine the prevalence rates for overweight and obesity among male adolescents in the States of Northeast Brazil from 1980 to 2000, and to compare them over time to identify trends. The Brazilian Army database was used, with information on 316,925 adolescent conscripts. Overweight was defined as body mass index (BMI) from 25 to 29.9Kg/m and obesity as BMI > 30Kg/m . An upward curve was identified, showing that the secular tendency in the last twenty years increased for both overweight and obesity. The upward trend in overweight and obesity prevalence rates was observed in all States of Northeast Brazil. Although lower prevalence rates were observed than in developed countries, the speed of increase is cause for concern.

Adolescent↗
PubMed2004

[Periodontal disease in the Arturo's black community in Contagem, Minas Gerais, Brazil].

This was a cross-sectional study on periodontal disease in a black community in Brazil. The sample consisted of 104 individuals over 13 years of age (63 females and 41 males). All teeth were examined except the third molars. Six sites per tooth were analyzed in order to measure pocket depth and clinical loss of attachment. Four sites per tooth were used to measure bleeding on probing and presence of calculus. It was observed that bleeding on probing occurred in 97.9% of the total of individuals with teeth, with probing depth >or= 4mm in 43.3% and clinical attachment loss in 63.5%. Calculus was detected in 81.2% of the sample. In the study, individuals 46 to 60 years of age showed the highest mean clinical attachment loss, 8.3mm (+/- 4.27), and a probing depth of 4.6mm (+/- 3.5). Prevalence rate for periodontal disease in this community was similar to rates elsewhere in Brazil and the world, i.e., 9.6% for the severe form. Age, schooling, and tobacco use were identified as risk indicators statistically associated with periodontal disease.

Adolescent↗
PubMed2004

The concept and measurement of race and their relationship to public health: a review focused on Brazil and the United States.

Race has been widely used in studies on health and healthcare inequalities, especially in the United States. Validity and reliability problems with race measurement are of concern in public health. This article reviews the literature on the concept and measurement of race and compares how the findings apply to the United States and Brazil. We discuss in detail the data quality issues related to the measurement of race and the problems raised by measuring race in multiracial societies like Brazil. We discuss how these issues and problems apply to public health and make recommendations about the measurement of race in medical records and public health research.

Brazil↗
PubMed2004

Remote sensing as a tool to survey endemic diseases in Brazil.

The objective of this study, based on a systematic literature review, is to present the characteristics and potentialities of remote sensing as a useful environmental surveillance tool for applied research in the control of endemics in Brazil. Onboard satellite sensors allow for monitoring the territory, furnishing spatial and temporal information on various scales and regions in the electromagnetic spectrum. Based on the literature review on the application of this technology to the study of endemics and the identification of the potential of new sensors with better spectral, spatial, and temporal resolutions, this study highlights perspectives for the use of remote sensing in the study of important endemics for Brazil.

Brazil↗
PubMed2004

[Morbidity and mortality from external causes in Brazil, 2000].

Since the early 1980s, external causes have been the second greatest cause of death in Brazil. They also place a growing demand on health care services. The current study analyzes morbidity and mortality from external causes in Brazil. The study material consists of 118,367 deaths and 652,249 hospitalizations due to external causes during the year 2000. The data are from the National Mortality Information System and Hospital Information System. The mortality coefficient from external causes was 69.7/ 100 thousand (119.0/100 thousand for males and 21.8/100 thousand for women). Homicides were the leading cause of death (38.3% of the total), with a high coefficient of 26.7/100 thousand, while falls were the leading cause of hospitalizations (42.8% of the total). Motor vehicle accidents were a major cause of both morbidity and mortality. Fractures, mostly occurring in the upper and lower limbs, accounted for 42.6% of hospitalizations. Based on the findings, preventive programs should aim to decrease both mortality and morbidity, with special emphasis on homicides, traffic accidents, and falls.

Adolescent↗
PubMed2004

Childhood tuberculosis incidence in Southeast Brazil, 1996.

This study aims to describe childhood tuberculosis incidence in Southeast Brazil in 1996. It is a descriptive study based on secondary records from the Tuberculosis Division of the Sao Paulo State Health Department. The study area includes 40 cities, has some 1,800,000 inhabitants, and is located between Sao Paulo and Rio de Janeiro, the largest cities in Brazil. The study included cases up to 15 years of age. Independent variables were: sex, age, type of case, clinical presentation, radiology, AFB microscopy, HIV antibody tests, and method of discovery. The incidence rate in this age bracket was 10.4/100,000. Pulmonary manifestations were the most common, and control of contacts was the most common method of case discovery. AFB microscopy was performed in 18.6% of the cases and HIV testing was done in 14.9%. Incidence in this study was higher than for the State of Sao Paulo as a whole. Poor socioeconomic level, deterioration of public health services, treatment dropout by adults and their persistence as sputum-positive carriers, and flaws in case reporting and follow-up could explain these results.

Adolescent↗
PubMed2004

[Socioeconomic inequalities and low birth weight and perinatal mortality in Rio de Janeiro, Brazil].

Socioeconomic inequalities in early infant mortality have been evidenced in Brazil, with a greater mortality risk associated with the mother's socioeconomic status (SES). The aim of this paper is to identify socioeconomic inequalities in relation to low birth weight and perinatal mortality in the City of Rio de Janeiro, Brazil, discussing the appropriateness of the main health inequality indexes proposed in the international literature. As the information source, we use data collected in a survey of approximately 10,000 mothers selected for interview within 48 hours after delivery in public and private hospitals in the city. Using educational level and head of household's income as indicators of SES, as well as population attributable risk and slope index of inequality as health inequality measures, the results show a steep socioeconomic gradient in the proportion of low birth weight, and especially in the perinatal mortality rate. The persistent association between socioeconomic indicators and adverse results in pregnancy indicates (at least partially) the health system's inefficacy in diminishing perinatal health inequalities in Rio de Janeiro.

Brazil↗
PubMed2004

Effect of Integrated Management of Childhood Illness (IMCI) on health worker performance in Northeast-Brazil.

A multi-country evaluation is being carried out in Brazil and four other countries to determine the effectiveness, cost, and impact of the Integrated Management of Childhood Illness (IMCI). We examine the effect of IMCI on the quality of health care provided to children under five visiting health facilities. A health facility survey was conducted at 24 facilities (12 with IMCI) in each of four States in the Northeast. We assessed the quality of care provided to children between 2 months and 5 years attending the facilities. Health workers trained in IMCI provided significantly better care than those not trained. Significant differences between health workers who were trained or not trained in IMCI were found in the assessment of the child, disease classification, treatment, and caretaker communication. Nurses trained in IMCI performed as well as, and sometimes better than, medical officers trained in IMCI. We conclude that while there is room for further improvement, IMCI case management training significantly improves health worker performance, and that parts of Brazil that have not yet introduced IMCI should be encouraged to do so.

Brazil↗
PubMed2005

Risk factors for breast cancer: a systematic review of studies with female samples among the general population in Brazil.

A systematic review of studies was conducted to determine the characteristics of epidemiological research on risk factors for breast cancer in female samples from the general population in Brazil. Of the 23 articles identified, only 14 were selected for review. Most of the studies were from Southeast Brazil. Three were cross-sectional, conducted in specific populations, and 11 used case-control designs. The sample sizes varied from 40 to 164,269 women. Twenty-nine risk factors were researched, and among these, 11 were investigated in four or more studies. Nulliparity was the most frequent factor, found in 12 of the studies. Prevalence of the factors varied widely among the samples, and since the samples were heterogeneous and the studies presented several methodological limitations, a summary mean was not calculated.

Brazil↗
PubMed2005

[Access to medical appointments by men with sexually transmitted diseases at a health unit in Fortaleza, Ceará, Brazil].

Access to healthcare services is one of the important aspects of the Unified National Health System in Brazil, and the supply and management of such services is the responsibility of municipalities. This study focuses on difficulties faced by men with sexually transmitted diseases (STDs) in accessing appointments for treatment. This was a qualitative study of men treated at an STD clinic in Fortaleza, Ceará State, Brazil, in November 2003, using content analysis technique and interpretation of interviews, focusing on access as the category. Men with STDs encountered extensive difficulty in accessing medical appointments, even when they used different strategies for this purpose. Scheduling of services is incompatible with patients' available time. At the primary care level, the supply of appointments for STDs scarcely exists. More investment is needed in the Unified National Health System in order to improve access to appointments for men with STDs, and the supply of services should take the population's demand into account.

Adult↗
PubMed2005

Evaluation of the impact of a nutritional program for undernourished children in Brazil.

To assess the effectiveness on child growth and body composition of a supplementary feeding program (Milk Supplement Program), a prospective, controlled study was conducted in Northeast Brazil. When entering the Program, children from 10 municipalities with the highest coverage rates in the Program (intervention group) were compared to non-beneficiary children from 10 municipalities with the lowest coverage rates (control group). A total of 219 children aged 6-18 months were enrolled. At entry, both groups were comparable in terms of age, sex, and nutritional status. There were frequent gaps in delivery of the supplement, no extra milk was provided to siblings less than 5 years of age, intra-household redistribution of milk was high, and maternal compliance with recommendations was low. Adjusted analyses by multilevel modelling showed average changes in weight, length, weight-age and length-age Z-scores, and % body water (deuterium method), at 6 months, of 1.53 kg, 6.34 cm, 0.33, 0.05, and 1.11% respectively among supplemented children as compared to 1.54 kg, 6.5 cm, 0.26, 0.07, and 4.10% among controls, with no statistically significant difference between groups. Thus, the Program failed to compensate for nutritional deficiencies in undernourished children in Northeast Brazil.

Body Composition↗
PubMed2005

Adherence to antiretroviral therapy: a qualitative study with physicians from Rio de Janeiro, Brazil.

Brazil provides free antiretroviral (ARV) therapy to some 150,000 individuals living with HIV/ AIDS). ARV regimens require optimal adherence to achieve undetectable viral loads and to avoid viral resistance. Physicians play a key role to foster ARV adherence, but until now little is known about the communication between physicians/ people living with HIV/AIDS in this setting. In-depth interviews were conducted with 40 physicians treating people living with HIV/AIDS at six public reference centers in Rio de Janeiro, Brazil. Interview topics included: experiences in the treatment of people living with HIV/AIDS, relationship and dialogue with patients, barriers/facilitators to adherence, and effectiveness of available services. Barriers to ARV adherence were mainly related to the low quality of patient-provider relationship. Other barriers were related to "chaotic" patients' lifestyles, and inadequate knowledge and/or negative beliefs about HIV/AIDS and ARV effectiveness. It is necessary to improve networking between services, establish agile referral systems, and improve health professionals' integration. These structural changes could contribute to improved adherence, resulting in improved quality of life for people living with HIV/AIDS.

Acquired Immunodeficiency Syndrome↗
PubMed2006

[Prevalence and determinants of medicines consumption in Fortaleza, Ceará, Brazil].

The objective of this work was to investigate the prevalence and determinants of medicines consumption in Fortaleza, Ceará, Brazil. A population-based cross-sectional study was carried out in a representative sample of 331 households. A total of 1,370 persons living in Fortaleza were interviewed from October 2002 to January 2003, and 1,366 were selected for this study. Consumers were defined as all persons having used one or more drugs during the preceding 15 days. The prevalence of medicine consumption was 49.7%. The following were the predictive factors for medicines consumption according to the multivariate logistic regression analysis: family income > 3 minimum wages, older age ( > or = 50), female gender, > or = 3 persons living in household, chronic disease, having a health insurance plan, and one or more visits to the doctor in the last three months. Prevalence of medication use was high in Fortaleza but was similar to that found elsewhere in Brazil and in other countries. Inequality in the access of medications was identified.

Adolescent↗