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ABSTRACT BACKGROUND: Brazil is facing increasing cycles of numbers of infected people and deaths resulting from coronavirus disease 2019 (COVID-19). This situation involves a series of factors, including the behavior of the population, that can be decisive for controlling the disease. OBJECTIVE: To determine the knowledge, attitudes and practices of the Brazilian population regarding COVID-19. DESIGN AND SETTING: Cross-sectional survey-type study, conducted using a population sample from different Brazilian states. METHODS: A quantitative, descriptive and analytical approach was used. Sampling was done according to convenience and via snowballing. The data collection instrument was a knowledge, attitudes and practices system. RESULTS: 1,655 people from all over Brazil participated in the survey; 80% were living in the southern region and 70.15% were female. More than 90% had knowledge and good attitudes relating to the means of transmission, preventive care and symptoms associated with COVID-19, although their knowledge and attitudes were not fully reflected in daily practices, for which there was lower adherence (80%). Greater knowledge was correlated with older participants, larger number of children, female sex and marital status; better attitude, with female sex and complete higher education; and better practices, with greater age, larger number of children and female sex. CONCLUSION: A large part of the population has general knowledge about COVID-19, but not all knowledge was applied in practice. Older people, females and university graduates stood out as the best informed and most committed to controlling the disease.

https://doi.org/10.1590/1516-3180.2021.0541.23072021

Mortality due to hepatocellular carcinoma associated with hepatitis B and C viruses in the state of São Paulo, Brazil
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Cavalcante, Débora Ferro

; Garcia, Érica Marvila

; Farias, Norma Suely de Oliveira

; Koizumi, Inês Kazue

; Figueiredo, Gerusa Maria

; Sato, Ana Paula Sayuri

Revista Brasileira de Epidemiologia

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2022, Volume 25 elocation e220004

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

RESUMO: Objetivos: Este estudo tem como objetivo descrever e analisar a distribuição temporal e espacial dos óbitos por carcinoma hepatocelular associados às hepatites virais B e C no estado de São Paulo. Métodos: Estudo ecológico dos óbitos por carcinoma hepatocelular associados a hepatites virais B e hepatites virais C no estado de São Paulo, de 2009 a 2017, com dados do Sistema de Informação sobre Mortalidade. A tendência temporal foi analisada por regressão linear, com método de Prais-Winsten. Os óbitos foram descritos segundo as características sociodemográficas, por meio de frequências absolutas e relativas, e foram espacialmente distribuídos segundo departamento regional de saúde. Resultados: Dos óbitos por carcinoma hepatocelular, 26,3% foram associados a hepatites virais B ou hepatites virais C. Observou-se maior proporção de óbitos por carcinoma hepatocelular associado a hepatites virais C (22,2%) quando comparada àquela associada a hepatites virais B (3,9%). A taxa de mortalidade por carcinoma hepatocelular associado a hepatites virais B apresentou tendência de queda, no entanto a taxa de mortalidade por carcinoma hepatocelular associado a hepatites virais C apresentou tendência estacionária. Predominaram óbitos de pacientes do sexo masculino, de cor branca, de 50–59 anos e com oito a 11 anos de estudo. A análise espacial revelou distribuição heterogênea dos óbitos no estado de São Paulo. Conclusão: A tendência de queda nas taxas de mortalidade por carcinoma hepatocelular associado a hepatites virais B revela um importante avanço no controle do agravo. Entretanto, a taxa de mortalidade por carcinoma hepatocelular associado a hepatites virais C vem-se mantendo estável ao longo do período estudado. A distribuição espacial dos óbitos pode contribuir para levantar hipóteses com vistas ao conhecimento mais aprofundado desses agravos nas regiões.

ABSTRACT: Objective: This study aimed to describe and analyze the temporal and spatial distribution of deaths due to hepatocellular carcinoma (HCC) associated with hepatitis B (HBV) and C viruses (HCV) in the state of São Paulo. Methods: This is an ecological study of HCC deaths associated with HBV and HCV in the state of São Paulo, from 2009 to 2017, with data from the Mortality Information System (SIM). The temporal trend was analyzed by linear regression with Prais–Winsten estimation. Deaths were described according to sociodemographic characteristics by means of absolute and relative frequencies and were spatially distributed according to the regional health department. Results: It is found that 26.3% of deaths due to HCC were associated with HBV or HCV. A higher proportion of deaths due to HCC associated with HCV was observed (22.2%) when compared to HBV (3.9%). The mortality rate due to HCC associated with HBV showed a downward trend, and the mortality rate due to HCC associated with HCV showed a steady trend. Deaths of males, white individuals, those who aged from 50 to 59 years, and those who had 8–11 years of schooling predominated. Spatial analysis revealed a heterogeneous distribution of deaths in the state of São Paulo. Conclusions: The downward trend in mortality rates due to HCC associated with HBV shows an important advance in the disease control. However, the mortality rate due to HCC associated with HCV has remained stable throughout the study period. The spatial distribution of deaths may contribute to raise hypotheses for deeper knowledge of these diseases in the regions.

https://doi.org/10.1590/1980-549720220004

Mortality due to hepatocellular carcinoma associated with hepatitis B and C viruses in the state of São Paulo, Brazil
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Cavalcante, Débora Ferro

; Garcia, Érica Marvila

; Farias, Norma Suely de Oliveira

; Koizumi, Inês Kazue

; Figueiredo, Gerusa Maria

; Sato, Ana Paula Sayuri

Revista Brasileira de Epidemiologia

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2022, Volume 25 elocation e220004

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

https://doi.org/10.1590/1980-549720220004

Prevalence of hepatitis A in the capitals of the States of North, Southeast and South regions of Brazil: decrease in prevalence and some consequences
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Pereira, Leila M. M. B.

; Stein, Airton T.

; Figueiredo, Gerusa Maria

; Coral, Gabriela Perdomo

; Montarroyos, Ulisses R.

; Cardoso, Maria Regina Alves

; Braga, Maria Cynthia

; Moreira, Regina Celia

; Santos, Alex A. dos

; Ximenes, Ricardo Alencar

Revista do Instituto de Medicina Tropical de São Paulo

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2021, Volume 63 elocation e34

Abstract: En | Text: En | PDF: En

ABSTRACT Hepatitis A virus (HAV) infection has been considered one of the leading causes of acute hepatitis. The aim of the present study was to estimate the prevalence of HAV among children and adolescents in a population-based study in the capitals of the States of the North, Southeast and South of Brazil and identify predictive factors for the infection. A multi-stage sampling was used to select subjects aged between 5-9 and 10-19 years. Individual and household levels aside from the level of variables in the areas were collected. The outcome was the total IgG antibodies to HAV levels detected using a commercial Enzyme Immuno Assay (EIA). The associations between HAV and the independent variables were assessed using the odds ratio. A multilevel analysis was performed by GLLAMM using the Stata software. The prevalence of HAV infection in the 5-9 and 10-19 age groups was 28.7% and 67.5%, respectively for the North, 20.6% and 37.7%, for the Southeast and 18.9% and 34.5% for the South Region. The prevalence of HAV increased according to age in all sites. Variables related to education at the individual level (North and South), family and area level (South and Southeast) and family income level (Southeast and South) were independently associated with HAV infection. This emphasizes the need for individualized strategies to prevent the infection.

https://doi.org/10.1590/s1678-9946202163034

Ocorrência de hepatite B em gestantes e seguimento de crianças expostas no estado de São Paulo, em 2012
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Farias, Norma Suely de Oliveira

; Holcman, Marcia Moreira

; Compri, Adriana Parise

; Silva, Célia Regina Cicolo da

; Figueiredo, Gerusa Maria

; Moreira, Regina Célia

; Pinho, Maria Eunice Rebello

; Bersusa, Ana Aparecida Sanches

; Coelho, Débora Moraes

; Koizumi, Inês Kazue

; Sato, Helena Keico

; Araujo, Núbia Virginia D’Avila Limeira de

; Caminada, Sirlene

Epidemiologia e Serviços de Saúde

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2020, Volume 29 N. 2 elocation e2019443

Abstract: Pt En Es | Text: Pt En Es | PDF: Pt | PDF: En | PDF: Es

Resumo Objetivo: descrever a ocorrência da hepatite B entre gestantes, a realização de imunoprofilaxia e a transmissão vertical e perinatal nas crianças expostas ao vírus na rede de Atenção Primária à Saúde do estado de São Paulo, Brasil. Métodos: estudo transversal sobre registros de pré-natal de gestantes atendidas de janeiro a junho de 2012 e coorte dos recém-nascidos; foram descritas as frequências dos resultados e calculada a estimativa da ocorrência da hepatite B. Resultados: foram incluídas 6.233 gestantes, das quais 53,1% com 20 a 29 anos de idade, 58,7% com 8 a 11 anos de estudo, 53,3% brancas e 73,9% com companheiro; a ocorrência de hepatite B foi de 0,13% (IC95%: 0,04 a 0,21%); das oito crianças de mães com hepatite B crônica, seis tiveram esquema vacinal completo e não houve transmissão vertical ou perinatal. Conclusão: observou-se baixa ocorrência de hepatite B em gestantes e ausência de transmissão vertical ou perinatal.

Abstract Objective: to describe the occurrence of hepatitis B among pregnant women, immunoprophylaxis and vertical and perinatal transmission in children exposed to the virus in the São Paulo state primary care network, Brazil. Methods: this was a cross-sectional study using prenatal records of pregnant women attending health services between January and June 2012 and a cohort of newborns; the frequencies of the results were described and the estimated occurrence of hepatitis B was calculated. Results: 6,233 pregnant women were included, of whom 53.1% were between 20-29 years old, 58.7% had 8-11 years of schooling, 53.3% were white, and 73.9% lived with a partner; occurrence of hepatitis B was 0.13% (95%CI 0.04; 0.21); of the eight children of mothers with chronic hepatitis B, six had a complete vaccination schedule, and there was no vertical or perinatal transmission. Conclusion: there was low occurrence of hepatitis B in pregnant women and absence of vertical or perinatal transmission.

Resumen Objetivo: describir el aparecimiento de hepatitis B en mujeres embarazadas, la inmunoprofilaxis y la transmisión vertical y perinatal en niños expuestos al virus en la red de atención primaria en el estado de São Paulo, Brasil. Métodos: estudio transversal con registros prenatales de mujeres embarazadas atendidas de enero a junio de 2012 y cohorte de recién nacidos; se describieron las frecuencias y se calculó el surgimiento de la hepatitis B. Resultados: se incluyeron 6.233 gestantes, de las cuales 53,1% con 20 a 29 años de edad, 58,7% con 8 a 11 años de estudios, 53,3% blancas y 73,9% viviendo en pareja; la ocurrencia de hepatitis B fue del 0,13% (IC95%: 0,04 to 0,21%); entre ocho hijos de madres con hepatitis B crónica, seis tenía un calendario de vacunación completo y no había transmisión vertical o perinatal. Conclusión: hubo baja ocurrencia de hepatitis B en mujeres embarazadas y ausencia de transmisión vertical o perinatal.

https://doi.org/10.5123/s1679-49742020000200018

Ocorrência de hepatite B em gestantes e seguimento de crianças expostas no estado de São Paulo, em 2012
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Farias, Norma Suely de Oliveira

; Holcman, Marcia Moreira

; Compri, Adriana Parise

; Silva, Célia Regina Cicolo da

; Figueiredo, Gerusa Maria

; Moreira, Regina Célia

; Pinho, Maria Eunice Rebello

; Bersusa, Ana Aparecida Sanches

; Coelho, Débora Moraes

; Koizumi, Inês Kazue

; Sato, Helena Keico

; Araujo, Núbia Virginia D’Avila Limeira de

; Caminada, Sirlene

Epidemiologia e Serviços de Saúde

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2020, Volume 29 N. 2 elocation e2019443

Abstract: Pt En Es | Text: Pt En Es | PDF: Pt | PDF: En | PDF: Es

https://doi.org/10.5123/s1679-49742020000200018 1043 downloads

Mortality trend due to Hepatitis B and C in the city of São Paulo, 2002–2016
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Sato, Ana Paula Sayuri

; Koizumi, Inês Kazue

; Farias, Norma Suely de Oliveira

; Silva, Célia Regina Ciccolo da

; Cardoso, Maria Regina Alves

; Figueiredo, Gerusa Maria

Revista de Saúde Pública

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2020, Volume 54 elocation 124

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

RESUMO OBJETIVO: Descrever a mortalidade por hepatites B e C como causa básica no município de São Paulo, verificando a tendência dessas taxas, e avaliar a associação dessas doenças a outras no período de 2002 a 2016. MÉTODOS: Trata-se de um estudo de série temporal sobre mortalidade por hepatites B e C segundo sexo, com dados do Sistema de Informação de Mortalidade. A regressão de Prais Winsten foi usada na análise de tendência das taxas. RESULTADOS: Os achados do presente estudo mostraram tendência de declínio da mortalidade por hepatites B e C nos últimos anos, particularmente entre pessoas do sexo masculino. Essas infecções foram causas associadas importantes ao carcinoma de células hepáticas e ao HIV. Destaca-se a proporção de óbitos com menos de 70 anos de idade. CONCLUSÕES: O estudo fornece uma linha de base para pesquisas de tendência de mortalidade e de impacto de intervenções, visto o histórico de ampliação da detecção e oferta de tratamentos, incluindo os mais recentes antivirais no Brasil, desde 2015.

ABSTRACT OBJECTIVE: To describe mortality due to hepatitis B and C as underlying cause in the municipality of São Paulo, verifying the trend of these rates, and to assess the association of these diseases with others, from 2002 to 2016. METHODS: This is a time series study on mortality due to hepatitis B and C according to sex, with data from the Sistema de Informação de Mortalidade (SIM – Mortality Information Sistem). Prais Winsten regression was used in rate trend analysis. RESULTS: The findings of this study showed a trend of decline of mortality from hepatitis B and C in recent years, particularly among males. These infections were important associated causes of liver cell carcinoma and HIV. The proportion of deaths under 70 years of age stands out. CONCLUSIONS: The study provides a baseline for research on mortality trend and the impact of interventions, given the history of expanded detection and supply of treatments, including the most recent antivirals in Brazil, since 2015.

https://doi.org/10.11606/s1518-8787.2020054002231 609 downloads

Mortality trend due to Hepatitis B and C in the city of São Paulo, 2002–2016
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Sato, Ana Paula Sayuri

; Koizumi, Inês Kazue

; Farias, Norma Suely de Oliveira

; Silva, Célia Regina Ciccolo da

; Cardoso, Maria Regina Alves

; Figueiredo, Gerusa Maria

Revista de Saúde Pública

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2020, Volume 54 elocation 124

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

https://doi.org/10.11606/s1518-8787.2020054002231

Increase of immigrants in emerging countries: free public healthcare and vaccination as preventive measures in Brazil
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Fujita, Dennis Minoru

; Salvador, Felipe Scassi

; Damião, Giselle Pacífico Sartori

; Figueiredo, Gerusa Maria

; Nali, Luiz Henrique da Silva

Cadernos de Saúde Pública

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2019, Volume 35 N. 2 elocation e00228118

Abstract: En | Text: En | PDF: En

https://doi.org/10.1590/0102-311x00228118 6 downloads

10.

Increase of immigrants in emerging countries: free public healthcare and vaccination as preventive measures in Brazil
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Fujita, Dennis Minoru

; Salvador, Felipe Scassi

; Damião, Giselle Pacífico Sartori

; Figueiredo, Gerusa Maria

; Nali, Luiz Henrique da Silva

Cadernos de Saúde Pública

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2019, Volume 35 N. 2 elocation e00228118

Abstract: En | Text: En | PDF: En

https://doi.org/10.1590/0102-311x00228118 1290 downloads

11.

Methodology of a nationwide cross-sectional survey of prevalence and epidemiological patterns of hepatitis A, B and C infection in Brazil
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Ximenes, Ricardo Arraes de Alencar

; Pereira, Leila Maria Beltrão

; Martelli, Celina Maria Turchi

; Merchán-Hamann, Edgar

; Stein, Airton Tetelbom

; Figueiredo, Gerusa Maria

; Braga, Maria Cynthia

; Montarroyos, Ulisses Ramos

; Brasil, Leila Melo

; Turchi, Marília Dalva

; Fonseca, José Carlos Ferraz da

; Lima, Maria Luiza Carvalho de

; Alencar, Luis Cláudio Arraes de

; Costa, Marcelo

; Coral, Gabriela

; Moreira, Regina Celia

; Cardoso, Maria Regina Alves

Cadernos de Saúde Pública

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sep 2010, Volume 26 N. 9 Pages 1693 - 1704

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

Um inquérito de base populacional foi conduzido na população urbana de todas as capitais e do Distrito Federal no Brasil para fornecer informações sobre a prevalência de hepatites virais e fatores de risco, entre 2005 e 2009. Este artigo descreve o delineamento e a metodologia do estudo que envolveu a população com idade entre 5 e 19 anos para hepatite A e 10 a 69 anos para hepatite B e C. As entrevistas e amostras de sangue foram obtidas através de visitas domiciliares e a amostra selecionada a partir de uma amostragem estratificada em múltiplos estágios (por conglomerado) com igual probabilidade para cada domínio de estudo (região e faixa etária). Nacionalmente, 19.280 residências e ~31.000 indivíduos foram selecionados. O tamanho da amostra foi suficiente para detectar uma prevalência em torno de 0,1% e para avaliar os fatores de risco por região. A metodologia apresentou-se viável para distinguir entre diferentes padrões epidemiológicos da hepatite A, B e C. Estes dados serão de valia para a avaliação das políticas de vacinação e para o desenho de estratégias de controle.

A population-based survey to provide information on the prevalence of hepatitis viral infection and the pattern of risk factors was carried out in the urban population of all Brazilian state capitals and the Federal District, between 2005 and 2009. This paper describes the design and methodology of the study which involved a population aged 5 to 19 for hepatitis A and 10 to 69 for hepatitis B and C. Interviews and blood samples were obtained through household visits. The sample was selected using stratified multi-stage cluster sampling and was drawn with equal probability from each domain of study (region and age-group). Nationwide, 19,280 households and ~31,000 residents were selected. The study is large enough to detect prevalence of viral infection around 0.1% and risk factor assessments within each region. The methodology seems to be a viable way of differentiating between distinct epidemiological patterns of hepatitis A, B and C. These data will be of value for the evaluation of vaccination policies and for the design of control program strategies.

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Methodology of a nationwide cross-sectional survey of prevalence and epidemiological patterns of hepatitis A, B and C infection in Brazil
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Ximenes, Ricardo Arraes de Alencar

; Pereira, Leila Maria Beltrão

; Martelli, Celina Maria Turchi

; Merchán-Hamann, Edgar

; Stein, Airton Tetelbom

; Figueiredo, Gerusa Maria

; Braga, Maria Cynthia

; Montarroyos, Ulisses Ramos

; Brasil, Leila Melo

; Turchi, Marília Dalva

; Fonseca, José Carlos Ferraz da

; Lima, Maria Luiza Carvalho de

; Alencar, Luis Cláudio Arraes de

; Costa, Marcelo

; Coral, Gabriela

; Moreira, Regina Celia

; Cardoso, Maria Regina Alves

Cadernos de Saúde Pública

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sep 2010, Volume 26 N. 9 Pages 1693 - 1704

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

7640 downloads

13.

Uso da Classificação Internacional de Doenças em inquéritos de saúde
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Cesar, Chester Luiz Galvão

; Laurenti, Ruy

; Buchala, Cássia Maria

; Figueiredo, Gerusa Maria

; Carvalho, Wladithe Organ de

; Caratin, Carla V. de S.

Revista Brasileira de Epidemiologia

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aug 2001, Volume 4 N. 2 Pages 120 - 129

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

O objetivo do trabalho foi descrever a morbidade "referida" em inquérito de saúde, comparando o uso da CID-9 com o da CID-10. O estudo foi realizado com uma amostra populacional de 10.199 indivíduos, identificando-se as doenças ou os acidentes ocorridos num período de quinze dias. Realizou-se também uma comparação entre a CID-9 e a CID-10, reclassificando-se pela CID-10 as morbidades classificadas pela CID-9 como Capítulo XVI (Sintomas, Sinais e Afecções Mal Definidas). Cerca de 30% dos entrevistados referiu algum problema de saúde, somando 4415 queixas ou diagnósticos. Um total de 1403 queixas foram classificadas, pela CID-9, em 51 códigos do Capítulo XVI. Estas mesmas queixas recodificadas pela CID-10 transformaram-se em 70 Códigos, ganhando maior especifididade. Concluiu-se que foi satisfatória a classificação das morbidades referidas pelos entrevistados por meio da CID, sendo que a CID-10 apresentou vantagens em relação à CID-9, possibilitando classificar subcategorias residuais ao longo dos diferentes capítulos e apresentado maior especificidade do Capítulo XVIII.

The objective of the study was to describe morbidity "referred" in health surveys, comparing ICD-9 and ICD-10. The study identified the conditions or injuries occurring within a 15-day period in a population sample of 10,199 individuals. ICD-9 and ICD-10 were also compared, by reclassifying conditions formerly classified as ICD-9 Chapter XVI (Symptoms, Signs and Ill-Defined Conditions) using ICD-10. Approximately 30% of interviewees referred some health condition, totaling 4,415 complaints or diagnoses. A total of 1,403 complaints were classified, by ICD-9, into 51 Chapter XVI codes. The same complaints, recoded by ICD-10, turned into 70 Codes, therefore gaining greater specificity. The conclusion is that the classification of morbidity referred by interviewees using ICD was satisfactory. ICD-10 had advantages in relation to ICD-9, once it enabled the classification of residual subcategories in various chapters, thus providing greater specificity in Chapter XVIII.

9454 downloads

14.

Uso da Classificação Internacional de Doenças em inquéritos de saúde
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Cesar, Chester Luiz Galvão

; Laurenti, Ruy

; Buchala, Cássia Maria

; Figueiredo, Gerusa Maria

; Carvalho, Wladithe Organ de

; Caratin, Carla V. de S.

Revista Brasileira de Epidemiologia

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aug 2001, Volume 4 N. 2 Pages 120 - 129

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

3702 downloads

15.

Morbidade referida e utilização de serviços de saúde em localidades urbanas brasileiras: metodologia
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Cesar, Chester L. G.

; Figueiredo, Gerusa Maria

; Westphal, Márcia F.

; Cardoso, Maria Regina A.

; Costa, Maria Zilda de A.

; Gattás, Vera Lucia

Revista de Saúde Pública

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apr 1996, Volume 30 N. 2 Pages 153 - 160

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

A reformulação do sistema de saúde, que vem ocorrendo em nível nacional e particularmente no Estado de São Paulo, tem motivado revisões do processo de planejamento, criando novas necessidades na área de informações. A criação do Sistema Único de Saúde e o processo de municipalização retomaram as propostas de integração das atividades curativas e preventivas, bem como a estruturação de sistemas de saúde regionalizados e hierarquizados. Nesse contexto, surgem como áreas de conhecimento, de particular interesse, o perfil de morbidade populacional e o padrão de utilização de serviços de saúde. As respostas a essas necessidades podem ser dadas por inquéritos domiciliares de saúde. Descreve-se a metodologia utilizada em um inquérito domiciliar realizado em municípios da região sudoeste da Área Metropolitana de São Paulo, SP, Brasil, no período de julho de 1989 a junho de 1990. Esse inquérito apresenta algumas características metodológicas específicas, entre elas o processo amostral utilizado, que definiu domínios para a amostra que permitiram análise de grupos pouco representados na população, como os menores de um ano de idade e a população idosa, bem como o ajuste da amostra a partir dos dados censitários de 1991.

The reorganization of the Brazilian health system in the last few years has been based on the decentralization of the services and the integration of preventive and curative medicine, then creating new needs in term of the health information needed for health planning. The planning and administration of a regionalized and integrated health system calls for information about the population's morbidity profile, and the description of the pattern of the utilization of the health services, which can be obtained by means of household health surveys. The methodology utilized in a household health survey carried out in the Metropolitan Area of S. Paulo, Brazil, from July 1989 to June 1990, is described. This survey has some distinct methodological characteristics, such as the sampling process that defined the domains by age and sex, allowing an analysis of populational groups less well represented in the general population, as that of less than one year of age and that of aged people, as well as the use of the results of the lastest Brazilian Census in 1991 for adjusting the sample.

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