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Temporal trends and spatial patterns of Hepatitis C-related mortality in Brazil
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Hyppolito, Elodie Bomfim

; Ramos Júnior, Alberto Novaes

; Ferreira, Anderson Fuentes

; Dantas, Thor Oliveira

; Lima, José Milton de Castro

; Silva, Taynara Laís

; Pires Neto, Roberto da Justa

Revista de Saúde Pública

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2025, Volume 59 elocation e1

Abstract: En | Text: En | PDF: En

ABSTRACT OBJECTIVE: To analyze the trends and spatial patterns of hepatitis C-related mortality in Brazil from 2000 to 2020. METHODS: A population-based, mixed ecological study of spatial and temporal trends, using secondary data from death certificate (DC) registries, in which hepatitis C was mentioned as an underlying or associated cause of mortality. Temporal trends were analyzed by joinpoint regression, and spatial analysis by the distribution of adjusted rates by age and sex, and spatial autocorrelation by the local Moran index and the Getis-Ord Gi* index (Gi star). RESULTS: From 2000 to 2020, 64,029 deaths due to hepatitis C were recorded in the Mortality Information System (SIM), representing 0.26% of deaths in Brazil. Most deaths were due to underlying causes (n = 33,652, 52.6%). Areas with high rates in all five analyzed periods were identified in the states of São Paulo, southern Minas Gerais, southern Rio de Janeiro, northern Paraná, southern and coastal Santa Catarina, eastern Mato Grosso do Sul, and Rio Grande do Sul. The states of Acre and southern Amazonas showed high rates after 2004, which spread to northern Rondônia from 2016 to 2020. The joinpoint regression model showed an increasing trend in hepatitis C mortality in Brazil from 2000 to 2015, but a decreasing trend from 2016-2020. The mortality rate was higher in men and people over sixty years of age. CONCLUSION: Differences were observed in the temporal and spatial trend of hepatitis C mortality in different regions of Brazil. These data may support the design of hepatitis C elimination strategies in Brazil, according to regional specificities.

https://doi.org/10.11606/s1518-8787.2025059006139

Segurança e Eficácia dos Antivirais de Ação Direta no Tratamento da Hepatite C em Transplantados
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Hyppolito, Elodie Bomfim

; Pires Neto, Roberto da Justa

; Teixeira, Larissa Peixoto

; Marques, Lara Martins Sampaio

; Alencar, Vitória Bezerra de

; Pereira, Karla Brandão

; Linhares, Lívia Melo Carone

; Araújo Filho, Antônio Haroldo

; Viana, Cyntia Ferreira Gomes

; Rocha, Tarciso Daniel dos Santos

; Lima, Clébia Azevedo de

; Ferreira, Anderson Fuentes

; Ramos Júnior, Alberto Novaes

; Garcia, José Huygens Parente

Brazilian Journal of Transplantation

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2025, Volume 28 elocation e1425

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

RESUMO Objetivos: Realizar uma análise comparativa, avaliando cuidadosamente os perfis de eficácia e segurança em uma coorte de receptores de transplante de fígado e não receptores de transplante de fígado infectados com hepatite C e tratados com antivirais de ação direta. Métodos: Este estudo é uma análise observacional retrospectiva da vida real de indivíduos com hepatite C crônica que foram tratados com antivirais de ação direta. Durante esse período, 990 pacientes diagnosticados com hepatite C receberam terapia com antivirais de ação direta, 165 dos quais foram submetidos a transplante de fígado. Os critérios de exclusão incluíram pacientes HIV positivos e aqueles sem avaliação de resposta virológica sustentada. Resultados: A resposta virológica sustentada foi de 95,8 e 95,6% em receptores e não receptores de transplante de fígado, respectivamente (p = 0,94). A maioria dos pacientes foi tratada com sofosbuvir (SOF) em combinação com daclatasvir, simeprevir e ledipasvir. A ribavirina (RBV) foi administrada a 43,2% dos pacientes, resultando em ausência de melhora na resposta virológica sustentada e aumento de eventos adversos. O tratamento de pacientes do genótipo 2 com SOF e RBV e de pacientes do genótipo 3 com SOF, interferon e RBV por apenas 12 semanas mostrou eficácia subótima (89,5 e 83,3%), respectivamente. Conclusão: O tratamento da hepatite C com antivirais de ação direta é tão eficaz e seguro em pacientes transplantados hepáticos quanto em pacientes não transplantados hepáticos, e a prescrição de RBV é desaconselhável devido ao aumento de eventos adversos graves sem melhora da resposta virológica sustentada.

ABSTRACT Objectives: To perform a comparative analysis, evaluating the efficacy and safety profiles discerningly in a cohort of liver transplant recipients and non-liver transplant recipients infected with hepatitis C and treated with direct-acting antivirals (DAA). Methods: This study is a real-life retrospective, observational analysis of individuals with chronic hepatitis C who were treated with DAA. During this period, 990 patients diagnosed with hepatitis C received DAA therapy, 165 of whom had undergone liver transplantation. Exclusion criteria included HIV-positive patients and those without a sustained virologic response (SVR) assessment. Results: The SVR was 95.8 and 95.6% in liver transplant recipients and nonrecipients, respectively (p = 0.94). The majority of patients were treated with sofosbuvir (SOF) in combination with daclatasvir, simeprevir, and ledipasvir. Ribavirin (RBV) was co-administered to 43.2% of patients, resulting in no improvement in SVR and an increase in adverse events. Treatment of genotype 2 patients with SOF and RBV and genotype 3 patients with SOF, interferon, and RBV for only 12 weeks showed suboptimal efficacy (89.5 and 83.3%), respectively. Conclusion: The treatment of hepatitis C with DAA is as effective and safe in liver transplant patients as in non-liver transplant patients, and the prescription of RBV is inadvisable due to the increase in serious adverse events without improvement in SVR.

https://doi.org/10.53855/bjt.v28i1.662_port

Temporal trends and spatial patterns of Hepatitis C-related mortality in Brazil
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Hyppolito, Elodie Bomfim

; Ramos Júnior, Alberto Novaes

; Ferreira, Anderson Fuentes

; Dantas, Thor Oliveira

; Lima, José Milton de Castro

; Silva, Taynara Laís

; Pires Neto, Roberto da Justa

Revista de Saúde Pública

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2025, Volume 59 elocation e1

Abstract: En | Text: En | PDF: En

https://doi.org/10.11606/s1518-8787.2025059006139

Use of insect repellent as personal protection among women of childbearing age in an arbovirus endemic area in Northeastern Brazil
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Dias, Livia Karla Sales

; Sanhueza-Sanzana, Carlos

; Pinheiro Júnior, Francisco Marto Leal

; Martins, Adriano Ferreira

; Correia, Francisco Gustavo Silveira

; de Aguiar, Italo Wesley Oliveira

; Ferreira, Nayane Cavalcante

; Stolow, Jeni

; Rutherford, George

; Teixeira, Maria Gloria

; Pires Neto, Roberto da Justa

; de Almeida, Rosa Livia Freitas

; Coelho, Ivo Castelo Branco

; Frota, Cristiane Cunha

; Kendall, Carl

; Kerr, Ligia Regina Franco Sansigolo

Revista Brasileira de Epidemiologia

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2024, Volume 27 elocation e240025

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

RESUMO Objetivo: Analisar os fatores associados ao uso de repelente individual por mulheres em idade fértil residentes em área endêmicas para arboviroses em Fortaleza, Brasil. Métodos: Coorte realizada entre 2018 e 2019, com mulheres entre 15 e 39 anos, moradoras em Fortaleza, Ceará, Brasil. Participaram 1.173 mulheres, usuárias de quatro unidades primárias de saúde do município. O desfecho foi categorizado em: uso continuado, uso descontinuado e não uso de repelente. Realizada análise de regressão logística multinominal norteada por modelo hierárquico, com apresentação dos respectivos odds ratio (OR) e intervalos de confiança de 95% (IC95%). As variáveis independentes incluem: dados socioeconômicos e demográficos, características ambientais e sanitárias, conhecimento sobre o repelente e aspectos comportamentais e relacionados à gravidez. Resultados: Somente 28% das participantes referiram o uso de repelente durante as duas ondas da coorte. Mulheres com escolaridade superior (OR=2,55; IC95% 1,44–4,51); com emprego (OR=1,51; IC95% 1,12–2,03); que receberam orientações por profissionais da saúde (OR=1,74; IC95% 1,28–2,36) e pela mídia (OR=1,43; IC95% 1,01–2,02); que intensificaram os cuidados contra o mosquito na epidemia (OR=3,64; IC95% 2,29–5,78); estavam grávidas entre 2016 e 2019 (OR=2,80; IC95% 1,83–4,30) tiveram as chances aumentadas para uso continuado de repelente. Conclusões: O uso de repelente entre mulheres em idade fértil mostrou-se associado a um maior nível de escolaridade, ao emprego, às orientações sobre repelente fornecidas por profissionais de saúde e pela mídia, às mudanças comportamentais de cuidado contra o mosquito durante a epidemia da Zika e à gravidez quando ocorrida a partir do início do período epidêmico.

ABSTRACT Objective: To analyze the factors associated with the individual use of insect repellent by women of childbearing age living in area endemic for arboviruses in Fortaleza, Brazil. Methods: This is a cohort study carried out between 2018 and 2019 with women aged between 15 and 39 years in Fortaleza, state of Ceará, Brazil. A total of 1,173 women users of one of the four selected primary health care units participated in the study. The outcome was divided into: continued use, discontinued use, and nonuse of insect repellent. Crude and adjusted multinominal logistic regression analysis was carried out guided by a hierarchical model, with presentation of the respective odds ratio (OR) and 95% confidence intervals (95%CI). The independent variables include: socioeconomic and demographic data, environmental and sanitary characteristics, knowledge of the insect repellent, and behavioral and pregnancy-related aspects. Results: Only 28% of the participants reported using insect repellent during the two waves of the cohort. Women with higher education (OR=2.55; 95%CI 1.44–4.51); who are employed (OR=1.51; 95%CI 1.12–2.03); who received guidance from healthcare professionals (OR=1.74; 95%CI 1.28–2.36) and the media (OR=1.43; 95%CI 1.01–2.02); who intensified precautions against mosquitoes during the epidemic (OR=3.64; 95%CI 2.29–5.78); and who were pregnant between 2016 and 2019 (OR=2.80; 95%CI 1.83–4.30) had increased odds for continued use of insect repellent. Conclusion: The use of insect repellent among women of childbearing age was associated with a higher level of education, employment, guidance on insect repellent provided by healthcare professionals and the media, behavioral changes to protect against mosquitoes during the Zika virus epidemic, and pregnancy when occurring as of the beginning of the epidemic period.

https://doi.org/10.1590/1980-549720240025

Effectiveness and Safety of Direct-Acting Antivirals in the Treatment of Chronic Hepatitis C: A Real-life Study in Northeastern Brazil
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Hyppolito, Elodie Bomfim

; Ramos Jr, Alberto Novaes

; Teixeira, Larissa Peixoto

; Bezerra, Arthur Machado

; Mendes, Lucas Arruda

; Silva, Taynara Lais

; Lima, José Milton de Castro

; Arruda, Érico Antonio Gomes de

; Guerra, Eder Janes

; Tavares, Maria Macedo Saraiva

; Lima, Carlos Eduardo Pereira

; Esmeraldo, Ticiana Mota

; Pessoa, Francisco Sérgio Rangel de Paula

; Pierre, Alessandra Maria Montalverne

; Pereira, Karla Brandão

; Araújo Filho, Antônio Haroldo

; Linhares, Lívia Melo Carone

; Ferreira, Anderson Fuentes

; Pires Neto, Roberto da Justa

Revista da Sociedade Brasileira de Medicina Tropical

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2024, Volume 57 elocation e00423-2024

Abstract: En | Text: En | PDF: En

ABSTRACT Background: This study aimed to evaluate the effectiveness and safety of direct-acting antivirals (DAAs) for hepatitis C treatment by measuring sustained virologic response (SVR) and serious adverse events to help design effective interventions for reducing disease prevalence. Methods: This was a retrospective, observational, real-life study of patients with chronic hepatitis C receiving DAA treatment in the state of Ceará, Brazil. Data were collected in REDCap and analyzed using R® software by the Student's t, chi-square, and Fisher’s exact tests, with a significance level of 5%. Results: In this study, 1075 patients who were diagnosed with hepatitis C infection between October 2015 and October 2023 were included. The mean age of the participants was 56.6 ± 11 years and 60.2% were men. The sample included 51 HIV-infected patients (6.6%), 166 (15,4%) liver transplant recipients, 34 (3,1%) kidney transplant recipients, and 446 patients with cirrhosis (41.4%). The overall SVR rate was 96.4%. The sofosbuvir/daclatasvir/ribavirin regimen used in 354 (32.9%) patients achieved an SVR of 96%. The cure rate was 96.5%, with a lower SVR in patients with cirrhosis (93.4%) than in those with less severe fibrosis (97.9%) (p=0.0015). Serious adverse events associated with ribavirin use occurred in 3.5% of patients. Conclusions: DAA treatment for hepatitis C achieved SVR in real life in all patient profiles, including transplant recipients, HIV carriers, and patients with cirrhosis. Although these drugs are safe, a few decompensated patients with cirrhosis died during treatment.

https://doi.org/10.1590/0037-8682-0192-2024

Trachoma-associated morbidity and mortality in Brazil: an ecological study focusing on hospitalization and mortality data, 2000−2022
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Maciel, Adjoane Maurício Silva

; Ferreira, Anderson Fuentes

; Almeida, Nádia Maria Girão Saraiva de

; Maciel, Manuella Maurício Silva

; Silva, Taynara Lais

; Araújo, Mirele Coelho

; Pires Neto, Roberto da Justa

; Ramos Jr, Alberto Novaes

Revista da Sociedade Brasileira de Medicina Tropical

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2024, Volume 57 elocation e00414-2024

Abstract: En | Text: En | PDF: En

ABSTRACT Background: Trachoma is the leading infectious cause of blindness worldwide. It is a neglected tropical disease caused by Chlamydia trachomatis. The objective of this study was to analyze the trachoma-associated morbidity and mortality in Brazil from 2000 to 2022. This ecological time-series study was based on secondary data on trachoma obtained from hospital admissions (trachoma as the primary or secondary cause) and death certificates (trachoma as the underlying or associated cause). Methods: We calculated the sex- and age-standardized rates of hospital admissions and trachoma-specific mortality according to sociodemographic variables and analyzed the spatial distribution. Results: We identified 141/263,292,807 hospital admissions (primary cause: 83.0%) and 126/27,596,830 death certificates (associated cause: 91.3%) related to trachoma. Trachoma-related sequelae were reported in 8.5% of hospital admissions and 6.3% of death certificates. Trachoma was more common in males (hospital admissions and death certificates), people aged ≥70 years (hospital admissions and death certificates), those with brown skin (hospital admissions and death certificates), and those living in the North (hospital admissions) and Northeast (death certificates) regions of Brazil. Conclusions: Despite the relatively low rates of trachoma morbidity in Brazil, the associated mortality rates are of concern. The heterogeneous patterns of occurrence in the country in terms of population and territory reinforce the need to evaluate and monitor the available data, despite the low prevalence, in order to achieve and maintain the elimination targets in Brazil in the future.

https://doi.org/10.1590/0037-8682-0158-2024

Preditores de Terapias Apropriadas e Óbito em Pacientes com Cardiodesfibrilador Implantável e Cardiopatia Chagásica Crônica
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Pereira, Francisca Tatiana Moreira

; Rocha, Eduardo Arrais Gondim, Davi Sales Pereira Almeida, Rosa Livia Freitas de Pires Neto, Roberto da Justa

Arquivos Brasileiros de Cardiologia

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2024, Volume 121 N. 6 elocation e20230337

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

Abstract Background: There are few retrospective and prospective studies on implantable cardioverter-defibrillators (ICD) in primary and secondary prevention of sudden death in chronic Chagas heart disease (CCHD). Objectives: To describe the long-term evolution of patients with CCHD and ICD and to identify and analyze predictors of mortality and appropriate device therapy in this population. Methods: This was a historical prospective study with 117 patients with ICD and CCHD. Devices were implanted from January 2003 to December 2021. Predictors of appropriate therapies and long-term mortality were identified and analyzed. The level of statistical significance was p < 0.05. Results: Patients (n = 117) had a median follow-up of 61 months (25 to 121 months); they were predominantly male (74%), with a median age of 55 years (48 to 64 years). There were 43.6% appropriate shocks, 26.5% antitachycardia pacing (ATP), and 51% appropriate therapies. During follow-up, 46 patients (39.7%) died. Mortality was 6.2% person-years (95% confidence interval [CI]: 4.6 to 8.3), with 2 sudden deaths during follow-up. Secondary prevention (hazard ratio [HR] 2.1; 95% CI: 1.1 to 4.3; p = 0.029) and ejection fraction less than 30% (HR 1.8; 95% CI: 1.1 to 3.1; p < 0.05) were predictors of appropriate therapies. Intermediate Rassi score showed a strong association with the occurrence of ATP alone (p = 0.015). Functional class IV (p = 0.007), left ventricular ejection fraction < 30 (p = 0.010), and age above 75 years (p = 0.042) were predictors of total mortality. Conclusion: ICDs in CCHD showed a high incidence of appropriate activation, especially in patients with secondary prevention, low left ventricular ejection fraction, and intermediate Rassi score. Patients with congestive heart failure, elevated functional class, and age over 75 years showed elevated mortality.

Resumo Fundamento: Existem poucos estudos retrospectivos e prospectivos sobre cardiodesfibrilador implantável (CDI) na prevenção primária e secundária de morte súbita na cardiopatia chagásica crônica (CCC). Objetivos: Descrever a evolução a longo prazo dos portadores de CCC com CDI e identificar e analisar os preditores de mortalidade e de terapia apropriada do dispositivo nessa população. Métodos: Trata-se de um estudo prospectivo histórico com 117 pacientes portadores de CDI e CCC. Dispositivos foram implantados de janeiro de 2003 a dezembro de 2021. Fatores preditores de terapias apropriadas e mortalidade a longo prazo foram identificados e analisados. O nível de significância estatística é de p < 0,05. Resultados: Pacientes (n = 117) tiveram mediana de seguimento de 61 meses (25 a 121 meses), sendo o gênero masculino (74%) predominante e a mediana de idade de 55 anos (48 a 64 anos). Houve 43,6% de choques apropriados, 26,5% de estimulação cardíaca antitaquicardia (ATP) e 51% de terapias apropriadas. Durante o seguimento, 46 pacientes (39,7%) foram a óbito. A mortalidade foi de 6,2% pessoas-ano (intervalo de confiança [IC] 95%: 4,6 a 8,3), com 2 mortes súbitas durante o seguimento. A prevenção secundária (hazard ratio [HR] 2.1; IC 95%: 1,1 a 4,3; p = 0,029) e a fração de ejeção menor que 30% (HR 1.8; IC 95%: 1,1 a 3,1; p < 0,05) foram preditores de terapias apropriadas. Escore de Rassi intermediário apresentou uma forte associação com ocorrência de ATP isoladamente (p = 0,015). A classe funcional IV (p = 0,007), fração de ejeção do ventrículo esquerdo < 30 (p = 0,010) e a idade maior que 75 anos (p = 0,042) foram preditores de mortalidade total. Conclusão: Os desfibriladores na CCC apresentaram elevada incidência de acionamento apropriado especialmente naqueles pacientes de prevenção secundária, fração de ejeção do ventrículo esquerdo baixa e escore de Rassi intermediário. Os pacientes com insuficiência cardíaca congestiva, classe funcional avançada e idade maior que 75 anos apresentaram elevada mortalidade.

https://doi.org/10.36660/abc.20230337

Use of insect repellent as personal protection among women of childbearing age in an arbovirus endemic area in Northeastern Brazil
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Dias, Livia Karla Sales

; Sanhueza-Sanzana, Carlos

; Pinheiro Júnior, Francisco Marto Leal

; Martins, Adriano Ferreira

; Correia, Francisco Gustavo Silveira

; de Aguiar, Italo Wesley Oliveira

; Ferreira, Nayane Cavalcante

; Stolow, Jeni

; Rutherford, George

; Teixeira, Maria Gloria

; Pires Neto, Roberto da Justa

; de Almeida, Rosa Livia Freitas

; Coelho, Ivo Castelo Branco

; Frota, Cristiane Cunha

; Kendall, Carl

; Kerr, Ligia Regina Franco Sansigolo

Revista Brasileira de Epidemiologia

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2024, Volume 27 elocation e240025

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

https://doi.org/10.1590/1980-549720240025

Hipertensão em mulheres presas no Brasil: muito além do biológico
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Silva, Paula Negrão da

; Kendall, Carl

; Silva, Ana Zaira da

; Mota, Rosa Maria Salani

; Araújo, Larissa Fortunato

; Pires Neto, Roberto da Justa

; Leal Júnior, Francisco Marto Pinheiro

; Macena, Raimunda Hermelinda Maia

; Kerr, Ligia Regina Franco Sansigolo

Ciência & Saúde Coletiva

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jan 2023, Volume 28 N. 1 Pages 37 - 48

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

Resumo Objetivou-se estimar a prevalência de hipertensão arterial (HA) e os fatores de risco associados em mulheres presas. Utilizou-se dados do Inquérito Nacional de Saúde na População Penitenciária Feminina e em Servidoras Prisionais, investigando-se características sociodemográficas, fatores das prisões, comportamentos e condições de saúde. As informações foram coletadas por meio de questionário autoaplicado, sendo a magnitude da associação estimada por odds ratio e intervalo de confiança de 95%. Das 1.327 participantes, 24,4% eram hipertensas, a maioria tinha 31 anos ou mais (54,6%), 51,5% autorreferiram etnia/cor parda. Após mutual ajustamento pelos fatores de risco associados na análise bivariada, observou-se relação direta e com gradiente entre idade e HA, em que idade igual/maior a 41 anos foi associada independentemente com uma chance sete vezes maior de ter HA, se comparado a quem tem menos de 25 anos. Aquelas que autorreferiram etnia/cor negra apresentaram colesterol alto e estavam obesas, também foram associadas de forma independente com maior prevalência de HA. O maior número de pessoas com que a presa divide cela esteve associado à maior prevalência de há, sem uma relação dose-resposta. Conclui-se que idade, etnia/cor, obesidade, inatividade física e estresse são fatores de risco para HA em mulheres presas.

Abstract The scope was to estimate the prevalence of arterial hypertension (AHT) and associated risk factors among female prisoners. Data from the National Health Survey of the Female Prison Population and Prison Guards were used, investigating sociodemographic variables, prison characteristics, health behaviors and conditions. Information was collected through a self-administered questionnaire, and the magnitude of the association was estimated by the odds ratio and 95% confidence interval. Of the 1,327 prisoner participants, 24.4% were hypertensive, the majority were 31 years of age or older (54.6%), and 51.5% self-reported mixed race. After adjustment for associated risk factors in the bivariate analysis, a direct relationship between age and AHT was observed, in which age equal to/over 41 years was independently associated with a 7-fold greater chance of having AHT, compared to those under 25 years of age. Those who self-reported mixed race, had high cholesterol, were obese and were also independently associated with a higher prevalence of AHT. The greater the number of people with whom the inmate shares a cell was associated with a higher prevalence of AHT, but without a dose-response relationship. The conclusion drawn is that age, race, obesity, physical inactivity and stress are risk factors for AHT in female prisoners.

https://doi.org/10.1590/1413-81232023281.10672022

10.

Estratificação do Risco de Mortalidade na Insuficiência Cardíaca. A Busca pelo Santo Graal Continua! A Análise do Sistema Nervoso Autônomo está de Volta!
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Rocha, Eduardo Arrais

; Cunha, Bianca Lopes

; Brasil, Helena Nogueira Pereira, Francisca Tatiana Moreira Pires Neto, Roberto da Justa

Arquivos Brasileiros de Cardiologia

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2023, Volume 120 N. 11 elocation e20230761

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

https://doi.org/10.36660/abc.20230761

11.

Leprosy among female prisoners in Brazil
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Parente, Eriza de Oliveira

; Leal, Marto

; Kendall, Carl

; Mota, Rosa Maria Salani

; Pires Neto, Roberto da Justa

; Macena, Raimunda Hermelinda Maia

; Kerr, Ligia

Ciência & Saúde Coletiva

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2022, Volume 27 N. 12 Pages 4485 - 4492

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

Resumo Objetivou-se estimar a prevalência de hanseníase entre presidiárias brasileiras e identificar fatores associados à doença. Estudo transversal realizado entre 2014 e 2015 em 15 presídios femininos brasileiros. Os dados de 1.327 mulheres foram coletados por meio de autoentrevista assistida por computador e exame dermatológico e neurológico para identificar lesões suspeitas de hanseníase. A idade média foi de 33,4 anos. A suspeita de hanseníase foi identificada em 5,1% das mulheres na prisão, e a prevalência autorreferida ao longo da vida foi de 7,5%. As variáveis que se associaram à hanseníase autorrelatada ao longo da vida foram: mulheres presas uma vez com duas vezes mais chance de ter hanseníase; mulheres brancas tinham 1,4 vez mais chance de ter hanseníase do que mulheres não brancas; mulheres que conheciam alguém com hanseníase tinham 1,9 vez mais chance de ter hanseníase; e mulheres que compartilhavam uma cela com 11 ou mais mulheres tinham 2,5 vezes mais chance de ter hanseníase do que mulheres que compartilhavam uma cela com duas ou menos pessoas. A prevalencia de hanseníase entre presidiárias no Brasil foi maior do que a encontrada entre mulheres da população geral e evidencia a vulnerabilidade dessa população gerada pela pobreza pré-reclusão, bem como o potencial de transmissão na prisão.

Abstract To estimate the prevalence of leprosy among Brazilian female prisoners and identify factors associated with the disease. Cross-sectional study conducted between 2014 and 2015 in 15 Brazilian female prisons. The data of 1,327 women were collected using Audio Computer-Assisted Self-Interviewing and dermatological and neurological examination to identify suspicious lesions of leprosy. The average age was 33.4 years. Suspicion of leprosy was identified in 5.1% of women in prison, and lifetime self-reported prevalence was 7.5%. The variables that were associated with lifetime self-reported leprosy were: women in prison once being twice as likely to have leprosy; white women were 1.4 time more likely to have leprosy than non-white women; women who knew someone with leprosy was 1.9 time more likely to have leprosy; and women who shared a cell with 11 or more women were 2.5 times more likely to have leprosy than women who shared a cell with two or fewer people. The leprosy prevalence among female prisoners in Brazil were greater than that found in a Brazilian woman of the general population and show the extremely high vulnerability of this population generated through pre-incarceration poverty, as well as potential transmission in prison.

https://doi.org/10.1590/1413-812320222712.08842022

12.

Health of female prisoners in Brazil
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Leal, Marto

; Kerr, Ligia

; Mota, Rosa Maria Salani

; Pires Neto, Roberto da Justa

; Seal, David

; Kendall, Carl

Ciência & Saúde Coletiva

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2022, Volume 27 N. 12 Pages 4521 - 4529

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

Resumo A maioria das mulheres nas prisões vem das camadas mais pobres da sociedade, com acesso limitado a educação, renda e serviços de saúde. Isso contribui para o fato de que presidiárias têm maior carga de eventos adversos à saúde do que presidiários do sexo masculino e mulheres da população em geral. Objetivamos estimar a prevalência de diferentes morbidades e fatores de risco entre presidiárias no Brasil. Um total de 1.327 mulheres foram recrutadas neste estudo transversal. Os dados foram coletados por meio de um questionário de autoentrevista com áudio assistido por computador, testes rápidos de anticorpos e exame físico. As maiores prevalências foram de sífilis, infecções sexualmente transmissíveis, hipertensão arterial, asma, transtornos mentais comuns e violência física grave. Em relação aos fatores de risco, 36,3% têm bom conhecimento sobre o HIV, 55,8% são fumantes, 72,3% já usaram alguma droga ilícita, 92,1% são sedentários e 92,1% mantêm alimentação não saudável. As presidiárias são desproporcionalmente afetadas por várias condições adversas de saúde. É necessário um sistema de vigilância eficaz dentro das prisões para o diagnóstico e tratamento precoce.

Abstract The majority of the women in prisons comes from the poorest strata of society with limited access to education, income and health services. This contributes to the fact that female prisoners have a higher burden of adverse health events than both male prisoners and women in general population We objectived to estimate the prevalence of different morbidities and risk factors among female prisoners in Brazil. A total of 1,327 women were recruited in this cross-sectional study. Data were collected using a using audio computer-assisted self-interviewing questionnaire, rapid antibody tests and physical examination. The higher prevalences was of syphilis, infection sexually disease, arterial hypertense, asthma, common mental disorders and severe physical violence. Regarding risk factors, 36.3% have good knowledge about HIV, 55.8% were smokers, 72.3% had ever used any illicit drug, 92.1% are sedentary and 92.1% maintained an unhealthy diet. Female prisoners are disproportionately affected by various adverse health conditions. There is a need for an effective surveillance system inside prisons for early diagnosis and treatment.

https://doi.org/10.1590/1413-812320222712.10222022

13.

Scientometric analysis of research on trachoma in Brazil, 2000–2020
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Maciel, Adjoane Maurício Silva

; Ramos Júnior, Alberto Novaes

; Ferreira, Anderson Fuentes

; Almeida, Nádia Maria Girão Saraiva de

; Gomes, Vivian da Silva

; Gómez, Daniela Vaz Ferreira

; Pires Neto, Roberto da Justa

Revista de Saúde Pública

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2022, Volume 56 elocation 97

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

RESUMO OBJETIVO Analisar o perfil cienciométrico das pesquisas sobre tracoma no Brasil. MÉTODOS Pesquisa bibliográfica de publicações sobre tracoma no Brasil indexadas pela base de dados da Scopus, a partir de critérios específicos no período de 2000 a 2020. Foram extraídos e analisados dados sobre autoria, país de origem, instituições e descritores, com análises de tendências temporais. As redes bibliográficas foram construídas via software de visualização cienciométrica VOSviewer® 1.6.16. RESULTADOS Do total de 42 publicações analisadas sobre tracoma no Brasil, observou-se média anual de dois artigos, com incremento de aproximadamente 50% no período. Verificou-se média de três autores por documento e os inquéritos escolares foram a categoria de assunto mais comum. Os artigos publicados provêm majoritariamente de instituições brasileiras (95,2%), principalmente das sediadas nas regiões Sudeste e Norte. Dez autores mais produtivos estão mencionados nas primeiras autorias em 26,2% (11/42) das publicações e as instituições predominantes estão afiliadas ao estado de São Paulo. O termo Trachoma (n = 18) apresenta maior recorrência como descritor. CONCLUSÃO Esta primeira análise cienciométrica sobre tracoma no Brasil evidencia limitado número de pesquisas sobre essa doença. Há discreto incremento da produção científica, apesar da concentração da origem em áreas geográficas com menor endemicidade da doença. Maiores investimentos são necessários para o melhor entendimento e controle dessa doença tropical negligenciada. A análise da produção bibliográfica tem papel relevante para fortalecimento do desenvolvimento de pesquisas e planejamento estratégico de programas para o controle de tracoma e doenças tropicais negligenciadas em geral.

ABSTRACT OBJECTIVE To analyze the scientometric profile of research on trachoma in Brazil. METHODS Bibliographic research of publications on trachoma in Brazil indexed by the Scopus database from 2000 to 2020, based on specific criteria. Data on authorship, country of origin, institutions, and keywords were collected and analyzed with analysis of time trends. Bibliographic networks were constructed via a scientometric visualization software—VOSviewer® 1.6.16. RESULTS We analyzed 42 publications on trachoma in Brazil. The annual average was two articles, with an increase of about 50% during the period. The average number of authors was three per document and school surveys were the most common subject category. Most published articles came from Brazilian institutions (95.2%), mainly those based in Southeast and North Brazil. Of the most productive authors, 10 were mentioned as first author in 26.2% of publications (11/42) and the predominant institutions are based in the state of São Paulo. The term “trachoma” (n = 18) was the most recurrent keyword. CONCLUSION This first scientometric analysis of research on trachoma in Brazil showed a limited number of studies on this disease. The scientific production slightly increased, although the origin of many studies is geographical areas with lower endemicity of this disease. Greater investments are needed for a better understanding and control of this neglected tropical disease. The analysis of bibliographic production on this topic is important to strengthen the development of research and strategic planning of programs for the control of trachoma and neglected tropical diseases in general.

https://doi.org/10.11606/s1518-8787.2022056004144

14.

Epidemiologia da raiva humana no estado do Ceará, 1970 a 2019
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Duarte, Naylê Francelino Holanda

; Pires Neto, Roberto da Justa

; Viana, Victoria Forte

; Feijão, Levi Ximenes

; Abreu, Karina Gatti de

; Melo, Iva Maria Lima Araújo

; Sousa, Anastácio Queiroz

; Alencar, Carlos Henrique

; Heukelbach, Jorg

Epidemiologia e Serviços de Saúde

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2021, Volume 30 N. 1 elocation e2020354

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

Resumo Objetivo Descrever os casos de raiva humana no estado do Ceará, Brasil, no período 1970-2019. Métodos Estudo descritivo, sobre dados secundários da Secretaria da Saúde e do hospital de referência do Ceará. Resultados Dos 171 casos, 75,7% ocorreram em homens, 60,0% nas idades até 19 anos e 56,0% em áreas urbanas. O cão foi agente transmissor em 74,0% dos casos; sagui em, 16,7%; e morcego, em 7,3%. Entre 1970 e 1978, houve crescimento do número de casos (pelo Joinpoint Regression Program, percentual da mudança anual [APC] = 13,7 - IC95% 4,6;41,5); e entre 1978 e 2019, redução (APC = -6,7 - IC95% -8,8;-5,9). Houve redução da transmissão por cães (71 casos; último caso em 2010) e aumento relativo por mamíferos silvestres (5 casos a partir de 2005). Conclusão O estudo evidencia mudança na dinâmica da transmissão da raiva no período observado, com redução da transmissão por cão e incremento de casos por animais silvestres.

Resumen Objetivo Describir los casos de la rabia humana en Ceará, Brasil, 1970-2019. Métodos Estudio descriptivo con datos secundarios de la Secretaría de Salud y del hospital de referencia de Ceará. Resultados De los 171 casos, 75,7% ocurrió en hombres, el 60,0% en los 19 años y el 56,0% en áreas urbanas. El perro fue transmisor en 74,0%, el mono tití en 16,7% y el murciélago el 7,3%. Entre 1970 y 1978, hubo un aumento de casos (por el Joinpoint Regression Program, cambio porcentual anual [APC] = 13,7 - IC95% 4,6; 41,5), entre 1978 y 2019 una disminución (APC= -6,7 - IC95% -8,8; -5,9). Hubo una reducción de la transmisión por perros (71 casos, el último en 2010) y un aumento por mamíferos salvajes (5 casos, desde 2005). Conclusión El estudio muestra un cambio en la dinámica de la transmisión de la rabia en los últimos años, con reducción de la transmisión por perros y aumento de casos por animales salvajes.

Abstract Objective To describe cases of human rabies in Ceará State, Brazil between 1970 and 2019. Methods This was a descriptive study using secondary data from the Ceará State Department of Health and the state reference hospital. Results Of 171 cases, 75.7% occurred in males, 60.0% in <19-year-olds, and 56.0% in urban areas. Rabies was transmitted by dogs in 74.0% of cases, marmosets in 16.7% and bats in 7.3%. Between 1970 and 1978, there was an increase of cases (using the Joinpoint Regression Program, annual percentage change [APC] = 13.7 - 95%CI 4.6;41.5), while between 1978 and 2019 there was a decrease (APC = -6.7 - 95%CI -8.8;-5.9). There was a reduction in transmission by dogs (71 cases, last case in 2010) and an increase by sylvatic animals (5 cases since 2005). Conclusion This study demonstrates changes in rabies transmission dynamics during the period studied, with a reduction in transmission by dogs and an increase of transmission by sylvatic animals.

https://doi.org/10.1590/s1679-49742021000100010

15.

Physical violence inside female prisons in Brazil: prevalence and related factors
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Gama-Araujo, Isabelle Silva

; Bezerra Filho, José Gomes

; Kerr, Ligia

; Kendall, Carl

; Macena, Raimunda Hermelinda Maia

; Mota, Rosa Salani

; Ferreira, Marcelo

; Pires Neto, Roberto da Justa

Ciência & Saúde Coletiva

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feb 2020, Volume 25 N. 2 Pages 623 - 632

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

Resumo O presente artigo objetiva identificar a prevalência de violência física no interior das prisões femininas brasileiras, bem como fatores associados. Estudo transversal de abrangência nacional, realizado em 15 unidades prisionais femininas nas cinco regiões do Brasil em amostra selecionada por múltiplos estágios. Realizou-se análise univariada; análise estratificada em relação ao desfecho (sofrer violência física dentro da prisão) e as variáveis preditoras através do teste de Chi-quadrado de Pearson; cálculo da Odds Ratio; e regressão logística múltipla. Utilizou-se o teste Hosmer-Lemeshow para análise de qualidade de ajuste e adequação do modelo. A prevalência de violência física dentro das prisões femininas brasileiras foi de 37.4%. Houve correlação entre a vitimização da violência física na prisão e as seguintes variáveis: vitimização física prévia (p = 0.013), isolamento (p = 0.000), sofrimento mental (p = 0.003), ingestão abusiva e/ou dependência alcoólica (p = 0.011), uso atual ou prévio de cocaína injetável (p = 0.002) e ócio prisional (p = 0.003). A violência física tornou-se inerente ao sistema prisional feminino brasileiro. Estudos futuros são necessários no intuito de fornecer propostas para intervenções efetivas de modo a prevenir a violência física dentro das instalações prisionais.

Abstract The present study aims to identify the prevalence of physical violence against female prisoners in Brazil, as well as related factors. This is a cross-sectional national survey conducted in 15 female prisons in five regions of Brazil selected in multiple stages. The following types of analysis were performed: univariate analysis; stratified analysis relating the outcome (suffer physical violence inside prison) to predictor variables, using the Pearson chi-square test; calculation of the Odds Ratio (O.R.); and multiple logistic regression. The Hosmer-Lemeshow test was used for analysis of goodness of fit and adequacy of the model. The prevalence of physical violence inside female prisons was 37.4%. There was a correlation between physical violence victimization in prison and the following variables: physical victimization prior to arrest (p = 0.013), solitary confinement (p = 0.000), mental suffering (p = 0.003), current or previous abusive intake of alcohol (p = 0.011), current or previous injection of cocaine (p = 0.002) and not performing prison labor (p = 0.003). Physical violence has become inherent in the Brazilian female prison system. Continued studies are needed to monitor the situation and to develop interventions to prevent physical violence inside the facilities.

https://doi.org/10.1590/1413-81232020252.10842018

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