Cheila Marina Lima

Mortalidade por acidentes de transporte terrestre no Brasil na última década: tendência e aglomerados de risco

OBJECTIVE To analyze the temporal trends of mortality due to Road Traffic Accidents (RTA) as well as identify the existence and location of high risk death clusters for RTA using spatial analysis. METHODOLOGY Descriptive study of temporal trends by RTA, pedestrians, motorcyclists, motorists and passengers and spatial analysis for 2000 and 2010. The data was obtained from the Mortality Information System, and standardized rates were calculated by age in Brazilian states and municipalities grouped by population size. RESULTS The mortality rates due to RTA between 2000 and 2010 varied from 18 to 22.5 deaths/100,000 inhabitants. The risk of death for pedestrians decreased in recent years, though motorists, motorcyclists and passengers saw a rising trend. A higher risk of death by RTA occurred in municipalities with populations up to 20,000 inhabitants and in those from 20,000 to 100,000 inhabitants. Spatial analysis revealed risk clusters for RTA and motorcyclists and pillion riders with an increase between 2000 and 2010 and enlargement of the areas most at risk in the Northeast. CONCLUSION Increase in the rates of mortality by RTA mostly in the Northeast. Coordinated action between government, civil society and the citizens themselves is required to tackle this problem.

Violence against children: revealing the characteristics of emergency treatment, Brazil, 2006 and 2007

The aim of this article was to describe the profile of emergency care for injuries resulting from violence against children (< 10 years of age) treated Surveillance System for Violence and Accidents (VIVA) of the Ministry of Health, for 30 consecutive days in 2006 and 2007 in selected cities of Brazil. The 518 children in the sample were predominantly male (60.6%), aged 5-9 years (52.1%), and black (71.2%). The majority (55%) of the cases occurred in the home, 34.2% involved sharp objects, and 68.7% evolved to discharge. The most frequent form of violence was physical aggression (67.4%), involving beating, sharp objects, and firearms. The other types of violence included neglect (32%), psychological abuse (9.5%), and sexual assault (3.5%). The aggressors were largely male (48.1%) and family members of the victim (36.3%). The study shows childrens vulnerability to situations of violence. It is necessary to develop specific strategies for inter-sector care and social mobilization to intervene in this problem.

Impacto da Legislação Restritiva do Álcool na Morbimortalidade por Acidentes de Transporte Terrestre ­ Brasil, 2008

Jose Gomes Temporao - Fundacao Oswaldo Cruz. Escola Nacional de Saude Publica Sergio Arouca. Rio de Janeiro, RJ, Brasil. / Gerson Oliveira Penna - Fundacao Oswaldo Cruz. Fiocruz Brasilia. Brasilia, DF, Brasil. Documento produzido em parceria ou por autor vinculado a Fiocruz, mas nao consta a informacao no documento.

Fatores de risco para acidentes de transporte terrestre entre adolescentes no Brasil: Pesquisa Nacional de Saúde do Escolar (PeNSE)

Road traffic injuries are the cause of an expressive number of deaths and hospitalizations among young people in the world. In Brazil, it is responsible for 17.1% of all deaths among adolescents aged 10 to 14 years. This article presents the results of the National Adolescent School-based Health Survey (PeNSE), using a probabilistic sample of students in the 9th grade of high schools (public and private) of the Brazilian capitals in 2009. The prevalence (and 95%CI) of risk factors for road traffic injury among adolescents were estimated. Main results from the 60,973 interviews were: in the last 30 days, 26.3% (25.5% to 27.0% 95%CI) reported no use of seat-belts while riding in a moving vehicle; 18.5% (18.0% to 19.1% 95%CI) of youths younger than 18 years reported driving a motor vehicle (> once); 18.7% (18.1% a 19.2% 95%CI) reported a history of being driven by a driver who had been drinking (> once); and 35.0% (33.8% to 36.2% 95%CI) reported no use of helmets while riding a motorcycle (> once). The results are in accordance with the high rates of morbidity and mortality from traffic injury among youths, reinforcing the need of integrated intersectoral actions, specific legal measures and strict control.

Situations of violence experienced by students in the state capitals and the Federal District: results from the National Adolescent School-based Health Survey (PeNSE 2012)

OBJECTIVE To describe violent events experienced by school-aged adolescents in school, around the school and in the family context, and to compare the results of the National Adolescent School-based Health Survey of 2009 and 2012. METHODS Indicators related to violence involving teenagers were analyzed. The prevalence rates and confidence intervals of 95% were calculated for events of interest according to gender and type of school (public or private) and regions. RESULTS Prevalence rates were: insecurity in the route between home-school (9.1%), insecurity in school (8.0%), physical assault in the last 12 months (18.2%), engaging in fights in the last 12 months (20.7%), fighting with a cold weapon (8.3%), fighting with firearms (6.9%), physical assault by a family member (11.6%) and having been seriously injured in the last 12 months (10.3%). The situations of violence were more prevalent among male students from public schools. The comparison with the 2009 survey showed increased prevalence in all the variables studied. CONCLUSION Teenagers are exposed to different forms of violence, and the data from the National Survey of School Health can support the planning of preventive actions.

Perfil das vítimas de violências e acidentes atendidas em serviços de urgência e emergência selecionados em capitais brasileiras: Vigilância de Violências e Acidentes, 2009

Objetivo: descrever perfil das vitimas de violencias/acidentes atendidas em servicos de urgencia/emergencia do Sistema Unico de Saude durante 2009. Metodos: estudo transversal com vitimas de violencias/acidentes atendidas em 74 servicos de urgencia/ emergencia no Distrito Federal e 23 capitais. Utilizou-se amostragem por conglomerados em unico estagio. Os dados foram coletados em turnos de 12 horas, selecionados aleatoriamente, durante 30 dias consecutivos. Resultados: 89,9% dos atendimentos foram por acidentes. Os homens representaram 64,2 e 71,1% dentre as vitimas de acidentes e violencias, respectivamente. 22,9% das vitimas atendidas por acidentes pertenciam a faixa etaria de 20 a 29 anos, os adultos de 20 a 29 anos representaram 34,8% dos atendimentos devido a violencias. Conclusao: maiores proporcoes de atendimentos de vitimas de acidentes e violencias foram: individuos do sexo masculino, com baixa escolaridade, raca/cor da pele parda, situacoes relacionadas ao consumo de alcool e como locais de ocorrencia a residencia e a via publica.

Characteristics of motorcyclists involved in road traffic accidents attended at public urgent and emergency services

Resumo As lesoes decorrentes dos acidentes com motociclistas constituem importante problema de saude publica no Brasil. Objetivou-se descrever as caracteristicas de motociclistas envolvidos em acidentes de transporte, atendidos em servicos publicos de urgencia e emergencia nas capitais de estado e no Distrito Federal. Estudo transversal com base nos dados do Inquerito sobre Violencias e Acidentes em Servicos de Urgencia e Emergencia (VIVA Inquerito) de 2014. Os dados foram analisados segundo caracteristicas sociodemograficas, do evento e do atendimento. Diferencas proporcionais entre os sexos foram analisadas pelo teste do qui-quadrado (Rao-Scott) com nivel de significância de 5%. Do total de atendimentos de motociclistas, predominaram homens (n = 9.673), (razao de sexo = 3,2), jovens de 20 a 39 anos (65,7%), pretos/pardos (73,6%), com atividade remunerada (76,4%). Uso de capacete foi relatado por 79,1% das vitimas, 13,3% haviam consumido alcool nas seis horas anteriores ao acidente, 41,4% dos eventos estavam relacionados ao trabalho da vitima. Os acidentes foram mais frequentes nos finais de semana, durante a manha e final da tarde. Estas caracteristicas pode apoiar o desenvolvimento de politicas publicas de prevencao de acidentes e na promocao da saude.Injuries resulting from motorcycle road traffic accidents are an important public health issue in Brazil. This study aimed to describe the characteristics of motorcyclists involved in traffic accidents attended in public urgent and emergency services in the state capitals and the Federal District. This is a cross-sectional study based on data from the Violence and Accident Surveillance System (VIVA Survey) in 2014. Data were analyzed according to sociodemographic, event and attendance characteristics. Proportional differences between genders were analyzed by chi-square test (Rao-Scott) with 5% significance level. Motorcyclist-related attendances (n = 9,673) reported a prevalence of men (gender ratio = 3.2), young people aged 20-39 years (65.7%), black / brown (73.6%), paid work (76.4%). Helmet use was reported by 79.1% of the victims, 13.3% had consumed alcohol in the six hours prior to the accident, 41.4% of the events were related to the victims work. Accidents were more frequent on weekends, in the morning and late afternoon. These characteristics can support the development of public accident prevention policies and health promotion.

PW 2550 Data quality of the interpersonal and self-inflicted violence notification information system – brazil, 2011–2014

Introduction The notification of interpersonal and self-inflicted violence (ISV) is a component of the epidemiological surveillance of this public health issue. Brazil has a large network of Health Information Systems that allows to describe the epidemiological reality and to manage the health services, but it is fundamental that the information provided by these systems be reliable and real. Thus, completeness is one of the attributes used to evaluate the quality of the information in public health surveillance systems. Objective Evaluate the data quality of the Interpersonal and Self-inflicted Violence Notification Information System (ISVNIS) in Brazil, from 2011 to 2014. Methods a descriptive study of the ISVNIS data was carried out considering de percentage of incompleteness of essential e mandatory variables among all variables of ISV notification form. Percentages of incompleteness were calculated on the basis of the not filled fields (filled in with ignored or blank) for each variable by year of notification. The annual average of incompleteness was calculated and classified as follow: Excellent (incompleteness <5%), Good (5%–9.9%), Regular (10%–19.9%), Bad (20%–49.9%) and Too Bad (≥50%). Findings from 2011 to 2014, the number of ISV notifications increased 84.3%. In general, the average incompleteness of the variables analyzed was classified as Bad (22.4%), ranging from Regular for the individual notification (14.4%) and the victim identification (14.6%) variables, to Bad for closure of notification (30.8%) and case referral (32.9%) variables. Conclusion and policy implications The ISV notification data presented bad completion quality, despite the increase in the number of notifications in the analyzed period. Data monitoring and training of professionals in the correct filling of ISV notifications is recommended.

Violência de gênero: comparação da mortalidade por agressão em mulheres com e sem notificação prévia de violência

Violence against women is an important public health problem in Brazil and in the world. The objective of the present study was to describe the profile of mortality due to aggression against women, and analyze whether the victims of reported violence are more likely to die from aggression than the general female population. This is a descriptive study of mortality due to aggression against women, from database linkage. The databases used for linkage were SINAN Brazils Notifiable Diseases Information System (reports of violence against women) (2011 - 2015), and SIM, the Mortality Information System (women dying as a result of aggression) (2011 - 2016). The risk of death due to aggression among women previously reporting violence is higher than in the general female population, thus revealing a situation of vulnerability. Black women with lower schooling are the main victims of violence and homicides. The large number of women killed by aggression and repeated violence reveal the fragility of the care and protection networks in providing comprehensive, qualified and timely care for victims.Resumo A violencia contra a mulher constitui um importante problema de saude publica no Brasil e no mundo. O objetivo do presente estudo foi descrever o perfil de mortalidade por agressao em mulheres e analisar se as vitimas de violencia notificadas apresentam taxas de mortalidade por esse motivo mais elevadas do que a populacao feminina geral. Trata-se de um estudo descritivo da mortalidade por agressao em mulheres, a partir do linkage de bancos de dados. Os dados utilizados para o linkage foram todas as notificacoes de violencia contra mulheres registradas no SINAN (Sistema de Informacao de Agravos de Notificacao) no periodo de 2011 a 2015 e os obitos de mulheres por agressao registrados no SIM (Sistema de Informacoes sobre Mortalidade), no periodo de 2011 a 2016. O risco de morte por agressao nas mulheres notificadas por violencia foi maior do que na populacao feminina geral, revelando assim uma situacao de vulnerabilidade. Mulheres negras, de menor escolaridade foram as principais vitimas de violencia e homicidios. O elevado numero de mulheres mortas por agressao e a violencia de repeticao revelaram a fragilidade das redes de atencao e protecao no atendimento integral, qualificado e oportuno as vitimas.

Estupro e gravidez de meninas de até 13 anos no Brasil: características e implicações na saúde gestacional, parto e nascimento

Sexual violence against children and adolescents is a serious threat to the rights and full health of this age group. This study aims to describe the characteristics of mothers aged up to 13, and analyze the profile of cases of notified rape in this age range and repercussions of this violence during pregnancy and childbirth. It is a comparative study of the characteristics of gestation and childbirth of girls aged up to 13 who have had children, without or with notification of rape, in the Violence & Accidents Vigilance (VIVA) System of the Brazilian Case Registry Database (Sistema de Informação de Agravos de Notificação - SINAN). A significant percentage (67.5%) of the girls aged up to 13 with children were of the black race/color category. There was repeated violence in 58.2% of cases. The notified rape victims have a higher percentage of birth by cesarean section, late onset and a lower number of prenatal consultations; and their babies had lower birthweight and lower 1-minute Apgar scores than mothers without rape notification. Rape of children and adolescents is an important risk factor that has repercussions during pregnancy, and complications in delivery and childbirth.