Deborah Carvalho Malta

Análise de séries temporais da mortalidade por doenças isquêmicas do coração e cerebrovasculares, nas cinco regiões do Brasil, no período de 1981 a 2001

OBJECTIVEnThe aim of this study was to evaluate the trends of ischemic and cerebrovascular death risk in the five regions--Midwest, Northeast, North, Southeast and South--of Brazil from 1981 to 2001.nnnMETHODSnData on mortality due to cerebrovascular and coronary heart diseases in the five regions of Brazil were obtained from the Brazilian Ministry of Health. The data source was the SIM--Sistema de Informações sobre Mortalidade (System of Information on Mortality), from the Department of Health Information Analysis. The population estimates were obtained from the IBGE (Brazilian Institute of Geography and Statistics) census of 1991 and 2000, and population estimates of 1996, all from DATASUS. The codes used in this study were International Classification of Diseases ICD-9 430-438 and ICD-10 I60-I69 for cerebrovascular diseases and ICD-9 410-414 and ICD-10 I21-I25 for ischemic disease. Statistical analysis was carried out by adjusted linear models.nnnRESULTSnThere was a decline trend in death rates due to cerebrovascular disease at all age ranges and in both sexes in the South, Southwest, and Midwest regions. Additionally, death rates due to ischemic heart disease declined in the South and Southwest regions. There was a stabilization of the death risk in the Midwest and an increase in the Northeast region.nnnCONCLUSIONnThe risk of death due to cerebrovascular and ischemic heart diseases declined in the Southwest and South, which are the more developed regions of Brazil, whereas the risk increased in the less developed ones, mainly in the Northeast region.

Validade e reprodutibilidade de marcadores do consumo de alimentos e bebidas de um inquérito telefônico realizado na cidade de Belo Horizonte (MG), Brasil

OBJECTIVEnTo evaluate the validity and reproducibility markers of food and beverage intake obtained by means of a telephone-based surveillance system.nnnMETHODSnReproducibility was assessed by means of repeated interviews with a 7-15 day interval after the first interview of the system (n=258). Validity was analyzed based on three interviews corresponding to the 24 hour recall method, used as gold standard, 3 days a week, 7 to 15 days after the original telephone interview (n=217). In the study of reproducibility, kappa statistics was used to measure the similarity between the results of the proportions obtained in the first and second interviews. For validation, the proportion of positive reports regarding foods and beverages at the original telephone interview was compared to that obtained by the 24 hour recall method, and the results was analyzed by calculating sensitivity, specificity and positive predictive value.nnnRESULTSnIn the reproducibility study, the agreement was almost perfect for the marker milk consumption (0.86), substantial for fruit consumption (0.67), intake of fruits and vegetables, intake of meat with fat and alcohol abuse. The agreement was moderate for the intake of soft drink, and fair for the consumption of vegetables. Regarding the validity, there was an underestimation of fruit, vegetable and milk consumption, except for meat and alcohol when compared with the consumption frequency estimated from the three 24-hours recalls, differences related to soft drink consumption was inexpressive.nnnCONCLUSIONnThe instruments enabled the surveillance of factors which were potentially associated with chronic diseases, however, it is a priority to continue with validation studies in other populations to provide greater system reliability, always considering possible limiting factors.OBJETIVO: avaliar a reprodutibilidade e validade de indicadores de consumo de alimentos e bebidas levantados por meio de entrevistas telefonicas pelo Sistema de Vigilância de Fatores de Risco e Protecao para Doencas Cronicas por Telefone (VIGITEL). METODOS: A reprodutibilidade foi aferida por meio de entrevistas repetidas com intervalos de 7 a 15 dias a partir da primeira entrevista original do sistema (n=258). A validade foi avaliada usando como padrao ouro 3 entrevistas correspondentes a recordatorios de 24h (R24h) em 3 dias da semana, apos 7 a 15 dias da entrevista telefonica original (n=217). No estudo de reprodutibilidade a estatistica kappa foi utilizada para medir a concordância entre os resultados das proporcoes obtidas na primeira e na segunda entrevista. Para a validacao, a proporcao de referencia positiva de alimentos e bebidas na entrevista telefonica original foi comparada aquela obtida nos R24h e sua avaliacao foi analisada por meio do calculo da sensibilidade, especificidade e valor preditivo positivo. RESULTADOS: No estudo de reprodutibilidade, observou-se concordância quase perfeita para o indicador de consumo de leite com teor integral de gordura (0,86); concordância substancial para consumo de frutas (0,67), consumo de frutas e hortalicas, consumo de carne com gordura ou frango com pele e consumo abusivo de bebida alcoolica; concordância moderada para o indicador de consumo de refrigerante; e concordância regular para o indicador do consumo de hortalicas. Com relacao ao estudo de validacao, observou-se subestimacao de indicadores de consumo de frutas, hortalicas e leite integral, exceto para consumo de carne/frango com gordura e bebida alcoolica, quando comparados com a frequencia desse consumo estimada a partir dos tres R24horas; as diferencas para o consumo de refrigerantes foi inexpressiva. CONCLUSAO: Verificou-se que os instrumentos utilizados permitem a vigilância de fatores potencialmente associados a doencas nao transmissiveis, entretanto, e prioritaria a continuidade de estudos de validacao em outras populacoes do sistema, com o objetivo de oferecer maior confiabilidade aos mesmos, sempre considerando as potenciais limitacoes.