Gabriela Drummond Marques da Silva

Bayesian rates for homicide mapping in Brazilian municipalities

This study analyzes homicide incidence per municipality (county) in Brazil in the year 2008. The authors estimate and compare homicide rates according to different methods, finding evidence that depending on the method employed, the results can differ significantly, especially for small municipalities. Bayesian spatial procedures were employed, allowing minimization of variation in the rate estimates. The methods consider a priori distributions and information on contiguity of municipalities. According to the findings, the impact of corrective procedures is not relevant for large municipalities, but such estimates present significant differences for small municipalities. Comparing the different estimates, the authors conclude that there may be distortions in the rates published in the literature. To overcome such potential distortions, it is necessary to take the main goal in each analysis into account. When the emphasis is on overall visualization of the homicide phenomenon, the best option is spatial corrections. However, to obtain more accurate local estimates, Bayesian methods are more appropriate.

Evaluation of the impact of serogroup C meningococcal disease vaccination program in Brazil and its regions: a population-based study, 2001-2013

BACKGROUND Meningococcal C conjugate (MenC) vaccine was introduced as part of the Brazilian National Immunisation Program in 2010 for children < 1 year of age. OBJECTIVES The study objective was to evaluate the impact of this vaccination strategy. METHODS An observational, mixed ecological and analytical study was conducted, based on time series panel data from surveillance records (2001-2013). FINDINGS A total of 37,538 of meningococcal disease cases were recorded during the study period. Of these, 19,997 were attributed to serogroup C. A decrease in meningococcal disease serogroup C (MDC) incidence among children aged < 1 year [65.2%; 95% confidence interval (CI): 20.5-84.7%] and 1-4 years (46.9%; 95%CI: 14.6-79.1%) were found in the three years following vaccination introduction. Vaccination impact on the reduction of MDC incidence varied from 83.7% (95%CI: 51.1-100.0%) in the Midwest region to 56.7% (95%CI: 37.4-76.0%) in the Northeast region. MAIN CONCLUSIONS Vaccination against MDC in Brazil had a positive impact on the population of children aged < 1 year, across all regions, and on the 1-4 year-old cohort. Nevertheless, in our view there is scope for improving the vaccination strategy adopted in Brazil.

Avaliação da qualidade dos dados, oportunidade e aceitabilidade da vigilância da tuberculose nas microrregiões do Brasil

This study aimed to evaluate quality, acceptability and timeliness of the data in the tuberculosis surveillance system in Brazilian micro-regions. An ecological cross-sectional study was carried out, after a qualitative stage for selecting indicators. All 558 Brazilian micro-regions were used as units of analysis. Data available in the National Notifiable Diseases Information System (SINAN), from 2012 to 2014, were used to calculate 14 indicators relating to four attributes: completeness, consistency, timeliness and acceptability. The study made use of cluster analysis to group micro-regions according to acceptability and timeliness. Three clusters were identified among the 473 micro-regions with optimal or regular completeness (70% to 100%) and with over five notifications. Cluster 1 (n = 109) presented mean timeliness of notification and treatment equal to 62.8% and 24.9%, respectively. Cluster 2 (n = 143) had a mean percentage of cases tested for HIV equal to 55.9%. Cluster 3 (n = 221) had the best performing tuberculosis indicators. Results suggest priority areas for improving surveillance of tuberculosis, predominantly in the central-north part of the country. They also point to the need to increase the timeliness of treatment and the percentage of cases tested for HIV.This study aimed to evaluate quality, acceptability and timeliness of the data in the tuberculosis surveillance system in Brazilian micro-regions. An ecological cross-sectional study was carried out, after a qualitative stage for selecting indicators. All 558 Brazilian micro-regions were used as units of analysis. Data available in the National Notifiable Diseases Information System (SINAN), from 2012 to 2014, were used to calculate 14 indicators relating to four attributes: completeness, consistency, timeliness and acceptability. The study made use of cluster analysis to group micro-regions according to acceptability and timeliness. Three clusters were identified among the 473 micro-regions with optimal or regular completeness (70% to 100%) and with over five notifications. Cluster 1 (n = 109) presented mean timeliness of notification and treatment equal to 62.8% and 24.9%, respectively. Cluster 2 (n = 143) had a mean percentage of cases tested for HIV equal to 55.9%. Cluster 3 (n = 221) had the best performing tuberculosis indicators. Results suggest priority areas for improving surveillance of tuberculosis, predominantly in the central-north part of the country. They also point to the need to increase the timeliness of treatment and the percentage of cases tested for HIV.

La violencia doméstica y familiar contra la mujer: estudio de casos y controles con víctimas tratadas en salas de emergencia

O objetivo deste estudo foi identificar fatores associados ao atendimento por violencia domestica e familiar entre vitimas atendidas em servicos de urgencia e emergencia no Brasil. Realizou-se estudo de casos e controles baseado no Sistema de Vigilância de Violencias e Acidentes (VIVA), 2011. Foram selecionadas mulheres com 18 anos ou mais de idade, vitimas de violencia domestica e familiar (casos) em comparacao com aquelas vitimas de acidentes (controles). As razoes de chances ajustadas foram estimadas por regressao logistica nao condicional. Foram incluidos 623 casos e 10.120 controles. Na analise ajustada, foram fatores de risco: idade mais jovem (18-29 anos), baixa escolaridade, nao exercer atividade remunerada, consumo de bebida alcoolica, procura de atendimento em outro servico, ocorrencia em final de semana e durante a noite ou madrugada. A violencia domestica e familiar teve o consumo de bebida alcoolica como fator fortemente associado. Os dias e horas de maior ocorrencia evidenciam a necessidade de adequacao dos servicos de atendimento as vitimas.This study aimed to identify factors associated with treatment of victims of domestic and family violence in emergency rooms in Brazil. This is a case-control study based on the Surveillance System for Violence and Accidents (VIVA), 2011. Women ≥ 18 years who were victims of family and domestic violence were selected as cases and compared to accident victims (controls). Adjusted odds ratios were estimated by unconditional logistic regression. 623 cases and 10,120 controls were included. Risk factors according to the adjusted analysis were younger age (18-29 years), low schooling, lack of paid work, alcohol consumption, having sought treatment in a different health service, and violence on weekends or at night or in the early morning hours. The study concludes that domestic and family violence shows alcohol consumption as a strongly associated factor. Days and hours with the highest ocurrence reveal the need to adjust emergency services to treat victims.

Violência doméstica e familiar contra a mulher: estudo de casos e controles com vítimas atendidas em serviços de urgência e emergência

O objetivo deste estudo foi identificar fatores associados ao atendimento por violencia domestica e familiar entre vitimas atendidas em servicos de urgencia e emergencia no Brasil. Realizou-se estudo de casos e controles baseado no Sistema de Vigilância de Violencias e Acidentes (VIVA), 2011. Foram selecionadas mulheres com 18 anos ou mais de idade, vitimas de violencia domestica e familiar (casos) em comparacao com aquelas vitimas de acidentes (controles). As razoes de chances ajustadas foram estimadas por regressao logistica nao condicional. Foram incluidos 623 casos e 10.120 controles. Na analise ajustada, foram fatores de risco: idade mais jovem (18-29 anos), baixa escolaridade, nao exercer atividade remunerada, consumo de bebida alcoolica, procura de atendimento em outro servico, ocorrencia em final de semana e durante a noite ou madrugada. A violencia domestica e familiar teve o consumo de bebida alcoolica como fator fortemente associado. Os dias e horas de maior ocorrencia evidenciam a necessidade de adequacao dos servicos de atendimento as vitimas.This study aimed to identify factors associated with treatment of victims of domestic and family violence in emergency rooms in Brazil. This is a case-control study based on the Surveillance System for Violence and Accidents (VIVA), 2011. Women ≥ 18 years who were victims of family and domestic violence were selected as cases and compared to accident victims (controls). Adjusted odds ratios were estimated by unconditional logistic regression. 623 cases and 10,120 controls were included. Risk factors according to the adjusted analysis were younger age (18-29 years), low schooling, lack of paid work, alcohol consumption, having sought treatment in a different health service, and violence on weekends or at night or in the early morning hours. The study concludes that domestic and family violence shows alcohol consumption as a strongly associated factor. Days and hours with the highest ocurrence reveal the need to adjust emergency services to treat victims.

[Domestic and family violence against women: a case-control study with victims treated in emergency rooms].

O objetivo deste estudo foi identificar fatores associados ao atendimento por violencia domestica e familiar entre vitimas atendidas em servicos de urgencia e emergencia no Brasil. Realizou-se estudo de casos e controles baseado no Sistema de Vigilância de Violencias e Acidentes (VIVA), 2011. Foram selecionadas mulheres com 18 anos ou mais de idade, vitimas de violencia domestica e familiar (casos) em comparacao com aquelas vitimas de acidentes (controles). As razoes de chances ajustadas foram estimadas por regressao logistica nao condicional. Foram incluidos 623 casos e 10.120 controles. Na analise ajustada, foram fatores de risco: idade mais jovem (18-29 anos), baixa escolaridade, nao exercer atividade remunerada, consumo de bebida alcoolica, procura de atendimento em outro servico, ocorrencia em final de semana e durante a noite ou madrugada. A violencia domestica e familiar teve o consumo de bebida alcoolica como fator fortemente associado. Os dias e horas de maior ocorrencia evidenciam a necessidade de adequacao dos servicos de atendimento as vitimas.This study aimed to identify factors associated with treatment of victims of domestic and family violence in emergency rooms in Brazil. This is a case-control study based on the Surveillance System for Violence and Accidents (VIVA), 2011. Women ≥ 18 years who were victims of family and domestic violence were selected as cases and compared to accident victims (controls). Adjusted odds ratios were estimated by unconditional logistic regression. 623 cases and 10,120 controls were included. Risk factors according to the adjusted analysis were younger age (18-29 years), low schooling, lack of paid work, alcohol consumption, having sought treatment in a different health service, and violence on weekends or at night or in the early morning hours. The study concludes that domestic and family violence shows alcohol consumption as a strongly associated factor. Days and hours with the highest ocurrence reveal the need to adjust emergency services to treat victims.