Luciana Petrucci Gigante

Postnatal depression in Southern Brazil: prevalence and its demographic and socioeconomic determinants.

BackgroundStudies investigating the prevalence of postnatal depression (PND) show rates ranging from 5% to 36.7%. The investigation of age, race, educational levels, religion and income as risk factors for PND has yielded conflicting results. The aim of this study is to investigate the prevalence of PND in women residing in Southern Brazil and the associated risk factors.MethodsThis is population-based cross-sectional study of women residing in Porto Alegre who delivered in June 2001. A sample of 271 participants were selected from the Record of Living Newborn Infants of the State Health Department (the official Brazilian database and stores the name and address of all women who give birth to living newborn infants) using a process based on pseudo-random numbers which choose a random sample from 2.000 records. Once the addresses were identified, the women were visited at their place of residence (home, hotel, boarding house and prison), with the interviews taking place between the 6th and the 8th week after delivery.The association between the risk factors and PND was investigated through bivariate analysis using Pearsons chi-square test. Students t-test was used to analyze the continuous variables. To identify independent risk factors, multivariate analysis was performed using hierarchical levels with a predefined model that took into account the time relationship between PND and the risk factors. Coxs regression was used to calculate the prevalence ratios.ResultsThe PND prevalence rate found was 20.7% (CI 95% 15.7 – 25.7). After adjusting for confounding variables, per capita income was found to have a significant association with PND.ConclusionThe prevalence of PND is higher than the figures found in most developed countries and similar to the figures found in developing countries. Differences in PND by regions or countries can be partially explained by the effect of income on the mediation of risk factors. In low income populations, women should be routinely evaluated for postnatal depression, and those with no partner or spouse are likely to require further care from health services and should be given the benefit of mental health prevention programs.

Hearing impairment and socioeconomic factors: a population-based survey of an urban locality in southern Brazil

OBJECTIVE To provide the first population-based data on deafness and hearing impairment in Brazil. METHODS In 2003, a cross-sectional household survey was conducted of 2,427 persons 4 years old and over. The study population was composed of 1,040 systematically chosen households in 40 randomly selected census tracts (dwelling clusters) in the city of Canoas, which is in the state of Rio Grande do Sul, in southern Brazil. Hearing function was evaluated in all subjects by both pure-tone audiometry and physical examination, using the World Health Organization Ear and Hearing Disorders Survey Protocol and definitions of hearing levels. The socioeconomic data that were gathered included the amount of schooling of all individuals tested and the income of the head of the household. RESULTS It was found that 26.1% of the population studied showed some level of hearing impairment, and 6.8% (95% confidence interval (CI) = 5.5%-8.1%) were classified in the disabling hearing impairment group. The prevalence of moderate hearing loss was 5.4% (95% CI = 4.4%-6.4%); for severe hearing loss, 1.2% (95% CI = 0.7%-1.7%); and for profound hearing loss, 0.2% (95% CI = 0.03%-0.33%). The groups at higher risk for hearing loss were men (odds ratio (OR) = 1.54; 95% CI = 1.06-2.23); participants 60 years of age and over (OR = 12.55; 95% CI = 8.38-18.79); those with fewer years of formal schooling (OR = 3.92; 95% CI = 2.14-7.16); and those with lower income (OR = 1.56; 95% CI = 1.06-2.27). CONCLUSIONS These results support advocacy by health policy planners and care providers for the prevention of deafness and hearing impairment. The findings could help build awareness in the community, in universities, and in government agencies of the health care needs that hearing problems create.

Child sexual abuse in southern Brazil and associated factors: a population-based study

BackgroundThe prevalence of child sexual abuse (CSA) in the population has been poorly described in developing countries. Population data on child sexual abuse in Brazil is very limited. This paper aims to estimate lifetime prevalence of child sexual abuse and associated factors in a representative sample of the population aged 14 and over in a city of southern Brazil.MethodsA two-stage sampling strategy was used and individuals were invited to respond to a confidential questionnaire in their households. CSA was defined as non-consensual oral-genital, genital-genital, genital-rectal, hand-genital, hand-rectal, or hand-breast contact/intercourse between ages 0 and 18. Associations between socio-demographic variables and CSA, before and after age 12, were estimated through multinomial regression.ResultsComplete data were available for 1936 respondents from 1040 households. Prevalence of CSA among girls (5.6% 95%CI [4.8;7.5]) was higher than among boys (1.6% 95%CI [0.9;2.6]). Boys experienced CSA at younger ages than girls and 60% of all reported CSA happened before age 12. Physical abuse was frequently associated with CSA at younger (OR 5.6 95%CI [2.5;12.3]) and older (OR 9.4 95%CI [4.5;18.7]) ages. CSA after age 12 was associated with an increased number of sexual partners in the last 2 months.ConclusionResults suggest that CSA takes place at young ages and is associated with physical violence, making it more likely to have serious health and developmental consequences. Except for gender, no other socio-demographic characteristic identified high-risk sub-populations.

Prevalência de internação hospitalar e fatores associados: um estudo de base populacional em um centro urbano no Sul do Brasil

This cross-sectional study investigates the use of health services and associated factors in individuals > or = 14 years of age in Canoas, Rio Grande do Sul, Brazil. 1,954 persons were interviewed in 40 census tracts. One-year prevalence of hospital admissions was 9.4%. Adjusted data analysis showed that hospitalization was associated with: age > or = 60 years (RP = 4.14; 95% CI: 2.07-8.25), physician visit in the previous two months (RP = 2.79; 95%CI: 2.03-3.83), and > or = 2 stressful life events (RP = 1.83; 95%CI: 1.19-2.80). Individual income of > or = 2.10 times the prevailing minimum wage was associated with decreased likelihood of hospitalization (RP = 0.60; 95% CI: 0.41-0.87). Prevalence of hospital admissions was consistent with other studies. Higher prevalence of hospitalization in lower-income groups may indicate decreased access to primary health care. Other possible factors are higher morbidity and severity of diseases among lower-income groups. Future research should focus on the relationship between morbidity and stressful life events.

Access by hearing-disabled individuals to health services in a southern Brazilian city

This cross-sectional study aimed to compare access to health services and preventive measures by persons with hearing disability and those with normal hearing in Canoas, Rio Grande do Sul State, Brazil. The sample included 1,842 individuals 15 years or older (52.9% of whom were females). The most frequent income bracket was twice the minimum wage or more, or approximately U

Violência física e fatores associados: estudo de base populacional no sul do Brasil

360/month (42.7%). Individuals with hearing disability were more likely to have visited a physician in the previous two months (PR = 1.3, 95%CI: 1.10-1.51) and to have been hospitalized in the previous 12 months (PR = 2.1, 95%CI: 1.42-3.14). Regarding mental health, individuals with hearing disability showed 1.5 times greater probability of health care due to mental disorders and 4.2 times greater probability of psychiatric hospitalization as compared to those with normal hearing. Consistent with other studies, women with hearing disability performed less breast self-examination and had fewer Pap smears. The data indicate the need to invest in specific campaigns for this group of individuals with special needs.

Prevalência de aleitamento materno exclusivo e fatores associados: estudo transversal com mães adolescentes de 14 a 16 anos em Porto Alegre, RS, Brasil

OBJETIVO: Estimar a prevalencia de violencia fisica e sua associacao com aspectos sociodemograficos, eventos estressantes e utilizacao de servicos de saude por problemas emocionais. METODOS: Estudo transversal de base populacional realizado em amostra de 1.954 sujeitos com 14 anos ou mais, residentes em Canoas, RS, 2002-2003. A amostragem por conglomerados seguiu sistematica pre-estabelecida. Os dados foram coletados em visitas domiciliares com questionario semi-estruturado e confidencial. Foram realizadas as analises: bivariada, por meio de regressao logistica multinomial e multivariada, por regressao politomica, categorizando o desfecho por faixa etaria. RESULTADOS: Foi encontrada prevalencia de 9,7% (IC 95%: 8,37;11,03) e associacao com: sexo feminino a partir dos 20 anos de idade (OR=2,74; IC 95%: 1,52;4,94), maior escolaridade (p 0,001). CONCLUSOES: A prevalencia da violencia fisica na populacao foi significativa, com consequencias emocionais e impacto nos servicos de saude, requerendo capacitacao dos profissionais da area.

Prevalência da soropositividade do anti-HCV em pacientes dialisados

This is a cross-sectional study to verify the prevalence and associated factors related to exclusive breastfeeding in adolescent mothers between 14 and 16 years of age with 6-month-old or younger babies, born in Porto Alegre in the State of Rio Grande do Sul, Brazil, in 2009. The sample was based on 50% of the newborn babies from the population surveyed. A total of 341 adolescent mothers were interviewed in their homes. The variables considered as potential determinants of exclusive breastfeeding were social and demographic, pre- and post-natal assistance, emotional aspects of the mother, birth conditions and baby characteristics. Prevalence ratios (PR) were estimated by Poisson regression by means of hierarchical analysis. The prevalence of exclusive breastfeeding ranged from 47.8% in the first month of life up to 13.8% after six months and declined, on average, 24% for each month of life (RP = 0.76; CI95%: 0.68-0.85). Besides the babys age, the factors associated with exclusive breastfeeding were maternal education (PR=1.53; CII95%: 1.18-1.98) and multiple births (PR=1.57; CI95%:1.02-2.46), the latter observed in only 4.7% of the sample. Teenage mothers with higher schooling and with live children from earlier pregnancies manifested higher prevalence of exclusive breastfeeding.Os povos indigenas no Brasil vivenciam acelerado processo de transicao nutricional e epidemiologica, verificando-se a emergencia de doencas e agravos nao transmissiveis, como hipertensao arterial (HA). Realizou-se, em 2005, um estudo transversal para descrever os niveis tensionais em adultos (> 20 anos) indigenas Surui, Rondonia, e investigar sua relacao com o estado nutricional e o nivel socioeconomico (SSE). Foram visitadas 9 aldeias e avaliados 251 individuos (87,4% dos elegiveis). As medias de pressao arterial sistolica (PAS) e pressao arterial diastolica (PAD) foram maiores no sexo masculino e superiores as verificadas em 1988, com incremento na media da PAS de 7,9 mmHg e de 1,4 mmHg, em mulheres e homens, respectivamente. A PAS correlacionou-se positivamente com a razao cintura quadril (RCQ) em ambos os sexos, e com a idade, no sexo feminino. A PAD apresentou correlacoes estatisticamente significativas com todas as variaveis antropometricas, exceto com estatura e area muscular do braco. A prevalencia de HA foi de 2,8% (M: 2,4%; F: 3,1%). Essa prevalencia foi maior nos individuos > 40 anos, com perimetro da cintura (PC) ou RCQ elevados, sobretudo no grupo feminino e tambem no grupo de mais baixo de SSE. A HA e um problema de saude emergente entre os Surui, devendo receber atencao do sistema de saude e dos pesquisadores.

Physical violence and associated factors: a population-based study in Southern Brazil

This cross-sectional study evaluated the prevalence of anti-hepatitis antibodies and associated factors in dialysis patients. Data were collected from records of all patients receiving dialysis treatment [n=1,261] in the city of Porto Alegre, in Southern Brazil, from August to December 2003. The statistical analyses used Chi-squared and the linear tendency test. Prevalence ratios were also calculated. Multiple logistic regression analysis was performed through Cox regression. The prevalence of anti-hepatitis antibodies was of 29.1%, and was higher among patients treated by hemo-dialysis where there was no segregation of seropositive and seronegative patients and where dialyzers were reused. This association remained even when controlling for confounding factors. Patients who received blood transfusions had a linear increase in the prevalence of anti-hepatitis antibodies. The duration of dialysis treatment showed a dose-response curve with the prevalence of anti-hepatitis antibodies.

Violencia física y factores asociados: estudio de base poblacional en el sur de Brasil

OBJETIVO: Estimar a prevalencia de violencia fisica e sua associacao com aspectos sociodemograficos, eventos estressantes e utilizacao de servicos de saude por problemas emocionais. METODOS: Estudo transversal de base populacional realizado em amostra de 1.954 sujeitos com 14 anos ou mais, residentes em Canoas, RS, 2002-2003. A amostragem por conglomerados seguiu sistematica pre-estabelecida. Os dados foram coletados em visitas domiciliares com questionario semi-estruturado e confidencial. Foram realizadas as analises: bivariada, por meio de regressao logistica multinomial e multivariada, por regressao politomica, categorizando o desfecho por faixa etaria. RESULTADOS: Foi encontrada prevalencia de 9,7% (IC 95%: 8,37;11,03) e associacao com: sexo feminino a partir dos 20 anos de idade (OR=2,74; IC 95%: 1,52;4,94), maior escolaridade (p 0,001). CONCLUSOES: A prevalencia da violencia fisica na populacao foi significativa, com consequencias emocionais e impacto nos servicos de saude, requerendo capacitacao dos profissionais da area.