Luisa Sorio Flor

Social Media as a Sentinel for Disease Surveillance: What Does Sociodemographic Status Have to Do with It?

Introduction: Data from social media have been shown to have utility in augmenting traditional approaches to public health surveillance. Quantifying the representativeness of these data is needed for making accurate public health inferences. Methods: We applied machine-learning methods to explore spatial and temporal dengue event reporting trends on Twitter relative to confirmed cases, and quantified associations with sociodemographic factors across three Brazilian states (São Paulo, Rio de Janeiro, and Minas Gerais) at the municipality level. Results: Education and income were positive predictors of dengue reporting on Twitter. In contrast, municipalities with a higher percentage of older adults, and males were less likely to report suspected dengue disease on Twitter. Overall, municipalities with dengue disease tweets had higher mean per capita income and lower proportion of individuals with no primary school education. Conclusions: These observations highlight the need to understand population representation across locations, age, and racial/ethnic backgrounds in studies using social media data for public health research. Additional data is needed to assess and compare data representativeness across regions in Brazil.

Diabetes burden in Brazil: fraction attributable to overweight, obesity, and excess weight

OBJECTIVE To estimate the burden of type 2 diabetes mellitus and its percentage attributable to overweight and obesity in Brazil. METHODS The burden of diabetes mellitus was described in terms of disability-adjusted life years, which is the sum of two components: years of life lost and years lived with disability. To calculate the fraction of diabetes mellitus attributable to overweight, obesity, and excess weight, we used the prevalence of these risk factors according to sex and age groups (> 20 years) obtained from the 2008 Pesquisa Dimensões Sociais das Desigualdades (Social Dimensions of Inequality Survey) and the relative risks derived from the international literature. RESULTS Diabetes mellitus accounted for 5.4% of Brazilian disability-adjusted life years in 2008, with the largest fraction attributed to the morbidity component (years lived with disability). Women exhibited higher values for disability-adjusted life years. In Brazil, 49.2%, 58.3%, and 70.6% of diabetes mellitus in women was attributable to overweight, obesity, and excess weight, respectively. Among men, these percentages were 40.5%, 45.4%, and 60.3%, respectively. Differences were observed with respect to Brazilian regions and age groups. CONCLUSIONS A large fraction of diabetes mellitus was attributable to preventable individual risk factors and, in about six years, the contribution of these factors significant increased, particularly among men. Policies aimed at promoting healthy lifestyle habits, such as a balanced diet and physical activity, can have a significant impact on reducing the burden of diabetes mellitus in Brazil.

Mortalidade por raça/cor: evidências de desigualdades sociais em Vitória (ES), Brasil

OBJETIVO: Analisar a mortalidade por causa basica, sexo e raca/cor a partir do sistema de informacoes sobre mortalidade (SIM), em Vitoria (ES), no periodo de 2003 a 2006. METODOS: Foram calculados e analisados os coeficientes de mortalidade, segundo causa basica e sexo por raca/cor, bem como a idade media e mediana de obito por causa basica, sexo e raca/cor. Foi calculado o risco relativo (RR) por sexo, idade e causa basica (p<0,05 e IC 95%). RESULTADOS: A completitude da variavel raca/cor no SIM variou de 1% em 1996 para 81% em 2006. Foi observado maior RR de obito entre negros para transtornos mentais e comportamentais (RR=9,29), causas mal definidas (RR=8,71) e causas externas (RR=5,71). Entre mulheres negras, as causas externas apresentaram maior RR (2,38). Foi encontrada uma variacao de ate 33 anos na idade mediana do obito entre brancos e negros. Conclusao: Este estudo reitera a existencia de desigualdades raciais/etnicas na mortalidade, destacando-se a mortalidade por transtornos mentais e causas externas, alem da mortalidade precoce que ocorre na populacao negra.

Prevalência de diabetes mellitus e fatores associados na população adulta brasileira: evidências de um inquérito de base populacional

Objective: To estimate the prevalence of self-reported diabetes mellitus (DM) and its associated factors among the Brazilian adult population. Methods: The prevalence of DM was assessed in the Survey on Social Dimensions of Inequalities, a national survey with macro-regions representativeness carried out in 2008. Data were collected by a personal face-to-face interview with 12,423 individuals of both sexes, aged over 20 years. The χ2 test at 5.0% was performed in order to identify associated factors, and logistic regression was used to estimate adjusted odds ratios. Results: The prevalence of DM in Brazil was 7.5%. After adjusting for potential confounders, diabetes remained associated with age (≥ 40 years), education (< 8 years of study), marital status (non-married), obesity, sedentary lifestyle, comorbidity with hypertension and hypercholesterolemia, as well as the demand for health services. Conclusion: Results indicate a high prevalence of DM and its associated preventable factors in Brazil. Thus, they highlight the need for a behavioral change as a strategy for prevention and control of diabetes and its complications.RESUMO: Objetivo: Estimar a prevalencia de diabetes mellitus (DM) autorreferida e fatores associados na populacao adulta brasileira. Metodos: A prevalencia de DM foi aferida na Pesquisa Dimensoes Sociais das Desigualdades (PDSD), um survey nacional com representatividade para as macrorregioes, conduzido em 2008. Foram entrevistados 12.423 individuos de ambos os sexos, com idade igual ou superior a 20 anos. Para a identificacao de fatores associados, foi realizado teste do χ2 ao nivel 5,0% e calculadas as razoes de chance ajustadas por meio de regressao logistica. Resultados: A prevalencia de DM no Brasil foi de 7,5%. Apos o ajuste para potenciais fatores de confusao, o diabetes permaneceu associado com a idade (≥ 40 anos), a escolaridade (< 8 anos de estudo), o estado conjugal (nao casados), a obesidade, o sedentarismo, a comorbidade com hipertensao arterial e hipercolesterolemia, bem como com a procura por servicos de saude. Conclusao: Resultados indicam elevada prevalencia de DM e varios dos seus fatores associados (identificados como evitaveis) apontam a necessidade de mudancas comportamentais como estrategia para prevencao e controle do diabetes e suas complicacoes.

Carga de doença no Brasil: um olhar sobre o álcool e a cirrose não viral

Alcohol use/dependence are an important risk factor for cirrhosis of the liver. The article aims to describe and conduct a comparative analysis of Disability Adjusted Life Years (DALY), Years of Life Lost (YLL) and Years Lived with Disability (YLD) of alcohol use disorders and non-viral cirrhosis in Brazil in 2008. DALY was calculated as the sum of YLL and YLD. For YLL estimates, the mean number of deaths from 2007- 2009 in the country was considered. After revision of epidemiological data, prevalence of each disease was modelled with the DisMod tool, which generated incidence data for YLD estimates. Alcohol and non-viral cirrhosis were responsible for 3% and 1% of total DALYs, respectively. In both diseases, men contributed to a greater proportion of DALYs. Among the first ten causes of DALYs, alcohol use disorders occupied the second, third and sixth positions at the ages of 15-29, 30-44 and 45- 59, respectively. Non-viral cirrhosis was the eighth cause of DALY in the 30-44 age group in men; the fifth, in the 45-59 group and the eighth, in the 60-69 group. Age distribution suggests that interventions directed against alcohol use/dependence would have effects on the burden of alcoholic cirrhosis in the country.Alcohol use/dependence are an important risk factor for cirrhosis of the liver. The article aims to describe and conduct a comparative analysis of Disability Adjusted Life Years (DALY), Years of Life Lost (YLL) and Years Lived with Disability (YLD) of alcohol use disorders and non-viral cirrhosis in Brazil in 2008. DALY was calculated as the sum of YLL and YLD. For YLL estimates, the mean number of deaths from 2007- 2009 in the country was considered. After revision of epidemiological data, prevalence of each disease was modelled with the DisMod tool, which generated incidence data for YLD estimates. Alcohol and non-viral cirrhosis were responsible for 3% and 1% of total DALYs, respectively. In both diseases, men contributed to a greater proportion of DALYs. Among the first ten causes of DALYs, alcohol use disorders occupied the second, third and sixth positions at the ages of 15-29, 30-44 and 45- 59, respectively. Non-viral cirrhosis was the eighth cause of DALY in the 30-44 age group in men; the fifth, in the 45-59 group and the eighth, in the 60-69 group. Age distribution suggests that interventions directed against alcohol use/dependence would have effects on the burden of alcoholic cirrhosis in the country.

Método para estimação de prevalência de hepatites B e C crônicas e cirrose hepática - Brasil, 2008

OBJETIVO:estimar as prevalencias nacionais de hepatites virais cronicas e cirrose hepatica no Brasil em 2008.METODOS:as estimativas das hepatites B e C basearam-se em inquerito nacional, considerando-se casos cronicos todos os HBsAg (antigeno de superficie de hepatite B) positivos e 70% dos anti-HCV (marcador sorologico para hepatite C) positivos; sobre dados do inquerito, estimou-se a prevalencia de cirrose viral; complementarmente, calculou-se a prevalencia da cirrose por alcool.RESULTADOS:as prevalencias nacionais de hepatites B e C cronicas foram de 370/100 mil e 959/100 mil habitantes, respectivamente; a cirrose apresentou prevalencia de 0,35% no pais, com 151/100 mil hab. para hepatite C, 17/100 mil hab. para hepatite B e 182/100 mil hab. para alcool e outras causas.CONCLUSAO:tais prevalencias, embora compativeis com baixa endemicidade, destacam as hepatites virais e a cirrose como relevantes problemas de saude no pais; estudos de base populacional contribuiriam no refinamento das estimativas apresentadas.OBJECTIVE to estimate chronic viral hepatitis and liver cirrhosis prevalence in Brazil, 2008. METHODS: hepatitis B and C prevalence estimates were calculated based on a national survey, considering chronic cases to be all positive HBsAg and 70% of positive anti-HCV. Hepatitis prevalence was used to estimate viral cirrhosis and cirrhosis due to alcohol and other causes were considered complementary to the former. RESULTS: national chronic hepatitis B and C prevalence estimates were 370/100,000 and 959/100,000 inhabitants, respectively. Liver cirrhosis prevalence was 0.35% overall, with the following distribution by causes: 151/100,000 for hepatitis C; 17/100,000 for hepatitis B and 182/100,000 for alcohol and other causes. CONCLUSION: prevalence estimates, although compatible with low endemicity, highlight viral hepatitis and cirrhosis as relevant health problems in the country. Further population-based studies are required in order to obtain better prevalence estimates.

Método para estimación de prevalencia de hepatitis B y C crónicas y cirrosis hepática - Brasil, 2008

OBJETIVO:estimar as prevalencias nacionais de hepatites virais cronicas e cirrose hepatica no Brasil em 2008.METODOS:as estimativas das hepatites B e C basearam-se em inquerito nacional, considerando-se casos cronicos todos os HBsAg (antigeno de superficie de hepatite B) positivos e 70% dos anti-HCV (marcador sorologico para hepatite C) positivos; sobre dados do inquerito, estimou-se a prevalencia de cirrose viral; complementarmente, calculou-se a prevalencia da cirrose por alcool.RESULTADOS:as prevalencias nacionais de hepatites B e C cronicas foram de 370/100 mil e 959/100 mil habitantes, respectivamente; a cirrose apresentou prevalencia de 0,35% no pais, com 151/100 mil hab. para hepatite C, 17/100 mil hab. para hepatite B e 182/100 mil hab. para alcool e outras causas.CONCLUSAO:tais prevalencias, embora compativeis com baixa endemicidade, destacam as hepatites virais e a cirrose como relevantes problemas de saude no pais; estudos de base populacional contribuiriam no refinamento das estimativas apresentadas.OBJECTIVE to estimate chronic viral hepatitis and liver cirrhosis prevalence in Brazil, 2008. METHODS: hepatitis B and C prevalence estimates were calculated based on a national survey, considering chronic cases to be all positive HBsAg and 70% of positive anti-HCV. Hepatitis prevalence was used to estimate viral cirrhosis and cirrhosis due to alcohol and other causes were considered complementary to the former. RESULTS: national chronic hepatitis B and C prevalence estimates were 370/100,000 and 959/100,000 inhabitants, respectively. Liver cirrhosis prevalence was 0.35% overall, with the following distribution by causes: 151/100,000 for hepatitis C; 17/100,000 for hepatitis B and 182/100,000 for alcohol and other causes. CONCLUSION: prevalence estimates, although compatible with low endemicity, highlight viral hepatitis and cirrhosis as relevant health problems in the country. Further population-based studies are required in order to obtain better prevalence estimates.

Method for estimating the prevalence of chronic hepatitis B and C and cirrhosis of the liver in Brazil, 2008

OBJETIVO:estimar as prevalencias nacionais de hepatites virais cronicas e cirrose hepatica no Brasil em 2008.METODOS:as estimativas das hepatites B e C basearam-se em inquerito nacional, considerando-se casos cronicos todos os HBsAg (antigeno de superficie de hepatite B) positivos e 70% dos anti-HCV (marcador sorologico para hepatite C) positivos; sobre dados do inquerito, estimou-se a prevalencia de cirrose viral; complementarmente, calculou-se a prevalencia da cirrose por alcool.RESULTADOS:as prevalencias nacionais de hepatites B e C cronicas foram de 370/100 mil e 959/100 mil habitantes, respectivamente; a cirrose apresentou prevalencia de 0,35% no pais, com 151/100 mil hab. para hepatite C, 17/100 mil hab. para hepatite B e 182/100 mil hab. para alcool e outras causas.CONCLUSAO:tais prevalencias, embora compativeis com baixa endemicidade, destacam as hepatites virais e a cirrose como relevantes problemas de saude no pais; estudos de base populacional contribuiriam no refinamento das estimativas apresentadas.OBJECTIVE to estimate chronic viral hepatitis and liver cirrhosis prevalence in Brazil, 2008. METHODS: hepatitis B and C prevalence estimates were calculated based on a national survey, considering chronic cases to be all positive HBsAg and 70% of positive anti-HCV. Hepatitis prevalence was used to estimate viral cirrhosis and cirrhosis due to alcohol and other causes were considered complementary to the former. RESULTS: national chronic hepatitis B and C prevalence estimates were 370/100,000 and 959/100,000 inhabitants, respectively. Liver cirrhosis prevalence was 0.35% overall, with the following distribution by causes: 151/100,000 for hepatitis C; 17/100,000 for hepatitis B and 182/100,000 for alcohol and other causes. CONCLUSION: prevalence estimates, although compatible with low endemicity, highlight viral hepatitis and cirrhosis as relevant health problems in the country. Further population-based studies are required in order to obtain better prevalence estimates.

Mobilidade social intergeracional e saúde no Brasil: uma análise do survey "Pesquisa dimensões sociais das desigualdades (PDSD)", 2008

Although most studies consider health to be the result of social and economic insertion of the individuals, health may be considered a determining factor of the social opportunities achieved, especially with respect to chances of social mobility. The scope of this article is to understand the magnitude of the concurrent associations that sociodemographic, health and quality of life conditions (SF-36) exercise on chances of intergenerational social mobility on a probability sample of Brazilian homes in 2008. Social mobility was determined by the transition between occupational groups, which were defined using the Ganzeboom scale. Sociodemographic, health and quality of life features were associated with upward social mobility through logistic regression. A high level of schooling was the main determinant of chances of intergenerational social mobility. Women and youngsters ascended more intergenerationally. A positive association was observed between self assessment of health, physical health scores and upward mobility. Social mobility has become established as a multideterminate event. Physical health and perceived health were capable of influencing social transitions.