Maria de Fátima dos Santos Costa

Morbidity and mortality associated with injuries: results of the Global Burden of Disease study in Brazil, 2008

The aim of this study was to estimate the global burden of disease from external causes in 2008 in Brazil, based on DALYs (disability-adjusted life years). YLLs (years of life lost) were estimated according to the method proposed by Murray & Lopez (1996). Meanwhile, the method for estimating YLDs (years lived with disability) included methodological adjustments taking the Brazilian reality into account. The study showed a total of 195 DALYs per 100 thousand inhabitants, of which 19 DALYs were related to external causes. Among YLLs, 48% were from unintentional causes and 52% from intentional causes. Among YLDs, unintentional causes predominated, with 95%. The share of YLLs in DALYs was 90%. The cause with the highest proportion of YLLs was “homicide and violence” (43%), followed by “road traffic accidents” (31%). Falls accounted for the highest share of YLDs (36%). The sex ratio (male-to-female) was 4.8 for DALYs, and the predominant age bracket was 15-29 years. Since external causes are avoidable, the study provides potentially useful information for policymakers in public security and health.

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.

Diferenciais de morbimortalidade por causas externas: resultados do estudo carga global de doenças no Brasil, 2008

The aim of this study was to estimate the global burden of disease from external causes in 2008 in Brazil, based on DALYs (disability-adjusted life years). YLLs (years of life lost) were estimated according to the method proposed by Murray & Lopez (1996). Meanwhile, the method for estimating YLDs (years lived with disability) included methodological adjustments taking the Brazilian reality into account. The study showed a total of 195 DALYs per 100 thousand inhabitants, of which 19 DALYs were related to external causes. Among YLLs, 48% were from unintentional causes and 52% from intentional causes. Among YLDs, unintentional causes predominated, with 95%. The share of YLLs in DALYs was 90%. The cause with the highest proportion of YLLs was “homicide and violence” (43%), followed by “road traffic accidents” (31%). Falls accounted for the highest share of YLDs (36%). The sex ratio (male-to-female) was 4.8 for DALYs, and the predominant age bracket was 15-29 years. Since external causes are avoidable, the study provides potentially useful information for policymakers in public security and health.

National and regional estimates of disability-adjusted life-years (DALYs) in Brazil, 2008: a systematic analysis

Abstract Background Since Murray and Lopezs 1996 seminal study on burden of disease, the disability-adjusted life-year (DALY) has become a valuable tool to measure the health loss of populations and evaluate health-system performance. Such indicators are essential in a country like Brazil, marked with rapidly changing epidemiology and wide regional inequalities. This study presents timely subnational estimates of burden of disease in Brazil in 2008 to inform health policy. Methods DALYs are the sum of years of life lost (YLLs) and years lived with disability (YLDs). Mortality data were used to estimate YLLs for Brazil, with adjustments for incomplete information on cause of death, sex, and age. YLDs were estimated from multiple sources, including health databases, literature reviews, and expert consensus. Findings We estimated a national average of 195 DALYs per 1000 inhabitants (95% CI 194–196) in 2008. Five causes accounted for almost a third of total DALYs: depression (8·31%, 95% CI 8·31–8·32), ischaemic heart disease (6·78%, 6·76–6·80), diabetes (4·72%, 4·70–4·74), stroke (4·60%, 4·58–4·61), and homicide/violence (3·70%, 3·69–3·71). Large regional disparities were found: from a low of 177 DALYs per 1000 inhabitants (95% CI 177–178) in the Central West region to a high of 209 per 1000 inhabitants (208–210) in the Northeast. In the (more affluent) Southeast and South regions, chronic obstructive pulmonary disease was a greater contributor to health loss than homicide/violence. Neonatal sepsis and birth trauma and asphyxia were among the 20 principal DALY contributors in the (poorer) North and Northeast regions. Interpretation Non-communicable chronic diseases, mental health, and injuries weigh heavily on the Brazilian epidemiological profile. However, in the more vulnerable regions, the North and Northeast, diseases associated with poverty and health-system precariousness persist. Health policies need to consider the balance between acute care services and chronic care management to meet population health needs across the country. More research is needed on the underlying social and economic determinants contributing to disparities in health outcomes. Funding Department of Science and Technology, Secretary of Science, Technology and Strategic Inputs, Ministry of Health of Brazil (DECIT/MoH).

Perfil dos óbitos de recém-nascidos ocorridos na sala de parto de uma maternidade do Rio de Janeiro, 2010-2012

Objective: to describe the main characteristics of newborn babies who died in the delivery room of a maternity hospital in Rio de Janeiro (RJ). Method: a descriptive case series study using secondary data. We included all live births between January 1st 2010 and January 31st 2012 that died in the delivery room. Results: one hundred and six infants died in the delivery room. Most deaths occurred in newborn females (51.9%), with low birth weight (77.0%), Apgar score of less than seven at one minute (98.1%), and at five minutes (99.0%) after birth, and congenital malformations (92.5%). Conclusions: the most common features among newborn babies who died included: low birth weight, presence of asphyxia and congenital malformations.

Estimativa da prevalência e da mortalidade por complicações da úlcera péptica, Brasil, 2008: uma proposta metodológica

OBJETIVO:estimar a mortalidade e a prevalencia da ulcera peptica no Brasil e suas macrorregioes, segundo sexo e faixa etaria, em 2008.METODOS:a prevalencia foi estimada pelo Sistema de Informacoes Hospitalares, considerando-se os casos internados como casos de ulcera complicada e ajustes conforme a cobertura do Sistema Unico de Saude; a mortalidade foi calculada com dados do Sistema de Informacoes sobre Mortalidade, segundo metodologia dos estudos de carga de doenca.RESULTADOS:no Brasil, a prevalencia de ulcera em homens e mulheres foi de 0,2% e 0,1%, respectivamente; a taxa de mortalidade nacional, de 3,0/100 mil habitantes (3,6/100 mil em homens; 2,3/100 mil em mulheres); as prevalencias e taxas de mortalidade aumentaram com a idade, independentemente do sexo, com maiores valores entre homens.CONCLUSAO:evidencia-se a relevância da ulcera peptica no cenario brasileiro e a necessidade de pesquisas para estimativas mais precisas de sua ocorrencia no pais.

Estimating prevalence and mortality due to peptic ulcer complications, Brazil, 2008: a methodological proposal

OBJETIVO:estimar a mortalidade e a prevalencia da ulcera peptica no Brasil e suas macrorregioes, segundo sexo e faixa etaria, em 2008.METODOS:a prevalencia foi estimada pelo Sistema de Informacoes Hospitalares, considerando-se os casos internados como casos de ulcera complicada e ajustes conforme a cobertura do Sistema Unico de Saude; a mortalidade foi calculada com dados do Sistema de Informacoes sobre Mortalidade, segundo metodologia dos estudos de carga de doenca.RESULTADOS:no Brasil, a prevalencia de ulcera em homens e mulheres foi de 0,2% e 0,1%, respectivamente; a taxa de mortalidade nacional, de 3,0/100 mil habitantes (3,6/100 mil em homens; 2,3/100 mil em mulheres); as prevalencias e taxas de mortalidade aumentaram com a idade, independentemente do sexo, com maiores valores entre homens.CONCLUSAO:evidencia-se a relevância da ulcera peptica no cenario brasileiro e a necessidade de pesquisas para estimativas mais precisas de sua ocorrencia no pais.

Estimación de la prevalencia y de la mortalidad por complicaciones de úlcera péptica, Brasil, 2008: una propuesta metodológica

OBJETIVO:estimar a mortalidade e a prevalencia da ulcera peptica no Brasil e suas macrorregioes, segundo sexo e faixa etaria, em 2008.METODOS:a prevalencia foi estimada pelo Sistema de Informacoes Hospitalares, considerando-se os casos internados como casos de ulcera complicada e ajustes conforme a cobertura do Sistema Unico de Saude; a mortalidade foi calculada com dados do Sistema de Informacoes sobre Mortalidade, segundo metodologia dos estudos de carga de doenca.RESULTADOS:no Brasil, a prevalencia de ulcera em homens e mulheres foi de 0,2% e 0,1%, respectivamente; a taxa de mortalidade nacional, de 3,0/100 mil habitantes (3,6/100 mil em homens; 2,3/100 mil em mulheres); as prevalencias e taxas de mortalidade aumentaram com a idade, independentemente do sexo, com maiores valores entre homens.CONCLUSAO:evidencia-se a relevância da ulcera peptica no cenario brasileiro e a necessidade de pesquisas para estimativas mais precisas de sua ocorrencia no pais.

Morbimortalidad por las causas externas: resultados del estudio Carga Global de las Enfermedades en Brasil, 2008

The aim of this study was to estimate the global burden of disease from external causes in 2008 in Brazil, based on DALYs (disability-adjusted life years). YLLs (years of life lost) were estimated according to the method proposed by Murray & Lopez (1996). Meanwhile, the method for estimating YLDs (years lived with disability) included methodological adjustments taking the Brazilian reality into account. The study showed a total of 195 DALYs per 100 thousand inhabitants, of which 19 DALYs were related to external causes. Among YLLs, 48% were from unintentional causes and 52% from intentional causes. Among YLDs, unintentional causes predominated, with 95%. The share of YLLs in DALYs was 90%. The cause with the highest proportion of YLLs was “homicide and violence” (43%), followed by “road traffic accidents” (31%). Falls accounted for the highest share of YLDs (36%). The sex ratio (male-to-female) was 4.8 for DALYs, and the predominant age bracket was 15-29 years. Since external causes are avoidable, the study provides potentially useful information for policymakers in public security and health.

Estimativa de taxa de mortalidade e taxa de incidência de sequelas cardíacas e digestivas por doença de Chagas no Brasil, 2008

OBJETIVO:estimar a incidencia de sequelas, nas formas cardiaca e digestiva, de doenca de Chagas (DC) e descrever a mortalidade por DC no Brasil, no periodo 2007-2009.METODOS:a estimativa dos casos com sequelas baseou-se na historia natural da doenca, utilizando dados de inquerito de DC realizado na decada de 1990; taxas de mortalidade e incidencia foram calculadas por 100 mil habitantes.RESULTADOS:a mortalidade por DC foi maior na macrorregiao Centro-Oeste (9,7/100 mil no sexo masculino; 7,4/100 mil no feminino) e a incidencia maior foi na macrorregiao Sul (45/100 mil em ambos os sexos); a taxa de incidencia de sequelas decresceu ate a idade de 59 anos.CONCLUSAO:em contrapartida ao decrescimo da taxa de incidencia de sequelas ate os 59 anos, observou-se aumento da taxa de mortalidade em idades maiores; a disponibilizacao e a analise de dados de morbimortalidade por DC podem subsidiar politicas publicas para seu diagnostico e tratamento.