Maryane Oliveira-Campos

Trend of the risk and protective factors of chronic diseases in adolescents, National Adolescent School-based Health Survey (PeNSE 2009 e 2012)

OBJECTIVE To compare the prevalence of major risk and protection factors for chronic non-communicable diseases in school-aged children in Brazilian capitals surveyed in the National Adolescent School-based Health Survey in its two editions, 2009 and 2012. METHODS The frequencies, with Confidence Interval of 95%, of the following demographic variables were compared: food intake, body image, physical activity, smoking, alcohol and other drugs. Prevalence was compared in the two editions of the survey. RESULTS The proportion of students who attend two physical education classes a week was maintained at 49% between 2009 and 2012, increasing in public schools from 50.6% (95%CI 49.8 - 51.4) to 52.5% (95%CI 49.2 - 55.7), and decreasing in private schools. There was no change in the proportion of students who watch two hours or more of television daily, about 80%. As for body image, there was no change between the two editions, and about 60% considered themselves being of normal weight. There was a reduction in the percentage of adolescents who experienced cigarettes, from 24.2% (95%CI 23.6 - 24.8) to 22.3% (95%CI 21.4 - 23.2), and the prevalence of smoking was maintained at about 6% (there was no statistical difference between 2009 and 2012). The consumption of beans, fruits, sweets and soft drinks also decreased. Frequency of drug experimentation was of 8.7% (95%CI 8.3 - 9.1) in 2009, and 9.6% (95%CI 9.0 - 10.3) in 2012, with no difference between confidence intervals, and the frequency of alcohol experimentation was maintained at about 70%; the percentage of use in the past 30 days was also maintained at around 27%. CONCLUSION In the Brazilian capitals, the vast majority of prevalence of risk factors were kept stable in the two editions of the National Survey of School. These data generate evidence to guide the implementation of public policies to minimize the exposure of adolescents to risk factors.

Prevalence of asthma symptoms among adolescents in Brazil: National Adolescent School-based Health Survey (PeNSE 2012)

OBJECTIVE This study aims to describe the prevalence rates of asthma symptoms in Brazil, its Regions and State capitals, according to data from the National Adolescent School-based Health Survey, 2012. Furthermore, it aims to compare the prevalence of asthma in the capitals evaluated by PeNSE 2012 with previous results of the International Study of Asthma and Allergies in Childhood (ISAAC). METHODS Cross sectional study of 9th grade students at public and private schools of all Brazilian states and the Federal District (Brasília). A self reported questionnaire containing items from the ISAAC was applied in order to identify the presence of asthma symptoms. RESULTS The results of PeNSE indicate a high prevalence of asthma symptoms (23.2%) and of reports of a previous medical diagnosis of asthma (12.4%). Of the five state capitals in which the PeNSE results were compared to the ISAAC, São Paulo, Curitiba and Porto Alegre presented an increase in the prevalence of asthma symptoms. In Salvador, there was a reduction. CONCLUSION Brazil is among the countries with the highest prevalence of asthma in the world, and the prevalence is still growing.

Alcohol consumption among Brazilian Adolescents according to the National Adolescent School-based Health Survey (PeNSE 2012).

OBJECTIVE To describe the prevalence of alcohol consumption among Brazilian students and identify the sociodemographic factors associated alcohol consumption in the last 30 days. METHODS Cross-sectional study with a cluster sample of 109,104 9th grade students in Brazilian public and private schools in 2012. The prevalence and 95% confidence intervals of the indicators of alcohol consumption were analyzed. RESULTS Of the students analyzed, 50.3% (95%CI 49.0 - 51.6) experimented one dose of alcoholic beverages or more. The consumption of alcohol in the last 30 days was 26.1% (95%CI 24.5 - 27.7), and there was no difference in prevalence between students from public and private schools. Drunkenness episodes were reported by 21.8% (95%CI 21.1 - 22.5) of the students. The perception of students about the negative reaction of their family if they came home drunk occurred in 89,7% (95%CI 89,6 - 89,9) of cases, and 10% (95%CI 8.9 - 11.1) of them reported having problems with their families or friends because they had been drinking. Among adolescents aged less than 14 years old, the first alcoholic drink intake was predominantly at 12 to 13 years old. The most common way to get a drink was at parties, with friends, buying in them in supermarkets, stores or bars and at home. The consumption of alcohol in the last 30 days was less frequent among boys, increasing with age. CONCLUSION The study demonstrates the extension of alcohol as a problem, making it important to advance in measures such as the improvement of protective legislation for children and adolescents and stricter enforcement in alcohol sales.

Psychoactive substance use, family context and mental health among Brazilian adolescents, National Adolescent School-based Health Survey (PeNSE 2012)

OBJECTIVE To evaluate the association between the consumption of psychoactive substances (tobacco, alcohol and illicit drugs) and demographic variables, mental health and family context among school-aged children. METHODS The National Adolescent School-based Health Survey was held with a national sample of 109,104 students. Data regarding demographic variables, family background and mental health were collected. Logistic regression was used to evaluate the associations of interest. RESULTS Multivariate analyses showed that alcohol consumption was higher among girls, drug experimentation was more frequent among boys and that there was no difference between sexes for smoking. Being younger and mulatto were negatively associated with the use of tobacco, alcohol and illicit drugs. Also negatively associated with such risk behaviors were characteristics of the family context represented by: living with parents, having meals together and parental supervision (when parents know what the child does in their free time). Moreover, characteristics of mental health such as loneliness and insomnia were positively associated with use of tobacco, alcohol and illicit drugs. Not having friends was positively associated with use of tobacco and illicit drugs and negatively associated with alcohol use. CONCLUSIONS The study shows the protective effect of family supervision in the use of tobacco, alcohol and drugs and, on the contrary, the increasing use of substances according to aspects of mental health, such as loneliness, insomnia and the fact of not having friends. The studys findings may support actions from health and education professionals, as well as from the government and families in order to prevent the use of these substances by adolescents.

Características clínicas e epidemiológicas da leishmaniose visceral em crianças internadas em um hospital universitário de referência no norte de Minas Gerais, Brasil

OBJETIVO: Descrever as caracteristicas clinicas e epidemiologicas e o tratamento das criancas internadas com leishmaniose visceral (LV) em hospital universitario de referencia no norte de Minas Gerais, Brasil. METODOS: Estudo retrospectivo e documental de criancas de 0 a 12 anos internadas com diagnostico de LV no Hospital Universitario Clemente de Faria, Montes Claros, MG. Foram analisados os prontuarios referentes ao periodo de janeiro de 2006 a dezembro de 2007. RESULTADOS: Foram identificadas 51 criancas com LV, sendo 51% do sexo feminino e a faixa etaria de maior incidencia da doenca foi em menores de 5 anos (74,5% dos casos). Verificou-se que 31% dessas criancas residiam em Montes Claros e 69% procediam de 20 municipios do norte de Minas Gerais, dos quais 72,5% eram originarias da zona urbana e 21,6% da zona rural. A principal manifestacao clinica foi a febre (96,1%) e os principais achados clinicos na admissao foram esplenomegalia (98%) e hepatomegalia (94%). O tratamento de escolha foi Glucantime (70,6%), Anfotericina B convencional (13,7%), Anfotericina B lipossomal (2%) e Glucantime associado a Anfotericina B (15,7%). 35,4% dos casos desenvolveram processos infecciosos durante o periodo da internacao, destacando-se as infeccoes de pele em 11,8%. O tempo de permanencia hospitalar medio foi de 19 dias (DP = ±5,4), 96,1% receberam alta medica e 3,9% evoluiram para obito. CONCLUSOES: A partir das caracteristicas clinicas e epidemiologicas identificadas no estudo, sugere-se uma observacao mais eficaz por parte dos profissionais de saude, visando ao reconhecimento precoce e tratamento adequado da doenca e suas complicacoes.

Lifetime use of illicit drugs and associated factors among Brazilian schoolchildren, National Adolescent School-based Health Survey (PeNSE 2012)

OBJECTIVE This study aimed at describing the prevalence of illicit drug use among 9th grade students in the morning period of public and private schools in Brazil, and assessing associated factors. METHOD The Brazilian survey PeNSE (National Adolescent School-based Health Survey) 2012 evaluated a representative sample of 9th grade students in the morning period, in Brazil and its five regions. The use of illicit drugs at least once in life was assessed for the most commonly used drugs, such as marijuana, cocaine, crack, solvent-based glue, general ether-based inhalants, ecstasy and oxy. Data were subjected to descriptive analysis, and Pearsons χ² test and logistic regression was used in the multivariate analysis. RESULTS The use of illicit drugs at least once in life was reported by 7.3% (95%CI 5.3 - 9.4) of the respondents. Logistic regression was used for multivariate analysis and the evidences suggest that illicit drug use is associated to social conditions of greater consumption power, the use of alcohol and tobacco, behaviors related to socialization, such as having friends or sexual activity, and also the perception of loneliness, loose contact between school and parents and experiences of abuse in the family environment. The outcome was inversely associated with close contact with parents and parental supervision. CONCLUSION In addition to the association with the processes of socialization and consumption, the influence of family and school is expressed in a particularly protective manner in different records of direct supervision and care.

Body image and extreme attitudes toward weight in Brazilian schoolchildren (PeNSE 2012)

INTRODUCTION Adolescence is a period characterized by changes such as accelerated physical growth and sexual development. Besides having to deal with these changes, adolescents are faced with beauty standards and extreme valorization of physical appearance. OBJECTIVE This article aims to describe body image and the practice of extreme attitudes regarding weight in Brazilian students. METHODS Data from the National Survey of School Health (PeNSE) 2012 were used in this study. PeNSE 2012 has a representative sample of students in the 9th grade of elementary school in public and private schools across the country. A self-administered questionnaire on body image, practice of extreme measures in relation to weight and sociodemographic data was used. Body image and the practice of extreme attitudes were described for the total sample and according to gender. Poisson regression analyzes were used to identify differences in the practices of extreme attitudes between the different types of body image. RESULTS More than 38% of the adolescents did not consider their body image as normal. Over 15% of the students referred to carry out extreme weight control practices, combining practices to loose and gain weight. Adolescents who considered themselves fat presented frequency of extreme practices for weight loss 92% higher than that shown by individuals who considered themselves normal. Similarly, adolescents who considered themselves thin presented frequency of extreme attitudes to gain weight (9.7%) higher than that shown by students who considered themselves normal (5.6%). CONCLUSIONS The high frequency of extreme weight control practices among Brazilian adolescents is alarming and should be subject of measures in health and education fields.

Population dynamics and the profile of mortality in the municipality of Montes Claros, Minas Gerais State, Brazil

This study is an ecological study of time trend. The objective of this study is to assess the population dynamics as the 1980 Census, 1991 and 2000, and the profile of mortality in the period between 1996 and 2005, in Montes Claros, Minas Gerais State. We used the information systems database of Datasus and IBGE. The main results indicate that the elderly group increased from 4.1% in 1980, 5.0% in 1991 to 6.6% in 2000. On the proportional mortality by cause, diseases of the circulatory system were the first cause of death, and 23.05% in 1996 and 28.26% in 2005, followed by cancer 14.13% in 1996 and 15.69% in 2005, external causes of morbidity and mortality 11.87% in 1996 and 12.74% in 2005 and infectious and parasitic diseases 8.42% in 1996 and 5.43% in 2005. The profile of mortality followed the population dynamics of the city observed a reduction of infectious diseases and an increase in chronic diseases, consistent with the process of population aging.

Healthy behavior patterns and levels of schooling in Brazil: time trend from 2008 to 2013.

This study analyzed data from the telephone-based Surveillance System of Risk and Protective Factors for Chronic Non-Communicable Diseases (VIGITEL) to assess the prevalence of clusters of healthy behavior patterns (non-smoker, non-alcohol-drinker, regular leisure-time physical activity and recommended consumption of fruit and vegetables) and the temporal trend between 2008 and 2013. Additionally, we evaluated whether the association between level of schooling and clustering of three or more healthy behavior patterns decreased in this same period. Prevalence ratios were obtained using Poisson regression. We found that between 2008 and 2013, the clustering prevalence of three or more healthy behavior patterns increased from 20% to 25% in men, and from 26% to 32% in women, suggesting an increase in the prevalence of healthy behavior patterns in Brazil. This increase was found at all levels of schooling. However, the association between levels of schooling and the prevalence of clustering of three or more healthy behavior patterns remained constant during the period. Thus, the results suggest that educational disparities in clustering of three or more healthy behavior patterns did not change over time, despite the social improvements observed in the country in recent years.