Rosália Garcia Neves

Tendência da incidência de dengue no Brasil, 2002-2012

Resumo OBJETIVO: analisar a tendencia da incidencia de dengue no Brasil, no periodo de 2002 a 2012. METODOS: estudo ecologico com dados do Sistema de Informacao de Agravos e Notificacao (Sinan); a taxa de incidencia de dengue foi calculada segundo grupos etarios, unidades da federacao (UF) e grandes regioes do pais, utilizando-se a regressao de Prais-Winsten. RESULTADOS: as taxas de incidencia de dengue no Brasil, em 2002 e 2012, foram de 401,6 e 301,5 por 100 mil habitantes, respectivamente; as taxas de incremento anual revelaram-se estaveis (21,4%; IC95% -19,8;83,7) na maioria das UF, a excecao de Alagoas (38,9%; IC95% 5,1;83,5) e Tocantins (50,4%; IC95% 12,6;100,7); a regiao Norte foi a unica a apresentar tendencia de crescimento da incidencia de dengue. CONCLUSAO: embora as taxas tenham permanecido estaveis na maioria das UF, ainda sao altas no pais; politicas mais amplas com foco em novas estrategias de combate a dengue mostram-se necessarias.OBJECTIVE to analyze dengue incidence trend in Brazil from 2002 to 2012. METHODS this was an ecological study with data of the Information System for Notifiable Diseases (Sinan); the incidence rate was calculated by age groups, states and macroregions, through Prais-Winsten regression. RESULTS dengue incidence rates in Brazil, in 2002 and 2012, were of 401.6 and 301.5 per 100,000 inhabitants, respectively; annual increment rates were stable (21.4%; 95%CI -19.8;83.7) in most of the states, except for Alagoas (38.9%; 95%CI 5.1;83.5) and Tocantins (50.4%; 95%CI 12.6;100.7); the North Region was the only region to present increase trend in the incidence of dengue. CONCLUSION although rates have remained stable in most of the states, they are still high in Brazil; broader public policies focusing on new dengue control strategies are necessary.

Social inequalities in care for the elderly with diabetes in Brazil

ABSTRACT Objective. To measure the prevalence of various care services offered to the elderly with diabetes mellitus in Brazil, and to assess the social inequalities in these services. Methods. This cross-sectional, population-based study was carried out in 2013. The care services offered were evaluated in terms of the following eight indicators: recommendations to lower carbohydrates, to measure blood glucose, and to examine the feet; requests made for blood tests, for glycated hemoglobin tests, and for glycemic curve tests; and whether service users had had their eyes or feet examined in the previous year. We used the slope index of inequality and the concentration index to assess the inequalities among wealth quintiles. Results. A total of 1 685 elderly persons with diabetes were evaluated. Overall, 41.7% of them had had their eyes examined in the preceding year, 35.4% had had their feet examined in the preceding year, and 10.9% had been offered all eight of the care services. The largest absolute differences (in percentage points) between the first (poorest) and fifth (richest) wealth quintiles in terms of the care services that were offered to the users were for: a recommendation to measure blood glucose (25.8), a glycated hemoglobin test request (27.4), a glycemic curve test request (31.9), having the eyes examined in the preceding year (29.3), and having the feet examined in the preceding year (27.0). Conclusion. There were notable inequalities in the prevalences of the care services. In the future, measurement of blood glucose and examination of the feet should be emphasized, especially for elderly persons in a lower socioeconomic level.