Mortality, years of life lost, and incidence of occupational accidents in the State of Bahia, Brazil

This study of occupational accidents presents estimates for mortality, years of potential life lost, and cumulative incidence of severe cases (over 15 workdays lost) in Bahia State, Brazil, 2000. A correction factor was produced by comparing different data sources. Data were taken from compensation claims in the National Social Security Unified Benefits System (SUB), death certificates from the Ministry of Health Mortality Information System, and national census. Occupational accident-related mortality was estimated as 0.79 per 100,000 workers using the Mortality Information System, but increased to 13.17 per 100,000 using the SUB database. Assuming the latter result for the entire workforce produced a correction factor of 16.67 for the Mortality Information System database. Years of potential life lost were 23,249, and the cumulative incidence of severe occupational accidents was 2.3%. Occupational accidents are preventable, but still common in Brazil. Underreporting is widespread, and corrected statistics need to be published, thereby turning this neglected public health problem into a policy priority.     

Spatial distribution of tuberculosis mortality in Salvador,Bahia, Brazil

An ecological study was conducted to describe the urban spatial distribution of mortality attributable to tuberculosis in Salvador, Bahia, Brazil in 1991, 1994, and 1997. The unit of analysis was the Health District (HD). The HD with the highest standardized rates was Sub rbio Ferrovi rio in 1991, 1994, and 1997, with 15.7, 10.6, and 10.6/100.000 inhabitants, respectively. Inequalities in mortality between HDs were high. The year 1997 showed the lowest standardized rates. The proportional mortality ratios for tuberculosis when compared with total deaths from infectious diseases were 20.7%, 18.2%, and 16.9% for 1991, 1994, and 1997 respectively. The highest rates were observed in the age group over 65 years. The authors argue the possibilities of using the results for the implementation of equitable local health policies and health surveillance measures, since the methodology identified both the HD with the highest risk and the most heavily affected age groups.     

Underreporting of tuberculosis in the Information System on Notifiable Diseases (SINAN): primary default and case detection from additional data sources using probabilistic record linkage

This study aimed to analyze underreporting of tuberculosis (TB) cases in the Information System on Notifiable Diseases (SINAN), based on the following data sources: Mortality Information System (SIM), Registry and Follow-up Book for TB Case Treatment (LPATB), and Laboratory Registry Book (LRLAB). Probabilistic record linkage was used between the SIM (2007-2008) and SINAN (2002-2008). A search was conducted in LPATB and LRLAB (2007-2008) for cases not recorded in SINAN. There were 125 deaths, of which 44.8% were not recorded in SINAN. In LPATB, 58 cases (5.1%) were in treatment and were not reported in SINAN. LRLAB showed 32 smear-positive cases not reported to SINAN and without treatment, representing primary default. Addition of the retrieved cases, led to a 14.6% increase in the incidence rate in 2007 and 11.6% in 2008. Underreporting of deaths from or with TB in the Mortality Information System and primary default revealed difficulties in access to adequate and timely treatment, calling for rethinking of strategies to detect cases for timely treatment.     

2006-2015年北京市昌平区肺结核报告发病情况分析

目的 分析2006-2015年北京市昌平区肺结核报告发病情况及其流行病学特征,为针对性的制定结核病防治策略提供依据。 方法 利用《传染病报告信息管理系统》的统计报表模块收集肺结核数据信息,运用描述性统计学方法对监测数据进行分析。 结果 2006-2015年昌平区报告肺结核病例7 082例,发病率由2006年的76.87/10万上升到2008年的127.55/10万,又下降到2015年的40.69/10万,各年发病率差异有统计学意义(P<0.0001),10年间共报告1 672例涂阳患者(占23.61%),发病率由2006年19.36/10万上升到2008年的28.50/10万,又下降到2015年的10.53/10万,差异有统计学意义(P<0.0001)。报告病例中男性(4 633例)是女性(2 449例)的1.89倍,各年度男性与女性患者发病率差异均有统计学意义(P<0.0001)。报告病例主要集中在15~25岁年龄组(47.99%)和65岁以上(9.90%)人群,职业分布以农民、家务及待业、学生、干部职员、工人为主,占报告病例的71.19%。本地户籍患者报告病例(5 441例)是非户籍患者(1 641例)的3.32倍,各年度本地户籍与非本地户籍患者报告发病率差异均有统计学意义(P<0.0001),非户籍患者报告发病率整体上呈先升后降的趋势,在2008年达到近十年的高峰,发病率为53.26/10万。 结论 2006-2015年北京市昌平区肺结核发病率呈下降趋势,但是结核病的流行仍然严重,应继续加强对重点人群的结核病防治工作。     

Evaluation of primary care coverage in Salvador, Bahia State, Brazil (2000 to 2007)

In order to test a method for evaluating coverage of primary healthcare services in Salvador, Bahia State, Brazil (2000-2007), a study of spatial and temporal clusters was performed, with the city and its 12 health districts as the analytical units. The real and potential coverage rates were estimated for various primary care procedures. Estimation of coverage rates used both the Ministry of Health guideline and a second standard aimed at establishing an approximation to the population's health needs. The data were obtained from the Outpatient Information System of the Unified National Health System (SIA-SUS). Low coverage rates were observed, despite a slight increase in real coverage for medical consultations (7.8%) and basic nursing care (66.7%). Meanwhile, dental consultations showed a 40% reduction. The study discussed the possibilities for using the methodology to monitor coverage and its limitations given the deficiencies in the information systems.     

The Global Impact of Alcohol Consumption on Premature Mortality and Health in 2016

This study aimed to estimate the impact of alcohol use on mortality and health among people 69 years of age and younger in 2016. A comparative risk assessment approach was utilized, with population-attributable fractions being estimated by combining alcohol use data from the Global Information System on Alcohol and Health with corresponding relative risk estimates from meta-analyses. The mortality and health data were obtained from the Global Health Observatory. Among people 69 years of age and younger in 2016, 2.0 million deaths and 117.2 million Disability Adjusted Life Years (DALYs) lost were attributable to alcohol consumption, representing 7.1% and 5.5% of all deaths and DALYs lost in that year, respectively. The leading causes of the burden of alcohol-attributable deaths were cirrhosis of the liver (457,000 deaths), road injuries (338,000 deaths), and tuberculosis (190,000 deaths). The numbers of premature deaths per 100,000 people were highest in Eastern Europe (155.8 deaths per 100,000), Central Europe (52.3 deaths per 100,000 people), and Western sub-Saharan Africa (48.7 deaths per 100,000). A large portion of the burden of disease caused by alcohol among people 69 years of age and younger is preventable through the implementation of cost-effective alcohol policies such as increases in taxation.     

2012－2017年陕西汉中市结核病实验室痰涂片镜检数据分析

目的 了解汉中市2012－2017年肺结核抗酸杆菌痰涂片结果及变化情况,分析涂阳肺结核患者特征。 方法 从中国结核病管理信息系统、结核病实验室登记本中收集整理痰涂片镜检数据,并对6年来肺结核患者痰涂片镜检结果进行数据分析。 结果 6年来痰涂片阳性率从6.48%下降到4.42%,各年发病率差异有统计学意义(P<0.05),各县区痰涂片阳性率差异有统计学意义(P<0.05),各年龄组间涂阳结核病患者阳性差异有统计学意义(P<0.01),涂阳肺结核患者男女构成比差异有统计学意义(P<0.01);45~54岁年龄组患者数最多,占涂阳肺结核患者的19.60％,其次为55~64岁年龄组,占17.04％;男性肺结核患者数多于女性,男、女患者比平均为2.82:1。 结论 汉中市2012－2017年结核病疫情呈下降趋势,男性与中老年肺结核患者是防控的重点人群。     

河南省2009年肺结核疫情特征流行病学分析

[目的]了解2009年河南省肺结核发生水平及其流行特征。[方法]采用中国疾病预防控制中心开发的"国家疾病报告管理信息系统"和Excel软件对2009年河南省肺结核疫情进行分析。[结果]2009年河南省共报告肺结核77771例,发病率为82.48/10万,其中报告死亡268例,报告死亡率为0.28/10万,与2008年结果相比,发病率下降11.16%,死亡率上升67.27%。在28种甲乙类传染病中,发病率仅次于病毒性肝炎,居第2位,死亡率仅次于艾滋病,同样居第2位。全年肺结核发病数比较,冬春季节多于夏秋季节,但季节性高发特点不明显;不同地区分布特点,发病率豫南豫东高于豫北豫西;年龄分布患者以青壮年较多,男性多于女性,职业分布以农民最多。[结论]当前肺结核仍然是严重危害当地居民身体健康和生命安全的重要公共卫生问题之一。     

2011—2019年南京市学生肺结核流行病学特征分析

目的 了解南京市学生肺结核流行病学特征，为学校结核病防控工作提出可行性建议。方法 从《结核病管理信息系统》导出2011—2019年全市学生肺结核资料，对患者的发病情况、分布特点、来源与治疗转归、延迟情况等进行统计分析。结果 2011—2019年学生肺结核年均发病率10.67/10万，9年间发病率从14.92/10万下降到9.18/10万（EAPC=-6.6%，P=0.044），下降38.46%。病原学阳性肺结核年均发病率3.47/10万。男女发病比例1.7[DK]∶1，19～22岁组病例占48.39%。每年4-5月和9月为发病高峰期，学生患者以因症就诊（56%）发现为主，就诊延迟率为38.51%，确诊延迟率为31.77%。结论 南京市学生肺结核发病仍具有一定水平，肺结核就诊延迟情况严峻，应采取相关措施继续加强学校结防工作。     

2012-2017年淮安市学生肺结核流行病学分析

目的 了解淮安市学生肺结核发病趋势和流行特征,为学校结核病防控工作提出可行性建议。方法 从结核病管理信息系统导出2012-2017年全市学生肺结核资料,对患者的发病情况、分布特征、发现方式和延误情况等进行统计学分析。结果 2012-2017年学生活动肺结核的年均发病率为7.92/10万,6年间活动性肺结核发病率从12.09/10万下降到5.76/10万,下降了52.36%;学生菌阳肺结核的年均发病率为2.04/10万,菌阳肺结核发病率从3.80/10万下降到1.65/10万,下降了56.58%。男女性别比为1.74〖DK〗∶1,16～19岁年龄段病例占44.64%。 3-5月为发病高峰期,学生患者以转诊(35.94%)发现为主,就诊延误率为60.87%,诊断延误率为11.89%。结论 淮安市学生肺结核发病数处于较低水平,仍高于全省平均水平,且学生肺结核就诊延误较为严重,应采取综合措施进一步加强学校结核病防控工作。     

2008-2016年安徽省学生肺结核变化趋势及特征分析

目的 了解安徽省学生肺结核（tuberculosis,TB）流行特征,为制定学校结核病防控措施提供科学依据。方法 收集安徽省2008-2016年"结核病管理信息系统"中有关学生结核病发病资料及《安徽省统计年鉴》中有关学生资料。结果 2008-2015年学生活动性肺TB患者平均发病率为13.58/10万,其中涂阳患者平均发病率为4.89/10万,涂阳患者发病率呈逐年下降趋势（χ_趋势2=678.71,P<0.001）。2008-2016年报告的学生活动性肺TB患者共11 880例,男女性别比为1.75:1。以15~岁患者为主,春季为高发季节。患者以涂阴肺TB为主,占59.74%,涂阳肺TB所占比例呈逐年下降趋势（χ_趋势2=1 091.46,P<0.001）,涂阴肺TB及结核性胸膜炎所占比例呈逐年上升趋势（χ_趋势12=711.69,P<0.001;χ_趋势22=145.55,P<0.001）。学生患者平均就诊延迟率和确诊延迟率分别为53.71%和13.59%。患者发现方式以转诊为主,占45.20%,健康体检发现方式所占比例呈逐年上升趋势（χ_趋势2=64.70,P<0.001）。结论 2008-2016年安徽省学生涂阳肺TB患者发病率逐年下降,15~岁为重点发病人群,春季为高发季节,健康体检等发现方式逐年增加。下一步将根据重点人群及高发时间,加强学生TB防控工作,继续关注健康体检在学生肺TB发现中的作用。     

上海市常住人口中肺结核病流行趋势与成因分析

目的　评估本市肺结核病的流行动态和趋势,为防制决策服务。方法　对肺结核登记发病资料和死亡资料进行分析。研究对象包括１９８４ ～１９９８ 年本市户口的新登记肺结核病例和死亡病例。结果　１９８４ ～１９９４年,上海市肺结核病登记发病率逐年下降,年递降率达５ ．３４ ％ 。但自１９９４ 年以来,肺结核病登记发病率出现转折,呈回升趋势。１９９４ ～１９９８ 年的４ 年中,实际报告人数较预计报告人数超出３６４２ 例。低年龄组的发病率不再下降。１９９８ 年较１９９７ 年死亡率出现大幅上升。结论　近年来,人群的结核新感染率可能出现上升。外来流动人口的结核病问题已影响本市的结核病疫情,结核病控制工作不应被忽视。     

The impact of AIDS, immigration and housing overcrowding on tuberculosis deaths in São Paulo, Brazil, 1994-1998

The objective of this paper was to describe the distribution of tuberculosis (TB) mortality by area in the municipality of S?o Paulo, Brazil, from 1994 to 1998, and to evaluate its statistical association with several population characteristics. We surveyed TB deaths grouped by residential area, at the district level, and we calculated the rates for these areas standardized by gender and age groups. We applied simultaneous autoregressive--SAR regression analysis (autocorrelated errors model) in order to fit a "stepwise" model correlating TB deaths with the variables of interest. Significant associations were found between TB mortality rates and AIDS mortality rates, overcrowding at the household level, social development (expressed by a socioeconomic index), and rates of foreign immigration and immigration from other Brazilian States. Regression analysis allowed us to estimate the frequency of TB deaths virtually attributable to co-infection with HIV at 22.37% (95% confidence interval: 12.15-41.17%). TB death rates and utilization of public health services were not statistically associated, suggesting a reduced effectiveness of programs directed at control of the disease. The correlation between TB death rates and deprivation, measured by the socioeconomic index, indicates higher mortality in underprivileged areas. The significance of the association between housing overcrowding and TB deaths, in contrast to the absence of association with district-level overcrowding, indicates that prolonged contact is needed for disease transmission. Although the influx of foreigners and national migrants to the city diminished after the 1980s, immigration rates have been significantly correlated with TB mortality, suggesting greater vulnerability of these population segments to the disease.     

Trends in mortality due to respiratory diseases in elderly,Brazil, 1980 to 1998

INTRODUCTION: The increase in life expectancy and the decline in mortality rates in Brazil have an impact on social programs to the elderly, especially related to health care.The objective of the study isto analyze the mortality trends for respiratory diseases in elderly. METHODS: An ecological time series was carried out and mortality data was obtained from the Mortality Information System of the Ministry of Health (SIM/MS-DATA-SUS). it was analyzed the time trends of standardized mortality rates according to age groups (60 to 69, 70 to 79 and 80 years old and more) and gender, using linear regression models. The proportional mortality for this disease group compared to all causes of death was also studied. RESULTS: There were increasing trends for mortality rates in both sexes, especially among males. The proportion of deaths due to respiratory diseases was higher among older ages. CONCLUSION: Respiratory diseases are one of the main causes of hospitalization and death in the elderly population. Prevention and care for elderly, as well as further etiology studies should be a priority in Brazil.     

Correction approach for underreporting of deaths and hospital admissions due to ill-defined causes

OBJECTIVE: To propose a correction approach for underreporting and relocation of ill-defined causes of morbidity and mortality in the National Health System Mortality and Hospital Information Systems. METHODS: Modified James-Stein empirical Bayes estimators for events in delimited geographic areas were applied as a correction approach for underreporting in Brazilian municipalities in 2001. RESULTS: There was an increase of 55,671 deaths in the Mortality Information System, an underreporting correction of 5.85%. It was more effective at the age groups under five (8.1%) and 70 years old and more (6.4%); for neonatal (8.7%) and ill-defined (8.0%) causes of death; and in the states of Maranh?o (10.6%), Bahia (9.5%) and Alagoas (8.8%). Relocation of ill-defined causes of mortality changed the structure of proportional mortality in the Northern and Northeastern regions, and increased the proportion of deaths due to cardiovascular diseases and reduced those due to external and neonatal causes. Relocation of ill-defined causes of hospital admissions did not affect hospital proportional morbidity. CONCLUSIONS: The results of underreporting correction were consistent with previous studies, in terms of age groups, causes and geographic areas. Relocation of ill-defined causes of death was spatially consistent. The approach studied may be applicable on Brazilian Health Information since it can be implemented in computational algorithms. Some improvements, however, may be considered, like estimation approaches based on time-space event distribution.     

Trends in tuberculosis incidence and their determinants in 134?countries

Objective

To determine whether differences in national trends in tuberculosis incidence are attributable to the variable success of control programmes or to biological, social and economic factors.

Methods

We used trends in case notifications as a measure of trends in incidence in 134 countries, from 1997 to 2006, and used regression analysis to explore the associations between these trends and 32 measures covering various aspects of development (1), the economy (6), the population (3), behavioural and biological risk factors (9), health services (6) and tuberculosis (TB) control (7).

Findings

The TB incidence rate changed annually within a range of ±10% over the study period in the 134 countries examined, and its average value declined in 93 countries. The rate was declining more quickly in countries that had a higher human development index, lower child mortality and access to improved sanitation. General development measures were also dominant explanatory variables within regions, though correlation with TB incidence trends varied geographically. The TB incidence rate was falling more quickly in countries with greater health expenditure (situated in central and eastern Europe and the eastern Mediterranean), high-income countries with lower immigration, and countries with lower child mortality and HIV infection rates (located in Latin America and the Caribbean). The intensity of TB control varied widely, and a possible causal link with TB incidence was found only in Latin America and the Caribbean, where the rate of detection of smear-positive cases showed a negative correlation with national incidence trends.

Conclusion

Although TB control programmes have averted millions of deaths, their effects on transmission and incidence rates are not yet widely detectable.     

Tuberculosis notifications in Australia, 2002.

In 2002, there were 1,028 cases of tuberculosis (TB) reported to the National Notifiable Disease Surveillance System, of which 997 were new cases, 30 were relapses and 1 unknown. The incidence rate of TB in Australia in 2002 was 5.2 cases per 100,000 population. The highest incidence of TB was reported in people born overseas (20.2 cases per 100,000 population), followed by Indigenous Australians (8.5 cases per 100,000 population). By contrast, the incidence rate of TB in the nonIndigenous Australian-born population was 1.1 cases per 100,000 population. This pattern of TB incidence rates amongst the sub-populations of Australia has been observed for over 10 years. The rates were evaluated against the performance indicators set by the National Tuberculosis Advisory Committee to ensure that Australia's record of TB control is maintained and improved.     

Infant mortality and its preventability in Mato Grosso do Sul State, Brazil, 2000-2002

This retrospective study describes the epidemiological profile of infant mortality in 2000-2002 in 16 counties in Mato Grosso do Sul State, Brazil, and evaluates the preventability of such deaths, using the International Statistical Classification of Diseases and Related Health Problems (ICD-10) and the List of Causes of Death Preventable by Interventions in the Setting of the Brazilian Unified National Health System in Children Under Five Years. Perinatal causes accounted for 54.3% of the 1,537 deaths, according to the Mortality Information System; congenital anomalies 14.9%; infectious and parasitic diseases 9.4%; and respiratory disorders 7%. A full 73.1% of deaths were preventable, and most (69.5%) resulted from inadequate prenatal, obstetric, and neonatal care. Additional causes were related to vaccine prevention (0.7%), diagnosis and treatment (10.4%), and health promotion (11.2%). Causes not entirely avoidable accounted for 24.3% of deaths. The findings emphasize the relevance of monitoring adverse maternal-infant conditions and events, particularly to reduce early neonatal mortality (<7 days of life).     

1990-2017年中国结核病流行与控制情况

目的 分析1990-2017年我国结核病的流行及控制情况,为制定结核病防控策略提供科学依据。方法 利用2017年全球疾病负担研究结果,分析1990-2017年中国结核病发病和死亡的变化趋势。结果 2017年中国结核病的发病数和死亡数分别是83.10万（年龄标化发病率为54.18/10万）和3.93万（年龄标化死亡率为2.17/10万）,较1990年分别下降了51.05%和76.24%。1990-2017年,我国结核病的发病数和死亡数的年均递降率分别为2.61%和5.18%;我国结核病的发病数从2016年的83.36万下降到2017年的83.10万,仅下降了0.31%,死亡数从2016年的4.07万下降到2017年的3.93万,下降了3.44%。1990-2017年药物敏感结核病的发病数和死亡数均呈现逐年下降的趋势,耐多药和广泛耐药结核病的发病数及死亡数均呈现先升后降的趋势。广泛耐药结核病的发病数从2016年的2 979例增长到2017年的3 018例,增加了1.32%;死亡数从2016年的819例增长到2017年的829例,增加了1.22%。结论 1990-2017年我国结核病疫情总体呈下降趋势,但近年来下降速率缓慢,其中广泛耐药结核病的增加应引起重视。     

2010—2019年广州市肝癌死亡情况与趋势分析

目的 分析2010—2019年广州市肝癌死亡情况及趋势,为降低肝癌死亡率的科学防控提供数据支持。 方法 人口资料来源于市公安局。死亡数据来源于中国疾病预防控制信息系统“人口死亡信息登记管理系统”。计算死亡率、年龄别死亡率、世界人口标化死亡率(简称世标率)和年度变化百分比(annual percentage change, APC)。利用Joint Regression Program软件分析肝癌死亡的时间变化趋势。 结果 2010—2019年广州市肝癌年平均死亡率为24.40/10万,男性(38.37/10万)高于女性(10.25/10万),男性死亡中位年龄比女性早11岁。49.69%的男性肝癌死亡发生在45～64岁组,68.95%的女性集中在65岁以上组。近10年肝癌整体、男性和女性死亡均呈下降趋势且有统计学意义,APC分别为-2.06%、-1.82%和-2.49%。15～44岁、45～64岁和65岁以上组肝癌死亡均呈下降趋势,APC分别为-3.78%、-2.01%和-1.17%。 结论 广州市近10年肝癌死亡率呈下降趋势,男性和老年人为防控重点。应重视肝癌筛查,进一步提升居民健康素养,加强自我管理能力,降低死亡风险。