Perinatal mortality in southern Brazil: a population-based study of 7392 births

Perinatal, fetal and early neonatal mortality rates were determined in a population of 7392 babies born in hospitals in Pelotas (total population, 260 000) during 1982. These babies represented over 99% of all births in the city in that year. The perinatal mortality rate for singletons was 31.9 per 1000 total births, the fetal mortality rate being 16.2 and the early neonatal mortality rate 15.9 per 1000 total births.     

Epidemiology of leisure-time physical activity: a population-based study in southern Brazil

We aimed to measure the prevalence of physical inactivity (PI) during leisure time and to identify variables associated with it in a southern Brazilian adult population. A population-based cross-sectional study was carried out, covering a multiple-stage sample of 1,968 subjects aged 20-69 years. Weekly participation in leisure-time physical activity was addressed. For each activity, energy expenditure was calculated using data on duration, metabolic equivalent, and body weight. Energy expenditures of individual activities were summed to give a weekly total. PI was defined as fewer than 1,000 kilocalories per week. The prevalence of PI was 80.7% (95%CI: 78.9-82.4). After adjusted analyses, the following variables were positively associated with the outcome: female gender, age, living with a partner, and smoking. Schooling and economic status were inversely associated with PI. Chronically undernourished individuals were significantly more likely to be inactive. We found no differences according to skin color or alcohol consumption. In conclusion, the prevalence of PI in this adult population was higher than in populations from developed countries, but the associated variables were similar.     

Child sexual abuse in southern Brazil and associated factors: a population-based study

Background  

The prevalence of child sexual abuse (CSA) in the population has been poorly described in developing countries. Population data on child sexual abuse in Brazil is very limited. This paper aims to estimate lifetime prevalence of child sexual abuse and associated factors in a representative sample of the population aged 14 and over in a city of southern Brazil.     

A population-based study on use of medication by the elderly in Greater Metropolitan Belo Horizonte, Minas Gerais, Brazil

The aim of this study was to investigate the use of medication and associated factors (sociodemographics, health conditions, and health services use) in a representative sample of 1,598 elderly individuals (60+ years) in Greater Metropolitan Belo Horizonte, Minas Gerais State, Brazil. The dependent variable was the number of drugs used in the preceding two weeks. Prevalence of medication was 72.1%, and mean consumption was 2.18 drugs, most of which acting on the cardiovascular system. Use of medication (any amount) was independently associated with gender (female), age (80+ years), having consulted a physician, and presence of any chronic health condition. Use of five or more drugs was significantly associated with schooling (8+ years, OR=2.28), worse self-rated health (fair, OR = 5.45; bad/very bad, OR = 5.35). The results show that the types of medications used and factors associated with consumption were similar to those observed in other populations, suggesting some uniformity among various populations in the use of medication and its determinants.     

Hearing impairment and socioeconomic factors: a population-based survey of an urban locality in southern Brazil.

OBJECTIVE: To provide the first population-based data on deafness and hearing impairment in Brazil. METHODS: In 2003, a cross-sectional household survey was conducted of 2,427 persons 4 years old and over. The study population was composed of 1,040 systematically chosen households in 40 randomly selected census tracts (dwelling clusters) in the city of Canoas, which is in the state of Rio Grande do Sul, in southern Brazil. Hearing function was evaluated in all subjects by both pure-tone audiometry and physical examination, using the World Health Organization Ear and Hearing Disorders Survey Protocol and definitions of hearing levels. The socioeconomic data that were gathered included the amount of schooling of all individuals tested and the income of the head of the household. RESULTS: It was found that 26.1% of the population studied showed some level of hearing impairment, and 6.8% (95% confidence interval (CI) = 5.5%-8.1%) were classified in the disabling hearing impairment group. The prevalence of moderate hearing loss was 5.4% (95% CI = 4.4%-6.4%); for severe hearing loss, 1.2% (95% CI = 0.7%-1.7%); and for profound hearing loss, 0.2% (95% CI = 0.03%-0.33%). The groups at higher risk for hearing loss were men (odds ratio (OR) = 1.54; 95% CI = 1.06-2.23); participants 60 years of age and over (OR = 12.55; 95% CI = 8.38-18.79); those with fewer years of formal schooling (OR = 3.92; 95% CI = 2.14-7.16); and those with lower income (OR = 1.56; 95% CI = 1.06-2.27). CONCLUSIONS: These results support advocacy by health policy planners and care providers for the prevention of deafness and hearing impairment. The findings could help build awareness in the community, in universities, and in government agencies of the health care needs that hearing problems create.     

Gender differences in self-reported morbidity: evidence from a population-based study in southern Brazil

This paper aims to assess variations in self-reported morbidity between men and women using six different measures of reported illness. The cross-sectional study was conducted in the municipality of Rio Grande, southern Brazil. Demographic, socioeconomic, and morbidity data were collected from a probabilistic sample of 1,260 persons aged 15 years or over, using a specific questionnaire. Statistical analysis included a multivariate Poisson regression analysis. Prevalence Ratios (PR) with 95% confidence intervals (95%CI) were calculated. After adjusting for some confounding variables (age, race, unemployment, marital status, income, social class, and education), women showed greater risk of any symptom (PR = 3.21; 95%CI: 2.71-3.83), three or more symptoms (PR = 4.22; 95%CI: 2.97-5.98), potentially serious symptoms (PR = 1.75; 95%CI: 1.31-2.34), poor/fair health (PR = 1.78; 95%CI: 1.37-2.32), and minor psychiatric disorders (PR = 1.76; 95%CI: 1.31-2.37). The study revealed dissimilarity in self-reported morbidity between men and women in southern Brazil, but with different degrees depending on type of morbidity. This excess can be explained by gender difference in health-seeking behavior for perceiving or reporting health problems.     

Socioeconomic differences in diet composition of the adult population in southern Brazil: a population-based study

Aim

To describe the intake of macro- and micronutrients, verify its adequacy, and analyze their distribution by the socioeconomic and demographic profile of adults.

Subject and methods

Longitudinal population-based study with a sample of 1222 people aged 22–63 years from Florianópolis, Southern Brazil. The dietary intake data were collected with a 24-h recall in the total sample, plus a second recall applied on a sub-sample of participants with subsequent adjustment of regular consumption. Diet composition and adequacy of intake were compared between the different educational groups and stratified by sex.

Results

The mean energy consumption was 1851 Kcal [standard error (SE) = 15.0 Kcal] and 2259 Kcal (SE = 27.8 Kcal) in females and males, respectively (p-value <0.001). With increasing education, women showed an increasing trend in energy consumption, carbohydrates, proteins, lipids, saturated, polyunsaturated and monounsaturated fat, cholesterol, and fiber. In men, the same differences were found only in saturated fat and cholesterol (p-value <0.05 for all). Analyzing the adequate consumption of nutrients, differences were found regarding saturated fat and cholesterol in women and carbohydrates, saturated and polyunsaturated fat in men. The prevalence of inadequacy was up to 47% comparing the different educational groups.

Conclusion

A lower percentage of adequacies in food consumption was found in both sexes for those with more years of schooling. Public policy should also target the group with higher education.

     

Cervical cancer screening coverage and associated factors in a city in southern Brazil: a population-based study

This study focused on coverage of screening for cervical cancer and associated factors in women 20 to 59 years of age in Florianópolis, Santa Catarina State, Brazil, in 2009. This was a cross-sectional study using cluster random sampling. Two outcomes were examined: a history of at least one Papanicolaou test and delaying the test (never performed or performed more than three years previously). Among 952 women, 93% (95%CI: 91.5-94.7) had ever had a Pap smear, whereas 14% (95%CI: 11.8-16.2) had delayed the test. According to Poisson regression, both outcomes were associated with marital status, schooling, presence of chronic disease, and consulting a physician for other reasons. Age, income, and hospitalization in the previous year were only associated with ever having a Pap smear. Although test coverage was high, much of the screening was opportunistic. In addition, various social, economic, and demographic disparities influenced the odds of being screened.     

Functional status and associated factors among the elderly in a southern Brazilian city: a population-based study

The goal of this study was to estimate the prevalence of low functional capacity and associated factors in Joa?aba, Santa Catarina State, Brazil, in 2003-2004, using a household survey (n = 345). Subjects who demonstrated difficulty in performing 6 or more activities or inability to conduct 3 of the activities according to the scale proposed by Rikli & Jones were defined as having low functional capacity. A questionnaire covering socioeconomic, demographic, housing, and self-perceived socioeconomic variables was applied. The study included distribution of the target variables' simple frequency, chi-square association tests, and multiple logistic regression analysis. The response rate was 92.7%, with a low functional prevalence of 37.1% (95%CI: 32.0-42.2). Mean age was 69.5 years. After adjusting for confounding variables, the factors associated with low functional capacity were: age > 70 years, female gender, and negative self-perceived socioeconomic status. A high percentage of elderly citizens in Joa?aba show low functional capacity, leading to dependency. Health programs that delay the onset of such disabilities could contribute to healthier aging.     

Time trends in smoking in an urban population: a population-based study in Southern Brazil

This study evaluated time trends in smoking prevalence according to gender and family income among individuals 20 years or older in Pelotas, Rio Grande do Sul State, Brazil. Five population-based surveys using census tracts were conducted in the city from 2002 to 2010. Smoking was defined as consumption of one or more cigarettes per day for at least one month. Time trend was assessed using the chi-square test for linear trend. 15,136 individuals were enrolled in these surveys. During this period, overall smoking prevalence decreased from 28% (25.8-30.4) in 2002 to 21% (19.5-23.5) in 2010. This 23% decline was similar in both genders, but differed significantly according to family income (smoking prevalence increased as income dropped). From 2002 to 2010, smoking decreased by 26% in the lowest income quintile and 39% in the highest. Despite such reductions, smoking prevalence is still high, indicating the need to boost control measures, especially among low-income groups.     

上海市城乡老年人跌倒的流行病学特征

目的 了解老年人跌倒的流行病学特征及城乡差异,为有针对性的老年人跌倒预防和干预提供证据支持。方法 2017年1－3月先后对上海市7个城市社区和6个农村社区方便抽取的≥60岁常住老年人进行问卷调查,了解老年人跌倒现状、流行病学特征,分析老年人跌倒的性别和城乡差异。结果 共调查城市老年人3 386人,其中441人（13.0%）发生跌倒,261人（7.7%）发生跌伤;共调查农村老年人2 826人,其中320人（11.3%）发生跌倒,169人（6.0%）发生跌伤;城市和农村老年女性的跌倒风险均较男性高,OR值（95% CI）分别为1.62（1.42～1.86）、1.16（1.38～1.98）,而跌伤风险差异无统计学意义。与城市相比,农村老年人的跌倒和跌伤风险合计均较低,OR值（95% CI）分别为0.86（0.73～0.99）、0.74（0.56～0.99）,其中男性老年人跌倒风险较低、女性老年人跌伤风险较低,OR值（95% CI）分别为0.68（0.51～0.90）、0.66（0.47～0.93）。老年人的跌倒地点主要为家中,城市老年人跌倒发生在上下楼梯时的比例较高,农村则在干农活过程中的比例较高,>60%的老年人跌倒发生时有环境因素,以地面较滑和地面不平为主,跌伤中骨折的发生比例较高,城市骨折发生89人次（28.2%）,农村为64人次（36.1%）。结论 上海市老年人跌倒风险存在性别和城乡差异,宜根据老年人跌倒发生特征开展有针对性的干预。     

Maternal smoking during pregnancy and anthropometric measurements of newborns: a population-based study in southern of Brazil

This cross-sectional study aimed to investigate the prevalence of maternal smoking during pregnancy and its impact on anthropometric measurements of newborns. A standardized questionnaire was applied to all pregnant women admitted for delivery in the maternity units in Rio Grande, Rio Grande do Sul State, Brazil, in 2007. Measurements were taken of the newborns' weight, length, and head circumference. Prevalence rates were 23% for maternal smoking during pregnancy and 29% for exposure to environmental tobacco smoke. After adjusting for potential confounding factors, compared with those whose mothers never smoked, newborns whose mothers smoked throughout pregnancy showed average decreases of 223.4 g in birth weight (95%CI: 156.7;290.0), 0.94 cm in birth length (95%CI: 0.60;1.28), and 0.69 cm in head circumference (95%CI: 0.42-0.95). In conclusion, prevalence of maternal smoking during pregnancy was high in this municipality. Maternal smoking during pregnancy was inversely associated with birth weight, length, and head circumference.     

Socioeconomic and demographic inequalities as risk factors for self-reported arthritis: a population-based study in southern Brazil

The study aimed to estimate prevalence of self-reported arthritis or rheumatism and associated factors. This was a cross-sectional population-based study in Florianopolis, Santa Catarina State, Brazil, with 1,720 adults ranging from 20 to 59 years of age. Presence of self-reported arthritis or rheumatism was analyzed with a hierarchical approach, considering demographic, socioeconomic, and behavioral variables and use of health services. Logistic regression was used to evaluate the association between the outcome and independent variables. Prevalence of self-reported arthritis or rheumatism was 7.7% (95%CI: 6.4-8.9). The odds of self-reported arthritis were twice as high in women, and increased self-reported arthritis was directly associated with BMI > 30kg/m2 and increasing age and inversely proportional to schooling. Self-reported arthritis or rheumatism was higher in this sample than in Brazilian adults in general in 2008. The results suggest the need to plan public health policies to address this problem.     

Mortality by socio-occupational categories in urban and rural areas

Mortality data in France are studied by a cross sectional analysis including both population density (urban or rural aggregates) and socio-economic groups. The socio-economic differentials in mortality increase with the size of localities. Specific social class distribution partly explains the excess of mortality in rural areas and the lowest mortality in the parisian agglomeration. On the contrary social class distribution does not affect mortality in small towns. Nevertheless, the expected effect of social class does not explain all the discrepancies in mortality between urban and rural areas. The population density is a parameter that should be taken into account when analyzing mortality.     

Anthropometric measures change and quality of life in elderly people: a longitudinal population-based study in Southern Brazil

Purpose

To analyze the effects of anthropometric measures change on quality of life (QoL) in elderly, using measured anthropometric data on body mass index (BMI) and waist circumference (WC).

Method

Population-based cohort study investigating a sample of elderly (≥60) assessed in 2009 (n = 1705) and followed up in 2013 (n = 1197). QoL was evaluated in 2013 using the CASP-19. Variables evaluated as exposure including BMI and WC in 2009 (both standardized), categories of anthropometric measures change from 2009 to 2013 (excess weight = BMI ≥ 25.0 kg/m²; large WC = top quartile), and the absolute BMI and WC change in same period. Multivariate linear regressions adjusted for possible confounding factors and mediators were used.

Results

Both BMI and WC at baseline were associated with lower QoL scores, even after adjustment for confounding variables (β _BMI = ?0.9; 95 % CI ?1.5; ?0.3 and β _WC = ?1.0; 95 % CI ?1.7; ?0.4). Additionally, QoL scores were lower among elderly with excess weight (β = ?1.4; 95 % CI ?2.9; 0.0) or large WC (β = ?3.3; 95 % CI ?5.2; ?1.4) in both waves than among those whose BMI and WC were always normal, but changes in anthropometric measures did not affect QoL. The presence of chronic diseases was a partial mediator of these associations, especially for effects of BMI change. Anthropometric measures change treated as a continuous variable was not associated with QoL.

Conclusions

Having excess weight and large WC in both waves was associated with lower QoL scores in elderly, but changing the anthropometric measures did not affect this outcome. Maintaining weight and WC within normal limits during aging can help to preserve QoL.

     

Use of cellular telephones and brain tumour risk in urban and rural areas

Aims: To investigate the association between the use of cellular or cordless telephones and the risk for brain tumours in different geographical areas, urban and rural.     

Malaria in urban and rural areas of southern Ghana: a survey of parasitaemia, antibodies, and antimalarial practices

A comparative cross-sectional survey was undertaken in two populations, urban and rural, in southern Ghana to assess the impact of urbanization on the prevalence of malaria parasitaemia and antibodies. At the same time, a survey of antimalarial practices was conducted on sample populations in the two communities. The results showed a low parasite rate (1.6%) and correspondingly low titres of malaria antibodies in a significant proportion of the urban community, particularly in children less than 10 years old. This was associated with widespread use in the urban community of antimalarial drugs, particularly chloroquine, as prophylaxis. The parasite rate in the rural community was 22%, and 97% of the sample population over 1 year of age had antibodies against Plasmodium falciparum. These results demonstrate that a substantial proportion of urban children are growing up with little exposure to malaria, even in a region considered endemic for malaria. The implications of these findings are discussed.     

Quality of registration of maternal deaths in Mozambique: a community-based study in rural and urban areas

Maternal mortality is an important indicator used to assess the level of development of a country and particularly the coverage of health services. In Africa where the maternal mortality ratios are about 100 times higher than those of developed countries the situation is even worse due to problems of underregistration. In Mozambique the figures officially used are derived from the data of some hospitals in the main cities. This leaves out the 60% of pregnant women who do not attend health facilities. It was against this background that the present study was designed to be a prospective community-based study carried out in the central region of Mozambique involving a population of 207,369 inhabitants. The study covered a 12-month period, from 01/08/96 to 31/07/97 and found 214 deaths among women in reproductive age (15-49 yr) of whom 40 were classified as maternal deaths. Gross underregistration was revealed, as the health institutions failed by 86% in recording maternal deaths, the same happening with other official sources, like the Civil Register and the Funeral Services registering only 9% of the maternal deaths. This kind of study is however complex and labour intensive and a practical way of monitoring has to be found; for the region where the study took place close collaboration with private cemeteries appears to be a way to be further explored.