Overweight among adults in Pernambuco State, Brazil: prevalence and associated factors

In order to evaluate the prevalence of overweight and associated factors in Pernambuco State, Brazil, a cross-sectional population-based study was conducted in 2006, including 1,580 adults 25 to 59 years of age. Overweight was defined as body mass index > 25kg/m2. The conceptual model included demographic, socioeconomic, reproductive, and behavioral variables. Prevalence of overweight was 51.1% (95%CI: 48.6-53.6) and was statistically associated with age over 40 years (PR = 1.27; 95%CI: 1.10-1.46), female gender (PR = 1.29; 95%CI: 1.16-1.43), former smoking (PR = 1.42; 95%CI: 1.20-1.69), higher income (PR = 1.49; 95%CI: 1.30-1.71), and history of early pregnancy (< 18 years) (PR = 1.25; 95%CI: 1.11-1.66). There was no association with alcohol consumption, level of physical activity, or specific foods. The high prevalence of overweight is consistent with epidemic levels of this problem elsewhere in world, and the association with several factors supports its multifactor etiology.     

Hospital costs due to violence against children and adolescents in Pernambuco State,Brazil, during 1999

This study focused on expenditures under the Brazilian National Unified Health System (SUS) due to hospitalization of children and adolescents as the result of violence in Pernambuco State in 1999. Data were collected from the Hospital Admittance Forms covering the State of Pernambuco. Some 9,220 hospital admissions due to external causes were identified, with a cost of R$3,659,558.62. Mean cost of hospitalization for children and adolescents in Pernambuco State in 1999 was R$306.49. Mean cost of hospitalization due to external causes was R$396.91. Traumatic lesions were the most common reason for hospital admission (84.7%). Violence against children and adolescents in Greater Metropolitan Recife accounted for 65.1% of hospital admissions and 77.9% of all hospital costs in Pernambuco State.     

Mother-child anemia in the State of Pernambuco, Brazil

Prevalence of anemia and associated factors were analyzed in mothers (n = 1,022) and their children under 5 years of age (n = 1,242) in Pernambuco State, Brazil, 2006. This was a cross-sectional population-based study with a probabilistic sample in an urban and rural area. Anemia was diagnosed by hemoglobin level (children < 11.0 g/dL, women < 12.0 g/dL) using HemoCue. Univariate and multivariate analyses used Poisson regression with robust adjustment of standard error, adopting a hierarchical model for determination in children with anemia as the outcome. This same procedure was not applied to mothers because of the small number of associated factors in the univariate analyses. Anemia prevalence was 16.4% in mothers and 34.4% in children. Anemic as compared to non-anemic mothers showed a prevalence ratio of 1.44 (95%CI: 1.21-1.72) for anemia in their children, maintaining similar values in the adjusted model (PR = 1.39: 95%CI: 1.16-1.66). Anemia prevalence in children was double that of mothers, with the final model showing only one common factor: per capita family income.     

Health care user satisfaction in Pernambuco State, Brazil, 2005

Researching the users' satisfaction is a key task for management. With the Project for Strengthening the Evaluation Capacity of the State, the Pernambuco Health Secretariat has defined to evaluate the health system performance as priority. The current study aimed to know the factors associated with the users' satisfaction of the Pernambuco health system. It was an evaluative study based on the results obtained in a population survey carried out on 2005 in Pernambuco. The data analysis considered the use of multivariate methods and the satisfaction as dependent variable. The main analyzed aspects were the professionals quality, the health services quality and the health system resolubility. The analysis has revealed that the waiting time for health care and the availability of medicines were the factors with the lowest percentage of users' satisfaction, what generate reflections about if the access has been actually related to the offering of health services, adequate or not to the people demands and the pharmaceutical assistance policy in the state. In conclusion, it was possible to obtain a more complete overview about how the health system of Pernambuco has attended the people expectations by the users perspectives.     

Living conditions and infant mortality: intra-urban differentials in Recife, Pernambuco State, Brazil

The objective of this study was to show infant mortality differentials in different areas of Recife, analyzing the relationship between living conditions and mortality risk. An ecological study design compared infant mortality coefficients in 1995 with living conditions indicators obtained from the 1991 National Demographic Census. Information on the 770 infant deaths and 27,965 live births were collected from death and birth certificates. Information on water supply, sanitation, garbage collection, literacy, schooling, income, and overcrowding were used to establish a compound indicator for living conditions, constructed through factor analysis. The neighborhoods were then ordered according to the level of living conditions and grouped in 4 clusters, through hierarchical cluster analysis. Infant, neonatal, and post-neonatal mortality coefficients were 23.94, 17.66, and 6.28, respectively, for cluster I; and 32.04, 20.24, and 11.80 for cluster IV. In general, an inverse relationship was found between infant mortality and living conditions in clusters from Recife, revealing inequalities that are disguised when coefficients are expressed as averages for the entire city.     

Overweight among children and adolescents in a Native Canadian community: prevalence and associated factors

BACKGROUND: The prevalence of pediatric obesity in North America is increasing. Native American children are at especially high risk. OBJECTIVES: The objective was to evaluate the prevalence of pediatric overweight and associated behavioral factors in a Native Canadian community with high rates of adult obesity and type 2 diabetes mellitus. DESIGN: Height and weight were measured in 445 children and adolescents aged 2-19 y. Fitness level, television viewing, body image concepts, and dietary intake were assessed in 242 subjects aged 10-19 y. Overweight was defined as a body mass index > or =85th percentile value for age- and sex-specific reference data from the third National Health and Nutrition Examination Survey (NHANES III). Multiple logistic regression was used to examine factors associated with overweight, with adjustment for age and sex. RESULTS: The overall prevalence of overweight in subjects aged 2-19 y was significantly higher than NHANES III reference data [boys: 27. 7% (95% CI: 21.8, 34.5); girls: 33.7% (95% CI: 27.9, 40.1)]. In the subset aged 10-19 y, > or =5 h television viewing/d was associated with a significantly higher risk of overweight than was < or =2 h/d [odds ratio (OR) = 2.52; 95% CI: 1.06, 5.98]. Subjects in the third and fourth quartiles of fitness had a substantially lower risk of overweight than did those in the first quartile [third quartile compared with first quartile: OR = 0.24 (95% CI: 0.09, 0.66); fourth quartile compared with first quartile: OR = 0.13 (95% CI: 0.03, 0. 48)]. Fiber consumption on the previous day was associated with a decreased risk of overweight (OR = 0.69; 95% CI: 0.47, 0.99 for each 0.77 g/MJ increase in fiber intake). CONCLUSIONS: Pediatric overweight is a harbinger of future diabetes risk and indicates a need for programs targeting primary prevention of obesity in children and adolescents.     

Hemoglobin level and anemia in children in the State of Pernambuco, Brazil: association with socioeconomic and food consumption factors

This study aimed to assess hemoglobin level and anemia prevalence and their association with food-consumption and socioeconomic variables. A cross-sectional survey was conducted in the State of Pernambuco, Brazil, in 1997, using three-stage sampling which included 746 6-to-59-month-old children. Hemoglobin testing and a 24-hour food recall interview were performed. The anemia rate was 40.6% and was higher in the rural area and inversely proportional to age, income, and maternal schooling. Most children (88.9%) consumed cow's milk. Anemia was associated directly with the proportion of calories from cow's milk and indirectly with the iron level. Child's age, geographic area, per capita family income, maternal schooling, iron density (total, heme, and non-heme), and the proportion of calories from cow's milk in the diet were determinants for anemia.     

Monitoring of infant growth by health services in Pernambuco State, Brazil

A situational diagnosis was performed on infant growth monitoring in Greater Metropolitan Recife and in the interior of the State of Pernambuco, Brazil, using the database from the Survey on Maternal and Child Health in the State of Pernambuco, 1998, which included 816 infants (< 1 year of age) and 120 health units. Epi Info version 6.04 was used for the analysis. In the health services infrastructure, 15.8% of the health units lacked infant scales and the Child's Health Card, and 75.4% lacked the guidelines for monitoring growth and development. Of these variables, the first two showed a difference between the two study areas. As for process evaluation, 81.2% of the mothers had the Child's Health Card, 53.1% of the children had been weighed, and only 21% had been measured. Mothers had received insufficient orientation. These variables also showed differences between the two study areas. Care for children with nutritional risk received little attention in the two areas, although there was a difference between the interior and Metropolitan Recife. In conclusion, monitoring of infant growth has not been effectively consolidated in the State of Pernambuco.     

Risk factors for perinatal mortality in Recife, Pernambuco State, Brazil, 2003

The aim of this study was to identify and analyze risk factors for perinatal mortality in Recife, Pernambuco State, Brazil, in 2003, using a multilevel hierarchical model. In this case-control study, cases consisted of all perinatal deaths in 2003 in singleton infants with birth weight > 500g and without congenital malformations. The controls were live births from December 26, 2002, to December 31, 2003, with the same characteristics as the study group, but who survived > 6 days. By using record linkage techniques, 403 cases and 1,612 controls were obtained. All variables, when submitted jointly to multiple logistic regression, showed statistical significance in decreasing order of risk, as follows: prematurity (OR = 18.23), low birth weight (OR = 4.90), maternal age > 35 (OR = 1.97), delivery in public hospitals (OR = 1.93), and maternal schooling < 4 years (OR = 1.78).     

Caries prevalence in 4-year-old preschoolers attending public schools in Recife, Pernambuco, Brazil

The aim of this study was to determine caries prevalence in 4-year-old preschoolers of both sexes in municipal schools in Recife, Pernambuco, Brazil, in 2002, emphasizing their needs assessment. Data were collected by examining 861 preschoolers from 45 municipal schools. Examination was conducted by one examiner (Kappa = 1) in the school and after parental consent forms were obtained. Dental caries was recorded using the dmf-t (decayed, missing, and filled teeth) index. Data analysis showed caries prevalence of 47.00% and dmf-t of 2.06. Only 6.40% of the children had their teeth treated. The examined children showed high dental caries prevalence (47.00%), despite a low prevalence of severe caries (8.94%).     

Yellow fever in children and adolescents previously immunized in Minas Gerais State,Brazil

Background - Yellow fever (YF) is a viral hemorrhagic fever that is transmitted by arthropods. It can occur with little symptomatic manifestations to the most fulminant forms. The most effective way to avoid YF is through vaccination. There is a lack of information about the immune response of the vaccine in childhood. Methods - We described children and adolescents with YF who had been previously immunized in Minas Gerais State from July 2017 to June 2018. Results − 527 cases of YF were observed representing an incidence of 7.6/100,000 inhabitants. Only 26 patients (4.9%) were ≤ 20 years and 501 (95.1%) were > 20 years. Only 9 vaccinated patients were ≤ 20 years and 15 were > 20 years. 34.6% (9/26) of YF patients ≤ 20 years were previously vaccinated and 3% (15/501) of those > 20 years (p < 0.001). The median age at vaccination was 1 year between those ≤ 20 years and 31 years between those > 20 years (p = 0.002). Among 9 vaccinated children and adolescents ≤ 20 years, age ranged from 7 to 18 years, the most described symptoms were fever (88%), headache (77%), myalgia (77%), and abdominal pain (66%). All patients recovered from the disease and none died. Conclusion - Prior YF vaccination may be associated with mild forms of the disease in children and adolescents. YF vaccination in the first years of life may be associated with poor vaccine response and high infection rates in this group as it fail to seroconvert a significant proportion of infants.     

Factors associated with dental caries in preschoolers in Recife, Pernambuco State, Brazil

To investigate factors associated with dental caries in deciduous dentition, a nested case-control study was conducted in a prevalence survey of preschool children (n = 1,690) aged 18 to 36 months and 5 years of age, treated under the Family Health Program in Recife, Pernambuco State, Brazil, in 2006. Cases were children with dmft > 1 and controls with dmft = 0. The independent variables were analyzed in blocks: demographic, environmental, family structure, health care, and dental services use. OR and 95%CI were estimated. Variables associated with the outcome at p < 0.20 in the univariate analysis were included in a multivariate logistic regression model. The cutoff for remaining in the final model was p < 0.10. Larger households (more members), lack of running supply, time of residence, maternal (or caregiver's) schooling, attendance in public preschool, demand for dental services, and sugar intake patterns were associated factors. Variables related to social context were the main predictors of caries, thus highlighting the need for comprehensive measures to address other common childhood health problems.     

Overweight children in Beirut: prevalence estimates and characteristics

OBJECTIVE: To estimate, for the first time, overweight prevalence and associated characteristics in a representative sample of prepubertal children in Beirut, Lebanon's capital. DESIGN: A cross-sectional study with a home interview including measurements of weight and height and a structured questionnaire. SUBJECTS: A total of 234 children aged 6-8 years in Beirut: 131 boys, 103 girls. METHODS: Prevalence of overweight and obesity was based on the international cut-off points for body mass index (BMI) by age and gender proposed by the International Obesity Task Force. The characteristics of overweight examined were: age, gender, household and family size, single- vs. two-parent family, parents' level of education and profession, physical activity and dietary intake of children. RESULTS: Prevalence of overweight and obesity was 26% and 7% respectively in boys, 25% and 6% in girls. Overweight was significantly associated with low physical activity (P < 0.05) and mother's BMI (P < 0.05). CONCLUSIONS: This study identified a high proportion of overweight in 6- to 8-year-old children in Beirut. Reduced physical activity was the most significant factor associated with childhood overweight. Further studies in different regions in Lebanon are necessary to identify national characteristics; prevention efforts will be designed accordingly.     

Factors associated with Hb concentration in children aged 6-59 months in the State of Pernambuco, Brazil

In 1997, the prevalence of anaemia was 40.9 % among children aged 6-59 months in the State of Pernambuco, north-east Brazil. Using the same sample of children, we have investigated possible reasons for this high prevalence. A representative sample was selected through a three-stage process: proportional systematic random sampling of municipalities in the State, systematic random sampling of census sectors within these municipalities, and finally, simple random sampling of households with children aged 6-59 months to obtain the sample of 650 children. Data collection included demographic, environmental, socio-economic and maternal variables, and nutritional status and dietary intakes of the children. Multiple linear regression analysis was based on a hierarchical model of factors associated with Hb concentration. The mean Hb concentration of children aged 6-23 months was 10 g/l lower than that of older children. In the regression analysis, child age explained 8.3 % of the variance in Hb concentration. The intake of bioavailable Fe explained a further 3.3, serum retinol 2.7, diarrhoea 2.4, water treatment 1.7, sanitation 1.3 and low birth-weight 0.5 %. The final model explained 23.4 % of the variance in Hb concentration. We conclude that child age, bioavailable-Fe intake, serum retinol concentration, diarrhoea, water treatment, sanitation and low birth-weight are independently associated with Hb concentration. In north-east Brazil, anaemia prevention programmes among children should focus on those aged <2 years and should consider feasible strategies to improve intakes of bioavailable Fe and vitamin A, and reduce infection. Supplemental Fe should be given to low birth-weight infants.     

Overweight and obesity prevalence and determinants in Italy: an update to 2010

Purpose

To provide updated information on trends and determinants of underweight, overweight, and obesity in Italian adults.

Methods

We considered data from 5 surveys conducted annually between 2006 and 2010, on a total of 14,135 subjects aged 18 years or more (6,834 men and 7,301 women), representative of the Italian adult population, including self-reported information on height and weight.

Results

Overall, 3.1 % of the Italian adult population was underweight (body mass index, BMI, <18.5 kg/m²; 0.8 % men, 5.3 % women), 31.8 % overweight (25≤ BMI <30 kg/m²; 39.8 % men, 24.4 % women), and 8.9 % obese (BMI ≥30 kg/m²; 8.5 % men, 9.4 % women). We observed no specific pattern of overweight/obesity across calendar years in men (multivariate prevalence ratios, PR, for 2010 vs 2006: 0.95; p for trend: 0.980) and a non-significant decreased trend in women (PR: 0.92; p for trend: 0.051). Prevalence of overweight/obesity significantly increased with age (PRs for ≥65 vs 18–24 years: 2.01 in men, 2.65 in women), decreased with education (PRs for high vs low education: 0.79 in men, 0.54 in women), and was less frequent in single than in married adults (PRs: 0.85 in men, 0.78 in women). Overweight/obesity was significantly more frequent in adults from southern versus northern Italy (PRs: 1.13 in men, 1.32 in women) and in former versus never smokers (PRs: 1.23 in men, 1.19 in women).

Conclusions

In Italy, we did not find unfavorable trends in overweight and obesity prevalence across calendar years. However, there are specific subgroups of the population with elevated prevalence of overweight and obesity, mainly adults from southern Italy and less educated ones.     

Overweight schoolchildren in New York State: prevalence and characteristics.

OBJECTIVES. Childhood overweight is an increasing public health concern. This study was undertaken to determine the prevalence of overweight in elementary school children in New York State and to identify characteristics associated with child fatness. METHODS. Weight, height, triceps skinfold, midarm circumference, and a 24-hour dietary recall were taken on 1797 second- and fifth-grade students from 51 randomly selected schools in New York State outside of New York City. Parents completed a brief questionnaire. RESULTS. In comparison with 1974 and 1980 national reference data, up to twice the expected percentages of children had values above the 85th, 90th, and 95th percentiles for body mass index, triceps skinfold, and arm fat area. Regression analyses suggested that children who tended to be fatter were members of low socioeconomic status, two-parent (but not single-parent) households; those with few or no siblings; those who ate school lunch; and those who skipped breakfast. CONCLUSIONS. The findings suggest that overweight is a problem among many elementary school children in New York State and that sociodemographic characteristics may be useful for targeting preventive efforts.     

Sexual violence and its prevalence among adolescents,Brazil

OBJECTIVE: To assess the prevalence o sexual violence among adolescents of public schools. METHODS: Fifty-two public elementary schools of Porto Alegre, Brazil, were selected through random sampling stratified by school size. An 8th grade class was selected in each school through simple random sampling and all adolescents attending the classes who agreed to participate were included in the study. The Screening Survey of Children's Exposure to Community Violence was used to identify adolescents who were victims, witnesses or knew someone who had been a victim of sexual violence. RESULTS: There were 1,193 adolescents included in the study, representing 10.3% of all students enrolled on 8th grade classes in the city's public schools. Twenty-seven adolescents (2.3%) reported being victims of sexual violence, 54 (4.5%) reported witnessing some episode of sexual violence and 332 (27.9%) reported knowing someone who was a victim of sexual violence. CONCLUSIONS: Exposure to sexual violence in any of the three forms of contact was a common event among the studied adolescents. Studies focusing sexual violence as a broad social phenomenon with multiples associated factors are necessary to support preventive and treatment strategies at the community level.