Trends in social inequalities in breastfeeding and infant formulas in Latin American countries between the 1990 and 2010 decades

Abstract Objective: To analyse trends of social inequality in breastfeeding and infant formula (IF) use in Latin America between 1990 and 2010 decades. Design: Time-series cross-sectional study with data from Demographic and Health Surveys. We described the prevalence of exclusive breastfeeding (EBF), breastfeeding between 6 and 12 months (BF6-12) and IF for infants under 6 months (IF < 6) and between 6 and 12 months (IF6-12). Social inequalities were assessed using the slope index of inequality (SII) and concentration index (CIX). Trends in the prevalence of breastfeeding, IF and index of social inequality were analysed by a linear regression model with weighted least squares variance. Setting: Bolivia, Colombia, Dominican Republic, Guatemala, Haiti and Peru. Participants: 51·358 alive infants younger than 12 months. Results: Five countries showed an increasing trend for EBF and BF6-12, four increased for IF < 6 and six for IF6-12. Simultaneous decrease in IF < 6 (Colombia: −0·3/year; Haiti: −0·02/year) and increase in EBF (Colombia: +2·0/year; Haiti: +1·9/year) were observed only in two countries. EBF prevalence was high in the lowest income quintiles in five countries, and IF prevalence was high in the highest income quintiles in all countries and over the decades. For BF6-12, a decrease in inequality (prevalence increased in the highest quintile) was observed in Guatemala (SII1995 = −0·42; SII2015 = −0·28) and the Dominican Republic (SII1996 = −0·54; SII2013 = −0·26). Guatemala was the only country showing a decrease in inequality for BF (SII = −0·005; CIX = −0·0035) and an increase for IF (SII = 0·022; CIX = 0·01). Conclusions: The inequality in BF and IF remained over time. However, inequality in IF < 6 has decreased because low-income infants have increased use and high-income infants have decreased.

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Sociodemographic, health and pro-breastfeeding policies and programmes associated with breastfeeding duration in Latin American countries

Public Health Nutrition ◽

10.1017/s1368980020005145 ◽

2020 ◽

pp. 1-28

Author(s):

Danielle Mendonça Buiatti Lamounier ◽

Catarina Machado Azeredo ◽

José Leopoldo Ferreira Antunes ◽

Wolney Lisboa Conde ◽

Ana Elisa Madalena Rinaldi

Keyword(s):

Dominican Republic ◽

Latin American ◽

Cross Sectional Study ◽

Breastfeeding Duration ◽

Demographic And Health Surveys ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Nationally Representative ◽

Duration Of Breastfeeding ◽

Latin American Countries

ABSTRACT Objective: To describe the duration of breastfeeding between 1990 and 2013 and to estimate the association between breastfeeding duration and sociodemographic, health and pro-breastfeeding policies and programmes in Latin American countries. Design: This is a cross-sectional study with data from Demographic and Health Surveys program conducted in Bolivia, Brazil, Colombia, Peru and the Dominican Republic between 1990 and 2013. The median duration of BF was estimated by survival analysis. Information on pro-breastfeeding policies and programmes was extracted from the World on Breastfeeding Trends Initiative (WBTi) tool. The association between the duration of breastfeeding and WBTi tool score was analysed by multilevel survival regression. Setting: Nationally representative cross-sectional survey from Bolivia, Brazil, Colombia, Peru and Dominican Republic. Participants: We included children under 24 months of age, totalling 17,318 children. Results: Breastfeeding duration showed a significant increase in all countries, except the Dominican Republic. Mothers with higher schooling level (HR=1.66;95%CI:1.35;2.04), higher income (HR=1.58;95%CI:1.40;1.77) and overweight (HR=1.14;95%CI:1.05;1.23) breastfed for a shorter time. Breastfeeding in the first hour of life (HR=0.79;95%CI:0.74;0.83) was associated to increase in the duration of breastfeeding. Regarding WBTi, Peru presented the lowest score and the Dominican Republic presented the highest score. WBTi score was inversely related with the duration of breastfeeding for this set of countries (HR=1.07;95%CI:1.02;1.12). Conclusions: Mothers with better socioeconomic conditions and overweight breastfed for a shorter time. Breastfeeding in the first hour was associated to longer duration of breastfeeding. In this set of countries, higher scores from WBTi tool did not result in longer duration of breastfeeding.

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Malnutrition in all its forms and social inequalities in Brazil

Public Health Nutrition ◽

10.1017/s136898001900274x ◽

2019 ◽

Vol 23 (S1) ◽

pp. s29-s38

Author(s):

Daniela Silva Canella ◽

Ana Clara Duran ◽

Rafael Moreira Claro

Keyword(s):

Short Stature ◽

Low Income ◽

Social Inequalities ◽

Mixed Race ◽

Cross Sectional Study ◽

Excess Weight ◽

White Adolescents ◽

Cross Sectional ◽

Race Ethnicity ◽

Low Educated

AbstractObjective:To describe malnutrition (undernutrition and excess weight) by income, education and race/ethnicity in the Brazilian population.Design:Cross-sectional study.Setting:Brazil.Participants:Children aged <5 years (n 14 580), adolescents aged 11–19 years (n 31 892) and adults aged 20–49 years (n 84 660).Results:Among children, prevalence of excess weight, wasting and stunting was 16·9, 2·8 and 6·0 %, respectively. Differences related to income, education and race/ethnicity were verified, except for prevalence of wasting by education level. Girls and boys presented 18·4 and 20·5 % of excess weight, 2·8 and 3·7 % of underweight and 5·5 and 7·3 % of stunting, respectively. Prevalence of excess weight was lower among poorer, lower-educated (only for boys) and white adolescents, while stunting was lower among higher-income, higher-educated and white adolescents. Over three-quarters of women and almost half of men presented excess weight. Among adults, 3·9 % of women and 1·7 % of men were underweight, and 5·7 % of women and 0·2 % of men presented short stature. Prevalence of excess weight for women was higher among lower education and black, while for men it was higher among higher income and education and white. Short stature was more prevalent among black and mixed-race, low-educated and low-income women. Underweight prevalence was higher among low-educated, black and mixed-race women.Conclusions:In Brazil, the prevalence of excess weight was at least threefold higher than that of undernutrition for children and adolescents and at least sevenfold higher for adults. Social inequalities were observed in the distribution of malnutrition across the lifespan and by gender.

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“Where Have I Heard It?” Assessing the Recall of Traffic Safety Campaigns in the Dominican Republic

Energies ◽

10.3390/en14185792 ◽

2021 ◽

Vol 14 (18) ◽

pp. 5792

Author(s):

Francisco Alonso ◽

Mireia Faus ◽

Cesáreo Fernández ◽

Sergio A. Useche

Keyword(s):

Dominican Republic ◽

Traffic Safety ◽

Low Income ◽

Cross Sectional Study ◽

Low Income Countries ◽

Related Factors ◽

Cross Sectional ◽

Safety Issues ◽

Driver's License ◽

The Impact

Although traffic crashes are the eighth leading cause of death in the world, and are linked to vehicle and infrastructure-related factors, crash-related fatality rates are much higher in low-income countries. Particularly, the Dominican Republic is the country with the highest accident rate in the whole American continent. Therefore, in the past few years, public agencies have been developing different measures aimed at reducing traffic fatalities, including road safety campaigns. The aim of the present study was to assess the recalling of such campaigns among the Dominican population, which may serve as an additional indicator to evaluate their effectiveness in this and other countries of the region presenting similar traffic safety issues. For this cross-sectional study, a nationwide sample composed of 1260 people (50% males and 50% females) with a mean age of 39.3 years was used. The data were collected through personal interviews. Overall, the recall of traffic safety campaigns was found to be very low (9%); male drivers who were employed, possessed a driver’s license and habitually drove were the ones who could commonly remember these campaigns. The results of this study suggest that further evaluation and follow-up could help to maximize the impact of future traffic campaigns and advertisements in the Dominican Republic, as well as in other emerging countries of the region with similar characteristics. Further, key segments of the population such as the female, young, less formally educated and non-driving populations should be also targeted for further actions in this regard.

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Desigualdade social em doentes renais crônicos/ Social inequality in chronic renal patients

REVISTA CIÊNCIAS EM SAÚDE ◽

10.21876/rcsfmit.v1i1.16 ◽

1970 ◽

Vol 1 (1) ◽

pp. 44-49

Author(s):

Beatriz Bertolaccini Martínez ◽

Fernanda Marcelino Da Silva ◽

Vinícius Tavares Veiga ◽

Rodrigo Pereira Custódio ◽

José Vítor Da Silva

Keyword(s):

Social Inequality ◽

Access To Health Care ◽

Young Patients ◽

Cross Sectional Study ◽

Access To Health Services ◽

Access To Treatment ◽

Cross Sectional ◽

Economic Class ◽

Access To Health ◽

Clinical Background

Introdução: A pobreza influencia na evolução dos pacientes com doenças crônicas, porque contribui para o seu agravamento e dificulta o acesso à assistência médica. O objetivo deste trabalho foi avaliar os aspectos relacionados à desigualdade social de pacientes em hemodiálise. Métodos: Estudo transversal com 123 pacientes em hemodiálise no Hospital Samuel Libânio – Pouso Alegre, MG, divididos, de acordo com a classe econômica, em 3 grupos: AB (n=23), C (n=60) e DE (n=40),. Foram coletados dados sociodemográficos e econômicos, antecedentes clínicos e informações sobre o acesso a serviços de saúde. Para a análise dos resultados, foi utilizada estatística analítica e descritiva. Adotou-se p £ 0,05. Resultados: O grupo AB apresentou um menor número de pacientes jovens (4,3% em AB vs 40% em C e 25% em DE, p < 0,05), um maior número de indivíduos com mais anos de escolaridade (65,3% em AB vs 18,3% em C e 2,5% em DE; p < 0,05), predomínio de pacientes com menos de um ano em tratamento de hemodiálise (65,2% em AB vs 10% em C e 5% em DE, p < 0,05), menor número de usuários do SUS (40% em C e 25% em DE vs 4,3% em AB; p < 0,05) e maior acesso ao tratamento com nefrologista (73,9% em AB vs 46,7% em C e 52,5 em DE; p < 0,05). Conclusão: Classes economicamente desfavorecidas agregam indivíduos mais jovens, com menor escolaridade, usuários do SUS, com maior tempo em hemodiálise e pior acesso ao tratamento com nefrologista.Introduction: The poverty influence on the evolution of patients with chronic diseases because it contributes to your aggravation and hinders access to health care. Our goal was to evaluate the aspects related to social inequality on hemodialysis patients. Methods: cross-sectional study with 123 patients on hemodialysis in Samuel Libânio Hospital – Pouso Alegre, MG, divided according to the economic class, into 3 groups: AB (n = 23), C (n = 60) and DE (n = 40). Were collected socio-demographic and economic data, clinical background and information about access to health services. For analysis of the results has been used statistical analytical and descriptive. We take p £ 0,05. Results: The AB group has fewer young patients (4,3% in AB vs 40% in C and 25% in DE, p< 0,05), a greater number of individuals with more years of schooling (65,3% in AB vs 18,3% in C and 2,5% in DE; p< 0,05), predominance of patients with less than a year on haemodialysis treatment (65,2% in AB vs 10% in C and 5% in DE, p< 0,05), smaller number of users of SUS (40% in C and 25% in DE vs 4,3% in AB; p< 0,05), greater access to treatment with nephrologist (73,9% in AB vs 46,7% in C and 52,5% in DE; p< 0,05). Conclusion: Economically disadvantaged classes bring younger patients, with less schooling, users of SUS, patients with greater time on hemodialysis and worse access to treatment with nephrologist.

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Prevalence and distribution of peripheral musculoskeletal manifestations in spondyloarthritis including psoriatic arthritis: results of the worldwide, cross-sectional ASAS-PerSpA study

RMD Open ◽

10.1136/rmdopen-2020-001450 ◽

2021 ◽

Vol 7 (1) ◽

pp. e001450

Author(s):

Clementina López-Medina ◽

Anna Molto ◽

Joachim Sieper ◽

Tuncay Duruöz ◽

Uta Kiltz ◽

...

Keyword(s):

Psoriatic Arthritis ◽

Latin American ◽

Underlying Disease ◽

Cross Sectional Study ◽

Joint Disease ◽

Joint Involvement ◽

Cross Sectional ◽

Small Joint ◽

Musculoskeletal Manifestations ◽

Inflammatory Bowel

ObjectivesTo characterise peripheral musculoskeletal involvement in patients with spondyloarthritis (SpA) including psoriatic arthritis (PsA), across the world.MethodsCross-sectional study with 24 participating countries. Patients with a diagnosis of axial SpA (axSpA), peripheral SpA (pSpA) or PsA according to their rheumatologist were included. The investigators were asked which diagnosis out of a list of six (axSpA, PsA, pSpA, inflammatory bowel disease-associated SpA, reactive arthritis or juvenile SpA (Juv-SpA)) fitted the patient best. Peripheral manifestations (ie, peripheral joint disease, enthesitis, dactylitis and root joint disease), their localisation and treatments were evaluated.ResultsA total of 4465 patients were included (61% men, mean age 44.5 years) from four geographic areas: Latin America (n=538), Europe plus North America (n=1677), Asia (n=975) and the Middle East plus North Africa (n=1275). Of those, 78% had ever suffered from at least one peripheral musculoskeletal manifestation; 57% had peripheral joint disease, 44% had enthesitis and 15% had dactylitis. Latin American had far more often peripheral joint disease (80%) than patients from other areas. Patients with PsA had predominantly upper limb and small joint involvement (52%).Hip and shoulder involvement was found in 34% of patients. The prevalence of enthesitis ranged between 41% in patients with axSpA and 65% in patients with Juv-SpA. Dactylitis was most frequent among patients with PsA (37%).ConclusionThese results suggest that all peripheral features can be found in all subtypes of SpA, and that differences are quantitative rather than qualitative. In a high proportion of patients, axial and peripheral manifestations coincided. These findings reconfirm SpA clinical subtypes are descendants of the same underlying disease, called SpA.

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Acceptance of a COVID-19 Vaccine in Japan during the COVID-19 Pandemic

Vaccines ◽

10.3390/vaccines9030210 ◽

2021 ◽

Vol 9 (3) ◽

pp. 210

Author(s):

Masaki Machida ◽

Itaru Nakamura ◽

Takako Kojima ◽

Reiko Saito ◽

Tomoki Nakaya ◽

...

Keyword(s):

Low Income ◽

Multiple Logistic Regression Analysis ◽

Sociodemographic Factors ◽

Cross Sectional Study ◽

Internet Survey ◽

Protective Measure ◽

Attitudes And Beliefs ◽

Perceived Effectiveness ◽

Cross Sectional ◽

Vaccine Acceptance

Vaccination could be a key protective measure against coronavirus disease 2019 (COVID-19), and it is important to understand the acceptability of the COVID-19 vaccine among the general public. However, there is no study on the acceptance of a COVID-19 vaccine in Japan. Therefore, this study aimed to describe the COVID-19 vaccine acceptance and hesitancy situation in Japan and assess the factors associated with such issues. This was a cross-sectional study based on an internet survey completed by 2956 people. Participants were asked to indicate how likely they were to get vaccinated for COVID-19. In addition, the participants responded to questions regarding sociodemographic factors, attitudes, and beliefs regarding COVID-19 infection and vaccination. The proportion of participants with a high likelihood of getting a COVID-19 vaccine was 62.1%. Multiple logistic regression analysis showed that vaccine acceptance was lower among several sociodemographic groups, such as women, adults aged 20–49 years, and those with a low-income level. Several psychological factors, especially the perceived effectiveness of the COVID-19 vaccine, and willingness to protect others by getting oneself vaccinated, were associated with vaccine acceptance. Our results indicate that the perceived effectiveness of the vaccine and willingness to protect others may play an important role in the acceptance of the COVID-19 vaccine.

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Malaria among migrants in a university hospital in Colombia during 2018: A case series

Tropical Doctor ◽

10.1177/0049475520981301 ◽

2020 ◽

pp. 004947552098130

Author(s):

Fabián R Carreño-Almánzar ◽

Adán Coronado-Galán ◽

Sonia A Cala-Gómez ◽

Agustín Vega-Vera

Keyword(s):

Latin American ◽

Previous History ◽

Case Series ◽

Cross Sectional Study ◽

Imported Malaria ◽

University Hospital ◽

Sectional Study ◽

Cross Sectional ◽

History Of ◽

Clinical Profiles

Imported malaria has increased in Colombia since 2015 and has been attributed to migrants coming from Venezuela. We present a series of malaria cases, nested in a retrospective cross-sectional study between 2017 and 2018, aimed at calculating the prevalence of medical diseases among immigrants in a University Hospital in Colombia. Among 154 immigrants admitted for medical causes between 2017 and 2018, 8 were diagnosed with malaria, all due to Plasmodium vivax. Of these, seven had uncomplicated malaria, five had a previous history of malaria, one was critically ill, but none died. We highlight that, similar to other case series of imported malaria, Latin American migrants were young, with similar clinical profiles, having a low proportion of severe cases, and P. vivax was the most frequent cause.

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School-Time Movement Behaviors and Fundamental Movement Skills in Preschoolers: An Isotemporal Reallocation Analysis

Perceptual and Motor Skills ◽

10.1177/00315125211013196 ◽

2021 ◽

pp. 003151252110131

Author(s):

Clarice Maria de Lucena Martins ◽

Cain Craig Truman Clark ◽

Rafael Miranda Tassitano ◽

Anastácio Neco de Souza Filho ◽

Anelise Reis Gaya ◽

...

Keyword(s):

Low Income ◽

Motor Development ◽

Compositional Analysis ◽

Cross Sectional Study ◽

Fine Motor ◽

Cross Sectional ◽

Movement Skills ◽

School Time ◽

Fundamental Movement Skills ◽

Time Movement

Little is known of how reallocations of time spent in different movement behaviors during preschool might relate to preschoolers’ fundamental movement skills (FMS), a key predictor of later physical activity (PA). Thus, the aim of this study was to examine (a) whether preschoolers’ school-time movement was associated with their FMS and (b) the effects on FMS of reallocating time between PA and sedentary behavior (SB). This was a cross-sectional study, using intervention data with Brazilian low-income preschoolers. We observed Brazilian preschoolers of both sexes ( Mage = 4.5, SD = 0.8 years-old; 101boys) over 10 hours of school-time and objectively assessed their PA and SB with Actigraph wGT3X and their FMS with the Test of Gross Motor Development – Second Edition. We explored the associations between school-time movement behaviors and FMS and between reallocated school-time movement behaviors and FES using compositional analysis in R (version 1.40-1), robCompositions (version 0.92-7), and lmtest (version 0.9-35) packages. This isotemporal reallocation showed that, for manipulative skills, reallocating time (5, 10, and 15 minutes, respectively) from light PA to SB was associated with increasing skill (0.14, 0.28, and 0.42 FMS units), raising questions as to whether fine motor activity occurred during SB. Thus, school-time movement significantly predicted FMS, with a modest increase in SB, at the expense of light PA eliciting improved manipulative skills.

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Seroprevalence of hepatitis E virus in risk populations and blood donors in a referral hospital in the south of Brazil

Scientific Reports ◽

10.1038/s41598-021-85365-5 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Marisa Boff Costa ◽

Michele Soares Gomes Gouvêa ◽

Samira Chuffi ◽

Gustavo Hirata Dellavia ◽

Felipe Ornel ◽

...

Keyword(s):

Low Income ◽

Hepatitis E Virus ◽

Blood Donors ◽

Total Sample ◽

Hepatitis E ◽

Cross Sectional Study ◽

Elisa Test ◽

Confirmatory Test ◽

Cross Sectional ◽

Populations At Risk

AbstractThe prevalence of anti-hepatitis E virus (HEV) antibodies has a high heterogeneity worldwide. South American data are still scarce. The aim of this study was to evaluate the prevalence of HEV in populations at risk in comparison to blood donors (BD). A cross-sectional study was carried out in adults of different risk populations including crack users (CK), residents in a low income area (LIA), cirrhotic (CIR) and liver transplant patients (LT) compared with BD. The WANTAI HEV ELISA test was used and real-time PCR (in-house for screening and ALTONA as confirmatory test) for HEV RNA screening. A total of 400 participants were included. Anti-HEV IgG was positive in 19.5% of the total sample, reaching the highest rate in the CIR group, 22.5%, followed by CK, LT, and LIA (20%, 18.7%, and 17.5%, respectively). The prevalence found in BD individuals was of 18.7% (p = NS). Anti-HEV IgM was positive in only 1.5% of the sample (6/400). No blood or stools samples were positive for HEV RNA. The seroprevalence reported is among the highest rates ever found in Brazil. Considering the intense diagnostic investigation, data show that HEV circulation is more common that might be expected in our country.

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Mix of destinations and sedentary behavior among Brazilian adults: a cross-sectional study

BMC Public Health ◽

10.1186/s12889-020-10123-7 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Alex Antonio Florindo ◽

Gavin Turrell ◽

Leandro Martin Totaro Garcia ◽

João Paulo dos Anjos Souza Barbosa ◽

Michele Santos Cruz ◽

...

Keyword(s):

Built Environment ◽

Sedentary Behavior ◽

Latin American ◽

Cross Sectional Study ◽

Sao Paulo ◽

Sitting Time ◽

São Paulo ◽

Related Factors ◽

Cross Sectional ◽

Economies In Transition

Abstract Background Sedentary behavior is influenced by contextual, social, and individual factors, including the built environment. However, associations between the built environment and sitting time have not been extensively investigated in countries with economies in transition such as Brazil. The objective of this study is to examine the relationship between sitting-time and access to a mix of destinations for adults from Sao Paulo city, Brazil. Methods This study uses data from the Health Survey of Sao Paulo. Sedentary behavior was assessed by a questionnaire using two questions: total sitting time in minutes on a usual weekday; and on a usual weekend day. The mix of destinations was measured by summing the number of facilities (comprising bus stops, train/subway stations, parks, squares, public recreation centres, bike paths, primary health care units, supermarkets, food stores, bakeries, and coffee-shops) within 500 m of each participant’s residence. Minutes of sitting time in a typical weekday and weekend day were the outcomes and the mix of destinations score in 500 m buffers was the exposure variable. Associations between the mix of destinations and sitting time were examined using multilevel linear regression: these models accounted for clustering within census tracts and households and adjusted for environmental, sociodemographic, and health-related factors. Results After adjustment for covariates, the mix of destinations was inversely associated with minutes of sitting time on a weekday (β=− 8.8, p=0.001) and weekend day (β=− 6.1, p=0.022). People who lived in areas with a greater mix of destinations had shorter average sitting times. Conclusion Greater mix of destinations within 500 m of peoples’ residences was inversely associated with sitting time on a typical weekday and weekend day. In Latin American cities like Sao Paulo built environments more favorable for walking may contribute to reducing sedentary behavior and prevent associated chronic disease.

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