scholarly journals Prevalence of health services usage and associated factors in the Amazon region of Brazil: a population-based cross-sectional study

BMJ Open ◽  
2017 ◽  
Vol 7 (11) ◽  
pp. e017966 ◽  
Author(s):  
Maria Elizete A Araujo ◽  
Marcus T Silva ◽  
Tais F Galvao ◽  
Mauricio G Pereira

ObjectivesTo estimate the prevalence of healthcare use and associated factors in the Manaus metropolitan region and to describe the reasons for lack of access.DesignCross-sectional population-based study.SettingA survey conducted between May and August of 2015 in eight cities from Manaus metropolitan region, Amazonas, Brazil.Participants4001 adults ≥18 years of age.Primary outcomes measuresPhysician visits, dentist visits and hospitalisations in the last 12 months were the primary outcomes. Associated factors were investigated through the calculation of prevalence ratio (PR) obtained by hierarchical Poisson regression modelling.Results4001 adults were included in the study, 53% of whom were women. The self-reported prevalence of medical visits was 77% (95% CI 75% to 77%); dentist visits, 36% (95% CI 34% to 37%) and hospital admission, 7% (95% CI 6% to 7%). Physician visits were higher in women PR=1.18 (95% CI 1.14 to 1.23), the elderly PR=1.18 (95% CI 1.10 to 1.26) and people with health insurance PR=1.14 (95% CI 1.10 to 1.19). Dentist visits declined with older age PR=0.38 (95% CI 0.30 to 0.49), lower education level PR=0.62 (95% CI 0.51 to 0.74) and lower economic class PR=0.65 (95% CI 0.57 to 0.75). Hospitalisations were found to be twice as frequent for women than for men and three times as frequent among those who reported very poor health status. Among the individuals who did not receive medical attention in the previous 2 weeks, 58% reported lack of facilities or appointment unavailable and 14% reported lack of doctors.ConclusionWhile more than half visited the doctor in the last year, a lower proportion of people with socioeconomic inequities visited the dentist. Organisational and service policies are needed to increase equity in health services in the region.

2020 ◽  
pp. 1-11
Author(s):  
Tais Freire Galvao ◽  
Gustavo Magno Baldin Tiguman ◽  
Bruno Vianei Real Antonio ◽  
Raquel Rodrigues Ferreira Rocha de Alencar ◽  
Leila Posenato Garcia ◽  
...  

2011 ◽  
Vol 27 (suppl 2) ◽  
pp. s198-s208 ◽  
Author(s):  
Marilisa Berti de Azevedo Barros ◽  
Priscila Maria Stolses Bergamo Francisco ◽  
Margareth Guimarães Lima ◽  
Chester Luiz Galvão César

The aim of the present study was to assess social inequalities in health status, health behavior and the use of health services based on education level. A population-based cross-sectional study was carried out involving 1,518 elderly residents of Campinas, São Paulo State, Brazil. Significant demographic and social differences were found between schooling strata. Elderly individuals with a higher degree of schooling are in greater proportion alcohol drinkers, physically active, have healthier diets and a lower prevalence of hypertension, diabetes, dizziness, headaches, back pain, visual impairment and denture use, and better self-rated health. But, there were no differences in the use of health services in the previous two weeks, in hospitalizations or surgeries in the previous year, nor in medicine intake over the previous three days. Among elderly people with hypertension and diabetes, there were no differences in the regular use of health services and medication. The results demonstrate social inequalities in different health indicators, along with equity in access to some health service components.


2014 ◽  
Vol 35 (4) ◽  
pp. 35-41 ◽  
Author(s):  
Joana Darc Chaves Cardoso ◽  
Rosemeiry Capriata de Souza Azevedo ◽  
Annelita Almeida Oliveira Reiners ◽  
Cecília Victorazzo Louzada ◽  
Mariano Martinez Espinosa

The purpose of this study was to examine the prevalence of bad self-rated health in the elderly and associated demographic and socioeconomic factors. This was an epidemiological, cross-sectional study. Data were collected through interviews using the BOAS (Brazil Old Age Schedule) questionnaire. The study included 573 elderly residents in the urban area of Cuiabá-MT, Brazil. The adopted measure of association was the prevalence ratio. For multivariate analysis, multiple Poisson regression was used. The prevalence of poor/very poor self-rated health was 30.9% and the associated factors were income, number of morbidities and urinary incontinence. The association of demographic and socioeconomic factors with poor/very poor self-rated health among the elderly in this study shows the need for assistance and policies that minimize the impact of these factors on the lives and health of the elderly.


2021 ◽  
Vol 39 ◽  
Author(s):  
Gustavo Magno Baldin Tiguman ◽  
Marina Borges Dias de Almeida ◽  
Marcus Tolentino Silva ◽  
Tais Freire Galvao

ABSTRACT Objective: The availability of hazardous products in households increases the risks of poisoning. The present study aimed to assess the frequency and associated factors of the availability and storage of hazardous products in residences in the metropolitan region of Manaus. Methods: Population-based and cross-sectional study conducted in 2015 with adults selected with three-stage probabilistic sampling. Participants were interviewed face-to-face. Prevalence ratio (PR) of the presence of hazardous products (presence of chumbinho [illegal anti-cholinesterase rodenticide], artisanal cleaning products, and unsafe storage of these products and medications) and 95% confidence intervals (95%CI) were calculated with Poisson regression with robust variance, weighted by the complex sampling method adopted. Results: A total of 4,001 participants was included, of which 53.0% (95%CI 51.5-54.6) reported presence of hazardous products in their households, 36.3% (95%CI 34.8-37.8) had unsafe storage, 16.2% (95%CI 15.1-17.4) had artisanal cleaning products, and 8.2% (95%CI 7.4-9.1) had chumbinho. Households with children ≤5 years old had safer storage (PR=0.78; 95%CI 0.71-0.86) and more artisanal products (PR=1.30; 95%CI 1.11-1.51). Presence of artisanal products was higher in lower educational levels (PR=2.20; 95%CI 1.36-3.57) and lower economic classifications (PR=1.63; 95%CI 1.25-2.13). Conclusions: Over half of the households in the metropolitan region of Manaus kept hazardous products; one-third stored them unsafely. Artisanal cleaning products and chumbinho were frequently present. Households with children had safer storage of products, and socioeconomic factors affected the availability of such hazardous products.


Nutrition ◽  
2018 ◽  
Vol 55-56 ◽  
pp. 104-110 ◽  
Author(s):  
Luciana M.B. Stoffel ◽  
Francisco Wilker M.G. Muniz ◽  
Paulo R.G. Colussi ◽  
Cassiano K. Rösing ◽  
Eliane L. Colussi

BMJ Open ◽  
2018 ◽  
Vol 8 (11) ◽  
pp. e023398 ◽  
Author(s):  
Maria Elizete A Araujo ◽  
Marcus T Silva ◽  
Tais F Galvao ◽  
Bruno P Nunes ◽  
Mauricio G Pereira

ObjectivesTo estimate the prevalence of multimorbidity and to identify factors associated with it in the adult population from the metropolitan region of Manaus.DesignCross-sectional population-based study.SettingInterviews conducted between May and August of 2015 in eight cities that compose the metropolitan region of Manaus, Amazonas, Brazil.Participants4001 adults aged ≥18 years.Primary outcome measuresMultimorbidity, measured by the occurrence of ≥2 and ≥3 chronic diseases, was the primary outcome. The associated factors were investigated by calculating the prevalence ratio (PR) obtained by Poisson regression, with robust adjustment of the variance in a hierarchical model. A factor analysis was conducted to investigate multimorbidity clusters.ResultsHalf of the interviewees were women. The presence of a chronic disease was reported by 57.2% (95% CI 56.6% to 59.7%) of the interviewees, and the mean morbidity was 1.2 (1.1–1.2); 29.0% (95% CI 27.6% to 30.5%) reported ≥2 morbidities and 15.2% (95% CI 14.1% to 16.4%) reported ≥3 chronic conditions. Back pain was reported by one-third of the interviewees. Multimorbidity was highest in women, PR=1.66 (95% CI 1.50 to 1.83); the elderly, PR=5.68 (95% CI 4.51 to 7.15) and individuals with worse health perception, PR=3.70 (95% CI 2.73 to 5.00). Associated factors also included undergoing medical consultations, hospitalisation in the last year, suffering from dengue in the last year and seeking the same healthcare service. Factor analysis revealed a pattern of multimorbidity in women. The factor loading the most strength of association in women was heart disease. In men, an association was identified in two groups, and lung disease was the disease with the highest factorial loading.ConclusionMultimorbidity was frequent in the metropolitan region of Manaus. It occurred most often in women, in the elderly and in those with worse health perception.


BMJ Open ◽  
2021 ◽  
Vol 11 (2) ◽  
pp. e041755
Author(s):  
Srinivas Marmamula ◽  
Satya Brahmanandam Modepalli ◽  
Thirupathi Reddy Kumbham ◽  
Rajesh Challa ◽  
Jill E Keeffe

ObjectivesTo assess the prevalence of disabilities (vision, hearing, mobility, cognitive, self-care and communication) and non-communicable diseases (NCDs) among the elderly population in two districts in Telangana, India.DesignPopulation-based cross-sectional study using a cluster random sampling method to select the study clusters.SettingElderly population in Khammam and Warangal districts were recruited. Detailed interviews were conducted by trained community health workers. Personal and demographic information such as age, gender, level of education and a self-report of NCDs was collected. The Washington Disability Questionnaire was administered to assess the presence of disabilities.Participants1821 participants aged ≥60 years, 54.5% were women, and 73.3% had no education.Primary outcome measurePrevalence of disabilities and NCDs.ResultsOverall, the prevalence of at least disability was 20.3% (95% CI 16.3 to 24.9). The prevalence of self- reported disabilities were: seeing (5.9%; 95% CI 4.4 to 7.8), mobility (12.8%; 95% CI 9.7 to 16.8), hearing (3.6%; 95% CI 2.7 to 4.8), cognition (4.8%; 95% CI 3.5 to 6.7), self-care (3.3%; 95% CI 2.3 to 4.7) and communication (1.8%; 95% CI 1.2 to 2.6). Overall, the prevalence of at least one NCD was 34.2% (95% CI 30.9 to 37.7). Hypertension was the most common systemic condition (25.4%; 95% CI 22.4 to 28.7), followed by diabetes (9.0%; 95% CI 7.3 to 11.0), and body pains (muscle-skeletal) (9.9%; 95% CI 8.1 to 12.2).ConclusionEvery fifth elderly person in the districts of Khammam and Warangal in Telangana had at least one self-reported disability. Besides, a third of the elderly had at least one NCD. There is a definite need to develop comprehensive public health strategies to address disabilities and NCDs in Telangana.


BMJ Open ◽  
2021 ◽  
Vol 11 (7) ◽  
pp. e048554
Author(s):  
Hanyu Wang ◽  
Eric Frasco ◽  
Jie Shang ◽  
Minne Chen ◽  
Tong Xin ◽  
...  

ObjectivesThis study aims to explore the association between maternal depression and the loss of the only child under the family-planning (FP) policy.DesignCross-sectional data from a Chinese population-based study were analysed.SettingPopulation from 10 (5 rural and 5 urban) areas in China.ParticipantsAround 300 000 females were included in the study. The FP group was defined as women with one or two live births. Those with no surviving child were classified into the loss-of-only-child group. The non-FP group included women who had more than two live births. Logistic regression was used to assess the relationship between major depressive disorder (MDD) and family types, after stratification and adjustment.OutcomeMDD was assessed using the Composite International Diagnostic Inventory.ResultsThe odds of MDD are 1.42 times higher in the FP group in general (OR=1.42, 95% CI: 1.28 to 1.57), as opposed to the non-FP group. In particular, the odds of MDD are 1.36 times greater in the non-loss-of-only-child group (OR=1.36, 95% CI: 1.21 to 1.51) and 2.80 (OR=2.80, 95% CI: 0.88 to 8.94) times greater in the loss-of-only-child group, compared with the non-FP group. The associations between FP groups and MDD appeared to be stronger in the elderly population, in those who were married, less educated and those with a higher household income. The association was found progressively stronger in those who lost their only child.ConclusionsPeople in the FP group, especially those who lost their only child, are more susceptible to MDD than their counterparts in the non-FP group. Mental health programmes should give special care to those who lost their only child and take existing social policies and norms, such as FP policies, into consideration.


2014 ◽  
Vol 17 (3) ◽  
pp. 705-718 ◽  
Author(s):  
Iara Guimarães Rodrigues ◽  
Gustavo Pereira Fraga ◽  
Marilisa Berti de Azevedo Barros

Purpose: The aim of the present study was to identify factors associated with the occurrence of falls among elderly adults in a population-based study (ISACamp 2008). Methods: A population-based cross-sectional study was carried out with two-stage cluster sampling. The sample was composed of 1,520 elderly adults living in the urban area of the city of Campinas, São Paulo, Brazil. The occurrence of falls was analyzed based on reports of the main accident occurred in the previous 12 months. Data on socioeconomic/demographic factors and adverse health conditions were tested for possible associations with the outcome. Prevalence ratios (PR) were estimated and adjusted for gender and age using the Poisson multiple regression analysis. Results: Falls were more frequent, after adjustment for gender and age, among female elderly participants (PR = 2.39; 95% confidence interval (95%CI) 1.47 - 3.87), elderly adults (80 years old and older) (PR = 2.50; 95%CI 1.61 - 3.88), widowed (PR = 1.74; 95%CI 1.04 - 2.89) and among elderly adults who had rheumatism/arthritis/arthrosis (PR = 1.58; 95%CI 1.00 - 2.48), osteoporosis (PR = 1.71; 95%CI 1.18 - 2.49), asthma/bronchitis/emphysema (PR = 1,73; 95%CI 1.09 - 2.74), headache (PR = 1.59; 95%CI 1.07 - 2.38), mental common disorder (PR = 1.72; 95%CI 1.12 - 2.64), dizziness (PR = 2.82; 95%CI 1.98 - 4.02), insomnia (PR = 1.75; 95%CI 1.16 - 2.65), use of multiple medications (five or more) (PR = 2.50; 95%CI 1.12 - 5.56) and use of cane/walker (PR = 2.16; 95%CI 1.19 - 3,93). Conclusion: The present study shows segments of the elderly population who are more prone to falls through the identification of factors associated with this outcome. The findings can contribute to the planning of public health policies and programs addressed to the prevention of falls.


2014 ◽  
Vol 27 (5) ◽  
pp. 392-398 ◽  
Author(s):  
Andréa Mathes Faustino ◽  
Lenora Gandolfi ◽  
Leides Barroso de Azevedo Moura

Objective To verify whether there is a connection between the functional capacity of the elderly and the presence of violent situations in their daily lives. Methods A population-based cross-sectional study developed with 237 elderly individuals. Standard and validated research instruments were used. Results Mean age of 70.25 years (standard deviation of 6.94), 69% were female, 76% were independent in basic activities of daily living and 54% had a partial dependence on at least one instrumental activity. The most prevalent violence was psychological and the relation between being dependent on basic activities of daily living and suffering physical violence was statistically significant. Conclusion When the elderly needs assistance to perform self-care activities, there is a greater chance of exposure to a situation of abuse, such as physical violence.


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