Economic impact of localized cutaneous leishmaniasis on adult patients of a referral service in Belo Horizonte, Minas Gerais State, Brazil

Cutaneous leishmaniasis (CL) is a disease associated with low-income populations. Thus, in assessing the burden of this disease, it is important to include its economic impact on individuals. We aimed to evaluate CL economic impact on patients treated at a referral service in the State of Minas Gerais, Brazil. This is a cross-sectional study based on the analysis of interviews and medical records from which we assembled direct medical and non-medical costs related to CL, from a societal perspective. One hundred patients were included; 50% had a monthly per capita income of up to USD 259.60 and spent on average USD 187.32 with the disease, representing an average monthly impact of 22.5% (USD 133.80). The disease imposed direct medical costs, such as: private medical appointments, medications, medical exams, dressing material, and co-participation in health insurances. Direct non-medical costs were mainly related to patients’ transportation to health centers (USD 4,911.00), but also included medically-necessary care, food, and domestic and business outsourcing services. Although the Brazilian public health system guarantees access to health care, CL still represents a substantial economic impact for patients. The main action to reduce the expenses with this disease is decentralizing services for CL diagnosis and therapeutic approach, as well as increasing their efficiency.

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Conhecimento de enfermeiros em relação a sepse: estudo transversal

Revista Recien - Revista Científica de Enfermagem ◽

10.24276/rrecien2021.11.34.160-167 ◽

2021 ◽

Vol 11 (34) ◽

pp. 160-167

Author(s):

André Luiz Silva Alvim ◽

Arley Lucas de Souza Nunes ◽

Lucas Rafael de Jesus Alves ◽

Michelle Bárbara Silva ◽

Rafaela Tamara Rocha ◽

...

Keyword(s):

Signs And Symptoms ◽

Cross Sectional Study ◽

Minas Gerais ◽

Formation Time ◽

Multiple Choice Questions ◽

Current Position ◽

Chi Square ◽

Cross Sectional ◽

Training Time ◽

Belo Horizonte

Analisar o conhecimento de enfermeiros em relação a sepse e as novas atualizações do consenso Sepsis-3. Estudo transversal realizado com 123 enfermeiros de um hospital geral localizado na região de Belo Horizonte, Minas Gerais, Brasil. Foi aplicado um questionário estruturado com 10 questões de múltipla escolha. Analisou-se dados por meio de estatística descritiva, teste qui-quadrado e regressão logística múltipla. A idade dos participantes variou de 23 a 54 anos, com média de 34 (±7,4). A maioria era do sexo feminino (68,3%) com tempo de formação igual ou superior a 5 anos (50,4%). O tempo de formação (p=0,011) e período no cargo atual (p=0,006) foram associados ao conhecimento satisfatório em relação a Sepse. Conclui-se que o tempo de formação e o período no cargo atual tiveram relação com o conhecimento satisfatório, no entanto, os resultados precisam ser interpretados com cautela entre os participantes deste estudo.Descritores: Sepse, Qualidade da Assistência à Saúde, Sinais e Sintomas, Equipe de Enfermagem. Knowledge of nurses in relation to sepsis: a cross-section studyAbstract: To analyze the knowledge of nurses regarding sepsis and the new updates to the Sepsis-3 consensus. Cross-sectional study carried out with 123 nurses from a general hospital located in the region of Belo Horizont located in Minas Gerais, Brazil. A structured questionnaire with 10 multiple-choice questions was applied. The data were analyzed using descriptive statistics, chi-square test and multiple logistic regression. The age of the participants ranged from 23 to 54 years, with an average of 34 (± 7.4). The majority were female (68.3%) with training time equal to or greater than 5 years (50.4%). Formation time (p=0.011) and period in current position (p=0.006) were associated with satisfactory knowledge in relation to Sepsis. The conclusion showed that formation time and the period in the current position were related to satisfactory knowledge, however, the results need to be interpreted with caution among the participants of this study.Descriptors: Sepsis, Quality of Health Care, Signs and Symptoms, Nursing Team. Conocimiento de enfermeras en relación con sepsis: un estudio transversalResumen: Analizar el conocimiento de las enfermeras sobre la sepsis y las nuevas actualizaciones del consenso Sepsis-3. Estudio transversal realizado con 123 enfermeras de un hospital general ubicado en la región de Belo Horizonte, Minas Gerais, Brasil. Se aplicó un cuestionario estructurado con 10 preguntas de opción múltiple. Los datos se analizaron mediante estadística descriptiva, prueba de ji cuadrado y regresión logística múltiple. La edad de los participantes osciló entre 23 y 54 años, con un promedio de 34 (±7,4). La mayoría eran mujeres (68.3%) con un tiempo de entrenamiento igual o mayor a 5 años (50.4%). El tiempo de entrenamiento (p=0,011) y el período en la posición actual (p=0,006) se asociaron con un conocimiento satisfactorio en relación con la sepsis. La conclusión mostro que el tiempo transcurrido desde la graduación y el período en el puesto actual se relacionaron con un conocimiento satisfactorio, sin embargo, los resultados deben interpretarse con cautela entre los participantes de este estudio.Descriptores: Sepsis, Calidad de la Atención de Salud, Signos y Síntomas, Grupo de Enfermería.

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Factors associated with alcohol intake and alcohol abuse among women in Belo Horizonte, Minas Gerais State, Brazil

Cadernos de Saúde Pública ◽

10.1590/s0102-311x2013000700018 ◽

2013 ◽

Vol 29 (7) ◽

pp. 1449-1459 ◽

Cited By ~ 13

Author(s):

Ísis Eloah Machado ◽

Francisco Carlos Félix Lana ◽

Mariana Santos Felisbino-Mendes ◽

Deborah Carvalho Malta

Keyword(s):

Alcohol Use ◽

Alcohol Abuse ◽

Alcohol Intake ◽

Cross Sectional Study ◽

Minas Gerais ◽

Adult Women ◽

Cross Sectional ◽

Factors Associated ◽

Minas Gerais State ◽

Belo Horizonte

The main objective of this cross-sectional study was to analyze factors associated with alcohol consumption among adult women living in Belo Horizonte, Minas Gerais State, Brazil, in 2011. Data for Belo Horizonte were obtained from the VIGITEL system (Telephone-Based Surveillance of Risk and Protective Factors for Chronic Diseases). Alcohol use was defined as self-reported intake of at least one dose in the previous 30 days; alcohol abuse was defined as four or more doses on at least one occasion during the same period. Polytomous logistic regression was used to evaluate factors associated with alcohol use and abuse. Alcohol use was more prevalent among women 25 to 34 years of age. Alcohol abuse was associated with age, schooling, health status, and smoking. The results suggest the need for policies to prevent alcohol abuse among women, especially targeting those who are younger, single, smokers, and with more education.

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Prevalence of elimination stomas in a microregion in the north of Minas Gerais

ESTIMA Brazilian Journal of Enterostomal Therapy ◽

10.30886/estima.v16.654_in ◽

2018 ◽

Author(s):

Elisangela Barros ◽

Eline Borges ◽

Célia Oliveira ◽

Keyword(s):

Low Income ◽

Cross Sectional Study ◽

Minas Gerais ◽

Clinical Aspects ◽

Cross Sectional ◽

The North ◽

The People ◽

Colon And Rectum ◽

Main Complication

Objectives: To estimate the prevalence of people with elimination stoma and to characterize them for sociodemographic and clinical aspects. Method: A descriptive cross-sectional study with a sample of 27 patients with elimination stomas residing in a microregion in the north of Minas Gerais, who met the inclusion criteria. The data collected were recorded in an instrument used in previous studies and analyzed using descriptive statistics. Study approved by the Ethics Committee. Results: The prevalence of people with stoma was 2.16/10.000, the sample contained 55.6% of men, 40.7% were married, mean age 59.1 years, 59.2% were literate and 74.0% had low income; 59.3% of the stomas were cancerous, more frequent colon and rectum tumours, 70.4% of the stomas were deﬁnitive, and 74.0% were colostomies. Dermatitis was the main complication and 68.2% of the patients presented eﬄuent of pasty consistency and performed self-care. Conclusion: The prevalence of people with stoma was like that of other municipalities in Minas Gerais and below that expected by the National and International Ostomized Associations. The characterization of the people, of the stomas and the management of these, will contribute for health professionals and managers to review the assistance protocols used in the studied microregion.

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Medical costs and out-of-pocket expenditures associated with multimorbidity in China: quantile regression analysis

BMJ Global Health ◽

10.1136/bmjgh-2020-004042 ◽

2021 ◽

Vol 6 (2) ◽

pp. e004042

Author(s):

Yang Zhao ◽

Rifat Atun ◽

Kanya Anindya ◽

Barbara McPake ◽

Tiara Marthias ◽

...

Keyword(s):

Chronic Diseases ◽

Medical Cost ◽

Low Income ◽

Medical Costs ◽

Cross Sectional Study ◽

Cross Sectional ◽

Middle Income ◽

Nationally Representative ◽

The Cost ◽

The Impact

ObjectiveMultimorbidity is a growing challenge in low-income and middle-income countries. This study investigates the effects of multimorbidity on annual medical costs and the out-of-pocket expenditures (OOPEs) along the cost distribution.MethodsData from the nationally representative China Health and Retirement Longitudinal Study (CHARLS 2015), including 10 592 participants aged ≥45 years and 15 physical and mental chronic diseases, were used for this nationally representative cross-sectional study. Quantile multivariable regressions were employed to understand variations in the association of chronic disease multimorbidity with medical cost and OOPE.ResultsOverall, 69.5% of middle-aged and elderly Chinese had multimorbidity in 2015. Increased number of chronic diseases was significantly associated with greater health expenditures across every cost quantile groups. The effect of chronic diseases on total medical cost was found to be larger among the upper tail than those in the lower tail of the cost distributions (coefficients 12, 95% CI 6 to 17 for 10th percentile; coefficients 296, 95% CI 71 to 522 for 90th percentile). Annual OOPE also increased with chronic diseases from the 10th percentile to the 90th percentile. Multimorbidity had larger effects on OOPE and was more pronounced at the upper tail of the health expenditure distribution (regression coefficients of 8 and 84 at the 10th percentile and 75th percentile, respectively).ConclusionMultimorbidity is associated with escalating healthcare costs in China. Further research is required to understand the impact of multimorbidity across different population groups.

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

Public Health Nutrition ◽

10.1017/s1368980021000392 ◽

2021 ◽

pp. 1-10

Author(s):

Camila S Ferreira ◽

Catarina M Azeredo ◽

Ana Elisa M Rinaldi

Keyword(s):

Dominican Republic ◽

Social Inequality ◽

Latin American ◽

Low Income ◽

Social Inequalities ◽

Weighted Least Squares ◽

Cross Sectional Study ◽

Demographic And Health Surveys ◽

Cross Sectional ◽

Simultaneous Decrease

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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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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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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33. Concerning Trends of Pediatric Leprosy in Minas Gerais, Brazil and Associations with Number of Municipality Medical Facilities

Open Forum Infectious Diseases ◽

10.1093/ofid/ofaa417.032 ◽

2020 ◽

Vol 7 (Supplement_1) ◽

pp. S17-S17

Author(s):

Taylor Landay ◽

Julie A Clennon ◽

José A Ferreira ◽

Lucia A Fraga ◽

Maria Aparecida F Grossi ◽

...

Keyword(s):

Cross Sectional Study ◽

Minas Gerais ◽

Chi Square ◽

Cross Sectional ◽

Period 2 ◽

Time Period ◽

Medical Facilities ◽

Age Of Diagnosis ◽

Using Data ◽

Incident Cases

Abstract Background Leprosy in children under 15 years of age, and in particular, the presence of leprosy grade 2 disability (G2D) in children, signifies ongoing transmission and the need for improved surveillance. Our objective was to describe the epidemiology of pediatric leprosy in Minas Gerais, Brazil and to explore associations with access to medical facilities. Methods A cross-sectional study was conducted using data from the Brazilian Notifiable Diseases Surveillance System (SINAN) from 2002–2017. Incident cases were included if they resided in a municipality with both adult and pediatric cases. Municipalities were divided by the number of medical facilities per municipality: < 5, 5–17, and 18 or higher. Analyses compared pediatric cases across two time periods (2002–2009 and 2010–2017) and number of medical facilities / municipality using chi-square, t-tests, and logistic regression. Results A total of 27,725 cases were reported with 1,611 under 15 years of age. Overall incidence declined from 34.8 per 100,000 to 13.6 per 100,000 during the study period with pediatric incidence declining from 2.6 per 100,000 to 0.8 per 100,000. Time period 2 (TP2) showed an increase in the proportion of pediatric G2D (2.58% vs 1.91%, p < 0.0001) when compared to time period 1 (TP1). Mean age of diagnosis in children was younger in TP2 then in TP1 (10.06 vs 10.43, p=0.02). In 2017, the pediatric incidence in municipalities with the fewest medical facilities was 0.95 per 100,000 compared to 0.23 per 100,000 in municipalities with > 5 facilities (p=0.009). There was significantly higher odds of disability at diagnosis (grades 1 and 2) in pediatric cases residing in municipalities with < 5 medical facilities (aOR 1.88; 95% CI 1.37–2.59), adjusted for age and sex. See map (Fig 1). Figure 1. Cases of Pediatric Disability By Number of Municipality Medical Facilities from 2002–2017 (White areas without reported pediatric leprosy) Conclusion The increasing proportion of G2D in children in the second half of the study period despite declining incidence suggest occult infections among children and adults alike in Minas Gerais. Furthermore, the average age of diagnosis in children should increase, not decrease, if M. leprae transmission was truly declining. Lastly, the association between fewer municipality health facilities and increased disability suggest barriers to timely diagnosis and a critical area of focus for research into access to healthcare and leprosy risk. Disclosures All Authors: No reported disclosures

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