[Show abstract][Hide abstract] ABSTRACT: sec> OBJECTIVE
To analyze the prevalence of bullying and its associated factors in Brazilian adolescents.
Data were used from a population-based household survey conducted by the Urban Health Observatory (OSUBH) utilizing probability sampling in three stages: census tracts, residences, and individuals. The survey included 598 adolescents (14-17 years old) who responded questions on bullying, sociodemographic characteristics, health-risk behaviors, educational well-being, family structure, physical activity, markers of nutritional habits, and subjective well-being (body image, personal satisfaction, and satisfaction with their present and future life). Univariate and multivariate analysis was done using robust Poisson regression.
The prevalence of bullying was 26.2% (28.0% among males, 24.0% among females). The location of most bullying cases was at or on route to school (70.5%), followed by on the streets (28.5%), at home (9.8%), while practicing sports (7.3%), at parties (4.6%), at work (1.7%), and at other locations (1.6%). Reports of bullying were associated with life dissatisfaction, difficulty relating to parents, involvement in fights with peers and insecurity in the neighborhood.
A high prevalence of bullying among participating adolescents was found, and the school serves as the main bullying location, although other sites such as home, parties and workplace were also reported. Characteristics regarding self-perception and adolescent perceptions of their environment were also associated with bullying, thus advancing the knowledge of this type of violence, especially in urban centers of developing countries.
Revista de saude publica 08/2015; 49:1-10. DOI:10.1590/S0034-8910.2015049005188 · 0.73 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Health status is often analyzed in population surveys. Self-rated health (SRH) is a single-item summary measure of the perception of one's health. In Brazil, studies on the SRH of adolescents remain scarce, especially those aiming to understand the domains that compose this construct. Therefore, the aim of this study is to determine the prevalence of poor SRH and its associated factors among 11- to 13-year-olds and 14- to 17-year-olds living in a large urban center in Brazil. This cross-sectional study was conducted using a household survey across Belo Horizonte that included 1,042 adolescents. Stratified logistic regression models were used for each age group to assess the associations between worse SRH and the following variables: socio-demographic, social and family support, lifestyles, psychological health, and anthropometry. Approximately 11% (95% CIs = 8.7-13.6) of the studied adolescents rated their health as poor, and SHR decreased with age among males and females. This trend was more pronounced among girls (from 6.9% among 11- to 13-year-old girls to 16.9% among 14- to 17-year-old girls) than boys (from 8.3% among 11- to 13-year-old boys to 11% among 14- to 17-year-old boys). Worse SRH was associated with family support (as assessed by the absence of parent-adolescent conversations; odds ratio [OR] = 3.5 among 11- to 13-year-olds), family structure (OR = 2.8 among 14- to 17-year-olds), and argument reporting (OR = 8.2 among 14- to 17-year-olds). Among older adolescents, the consumption of fruit fewer than five times per week (OR = 2.4), life dissatisfaction (OR = 2.8), underweight status (OR = 6.7), and overweight status (OR = 2.7) were associated with poor SRH. As adolescents age, their universe expands from their relationship with their parents to include more complex issues, such as their lifestyles and life satisfaction. Therefore, these results suggest the importance of evaluating SRH across adolescent age groups and demonstrate the influence of the family environment (in addition to other factors) on negative health assessments, particularly among 14- to 17-year-olds.
PLoS ONE 07/2015; 10(7):e0132254. DOI:10.1371/journal.pone.0132254 · 3.23 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: This study aimed to determine if individual and socio-environmental characteristics can influence the self-rated health among Brazilian adolescents.
It included 1,042 adolescents from 11 to 17 years old who participated in the Beagá Health Study (Estudo Saúde em Beagá), a multistage household survey in an urban setting. Logistic regression analyses were performed to determine the association between the self-rated health and the following explanatory variables: sociodemographic factors, social support, lifestyle, physical and psychological health.
Good/very good and reasonable/poor/very poor self-rated health were reported by 88.5 and 11.5% of adolescents, respectively. The data on sociodemographic factors (SES), social support, lifestyle, psychological and physical health were associated with poor self-rated health (p ≤ 0.05). The associated variables were: age 14 - 17 years (OR =1.71; 95%CI 1.06 - 2.74), low SES (OR =1.68; 95%CI 1.05 - 2.69), few (OR = 2.53; 95%CI 1.44 - 4.46) and many quarrels in family (OR = 9.13; 95%CI 4.53 - 18.39), report of unkind and unhelpful peers (OR = 2.21; 95%CI 1.11 - 4.43), consumption of fruits < 5 times a week (OR = 1.78; 95CI% 1.07 - 2.95), physical inactivity (OR = 2.31; 95%CI 1.15 - 4.69), overweight (OR = 2.42; 95%CI 1.54 - 3.79) and low level of life satisfaction (OR = 2.31; 95%CI 1.34 - 3.98).
Poor self-rated health among adolescents was associated with individual and socio-environmental characteristics related to family, school and neighborhood issues. Quantifying the self-rated health according to the theoretical framework of the child's well-being should help in arguing that self-rated health might be a strong indicator of social inequities for the studied population.
Revista Brasileira de Epidemiologia 07/2015; 18(3):538-51. DOI:10.1590/1980-5497201500030002
[Show abstract][Hide abstract] ABSTRACT: There is a growing interest in evaluating the impact of neighborhood characteristics on health. The definition of neighborhood involves two main strategies, one using artificial boundaries, usually created for administrative purposes, and the other based on the individual's definition, namely the perceived neighborhood. The aim of this study was to identify factors associated with heterogeneity in the perceived neighborhood among participants in a health survey in Belo Horizonte, Minas Gerais State, Brazil. Ordinal logistic regression was used to determine and quantify this association. Larger size of the perceived neighborhood was associated with better socioeconomic status, positive employment status, positive assessment of aesthetic aspects and mobility within the neighborhood, active identification of problems in the neighborhood, less involvement in sports/leisure activities, and knowing more neighbors. The study's results can help produce more significant neighborhood definitions that are more consistent with residents' own perceptions, thereby favoring more accurate estimates of neighborhood impact on health.
Cadernos de saúde pública / Ministério da Saúde, Fundação Oswaldo Cruz, Escola Nacional de Saúde Pública 09/2014; 30(9):1935-1946. DOI:10.1590/0102-311X00176112 · 0.98 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Although human T-cell lymphotropic viruses (HTLV-1/2) were described over 30 years ago, they are relatively unknown to the
public and even to healthcare personnel. Although HTLV-1 is associated with severe illnesses, these occur in only approximately
10% of infected individuals, which may explain the lack of public knowledge about them. However, cohort studies are showing
that a myriad of other disease manifestations may trouble infected individuals and cause higher expenditures with healthcare.
Testing donated blood for HTLV-1/2 started soon after reliable tests were developed, but unfortunately testing is not available
for women during prenatal care. Vertical transmission can occur before or after birth of the child. Before birth, it occurs
transplacentally or by transfer of virus during cesarean delivery, but these routes of infection are rare. After childbirth,
viral transmission occurs during breastfeeding and increases with longer breastfeeding and high maternal proviral load. Unlike
the human immunodeficiency virus types 1 and 2, HTLV is transmitted primarily through breastfeeding and not transplacentally
or during delivery. In this study, we review what is currently known about HTLV maternal transmission, its prevention, and
the gaps still present in the understanding of this process.
[Show abstract][Hide abstract] ABSTRACT: The objective of this study was to examine the association between individual satisfaction with social and physical surroundings and the habit of smoking cigarettes. Data from the Health Survey of Adults from the metropolitan area of Belo Horizonte, Minas Gerais, Brazil, were used. Based on a probability sample, participants (n = 12,299) were selected among residents aged 20 years old or more. The response variable was the smoking habit and the explanatory variable of interest was the neighborhood perception. Potential confounding variables included demographic characteristics, health behaviors and other indicators of socioeconomic position. The prevalence of current smokers, former smokers and never smokers were 20.8, 14.1 and 65.1%, respectively; 74.4 and 25.5% of the participants were categorized as being more satisfied and less satisfied with the neighborhood, respectively. Compared to those who never smoked, former smokers (adjusted odds ratio = 1.40, 95% confidence interval 1.20 - 1.62) and current smokers (adjusted odds ratio = 1.17, 95% confidence interval 1.03 - 1.34) were less satisfied with the neighborhood compared to those who never smoked. The results of this study indicate there is an independent association between the smoking habit and a less satisfying neighborhood perception in the metropolitan region of Belo Horizonte, which does not depend on individual characteristics, traditionally reported as being associated with smoking.
Revista Brasileira de Epidemiologia 09/2014; 17(3):775-786. DOI:10.1590/1809-4503201400030016
[Show abstract][Hide abstract] ABSTRACT: This study aimed to analyze the prevalence of negative self-rated health and associated factors in the quilombola community (descendants of escaped slaves) in Vitória da Conquista, Bahia State, Brazil. A household survey was conducted with 797 adults in 2011. Data on self-rated health, socioeconomic and demographic characteristics, lifestyle, social support, health status, and access to health services were obtained through questionnaires. Multivariate logistic regression analysis was performed, adjusted for sex and age. Prevalence of negative self-rated health was 12.5%. After statistical modeling, the following variables remained associated with self-rated health: skin color, schooling, adequate consumption of fruits and vegetables, chronic illness, physical limitations, and at least one medical visit in the previous 12 months. Self-rated health was associated with socioeconomic/demographic dimensions, lifestyle, social support, and health status.
[Show abstract][Hide abstract] ABSTRACT: Systematic social observation has been used as a health research methodology for collecting information from the neighborhood physical and social environment. The objectives of this article were to describe the operationalization of direct observation of the physical and social environment in urban areas and to evaluate the instrument's reliability. The systematic social observation instrument was designed to collect information in several domains. A total of 1,306 street segments belonging to 149 different neighborhoods in Belo Horizonte, Minas Gerais, Brazil, were observed. For the reliability study, 149 segments (1 per neighborhood) were re-audited, and Fleiss kappa was used to access inter-rater agreement. Mean agreement was 0.57 (SD = 0.24); 53% had substantial or almost perfect agreement, and 20.4%, moderate agreement. The instrument appears to be appropriate for observing neighborhood characteristics that are not time-dependent, especially urban services, property characterization, pedestrian environment, and security.
Cadernos de saúde pública / Ministério da Saúde, Fundação Oswaldo Cruz, Escola Nacional de Saúde Pública 10/2013; 29(10):2093-2104. DOI:10.1590/0102-311X00086812 · 0.98 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Background:
Studies analyzing motivation factors that lead to blood donation have found altruism to be the primary motivation factor; however, social capital has not been analyzed in this context. Our study examines the association between motivation factors (altruism, self-interest, and response to direct appeal) and social capital (cognitive and structural) across three large blood centers in Brazil.
Study design and methods:
We conducted a cross-sectional survey of 7635 donor candidates from October 15 through November 20, 2009. Participants completed self-administered questionnaires on demographics, previous blood donation, human immunodeficiency virus testing and knowledge, social capital, and donor motivations. Enrollment was determined before the donor screening process.
Among participants, 43.5 and 41.7% expressed high levels of altruism and response to direct appeal, respectively, while only 26.9% expressed high levels of self-interest. More high self-interest was observed at Hemope-Recife (41.7%). Of participants, 37.4% expressed high levels of cognitive social capital while 19.2% expressed high levels of structural social capital. More high cognitive and structural social capital was observed at Hemope-Recife (47.3 and 21.3%, respectively). High cognitive social capital was associated with high levels of altruism, self-interest, and response to direct appeal. Philanthropic and high social altruism were associated with high levels of altruism and response to direct appeal.
Cognitive and structural social capital and social altruism are associated with altruism and response to direct appeal, while only cognitive social capital is associated with self-interest. Designing marketing campaigns with these aspects in mind may help blood banks attract potential blood donors more efficiently.
[Show abstract][Hide abstract] ABSTRACT: The incidence of human T-cell lymphotropic virus type 1 (HLTV-1)-associated myelopathy/tropical spastic paraparesis (HAM/TSP) is not well defined in the literature. Several studies have reported different incidence rates, and recent publications suggest a higher incidence and prevalence of HAM/TSP. The interdisciplinary HTLV Research Group (GIPH) is a prospective open cohort study of individuals infected with HTLV-1/2. This study describes the demographic data and HAM/TSP incidence rate observed in 181 HTLV-1-seropositive individuals and compares the results with previous reports in the literature. HAM/TSP was diagnosed on the basis of the World Health Organization diagnostic criteria and Castro-Costa et al., 2006. Seven HAM/TSP incident cases were observed during the follow-up. The HAM/TSP incidence density was 5.3 cases per 1,000 HTLV-1-seropositive cases per year (95% confidence interval: 2.6-10.9), with a mean follow-up of 7 ± 4 years (range: 1 month to 15 years). HAM/TSP was more frequent in women in their 40s and 50s with probable infection via the sexual route. The HAM/TSP incidence density among HTLV-1-seropositive cases observed in the present study is higher than that in previous studies. HAM/TSP may be underdiagnosed in countries like Brazil where HTLV infection is prevalent. Orientation and prevent transmission of HTLV programs are needed. Currently, preventing HTLV-1 transmission is the most effective way to reduce the impact of HAM/TSP on society.
AIDS research and human retroviruses 04/2013; 29(9). DOI:10.1089/AID.2013.0086 · 2.33 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Resumo Introdução: a urbanização desordenada caracteriza-se pela existência de agregados espaciais com diferentes condições socioeconômicas e ambientais e que apresentam condições propícias à proliferação de insetos, vetores de várias doenças, especial-mente da dengue. O presente estudo descreveu e comparou a incidência da dengue em determinadas áreas (denominadas estratos) com diferentes níveis de infestação e de resultados em relação às intervenções em curso em Belo Horizonte. Objetivo: determinar e quantificar a associação entre a ocorrência da dengue e indicadores de infestação vetorial e de intervenção no município de Belo Horizonte. Métodos: adotou--se estudo observacional com delineamento ecológico. Foi realizada análise univariada entre as taxas estimadas de incidência de dengue e as categorias dos indicadores en-tomológicos e de intervenção utilizando-se o modelo binomial negativo. Utilizaram-se subdivisões geográficas do município (estratos) como unidade geográfica de análise. Resultados: verificou-se heterogeneidade nas taxas de incidência de dengue entre os estratos (mínimo de 276,4 e máximo de 9398,1/100.000), com média de 3285,5. Estratos com índice de infestação predial (IIP) ≥3% apresentaram RR=2,9 (IC95%: 1,3–6,4), quan-do contrastados a estrados com IIP <2%. Em estratos com média de ovos ≥ 20, RR=3,3 (IC95%: 1,5–7,3), quando contrastados com aqueles com <10. Locais não acessados por recusa ou ausência de morador num percentual entre 10,0 e 24,9 apresentaram RR=7,9 (IC95%: 4,4–14,4) em relação àqueles cujo percentual de não acesso foi inferior a 10,0%. Já a cobertura de imóveis vistoriados em relação à meta não teve associação com a taxa de incidência da doença. Conclusões: índices de infestação e imóveis não aces-sados para o tratamento focal associaram-se ao elevado risco de ocorrência de dengue nos distritos sanitários e estratos de Belo Horizonte, ocorrendo ainda heterogeneidade entre estratos quanto à incidência da dengue. Palavras-chave: Dengue/epidemiologia; Dengue/prevenção & controle; Zonas Urba-nas; Entomologia. absTRacT Introduction: Unplanned, uncontrolled urbanization is characterized by areas with different socioeconomic and environmental conditions that are conductive to the proliferation of insects, vectors of several diseases, especially dengue. This study describes and compares dengue incidence in selected areas (called strata) with different levels of both infestation and results of active prevention measures carried out in Belo Horizonte. Objective: To determine and quantify the association of dengue incidence with indicators of vectorial infestation and preventive measures in the Municipality of Belo Horizonte. Methods: This is an observa-tional study with ecological approach. Univariate analysis was carried out to assess the estimated rates of dengue incidence and the categories of entomological and active
Revista da Associação Médica de Minas Gerais 04/2013; 22:265-273.
[Show abstract][Hide abstract] ABSTRACT: Introduction
Perceived discrimination is related to poor health and has been offered as one explanation for the persistence of health inequalities in some societies. In this study, we explore the prevalence and correlates of perceived discrimination in a large, multiracial Brazilian metropolitan area.
The study uses secondary analysis of a regionally representative household survey conducted in 2010 (n=12,213). Bivariate analyses and multiple logistic regression assess the magnitude and statistical significance of covariates associated with reports of any discrimination and with discrimination in specific settings, including when seeking healthcare services, in the work environment, in the family, in social occasions among friends or in public places, or in other situations.
Nearly 9% of the sample reported some type of discrimination. In multivariable models, reports of any discrimination were higher among people who identify as black versus white (OR 1.91), higher (OR 1.21) among women than men, higher (OR 1.33) among people in their 30’s and lower (OR 0.63) among older individuals. People with many health problems (OR 4.97) were more likely to report discrimination than those with few health problems. Subjective social status (OR 1.23) and low social trust (OR 1.27) were additional associated factors. Perceived discrimination experienced while seeking healthcare differed from all other types of discrimination, in that it was not associated with skin color, social status or trust, but was associated with sex, poverty, and poor health.
There appear to be multiple factors associated with perceived discrimination in this population that may affect health. Policies and programs aimed at reducing discrimination in Brazil will likely need to address this wider set of interrelated risk factors across different populations.
International Journal for Equity in Health 12/2012; 11(1):80. DOI:10.1186/1475-9276-11-80 · 1.71 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Dengue virus (DENV) is the most prevalent arbovirus in the world, found mainly in tropical regions. As clinical manifestations present frequently as nonspecific febrile illness, laboratory diagnosis is essential to confirm DENV infections and for epidemiological studies. Recombinant envelope (E) antigens of four serotypes of DENV were used to develop an immunoglobulin G enzyme-linked immunosorbent assay (IgG-ELISA). To evaluate the IgG-ELISA, a panel of serum samples that had been tested previously by a plaque reduction neutralization test (PRNT) was investigated for the presence of anti-E antibodies against the four DENV serotypes. IgG-ELISA was found to have a sensitivity (91%) and specificity (98%) at a receiver-operating characteristic (ROC) optimized cutoff and demonstrated high performance as well as good indexes. A concordance of 97% was achieved between both assays, and only 21/704 (3%) samples were not concordant. The results of the present study demonstrate a moderate correlation between neutralizing antibody titers and IgG-ELISA values. These findings indicate that the recombinant protein-based IgG-ELISA is a suitable method for routine serodiagnosis, monitoring and seroepidemiological studies of DENV infections.
[Show abstract][Hide abstract] ABSTRACT: Background and Objectives Higher risk of HIV infection could be associated with test seeking, which is one motivation for donating blood. Cognitive social capital is defined as the social support, trust and co-operation that guide community behaviour. Structural social capital refers to an individual’s participation in institutions and organizations. The association between social capital and test seeking was assessed.
Materials and Methods A survey of over 7500 donors in three Brazilian blood centres was conducted. Test seeking was classified into four non-overlapping categories (non-test seeker, possible, presumed and self-disclosed test seekers) using one direct and two indirect questions. Social capital was summarized into cognitive and structural categorizations. Multivariable logistic regression analysis was performed.
Results Compared with non-test seekers (62% of survey respondents), cognitive social capital was higher for each category of test seeking (OR = 1.1, 7.4, 7.1, P < 0.05 respectively). Male gender, lower education and lower income were also significantly associated with test seeking.
Conclusion As test seekers appear to have strong social networks, blood banks may leverage this to convince them to seek testing at other locations.