[show abstract][hide abstract] ABSTRACT: The aim of this study was to investigate excess mortality from dengue in Greater Metropolitan Rio de Janeiro, Brazil, during an epidemic in 2007-2008. A Poisson dynamic model was tested to predict the number of deaths during these epidemic years. Inference was conducted with a Bayesian approach. Excess mortality was detected in March 2008 in children < 15 years. In addition, the highest number of reported dengue cases in Rio de Janeiro was in March and April 2008. Since the increase in mortality should be preceded by an increase in morbidity, one can hypothesize that there was excess mortality from dengue in children during the epidemic in Greater Metropolitan Rio de Janeiro in March 2008.
Cadernos de saúde pública / Ministério da Saúde, Fundação Oswaldo Cruz, Escola Nacional de Saúde Pública 10/2013; 29(10):2057-2070. · 0.83 Impact Factor
[show abstract][hide abstract] ABSTRACT: Obesity is a major global epidemic and a burden to society and health systems. It is well known risk factor for a number of chronic medical conditions with high morbidity and mortality. This study aimed to provide an estimate of the direct costs associated to outpatient and inpatient care of overweight and obesity related diseases in the perspective of the Brazilian Health System (SUS).
Population attributable risk (PAR) was calculated for selected diseases related to overweight and obesity and with the following parameters: Relative risk (RR) ≥ 1.20 or RR ≥ 1.10 and < 1.20, but important problem of public health due its high prevalence. After a broad search in the literature, two meta-analysis were selected to provide RR for PAR calculation. The prevalence rates of overweight and obesity in Brazilians with ≥ 18 years were obtained from large national survey. The national health database (DATASUS) was used to estimate the annual cost of the Brazilian Unified Health System (SUS) with the diseases included in the analysis. The extracted values were stratified by sex, type of service (inpatient or outpatient care) and year. Data were collected from 2008 to 2010 and the results reflect the average of 3 years. Brazilian costs were converted into US dollars during the analysis using a purchasing power parity basis (2010).
The estimated total costs in one year with all diseases related to overweight and obesity are US$ 2,1 billion; US$ 1,4 billion (68.4% of total costs) due to hospitalizations and US$ 679 million due to ambulatory procedures. Approximately 10% of these cost is attributable to overweight and obesity.
The results confirm that overweight and obesity carry a great economic burden for Brazilian health system and for the society. The knowledge of these costs will be useful for future economic analysis of preventive and treatment interventions.
BMC Public Health 06/2012; 12:440. · 2.08 Impact Factor
[show abstract][hide abstract] ABSTRACT: Environmental Macro-Area Five (EMA-5) is located in Rio de Janeiro. Their municipalities are suffering the consequences of rapid urbanization, especially after the discovery of large reserves of petroleum and natural gas (PNG) in the Campos Basin.
To describe the socio-economic profile of the region and compare their indicators in space and time.
This is an ecological study, which made comparisons between the 11 municipalities of EMA-5. It is based on the behavior of the indicators before and after the increase in royalties and special participatioms (RPE) and the division of the production areas of PNG (main production area - MPA - and the border zone of MPA, BZMPA). The period of analysis of the indicators ranged from 1991 to 2005.
Higher values of gross domestic product per capita were found in the municipalities of MPA, especially Macaé. The same occurred in the RPE per capita, especially Rio das Ostras (higher value) and Nova Friburgo (lower value). In 2004, more than 50% of total revenues of municipalities were dependent on the funds derived from royalties. In 2000, Nova Friburgo had the best Human Development Index. The highest value of the Quality Index of Municipalities Potential for Development was found in Macaé. The major indexes of Social Exclusion was found in Macaé, Nova Friburgo and Rio das Ostras.
It was found, in the municipalities of MPA, economic growth with great exclusive reliance on royalties. It should invest in alternative economic activities for which there is no damage to the population with the completion of these resources.
Revista Brasileira de Epidemiologia 09/2011; 14(3):372-85.