Maristela G Monteiro

Maristela G Monteiro
Pan American Health Organization (PAHO) | PAHO · Non Communicable Diseases and Mental Health

M.D., Ph.D.

About

147
Publications
33,348
Reads
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11,075
Citations
Additional affiliations
December 2003 - present
Pan American Health Organization (PAHO)
Position
  • Senior Advisor on Alcohol and Substance Abuse
April 1998 - November 2003
World Health Organization WHO
Position
  • Coordinator Program on Substance Abuse

Publications

Publications (147)
Article
The objective of this study is to summarize the research on the relationships between exposure to the COVID‐19 pandemic or previous pandemics and changes in alcohol use. A systematic search of Medline and Embase was performed to identify cohort and cross‐sectional population studies that examined changes in alcohol use during or following a pandemi...
Article
The objective of this study was to estimate trends in alcohol per capita consumption from 1990 to 2016 in the Region of the Americas, covering 35 Member States. Data from the WHO Global Information System on Alcohol and Health were used to calculate the annual percent change of alcohol per capita consumption in each of the 35 countries of the Ameri...
Article
Aims To describe mortality in the Americas from 2013 to 2015 inclusive resulting from diseases, conditions and injuries which are 100% attributable to alcohol consumption. Design and setting Mortality registry, population‐based study. The data come from 30 of the 35 countries of the Americas for the triennium of 2013 to 2015. Participants and cas...
Article
Full-text available
Objective . To report demographic and substance use characteristics and risk of road traffic injury (RTI) from alcohol use, cannabis use, and combined use in a sample of emergency department patients from two countries in Latin America and the Caribbean. Methods . A cross-sectional study in which patients 18 years and older admitted within six hour...
Article
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In recent years, there has been a great increase in seizures and forensic analysis of new psychotropic substances (NPS) in the state of Rio Grande do Sul. The analysis of these compounds needs to be performed in biological samples in cases of violent deaths. A sensitive and reliable liquid chromatography-tandem mass spectrometry with electrospray i...
Article
Objective: Drinking norms vary with the situation and the person's role in it. They may be located at a societal level or may be specific to subgroups in the society. This article compares norms about drinking at the societal level as reported in surveys in 12 countries, testing the degree of consensus on the norms by comparing answers of abstaine...
Article
Objectives: To investigate how various alcohol-drinking behaviours are associated with sociodemographics, lifestyle factors and health status indicators in Brazil. Study design: This study is based on a household survey of 53,034 adults aged 18 + years from all 26 Brazilian capitals and the Federal District conducted in 2017. Methods: Sex-stra...
Article
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Background: The Alcohol Use Disorders Identification Test (AUDIT) was developed for use in primary health care settings to identify hazardous and harmful patterns of alcohol consumption, and is often used to screen for alcohol use disorders (AUDs). This study examined the AUDIT as a screening tool for AUDs. Methods: A systematic literature searc...
Article
Aims: The risk of injury from alcohol consumption was analyzed by gender, controlling for frequency of heavy drinking occasions, and by cause of injury (traffic, violence, fall, other). Methods: Case-crossover analysis was conducted on 18,627 injured patients arriving at the emergency department (ED) within six hours of the event. Findings: Ri...
Article
Background The dose‐response relationship of alcohol and injury and the effects of country‐level detrimental drinking pattern (DDP) and alcohol control policy on this relationship is examined for specific causes of injury. Method The dose‐response risk of injury is analyzed on 18,627 injured patients in 22 countries included in the International C...
Article
Background and Aims Societal‐level volume and pattern of drinking and alcohol control policy have received little attention in the alcohol and injury literature. The aim of this study was to estimate the association between alcohol‐related injury, individual‐level drinking variables, country‐level detrimental drinking pattern and alcohol policy. D...
Article
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Objective: The current work develops the International Alcohol Policy Injury Index (IAPII) to measure the effectiveness of control policies that impact reduction of alcohol-related injury. Methods: Using cross-sectional data on alcohol policies from five policy domains (physical availability, drinking context, pricing, advertising, and vehicular...
Article
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Objectives: The risk for violence-related injury from drinking and attributable burden in the Latin American and Caribbean region was explored. Methods: A probability sample of 1024 emergency department patients reporting a violence-related injury was analyzed from 11 countries, using case-crossover fractional polynomial analysis of the number o...
Article
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Objective To analyze trends in mortality due to diseases and conditions fully attributable to alcohol in Brazil. Methods This was an ecological time-series study. Proportional, specific, and age-standardized mortality rates between 2000 and 2013 that were due to underlying or contributing causes fully attributable to alcohol use were analyzed by s...
Article
Objective: This study assessed four alcohol policy indicators and their associations with adolescent alcohol use in Latin America and the Caribbean. Method: A secondary data analysis of nationally representative, cross-sectional data sets (years 2007-2013) from 26 Latin American and Caribbean countries was performed (N = 55,248 13- to 15-year-ol...
Article
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Background: It is estimated that up to a third of injuries requiring emergency department (ED) admission are alcohol-related. While injuries that are alcohol-related are unsurprising to ED staff, less is understood about the precursors to the injury event. Methods: Using data from representative ED injury patients in 22 countries, we examined assoc...
Article
Background: This study reports dose-response estimates for the odds ratio (OR) and population attributable risk of acute alcohol use and road traffic injury (RTI). Methods: Data were analyzed on 1,119 RTI patients arriving at 16 emergency departments (EDs) in Argentina, Brazil, Costa Rica, Dominican Republic, Guatemala, Guyana, Mexico, Nicaragua...
Article
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Objective: To analyze sociodemographic factors associated with alcohol use according to gender in Brazil. Methods: Cross-sectional study using data from 2013 Brazilian Health Survey about 60,202 adults. We analyzed recent alcohol use and heavy episodic drinking in the 30 days prior to the research stratified by gender. The covariates were: age, ed...
Article
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Objective To estimate the prevalence of alcohol consumption during pregnancy among the general population of Latin America and the Caribbean, by country, in 2012. Methods Three steps were taken: a comprehensive, systematic literature search; meta-analyses, assuming a random-effects model for countries with published studies; and regression modelli...
Chapter
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Alcohol consumption is a large risk factor for the global burden of disease. Both average volume of consumption and the patterns of consumption are important alcohol consumption dimensions that need to be measured when estimating the impact of alcohol on a population. Based on World Health Organization (WHO) guidelines and on the WHO Global Informa...
Article
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Background Violence-related injury has been an important harmful consequence of drinking in the Latin American and Caribbean (LAC) region, but the risk at which drinking places the individual for violence-related injury or the burden this places on the population is unknown. Methods A probability sample of 969 emergency room (ER) patients reportin...
Article
This study reports dose–response estimates for the relative risk and population attributable risk (PAR) between acute alcohol use and serious suicide attempt. Data were analyzed on 272 suicide attempters arriving at 38 emergency departments within 6 hours of the event in 17 countries. Case-crossover analysis, pair-matching the number of standard dr...
Article
Background and aims: To identify the nature of visual alcohol references in alcohol advertisements during televised broadcasts of the 2014 FIFA World Cup tournament matches and to evaluate cross-national differences according to alcohol marketing policy restrictiveness. Design: Content analysis using the Delphi method and identification of in-ga...
Chapter
There are many challenges faced by home visitation programs, in terms of costs, sustainability, viability in different cultural settings and contexts, human and financial resources, and cost effectiveness, among others. Additional challenges to the well-being of the child and family include problems related to excessive alcohol consumption and the...
Chapter
Alcohol consumption is a significant risk factor for the burden of disease worldwide. Both the average per capita consumption and the patterns of consumption are important dimensions which need to be taken into account when estimating the impact of alcohol in a population. Based on WHO guidelines for monitoring alcohol consumption and related harm,...
Article
Full-text available
Objective: To describe the volume and patterns of alcohol consumption up to and including 2012, and to estimate the burden of disease attributable to alcohol consumption as measured in deaths and disability-adjusted life years (DALYs) lost in the Americas in 2012. Methods: Measures of alcohol consumption were obtained from the World Health Organ...
Conference Paper
Different models and tools are available in order to simulate homogeneous crowds taking into account different parameters. In this paper we present a framework to simulate heterogeneous crowds where we emphasize how the presence of alcohol into the simulated agents can make influence on the crowd behavior. Despite the obvious difficulty to evaluate...
Article
To calculate the alcohol-attributable fraction (AAF) of injury morbidity by volume of consumption prior to injury based on newly reported relative risk (RR) estimates. AAF estimates based on the dose-response RR estimates obtained from previous pair-matched case-crossover fractional polynomial analysis of mean volume in volume categories were calcu...
Article
AimsTo update and extend analysis of the dose-response relationship of injury and drinking by demographic and injury subgroups and country-level drinking pattern, and examine the validity and efficiency of the fractional polynomial approach to modeling this relationship.DesignPair-matched case-crossover analysis of drinking prior to injury, using c...
Article
Full-text available
Although the relationship between the Y90 (blood alcohol concentration, BAC) and Y91 (clinician intoxication assessment) ICD-10 codes has received attention recently, the role of 10 signs of intoxication in the Y91-Y90 relationship has not been studied yet. This work examines these signs in the estimation of alcohol intoxication levels of patients...
Article
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Background Previous studies have already substantiated alcohol's causal role in injuries. Yet the role that alcoholic beverage preferences and the drinking context play in the risk for injury is still under-investigated. In this study, a cross-national comparison of the association between alcohol and injury focusing on beverage type preference and...
Article
To describe mortality from diseases, conditions and injuries where alcohol was a necessary cause in selected countries in the Americas. A descriptive, population-based study. The data come from 16 countries in North, Central and South America for the triennium 2007-09 (latest available data). A total of 238 367 deaths were analyzed. We calculated a...
Chapter
Screening and brief intervention (SBI) is one of the most promising measures to reduce alcohol-related injuries targeted at the individual level. Because SBI is relatively easy to perform, low in cost, and can be carried out quickly, it is ideally suited for implementation in busy health care settings such as emergency departments (EDs). As many in...
Article
Zhang, C. & Monteiro, M. (2013). Tactics and practices of the alcohol industry in Latin America: What can policy makers do? International Journal of Alcohol and Drug Research, 2(2), 75-81-6. doi: 10.7895/ijadr.v2i2.95 ( http://dx.doi.org/10.7895/ijadr.v2i2.95 ) Aim: This paper describes the practices and tactics of the alcohol industry in Latin Ame...
Article
Full-text available
Alcohol consumption is a public health problem in Latin America, being responsible for thousands of annual deaths and millions of healthy life years lost to acute and chronic conditions caused by alcohol. Consumption is higher and more prevalent among men, but women and adolescent girls are increasing their consumption more rapidly than men and ado...
Article
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Introduction and AimsPrior work suggests that recall bias may be a threat to the validity of relative risk estimation of injury due to alcohol consumption, when the case-crossover method is used based on drinking during the same six hours period the week prior to injury as the control period. This work explores the issue of alcohol recall bias used...
Article
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This article describes epidemiological evidence on the association between alcohol use and diabetes, and the implications for clinical management and public health policies in the Americas. Heavy alcohol use is a risk factor for both diabetes and poor treatment adherence, despite evidence that moderate drinking can protect against type 2 diabetes u...
Article
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This study aimed to: (i) provide relative risk (RR) estimates between acute alcohol use and injuries from emergency departments (EDs) in the Dominican Republic, Guatemala, Guyana, Nicaragua and Panama, and (ii) test whether the RR differs if two control periods for the estimates were used. Case–crossover methodology was used to obtain estimates of...
Chapter
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Knowledge about a number of public health problems is gathered mainly from mortality statistics, which traditionally have provided the highest–quality and highest–coverage information about health available in many countries. The quality of mortality data in the Region of the Americas has improved in recent years, as national vital statistics syst...
Article
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Harmful alcohol use and the related health effects are a global problem and therefore need to be addressed not only by individual nations but also on an international level. For example, the World Health Organization (WHO) noted that harmful alcohol use is the third leading risk factor for premature deaths and disabilities in the world, accounting...
Article
Aim: Describe the management of patients with methamphetamine (MA)-induced psychosis and offer recommendations for effective treatment. Methods: Prospective assessment of consecutive admissions at 6 public psychiatric treatment services in Australia, the Philippines, and Thailand. One hundred and fifty patients (aged 17 to 48 y) who screened negati...
Conference Paper
According to the World Health Organization (WHO), in 2004, alcohol consumption caused over 347,000 deaths and over 13 million of disability adjusted life years lost in the region of the Americas, placing alcohol as the leading risk factor among 24 other risk factors assessed globally and regionally. Alcohol consumption is relatively high, more prev...
Article
The World Health Organization (WHO) Progamme on Substance Abuse (PSA) studies and revises the health effects of natural and manufactured psychotropic products. This updated information is available to assist member states establish control policies and national programmes to prevent, care and treat problems related to the use of such substances. Th...
Article
Traditionally, the medical approach to the management of alcohol-related problems has been limited to the treatment of ‘alcoholism’, based on intensive medical and social rehabilitation, made by psychiatrists with a specialization in ‘addiction’, often in inpatient settings and for long periods of time. Treatment was given for those with presenting...
Article
Considerable progress has been made over the last 25 years in the areas of epidemiology and treatment for substance use disorders. However, there is a great gap between what is known and what is done at a global level. This article summarizes major advances made in the area of treatment and shows the main results of a World Health Organization key...
Article
The International Classification of Impairments, Disabilities and Handicaps was developed by the World Health Organization in the 1970s and published in 1980. The revision process of such classification has started and will lead to a new version in 1999. In this article, the author gives personal views on the implications of such classification for...
Article
This paper presents an overview of the development and implementation of a brief intervention for harmful alcohol use in primary care settings by the World Health Organization. It started with the development of a valid, reliable and suitable clinical screening instrument to identify persons with early alcohol problems, a 10-item questionnaire call...
Article
The feasibility, relevance and organization of a Cochrane Collaborative Review Group on Drug and Alcohol Addiction was discussed in a first exploratory meeting in January 1997, especially focusing on evaluation of treatments and prevent ional approaches for substance use and related problems. The goals, process and implications of such an endeavor...
Article
The concurrent, construct and discriminative validity of the World Health Organization's Alcohol, Smoking and Substance Involvement Screening Test (ASSIST) were examined in a multi-site international study. One thousand and 47 participants, recruited from drug treatment (n = 350) and primary health care (PHC) settings (n = 697), were administered a...
Chapter
Alcoholl is a major risk factor for mortality and morbidity in the Americas. Overall in the Americas, alcohol consumption levels are higher than the global average while abstention rates for both men and women are consistently lower. In terms of the burden of disease, alcohol caused approximately 323,000 deaths, 6.5 million years of life lost,...
Article
This study evaluates the hypothesis that the decreased reaction to ethanol reported for sons of alcoholics will also be observed following infusions of a benzodiazepine. The investigation compared 37 men who were family history positive for alcoholism with 37 family history negative controls on postinfusion levels of cortisol, prolactin, and growth...
Article
The liver disease characteristic of alcohol dependence encompasses three main related entities: steatosis, alcoholic hepatitis, and cirrhosis. Alcoholic cirrhosis is a leading cause of global morbidity and mortality. Alcohol intake among injecting drug users is a major contributor to transmission of viral infections, such as human immunodeficiency...
Article
This paper discusses diagnostic and treatment approaches for dealing with patients who present with two or more psychiatric disorders. We emphasize the relationship between depressive and anxiety syndromes on one hand, and alcohol abuse on the other. Some reasons for diagnostic confusion are noted, such as the need to distinguish between drinking a...
Article
To describe patterns of alcohol consumption in the Americas, to estimate the burden of disease attributable to alcohol in the year 2000, and to suggest implications for policies to reduce alcohol-related disease burden. Two dimensions of alcohol exposure were included in this secondary data analysis: average volume of alcohol consumption and patter...
Article
Intervention strategies are available for reducing the high global burden of hazardous alcohol use as a risk factor for disease, but little is known about their potential costs and effects at a population level. This study set out to estimate these costs and effects. Analyses were carried out for 12 epidemiological World Health Organization subregi...
Article
The World Health Organization (WHO) report on the Neuroscience of Psychoactive Substance Use and Dependence represents a summary of the latest scientific knowledge on the role of the brain in substance dependence. The findings of the report have important applications to both interventions and public health policy. Specifically, the report notes th...
Article
Aim: To make quantitative estimates of the burden of disease attributable to alcohol in the year 2000 on a global basis. Design: Secondary data analysis. Measurements: Two dimensions of alcohol exposure were included: average volume of alcohol consumption and patterns of drinking. There were also two main outcome measures: mortality , i.e. the numb...
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The provision of care and support to persons living with human immunodeficiency virus (HIV) in Brazil who also use drugs and/or alcohol represents special challenges because of the combined effects of addiction, poverty, stigma, and discrimination. This paper presents details on a program providing both clinic- and field-based care to HIV-infected...
Article
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The present study was aimed at exploring the prevalence and factor structure of methamphetamine (MA) psychotic symptoms. The data were obtained from a cross-country evaluation of substance use, health, and treatment in MA psychotic in-patients. The prevalence rates of lifetime and current psychotic symptoms were determined by using Mini-Internation...
Article
Full-text available
To make quantitative estimates on a global basis of exposure of disease-relevant dimensions of alcohol consumption, i.e. average volume of alcohol consumption and patterns of drinking. Secondary data analysis. Level of average volume of drinking was estimated by a triangulation of data on per capita consumption and from general population surveys....