Maristela G. Monteiro

• M.D., Ph.D.
• Consuitant at Pan American Health Organization (PAHO)

Aims The aims of this study were to identify alcohol‐related population surveys administered in the Americas, determine which alcohol‐related measures are examined and identify coverage gaps regarding alcohol‐related measures. Methods As part of the Global Information System on Alcohol and Health study, a systematic search was performed in accorda...

This article updates a 2017 review on the effectiveness of digital interventions for reducing alcohol use in the general population. An updated systematic search of the MEDLINE database was performed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses criteria to identify randomized controlled trials (RCTs) pub...

La Unidad de Investigación en Salud Pública del Centro de Investigación y Desarrollo en Ciencias de la Salud, realizó en el mes de septiembre del 2022, un evento académico científico, que tuvo como objetivo presentar un acercamiento a los diferentes efectos que la enfermedad por COVID-19 tuvo en diferentes esferas familiares, como el caso del consu...

This article describes progress in tackling noncommunicable diseases (NCDs) in the Americas since the Pan American Health Organization (PAHO) started its NCD program 25 years ago. Changes in the epidemiology of NCDs, NCD policies, health service capacity, and surveillance are discussed. PAHO’s NCD program is guided by regional plans of action on sp...

Background and aims: Excise taxes represent one of the most cost-effective policies to reduce the harmful use of alcohol. Existing information about their design is limited and no standardized metric has been used to compare tax levels in the Region of the Americas. This study aimed to compare alcohol excise tax policies across the Americas, compa...

The WHO’s report Health literacy development for the prevention and control of non-communicable diseases (NCDs) delivers practical what-to-do how-to-do guidance for health literacy development to build, at scale, contextually-relevant public health actions to reduce inequity and the burden of NCDs on individuals, health systems and economies. The k...

The World Health Organization (WHO) African Region is struggling with increasing harm associated with alcohol consumption. Legislators of Sao Tome and Principe, concerned about this harm and the high prevalence of alcohol use disorders, designed a comprehensive alcohol control bill to tackle this situation. Input into the design of the bill was obt...

BACKGROUND There is widespread misinformation about the effects of alcohol consumption on health, due to a complex number of strategies used by the alcohol industry due to marketing, the lack of marketing regulation, the lack of political commitment from governments to tackle alcohol related problems, among other factors. This misinformation was am...

Introduction On 19 November 2021 the Pan American Health Organization (PAHO) developed and deployed the first-ever digital health worker dedicated to alcohol-related topics, named Pahola. This paper describes this developmental process and the first results of its uptake and interactions with the public. Methods PAHO secured a non-exclusive worldw...

Background: Background: There is widespread misinformation about the effects of alcohol consumption on health, which were amplified during the COVID-19 pandemic through social media and internet channels. Chatbots and conversational agents became an important piece of the WHO response during the COVID-19 pandemic to quickly disseminate evidence-ba...

O conhecimento acerca do perfil das vítimas jovens de suicídio no estado do Rio Grande do Sul (RS) faz-se necessário para o enfrentamento desse grave problema de saúde pública. Nesse trabalho, foram avaliados todos os laudos periciais e ocorrências policiais relacionados ao suicídio na faixa de 15 a 29 anos ocorridos entre 2017 e 2019 no RS. O estu...

Objective To report the risk from alcohol, cannabis, and their combined use for non-fatal road traffic injuries for drivers, passengers, and pedestrians. Methods Risk was estimated using the case-crossover method. Participants (N= 306) were injured patients from an emergency department in Mar del Plata, Argentina. Results Alcohol use (OR= 6.78, C...

Objectives The aim of this study was to analyse associations between the COVID-19 pandemic, alcohol consumption and anxiety symptoms among people with self-reported disabilities and family caregivers in Latin America and the Caribbean. Study design Cross-sectional study with secondary data analysis of the ‘Alcohol Use during the COVID-19 pandemic...

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...

Objective: The purpose of this study was to identify priority variables to evaluate alcohol brief interventions from the perspective of experts in the field in Latin America. Method: A two-round Delphi procedure was carried out through online surveys of 465 individuals from 18 Latin American countries, including core outcome set developers, rese...

Objective: The purpose of this study was to estimate the alcohol-attributable disease burden in the Americas in 2000 and 2016. Method: The alcohol-attributable disease burden was estimated using a comparative risk assessment approach. Alcohol exposure and relative risk estimates were obtained from systematic reviews and meta-analyses. Burden of...

Background National alcohol policies need to be systematized and evaluated to identify the gaps that should be filled by future laws. This study aims to search for and classify Brazilian public alcohol policies at the federal and state levels, based on the ten Alcohol Policy Scoring (APS) domains used by the Pan American Health Organization (PAHO),...

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...

Introdução: O suicídio de idosos (pessoas com 60 anos ou mais) é um grave problema de saúde pública. Objetivo: Apresentar o perfil geográfico, temporal, epidemiológico e toxicológico das vítimas idosas de suicídio no estado do Rio Grande do Sul, Brasil, entre 2017 e 2019. Método: Estudo descritivo e transversal a partir de consulta a todas ocorrênc...

Objective: The purpose of this study was to report the "Outcome Reporting in Brief Intervention Trials: Alcohol" (ORBITAL) recommended core outcome set (COS) to improve efficacy and effectiveness trials/evaluations for alcohol brief interventions (ABIs). Method: A systematic review identified 2,641 outcomes in 401 ABI articles measured by 1,560...

Introduction: More comprehensive state-level alcohol policy environments are associated with lower alcohol-attributable homicide rates in the U.S., but few studies have explored this internationally. This study tests whether 3 national-level alcohol policy scores are associated with alcohol-attributable homicide rates. Methods: Data were from th...

Objective. To assess the association between drinking behaviors during the COVID-19 pandemic and quarantine, anxiety symptoms, and sociodemographic characteristics in Latin America and the Caribbean (LAC). Method. Data was collected through a cross-sectional online survey (non-probabilistic sample) conducted by the Pan American Health Organization...

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...

Introduction Despite a marked reduction in new cases of liver cirrhosis caused by hepatitis C virus (HCV) infection, over 500,000 new cirrhosis cases in this category were estimated globally in 2019. This contribution quantifies the relationship between alcohol use and the progression of liver disease in people with HCV infections. Materials and M...

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...

Objective: To describe the toxicology of suicide cases recorded in the state of Rio Grande do Sul, Brazil, from 2017 to 2019. Method: The present descriptive, cross-sectional study examined all the medico-legal reports and police records related to suicide deaths in the state. Multiple correspondence analyses were performed along with independen...

Background To estimate the prevalence of changes in the frequency of self-reported heavy episodic drinking (HED) among drinkers in Latin America and Caribbean countries on alcohol consumption during the COVID-19 pandemic, and to assess self-reported factors associated with the increased frequency of HED. Methods Data from 12,328 adults who respond...

Introduction The aim of this paper is to describe the context of alcohol use and problems in Latin America and the Caribbean (LAC), the environmental context for alcohol‐related policy, drinking trends, harm and policy and to systematically review policies implemented to reduce alcohol‐related burden. Methods LAC‐based studies relating to the exis...

Objective To assess heavy episodic drinking trends in the 26 Brazilian state capitals and Federal District, overall and according to sex. Methods This was an ecological time series study of heavy episodic drinking patterns among adults, from 2006 to 2018. The data were obtained from VIGITEL Survey time series. Prais-Winsten regression was used. R...

Fetal alcohol spectrum disorders (FASD) represent a range of physical, mental, and behavioral disabilities caused by alcohol use during pregnancy, or prenatal alcohol exposure (PAE). FASDs are considered to be one of the leading preventable causes of developmental disability. Despite its high prevalence, FASD is often misdiagnosed or underdiagnosed...

The WHO has worked with partners to develop a set of new materials to address misinformation and provide guidance to individuals and countries during the pandemic. This includes answers to a set of frequently asked questions on alcohol and COVID-19 collected in the WHO fact sheet “Alcohol and COVID-19: what you need to know”.

Совместо с разными партнёрами, ВОЗ разработала набор новых материалов для борьбы с дезинформацией и предоставления рекомендаций отдельным лицам и странам во время пандемии COVID-19. Это включает в себя ответы на ряд часто задаваемых вопросов об алкоголе и COVID-19, собранных в информационном бюллетене ВОЗ «Алкоголь и COVID-19: что вам нужно знать».

Based on a literature search undertaken to determine the impacts of past public health crises, and a systematic review of the effects of past economic crises on alcohol consumption, two main scenarios—with opposite predictions regarding the impact of the current COVID‐19 pandemic on the level and patterns of alcohol consumption—are introduced. The...

Objective: to analyze the epidemiological and toxicological profile of suicide cases in Rio Grande do Sul, Brazil, in 2017 and 2018. Methods: this was a cross-sectional study with data from police incident reports and state General Forensic Institute records; multiple correspondence analyses were performed and logistic regression models were built...

This WHO factsheet provides important information that individuals and governments should know about alcohol consumption and COVID-19. It addresses, among other things, the misinformation that is being spread through social media and other communication channels about alcohol and COVID-19.

COVID-19 (новая коронавирусная инфекция), все страны мира должны принять решительные меры в целях прекращения распространения коронавируса среди населения. В данных критических обстоятельствах принципиально важно донести до людей информацию о других рисках и опасностях для здоровья в целях обеспечения безопасности и здоровья населения. В данном фак...

Para afrontar la pandemia de la COVID-19 (la nueva enfermedad por coronavirus), los países del mundo deben adoptar medidas para detener la propagación del virus. En estas circunstancias críticas, es esencial que todos estemos informados sobre otros riesgos y peligros para la salud, con el fin de mantenernos sanos y salvos. La presente hoja informa...

Frente à pandemia de COVID-19 (nova doença pelo coronavirus), os países do mundo precisam tomar medidas decisivas, para impedir a propagação do vírus. Nessas circunstâncias críticas, é essencial manter todos bem informados sobre outros riscos e perigos para a saúde para que possam permanecer seguros e sadios. Este folheto informativo contém infor...

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...

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...

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...

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 search wa...

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 are examined for specific causes of injury. Methods The dose–response risk of injury is analyzed on 18,627 injured patients in 22 countries included in the International...

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...

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...

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...

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...

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...

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...

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...

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...

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...

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...

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...

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...

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...

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...

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...

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,...

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...

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...

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...

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...

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...

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...

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...

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...

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...

El consumo de alcohol es un problema de salud pública en toda América Latina, siendo el causante de miles de muertes anuales y de millones deaños de vida saludable perdidos por enfermedades agudas y crónicas causadas por su consumo. Aunque el consumo es mayor y más frecuente entre los hombres, las mujeres y las adolescentes están incrementando su c...

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...

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...

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...

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...

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...

Psicólogos, enfermeiros, assistentes sociais, médicos, terapeutas ocupacionais, nutricionistas: ao todo, 28 autores com variados perfis e experiências produziram os 16 capítulos deste livro, cujas análises, muitas vezes, põem em xeque o senso comum. “Senso comum que insiste em tingir com alarmismo apocalíptico as drogas, investindo-as de um caráter...

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...

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...