Revista Brasileira de Epidemiologiahttps://www.scielosp.org/feed/rbepid/2014.v17suppl1/2017-01-10T00:03:00ZUnknown authorVol. 17 - 2014WerkzeugNon-communicable disease surveillance and population surveys10.1590/1809-45032014000500012017-01-10T00:03:00Z2017-01-10T00:03:00ZAdolescent drivers in Brazil: prevalence and associated factors estimated from the National Adolescent School-based Health Survey (PeNSE 2012)10.1590/1809-45032014000500022017-01-10T00:03:00Z2017-01-10T00:03:00ZDuarte, Elisabeth CarmenGarcia, Leila Posenato
<em>Duarte, Elisabeth Carmen</em>;
<em>Garcia, Leila Posenato</em>;
<br/><br/>
INTRODUCTION: There is evidence that adolescent drivers can represent risks to themselves, to passengers and to society in general. OBJECTIVE: To estimate the prevalence of history of driving among adolescent students (under the age of 18) and associated factors, in Brazil, in 2012. METHODS: This study analyzed data from the National Adolescent School-based Health Survey (PeNSE), held in 2012. The prevalence of history (at least once in the past 30 days) of driving motorized vehicles (cars, motorcycles or boats) by students aged less than 18 years old, as well as crude and adjusted odds ratios (OR) related to frequent driving (four or more times in the past 30 days) as the outcome, were estimated. RESULTS: Among the 106,621 interviewed students, 27.0% (95%CI 22.9 - 31.5) reported having driven a motorized vehicle, and 12.9% (95%CI 10.0 - 16.5) reported being a frequent driver (four or more times). Factors associated with frequent driving were: older age, male, mothers with higher schooling, living in a household with fewer members, living in the North and Northeast regions, living with someone who has a motorcycle or a car, when their school is not located in a state-capital, drinking alcohol and not wearing a seatbelt. CONCLUSION: The higher prevalence of history of driving among adolescent students in Brazil and the identified associated factors might help authorities to prioritize policies and to reinforce the adherence to traffic legislation among specific groups.Labor in early life, vulnerability for health in Brazilian schoolchildren: National Adolescent School-based Health Survey (PeNSE 2012)10.1590/1809-45032014000500032017-01-10T00:03:00Z2017-01-10T00:03:00ZGiatti, LuanaCampos, Maryane OliveiraCrespo, Claudio DutraAndrade, Silvania Suely Caribé de AraújoBarreto, Sandhi Maria
<em>Giatti, Luana</em>;
<em>Campos, Maryane Oliveira</em>;
<em>Crespo, Claudio Dutra</em>;
<em>Andrade, Silvania Suely Caribé De Araújo</em>;
<em>Barreto, Sandhi Maria</em>;
<br/><br/>
OBJECTIVE: This study describes exposure labor among Brazilian 9th grade students from public and private schools and investigates socio-demographic characteristics, behaviors, violent situations and psychosocial factors associated with labor among adolescents. METHODS: The present study included 108,984 students from the National Adolescent School-based Health Survey carried out in 2012. Variables were grouped into sociodemographic characteristics, behavioral factors, violent situations and psychosocial aspects. Associations between labor and several health risk variables were identified by multiple logistic regression analysis, after adjustment for sex and age. RESULTS: Approximately 13% of the students reported having a job: 17.4% of them were male. The chance of working was lower between females and individuals whose fathers' have incomplete superior education. Students who worked had greater chances to smoke (OR = 2.26; 95%CI 2.04 - 2.51), drink alcohol, use illicit drugs (OR = 2.63; 95%CI 2.29 - 3.02), drive motorized vehicles (OR = 2.15; 95%CI 2.03 2.27), have sexual intercourse (OR = 2.10; 95%CI 1.99 - 2.24), suffer physical violence (OR = 1.57; 95%CI 1.46 1.68), engage in fights (OR = 1.65; 95%CI 1.55 - 1.76), feel lonely (OR = 1.26; 95%CI 1.17 - 1.36) and report sleeping problems (OR = 1.46; 95%CI 1.34 - 1.60). They also have lower chances of having close friends (OR = 0.78; 95%CI 0.68 - 0.90). CONCLUSION: The prevalence of labor among students is high. Socioeconomical disadvantages increase the chances of early working. Early working is also associated to health damaging behavior, violent situations, sleeping problems, and social isolation. Adolescents who study and work experiment expositions that may affect distinct health dimensions and perpetuate disadvantages over lifetime.Lifetime use of illicit drugs and associated factors among Brazilian schoolchildren, National Adolescent School-based Health Survey (PeNSE 2012)10.1590/1809-45032014000500042017-01-10T00:03:00Z2017-01-10T00:03:00ZHorta, Rogério LessaHorta, Bernardo LessaCosta, Andre Wallace Nery daPrado, Rogério Ruscitto doOliveira-Campos, MaryaneMalta, Deborah Carvalho
<em>Horta, Rogério Lessa</em>;
<em>Horta, Bernardo Lessa</em>;
<em>Costa, Andre Wallace Nery Da</em>;
<em>Prado, Rogério Ruscitto Do</em>;
<em>Oliveira-Campos, Maryane</em>;
<em>Malta, Deborah Carvalho</em>;
<br/><br/>
OBJECTIVE: This study aimed at describing the prevalence of illicit drug use among 9th grade students in the morning period of public and private schools in Brazil, and assessing associated factors. METHOD: The Brazilian survey PeNSE (National Adolescent School-based Health Survey) 2012 evaluated a representative sample of 9th grade students in the morning period, in Brazil and its five regions. The use of illicit drugs at least once in life was assessed for the most commonly used drugs, such as marijuana, cocaine, crack, solvent-based glue, general ether-based inhalants, ecstasy and oxy. Data were subjected to descriptive analysis, and Pearson's χ2 test and logistic regression was used in the multivariate analysis. RESULTS: The use of illicit drugs at least once in life was reported by 7.3% (95%CI 5.3 - 9.4) of the respondents. Logistic regression was used for multivariate analysis and the evidences suggest that illicit drug use is associated to social conditions of greater consumption power, the use of alcohol and tobacco, behaviors related to socialization, such as having friends or sexual activity, and also the perception of loneliness, loose contact between school and parents and experiences of abuse in the family environment. The outcome was inversely associated with close contact with parents and parental supervision. CONCLUSION: In addition to the association with the processes of socialization and consumption, the influence of family and school is expressed in a particularly protective manner in different records of direct supervision and care.Psychoactive substance use, family context and mental health among Brazilian adolescents, National Adolescent School-based Health Survey (PeNSE 2012)10.1590/1809-45032014000500052017-01-10T00:03:00Z2017-01-10T00:03:00ZMalta, Deborah CarvalhoOliveira-Campos, MaryanePrado, Rogério Ruscitto doAndrade, Silvania Suely CaribéMello, Flávia Carvalho Malta deDias, Antonio José RibeiroBomtempo, Denise Birche
<em>Malta, Deborah Carvalho</em>;
<em>Oliveira-Campos, Maryane</em>;
<em>Prado, Rogério Ruscitto Do</em>;
<em>Andrade, Silvania Suely Caribé</em>;
<em>Mello, Flávia Carvalho Malta De</em>;
<em>Dias, Antonio José Ribeiro</em>;
<em>Bomtempo, Denise Birche</em>;
<br/><br/>
OBJECTIVE: To evaluate the association between the consumption of psychoactive substances (tobacco, alcohol and illicit drugs) and demographic variables, mental health and family context among school-aged children. METHODS: The National Adolescent School-based Health Survey was held with a national sample of 109,104 students. Data regarding demographic variables, family background and mental health were collected. Logistic regression was used to evaluate the associations of interest. RESULTS: Multivariate analyses showed that alcohol consumption was higher among girls, drug experimentation was more frequent among boys and that there was no difference between sexes for smoking. Being younger and mulatto were negatively associated with the use of tobacco, alcohol and illicit drugs. Also negatively associated with such risk behaviors were characteristics of the family context represented by: living with parents, having meals together and parental supervision (when parents know what the child does in their free time). Moreover, characteristics of mental health such as loneliness and insomnia were positively associated with use of tobacco, alcohol and illicit drugs. Not having friends was positively associated with use of tobacco and illicit drugs and negatively associated with alcohol use. CONCLUSIONS: The study shows the protective effect of family supervision in the use of tobacco, alcohol and drugs and, on the contrary, the increasing use of substances according to aspects of mental health, such as loneliness, insomnia and the fact of not having friends. The study's findings may support actions from health and education professionals, as well as from the government and families in order to prevent the use of these substances by adolescents.Experimentation and use of cigarette and other tobacco products among adolescents in the Brazilian state capitals (PeNSE 2012)10.1590/1809-45032014000500062017-01-10T00:03:00Z2017-01-10T00:03:00ZBarreto, Sandhi MariaGiatti, LuanaOliveira-Campos, MaryaneAndreazzi, Marco AntonioMalta, Deborah Carvalho
<em>Barreto, Sandhi Maria</em>;
<em>Giatti, Luana</em>;
<em>Oliveira-Campos, Maryane</em>;
<em>Andreazzi, Marco Antonio</em>;
<em>Malta, Deborah Carvalho</em>;
<br/><br/>
INTRODUCTION: Nicotine dependence establishes itself more rapidly among adolescents than among adults. Tobacco occupies the fourth place in the rank of main risk factors for non-communicable diseases in the continent. Studies reveal that other forms of tobacco use have increased among adolescents. METHODS: Were included the 9th grade students from the 26 State Capitals and the Federal District. who were participants of the National Adolescent School-based Health Survey (PeNSE), in 2012. Factors independently associated with experimentation and regular use of cigarettes were investigated by means of multinomial logistic regression, using as reference "never tried a cigarette". The use of other tobacco products included cigar, pipe, narghile and others. RESULTS: Of the in the 61,037 participants in the 26 Brazilian capitals and the Federal District, 22.7% (95%CI 21.7 - 23.5) had experimented cigarettes, 6.1% (95%CI 5.6 - 6.6) are regular smokers and 7.1% (95%CI 6.5 - 7.7) had used other tobacco products, with half of them also being regular smokers. The chances of experimenting and being a regular smoker increased with age and according to the frequency of weekly exposure to other smokers. These chances were also higher among students who worked, who lived in monoparental families or without their parents, and those who felt that their parents would not mind if they smoked. CONCLUSION: Results reinforce the association between social disadvantages and experimenting and regular smoking. In addition, the use of other tobacco products is worthy of attention and may lead to regular smoking.Trend of the risk and protective factors of chronic diseases in adolescents, National Adolescent School-based Health Survey (PeNSE 2009 e 2012)10.1590/1809-45032014000500072017-01-10T00:03:00Z2017-01-10T00:03:00ZMalta, Deborah CarvalhoAndreazzi, Marco Antonio Ratzsch deOliveira-Campos, MaryaneAndrade, Silvania Suely Caribé de AraújoSá, Naíza Nayla Bandeira deMoura, Lenildo deDias, Antonio José RibeiroCrespo, Claudio DutraSilva Júnior, Jarbas Barbosa da
<em>Malta, Deborah Carvalho</em>;
<em>Andreazzi, Marco Antonio Ratzsch De</em>;
<em>Oliveira-Campos, Maryane</em>;
<em>Andrade, Silvania Suely Caribé De Araújo</em>;
<em>Sá, Naíza Nayla Bandeira De</em>;
<em>Moura, Lenildo De</em>;
<em>Dias, Antonio José Ribeiro</em>;
<em>Crespo, Claudio Dutra</em>;
<em>Silva Júnior, Jarbas Barbosa Da</em>;
<br/><br/>
OBJECTIVE: To compare the prevalence of major risk and protection factors for chronic non-communicable diseases in school-aged children in Brazilian capitals surveyed in the National Adolescent School-based Health Survey in its two editions, 2009 and 2012. METHODS: The frequencies, with Confidence Interval of 95%, of the following demographic variables were compared: food intake, body image, physical activity, smoking, alcohol and other drugs. Prevalence was compared in the two editions of the survey. RESULTS: The proportion of students who attend two physical education classes a week was maintained at 49% between 2009 and 2012, increasing in public schools from 50.6% (95%CI 49.8 - 51.4) to 52.5% (95%CI 49.2 - 55.7), and decreasing in private schools. There was no change in the proportion of students who watch two hours or more of television daily, about 80%. As for body image, there was no change between the two editions, and about 60% considered themselves being of normal weight. There was a reduction in the percentage of adolescents who experienced cigarettes, from 24.2% (95%CI 23.6 - 24.8) to 22.3% (95%CI 21.4 - 23.2), and the prevalence of smoking was maintained at about 6% (there was no statistical difference between 2009 and 2012). The consumption of beans, fruits, sweets and soft drinks also decreased. Frequency of drug experimentation was of 8.7% (95%CI 8.3 - 9.1) in 2009, and 9.6% (95%CI 9.0 - 10.3) in 2012, with no difference between confidence intervals, and the frequency of alcohol experimentation was maintained at about 70%; the percentage of use in the past 30 days was also maintained at around 27%. CONCLUSION: In the Brazilian capitals, the vast majority of prevalence of risk factors were kept stable in the two editions of the National Survey of School. These data generate evidence to guide the implementation of public policies to minimize the exposure of adolescents to risk factors.Bullying in Brazilian school children: analysis of the National Adolescent School-based Health Survey (PeNSE 2012)10.1590/1809-45032014000500082017-01-10T00:03:00Z2017-01-10T00:03:00ZMalta, Deborah CarvalhoPorto, Denise LopesCrespo, Claudio DutraSilva, Marta Maria AlvesAndrade, Silvania Suely Caribé deMello, Flavia Carvalho Malta deMonteiro, RosaneSilva, Marta Angélica Iossi
<em>Malta, Deborah Carvalho</em>;
<em>Porto, Denise Lopes</em>;
<em>Crespo, Claudio Dutra</em>;
<em>Silva, Marta Maria Alves</em>;
<em>Andrade, Silvania Suely Caribé De</em>;
<em>Mello, Flavia Carvalho Malta De</em>;
<em>Monteiro, Rosane</em>;
<em>Silva, Marta Angélica Iossi</em>;
<br/><br/>
OBJECTIVE: To describe the victimization and bullying practice in Brazilian school children, according to data from the National Adolescent School-based Health Survey and to compare the surveys from 2009 and 2012. METHODS: This is a cross-sectional study with univariate and multivariate analyzes of the following variables: to have been treated badly by colleagues, to have been bullied and to have bullied other children. The following independent variables were analyzed: age, sex, race/color, type of school, maternal education. Prevalence rates were compared between the editions of 2009 and 2012 of the survey. RESULTS: Of all the adolescents analyzed, 27.5% have not been treated well by peers at school, with greater frequency among boys (OR = 1.50), at the age of 15 years (OR = 1.29) and 16 (OR = 1.41), public school students (OR = 2.08), black (OR = 1.18) and whose mothers had less education; 7.2% reported having been bullied, with a greater chance in younger students (13 years old), male (OR = 1.26), black (OR = 1.15) and indigenous (OR = 1.16) and whose mothers had less education; 20.8% reported to have bullied other children, with a greater chance for older students, at the age of 14 (OR = 1.08) and 15 years (OR = 1.18), male (OR = 1.87), black (OR = 1.14) and yellow (OR = 1.15), children of mothers with higher education, private school students. There was an increase of bullying in the Brazilian capitals, from 5.4 to 6.8%, between 2009 and 2012. DISCUSSION: The occurrence of bullying reveals that the Brazilian school context is also becoming a space of reproduction of violence, in which it is crucial to act intersectorally and to articulate social protection networks, aiming to face this issue.Prevalence of asthma symptoms among adolescents in Brazil: National Adolescent School-based Health Survey (PeNSE 2012)10.1590/1809-45032014000500092017-01-10T00:03:00Z2017-01-10T00:03:00ZBarreto, Maurício LimaRibeiro-Silva, Rita de CássiaMalta, Deborah CarvalhoOliveira-Campos, MaryaneAndreazzi, Marco AntonioCruz, Alvaro Augusto
<em>Barreto, Maurício Lima</em>;
<em>Ribeiro-Silva, Rita De Cássia</em>;
<em>Malta, Deborah Carvalho</em>;
<em>Oliveira-Campos, Maryane</em>;
<em>Andreazzi, Marco Antonio</em>;
<em>Cruz, Alvaro Augusto</em>;
<br/><br/>
OBJECTIVE: This study aims to describe the prevalence rates of asthma symptoms in Brazil, its Regions and State capitals, according to data from the National Adolescent School-based Health Survey, 2012. Furthermore, it aims to compare the prevalence of asthma in the capitals evaluated by PeNSE 2012 with previous results of the International Study of Asthma and Allergies in Childhood (ISAAC). METHODS: Cross sectional study of 9th grade students at public and private schools of all Brazilian states and the Federal District (Brasília). A self reported questionnaire containing items from the ISAAC was applied in order to identify the presence of asthma symptoms. RESULTS: The results of PeNSE indicate a high prevalence of asthma symptoms (23.2%) and of reports of a previous medical diagnosis of asthma (12.4%). Of the five state capitals in which the PeNSE results were compared to the ISAAC, São Paulo, Curitiba and Porto Alegre presented an increase in the prevalence of asthma symptoms. In Salvador, there was a reduction. CONCLUSION: Brazil is among the countries with the highest prevalence of asthma in the world, and the prevalence is still growing.Sexual behavior among Brazilian adolescents, National Adolescent School-based Health Survey (PeNSE 2012)10.1590/1809-45032014000500102017-01-10T00:03:00Z2017-01-10T00:03:00ZOliveira-Campos, MaryaneNunes, Marília LavocartMadeira, Fátima de CarvalhoSantos, Maria GorethBregmann, Silvia ReiseMalta, Deborah CarvalhoGiatti, LuanaBarreto, Sandhi Maria
<em>Oliveira-Campos, Maryane</em>;
<em>Nunes, Marília Lavocart</em>;
<em>Madeira, Fátima De Carvalho</em>;
<em>Santos, Maria Goreth</em>;
<em>Bregmann, Silvia Reise</em>;
<em>Malta, Deborah Carvalho</em>;
<em>Giatti, Luana</em>;
<em>Barreto, Sandhi Maria</em>;
<br/><br/>
OBJECTIVE: This study describes the sexual behavior among students who participated in the National Adolescent School-based Health Survey (PeNSE) 2012 and investigates whether social inequalities, the use of psychoactive substances and the dissemination of information on sexual and reproductive health in school are associated with differences in behavior. METHODOLOGY: The response variable was the sexual behavior described in three categories (never had sexual intercourse, had protected sexual intercourse, had unprotected sexual intercourse). The explanatory variables were grouped into socio- demographic characteristics, substance use and information on sexual and reproductive health in school. Variables associated with the conduct and unprotected sex were identified through multinomial logistic regression, using "never had sexual intercourse" as a reference. RESULTS: Over nearly a quarter of the adolescents have had sexual intercourse in life, being more frequent among boys. About 25% did not use a condom in the last intercourse. Low maternal education and work increased the chance of risky sexual behavior. Any chance of protected and unprotected sex increased with the number of psychoactive substances used. Among those who don't receive guidance on the prevention of pregnancy in school, the chance to have sexual intercourse increased, with the largest magnitude for unprotected sex (OR = 1.41 and OR = 1.87 ). CONCLUSION: The information on preventing pregnancy and STD/AIDS need to be disseminated before the 9th grade. Social inequalities negatively affect risky sexual behavior. Substance use is strongly associated with unprotected sex. Information on the prevention of pregnancy and STD/AIDS need to be disseminated early.Bullying and associated factors among Brazilian adolescents: analysis of the National Adolescent School-based Health Survey (PeNSE 2012)10.1590/1809-45032014000500112017-01-10T00:03:00Z2017-01-10T00:03:00ZMalta, Deborah CarvalhoPrado, Rogério Ruscitto doDias, Antônio José RibeiroMello, Flavia Carvalho M.Silva, Marta Angelica IossiCosta, Michelle Ralil daCaiaffa, Waleska Teixeira
<em>Malta, Deborah Carvalho</em>;
<em>Prado, Rogério Ruscitto Do</em>;
<em>Dias, Antônio José Ribeiro</em>;
<em>Mello, Flavia Carvalho M.</em>;
<em>Silva, Marta Angelica Iossi</em>;
<em>Costa, Michelle Ralil Da</em>;
<em>Caiaffa, Waleska Teixeira</em>;
<br/><br/>
OBJECTIVE: To estimate the prevalence of bullying from the victim's perspective in Brazilian school children and to analyze its association with individual and family context variables. METHODS: An analysis of the data on 109,104 adolescents, obtained by the National Adolescent School-based Health Survey, held in schools in 2012, was carried out. An association model between bullying and explanatory variables was tested in different contexts: sociodemographic, risk behaviors, mental health and family context. Univariate and multivariate analyzes were performed, calculating the Odds Ratio and confidence intervals. RESULTS: The prevalence of bullying found in this study was of 7.2% (95%CI 6.6 - 7.8). A higher chance of bullying was found among male students (OR = 1.58; 95%CI 1.51 - 1.66), with an inverse relation between age and bullying, with the magnitude of risk among adolescents younger than 13 years of age being higher when compared to those with 16 years of age or more. Of individual risk behaviors, only being a smoker remained in the final model (OR = 1.11; 95%CI 1.01 - 1.23). Mental health variables associated with bullying were: feeling lonely (OR = 2.66; 95%CI 2.52 - 2.81), insomnia (OR = 1.92; 95%CI 1.80 - 2.05), not having friends (OR = 1.71; 95%CI 1.54 - 1.89), and, in the family context, those who skip class without telling their parents (OR = 1.13; 95%CI 1,07 - 1,19) and those who suffer physical abuse by family members (OR = 2.03; 95%CI 1.91 - 2.146). CONCLUSION: Bullying was associated to male students, younger, of black color, smokers, with mental health vulnerabilities and victims of domestic violence. This suggests the need for a holistic approach from education and health professionals, parents and the community in seeking measures for the prevention of bullying.Body image and extreme attitudes toward weight in Brazilian schoolchildren (PeNSE 2012)10.1590/1809-45032014000500122017-01-10T00:03:00Z2017-01-10T00:03:00ZClaro, Rafael MoreiraSantos, Maria Aline SiqueiraOliveira-Campos, Maryane
<em>Claro, Rafael Moreira</em>;
<em>Santos, Maria Aline Siqueira</em>;
<em>Oliveira-Campos, Maryane</em>;
<br/><br/>
INTRODUCTION: Adolescence is a period characterized by changes such as accelerated physical growth and sexual development. Besides having to deal with these changes, adolescents are faced with beauty standards and extreme valorization of physical appearance. OBJECTIVE: This article aims to describe body image and the practice of extreme attitudes regarding weight in Brazilian students. METHODS: Data from the National Survey of School Health (PeNSE) 2012 were used in this study. PeNSE 2012 has a representative sample of students in the 9th grade of elementary school in public and private schools across the country. A self-administered questionnaire on body image, practice of extreme measures in relation to weight and sociodemographic data was used. Body image and the practice of extreme attitudes were described for the total sample and according to gender. Poisson regression analyzes were used to identify differences in the practices of extreme attitudes between the different types of body image. RESULTS: More than 38% of the adolescents did not consider their body image as normal. Over 15% of the students referred to carry out extreme weight control practices, combining practices to loose and gain weight. Adolescents who considered themselves fat presented frequency of extreme practices for weight loss 92% higher than that shown by individuals who considered themselves normal. Similarly, adolescents who considered themselves thin presented frequency of extreme attitudes to gain weight (9.7%) higher than that shown by students who considered themselves normal (5.6%). CONCLUSIONS: The high frequency of extreme weight control practices among Brazilian adolescents is alarming and should be subject of measures in health and education fields.Situations of violence experienced by students in the state capitals and the Federal District: results from the National Adolescent School-based Health Survey (PeNSE 2012)10.1590/1809-45032014000500132017-01-10T00:03:00Z2017-01-10T00:03:00ZMalta, Deborah CarvalhoMascarenhas, Márcio Dênis MedeirosDias, Antônio RibeiroPrado, Rogério Ruscitto doLima, Cheila MarinaSilva, Marta Maria Alves daSilva Júnior, Jarbas Barbosa da
<em>Malta, Deborah Carvalho</em>;
<em>Mascarenhas, Márcio Dênis Medeiros</em>;
<em>Dias, Antônio Ribeiro</em>;
<em>Prado, Rogério Ruscitto Do</em>;
<em>Lima, Cheila Marina</em>;
<em>Silva, Marta Maria Alves Da</em>;
<em>Silva Júnior, Jarbas Barbosa Da</em>;
<br/><br/>
OBJECTIVE: To describe violent events experienced by school-aged adolescents in school, around the school and in the family context, and to compare the results of the National Adolescent School-based Health Survey of 2009 and 2012. METHODS: Indicators related to violence involving teenagers were analyzed. The prevalence rates and confidence intervals of 95% were calculated for events of interest according to gender and type of school (public or private) and regions. RESULTS: Prevalence rates were: insecurity in the route between home-school (9.1%), insecurity in school (8.0%), physical assault in the last 12 months (18.2%), engaging in fights in the last 12 months (20.7%), fighting with a cold weapon (8.3%), fighting with firearms (6.9%), physical assault by a family member (11.6%) and having been seriously injured in the last 12 months (10.3%). The situations of violence were more prevalent among male students from public schools. The comparison with the 2009 survey showed increased prevalence in all the variables studied. CONCLUSION: Teenagers are exposed to different forms of violence, and the data from the National Survey of School Health can support the planning of preventive actions.Sexual behavior of school-aged adolescents in the city of Goiânia, Goiás10.1590/1809-45032014000500142017-01-10T00:03:00Z2017-01-10T00:03:00ZSasaki, Reinaldo Satoru AzevedoSouza, Márcia Maria deLeles, Cláudio RodriguesMalta, Deborah CarvalhoSardinha, Luciana Monteiro VasconcelosFreire, Maria do Carmo Matias
<em>Sasaki, Reinaldo Satoru Azevedo</em>;
<em>Souza, Márcia Maria De</em>;
<em>Leles, Cláudio Rodrigues</em>;
<em>Malta, Deborah Carvalho</em>;
<em>Sardinha, Luciana Monteiro Vasconcelos</em>;
<em>Freire, Maria Do Carmo Matias</em>;
<br/><br/>
OBJECTIVE: To investigate the characteristics of sexual behavior in school-aged adolescents and possible differences regarding sex and type of school. METHODS: Cross-sectional study using data from the National Adolescent School-based Health Survey (PeNSE) 2009, carried out by the Brazilian Ministry of Health, in partnership with the Brazilian Institute of Geography and Statistics (IBGE). The sample consisted of 3,099 9th graders living in Goiânia, State of Goiás, Brazil, mostly aged between 13 to 15 years old, who answered a self-applicable questionnaire on risk and protective health factors. The Rao-Scott test was used in the statistical analysis, considering the complex sample design. RESULTS: The prevalence of sexual intercourse was of 26.5% (95%CI 23.8 - 29.4) at least once in life and of 18.5% (95%CI 16.5 - 20.8) in the last year. Both behaviors were more frequent among male students and among those attending public schools. Most of the respondents had their first intercourse at the age of 13 or younger, with up to 3 partners. They had also used a pregnancy prevention method in the last intercourse, and received guidance on prevention at school. The age of the first intercourse was earlier and the number of partners was higher among male students. More females and those attending public schools reported having received information on pregnancy prevention. Guidance on STD/AIDS was also more frequent in public schools. CONCLUSION: Results showed a need for health education measures involving education and health professionals, as well as parents, to reduce the discrepancies found regarding sex and type of school.Factors associated with injuries in adolescents, from the National Adolescent School-based Health Survey (PeNSE 2012)10.1590/1809-45032014000500152017-01-10T00:03:00Z2017-01-10T00:03:00ZMalta, Deborah CarvalhoPrado, Rogério Ruscitto doCaribe, Silvania Suely AndradeSilva, Marta Maria Alves daAndreazzi, Marco Antonio Ratzsch deSilva Júnior, Jarbas Barbosa daMinayo, Maria Cecilia de Souza
<em>Malta, Deborah Carvalho</em>;
<em>Prado, Rogério Ruscitto Do</em>;
<em>Caribe, Silvania Suely Andrade</em>;
<em>Silva, Marta Maria Alves Da</em>;
<em>Andreazzi, Marco Antonio Ratzsch De</em>;
<em>Silva Júnior, Jarbas Barbosa Da</em>;
<em>Minayo, Maria Cecilia De Souza</em>;
<br/><br/>
OBJECTIVE: To estimate the prevalence of injuries among teenagers and to examine the associated risk factors, such as sociodemographic characteristics, risk behaviors, family ties and other factors. METHOD: The prevalence of the outcome (injury) was estimated with a 95%confidence interval. In order to verify factors associated with the injury, a bivariate analysis was made with estimated odds ratio (OR) and its respective confidence intervals. Then, a multivariate analysis was carried out, only with variables whose descriptive level was equal to or lower than 5% (p < 0.05) remaining in the model. RESULTS: The study of injury in adolescents, based on the data from the National Adolescent School-based Health Survey (PeNSE), pointed out that 10.3% of the teenagers suffered severe injuries in the past 12 months, such as cuts or perforations, broken bones or dislocated joints. The following variables remained independently associated with "suffering severe injuries": being a male teenager; black, mulatto or indigenous race/color and working. Factors related to family ties are significant when the relations are fragile amongst members: adolescents that are injured the most are the ones who suffer most aggressions at home, who skip classes without notifying their parents, those who do not live with their parents and have low family control. The most relevant aspects of mental health are insomnia and loneliness. The factors associated to the exposure to situations of violence that remained in the model were: insecurity in school and in the route home-school; getting a ride with someone inebriated; drinking and driving motorized vehicles; not wearing the seatbelt; not wearing a helmet and being bullied. Among the factors of individual behavior, the following can be emphasized: use of alcohol, cigarettes, trying illicit drugs and early sexual intercourse. CONCLUSION: The analysis of the determinants for suffering injuries in childhood and adolescence shows the complex relationship between associated factors, which points to the need for action towards several aspects to reduce social inequalities, strengthen family ties and prevent violent contexts and individual risk factors.Alcohol consumption among Brazilian Adolescents according to the National Adolescent School-based Health Survey (PeNSE 2012)10.1590/1809-45032014000500162017-01-10T00:03:00Z2017-01-10T00:03:00ZMalta, Deborah CarvalhoMachado, Isis EloahPorto, Denise LopesSilva, Marta Maria Alves daFreitas, Paula Carvalho deCosta, André Wallace Ney daOliveira-Campos, Maryane
<em>Malta, Deborah Carvalho</em>;
<em>Machado, Isis Eloah</em>;
<em>Porto, Denise Lopes</em>;
<em>Silva, Marta Maria Alves Da</em>;
<em>Freitas, Paula Carvalho De</em>;
<em>Costa, André Wallace Ney Da</em>;
<em>Oliveira-Campos, Maryane</em>;
<br/><br/>
OBJECTIVE: To describe the prevalence of alcohol consumption among Brazilian students and identify the sociodemographic factors associated alcohol consumption in the last 30 days. METHODS: Cross-sectional study with a cluster sample of 109,104 9th grade students in Brazilian public and private schools in 2012. The prevalence and 95% confidence intervals of the indicators of alcohol consumption were analyzed. RESULTS: Of the students analyzed, 50.3% (95%CI 49.0 - 51.6) experimented one dose of alcoholic beverages or more. The consumption of alcohol in the last 30 days was 26.1% (95%CI 24.5 - 27.7), and there was no difference in prevalence between students from public and private schools. Drunkenness episodes were reported by 21.8% (95%CI 21.1 - 22.5) of the students. The perception of students about the negative reaction of their family if they came home drunk occurred in 89,7% (95%CI 89,6 - 89,9) of cases, and 10% (95%CI 8.9 - 11.1) of them reported having problems with their families or friends because they had been drinking. Among adolescents aged less than 14 years old, the first alcoholic drink intake was predominantly at 12 to 13 years old. The most common way to get a drink was at parties, with friends, buying in them in supermarkets, stores or bars and at home. The consumption of alcohol in the last 30 days was less frequent among boys, increasing with age. CONCLUSION: The study demonstrates the extension of alcohol as a problem, making it important to advance in measures such as the improvement of protective legislation for children and adolescents and stricter enforcement in alcohol sales.Prevalence of self-reported arterial hypertension in Brazilian capitals in 2011 and analysis of its trends in the period between 2006 and 201110.1590/1809-45032014000500172017-01-10T00:03:00Z2017-01-10T00:03:00ZAndrade, Silvania Suely Caribé de AraújoMalta, Deborah CarvalhoIser, Betine MoehleckeSampaio, Patricia ChueriMoura, Lenildo de
<em>Andrade, Silvania Suely Caribé De Araújo</em>;
<em>Malta, Deborah Carvalho</em>;
<em>Iser, Betine Moehlecke</em>;
<em>Sampaio, Patricia Chueri</em>;
<em>Moura, Lenildo De</em>;
<br/><br/>
OBJECTIVE: To describe the prevalence of self-reported arterial hypertension in the adult population in the Brazilian state capitals and Federal District in 2011, and analyze the trend from 2006 to 2011. METHODS: A time series study was conducted with data from the monitoring system by telephone survey (Vigitel) in the period between 2006 and 2011. Approximately 54,000 individuals were assessed per year in the locations studied. A polynomial regression model was used for trend analysis according to gender, age, education and region of the country. RESULTS: The prevalence of hypertension was 22.7% in 2011, higher in women (25.4%; 95%CI 24.2 - 26.5) than in men (19.5%; 95%CI 18.4 - 20.7). In the period between 2006 and 2011, the lower frequency of hypertension was observed in 2006 (21.5%), and the higher in 2009 (24.4%), with no statistically significant difference in the period. CONCLUSION: There was no significant sex-specific trend, maintaining the higher frequency among women. The prevalence of hypertension increased progressively with age and was higher among adults with lower education (0 - 8 years of study). The South was the only region that showed a statistically significant increasing trend for the years between 2006 and 2011 (15% per year).Analysis of care given to patients with hypertension in Belo Horizonte, according to telephone survey10.1590/1809-45032014000500182017-01-10T00:03:00Z2017-01-10T00:03:00ZPaulucci, Tatiana DiasVelasquez-Melendez, GustavoBernal, Regina Ivata TomieLana, Francisco FélixMalta, Deborah Carvalho
<em>Paulucci, Tatiana Dias</em>;
<em>Velasquez-Melendez, Gustavo</em>;
<em>Bernal, Regina Ivata Tomie</em>;
<em>Lana, Francisco Félix</em>;
<em>Malta, Deborah Carvalho</em>;
<br/><br/>
OBJECTIVE: To examine the care given to patients with hypertension in the Brazilian public and private health services in the population of Belo Horizonte, Minas Gerais. METHODS: Telephone interviews were conducted in a sample of hypertensive adults in the year 2009, in Belo Horizonte (n = 100). We compared the care provided to hypertensive users of the Unified Health System (SUS) and of the Supplementary Health (SS), using the χ2 test or Fisher's exact test. The prevalence ratio was calculated by the Poisson regression model, adjusted for the variables age, education and skin color. RESULTS: In the descriptive analysis, hypertensive users of private health plans had a higher frequency of physician referral and greater blood pressure control. Unified Health System users were the ones who participated in health promotion groups the most. The acquisition of antihypertensive medications by beneficiaries of private health insurance was more frequent in private pharmacies, and in Health Centers among users of the Unified Health System. The differences disappeared when adjusting the variables for age, race and education. There was no difference regarding the guidance received for a change of habits, or regarding the incorporation of these healthy practices promotion by hypertensive patients. CONCLUSION: A healthier diet, the practice of physical activity, and the non-use of alcohol and tobacco have been incorporated by hypertensive patients, whether owning private health insurance or not. Promotion practices, proper use of medication a clinical follow-up are important for the control of blood pressure levels.Comparison of risk and protective factors for chronic diseases in the population with and without health insurance in the Brazilian capitals, 201110.1590/1809-45032014000500192017-01-10T00:03:00Z2017-01-10T00:03:00ZMalta, Deborah CarvalhoBernal, Regina Tomie Ivata
<em>Malta, Deborah Carvalho</em>;
<em>Bernal, Regina Tomie Ivata</em>;
<br/><br/>
INTRODUCTION: The article compares the risk and protective factors for Non-communicable Diseases (NCD), referred morbidity and access to preventive examinations in the population with and without health insurance in all Brazilian State capitals. METHODS: The study population consists of adults (≥ 18 years old) living in households with landlines in 26 Brazilian State capitals and the Federal District. Estimates of selected variables are presented according to possession of health plans ("Yes" or "No") and sex. A post-stratification was performed according to age, gender and education in both populations, and prevalence ratios were calculated, adjusted for age and sex between people with and without health insurance for the risk and protective factors for NCDs. RESULTS: A total of 54,099 people at the age of 18 or older were evaluated, 47.4% of them were beneficiaries of health plans. The coverage of health insurance tends to increase with age and level of education. Compared to non-beneficiaries of health plans, beneficiaries were more likely to have protective factors, such as healthy eating, physical activity, coverage tests, such as mammography and Pap test, and lower prevalence of risk factors such as smoking, physical inactivity, poor health assessment and hypertension. Alcohol abuse, consumption of excessively fat meats, overweight, obesity and diabetes were not associated with the variable possession of health insurance. When controlled by education, individuals who have health insurance generally have better indicators. CONCLUSION: This information is important to establish measures for reducing differences among people with and without health insurance.Utilization of public and private health services by the population of Belo Horizonte10.1590/1809-45032014000500202017-01-10T00:03:00Z2017-01-10T00:03:00ZCastanheira, Carlos Henrique CamposPimenta, Adriano MarçalLana, Francisco Carlos FélixMalta, Deborah Carvalho
<em>Castanheira, Carlos Henrique Campos</em>;
<em>Pimenta, Adriano Marçal</em>;
<em>Lana, Francisco Carlos Félix</em>;
<em>Malta, Deborah Carvalho</em>;
<br/><br/>
OBJECTIVE: To analyze the differences in health services utilization by users of Brazilian Unified Health System (SUS) and beneficiaries of Supplemental Health (SH). METHODS: A total of 288 adult subjects, residing in Belo Horizonte, who participated in the VIGITEL telephone survey in 2009, composed the sample, whose variables were analyzed according to the classification as users of SUS or beneficiaries of SH. Prevalence Ratios (PR), adjusted for sex, age and schooling, were calculated to evaluate differences between groups. RESULTS: Need and demand for health services were similar between groups, and users of SUS were less successful in obtaining service (PR = 0.78; p = 0.027). Most participants in both groups evaluated the health care received as very good/good without significant differences (72.1% for SUS, 84.0% for SH; p > 0.05). CONCLUSION: Although there are differences in the utilization of health services in Belo Horizonte, the service obtained is well rated by both users of SUS and health plans.Trends in prevalence of overweight and obesity in adults in 26 Brazilian state capitals and the Federal District from 2006 to 201210.1590/1809-45032014000500212017-01-10T00:03:00Z2017-01-10T00:03:00ZMalta, Deborah CarvalhoAndrade, Silvania CaribéClaro, Rafael MoreiraBernal, Regina Tomie IvataMonteiro, Carlos Augusto
<em>Malta, Deborah Carvalho</em>;
<em>Andrade, Silvania Caribé</em>;
<em>Claro, Rafael Moreira</em>;
<em>Bernal, Regina Tomie Ivata</em>;
<em>Monteiro, Carlos Augusto</em>;
<br/><br/>
OBJECTIVE: To describe the annual evolution of the prevalence of overweight and obesity in the adult population of the 26 Brazilian state capitals and the Federal District from 2006 to 2012. METHODS: Annual interviews (around 54,000 per year) from VIGITEL (Surveillance System of Risk and Protective Factors for Chronic Non-Communicable Diseases through Telephone Interviews) were used. Self-reported weight and height were used to estimate body mass index and nutritional status. Prevalence estimates of overweight and obesity are presented according to gender, age and schooling and to each city. Linear regression model was used to evaluate the time trend of prevalence. RESULTS: Prevalence of overweight in adults in the 27 cities monitored by VIGITEL increased from 43.2% (2006) to 51.0% (2012), with an annual increase rate of 1.37%. Prevalence of obesity increased from 11.6% to 17.4%, with an annual increase rate of 0.89%. The study showed a statistically significant increase in the prevalence of overweight in all cities, and for both genders, all age groups and all levels of schooling. Similar trends were also verified for obesity. CONCLUSIONS: If the trends verified from 2006 to 2012 are maintained, in ten years, around two-thirds of the adults in Brazilian state capitals will be overweight, and a quarter will be obese. This perspective requests urgent response from government and intersectoral actions to combat the obesogenic environment.