Revista Brasileira de Epidemiologiahttps://www.scielosp.org/journal/rbepid/feed/2017-01-10T00:03:00ZVol. 27 - 2024WerkzeugSuicide attempts in the adult Mexican population: an analysis of sociodemographic characteristics and associated factors10.1590/1980-5497202400142017-01-10T00:03:00Z2017-01-10T00:03:00ZDavila-Cervantes, Claudio AlbertoLuna-Contreras, Marisol
<em>Davila-Cervantes, Claudio Alberto</em>;
<em>Luna-Contreras, Marisol</em>;
<br/><br/>
ABSTRACT Objective: Suicide is the culmination of a process or continuum known as suicidal behavior that proceeds from ideation and planning to attempt. The objective was to estimate the prevalence of suicide attempts in the adult Mexican population and to analyze their main associated factors. Methods: We conducted an observational, cross-sectional, and descriptive study with information from the National Health and Nutrition Survey (2018). Self-reported lifetime suicide attempt was used in the analysis. We analyzed depression, obesity, tobacco smoking, and alcohol consumption as suicide attempt-associated factors using a multivariate logistic regression model. Results: The prevalence of adult suicide attempt was 2.0% (95%CI 1.8–2.2) and it was higher among women (2.4%; 95%CI 2.2–2.8) and young people (2.9%; 95%CI 2.4–3.4). Low education (OR=1.6; 95%CI 1.2–2.2), being single (OR=1.3; 95%CI 1.0–1.6), having obesity (OR=1.4; 95%CI 1.1–1.8), consumption of alcohol (OR=2.4; 95%CI 1.7–3.4) or tobacco smoking (OR=1.8; 95%CI 1.4–2.4), and having strong symptoms of depression (OR=10.1; 95%CI 6.2–16.3) were associated with a higher prevalence of suicide attempts. Conclusion: These results help better understand suicidal behavior in Mexico and identify the factors that increase the likelihood of suicide attempts, which is essential to help reduce suicide mortality. This research is crucial for developing early interventions and prevention programs aimed at reducing suicide's public health burden.Early-onset neonatal sepsis as a risk factor for peri-intraventricular hemorrhage in premature infants10.1590/1980-5497202400132017-01-10T00:03:00Z2017-01-10T00:03:00ZDenicol, Mariana MartinsLeotti, Vanessa BielefeldtSoares, Cátia Rejane Soares deHilgert, Juliana Balbinot
<em>Denicol, Mariana Martins</em>;
<em>Leotti, Vanessa Bielefeldt</em>;
<em>Soares, Cátia Rejane Soares De</em>;
<em>Hilgert, Juliana Balbinot</em>;
<br/><br/>
ABSTRACT Objective: To assess early-onset sepsis as a risk factor of peri-intraventricular hemorrhage in premature infants born at less than or equal to 34 weeks’ gestation and admitted to a neonatal intensive care unit (NICU). Methods: This retrospective cohort study included premature patients born at less than or equal to 34 weeks’ gestation who were admitted to the NICU of a tertiary hospital in southern Brazil, and born from January 2017 to July 2021. Data were collected from patients’ medical records. Early-onset sepsis was measured according to the presence or absence of diagnosis within the first 72 hours of life, whereas the outcome, peri-intraventricular hemorrhage, was described as the presence or absence of hemorrhage, regardless of its grade. Results: Hazard ratios were calculated using Cox regression models. A total of 487 patients were included in the study, of which 169 (34.7%) had some degree of peri-intraventricular hemorrhage. Early-onset sepsis was present in 41.6% of the cases of peri-intraventricular hemorrhage, which revealed a significant association between these variables, with increased risk of the outcome in the presence of sepsis. In the final multivariate model, the hazard ratio for early-onset sepsis was 1.52 (95% confidence interval 1.01–2.27). Conclusion: Early-onset sepsis and the use of surfactants showed to increase the occurrence of the outcome in premature children born at less than or equal to 34 weeks’ gestation. Meanwhile, factors such as antenatal corticosteroids and gestational age closer to 34 weeks’ gestations were found to reduce the risk of peri-intraventricular hemorrhage.Cancer mortality in workers at risk of occupational exposure to ionizing radiation in a company in the nuclear sector headquarters in São Paulo10.1590/1980-5497202400112017-01-10T00:03:00Z2017-01-10T00:03:00ZVieira, Glacy SabraMartinez, Maria CarmenCardoso, Maria Regina Alves
<em>Vieira, Glacy Sabra</em>;
<em>Martinez, Maria Carmen</em>;
<em>Cardoso, Maria Regina Alves</em>;
<br/><br/>
ABSTRACT Objective: To compare cancer mortality among workers exposed to gamma and X radiation and the general population of the city of São Paulo, as well as that of the subgroup monitored with those not monitored for gamma and X radiation in a work unit with ionizing radiation based in the city of São Paulo. Methods: Between 2016 and 2021, a retrospective open cohort study was carried out with workers who were employed from 08/31/1956 to 12/31/2016 based on data collected at the company and in official institutions. Standardized mortality ratios (SMR) were calculated by sex, age and calendar period of cancers grouped according to type, risk factor and organ system in two analyses: in the external analysis, the mortality of the study population was compared with that of the general population of the city of São Paulo; In the internal analysis, the mortality of the monitored subgroup was compared with that of the subgroup not monitored for gamma and X radiation. Results: The external mortality analysis showed SMR=0.224 (95%CI 0.208–0.240) and the healthy worker effect, while the internal mortality analysis showed SMR=0.685 (95%CI 0.618–0.758). Conclusion: This study showed lower cancer mortality among exposed workers when compared to mortality in the general population and the healthy worker effect. Among workers monitored for gamma and X radiation, cancer mortality was lower when compared to those not monitored.Sociodemographic inequalities in the incidence of COVID-19 in National Household Sample Survey cohort, Brazil, 202010.1590/1980-5497202400122017-01-10T00:03:00Z2017-01-10T00:03:00ZAguiar, Italo Wesley OliveiraPinto Junior, Elzo PereiraKendall, CarlKerr, Ligia Regina Franco Sansigolo
<em>Aguiar, Italo Wesley Oliveira</em>;
<em>Pinto Junior, Elzo Pereira</em>;
<em>Kendall, Carl</em>;
<em>Kerr, Ligia Regina Franco Sansigolo</em>;
<br/><br/>
ABSTRACT Objective: To verify the association between sociodemographic factors and the time until the occurrence of new cases of COVID-19 and positive tests for SARS-CoV-2 in Brazil, during the period from May to November 2020, based on a cohort of Brazilians participating in the COVID-19 National Household Sample Survey. Methods: A concurrent and closed cohort was created using monthly data from the PNAD COVID-19, carried out via telephone survey. A new case was defined based on the report of the occurrence of a flu-like syndrome, associated with loss of smell or taste; and positivity was defined based on the report of a positive test, among those who reported having been tested. Cox regression models were applied to verify associations. The analyzes took into account sample weighting, calibrated for age, gender and education distribution. Results: The cumulative incidence of cases in the overall fixed cohort was 2.4%, while that of positive tests in the fixed tested cohort was 27.1%. Higher incidences were observed in the North region, in females, in residents of urban areas and in individuals with black skin color. New positive tests occurred more frequently in individuals with less education and healthcare workers. Conclusion: The importance of prospective national surveys is highlighted, contributing to detailed analyzes of social inequalities in reports focused on public health policies.Spatial patterns of prematurity and its determinants in the metropolitan region of São Paulo, Brazil, 2010-201910.1590/1980-5497202400082017-01-10T00:03:00Z2017-01-10T00:03:00ZRodríguez, Elias Carlos AguirreRodríguez, Elen Yanina AguirreMarins, Fernando Augusto SilvaSilva, Aneirson Francisco daNascimento, Luiz Fernando Costa
<em>Rodríguez, Elias Carlos Aguirre</em>;
<em>Rodríguez, Elen Yanina Aguirre</em>;
<em>Marins, Fernando Augusto Silva</em>;
<em>Silva, Aneirson Francisco Da</em>;
<em>Nascimento, Luiz Fernando Costa</em>;
<br/><br/>
ABSTRACT Objective: To analyze spatial distribution of preterm births and their association with maternal, social, and health services indicators in the metropolitan region of São Paulo, Brazil, 2010-2019. Methods: Ecological study using data on preterm newborns from 39 municipalities in the metropolitan region of São Paulo. Univariate global Moran’s index (Im) was used to evaluate spatial association of prematurity, and univariate local Moran’s index by using the cluster map (LISA) to identify spatial patterns and clusters. Bivariate global Moran’s index was also used to analyze spatial autocorrelation with maternal, social, and health services indicators. Results: A total of 3,103,898 live births were registered in period 2010-2019, of which 331,174 (10.7%) were preterm. The global Moran’s index showed spatial independence (Im=0.05; p-value=0.233) of the proportion of preterm births between municipalities. However, in the local spatial analysis it was possible to identify a statistically significant spatial cluster between the municipalities of Biritiba Mirim, Guararema and Salesópolis, with high proportions of preterm births. In the bivariate analysis, a significant positive spatial association was identified with proportions of mothers under 20 years old (Im=0.17; p-value=0.024) and mothers with low schooling (Im=0.17; p-value=0.020), and a significant negative spatial association with HDI (Im=-0.14; p-value=0.039). Conclusions: The local spatial approach identified a spatial cluster located in the far east of the metropolitan region of São Paulo, where actions by health managers are needed to minimize occurrence of preterm births.Maternal health surveillance panel: a tool for expanding epidemiological surveillance of women’s health and its determinants10.1590/1980-5497202400092017-01-10T00:03:00Z2017-01-10T00:03:00ZDomingues, Rosa Maria Soares MadeiraRodrigues, Agatha SacramentoDias, Marcos Augusto BastosSaraceni, ValeriaFrancisco, Rossana Pulcineli VieiraPinheiro, Rejane SobrinhoCoeli, Claudia Medina
<em>Domingues, Rosa Maria Soares Madeira</em>;
<em>Rodrigues, Agatha Sacramento</em>;
<em>Dias, Marcos Augusto Bastos</em>;
<em>Saraceni, Valeria</em>;
<em>Francisco, Rossana Pulcineli Vieira</em>;
<em>Pinheiro, Rejane Sobrinho</em>;
<em>Coeli, Claudia Medina</em>;
<br/><br/>
ABSTRACT Objective: To present the methodology used in the development of two products for maternal health surveillance and its determinants and discuss their possible uses. Methods: Based on a theoretical model of the determinants of maternal death and databases of Brazilian health information systems, two free products were developed: an interactive panel “surveillance of maternal health” and an educational material “Aparecida: a story about the vulnerability of Brazilian women to maternal death”, both available on the website of the Brazilian Obstetric Observatory. Results: More than 30 indicators were calculated for the period 2012-2020, containing information on socioeconomic conditions and access to health services, reproductive planning, prenatal care, delivery care, conditions of birth and maternal mortality and morbidity. The indicators related to severe maternal morbidity in public hospitalizations stand out, calculated for the first time for the country. The panel allows analysis by municipality or aggregated by health region, state, macro-region and country; historical series analysis; and comparisons across locations and with benchmarks. Information quality data are presented and discussed in an integrated manner with the indicators. In the educational material, visualizations with national and international data are presented, aiming to help in the understanding of the determinants of maternal death and facilitate the interpretation of the indicators. Conclusion: It is expected that the two products have the potential to expand epidemiological surveillance of maternal health and its determinants, contributing to the formulation of health policies and actions that promote women’s health and reduce maternal mortality.Characteristics of house calls in Brazil: analysis of PMAQ-AB external evaluation cycles10.1590/1980-5497202400072017-01-10T00:03:00Z2017-01-10T00:03:00ZRocha, Luan Henrique HonórioRibeiro, Ana Graziela AraujoSilva, Vanessa AlmeidaSousa, Francenilde Silva deThomaz, Erika Barbara Abreu Fonseca
<em>Rocha, Luan Henrique Honório</em>;
<em>Ribeiro, Ana Graziela Araujo</em>;
<em>Silva, Vanessa Almeida</em>;
<em>Sousa, Francenilde Silva De</em>;
<em>Thomaz, Erika Barbara Abreu Fonseca</em>;
<br/><br/>
ABSTRACT Objective: To analyze characteristics of the home visit (HV) in Brazil, 2012 and 2017. Methods: Ecological study, with panel data whose units of analysis were the Primary Health Care teams in Brazil, participants of the 1st and 3rd cycles of the Program to Improve Access and Quality of Primary Care of the Unified Health System. Descriptive, inferential and spatial analyzes (alpha=5%) were performed. Results: There was an increase in the proportion of teams that carried out home visits at a frequency defined based on risk and vulnerability analysis and actively searched for people with respiratory symptoms and women with delayed and altered cytopathological examination. In the heat maps, the Northeast, Southeast and South regions had a higher concentration of teams that carried out the HV and carried out an active search. Conclusion: The maintenance and qualification of HVs must be a priority in Brazil, since there are few countries in the world with such capillarity of health services, reaching the homes of millions of people.Was the COVID-19 epidemic synchronous in space? An analysis in the health regions of the Rio de Janeiro state, 2020-202210.1590/1980-5497202400102017-01-10T00:03:00Z2017-01-10T00:03:00ZAmaral, Léa de FreitasLana, Raquel MartinsBastos, Leonardo Soares
<em>Amaral, Léa De Freitas</em>;
<em>Lana, Raquel Martins</em>;
<em>Bastos, Leonardo Soares</em>;
<br/><br/>
ABSTRACT Objective: To analyze the spatio-temporal dynamics of COVID-19 in the Rio de Janeiro state within the nine health regions, between March 2020 and December 2022. Methods: The Poisson model with random effects was used to smooth and estimate the incidence of COVID-19 hospitalizations reported in the Influenza Epidemiological Surveillance Information System (SIVEP-Gripe) to verify the synchronicity of the epidemic in the state. Results: The COVID-19 epidemic in the state is characterized by the presence of seven peaks during the analyzed period corresponding to seven found. An asynchrony in hospitalizations was identified, varying according to the different virus variants in the nine health regions of the state. The incidence peaks of hospitalizations ranged from 1 to 12 cases per 100,000 inhabitants during the pandemic. Conclusion: This spatio-temporal analysis is applicable to other scenarios, enabling monitoring and decision-making for the control of epidemic diseases in different areas.Sleep duration, insomnia and cognitive performance in the Elsa-Brasil cohort: a cross-sectional analysis10.1590/1980-5497202400062017-01-10T00:03:00Z2017-01-10T00:03:00ZRezende, Tamiris AmandaGiatti, LuanaMenezes, Sara Teles deGriep, Rosane HarterRibeiro, Pricila Cristina CorreaBarreto, Sandhi Maria
<em>Rezende, Tamiris Amanda</em>;
<em>Giatti, Luana</em>;
<em>Menezes, Sara Teles De</em>;
<em>Griep, Rosane Harter</em>;
<em>Ribeiro, Pricila Cristina Correa</em>;
<em>Barreto, Sandhi Maria</em>;
<br/><br/>
ABSTRACT Objective: To investigate the single and combined associations between sleep disturbances (sleep duration, insomnia symptoms in the last 30 nights, and daytime tiredness) and performance in cognitive tests. Methods: Cross-sectional analysis of data from visit 2 (2012–2014) of the Longitudinal Study of Adult Health from a cohort of active and retired civil servants from six Brazilian capitals. Polynomial regression with quadratic term and multiple linear regression models were performed to assess single and combined associations between sleep disturbances and memory performance, fluency, executive functions, and global cognition. Results: A total of 7,248 participants were included, with a mean age of 62.7 years (standard deviation [SD]=5.9), and 55.2% were women. Inverted U-shaped associations were observed between sleep duration and performance on all cognitive abilities, suggesting that durations shorter or longer than seven hours are associated with worse performance, regardless of age. Reported insomnia was associated with worse executive function (β: -0.08; 95% confidence interval [CI]: -0.15 to -0.01), and the magnitudes of associations were higher for individuals with insomnia at two or more moments (β: -0.12; 95%CI -0.19 to -0.05) or, especially, insomnia combined with short sleep (β: -0.18; 95%CI -0.24 to -0.11). Insomnia in two or more periods was also associated with lower memory and global cognition. There was no association between any sleep disturbance tested and verbal fluency. Isolated daytime tiredness was not associated with performance in the evaluated tests. Conclusion: The results suggest that extreme sleep durations are detrimental to almost all cognitive abilities investigated, whereas insomnia appears to affect more severely the executive function.Factors associated with hospitalizations and deaths of pregnant women from Paraná due to COVID-19: a cross-sectional study10.1590/1980-5497202400052017-01-10T00:03:00Z2017-01-10T00:03:00ZBergantini, Larissa SilvaIchisato, Sueli Mutsumi TsukudaSalci, Maria AparecidaBirolim, Marcela MariaSantos, Márcia Lorena Alves dosHöring, Carla FrancieleRossa, RobertaFacchini, Luiz Augusto
<em>Bergantini, Larissa Silva</em>;
<em>Ichisato, Sueli Mutsumi Tsukuda</em>;
<em>Salci, Maria Aparecida</em>;
<em>Birolim, Marcela Maria</em>;
<em>Santos, Márcia Lorena Alves Dos</em>;
<em>Höring, Carla Franciele</em>;
<em>Rossa, Roberta</em>;
<em>Facchini, Luiz Augusto</em>;
<br/><br/>
ABSTRACT Objective: To analyze the factors associated with hospitalization in the ward and intensive care unit (ICU), and with death from COVID-19 in pregnant women with confirmed cases. Methods: Observational, cross-sectional study, carried out with data from pregnant women with a confirmed case of COVID-19 from the Influenza Epidemiological Surveillance Information System and the Paraná’s state COVID-19 notification system. The association between the independent and dependent variables (hospitalization in the ward and ICU, and death) was investigated using the Poisson regression model with robust variance. Results: 4,719 pregnant women comprised the study population. 9.6 and 5.1% were hospitalized in wards and ICU, respectively. 1.9% died. There was an association between advanced maternal age and hospitalization in wards (PR=1.36; 95%CI 1.10–1.62) and ICU (PR=2.25; 95%CI 1.78–2.71), and death (PR=3.22; 95%CI 2.30–4.15). An association was found between the third trimester and hospitalization in wards (PR=5.06; 95%CI 2.82–7.30) and ICU (PR=6.03; 95%CI 3.67–8.39) and death (PR=13.56; 95%CI 2.90–24.23). The second trimester was associated with ICU admission (PR=2.67; 95%CI 1.36–3.99). Pregnant women with cardiovascular disease had a higher frequency of hospitalization in wards (PR=2.24; 95%CI 1.43–3.05) and ICU (PR=2.66; 95%CI 1.46–3.87). Obesity was associated with ICU admission (PR=3.79; 95%CI 2.71–4.86) and death (PR=5.62; 95%CI 2.41–8.83). Conclusions: Advanced maternal age, the end of the gestational period and comorbidities were associated with severe COVID-19.Interactive monitoring dashboards for the COVID-19 pandemic in the world anticipating waves of the disease in Brazil with the use of open data10.1590/1980-5497202400042017-01-10T00:03:00Z2017-01-10T00:03:00ZSchrarstzhaupt, Isaac NegrettoBragatte, Marcelo Alves de SouzaKawano-Dourado, LetíciaOliveira, Leonardo Rovatti deVieira, Gustavo FioravantiDiaz-Quijano, Fredi AlexanderFontes-Dutra, Mellanie
<em>Schrarstzhaupt, Isaac Negretto</em>;
<em>Bragatte, Marcelo Alves De Souza</em>;
<em>Kawano-Dourado, Letícia</em>;
<em>Oliveira, Leonardo Rovatti De</em>;
<em>Vieira, Gustavo Fioravanti</em>;
<em>Diaz-Quijano, Fredi Alexander</em>;
<em>Fontes-Dutra, Mellanie</em>;
<br/><br/>
ABSTRACT Objective: Describe the development, implementation, and utilization of dashboards for epidemiological analysis through open data research during the COVID-19 pandemic. Methods: The dashboards were designed to analyze COVID-19 related public data from various sources, including official government data and social media, at world level. Data processing and cleaning techniques were used to join datasets. We calculated Spearman correlation coefficient between the COVID-like symptoms data of the University of Maryland and Facebook Health research, called COVID Trends and Impacts Survey (CTIS) and the official data of notified COVID-19 cases by the Brazilian Health Ministry. Results: The dashboards were successful in predicting the onset of new waves of COVID-19 in Brazil. The data analysis revealed a correlation between the CTIS and the official number of cases the country. This article shows the potential of interactive dashboards as a decision-making tool in the context of public health emergencies, as it was used by the official communication of the Rio Grande do Sul state government. Conclusion: The use of dashboards for predicting the spread of COVID-19 in Brazil was a useful tool for decision-making. To anticipate waves of the disease gives time so that these decisions can be potentially more assertive. This drafts the need of more interdisciplinary actions of this nature, with visualization tools on epidemiologic research.Cancer mortality in childhood and adolescence: analysis of trends and spatial distribution in the 133 intermediate Brazilian regions grouped by macroregions10.1590/1980-5497202400032017-01-10T00:03:00Z2017-01-10T00:03:00ZVelame, Kamila TessaroloAntunes, José Leopoldo Ferreira
<em>Velame, Kamila Tessarolo</em>;
<em>Antunes, José Leopoldo Ferreira</em>;
<br/><br/>
ABSTRACT Objective: To assess the magnitude, trend, and spatial patterns of childhood and adolescent cancer mortality between 1996 and 2017 in 133 Brazilian intermediate regions by using socioeconomic and healthcare services indicators. Methods: This is an ecological study for analyzing the trend of mortality from cancer in childhood and adolescence through time series. Data on deaths were extracted from the Brazilian Mortality Information System. Data on population were extracted from the 1991, 2000, and 2010 demographic censuses of the Brazilian Institute of Geography and Statistics, with interpolation for intercensal years. Time series were delineated for mortality by type of cancer in each intermediate region. Such regions were grouped by macroregions to present the results. The calculation and interpretation of mortality trends use the Prais-Winsten autoregression procedure. Results: Mortality rates for all neoplasms were higher in the Northern region (7.79 deaths per 100 thousand population), while for leukemias, they were higher in the Southern region (1.61 deaths per 100 thousand population). In both regions, mortality was higher in boys and in the 0-4 age group. The trend was decreasing (annual percent change [APC] – -2.11 [95%CI: -3.14; - 1.30]) for all neoplasms in the Brazilian regions and stationary (APC – -0.43 [95%CI: -1.61; 2.12]) for leukemias in the analyzed period. Conclusion: The mortality rate for all neoplasms showed higher values in regions with smaller numbers of ICU beds in the public healthcare system.Trends on deaths from acute pesticide poisoning in Mexico, 2000–202110.1590/1980-5497202400012017-01-10T00:03:00Z2017-01-10T00:03:00ZMoreno-Godínez, Ma. ElenaFlores-Alfaro, EugeniaParra-Rojas, IselaMedina-Diaz, Irma MarthaRojas-García, Aurora ElizabethAvilés-Ramírez, CristianCampos-Viguri, GabrielaRamírez-Vargas, Marco Antonio
<em>Moreno-Godínez, Ma. Elena</em>;
<em>Flores-Alfaro, Eugenia</em>;
<em>Parra-Rojas, Isela</em>;
<em>Medina-Diaz, Irma Martha</em>;
<em>Rojas-García, Aurora Elizabeth</em>;
<em>Avilés-Ramírez, Cristian</em>;
<em>Campos-Viguri, Gabriela</em>;
<em>Ramírez-Vargas, Marco Antonio</em>;
<br/><br/>
ABSTRACT Objetive: To provide a comprehensive analysis of mortality trends from acute pesticide poisoning in Mexico from 2000 through 2021. Methods: The governmental records of deaths from acute pesticide poisoning were used. The age-standardized years of life lost and aged-standardized mortality rates were estimated. Significant changes in trends of annual percentage change were identified using Joinpoint regression. Results: Between 2000 and 2021, mortality was primarily observed in individuals aged 15 to 19 years. Males were the most affected. Self-inflicted pesticide poisoning was the primary registered reason for death. The age-standardized mortality rate from acute pesticide poisoning was reduced from 2012 to 2021 (APC: -4.4; p=0.003). Conclusion: This report is the first study about the mortality rate from acute pesticide poisoning in Mexico. The results provided evidence to consider in developing laws to prevent acute pesticide poisoning.Spatial analysis of care for patients undergoing dialysis therapy in the state of Minas Gerais, Brazil, between 2015 and 201910.1590/1980-5497202400022017-01-10T00:03:00Z2017-01-10T00:03:00ZPereira, Claudio VitorinoLeite, Isabel Cristina GonçalvesNogueira, Mário CírioFerreira, Gustavo Fernandes
<em>Pereira, Claudio Vitorino</em>;
<em>Leite, Isabel Cristina Gonçalves</em>;
<em>Nogueira, Mário Círio</em>;
<em>Ferreira, Gustavo Fernandes</em>;
<br/><br/>
ABSTRACT Objective: To analyze the spatial flow of care for patients undergoing dialysis therapy in the health regions of the State of Minas Gerais. Methods: Ecological study whose population was patients undergoing dialysis therapy in public, philanthropic institutions or whose treatment was paid for by the Unified Health System in private clinics in partnership, in the State of Minas Gerais. Patients were grouped by health region of residence. The proportions of patients who underwent dialysis were calculated, as well as enrollment on the kidney transplant list in their own region of residence or outside it. Person correlations of these proportions with socioeconomic and care indicators of the health regions were estimated. Spatial exploratory techniques estimated general (Moran’s I) and local (LISA) spatial correlation coefficients. Results: Regions with higher GDP had a higher number of nephrologists and a higher proportion of registrations in the region of residence. A cluster of regions with low GDP was identified further to the northeast of the State (also with lower nephrologist ratio values), a cluster with a high proportion of those registered on the transplant list in the center of the State, and a cluster with a low proportion of dialysis in the same region of residence further southeast. Conclusion: Regional disparities were evident in relation to the proportion of patients registered on the waiting list for kidney transplantation, the proportion of patients undergoing dialysis in the same region of residence and the proportion of patients registered on the waiting list for kidney transplantation in the same region of residence. residence.