BackgroundWith an estimated 74% of all deaths attributable to non-communicable diseases (NCDs) in 2010, NCDs have become a major health priority in Brazil. The objective of the study was to conduct a comprehensive literature review on diabetes in Brazil; specifically: the epidemiology of type 2 diabetes, the availability of national and regional sources of data (particularly in terms of direct and indirect costs) and health policies for the management of diabetes and its complications.MethodsA literature search was conducted using PubMed to identify articles containing information on diabetes in Brazil. Official documents from the Brazilian government and the World Health Organization, as well as other grey literature and official government websites were also reviewed.ResultsFrom 2006 to 2010, an approximate 20% increase in the prevalence of self-reported diabetes was observed. In 2010, it was estimated that 6.3% of Brazilians aged 18 years or over had diabetes. Diabetes was estimated to be responsible for 278,778 years of potential life lost for every 100,000 people. In 2013, it is estimated that about 7% of patients with diabetes has had one or more of the following complications: diabetic foot ulcers, amputation, kidney disease, and fundus changes. The estimated annual direct cost of diabetes was USD $3.952 billion in 2000; the estimated annual indirect cost was USD $18.6 billion. The two main sources of data on diabetes are the information systems of the Ministry of Health and surveys. In the last few years, the Brazilian Ministry of Health has invested considerably in improving surveillance systems for NCDs as well as implementing specific programmes to improve diagnosis and access to treatment.ConclusionsBrazil has the capacity to address and respond to NCDs due to the leadership of the Ministry of Health in NCD prevention activities, including an integrated programme currently in place for diabetes. Strengthening the surveillance of NCDs is a national priority along with recognising the urgent need to invest in improving the coverage and quality of mortality data. It is also essential to conduct regular surveys of risk factors on a national scale in order to design effective preventive strategies.

BackgroundWe describe the temporal variation in viral agents detected in influenza like illness (ILI) patients before and after the appearance of the ongoing pandemic influenza A (H1N1) (pH1N1) in Peru between 4-January and 13-July 2009.MethodsAt the health centers, one oropharyngeal swab was obtained for viral isolation. From epidemiological week (EW) 1 to 18, at the US Naval Medical Research Center Detachment (NMRCD) in Lima, the specimens were inoculated into four cell lines for virus isolation. In addition, from EW 19 to 28, the specimens were also analyzed by real time-polymerase-chain-reaction (rRT-PCR).ResultsWe enrolled 2,872 patients: 1,422 cases before the appearance of the pH1N1 virus, and 1,450 during the pandemic. Non-pH1N1 influenza A virus was the predominant viral strain circulating in Peru through (EW) 18, representing 57.8% of the confirmed cases; however, this predominance shifted to pH1N1 (51.5%) from EW 19–28. During this study period, most of pH1N1 cases were diagnosed in the capital city (Lima) followed by other cities including Cusco and Trujillo. In contrast, novel influenza cases were essentially absent in the tropical rain forest (jungle) cities during our study period. The city of Iquitos (Jungle) had the highest number of influenza B cases and only one pH1N1 case.ConclusionsThe viral distribution in Peru changed upon the introduction of the pH1N1 virus compared to previous months. Although influenza A viruses continue to be the predominant viral pathogen, the pH1N1 virus predominated over the other influenza A viruses.

Este trabalho tem o objetivo de analisar a relação de causalidade entre renda e saúde, buscando controlar as potenciais diferenças dessa relação ao longo do território brasileiro. Para tanto, três testes de causalidade de Granger para dados em painel, propostos respectivamente por Holtz-Eakin et al. (1988), Granger e Huang (1997) e Hurlin (2005, 2007), são aplicados para uma base de dados com os estados brasileiros, no períodocompreendido entre 1981-2007. Os principais resultados mostram que as conclusões podem ser enganosas quando são baseadas em testes com uma estrutura homogênea nos parâmetros. E assim, o teste proposto por Hurlin (2005, 2007), que controla os diferentes tipos de heterogeneidade, aponta que, no Brasil, as evidências são mais claras para causalidade no sentido da saúde para a renda.

Resumo: O artigo estuda a relação entre as variações da taxa de câm-bio e os preços das exportações dos principais produtos exportados pelo Brasil, o chamado pass-through da taxa de câmbio. Utiliza-se o modelo de parâmetros variáveis no tempo para estimar os coeficientes de pass-through. Os resultados sugerem que o pass-through incompleto das taxas de câmbio predomina nos setores analisados, bem como com relação às exportações totais. Esses resultados confirmam as estimativas de outros estudos e também mostram que o comportamento desse fenômeno, ao longo do tempo, depende do setor analisado.Palavras-chave: coeficiente de pass-through, taxa de câmbio, preços das exportações, Brasil.

High fertility rates among disadvantaged subgroups are a public health problem because fertility levels significantly affect socioeconomic conditions and a population’s welfare. This paper aims to analyze the sociodemographic, behavioral, and reproductive factors associated with fertility rates among Brazilian women aged between 15–49 years. A Poisson regression was used to analyze data from the 2006 PNDS (Pesquisa Nacional de Demografia e Saúde da Criança e da Mulher), which evaluates socioeconomic, demographic, geographic, reproductive, behavioral, and chronic disease variables. The results show that the following characteristics are positively associated with an increase in the number of children born: being aged 20–24, residing in the North, being nonwhite, not being in paid employment, having lower education levels, having lower socioeconomic status, being in a stable union, having the first sexual intercourse before the age of 16 and having the first child before the age of 20. Thus, it is important to implement efficient family planning policies targeting these subgroups in order to improve life conditions, reduce inequalities and avoid the adverse outcomes of high fertility.

Desigualdade no acesso a medicamentos para doenças crônicas em mulheres brasileiras Inequality in Brazilian women's access to medicines for chronic diseases Inequidad en el acceso a medicamentos para enfermedades crónicas en mujeres brasileñas

BackgroundThe present study aimed to examine the impact of socioeconomic, demographic, and health status-related factors on out-of-pocket expenditure on health care for children.MethodsData were obtained from a birth cohort study conducted in the city of Pelotas, state of Rio Grande do Sul (RS), southern Brazil, in 2004. The final sample is a result of adjusts made in order to keep in the analysis only those that attended to 3 follow-ups (at 12, 24 and 48 months of age). Estimates were carried out using the Panel Data Tobit Model with random effects.ResultsThe study showed that expenditure on medicines was 20 % less likely in those considered healthy children by their mothers and, if there was any expenditure with healthy children, the expected expenditure was reduced by 58 %. A 1 % increase in household income increased the expected expenditure on medicines by 16 %, and by 23 % in children with private health insurance coverage.ConclusionsAll types of health care expenditures examined were higher for children covered by private health insurance. Although total health care expenditure was higher for children of better-off families, it represented a lower share of these families’ income evidencing income inequality in health care expenditures.Electronic supplementary materialThe online version of this article (doi:10.1186/s12939-015-0180-0) contains supplementary material, which is available to authorized users.

Este trabalho tem o objetivo de analisar os determinantes socioeconômicos do estado de saúde das crianças do Brasil rural por meio dos dados da PNAD 2008. Para tanto, foram utilizados os modelos probit e probit ordenado. Os principais resultados mostram que fatores como melhor saúde dos pais, maior nível de renda, maiores níveis de informação, acesso à água de melhor qualidade, além de políticas públicas como o Programa Saúde da Família se relacionam positivamente com a saúde das crianças. Além do impacto negativo das condições socioeconômicas precárias sobre a saúde na infância, sabe-se que a pior saúde infantil pode gerar, no futuro, novas condições socioeconômicas precárias para estas crianças. Deste modo, este círculo pode ser um mecanismo de perpetuação da pobreza.Portanto, políticas públicas que afetem a saúde na infância podem ser bastante benéficas para a população
This study aims to analyze the socioeconomic determinants of children's individual health state in the countryside of Brazil, using data from PNAD 2008. Probit and ordered probit were used in the analysis. Main results show that elements, such as better health of parents, higher income, higher information levels, access to high quality water, besides governmental policies, such as ProgramaSaúde da Família,are positively related with children's health. Besides the negative effect of the poor socioeconomic conditions on health in childhood, it is known that worse health in childhood can generate, in the future, new poor socioeconomic conditions forthese children. Thus, this circle could be a mechanism of poverty perpetuation. Therefore, governmental policies which affect children's health in a positive way can promote favorable resultsfor the population