Background Hypertension can be detected at the primary health-care level and low-cost treatments can effectively control hypertension. We aimed to measure the prevalence of hypertension and progress in its detection, treatment, and control from 1990 to 2019 for 200 countries and territories. MethodsWe used data from 1990 to 2019 on people aged 30-79 years from population-representative studies with measurement of blood pressure and data on blood pressure treatment. We defined hypertension as having systolic blood pressure 140 mm Hg or greater, diastolic blood pressure 90 mm Hg or greater, or taking medication for hypertension. We applied a Bayesian hierarchical model to estimate the prevalence of hypertension and the proportion of people with hypertension who had a previous diagnosis (detection), who were taking medication for hypertension (treatment), and whose hypertension was controlled to below 140/90 mm Hg (control). The model allowed for trends over time to be non-linear and to vary by age.Findings The number of people aged 30-79 years with hypertension doubled from 1990 to 2019, from 331 (95% credible interval 306-359) million women and 317 (292-344) million men in 1990 to 626 (584-668) million women and 652 (604-698) million men in 2019, despite stable global age-standardised prevalence. In 2019, age-standardised hypertension prevalence was lowest in Canada and Peru for both men and women; in Taiwan, South Korea, Japan, and some countries in western Europe including Switzerland, Spain, and the UK for women; and in several low-income and middle-income countries such as Eritrea, Bangladesh, Ethiopia, and Solomon Islands for men. Hypertension prevalence surpassed 50% for women in two countries and men in nine countries, in central and eastern Europe, central Asia, Oceania, and Latin America. Globally, 59% (55-62) of women and 49% (46-52) of men with hypertension reported a previous diagnosis of hypertension in 2019, and 47% (43-51) of women and 38% (35-41) of men were treated. Control rates among people with hypertension in 2019 were 23% (20-27) for women and 18% (16-21) for men. In 2019, treatment and control rates were highest in South Korea, Canada, and Iceland (treatment >70%; control >50%), followed by the USA, Costa Rica, Germany, Portugal, and Taiwan. Treatment rates were less than 25% for women and less than 20% for men in Nepal, Indonesia, and some countries in sub-Saharan Africa and Oceania. Control rates were below 10% for women and men in these countries and for men in some countries in north Africa, central and south Asia, and eastern Europe. Treatment and control rates have improved in most countries since 1990, but we found little change in most countries in sub-Saharan Africa and Oceania. Improvements were largest in high-income countries, central Europe, and some upper-middle-income and recently high-income countries including
Obesity is the nutritional disorder which has shown the greatest increase in prevalence, even in those countries in which deficiency diseases represent a severe public health problem. The goal of the present study was to analyse the anthropometric profile of a community living in the outskirts of Maceió, capital of Alagoas (northeastern Brazil), and to investigate the hypothesis of a coexistence of undernutrition and obesity in a very low-income population. The survey was conducted on 315 families (1247 individuals). Among the children (aged < or =10 years), the prevalence of wasting, stunting and wasting plus stunting was 3.8, 8.3 and 8.7 % respectively. Wasting (10.2 %) was the most prevalent form of undernutrition among adolescents; nonetheless, a higher frequency of stunting (11 %) and overweight-obesity (5.5 %) was seen specifically in girls, in agreement with trends found in other studies. Adults exhibited a high prevalence of overweight-obesity (25 %), but stunting was also present (22 %). Of the stunted individuals, 30 % were overweight-obese and 16.3 % were underweight. There were eighty-six families with at least one parent who was underweight (27 %) and 104 families with at least one parent who was overweight (33 %). Underweight and overweight-obesity were both present in ninety-six households (30 %). These results may indicate that better living conditions in urban areas in a population 'adapted' to chronic famine might increase the susceptibility to obesity. Considering the harm caused by the cumulative effect of these two conditions (undernutrition in childhood and obesity in adult life) there is a clear need for new studies to uncover the determinant factors so that preventive measures can be implemented.
Prevalência e fatores associados à Insegurança Alimentar e Nutricional em famílias dos municípios do norte de Alagoas, Brasil, 2010Prevalence and factors associated with food and nutrition insecurity in families in municipalities of the north of the State of Alagoas, Brazil, 2010
Este trabalho teve por objetivo estimar a prevalência de anemia em crianças brasileiras segundo diferentes cenários epidemiológicos. Para isso, realizou-se uma revisão sistemática com metanálise dos resultados de estudos observacionais publicados nos últimos dez anos. A pesquisa de artigos foi efetuada nas bases do SciELO e PubMed, usando-se a palavra-chave "anemia" combinada com criança e Brasil. Após aplicação dos critérios de exclusão (artigos de revisão; anemia de etiologia não nutricional; diagnóstico não baseado no nível de hemoglobina (Hb<11g/dL); amostra envolvendo crianças >7 anos; ausência de dados de prevalência; e não identificação do local de estudo, da amostra, da faixa etária e/ou do método diagnóstico), foram selecionados 35 artigos, posteriormente categorizados segundo a origem de suas amostras: creches/escolas n=8, serviços de saúde n=12, populações em iniquidades n=6 e estudos de base populacional n=9. Por meio de metanálise, calcularam-se a prevalência média de anemia ponderada pelos respectivos tamanhos amostrais e a razão de chances para um intervalo de confiança de 95%, assumindo-se a prevalência de estudos de base populacional como referência n=1 (CRC=1), e obtiveram-se os seguintes resultados, respectivamente: creches/escolas: 52,0%, 1,61 (1,5-1,8); serviços de saúde: 60,2%, 2,26 (2,1-2,4); populações em iniquidades: 66,5%, 2,96 (2,6-3,4) e estudos de base populacional: 40,1%, com p<0,0001 para todas as comparações (χ2). A anemia continua representando um grave problema de saúde pública nos distintos cenários analisados, justificando receber atenção prioritária por parte dos gestores das políticas públicas das diferentes esferas de governo no País.
anemia prevalence in pregnant women from the semiarid region of Alagoas constitutes a major health problem, deserving special attention by the people in charge of public policy.
Objective: To investigate the prevalence of overweight and its association with socioeconomic, biological, and maternal factors in children under 5 years of age in the semiarid region of the state of Alagoas.Methods: This was a cross-sectional study with a representative sample. We evaluated child variables (excess weight, sex, birth weight, prematurity, duration of breastfeeding, and origin) and mother variables (excess weight, central obesity, income, education, and smoking during pregnancy). Excess weight in children was defined based on the weightfor-height ≥ 1 z score; in mothers, overweight and central obesity were identified by mass body index ≥ 30 kg/m 2 and waist circumference ≥ 80 cm, respectively. We conducted logistic regression, adopting overweight as an outcome, considering as significant p < 0.05. Results:The sample comprised 963 children, with a mean age of 27.7 months (SD ±17.3). The prevalence of overweight children was 28.5%, directly associated with central obesity in the mother (odds ratio = 1.46; 95%CI 1.07-1.98) and duration of non-exclusive breastfeeding for a period of less than 6 months (odds ratio = 1.82, 95%CI 1.31-2.51). Conclusions:This study showed a high prevalence of overweight children under 5 years of age associated with central obesity in the mother and non-exclusive breastfeeding for a period less than 6 months. These findings suggest that breastfeeding may protect children against overweight and point to the need for primary and secondary prevention of maternal central obesity.J Pediatr (Rio J). 2012;88(4):347-52: Overweight, obesity, anthropometry, childhood. ResumoObjetivo: Investigar a prevalência do excesso de peso e sua associação com fatores socioeconômicos, biológicos e maternos em menores de 5 anos da região semiárida do estado de Alagoas.Métodos: Estudo transversal, com amostra representativa. Foram avaliadas variáveis da criança (excesso de peso, sexo, peso ao nascer, prematuridade, duração do aleitamento materno e procedência) e da mãe (excesso de peso, obesidade central, renda, escolaridade e fumo durante a gestação). O excesso de peso nas crianças foi definido com base no índice peso/estatura ≥ 1 escore z, e nas mães, o excesso de peso e a obesidade central foram identificados pelo índice de massa corporal ≥ 30 kg/m 2 e circunferência da cintura ≥ 80 cm, respectivamente. Realizou-se regressão logística, adotando-se o excesso de peso como desfecho, considerando-se significante p < 0,05. Resultados:A amostra foi composta por 963 crianças, com média de idade de 27,7 meses (desvio padrão ±17,3). A prevalência de excesso de peso em crianças foi de 28,5% e diretamente associada à obesidade central na mãe (odds ratio = 1,46; IC95% 1,07-1,98) e duração do aleitamento materno não exclusivo por um período inferior a 6 meses (odds ratio = 1,82; IC95% 1,31-2,51). Conclusões:Este estudo mostrou uma elevada prevalência de excesso de peso em menores de 5 anos associada à obesidade central na mãe e ao aleitamento materno não exclusivo por um período inferior a 6 meses. ...
OBJETIVOS: verificar a prevalência de desnutrição energético-protéica (DEP), anemia e enteroparasitoses em crianças de uma favela do "Movimento dos Sem Teto". MÉTODOS: estudo transversal envolvendo 137 crianças (6-60 meses). Como indicador da DEP aplicou-se o ponto de corte z < -2 aos indicadores peso para idade (P/I), altura para idade (A/I) e peso para altura (P/A), relativamente ao padrão do NCHS. Para caracterização da anemia, usou-se método da Organização Mundial de Saúde, (haemoglobin colour scale). Concentração de hemoglobina < 11g/dl caracterizou o estado de anemia. Todas as crianças foram submetidas a exame parasitológico de fezes. RESULTADOS: as prevalências de deficits nutricionais para os indicadores A/I, P/I e P/A foram, respectivamente, 22,6%, 16,1% e 1,5%. Quase todas as crianças apresentaram pelo menos um tipo de parasita (83,2%). Destas, 50,9% eram poliparasitadas. As associações mais freqüentes foram Ascaris + Trichuris (15,7%) e Ascaris + Giardia (13%). A anemia foi detectada em 96,4% das crianças. CONCLUSÕES: em virtude das altas prevalências de DEP, anemia e parasitoses e, considerando o efeito sinérgico entre desnutrição e infecções, conclui-se que o quadro de saúde verificado é extremamente precário, requerendo intervenção imediata a fim de garantir melhores condições de crescimento, desenvolvimento para essas crianças.
Resumo: Neste artigo, encontra-se estudado o direito à saúde indígena, por normas pouco analisadas no sistema jurídico brasileiro. Para isto, foi investigada sua construção histórica e foram coletados documentos e registros verbais por trabalho de campo frente aos povos de Alagoas. Abstract: In this article, the right to indigenous health is studied, by norms little analyzed in the Brazilian legal system. For this, its historical construction was investigated and verbal documents and records were collected for field work in contact with Alagoas peoples. Sumário: Considerações Iniciais 1. A relevância das Conferências sobre saúde indígena. 2. A distribuição e aspectos históricos das etnias indígenas no estado. 3. A relação dos povos indígenas com gestores de saúde. Considerações Finais. Referências.
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