Neonatal screening tests in Brazil: prevalence rates and regional and socioeconomic inequalities

Mallmann, Mariana B.; Tomasi, Yaná Tamara; Boing, Antônio Fernando

doi:10.1016/j.jped.2019.02.008

Cited by 37 publications

(49 citation statements)

References 24 publications

(26 reference statements)

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“…The antibiotics used to treat a bacterial infection, especially in sick babies with a genetic predisposition, may affect their hearing health. Thus, many individuals with disabling hearing impairment are disadvantaged children who have been exposed to several risk factors during their prenatal, perinatal, or neonatal period of development or have experienced inequalities in access to screening tests ( Mallmann et al., 2020 ). Parent SEP’s role is crucial, as many of these factors are closely linked to socially and economically deprived households and neighborhoods, for example, the cytomegalovirus infection, or nutritional deficiencies ( Olusanya et al., 2014 ).…”

Section: Resultsmentioning

confidence: 99%

Conceptual Model of Hearing Health Inequalities (HHI Model): A Critical Interpretive Synthesis

et al. 2021

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Hearing loss is a major health challenge that can have severe physical, social, cognitive, economic, and emotional consequences on people’s quality of life. Currently, the modifiable factors linked to socioeconomic inequalities in hearing health are poorly understood. Therefore, an online database search (PubMed, Scopus, and Psych) was conducted to identify literature that relates hearing loss to health inequalities as a determinant or health outcome. A total of 53 studies were selected to thematically summarize the existing literature, using a critical interpretive synthesis method, where the subjectivity of the researcher is intimately involved in providing new insights with explanatory power. The evidence provided by the literature can be summarized under four key themes: (a) There might be a vicious cycle between hearing loss and socioeconomic inequalities and lifestyle factors, (b) socioeconomic position may interact with less healthy lifestyles, which are harmful to hearing ability, (c) increasing health literacy could improve the diagnosis and prognosis of hearing loss and prevent the adverse consequences of hearing loss on people’s health, and (d) people with hearing loss might be vulnerable to receiving low-quality and less safe health care. This study uses elements from theoretical models of health inequalities to formulate a highly interpretive conceptual model for examining hearing health inequalities. This model depicts the specific mechanisms of hearing health and their evolution over time. There are many modifiable determinants of hearing loss, in several stages across an individual’s life span; tackling socioeconomic inequalities throughout the life-course could improve the population’s health, maximizing the opportunity for healthy aging.

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Section: Resultsmentioning

confidence: 99%

Conceptual Model of Hearing Health Inequalities (HHI Model): A Critical Interpretive Synthesis

et al. 2021

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“…We found a higher prevalence for the Guthrie test because it has been instituted and required since 1976, but the prevalence rate was only 63.6%, and the test was done between the newborns’ third and seventh days. This rate was lower than the national prevalence rate (70.8%) found in the National Health Survey ( PNS per its Portuguese acronym) performed in Brazil in 2013, and low compared with other countries in Latin America (99%) [ 16 ], even though the prevalence rate in rural settings increased by approximately 10% between 2004 and 2017 [ 10 ] The PNS shows regional inequalities, with a higher prevalence of testing in the South and Southeast regions. When we analyzed the results at the end of the neonatal study period, we found considerable improvement over the prevalence reported in the Neonatal Call Survey conducted in the state of RN in 2010 [ 14 ], but lower than that of the 2013 NHS survey [ 10 ].…”

Section: Discussionmentioning

confidence: 87%

Prevalence of the five newborn screening tests

et al. 2021

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Neonatal screening is essential for child health and has the following purposes: (1) pulse oximetry screening to evaluate congenital heart diseases; (2) red reflex examination to investigate eye diseases; (3) newborn hearing screening test to evaluate congenital hearing diseases; (4) tongue test to evaluate the lingual frenulum and identify communication and feeding problems; (5) the Guthrie test to screen for metabolic diseases. This study investigated the prevalence of the five neonatal screening tests and its associated institutional and socio-cultural factors using a cross-sectional study with 415 mother and baby binomials from public maternity hospitals in Natal, RN, Brazil in 2019. Pearson’s chi-squared, Mann-Whitney and Poisson regression tests were used, with a significance of p ≤ 0.05 and a 95% confidence interval. The sample loss was 71 mothers (17%). The prevalence in the first week and at the end of 28 days was 93% and 99.5% (pulse oximetry screening), 60% and 97.6% (red reflex examination), 71.9% and 93.6% (Guthrie test), 35.5% and 68.2% (hearing screening test), and 19% and 48.9% (tongue test). Only 152 newborns (36.6%) underwent all five tests. The performance of the tests was associated in the final model (p ≤ 0.05) with the residence of the mothers in the state capital (PR = 1.36; 95% CI = 1.18–1.56) and the provision of guidance for mothers about the five tests in maternity hospitals (PR = 1.30; 95% CI = 1.08–1.67). None of the tests met full coverage, and regional inequities were identified indicating the need to restructure the institutions, training and qualification procedures to improve of the work processes and longitudinal care.

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“…(19) Teoricamente, todos os estados brasileiros realizam a triagem neonatal de FC desde 2013, mas há evidências de que existem desigualdades entre as regiões/estados. (20) O achado de que a mediana e a média de idade de óbito aumentaram significativamente no período de 1999 a 2017 foi antecipado em virtude dos avanços no tratamento da FC (1,16) ; entretanto, trata-se de um achado paradoxal no contexto da tendência de aumento das taxas de mortalidade relacionada à FC, que não pode ser atribuída à introdução de moduladores de CFTR, porque esses medicamentos ainda não estão disponíveis para a maioria dos pacientes com FC no Brasil. Embora a expansão da triagem neonatal de FC tenha contribuído significativamente para o diagnóstico precoce da FC no Brasil, (8) nossos achados a respeito da idade de óbito provavelmente não estão relacionados com a triagem Tabela 2.…”

Section: Discussionunclassified

“…19 Theoretically, all Brazilian states have been performing CF-NBS since 2013, but there is evidence that there are inequalities among the regions/states. 20 …”

Section: Discussionmentioning

confidence: 99%

Cystic fibrosis-related mortality trends in Brazil for the 1999-2017 period: a multiple-cause-of-death study

Santo

Filho

2021

J Bras Pneumol.

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Objetivo: Descrever as causas de morte e dados sobre mortalidade relacionada à fibrose cística (FC) por meio da metodologia de causas múltiplas de morte. Métodos: Dados sobre a mortalidade anual no período de 1999 a 2017 foram extraídos do Sistema de Informações sobre Mortalidade do Ministério da Saúde do Brasil. Foram selecionadas todas as declarações de óbito em que a categoria E84 (FC) da CID-10 foi citada como causa básica ou associada de morte. Foram descritos os dados epidemiológicos e clínicos e calculadas as taxas padronizadas de mortalidade por ano e para o período de 2000 a 2017. Foi realizada a análise de regressão por pontos de inflexão para detectar mudanças nas taxas de mortalidade durante o período estudado. Resultados: No total, foram identificadas 2.854 mortes relacionadas à FC durante o período de estudo: de 68 em 1999 a 289 em 2017. A FC foi a causa básica de morte em 83,5% das declarações de óbito. Observou-se uma tendência contínua de aumento das taxas de mortalidade, com variação percentual anual significativa de 6,84% (5,3-8,4%) nos homens e de 7,50% (6,6-8,4%) nas mulheres. A mediana da idade de óbito aumentou de 7,5 anos em 1999 para 56,5 anos em 2017. As doenças do aparelho respiratório representaram 77% das causas associadas nas declarações de óbito em que a FC foi a causa básica de morte. Conclusões:Observou-se no Brasil um aumento significativo e contínuo das taxas de mortalidade relacionada à FC nos últimos anos, bem como um aumento concomitante da mediana da idade de óbito.

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Neonatal screening tests in Brazil: prevalence rates and regional and socioeconomic inequalities

Cited by 37 publications

References 24 publications

Conceptual Model of Hearing Health Inequalities (HHI Model): A Critical Interpretive Synthesis

Conceptual Model of Hearing Health Inequalities (HHI Model): A Critical Interpretive Synthesis

Prevalence of the five newborn screening tests

Cystic fibrosis-related mortality trends in Brazil for the 1999-2017 period: a multiple-cause-of-death study

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