SP1-101 A model of international multi-site collaboration for chronic disease research in developing countries

Abstract

1970. Mortality inequalities continue to exist between population sub-groups. Methods Ecological study using data about mortality of the Improvement Program of Information on Mortality of São Paulo and population estimates by demographic census (IBGEe2000). Areas were drawn from the Social Inclusion Map for the City. The outline was based on territorial classification of the 96 administrative districts in five areas, according to the index of social districts: Areas 1 and 2 (inclusion) and 3, 4, 5 areas (exclusion). We examined cardiovascular mortality rates calculated for 3-year averages age-standardised, relative to differences and rates ratio between areas (CI of 95%). Results Cardiovascular mortality declined in all areas and both male and female sexes in these periods. It was observed major decline (30%) between 1996e1998 and 2003e2005 in rich areas and it was smaller in poor areas (5%). The highest differential was among male, with rate ratio (A5/A1) that it changed from 1.02 (95% CI 0.99 to 1.05) in first period for 1.38 in the last period (95% CI 1.34 to 1.42). In the women this ratio changed from 0.79 (95% CI 0.77 to 0.81) for 1.07 (95% CI 1.03 to 1.09). Conclusion Although overall decline in cardiovascular mortality in all socioeconomic status, it was observed increasing of the inequality in reduction of this death rates, which may reflect worsening living conditions or less access to the health services and to the development diagnostic and therapeutic methods. Introduction Rheumatic heart disease (RHD) is still prevalent in developing countries, with 332.000 annual deaths estimated worldwide. In Brazil, RHD remains a major problem, responsible for high mortality/morbidity and great social impact, with many patients requiring surgical intervention during childhood. Our aim was to investigate the time and risk factors leading to valve surgery in children and adolescents with RHD in a tertiary center in Rio de Janeiro. Methods Data were reviewed on 137 patients followed-up between 1988 and 2007. RHD diagnosis was assigned with revised Jones criteria and/or Doppler-echocardiography indicating chronic mitral/aortic lesions. KaplaneMeier method was used to determine time until surgery and Cox model to evaluate potential risk factors: age; gender; clinical status (acute; recurrence; chronic heart disease); recurrence rate; secondary prophylactic status and endocarditis. SP1-100 SURVIVAL ANALYSIS AND RISK FACTORS FOR VALVE SURGERY IN BRAZILIAN CHILDREN AND ADOLESCENTS WITH RHEUMATIC HEART DISEASEResults The studied population was 52.5% female, median age 11.2 years. Median follow-up time 7.3 years. The proportions were 33.5% for non-adherence to prophylaxis, 31.4% for recurrence rate, 8.8% for endocarditis where most underwent surgery (83.3%). Surgical rate (41%) was different between male (53.8%) and female (29.2%). Survival curves showed most events on the first 2 years and none after 10 years. Cox analysis confirmed the male gender and endocarditis as significant factors. Conclusion Brazilian RHD children...