Cadernos de saúde pública
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Cadernos de saúde pública · Jan 2021
Inequality, geographic situation, and meanings of action in the COVID-19 pandemic in Brazil.
This Essay reflects on how socio-spatial inequalities and geographic situations condition the COVID-19 pandemic in Brazil, as well as actions to deal with the pandemic, with arguments backed by the literature. Socio-spatial inequality is defined as a process and structural condition of a territory marked by inherited and updated vulnerabilities, resulting from a relationship of exploitation, spoliation, and oppression in the current period of globalization. The authors argue that the COVID-19 pandemic can have more serious repercussions in contexts of greater socio-spatial inequality, with systemic and chronic deepening of the economic and social crises in places. ⋯ The analysis of geographic situation contributes to understanding the inherited territory and different experiences with COVID-19, inextricably linked to the conditions and meanings of action in the face of the pandemic in each place. Geographic situation expresses the tension between freedom and the condition for action. The crisis is not only a health crisis, but a manifestation of the current time, and inequality proves to be the most serious emergency of the 21st century.
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Cadernos de saúde pública · Sep 2020
ReviewCOVID-19 and food and nutritional (in)security: action by the Brazilian Federal Government during the pandemic, with budget cuts and institutional dismantlement.
The COVID-19 pandemic poses one of this century's greatest public health challenges, with impacts on the health and living conditions of populations worldwide. The literature has reported that the pandemic affects the hegemonic food system in various ways. In Brazil, the pandemic amplifies existing social, racial, and gender inequalities, further jeopardizing the Human Right to Adequate Food (HRAF) and the attainment of food and nutritional security, especially among more vulnerable groups. ⋯ The analysis identified the creation of institutional crisis management arrangements. The proposed actions feature those involving access to income, emergency aid, and food, such as authorization for food distribution outside schools with federal funds from the National School Feeding Program. However, the setbacks and dismantlement in food and nutritional security may undermine the Federal Government's capacity to respond to COVID-19.
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Cadernos de saúde pública · Jan 2020
Social distancing measures in the fight against COVID-19 in Brazil: description and epidemiological analysis by state.
Social distancing measures have been widely adopted to mitigate the COVID-19 pandemic. However, little is known about the timing of measures' implementation, scope, and duration in relation to their impact. The study aimed to describe the social distancing measures implemented by Brazil's states and the Federal District, including the types of measures and the timing of their implementation. ⋯ All the states implemented distancing measures, mostly during the latter half of March 2020. Economic lockdown was implemented early, prior to the 10th case by 67% of the states and prior to the 1st death from COVID-19 by 89% of the states. Early social distancing measures were widely implemented in Brazil, before or in the initial phase of the exponential growth curve of COVID-19 cases and deaths in the great majority of states.
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Cadernos de saúde pública · Jan 2020
[Brazilian validation of the item banks on Sleep Disturbance and Wake Disturbance in the Patient-Reported Outcomes Measurement Information System (PROMIS)].
This study aimed to validate the Brazilian version of the item banks for Sleep Disturbance and Wake Disturbance from the Patient-Reported Outcomes Measurement Information System (PROMIS). Validation of these item banks used classical test theory, item response theory, calibrations of items according to the gradual response model proposed by Samejima, and analysis of Differential Item Functioning (DIF), with a sample consisting of 627 participants over 18 years of age. As for data quality, there were no missing data, five items from the Sleep Disturbance bank and four items from the WE bank showed a floor effect, and none of the banks showed a ceiling effect. ⋯ The calibration showed that the items' psychometric properties were satisfactory with good coverage of the sleep-wake construct. As for DIF, both the Sleep Disturbance and Wake Disturbance banks proved to be homogeneous for the different test groups. In conclusion, the version in Brazilian Portuguese for the item banks on Sleep Disturbance and Wake Disturbance in the PROMIS proved to be a reliable, precise, and valid instrument with robust psychometric analyses.
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Cadernos de saúde pública · Jan 2020
Comparative StudyCOVID-19 and hospitalizations for SARI in Brazil: a comparison up to the 12th epidemiological week of 2020.
Surveillance of the severe acute respiratory illness (SARI) in Brazil aims to characterize the circulation of the Influenza A and B viruses in hospitalized cases and deaths, having been expanded in 2012 to include other respiratory viruses. COVID-19 was detected in Brazil for the time in the 9th epidemiological week of 2020, and the test for the SARS-CoV-2 virus was included in the surveillance protocol starting in the 12th epidemiological week. This study's objective was to investigate the pattern of hospitalizations for SARI in Brazil since the entry of SARS-CoV-2, comparing the temporal and age profiles and laboratory results to the years 2010 through 2019. ⋯ There was a considerable increase in negative laboratory tests, suggesting circulation of a different virus from those already present in the panel. We concluded that the increase in hospitalizations for SARI, the lack of specific information on the etiological agent, and the predominance of cases among the elderly during the same period in which there was an increase in the number of new cases of COVID-19 are all consistent with the hypothesis that severe cases of COVID-19 are already being detected by SARI surveillance, placing an overload on the health system. The inclusion of testing for SARS-CoV-2 in the SARI surveillance protocol and the test's effective nationwide deployment are extremely important for monitoring the evolution of severe COVID-19 cases in Brazil.