Nucci Luciana B, Toscano Cristiana M, Maia Ana Lourdes M, Fonseca Claudio D, Britto Maria Moema B, Duncan Bruce B, Schmidt Maria Inês
Federal University of Rio Grande do Sul, School of Medicine, Graduate Studies Program in Epidemiology, Porto Alegre, Rio Grande do Sul, Brazil.
Rev Panam Salud Publica. 2004 Nov;16(5):320-7. doi: 10.1590/s1020-49892004001100005.
In 2001, persons throughout Brazil who were 40 years old or older were invited to participate in community screening for diabetes as part of the Brazilian Ministry of Health's Plan for the Reorganization of Care for Arterial Hypertension and Diabetes Mellitus. This report describes the overall participation rate and positivity rate of the screening campaign, as well as factors associated with the level of participation among the municipalities in Brazil.
Screening test positivity was defined as a fasting glucose of > or = 100 mg/dL or a casual glucose of > or = 140 mg/dL. Screening data were obtained from the Ministry of Health and were analyzed for each municipality.
Out of the 5 561 municipalities in Brazil, 5 301 of them (95.3%) participated and reported results. Of the 30.2 million persons in the target population, 22.1 million of them (73.0%) were tested, and 3.5 million of the persons tested (15.7%) were positive. Higher odds of a high population participation rate (> or = 80%) were seen in municipalities that were of small size (risk ratio (RR) = 5.0, comparing extremes), were located in the North region of the country (RR = 1.8), were located outside of a metropolitan region (RR = 1.4), and had a higher proportion of their population who had completed elementary school (RR = 1.2) (P < 0.05). There was a parallel increase in glucose testing nationwide during and immediately after the campaign, presumably in part for diagnostic confirmation of cases identified during screening.
The massive response to the campaign attests to the potential that this type of program has to raise diabetes awareness and to set the stage for capacity-building at the primary care level.
2001年，巴西各地40岁及以上的人群被邀请参加糖尿病社区筛查，这是巴西卫生部高血压和糖尿病护理重组计划的一部分。本报告描述了筛查活动的总体参与率和阳性率，以及巴西各城市参与水平的相关因素。
筛查试验阳性定义为空腹血糖≥100mg/dL或随机血糖≥140mg/dL。筛查数据来自卫生部，并对每个城市进行了分析。
在巴西的5561个城市中，有5301个（95.3%）参与并报告了结果。在目标人群的3020万人中，有2210万人（73.0%）接受了检测，其中350万人（15.7%）检测呈阳性。在规模较小的城市（风险比（RR）=5.0，比较极端情况）、位于该国北部地区的城市（RR=1.8）、位于大都市地区以外的城市（RR=1.4）以及小学毕业人口比例较高的城市（RR=1.2），人群高参与率（≥80%）的几率更高（P<0.05）。在活动期间及活动刚结束后，全国范围内的血糖检测呈平行上升，推测部分原因是对筛查中发现的病例进行诊断确认。
对该活动的大量响应证明了这类项目在提高糖尿病意识以及为初级保健层面的能力建设奠定基础方面的潜力。
