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[巴西各市慢性恰加斯病患病率的估计巴西各市慢性恰加斯病患病率的估计]

[Estimation of prevalence of chronic Chagas disease in Brazilian municipalitiesEstimación de la prevalencia de la enfermedad de Chagas crónica en los municipios brasileños].

作者信息

Laporta Gabriel Zorello, Lima Mayara Maia, Maia da Costa Veruska, de Lima Neto Milton Martins, Palmeira Swamy Lima, Rodovalho Sheila Rodrigues, Aragón López Miguel Angel

机构信息

Centro Universitário FMABC Santo AndréSP Brasil Centro Universitário FMABC, Santo André, SP, Brasil.

Secretaria de Vigilância em Saúde e Ambiente Ministério da Saúde BrasíliaDF Brasil Secretaria de Vigilância em Saúde e Ambiente, Ministério da Saúde, Brasília, DF, Brasil.

出版信息

Rev Panam Salud Publica. 2024 Apr 4;48:e28. doi: 10.26633/RPSP.2024.28. eCollection 2024.

Abstract

OBJECTIVE

The objective of this study is to estimate the prevalence of chronic Chagas disease (CCD) in Brazil: in the general population, in women, and in women of childbearing age.

METHODS

A meta-analysis of the literature was conducted to extract data on the prevalence of CCD in municipalities in Brazil in the 2010-2022 period: in the general population, in women, and in women of childbearing age. Municipal-level CCD indicators available in health information systems were selected. Statistical modeling of the data extracted from the meta-analysis (based on data obtained from information systems) was applied to linear, generalized linear, and additive models.

RESULTS

The five most appropriate models were selected from a total of 549 models tested to obtain a consensus model (adjusted = 54%). The most important predictor was self-reported CCD in the primary health care information system. Zero prevalence was estimated in 1 792 (32%) of Brazil's 5 570 municipalities; in the remaining 3 778 municipalities, average prevalence of the disease was estimated at 3.25% (± 2.9%). The number of carriers of CCD was estimated for the Brazilian population (3.7 million), for women (2.1 million) and for women of childbearing age (~590 000). The disease reproduction rate was calculated at 1.0336. All estimates refer to the 2015-2016 period.

CONCLUSIONS

The estimated prevalence of CCD, especially among women of childbearing age, highlights the challenge of vertical transmission in Brazilian municipalities. Mathematical projections suggest that these estimates should be included in the national program for the elimination of vertical transmission of Chagas disease.

摘要

目的

本研究旨在估算巴西慢性恰加斯病(CCD)的患病率,包括普通人群、女性以及育龄期女性的患病率。

方法

对文献进行荟萃分析,以提取2010 - 2022年巴西各市普通人群、女性及育龄期女性中CCD患病率的数据。选取了卫生信息系统中可用的市级CCD指标。对荟萃分析提取的数据(基于从信息系统获得的数据)进行统计建模,并应用于线性模型、广义线性模型和加法模型。

结果

从总共测试的549个模型中选出了五个最合适的模型,以获得一个共识模型(调整后 = 54%)。最重要的预测因素是初级卫生保健信息系统中自我报告的CCD。在巴西5570个市中的1792个(32%)估计患病率为零;在其余3778个市中,该病的平均患病率估计为3.25%(±2.9%)。估算了巴西人口(约370万)、女性(约210万)和育龄期女性(约59万)中的CCD携带者数量。计算出疾病繁殖率为1.0336。所有估计均指2015 - 2016年期间。

结论

CCD的估计患病率,尤其是在育龄期女性中的患病率,凸显了巴西各市垂直传播的挑战。数学预测表明,这些估计应纳入国家消除恰加斯病垂直传播计划。

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