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2008年至2022年巴西儿童镰状细胞病的流行病学概况趋势及成本

Epidemiological profile trends and cost of pediatric sickle cell disease in Brazil from 2008 to 2022.

作者信息

Telles Luiza, Melo Paulo Henrique Moreira, Dornelas Luana Baptistele, Lech Gabriele Eckerdt, Sampaio Natália Zaneti, Gerk Ayla, Carroll Madeleine, Camargo Cristina Pires

机构信息

Instituto de Educação Médica (IDOMED/Estácio, Campus Vista Carioca), Rio de Janeiro, RJ, Brazil.

Universidade Federal de Minas Gerais, Faculdade de Medicina, Belo Horizonte, MG, Brazil.

出版信息

J Pediatr (Rio J). 2025 Jan-Feb;101(1):110-116. doi: 10.1016/j.jped.2024.07.010. Epub 2024 Sep 7.

Abstract

OBJECTIVE

This study aimed to investigate the epidemiological trends of Pediatric Sickle Cell Disease (SCD) in Brazil over the period 2008-2022, with a focus on understanding the incidence, mortality rates, and associated healthcare costs. The study explored potential associations between patient characteristics and the occurrence of crises in pediatric SCD cases.

METHODS

A cross-sectional study was conducted, analyzing national annual rates of pediatric SCD hospitalizations using data from the FioCruz platform. Descriptive and inferential analyses, including time series and ARIMA regression, were employed. Economic dimensions were assessed using cost categorization. The study followed STROBE reporting guidelines.

RESULTS

Data on 81,942 pediatric SCD hospitalizations were collected, with a predominance of crisis-related cases (74.08 %). Males and children under five years old were most affected. Regional disparities were observed, with the Southwest region recording the highest hospitalization rates. ICU costs were higher for crisis-related hospitalizations. Mortality rates were significantly higher for crisis-related cases (p < 0.001), with ARIMA regression indicating a significant association between hospitalizations for crisis-related cases and mortality.

CONCLUSION

This study highlights the significant burden of pediatric SCD in Brazil, particularly crisis-related cases, suggesting a need for focused interventions. By prioritizing early detection, equitable access to healthcare, and evidence-based interventions, Brazil can mitigate the burden of SCD and improve patient outcomes. These findings contribute to informing public health policies and interventions aimed at addressing the challenges of pediatric SCD management in Brazil.

摘要

目的

本研究旨在调查2008年至2022年期间巴西儿童镰状细胞病(SCD)的流行病学趋势,重点是了解发病率、死亡率及相关医疗费用。该研究探讨了儿童SCD病例的患者特征与危机发生之间的潜在关联。

方法

开展了一项横断面研究,使用菲奥克鲁兹平台的数据分析儿童SCD住院的全国年度发生率。采用了描述性和推断性分析,包括时间序列和自回归积分移动平均(ARIMA)回归。通过成本分类评估经济层面。该研究遵循加强流行病学观察性研究报告规范(STROBE)。

结果

收集了81942例儿童SCD住院数据,其中与危机相关的病例占主导(74.08%)。男性和五岁以下儿童受影响最大。观察到地区差异,西南地区住院率最高。与危机相关的住院患者重症监护病房费用更高。与危机相关的病例死亡率显著更高(p<0.001),ARIMA回归表明与危机相关病例的住院和死亡率之间存在显著关联。

结论

本研究突出了巴西儿童SCD的重大负担,尤其是与危机相关的病例,表明需要有针对性的干预措施。通过优先考虑早期检测、公平获得医疗服务和循证干预措施,巴西可以减轻SCD负担并改善患者结局。这些发现有助于为旨在应对巴西儿童SCD管理挑战的公共卫生政策和干预措施提供信息。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/df45/11763541/66f6f14f8502/gr1.jpg

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