Prevalence of musculoskeletal disorders in the lower limbs of artisanal fisherwomen / shellfish gatherers of Brazil

Objective: to estimate the prevalence of musculoskeletal disorders (MSDs) in the lower limbs of artisanal fishermen/fisherwomen from Saubara, Bahia, Brazil. Methods: A cross-sectional study, using the Nordic Musculoskeletal Questionnaire (NMQ), the Brazilian version of the Job Content Questionnaire (JCQ) and a questionnaire about physical demands, were used to collectinformation in a random sample of artisanal fishermen/shellfish gatherers, in 2013.  Results: The prevalence of MSDs in lower limbs in the sample was 65.5% (n=137). The prevalence of MSDs in the thigh/knee segment, leg and ankle/foot were 48.7% (n=92), 47.7% (n=95) and 38.1% (n=72), respectively. There was also a high frequency of obesity, poor education, low wages, early age at onset of labor, and excessive workload. Conclusion: The high prevalence of MSDs in lower limbs in female artisanal fishermen indicates the need to develop strategies for prevention, diagnosis and reporting of these diseases.Introdução: a pesca em pequena escala é responsável por pelo menos 40% do pescado consumido no mundo e, no Brasil, o trabalhador desse setor é o pescador artesanal, que contabiliza um a cada 200 brasileiros. Por se tratar de uma atividade da economia informal, as patologias que afetam esses pescadores são praticamente invisíveis nas estatísticas oficiais do país. Nesse contexto, os distúrbios musculoesqueléticos representam um grande problema socioeconômico e de saúde pública, mas sua prevalência é pouco conhecida entre trabalhadores não formais. Objetivo: estimar a prevalência de distúrbios musculoesqueléticos nos membros inferiores e fatores associados, em pescadores artesanais/marisqueiras de Saubara, Bahia, Brasil. Metodologia: trata-se de um estudo transversal, utilizando o Nordic Musculoskeletal Questionnaire, a versão brasileira do Job Content Questionnaire e um questionário sobre demandas físicas, para a coleta de informações em uma amostra aleatória de pescadores artesanais/marisqueiras, ocorridaem 2013. Resultados: a prevalência de distúrbios musculoesqueléticos em membros inferiores na amostra foi de 65,5% (n=137); a prevalência no segmento coxa/joelho, perna e tornozelo/pé foi de 48,7% (n=92), 47,7% (n=95) e 38,1% (n=72), respectivamente. Observaram-se também alta frequência de obesidade, baixa escolaridade, baixos salários, idade precoce para o início do trabalho e carga horária excessiva. Fatores como idade, tabagismo, demandas físicas, tempo de trabalho, ausência de pausas e trabalho anterior, estavam associados aos referidos distúrbios. Conclusão: A alta prevalência de distúrbios musculoesqueléticos dos membros inferiores em pescadoras artesanais indica a necessidade de desenvolver estratégias de prevenção, diagnóstico e notificação dessas doenças

Health-Related Quality of Life among Artisanal Fisherwomen/Shellfish Gatherers: Lower than the General Population

Quality of life is an indicator of how well one perceives that he/she is functioning physically and mentally. The aim of this paper is to determine the health-related quality of life (HRQOL) of artisanal fisherwomen/shellfish gatherers from the Saubara municipality in Bahia, Brazil in comparison to the general population. A structured questionnaire was administered to a sample of 209 artisanal fisherwomen selected at random. The HRQOL questionnaire, known as the 36-Item Short-Form Health Survey version 1 (SF-36v01), was also used, having been translated and verified cross-culturally for the Brazilian population. Sociodemographic, lifestyle and comorbidity information was also collected. Chronic diseases and indicators of musculoskeletal disorders (MSDs) were self-reported. The study population consisted primarily of individuals between 30 and 45 years of age (78%), of self-classified races black or brown (96.2%), with no more than an elementary school education (77%) and married (64.6%). In all the SF-36v01 dimensions, the values in the sample were lower than in the general population of Brazil, which was used as the reference population. In the “Physical Health” domain (Physical Functioning; Physical Role Limitations; Bodily Pain; General Health Perception) a tendency toward a lower health-related quality of life was observed among those who were older, had a lower education level, and had a prevalence of MSDs, hypertension or arthritis. The interference of health conditions linked to the fisherwomen’s work activities may contribute to lower HRQOL in all analyzed aspects, in comparison to the general population. In light of these findings, public health policies must consider these informal workers who contribute greatly to Brazil’s economy and food system

Artisanal fisherwomen/shellfish gatherers: analyzing the impact of upper limb functioning and disability on health-related quality of life

Abstract The aim is to analyze upper limb functioning and disability, and its association with health-related quality of life among artisanal fisherwomen from Bahia, Brazil. Cross-sectional epidemiological study was conducted with a sample of 209 fisherwomen. Structured questionnaires were used for socio-demographic and comorbidity information, as well as the instruments Disabilities of the Arm, Shoulder and Hand (DASH) and Short-Form Healthy Survey (SF-36) respectively, to evaluate the upper limbs and health-related quality of life. The results demonstrated that the presence of musculoskeletal disorders in the upper limbs directly affects the values of the DASH instrument and the SF-36v01 questionnaire scores, while also generating a negative correlation between the DASH and SF-36v01. The varying functioning abilities, pain and social aspects negatively affect upper limb function, and the daily activities and work of fisherwomen. The presence of chronic disease and the absence of intervention and rehabilitation for these professionals, that could produces, in a long-term, cases of disability

COVID-19, Food Insecurity and Malnutrition: A Multiple Burden for Brazil.

No abstract available

Factors associated with low birth weight at term: a population-based linkage study of the 100 million Brazilian cohort.

BACKGROUND: Factors associated with low birth weight at term (TLBW), a proxy for intrauterine growth restriction (IUGR), are not well-elucidated in socioeconomically vulnerable populations. This study aimed to identify the factors associated with TLBW in impoverished Brazilian women. METHODS: Records in the 100 Million Brazilian Cohort database were linked to those in the National System of Information on Live Births (SINASC) to obtain obstetric, maternal, birth and socioeconomic data between 2001 and 2015. Multivariate logistic regression was performed to investigate associations between variables of exposure and TLBW. RESULTS: Of 8,768,930 term live births analyzed, 3.7% presented TLBW. The highest odds of TLBW were associated with female newborns (OR: 1.49; 95% CI: 1.47-1.50), whose mothers were black (OR: 1.20; 95% CI: 1.18-1.22), had a low educational level (OR: 1.57; 95% CI: 1.53-1.62), were aged ≥35 years (OR: 1.44; 95% CI: 1.43-1.46), had a low number of prenatal care visits (OR: 2.48; 95% CI: 2.42-2.54) and were primiparous (OR: 1.62; 95% CI: 1.60-1.64). Lower odds of TLBW were found among infants whose mothers lived in the North, Northeast and Center-West regions of Brazil compared to those in the South. CONCLUSION: Multiple aspects were associated with TLBW, highlighting the need to comprehensively examine the mechanisms underlying these factors, especially in more vulnerable Brazilian populations, in order to contribute to the elaboration of health policies and promote better conditions of life for poor and extremely poor mothers and children

Differences in risk factors for incident and recurrent preterm birth: a population-based linkage of 3.5 million births from the CIDACS birth cohort.

BACKGROUND: Preterm birth (PTB) is a syndrome resulting from a complex list of underlying causes and factors, and whether these risk factors differ in the context of prior PTB history is less understood. The aim of this study was to explore whether PTB risk factors in a second pregnancy were different in women with versus without previous PTB. METHODS: We conducted a population-based cohort study using data from the birth cohort of the Center for Data and Knowledge Integration for Health (CIDACS) for the period 2001 to 2015. We used longitudinal transition models with multivariate logistic regression to investigate whether risk factors varied between incident and recurrent PTB. RESULTS: A total of 3,528,050 live births from 1,764,025 multiparous women were analyzed. We identified different risk factors (Pdifference <0.05) between incident and recurrent PTB. The following were associated with an increased chance for PTB incidence, but not recurrent: household overcrowding (OR 1.09), maternal race/ethnicity [(Black/mixed-OR 1.04) and (indigenous-OR 1.34)], young maternal age (14 to 19 years-OR 1.16), and cesarean delivery (OR 1.09). The following were associated with both incident and recurrent PTB, respectively: single marital status (OR 0.85 vs 0.90), reduced number of prenatal visits [(no visit-OR 2.56 vs OR 2.16) and (1 to 3 visits-OR 2.44 vs OR 2.24)], short interbirth interval [(12 to 23 months-OR 1.04 vs OR 1.22) and (<12 months, OR 1.89, 95 vs OR 2.58)], and advanced maternal age (35-49 years-OR 1.42 vs OR 1.45). For most risk factors, the point estimates were higher for incident PTB than recurrent PTB. CONCLUSIONS: The risk factors for PTB in the second pregnancy differed according to women's first pregnancy PTB status. The findings give the basis for the development of specific prevention strategies for PTB in a subsequent pregnancy

Combined association of obesity and other cardiometabolic diseases with severe COVID-19 outcomes: a nationwide cross-sectional study of 21 773 Brazilian adult and elderly inpatients.

OBJECTIVES: To investigate the combined association of obesity, diabetes mellitus (DM) and cardiovascular disease (CVD) with severe COVID-19 outcomes in adult and elderly inpatients. DESIGN: Cross-sectional study based on registry data from Brazil's influenza surveillance system. SETTING: Public and private hospitals across Brazil. PARTICIPANTS: Eligible population included 21 942 inpatients aged ≥20 years with positive reverse transcription-PCR test for SARS-CoV-2 until 9 June 2020. MAIN OUTCOME MEASURES: Severe COVID-19 outcomes were non-invasive and invasive mechanical ventilation use, intensive care unit (ICU) admission and death. Multivariate analyses were conducted separately for adults (20-59 years) and elders (≥60 years) to test the combined association of obesity (without and with DM and/or CVD) and degrees of obesity with each outcome. RESULTS: A sample of 8848 adults and 12 925 elders were included. Among adults, obesity with DM and/or CVD showed higher prevalence of invasive (prevalence ratio 3.76, 95% CI 2.82 to 5.01) and non-invasive mechanical ventilation use (2.06, 1.58 to 2.69), ICU admission (1.60, 1.40 to 1.83) and death (1.79, 1.45 to 2.21) compared with the group without obesity, DM and CVD. In elders, obesity alone (without DM and CVD) had the highest prevalence of ICU admission (1.40, 1.07 to 1.82) and death (1.67, 1.00 to 2.80). In both age groups, obesity alone and combined with DM and/or CVD showed higher prevalence in all outcomes than DM and/or CVD. A dose-response association was observed between obesity and death in adults: class I 1.32 (1.05 to 1.66), class II 1.41 (1.06 to 1.87) and class III 1.77 (1.35 to 2.33). CONCLUSIONS: The combined association of obesity, diabetes and/or CVD with severe COVID-19 outcomes may be stronger in adults than in elders. Obesity alone and combined with DM and/or CVD had more impact on the risk of COVID-19 severity than DM and/or CVD in both age groups. The study also supports an independent relationship of obesity with severe outcomes, including a dose-response association between degrees of obesity and death in adults

Time trends and social inequalities in infant and young child feeding practices: national estimates from Brazil’s Food and Nutrition Surveillance System, 2008–2019

Abstract Objective: To describe the time trends and socio-economic inequalities in infant and young child feeding practices in accordance with the Brazilian deprivation index (BDI). Design: This time-series study analysed the prevalence of multiple breast-feeding and complementary feeding indicators based on data from the Brazilian Food and Nutrition Surveillance System, 2008–2019. Prais–Winsten regression models were used to analyse time trends. Annual percent change (APC) and 95 % CI were calculated. Setting: Primary health care services, Brazil. Participants: Totally, 911 735 Brazilian children under 2 years old. Results: Breast-feeding and complementary feeding practices differed between the extreme BDI quintiles. Overall, the results were more favourable in the municipalities with less deprivation (Q1). Improvements in some complementary feeding indicators were observed over time and evidenced such disparities: minimum dietary diversity (Q1: Δ 47·8–52·2 %, APC + 1·44, P = 0·006), minimum acceptable diet (Q1: Δ 34·5–40·5 %, APC + 5·17, P = 0·004) and consumption of meat and/or eggs (Q1: Δ 59·7–80·3 %, APC + 6·26, P < 0·001; and Q5: Δ 65·7–70·7 %, APC + 2·20, P = 0·041). Stable trends in exclusive breast-feeding and decreasing trends in the consumption of sweetened drinks and ultra-processed foods were also observed regardless the level of the deprivation. Conclusions: Improvements in some complementary food indicators were observed over time. However, the improvements were not equally distributed among the BDI quintiles, with children from the municipalities with less deprivation benefiting the most

Time trends and social inequalities in child malnutrition: nationwide estimates from Brazil's food and nutrition surveillance system, 2009-2017

Objective In Brazil, national estimates of childhood malnutrition have not been updated since 2006. The use of health information systems is an important complementary data source for analysing time trends on health and nutrition. This study aimed to examine temporal trends and socio-demographic inequalities in the prevalence of malnutrition in children attending primary health care services between 2009 and 2017. Design Time trends study based on data from Brazil's Food and Nutrition Surveillance System. Malnutrition prevalence (stunting, wasting, overweight and double burden) was annually estimated by socio-demographic variables. Prais-Winsten regression models were used to analyse time trends. Annual percent change (APC) and 95 % CI were calculated. Setting Primary health care services, Brazil. Participants Children under 5 years old. Results In total, 15,239,753 children were included. An increase in the prevalence of overweight (APC = 3·4 %; P = 0·015) and a decline in the prevalence of wasting (-6·2 %; P = 0·002) were observed. The prevalence of stunting (-3·2 %, P = 0·359) and double burden (-1·4 %, P = 0·630) had discrete and non-significant reductions. Despite the significant reduction in the prevalence of undernutrition among children in the most vulnerable subgroups (black, conditional cash transfer's recipients and residents of poorest and less developed areas), high prevalence of stunting and wasting persist alongside a disproportionate increase in the prevalence of overweight in these groups. Conclusions The observed pattern in stunting (high and persistent prevalence) and increase in overweight elucidate setbacks in advances already observed in previous periods and stresses the need for social and political strategies to address multiple forms of malnutrition