Perfil da mortalidade por intoxicação com medicamentos no Brasil, 1996-2005: retrato de uma década Profile of mortality by intoxication with medication in Brazil, 1996-2005: portrait of a decade

A ocorrência de óbitos por intoxicação com medicamentos tem sido considerada um dos agravos de saúde pública. O estudo descreve o perfil epidemiológico da mortalidade por intoxicação com medicamentos na população do Brasil entre 1996 e 2005. Realizou-se um estudo descritivo com dados do Sistema de Informações sobre Mortalidade do Ministério da Saúde. Selecionaram-se os óbitos segundo a Classificação Internacional de Doenças (CID-10). Foram identificados 4.403 óbitos ocorridos em homens (53,9%), solteiros (53,7%) e faixa etária de 20-39 anos (44,0%). A maioria dos óbitos foi por autointoxicação intencional por anticonvulsivantes, sedativos, antiparkinsonianos e psicotrópicos. A taxa padronizada de mortalidade foi maior na região Centro-Oeste e os Anos Potenciais de Vida Perdidos aumentou durante o período estudado em 15,50%. O estudo apresentou as características e variações na mortalidade por intoxicação com medicamentos no Brasil que pode ser um reflexo do padrão de consumo dos medicamentos no país atrelado à necessidade de aprimoramento das políticas de vigilância sanitária.<br>The occurrence of deaths caused by intoxication with medication have been considered a worsening public health problem. The study describes the epidemiological profile of medication-related intoxication in the general Brazilian population from 1996 to 2005. A descriptive study was conducted with mortality data obtained from the Mortality Information System of the Brazilian Ministry of Health. Deaths were selected according to the codes of the International Classification of Diseases (ICD-10). A total of 4,403 deaths were found inn males (53.9%), bachelors (53.7%) and the 20 to 39 year-old age bracket (44%). The majority of deaths were caused by intentional self-intoxication using anticonvulsants, sedatives, antiparkinsonians and psychotropics. The standardized mortality rate was higher in the Midwest region and Potential Life-Years Lost increased by 15.5%. The study showed the characteristics and variations in mortality by intoxication with medication in Brazil, which can be a reflex of the medication consumption patterns of the country, indicating the need for enhancement of sanitary vigilance policies

A structural equation analysis on the relationship between maternal health services utilization and newborn health outcomes: a cross-sectional study in Eastern Uganda

Abstract Background Neonatal and maternal health services have a bearing on neonatal mortality. Direct and indirect factors affecting neonatal health outcomes therefore require understanding to enable well-targeted interventions. This study, therefore, assessed the interrelationship between newborn health outcomes and maternal service utilization factors. Methods We investigated maternal health utilization factors using health facility delivery and at least four Antenatal Care (ANC) visits; and newborn health outcomes using newborn death and low birth weight (LBW). We used data from a household cross-sectional survey that was conducted in 2015 in Kamuli, Pallisa and Kibuku districts. We interviewed 1946 women who had delivered in the last 12 months. The four interrelated (Endogenous) outcomes were ANC attendance, health facility delivery, newborn death, and LBW. We performed analysis using a structural equation modeling technique. Results A history of newborn death (aOR = 12.64, 95% CI 5.31–30.10) and birth of a LBW baby (aOR = 3.51, 95% CI 1.48–8.37) were directly related to increased odds of newborn death. Factors that reduced the odds of LBW as a mediating factor for newborn death were ANC fourth time attendance (aOR = 0.62, 95% CI 0.45–0.85), having post-primary level education (aOR = 0.68, 95% CI 0.46–0.98) compared to none and being gravida three (aOR = 0.49, 95% CI 0.26–0.94) compared to being gravida one. Mother’s age group, 20–24 (aOR = 0.24, 95% CI 0.08–0.75) and 25–29 years (aOR = 0.20, 95% CI 0.05–0.86) compared to 15–19 years was also associated with reduced odds of LBW. Additionally, ANC visits during the first trimester (aOR = 2.04, 95% CI 1.79–2.34), and village health teams (VHTs) visits while pregnant (aOR = 1.14, 95% CI 1.01–1.30) were associated with increased odds of at least four ANC visits, which is a mediating factor for health facility delivery, LBW and newborn death. Surprisingly, newborn death was not significantly different between health facility and community deliveries. Conclusions Attending ANC at least four times was a mediating factor for reduced newborn death and low birth weight. Interventions in maternal health and newborn health should focus on factors that increase ANC fourth time attendance and those that reduce LBW especially in resource-limited settings. Targeting women with high-risk pregnancies is also crucial for reducing newborn deaths