Perfil epidemiológico das intoxicações agudas no Brasil no período de 2007 a 2019
Data
2023-05-11
Autores
Castro, Braian Valério Cassiano 
Orientadores
Cunha, Lucas Leite
Tipo
Dissertação de mestrado
Título da Revista
ISSN da Revista
Título de Volume
Resumo
Objetivo: Definir o perfil epidemiológico das intoxicações no Brasil, de 2007 a 2019. Métodos: Trata-se de um estudo ecológico de séries temporais, sobre intoxicações agudas no Brasil, no período de 2007 a 2019. Os dados foram extraídos do Sistema de Informação de Agravos de Notificação (SINAN), por meio do TABNET, software desenvolvido pelo DATASUS que dá acesso a base de dados de domínio público do Ministério da Saúde. Através da estatística descritiva, os resultados foram estratificados para análise por macrorregiões (Sudeste, Norte, Nordeste, Sul, Centro-Oeste) de acordo com variáveis demográficas individuais (sexo e idade) e variáveis de exposição (circunstância e agentes tóxicos). Outrossim, foram calculados os indicadores de saúde: incidência, letalidade, mortalidade geral e específica. O modelo de Prais Winsten foi utilizado para analisar a tendência da série temporal. Resultados: Observou-se um aumento de 684,35% no número de notificações de 2007 a 2019. Considerando a distribuição das notificações por sexo, a maioria das intoxicações ocorreram em pacientes do sexo feminino (55,6%; n=648.390), enquanto a maior parte dos óbitos (59,6%; n=7.076) no sexo masculino. A faixa etária mais notificada no período foi a dos adultos (20 a 59 anos), e o agente tóxico medicamento e a circunstância tentativa de suicídio foram as principais relacionadas ao número de casos novos e aos óbitos. Referente aos indicadores de saúde, a maior incidência e mortalidade ocorreram na região Sul (59,1 casos por 100.000 habitantes e 6,91 óbitos por 1.000.000 de habitantes, respectivamente). Semelhantemente às notificações segundo o sexo, em todas as grandes regiões e no Brasil, a maior incidência se deu no sexo feminino (48,9 casos por 100.000 habitantes) e a maior mortalidade no sexo masculino (5,56 óbitos por 1.000.000 habitantes), contudo, apesar das notificações terem sido mais frequentes nos adultos, a incidência foi maior nas crianças (≤ 9 anos). Em relação aos agentes tóxicos, quase metade dos casos incidentes no período analisado foram pelo uso de medicamento (43,7%; 19,61 casos por 100.000 habitantes), seguido pela droga de abuso (11,9%; 5,33 casos por 100.000 habitantes) e alimento e bebida (8,2%; 3,69 casos por 100.000 habitantes). No que tange as circunstâncias envolvidas, nota-se a tentativa de suicídio (38,1%; 17,09 casos por 100.000 habitantes) como principal, seguido do uso acidental (18,6%; 8,3 casos por 100.000 habitantes) e abuso (12,4%; 5,57 casos por 100.000 habitantes). Por fim, observou-se a tendência ascendente da incidência e da mortalidade geral em todas as macrorregiões e no país. Conclusões: Os resultados epidemiológicos encontrados na população brasileira permitem concluir que as intoxicações agudas ocorrem mais frequentemente e são mais incidentes no sexo feminino, pelo uso de medicamentos e no contexto de tentativa de suicídio, principalmente nas macrorregiões Sul e Sudeste. O adulto é o grupo etário majoritariamente notificado, contudo a incidência é maior nas crianças, sobretudo pelo uso acidental. Os óbitos, a letalidade e a mortalidade geral foram maiores no sexo masculino e configura-se uma tendência ascendente da mortalidade geral e da incidência nos próximos anos. Os resultados, portanto, poderão nortear ações de promoção e prevenção de saúde no país.
Objective: Define the epidemiological profile of intoxications in Brazil, from 2007 to 2019. Methods: This is an ecological time-series study on acute intoxications in Brazil, from 2007 to 2019. Data were extracted through the Sistema de Informação de Agravos de Notificação (SINAN) using the TABNET, software developed by DATASUS that gives access to the public domain database of the Ministry of Health. Through it, the results were analyzed using descriptive statistics, and the health indicators were calculated: incidence, lethality, general and specific mortality. Furthermore, data were tabulated for analysis by macro-regions (Southeast, North, Northeast, South, Midwest) according to individual demographic variables (gender and age) and exposure variables (circumstance and toxic agents). The Prais Winsten model was used to analyze the trend of the time-series. Results: There was an increase of 684,35% in the number of notifications from 2007 to 2019. Considering the distribution of notifications by sex, most poisonings occurred in female patients (55,6%; n=648.390), while the majority of deaths (59,6%; n=7.076) were in males. The most notified age group in the period was adults (20 to 59 years old), and the toxic agent medication and the circumstance suicide attempt were the main ones related to the number of new cases and deaths. Regarding health indicators, the highest incidence and mortality occurred in the South region (59,1 cases per 100.000 inhabitants and 6,91 deaths per 1.000.000 inhabitants, respectively). Similar to notifications according to sex, in all major regions and in Brazil, the highest incidence occurred in females (48,9 cases per 100.000 inhabitants) and the highest mortality in males (5,56 deaths per 1.000.000 inhabitants), however, although notifications were more frequent in adults, the incidence was higher in children (≤ 9 years). Regarding toxic agents, almost half of the incident cases in the analyzed period were due to the use of medication (43,7%; 19,61 cases per 100.000 inhabitants), followed by the drug of abuse (11,9%; 5,33 cases per 100.000 inhabitants) and food and drink (8,2%; 3,69 cases per 100.000 inhabitants). With regard to the circumstances involved, the suicide attempt (38,1%; 17,09 cases per 100.000 inhabitants) is the main one, followed by accidental use (18,6%; 8,3 cases per 100.000 inhabitants) and abuse (12,4%; 5,57 cases per 100.000 inhabitants). Finally, there was an upward trend in incidence and general mortality in all macro-regions and in the country. Conclusions: The epidemiological results found in the Brazilian population allow us to conclude that acute intoxications occur more frequently and are more incident in females, due to the use of medication and in the context of suicide attempt, mainly in the South and Southeast macro-regions. Adults are the age group mostly notified, however the incidence is higher in children, mainly due to accidental use. Deaths, lethality and general mortality were higher in males and the is an upward trend in general mortality and incidence in the coming years. The results, therefore, may guide health promotion and prevention actions in the country.
Objective: Define the epidemiological profile of intoxications in Brazil, from 2007 to 2019. Methods: This is an ecological time-series study on acute intoxications in Brazil, from 2007 to 2019. Data were extracted through the Sistema de Informação de Agravos de Notificação (SINAN) using the TABNET, software developed by DATASUS that gives access to the public domain database of the Ministry of Health. Through it, the results were analyzed using descriptive statistics, and the health indicators were calculated: incidence, lethality, general and specific mortality. Furthermore, data were tabulated for analysis by macro-regions (Southeast, North, Northeast, South, Midwest) according to individual demographic variables (gender and age) and exposure variables (circumstance and toxic agents). The Prais Winsten model was used to analyze the trend of the time-series. Results: There was an increase of 684,35% in the number of notifications from 2007 to 2019. Considering the distribution of notifications by sex, most poisonings occurred in female patients (55,6%; n=648.390), while the majority of deaths (59,6%; n=7.076) were in males. The most notified age group in the period was adults (20 to 59 years old), and the toxic agent medication and the circumstance suicide attempt were the main ones related to the number of new cases and deaths. Regarding health indicators, the highest incidence and mortality occurred in the South region (59,1 cases per 100.000 inhabitants and 6,91 deaths per 1.000.000 inhabitants, respectively). Similar to notifications according to sex, in all major regions and in Brazil, the highest incidence occurred in females (48,9 cases per 100.000 inhabitants) and the highest mortality in males (5,56 deaths per 1.000.000 inhabitants), however, although notifications were more frequent in adults, the incidence was higher in children (≤ 9 years). Regarding toxic agents, almost half of the incident cases in the analyzed period were due to the use of medication (43,7%; 19,61 cases per 100.000 inhabitants), followed by the drug of abuse (11,9%; 5,33 cases per 100.000 inhabitants) and food and drink (8,2%; 3,69 cases per 100.000 inhabitants). With regard to the circumstances involved, the suicide attempt (38,1%; 17,09 cases per 100.000 inhabitants) is the main one, followed by accidental use (18,6%; 8,3 cases per 100.000 inhabitants) and abuse (12,4%; 5,57 cases per 100.000 inhabitants). Finally, there was an upward trend in incidence and general mortality in all macro-regions and in the country. Conclusions: The epidemiological results found in the Brazilian population allow us to conclude that acute intoxications occur more frequently and are more incident in females, due to the use of medication and in the context of suicide attempt, mainly in the South and Southeast macro-regions. Adults are the age group mostly notified, however the incidence is higher in children, mainly due to accidental use. Deaths, lethality and general mortality were higher in males and the is an upward trend in general mortality and incidence in the coming years. The results, therefore, may guide health promotion and prevention actions in the country.