Abstract
Secular trends in rates of low birth weight in Brazilian state capital cities were evaluated for the period 1996 to 2010 using joinpoint regression models. The rates were calculated using data from the Live Births Information System. Newborns weighing less than 500 g were excluded. Only data for capital cities was included since under-registration of births in these cities is lower and new trends can be detected earlier. There was a significant increase in the rate of low birth weight in the Brazilian capitals of the North Region, Northeast Region, South Region and Southeast Region up to 2003/2004, stabilizing thereafter. In the capitals of the Center-west Region the rate increased throughout the whole study period. The rate of low birth weight was higher in the capitals of the more developed regions. The rate of multiple births increased significantly in all Brazilian capitals, while the stillbirth rate decreased and showed a negative correlation with the rate of low birth weight. The increase in the rate of low birth weight may be partially explained by the increase in multiple births, an increase in the birth of infants weighing 500 to 999 g and by the reduction in the stillbirth rate.
Highlights
Malaria epidemics occur annually in various municipalities in the Brazilian Amazon
This article aimed to characterize malaria epidemics in the Brazilian Amazon Region based on their duration, the Plasmodium species involved, and the population’s degree of vulnerability
An automatic malaria incidence monitoring system based on quartiles was assessed for prompt identification of malaria epidemics
Summary
O presente estudo tem como unidade de análise os 807 municípios dos estados da Amazônia Brasileira. Foi identificado o terceiro quartil como limite superior do diagrama de controle, para cada um dos municípios estudados. Para construção do limite superior do diagrama de controle foram usados dados mensais de casos novos de malária dos anos de 2003 a 2009, excluindo-se as duas maiores incidências de cada mês, conforme método utilizado em estudo realizado em Cruzeiro do Sul (Acre) 11. De acordo com o Programa Nacional de Controle da Malária, as lâminas de verificação de cura são classificadas como exames de microscopia realizados durante e após tratamento recente, em pacientes previamente diagnosticados para P. vivax ou para P. falciparum, que foram tratados para P. vivax dentro dos últimos 60 dias do diagnóstico atual, ou para P. falciparum dentro dos últimos 40 dias do diagnóstico atual. Acima de um caso, que ultrapassou o limite superior do diagrama de controle foi considerada uma epidemia (mês epidêmico)
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