Birth Information System Research Articles

Spatial analysis of vaccine coverage on the first year of life in the northeast of Brazil

BackgroundOver time, vaccination has been consolidated as one of the most cost effective and successful public health interventions and a right of every human being. This study aimed to assess the spatial dynamics of the vaccine coverage (VC) rate of children aged < 1 year per municipality in the Brazilian Northeast at 2016 and 2017.MethodsThis is a mixed-type ecological study that use a Public domain data Health Information. Vaccine doses were obtained from the Information System of the Brazilian National Immunization Program, and live births from the Brazilian Information System of Live Births of the Brazilian Unified Health System. Descriptive analysis of the coverage of all the vaccines for each year of the study was conducted, and Mann–Whitney U test was used to compare VC between the study years. Chi-squared test was used to evaluate the association between the years and VC, which was stratified into four ranges, very low, low, adequate, and high. Spatial distribution was analyzed according to both each study year and vaccine and presented as thematic maps. Spatial autocorrelation was analyzed using Moran’s Global and Local statistics.ResultsCompared with 2017, 2016 showed better VC (p < 0.05), except for Bacillus Calmette–Guérin. In the spatial analysis of the studied vaccines, the Global Moran’s Index did not show any spatial autocorrelation (p > 0.05), but the Local Moran’s Index showed some municipalities, particularly the Sertão Paraibano region, with high VC, high similarity, and a positive influence on neighboring municipalities (p < 0.05). In contrast, most municipalities with low VC were concentrated in the Mata Paraibano region, negatively influencing their neighbors (p < 0.05).ConclusionUneven geographic regions and clusters of low VC for children aged < 1 year in the State of Paraíba were spatially visualized. Health policy makers and planners need to urgently devise and coordinate an action plan directed at each state’s regions to fulfill the vaccination calendar, thereby reversing the vulnerability of this age group, which is at a higher risk of diseases preventable by vaccination.

Temporal trend and factors associated to teenage pregnancy.

To analyze the trend and factors associated to teenage pregnancy in a municipality in Paraná state. Ecological study conducted with registers of babies born to teenage mothers between 2000 and 2015 from the Birth Information System (Sistema de Informação sobre Nascimento). Proportions were calculated year by year for a trend analysis of teenage pregnancy. Two series of three-year periods were collected for an odds ratio analysis of associated factors. The following variables were associated to teenage pregnancy: not having a partner; less than eight years of schooling; primiparity; gestational age shorter than thirty-seven weeks; caesarean section; less than seven appointments; and Apgar below seven in the first minute. A decline trend was observed among pregnant teenagers who had partners; growing trend for teenage expectant mothers who had more than eight years of schooling and premature birth; decline/growing for normal birth; growing for number of prenatal appointments; decline for first and fifth minute Apgar score; growing for congenital anomalies. The analysis provided information that can be used to promote pregnancy prevention strategies and assistance to adolescent mothers.

Qualidade das informações sobre fecundidade no Censo Demográfico de 2010

O objetivo desta nota de pesquisa é examinar a qualidade da informação sobre fecundidade no Censo Demográfico brasileiro de 2010, para inferir sobre a precisão das estimativas da taxa de fecundidade total (TFT) e das taxas específicas por idade provenientes dessa fonte de dados. As bases de dados utilizadas são os microdados do Censo Demográfico de 2010 e o Sistema de Informações sobre Nascimentos (Sinasc) de 2009 e 2010. Serão aplicados indicadores demográficos básicos e o método indireto da razão P/F de Brass para a estimação da TFT, utilizando as duas fontes de dados. Os resultados mostram que os dados censitários são bastante consistentes, mas apresentam alguns problemas de subenumeração por idade da fecundidade corrente, como amplamente conhecido na demografia. Esta subenumeração deve ser levada em consideração na estimação do nível de fecundidade no país. As mudanças na estrutura da fecundidade afetam a TFT por ser taxa de período, mas o método P/F de Brass ainda mostra bons resultados. Ao final, são feitas recomendações para possíveis melhorias em novas coletas de dados, principalmente nos censos e pesquisas por amostra de domicílios, que são fontes essenciais para a estimação da fecundidade e acompanhamento de suas tendências, necessárias para a atualização das projeções desse indicador no médio e longo prazos.DOI http://dx.doi.org/10.20947/S0102-309820160010

Developing a Measure of Prenatal Case Management Dosage

Recently, federal funding was designated through the Patient Protection and Affordable Care Act giving states the opportunity to expand their prenatal case management programs (PCM) through home visitation. Studies evaluating the effect of PCM on birth outcomes have shown little or no positive results. One suggested reason for these findings is a lack of attention in the assessment of dosage. The objective of this study is to demonstrate the use of measuring PCM dosage when assessing pregnancy outcomes. A birth cohort (N = 4,582) encompassing Medicaid-insured Iowa residents enrolled in PCM who gave birth to a singleton from October 2005 to December 2006 was constructed from linked Iowa birth, Medicaid Claims, and Women's Health Information Systems datasets. Data was used to create a dosage measure capturing the duration of enrollment, amount of time spent with a case manager, and breadth of interventions. Bivariate analysis and logistic regression were used to assess the relationship between PCM dosage and the birth outcomes. Dosage was significantly associated with LBW (X (2) = 31.1, P < 0.001) and PTB (X (2) = 56.2, P < 0.001). After adjustment for potential confounders, the likelihood of LBW and PTB were aOR: 0.47 (95% CI: 0.36-0.63) and aOR: 0.60 (95% CI: 0.44-0.82) for women with medium dosage (compared to low dosage), respectively. For women with high PCM dosage the likelihood of LBW and PTB was aOR 0.40 (95% CI: 0.31-0.51) and aOR = 0.62 (95% CI: 0.48-0.81), respectively. This study showed that PCM dosage was significantly associated with lower odds of an adverse pregnancy outcome occurring.