scholarly journals COVID-19 mortality among Indigenous people in Brazil: a nationwide register-based study

2020 ◽  
Author(s):  
Victor Santana Santos ◽  
Adriano Antunes Souza Araújo ◽  
Jarbas Ribeiro de Oliveira ◽  
Lucindo José Quintans-Júnior ◽  
Paulo Ricardo Martins-Filho
Keyword(s):  
Mortality Rate ◽  
Incidence Rate ◽  
Indigenous People ◽  
Social Protection ◽  
Black People ◽  
Indigenous Population ◽  
Case Fatality ◽  
The North ◽  
Minority Ethnic Groups ◽  
The Impact

Abstract Coronavirus disease 2019 (COVID-19) has disproportionately affected Black people and minority ethnic groups, but there are limited data regarding the impact of disease on Indigenous people. Herein, we investigated the burden of COVID-19 on the Indigenous population in Brazil. We performed a populational-based study including all cases and deaths from COVID-19 among Brazilian Indigenous people from 26 February to 28 August 2020. Data were obtained from official Brazilian information systems. We calculated incidence, mortality and fatality rates for the Indigenous population for each of the five Brazilian regions. Brazil had an incidence and a mortality rate of 3546.4 cases and 65.0 deaths per 100 000 population, respectively. The case fatality rate (CFR) was 1.8%. The Central-West had the higher estimates of disease burden among Brazilian Indians (incidence rate: 3135.0/100 000; mortality rate: 101.2/100 000 and CFR: 3.2%) followed by the North region (incidence rate: 5664.4/100 000; mortality rate: 92.2/100 000 and CFR: 1.6%). Governmental actions should guarantee the isolation, monitoring and testing capabilities of Indigenous people and rapidly to provide social protection and health facilities.

scholarly journals FAKTOR-FAKTOR YANG BERPENGARUH DALAM LUARAN KLINIS PASIEN TETANUS DI RSUP DR. MOHAMMAD HOESIN PALEMBANG

2018 ◽  
Vol 35 (3) ◽  
Author(s):  
Luther Theng ◽  
Theresia Christin ◽  
Erial Bahar
Keyword(s):  
Mortality Rate ◽  
Clinical Outcome ◽  
Incidence Rate ◽  
Medical Record ◽  
Case Fatality ◽  
Bivariate Analysis ◽  
Cross Sectional ◽  
Factors Affecting ◽  
Isolation Room ◽  
Reduce Mortality Rate

FACTORS AFFECTING THE CLINICAL OUTCOME OF TETANUS PATIENTS IN MOHAMMAD HOESIN GENERAL HOSPITAL PALEMBANGABSTRACTIntroduction: Tetanus is a serious health problem with mortality rate up to 60% despite the decreasing incidence rate every year. Knowledge about factors affecting clinical outcome of tetanus patients may reduce mortality rate, better understanding on prevention and management of the disease. The clinical outcomeAim: To know the incidence and factors that affect the clinical outcome of tetanus patients.Method: Retrospective study with cross sectional analytic using hospital-based secondary data. Inclusion criteria were hospitalized tetanus patients within 3 years period (2013-2015) and complete medical record. Incidence, case fatality rate and other which other factors associated with clinical outcome were counted from medical record and analyzed by univariate and bivariate analysis, and logistic regression for multivariate analysis.Result: The incidence rate of tetanus patients in 2013 was (4.28%), 2014 (1.62%), 2015 (2.87%) and the mortality rate reaches 28.41%. From 41 subjects, univariate, bivariate and multivariate analyses were performed. The four selected variables were gender, port d’entrée, onset, and isolation room. Dsicussion: Mortality rate reached 28.41% despite the decreasing incidence every year. Sex, port d’entrée, onset, and isolation room treatment are factors that affect clinical outcome of tetanus patients.Keywords: Clinical outcome, mortality rate, tetanusABSTRAKPendahuluan: Tetanus merupakan masalah kesehatan serius dapat menyebabkan angka kematian mencapai 60% walaupun angka insiden semakin menurun setiap tahunnya. Pengetahuan mengenai faktor-faktor yang memengaruhi luaran klinis pasien dapat menurunkan angka kematian, upaya pencegahan penyakit dan keberhasilan penatalaksanaan.Tujuan: Mengetahui insiden serta faktor–faktor yang memengaruhi luaran klinis pasien tetanus.Metode: Studi bersifat retrospektif dengan metode potong lintang analitik dengan data sekunder berbasis RS. Kriteria inklusi adalah pasien tetanus yang dirawat sejak tiga periode 2013-2015 dan memiliki data rekam medis lengkap. Insiden, angka kematian dan hal-hal yang diperkirakan berhubungan dengan luaran ditelusuri dari rekam medis kemudian dilakukan analisis univariat, bivariat, dan multivariat menggunakan regresi logistik.Hasil: Angka insiden tetanus tahun 2013 (4,28%), 2014 (1,62%), 2015 (2,87%) dengan angka kematian rata-rata28,41%. Dari 41 subjek penelitian dilakukan analisis univariat, bivariat, dan multivariat. Empat variabel yang terpilih adalah jenis kelamin, port d’entrée, onset, dan perawatan pasien ruang isolasi.Diskusi: Angka kematian kasus tetanus masih mencapai 28,41% walaupun angka insiden semakin menurun setiap tahunnya. Jenis kelamin, port d’entry, onset, dan perawatan di ruang isolasi merupakan faktor-faktor berpengaruh terhadap luaran klinis pasien tetanus.Kata kunci: Angka kematian, luaran klinis, tetanus

scholarly journals Risk factors for incidence and case-fatality rates of healthcare-associated infections: a 20-year follow-up of a hospital-based cohort

2015 ◽  
Vol 144 (1) ◽  
pp. 198-206 ◽  
Author(s):  
R.-F. WANG ◽  
S.-H. SHEN ◽  
A. M.-F. YEN ◽  
T.-L. WANG ◽  
T.-N. JANG ◽  
...  
Keyword(s):  
Risk Factors ◽  
Mortality Rate ◽  
Incidence Rate ◽  
Case Fatality Rate ◽  
Tertiary Care ◽  
Case Fatality ◽  
Healthcare Associated Infections ◽  
Fatality Rate ◽  
Infection Site ◽  
Healthcare Associated

SUMMARYInformation is lacking on the integrated evaluation of mortality rates in healthcare-associated infections (HAIs). Our aim was to differentiate the risk factors responsible for the incidence from those for the case-fatality rates in association with HAIs. We therefore examined the time trends of both incidence and case-fatality rates over a 20-year period at a tertiary-care teaching medical centre in Taiwan and the mortality rate was expressed as the product of the incidence rate and the case-fatality rate. During the study period the overall mortality rate fell from 0·46 to 0·32 deaths/1000 patient-days and the incidence rate fell from 3·41 to 2·31/1000 patient-days, but the case-fatality rate increased marginally from 13·5% to 14·0%. The independent risk factors associated with incidence of HAIs were age, gender, infection site, admission type, and department of hospitalization. Significant prognostic factors for HAI case-fatality were age, infection site, intensive care, and clinical department. We conclude that the decreasing trend for the HAI mortality rate was accompanied by a significant decline in the incidence rate and this was offset by a slightly increasing trend in the case-fatality rate. This deconstruction approach could provide further insights into the underlying complex causes of mortality for HAIs.

scholarly journals In the land of Iara, Iracema and Macyrajara, what health practices will I offer? Analysis of the trajectories and perspectives of health policies for indigenous peoples in Brazil

2021 ◽  
Vol 10 (11) ◽  
pp. e44101118992
Author(s):  
Edson Oliveira Pereira ◽  
Bernardino Vitoy ◽  
Daniel Ignacchiti Lacerda ◽  
Damaris Silveira
Keyword(s):  
Indigenous People ◽  
Indigenous Population ◽  
Indigenous Health ◽  
Healthcare Services ◽  
Health Policies ◽  
Central Position ◽  
South American ◽  
The North ◽  
European Colonization ◽  
North And South

There are indigenous people on the North and South American continents who dwelled there before the Portuguese, Spanish, French, English, or Dutch invasions. With the European colonization, much of the indigenous population was enslaved, Christianized, and decimated almost completely. Presently, besides everyday challenges, such as rights and access to the homeland, agribusiness clashes, and other threats, there is a precariousness in the management and provision of healthcare provided to the Amerindians. This paper aims to draw a timeline on the state of health of Brazilian indigenous people, identifying its subjects, assessing its contexts, and discussing the legal milestones. Indigenous health policies hold (or at least should hold) a central position in the provision of healthcare to the indigenous population wherein they offer integral, universal, and equanimous healthcare services. Despite this, the urge to recognize some fragility restrains the management and provision of the health policies for the indigenous people.

scholarly journals Incidence, clinical features, and outcomes of COVID-19 in Canada: impact of sex and age

2020 ◽  
Vol 13 (1) ◽  
Author(s):  
Jacob O’Brien ◽  
Kevin Y. Du ◽  
Chun Peng
Keyword(s):  
Incidence Rate ◽  
Age Groups ◽  
Case Fatality ◽  
Risk Groups ◽  
Older Age ◽  
Reproductive Age ◽  
Term Care ◽  
Severity Of The Disease ◽  
Lower Incidence Rate ◽  
The Impact

AbstractMale sex and older age have been reported to be associated with worse outcomes from COVID-19. It was postulated that estrogens may play a role in reducing the severity of the disease and may therefore offer a treatment option for COVID-19 patients. However, more female cases and deaths from COVID-19 have been recorded in Canada. To determine the potential role of estrogens, we analyzed COVID-19 data from Canada, focusing on the impact of sex and age. Although the overall incidence rate is higher in females than in males, when several high risk groups, including health care workers and long-term care residences, which are predominantly females, were excluded, we found that females had a lower incidence rate than males between the ages of 20s to 70s. Interestingly, this sex-based difference is more evident in females of the reproductive ages (20–49) than in postmenopausal patients (60s or older). Males have significantly higher hospitalization, ICU admission, and case fatality rates; however, a greater difference was observed in the older age groups. Finally, symptom manifestation varied between sexes. Some of the symptoms, which were more frequently observed in patients who recovered than patients who died, were more commonly observed in females of the reproductive age compared to their male counterparts. Since only females of the reproductive age have much higher circulating estrogens than males, these findings suggest that estrogens may play a role in reducing COVID-19 incidence and in the development of symptoms, especially those related to better survival.

The impact of international law on natural resource governance in Greenland

Polar Record ◽  
2020 ◽  
Vol 56 ◽  
Author(s):  
Rachael Lorna Johnstone
Keyword(s):  
Natural Resources ◽  
International Law ◽  
Indigenous People ◽  
Indigenous Peoples ◽  
International Standards ◽  
The Self ◽  
Current Status ◽  
Resource Governance ◽  
The North ◽  
The Impact

Abstract The paper demonstrates how the evolution of international law on colonial and indigenous peoples, in particular evolving rights to sovereignty over natural resources, shaped the changing relationship between Greenland and the rest of the Danish Realm. Greenland today is in a unique position in international law, enjoying an extremely high degree of self-government. This paper explores the history, current status and future of Greenland through the lens of international law, to show how international obligations both colour its relationship with the Kingdom of Denmark and influence its approaches to resource development internally. It considers the invisibility of the Inuit population in the 1933 Eastern Greenland case that secured Danish sovereignty over the entire territory. It then turns to Denmark’s registration of Greenland as a non-self-governing territory (colony) in 1946 before Greenland’s-purported decolonisation in 1953 and the deficiencies of that process. In the second part of the 20th century, Denmark began to recognise the Greenland Inuit as an indigenous people before a gradual shift towards recognition of the Greenlanders as a people in international law, entitled to self-determination, including the right to permanent sovereignty over their natural resources. This peaked with the Self-Government Act of 2009. The paper will then go on to assess competing interpretations of the Self-Government Act of 2009 according to which the Greenland self-government is the relevant decision-making body for an increasing number of fields of competence including, since 1 January 2010, the governance of extractive industries. Some, including members of the Greenland self-government, argue that the Self-Government Act constitutes full implementation of the UN Declaration on the Rights of Indigenous Peoples (UNDRIP 2007), but this view is not universally shared. The paper also considers the status and rights of two Greenland minorities: the North Greenlanders (Inughuit) and the East Greenlanders, each of whom has distinct histories, experiences of colonisation, dialects (or languages) and cultural traditions. While the Kingdom of Denmark accepts the existence of only one indigenous people, namely, the Inuit of Greenland, this view is increasingly being challenged in international fora, including the UN human rights treaty bodies, as the two minorities are in some cases considered distinct indigenous peoples. Their current position in Greenland as well as in a future fully independent Greenland is examined, and the rights that they hold against the Greenland self-government as well as the Kingdom of Denmark explored. Greenland’s domestic regime for governance of non-renewable natural resources (principally mining and hydrocarbons) is briefly analysed and compared with international standards, with a particular emphasis on public participation. The paper assesses the extent to which it complies with the standards in key international instruments.

scholarly journals Trends of Neonatal Mortality in context of Case Overload in Al - Alwyia Pediatric Teaching Hospital at Baghdad during 2005-2012

2016 ◽  
Vol 12 (2) ◽  
pp. 43-48
Author(s):  
Tareef Fadhil Raham ◽  
Assad Muhsen Abood
Keyword(s):  
Mortality Rate ◽  
Neonatal Mortality ◽  
Teaching Hospital ◽  
Hospital Admissions ◽  
Significant Proportion ◽  
Case Fatality ◽  
Childhood Mortality ◽  
P Value ◽  
Total Hospital ◽  
The Impact

Background: Data on the impact of neonatal and total pediatric admissions volume on neonatal mortality are sparse. Objectives: This study is done to estimate the neonatal mortality in relation to neonatal admissions and to total hospital admissions in Al-Alwyia Pediatric Teaching Hospital through years 2005-2012 Type of the study: A retrospective study.Methods: statistical records of all cases admitted to APTH were studied during 2005-2012.Results: Neonatal mortality decreased to the nadir at last year of study period (2012) and reached 6.1% of neonatal admissions compared to 2005 level which was 9.7 %. Mortality rate among premature and low birth weight (LBW) infants decreased also. The study also reveals that neonatal mortality constitute significant a contribution to childhood mortality (61.4 %) and morbidity (28.3%) throughout the study years. With a highly significant p value parallel to increasing number of neonatal admissions (case over load) , there is a trend of neonatal mortality rate to be decreased Case fatality rate also decreased among overall children to 3.5% in 2005 and to 3.3% in 2013 in spite of 2.4 times increase in neonatal admission during the study period.This neonatal overload is more than overall pediatric over load, because the total hospital admissions are increased just 1.2 times.Conclusions: The neonatal admissions case overload is high and increasing and constitutes a significant proportion of total childhood mortality. Neonatal mortality including premature and (LBW) infants is decreasing .Further actions are needed to meet global goals.

scholarly journals Global Pandemic Trends of COVID-19 in 2020

2021 ◽  
Author(s):  
Hai-Zhen Chen ◽  
Bo Cai ◽  
Jian-Guo Chen
Keyword(s):  
Public Health ◽  
United States ◽  
Mortality Rate ◽  
Incidence Rate ◽  
Case Fatality Rate ◽  
Case Fatality ◽  
The United States ◽  
Cumulative Number ◽  
Fatality Rate ◽  
The World

Abstract Background: The novel coronavirus pneumonia (COVID-19) has been global threaten to public health. This paper provides perspective to the decision-making for public health control of the pandemic or the spread of epidemic.Methods: According to the WHO global reported database, we developed and used the number of cumulative cases, and the number of cumulative deaths to calculate and analyze rates of incidence, mortality, and fatality by country, with respect to the 30 highest outbreak (Top 30) countries.Results： As of December 31, 2020, of the global population of 7.585 billion, the cumulative number of reported cases was 81,475,053, and the cumulative number of deaths was 1,798,050. The incidence rate of COVID-19 was 1074.13 per 100,000 population, the mortality rate was 23.70 per 100,000, and the case fatality rate was 2.21%. Among the Top 30 countries, the five countries with the highest number of reported cumulative cases were, in rank, the United States (19,346,790 cases), India (10,266,674), Brazil (7,563,551), Russia (3,159,297) and France (2,556,708), and the five countries with the highest number of cumulative deaths were the United States (335,789 cases), Brazil (192,681), India (148,738), Mexico (123,845) and Italy (73,604). Globally, the countries with the highest incidence rate were, in rank, Andorra, Luxembourg, Montenegro, San Marino, and Czechia; the countries with the highest mortality rate were, in rank, San Marino, Belgium, Slovenia, Italy, and North Macedonia. The highest fatality rate was found in Yemen, Mexico, Montserrat, Isle of Man, and Ecuador, respectively. In China, 96,673 cases of COVID-19 and 4788 deaths were reported in 2020, ranking the 78th and the 43rd, respectively, in the world. The incidence rate and mortality rate were 6.90/105 and 0.34/105, respectively, ranking 207th and 188th in the world. The case fatality rate was 4.95%, ranking 11th in the world.Conclusions： The COVID-19 prevalence is still on the rise, and the turning points of incidence and mortality are not yet forecasted. Personal protection, anti-epidemic measures and efforts from public health personnel, medical professionals, biotechnology R&D personnel, effectiveness of the vaccination programs and the governments, are the important factors to determine the future prevalence of this coronavirus disease.

scholarly journals A register-based SAH study in Japan: high incidence rate and recent decline trend based on lifestyle

2020 ◽  
pp. 1-9 ◽  
Author(s):  
Fusao Ikawa ◽  
Akio Morita ◽  
Takeo Nakayama ◽  
Yoshihito Goto ◽  
Nobuyuki Sakai ◽  
...  
Keyword(s):  
Mortality Rate ◽  
Incidence Rate ◽  
Smoking Status ◽  
Cerebral Aneurysms ◽  
Case Fatality ◽  
Treatment Rate ◽  
Cholesterol Lowering ◽  
Current Smoking Status ◽  
Current Smoking ◽  
Neurosurgical Society

OBJECTIVEJapan has been reported to have the highest (and increasing) incidence of subarachnoid hemorrhage (SAH) in the world. However, there has never been a report on the nationwide incidence rate and recent trends for SAH in Japan. In this register-based study, the authors aimed to clarify the estimated nationwide SAH incidence rate and the recent trend in SAH incidence in Japan and the reasons for any changes in this trend.METHODSThe authors compiled data from the Japanese Ministry of Health, Labour and Welfare and from the records of the Japan Neurosurgical Society. They reviewed the age-standardized nationwide SAH mortality rate, the estimated age-standardized SAH incidence rate according to the age-standardized SAH mortality rate, and the estimated crude SAH incidence rate, including the 95% confidence intervals, from 2003 to 2015. The trends in the number of treatments for unruptured and ruptured cerebral aneurysms, as well as the prevalence of hypertension, current smoking status, and use of cholesterol-lowering drugs, were assessed. The estimated treatment rate for unruptured cerebral aneurysms (UCAs) was also calculated along with the 95% confidence interval.RESULTSThe estimated age-standardized nationwide SAH incidence rate significantly declined from 31.34 cases (95% CI 31.32–31.34) to 27.63 (95% CI 27.59–27.63; decrease by 11.8%) per 100,000 person-years. This decline was based on the 2010 population as the reference from 2003 through 2015 and a case-fatality rate of SAH that was assumed to decrease by 1% annually from 44% in 2003 to 32% in 2015. According to sensitivity analysis, the change rate of the estimated age-standardized SAH incidence rate ranged from −56.69% to 23.27%, with a mean of −30.91% (SD 20.52%), and there were decline trends in 92% of all trends. The estimated nationwide crude SAH incidence rate also showed a significant decline from 23.79 (95% CI 23.78–23.79) to 20.25 (95% CI 20.24–20.25; decrease by 14.9%) per 100,000 person-years. The trend in treatment numbers for UCAs increased significantly (p < 0.0001) from 2003 through 2015; however, the estimated treatment rate for UCAs was only 0.19 (95% CI 0.19–0.20) to 0.51 (95% CI 0.50–0.51) among all UCA patients. The prevalence of hypertension (males, p = 0.0003; females, p < 0.0001) and current smoking status (males, p < 0.0001; females, p = 0.0002) declined significantly from 2003 through 2015, while the use of cholesterol-lowering drugs increased significantly (males, p < 0.0001; females, p = 0.0005) during the same period.CONCLUSIONSThe estimated nationwide SAH incidence rate in Japan was higher than rates in other countries, although it has declined recently. An improving lifestyle may have contributed to the declining rate of SAH incidence in Japan.

scholarly journals The Relationship Between Demographic, Socioeconomic, and Health-Related Parameters and the Impact of COVID-19 on 24 Regions in India: Exploratory Cross-Sectional Study (Preprint)

2020 ◽  
Author(s):  
Ravi Philip Rajkumar
Keyword(s):  
Mortality Rate ◽  
Sex Ratio ◽  
Multivariate Analyses ◽  
Case Fatality ◽  
Negatively Associated ◽  
Crude Mortality Rate ◽  
Crude Mortality ◽  
Health Related ◽  
The Impact ◽  
The Relationship

BACKGROUND The impact of the COVID-19 pandemic has varied widely across nations and even in different regions of the same nation. Some of this variability may be due to the interplay of pre-existing demographic, socioeconomic, and health-related factors in a given population. OBJECTIVE The aim of this study was to examine the statistical associations between the statewise prevalence, mortality rate, and case fatality rate of COVID-19 in 24 regions in India (23 states and Delhi), as well as key demographic, socioeconomic, and health-related indices. METHODS Data on disease prevalence, crude mortality, and case fatality were obtained from statistics provided by the Government of India for 24 regions, as of June 30, 2020. The relationship between these parameters and the demographic, socioeconomic, and health-related indices of the regions under study was examined using both bivariate and multivariate analyses. RESULTS COVID-19 prevalence was negatively associated with male-to-female sex ratio (defined as the number of females per 1000 male population) and positively associated with the presence of an international airport in a particular state. The crude mortality rate for COVID-19 was negatively associated with sex ratio and the statewise burden of diarrheal disease, and positively associated with the statewise burden of ischemic heart disease. Multivariate analyses demonstrated that the COVID-19 crude mortality rate was significantly and negatively associated with sex ratio. CONCLUSIONS These results suggest that the transmission and impact of COVID-19 in a given population may be influenced by a number of variables, with demographic factors showing the most consistent association.

scholarly journals COVID-19 in Brazil: spatial risk, social vulnerability, human development, clinical manifestations and predictors of mortality – a retrospective study with data from 59 695 individuals

2021 ◽  
Vol 149 ◽  
Author(s):  
Jussara Almeida Oliveira Baggio ◽  
Michael Ferreira Machado ◽  
Rodrigo Feliciano do Carmo ◽  
Anderson da Costa Armstrong ◽  
Alan Dantas dos Santos ◽  
...  
Keyword(s):  
Mortality Rate ◽  
Human Development ◽  
Incidence Rate ◽  
Social Vulnerability ◽  
Clinical Manifestations ◽  
Case Fatality ◽  
Advanced Age ◽  
Social Vulnerability Index ◽  
Cross Sectional ◽  
Spatial Risk

Abstract Brazil ranks second in the number of confirmed cases of COVID-19 worldwide. In spite of this, coping measures differ throughout the national territory, as does the disease's impact on the population. This cross-sectional observational study, with 59 695 cases of COVID-19 registered in the state of Alagoas between March and August 2020, analysed clinical-epidemiological variables, incidence rate, mortality rate, case fatality rate (CFR) and the social indicators municipal human development index (MHDI) and social vulnerability index (SVI). Moran statistics and regression models were applied. Logistic regression analysis was applied to determine the predictors of death. The incidence rate was 1788.7/100 000 inhabitants; mortality rate was 48.0/100 000 and CFR was 2.7%. The highest incidence rates were observed in municipalities with better human development (overall MHDI (I = 0.1668; p = 0.002), education MHDI (I = 0.1649; p = 0.002) and income MHDI (I = 0.1880; p = 0.005)) and higher social vulnerability (overall SVI (I = 0.0599; p = 0.033)). CFR was associated with higher social vulnerability (SVI human capital (I = 0.0858; p = 0.004) and SVI urban infrastructure (I = 0.0985; p = 0.040)). Of the analysed cases, 55.4% were female; 2/3 were Black or Brown and the median age was 41 years. Among deaths, most were male (919; 57.4%) and elderly (1171; 73.1%). The predictors of death were male sex, advanced age and the presence of comorbidities. In Alagoas, Brazil, the disease has undergone a process of interiorisation and caused more deaths in poorer municipalities. The presence of comorbidities and advanced age were predictors of death.

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