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Percorrer Departamento de Epidemiologia por Objetivos de Desenvolvimento Sustentável (ODS) "03:Saúde de Qualidade"
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- The 24-Hour Activity Checklist for Cerebral Palsy: Translation, Content Validity and Test-Retest Reliability of Portuguese VersionsPublication . Vila-Nova, Fabio; Sá, Cristina; Leite, Hércules Ribeiro; Cadete, Ana; Folha, Teresa; Longo, Egmar; Martins, Maria Elisabete; Oliveira, RaulBackground: The importance of 24-h movement behaviour, including sleep, physical activity (PA) and sedentary behaviour (SB), has gained prominence due to its significant impact on the health and development of children, including those with cerebral palsy (CP). The 24-h activity checklist for CP, a tool developed in the Netherlands to monitor the activity in CP paediatric population, requires translation and cultural adaptation to Portuguese for use in Brazil and Portugal. Methods: This cross-sectional methodological study involved translating and culturally adapting the 24-h activity checklist for CP into Brazilian Portuguese (BP) and European Portuguese (EP) languages. The process included forward translation, synthesis and backward translation, expert panel evaluation and pretesting. Brazilian and Portuguese experts appraised content validity, assessed by the individual item (I-CVI) and scale level content validity index scores (S-CVI/Ave). Sixty parents of children with CP participated in the test-retest analysis, reported with the Intraclass Correlation Coefficients (ICCs). Results: I-CVI scores were higher than 0.78 for both versions. S-CVI/Ave scores were considered excellent for BP (0.91) and EP version (1.0). Expert's appraisal results in the inclusion of a question about sleep-related time indicators and the split of sleep, PA, and screen time questions for weekdays and weekends. Brazilian and Portuguese parents of children with CP reported understanding on instructions, questions, and answer options. The ICC values range from 0.81 to 0.99 and 0.6 to 0.98, for BP and EP, respectively. Conclusions: The BP and EP versions of 24-h activity checklist for CP demonstrated good content validity and test-retest reliability, supporting its use in Brazil and Portugal. This tool can contribute to improving communication between families and healthcare professionals to monitor and develop tailored interventions for healthy movement behaviours in children with CP.
- Acidentes domésticos e de lazer por animais em Portugal, admitidos nas urgências hospitalaresPublication . JORGE SILVA ALVES, TATIANA DANIELA; das Neves Pereira da Silva, Susana; Braz, Paula; Aniceto, Carlos; Papadakaki, Maria; Mexia, Ricardo; Matias-Dias, CarlosOs acidentes domésticos e de lazer envolvendo animais são considerados um importante problema de saúde pública, estando a maioria dos acidentes relacionados com mordeduras de cães e gatos. Estes eventos representam uma carga evitável para a saúde pública que poderá ser minimizada através da promoção de medidas de segurança adequadas relativas à presença de animais de companhia e de responsabilização pelo controlo dos mesmos. O presente estudo tem como objetivo aumentar o conhecimento epidemiológico sobre acidentes domésticos e de lazer envolvendo animais, os quais implicaram o atendimento nas urgências hospitalares, do Serviço Nacional de Saúde, no ano 2023, em Portugal, Realizou-se um estudo epidemiológico observacional, descritivo e transversal, com análise dos dados recolhidos através do sistema de monitorização EVITA relativos a episódios de recurso a urgência hospitalar no ano 2023, em Portugal. Procedeu-se à análise descritiva dos dados, com o apuramento das frequências absolutas e relativas (percentagens). Comparações entre proporções foram realizadas através do teste do Qui-quadrado de Pearson com um nível de significância de 5%. Nesta análise foi utilizado o programa estatístico SPSS V.30. Neste estudo foram analisados os 1356 episódios de admissão ao SU por acidente doméstico e de lazer com envolvimento de animais, descritos em EVITA. A maior parte destes acidentes ocorreu nas crianças e jovens até aos 19 anos (34,4%). As crianças e jovens até aos 14 anos, no sexo masculino, foram mais afetadas, sendo que dos 15 anos em diante a maior proporção de acidentes foi observada no sexo feminino. Estes acidentes ocorreram sobretudo nos meses de verão (56,3%), ao fim de semana (34,0%) e no período da tarde, entre as 15H e as 20H (47,9%). Foram encontradas diferenças significativas na distribuição dos acidentes no momento em que ocorreram e grupo etário. Os acidentes provocados por animais não ocorreram nos diferentes locais de forma uniforme, destacaram-se os locais da casa (35,1%) e ao ar livre (24,9%). As crianças até aos 4 anos foram as que mais sofreram acidentes em casa, enquanto que, ao ar livre observou-se maior frequência destes acidentes nos adultos entre 20 e os 34 (p<0,001). Globalmente, os animais mais frequentemente envolvidos nestes acidentes foram os insetos (abelha/vespa) (48,4%) e os cães/gatos (35,2%). Este estudo contribuiu para o melhor conhecimento da epidemiologia dos acidentes causados por animais, afigurando-se útil na perspetiva da promoção da saúde e da segurança, sensibilizando a comunidade para medidas de prevenção de mordedura por cães/gatos, responsabilidade civil dos donos desses animais e prevenção de picada de insetos.
- Assessing the role of children in the COVID-19 pandemic in Belgium using perturbation analysisPublication . Angeli, Leonardo; Caetano, Constantino Pereira; Franco, Nicolas; Coletti, Pietro; Faes, Christel; Molenberghs, Geert; Beutels, Philippe; Abrams, Steven; Willem, Lander; Hens, NielUnderstanding the evolving role of different age groups in virus transmission is essential for effective pandemic management. We investigated SARS-CoV-2 transmission in Belgium from November 2020 to February 2022, focusing on age-specific patterns. Using a next generation matrix approach integrating social contact data and simulating population susceptibility evolution, we performed a longitudinal perturbation analysis of the effective reproduction number to unravel age-specific transmission dynamics. From November to December 2020, adults in the [18, 60) age group were the main transmission drivers, while children contributed marginally. This pattern shifted between January and March 2021, when in-person education resumed, and the Alpha variant emerged: children aged under 12 years old were crucial in transmission. Stringent social distancing measures in March 2021 helped diminish the noticeable contribution of the [18, 30) age group. By June 2021, as the Delta variant became the predominant strain, adults aged [18, 40) years emerged as main contributors to transmission, with a resurgence in children’s contribution during September-October 2021. This study highlights the effectiveness of our methodology in identifying age-specific transmission patterns.
- Associação entre o Índice de Vulnerabilidade à Pobreza Energética e os Níveis de Tensão Arterial na População PortuguesaPublication . Rodrigues, Madalena; Gouveia, João Pedro; Sousa-Uva, MafaldaEm Portugal, estima-se que entre 1,8 e 3 milhões de pessoas vivam em situação de pobreza energética, estando entre 609 mil e 660 mil em condição severa. A exposição a temperaturas extremas dentro das habitações pode agravar problemas de saúde existentes e aumentar o risco de doenças cardiovasculares, como a hipertensão arterial, que afeta cerca de 36% da população portuguesa entre 25 e 74 anos. A pobreza energética resulta da combinação de baixos rendimentos, má eficiência energética das habitações e dificuldades no pagamento das faturas de energia. Este problema é intensificado pelas alterações climáticas, que elevam a frequência de eventos extremos. Apesar das preocupações expressas em políticas europeias, poucos estudos populacionais avaliaram a associação entre pobreza energética e saúde utilizando medidas objetivas. Este trabalho tem como objetivo estimar a associação entre o Índice de Vulnerabilidade à Pobreza Energética (IVPE) desenvolvido ao nível da freguesia (#3092) e os níveis de tensão arterial na população adulta portuguesa. Trata-se de um estudo epidemiológico, observacional, transversal e analítico, com dados do Inquérito Nacional de Saúde com Exame Físico 2015 (INSEF), abrangendo 4911 indivíduos de 25 a 74 anos. O IVPE foi categorizado em tercis (baixo, médio e alto) e as associações foram analisadas por regressão linear, ajustada para fatores sociodemográficos e económicos. Os resultados evidenciam que viver em áreas com elevada vulnerabilidade à pobreza energética está associado a um aumento significativo da tensão arterial. No contexto do arrefecimento, observou-se um acréscimo de 2,28% na Tensão Arterial Sistólica (TAS) e de 2,08% na Tensão Arterial Diastólica (TAD), enquanto para o aquecimento verificou-se um aumento significativo na TAS, mas sem relevância na TAD. Estes reforçam a pobreza energética como um fator de risco relevante para a saúde, sublinhando a necessidade de políticas públicas eficazes para mitigar os seus impactos. Num contexto de alterações climáticas e envelhecimento da população portuguesa, garantir condições habitacionais adequadas pode ser uma estratégia essencial para reduzir desigualdades sociais, promover a saúde e o bem-estar, bem como aliviar a pressão sobre os sistemas de saúde pública.
- A atividade do Instituto Nacional de Saúde Doutor Ricardo Jorge à luz dos Objetivos do Desenvolvimento Sustentável [Editorial]Publication . Dias, Carlos Matias; Almeida, Fernando deAo percorrer os 15 artigos incluídos neste trigésimo oitavo número do Boletim Epidemiológico Observações do Instituto Nacional de Saúde Doutor Ricardo Jorge (INSA), podemos, adotando uma interpretação lata da Agenda 2030 preconizada pela Organização Mundial da Saúde (OMS), associar, diretamente ou indiretamente, dez daqueles artigos ao terceiro Objetivo do Desenvolvimento Sustentável (ODS 3: Garantir o acesso à saúde de qualidade e promover o bem-estar para todos, em todas as idades), constatação natural num Instituto público do sector da saúde como INSA. (...)
- Characteristics and incidence trends of adults hospitalized with community-acquired pneumonia in Portugal, pre-pandemicPublication . Carneiro, Joana; Teixeira, Rita; Leite, Andreia; Lahuerta, Maria; Catusse, Julie; Ali, Mohammad; Lopes, SílviaCommunity-acquired pneumonia (CAP) is a major cause of hospitalization that leads to substantial morbidity, mortality, and costs. Evaluating CAP trends over time is important to understand patterns and the impact of public health interventions. This study aims to describe the characteristics and trends in the incidence of adults hospitalized with CAP in Portugal between 2010 and 2018. In this study, we included hospitalization data, prevalence of comorbidities, and population data. CAP hospitalizations of adults (≥18y) living in mainland Portugal discharged from public hospitals were identified using ICD-9-CM or ICD-10-CM codes. Based on previous CAP studies, we selected nine relevant comorbidities. We described the frequency and incidence of CAP hospitalizations per sex, age group, comorbidity, and year of discharge. Trends were explored using Joinpoint regression. We observed 470,545 CAP hospitalizations falling into the 2010-18 period. The majority were males (54.8%) and aged ≥75 years (65.3%). Most often recorded comorbidities were congestive heart failure (26.4%), diabetes (25.5%), and chronic pulmonary disease (19.2%). The Joinpoint regression identified a gradual decline in the incidence rates of CAP hospitalizations for both sexes and all age groups. Of the nine comorbidities selected, seven showed a progressive increase in incidence rates followed by a subsequent decline (all except HIV/AIDS and chronic renal disease). Our findings offer valuable insights for selecting priority groups for public health interventions and design strategies to mitigate the burden of CAP.
- Characterizing stakeholders in cancer primary prevention in European countries: an exploration of challenges and opportunities using a penta-helix frameworkPublication . Roxo, Luis; Carvalho da Silva Santos, Ana João; Girvalaki, Charis; Geantă, Marius; 4P-CAN WP2 study team; Sousa Uva, MafaldaObjectives: Cancer incidence has been increasing in Europe, with stark disparities between Western and Eastern regions. Cancer primary prevention (CPP) is a cost-effective strategy tackling lifestyle and risk factor exposure, but its implementation goes beyond the actions of the governments. This study aims to characterize stakeholders’ role in CPP, using a penta-helix approach, with the objective of shedding a new light in the Iron Curtain of Cancer Cases. Methods: We followed a mixed-methods approach, with quantitative and qualitative data from CPP stakeholders from the public sector, academia/research, private sector, media and civil society. Snowball sampling was used to distribute a survey where participants (n = 110) were asked which sector was the main driver of change, the most proactive and the most influential. Purposive sampling was used for semi-structured interviews (n = 33), where stakeholders were asked about their CPP activities, motivations, barriers and opportunities, and the role of other sectors. Countries were coded as Western or Eastern. Descriptive analysis was used for quantitative data, while thematic analysis was used for qualitative data. Results: The public sector is viewed as the main driver of change, and the most proactive and influential in both Western and Eastern Europe. However, Eastern European countries emphasize the role of other sectors in CPP more strongly. Thematic analysis identified key roles and themes for the public sector (Strategy: “Looking after citizen’s health,” “Making the system work,” “Operational Engagement”), academia/research (Knowledge: “Scientific credibility,” “Diversity of approaches,” “Getting out of the lab,” “Life in academia/research”), private sector (Responsibility: “Profit-oriented,” “Resources and operational activities,” “Ethics and responsibility”), media (Dissemination: “Capacity to reach people,” “Diversity and scope,” “Information and dissemination”) and civil society (Engagement: “Proximity to people,” “Advocacy and voice,” “Do what others do not do”). Although no meaningful differences were identified between Western and Eastern countries, the results highlight opportunities for Eastern countries to reduce regional disparities. Conclusion: Overall, results point to the complementary role of the sectors, emphasizing that involving different stakeholders and promoting adequate collaborations between them is crucial to unravel the full potential of CPP.
- Comparative Analysis of Direct Costs of Cancer and Risk Factors in EuropePublication . Herțeliu, Claudiu; Horobeț, Alexandra; Nerău, Vlad; Paraschiv, Anca (Gherman); Ștefan, George; Volintiru, Clara; Zaharia, Rodica Milena; Geantă, Marius; Boata Azis, Adriana Elena; Popescu, Ramona; Semenov, Viktor; Kriachkova, Lilia; Kuzmanovska, Milica; Carvalho da Silva Santos, Ana João; Boccia, Stefania; Villani, Leonardo; Espina, Carolina; Mileva, Bilyana; Tchalakov, Ivan; Petrov, Ivaylo; Roxo, Luis Filipe de Almeida; Sousa Uva, Mafalda; Loghin, Cornel Radu; Girvalaki, CharisThis study explores the direct costs and risk factors associated with cancer across European Union member states, emphasizing the economic and public health implications. A Cancer Risk Factors Index (CRFI) is developed to quantify and compare the impact of various determinants, including obesity, smoking, alcohol consumption, socioeconomic conditions, and pollution. Using data from Eurostat and other authoritative sources, we analyze the correlation between CRFI scores, healthcare expenditures, and cancer mortality rates. Results reveal significant disparities in cancer risk factors and healthcare investments across countries, with lower CRFI scores generally associated with higher healthcare spending and improved outcomes. The findings underscore the importance of comprehensive public health strategies and targeted interventions to address modifiable risk factors, reduce cancer-related mortality, and promote equitable healthcare access.
- COVID-19 Vaccine Effectiveness Against Hospitalization in Older Adults, VEBIS Hospital Network, Europe, September 2024-May 2025Publication . Rojas-Castro, Madelyn; Verdasca, Nuno; Monge, Susana; De Mot, Laurane; Trobajo-Sanmartín, Camino; Duffy, Róisín; Túri, Gergő; Kuliese, Monika; Duerrwald, Ralf; Borg, Maria-Louise; Popovici, Odette; Gomez, Verónica; Makarić, Zvjezdana Lovrić; Launay, Odile; Marques, Diogo F.P.; Pozo, Francisco; Witdouck, Arne; Martínez-Baz, Iván; Fitzgerald, Margaret; Oroszi, Beatrix; Jančorienė, Ligita; Buda, Silke; Dziugyte, Ausra; Lazăr, Mihaela; Machado, Ausenda; Tabain, Irena; Nguyen, Liem Binh Luong; Wagner, Eva Rivas; Dufrasne, François; Castilla, Jesús; Domegan, Lisa; Velkey, Viktória; Majauskaite, Fausta; Hackmann, Carolin; Nicolay, Nathalie; Bacci, Sabrina; Rose, Angela M.C.; European Hospital Vaccine Effectiveness GroupWe estimated COVID-19 vaccine effectiveness (VE) against PCR-confirmed SARS-CoV-2 hospitalization in patients ≥ 60 years with severe acute respiratory infection, using a multicenter, test-negative, case-control study across seven sites in six European countries between September 2024 and May 2025. We included 352 cases (115 vaccinated; 33%) and 9980 controls (5024 vaccinated; 50%). VE was 42% (95% CI: 15; 61) 14-59 days post-vaccination, 32% (95% CI: -1; 54) at 60-119 days, and 36% (95% CI: 2; 60) at 120-179 days, and no effect thereafter. Among adults aged 60-79 and ≥ 80 years, we observed moderate VE against COVID-19 hospitalization for up to 2 and 4 months, respectively.
- COVID-19 vaccine effectiveness in the paediatric population aged 5-17 years: a multicentre cohort study using electronic health registries in six European countries, 2021 to 2022Publication . Soares, Patricia; Machado, Ausenda; Nicolay, Nathalie; Monge, Susana; Sacco, Chiara; Hansen, Christian Holm; Meijerink, Hinta; Martínez-Baz, Iván; Schmitz, Susanne; Humphreys, James; Fabiani, Massimo; Echeverria, Aitziber; AlKerwi, Ala'a; Nardone, Anthony; Mateo-Urdiales, Alberto; Castilla, Jesús; Kissling, Esther; Nunes, Baltazar; VEBIS-Lot 4 working groupBackground: During the first year of the COVID-19 pandemic, vaccination programmes targeted children and adolescents to prevent severe outcomes of SARS-CoV-2 infection. Aim: To estimate COVID-19 vaccine effectiveness (VE) against hospitalisation due to COVID-19 in the paediatric population, among those with and without previously documented SARS-CoV-2 infection. Methods: We established a fixed cohort followed for 12 months in Denmark, Norway, Italy, Luxembourg, Navarre (Spain) and Portugal using routine electronic health registries. The study commenced with paediatric COVID-19 vaccination campaign at each site between June 2021 and January 2022. The outcome was hospitalisation with a laboratory-confirmed SARS-CoV-2 infection or COVID-19 as the main diagnosis. Using Cox proportional hazard models, VE was estimated as 1 minus the confounder-adjusted hazard ratio of COVID-19 hospitalisation between vaccinated and unvaccinated. A random-effects meta-analysis was used to pool VE estimates. Results: We included 4,144,667 5-11-year-olds and 3,861,841 12-17-year-olds. In 12-17-year-olds without previous infection, overall VE was 69% (95% CI: 40 to 84). VE declined with time since vaccination from 77% ≤ 3 months to 48% 180-365 days after immunisation. VE was 94% (95% CI: 90 to 96), 56% (95% CI: 3 to 80) and 41% (95% CI: -14 to 69) in the Delta, Omicron BA.1/BA.2 and BA.4/BA.5 periods, respectively. In 12-17-year-olds with previous infection, one dose VE was 80% (95% CI: 18 to 95). VE estimates were similar for 5-11-year-olds but with lower precision. Conclusion: Vaccines recommended for 5-17-year-olds provided protection against COVID-19 hospitalisation, regardless of a previously documented infection of SARS-CoV-2, with high levels of protection in the first 3 months of the vaccination.