Thales Philipe Rodrigues da Silva

Association between contextual factors and vaccine coverage against human papilomavirus in adolescents in the state of Minas Gerais, Brazil: global spatial regressions

This study aimed to identify the associations between socioeconomic factors, the social environment, and human papillomavirus (HPV) vaccine coverage among adolescents in the state of Minas Gerais (MG), Brazil. This ecological study utilized secondary data from 853 municipalities in MG, covering female adolescents from 2014 to 2022 and male adolescents from 2017 to 2022, as provided by the information system of the National Immunization Program. Spatial statistical analysis was conducted to assess spatial dependence and identify spatial clusters of municipalities with high and low HPV vaccine coverage. The first and second dose coverage among male adolescents in most municipalities in MG was classified as very low (< 50%) or low (≥ 50% to < 80%). Among female adolescents, the majority of coverage rates were adequate (≥ 80%) or low (≥ 50% to < 80%). Socioeconomic factors, area-specific factors, and their interactions may influence HPV vaccination rates. The disparities in vaccination coverage rates observed across the state highlight the need for targeted interventions to increase coverage and reduce health issues, such as cervical cancer.

Time trend analysis and impacts of the COVID-19 pandemic on mammography and Papanicolaou test coverage in Brazilian state capitals

Breast and cervical cancer are major public health issues globally. The reduction in incidence and mortality rates of these cancers is linked to effective prevention, early detection, and appropriate treatment measures. This study aims to analyze the temporal trends in the prevalence of mammography and Papanicolaou test coverage among women living in Brazilian state capitals between 2007 and 2023, and to compare the coverage of these tests before and during the Covid-19 pandemic. A time series study was conducted using data from the Surveillance System for Risk and Protective Factors for Chronic Diseases by Telephone Survey from 2007 to 2023. The variables analyzed included mammography and Papanicolaou test coverage according to education level, age group, race/skin color, regions, and Brazilian capitals. The Prais-Winsten regression model was used to analyze the time series, and Student's t-test was employed to compare the prevalence rates between 2019 and 2023. Between 2007 and 2023, mammography coverage showed a stationary trend (71.1% in 2007 and 73.1% in 2023; p-value = 0.75) with a declining trend observed among women with 12 years or more of education (APC= -0.52% 95%CI -1.01%; -0.02%). Papanicolaou test coverage for all women aged between 25 and 64 exhibited a downward trend from 82% in 2007 to 76.8% in 2023 (APC= -0.45% 95%CI -0.76%; -0.13%). This decline was also noticed among those with 9 years or more of education; in the 25 to 44 age group; among women with white and mixed race; and in the Northeast, Central-West, Southeast, and South regions. When comparing coverage before and during Covid-19 pandemic, a reduction was noted for both tests. Over the years, there has been stability in mammography coverage and a decline in Papanicolaou test. The COVID-19 pandemic negatively impacted the number of these tests carried out among women, highlighting the importance of actions aimed at increasing coverage, especially among the most vulnerable groups.