Objective: To present official longitudinal data on the impact of asthma in Brazil between 2008 and 2013. Methods: This was a descriptive study of data collected between 2008 and 2013 from an official Brazilian national database, including data on asthma-related number of hospitalizations, mortality, and hospitalization costs. A geographical subanalysis was also performed. Results: In 2013, 2,047 people died from asthma in Brazil (5 deaths/day), with more than 120,000 asthma-related hospitalizations. During the whole study period, the absolute number of asthma-related deaths and of hospitalizations decreased by 10% and 36%, respectively. However, the in-hospital mortality rate increased by approximately 25% in that period. The geographic subanalysis showed that the northern/northeastern and southeastern regions had the highest asthma-related hospitalization and in-hospital mortality rates, respectively. An analysis of the states representative of the regions of Brazil revealed discrepancies between the numbers of asthma-related hospitalizations and asthma-related in-hospital mortality rates. During the study period, the cost of asthma-related hospitalizations to the public health care system was US$ 170 million. Conclusions: Although the numbers of asthma-related deaths and hospital admissions in Brazil have been decreasing since 2009, the absolute numbers are still high, resulting in elevated direct and indirect costs for the society. This shows the relevance of the burden of asthma in middle-income countries.

Keywords: Asthma/epidemiology; Asthma/mortality; Public health; Hospitalization.

Objective: To analyze the number of hospitalizations, the length of hospital stay, and mortality due to asthma, as well as the costs to the Unified Health Care System in Brazil between 2008 and 2021. Methods: This was a cross-sectional epidemiological study using data from the Information Technology Department of the Brazilian Unified Health Care System. Proportional hospitalization and death rates were estimated per 100,000 population by age, microregion, and year. Results: The number of hospitalizations and deaths due to asthma decreased from 2008 to 2021 (205,392 vs. 55,009 and 822 vs. 327, respectively). In addition, a between-sex difference was observed in asthma-related hospitalizations in 2008, and more men were hospitalized in 2021 (51.8%). Asthma mortality rates were similar for both sexes (50.0% each) in 2008, and a slight increase was observed in women's deaths in 2021 (52.9%). Even so, approximately one death/day and more than 55,000 hospitalizations were observed yearly, with a mean length of hospital stay of three days. Additionally, the Southeast region allocated more financial resources to asthma-related hospitalizations. Conclusions: Our results showed that the number of deaths and hospitalizations due to asthma substantially declined during the study period.

Keywords: Asthma/mortality; Asthma/epidemiology; Hospitalization; National health programs.

Objective: The aim of this study was to present epidemiological data on hospitalizations and deaths related to asthma in Brazil over the past 11 years. Methods: An ecological study was conducted on asthma-related hospitalizations and mortality in Brazil from 2013 to 2023, using data extracted from the Department of Informatics of the Brazilian Unified Health System and the Mortality Information System. Results: Asthma-related deaths showed an increasing trend during the analyzed period. A surge in deaths was observed in 2022 compared to 2014 (difference between means = 56.08 ± 19.7; 95% CI = 15.2-96.9). The mean number of deaths was higher among females, with their rate remaining stable, while the rate for males increased. Individuals aged >60 years accounted for approximately 65% of all asthma-related deaths from 2013 to 2023, with a strong direct correlation observed between age and the number of deaths, regardless of sex. During the same period, the total number of asthma-related hospitalizations in Brazil showed a declining trend, decreasing from 134,322 in 2013 to 87,707 in 2023. Conclusion: Over the past 11 years, asthma-related deaths have increased in Brazil, with the majority occurring among females. Older individuals accounted for most asthma-related deaths, and a positive correlation was observed between age and the number of deaths.

Keywords: asthma, mortality, hospitalization, epidemiology.

Objective: Respiratory syncytial virus (RSV) is a major cause of severe respiratory infections in older adults, particularly those with comorbidities. Despite its clinical impact, RSV remains underdiagnosed and underreported. We sought to assess the burden of RSV in older adults (= 60 years of age) in Brazil using national surveillance data for the 2022-2023 period. Methods: We analyzed RSV cases reported in the Sistema de Informação de Vigilância Epidemiológica, identifying them among reported cases of SARS. Cases were examined by demographic characteristics, seasonal trends, and clinical outcomes. RSV cases were compared across defined etiologies. Results: Among 355,230 reported cases of SARS in older adults, 201,965 (56.8%) had a defined etiology, and 1,465 (0.7%) were confirmed as RSV cases. Cases peaked in the second quarter of each year, with the highest incidence in the southern and southeastern regions. Despite a low hospitalization rate (2.3 per 100,000 population), severe outcomes were common: 30.4% required ICU admission, and 24.9% resulted in death, with mortality being highest in those = 90 years of age. Conclusions: RSV-related hospitalizations in Brazil appear underestimated, with reported cases likely representing the most severe spectrum due to underreporting and diagnostic limitations. Seasonal patterns peaked in April-May, and regional differences highlight a higher incidence in the southern and southeastern regions, likely due to epidemiological factors and diagnostic disparities. Although the recent approval of RSV vaccines offers an opportunity to reduce disease burden, successful implementation requires broader access and inclusion in the Brazilian National Immunization Program. Strengthening surveillance, diagnostic capacity, and reporting processes is critical for better disease assessment and public health planning.

Keywords: Respiratory syncytial virus infections; Severe acute respiratory syndrome; Hospitalization; Epidemiology; Aged; Surveillance.

Objective: To provide an update on asthma mortality trends in Brazil and its regions between 2014 and 2021. Methods: This was a retrospective descriptive observational study based on asthma mortality data from the Brazilian National Ministry of Health Mortality Database for the 2014-2021 period. Results: In the study period, there were 18,584 asthma deaths in Brazil, with an annual increase of 2.5%, corresponding to 0.03 deaths/100,000 population (95% CI, 0.01-0.04; p = 0.01). The northeastern region of the country had the highest prevalence of asthma deaths (1.50 deaths/100,000 population), and the southern region showed the greatest variation in the study period (44%). We observed a higher proportion of deaths among females and elderly patients, and when analyzing asthma deaths by place of occurrence, we observed that 28% of all deaths occurred at home. Conclusions: Asthma mortality remains high and shows an increasing trend for the first time in the past decades. This constitutes an important public health concern, given the treatable nature of the disease.

Keywords: Public health; Asthma; Mortality.

Objectives: To determine the trend of self-reported asthma diagnosed prevalence and to describe the factors associated with asthma in Brazilian adults. Method: Epidemiological cross-sectional study based on databases analysis from three national household surveys: Pesquisa Nacional por Amostra de Domicílios (PNAD) 2003, PNAD 2008 and Pesquisa Nacional de Saúde (PNS) 2013. Participants between 18-45 years old were included. Trend analysis of asthma diagnosed prevalence was conducted using a logistic general linear model. A hierarchical logistic regression model was used to select factors significantly associated with asthma prevalence. Results: Asthma diagnosed prevalence was 3.6% (2003), 3.7% (2008) and 4.5% (2013), showing a statistically significant increased trend. Asthma diagnosed prevalence also increased when analysed by gender (annual change for men: 2.47%, p < 0.003; women: 2.16%, p < 0.001), urban area (annual change for urban: 2.15%, p < 0.001; rural: 2.69%, p = 0.072), healthcare insurance status (annual change without healthcare insurance: 2.18%, p < 0.001; with healthcare insurance: 1.84%, p = 0.014), and geographic regions (annual change North: 4.68%, p < 0.001; Northeast: 4.14%, p < 0.001; and Southeast: 1.84%, p = 0.025). Female gender, obesity, living in urban areas and depression were associated with asthma diagnosed prevalence. Discussion: PNAD and PNS surveys allow for a very large, representative community-based sample of the Brazilian adults to investigate the asthma prevalence. From 2003 to 2013, the prevalence of self-reported physician diagnosis of asthma increased, especially in the North and Northeast regions. Gender, region of residence, household location (urban/rural), obesity, and depression diagnosis seem to play significant roles in the epidemiology of asthma in Brazil.

Keywords: Adults; Asthma; Logistic models; Prevalence; Risk factors.

Objective: To quantify the use of health care resources among patients enrolled in the Bahia State Asthma and Allergic Rhinitis Control Program. Methods: As of January of 2006, 1405 patients had enrolled in the program, which is carried out in four referral centers in the city of Salvador. These patients formed the basis of this retrospective/prospective, observational cohort study. The preliminary analysis involved 269 consecutive patients, all above the age of 12 and diagnosed with severe asthma. After being seen by pulmonologists, nurses, pharmacologists and psychologists, the patients received inhaled asthma medications. Based on patient interviews and charts, the year preceding enrollment in the program was compared with the first year enrolled in the program in terms of the following quantifiable parameters: hospital admissions; emergency room visits; courses of oral corticosteroids; and days of school/work missed due to asthma attacks. Results: In this sample of patients with severe asthma, enrollment in the program resulted in significant reductions in the number of emergency room visits and hospital admissions (of 85% and 90%, respectively). There were also reductions in the number of school/work days missed due to asthma attacks and in the number of courses of oral corticosteroids (of 86% and 67%, respectively). Conclusion: A program designed to control severe asthma in referral outpatient clinics and including pharmacological services at no charge can lead to a pronounced reduction in the demand for Unified Health Care System resources.

Keywords: Asthma/therapy; Asthma/prevention  control; Hospitalization; National Health System (BR)

Objective: To present epidemiological data on patients diagnosed with tuberculosis, as well as on associated factors, and to determine the efficacy of the National Tuberculosis Control Program in Bagé, Brazil. Methods: A retrospective study was carried out at the Pablo Barcellos Center, analyzing cases of tuberculosis reported from January 2001 to December 2004. Data were collected through the review of clinical charts and from the National Case Registry database. Results: During this period, of the 4468 sputum smear microscopies performed, 131 were positive, with higher prevalence among males aged 26 to 35 years old. Prevalence was lower among those aged 65 and above. Over 50% of the patients were Caucasian, had only 1 to 3 years of schooling and worked in low-income jobs (mean salary, 265 Brazilian reals/month). There was no significant difference between smokers and former smokers/nonsmokers, and only one of the 131 cases was HIV positive. Conclusion: The number of sputum smear microscopies performed in Bagé increased in the past four years. In 2003 and 2004, it exceeded the goal of the National Tuberculosis Control Program. However, the number of new cases decreased, demonstrating the efficacy of the active search for tuberculosis cases in the city.

Keywords: Tuberculosis; Epidemiology; Communicable disease control.

Objective: To investigate the completeness of tuberculosis control program records for the 2001-2005 period in the case registry database of the state of Espírito Santo, Brazil. Methods: A descriptive study using secondary data analysis. The following variables were studied: race/color; educational level, supervised treatment, sputum culture at treatment outcome, HIV status, smear sputum microscopy at the sixth month of treatment and treatment outcome. Results: Using technical parameters of the case registry database of the Brazilian National Ministry of Health regarding the percentage of completeness of data on the reporting forms, the tuberculosis database of the state of Espírito Santo can be classified as fair to excellent. The state of Espírito Santo has 78 cities, 8 of which are considered priorities for tuberculosis control. For the variables studied, the cities not considered priorities presented better completeness of records than did those considered priorities, the exception being the variable treatment outcome, for which the percentage of completeness was comparable among all of the cities. Conclusions: Since the cities that are considered priorities accounted for 70.2% of the total number of reports, the responsible officials in those cities should improve the quality of those reports in terms of the completeness of forms and the updating of data, which are fundamental to the reliability of epidemiological analyses. That will make it possible to plan activities aimed at the prevention and control of tuberculosis in the state.

Keywords: Tuberculosis; Disease notification; Information systems; Databases as topic.

Objective: To determine the efficacy of the scoring system, recommended by the Brazilian National Ministry of Health (NMH), for the diagnosis of pulmonary tuberculosis (TB) in children and adolescents, regardless of their HIV status. Methods: This was a cross-sectional analytical study carried out between January of 2002 and December of 2006, involving 239 individuals less than 15 years of age. The patients were divided into four groups: latent TB (LTB group; n = 81); no-TB (NTB group; n = 41); TB group (n = 104); and TB/HIV group (n = 13). We studied the clinical, radiological and laboratory findings according to the scoring system. Results: Reports of fever, cough, asthenia and weight loss for at least two weeks were significantly higher in the TB group (p < 0.0001). The proportion of cases with a history of any contact and household contact with a TB patient was, respectively, 95.0% and 86.1% in the TB group, versus 75.0% and 58.3% in the TB/HIV group. In the TB and TB/HIV groups, respectively, chest X-rays revealed parenchymal alterations in 75.0% and 53.9%, revealing combined parenchymal/lymph node alterations in 18.2% and 30.8%. There were no significant differences among the groups regarding the tuberculin skin test results. In the TB group, 16.3% of the patients were malnourished (p < 0.005 vs. the LTB group). The mean NMH system scores in the LTB, NTB, TB and TB/HIV groups were, respectively, 24.2, 18.5, 45.3 and 41.5. Conclusions: The NMH system scores were significantly higher in the TB and TB/HIV groups than in the other two groups. Therefore, this scoring system was valid for the diagnosis of pulmonary TB in this population, regardless of HIV status.

Keywords: Tuberculosis/diagnosis; HIV seropositivity; Diagnostic techniques and procedures.