A nationwide population screening program for diabetes in Brazil.
OBJECTIVE
In 2001, persons throughout Brazil who were 40 years old or older were invited to participate in community screening for diabetes as part of the Brazilian Ministry of Health's Plan for the Reorganization of Care for Arterial Hypertension and Diabetes Mellitus. This report describes the overall participation rate and positivity rate of the screening campaign, as well as factors associated with the level of participation among the municipalities in Brazil.


METHODS
Screening test positivity was defined as a fasting glucose of > or = 100 mg/dL or a casual glucose of > or = 140 mg/dL. Screening data were obtained from the Ministry of Health and were analyzed for each municipality.


RESULTS
Out of the 5 561 municipalities in Brazil, 5 301 of them (95.3%) participated and reported results. Of the 30.2 million persons in the target population, 22.1 million of them (73.0%) were tested, and 3.5 million of the persons tested (15.7%) were positive. Higher odds of a high population participation rate (> or = 80%) were seen in municipalities that were of small size (risk ratio (RR) = 5.0, comparing extremes), were located in the North region of the country (RR = 1.8), were located outside of a metropolitan region (RR = 1.4), and had a higher proportion of their population who had completed elementary school (RR = 1.2) (P < 0.05). There was a parallel increase in glucose testing nationwide during and immediately after the campaign, presumably in part for diagnostic confirmation of cases identified during screening.


CONCLUSIONS
The massive response to the campaign attests to the potential that this type of program has to raise diabetes awareness and to set the stage for capacity-building at the primary care level.
Nucci
Luciana B
LB
Federal University of Rio Grande do Sul, School of Medicine, Graduate Studies Program in Epidemiology, Porto Alegre, Rio Grande do Sul, Brazil. lbnucci@terra.com.br
Toscano
Cristiana M
CM
Maia
Ana Lourdes M
AL
Fonseca
Claudio D
CD
Britto
Maria Moema B
MM
Duncan
Bruce B
BB
Schmidt
Maria Inês
MI
D000328:Adult; D001786:Blood Glucose / Q000032:analysis; D001938:Brazil; D016001:Confidence Intervals; D003920:Diabetes Mellitus / Q000097:blood / Q000175:diagnosis*; D005951:Glucose Tolerance Test; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D016015:Logistic Models; D008403:Mass Screening; D012306:Risk; D013997:Time Factors
D001786:Blood Glucose; D006442:Glycated Hemoglobin