| Autor | Caetano, Michele Costa | |
| Autor | Emmerick, Isabel Cristina Martins | |
| Autor | Campos, Mônica Rodrigues | |
| Autor | Pires, Débora Castanehira | |
| Autor | Wirtz, Veronika J. | |
| Autor | Luiza, Vera Lucia | |
| Data de acesso | 2025-04-17T03:01:22Z | |
| Data de disponibilização | 2025-04-17T03:01:22Z | |
| Data do publicação | 2025 | |
| Citação | CAETANO, Michele Costa et al. Effect of Covid-19 pandemic on azithromycin, chloroquine/hydroxychloroquine and ivermectin outpatient consumption in Brazil: a joinpoint regression analysis. BMC Public Health, v. 25, n. 1250, p. 1-13, Apr. 2025. | en_US |
| ISSN | 1471-2458 | en_US |
| URI | https://www.arca.fiocruz.br/handle/icict/69714 | |
| Fomento | The principal investigator received funding from the Coordination for the Improvement of Higher Education Personnel (Coordenação de Aperfeiçoamento de Pessoal de Nível Superior in Portuguese– CAPES) to study abroad. It covered a six-month Ph.D. scholarship at the UMass Chan Medical School with collaboration at Boston University, during which the study was performed. The funding source had no say in how the analysis was conducted, and it did not present any risk of bias for the results. The open access costs have been funded with support from VDPI/ENSP. The open access costs have been funded with support from VDPI/ENSP. | en_US |
| Idioma | eng | en_US |
| Editor | BioMed Central | en_US |
| Direito Autoral | open access | en_US |
| Título | Effect of Covid-19 pandemic on azithromycin, chloroquine/hydroxychloroquine and ivermectin outpatient consumption in Brazil: a joinpoint regression analysis | en_US |
| Tipo do documento | Article | en_US |
| DOI | 10.1186/s12889-025-21712-9 | |
| Resumo em Inglês | Background: The endorsement of unproven COVID-19 treatment marked the political bias in Brazil's pandemic response. This study aimed to analyze the trends in the consumption of azithromycin (AZI), chloroquine/ hydroxychloroquine (CQ/HCQ), and ivermectin (IVM) considering COVID-19 cases and key political events. Methods: A retrospective cohort study was conducted to analyze the weekly outpatient dispensing records of AZI, CQ/HCQ, and IVM from the National Database of Actions and Services of Pharmaceutical Services in SUS (BNAFAR) and the COVID-19 incidence rates from January 2019 to December 2021. A joinpoint regression analysis was employed to assess shifts in COVID-19 incidence rates and AZI, CQ/HCQ, and IVM consumption in outpatients, expressed as Defined Daily Dose per 1,000 inhabitants per day (DID), in Brazil and its five geographical regions taking into consideration the timing of three political events. Results: There was a significant increase in AZI, CQ/HCQ, and IVM consumption during the COVID-19 pandemic in Brazil of 62.8%, 504.6%, and 525.7%, respectively. Adults and women had higher DID; however, a higher proportional rise was observed among men, especially for CQ/HCQ. A notable increase in the consumption of CQ/HCQ during the first COVID-19 wave, IVM in the second, and AZI in both waves was more pronounced in the South, Midwest, and North of Brazil. This pattern coincided closely with the timeline of COVID-19 incidence rates and showed an upward trend in all three medicines after key political events that endorsed their use, particularly in these three regions. No corresponding downward trend in COVID-19 cases was observed despite the increased use of these medicines. A significant reduction in consumption nationwide was observed after an increase in vaccination coverage, resulting in a DID near pre-pandemic levels. Conclusion: The study provides substantial evidence on the relationship between COVID-19 incidence, political events, and the consumption of AZI, CQ/HCQ, and IVM during the pandemic in Brazil. The findings suggest that consumption trends were aligned with regional political affiliations and the COVID-19 incidence rates. These highlight the importance of political determinants of inappropriate medicine utilization that wastes scarce resources and increases the risk of adverse health outcomes and antimicrobial resistance. | en_US |
| Afiliação | Federal University of Rio de Janeiro. Martagão Gesteira Institute of Childcare and Pediatrics. Division of Pharmacy. Rio de Janeiro, RJ, Brazil / Fundação Oswaldo Cruz. Escola Nacional de Saúde Pública Sergio Arouca. Programa de Pós-Graduação em Saúde Pública. Rio de Janeiro, RJ, Brasil. | en_US |
| Afiliação | University of Massachusetts. UMass Chan Medical School. Department of Surgery. Division of Thoracic Surgery. Worcester, MA, USA. | en_US |
| Afiliação | Fundação Oswaldo Cruz. Escola Nacional de Saúde Pública Sergio Arouca. Departamento de Ciências Sociais. Rio de Janeiro, RJ, Brasil. | en_US |
| Afiliação | Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Rio de Janeiro, RJ, Brasil. | en_US |
| Afiliação | Boston University School of Public Health. Department of Global Health. Boston, MA, USA. | en_US |
| Afiliação | Fundação Oswaldo Cruz. Escola Nacional de Saúde Pública Sergio Arouca. Departamento de Política de Medicamentos e Assistência Farmacêutica. Rio de Janeiro, RJ, Brasil. | en_US |
| Palavras-chave em inglês | COVID-19 | en_US |
| Palavras-chave em inglês | Drug utilization | en_US |
| Palavras-chave em inglês | Health policy | en_US |
| Palavras-chave em inglês | Azithromycin | en_US |
| Palavras-chave em inglês | Chloroquine | en_US |
| Palavras-chave em inglês | Hydroxychloroquine | en_US |
| Palavras-chave em inglês | Ivermectin | en_US |
| Palavras-chave em inglês | Brazil | en_US |
| e-ISSN | 1471-2458 | |
