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. 2023 Nov 11;9(11):e21960.
doi: 10.1016/j.heliyon.2023.e21960. eCollection 2023 Nov.

Covid-19 impacts: Ethnic and regional inequalities in sickle cell disease patient care in Brazil

Rui Leandro Santos  1 , Waldecy Rodrigues  1 , David Prata  1 , Daniela Mascarenhas de Queiroz Trevisan  1 , Paulo Henrique de Souza Bermejo  2 , Marina Figueiredo Moreira  2
Affiliations

Covid-19 impacts: Ethnic and regional inequalities in sickle cell disease patient care in Brazil

Rui Leandro Santos et al. Heliyon. .

Abstract

Brazil is a continental country with significant socioeconomic and ethnic inequalities. It is important to understand how these differences are reflected in health care, especially during the COVID-19 pandemic. We investigated the potential impacts of the reduced number Transcranial Doppler Ultrasound (TCD) tests performed in Brazil during the COVID-19 pandemic, and its reflections according to region and race/color for patients with Sickle Cell Disease (SCD). This study performed data queries from the Brazilian Ministry of Health, literature research, and quantitative analysis using descriptive statistical analysis. We found evidence for a decrease in the number of TCD tests performed during the pandemic (-83 %) relative to the same non-pandemic period, and disparities in tests given in five regions in Brazil. Our data show, that in absolute numbers, most people with SCD are brown, but the highest prevalence of cases was among blacks. We also found evidence for racial discrimination when performing TCD test, which leads us to believe that the Brazilian Unified Health System (SUS) may be susceptible to racism when treating this disease. The implications of these findings serve as a warning to other countries with high indices of mixed ancestry in formulating health care policies for patients with SCD.

Keywords: COVID-19; Racism; Sickle cell disease; Transcranial Doppler.

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Conflict of interest statement

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Figures

Fig. 1
Fig. 1
Geographic distribution of people with sickle cell disease in Brazil per 1,000,000 inhabitants.
Graph 1
Graph 1
Patients with sickle cell disease per age group in Brazil.
Graph 2
Graph 2
Patients with sickle cell disease per region in Brazil.
Graph 3
Graph 3
Brazilian population and population with sickle cell disease.
Graph 4
Graph 4
TCD exams performed per region in Brazil, 2016–2020.
Graph 5
Graph 5
TCD exams performed for the age group 0–19 years old in Brazil from 2016 to 2020.
Graph 6
Graph 6
TCD exams performed on patients 0–19 age, grouped by race.
See this image and copyright information in PMC

References

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