Tendência da incidência e características epidemiológicas da leishmaniose visceral em cidade do nordeste do Brasil

Objective: To determine the incidence trend and describe the epidemiological characteristics of cases of visceral leishmaniasis in Imperatriz - MA from 2011 to 2020. Methods: Descriptive epidemiological study, with a quantitative approach, based on compulsory notifications of new cases of the disease available by DATASUS. Incidence coefficients were calculated each year and trend analysis was performed using Prais-Winsten regressions. Epidemiological variables were treated using descriptive statistics. Results: A stable incidence trend was observed, with a predominance of cases in males, aged 1 to 4 years, brown, with non-applicable education, living in urban areas, laboratory diagnosed, not co-infected with VL/HIV and who evolved into healing. Conclusion: Such findings denote the importance of surveillance and prevention programs aimed at vulnerable populations and training of health professionals regarding the notification, diagnosis and treatment of the disease.Objetivo: determinar a tendência da incidência e descrever características epidemiológicas dos casos de leishmaniose visceral em Imperatriz – MA no período de 2011 a 2020. Metodologia: estudo observacional descritivo transversal, realizado a partir das notificações compulsórias de casos novos da doença disponíveis via DATASUS. Foram calculados os coeficientes de incidência a cada ano e a análise de tendência foi processada por meio de regressões de Prais-Winsten. As variáveis epidemiológicas foram tratadas por meio da estatistica descritiva. Resultados: Observou-se tendencia estável da incidência, com predomínio dos casos em indivíduos do sexo masculino, faixa etária de 1 a 4 anos, pardos, em idade não escolar, residentes na zona urbana, diagnosticados laboratorialmente, não coinfectados LV/HIV e que evoluíram para a cura. Conclusão: tais achados denotam a importância de programas de vigilância e prevenção direcionadas às populações vulneráveis e capacitação dos profissionais de saúde quanto à notificação, diagnóstico etratamento da doença

Condições de nascimento de filhos de mulheres vivendo com HIV

Objetivou-se identificar as condições de nascimento de filhos de mulheres vivendo com HIV no período compreendido entre 2009 e 2019, no Hospital Regional Materno Infantil de Imperatriz (MA). Estudo transversal, quantitativo, documental, com análise descritiva dos dados e realizado em maternidade de referência entre os meses de agosto de 2020 e julho de 2021. Incluíram-se informações dos prontuários das gestantes soropositivas para HIV e de seusfilhos recém-nascidos. Os resultados levantaram 314 prontuários, destes, 195 eram elegíveis. Sobre as condições de nascimento dos recém-nascidos, em 56,41% o teste rápido foi negativo; 72,82% usaram profilaxia pós-nascimento; 75,38% não receberam leite materno; 68,2% receberam vacinas logo ao nascer; 40,51% não faziam uso de nenhuma medicação; 20,51% das mães tinham entre 36 a 40 anos; 59,48% não residiam no município pesquisado;23,6% eram donas de casa; 65,64 eram multigestas; 46,15% receberam o diagnóstico de HIV na gestação;67,17% não tinham coinfecções; 82,05% realizaram o pré-natal; 60,51% fizeram uso da profilaxia intraparto; e 77,43% fizeram cesariana. O acompanhamento no pré-natal e parto da maioria dessas mulheres vivendo com HIV refletiu positivamente nas condições de nascimento de seus filhos, sendo uma importante estratégia, visando a não transmissão vertical e prevenção da doença nas crianças.The objective was to identify the conditions of birth of children of women living with HIV in the period between 2009 and 2019, at the Regional Maternal and Child Hospital of Imperatriz (MA). Cross-sectional, quantitative, documentary study, with descriptive analysis of the data and carried out in a reference maternity hospital between August2020 and July 2021. Information from the medical records of HIV-positive pregnant women and their newborn children was included. The results collected 314 medical records, of which 195 were eligible. Regarding the birth conditions of the newborns, in 56.41% the rapid test was negative; 72.82% used post-birth prophylaxis; 75.38% did not receive breast milk; 68.2% received vaccines at birth; 40.51% did not use any medication. 20.51% of the mothers were between 36 and 40 years old; 59.48% did not live in the municipality surveyed; 23.6% were housewives; 65.64 were multipara women; 46.15% were diagnosed with HIV during pregnancy; 67.17% had no coinfections; 82.05% underwent prenatal care; 60.51% used intrapartum prophylaxis; and 77.43% underwent cesarean section. The prenatal and childbirth follow-up of most of these women living with HIV reflected positively on the conditions of birth of their children, being an important strategy, aiming at the non-vertical transmission andprevention of the disease in children.El objetivo fue identificar las condiciones de nacimiento de los hijos de mujeres que viven con el VIH entre 2009 y 2019. Estudio transversal, cuantitativo, documental, realizado en un hospital de maternidad de referencia, entre agosto de 2020 y julio de 2021. Comprendía información de los registros médicos de las mujeres embarazadas seropositivas y sus hijos recién nacidos. Los resultados obtuvieron 314 historias clínicas, de las cuales 195 eran admisibles. En cuanto a las condiciones de nacimiento de los recién nacidos, en el 56,41% la prueba rápida fue negativa; el 72,82% utilizó profilaxis posparto; el 75,38% no recibió leche materna; el 68,2% recibió vacunas poco después del nacimiento; el 40,51% no utilizó ninguna medicación. El 20,51% de las madres tenían entre 36 y 40 años; el 59,48% no vivían en el municipio estudiado; el 23,6% eran amas de casa; el 65,64 eran multigénero; el 46,15% fueron diagnosticadas de VIH durante el embarazo; el 67,17% no tenían coinfecciones; el 82,05% tuvieron atención prenatal; el 60,51% utilizaron profilaxis intraparto; y el 77,43% tuvieron cesárea. El seguimiento prenatal y durante el parto de la mayoría de estas mujeres que viven con el VIH se reflejó positivamente en las condiciones de nacimiento de sus hijos, siendo una estrategia importante, con el objetivo de la no transmisión vertical y la prevención de la enfermedad en los niños

Mortality from gastrointestinal congenital anomalies at 264 hospitals in 74 low-income, middle-income, and high-income countries: a multicentre, international, prospective cohort study

Summary Background Congenital anomalies are the fifth leading cause of mortality in children younger than 5 years globally. Many gastrointestinal congenital anomalies are fatal without timely access to neonatal surgical care, but few studies have been done on these conditions in low-income and middle-income countries (LMICs). We compared outcomes of the seven most common gastrointestinal congenital anomalies in low-income, middle-income, and high-income countries globally, and identified factors associated with mortality. Methods We did a multicentre, international prospective cohort study of patients younger than 16 years, presenting to hospital for the first time with oesophageal atresia, congenital diaphragmatic hernia, intestinal atresia, gastroschisis, exomphalos, anorectal malformation, and Hirschsprung’s disease. Recruitment was of consecutive patients for a minimum of 1 month between October, 2018, and April, 2019. We collected data on patient demographics, clinical status, interventions, and outcomes using the REDCap platform. Patients were followed up for 30 days after primary intervention, or 30 days after admission if they did not receive an intervention. The primary outcome was all-cause, in-hospital mortality for all conditions combined and each condition individually, stratified by country income status. We did a complete case analysis. Findings We included 3849 patients with 3975 study conditions (560 with oesophageal atresia, 448 with congenital diaphragmatic hernia, 681 with intestinal atresia, 453 with gastroschisis, 325 with exomphalos, 991 with anorectal malformation, and 517 with Hirschsprung’s disease) from 264 hospitals (89 in high-income countries, 166 in middleincome countries, and nine in low-income countries) in 74 countries. Of the 3849 patients, 2231 (58·0%) were male. Median gestational age at birth was 38 weeks (IQR 36–39) and median bodyweight at presentation was 2·8 kg (2·3–3·3). Mortality among all patients was 37 (39·8%) of 93 in low-income countries, 583 (20·4%) of 2860 in middle-income countries, and 50 (5·6%) of 896 in high-income countries (p<0·0001 between all country income groups). Gastroschisis had the greatest difference in mortality between country income strata (nine [90·0%] of ten in lowincome countries, 97 [31·9%] of 304 in middle-income countries, and two [1·4%] of 139 in high-income countries; p≤0·0001 between all country income groups). Factors significantly associated with higher mortality for all patients combined included country income status (low-income vs high-income countries, risk ratio 2·78 [95% CI 1·88–4·11], p<0·0001; middle-income vs high-income countries, 2·11 [1·59–2·79], p<0·0001), sepsis at presentation (1·20 [1·04–1·40], p=0·016), higher American Society of Anesthesiologists (ASA) score at primary intervention (ASA 4–5 vs ASA 1–2, 1·82 [1·40–2·35], p<0·0001; ASA 3 vs ASA 1–2, 1·58, [1·30–1·92], p<0·0001]), surgical safety checklist not used (1·39 [1·02–1·90], p=0·035), and ventilation or parenteral nutrition unavailable when needed (ventilation 1·96, [1·41–2·71], p=0·0001; parenteral nutrition 1·35, [1·05–1·74], p=0·018). Administration of parenteral nutrition (0·61, [0·47–0·79], p=0·0002) and use of a peripherally inserted central catheter (0·65 [0·50–0·86], p=0·0024) or percutaneous central line (0·69 [0·48–1·00], p=0·049) were associated with lower mortality. Interpretation Unacceptable differences in mortality exist for gastrointestinal congenital anomalies between lowincome, middle-income, and high-income countries. Improving access to quality neonatal surgical care in LMICs will be vital to achieve Sustainable Development Goal 3.2 of ending preventable deaths in neonates and children younger than 5 years by 2030

Influence of simultaneous comorbidities on COVID-associated acute respiratory distress syndrome mortality in people with diabetes

الملخص: أهداف البحث: هدفت هذه الدراسة إلى تحليل تأثير 23 حالة مرضية مصاحبة على وفيات متلازمة الضائقة التنفسية الحادة المرتبطة بكوفيد، حصريا لدى الأشخاص الذين لديهم تاريخ من مرض السكري. طريقة البحث: تم استخدام دراسة رصدية وتحليلية ومقطعية للتحقيق في البيانات من 6723 خدمة صحية في البرازيل، تضم 5433 شخصا يعانون من مرض السكري. تم استخدام نماذج الانحدار اللوجستي المعدلة للعوامل الديموغرافية مثل العمر والجنس والعرق لتحليل العلاقة بين وفيات متلازمة الضائقة التنفسية الحادة المرتبطة بكوفيد والأمراض المصاحبة. النتائج: الأشخاص الذين لديهم اثنين، وثلاثة، وأربعة، وخمسة من الأمراض المصاحبة المتزامنة لديهم فرصة أكبر للوفاة. لقد حددنا أن مرضى السكري الذين يعانون من أمراض استقلابية مصاحبة، أو اضطرابات عصبية، أو كانوا مدخنين لديهم خطر وفاة أعلى متوقع بناء على متلازمة الضائقة التنفسية الحادة المرتبطة بكوفيد. الاستنتاجات: يلعب عدد الأمراض المصاحبة دورا حاسما في وفيات متلازمة الضائقة التنفسية الحادة المرتبطة بكوفيد لدى مرضى السكري، وخاصة أولئك الذين يعانون من التدخين والأمراض العصبية في وقت واحد. Abstract: Objectives: This study analyzed the influence of 23 comorbidities on COVID-associated acute distress respiratory syndrome (CARDS) mortality in people with a history of diabetes mellitus. Methods: An observational, analytical, cross sectional study was utilized to investigate data from 6723 health services in Brazil, comprising 5433 people with diabetes. Adjusted logistic regression models for demographic factors such as age, sex, and race were used to analyze the association between CARDS mortality and comorbidities. Results: Persons with two (p < 0.001), three (p < 0.001), four (p < 0.001), and five (p < 0.001) simultaneous comorbidities had a higher chance of dying. We identified that diabetes patients who had concomitant metabolic diseases (p = 0.019), neurological disorders (p < 0.001), or were smokers (p < 0.001) had a higher predicted mortality risk based on CADRS. Conclusion: The number of comorbidities plays a determining role in CARDS mortality in people with diabetes, especially those who suffer from smoking and neurological diseases simultaneously

Neotropical xenarthrans: a dataset of occurrence of xenarthran species in the Neotropics.

International audienceXenarthrans—anteaters, sloths, and armadillos—have essential functions forecosystem maintenance, such as insect control and nutrient cycling, playing key roles as ecosys-tem engineers. Because of habitat loss and fragmentation, hunting pressure, and conflicts withdomestic dogs, these species have been threatened locally, regionally, or even across their fulldistribution ranges. The Neotropics harbor 21 species of armadillos, 10 anteaters, and 6 sloths.Our data set includes the families Chlamyphoridae (13), Dasypodidae (7), Myrmecophagidae(3), Bradypodidae (4), and Megalonychidae (2). We have no occurrence data onDasypus pilo-sus(Dasypodidae). Regarding Cyclopedidae, until recently, only one species was recognized,but new genetic studies have revealed that the group is represented by seven species. In thisdata paper, we compiled a total of 42,528 records of 31 species, represented by occurrence andquantitative data, totaling 24,847 unique georeferenced records. The geographic range is fromthe southern United States, Mexico, and Caribbean countries at the northern portion of theNeotropics, to the austral distribution in Argentina, Paraguay, Chile, and Uruguay. Regardinganteaters,Myrmecophaga tridactylahas the most records (n=5,941), andCyclopessp. havethe fewest (n=240). The armadillo species with the most data isDasypus novemcinctus(n=11,588), and the fewest data are recorded forCalyptophractus retusus(n=33). Withregard to sloth species,Bradypus variegatushas the most records (n=962), andBradypus pyg-maeushas the fewest (n=12). Our main objective with Neotropical Xenarthrans is to makeoccurrence and quantitative data available to facilitate more ecological research, particularly ifwe integrate the xenarthran data with other data sets of Neotropical Series that will become available very soon (i.e., Neotropical Carnivores, Neotropical Invasive Mammals, andNeotropical Hunters and Dogs). Therefore, studies on trophic cascades, hunting pressure,habitat loss, fragmentation effects, species invasion, and climate change effects will be possiblewith the Neotropical Xenarthrans data set. Please cite this data paper when using its data inpublications. We also request that researchers and teachers inform us of how they are usingthese data

NEOTROPICAL ALIEN MAMMALS: a data set of occurrence and abundance of alien mammals in the Neotropics

Biological invasion is one of the main threats to native biodiversity. For a species to become invasive, it must be voluntarily or involuntarily introduced by humans into a nonnative habitat. Mammals were among first taxa to be introduced worldwide for game, meat, and labor, yet the number of species introduced in the Neotropics remains unknown. In this data set, we make available occurrence and abundance data on mammal species that (1) transposed a geographical barrier and (2) were voluntarily or involuntarily introduced by humans into the Neotropics. Our data set is composed of 73,738 historical and current georeferenced records on alien mammal species of which around 96% correspond to occurrence data on 77 species belonging to eight orders and 26 families. Data cover 26 continental countries in the Neotropics, ranging from Mexico and its frontier regions (southern Florida and coastal-central Florida in the southeast United States) to Argentina, Paraguay, Chile, and Uruguay, and the 13 countries of Caribbean islands. Our data set also includes neotropical species (e.g., Callithrix sp., Myocastor coypus, Nasua nasua) considered alien in particular areas of Neotropics. The most numerous species in terms of records are from Bos sp. (n = 37,782), Sus scrofa (n = 6,730), and Canis familiaris (n = 10,084); 17 species were represented by only one record (e.g., Syncerus caffer, Cervus timorensis, Cervus unicolor, Canis latrans). Primates have the highest number of species in the data set (n = 20 species), partly because of uncertainties regarding taxonomic identification of the genera Callithrix, which includes the species Callithrix aurita, Callithrix flaviceps, Callithrix geoffroyi, Callithrix jacchus, Callithrix kuhlii, Callithrix penicillata, and their hybrids. This unique data set will be a valuable source of information on invasion risk assessments, biodiversity redistribution and conservation-related research. There are no copyright restrictions. Please cite this data paper when using the data in publications. We also request that researchers and teachers inform us on how they are using the data

NEOTROPICAL CARNIVORES: a data set on carnivore distribution in the Neotropics

Mammalian carnivores are considered a key group in maintaining ecological health and can indicate potential ecological integrity in landscapes where they occur. Carnivores also hold high conservation value and their habitat requirements can guide management and conservation plans. The order Carnivora has 84 species from 8 families in the Neotropical region: Canidae; Felidae; Mephitidae; Mustelidae; Otariidae; Phocidae; Procyonidae; and Ursidae. Herein, we include published and unpublished data on native terrestrial Neotropical carnivores (Canidae; Felidae; Mephitidae; Mustelidae; Procyonidae; and Ursidae). NEOTROPICAL CARNIVORES is a publicly available data set that includes 99,605 data entries from 35,511 unique georeferenced coordinates. Detection/non-detection and quantitative data were obtained from 1818 to 2018 by researchers, governmental agencies, non-governmental organizations, and private consultants. Data were collected using several methods including camera trapping, museum collections, roadkill, line transect, and opportunistic records. Literature (peer-reviewed and grey literature) from Portuguese, Spanish and English were incorporated in this compilation. Most of the data set consists of detection data entries (n = 79,343; 79.7%) but also includes non-detection data (n = 20,262; 20.3%). Of those, 43.3% also include count data (n = 43,151). The information available in NEOTROPICAL CARNIVORES will contribute to macroecological, ecological, and conservation questions in multiple spatio-temporal perspectives. As carnivores play key roles in trophic interactions, a better understanding of their distribution and habitat requirements are essential to establish conservation management plans and safeguard the future ecological health of Neotropical ecosystems. Our data paper, combined with other large-scale data sets, has great potential to clarify species distribution and related ecological processes within the Neotropics. There are no copyright restrictions and no restriction for using data from this data paper, as long as the data paper is cited as the source of the information used. We also request that users inform us of how they intend to use the data