Testagem anti-HIV em mulheres grávidas no Brasil: taxas e preditores

OBJETIVO: Estimar las tasas de oferta y realización de la prueba anti-HIV y sus predictivos entre mujeres que recibieron atención prenatal. MÉTODOS: Se realizó un estudio transversal, de base poblacional, con 2.234 puérperas en 12 ciudades de Brasil. Las muestras probabilísticas fueron seleccionadas independientemente por ciudad, entre puérperas que asistieron a por lo menos una visita prenatal. Se colectaron datos sociodemográficos, informaciones sobre cuidado prenatal y acceso a intervenciones de prevención del HIV durante el embarazo, con la utilización de una encuesta. Se realizaron análisis bivariadas y multivariadas para verificar los efectos independientes de las co-variables en la oferta y realización de la prueba anti-HIV. Los datos fueron colectados en el período de noviembre de 1999 a abril de 2000. RESULTADOS: La realización de la prueba anti-HIV durante el embarazo fue realizada por el 77,5% de las encuestadas. La oferta de la prueba fue positivamente asociada con: el conocimiento previo sobre la prevención de la transmisión materno-infantil del HIV; mayor número de visitas prenatal; mayor nivel de escolaridad y presencia de color blanco de piel. La tasa de aceptación de la prueba anti-HIV fue de 92,5%. CONCLUSIONES: Los resultados indican que La diseminación de la información sobre prevención de la transmisión materno-infantil del HIV puede contribuir para aumentar la cobertura de la evaluación anti-HIV durante el embarazo. Las mujeres no-blancas con menores niveles de educación deben ser priorizadas. La estrategias para aumentar la participación de poblaciones vulnerables al cuidado prenatal y la sensibilización de trabajadores de la salud son de gran importancia.OBJETIVO: Estimar as taxas de oferta e realização do teste anti-HIV e seus preditores entre mulheres que receberam atendimento pré-natal. MÉTODOS: Foi conduzido estudo transversal, de base populacional, com 2.234 puérperas em 12 cidades do Brasil. Amostras probabilísticas foram selecionadas independentemente por cidade, entre puérperas que compareceram a pelo menos uma visita pré-natal. Foram coletados dados sociodemográficos, informações sobre cuidado pré-natal e acesso a intervenções de prevenção do HIV durante a gravidez corrente, com a utilização de um questionário. Foram realizadas análises bivariadas e multivariadas para verificar os efeitos independentes das covariáveis na oferta e realização do teste anti-HIV. Os dados foram coletados no período de novembro de 1999 a abril de 2000. RESULTADOS: A realização do teste na gravidez foi relatada por 77,5% das entrevistadas. A oferta do teste anti-HIV foi positivamente associada a: conhecimento prévio sobre a prevenção da transmissão materno-infantil do HIV; maior número de visitas pré-natal; maior nível de escolaridade e ter cor da pele branca. A taxa de aceitação do teste anti-HIV foi de 92,5%. CONCLUSÕES: Os resultados indicam que a disseminação da informação sobre prevenção da transmissão materno-infantil do HIV pode contribuir para aumentar a cobertura da testagem anti-HIV durante a gravidez. Mulheres não-brancas com menores níveis educacionais devem ser priorizadas. Estratégias para aumentar a participação de populações vulneráveis ao cuidado pré-natal e a sensibilização de trabalhadores de saúde são de grande importância.OBJECTIVE: To assess rates of offering and uptake of HIV testing and their predictors among women who attended prenatal care. METHODS: A population-based cross-sectional study was conducted among postpartum women (N=2,234) who attended at least one prenatal care visit in 12 cities. Independent and probabilistic samples were selected in the cities studied. Sociodemographic data, information about prenatal care and access to HIV prevention interventions during the current pregnancy were collected. Bivariate and multivariate analyses were carried out to assess independent effects of the covariates on offering and uptake of HIV testing. Data collection took place between November 1999 and April 2000. RESULTS: Overall, 77.5% of the women reported undergoing HIV testing during the current pregnancy. Offering of HIV testing was positively associated with: previous knowledge about prevention of mother-to-child transmission of HIV; higher number of prenatal care visits; higher level of education and being white. HIV testing acceptance rate was 92.5%. CONCLUSIONS: The study results indicate that dissemination of information about prevention of mother-to-child transmission among women may contribute to increasing HIV testing coverage during pregnancy. Non-white women with lower level of education should be prioritized. Strategies to increase attendance of vulnerable women to prenatal care and to raise awareness among health care workers are of utmost importance

OCCURRENCE OF Calodium hepaticum (BANCROFT, 1893) MORAVEC, 1982 EGGS IN FECES OF DOGS AND CATS IN LAGES, SANTA CATARINA, BRAZIL

This study aims to report the incidence of Calodium hepaticum among dogs and cats, pets or stray animals, captured by the Zoonosis Control Center (CCZ) in Lages, Santa Catarina, Brazil. Fecal samples from 108 pet dogs and eight pet cats, and from 357 stray dogs and 97 stray cats, captured by CCZ, were analyzed within the period from July 2010 to November 2012. Coproparasitological exams were performed by techniques of sedimentation, centrifuge-flotation, and simple flotation. Among 465 fecal samples from dogs and 105 from cats, the overall spurious infections for C. hepaticum eggs were 1.05%. For dogs, this positivity was 0.43% and for cats it was 3.81%. The two positive dogs were stray and out of the four cats, three were stray and one was a pet. Although the occurrence of C. hepaticum eggs was low, these data reveal the existence of infected rodents, especially in public places, since, out of the six infected animals, five (83.33%) were stray. These results are discussed and analyzed with an emphasis on the risk to public health

H1N1pdm09 Adjuvanted Vaccination in HIV-Infected Adults: A Randomized Trial of Two Single versus Two Double Doses

Since human immunodeficiency virus (HIV)-infected individuals are at increased risk of severe disease from pandemic influenza A (H1N1pdm09), vaccination was recommended as a prevention strategy. The aim of the present study was to evaluate the safety, immunogenicity and persistence of the immune response after vaccination against pandemic influenza A (H1N1pdm09) with an adjuvanted vaccine in human immunodeficiency virus (HIV)-infected adults using two single and two double doses.Open label, randomized trial to evaluate the immune response following H1N1pdm09 vaccination in HIV-infected participants compared to HIV-negative controls (NCT01155037). HIV-infected participants were randomized to receive 2 single (3.75 µg hemagglutinin) or 2 double (7.5 µg hemagglutinin) doses of the vaccine, 21 days apart. Controls received one dose of the vaccine. The primary endpoint was seroconversion as measured by hemagglutination inhibition assay. Two hundred fifty six HIV-infected participants (129 and 127 randomized to single and double doses, respectively) and 71 HIV-negative controls were enrolled. Among HIV-infected participants, seroconversion increased from 46.7% and 51.7% after the first dose to 77.2% and 83.8% after the second dose of the vaccine using single and double doses, respectively. Participants aged >40 years showed higher seroconversion compared to younger participants. Seroconversion among HIV-infected women and those with nadir CD4<200 cells/mm(3) was significantly higher with double doses. Persistence of protective antibodies six months after vaccination was achieved by 80% and 89.9% of the HIV-infected participants who received single and double doses, respectively.Our results support the recommendation of two double doses of adjuvanted H1N1pdm09 vaccine for HIV-infected individuals, particularly women, and those aged >40 years or with nadir CD4<200 cells/mm(3), to achieve antibody levels that are both higher and more sustained.ClinicalTrials.gov NCT01155037

The use of income information of census enumeration area as a proxy for the household income in a household survey

<p>Abstract</p> <p>Background</p> <p>Some of the Census Enumeration Areas' (CEA) information may help planning the sample of population studies but it can also be used for some analyses that require information that is more difficult to obtain at the individual or household level, such as income. This paper verifies if the income information of CEA can be used as a proxy for household income in a household survey.</p> <p>Methods</p> <p>A population-based survey conducted from January to December 2003 obtained data from a probabilistic sample of 1,734 households of Niterói, Rio de Janeiro, Brazil. Uniform semi-association models were adjusted in order to obtain information about the agreement/disagreement structure of data. The distribution of nutritional status categories of the population of Niterói according to income quintiles was performed using both CEA- and household-level income measures and then compared using Wald statistics for homogeneity. Body mass index was calculated using body mass and stature data measured in the households and then used to define nutritional status categories according to the World Health Organization. All estimates and statistics were calculated accounting for the structural information of the sample design and a significance level lower than 5% was adopted.</p> <p>Results</p> <p>The classification of households in the quintiles of household income was associated with the classification of these households in the quintiles of CEA income. The distribution of the nutritional status categories in all income quintiles did not differ significantly according to the source of income information (household or CEA) used in the definition of quintiles.</p> <p>Conclusion</p> <p>The structure of agreement/disagreement between quintiles of the household's monthly per capita income and quintiles of the head-of-household's mean nominal monthly income of the CEA, as well as the results produced by these measures when they were associated with the nutritional status of the population, showed that the CEA's income information can be used when income information at the individual or household levels is not available.</p

Expressão da esterilidade feminina e da carpeloidia em mamoeiro sob diferentes ambientes de cultivo protegido.

O presente estudo teve por objetivo avaliar a ocorrência de esterilidade feminina e de carpeloidia em mamoeiros hermafroditas 'Baixinho-de-Santa Amália' cultivados sob manejo orgânico, em diferentes tipos de ambiente de proteção,e conduzido com ou sem bifurcação do tronco no transcorrer das quatro estações do ano. Foram construídos três tipos de estruturas de proteção contíguas: (i) estufa (cobertura de plástico); (ii) estufa sombreada (cobertura adicional de tela 'sombrite' - 30% sobre o plástico), e (iii) telado (cobertura exclusiva de tela 'sombrite' - 30%), ao lado de uma área de ambiente natural, a pleno sol. Nestes locais, foram cultivados, dentro das normas técnicas da agricultura orgânica, mamoeiros da cv. Baixinho-de-Santa-Amália. Em metade das plantas, abrangendo todos os ambientes de cultivo, a gema apical foi incisada, logo após a sexagem, visando à bifurcação do tronco. Para efeito de análise de variância, foram considerados quatro blocos por ambiente de cultivo, tendo cada bloco três repetições relativas ao modo de condução das plantas (com e sem bifurcação do tronco). Para análise estatística, procedeu-se à "análise conjunta de experimentos", no caso, os ambientes de cultivo. Nos mamoeiros com tronco bifurcado, houve diminuição do número de frutos carpeloides e aumento do número de flores fêmeas estéreis. No entanto, essa bifurcação não influenciou a frequência de frutos normais. Durante a primavera (setembro a dezembro), e notadamente na estufa, o maior número de frutos carpeloides por planta correlacionou-se a temperaturas mais elevadas, maior amplitude térmica e maior vigor vegetativo; já, a maior ocorrência de flores estaminadas correlacionou-se também a temperaturas elevadas, baixa luminosidade e menor vigor vegetativo. Por outro lado, essas mesmas condições ambientais e fenológicas favoráveis à carpeloidia aumentaram a quantidade de frutos normais, assim contribuindo positivamente para a produtividade do mamoeiro