Trend of morbidity and mortality indicators due to acute diarrheal disease in children under five years old in the State of Piauí (2000–2019)

Abstract Objectives: to analyze the trend of morbidity and mortality indicators due to acute diarrheal diseases in children under five years old in Piauí. Methods: ecological study with data from the Information Technology Department at the Public Health System. The indicators of hospitalization rate and coefficient of mortality from the disease between 2000 and 2019 were calculated. A descriptive analysis of the indicators was carried out in the studied period and by the macro-regions in the State. For trend analysis, the simple linear regression model with log-transformation was used. Trends were classified as increasing, decreasing and stable, with a significance level of 5%. Results: the average on hospitalization rate was higher in the semi-arid macro-region (36.6/1000 children under five years old) and lower in Teresina (14.9/1000 children under five years old). The mean mortality coefficients were higher in the coastal macro-region (0.98/1000 live births) and lower in Teresina (0.47/1000 live births). The indicators showed a downward trend in all analyzed locations (p<0.05). A turning point was noted from 2009, with a significant reduction in hospitalization rates in the savanna and semi-arid macro-regions. Conclusion: indicators of morbidity and mortality due to acute diarrheal diseases in children under five years old showed a downward trend in Piauí between 2000 and 2019, with differences in trends between the evaluated macro-regions

Saúde da mulher: papel dos pactos internacionais na evolução da proteção aos direitos humanos

Objetivo: Evaluar si la adhesión a los pactos internacionales sobre los derechos humanos de las mujeres ha influenciado su estado de salud, especialmente sobre el asesoramiento del planeamiento familiar. Métodos: Estudio ecológico, analítico y cuantitativo realizado en el segundo semestre de 2019 a partir de ocho indicadores de la estrategia global para la salud de la mujer de la Organización Mundial de la Salud (OMS) estimados entre 1993 y 2018. Las mensuraciones incluyeron 190 países que adhirieron a la Convención sobre la Eliminación de Todas las Formas de Discriminación contra la Mujer (CEDAW) y 115 países que adhirieron al Protocolo Facultativo a la Convención sobre la Eliminación de Todas las Formas de Discriminación contra la Mujer (OP-CEDAW). Se realizó el análisis descriptivo de la evolución de los indicadores de la OMS y de las adhesiones a los tratados en ese período. A posteriori, se ha organizado los datos en categorías de países según la renta (alta, media alta, media baja y baja) para fines de comparación. Se calculó la significancia estadística de la diferencia entre las medias de los indicadores de salud de las mujeres en los cinco años antes del país ratificar el tratado, en la fecha de la ratificación y en los cinco años siguientes. Resultados: El planeamiento familiar ha sido estadísticamente significativo para ambos los pactos, el CEDAW (p-valor=0,05) y el OP-CEDAW (p-valor=0,007). La anemia en mujeres embarazadas y la cobertura de los cuidados prenatales han sido significativos respecto el OP-CEDAW (p-valor=0,03 y 0,01, respectivamente). Conclusión: La mayoría de los indicadores de salud de las mujeres analizados parece no haber sufrido la influencia de la adhesión a los pactos a excepción del planeamiento familiar que ha sido el único indicador impactado positivamente por los dos tratados.Objetivo: Avaliar se a adesão aos pactos internacionais relativos aos direitos humanos das mulheres influenciou o estado de saúde delas, especialmente no que diz respeito ao assessoramento sobre o planejamento da família. Métodos: Estudo ecológico, analítico e quantitativo realizado no segundo semestre de 2019 a partir de oito indicadores da estratégia global para a saúde da mulher da Organização Mundial da Saúde (OMS), estimados entre 1993 a 2018. As mensurações envolveram 190 países que aderiram à Convenção sobre a Eliminação de Todas as Formas de Discriminação contra a Mulher (CEDAW) e 115 países que aderiram ao Protocolo Facultativo à Convenção sobre a Eliminação de Todas as Formas de Discriminação contra a Mulher (OP-CEDAW). Realizou-se análise descritiva da evolução dos indicadores da OMS e das adesões aos tratados nesse período. Posteriormente, organizaram-se os dados nas categorias de países conforme a renda (alta, média alta, média baixa e baixa) para fins de comparação. Calculou-se a significância estatística da diferença entre as médias dos indicadores de saúde das mulheres nos cinco anos antes do país ratificar o tratado, na data da ratificação e nos cinco anos seguintes. Resultados: O planejamento familiar foi estatisticamente significativo para ambos os pactos, CEDAW (p-valor=0,05) e OP-CEDAW (p-valor=0,007). A anemia em mulheres grávidas e a cobertura de cuidados pré-natais foram significativos em relação ao OP-CEDAW (p-valor=0,03 e 0,01, respectivamente). Conclusão: A maioria dos indicadores de saúde das mulheres analisados parece não ter sofrido a influência da adesão aos pactos, com exceção do planejamento familiar, o único indicador impactado positivamente pelos dois tratados

Effects of the Optional Protocols to the Convention on the Rights of the Child on the causes of child death: a statistical study on a global scale

The Convention on the Rights of the Child (CRC) and the Optional Protocol to the Convention on the Rights of the Child on a Communications Procedure (OPCP) make commitments and guarantees in relation to child health. The aim of the study is to verify the effects of these commitments on the causes of child death. To analyze these effects, we apply the one-way analysis of variance. For each group, we calculated the averages of child deaths in their respective countries for the years 2002, 2007, 2012, and 2017. The p-value resulting indicated whether there was a difference between the means of child deaths in those years that were compared. We also observed the time series for each cause of death over the years 2000 to 2017. The CRC has an expressive adhesion. OPCP has a smaller number of acceptors in all regions compared to CRC. The acceptance of OPCP did not significantly alter the results of the number of deaths in the accepting countries in any of the 13 causes of child death observed. In the non- accepting group, significant differences were found concerning five causes of child death: HIV/AIDS, diarrhoeal diseases, measles, meningitis/encephalitis, and acute lower respiratory infections (p-values 0.01, 0.01, 0.003, 0.002, and 0.003, respectively). Our results suggest that the group of countries that have accepted the OPCP are more committed to issues of child deaths causes studied. In all of them the annual death numbers were considerably lower in this group

Desenvolvimento da Vigilância Epidemiológica de Fronteira no contexto da Globalização: conceitos e marcos teóricos.

Objetivo. Apresentar e analisar as ações desenvolvidas para a implementação e desenvolvimento de Vigilância Epidemiológica de Fronteiras, nos Blocos Econômicos Multinacionais, particularmente na América do Sul e Brasil. Metodologia. Foi realizado um estudo de revisão narrativa incluindo artigos científicos, documentos técnicos, diretrizes, normas, manuais, pautas de reuniões ou qualquer outro documento que fosse relacionado ao desenvolvimento e implementação de ações e programas de Vigilância Epidemiológica em Fronteiras. O estudo foi baseado nos sites das instituições/organizações multinacionais e nas bases MedLine, PubMed, Scielo e Scopus. Resultados. Foram identificados a criação de órgãos e ações no intuito de implementar e desenvolver a vigilância epidemiológica de fronteiras para os seguintes blocos: União Europeia (Health Security Committee, European Center for Disease Prevention and Control, Sistema de alerta rápido e resposta, General Rapid Alert System e Rede de Monitoramento Ad Hoc); Tratado Norte-Americano de Livre Comércio (Border Infectious Disease Surveillance, “Projeto de Vigilância e Alerta Rápido de Doenças Infeciosas”) ; Mercado Comum do Sul ( Reunião de Ministros da Saúde do Mercosul, Subgrupo de Trabalho 11 Saúde e Subcomissão Controle Sanitário de Portos, Aeroportos, Terminais e Passos Fronteiriços Terrestres); e União de Nações Sul-Americanas. Conclusões. Os programas e politicas desenvolvidos até o momento refletem o reconhecimento da importância do assunto por parte dos Estados Membros da OMS. Uma maior integração, com troca de informações, incluindo fluxos, frameworks, planos de preparação e o fortalecimento de áreas estratégicas como de energia e transporte deve ser incentivada intra e inter blocos

Transfusion Transmissible Infections in Blood Donors in the Province of Bi&eacute;, Angola, during a 15-Year Follow-Up, Imply the Need for Pathogen Reduction Technologies

Transfusion transmissible infections (TTIs), caused by hepatitis B virus (HBV), human immunode-ficiency virus (HIV), hepatitis C virus (HCV), and syphilis, have a high global impact, especially in sub-Saharan Africa. We evaluated the trend of these infections over time in blood donors in Angola. A retrospective cross-sectional study was conducted among blood donors in Angola from 2005 to 2020. Additionally, frozen samples obtained from blood donors in 2007 were investigated to identify chronic HCV carriers and possible occult HBV infection (OBI). The overall prevalence of HBV, HCV, HIV, and syphilis was 8.5, 3, 2.1, and 4.4%, respectively, among 57,979 blood donors. HBV was predominant among male donors, while the remaining TTIs were predominant among women. Donors &gt;50 years had a significantly high prevalence for all TTIs. Chronic HCV infection was ab-sent in 500 samples tested and OBI was present in 3%. Our results show the continued high prev-alence of TTIs among blood donors in Angola. Most infections showed a significantly low preva-lence in years with campaigns seeking voluntary blood donors, thus, reinforcing the importance of this type of donor to ensure safe blood. Africa, with a high prevalence of diverse pathogens, should consider cost-effective pathogen reduction technologies, once they are commercially accessible, to increase the availability of safe blood

Before Direct-Acting Antivirals for Hepatitis C Virus: Evaluation of Core Protein R70Q and L/C91M Substitutions in Chronically Infected Brazilian Patients Unresponsive to IFN and/or RBV

Although chronic hepatitis C has been effectively treated with direct-acting antivirals (DAAs), the use of conventional therapy with peg-interferon (Peg-IFN) or (predominantly) ribavirin (RBV), remains widespread. R70Q/H and L/C91M amino acid substitutions in the hepatitis C virus (HCV) core protein may modulate responses to IFN and/or RBV, and are associated with cirrhosis, hepatocellular carcinoma (HCC), insulin resistance, and liver steatosis. We evaluated the R70Q/H and L/C91M substitutions, clinical and epidemiological profiles, and risk factors of Brazilian patients chronically infected with HCV subgenotypes 1a and 1b (HCV-GT1a and HCV-GT1b) unresponsive to IFN and/or RBV therapy. Sequencing and pyrosequencing analyses and sociodemographic and clinical predictive variables were used to assess the relationship between R70Q/H and L/C91M substitutions. Leukocyte counts, ALT levels, and ALT/AST ratios were significantly reduced in treated individuals, but more of these patients had advanced fibrosis and cirrhosis. L91M was more prevalent (19.7%), occurring only in HCV-GT1b, followed by R70Q/P (11.5%) and R70P (1.4%). R70Q/P exhibited higher mean AST, ALT, and GGT values, whereas L91M showed higher mean GGT values. Pyrosequencing of the L91M position revealed mutant subpopulations in 43.75% of samples