Health and Health Care of Mothers and Children in a Suburban Area of Luanda, Angola

Population health data available in Angola are often insufficient to guide the planning of health interventions. To address this gap, the goal of the present study was to investigate the health of mothers and infants in a suburban municipality in Luanda (Cacuaco), in order to provide a baseline for future comparisons. This was a prevalence study investigating infants younger than 2 years of age and their mothers. Mothers were interviewed, and children’s height and weight were measured. Of 749 mothers interviewed, 98.5 % (95 % CI 98.2–99.1 %) had at least one prenatal visit and 51.7 % (95 % CI 47.4–56.3 %) had a health card. Most mothers with a health card had their first prenatal visit before the 20th week of pregnancy, and had at least four prenatal visits; 81.1 % (95 % CI 78.3–84.1 %) of mothers also had their child’s health card. Prevalence of exclusive breastfeeding at 6 months was 19 % (95 % CI 16.2–23.1 %). Prevalence of low height-for-age and low BMI-for-age were 32 and 6 %, respectively. Mothers with higher education levels were more likely to have had their first prenatal visit earlier, to have had more prenatal visits, to have given birth at a health facility, and to have her own and her child’s health cards. Results showed a high prevalence of prenatal care and a low frequency of acute malnutrition. Maternal education level, among factors studied, was the predominant correlate of more positive health behaviors. These findings suggest important progress of mother and child health in Cacuaco, and may serve as a baseline for the planning of health interventions

Zika virus infection in pregnancy: a protocol for the joint analysis of the prospective cohort studies of the ZIKAlliance, ZikaPLAN and ZIKAction consortia

INTRODUCTION: Zika virus (ZIKV) infection in pregnancy has been associated with microcephaly and severe neurological damage to the fetus. Our aim is to document the risks of adverse pregnancy and birth outcomes and the prevalence of laboratory markers of congenital infection in deliveries to women experiencing ZIKV infection during pregnancy, using data from European Commission-funded prospective cohort studies in 20 centres in 11 countries across Latin America and the Caribbean. METHODS AND ANALYSIS: We will carry out a centre-by-centre analysis of the risks of adverse pregnancy and birth outcomes, comparing women with confirmed and suspected ZIKV infection in pregnancy to those with no evidence of infection in pregnancy. We will document the proportion of deliveries in which laboratory markers of congenital infection were present. Finally, we will investigate the associations of trimester of maternal infection in pregnancy, presence or absence of maternal symptoms of acute ZIKV infection and previous flavivirus infections with adverse outcomes and with markers of congenital infection. Centre-specific estimates will be pooled using a two-stage approach. ETHICS AND DISSEMINATION: Ethical approval was obtained at each centre. Findings will be presented at international conferences and published in peer-reviewed open access journals and discussed with local public health officials and representatives of the national Ministries of Health, Pan American Health Organization and WHO involved with ZIKV prevention and control activities

ATLANTIC EPIPHYTES: a data set of vascular and non-vascular epiphyte plants and lichens from the Atlantic Forest

Epiphytes are hyper-diverse and one of the frequently undervalued life forms in plant surveys and biodiversity inventories. Epiphytes of the Atlantic Forest, one of the most endangered ecosystems in the world, have high endemism and radiated recently in the Pliocene. We aimed to (1) compile an extensive Atlantic Forest data set on vascular, non-vascular plants (including hemiepiphytes), and lichen epiphyte species occurrence and abundance; (2) describe the epiphyte distribution in the Atlantic Forest, in order to indicate future sampling efforts. Our work presents the first epiphyte data set with information on abundance and occurrence of epiphyte phorophyte species. All data compiled here come from three main sources provided by the authors: published sources (comprising peer-reviewed articles, books, and theses), unpublished data, and herbarium data. We compiled a data set composed of 2,095 species, from 89,270 holo/hemiepiphyte records, in the Atlantic Forest of Brazil, Argentina, Paraguay, and Uruguay, recorded from 1824 to early 2018. Most of the records were from qualitative data (occurrence only, 88%), well distributed throughout the Atlantic Forest. For quantitative records, the most common sampling method was individual trees (71%), followed by plot sampling (19%), and transect sampling (10%). Angiosperms (81%) were the most frequently registered group, and Bromeliaceae and Orchidaceae were the families with the greatest number of records (27,272 and 21,945, respectively). Ferns and Lycophytes presented fewer records than Angiosperms, and Polypodiaceae were the most recorded family, and more concentrated in the Southern and Southeastern regions. Data on non-vascular plants and lichens were scarce, with a few disjunct records concentrated in the Northeastern region of the Atlantic Forest. For all non-vascular plant records, Lejeuneaceae, a family of liverworts, was the most recorded family. We hope that our effort to organize scattered epiphyte data help advance the knowledge of epiphyte ecology, as well as our understanding of macroecological and biogeographical patterns in the Atlantic Forest. No copyright restrictions are associated with the data set. Please cite this Ecology Data Paper if the data are used in publication and teaching events. © 2019 The Authors. Ecology © 2019 The Ecological Society of Americ

Worldwide trends in underweight and obesity from 1990 to 2022 : a pooled analysis of 3663 population-representative studies with 222 million children, adolescents, and adults

A list of authors and their affiliations appears online. A supplementary appendix is herewith attached.Background: Underweight and obesity are associated with adverse health outcomes throughout the life course. We estimated the individual and combined prevalence of underweight or thinness and obesity, and their changes, from 1990 to 2022 for adults and school-aged children and adolescents in 200 countries and territories. Methods: We used data from 3663 population-based studies with 222 million participants that measured height and weight in representative samples of the general population. We used a Bayesian hierarchical model to estimate trends in the prevalence of different BMI categories, separately for adults (age ≥20 years) and school-aged children and adolescents (age 5–19 years), from 1990 to 2022 for 200 countries and territories. For adults, we report the individual and combined prevalence of underweight (BMI 2 SD above the median). Findings: From 1990 to 2022, the combined prevalence of underweight and obesity in adults decreased in 11 countries (6%) for women and 17 (9%) for men with a posterior probability of at least 0·80 that the observed changes were true decreases. The combined prevalence increased in 162 countries (81%) for women and 140 countries (70%) for men with a posterior probability of at least 0·80. In 2022, the combined prevalence of underweight and obesity was highest in island nations in the Caribbean and Polynesia and Micronesia, and countries in the Middle East and north Africa. Obesity prevalence was higher than underweight with posterior probability of at least 0·80 in 177 countries (89%) for women and 145 (73%) for men in 2022, whereas the converse was true in 16 countries (8%) for women, and 39 (20%) for men. From 1990 to 2022, the combined prevalence of thinness and obesity decreased among girls in five countries (3%) and among boys in 15 countries (8%) with a posterior probability of at least 0·80, and increased among girls in 140 countries (70%) and boys in 137 countries (69%) with a posterior probability of at least 0·80. The countries with highest combined prevalence of thinness and obesity in school-aged children and adolescents in 2022 were in Polynesia and Micronesia and the Caribbean for both sexes, and Chile and Qatar for boys. Combined prevalence was also high in some countries in south Asia, such as India and Pakistan, where thinness remained prevalent despite having declined. In 2022, obesity in school-aged children and adolescents was more prevalent than thinness with a posterior probability of at least 0·80 among girls in 133 countries (67%) and boys in 125 countries (63%), whereas the converse was true in 35 countries (18%) and 42 countries (21%), respectively. In almost all countries for both adults and school-aged children and adolescents, the increases in double burden were driven by increases in obesity, and decreases in double burden by declining underweight or thinness. Interpretation: The combined burden of underweight and obesity has increased in most countries, driven by an increase in obesity, while underweight and thinness remain prevalent in south Asia and parts of Africa. A healthy nutrition transition that enhances access to nutritious foods is needed to address the remaining burden of underweight while curbing and reversing the increase in obesity.peer-reviewe

Program of Community Health Agents in Luanda, Angola: and the tack of beads on Cooperation in Brazil

Submitted by Gilvan Almeida ([email protected]) on 2016-08-10T18:28:01Z No. of bitstreams: 2 205.pdf: 1272963 bytes, checksum: b0d48b597a4efc2490913ce6f8dcdb47 (MD5) license.txt: 1748 bytes, checksum: 8a4605be74aa9ea9d79846c1fba20a33 (MD5)Approved for entry into archive by Maria Arruda ([email protected]) on 2018-01-31T14:13:15Z (GMT) No. of bitstreams: 2 205.pdf: 1272963 bytes, checksum: b0d48b597a4efc2490913ce6f8dcdb47 (MD5) license.txt: 1748 bytes, checksum: 8a4605be74aa9ea9d79846c1fba20a33 (MD5)Made available in DSpace on 2018-01-31T14:13:15Z (GMT). No. of bitstreams: 2 205.pdf: 1272963 bytes, checksum: b0d48b597a4efc2490913ce6f8dcdb47 (MD5) license.txt: 1748 bytes, checksum: 8a4605be74aa9ea9d79846c1fba20a33 (MD5) Previous issue date: 2014Fundação Oswaldo Cruz. Escola Nacional de Saúde Pública Sergio Arouca. Rio de Janeiro, RJ, Brasil.O Governo Provincial de Luanda e a UNICEF- Angola lançaram o Programa de Agentes Comunitários de Saúde de Luanda (PACS) como projeto piloto, em 2007. Esta experiência contou com a participação de consultores brasileiros e, após a aprovação de projetos do edital Pró-África, duas universidades brasileiras se juntaram a estes esforços. Porém, em 2012, o PACS Luanda pareceu não ter continuidade. Concomitante a isto ocorreram iniciativas da ABC e Fiocruz em instituir processos de cooperação em saúde, visando também, entre outros, a Atenção Primária à Saúde, através da cooperação bilateral e trilateral (juntamente ao Japão). Nesta época, também o Banco Mundial investiu em projeto que, em 2014, reverteu apoio ao PACS em outras províncias do país. O presente estudo buscou analisar as práticas, os sentidos e concepções da cooperação internacional em saúde no Brasil a partir da experiência de cooperação na implantação do PACS Luanda/Angola; identificando os atores e analisando as relações instituídas no âmbito deste projeto. Foram realizadas entrevistas com cinco atores brasileiros que participaram na implantação deste programa. Procedeu-se à análise de conteúdo, através da categorização e interpretação das falas. A partir da revisão de documentos, pesquisa bibliográfica, e da implicação da pesquisadora no projeto, foi possível construir novos sentidos e entendimentos aos processos estudados. Cada ator da cooperação ocupava uma posição que engendrava possibilidades e limitações diferentes; percebê-las fez-se necessário a fim de compreender e equacionar seus alcances. A cooperação cientifica na área das tecnologias leves pode ou não servir como instrumental de soft power, a depender do ângulo que a política externa do país a adota. No caso do PACS Luanda/Angola, o processo como um todo pode ser considerado uma ―cooperação periférica‖ e, portanto, carente de valor no rol das cooperações brasileiras. Já a constituição dos atores se aproximou do marco das colaborações cientificas que, de forma mais isolada e pouco articulada a uma política de cooperação, empreendeu esforços na latitude de suas crenças.Luanda‘s government and UNICEF launched the Community Health Workers Program in Luanda as a pilot, in 2007. This experience had Brazilian‘s consultants and, after the approval of ―Pró-África‖ projects, two Brazilian‘s universities joined this effort. But, in 2012, the CHW program in Luanda seemed to fade away. By this time, Fiocruz and ABC (The Brazilian Cooperation Agency) were trying to institute, together with Angola, international health cooperation proceedings in order to improve health system and primary health care, through bilateral and trilateral cooperation process. World Bank has also an investment project in health since 2012; in 2014 it started to support CHW program in other provinces of Angola. This study tried to analyze the practices, meanings and conceptions of international health cooperation in Brazil, from the experience of Luanda‘s CHW program implantation; through identification of actors and analysis of the relations established under this project. . Five Brazilian‘s actors were interviewed. Content analysis was made through categorization and interpretation of statements. From the review of documents, literature and the involvement of the researcher in the project, was possible to build new meanings and understandings for the analyzed processes. Each cooperation actor was in a position that engendered different possibilities and limitations; realize them is necessary to understand and address their ranges. Scientific Cooperation in soft technologies areas might be useful as a soft power instrument, depending on the foreign policy that the country adopts. In the Luanda‘s CHW program, the process as a whole can be considered as a ―peripheral cooperation‖ that seems to lack value in the list of the Brazilian official cooperation. The nature of the actors approached the framework of scientific collaborations, as it worked more isolated and poorly articulated to a cooperation policy, so the efforts undertaken were in the pursuit of their beliefs

Zika virus infection in pregnancy : a protocol for the joint analysis of the prospective cohort studies of the ZIKAlliance, ZikaPLAN and ZIKAction consortia

Introduction: Zika virus (ZIKV) infection in pregnancy has been associated with microcephaly and severe neurological damage to the fetus. Our aim is to document the risks of adverse pregnancy and birth outcomes and the prevalence of laboratory markers of congenital infection in deliveries to women experiencing ZIKV infection during pregnancy, using data from European Commission-funded prospective cohort studies in 20 centres in 11 countries across Latin America and the Caribbean. Methods and analysis: We will carry out a centre-by-centre analysis of the risks of adverse pregnancy and birth outcomes, comparing women with confirmed and suspected ZIKV infection in pregnancy to those with no evidence of infection in pregnancy. We will document the proportion of deliveries in which laboratory markers of congenital infection were present. Finally, we will investigate the associations of trimester of maternal infection in pregnancy, presence or absence of maternal symptoms of acute ZIKV infection and previous flavivirus infections with adverse outcomes and with markers of congenital infection. Centre-specific estimates will be pooled using a two-stage approach. Ethics and dissemination: Ethical approval was obtained at each centre. Findings will be presented at international conferences and published in peer-reviewed open access journals and discussed with local public health officials and representatives of the national Ministries of Health, Pan American Health Organization and WHO involved with ZIKV prevention and control activities