Factors which influence weaning in preterm infant

OBJETIVO: verificar os principais fatores que influenciam o desmame em prematuros nascidos em maternidade pública da cidade de São Paulo. MÉTODO: estudaram-se 89 prematuros de baixo peso acompanhados em ambulatório, no período de agosto de 2006 a maio de 2007. Esses prematuros foram divididos em dois grupos conforme a presença de desmame parcial (introdução de complemento lácteo por mamadeira) ou desmame total (interrupção do aleitamento materno). Foram estudadas variáveis maternas e das crianças, obtidas por meio de entrevista com a mãe e consulta a prontuários. Na análise estatística, utilizaram-se os testes t (Student) e de correlação (Spearman). Adotou-se o nível de significância de 5%. RESULTADOS: a média de idade para o desmame parcial foi de 1,41 meses. Mães que realizaram ordenha durante a internação, ou que iniciaram ou retornaram ao trabalho, introduziram mamadeira mais tardiamente. Quanto menor o peso ao nascer e a idade gestacional, mais tardia a introdução da mamadeira. Quanto menor a idade de introdução da chupeta, mais precoce o desmame parcial. A média de idade para o desmame total foi de 2,93 meses. Mães que internaram na enfermaria canguru, ou que iniciaram ou voltaram ao trabalho, interromperam o aleitamento materno mais tardiamente. CONSIDERAÇÕES FINAIS: os achados do presente trabalho apontam para a importância de fatores controláveis pela equipe de saúde na prevenção do desmame precoce em prematuros, como ordenha, metodologia canguru e orientação para o não uso de chupetas. Fatores não controláveis como peso ao nascer e trabalho materno, mostraram-se indicativos de maior permanência do aleitamento materno.OBJECTIVE: to verify the major factors influencing weaning in preterm infants born in a public maternity center in the city of Sao Paulo, Brazil. METHOD: a total of 89 low-birth-weight preterm infants followed on an outpatient basis were studied from August 2006 to May 2007. These premature infants were divided into two groups according to the presence of partial weaning (introduction of supplementary bottle feeding) or full weaning (breastfeeding cessation). Maternal and infant variables obtained by means of interviews with the mothers and from the medical records were studied. The Student's t test and Spearman rank correlation test were used for the statistical analysis. The significance level was set at 5%. RESULTS: mean age for partial weaning was 1.41 months. Mothers who pumped during hospitalization or who started working or returned to work started bottle feeding later. The lower the birth weight and the gestational age, the later bottle feeding was started. The lower the age at pacifier introduction, the earlier the partial weaning. Mean age for full weaning was 2.93 months. Mothers hospitalized in the kangaroo mother care unit, or those who started working or returned to work, stopped breastfeeding later. FINAL CONSIDERATIONS: the findings of the present study point to the importance of factors that can be controlled by the health care team - such as breast milk pumping, the kangaroo mother care method, and advice not to use pacifiers - in the prevention of early weaning in preterm infants. Uncontrollable factors such as birth weight and maternal work were predictive of longer breastfeeding

Soroprevalência de anticorpos do vírus SARS-CoV-2 em escolares no município de São Paulo, 2020

OBJECTIVE: To estimate seroprevalence of SARS-CoV-2 antibodies in schoolchildren aged 4 to 14 years living in the city of São Paulo, according to clinical, demographic, epidemiological, and social variables, during the school closure period as a measure against covid-19 spread. METHODS: A serological survey was made in September 2020 with a random sample stratified by school system (municipal public, state public and private) type. A venous blood sample was collected using the Wondfo SARS-CoV-2 Antibody Test (lateral flow method) for detection of total SARS-CoV-2 virus antibodies. Semi-structured questionnaires were applied to collect clinical, demographic, social, and epidemiological data. RESULTS: Seroprevalence of SARS-CoV-2 antibodies in schoolchildren was of 16.6% (95%CI 15.4–17.8). The study found higher seroprevalence in the municipal (18.5%; 95%CI 16.6–20.6) and state (16.2%; 95%CI 14.4–18.2) public school systems compared to the private school system (11.7; 95%CI 10.0–13.7), among black and brown students (18.4%; 95%CI 16.8–20.2) and in the most vulnerable social stratum (18.5 %;95%CI 16.9–20.2). Lower seroprevalence was identified in schoolchildren who reported following the recommended protective measures against covid-19. CONCLUSION: Seroprevalence of SARS-CoV-2 antibodies is found mainly in the most socially vulnerable schoolchildren. This study can contribute to support public policies that reinforce the importance of suspending face-to-face classes and developing strategies aimed at protective measures and monitoring of the serological status of those who have not yet been included in the vaccination schedule.OBJETIVO: Estimar a soroprevalência de anticorpos do vírus SARS-CoV-2 em escolares de quatro a 14 anos de idade residentes no município de São Paulo, segundo variáveis clínicas, demográficas, epidemiológicas e sociais, durante o período de fechamento das escolas como medida de controle da covid-19. MÉTODOS: Realizou-se um inquérito sorológico em setembro de 2020 com amostra aleatória estratificada por tipo de rede de ensino (pública municipal, pública estadual e privada). Foi coletada amostra de sangue venoso utilizando-se o teste de imunoensaio de fluxo lateral da fabricante Wondfo para detecção de anticorpos totais contra o vírus SARS-CoV-2. Aplicaram-se questionários semiestruturados para o levantamento de dados clínicos, demográficos, sociais e epidemiológicos. RESULTADOS: A soroprevalência de anticorpos do vírus SARS-CoV-2 em escolares foi de 16,6% (IC95% 15,4–17,8). O estudo encontrou soroprevalências mais elevadas na rede pública municipal (18,5%; IC95% 16,6–20,6) e estadual (16,2%; IC95% 14,4–18,2) em relação à rede privada (11,7; IC95% 10,0–13,7) e entre escolares da raça/cor preta e parda (18,4%; IC95% 16,8–20,2) e no estrato social mais vulnerável (18,5%; IC95% 16,9–20,2). A pesquisa identificou menores soroprevalências nos escolares que relataram seguir as medidas recomendadas de proteção contra a covid-19. CONCLUSÃO: A soroprevalência de anticorpos contra o vírus SARS-CoV-2 atinge principalmente os escolares socialmente mais vulneráveis. Este estudo pode contribuir para embasar políticas públicas que reforcem a importância da suspensão das aulas presenciais e da necessidade de estratégias de medidas de proteção e acompanhamento do status sorológico daqueles que ainda não foram contemplados no calendário vacinal

Prevalence evolution of SARS-CoV-2 infection in the city of São Paulo, 2020–2021

OBJECTIVE To estimate the evolution of the prevalence of SARS-CoV-2 virus infection among residents aged 18 years or over in the municipality of São Paulo. METHODS This is a population-based household survey conducted every 15 days, between June and September 2020, and January and February 2021. In total, the study comprised 11 phases. The presence of antibodies against SARS-CoV-2 was identified in venous blood using a lateral flow test, Wondfo Biotech. In the last phase, the researchers combined it with an immunoenzymatic test, Euroimmun. The participants also answered a semi-structured questionnaire on sociodemographic and economic factors, and on social distancing measures. Prevalence estimates and the 95% confidence interval were estimated according to regions, Human Development Index, sex, age group, ethnicity, education, income, and variables associated with risk or prevention of infection. To compare the frequencies among the categories of each variable, the chi-square test with Rao-Scott correction was used, considering a significance level of 5%. RESULTS In total, 23,397 individuals were interviewed and had their samples collected. The estimated prevalence of antibodies against SARS-CoV-2 ranged from 9.7% (95%CI: 7.9–11.8%) to 25.0% (95%CI: 21.7–28.7). The prevalence of individuals with antibodies against the virus was higher among black and brown people, people with lower schooling and income, and among residents of regions with lower Human Development Index. The lowest prevalences were associated with recommended measures of disease protection. The proportion of asymptomatic infection was 45.1%. CONCLUSION The estimated prevalence of the infection was lower than the cumulative incidence variation, except for the last phase of the study. The differences in prevalence estimates observed among subpopulations showed social inequality as a risk of infection. The lower prevalence observed among those who could follow prevention measures reinforce the need to maintain social distancing measures as a way to prevent SARS-CoV-2 infection