The magnitude of syphilis: from prevalence to vertical transmission

Introduction: In 2013, the World Health Organization (WHO) reported that 1.9 million pregnant women were infected with syphilis worldwide, of which 66.5% had adverse fetal effects in cases of untreated syphilis. Congenital syphilis contributes significantly to infant mortality, accounting for 305,000 perinatal deaths worldwide annually. Aim: To estimate the prevalence of syphilis in parturients, the incidence of congenital syphilis and the vertical transmission rate. Material and methods: a cross-sectional study with data collected from 2041 parturients who had undergone treatment between 2012 and 2014 in the maternity section of the Pedro Ernesto Hospital of the State University of Rio de Janeiro, in the metropolitan area of Rio de Janeiro. The inclusion criterion was positive VDRL and treponemal test in a hospital environment. Results: the prevalence of syphilis in pregnant women was 4.1% in 2012, 3.1% in 2013 and 5% in 2014, with official reporting of 15.6%, 25.0% and 48.1%, respectively. The incidence of congenital syphilis (CS) was 22/1,000 in live births (LB) in 2012; 17/1,000 LB in 2013 and 44.8/1,000 LB in 2014. CS underreporting during the period was 6.7%. Vertical transmission occurred in 65.8% of infants from infected mothers. It was concluded that, in 34.6% of the CS cases, maternal VDRL titers were = 1/4. Conclusion: Results demonstrate the magnitude of the disease, fragility of the reporting system in the assessment of the actual prevalence, impact on perinatal outcomes, and they are a warning about the real situation of syphilis, which is still underestimated in the State

Determinantes sociales de la salud y el estado nutricional en la Amazonía brasileña

[EN] An individual's nutritional condition influences his/her development, but the prevalence of unhealthy eating habits alters nutritional balance and triggers several health complications, which are also influenced by social determinants of health. For this reason, this study aimed to analyze the social determinants of health and the nutritional status of students from a public elementary and high school in a neighborhood on the outskirts of Belém, Pará State, Brazil. Along with the collection of anthropometric measures, an epidemiological and food census was used, following widely accepted protocols tested in the Amazon region, as well as an individual clinical evaluation. Z score and descriptive statistics were performed. 55 students were measured, 30 female and 25 male, with an average age of 13 years old, average BMI of 19.66 for the female group and 19.38 for the male, with 4% of the boys having “severe delay ”, while 3.7% of girls reported a“ delay ”in their growth. 13.3% of girls and 25% of boys drink alcohol. The students showed general physical status without major complications, there were no obese individuals, but there is a potential risk for the condition. However, because it is a peripheral area, the social determinants of health may strongly allow the processing of other nutritional diseases, such as malnutrition and especially stress, since we identified a student who self mutilates, and many others who experience daily violence and low life perspectives.[ES] La condición nutricional de un individuo influye en su desarrollo, pero la prevalencia de hábitos alimenticios poco saludables altera el equilibrio nutricional y desencadena varias complicaciones de salud y que también están influenciadas por los determinantes sociales de la salud. Por esta razón, este estudio tuvo como objetivo analizar los determinantes sociales de la salud y el estado nutricional de los estudiantes de una escuela primaria y secundaria pública en un barrio en las afueras de Belém, Estado de Pará, Brasil. Junto con la recopilación de medidas antropométricas, se utilizó un censo epidemiológico y alimentario, siguiendo protocolos ampliamente aceptados probados en la región amazónica, así como una evaluación clínica individual. Se realizó puntuación Z score y estadística descriptiva. Se midieron 55 estudiantes, 30 mujeres y 25 hombres, con una edad promedio de 13 años, un IMC promedio de 19.66 para el grupo femenino y 19.38 para el hombre, con un 4% de los niños con retraso severo, mientras que el 3.7% de Las niñas informaron un "retraso" en su crecimiento. El 13,3% de las niñas y el 25% de los niños beben alcohol. Los estudiantes mostraron un estado físico general sin complicaciones mayores, no hubo individuos obesos, pero existe un riesgo potencial para la afección. Sin embargo, debido a que es un área periférica, los determinantes sociales de la salud pueden fuertemente permitir el procesamiento de otras enfermedades nutricionales, como desnutrición y especialmente estrés, desde que identificamos un estudiante que se auto mutilan, y muchos otros que experimentan violencia diaria y baja esperanza de vida.Filgueiras, LA.; Sousa, RJDA.; Costa, AGDS.; Santos, JPND.; Guerreiro, JDS.; Santa Rosa, FVDJ.; Amaral, JDS.... (2021). The social determinants of health and the nutritional status of students from a city in the Brazilian Amazon. Revista sobre la infancia y la adolescencia. 0(21):1-18. https://doi.org/10.4995/reinad.2021.13769OJS118021- Abrantes, M. M., Lamounier, J. A., Colosimo, E. A. (2003). Prevalência de sobrepeso e obesidade nas regiões nordeste e sudeste do Brasil. Revista da Associação de Medicina Brasileira. 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L., Malkowski, J., Zutter, L. C. I., Ulbrich, A. Z. (2010). Estado nutricional, hábitos alimentares e conhecimentos de nutrição em escolares. Rev. Paul. Pediatr. 28(3): 303-8, Retrieved on June 5, 2019, of http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0103-05822010000300008 https://doi.org/10.1590/S0103-05822010000300008- Bezerra, M. A., Carvalho, E. F., Oliveira, J. S., Leal, V. S. (2017). Saúde e nutrição em escolas públicas e privadas de Recife. Rev. Bras. Saúde Matern. Infant. 17(1): 201-210, Retrieved on August 16, 2019, of http://www.scielo.br/scielo.php?pid=S1519-38292017000100191&script=sci_arttext&tlng=pt- Bloch, K. V., Klein, C. H., Szklo, M., Kuschnir, M. C. C., Abreu, G. A., Barufaldi, L. A., Veiga, G. V., Schaan, B. D., Silva, T. L. N., Moraes, A. J. P., Oliveira, A. M. A., Tavares, B. M., Magliano, E. S., Oliveira, C. L., Cunha, C. F., Giannini, D. T., Belfort, D. R., Santos, E. L., Leon, E. B., Oliveira, E. R. A., Fujimori, E., Borges, A. L. 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Bras. 16(3):205-213, Retrieved on December 7, 2019, of http://www.scielo.br/pdf/jvb/v16n3/1677-5449-jvb-1677-5449011816.pdf https://doi.org/10.1590/1677-5449.011816- DIRETRIZES DA SOCIEDADE BRASILEIRA DE DIABETES (2015-2016) / Adolfo Milech...[et. al.]; organização José Egidio Paulo de Oliveira, Sérgio Vencio - São Paulo: A.C. Farmacêutica, 2016, Retrieved on Abril 12, 2019, of https://www.diabetes.org.br/profissionais/images/docs/DIRETRIZES-SBD-2015-2016.pdf.- Dufour, D. L. & Teufell, N. I. Minimum data sets for the description of diet and measurements of food intake and nutritional status. In: Morán, E. F. (ed.) The Comparative Analysis of Human Societies: Towards Common Standards for Data Collection and Reporting (1995). Boulder, Lynne Rienner.- Engstrom, E. M., & Anjos, L. A. (1999). Déficit estatural nas crianças brasileiras: relação com condições sócio-ambientais e estado nutricional materno. Cad. Saúde Pública.15(3): 559-567, Retrieved on February 4, 2019, of http://www.scielo.br/pdf/csp/v15n3/0495.pdf https://doi.org/10.1590/S0102-311X1999000300013- Faria, E. R. D., Faria, F. R. D., Franceschini, S. D. C. C., Peluzio, M. D. C. G., Novaes, J. F. D., Ribeiro, S. M. R, Ribeiro, A. Q., Sant'ana, L. F. R., Priore, S. E. (2014). Resistência à insulina e componentes da síndrome metabólica, análise por sexo e por fase da adolescência. Arq. Bras. Endocrinol. Metab. 58 (6):610-618, Retrieved on August 7, 2019, of http://www.scielo.br/pdf/abem/v58n6/0004-2730-abem-58-6-0610.pdf https://doi.org/10.1590/0004-2730000002613- Fernández, J. R., Redden, D. T., Pietrobelli, A., Allison, D. B. (2004). Waist circumference percentiles in nationally representative samples of African-American, European-American, and Mexican-American children and adolescente. The Journal Pediatric. 145(4):439-444, Retrieved on Abril 30, 2020, of https://www.ncbi.nlm.nih.gov/pubmed/15480363 https://doi.org/10.1016/j.jpeds.2004.06.044- Filho, V. C. B., Lopes, A. S., Fagundesb, R. R, Campos, W. (2014) Índices antropométricos em escolares de um município no Sul do Brasil: análise descritiva utilizando o método LMS. Rev. Paul. Pediatr. 32(4):333-341, Retrieved on March 17, 2017, of https://www.redalyc.org/pdf/4060/406034052010.pdf https://doi.org/10.1016/j.rpped.2014.04.002- Fontanive, R. S., De Paula, P. T., Peres, W. A. F. (2002). Medidas Antropométricas. In: Duarte, A. C. G.; Castellani, F. R. (Org). Semiologia nutricional. Rio de Janeiro: Axcel Books.- Frisancho, R. A. (2008). Anthropometric standards: An interactive nutritional reference of body size and body composition for children and adults. Ann Arbor: University of Michigan Press. https://doi.org/10.3998/mpub.93311- Gaya, A. R., Brand, C., Lemes, V. B., Dias, A. F., Fochesatto, C. F., Pedretti, A., Mello, J. B., Gay, A. C. A. (2019). Sobrepeso e obesidade precoce e o risco à saúde cardiometabólica e musculoesquelética em crianças. Ciência & Saúde. 12(1), Retrieved on January 19, 2020, of http://revistaseletronicas.pucrs.br/ojs/index.php/faenfi/article/view/31888 https://doi.org/10.15448/1983-652X.2019.1.31888- Gonçalves, F., & Mourão, P. (2008). A avaliação da composição corporal - a medição de pregas adiposas como técnica para a avaliação da composição corporal. Revista de Desporto e Saúde da Fundação Técnica e Científica do Desporto. 4(4):13-21, Retrieved on November 22, 2018, of http://revistamotricidade.com/arquivo/2008_vol4_n4/v4n4a03.pdf https://doi.org/10.6063/motricidade.4(4).255- Gonçalves, V. S. S., Galvão, T. F., Andrade, K. R. C. D., Dutra, E. S., Bertolin, M. N. T., Carvalho, K. M. B. D., Pereira, M. G. (2016). Prevalência de hipertensão arterial entre adolescentes: revisão sistemática e metanálise. Revista de Saúde Pública. 50:27, Retrieved on December 4, 2019, of http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0034-89102016000100504- INSTITUTO BRASILEIRO DE GEOGRAFIA E ESTATÍSTICA. (2016). Pesquisa Nacional de Saúde do Escolar/2015. Coordenação de População e Indicadores Sociais. Rio de Janeiro, 132 p, Retrieved on Abril 14, 2020, of https://biblioteca.ibge.gov.br/visualizacao/livros/liv97870.pdf- INSTITUTO BRASILEIRO DE GEOGRAFIA E ESTATÍSTICA. (2009) Pesquisa Nacional de Saúde do Escolar 2009. Rio de Janeiro: IBGE, Retrieved on Abril 14, 2020, of https://biblioteca.ibge.gov.br/visualizacao/livros/liv43063.pdf- Kneipp, C., Habitzreuter, F., Mezadri, T., Höfelmann, D. A. (2015). Excesso de peso e variáveis associadas em escolares de Itajaí, Santa Catarina, Brasil. 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O., Cardoso, L. D., De Paula, H., Faria, E. R. (2011). Variáveis antropométricas e de composição corporal como preditores de risco cardiovascular e da síndrome metabólica em adolescentes. Arq. Bras. Cardiol. 96 (3):205-211, Retrieved on December 6, 2018, of https://pesquisa.bvsalud.org/portal/resource/pt/biblio-906156- Reis, A. A. C., Malta, D. C., Furtado, L. A. C. (2018). Desafios para as políticas públicas voltadas à adolescência e juventude a partir da Pesquisa Nacional de Saúde do Escolar (PeNSE). Ciência & Saúde Coletiva. 23(9)2879-2890, Retrieved on November 29, 2019, of http://www.scielo.br/scielo.php?script=sci_abstract&pid=S141381232018000902879&lng=en&nrm=iso&tlng=pt https://doi.org/10.1590/1413-81232018239.14432018- Ribeiro, R. Q., Lotufo, P. A., Lamounier, J. A., Oliveira, R. G., Soares, J. F., Botter, D. A. (2006). Fatores Adicionais de Risco Cardiovascular Associados ao Excesso de Peso em Crianças e Adolescentes. O Estudo do Coração de Belo Horizonte. 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Os estágios motivacionais de alcoolistas internados devido a doenças clínicas em hospitais gerais

The objective of this study is to compare the motivation to change drinking behavior in two distinct samples of alcohol-addicted patients, namely general hospital inpatients and patients seeking treatment in specialized addiction units. Ninety one subjects were recruited for a cross-sectional assessment; 42 had one or more clinical conditions related to alcohol addiction (group 1) and 49 were inpatients at a clinical dependence unit (group 2). Assessments were performed until the following instruments: We found significant differences between the two groups in the "action" (p = 0,006) and the "maintenance" (p < 0,00001) scores, but no significant differences in the "contemplation" and "pre-contemplation" scores (p = 0,0098 and 0,342, respectively). General hospital inpatients seem to be less motivated to change patterns in their addiction behavior than those treated in addiction units. Therefore it is important to reinforce motivation in order to change the addiction behavior among patients with physical illnesses who seek treatment in general hospital facilities.Esta pesquisa tem como objetivo comparar a motivação para mudança em dependentes de álcool internados em hospitais gerais para tratamento de doença clínica com pacientes alcoolistas que buscaram tratamento em unidades especializadas. Trata-se de um estudo transversal, de comparação entre dois grupos. A amostra teve 91 sujeitos: 42 com doença clínica associada à dependência do álcool (grupo 1) e 49 dependentes do álcool internados em unidades especializadas para o tratamento da dependência química (grupo 2). Os instrumentos utilizados no estudo foram: entrevista estruturada, o The Alcohol Use Disorder Test (AUDIT), o Short-Form Alcohol Dependence Data (SADD), o The Drinker Inventory of Consequences (DrInC) e a University of Rhode Island Change Assessment Scale (URICA). Os resultados demonstraram haver diferença significativa entre os grupos 1 e 2 no estágio da ação (p = 0,006), não sendo encontrada diferença nos estágios de pré-contemplação (p = 0,098) e contemplação (p = 0,342). Foi encontrada diferença significativa entre os grupos apenas no estágio de manutenção (p = 0,000). Os pacientes internados em hospitais gerais apresentaram-se menos motivados para mudança do comportamento dependente do que os internados em unidades especializadas em dependência química. Conclui-se, portanto, a importância de trabalhar a motivação para mudança do comportamento dependente em pacientes alcoolistas internados em hospitais gerais por complicações físicas

Building the capacity of community health workers to support health and social care for dependent older people in Latin America: a pilot study in Fortaleza, Brazil

Background: Brazil is seeing rapid population ageing, which is leading to new demands on primary health care services. There is a need to develop and assess the effectiveness of new interventions to build the capacity of staff, including community health workers, to meet the needs of groups such as care-dependent older people and their care-givers. This study examines the feasibility of a small training intervention piloted in the Brazilian city of Fortaleza. Methods: The study evaluated participants’ own assessments of key knowledge and skills related to the needs of care-dependent older people, both before and after the training intervention. It also assessed their capacity to implement a simple screening tool of geriatric risk factors. Results: The participant self-assessments indicate significant improvements in their perceived knowledge and capacity in responding to the health needs of care-dependent older people. Additionally, participants were able to successfully conduct the home visits and screening for risk factors. Conclusions: The study demonstrates the feasibility of developing interventions to enhance the capacity of community health workers to meet the needs of dependent older people in countries like Brazil. The evidence of effectiveness, though limited and subjective, provides justification for a larger, formally evaluated intervention. The experience of Fortaleza provides valuable lessons for other cities and countries in the region which are facing similar challenges

The magnitude of syphilis: from prevalence to vertical transmission

ABSTRACT Introduction: In 2013, the World Health Organization (WHO) reported that 1.9 million pregnant women were infected with syphilis worldwide, of which 66.5% had adverse fetal effects in cases of untreated syphilis. Congenital syphilis contributes significantly to infant mortality, accounting for 305,000 perinatal deaths worldwide annually. Aim: To estimate the prevalence of syphilis in parturients, the incidence of congenital syphilis and the vertical transmission rate. Material and methods: a cross-sectional study with data collected from 2041 parturients who had undergone treatment between 2012 and 2014 in the maternity section of the Pedro Ernesto Hospital of the State University of Rio de Janeiro, in the metropolitan area of Rio de Janeiro. The inclusion criterion was positive VDRL and treponemal test in a hospital environment. Results: the prevalence of syphilis in pregnant women was 4.1% in 2012, 3.1% in 2013 and 5% in 2014, with official reporting of 15.6%, 25.0% and 48.1%, respectively. The incidence of congenital syphilis (CS) was 22/1,000 in live births (LB) in 2012; 17/1,000 LB in 2013 and 44.8/1,000 LB in 2014. CS underreporting during the period was 6.7%. Vertical transmission occurred in 65.8% of infants from infected mothers. It was concluded that, in 34.6% of the CS cases, maternal VDRL titers were = 1/4. Conclusion: Results demonstrate the magnitude of the disease, fragility of the reporting system in the assessment of the actual prevalence, impact on perinatal outcomes, and they are a warning about the real situation of syphilis, which is still underestimated in the State

Impact of a twelve-year rotavirus vaccine program on acute diarrhea mortality and hospitalization in Brazil

Background Monitoring the impact of vaccine programs is necessary to identify changes in vaccine efficacy. We report the impact of the 12-year rotavirus vaccine program on diarrhea mortality and hospitalizations and their correlation to socioeconomic indicators. Methods this ecological study describes diarrhea hospitalizations and deaths from 2006 to 2018 in Brazil and correlates rotavirus vaccine coverage, hospitalizations and deaths to socioeconomic indicators and social vulnerability index (SVI) by state and region. Hospitalizations, deaths, and vaccine coverage trends were analyzed using Joinpoint regression models. Associations between hospitalizations, mortality and rotavirus vaccination coverage and socioeconomic and SVI indicators were established using Ordinary Least Square regressions. Results Rotavirus vaccine coverage remained stable between 2006 and 2018 (annual percentage changes (APC) [95%CI]: 4.4% [−0.3%, 9.2%]). Diarrhea hospitalization rates decreased 52.5% (−5.7% [−7.5%, −3.8%]), from 68.4 to 32.5 hospitalizations per 10,000 children <5 years-old between 2006 and 2018, with significant decreases in diarrhea mortality (−9.8% [−11.2%, −8.5%]). The Northeast region experienced the largest reductions (−13.9% [−15.7%, −12.2%]). Vaccination coverage and diarrhea-mortality were inversely correlated with the SVI. Conclusion The burden of childhood diarrhea has decreased over an extended period. States with high SVI, but high vaccination coverage had the largest reductions in hospitalizations and deaths

Pervasive gaps in Amazonian ecological research

Biodiversity loss is one of the main challenges of our time,1,2 and attempts to address it require a clear un derstanding of how ecological communities respond to environmental change across time and space.3,4 While the increasing availability of global databases on ecological communities has advanced our knowledge of biodiversity sensitivity to environmental changes,5–7 vast areas of the tropics remain understudied.8–11 In the American tropics, Amazonia stands out as the world’s most diverse rainforest and the primary source of Neotropical biodiversity,12 but it remains among the least known forests in America and is often underrepre sented in biodiversity databases.13–15 To worsen this situation, human-induced modifications16,17 may elim inate pieces of the Amazon’s biodiversity puzzle before we can use them to understand how ecological com munities are responding. To increase generalization and applicability of biodiversity knowledge,18,19 it is thus crucial to reduce biases in ecological research, particularly in regions projected to face the most pronounced environmental changes. We integrate ecological community metadata of 7,694 sampling sites for multiple or ganism groups in a machine learning model framework to map the research probability across the Brazilian Amazonia, while identifying the region’s vulnerability to environmental change. 15%–18% of the most ne glected areas in ecological research are expected to experience severe climate or land use changes by 2050. This means that unless we take immediate action, we will not be able to establish their current status, much less monitor how it is changing and what is being lostinfo:eu-repo/semantics/publishedVersio