Genomic ancestry and education level independently influence abdominal fat distributions in a Brazilian admixed population.

We aimed to identify the independent associations of genomic ancestry and education level with abdominal fat distributions in the 1982 Pelotas birth cohort study, Brazil. In 2,890 participants (1,409 men and 1,481 women), genomic ancestry was assessed using genotype data on 370,539 genome-wide variants to quantify ancestral proportions in each individual. Years of completed education was used to indicate socio-economic position. Visceral fat depth and subcutaneous abdominal fat thickness were measured by ultrasound at age 29-31y; these measures were adjusted for BMI to indicate abdominal fat distributions. Linear regression models were performed, separately by sex. Admixture was observed between European (median proportion 85.3), African (6.6), and Native American (6.3) ancestries, with a strong inverse correlation between the African and European ancestry scores (ρ = -0.93; p<0.001). Independent of education level, African ancestry was inversely associated with both visceral and subcutaneous abdominal fat distributions in men (both P = 0.001), and inversely associated with subcutaneous abdominal fat distribution in women (p = 0.009). Independent of genomic ancestry, higher education level was associated with lower visceral fat, but higher subcutaneous fat, in both men and women (all p<0.001). Our findings, from an admixed population, indicate that both genomic ancestry and education level were independently associated with abdominal fat distribution in adults. African ancestry appeared to lower abdominal fat distributions, particularly in men

Perfil das anomalias congênitas em nascidos vivos de Tangará da Serra, Mato Grosso, 2006-2016

Objective: to describe congenital anomalies (CA) among live births of mothers resident in Tangará da Serra, MT, Brazil, during the period 2006-2016. Methods: this was a descriptive study, using Brazilian Live Birth Information System (SINASC) data. Results: out of 15,689 births, 77 were registered with CA (prevalence of 4.9/1,000); there was an 80.7% increase of recorded CA in 2016, accounting for 10.3/1,000 live births, including five cases of microcephaly; CA prevalence was higher among children born to women aged over 35 years (prevalence ratio [PR] =1.91; confidence interval [95%CI] 1.01;3.60), preterm (PR=2.22; 95%CI 1.26;3.92) and low birth weight infants (PR=3.21; 95%CI 1.86;5.54). Conclusion: low CA prevalence was found, possibly related to under-recording at birth; the increase observed in 2016 may be related to the Zika epidemic causing microcephaly, as well as greater attention by health professionals in relation to CA during this public health emergency.Objetivo: descrever as anomalias congênitas (ACs) entre nascidos vivos de mães residentes em Tangará da Serra, MT, Brasil, durante o período 2006-2016. Métodos: estudo descritivo, com dados do Sistema de Informações sobre Nascidos Vivos (Sinasc). Resultados: de 15.689 nascimentos, 77 foram registrados com ACs (4,9/1.000); houve incremento de 80,7% no registro de AC em 2016, representando 10,3/1.000 nascidos vivos, incluídos cinco casos de microcefalia; a prevalência de AC foi maior entre crianças de mulheres maiores de 35 anos de idade (razão de prevalência [RP] =1,91; intervalo de confiança [IC95%] 1,01;3,60), prematuros (RP=2,22; IC95% 1,26;3,92) e com baixo peso ao nascer (RP=3,21; IC95% 1,86;5,54). Conclusão: observou-se baixa prevalência de AC, possivelmente relacionada ao sub-registro no nascimento; o aumento observado em 2016 pode estar relacionado à epidemia de Zika como causa de microcefalia, e à maior atenção dos profissionais de saúde às ACs durante a emergência em Saúde Pública

Determinantes da amamentação no primeiro ano de vida em Cuiabá, Mato Grosso

OBJECTIVE: To assess risk factors for breastfeeding discontinuation and weaning among children less than one year old. METHODS: A cross-sectional study was carried out in children under one year of age brought by their caregivers to immunization units in the city of Cuiabá, Midwestern Brazil, in 2004. Sampling first comprised drawing immunization units and then children in each unit were systematically drawn. Data was collected through semi-structured questionnaires applied to children's caregivers investigating social and demographic variables, as well as variables related to birth and maternal characteristics, pacifier use and feeding on the first day at home. Descriptive statistical and logistic regression analyses of risk factors by age group were conducted and odds ratios and 95% confidence intervals were estimated. RESULTS: A total of 920 children under one year of age were studied, of which 205 were less than 120 days old and 275 were less than 180 days old. Pacifier use, offering tea to children on their first day at home, and being a child of a mother with first or second grade schooling or primapara posed an increased risk for not being on exclusive breastfeeding at the age of 120 days. All these factors were also significantly associated in those under 180 days old, except tea offering, which was not investigated for this age group. Among children less than one year old, pacifier use was the only variable that remained significant. CONCLUSIONS: Social and cultural factors were determinants of breastfeeding status. Maternal education and awareness are crucial to prevent practices that can negatively affect breastfeeding.OBJETIVO: Avaliar os fatores de risco para a interrupção de aleitamento materno e desmame em crianças menores de um ano. MÉTODOS: Estudo transversal analítico com crianças menores de um ano de idade que compareceram aos postos de vacinação do município de Cuiabá, Mato Grosso, em 2004, acompanhadas de seus responsáveis. Para definição da amostra, foram sorteadas as unidades de vacinação, seguindo-se o sorteio das crianças em cada unidade, de forma sistemática. Para coleta de dados, aplicou-se um questionário semi-estruturado aos acompanhantes das crianças, investigando variáveis características sociodemográficas, referentes ao nascimento da criança e maternas, uso de chupeta e alimentação no primeiro dia em casa. Foram realizadas análise descritiva e regressão logística dos fatores de risco para cada faixa etária, apresentadas em odds ratio e intervalos de confiança. RESULTADOS: No total, 920 crianças menores de um ano foram avaliadas, das quais 205 menores de 120 dias e 275 menores de 180 dias. Verificou-se que usar chupeta, tomar chá no primeiro dia em casa, ter mãe com escolaridade até o primeiro ou segundo graus ou primípara, representam maior risco de não estar em amamentação exclusiva aos 120 dias de vida. Tais fatores se mostraram significativos também para menores de 180 dias, com exceção do consumo de chá, que não foi indagado para essa faixa etária. Nos menores de um ano, o uso de chupeta foi a única variável que manteve significância estatística. CONCLUSÕES: Fatores socioculturais mostraram-se determinantes da situação de aleitamento materno. Ressalta-se a importância da instrução e conscientização maternas, que refletem sobre as práticas que podem prejudicar a amamentação

Visceral and subcutaneous abdominal adiposity and pulmonary function in 30-year-old adults: a cross-sectional analysis nested in a birth cohort.

BACKGROUND: Several studies have verified body fat distribution in association with pulmonary function (PF), mainly waist circumference, but few have used measures able to distinguish abdominal fat compartments. The present study aims to verify the association of visceral adipose tissue (VAT) and subcutaneous adipose tissue (SAT) with PF measures. METHODS: In 1982, all hospital births occurring in Pelotas, Brazil, were identified and those livebirths have been followed. In 2012-13, the cohort participants were evaluated and VAT and SAT measured using ultrasound; forced expiratory volume in the first second (FEV1) or forced vital capacity (FVC) were patronized in z-scores stratified by sex. The associations were verified using crude and adjusted linear regressions. RESULTS: The present analyses comprised 3438 individuals (1721 women). VAT was inversely associated with spirometric parameters, in both crude and adjusted models. SAT showed inverse associations in the crude analyzes in males and a positive trend after adjustment, except for SAT and FVC in males. To each centimeter of VAT, mean adjusted FEV1 z-scores decreased 0.072 (95% CI -0.107; -0.036) in men and 0.127 (95% CI -0.164; -0.090) in women, and FVC z-scores decreased -0.075 (95% CI -0.111; -0.039) and 0.121 (95% CI -0.158; -0.083), in men and women, respectively. CONCLUSIONS: VAT has a consistent inverse association with FEV1 and FVC in both sexes. On the other hand, SAT showed inconsistent results with PF parameters

COVID-19 epidemic in Brazil : where are we at?

Objetive: To analyze the trends of COVID-19 in Brazil in 2020 by Federal Units (FU). Method: Ecological time-series based on cumulative confirmed cases of COVID-19 from March 11 to May 12. Joinpoint regression models were applied to identify points of inflection in COVID-19 trends, considering the days since the 50th confirmed case as time unit. Results: Brazil reached its 50th confirmed case of COVID-19 in 11 March 2020 and, 63 days after that, on May 12, 177,589 cases had been confirmed. The trends for all regions and FU are upward. In the last segment, from the 31st to the 63rd day, Brazil presented a daily percentage change (DPC) of 7.3% (95%CI= 7.2;7.5). For the country the average daily percentage change (ADPC) was 14.2% (95%CI: 13.8;14.5). The highest ADPC values were found in the North, Northeast and Southeast regions. Conclusions: In summary, our results show that all FUs in Brazil present upward trends of COVID-19. In some FUs, the slowdown in DPC in the last segment must be considered with caution. Each FU is at a different stage of the pandemic and, therefore, non-pharmacological measures should be adopted accordingly

Análise da soroprevalência por teste rápido e ELISA de infecção por zika vírus em unidade prisional de Mato Grosso

A emergência do Zika vírus no Brasil entre os anos de 2015 e 2016, com graves morbidades relacionadas, suscitou a necessidade da disponibilidade de teste diagnóstico de qualidade. Neste contexto, buscou-se analisar a soroprevalência da infecção por Zika em uma unidade prisional feminina do estado de Mato Grosso através do teste rápido (Bahiafarma) e do Ensaio Imunossorvente por Ligação Enzimática de Captura de Anticorpos para Zika. Trata-se de um estudo transversal, com abordagem quantitativa, pautado em dados coletados em 2018, em que se coletou sangue periférico e procedeuse análise com duas estratégias diagnósticas: o teste rápido e o Ensaio Imunossorvente por Ligação Enzimática de Captura de Anticorpos para Zika. Em ambos os testes detectou-se sororreatividade para Zika, com excelentes concordâncias, ou seja, foi calculado o coeficiente Kappa e foram obtidos os valores de 1 para IgM e 0,86 para IgG. Além dos achados laboratoriais, foram relatados fatores de risco para a infecção, decorrentes das características intrínsecas ao ambiente prisional e do modo de vida das participantes. A descrição da soroprevalência dessa arbovirose será importante para direcionar as ações de prevenção e controle a serem implementadas pela vigilância epidemiológica

Registros nacionais de anomalias congênitas no mundo: aspectos históricos e operacionais

Objective: To identify registries of congenital anomalies with national coverage existing around the world, highlighting its main historical and operational characteristics. Methods: Document review of literature on the Medline/Pubmed database and data from reports, official documents and websites. Works relating at least one national register were included. Results: 40 national registries of congenital anomalies were identified in 39 different countries. All registries included in the study were located in high- or uppermiddle-income countries, with a concentration in Europe. Most of the registries were population-based, with mandatory notification and time limit of notification of up to one year of age. The Brazilian registry presented the highest annual coverage. Conclusion: The registries discussed here presented different characteristics, which were related to the reality of each country. The presented results provide subsidies for surveillance of congenital anomalies, especially in places that wish to implement such an activity.Objetivo: Identificar registros de anomalias congênitas com cobertura nacional existentes no mundo, destacando suas principais características históricas e operacionais. Métodos: Revisão documental, mediante busca na base Medline/Pubmed e consulta a dados provenientes de relatórios, documentos oficiais e sítios eletrônicos. Foram incluídos trabalhos com relato de pelo menos um registro nacional. Resultados: Identificou-se 40 registros nacionais de anomalias congênitas em 39 países diferentes. Todos os registros incluídos no estudo localizavam-se em países de renda alta ou média superior, com concentração na Europa. A maior parte dos registros foi de base populacional, de notificação compulsória e com tempo limite para notificação de até um ano de idade. O registro brasileiro apresentou a maior cobertura anual. Conclusão: Os registros discutidos apresentaram características diversas, relacionadas à realidade de cada país. Os resultados apresentados fornecem subsídios para a temática da vigilância das anomalias congênitas, sobretudo em locais onde se deseja implementar tal atividade

Congenital anomalies from the health surveillance perspective : compilation of a list based on ICD-10

Objetivo: Propor uma lista de anomalias congênitas com códigos correspondentes na Classificação Estatística Internacional de Doenças e Problemas Relacionados à Saúde – 10ª Revisão (CID-10), visando a aplicação no âmbito da vigilância em saúde. Métodos: Em dezembro de 2019, realizou-se busca nas seguintes fontes de dados: CID-10; CID-11; anomalias monitoradas por três modelos de vigilância; base de informações sobre doenças raras (Orphanet). Realizou-se extração das anomalias a partir dessas fontes, processamento para correspondência com base na CID-10 e compilação mediante revisão manual. Resultados: Foram identificados 898 códigos, dos quais 619 (68,9%) constavam no capítulo XVII da CID-10. Dos 279 códigos de outros capítulos, 19 foram exclusivos da busca na CID-11, 72 dos modelos de vigilância, 79 da Orphanet e 36 da busca de termos na CID-10. Conclusão: Os códigos que constam do capítulo XVII da CID-10 não captam a totalidade das anomalias congênitas, indicando a necessidade de adoção de uma lista ampliada.Objetivo: Proponer una lista de anomalías congénitas con códigos correspondientes en la décima revisión de la Clasificación Internacional de Enfermedades (CIE), con el objetivo de su aplicación en el ámbito de la vigilancia de la salud. Métodos: En diciembre de 2019, se buscaron las siguientes fuentes: CIE-10; CIE-11; anomalías monitoreadas por tres modelos de vigilancia; y base de informaciones sobre enfermedades raras (Orphanet). Las anomalías se extrajeron de estas fuentes de datos, se procesó en base a la CIE-10 y se compiló con una revisión manual. Resultados: Se identificaron 898 códigos, de los cuales 619 (68,9%) estaban en el Capítulo XVII de la CIE-10. De los 279 códigos en otros capítulos, 19 fueron exclusivos de la búsqueda en la CIE-11, 72 de los modelos de vigilancia, 79 de Orphanet y 36 de la búsqueda de términos en la CIE-10. Conclusión: Los códigos contenidos en el capítulo XVII de la CIE-10 no capturan la totalidad de las anomalías congénitas, lo que indica la necesidad de adoptar una lista ampliada.Objective: To propose a list of congenital anomalies having corresponding codes in the International Statistical Classification of Diseases and Related Health Problems, 10th Revision (ICD-10), with the aim of applying it in health surveillance. Methods: In December 2019, the following data sources were searched: ICD-10; ICD-11; anomalies monitored by three surveillance programs; and a database of rare diseases (Orphanet). Anomalies were retrieved from these data sources, processed to check for correspondence with ICD-10 and reviewed manually to compile the list. Results: 898 codes were identified, of which 619 (68.9%) were contained in ICD-10 Chapter XVII. Of the 279 codes contained in other chapters, 19 were exclusive to the ICD-11 search, 72 to the surveillance programs, 79 to Orphanet and 36 to the search for terms in ICD-10. Conclusion: The codes contained in ICD-10 Chapter XVII do not capture the totality of congenital anomalies, indicating the need to adopt an expanded list

Microcephaly prevalence after the 2015 to 2016 Zika outbreak in Tangará da Serra, Brazil: a population-based study

Objective: Prenatal infection with the Zika virus (ZIKV) can lead to congenital Zika syndrome (CZS), characterized by microcephaly and brain injury. However, there are questions regarding the prevalence of microcephaly/CZS after the ZIKV outbreak in defined geographic areas. This study aimed to identify adverse outcomes in live births of fetuses exposed in utero to the ZIKV, compared to unexposed births, as well as maternal sociodemographic, delivery, and birth characteristics. Methods: Here, we conducted a cross-sectional observational study to investigate the characteristics of all live births in the city of Tangará da Serra, Mato Grosso, Brazil, in 2016, after the outbreak of ZIKV infection in late 2015. All live births of children to women residing in the municipality of Tangará da Serra between January 1 and December 31, 2016, were evaluated, and head circumference was measured at birth and after 24 hours. Children born with microcephaly or a maternal history of confirmed or suspected prenatal ZIKV infection were evaluated by a multidisciplinary team. The outcomes of the exposed and non-exposed children were compared. Prevalence ratios and their respective 95% confidence intervals were calculated for sociodemographic, delivery, and live birth characteristics. Results: Of 1,441 live births, 106 (7.3%) were from mothers with confirmed or highly probable exposure to ZIKV. The prevalence of severe congenital microcephaly (41.7/10,000) in Tangará da Serra in 2016 was ten-fold higher than that in Latin America before 2015. Conclusion: This study may serve as a model to investigate possible outbreaks of infections in a defined geographical space in the future