Tráfico de mulheres, crianças e adolescentes para fins de exploração sexual comercial: um fenômeno transnacional

O tráfico de seres humanos é um crime transnacional, movimenta um mercado altamente lucrativo, perdendo apenas para o tráfico de drogas e armas. Estima-se que 800.000 a 900.000 pessoas são traficadas por ano, destas, cerca de 20.000 entram nos Estados Unidos, e mais de meio milhão de mulheres são traficadas para Europa. A maioria é oriunda do Leste Europeu, da África Ocidental, do Leste Asiático e da América Latina. Também de acordo com a COATNET, o tráfico de seres humanos além de ser um negócio altamente lucrativo, age de forma articulada com o comércio clandestino de armas e de drogas. Neste cenário, o tráfico reflete profundas contradições históricas da relação dos homens entre si, com a natureza, com a produção e a ética. As pessoas são exploradas não somente para atividades sexuais comerciais (prostituição, turismo sexual, pornografia e tráfico para fins sexuais), mas também para o trabalho forçado e escravo (na agricultura, na pesca, nos serviços domésticos, na indústria e outros); extração de órgãos e para adoção, constituindo-se em formas modernas de escravidão. Assim, o tráfico humano é mais do que uma grave violação da lei. É uma afronta à dignidade humana

Coxsackievirus A6 strains causing an outbreak of hand-foot-and-mouth disease in Northeastern Brazil in 2018

Hand-foot-and-mouth disease (HFMD) is a highly contagious viral disease commonly associated to Enteroviruses (EV). During 2018, Brazil faced massive HFMD outbreaks spread across the country. This study aimed to characterize the EV responsible for the HFMD outbreak that occurred in Paraiba State, Brazilian Northeastern region, in 2018, followed by a phylogenetic analysis to detail information on its genetic diversity. A total of 49 serum samples (one from each patient) collected from children ≤ 15 years old, clinically diagnosed with HFMD were tested for EV using conventional RT-PCR and RT-qPCR. EV infection was confirmed in 71.4% (35/49) of samples. The mean and median ages were 1.83 years and one year old, respectively. Twenty-two EV-positive samples were successfully sequenced and classified as EV-A species; 13 samples were also identified with the CV-A6 genotype. The phylogenetic analysis (VP1 region) of three samples revealed that the detected CV-A6 strains belonged to sub-lineage D3. The CV-A6 strains detected here clustered with strains from South America, Europe and West Asia strains that were also involved in HFMD cases during the 2017-2018 seasons, in addition to the previously detected Brazilian CV-A6 strains from 2012 to 2017, suggesting a global co-circulation of a set of different CV-A6 strains introduced in the country at different times. The growing circulation of the emerging CV-A6 associated with HFMD, together with the detection of more severe cases worldwide, suggests the need for a more intense surveillance system of HFMD in Brazil. In addition, this investigation was performed exclusively on serum samples, and the analysis of whole blood samples should be considered and could have shown advantages when employed in the diagnosis of enteroviral HFMD outbreaks

Comparison of Oropharyngeal Dysphagia in Brazilian Children with Prenatal Exposure to Zika Virus, With and Without Microcephaly.

Severe brain damage associated with Zika-related microcephaly (ZRM) have been reported to result in oropharyngeal dysphagia (OPD); however, it is unknown if OPD presents in children with prenatal Zika virus (ZIKV) exposure but only mild or undetectable abnormalities. The aims of this study were: to compare the frequency and characteristics of OPD in children with ZRM and in children without microcephaly born to mothers who tested polymerase chain reaction positive (PCR+) for ZIKV during pregnancy; and to investigate the concordance of caregiver reports of OPD with the diagnosis from the clinical swallowing assessment (CSA). Between Mar/2017 and May/2018, we evaluated 116 children (n = 58 with microcephaly, n = 58 children without microcephaly born to ZIKV PCR + mothers) participating in the Microcephaly Epidemic Research Group (MERG) cohort of children born during the 2015-2016 ZIKV epidemic in Pernambuco, Brazil. To assess OPD we used: a CSA; a clinical assessment of the stomatognathic system; and a questionnaire administered to caregivers. The frequency of OPD was markedly higher in children with ZRM (79.3%) than in the exposed but normocephalic group (8.6%). The children with microcephaly also presented more frequently with anatomic and functional abnormalities in the stomatognathic system. There was a high degree of agreement between the caregiver reports of OPD and the CSA (κ = 0.92). In conclusion, our findings confirm that OPD is a feature of Congenital Zika Syndrome that primarily occurs in children with microcephaly and provide support for policies in which children are referred for rehabilitation with an OPD diagnosis based on caregiver report

Zika-related adverse outcomes in a cohort of pregnant women with rash in Pernambuco, Brazil.

BACKGROUND: While Zika virus (ZIKV) is now widely recognized as a teratogen, the frequency and full spectrum of adverse outcomes of congenital ZIKV infection remains incompletely understood. METHODS: Participants in the MERG cohort of pregnant women with rash, recruited from the surveillance system from December/2015-June/2017. Exposure definition was based on a combination of longitudinal data from molecular, serologic (IgM and IgG3) and plaque reduction neutralization tests for ZIKV. Children were evaluated by a team of clinical specialists and by transfontanelle ultrasound and were classified as having microcephaly and/or other signs/symptoms consistent with congenital Zika syndrome (CZS). Risks of adverse outcomes were quantified according to the relative evidence of a ZIKV infection in pregnancy. FINDINGS: 376 women had confirmed and suspected exposure to ZIKV. Among evaluable children born to these mothers, 20% presented with an adverse outcome compatible with exposure to ZIKV during pregnancy. The absolute risk of microcephaly was 2.9% (11/376), of calcifications and/or ventriculomegaly was 7.2% (13/180), of additional neurologic alterations was 5.3% (13/245), of ophthalmologic abnormalities was 7% (15/214), and of dysphagia was 1.8% (4/226). Less than 1% of the children experienced abnormalities across all of the domains simultaneously. Interpretation: Although approximately one-fifth of children with confirmed and suspected exposure to ZIKV in pregnancy presented with at least one abnormality compatible with CZS, the manifestations presented more frequently in isolation than in combination. Due to the rare nature of some outcomes and the possibility of later manifestations, large scale individual participant data meta-analysis and the long-term evaluation of children are imperative to identify the full spectrum of this syndrome and to plan actions to reduce damages

O Sistema Nacional de Combate ao Abuso e à Exploração Sexual Infantojuvenil e o Plano Nacional: um exemplo de política pública aplicada

Este artigo tem por objetivo principal tratar de uma política pública aplicada, qual seja, o Sistema Nacional de Combate ao Abuso e à Exploração Sexual Infantojuvenil. Para tanto, inicialmente, é apresentada uma breve definição dos termos, com o intuito de esclarecer a forma como foram interpretados e utilizados no texto. Além disso, é definido o significado de políticas públicas, para que se tenha maior clareza sobre como estas podem auxiliar no entendimento do tema. Por fim, são apresentados os impactos sociais do Sistema Nacional e feito um breve relato sobre o Plano Nacional

Educação em saúde: ensinando sobre a leishmaniose tegumentar americana Health education: teaching about American tegumentary leishmaniasis

Os conhecimentos sobre a circulação da leishmaniose tegumentar americana (LTA), assim como sua percepção pela população local, são de grande valia para o estabelecimento de campanhas de controle, pois mobiliza a comunidade em ações sanitárias. Este trabalho teve como objetivo esclarecer alunos e professores do ensino fundamental (1ª a 4ª série) das Escolas Municipais de Maricá sobre a LTA, por meio de palestras, cartazes e cartilhas com atividades, visando à conscientização do grupo. Em sete Escolas Municipais, foram ministradas palestras e atividades a 1.314 alunos do ensino fundamental e 56 professores. Foram também distribuídas cartilhas aos alunos com atividades para a fixação do assunto. Após dois meses, uma escola foi eleita para avaliação (Escola E), sendo que, dos 213 alunos que assistiram a palestra, 198 responderam ao questionário, 178 (89,9%) lembravam da doença, e 125 (63,1%) responderam corretamente como ocorria a transmissão. Assim, crianças e professores informados podem funcionar como difusores da informação em Saúde na sua comunidade, sendo capazes de atuar de forma relevante no controle de endemias.<br>Knowledge on the circulation of American tegumentary leishmaniasis (ATL) and perception by the local population are highly relevant for developing a control program, since they mobilize the community for effective health measures. This work aimed to orient primary school teachers and pupils (grades 1 through 4) in the public school system in Maricá, Rio de Janeiro State, Brazil, on ATL, using talks, posters, and leaflets with an interactive approach. Talks were given in seven municipal schools, and activities were held with 1,314 pupils and 56 teachers. Leaflets were distributed to the pupils with activities to help consolidate the content. Two months later one school was chosen for post-evaluation. Of the 213 pupils who had attended the talk, 198 answered a questionnaire, of whom 178 (89.9%) could remember the disease and 125 (63.1%) provided correct answers on transmission. Thus, informed children and teachers can function as information disseminators in health within their community and are therefore capable of contributing to control of endemic diseases