Nebulised hypertonic saline solution for acute bronchiolitis in infants.

BACKGROUND: Airway oedema (swelling) and mucus plugging are the principal pathological features in infants with acute viral bronchiolitis. Nebulised hypertonic saline solution (≥ 3%) may reduce these pathological changes and decrease airway obstruction. This is an update of a review first published in 2008, and updated in 2010, 2013, and 2017. OBJECTIVES: To assess the effects of nebulised hypertonic (≥ 3%) saline solution in infants with acute bronchiolitis. SEARCH METHODS: We searched the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, MEDLINE Epub Ahead of Print, In-Process & Other Non-Indexed Citations, Ovid MEDLINE Daily, Embase, CINAHL, LILACS, and Web of Science on 13 January 2022. We also searched the World Health Organization International Clinical Trials Registry Platform (WHO ICTRP) and ClinicalTrials.gov on 13 January 2022. SELECTION CRITERIA: We included randomised controlled trials (RCTs) and quasi-RCTs using nebulised hypertonic saline alone or in conjunction with bronchodilators as an active intervention and nebulised 0.9% saline or standard treatment as a comparator in children under 24 months with acute bronchiolitis. The primary outcome for inpatient trials was length of hospital stay, and the primary outcome for outpatients or emergency department (ED) trials was rate of hospitalisation. DATA COLLECTION AND ANALYSIS: Two review authors independently performed study selection, data extraction, and assessment of risk of bias in included studies. We conducted random-effects model meta-analyses using Review Manager 5. We used mean difference (MD), risk ratio (RR), and their 95% confidence intervals (CI) as effect size metrics. MAIN RESULTS: We included six new trials (N = 1010) in this update, bringing the total number of included trials to 34, involving 5205 infants with acute bronchiolitis, of whom 2727 infants received hypertonic saline. Eleven trials await classification due to insufficient data for eligibility assessment. All included trials were randomised, parallel-group, controlled trials, of which 30 were double-blinded. Twelve trials were conducted in Asia, five in North America, one in South America, seven in Europe, and nine in Mediterranean and Middle East regions. The concentration of hypertonic saline was defined as 3% in all but six trials, in which 5% to 7% saline was used. Nine trials had no funding, and five trials were funded by sources from government or academic agencies. The remaining 20 trials did not provide funding sources. Hospitalised infants treated with nebulised hypertonic saline may have a shorter mean length of hospital stay compared to those treated with nebulised normal (0.9%) saline or standard care (mean difference (MD) -0.40 days, 95% confidence interval (CI) -0.69 to -0.11; 21 trials, 2479 infants; low-certainty evidence). Infants who received hypertonic saline may also have lower postinhalation clinical scores than infants who received normal saline in the first three days of treatment (day 1: MD -0.64, 95% CI -1.08 to -0.21; 10 trials (1 outpatient, 1 ED, 8 inpatient trials), 893 infants; day 2: MD -1.07, 95% CI -1.60 to -0.53; 10 trials (1 outpatient, 1 ED, 8 inpatient trials), 907 infants; day 3: MD -0.89, 95% CI -1.44 to -0.34; 10 trials (1 outpatient, 9 inpatient trials), 785 infants; low-certainty evidence). Nebulised hypertonic saline may reduce the risk of hospitalisation by 13% compared with nebulised normal saline amongst infants who were outpatients and those treated in the ED (risk ratio (RR) 0.87, 95% CI 0.78 to 0.97; 8 trials, 1760 infants; low-certainty evidence). However, hypertonic saline may not reduce the risk of readmission to hospital up to 28 days after discharge (RR 0.83, 95% CI 0.55 to 1.25; 6 trials, 1084 infants; low-certainty evidence). We are uncertain whether infants who received hypertonic saline have a lower number of days to resolution of wheezing compared to those who received normal saline (MD -1.16 days, 95% CI -1.43 to -0.89; 2 trials, 205 infants; very low-certainty evidence), cough (MD -0.87 days, 95% CI -1.31 to -0.44; 3 trials, 363 infants; very low-certainty evidence), and pulmonary moist crackles (MD -1.30 days, 95% CI -2.28 to -0.32; 2 trials, 205 infants; very low-certainty evidence). Twenty-seven trials presented safety data: 14 trials (1624 infants; 767 treated with hypertonic saline, of which 735 (96%) co-administered with bronchodilators) did not report any adverse events, and 13 trials (2792 infants; 1479 treated with hypertonic saline, of which 416 (28%) co-administered with bronchodilators and 1063 (72%) hypertonic saline alone) reported at least one adverse event such as worsening cough, agitation, bronchospasm, bradycardia, desaturation, vomiting and diarrhoea, most of which were mild and resolved spontaneously (low-certainty evidence). AUTHORS' CONCLUSIONS: Nebulised hypertonic saline may modestly reduce length of stay amongst infants hospitalised with acute bronchiolitis and may slightly improve clinical severity score. Treatment with nebulised hypertonic saline may also reduce the risk of hospitalisation amongst outpatients and ED patients. Nebulised hypertonic saline seems to be a safe treatment in infants with bronchiolitis with only minor and spontaneously resolved adverse events, especially when administered in conjunction with a bronchodilator. The certainty of the evidence was low to very low for all outcomes, mainly due to inconsistency and risk of bias.

Prevalence of Overweight and Associated Factors in a Male Prison Population in the Extreme South of Brazil: A Cross-Sectional Study.

Background: This cross-sectional study serves as a first Brazilian inventory about overweight as a marker for metabolic health and risk factor to develop noncommunicable chronic diseases in prison populations. The prevalence of overweight, and its associated factors in prisoners of the Fifth Regional State Penitentiary of Rio Grande do Sul (5th DPR) in the extreme South of Brazil were investigated using a precoded questionnaire with sociodemographic, behavioral, and health questions, applied to proportional stratified random sampled prisoners. Methods: Five hundred eighty male prisoners (70%) in the closed regime agreed to answer the questionnaire and allowed anthropomorphic body measurement, carried out by trained scientists. We used bivariate Pearson's chi-squared test and adjusted multinomial logistic regression for analyses. Results: Considering that the studied incarcerated population is young (mean age 33 years) it is concerning that already 43.6% of them are overweight, report regular sweets and sugary soft drink consumption (77.7%, and 81.4%, respectively), 60.2% are smokers, and 19.4% are at elevated risk to develop cardiovascular diseases. Further, 13.8% of the respondents reported a diagnosis of hypertension, 4.9% hypercholesterolemia, and 2.7% diabetes mellitus type 2. Among those who reported not smoking, excess weight was almost four times higher (prevalence ratio: 3.79; 95% confidence interval: 2.61-5.50). Conclusions: Our study suggests that the prison environment promotes modifiable risk factors for chronic diseases. These data deserve attention and intervention, aiming to prevent and reduce the current levels of excess weight.

Prenatal care among adolescent women in the extreme South of Brazil: coverage and associated factors / Assistência pré-natal entre adolescentes no extremo sul do Brasil: adequação e fatores associados

Abstract Objectives: to evaluate coverage and identify factors associated with adequate prenatal care for adolescent mothers in Rio Grande, Southern Brazil, in a period of 13 years. Methods: over the years 2007, 2010, 2013, 2016 and 2019, a single standardized questionnaire was applied to all mothers at hospital level in this municipality. The outcome consisted of the proportion of puerperae women who started prenatal care in the first trimester and performed 6+ medical visits, completed 2+ HIV, syphilis, and urine tests. Chi-square test was used for proportions, Poisson regression in the multivariate analysis and the prevalence ratio (PR) as measure of effect. Results: among the 12,645 identified mothers, 2,184 (17.3%) were adolescents. Of this total, 35.2% (CI95%= 33.2%-37.2%) had received adequate prenatal care, ranging from 13.8% (10.8%-16.7%) in 2007 to 52,5% (46.8%-58.1%) in 2019. The adjusted analysis showed a higher PR for adequate prenatal care among those of older age and better schooling level, white/brown skin color, with a partner, never had an abortion, were primiparous and non-smokers. Conclusion: there was substantial improvement in coverage of adequate prenatal care over the period studied, but there is still a long way to go. The increase in this coverage depends on reaching adolescents who are younger, less educated, black skin color, living without a partner, multiparous and smokers.

Resumo Objetivos: estimar a realização de pré-natal adequado entre adolescentes no extremo sul do Brasil e identificar fatores associados à sua ocorrência ao longo de 13 anos. Métodos: em 2007, 2010, 2013, 2016 e 2019, entrevistadoras previamente treinadas aplicaram na maternidade questionário único, padronizado à todas as parturientes residentes no município de Rio Grande, RS. Considerou-se como tendo realizado pré-natal adequado a puérpera que iniciou consultas no primeiro trimestre da gravidez, realizou 6+ consultas e 2+ exames para HIV, sífilis e qualitativo de urina. Utilizou-se teste qui-quadrado para comparar proporções, regressão de Poisson na análise multivariável e razão de prevalências (RP) como medida de efeito. Resultados: dentre as 12.645 parturientes identificadas, 2.184 (17,3%) eram adolescentes. Destas, 35,2% (IC95%=33,2%-37,2%) realizaram pré-natal considerado adequado, variando de 13,8% (10,8%-16,7%) em 2007 a 52,5% (46,8%-58,1%) em 2019. A análise ajustada mostrou maior RP à realização de pré-natal adequado entre aquelas de maior idade (18-19 anos), de cor da pele branca e parda, vivendo com companheiro, com 9+ anos de escolaridade, que sofreram aborto, primíparas e não fumantes. Conclusões: houve substancial melhora na cobertura de pré-natal adequado no período estudado, mas ainda muito aquém do desejado. A melhoria destes índices depende de alcançar adolescentes de menor idade, pior escolaridade, cor da pele preta, vivendo sem companheiro, multíparas e fumantes.

Episiotomy in Southern Brazil: prevalence, trend, and associated factors.

OBJECTIVE: To identify and analyze the prevalence, trend, and factors associated with episiotomy in Rio Grande, in the state of Rio Grande do Sul, Southern Brazil. METHODS: A single, standardized questionnaire was applied to all pregnant women, residents in the municipality of Rio Grande, who had children in local hospitals between January 1 and December 12 of the years 2007, 2010, 2013, 2016 e 2019. Demographic and socioeconomic characteristics were investigated, as well as the assistance received during pregnancy and delivery. Chi-square test was used to compare proportions and Poisson regression with robust variance adjustment was used for multivariable analysis. Prevalence ratio (PR) was used as effect measure. RESULTS: Among the 12,645 births that occurred in the five years, 5,714 (45.2%) were vaginal delivery. Of these mothers, 2,930 (51.3%; 95%CI: 50.0%-52.6%) underwent episiotomy. Over this period, the episiotomy rate decreased from 70.9% (68.4-73.5) in 2007 to 19.4% (17.1-21.7) in 2019. Adjusted analysis showed a high PR of episiotomy occurrence among women who were young (PR = 2.23; 95%CI: 1.89-2.63), had higher education (PR = 1.21; 95%Cl: 1.03-1.42), had a higher family income (PR = 1.25; 95%CI: 1.10-1.41), were primiparous (PR = 3.41; 95%CI: 2.95-3.95), had prenatal care in the private sector (PR = 1.25; 95%CI: 1.07-1.46), had oxytocin-induced labor (PR = 1.18; 95%CI:1.09-1.27), underwent forceps (PR = 1.32; 95%CI: 1.16-1.50), and whose newborn weighed 4,000 g or more (PR = 1.43; 95%CI: 1.14-1.80). CONCLUSION: Although the prevalence of episiotomy fell sharply within the studied period, its occurrence is more likely among women at lower risk of birth complications.

Episiotomy in Southern Brazil: prevalence, trend, and associated factors

ABSTRACT OBJECTIVE To identify and analyze the prevalence, trend, and factors associated with episiotomy in Rio Grande, in the state of Rio Grande do Sul, Southern Brazil. METHODS A single, standardized questionnaire was applied to all pregnant women, residents in the municipality of Rio Grande, who had children in local hospitals between January 1 and December 12 of the years 2007, 2010, 2013, 2016 e 2019. Demographic and socioeconomic characteristics were investigated, as well as the assistance received during pregnancy and delivery. Chi-square test was used to compare proportions and Poisson regression with robust variance adjustment was used for multivariable analysis. Prevalence ratio (PR) was used as effect measure. RESULTS Among the 12,645 births that occurred in the five years, 5,714 (45.2%) were vaginal delivery. Of these mothers, 2,930 (51.3%; 95%CI: 50.0%-52.6%) underwent episiotomy. Over this period, the episiotomy rate decreased from 70.9% (68.4-73.5) in 2007 to 19.4% (17.1-21.7) in 2019. Adjusted analysis showed a high PR of episiotomy occurrence among women who were young (PR = 2.23; 95%CI: 1.89-2.63), had higher education (PR = 1.21; 95%Cl: 1.03-1.42), had a higher family income (PR = 1.25; 95%CI: 1.10-1.41), were primiparous (PR = 3.41; 95%CI: 2.95-3.95), had prenatal care in the private sector (PR = 1.25; 95%CI: 1.07-1.46), had oxytocin-induced labor (PR = 1.18; 95%CI:1.09-1.27), underwent forceps (PR = 1.32; 95%CI: 1.16-1.50), and whose newborn weighed 4,000 g or more (PR = 1.43; 95%CI: 1.14-1.80). CONCLUSION Although the prevalence of episiotomy fell sharply within the studied period, its occurrence is more likely among women at lower risk of birth complications.

Evolution of care during pregnancy and childbirth in the extreme south of Brazil.

OBJECTIVES: To describe the evolution of care during pregnancy and childbirth among postpartum women living in the municipality of Rio Grande, Southern Brazil, using data from surveys carried out every three years between 2007 and 2019. METHODS: Within 48 hours after delivery, a single, standardized questionnaire was applied to all mothers who had children in local hospitals and met the inclusion criteria. Demographic and reproductive characteristics, lifestyle habits, socioeconomic level of the family, and care received during pregnancy and childbirth were investigated. In the analysis, the chi-square test for linear trend was used to assess the distribution of indicators per survey. RESULTS: A total of 12,645 parturients were interviewed (98% of the women eligible to participate in the surveys). In the period evaluated, the proportion of births fell 35% among adolescents and increased 25% among women aged 35 years and over. Mothers gained, on average, two years of schooling, and their families experienced an important economic improvement, followed by loss of income in the last survey. Maternal smoking, before and during pregnancy, fell by half. The rate of mothers who started prenatal care in the first trimester and the number of consultations and laboratory tests increased. Almost 60% of prenatal consultations and 80% of births took place in the Brazilian Unified Health System. In 2019, vaginal delivery was once again the most common. The rates of low birth weight (9%) and prematurity (17%) virtually remained unchanged. CONCLUSIONS: We found an important change in the reproductive profile and increased coverage of various prenatal care and delivery services. Children continue to be born well, but low birth weight and prematurity remain endemic.

Influenza vaccination coverage in elderly and high-risk adults: characterization of associated factors.

OBJECTIVE: To evaluate the prevalence and factors associated with non-vaccination against influenza in the risk group. METHODS: A cross-sectional, population-based study, carried out in the city of Rio Grande (RS). The outcome was defined as belonging to risk groups and not having been vaccinated in the last 12 months. Demographic, socioeconomic, behavioral variables, and access for health services were analyzed. RESULTS: In this study, 680 individuals participated. The prevalence was 46.0% (95%CI: 41.8-50.3), ranging from 27.9% (elderly) to 81.8% (pregnant women). Young adults, single, intermediate socioeconomic bracket, smoker, with depressive symptoms, who did not perform physical activity and did not consult a physician in the last year, had a higher prevalence of non-vaccination. CONCLUSION: Half of the sample was not vaccinated in the period. Due to the similarity of influenza-like illness and the coronavirus 2019 disease (COVID-19), increasing vaccination would minimize mortality and use of hospital beds due to influenza, optimizing the response of hospital capacity.

Evolution of care during pregnancy and childbirth in the extreme south of Brazil / Evolução da assistência à gestação e ao parto no extremo sul do Brasil

ABSTRACT OBJECTIVES To describe the evolution of care during pregnancy and childbirth among postpartum women living in the municipality of Rio Grande, Southern Brazil, using data from surveys carried out every three years between 2007 and 2019. METHODS Within 48 hours after delivery, a single, standardized questionnaire was applied to all mothers who had children in local hospitals and met the inclusion criteria. Demographic and reproductive characteristics, lifestyle habits, socioeconomic level of the family, and care received during pregnancy and childbirth were investigated. In the analysis, the chi-square test for linear trend was used to assess the distribution of indicators per survey. RESULTS A total of 12,645 parturients were interviewed (98% of the women eligible to participate in the surveys). In the period evaluated, the proportion of births fell 35% among adolescents and increased 25% among women aged 35 years and over. Mothers gained, on average, two years of schooling, and their families experienced an important economic improvement, followed by loss of income in the last survey. Maternal smoking, before and during pregnancy, fell by half. The rate of mothers who started prenatal care in the first trimester and the number of consultations and laboratory tests increased. Almost 60% of prenatal consultations and 80% of births took place in the Brazilian Unified Health System. In 2019, vaginal delivery was once again the most common. The rates of low birth weight (9%) and prematurity (17%) virtually remained unchanged. CONCLUSIONS We found an important change in the reproductive profile and increased coverage of various prenatal care and delivery services. Children continue to be born well, but low birth weight and prematurity remain endemic.

RESUMO OBJETIVO Descrever a evolução da assistência à gestação e ao parto entre puérperas residentes no município de Rio Grande (RS) utilizando dados de inquéritos realizados a cada três anos, entre 2007 e 2019. MÉTODOS Em até 48 horas após o parto foi aplicado questionário único, padronizado, a todas as mães que tiveram filhos nos hospitais locais e cumpriram os critérios de inclusão. Foram investigadas características demográficas e reprodutivas, hábitos de vida, nível socioeconômico da família e cuidados recebidos durante a gestação e o parto. Na análise, utilizou-se o teste qui-quadrado de tendência linear para avaliar a distribuição dos indicadores por inquérito. RESULTADOS Ao todo, 12.645 parturientes foram entrevistadas (98% do total de mulheres aptas a participar da pesquisa). No período avaliado, a proporção de partos caiu 35% entre adolescentes e aumentou 25% entre mulheres com 35 anos ou mais. As mães ganharam, em média, dois anos de escolaridade, e suas famílias tiveram importante melhora econômica, seguida, porém, de perda de renda no último inquérito. O tabagismo materno, antes e durante a gravidez, caiu à metade. Houve aumento na taxa de mães que iniciaram o pré-natal no primeiro trimestre, e aumentou também o número de consultas e de testes laboratoriais. Quase 60% das consultas de pré-natal e 80% dos partos ocorreram no Sistema Único de Saúde. Em 2019, o parto vaginal voltou a ser o mais comum. As taxas de baixo peso ao nascer (9%) e prematuridade (17%) praticamente não se modificaram. CONCLUSÕES Houve mudança importante no perfil reprodutivo e aumento da cobertura de diversos serviços de assistência pré-natal e parto. As crianças seguem nascendo bem, mas o baixo peso ao nascer e a prematuridade continuam endêmicos.

Influenza vaccination coverage in elderly and high-risk adults: characterization of associated factors / Cobertura vacinal de influenza em idosos e adultos de alto risco: caracterização dos fatores associados

ABSTRACT Objective To evaluate the prevalence and factors associated with non-vaccination against influenza in the risk group. Methods A cross-sectional, population-based study, carried out in the city of Rio Grande (RS). The outcome was defined as belonging to risk groups and not having been vaccinated in the last 12 months. Demographic, socioeconomic, behavioral variables, and access for health services were analyzed. Results In this study, 680 individuals participated. The prevalence was 46.0% (95%CI: 41.8-50.3), ranging from 27.9% (elderly) to 81.8% (pregnant women). Young adults, single, intermediate socioeconomic bracket, smoker, with depressive symptoms, who did not perform physical activity and did not consult a physician in the last year, had a higher prevalence of non-vaccination. Conclusion Half of the sample was not vaccinated in the period. Due to the similarity of influenza-like illness and the coronavirus 2019 disease (COVID-19), increasing vaccination would minimize mortality and use of hospital beds due to influenza, optimizing the response of hospital capacity.

RESUMO Objetivo Avaliar a prevalência e os fatores associados à não vacinação contra influenza em grupos de risco. Métodos Estudo transversal, de base populacional, realizado em Rio Grande (RS). O desfecho foi definido como pertencer aos grupos de risco e não ter se vacinado nos últimos 12 meses. Foram analisadas variáveis demográficas, socioeconômicas, comportamentais e de acesso a serviços de saúde. Resultados Participaram 680 indivíduos. A prevalência foi de 46,0% (IC95%: 41,8-50,3), variando de 27,9% (idosos) a 81,8% (gestantes). Adultos jovens, solteiros, de nível econômico intermediário, tabagistas, com sintomas depressivos, que não praticavam atividade física e não consultaram um médico no último ano tiveram maior prevalência de não vacinação. Conclusão Metade da amostra não foi vacinada no período. Pela semelhança da síndrome gripal com a doença pelo coronavírus 2019 (COVID-19), aumentar a vacinação minimizaria a mortalidade e a utilização de leitos hospitalares devido à influenza, otimizando a resposta da capacidade hospitalar.

Food insecurity in rural families in the extreme south of Brazil. / Insegurança Alimentar em famílias de área rural do extremo sul do Brasil.

This study aimed to track the prevalence of Food Insecurity (FI) and to study associated factors in households with children, women and older adults in the rural area of the city of Rio Grande, RS. This is a cross-sectional population-based study, with systematic sampling of 80% of permanently inhabited households. A short version of the Brazilian Scale of Food Insecurity (EBIA) was employed. The associated factors included data referring to the head of the household, as well as data referring to the household. The levels of prevalence and prevalence ratios and their respective confidence intervals were calculated for food insecurity through Poisson regression with robust variance. Of the 1,627 domiciles interviewed, 26% were in an FI situation, and households that included three populations were higher. The most affected domiciles were those in which the head of the household had less than four years of schooling, with more residents, without animal husbandry, belonging to the lowest income quartile and receiving family grants ("Bolsa Família" Program). This study showed the relevance and magnitude of the FI problem in the rural region of Rio Grande since knowledge about the actual FI prevalence of this region is unknown.

O estudo objetivou rastrear a prevalência de Insegurança Alimentar (IA) e estudar fatores associados em domicílios com crianças, mulheres e idosos na área rural do município de Rio Grande, RS, em 2017. Foi um estudo transversal com amostragem sistemática de 80% dos domicílios permanentemente habitados. Utilizou-se uma versão reduzida da Escala Brasileira de Insegurança Alimentar (EBIA). Os fatores associados contemplaram dados referentes ao chefe da família, além de dados referentes ao domicílio. Prevalências e Razões de Prevalências e seus respectivos Intervalos de Confiança foram calculadas para a IA por meio da Regressão de Poisson com variância robusta. Dos 1.627 domicílios entrevistados, 26% se encontraram em situação de IA, sendo maior naqueles domicílios que continham as três populações. Os domicílios mais atingidos foram os que o chefe da família tinha menor escolaridade, maior número de moradores, sem criação de animais, pertencentes ao menor quartil de renda e que recebiam Bolsa Família. Esse estudo mostrou a importância e a dimensão do problema da IA na região rural de Rio Grande, já que o conhecimento da real prevalência de IA nessa região é desconhecido.

Oral health condition and the use of dental services among the older adults living in the rural area in the south of Brazil. / Condição de saúde bucal e utilização de serviços odontológicos entre idosos em área rural no sul do Brasil.

OBJECTIVES: To evaluate the oral health, the use of dental services and associated factors among individuals aged 60 years, or more, living in the rural area. METHOD: This is a population-based, cross-sectional study carried out in the rural area of a medium-sized municipality in the extreme south of Brazil. The outcome was to have used dental services in the 12 months before the date of the interview. The analysis included a description of the sample, prevalence of the use of dental services for each category of independent variables and multivariate analysis through Poisson Regression. RESULTS: In total, 1,030 older adults were interviewed, of which 49.9% were totally edentulous patients, and 13.9% had dental visits in the last year. The probability of visits was higher in females, with a partner, higher schooling, of the highest economic levels and that reported some oral health problem. On the other hand, elderly who reported being former smokers or were current smokers had fewer visits. CONCLUSIONS: Health planning should be reorganized to prioritize population groups with more significant difficulties in the use of dental services.

Este artigo objetiva avaliar a saúde bucal, a utilização de serviços odontológicos e os fatores associados entre indivíduos com 60 anos, ou mais, residentes em área rural. Estudo transversal, de base populacional, realizado na zona rural de um município de porte médio do extremo sul do Brasil. O desfecho foi ter utilizado serviços odontológicos nos 12 meses anteriores à data da entrevista. A análise abrangeu descrição da amostra, prevalência da utilização de serviços odontológicos para cada categoria das variáveis independentes e análise multivariada através da Regressão de Poisson. Foram entrevistados 1.030 idosos, sendo 49,9% edêntulos totais e tendo 13,9% consultado com dentista no último ano. A probabilidade de consultar foi maior em idosos do sexo feminino, com companheiros(as), com maior escolaridade, pertencentes aos melhores níveis econômicos e que referiram ter algum problema de saúde bucal. Por sua vez, idosos que relataram ser ex-fumantes ou fumantes consultaram menos. Planejamentos em saúde devem ser reorganizados com o intuito de priorizar grupos populacionais com maiores dificuldades na utilização dos serviços odontológicos.

Condição de saúde bucal e utilização de serviços odontológicos entre idosos em área rural no sul do Brasil / Oral health condition and the use of dental services among the older adults living in the rural area in the south of Brazil

Resumo Este artigo objetiva avaliar a saúde bucal, a utilização de serviços odontológicos e os fatores associados entre indivíduos com 60 anos, ou mais, residentes em área rural. Estudo transversal, de base populacional, realizado na zona rural de um município de porte médio do extremo sul do Brasil. O desfecho foi ter utilizado serviços odontológicos nos 12 meses anteriores à data da entrevista. A análise abrangeu descrição da amostra, prevalência da utilização de serviços odontológicos para cada categoria das variáveis independentes e análise multivariada através da Regressão de Poisson. Foram entrevistados 1.030 idosos, sendo 49,9% edêntulos totais e tendo 13,9% consultado com dentista no último ano. A probabilidade de consultar foi maior em idosos do sexo feminino, com companheiros(as), com maior escolaridade, pertencentes aos melhores níveis econômicos e que referiram ter algum problema de saúde bucal. Por sua vez, idosos que relataram ser ex-fumantes ou fumantes consultaram menos. Planejamentos em saúde devem ser reorganizados com o intuito de priorizar grupos populacionais com maiores dificuldades na utilização dos serviços odontológicos.

Abstract Objectives: To evaluate the oral health, the use of dental services and associated factors among individuals aged 60 years, or more, living in the rural area. Method: This is a population-based, cross-sectional study carried out in the rural area of a medium-sized municipality in the extreme south of Brazil. The outcome was to have used dental services in the 12 months before the date of the interview. The analysis included a description of the sample, prevalence of the use of dental services for each category of independent variables and multivariate analysis through Poisson Regression. Results: In total, 1,030 older adults were interviewed, of which 49.9% were totally edentulous patients, and 13.9% had dental visits in the last year. The probability of visits was higher in females, with a partner, higher schooling, of the highest economic levels and that reported some oral health problem. On the other hand, elderly who reported being former smokers or were current smokers had fewer visits. Conclusions: Health planning should be reorganized to prioritize population groups with more significant difficulties in the use of dental services.

Vaccination against influenza among pregnant women in southern Brazil and associated factors / Vacinação contra Influenza entre gestantes no Sul do Brasil e fatores associados

Abstract This article aims to identify the prevalence and factors associated with influenza vaccination in pregnant women. This is a cross-sectional study conducted in a municipality in the southernmost region of Brazil, which included all women giving birth in 2016. The outcome was having received the vaccine against influenza during pregnancy. Sociodemographic, behavioral and prenatal care characteristics and morbidities were analyzed. The analysis included sample description, the prevalence of vaccination for each independent variable and a multivariate analysis. Two thousand six hundred ninety-four pregnant women were interviewed, of which 53.9% reported having been vaccinated. Factors associated with increased prevalence of vaccination were mother's higher schooling, prenatal care, tetanus vaccination and prenatal care performed in a public service. On the other hand, prenatal care onset after the first quarter reduced the prevalence of vaccination. The results point to the need to reinforce the importance of vaccination against influenza among pregnant women and among health professionals, regardless of the severity of the current epidemiological setting.

Resumo O objetivo deste artigo é identificar a prevalência da imunização contra a gripe em mulheres grávidas e seus fatores associados. Estudo transversal realizado em um município no extremo sul do Brasil, que incluiu todas as mulheres que deram à luz no ano de 2016. O desfecho foi ter recebido a vacina contra a gripe durante a gravidez. Características sociodemográficas, comportamentais, do pré-natal e morbidades foram analisadas como fatores associados à vacinação. A análise constou de descrição da amostra, prevalência da vacinação para cada uma das variáveis independentes e análise multivariada. Foram entrevistadas 2.694 parturientes, das quais 53,9% informaram ter recebido a vacina. Os fatores associados a uma maior prevalência de imunização foram: maior escolaridade materna, realização do pré-natal, ter realizado a vacina antitetânica e fazer o pré-natal em um serviço público. Por outro lado, o início do pré-natal após o primeiro trimestre reduziu a prevalência de imunização. Os resultados apontam para a necessidade de reforçar a importância da imunização contra a Influenza entre mulheres grávidas e entre profissionais da saúde, independentemente da gravidade do atual cenário epidemiológico.

Vaccination against influenza among pregnant women in southern Brazil and associated factors.

This article aims to identify the prevalence and factors associated with influenza vaccination in pregnant women. This is a cross-sectional study conducted in a municipality in the southernmost region of Brazil, which included all women giving birth in 2016. The outcome was having received the vaccine against influenza during pregnancy. Sociodemographic, behavioral and prenatal care characteristics and morbidities were analyzed. The analysis included sample description, the prevalence of vaccination for each independent variable and a multivariate analysis. Two thousand six hundred ninety-four pregnant women were interviewed, of which 53.9% reported having been vaccinated. Factors associated with increased prevalence of vaccination were mother's higher schooling, prenatal care, tetanus vaccination and prenatal care performed in a public service. On the other hand, prenatal care onset after the first quarter reduced the prevalence of vaccination. The results point to the need to reinforce the importance of vaccination against influenza among pregnant women and among health professionals, regardless of the severity of the current epidemiological setting.

Positive self-perception of diet: a population-based study in the far south of Brazil. / Autopercepção positiva da alimentação: um estudo de base populacional no extremo sul do Brasil.

OBJECTIVE: to analyze prevalence of positive self-perception of diet and association with sociodemographic and behavioral factors, morbidity, self-perception of health and weight, and body weight care, in the city of Rio Grande, RS, Brazil, in 2016. METHODS: this was a cross-sectional study conducted with adults and elderly people resident in the city of Rio Grande using 13 indicators of healthy eating and positive self-perception of diet (outcome); Poisson regression was used. RESULTS: the sample consisted of 1,243 individuals, 72.4% of whom reported positive self-perception of diet; indicators such as weekly consumption of greens or vegetables (PR=133 - 95%CI 1.22;1.45) and fruit (PR=1.35 - 95%CI 1.22;1.48) were positively associated with the outcome; no significant difference was found between sexes. CONCLUSION: positive self-perception of diet is associated with healthy eating indicators among adults and the elderly and can be useful in epidemiological surveys.

[Psychometric Evaluation of the Brazilian Version of the "Sexually Transmitted Disease Knowledge Questionnaire"]. / Avaliação Psicométrica da versão brasileira do "Questionário sobre Conhecimento de Doenças Sexualmente Transmissíveis".

This study evaluated the psychometric properties of the Brazilian version of the Sexually Transmitted Disease Knowledge Questionnaire (STD-KQ). A convenience sample of 429 students of a Brazilian public university participated in the study. Exploratory Factor Analysis suggested one factor solution (variance explained = 61.1%, eigenvalue = 7.2), confirmed by the confirmatory analysis (Root Mean Square Error of Approximation = 0.04; Comparative Fit Index = 0.91; Tucker-Lewis Index = 0.90; Standardized Root Mean Square Residual = 0.05). Five items feature charges less than 0.30 and wer eliminated. The instrument demonstrated internal consistency (Composite reliability = 0.97; Cronbach's alpha = 0.83) and temporal stability (Pearson correlation = 0.86; kappa = 0.16) over a brief period. The knowledge significantly varies by age, sex and course of study. In conclusion, this study highlights the satisfactory psychometric proprieties of the Brazilian version of STD-KQ in university students.

Este estudo analisou as propriedades psicométricas da versão brasileira do Questionário sobre Conhecimento de Doenças Sexualmente Transmissíveis (STD-KQ). Participou uma amostra de conveniência de 429 estudantes de uma universidade pública brasileira. A análise fatorial exploratória sugere uma estrutura com um fator (variância explicada = 61,1%; eigenvalue = 7,2), sendo corroborada pela análise confirmatória (Root Mean Square Error of Approximation = 0,04; Comparative Fit Index = 0,91; Tucker-Lewis Index = 0,90; Standardized Root Mean Square Residual = 0,05). Cinco itens apresentaram carga menor que 0,30 e por isso foram excluídos. O instrumento demonstrou consistência interna (confiabilidade composta = 0,97; alfa de Cronbach = 0,83) e estabilidade temporal (correlação de Pearson = 0, 86; kappa = 0,16) para um curto período. O conhecimento significativamente variou conforme a idade, o sexo e o curso. Concluindo, o presente estudo destaca as satisfatórias propriedades psicométricas da versão brasileira do STD-KQ em estudantes universitários.

Avaliação Psicométrica da versão brasileira do "Questionário sobre Conhecimento de Doenças Sexualmente Transmissíveis" / Psychometric Evaluation of the Brazilian Version of the "Sexually Transmitted Disease Knowledge Questionnaire"

Resumo Este estudo analisou as propriedades psicométricas da versão brasileira do Questionário sobre Conhecimento de Doenças Sexualmente Transmissíveis (STD-KQ). Participou uma amostra de conveniência de 429 estudantes de uma universidade pública brasileira. A análise fatorial exploratória sugere uma estrutura com um fator (variância explicada = 61,1%; eigenvalue = 7,2), sendo corroborada pela análise confirmatória (Root Mean Square Error of Approximation = 0,04; Comparative Fit Index = 0,91; Tucker-Lewis Index = 0,90; Standardized Root Mean Square Residual = 0,05). Cinco itens apresentaram carga menor que 0,30 e por isso foram excluídos. O instrumento demonstrou consistência interna (confiabilidade composta = 0,97; alfa de Cronbach = 0,83) e estabilidade temporal (correlação de Pearson = 0, 86; kappa = 0,16) para um curto período. O conhecimento significativamente variou conforme a idade, o sexo e o curso. Concluindo, o presente estudo destaca as satisfatórias propriedades psicométricas da versão brasileira do STD-KQ em estudantes universitários.

Abstract This study evaluated the psychometric properties of the Brazilian version of the Sexually Transmitted Disease Knowledge Questionnaire (STD-KQ). A convenience sample of 429 students of a Brazilian public university participated in the study. Exploratory Factor Analysis suggested one factor solution (variance explained = 61.1%, eigenvalue = 7.2), confirmed by the confirmatory analysis (Root Mean Square Error of Approximation = 0.04; Comparative Fit Index = 0.91; Tucker-Lewis Index = 0.90; Standardized Root Mean Square Residual = 0.05). Five items feature charges less than 0.30 and wer eliminated. The instrument demonstrated internal consistency (Composite reliability = 0.97; Cronbach's alpha = 0.83) and temporal stability (Pearson correlation = 0.86; kappa = 0.16) over a brief period. The knowledge significantly varies by age, sex and course of study. In conclusion, this study highlights the satisfactory psychometric proprieties of the Brazilian version of STD-KQ in university students.

Detection and characterization of hepatitis E virus genotype 3 in HIV-infected patients and blood donors from southern Brazil.

BACKGROUND: Hepatitis E virus genotype 3 (HEV-3) infection usually causes self-limited acute hepatitis. In immunosuppressed patients, HEV-3 infection can rapidly progress to chronic hepatitis and cirrhosis. In southern Brazil, data on HEV seroprevalence are scarce. METHODS: Testing for HEV RNA and antibodies (anti-HEV) was performed for 320 HIV-infected patients followed at the HIV/AIDS Service of the Federal University of Rio Grande between 2012 and 2013, as well as 281 blood donor samples obtained in 2015. Variables associated with anti-HEV positivity were assessed by multivariable logistic regression analysis. RESULTS: HIV and blood donor groups showed similar HEV seroprevalence (6.7% and 7.1%, respectively). Risk factors associated with anti-HEV detection were older age, marital status, a higher number of sexual partners, poor sanitation, and alcohol use (HIV group), and living in a rural area (blood donors). HEV RNA was detected in eight serum samples from HIV-infected patients and in one blood donor, who was also positive for anti-HEV IgM and IgG. CONCLUSIONS: The prevalence rates of HEV infection were comparable between HIV-seropositive patients who were not severely immunocompromised and blood donors. The blood donor's HEV isolate showed high similarity with swine HEV strains from Brazilian herds in the same region, thus indicating a potential risk of foodborne and parenteral transmission via blood transfusion.

Self-perceived health among adult and elderly users of Primary Health Care. / Autopercepção da saúde entre adultos e idosos usuários da Atenção Básica de Saúde.

A cross-sectional study was conducted with 1,246 adults and senior men and women in Pelotas (RS), Brasil to evaluate the negative self-perception of health among Primary Health Care users. The prevalence of negative self-perception of health was reported by 41.6% of respondents. Women, those who were unemployed, who reported a diagnosis of three or more chronic noncommunicable diseases, who were food insecure and did not engage in physical activity reported a higher proportion of negative self-perceived health. Users with at least higher education level and those whose households had four or more residents were less predisposed to the outcome. The high prevalence of negative self-perceived health in this population, as well as the associations found, indicate the need for a better understanding of the influence of these factors on the search for care and, consequently, on adherence to treatment.

Com o objetivo de avaliar a autopercepção negativa da saúde entre usuários da atenção básica de saúde, foi realizado um estudo transversal com 1246 adultos e idosos, de ambos os sexos, em Pelotas, RS. A prevalência da autopercepção negativa da saúde foi referida por 41,6% dos entrevistados. As mulheres, aqueles que não estavam trabalhando, que referiram diagnóstico de três ou mais doenças crônicas não transmissíveis, que estavam em insegurança alimentar e não praticavam atividade física relataram em maior proporção, a autopercepção negativa da saúde. Enquanto que os usuários com no mínimo o ensino superior e aqueles cujos domicílios tinham quatro ou mais moradores foram menos predispostos ao desfecho. A elevada prevalência de autopercepção negativa da saúde nessa população, bem como as associações encontradas, indicam a necessidade de maior entendimento sobre a influência desses fatores na procura pelo atendimento e, consequentemente, na adesão ao tratamento.