Chemsex among men who have sex with men during the Mpox health crisis in Brazil: A nationwide web survey.

OBJECTIVE: To understand the factors associated with the practice of chemsex among MSM in Brazil, especially during the Mpox health crisis, and to design effective prevention and intervention strategies specifically for this population. DESIGN: A cross-sectional and analytical study using an electronic survey, conducted from September to December 2022, during the peak of the Mpox outbreak in Brazil. SAMPLE: A total of 1452 MSM aged 18 and older. MEASUREMENTS: Data were collected via the REDCap platform through a survey with 46 questions. These addressed demographic data, sexual affiliations, practices, experiences with Mpox, healthcare service usage, and stigma or fear related to Mpox. RESULTS: The prevalence of chemsex was 19.42% (n = 282). Multivariate Poisson modeling indicated a high incidence of chemsex among those diagnosed with Mpox and those involved in high-risk behaviors. The practice of chemsex was six times higher among those diagnosed with Mpox (95% CI: 4.73-9.10). MSM who engage in bugchasing had a prevalence twice that of the main outcome (95% CI: 1.31-3.16). CONCLUSION: There is a significant need for targeted interventions for MSM in Brazil, especially given the Mpox outbreak. This study highlights the strong relationships between chemsex, experiences with Mpox, and various sexual behaviors, underscoring the importance of effective public health initiatives.

Pre-exposure prophylaxis among Brazilian men who have sex with men: a comparative study between migrants and non-migrants.

Introduction: Investigating the use and adherence to pre-exposure prophylaxis (PrEP) in MSM is a global health priority in the fight against HIV. Strategies must be capable of increasing usage and reaching not only the population living in the country but also those who immigrate, who face additional vulnerabilities. Based on this, in this observational, cross-sectional, and analytical study, our aim is to analyze the use of PrEP among Brazilian men who have sex with men, whether they are migrants or not. We aim to highlight preventive opportunities and strategies for the global health scenario. Methods: We utilized a sample of Brazilians living in the country and Brazilian immigrants residing in Portugal, one of the main destinations for Brazilians in recent years. To estimate the prevalence ratio (PR) of PrEP use, we employed the Poisson regression model with robust variance estimation using a covariance matrix. Results: A total of 1,117 Brazilian MSM PrEP users participated in this study, with 788 residing in Brazil and 328 in Portugal. Multivariate analysis was conducted in three stages: overall, and for subgroups of residents in Brazil and immigrants in Portugal. We identified four convergent factors that increased the prevalence of PrEP use in Brazilians regardless of migration status: having two or more casual sexual partners per month, engaging in challenging sexual practices as the receptive partner, disclosing serological status on apps, and being single. Among native Brazilians, four unique factors stood out: being in a polyamorous relationship, having sexual relations with unknown casual partners, and having higher levels of education. Discussion: This study highlights the need to implement strategies to strengthen PrEP adherence in Brazil and create international programs that facilitate its usage among populations migrating between these two countries.

HIV testing among immigrant men who have sex with men in Brazil.

OBJECTIVE: To evaluate the prevalence of non-testing for HIV among immigrant men who have sex with men (MSM) residing in Brazil and identify associated factors. DESIGN: An analytical web-survey study was conducted across all Brazilian states from January 2020 to May 2021. SAMPLE: The study included 804 MSM immigrants from Portuguese-speaking countries. MEASUREMENTS: Odds ratio (OR) and adjusted Odds Ratio (AOR) were utilized to determine the strength of the association between non-HIV testing and associated factors. RESULTS: Among the participants, 63.7% had never undergone HIV testing. Multivariate analysis revealed several factors associated with a higher likelihood of not being tested for HIV: having a steady/monogamus partner (AOR: 1.5; 95%CI: 1.1-2.3) or both casual and steady partners (AOR: 1.8; 95%CI: 1.2-3.4), not engaging in bareback sex (AOR: 1.91; 95%CI: 3-3.5), being an immigrant in the country for less than 12 months (AOR: 3.7; 95%CI: 2.5-9.7), and having a preference for insertive (AOR: 1.5; 95%CI: 1.1-2.5) or receptive (AOR: 2.9; 95%CI: 1.4-5.7) roles. However, practicing chemsex was found to be a protective factor for testing (AOR: 4). CONCLUSION: To enhance HIV prevention strategies, it is crucial to implement specific measures that ensure accessibility, confidentiality, and a reduction in stigma associated with HIV testing.

Models of Support for Caregivers and Patients with the Post-COVID-19 Condition: A Scoping Review.

BACKGROUND: In December 2019, an outbreak of the coronavirus disease 2019 (COVID-19), caused by the novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), occurred in the city of Wuhan, China. On 30 January 2020, the World Health Organization declared the outbreak a public health emergency of international concern. In October 2021, with the advancement of the disease, the World Health Organization defined the post-COVID-19 condition. The post-COVID-19 condition occurs in individuals with a history of probable or confirmed infection with SARS-CoV-2, usually 3 months after the onset of the disease. The chronicity of COVID-19 has increased the importance of recognizing caregivers and their needs. METHODS: We conducted a scoping review following international guidelines to map the models of support for caregivers and patients with the post-COVID-19 condition. The searches were conducted in electronic databases and the grey literature. The Population, Concept, and Context framework was used: Population: patients with the post-COVID-19 condition and caregivers; Concept: models of caregiver and patient support; and Context: post-COVID-19 condition. A total of 3258 records were identified through the electronic search, and 20 articles were included in the final sample. RESULTS: The studies approached existing guidelines and health policies for post-COVID-19 condition patients and support services for patients and home caregivers such as telerehabilitation, multidisciplinary care, hybrid models of care, and follow-up services. Only one study specifically addressed the home caregivers of patients with this clinical condition. CONCLUSIONS: The review indicates that strategies such as telerehabilitation are effective for training and monitoring the patient-family dyad, but the conditions of access and digital literacy must be considered.

Abuse and neglect among Ethiopian children and adolescents.

Given the dramatic situation observed in Ethiopia, the biggest humanitarian crisis in decades, children and adolescents have been the most affected. The country experiences climate change and disarrays in the political structure of the state, which increases the risk of insecurity, displacement, and protection. The outlook tends to remain in 2022 due to the expansion of the conflict and the decrease in the access of partners' humanitarian aid groups to the affected regions. The country has high rates of malnutrition, low vaccination coverage, need for educational assistance, water, and sanitation emergency, lack of services to protect against violence, and high rates of children unaccompanied by their families. During the conflict, children, often to save their lives - because they have extended families or unhealthy inter-family relationships - end up looking for work on the streets and falling into a situation of vulnerability. In this context, they become constant victims of sexual abuse and physical violence, leaving deep marks. Still, the country's folk traditions fall back on the girls, significantly in a negative way, when genital mutilation and child marriage are in considerable proportion among girls in the country. However, the humanitarian actions did not concern themselves with referring to the particular needs of adolescent girls, including the involvement of caregivers to reduce the risk of violence. In this sense, it is important to point out that the increase in discrimination, stigmatization, and xenophobia contribute negatively to local tensions and to the improvement of vulnerability and social risk of children and adolescents. Therefore, there is a need for interventions to multisectoral nutrition, due to the prevalence of thinness and stunting that are above the threshold level of public health importance, and the need for urgent humanitarian assistance care to the more than 15 million children affected by this unprecedented crisis.

Fatores de risco e elementos primitivos no desenvolvimento de síndromes hipertensivas no pré-natal: revisão integrativa / Risk factors and primitive elements in the development of hypertensive syndromes in prenatal care: integrative review / Factores de riesgo y elementos primitivos en el desarrollo de síndromes hipertensivos en la atención prenatal: revisión integradora

Objetivo: identificar os fatores de risco e elementos primitivos associados às síndromes hipertensivas nas gestantes no pré-natal. Método: revisão integrativa nas bases: MEDLINE, SCOPUS, WoS, CINAHL, BDENF e LILACS no período de setembro a outubro de 2020. Para a extração dos dados utilizou-se a ferramenta Poronto. Resultados: incluíram-se 47 estudos, nos quais foram identificados 30 conceitos primitivos inter-relacionados que alertam para as necessidades das gestantes. As investigações permitiram identificar idade de 18 a 50 anos, raça negra, vulnerabilidade socioeconômica, baixa escolaridade e o baixo peso ao nascer como fatores de risco sensíveis de identificação na atenção primária. Conclusão: a literatura apresenta fatores pertinentes quanto ao desenvolvimento da síndrome hipertensiva permitindo clarificar os elementos primitivos e fatores de risco. Além do mais, subsidia o cuidado e aponta para o desenvolvimento de pesquisas que desenvolvam instrumentos voltados ao público estudado.

Objective: to identify the risk factors and primitive elements associated with hypertensive syndromes in pregnant women during prenatal care. Method: integrative review in the databases: MEDLINE, SCOPUS, WoS, CINAHL, BDENF and LILACS from September to October 2020. The Poronto tool was used to extract the data. Results: 47 studies were included, in which 30 interrelated primitive concepts were identified that alert to the needs of pregnant women. The investigations allowed the identification of age from 18 to 50 years, black race, socioeconomic vulnerability, low schooling and low birth weight as sensitive risk factors for identification in primary care. Conclusion: the literature presents relevant factors regarding the development of hypertensive syndrome allowing clarifying the primitive elements and risk factors. Moreover, it subsidizes care and points to the development of research that develops instruments aimed at the studied public.

Objetivo: identificar los factores de riesgo y elementos primitivos asociados a los síndromes hipertensivos en gestantes durante la atención prenatal. Método: revisión integradora en las bases de datos: MEDLINE, SCOPUS, WoS, CINAHL, BDENF y LILACS de septiembre a octubre de 2020. Se utilizó la herramienta Poronto para extraer los datos. Resultados: Se incluyeron 47 estudios, en los que se identificaron 30 conceptos primitivos interrelacionados que alertan a las necesidades de las gestantes. Las investigaciones permitieron identificar la edad de 18 a 50 años, la raza negra, la vulnerabilidad socioeconómica, la baja escolaridad y el bajo peso al nacer como factores de riesgo sensibles para la identificación en atención primaria. Conclusión: la literatura presenta factores relevantes respecto al desarrollo del síndrome hipertensivo permitiendo aclarar los elementos primitivos y factores de riesgo. Además, subvenciona la atención y apunta al desarrollo de investigación que desarrolle instrumentos dirigidos al público estudiado.

Análise de indicadores epidemiológicos de crianças e adolescentes acometidos pela Covid-19 no Nordeste do Brasil / Análisis de indicadores epidemiológicos de niños y adolescentes afectados por Covid-19 en el Noreste de Brasil / Analysis of epidemiological indicators of children and adolescents affected by Covid-19 in Northeastern Brazil

Objetivo: analisar os indicadores epidemiológicos de crianças e adolescentes acometidos pela Covid-19 na região Nordeste do Brasil. Método: estudo ecológico com casos de Covid-19, nos estados do Nordeste. Calculou-se taxas de letalidade, prevalência, índice acumulado diário e razão de leitos de UTI. Analisou-se dados consolidados até 21 de agosto de 2020. Resultados: houve 74.705 casos de Covid-19, com prevalência do sexo feminino e quanto a faixa etária àqueles entre 10 a 19 anos. Letalidade foi de 8%, prevalência de 321/100.000 habitantes e razão de leitos menor que dois. Houve significância para relação entre o maior número de óbitos e o menor número de leitos de UTI (p=0.001), maior prevalência de casos em razão da menor quantidade de leitos de UTI (p=0.007). Conclusão: os indicadores revelam insuficiência quanto aos leitos para a doença, alta letalidade e prevalência, bem como quantidade razoável dos leitos de UTI.

Objective: to analyze the epidemiological indicators of children and adolescents affected by Covid-19 in the Northeast region of Brazil. Method: ecological study with cases of Covid-19, in the northeastern states. Lethality, prevalence, daily accumulated index and ICU bed ratio were calculated. Consolidated data were analyzed until August 21, 2020. Results: there were 74,705 cases of Covid-19, with female prevalence and age group between 10 and 19 years. Lethality was 8%, prevalence of 321/100,000 inhabitants and bed ratio lower than two. There was significance for the relationship between the highest number of deaths and the lowest number of ICU beds (p=0.001), higher prevalence of cases due to the lower number of ICU beds (p=0.007). Conclusion: the indicators reveal insufficiency regarding beds for the disease, high lethality and prevalence, as well as a reasonable amount of ICU beds.

Objetivo: analizar los indicadores epidemiológicos de los niños y adolescentes afectados por Covid-19 en la región noreste de Brasil. Método: estudio ecológico con casos de Covid-19, en los estados del noreste. Se calcularon la letalidad, la prevalencia, el índice acumulado diario y la proporción de lechos de la UCI. Los datos consolidados se analizaron hasta el 21 de agosto de 2020. Resultados: hubo 74.705 casos de Covid-19, con prevalencia femenina y grupo de edad entre 10 y 19 años. La letalidad fue del 8%, la prevalencia de 321/100.000 habitantes y la proporción de camas inferior a dos. Hubo importancia para la relación entre el mayor número de muertes y el menor número de camas de UCI (p=0,001), mayor prevalencia de casos debido al menor número de camas de UCI (p=0,07). Conclusión: los indicadores revelan insuficiencia con respecto a las camas para la enfermedad, alta letalidad y prevalencia, así como una cantidad razonable de camas de UCI.

In vitro Antibiotic and Modulatory Activity of Mesosphaerum suaveolens (L.) Kuntze against Candida strains.

The emergence of fungal resistance to commercial drugs has been a major problem for the WHO. In this context, research with natural products is promising in the discovery of new active substances. Thus, this work evaluated the antifungal effect of a medicinal plant (i.e., Mesosphaerum suaveolens) against strains of the genus Candida, tested the combined effect with the drug fluconazole, and, finally, determined the phenolic constituents present in the species. Initially, aqueous extracts of leaves (AELMs) and aerial parts (AEAPMs) of the species were prepared. For microbiological assays, the minimum fungicidal concentration was determined by broth microdilution, and the combined effect of fluconazole extracts were verified by sub-inhibitory microdilution concentrations (CFM/8) followed by spectrophotometric readings which were used to determine the IC50. HPLC detected the presence of flavonoids and phenolic acids, detecting eight compounds present in the samples of which caffeic acid and quercetin were major components. The AELMs modulated fluconazole activity since it decreased fluconazole's IC50 from 7.8 µg/mL to an IC50 of 4.7 µg/mL (CA LM 77) and from 28.8 µg/mL to 18.26 µg/mL (CA INCQS 40006) for the C. albicans strains. The AEAPMs were able to potentiate the effect of fluconazole more effectively than the AELMs. Such an effect was significant for the 16 µg/mL concentration for CA LM 77 and 32 µg/mL for CA INCQS 40006. The AEAPMs as well as the AELMs presented clinically relevant activities for C. tropicalis strains. For the C. tropicalis LM 23 strain, the AEPMs obtained an IC50 of 25 µg/mL and the AELMs an IC50 of 359.9 µg/mL.