Your browser doesn't support javascript.
Show: 20 | 50 | 100
Results 1 - 20 de 1.412
Nursing (Säo Paulo) ; 25(290): 8137-8150, julho.2022.
Article in English, Portuguese | LILACS, BDENF | ID: biblio-1379898


Objetivo: analisar as percepções de mães adolescentes com HIV/Aids sobre a gestação e a transmissão vertical. Método: Estudo de revisão integrativa de literatura. As bases de informação utilizadas foram: Biblioteca Virtual de Saúde (BVS), Web of Science, PubMed e Science Direct, reunindo artigos do recorte temporal de 2012 a 2020. O período de coleta de dados se deu entre outubro de 2021 a dezembro de 2021. Resultados: Elencaram-se dois artigos que relataram a condição biopsicossocial da gestante adolescente, associada ao medo, insegurança, incapacidade e culpabilização. Os resultados foram agrupados em categorias, a saber: a maternidade sob ótica da adolescente soropositiva e a transmissão vertical do HIV durante a gestação na adolescência. Conclusão: Espera-se que a temática possa ser explorada a fim de contribuir para a assistência voltada para o público estudado e minimizar os riscos da transmissão vertical.(AU)

Objective: to analyze the perceptions of adolescent mothers with HIV/AIDS about pregnancy and vertical transmission. Method: Study of integrative literature review. The information bases used were: Virtual Health Library (VHL), Web of Science, PubMed and Science Direct, gathering articles from the time frame from 2012 to 2020. The data collection period took place between October 2021 and December 2021. Results: Two articles were reported on the biopsychosocial condition of pregnant adolescents, associated with fear, insecurity, disability and guilt. The results were grouped into categories, that is: maternity from the perspective of hiv-positive adolescents and vertical transmission of HIV during pregnancy in adolescence. Conclusion: It is expected that the theme can be explored in order to contribute to the assistance aimed at the studied public and minimize the risks of vertical transmission.(AU)

Objetivo: analizar las percepciones de las madres adolescentes con VIH/SIDA sobre el embarazo y la transmisión vertical. Método: Estudio de la revisión integradora de la literatura. Las bases de información utilizadas fueron: Biblioteca Virtual en Salud (BVS), Web of Science, PubMed y Science Direct, recopilando artículos del marco de tiempo de 2012 a 2020. El período de recolección de datos tuvo lugar entre octubre de 2021 y diciembre de 2021. Resultados: Se reportaron dos artículos sobre la condición biopsicosocial de adolescentes embarazadas, asociada con miedo, inseguridad, discapacidad y culpa. Los resultados se agruparon en categorías, es decir: maternidad desde la perspectiva de las adolescentes seropositivas y transmisión vertical del VIH durante el embarazo en la adolescencia. Conclusión: Se espera que el tema pueda ser explorado con el fin de contribuir a la asistencia dirigida al público estudiado y minimizar los riesgos de transmisión vertical.(AU)

Pregnancy in Adolescence , HIV , Infectious Disease Transmission, Vertical
Buenos Aires; GCBA. Gerencia Operativa de Epidemiología; 18 feb. 2022. a) f: 11 l:17 p. tab, graf.(Boletín Epidemiológico Semanal: Ciudad Autónoma de Buenos Aires, 6, 287).
Monography in Spanish | LILACS, InstitutionalDB, BINACIS, UNISALUD | ID: biblio-1359366


El hospital Materno Infantil Ramón Sardá, de la Ciudad de Buenos Aires, es un centro perinatológico de alta complejidad del subsector público de salud, que asiste más de 5000 nacimientos por año. Es el hospital que reportó la mayor cantidad de casos de sífilis congénita en el período 2018-2019. El objetivo de este informe es caracterizar los casos asistidos durante el trienio 2018-2020.

Humans , Female , Pregnancy , Syphilis, Congenital/diagnosis , Syphilis, Congenital/prevention & control , Syphilis, Congenital/transmission , Syphilis, Congenital/epidemiology , Infectious Disease Transmission, Vertical/statistics & numerical data , Disease Notification/methods , Disease Notification/statistics & numerical data , Epidemiological Monitoring , Hospitals, Maternity/statistics & numerical data
S. Afr. j. child health (Online) ; 16(1): 1-5, 2022. figures, tables
Article in English | AIM | ID: biblio-1359340


Background. Mother-to-child transmissions (MTCT) accounts for 90% of the 370 000 new HIV-positive children, globally. Despite progress in the prevention of mother-to-child transmission (PMTCT) of HIV, children still acquire HIV infection. Objective. To identify and describe the prevalence of maternal, infant and/or health system-related risk factors gleaned from the literature for HIV transmission in HIV-positive children admitted to the paediatric intensive care unit (PICU) at Inkosi Albert Luthuli Central Hospital (IALCH), Durban, South Africa. Method. A retrospective electronic chart review identifying all HIV-positive children under 2 years admitted to the PICU at IALCH between January 2017 and December 2019 was undertaken. Individual patient records were analysed using a standardised template. Results. Of the 80 mothers and children with HIV enrolled in the present study, 38.8% (n=31/80) of mothers were diagnosed prior to pregnancy, 42.5% (n=34/80) were diagnosed during pregnancy (unsure when exactly transmission occurred), and 18.8% (n=15/80) of mothers were diagnosed after delivery. The median (range) time of antiretroviral treatment (ART) was 225 (30 - 365) days for mothers. More than half of mothers (56.3%, n=45/80) whose babies became HIV-positive had poor adherence to antiretroviral drugs (HIV viral load >1 000 copies/mL). An HIV-positive diagnosis in the children of these mothers occurred throughout infancy and early childhood, especially in the first 6 months (87.5%, n=70/80). A third of mothers practised mixed feeding. Health system deficiency, mainly via cancellation of tests without notifying healthcare workers, was typical in infants (33%; n=26/80) and mothers (68.8%, n=55/80). All others (100%) were not counselled about the importance of PMTCT and 93.8% of mothers were not counselled about the importance of follow-up. Almost all HIV-positive infants (95%, n=76) presented with severe respiratory illness, mainly severe acute respiratory distress syndrome (62.5%, n=50/80) and pneumonia with hypoxic respiratory failure (32.5%, n=26/80). The overall mortality of the cohort was 22.5% (n=18/80), and most deaths were associated with cytomegalovirus (CMV), Pneumocystis jirovecii pneumonia (PJP) or both (61.1%, n=11/18). Conclusion. This present study confirmed that a new diagnosis of HIV positivity occurs throughout pregnancy and early childhood in infants. Poor adherence to ART in mothers and their infants, poor counselling, failure to attend antenatal and postnatal care, mixed feeding, and challenged laboratory services were common modifiable factors that need addressing.

Humans , Male , Female , Child, Preschool , HIV Infections , Child, Hospitalized , HIV Seropositivity , Infectious Disease Transmission, Vertical , Intensive Care Units , Postpartum Period
Niger. j. paediatr ; 49(1): 75-82, 2022. figures, tables
Article in English | AIM | ID: biblio-1372518


Background: Twenty five to forty percent of children will be infected with HIV in the absence of any form of intervention which is Prevention of Mother to Child Transmission (PMTCT). Objectives: This study determined the infant feeding knowledge and practices among HIV positive mothers attending HIV treatment centers in Lagos. Methods: A descriptive crosssectional design was used for the study. A multistage sampling technique was used to select / recruit 290 HIV positive mothers with babies between the ages of 2weeks to 18months, attending PMTCT services into the study Pre-tested interviewer administered structured questionnaire was used to collect data and analysis was done using Epi-info software. Chi-square and Fischer exact tests were used to determine association between the dependent and independent variables. The pvalue was set at 0.05. Results: Majority of the respondents (58.9%) were within the age range of 31 ­ 40 years and about half had a secondary school level of education. Exclusive formula feeding (40.3%) and exclusive breast feeding (42.4%) were feeding options known by the majority of the respondents. More than half (55.5%) of the mothers had a good knowledge of infant feeding options. Exclusive breastfeeding (EBF) was practiced by majority (55.5%) of the respondents, 21.4% practiced exclusive formula feeding (EFF) while only 6% practiced mixed feeding (MF). Knowledge of infant feeding options and the attitude towards exclusive breast feeding being enough in the first 6 months of life were associated with infant feeding options practiced; those with good knowledge of infant feeding options did not practice MF (9.7%) (p = 0.013). Conclusion: knowledge of infant feeding options was good and poor knowledge was associated with exclusive formula feeding. Majority practiced EBF. Educational programmes targeted at improving the knowledge of HIV and infant feeding options as well as strengthening of counseling sessions at PMTCT clinic would help reduce the risk of HIV transmission to the child.

Breast Feeding , Health Knowledge, Attitudes, Practice , HIV Seropositivity , Infectious Disease Transmission, Vertical
Afr. j. health sci ; 35(3): 371-377, 2022. tables
Article in English | AIM | ID: biblio-1380277


Background Approximately 37 million people were living with HIV by the end of 2015. This led to high morbidity and mortality among women of childbearing age, especially in SubSaharan Africa which was the epicentre of this global pandemic. Strengthening and implementing prevention of mother-to-child (PMTCT) services could reduce the incidence of vertical transmission and improve quality of life. We aimed to determine maternal and birth outcomes among HIV-positive pregnant mothers and HIV-exposed newborns in Nyahururu county referral hospital, Laikipia, Kenya. Main Outcomes Measures Reduce maternal morbidity and mortality and other birth-related complications. In addition, this will also reduce infant mortality and morbidity among HIV-exposed infants. Materials And Methods This was a hospital-based descriptive prospective study conducted at the PMTCT department at the Nyahururu County referral hospital. A sample of 180 HIV-positive pregnant women enrolled at the PMTCT consented to participate in the study. We monitored them until delivery and labour complications were addressed. Babies were scored against the APGAR scale, weighed and spot dried blood samples taken before breastfeeding; and started on prophylactic antiretroviral therapy. RESULTS Out of 180 participants, only 17 did not complete the study. Our findings indicate that 97.5 % of the mothers delivered in the hospital, had labour lasting less than 12 hours, 92.6% had a normal delivery and 94.9% had no complications during the labour period. About 2.5 % of the women had misoprostol administration. The majority of exposed babies had an average weight of between 2.51 - 3.00kg. No neonatal asphyxia was evident among exposed babies. Conclusions: The majority of the respondents delivered in the hospital; no neonatal asphyxia was evidenced and there was a significant correlation between APGAR scores and infant weight. There is a need for active follow-up and monitoring of HIV pregnant women and their unborn babies until delivery.

Humans , Female , Child , Adolescent , Adult , Middle Aged , HIV Infections , HIV Seropositivity , Infectious Disease Transmission, Vertical , Pregnancy Complications , Morbidity , Pregnant Women
Esc. Anna Nery Rev. Enferm ; 26: e20210013, 2022. tab, graf
Article in Portuguese | LILACS, BDENF | ID: biblio-1356223


Resumo Objetivo analisar a distribuição espacial da mortalidade fetal por sífilis congênita entre os bairros do Município do Recife-PE. Método estudo ecológico, realizado a partir do indicador epidemiológico taxa de mortalidade fetal por sífilis congênita, agregado ao nível dos bairros, em dois quinquênios: 2007 a 2011 e 2012 a 2016. O padrão de autocorrelação espacial foi determinado pelos Índices de Moran Global e Local, com significância estatística inferior a 5% e representado em mapas BoxMap e MoranMap que apontaram as áreas com taxas altas, baixas e em transição epidemiológica e os clusters de maior interesse epidemiológico. Resultados foram notificados 208 óbitos fetais. O Índice Global de Moran evidenciou autocorrelação espacial positiva em grau razoável, no primeiro quinquênio (I = 0,351 e p-valor = 0,01) e, em grau fraco, no segundo quinquênio (I = 0,189 e p-valor = 0,02). Os Distritos Sanitários I e VII obtiveram os maiores percentuais de bairros que formaram o cluster de altas taxas do indicador com 63,3% e 38,4% no primeiro e segundo quinquênios, respectivamente. Conclusões e implicações para a Prática a análise espacial apontou as áreas críticas para ocorrência do indicador, podendo contribuir para o investimento nas áreas prioritárias de prevenção da transmissão vertical da sífilis.

Resumen Objetivo Analizar la distribución espacial de la mortalidad fetal por sífilis congénita entre los barrios de Recife-PE. Método Estudio ecológico, basado en el indicador epidemiológico tasa de mortalidad fetal por sífilis congénita, agregada a nivel de barrio, en dos quinquenios: 2007 a 2011 y 2012 a 2016. El patrón de autocorrelación espacial fue determinado por los Índices Moran Global y Local, con significancia estadística menor al 5% y representados en mapas de BoxMap y MoranMap, que indicaron áreas con tasas de transición alta, baja y epidemiológica y conglomerados de mayor interés epidemiológico. Resultados Notificadas 208 muertes fetales. El Índice Global de Moran mostró un grado razonable de autocorrelación espacial positiva en el primer quinquenio (I = 0,351 y p-valor=0,01) y un grado débil en el segundo quinquenio (I = 0,189 y p-valor=0,02). Los Distritos Sanitarios I y VII presentaron los mayores porcentajes de barrios que formaron el cluster de tasas altas del indicador con 63,3% y 38,4% en el primer y segundo quinquenio, respectivamente. Conclusión e Implicación para la Práctica El análisis espacial señaló las áreas críticas para la ocurrencia del indicador, que podrían contribuir a la inversión en áreas prioritarias para la prevención de la transmisión vertical de sífilis.

Abstract Objective To analyze the spatial distribution of fetal mortality due to congenital syphilis among the neighborhoods of the city of Recife-PE. Method Ecological study, based on the epidemiological indicator fetal mortality rate due to congenital syphilis, aggregated at the neighborhood level, in two five-year periods: 2007 to 2011 and 2012 to 2016. The pattern of spatial autocorrelation was determined by the Moran Global and Local Indexes, with statistical significance lower than 5% and represented in BoxMap and MoranMap maps that indicated areas with high, low and epidemiological transition rates and clusters of greater epidemiological interest. Results It was reported 208 fetal deaths. The Moran Global Index showed a reasonable degree of positive spatial autocorrelation in the first five-year period (I = 0.351 and p-value = 0.01) and a weak degree in the second five-year period (I = 0.189 and p-value = 0.02). Sanitary Districts I and VII had the highest percentages of neighborhoods that formed the cluster of high rates of the indicator with 63.3% and 38.4% in the first and second five-year periods, respectively. Conclusions and Implications for Practice The spatial analysis pointed out the critical areas for the occurrence of the indicator, which could contribute to investment in priority areas for the prevention of vertical transmission of syphilis.

Humans , Female , Pregnancy , Syphilis, Congenital/epidemiology , Fetal Mortality , Spatial Analysis , Prenatal Care , Quality of Health Care , Syphilis, Congenital/prevention & control , Brazil/epidemiology , Incidence , Cross-Sectional Studies , Infectious Disease Transmission, Vertical , Disease Notification/statistics & numerical data , Social Vulnerability
Ciênc. rural (Online) ; 52(2): e20210081, 2022. tab, graf, ilus
Article in English | LILACS, VETINDEX | ID: biblio-1339657


Gilts represent a group risk for Mycoplasma hyopneumoniae vertical transmission in swine herds. Therefore, parity segregation can be an alternative to control M. hyopneumoniae infections. The study evaluated the effect of parity segregation on M. hyopneumoniae infection dynamics and occurrence and severity of lung lesions at slaughter. For that, three multiple site herds were included in the study. Herd A consisted of the farm where gilts would have their first farrowing (parity order (PO) 1). After the first farrowing PO 1 sows were transferred to herd B (PO2-6). Herd C was a conventional herd with gilt replacement (PO1-6). Piglets born in each herd were raised in separated nursery and finishing units. Sows (n = 33 (A), 37 (B), 34 (C)) in all herds were sampled prior to farrowing and piglets (n = 54 (A), 71 (B), 66 (C)) were sampled longitudinally at 21, 63, 100, 140 days of age and at slaughter for M. hyopneumoniae detection by PCR and lung lesions scoring. M. hyopneumoniae prevalence in sows did not differ among herds. Prevalence of positive piglets was higher at weaning in the PO1 herd (A) (P < 0.05). However, prevalence of positive pigs from 100 days of age to slaughter age was higher in the PO2-6 herd (B) (P < 0.05). Lung lesion occurrence and severity were higher in herd B. The authors suggested that the lack of a proper gilt acclimation might have influenced the results, leading to sows being detected positive at farrowing, regardless of the parity.

As leitoas consistem em um grupo de risco na transmissão vertical de Mycoplasma hyopneumoniae dentro do sistema de produção de suínos. Dessa forma, a segregação de partos poderia ser utilizada como alternativa para controlar as infecções por M. hyopneumoniae. O objetivo deste estudo foi avaliar o efeito da segregação de partos sobre a dinâmica de infecção de M. hyopneumoniae e a ocorrência e severidade das lesões pulmonares ao abate. Para isso três sistemas de produção de suínos com três sítios cada foram incluídos no estudo. A granja A consistia da unidade onde as leitoas tem o primeiro parto, ou seja, alojava somente de fêmeas de ordem de parto 1 (Granja OP1). Após o primeiro parto as fêmeas OP1 foram transferidas para a granja B (Granja OP2-6), ou seja, consistia de fêmeas de ordem de parto 2 a 6, e a granja C consistiu em uma granja convencional com reposição de leitoas (Granja OP1-6), com fêmeas de ordem de parto 1 a 6. Os leitões nascidos de cada granja foram transferidos e criados em creches e terminações segregadas. As matrizes (n = 33 (A), 37 (B), 34 (C)) de todas as granjas do estudo foram amostradas previamente ao parto e os leitões (n = 54 (A), 71 (B), 66 (C)) foram amostrados longitudinalmente aos 21, 63, 100 e 140 dias de idade e ao abate. Em todos os momentos de coleta, as amostras foram avaliadas por PCR para detecção de M. hyopneumoniae. As lesões pulmonares foram avaliadas e escores de lesão foram atribuídos ao abate. A prevalência de matrizes positivas para M. hyopneumoniae não diferiu entre as granjas (P > 0,05). A prevalência ao desmame foi maior na granja A (OP1) (P < 0,05). No entanto, dos 100 dias de idade até o abate a prevalência de leitões positivos para M. hyopneumoniae foi maior na granja B (OP2-6) (P < 0,05). A ocorrência e severidade de lesões pulmonares foram maiores na granja B. Os autores sugerem que a falta de uma aclimatação adequada das leitoas pode ter influenciado nos resultados, levando à detecção de matrizes positivas ao parto, independente da ordem de parto.

Animals , Female , Pregnancy , Swine/injuries , Swine/microbiology , Mycoplasma hyopneumoniae/isolation & purification , Pneumonia of Swine, Mycoplasmal/prevention & control , Polymerase Chain Reaction/veterinary , Infectious Disease Transmission, Vertical/veterinary , Birth Setting
Article in English | WPRIM | ID: wpr-928565


OBJECTIVES@#To study the effect of intrapartum antibiotic prophylaxis (IAP) of group B streptococcus (GBS) infection on the incidence and bacteriological profile of early-onset neonatal sepsis (EONS).@*METHODS@#A retrospective analysis was performed on the medical data of 494 pregnant women with positive GBS screening results and 526 neonates born by these women. According to whether the pregnant woman received IAP, the neonates were divided into two groups: IAP (n=304) and control (n=222). The two groups were compared in terms of clinical indices, incidence rate of EONS, and distribution of pathogenic bacteria in blood culture.@*RESULTS@#Compared with the control group, the IAP group had a significantly lower proportion of children with abnormal clinical manifestations (P<0.001) and a significantly lower incidence rate of EONS (P=0.022). In the IAP group, Escherichia coli (2.3%) was the most common type of pathogenic bacteria in blood culture of the neonates with EONS, while GBS (3.2%) was the most common type of pathogenic bacteria in the control group. The IAP group had a significantly higher detection rate of ampicillin-resistant Escherichia coli than the control group (P=0.029).@*CONCLUSIONS@#Although IAP can significantly reduce the incidence rate of EONS in neonates born to pregnant women with positive GBS screening results, the infection rate of ampicillin-resistant Escherichia coli may increase after IAP treatment. Therefore, it is needed to enhance the monitoring of blood culture results of neonates with EONS and timely adjust treatment plan according to drug susceptibility test results.

Anti-Bacterial Agents/therapeutic use , Antibiotic Prophylaxis , Child , Female , Humans , Incidence , Infant, Newborn , Infectious Disease Transmission, Vertical/prevention & control , Neonatal Sepsis/prevention & control , Pregnancy , Pregnancy Complications, Infectious , Retrospective Studies , Streptococcal Infections/prevention & control , Streptococcus agalactiae
Rev. bras. ginecol. obstet ; 43(12): 949-960, Dec. 2021. tab, graf
Article in English | LILACS | ID: biblio-1357093


Abstract Objective To analyze the clinical and obstetric aspects of pregnant women with COVID-19. Methods A systematic literature review in the MEDLINE/PubMed, LILACS, SCIELO, and CNKI databases was performed from March to May 2020, with the descriptors: Pregnancy; 2019-nCov; Coronavirus; SARS-Cov-2, Covid-19. Of those chosen were original titles, without language and period restriction and that addressed pregnant women with a clinical and/or laboratory diagnosis of COVID-19. Revisions, editorials, and duplicate titles were excluded. The Newcastle-Ottawa (NOS) and Murad et al. scales were used to assess the quality of the studies. Results We included 34 articles with 412 pregnant women infected with severe acute respiratory syndrome (SARS-Cov-2), with an average age of 27.5 years of age and 36.0 gestational weeks. The most common symptom was fever (205 [49.7%]), and 89 (21.6%) pregnant women progressed to severe viral pneumonia. Laboratory tests showed an increase in C-reactive protein (154 [37.8%]), and radiological tests showed pneumonia with peripheral ground-glass pattern (172 [51.4%]). Emergency cesarean delivery was indicated for most pregnant women, and the most common gestational complication was premature rupture of ovarian membranes (14 [3.4%;]). We detected 2 (0.5%) neonatal deaths, 2 (0.5%) stillbirths, and 1 (0.2%) maternal death. Conclusion Pregnant women with COVID-19 presented a clinical picture similar to that of non-infected pregnant women, with few obstetric or neonatal repercussions. There was a greater indication of cesarean deliveries before the disease aggravated, and there was no evidence of vertical transmission of the infection.

Resumo Objetivo Analisar os aspectos clínicos e obstétricos de gestantes com COVID-19. Métodos Revisão sistemática da literatura nas bases: MEDLINE/PubMed, LILACS, SCIELO e CNKI, realizada de março a maio de 2020, com os descritores Pregnancy; 2019-nCov; Coronavirus; SARS-Cov-2, Covid-19. Elegeram-se títulos originais, sem restrição de idioma e período e que abordassem gestantes com diagnóstico clínico e/ou laboratorial de COVID-19. Excluíram-se revisões, editoriais, títulos duplicados. As escalas de Newcastle-Ottawa (NOS, na sigla em inglês) e a de Murad et al. foram utilizadas para avaliar a qualidade dos estudos. Resultados Foram incluídos 34 artigos com 412 gestantes infectadas pela síndrome respiratória aguda grave (SARS-Cov, na sigla em inglês) com idade média de 27,5 anos e média de 36,0 semanas gestacionais. O sintoma mais incidente foi a febre (49,7%;205). e 89 (21,6%) gestantes evoluíram para pneumonia viral grave. Os exames laboratoriais demonstraram aumento da proteína C reativa (37,8%; 154) e os radiológicos mostraram pneumonia com padrão em vidro fosco periférico (51,4%; 172). O parto cesáreo de emergência foi indicado para a maior parte das gestantes, e a complicação gestacional mais comum foi a ruptura prematura de membranas ovulares (3,4%; 14). Foram detectados 2 (0,5%) mortes neonatais, 2 (0,5%) natimortos, e 1 (0,2%) morte materna. Conclusão Gestantes com doença coronavírus (COVID-19, na sigla em inglês apresentaram quadro clínico semelhante a gestantes não infectadas, com poucas repercussões obstétricas ou neonatais. Houve uma maior indicação de partos cesáreos antes do agravamento da doença e não se observaram evidências de transmissão vertical da infecção.

Humans , Female , Pregnancy , Infant, Newborn , Adult , Pregnancy Complications, Infectious/diagnosis , Pregnancy Complications, Infectious/epidemiology , Pregnancy Outcome , Parturition , COVID-19 , Infectious Disease Transmission, Vertical , Pregnant Women , Premature Birth , SARS-CoV-2
Av. enferm ; 39(3): 356-365, 01 de septiembre de 2021.
Article in English | LILACS, BDENF, COLNAL | ID: biblio-1291126


Objective: To establish the degree of pharmacological and clinical compliance of family caregivers of HIV-exposed children as well as the sociodemographic factors associated with care performance. Materials and methods: Cross-sectional study conducted with 40 caregivers of children exposed to HIV and under specialized care service. The Ability Assessment Scale for the Care of HIV-exposed Children was used. Data were analyzed according to descriptive statistics and bivariate analysis using the Chisquare and Fisher's exact tests. Results: Caregivers' high ability for drug administration and clinical monitoring of HIV-exposed children was verified. There was a statistically significant difference between the care ability and infants' age. In the group with high care ability, there was a higher prevalence of young mothers with partners, unemployed, high school equivalent education, living with four to seven people, and receiving family support. Conclusion: Health services should consider sociodemographic factors and family support in the follow-up of HIV-exposed children by developing an expanded care plan and longitudinal interventions aimed at monitoring the ability of family caregivers to provide medication and clinical follow-up for children. Incorporating these strategies will contribute to improve pharmacological and clinical adherence of HIV-exposed children and to enhance the quality of health care.

Objetivo: establecer el grado de cumplimiento farmacológico y clínico de los familiares cuidadores de niños expuestos a VIH y los factores sociodemográficos asociados a la ejecución de esta atención. Materiales y métodos: estudio transversal realizado con 40 cuidadores de niños expuestos al VIH, quienes reciben atención especializada. Se utilizó la Escala de Evaluación de Capacidades para el Cuidado de Niños Expuestos al VIH. Los datos fueron analizados mediante el uso de estadística descriptiva y análisis bivariado, empleando la prueba de chi-cuadrado y el test exacto de Fisher. Resultados: se evidenció una alta capacidad por parte de los cuidadores para la administración de medicamentos y el seguimiento clínico de los niños expuestos a HIV. Además, hubo diferencias estadísticamente significativas entre la capacidad de cuidado y la edad de los niños. En el grupo con alta capacidad de atención hubo mayor prevalencia de madres jóvenes, con pareja, desempleadas, escolaridad equivalente a secundaria, que viven con entre cuatro y siete personas, y reciben apoyo de sus familias. Conclusión: los factores sociodemográficos y el apoyo familiar deben ser considerados por los servicios de salud durante el seguimiento a niños expuestos al VIH, para lo cual se debe elaborar un plan de atención ampliado e intervenciones longitudinales dirigidas a monitorear la capacidad de los cuidadores familiares de proporcionar medicación y seguimiento clínico a los niños. La incorporación de estas estrategias contribuirá a mejorar la adherencia farmacológica y clínica de niños expuestos a VIH, así como la calidad de la atención en salud.

Objetivo: estabelecer o grau de conformidade farmacológica e clínica dos familiares cuidadores de crianças expostas ao HIV e os fatores sociodemográficos associados à execução desses cuidados. Materiais e métodos: estudo transversal desenvolvido com 40 cuidadores de crianças nascidas expostas ao HIV em um serviço especializado. Utilizou-se a Escala de Avaliação da Capacidade para Cuidar de Crianças Expostas ao HIV. Os dados foram analisados segundo a estatística descritiva e a análise bivariada, com o teste de Qui-Quadrado e o exato de Fisher. Resultados: evidenciou-se alta capacidade dos cuidadores para a administração medicamentosa e acompanhamento clínico da criança exposta ao HIV. Houve diferença estatisticamente significativa entre a capacidade para cuidar e a idade da criança. No grupo com alta capacidade para o cuidado, houve maior prevalência de mães jovens com companheiros, desempregadas, escolaridade equivalente ao ensino médio, que residiam com quatro a sete pessoas e recebiam apoio familiar. Conclusões: fatores sociodemográficos e apoio familiar devem ser considerados pelos serviços de saúde no seguimento das crianças expostas ao HIV, mediante elaboração de plano de cuidado ampliado e intervenções longitudinais direcionadas ao gerenciamento da capacidade dos familiares cuidadores para a oferta medicamentosa e o acompanhamento clínico infantil. A incorporação dessas estratégias contribuirá para melhorar a adesão farmacológica e clínica em crianças expostas ao HIV e para a qualidade da atenção à saúde.

Adult , Pediatric Nursing , HIV , Caregivers , Infectious Disease Transmission, Vertical , Treatment Adherence and Compliance
Rev. Bras. Saúde Mater. Infant. (Online) ; 21(3): 785-794, July-Sept. 2021. tab, graf
Article in English | LILACS | ID: biblio-1346997


Abstract Objectives: to analyze the variation in the incidence rates of congenital syphilis according to the spatial distribution of Life Condition Index (LCI) among neighborhoods in the city of Recife-PE. Methods: an ecological study, developed from 3,234 cases of congenital syphilis notified in the Sistema de Informação de Agravos de Notificação (Severe Disease Notification Information System), between 2007 and 2016. LCI was built from seven variables related to the dimensions of the environment, education and income, aggregated at the neighborhood levels and spatially distributed in four strata: very high, high, low and very low. The correlation between the rates of congenital syphilis in the strata and LCI was investigated by applying the Spearman correlation coefficient and demonstrated by means of scatter graphics. Results: the mean rate on disease incidence was 6.8 cases per thousand live births. There was a higher incidence in the strata of very low and low living conditions, as well as in Districts that presented poor sanitary conditions and low schooling for the head of the family (District VII), higher proportion of illiteracy among 10 and 14 year olds (District II) and low income of the head of the household (Districts I, II and VII). Conclusions: this study showed the persistence of health inequalities in areas with worse living conditions.

Resumo Objetivos: analisar a variação das taxas de incidência de sífilis congênita segundo a distribuição espacial do Índice de Condição de Vida (ICV) entre os bairros do município do Recife-PE. Métodos: estudo ecológico, desenvolvido a partir de 3234 casos de sífilis congênita notificados no Sistema de Informação de Agravos de Notificação, entre 2007 e 2016. O ICV foi construído a partir de sete variáveis relacionadas as dimensões ambiente, educação e renda, agregadas ao nível dos bairros, e distribuído espacialmente em quatro estratos: muito alto, alto, baixo e muito baixo. A correlação entre as taxas de sífilis congênita nos estratos e o ICV foi investigada aplicando-se o coeficiente de correlação de Spearman e demonstrada por meio de gráficos de dispersão. Resultados: a taxa média de incidência da doença foi de 6,8 casos por mil nascidos vivos. Houve maior incidência nos estratos de condição de vida muito baixa e baixa bem como nos Distritos que apresentaram condições sanitárias ruins e baixa escolaridade do chefe da família (Distrito VII), maior proporção de analfabetismo entre 10 e 14 anos (Distrito II) e baixa renda do chefe do domicílio (Distritos I, II e VII). Conclusões: o estudo evidenciou a persistência das desigualdades de saúde nas áreas com piores condições de vida.

Humans , Female , Pregnancy , Infant, Newborn , Socioeconomic Factors , Syphilis, Congenital/epidemiology , Health Status Disparities , Social Factors , Economic Factors , Quality of Life , Brazil/epidemiology , Demography , Statistics, Nonparametric , Infectious Disease Transmission, Vertical , Disease Notification , Pregnant Women , Ecological Studies , Geographic Mapping
Ciênc. Saúde Colet ; 26(7): 2653-2662, jul. 2021. tab
Article in English, Portuguese | LILACS | ID: biblio-1278781


Resumo Neste estudo investigamos como vivências de estigma do HIV se expressam entre jovens soropositivos, em transição para a clínica de adultos, no serviço de saúde, na família e nas interações afetivos-sexuais e sua relação com as desigualdades e hierarquias sociais. O estudo envolveu 31 jovens (idade mediana 21) em transição para a clínica de adultos (G1) e 12 jovens (idade mediana 30) que já fizeram essa transição (G2), ambos atendidos num serviço de saúde do Rio de Janeiro. Dentre os 43 jovens, 70% eram mulheres e 65% foi infectado por transmissão vertical. Os jovens responderam a questionários e participaram de grupos focais sobre estigma da aids e passagem para a vida adulta. A maioria relatou situações de discriminação associadas ao estigma do HIV na vida cotidiana e no cuidado em saúde. Os jovens do G1 revelaram maior preocupação com as consequências da revelação do HIV e dificuldades com o tratamento. Os relatos do G2 sugerem que a constituição de relações conjugais, incluindo parceiro/a e filhos soronegativos e o acesso ao tratamento, possibilitaram resignificar o receio da estigmatização. Os achados visam orientar a formação e ação de profissionais envolvidos na prevenção e cuidado de jovens vivendo com HIV.

Abstract This study analyzes how experiences of HIV-related stigma are expressed among HIV-positive young people transitioning to an adult clinic, the health service, the family, the affective-sexual interactions, and their relationship with inequalities and social hierarchies. This research included 31 young people (median age 21) transitioning to an adult clinic (G1) and 12 young people (median age 30) who had already made this transition (G2), both monitored at a health service in Rio de Janeiro. Seventy percent of the 43 young people were women and 65% were infected by mother-to-child transmission. Young people answered questionnaires and participated in focus groups on AIDS stigma and transition to adulthood. Most reported discrimination associated with HIV stigma in daily life and health care. G1 young people showed more significant concern about the consequences of HIV disclosure and difficulties with treatment. The G2 accounts suggest that establishing marital relationships, including HIV-negative partners and children, linked to treatment access allowed resignifying the fear of stigmatization. The findings aim to guide the training and action of professionals involved in the prevention and care of young people living with HIV.

Humans , Female , Adolescent , Adult , Young Adult , HIV Infections/epidemiology , Infectious Disease Transmission, Vertical , Brazil , Social Stigma , Hospitals, Public
Arch. argent. pediatr ; 119(3): 208-212, Junio 2021. tab, ilus
Article in English, Spanish | LILACS, BINACIS | ID: biblio-1223006


La infección crónica con el virus C de la hepatitis constituye un problema de salud a nivel mundial, tanto en niños como en adultos. Su eliminación espontánea puede ocurrir durante la infancia temprana, y luego es infrecuente. Aunque la mayoría de los casos son asintomáticos en la infancia y adolescencia, al llegar a la edad adulta, los pacientes pueden evolucionar a la cirrosis y presentar complicaciones, que incluyen el carcinoma hepatocelular. Un tratamiento eficaz debe tener como meta la eliminación del virus, lo que significaría la curación de la enfermedad. Recientemente, el advenimiento de varios agentes antivirales de acción directa ha posibilitado una alta resolución de la infección, del 97-100 % de los casos. Para lograr este objetivo costo-efectivo, es fundamental la concientización de los pediatras en la detección de los pacientes infectados y su derivación al especialista hepatólogo pediatra para la implementación del tratamiento adecuado.

Chronic hepatitis C virus infection is a health problem worldwide, both in children and adults. Its spontaneous resolution may occur during early childhood, and then it becomes uncommon. Although most cases are asymptomatic during childhood and adolescence, as adults, patients may progress to cirrhosis and develop complications, including hepatocellular carcinoma. The goal of an effective treatment should be virus elimination, i.e., disease cure. Recently, the emergence of several direct-acting antivirals has enabled a high rate of infection resolution in 97-100 % of cases. To achieve this cost-effective objective, it is critical to raise awareness among pediatricians so that they can detect infected patients and refer them to a pediatric liver specialist for an adequate management.

Humans , Male , Female , Pregnancy , Infant, Newborn , Infant , Child, Preschool , Child , Adolescent , Hepatitis C/therapy , Hepatitis C/transmission , Antiviral Agents/therapeutic use , Hepatitis C/etiology , Infectious Disease Transmission, Vertical
Medicina (B.Aires) ; 81(2): 257-268, June 2021. graf
Article in Spanish | LILACS | ID: biblio-1287278


Resumen La transmisión vertical de la infección por Toxoplasma gondii ocurre cuando la madre se infecta por primera vez en el transcurso del embarazo. El diagnóstico de la infección materna y la del re cién nacido se logra con el conjunto de pruebas serológicas, hallazgos clínicos y ecográficos. El reconocimiento temprano de la infección materna permite un tratamiento que reduce la tasa de transmisión y el riesgo de daño en el producto de la concepción. El objetivo de este consenso de expertos fue revisar la literatura científica para actualizar las recomendaciones de práctica clínica respecto de la prevención, el diagnóstico y el tratamiento de la toxoplasmosis congénita en nuestro país.

Abstract Mother-to-child transmission in Toxoplasma gondii infection occurs only when the infection is acquired for the first time during pregnancy. Diag nosis of maternal infection and the newborn is achieved by a combination of serological tests, clinical features and ultrasound images. An early diagnosis of maternal infection allows treatment that offers a reduction both in transmission rate and risk of congenital damage. The aim of this expert consensus was to review the scientific literature which would enable an update of the clinical practice guideline of prevention, diagnosis and treatment of congenital toxoplasmosis in our country.

Humans , Female , Pregnancy , Infant, Newborn , Child , Toxoplasma , Toxoplasmosis , Toxoplasmosis, Congenital/diagnosis , Toxoplasmosis, Congenital/prevention & control , Toxoplasmosis, Congenital/drug therapy , Pregnancy Complications, Parasitic , Infectious Disease Transmission, Vertical/prevention & control , Consensus , Medical History Taking
Rev. bras. ginecol. obstet ; 43(6): 474-479, June 2021. tab
Article in English | LILACS | ID: biblio-1341139


Abstract Placental pathophysiology in SARS-CoV-2 infection can help researchers understand more about the infection and its impact on thematernal/neonatal outcomes. This brief review provides an overview about some aspects of the placental pathology in SARSCoV- 2 infection. In total, 11 papers were included. The current literature suggests that there are no specific histopathological characteristics in the placenta related to SARSCoV- 2 infection, but placentas frominfected women aremore likely to show findings of maternal and/or fetal malperfusion. The most common findings in placentas from infected women were fibrin deposition and intense recruitment of inflammatory infiltrates. The transplacental transmission of this virus is unlikely to occur, probably due to low expression of the receptor for SARS-CoV-2 in placental cell types. Further studies are needed to improve our knowledge about the interaction between the virus and the mother-fetus dyad and the impact on maternal and neonatal/fetal outcomes.

Resumo A fisiopatologia da placenta na infecção por SARS-CoV-2 pode ajudar os pesquisadores a entender mais sobre a infecção e seu impacto nos resultados maternos/neonatais. Esta revisão breve fornece uma visão geral sobre alguns aspectos da patologia placentária na infecção por SARS-CoV-2. Ao todo, 11 artigos foram incluídos. A literatura atual sugere que não há características histopatológicas específicas nas placentas relacionadas à infecção por SARS-CoV-2, mas as placentas de mulheres infectadas têm maior probabilidade de apresentar achados de má perfusão materna e/ou fetal. Os achados mais comuns em placentas de mulheres infectadas foram deposição de fibrina e intenso recrutamento de infiltrado inflamatório. A transmissão transplacentária deste vírus é improvável, devido à baixa expressão do receptor para SARS-CoV-2 em tipos de células da placenta. Mais estudos são necessários para melhorar nosso conhecimento sobre a interação entre o vírus e a díade mãe-feto e o impacto nos resultados maternos e neonatais/fetais.

Humans , Female , Pregnancy , Placenta/pathology , Pregnancy Complications, Infectious/pathology , COVID-19/pathology , Placenta/physiopathology , Placenta/blood supply , Placenta/virology , Pregnancy Complications, Infectious/physiopathology , Pregnancy Complications, Infectious/virology , Infectious Disease Transmission, Vertical , COVID-19/physiopathology , COVID-19/virology
Arch. argent. pediatr ; 119(5): e531-e535, oct. 2021. tab, ilus
Article in English, Spanish | LILACS, BINACIS | ID: biblio-1292781


La enfermedad por coronavirus de 2019 (COVID-19), causada por el coronavirus 2 del síndrome respiratorio agudo grave (SARS-CoV-2), se convirtió en la primera pandemia del siglo XXI. La infección por SARS-CoV-2 se transmite principalmente a través de las gotículas. Si bien se han informado algunos casos de transmisión perinatal, no es claro si estas infecciones fueron resultado de la vía de contagio transplacentario o transcervical o de la exposición ambiental. En este artículo, presentamos el caso de un recién nacido que falleció por síndrome de dificultad respiratoria aguda neonatal con compromiso pulmonar grave. El bebé nació por cesárea de una madre con una PCR positiva para COVID-19 y se detectó que tenía una PCR positiva para COVID-19 mediante un hisopado nasofaríngeo en el transcurso de las 24 horas posteriores al parto debido a una sospecha de transmisión transplacentaria del SARS-CoV-2 de la madre al feto.

Coronavirus disease 2019 (COVID-19), caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), is the first pandemic of the 21st century. SARS-CoV-2 infection is mainly transmitted via droplets. Although some cases of peri-natal transmission have been reported, it is unclear whether these infections occurred via transplacental or transcervical routes or via environmental exposure. Herein, we present the case of a newborn who died with neo-natal acute respiratory distress syndrome exhibiting severe pulmonary involvement. The baby was born to a COVID-19 PCR (+) mother by C-section and was found to be COVID-19 PCR (+) from a nasopharyngeal swab sample tested within 24 hours of birth due to the suspected transplacental transmission of SARS-CoV-2 from the mother to the fetus.

Humans , Pregnancy , Infant, Newborn , Pregnancy Complications, Infectious/diagnosis , Respiratory Distress Syndrome, Newborn/diagnosis , Respiratory Distress Syndrome, Newborn/etiology , COVID-19 , Infectious Disease Transmission, Vertical , SARS-CoV-2
Rev. bras. ginecol. obstet ; 43(5): 384-394, May 2021. tab, graf
Article in English | LILACS | ID: biblio-1288564


Abstract Objective Coronavirus disease 2019 (COVID-19) is a disease caused by a newly discovered coronavirus, severe acute respiratory syndrome coronavirus 2 (SARSCoV-2), which usually leads to non-specific respiratory symptoms. Although pregnant women are considered at risk for respiratory infections by other viruses, such as SARS and Middle East respiratory syndrome (MERS), little is known about their vulnerability to SARS-CoV-2. Therefore, this study aims to identify and present the main studies on the topic, including the postpartum period. Methods In this narrative review, articles were searched in various databases, organizations, and health entities using keywords compatible with medical subject headings (MeSH), such as: COVID-19, pregnancy, vertical transmission, coronavirus 2019, and SARS-CoV-2. Results The review of the scientific literature on the subject revealed that pregnant women with COVID-19 did not present clinical manifestations significantly different from those of non-pregnant women; however, there are contraindicated therapies. Regarding fetuses, studies were identified that reported that infection by SARS-CoV-2 in pregnant women can cause fetal distress, breathing difficulties and premature birth, but there is no substantial evidence of vertical transmission. Conclusion Due to the lack of adequate information and the limitations of the analyzed studies, it is necessary to provide detailed clinical data on pregnant women infected with SARS-CoV-2 and on the maternal-fetal repercussions caused by this infection. Thus, this review may contribute to expand the knowledge of professionals working in the area as well as to guide more advanced studies on the risk related to pregnant women and their newborns. Meanwhile, monitoring of confirmed or suspected pregnant women with COVID-19 is essential, including in the postpartum period.

Resumo Objetivo A Coronavirus disease 2019 (COVID-19) é uma doença causada por um coronavírus recém descoberto, o severe acute respiratory syndrome coronavirus 2 (SARSCoV-2), que geralmente leva a sintomas respiratórios não específicos. Embora mulheres grávidas sejam consideradas em risco de infecções respiratórias por outros vírus, como SARS e Middle East respiratory syndrome (MERS), pouco se sabe sobre sua vulnerabilidade ao SARS-CoV-2. Portanto, este estudo tem como objetivo identificar e apresentar os principais estudos sobre o tema incluindo o período pós-parto. Métodos Nesta revisão narrativa, foram pesquisados artigos em diversas bases de dados, organizações e entidades de saúde, utilizando palavras-chave compatíveis com o MeSH, tais como: COVID-19, gravidez, transmissão vertical, coronavírus 2019, e SARSCoV-2. Resultados A revisão da literatura científica sobre o assunto revelou que as gestantes com COVID-19 não apresentaram manifestações clínicas significativamente diferentes das não gestantes, porém existem terapias contraindicadas. Em relação aos fetos, foramidentificados estudos que relataram que a infecção por SARS-CoV-2 em mulheres grávidas pode causar sofrimento fetal, dificuldades respiratórias e parto prematuro, mas não há evidências substanciais de transmissão vertical. Conclusão Devido à falta de informações adequadas e às limitações dos estudos analisados, é necessário fornecer dados clínicos detalhados sobre as gestantes infectadas pelo SARS-CoV-2 e sobre as repercussões materno-fetais causadas por esta infecção. Assim, esta revisão pode contribuir para ampliar o conhecimento dos profissionais que atuam na área, bem como para orientar estudos mais avançados sobre o risco relacionado à gestante e seu recém-nascido. Enquanto isso, o monitoramento de gestantes confirmadas ou suspeitas com COVID-19 é essencial, incluindo o pós-parto.

Humans , Female , Pregnancy , Pregnancy Complications, Infectious/diagnosis , Pregnancy Complications, Infectious/therapy , COVID-19/diagnosis , COVID-19/therapy , Pregnancy Complications, Infectious/virology , Infectious Disease Transmission, Vertical , COVID-19/transmission