ABSTRACT
Background: The COVID-19 situation in Brazil is complex due to large differences in the shape and size of regional epidemics. Understanding these patterns is crucial to understand future outbreaks of SARS-CoV-2 or other respiratory pathogens in the country. Methods: We tested 97,950 blood donation samples for IgG antibodies from March 2020 to March 2021 in 8 of Brazil's most populous cities. Residential postal codes were used to obtain representative samples. Weekly age- and sex-specific seroprevalence were estimated by correcting the crude seroprevalence by test sensitivity, specificity, and antibody waning. Results: The inferred attack rate of SARS-CoV-2 in December 2020, before the Gamma variant of concern (VOC) was dominant, ranged from 19.3% (95% credible interval [CrI] 17.5-21.2%) in Curitiba to 75.0% (95% CrI 70.8-80.3%) in Manaus. Seroprevalence was consistently smaller in women and donors older than 55 years. The age-specific infection fatality rate (IFR) differed between cities and consistently increased with age. The infection hospitalisation rate increased significantly during the Gamma-dominated second wave in Manaus, suggesting increased morbidity of the Gamma VOC compared to previous variants circulating in Manaus. The higher disease penetrance associated with the health system's collapse increased the overall IFR by a minimum factor of 2.91 (95% CrI 2.43-3.53). Conclusions: These results highlight the utility of blood donor serosurveillance to track epidemic maturity and demonstrate demographic and spatial heterogeneity in SARS-CoV-2 spread. Funding: This work was supported by Itaú Unibanco 'Todos pela Saude' program; FAPESP (grants 18/14389-0, 2019/21585-0); Wellcome Trust and Royal Society Sir Henry Dale Fellowship 204311/Z/16/Z; the Gates Foundation (INV- 034540 and INV-034652); REDS-IV-P (grant HHSN268201100007I); the UK Medical Research Council (MR/S0195/1, MR/V038109/1); CAPES; CNPq (304714/2018-6); Fundação Faculdade de Medicina; Programa Inova Fiocruz-CE/Funcap - Edital 01/2020 Number: FIO-0167-00065.01.00/20 SPU N°06531047/2020; JBS - Fazer o bem faz bem.
Subject(s)
COVID-19 , Antibodies, Viral , Blood Donors , Brazil/epidemiology , COVID-19/epidemiology , Cross-Sectional Studies , Female , Humans , Immunoglobulin G , Male , SARS-CoV-2 , Seroepidemiologic StudiesABSTRACT
Este trabalho é recorte de uma pesquisa desenvolvida em uma escola de Ensino Fundamental - anos iniciais. O objetivo da pesquisa foi analisar a percepção dos professores sobre a importância da sala de recursos multifuncional Tipo I - Atendimento Educacional Especializado - AEE, no processo de inclusão do aluno com deficiência intelectual no ensino regular. A pesquisa contou com a participação de quatro profissionais da educação, os quais exercem diferentes funções na escola. No estudo foram seguidos os pressupostos da pesquisa qualitativa, com ênfase nas práticas da pesquisa-ação, utilizando entrevistas com roteiros semiestruturados, para coleta de dados. O referencial teórico contempla breve histórico da Educação Especial, apontando a deficiência intelectual como um dos maiores desafios nesse processo. Apresenta a sala de recursos como apoio no processo inclusivo e a importância da presença do professor especializado, para esse atendimento. Os resultados ressaltam a importância da sala de recursos no processo inclusivo. Contudo, revela que o trabalho nela desenvolvido não deve e não pode ser confundido com reforço escolar ou repetição de conteúdos curriculares da classe regular. Ela deve ser um espaço de desafio no qual o aluno, com deficiência, encontra condições necessárias para o desenvolvimento do processo de aprendizagem, com vistas à superação de seu próprio limite, em busca da verdadeira inclusão.
This paper is part of a study carried out at an elementary school - beginning years. The study's aim was to analyze teachers - perceptions of the importance of a multifunctional resource classroom type I - Specialized Educational Service - SES in the inclusion process of students with intellectual disabilities in regular education. Four education professionals, who have different functions in the school, participated in the study. Qualitative research guidelines were followed, with emphasis on action-research practices, using a semi-structured interview guide for data collection. The theoretical framework covers a brief history of special education, indicating that intellectual disability is one of the biggest challenges in this process. The paper presents the resource classroom as a major support in the inclusive process, and highlights the importance of specialized teachers in this service. The results emphasize the importance of the resource classroom in the inclusive process. However, the study defends that the work carried out in that venue should not be confused with school tutoring or repetition of regular class curriculum content. It should provide challenging conditions in which students with disabilities encounter what they need in order to develop their learning process, so as to overcome their own limits, on the way to real inclusion.