Environmental and behavioral factors associated with household transmission of SARS-CoV-2 in children and adolescents.

Objective: To analyze the association between risk behaviors and environmental factors and SARS-CoV-2 infection in children and adolescents in the family environment. Methods: Cross-sectional study. A total of 267 children and adolescents aged 5-19 years who have contact with COVID-19-positive essential workers were tested between June and October 2020. Behavioral and environmental variables associated with SARS-CoV-2 infection were investigated. Association between these variables was performed using Poisson regression. Results: SARS-CoV-2 prevalence was 25.1%. Following the confirmation of COVID-19 diagnosis of the index case, 92.1% of adults reported hand hygiene and 83.5% showed habits of respiratory etiquette. However, 12.7% wore masks in common areas of the residence before COVID-19. Sharing common objects was a risk factor for SARS-CoV-2 infection in the sample. Conclusion: Sharing objects among family members was identified as a risk factor associated with SARS-CoV-2 infection in children and adolescents who lived with infected adults. There was high frequency of hand hygiene and low prevalence of mask use.

Timeliness and risk factors associated with delay for pneumococcal conjugate 10-valent routine immunization in Brazilian children.

BACKGROUND: Vaccination coverage is the usual metrics to evaluate the immunization programs performance. For the 10-valent pneumococcal conjugate (PCV10) vaccine, measuring the delay of vaccination is also important, particularly as younger children are at increased risk of disease. Routinely collected administrative data was used to assess the timeliness of PCV10 vaccination, and the factors associated with delay to receive the first and second doses, and the completion of the PCV10 3+1 schedule. METHODS: A population-based retrospective cohort study was conducted with children born in 2012 in Central Brazil. Children who received the PCV10 first dose in public health services were followed-up until 23months of age. Timeliness of receiving each PCV10 dose at any given age was defined as receiving the dose within 28days grace period from the recommended age by the National Immunization Program. Log-binomial regression models were used to examine risk factors for delays of the first dose and the completion PCV10 3+1 schedule. RESULTS: In total, 14,282 children were included in the cohort of study. Delayed vaccination occurred in 9.4%, 23.8%, 36.8% and 39.9% children for the first, second, third and the booster doses, respectively. A total of 1912 children (12.8% of the cohort) were not adequately vaccinated at the 6months of life; 1,071 (7%) received the second dose after 6months of age, 784 (5.4%) did not receive the second dose, and 57 (0.4%) received the first dose after six months of life. CONCLUSION: A considerable delay was found in PCV10 third and booster doses. Almost 2 thousand children had not received the recommended PCV10 doses at 6months of age. Timeliness of vaccination is an issue in Brazil although high vaccination coverages.

Effect of 10-valent pneumococcal vaccine on pneumonia among children, Brazil.

Pneumonia is most problematic for children in developing countries. In 2010, Brazil introduced a 10-valent pneumococcal conjugate vaccine (PCV10) to its National Immunization Program. To assess the vaccine's effectiveness for preventing pneumonia, we analyzed rates of hospitalization among children 2-24 months of age who had pneumonia from all causes from January 2005 through August 2011. We used data from the National Hospitalization Information System to conduct an interrupted time-series analysis for 5 cities in Brazil that had good data quality and high PCV10 vaccination coverage. Of the 197,975 hospitalizations analyzed, 30% were for pneumonia. Significant declines in hospitalizations for pneumonia were noted in Belo Horizonte (28.7%), Curitiba (23.3%), and Recife (27.4%) but not in São Paulo and Porto Alegre. However, in the latter 2 cities, vaccination coverage was less than that in the former 3. Overall, 1 year after introduction of PCV10, hospitalizations of children for pneumonia were reduced.

Projeto Nascer feliz: açôes integradas para a reduçâo da mortalidade infantil / Nascer feliz project: integrated actions to reduce infant mortality

Em 2003, a Secretaria Municipal da Saúde (SMS) de Goiânia, objetivando dar continuidade à reduçao da morbimortalidade infantil, propôs a implementaçao e implantaçao de um conjunto de ações de intervençao, com foco no período neonatal. A vigilância dos óbitos infantis apontouindicadores relativos àas causas básicas da mortalidade infantil na cidade. as ações desenvolvidas foram múltiplas, enfatizando o planejamento familiar, pré-natal, parto, atençao aos recém-nascidos, especialmente de alto risco. Como resultado, observou-se a reduçao da mortalidade infantil de 17,7 em 2000 para 14,4 para cada mil nascidos vivos em 2003. Destacam-se no mesmo período, quedas de 26,6 por cento dos óbitos fetais e 18 por cento de gravidez na adolescência, e aumento de 9 por cento do número de gestantes com mais de sete consultas de pré-natal