Striatal Dopamine Contributions to Skilled Motor Learning.

Coordinated multijoint limb and digit movements-"manual dexterity"-underlie both specialized skills (e.g., playing the piano) and more mundane tasks (e.g., tying shoelaces). Impairments in dexterous skill cause significant disability, as occurs with motor cortical injury, Parkinson's disease, and a range of other pathologies. Clinical observations, as well as basic investigations, suggest that corticostriatal circuits play a critical role in learning and performing dexterous skills. Furthermore, dopaminergic signaling in these regions is implicated in synaptic plasticity and motor learning. Nonetheless, the role of striatal dopamine signaling in skilled motor learning remains poorly understood. Here, we use fiber photometry paired with a genetically encoded dopamine sensor to investigate striatal dopamine release in both male and female mice as they learn and perform a skilled reaching task. Dopamine rapidly increases during a skilled reach and peaks near pellet consumption. In the dorsolateral striatum, dopamine dynamics are faster than in the dorsomedial and ventral striatum. Across training, as reaching performance improves, dopamine signaling shifts from pellet consumption to cues that predict pellet availability, particularly in medial and ventral areas of the striatum. Furthermore, performance prediction errors are present across the striatum, with reduced dopamine release after an unsuccessful reach. These findings show that dopamine dynamics during skilled motor behaviors change with learning and are differentially regulated across striatal subregions.

Impact of the COVID-19 pandemic on excess maternal deaths in Brazil: A two-year assessment.

BACKGROUND: Accurate estimates of the COVID-19 pandemic's indirect impacts are crucial, especially in low- and middle-income countries. This study aims to update estimates of excess maternal deaths in Brazil during the first two years of the COVID-19 pandemic. METHODS: This was an exploratory mixed ecological study using the counterfactual approach. The observed maternal deaths were gathered from the Mortality Information System (SIM) for the period between March 2015 and February 2022. Expected deaths from March 2020 to February 2022 were estimated using quasipoisson generalized additive models, considering quadrimester, age group, and their interaction as predictor variables. Analyses were performed in R version 4.1.2, RStudio, version 2023.03.1+446 and carried out with support from the "mgcv" and "plot_model" libraries. RESULTS: A total of 5,040 maternal deaths were reported, with varying excess mortality across regions and age groups, resulting in 69% excess maternal mortality throughout Brazil during the first two years of the pandemic. The Southeast region had 50% excess mortality throughout the first two years and 76% excess in the second year. The North region had 69% excess mortality, increasing in the second year, particularly among women aged 20-34. The Northeast region showed 80% excess mortality, with a significant increase in the second year, especially among women aged 35-49. The Central-West region had 75% excess mortality, higher in the second year and statistically significant among women aged 35-49. The South region showed 117% excess mortality, reaching 203% in the second year among women aged 20-34, but no excess mortality in the 10-19 age category. CONCLUSIONS: Over two years, Brazil saw a significant impact on maternal excess deaths, regardless of region and pandemic year. The highest peak occurred between March and June 2021, emphasizing the importance of timely and effective epidemic responses to prevent avoidable deaths and prepare for new crises.

Striatal dopamine contributions to skilled motor learning.

Coordinated multi-joint limb and digit movements - "manual dexterity" - underlie both specialized skills (e.g., playing the piano) and more mundane tasks (e.g., tying shoelaces). Impairments in dexterous skill cause significant disability, as occurs with motor cortical injury, Parkinson's Disease, and a range of other pathologies. Clinical observations, as well as basic investigations, suggest that cortico-striatal circuits play a critical role in learning and performing dexterous skills. Furthermore, dopaminergic signaling in these regions is implicated in synaptic plasticity and motor learning. Nonetheless, the role of striatal dopamine signaling in skilled motor learning remains poorly understood. Here, we use fiber photometry paired with a genetically encoded dopamine sensor to investigate striatal dopamine release as mice learn and perform a skilled reaching task. Dopamine rapidly increases during a skilled reach and peaks near pellet consumption. In dorsolateral striatum, dopamine dynamics are faster than in dorsomedial and ventral striatum. Across training, as reaching performance improves, dopamine signaling shifts from pellet consumption to cues that predict pellet availability, particularly in medial and ventral areas of striatum. Furthermore, performance prediction errors are present across the striatum, with reduced dopamine release after an unsuccessful reach. These findings show that dopamine dynamics during skilled motor behaviors change with learning and are differentially regulated across striatal subregions.

Risk factors for intensive care unit admission and death from COVID-19 in fully vaccinated patients hospitalized for severe COVID-19, Brazil, 2021–2022

[ABSTRACT]. Objectives. To assess factors associated with admission to an intensive care unit (ICU) and death from corona- virus disease 2019 (COVID-19) in fully vaccinated patients with severe COVID-19 in Brazil and the association between ICU admission and death from COVID-19. Methods. This was retrospective study of patients hospitalized for COVID-19 from February 12, 2021 to Jan- uary 10, 2022 across Brazil who were fully vaccinated against COVID-19 before hospitalization. Outcomes were admission in an ICU for COVID-19 and death from COVID-19. Variables evaluated were: sex; age; self-re- ported skin color; macroregion; comorbidities; time between full vaccination and onset of symptoms; and time between onset of symptoms and hospitalization. A Poisson regression model was used to estimate crude and adjusted risk ratios. Results. Of 74 991 patients hospitalized for severe COVID-19, 67.28% were ≥ 70 years and 68.32% had at least one comorbidity. Men, patients aged 60–69 years, and patients aged 18–39 years with obesity had the greatest risk of ICU admission. Patients aged 18–39 years with obesity, diabetes, or renal diseases had the highest risk of death from COVID-19. When age and time between onset of symptoms and hospitalization were considered effect modifiers, patients admitted to an ICU 9–13 days after symptom onset in each age category had the greatest risk of death from COVID-19. Conclusion. Although older patients were at greatest risk of ICU admission and death from COVID-19, the difference in the risk of dying from COVID-19 between patients admitted to an ICU and those not admitted was greatest for young adults.

[RESUMEN]. Objetivos. Evaluar los factores asociados con el ingreso en la unidad de cuidados intensivos (UCI) y la muerte por la enfermedad del coronavirus del 2019 (COVID-19) en pacientes con el esquema completo de vacunación que presentan un cuadro grave de COVID-19, así como la relación entre el ingreso en la UCI y la muerte por esta enfermedad en Brasil. Métodos. Se realizó en Brasil un estudio retrospectivo de pacientes hospitalizados con COVID-19 del 12 de febrero del 2021 al 10 de enero del 2022 que habían recibido el esquema completo de vacunación contra la COVID-19 antes de ser hospitalizados. Los resultados fueron el ingreso en la UCI debido a la COVID-19 y la muerte por esta enfermedad. Las variables evaluadas fueron sexo, edad, color de piel autonotificado, mac- rorregión, comorbilidades, período entre el esquema completo de vacunación y la aparición de los síntomas y período entre el inicio de los síntomas y la hospitalización. Se utilizó un modelo de regresión de Poisson para estimar los cocientes de riesgo crudo y ajustado. Resultados. De los 74 991 pacientes hospitalizados con un cuadro grave de COVID-19, 67,28% tenía 70 años o más y 68,32% tenía al menos una comorbilidad. Los varones, los pacientes de 60 a 69 años y los paci- entes de 18 a 39 años con obesidad presentaron el mayor riesgo de ingreso en la UCI. Los pacientes de 18 a 39 años con obesidad, diabetes o enfermedades renales presentaban el mayor riesgo de muerte por esta enfermedad. Cuando la edad y el período entre el inicio de los síntomas y la hospitalización se consideraron modificadores del efecto, los pacientes ingresados en la UCI entre 9 y 13 días después del inicio de los sín- tomas en cada categoría de edad presentaron el mayor riesgo de muerte debido a la COVID-19. Conclusión. Aunque los pacientes de mayor edad presentaron el mayor riesgo de ingreso en la UCI y muerte debido a la COVID-19, la diferencia en el riesgo de morir por esta enfermedad entre pacientes ingresados en la UCI y pacientes no ingresados fue más elevada en adultos jóvenes.

[RESUMO]. Objetivos. Avaliar fatores associados à admissão em unidade de tratamento intensivo (UTI) e óbito por doença do coronavírus 2019 em pacientes com COVID-19 grave, totalmente vacinados, no Brasil, bem como a relação entre a entrada na UTI e a morte por COVID-19. Métodos. Estudo retrospectivo de pacientes hospitalizados com COVID-19, de 12 de fevereiro de 2021 a 10 de janeiro de 2022, em todo o Brasil, que tinham o esquema vacinal completo contra a COVID-19 antes da hospitalização. Os desfechos foram a admissão em UTI devido à COVID-19 e a morte em decorrência da doença. As variáveis avaliadas foram sexo, idade, cor da pele autodeclarada, macrorregião, comorbidades, tempo entre a vacinação completa e o início dos sintomas, e tempo entre o início dos sintomas e a internação. Para estimar os coeficientes de risco bruto e ajustado foi usado um modelo de regressão de Poisson. Resultados. Dos 74.991 pacientes internados com quadro de COVID-19 grave, 67,28% tinham ≥ 70 anos e 68,32% apresentavam pelo menos uma comorbidade. Os homens, pacientes entre 60-69 anos e pacientes entre 18-39 anos com obesidade tinham o maior risco de internação na UTI. Os pacientes de 18-39 anos de idade com obesidade, diabetes ou doenças renais apresentavam o maior risco de morte por COVID-19. Quando a idade e o intervalo entre o início dos sintomas e a hospitalização foram considerados modificadores de efeito, os pacientes admitidos em UTI entre 9 e 13 dias após o início dos sintomas em cada categoria de idade tinham o maior risco de morte devido à COVID-19. Conclusão. Embora os pacientes mais velhos tivessem maior risco de admissão na UTI e morte por COVID- 19, a diferença no risco de óbito pelo coronavírus entre os pacientes admitidos em uma UTI e aqueles não admitidos foi maior para os adultos jovens.

Obesity and COVID-19 in-hospital fatality in southern Brazil: impact by age and skin color

ABSTRACT OBJECTIVES To estimate the relative risk (RR) of death associated with obesity, the attributable fraction in the exposed/with obesity (AFo), and the hospitalized population attributable risk (hospitalized PAR) associated with obesity of death among all adults and among Black and non-Black adults hospitalized for severe COVID-19 in the state of Rio Grande do Sul, Brazil. METHODS This retrospective cohort study of prognostic factors analyzed all cases of adults hospitalized for severe COVID-19 in the state of Rio Grande do Sul, Brazil. The occurrence of obesity was measured using secondary data from hospital teams' surveillance records. The outcome assessed was hospital deaths caused by severe COVID-19. Poisson regression was used to estimate RRs and 95% confidence intervals (95%CI). RESULTS The study sample consisted of 100,099 patients hospitalized for severe COVID-19, most of whom were White (84.7%) and male (54.7%). The effect of obesity was strongly modified by age, being higher in younger age groups. For the 18-39-year-old age group, RR = 2.54 (95%CI: 2.33-2.77), and in individuals 70 years and above, RR = 1.09 (95%CI: 1.05-1.13). For the 18-39-year-old age range, AFo = 60.6% and AFo = 42.5% in individuals 40-59 years old. For all hospitalizations, Hospitalized PAR measuring obesity for individuals 18-39 years old was 25.3%, while in the 40-59-year-old range, the hospitalized PAR = 11.2%. The hospitalized PAR was 31.7% in the Black population aged 18-39 years and 24.8% in non-Blacks. The hospitalized PAR was also larger in Blacks aged 40-59 years. CONCLUSIONS Obesity largely impacted in-hospital case-fatality rates among young adults and Black people contaminated by COVID-19. These data highlight the extent of the risk concerning obesity, a highly prevalent chronic condition.

Risk factors for intensive care unit admission and death from COVID-19 in fully vaccinated patients hospitalized for severe COVID-19, Brazil, 2021-2022 / Factores de riesgo para el ingreso en la unidad de cuidados intensivos y la muerte debido a la COVID-19 en pacientes con el esquema completo de vacunación hospitalizados por COVID-19 grave en Brasil, 2021-2022 / Fatores de risco para admissão em unidade de terapia intensiva e óbito pelo coronavírus em pacientes totalmente vacinados, internados por COVID-19 grave no Brasil, 2021-2022

ABSTRACT Objectives. To assess factors associated with admission to an intensive care unit (ICU) and death from coronavirus disease 2019 (COVID-19) in fully vaccinated patients with severe COVID-19 in Brazil and the association between ICU admission and death from COVID-19. Methods. This was retrospective study of patients hospitalized for COVID-19 from February 12, 2021 to January 10, 2022 across Brazil who were fully vaccinated against COVID-19 before hospitalization. Outcomes were admission in an ICU for COVID-19 and death from COVID-19. Variables evaluated were: sex; age; self-reported skin color; macroregion; comorbidities; time between full vaccination and onset of symptoms; and time between onset of symptoms and hospitalization. A Poisson regression model was used to estimate crude and adjusted risk ratios. Results. Of 74 991 patients hospitalized for severe COVID-19, 67.28% were ≥ 70 years and 68.32% had at least one comorbidity. Men, patients aged 60-69 years, and patients aged 18-39 years with obesity had the greatest risk of ICU admission. Patients aged 18-39 years with obesity, diabetes, or renal diseases had the highest risk of death from COVID-19. When age and time between onset of symptoms and hospitalization were considered effect modifiers, patients admitted to an ICU 9-13 days after symptom onset in each age category had the greatest risk of death from COVID-19. Conclusion. Although older patients were at greatest risk of ICU admission and death from COVID-19, the difference in the risk of dying from COVID-19 between patients admitted to an ICU and those not admitted was greatest for young adults.

RESUMEN Objetivos. Evaluar los factores asociados con el ingreso en la unidad de cuidados intensivos (UCI) y la muerte por la enfermedad del coronavirus del 2019 (COVID-19) en pacientes con el esquema completo de vacunación que presentan un cuadro grave de COVID-19, así como la relación entre el ingreso en la UCI y la muerte por esta enfermedad en Brasil. Métodos. Se realizó en Brasil un estudio retrospectivo de pacientes hospitalizados con COVID-19 del 12 de febrero del 2021 al 10 de enero del 2022 que habían recibido el esquema completo de vacunación contra la COVID-19 antes de ser hospitalizados. Los resultados fueron el ingreso en la UCI debido a la COVID-19 y la muerte por esta enfermedad. Las variables evaluadas fueron sexo, edad, color de piel autonotificado, macrorregión, comorbilidades, período entre el esquema completo de vacunación y la aparición de los síntomas y período entre el inicio de los síntomas y la hospitalización. Se utilizó un modelo de regresión de Poisson para estimar los cocientes de riesgo crudo y ajustado. Resultados. De los 74 991 pacientes hospitalizados con un cuadro grave de COVID-19, 67,28% tenía 70 años o más y 68,32% tenía al menos una comorbilidad. Los varones, los pacientes de 60 a 69 años y los pacientes de 18 a 39 años con obesidad presentaron el mayor riesgo de ingreso en la UCI. Los pacientes de 18 a 39 años con obesidad, diabetes o enfermedades renales presentaban el mayor riesgo de muerte por esta enfermedad. Cuando la edad y el período entre el inicio de los síntomas y la hospitalización se consideraron modificadores del efecto, los pacientes ingresados en la UCI entre 9 y 13 días después del inicio de los síntomas en cada categoría de edad presentaron el mayor riesgo de muerte debido a la COVID-19. Conclusión. Aunque los pacientes de mayor edad presentaron el mayor riesgo de ingreso en la UCI y muerte debido a la COVID-19, la diferencia en el riesgo de morir por esta enfermedad entre pacientes ingresados en la UCI y pacientes no ingresados fue más elevada en adultos jóvenes.

RESUMO Objetivos. Avaliar fatores associados à admissão em unidade de tratamento intensivo (UTI) e óbito por doença do coronavírus 2019 em pacientes com COVID-19 grave, totalmente vacinados, no Brasil, bem como a relação entre a entrada na UTI e a morte por COVID-19. Métodos. Estudo retrospectivo de pacientes hospitalizados com COVID-19, de 12 de fevereiro de 2021 a 10 de janeiro de 2022, em todo o Brasil, que tinham o esquema vacinal completo contra a COVID-19 antes da hospitalização. Os desfechos foram a admissão em UTI devido à COVID-19 e a morte em decorrência da doença. As variáveis avaliadas foram sexo, idade, cor da pele autodeclarada, macrorregião, comorbidades, tempo entre a vacinação completa e o início dos sintomas, e tempo entre o início dos sintomas e a internação. Para estimar os coeficientes de risco bruto e ajustado foi usado um modelo de regressão de Poisson. Resultados. Dos 74.991 pacientes internados com quadro de COVID-19 grave, 67,28% tinham ≥ 70 anos e 68,32% apresentavam pelo menos uma comorbidade. Os homens, pacientes entre 60-69 anos e pacientes entre 18-39 anos com obesidade tinham o maior risco de internação na UTI. Os pacientes de 18-39 anos de idade com obesidade, diabetes ou doenças renais apresentavam o maior risco de morte por COVID-19. Quando a idade e o intervalo entre o início dos sintomas e a hospitalização foram considerados modificadores de efeito, os pacientes admitidos em UTI entre 9 e 13 dias após o início dos sintomas em cada categoria de idade tinham o maior risco de morte devido à COVID-19. Conclusão. Embora os pacientes mais velhos tivessem maior risco de admissão na UTI e morte por COVID-19, a diferença no risco de óbito pelo coronavírus entre os pacientes admitidos em uma UTI e aqueles não admitidos foi maior para os adultos jovens.

Desigualdades en la salud maternoinfantil de los migrantes: el caso de Haití y la República Dominicana

[RESUMEN]. Objetivo. Evaluar la cobertura y las desigualdades en las intervenciones de salud maternoinfantil entre haitia-nos, migrantes haitianos en la República Dominicana y dominicanos.Métodos. Estudio transversal con datos de encuestas representativas en el nivel nacional realizadas en Haití en el 2012 y en la República Dominicana en el 2014. Se compararon nueve indicadores: la demanda de pla-nificación familiar satisfecha con métodos modernos, la atención prenatal, la atención del parto (por personal de salud calificado), la vacunación infantil (con vacuna con la tuberculosis, el sarampión y tres dosis de la vacuna triple bacteriana), la gestión de casos de enfermedad en la infancia (administración de sales de rehi-dratación oral para la diarrea y búsqueda de atención sanitaria ante la sospecha de neumonía) e índice de cobertura compuesto. La riqueza se midió mediante un índice basado en los activos, dividido en terciles, y el lugar de residencia (urbano o rural) se determinó según la definición del país.Resultados. La población haitiana mostró la menor cobertura respecto de la demanda de planificación fami-liar satisfecha con métodos modernos (44,2%), atención prenatal (65,3%), asistencia calificada en el parto (39,5%) y búsqueda de atención sanitaria ante la sospecha de neumonía (37,9%), y la mayor cobertura respecto de la administración de sales de rehidratación oral para la diarrea (52,9%); los migrantes haitianos presentaron la menor cobertura en DPT3 (44,1%) y la administración de sales de rehidratación oral para la diarrea (38%) y la mayor cobertura en la búsqueda de atención sanitaria ante la sospecha de neumonía (80,7%). La población dominicana presentó la cobertura más alta en la mayoría de los indicadores, excepto en la administración de sales de rehidratación oral para la diarrea y en la búsqueda de atención sanitaria ante la sospecha de neumonía. El índice de cobertura compuesto fue de 79,2% para los dominicanos, 69,0% para los migrantes haitianos y 52,6% para los haitianos. Las desigualdades socioeconómicas tuvieron, en general, un patrón a favor de los ricos y de las zonas urbanas en todos los grupos analizados.Conclusión. Los migrantes haitianos en la República Dominicana presentaron una mayor cobertura que la población haitiana residente en Haití, pero menor que la población dominicana. Ambos países deberían planificar acciones y políticas para aumentar la cobertura y abordar las desigualdades existentes en las inter-venciones de salud materna.

[ABSTRACT]. Objective. To assess coverage and inequalities in maternal and child health interventions among Haitians, Haitian migrants in the Dominican Republic and Dominicans.Methods. Cross-sectional study using data from nationally representative surveys carried out in Haiti in 2012 and in the Dominican Republic in 2014. Nine indicators were compared: demand for family planning satisfied with modern methods, antenatal care, delivery care (skilled birth attendance), child vaccination (BCG, meas-les and DPT3), child case management (oral rehydration salts for diarrhea and careseeking for suspected pneumonia), and the composite coverage index. Wealth was measured through an asset-based index, divided into tertiles, and place of residence (urban or rural) was established according to the country definition.Results. Haitians showed the lowest coverage for demand for family planning satisfied with modern methods (44.2%), antenatal care (65.3%), skilled birth attendance (39.5%) and careseeking for suspected pneumonia (37.9%), and the highest for oral rehydration salts for diarrhea (52.9%), whereas Haitian migrants had the lowest coverage in DPT3 (44.1%) and oral rehydration salts for diarrhea (38%) and the highest in careseeking for suspected pneumonia (80.7%). Dominicans presented the highest coverage for most indicators, except oral rehydration salts for diarrhea and careseeking for suspected pneumonia. The composite coverage index was 79.2% for Dominicans, 69.0% for Haitian migrants, and 52.6% for Haitians. Socioeconomic inequalities generally had pro-rich and pro-urban pattern in all analyzed groups.Conclusion. Haitian migrants presented higher coverage than Haitians, but lower than Dominicans. Both countries should plan actions and policies to increase coverage and address inequalities of maternal health interventions.

[RESUMO]. Objetivo. Avaliar cobertura e desigualdades nas intervenções em saúde materno-infantil entre os haitianos, migrantes haitianos na República Dominicana e dominicanos. Métodos. Estudo transversal utilizando dados de pesquisas representativas nacionalmente realizadas no Haiti em 2012, e na República Dominicana em 2014. Nove indicadores foram comparados: demanda por planejamento familiar atendida com métodos modernos, atendimento pré-natal, atendimento ao parto (pre-sença de profissional qualificado no parto), vacinação de crianças (BCG, sarampo e DPT3), atendimento de crianças (sais de reidratação oral para diarreia e demanda por assistência por suspeita de pneumonia) e índice composto de cobertura. A riqueza foi medida por meio de índice baseado em recursos, dividido em tercis, e o local de residência (urbano ou rural) foi estabelecido segundo a definição dos países. Resultados. Os haitianos apresentaram a menor cobertura de demanda por planejamento familiar atendida com métodos modernos (44,2%), atendimento pré-natal (65,3%), presença de profissional qualificado no parto (39,5%) e de atendimento por suspeita de pneumonia (37,9%), e a mais alta para sais de reidratação oral na diarreia (52,9%), enquanto os migrantes haitianos tiveram a menor cobertura de DPT3 (44,1%) e sais de reidratação oral para diarreia (38%), e a mais alta na assistência por suspeita de pneumonia (80,7%). Os dominicanos apresentaram a cobertura mais alta para a maioria dos indicadores, exceto para sais de reidratação oral para diarreia e demanda por assistência por suspeita de pneumonia. O índice composto de cobertura foi 79,2% para dominicanos, 69,0% para migrantes haitianos e 52,6% para os haitianos. De forma geral, as desigualdades socioeconômicas apresentaram padrão pró-riqueza e pró-urbano em todos os gru-pos analisados. Conclusões. Os migrantes haitianos apresentaram maior cobertura que os haitianos, mas coberturas inferio-res aos dominicanos. Ambos os países devem planejar ações e políticas para aumentar a cobertura e abordar as desigualdades nas intervenções em saúde materna.

Maternal and child health inequalities among migrants: the case of Haiti and the Dominican Republic

[ABSTRACT]. Objective. To assess coverage and inequalities in maternal and child health interventions among Haitians, Haitian migrants in the Dominican Republic and Dominicans. Methods. Cross-sectional study using data from nationally representative surveys carried out in Haiti in 2012 and in the Dominican Republic in 2014. Nine indicators were compared: demand for family planning satisfied with modern methods, antenatal care, delivery care (skilled birth attendance), child vaccination (BCG, measles and DPT3), child case management (oral rehydration salts for diarrhea and careseeking for suspected pneumonia), and the composite coverage index. Wealth was measured through an asset-based index, divided into tertiles, and place of residence (urban or rural) was established according to the country definition. Results. Haitians showed the lowest coverage for demand for family planning satisfied with modern methods (44.2%), antenatal care (65.3%), skilled birth attendance (39.5%) and careseeking for suspected pneumonia (37.9%), and the highest for oral rehydration salts for diarrhea (52.9%), whereas Haitian migrants had the lowest coverage in DPT3 (44.1%) and oral rehydration salts for diarrhea (38%) and the highest in careseeking for suspected pneumonia (80.7%). Dominicans presented the highest coverage for most indicators, except oral rehydration salts for diarrhea and careseeking for suspected pneumonia. The composite coverage index was 79.2% for Dominicans, 69.0% for Haitian migrants, and 52.6% for Haitians. Socioeconomic inequalities generally had pro-rich and pro-urban pattern in all analyzed groups. Conclusion. Haitian migrants presented higher coverage than Haitians, but lower than Dominicans. Both countries should plan actions and policies to increase coverage and address inequalities of maternal health interventions.

[RESUMEN]. Objetivo. Evaluar la cobertura y las desigualdades en las intervenciones de salud maternoinfantil entre haitianos, migrantes haitianos en la República Dominicana y dominicanos. Métodos. Estudio transversal con datos de encuestas representativas a nivel nacional realizadas en Haití en 2012 y en la República Dominicana en 2014. Se compararon nueve indicadores: demanda de planificación familiar satisfecha con métodos modernos, atención prenatal, atención del parto (por personal de salud calificado), vacunación infantil (BCG, sarampión y DPT3), gestión de casos de enfermedad en la infancia (administración de sales de rehidratación oral para la diarrea y búsqueda de atención sanitaria ante la sospecha de neumonía), e índice de cobertura compuesto. La riqueza se midió mediante un índice basado en los activos, dividido en terciles, y el lugar de residencia (urbano o rural) se determinó según la definición del país. Resultados. La población haitiana mostró la menor cobertura respecto de la demanda de planificación familiar satisfecha con métodos modernos (44,2%), atención prenatal (65,3%), asistencia calificada en el parto (39,5%) y búsqueda de atención sanitaria ante la sospecha de neumonía (37,9%), y la mayor respecto de la administración de sales de rehidratación oral para la diarrea (52,9%); los migrantes haitianos presentaron la menor cobertura en DPT3 (44,1%) y la administración de sales de rehidratación oral para la diarrea (38%) y la mayor en la búsqueda de atención sanitaria ante la sospecha de neumonía (80,7%). La población dominicana presentó la cobertura más alta en la mayoría de los indicadores, excepto en la administración de sales de rehidratación oral para la diarrea y en la búsqueda de atención sanitaria ante la sospecha de neumonía. El índice de cobertura compuesto fue de 79,2% para los dominicanos, 69,0% para los migrantes haitianos y 52,6% para los haitianos. Las desigualdades socioeconómicas generalmente tenían un patrón prorrico y prourbano en todos los grupos analizados. Conclusión. Los migrantes haitianos en la República Dominicana presentaron una mayor cobertura que la población haitiana residente en Haití, pero menor que la población dominicana. Ambos países deberían planificar acciones y políticas para aumentar la cobertura y abordar las desigualdades existentes en las intervenciones de salud materna.