Introduction of a hexavalent vaccine containing acellular pertussis into the national immunization program for infants in Peru: a cost-consequence analysis of vaccination coverage.

BACKGROUND: Infant vaccination coverage rates in Peru have declined in recent years, exacerbated by the COVID-19 pandemic. Introduction of the fully-liquid diphtheria, tetanus, and acellular pertussis (DTaP)-inactivated polio vaccine (IPV)-hepatitis B (HB)-Haemophilus influenzae type B (Hib) hexavalent vaccine (DTaP-IPV-HB-Hib) in Peru's infant National Immunization Program may help improve coverage. We evaluated costs and healthcare outcomes, including coverage, of switching from a pentavalent vaccine containing whole-cell pertussis component (DTwP-HB-Hib) plus IPV/oral polio vaccine (IPV/OPV) to the hexavalent vaccine for the primary vaccination scheme (2, 4 and 6 months). METHODS: The analysis was performed over a 5-year period on a cohort of children born in Peru in 2020 (N = 494,595). Four scenarios were considered: the pentavalent plus IPV/OPV scheme (S1); replacing the pentavalent plus IPV/OPV scheme with the hexavalent scheme (S2); expanded delivery of the pentavalent plus IPV/OPV scheme (S3); expanded delivery of the hexavalent scheme (S4). Vaccine coverage and incidence of adverse reactions (ARs) were estimated using Monte Carlo simulations and previous estimates from the literature. Cases of vaccine-preventable diseases were estimated using a Markov model. Logistical and healthcare costs associated with these outcomes were estimated. Impact of key variables (including coverage rates, incidence of ARs and vaccine prices) on costs was evaluated in sensitivity analyses. RESULTS: The overall cost from a public health payer perspective associated with the pentavalent plus IPV/OPV vaccine scheme (S1) was estimated at $56,719,350, increasing to $61,324,263 (+ 8.1%), $59,121,545 (+ 4.2%) and $64,872,734 (+ 14.4%) in scenarios S2, S3 and S4, respectively. Compared with the status quo (S1), coverage rates were estimated to increase by 3.1% points with expanded delivery alone, and by 9.4 and 14.3% points, if the hexavalent vaccine is deployed (S2 and S4, respectively). In both scenarios with the hexavalent vaccine (S2 and S4), pertussis cases would also be 5.7% and 8.7% lower, and AR rates would decrease by 32%. The cost per protected child would be reduced when the hexavalent vaccine scheme. Incidence of ARs was an important driver of cost variability in the sensitivity analysis. CONCLUSIONS: Implementation of the hexavalent vaccine in Peru's National Immunization Program has a positive public health cost consequence.

Long COVID: a new disease?

The definition of quaternary prevention as the set of interventions that avoids or mitigates the consequences of unnecessary or excessive activity of medical interventionism and the health system. The definition of a new disease is a complex process that involves the identification, characterization and description of a medical condition that has not been previously recognized or documented. Since mid-2020, the term chronic COVID/long COVID has been used to describe the presence of signs and symptoms after an acute SARS-CoV-2 infection, with multiple terminologies and definitions in international literature. Post-infectious syndromes, myalgia encephalomyelitis and fibromyalgia, are some of the diseases that have similarities with chronic COVID. This article presents an analysis relating the concepts of new disease and quaternary prevention with chronic COVID and other diseases described in the literature.

Se define prevención cuaternaria como el conjunto de intervenciones que evita o atenúa las consecuencias de la actividad innecesaria o excesiva del intervencionismo médico y del sistema sanitario. La definición de una nueva enfermedad es un proceso complejo que involucra la identificación, caracterización y descripción de un cuadro clínico que no ha sido previamente reconocida o documentada. Desde mediados del año 2020 se utiliza el término COVID crónico/long COVID para describir la presencia de signos y síntomas luego de una infección aguda por SARS-CoV-2, con múltiples terminologías y definiciones en la literatura internacional. Los síndromes posinfecciosos, la encefalomielitis mialgia y la fibromialgia, son algunas de las enfermedades que tienen similitudes con el COVID crónico. En este artículo se presenta un análisis relacionando los conceptos de nueva enfermedad y prevención cuaternaria con el COVID crónico y otras enfermedades descritas en la literatura.

[Effects of the COVID-19 pandemic on seminal quality]. / Efectos de la pandemia por COVID-19 sobre la calidad seminal.

INTRODUCTION: The discovery of the presence of the SARS-CoV-2 receptor and carrier protein in the testicles, along with the mandatory preventive social isolation during 2020 and subsequent immunization, prompted us to evaluate the effect of the COVID-19 pandemic on seminal variables in males seeking consultation at the laboratory. MATERIALS AND METHODS: An analytical and observational experimental design was employed. Seminal variables from semen analyses and kinetic values were analyzed using a computer-assisted sperm analysis system in 409 semen samples collected from patients attending the laboratory between April and December 2019, and April and December 2021. COVID-positive patients were stratified based on the time elapsed since the illness into three groups: less than 3 months (acute phase), 4-12 months, and more than 1 year. RESULTS: A significant difference (p=0.013) was found in the total sperm count per ejaculate in the COVID-positive group compared to the prepandemic and COVID-negative groups (Median (Q1-Q3): 67.49 (26.42-139.44) vs. 102.48 (43.86-197.05) and 96.72 (38.22-189.27)). When stratifying the COVID-positive group based on the time since the illness, the significant decrease (p=0.038) occurred during the acute phase, with recovery over time to values similar to the prepandemic and COVID-negative groups. Social isolation and vaccination did not have significant effects on seminal variables. DISCUSSION: The study revealed reversible changes in testicular function reflected by a decrease in sperm count in the total ejaculate of patients who had experienced COVID-19. These changes appear to be related to fever and inflammation rather than the virus infection itself.

Introducción: El hallazgo en testículo del receptor y la proteína transportadora del virus SARS-CoV-2, el aislamiento social preventivo obligatorio durante 2020 y la inmunización, nos condujeron a evaluar el efecto de la pandemia COVID-19 sobre las variables seminales de varones que consultaron al laboratorio. Materiales y métodos: Diseño experimental analítico, observacional y retrospectivo. Se analizaron las variables seminales del espermograma y los valores cinéticos mediante un sistema computarizado, en 409 muestras de semen de pacientes que concurrieron al laboratorio durante abril-diciembre 2019 y abril-diciembre 2021. Los pacientes COVID positivos fueron estratificados según el tiempo transcurrido desde la enfermedad en tres grupos: menos de 3 meses (fase aguda), 4-12 meses y más de 1 año. Resultados: Se halló diferencia significativa (p=0.013) en el recuento total de espermatozoides/eyaculado en el grupo COVID positivo con respecto al grupo prepandemia y COVID negativo (Mediana (Q1-Q3): 67.49 (26.42-139.44) vs. 102.48 (43.86-197.05) y 96.72 (38.22-189.27). Al estratificar el grupo COVID positivo según el tiempo transcurrido desde la enfermedad, la disminución significativa (p= 0.038) fue durante la fase aguda, recuperándose en el tiempo hasta llegar a valores similares a los grupos prepandemia y COVID negativo. El aislamiento social y la vacunación no tuvieron efectos significativos en las variables seminales. Discusión: El estudio evidenció cambios reversibles en la función testicular reflejado por la disminución de los espermatozoides en el total eyaculado de pacientes que habían tenido COVID-19. Estos cambios parecen estar relacionados con la fiebre y la inflamación y no a causa de la infección por el virus.

Salivary assessment of the immune/inflammatory responses and oxidative stress in older adults vaccinated with CoronaVac or ChadOx-1.

BACKGROUND: Although important information concerning COVID-19 vaccination is available, the effects of the CoronaVac and ChadOx-1 vaccines on immunity and the redox balance in the upper airway mucosa of the aged population are not fully understood. Therefore, the aim of this study was to investigate the impacts of two doses of the CoronaVac or ChadOx-1 vaccine on immune/inflammatory responses and oxidative stress in the airway mucosa of older adults. METHODS: Seventy-six older adults of both sexes, with a mean age of 75.1 ± 6.4 years, were separated according to vaccination status into the CoronaVac (n = 52) and ChadOx-1 (n = 24) groups. Saliva samples were collected before (pre) and 30 days after (post) the administration of the second dose of the CoronaVac or ChadOx-1 vaccine to assess the levels of antibodies (sIgA and IgG), antimicrobial peptides, cytokines, and oxidant/antioxidant agents. RESULTS: The immunogenicity in the ChadOx-1 group was 37.5% for sIgA and 25% for IgG, while that in the CoronaVac group was 18.9% for sIgA and 13.2% for IgG. Intergroup analysis revealed that (1) lower levels of IFN-α, IFN-γ, and IL-10 and a greater IFN-γ/IL-10 ratio, in addition to a greater IL-6/IL-10 ratio, were found in both the pre- and postvaccination periods, and (2) lower levels of total sIgA, IL-12p70, IL-17A, TNF-α, and the IL-12p70/IL-10 ratio, in addition to higher levels of specific sIgA for SARS-CoV-2 antigens and lysozyme, were observed only in the postvaccination period in the ChadOx-1 group than in the CoronaVac group. Intragroup analysis revealed (1) a significant increase in the salivary levels of total peroxides in the postvaccination period compared to those in the prevaccination period in both volunteer groups; (2) a decrease in the levels of lysozyme and the ratio between total antioxidant capacity (TAC) and total peroxides in the postvaccination period in the CoronaVac group compared with those in the prevaccination period; and (3) decreases in the TNF-α, IL-6, and IL-12p70 levels, and the IL-12p70/IL-10 ratio in the ChadoX-1 group, as well as a higher lactoferrin concentration in the postvaccination period than in the prevaccination period. Several positive and negative correlations between the parameters assessed here were found. CONCLUSIONS: In general, the ChadOx-1 group exhibited improvements in both immune/inflammatory responses and redox balance and greater immunogenicity than did the CoronaVac group.

Cost-effectiveness of SARS-CoV-2 self-testing at routine gatherings to minimize community-level infections in lower-middle income countries: A mathematical modeling study.

Places of worship serve as a venue for both mass and routine gathering around the world, and therefore are associated with risk of large-scale SARS-CoV-2 transmission. However, such routine gatherings also offer an opportunity to distribute self-tests to members of the community to potentially help mitigate transmission and reduce broader community spread of SARS-CoV-2. Over the past four years, self-testing strategies have been an impactful tool for countries' response to the COVID-19 pandemic, especially early on to mitigate the spread when vaccination and treatment options were limited. We used an agent-based mathematical model to estimate the impact of various strategies of symptomatic and asymptomatic self-testing for a fixed percentage of weekly routine gatherings at places of worship on community transmission of SARS-CoV-2 in Brazil, Georgia, and Zambia. Testing strategies assessed included weekly and bi-weekly self-testing across varying levels of vaccine effectiveness, vaccine coverage, and reproductive numbers to simulate developing stages of the COVID-19 pandemic. Self-testing symptomatic people attending routine gatherings can cost-effectively reduce the spread of SARS-CoV-2 within places of worship and the community, resulting in incremental cost-effectiveness ratios of $69-$303 USD. This trend is especially true in contexts where population level attendance at such gatherings is high, demonstrating that a distribution approach is more impactful when a greater proportion of the population is reached. Asymptomatic self-testing of attendees at 100% of places of worship in a country results in the greatest percent of infections averted and is consistently cost-effective but remains costly. Budgetary needs for asymptomatic testing are expensive and likely unaffordable for lower-middle income countries (520-1550x greater than that of symptomatic testing alone), promoting that strategies to strengthen symptomatic testing should remain a higher priority.

[Implementation of new technologies in nutritional teleconsultation by Nutrition Graduates from Entre Ríos, Argentina] / Implementación de nuevas tecnologías en la teleconsulta nutricional por Licenciados en Nutrición de Entre Ríos, Argentina.

Introduction: The COVID-19 pandemic in Argentina has challenged health professionals to implement teleconsultation to maintain continuity of care. Objectives: Describe the implementation of new technologies in teleconsultation by Nutrition professionals from Entre Ríos, from the beginning of the ASPO to the new normal.Methodology: Observational, descriptive, quantitative, and cross-sectional study, in which 72 Nutrition professionals from Entre Ríos, Argentina participated through a self-administered online questionnaire. The descriptive analysis of the data was carried out in the IBM® SPSS Statistics program. Results: 84.7% of professionals began to implement new technologies in teleconsultation since the beginning of the ASPO. Although the majority did not experience significant changes in their income, relationships with patients, or time spent in teleconsultation compared to in-person care, 78% did not receive specific training for the implementation of these technologies in remote care. Despite this challenge, 80% expressed their intention to continue with this type of care in the new normal, allocating hours of their workload for this purpose. Conclusions: The implementation of new technologies in teleconsultation has proven to be an ally in maintaining the continuity of nutritional care since the beginning of ASPO. However, to provide a quality service, it is necessary to select the most appropriate technologies and dedicate sufficient time to planning and implementation.

Introducción: La pandemia de COVID-19 en Argentina ha desafiado a los profesionales de la salud a implementar la teleconsulta para mantener la continuidad de la atención. Objetivos: Describir la implementación de nuevas tecnologías en la teleconsulta por profesionales en Nutrición de Entre Ríos, desde el inicio del ASPO hasta la nueva normalidad. Metodología: Estudio observacional, descriptivo, cuantitativo y transversal, en el que participaron 72 profesionales en Nutrición de Entre Ríos, Argentina a través de un cuestionario en línea autoadministrado. El análisis descriptivo de los datos se realizó en el programa IBM® SPSS Statistics. Resultados: El 84,7% de los profesionales comenzó a implementar nuevas tecnologías en la teleconsulta desde el inicio del ASPO. Aunque la mayoría no experimentó cambios significativos en sus ingresos, la relación con los pacientes ni en el tiempo dedicado a la teleconsulta en comparación con la atención presencial, el 78% no recibió capacitación específica para la implementación de estas tecnologías en la atención remota. A pesar de este desafío, el 80% expresó su intención de continuar con esta modalidad de atención en la nueva normalidad, asignando horas de su carga horaria para este propósito. Conclusión: La implementación de nuevas tecnologías en la teleconsulta ha demostrado ser un aliado para mantener la continuidad de la atención nutricional desde el inicio del ASPO. Sin embargo, para brindar un servicio de calidad, es necesario seleccionar las tecnologías más apropiadas y de dedicar suficiente tiempo a la planificación e implementación.

Responding to COVID-19: an exploration of EU country responses and directions for further research.

BACKGROUND: During COVID-19, scientists advising policymakers were forced to deal with high uncertainty and risks in an environment of unknowns. Evidence on which policies and measures were effective in responding to the pandemic remains underdeveloped to answer the key question 'what worked and why?'. This study aims to provide a basis for studies to go further to answer this critical question, by starting to look efficacy or how countries ensured that health services remained available and what measures were enacted to protect and treat their populations and workers. METHODS: We applied a three-phase sequential mixed methods design. In phase one, we started with a qualitative content analysis of the EU Country Profile reports to retrieve and analyse data on COVID-19 responses taken by 29 countries in the European region. Phase two is the step of data transformation, converting qualitative data into numerical codes that can be statistically analysed, which are then used in a quantitative cross-national comparative analysis that comprises phase three. The quantifying process resulted in a numerical indicator to measure the 'response efficacy' of the 29 countries, which is used in phase three's association of the response measure with country performance indicators that were derived from European Centre for Disease Control (ECDC) COVID-19 case and death rate data. RESULTS: Through comparing the frequency of COVID-19 measures taken, we found that many countries in the European region undertook similar actions but with differing effects. The cross-national analysis revealed an expected relationship: a lower COVID-19 response efficacy appeared to be related to a higher case and death rates. Still, marked variation for countries with similar response efficacy indicators was found, signalling that the combination and sequence of implementation of COVID-19 responses is possibly just as important as their efficacy in terms of which response measures were implemented. CONCLUSIONS: Many European countries employed similar COVID-19 measures but still had a wide variation in their case and death rates. To unravel the question 'what worked and why?', we suggest directions from which more refined research can be designed that will eventually contribute to mitigate the impact of future pandemics and to be better prepared for their economic and human burden.

Neonatal and maternal outcomes of mRNA versus Non-mRNA COVID-19 vaccines in pregnant patients: a systematic review and meta-analysis.

Objective: To compare the effectiveness and safety of non-mRNA versus mRNA COVID-19 vaccines on pregnant women and their newborns in a systematic review with meta-analysis. Data sources: We searched PubMed, Embase, and Cochrane Central in May 2023. Study selection: The search strategy yielded 4451 results, 16 studies were fully reviewed. We selected case-control studies analysing non-mRNA versus mRNA vaccines. Data collection and analysis: we assessed the risk of bias using the Cochrane Risk of Bias in Non-randomized Studies of Interventions (ROBINS-I) tool. Standardised mean differences were pooled using random-effect models. Data synthesis: We identified 8 prospective and retrospective studies with a total of 32,153 patients. Non-mRNA vaccines were associated with a higher incidence of fever (OR 2.67; 95% CI 2.08-3.43; p<0.001), and a lower incidence of fetal or neonatal death (OR 0.16; 95% CI 0.08-0.33; p<0.001). In subgroup analyses, the Jansen vaccine (Ad26.COV2.S) was found to have a higher rate of premature labor/delivery (OR 4.48; 95% CI 1.45-13.83; p=0.009) and missed/spontaneous abortion (OR 1.90; 95% CI 1.09-3.30; p=0.02), as compared with the Pfizer (BNT162b2) vaccine. Conclusion: non-mRNA vaccines are associated with a lower incidence of fetal or neonatal death among pregnant women who receive a Covid19 vaccine, although at an increased rate of pyrexia compared with mRNA vaccines. Other studies are required for better assessment. PROSPERO: CRD42023421814.

Advances in the development of new vaccines for tuberculosis and Brazil's role in the effort forward the end TB strategy.

Tuberculosis (TB) continues to be the world's leading killer of infectious diseases. Despite global efforts to gradually reduce the number of annual deaths and the incidence of this disease, the coronavirus disease 19 (COVID-19) pandemic caused decreased in TB detection and affected the prompt treatment TB which led to a setback to the 2019 rates. However, the development and testing of new TB vaccines has not stopped and now presents the possibility of implanting in the next five years a new vaccine that is affordable and might be used in the various key vulnerable populations affected by TB. Then, this assay aimed to discuss the main vaccines developed against TB that shortly could be selected and used worldwide, and additionally, evidence the Brazilian potential candidates' vaccines in developing in Brazil that could be considered among those in level advanced to TB end.

Estudio cualitativo sobre información, confianza y acceso a la vacunación contra COVID-19 en adolescentes en un centro de salud de Buenos Aires / Qualitative study on information, trust in and access to COVID-19 vaccines among adolescents at a healthcare center in Buenos Aires

Introducción. En la adolescencia, se comienzan a tomar decisiones autónomas sobre la salud. En la vacunación intervienen dimensiones contextuales, grupales y relativas a cada vacuna. Se busca conocer el proceso de información, confianza y decisión de vacunarse contra COVID-19 en adolescentes usuarios de un centro de salud en Buenos Aires. Objetivos. Identificar ámbitos y canales a través de los cuales los adolescentes accedieron a información sobre la vacuna contra COVID-19 en un centro de salud de Buenos Aires. Describir sus opiniones respecto a los distintos discursos sobre vacunación. Describir su participación en la vacunación contra COVID-19. Identificar barreras y facilitadores respecto del acceso a la vacunación contra COVID-19 en esta población. Población y métodos. Investigación cualitativa. Se hicieron entrevistas semiestructuradas a adolescentes usuarios del efector. La muestra fue heterogénea; su tamaño se definió por saturación teórica. Se realizó un análisis temático de los datos. Resultados. Se realizaron 14 entrevistas. Los entrevistados recibieron información sobre la vacuna contra COVID-19 de sus familias, la televisión y las redes sociales. Todos recibieron tanto publicidad oficial como discursos reticentes a la vacunación. Analizaron la información recibida y formaron opinión autónoma. Su decisión sobre vacunarse no siempre fue respetada. La desconfianza, la baja percepción del riesgo, el temor a las inyecciones, las barreras administrativas y geográficas fueron motivos de no vacunación. Conclusiones. Se requieren estrategias de comunicación destinadas a adolescentes que promuevan su participación en el acceso a la vacunación.

Introduction. During adolescence, individuals start to make autonomous decisions about their health. Vaccination involves contextual, group, and vaccine-specific dimensions. We sought to know the information, trust, and decision to receive the COVID-19 vaccine among adolescents who attended a healthcare center in Buenos Aires. Objectives. To identify settings and channels through which adolescents accessed information about the COVID-19 vaccine at a healthcare center in Buenos Aires. To describe their opinions about the different statements on vaccination. To describe their participation in COVID-19 vaccination. To identify barriers and facilitators to COVID-19 vaccination in this population. Population and methods. Qualitative study. Semi-structured interviews with adolescents who attended this healthcare facility. The sample was heterogeneous; the sample size was estimated by theoretical saturation. A thematic analysis of data was done. Results. A total of 14 interviews were conducted. Interviewees obtained information about the COVID-19 vaccine from their families, TV, and social media. All received information from both official campaigns and anti-vaccine communications. They analyzed the information they received and formed their own opinion. Their decision about the vaccine was not always respected. Hesitancy, a low perception of risk, fear of needles, administrative and geographic barriers were reasons for not receiving the vaccine. Conclusions. Communication strategies targeted at adolescents are required that encourage their involvement in access to vaccination.

The CEP-Conep System in 2020: confronting COVID-19, challenges and lessons learned. / O Sistema CEP-Conep em 2020: enfrentamento da COVID-19, desafios e lições aprendidas.

This paper presents the structuring dimensions of the CEP-Conep System in order to understand the actions promoted by the National Research Ethics Commission in response to demands for the processing and ethical analysis of research protocols related to COVID-19 in 2020. Based on CEP-Conep System public documents, an assessment of legislation, from 1988 to 2020, and its extension in terms of the number of Committees, users, and protocols, from 2012 to 2020 was presented. The minutes of Conep's Ordinary Meetings (RO), for 2020, of a confidential nature, were analyzed, to verify adaptations to the pandemic. At the end of 2020, the System had 844 Committees, 854,741 users, and 701,791 analyzed protocols. The Commission centralized the analysis of COVID-19 protocols, in January 2020, and promoted three decentralizations, as more knowledge was generated, with vaccine protocols for COVID-19 remaining centralized. The history of the CEP-Conep System provided ballast for the adoption of management, educational and communication measures that accelerated the approval of protocols and made the process transparent. The absence of indicators made it impossible to evaluate the performance in 2020, which was apparently satisfactory.

O artigo apresenta dimensões estruturantes do Sistema CEP-Conep para compreender as ações promovidas pela Comissão Nacional de Ética em Pesquisa nas respostas às demandas de tramitação e análise ética de protocolos de pesquisa relativos à COVID-19 no ano de 2020. Foi elaborado estudo de caso a partir de documentos públicos do Sistema CEP-Conep, para evidenciar seu marco regulatório, de 1988 a 2020, e sua extensão em termos de quantidade de comitês, usuários e protocolos, de 2012 a 2020. Foram examinadas as atas das reuniões ordinárias (RO) da comissão, de 2020, de caráter sigiloso, para caracterizar as adaptações à pandemia. No final de 2020, o sistema contabilizava 844 comitês, 854.741 usuários, e 701.791 protocolos analisados. A comissão centralizou a análise de protocolos de COVID-19, em janeiro de 2020, e promoveu três descentralizações, à medida que mais conhecimento era gerado, permanecendo centralizados os protocolos de vacinas para COVID-19. O histórico do Sistema CEP-Conep proveu lastro para a adoção de medidas de gestão, educativas e de comunicação que aceleraram a apreciação de protocolos e deram transparência ao processo. A ausência de indicadores não permitiu avaliar a performance em 2020, aparentemente satisfatória.

[The impact of the COVID-19 pandemic on the incidence of sexual violence against children and adolescents in the home environment in Brazil]. / Impacto da pandemia de COVID-19 na incidência de violência sexual domiciliar contra crianças e adolescentes no Brasil.

The scope of this article is to identify the impact of the COVID-19 pandemic on the incidence of sexual violence against children and adolescents in the home environment in Brazil. It involves an ecological time-series study using joinpoint regression based on data from the Notifiable Diseases Information System from 2009 to 2021. The relative frequency and crude incidence rates of sexual violence occurring in the home against the population group aged 0 to 19 years were analyzed, estimating the annual percentage change (APC) and average annual percentage change (AAPC), with a 95% confidence interval. The relative frequency of the problem was higher in 2020 (69.8%) and 2021 (71.7%), with an increase of 3.1% (p = 0.001) in 2017-2021. Girls were more affected, with rates rising in 2009-2012 (APC = 44.4; p = 0.010) and 2015-2019 (APC = 16.6; p=0.017) but falling in 2019-2021 (APC= -17.7; p = 0.042). All age groups showed a significant increase until 2019, and a reduction after this year for 5-9 years (APC = -18.6; p = 0.016), 10-14 years (APC = -14.1; p = 0.040) and 15-19 years (APC = -18.4; p = 0.021). The reduction in the incidence rates of this type of violence may have been influenced by the context of social isolation during the COVID-19 pandemic, which led to the underreporting of cases.

O objetivo do artigo é identificar o impacto da pandemia de COVID-19 na incidência de violência sexual de crianças e adolescentes no ambiente domiciliar no Brasil. Estudo ecológico de série temporal utilizando regressão joinpoint a partir de dados do Sistema de Informação de Agravos de Notificação, período 2009-2021. Analisaram-se frequência relativa e taxas brutas de incidência de violência sexual ocorrida na residência contra a população de 0 a 19 anos, estimando-se variação percentual anual (APC) e variação percentual anual média (AAPC), com intervalo de confiança de 95%. A frequência relativa do agravo obteve maiores valores em 2020 (69,8%) e 2021 (71,7%), com aumento de 3,1% (p = 0,001) em 2017-2021. As meninas foram mais atingidas, com elevação das taxas em 2009-2012 (APC = 44,4; p = 0,010) e 2015-2019 (APC = 16,6; p = 0,017), porém queda em 2019-2021 (APC = -17,7; p = 0,042). Todas as faixas etárias apresentaram aumento significativo até 2019, e redução após esse ano para 5-9 anos (APC = -18,6; p = 0,016), 10-14 anos (APC = -14,1; p = 0,040) e 15-19 anos (APC = -18,4; p = 0,021). A redução nas taxas de incidência desse tipo de violência pode ter sofrido influência do contexto de isolamento social na pandemia de COVID-19, que levou à subnotificação dos casos.

[Cooperative Intelligence Platform for Primary Health Care (Picaps): techno-scientific solutions in digital health to confront COVID-19 and other crises]. / Plataforma de Inteligência Cooperativa com a Atenção Primária à Saúde (Picaps): soluções tecnocientíficas em saúde digital no enfrentamento da COVID-19 e outras crises.

The arrival of COVID-19 in Brazil had a marked impact on the health network as well as on the professionals involved, due to the significant number of cases and constantly updated information. In this context, the Cooperative Intelligence Platform for Primary Health Care - Picaps - is set up as a technological platform that assists by systematizing the communication and negotiation processes among actors, with a focus on science and technology. This article sets out to describe the processes of Picaps, which consist of a collaborative system conceived of as a public solution capable of generating innovations in the areas of Science, Technology and Health, in order to tackle COVID-19 in territories with populations in socially vulnerable situations in the Federal District (DF). It integrates data collection and processing, as well as the dissemination of information for its use, both at the governmental and societal levels. Picaps can be seen as a powerful government instrument to help societies across the country, especially those in vulnerable situations, capable of assisting in the use of cooperative intelligence in primary care and health surveillance actions to build innovative solutions such as rapid responses to face health crises in modern times.

A chegada da COVID-19 ao Brasil gerou grande impacto no sistema de saúde, bem como em seus profissionais, com o elevado número de casos e informações constantemente publicadas. Nesse contexto, criou-se a Plataforma de Inteligência Cooperativa para a Atenção Primária à Saúde (Picaps), uma plataforma tecnológica que ajuda a sistematizar os processos de comunicação e negociação de atores, tendo como foco a ciência e a tecnologia. O presente trabalho tem como objetivo descrever os processos da Picaps, sendo esta constituída por um sistema colaborativo concebido como solução pública capaz de gerar inovações nas áreas de ciência, tecnologia e saúde para o enfrentamento da COVID-19 no Distrito Federal (DF). Nela integram-se processos de coleta e tratamento de dados, além da disseminação de informações visando o seu uso tanto em nível governamental quanto em nível societal. A Picaps pode ser vista como um poderoso instrumento governamental para auxiliar sociedades espalhadas pelo país, sobretudo as que se encontram em situação de vulnerabilidade, com capacidade de nortear o uso da inteligência cooperativa em ações de atenção primária e vigilância em saúde para construção de soluções inovadoras como respostas rápidas para o enfrentamento de crises sanitárias em tempos contemporâneos.

Biotechnological sovereignty is not a mere nationalist concept, it is a necessity for Colombia and Latin America.

During the pandemic, Latin American countries suffered the collapse of their health systems. This was caused by the high demand for care of patients infected with SARS-CoV-2, which was added to the care of patients with other diseases. The significant increase in demand for health services caused medical and laboratory supplies to decline rapidly. The COVID-19 pandemic exacerbated a health crisis in several developing countries, mainly caused by insufficient systematic policies for integrating scientific knowledge. The current Colombian government must formulate a Biotechnological or Biosecurity Sovereignty Law that guarantees scientific autonomy, ensuring that Colombia is self-sufficient in Science, Technology, and Innovation. Colombian government should also focus on establishing and developing pharmaceutical chemical production by acquiring active chemical ingredients from other countries. This strategy could reduce the production costs and final prices of medicines, as well as generate high-level employment and wealth for the country. In this way, the Colombian government could prevent shortage of essential medicines and excessive price increases by commercial intermediation. In conclusion, the manuscript focuses on the lack of biotechnological sovereignty in Colombia. We propose a model of a Latin American Science and Technology ecosystem to achieve biotechnological sovereignty via state funding of research, strengthening universities, and fostering participation among private companies and Ministries of Science, Education, Trade, and Health. Scientific autonomy based on innovative processes that strengthen biotechnological independence can contribute to the economy by generating gross added value, creating high-quality employment, and facilitating the appropriation and social dissemination of knowledge, and cost reduction.

[Sex workers in the Brazilian pandemic: effects on and relations with health]. / Trabalhadoras sexuais no marco pandêmico brasileiro: efeitos em e relações com a saúde.

This paper describes the results of the study I Want More! The Lives of Sex Workers During the COVID-19 Pandemic, which is part of the EPIC community research program. The study analyzed the effects of the pandemic on the lives of cis, trans and travesti sex workers in nine Brazilian states and 11 cities throughout 2020 and 2021. This article focuses on the qualitative component of the study, which was based on semi-structured, remote and face-to-face interviews carried out with 43 sex workers, and its comparison with the quantitative component. The effects are analyzed in relation to the Brazilian pandemic framework, considering the social, economic and political dimensions of the COVID-19 virus. Some of the key themes of the analysis are cases of illness, specific social isolation practices, prevention and care management practices, individual vaccination and collective vaccination strategies. We also share the daily and activist responses drawn up by sex workers in a political agenda that opposes the individualistic, familialist, domestic, and neoliberal logic of isolation by adopting community care perspectives, which was the only line of health action for this work category during the pandemic. Collective actions reposition sex work at the interface between public health and human rights and take as their principle the "street knowledge", from activism, and the workers' power of decision over their own bodies.

Este trabalho apresenta os resultados do estudo Eu Quero é Mais! A Vida de Profissionais do Sexo Durante a Pandemia da COVID-19, integrante do programa de investigação comunitária EPIC. O estudo analisou os efeitos da pandemia nas vidas de trabalhadoras sexuais cis, trans e travestis em nove Unidades da Federação e 11 cidades brasileiras ao longo de 2020 e 2021. O artigo tem como foco o componente qualitativo do estudo baseado em entrevistas semiestruturadas realizadas de forma presencial e remota com 43 trabalhadoras sexuais, e seu cotejamento com o componente quantitativo. Os efeitos são analisados em relação com o marco pandêmico brasileiro, considerando as dimensões sociais, econômicas e políticas do vírus da COVID-19. Entre as temáticas chaves da análise, se destacam: casos de adoecimento, práticas localizadas de isolamento social, práticas de prevenção e gerenciamento de cuidado, vacinação individual e estratégias coletivas de vacinação. Compartilhamos também as respostas cotidianas e ativistas traçadas por trabalhadoras sexuais numa agenda política que se contrapõe à lógica individualista, familiarista, doméstica e neoliberal de isolamento, por meio de perspectivas comunitárias de cuidado, o que se desenhou como a única linha de ação em saúde para a categoria durante a pandemia. As ações coletivas reposicionam o trabalho sexual na interface entre a saúde pública e os direitos humanos e tomam como princípio os conhecimentos das ruas, desde os ativismos, e o poder de decisão delas próprias sobre seus corpos.

Este trabajo presenta los resultados del estudio ¡Yo Quiero Más! La Vida de las Profesionales del Sexo Durante la Pandemia de la COVID-19, parte del programa de investigación comunitaria EPIC. El estudio analizó los efectos de la pandemia en la vida de trabajadoras sexuales cis, trans y travestis en 9 estados y 11 ciudades brasileñas a lo largo del 2020 y del 2021. El artículo se centra en el componente cualitativo del estudio basado en entrevistas semiestructuradas realizadas de forma presencial y remota a 43 trabajadoras sexuales y su comparación con el componente cuantitativo. Los efectos se analizan con relación al marco pandémico brasileño, considerando las dimensiones sociales, económicas y políticas del virus de la COVID-19. Entre las temáticas clave del análisis, destacan: casos de enfermedad, prácticas localizadas de aislamiento social, prácticas de prevención y gestión del cuidado, vacunación individual y estrategias colectivas de vacunación. Compartimos también las respuestas cotidianas y activistas esbozadas por las trabajadoras sexuales en una agenda política que se opone a la lógica individualista, familiarista, doméstica y neoliberal del aislamiento, por medio de perspectivas comunitarias de cuidado, lo que se diseñó como la única línea de acción en salud para la categoría durante la pandemia. Las acciones colectivas reposicionan el trabajo sexual en la interfaz entre la salud pública y los derechos humanos y toman como principio el conocimiento de la calle, desde el activismo, y su poder de decisión sobre sus cuerpos.

Sociocognitive factors determining compliance with standard precautions by nursing professionals during the COVID-19 pandemic.

OBJECTIVES: to assess the socio-cognitive factors determining adherence to standard precautions by nursing professionals in care practice during the COVID-19 pandemic in Brazil. METHODS: an analytical cross-sectional study, carried out with 9,039 nursing professionals in Brazil, using an electronic form containing participant sociodemographic, training and work variables, and the Brazilian version of the Standard Precautions Questionnaire. Descriptive and inferential statistics were used using the statistical software R. RESULTS: participants recognize standard precautions as effective measures to reduce infections and report intention to perform them. Training regarding standard precautions was evidenced as a facilitator of adherence (4.72; SD: 0.73), and problems related to materials (3.78; SD: 1.45) were a hindrance. CONCLUSIONS: among the determining factors, facilitating organization presented the highest score, followed by intention to perform. Facilitating and hindering factor identification makes it possible to develop intervention strategies to strengthen patient safety and reduce occupational risks among professionals.

Workers' healthy eating practices during the COVID-19 pandemic and their relationship with physical activity and quality of life.

The lifestyle of the population has undergone significant changes due to the COVID-19 pandemic, which could have influenced alterations in dietary habits and overall well-being among workers. This study aimed to evaluate healthy eating practices and their relationship with the workers' quality of life and physical activity during the COVID-19 pandemic. This was a cross-sectional investigation involving workers in the city of Curitiba, southern Brazil. The study was conducted through the application of an online questionnaire. The data were evaluated using non-parametric tests and fitting a logistic regression model. A total of 123 workers participated in the study, most of them male (53.2%), aged between 31 and 40 years (42.2%), with a predominance of workers with postgraduate degrees (62.6%, n = 77), and the majority of workers (68.2%, n = 84) were performing their professional activities remotely for at least one day during the week, and 73.2% (n = 90). It was observed that 52.8% had excellent healthy eating practices, and the older their age and the greater the practice of physical activity (time and frequency), the better the workers' healthy eating practices. When assessing quality of life, the lowest average score for healthy eating practices was in the domain of social relationships. A direct relationship of older age, social relationships, and the practice of physical activity with the best individuals' healthy eating practices was detected. Considering that remote work continues to be adopted post-pandemic, evaluating the dietary practices, physical activity, and quality of life of workers is necessary to understand this new labour phenomenon.

Sputnik V-Induced Antibodies against SARS-CoV-2 Variants during the Dissemination of the Gamma Variant in Venezuela.

The COVID-19 pandemic was characterized by the emergence and succession of SARS-CoV-2 variants able to evade the antibody response induced by natural infection and vaccination. To evaluate the IgG reactivity and neutralizing capacity of the serum of individuals vaccinated with Sputnik V (105 volunteers vaccinated) against different viral variants. IgG reactivity to the Spike protein (S) was evaluated by ELISA. A plaque reduction neutralization test was performed using different viral variant isolates. At 42 days post-vaccination, the frequency of recognition and reactivity to the S protein of the Omicron variant was lower compared to that of the other variants. In general, a higher average neutralization titer was seen against the ancestral variant compared to the variants, especially Omicron. However, some sera exhibited a higher neutralization titer to the Gamma variant compared to the ancestral variant, suggesting unapparent exposure during the clinical trial. Antibodies induced by Sputnik V can recognize, persist, and neutralize SARS-CoV-2 variants, with Omicron being the one that best evades this response. These results represent a unique report on the humoral response induced by a globally lesser-studied vaccine in terms of efficacy and immune escape, offering insights into developing vaccines targeting unknown coronaviruses.