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1.
Epidemiol Serv Saude ; 33(spe2): e20231188, 2024.
Artigo em Inglês, Português | MEDLINE | ID: mdl-39230126

RESUMO

OBJECTIVE: To describe vaccination coverage and hesitation for the basic children's schedule in Belo Horizonte and Sete Lagoas, Minas Gerais state, Brazil. METHODS: Population-based epidemiological surveys performed from 2020 to 2022, which estimated vaccine coverage by type of immunobiological product and full schedule (valid and ministered doses), according to socioeconomic strata; and reasons for vaccination hesitancy. RESULTS: Overall coverage with valid doses and vaccination hesitancy for at least one vaccine were, respectively, 50.2% (95%CI 44.1;56.2) and 1.6% (95%CI 0.9;2.7), in Belo Horizonte (n = 1,866), and 64.9% (95%CI 56.9;72.1) and 1.0% (95%CI 0.3;2.8), in Sete Lagoas (n = 451), with differences between socioeconomic strata. Fear of severe reactions was the main reason for vaccination hesitancy. CONCLUSION: Coverage was identified as being below recommended levels for most vaccines. Disinformation should be combated in order to avoid vaccination hesitancy. There is a pressing need to recover coverages, considering public health service access and socioeconomic disparities. MAIN RESULTS: Vaccination coverage of children up to 4 years old was 50.2% in Belo Horizonte, and 64.9% in Sete Lagoas. Fear of severe reactions and believing that vaccination against eradicated diseases is unnecessary were the main reasons for vaccination hesitancy. IMPLICATIONS FOR SERVICES: Recovery of high vaccination coverage among children, considering public health service access conditions and socioeconomic inequities. Acting on reasons for hesitancy that can assist in targeting actions. PERSPECTIVES: The multifactorial context of vaccination hesitancy demands the development of health education strategies to raise awareness about child immunization.


Assuntos
Fatores Socioeconômicos , Cobertura Vacinal , Hesitação Vacinal , Vacinação , Humanos , Brasil , Cobertura Vacinal/estatística & dados numéricos , Hesitação Vacinal/estatística & dados numéricos , Hesitação Vacinal/psicologia , Lactente , Vacinação/estatística & dados numéricos , Masculino , Feminino , Esquemas de Imunização , Pré-Escolar , Vacinas/administração & dosagem
2.
Thromb Res ; 242: 109115, 2024 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-39186847

RESUMO

INTRODUCTION: Hemophilia A is an inherited bleeding disorder caused by pathogenic variants in the factor VIII gene (F8), which leads to factor VIII (FVIII) deficiency. Immune tolerance induction (ITI) is a therapeutic approach to eradicate alloantibodies (inhibitors) against exogenous FVIII in people with inherited hemophilia A. Few studies have evaluated the role of F8 variants on ITI outcome. MATERIAL AND METHODS: We included people with severe hemophilia A (FVIII ˂ 1 international units/dL) and high-responding inhibitors (≥ 5 Bethesda units/mL lifelong) who underwent a first course of ITI. Socio-demographic, clinical and laboratory data were collected. ITI outcomes were defined as total, partial successes, and failure. Detection of intron 1 and 22 inversions was performed by polymerase-chain reaction, followed by F8 sequencing. RESULTS: We included 168 people with inherited hemophilia A and high-responding inhibitors, median age 6 years at ITI start. Intron 22 inversion was the most prevalent variant (53.6 %), followed by nonsense (16.1 %), small insertion/deletion (11.3 %), and large deletion (10.7 %). In comparison with intron 22 inversion, the odds of ITI failure were 15.5 times higher (odds ratio [OR] 15.50; 95 % confidence interval [95 % CI] 4.59-71.30) and 4.25 times higher (95 % CI, 1.53-12.3) among carriers of F8 large deletions and small insertions and deletions, respectively. CONCLUSION: F8 large deletions and small insertions/deletions predicted ITI failure after a first course of ITI in patients with severe hemophilia A and high-responding inhibitors. This is the first study to show F8 large deletions and small insertions/deletions as predictors of ITI failure.


Assuntos
Fator VIII , Hemofilia A , Tolerância Imunológica , Hemofilia A/genética , Hemofilia A/imunologia , Hemofilia A/tratamento farmacológico , Humanos , Fator VIII/imunologia , Fator VIII/genética , Fator VIII/uso terapêutico , Tolerância Imunológica/genética , Masculino , Criança , Pré-Escolar , Adulto , Adolescente , Feminino , Adulto Jovem , Isoanticorpos/imunologia , Isoanticorpos/sangue , Mutação INDEL
3.
Epidemiol Serv Saude ; 33(spe2): e20231216, 2024.
Artigo em Inglês, Português | MEDLINE | ID: mdl-39194084

RESUMO

OBJECTIVE: To describe timely vaccination completion and obstacles in the first 24 months of life in Brazil, examining associations with maternal race/skin color. METHODS: Study participants were 37,801 children born in 2017 and 2018 included in the National Immunization Coverage Survey. We calculated prevalence and 95% confidence intervals for timely vaccine completeness and obstacles at 5, 12 and 24 months of life, according to maternal race/skin color. Associations were analyzed using logistic regression. RESULTS: 7.2% (95%CI 6.3;8.2) of mothers faced difficulties in taking their children to be vaccinated, and 23.4% (95%CI 21.7;25.1) were not vaccinated when taken. These proportions were 75% (95%CI 1.25;2.45) and 97% (95%CI 1.57;2.48) higher, respectively, among Black mothers. At least one vaccination was delayed among 49.9% (95%CI 47.8;51.9) and 61.1% (95%CI 59.2;63.0) of children by 5 and 12 months, respectively. These rates were higher among Black/mixed race mothers. CONCLUSION: There are racial inequalities in both the obstacles faced and in vaccination rates in Brazil. MAIN RESULTS: Marked racial inequalities were found in the obstacles to vaccination of children under 24 months in Brazil and to timely vaccination at 5 months and in the first year of life. IMPLICATIONS FOR SERVICES: Racial inequalities in the occurrence of vaccination shortcomings in health services, in the objective restrictions faced by families in taking their children to vaccination centers and in incomplete vaccination in a timely manner need to be addressed by the Brazilian National Health System. PERSPECTIVES: Equal public policies to address barriers to vaccination and qualification of health services need to be implemented. Studies need to deepen understanding of the structural determinants that lead to racial disparities.


Assuntos
Disparidades em Assistência à Saúde , Mães , Vacinação , Humanos , Brasil , Lactente , Vacinação/estatística & dados numéricos , Feminino , Estudos Retrospectivos , Disparidades em Assistência à Saúde/estatística & dados numéricos , Mães/estatística & dados numéricos , Pré-Escolar , Masculino , Cobertura Vacinal/estatística & dados numéricos , Recém-Nascido , Adulto , Estudos de Coortes , Fatores Socioeconômicos , População Negra/estatística & dados numéricos , Fatores de Tempo , Programas de Imunização/estatística & dados numéricos , Acessibilidade aos Serviços de Saúde/estatística & dados numéricos , Adulto Jovem , População Branca/estatística & dados numéricos
4.
Chemosphere ; 364: 143193, 2024 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-39197685

RESUMO

The Iguaçu River basin, known for its rich endemic ichthyofauna, faces a significant threat from chemical pollution. The Jordão River, a major tributary, drains extensive agricultural and livestock areas and receives poorly treated domestic and industrial effluents before joining the Iguaçu River. This study investigated the pollution and toxic effects of water samples from the Iguaçu upstream (UI), Jordão (JR), and their confluence (DI) on Steindachneridion melanodermatum embryos and larvae. Chemical analyses of the water samples revealed that most contaminants were present at levels below detection limits or within the limits established by Brazilian legislation. However, cadmium in UI, aluminum in JR, and lead in DI exceeded the legal limits. Exposure up to 96 h post-fertilization revealed higher mortality and deformity rates in individuals exposed to water samples from UI and JR, despite JR having fewer detected pollutants. JR and DI samples induced increased superoxide dismutase activity, indicating activation of the antioxidant defense system due to xenobiotic exposure. Overall, the integrated biomarker response indexes showed that individuals exposed to JR water displayed the most significant variations in their responses compared to the control treatment, suggesting a higher level of contamination and toxicity. Although a direct link between water quality and toxicity in the Jordão and Iguaçu Rivers was inconclusive, the results confirmed pollution and risks to local wildlife. The study highlighted the harmful effects of pollutants, even at low concentrations. These findings underscore the need for conservation measures to safeguard endemic and endangered species in the Iguaçu River basin. Understanding pollutant effects on native species is crucial for effective mitigation strategies and ecological health preservation.


Assuntos
Monitoramento Ambiental , Rios , Poluentes Químicos da Água , Brasil , Animais , Rios/química , Poluentes Químicos da Água/análise , Poluentes Químicos da Água/toxicidade , Larva/efeitos dos fármacos , Cladocera/efeitos dos fármacos
5.
Res Pract Thromb Haemost ; 8(4): 102436, 2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-38840663

RESUMO

Background: Immune tolerance induction (ITI) is the treatment of choice to eradicate neutralizing anti-factor (F)VIII alloantibodies (inhibitors) in people with inherited hemophilia A. However, it is not successful in 10% to 40% of the cases. The biological mechanisms and biomarkers associated with ITI outcome are largely unknown. Objectives: The aim of this study was to investigate the association of plasma cytokines (interferon-γ, tumor necrosis factor, interleukin [IL]-2, IL-4, IL-5, IL-6, IL-10, and IL-17A), chemokines (IL-8/CXCL8, RANTES/CCL5, MIG/CXCL9, MCP-1/CCL2, and IP-10/CXCL10), and anti-FVIII immunoglobulin (Ig) G total, IgG1, and IgG4 with ITI outcome. Methods: In this cross-sectional analysis of the Brazilian Immune Tolerance Study, we assessed plasma levels of anti-FVIII IgGs using an enzyme-linked immunosorbent assay with plasma-derived FVIII and recombinant FVIII as target antigens, immobilized in microplates. Results: We assayed 98 plasma samples of moderately severe and severe (FVIII activity, <2%) people with hemophilia A after completion of a first ITI course. Levels of anti-recombinant FVIII IgG total and IgG4 were higher in people with hemophilia A who failed ITI (IgG total optical density [OD], 0.37; IQR, 0.15-0.73; IgG4 OD, 2.19; IQR, 0.80-2.52) than in those who had partial (IgG total OD, 0.03; IQR, 0.00-0.14; IgG4 OD, 0.39; IQR, 0.09-1.11; P < .0001 for both) or complete success (IgG total OD, 0.04; IQR, 0.00-0.07; IgG4 OD, 0.07; IQR, 0.06-0.40; P < .0001 for both). Plasma cytokines, chemokines, and anti-FVIII IgG1 were not associated with ITI outcome. Conclusion: Our results show that high levels of plasma anti-FVIII IgG4 and IgG total are associated with ITI failure.

6.
Environ Monit Assess ; 196(6): 564, 2024 May 21.
Artigo em Inglês | MEDLINE | ID: mdl-38773003

RESUMO

This study investigated the impact of micropollutants on fish health from Segredo hydroelectric reservoir (HRS) along the Iguaçu River, Southern Brazil, contaminated by urban, industrial, and agricultural activities. This is the first comprehensive study assessment in the river after the severe drought in the 2020s in three fish species from different trophic levels Astyanax spp. (water column depth/omnivorous), Hypostomus commersoni (demersal/herbivorous), and Pimelodus maculatus (demersal/omnivorous). Animals, water, and sediment samples were collected from three distinct sites within the reservoir: Floresta (upstream), Iratim (middle), and Station (downstream). The chemical analysis revealed elevated concentrations of metals (Al, Cu, Fe) and the metalloid As in water, or Cu, Zn, and As in sediment, surpassing Brazilian regulatory limits, while the organic pollutants as DDT, PAHs, PCBs, and PBDEs were found under the Brazilian regulatory limits. The metal bioaccumulation was higher in gills with no significant differences among sites. The species Astyanax spp. and H. commersoni displayed variations in hepatosomatic index (HSI) and P. maculatus in the condition factor index (K) between sites, while adverse effects due to micropollutants bioaccumulation were observed by biochemical, genotoxic, and histopathological biomarkers. The principal component analysis and integrated biomarker response highlighted the upstream site Floresta as particularly inhospitable for biota, with distinctions based on trophic level. Consequently, this multifaceted approach, encompassing both fish biomarkers and chemical analyses, furnishes valuable insights into the potential toxic repercussions of micropollutant exposure. These findings offer crucial data for guiding management and conservation endeavors in the Iguaçu River.


Assuntos
Monitoramento Ambiental , Rios , Poluentes Químicos da Água , Animais , Poluentes Químicos da Água/análise , Poluentes Químicos da Água/metabolismo , Brasil , Rios/química , Biomarcadores/metabolismo , Hidrocarbonetos Policíclicos Aromáticos/análise , Hidrocarbonetos Policíclicos Aromáticos/metabolismo , Metais/análise , Characidae , Bifenilos Policlorados/análise , Bifenilos Policlorados/metabolismo , Sedimentos Geológicos/química , Peixes/metabolismo
7.
Hist. enferm., Rev. eletronica ; 15(publicação contínua): e006, 20240410. ilus
Artigo em Inglês, Português | LILACS | ID: biblio-1568532

RESUMO

Objetivo: descrever a experiência na constituição do Comitê Estudantil Nacional da Associação Brasileira de Enfermagem, enfatizando seus avanços e desafios. Métodos: trata-se de estudo descritivo do tipo relato de experiência. As atividades foram desenvolvidas junto à Diretoria de Educação da Associação Brasileira de Enfermagem Nacional. Resultados: desenvolveu-se o relato por meio de três categorias, sendo: Constituição do primeiro comitê temático de estudantes na Associação Brasileira de Enfermagem Nacional; Avanços do Comitê Estudantil Nacional da Associação Brasileira de Enfermagem; Desafios passado, presente e, quiçá, futuro do comitê estudantil. Considerações finais: a participação estudantil na Associação Brasileira de Enfermagem Nacional e Seções, por meio do comitê estudantil, permite que os futuros enfermeiros contribuam para o fortalecimento da entidade, aproximando os estudantes, além de que vivenciem contextos de lutas pela enfermagem e pelas políticas públicas em educação e saúde.


Objective: to describe the experience in establishing the Brazilian Nursing Association National Student Committee, emphasizing its advances and challenges. Methods: this is a descriptive study and experience report. The activities were developed together with the Brazilian National Nursing Association Education Board. Results: the report was developed through three categories, namely: Establishment of the first thematic student committee in the Brazilian National Nursing Association; Advances of the Brazilian Nursing Association National Student Committee; Past, present and, perhaps, future challenges of the student committee. Final considerations: student participation in the Brazilian National Nursing Association and Sections, through a student committee, allows future nurses to contribute to strengthening the entity, bringing students together, in addition to experiencing contexts of struggles for nursing and public policies in education and health.


Objetivo: describir la experiencia en la constitución del Comité Nacional de Estudiantes de la Asociación Brasileña de Enfermería, destacando sus avances y desafíos. Métodos: se trata de un estudio descriptivo del tipo relato de experiencia. Las actividades fueron desarrolladas en conjunto con la Mesa de Educación de la Asociación Nacional de Enfermería de Brasil. Resultados: el informe fue desarrollado a través de tres categorías, a saber: Constitución del primer comité temático de estudiantes de la Asociación Nacional de Enfermería de Brasil; Avances del Comité Nacional de Estudiantes de la Asociación Brasileña de Enfermería; Desafíos pasados, presentes y, quizás, futuros del comité estudiantil. Consideraciones finales: la participación de los estudiantes en la Asociación Nacional de Enfermería y Secciones de Brasil, a través del comité de estudiantes, permite a los futuros enfermeros contribuir al fortalecimiento de la entidad, acercando a los estudiantes, además de vivir contextos de luchas por la enfermería y las políticas públicas en educación y salud.


Assuntos
Humanos , História do Século XX , História do Século XXI , Estudantes de Enfermagem
8.
Head Neck ; 46(7): 1683-1697, 2024 07.
Artigo em Inglês | MEDLINE | ID: mdl-38344932

RESUMO

INTRODUCTION: Clinical trials on tyrosine kinase inhibitors (TKI) treatment have shown an improvement in overall and progression-free survival in patients with advanced differentiated thyroid cancer. However, it is necessary to evaluate these studies to assess methodological biases and inconsistencies that may impact the effects. OBJECTIVE: To map and assess the methodological quality of randomized clinical trials (RCTs) regarding randomization, allocation concealment, blinding, and selective reporting bias. METHODS: RCTs assessing the efficacy and safety of TKI for the treatment of advanced differentiated thyroid cancer were included. The search was performed in the MEDLINE database. The included RCTs were assessed for the adequacy of the methodological steps, as recommended by the Cochrane Risk of Bias tool. RESULTS: Nine studies were analyzed, of which 77.7% were classified as low risk of bias regarding selective reporting and 33.3% as high risk of reporting bias. The mean time between protocol registration and study publication was approximately 5.11 years. Moreover, 66.7% were classified as low risk of bias for randomization and allocation concealment, and 33.3% did not specify the randomization process and allocation concealment in a way that would allow the identification of occurrences of bias. Concerning blinding of participants and outcome assessors, 77.8% of the RCTs reported adequate blinding and were classified as having a low risk of bias, 11.1% had a high risk of bias, and 11.1% had insufficient information and were classified as having unclear risk of bias. Regarding the blinding of the outcome assessors, 33.3% did the blinding correctly, 11.1% did not blind, and 55.6% did not provide enough information. CONCLUSION: Overall, the assessed RCTs were predominantly at low risk of bias. The critical evaluation of these studies is essential to have confidence in the treatment estimated effect that will support clinical decision-making and provide information to preclude future clinical study flaws.


Assuntos
Inibidores de Proteínas Quinases , Ensaios Clínicos Controlados Aleatórios como Assunto , Neoplasias da Glândula Tireoide , Humanos , Neoplasias da Glândula Tireoide/tratamento farmacológico , Neoplasias da Glândula Tireoide/patologia , Inibidores de Proteínas Quinases/uso terapêutico , Projetos de Pesquisa
10.
Chemosphere ; 349: 140812, 2024 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-38036225

RESUMO

Bioaccumulation studies in fish mark the initial phase of assessing the risk of chemical exposure to biota and human populations. The Iguaçu River boasting a diverse endemic ichthyofauna, is grappling with the repercussions of human activities. This study delved into the bioaccumulation of micropollutants, the early-warning effects on Rhamdia quelen and Oreochomis niloticus in the Segredo Reservoir (HRS) and the potential risk of human exposure. Two groups of caged fish in three sites of the reservoir were exposed during the autumn-winter and spring-summer, while a third group (O. niloticus) underwent a twelve-month exposure, and inorganic and organic chemicals analysis in water, sediment, and biota. Additionally, metallothionein expression and genotoxicity were employed as biomarkers. PAHs, PCBs, Al, Cu, Fe, and As in water and DDTs, Cu, Zn, and As in sediment surpassed the thresholds set by Brazilian regulations, where DDT exhibited bioaccumulation in muscle, alongside metals in liver, kidney, gills, and muscle tissues. R. quelen showed metallothionein expression whereas DNA damage and NMA frequencies were elevated in target organs and in brain and erythrocytes of O. niloticus during summer. In this species the DNA damage in liver was remarkable after twelve months. Target Hazard Quotients and Cancer Risk values shedding light on the vulnerability of both children and adults. The reservoir's conditions led to heightened sensitivity to micropollutants for R. quelen species. The data presented herein provides decision-makers with pertinent insights to facilitate effective management and conservation initiatives within the Iguaçu Basin.


Assuntos
Peixes-Gato , Poluentes Ambientais , Animais , Criança , Humanos , Rios , Brasil , Monitoramento Ambiental , Bioacumulação , Água , Metalotioneína
12.
Obes Surg ; 34(2): 549-557, 2024 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-38158501

RESUMO

OBJECTIVE: This study aims to describe and compare the prevalence of perceived barriers to physical activity (PBPA) in pre- and post-metabolic and bariatric surgery (MBS) patients and assess the association of these barriers with their physical activity levels. METHODS: A cross-sectional study included pre-operative (n = 63) and post-operative (n = 119) groups. Sociodemographic characteristics, leisure-time physical activity levels, and PBPA data were collected. Descriptive statistics, chi-square, and Fisher's exact tests, and binomial logistic regression analyses were used for comparisons and associations. RESULTS: Compared to the pre-operative group, the post-operative group had a lower prevalence of barriers in the physical domain (p = 0.036) and the behavioral domain (p = 0.004). However, there were no significant differences in the environmental (p = 0.531) or social (p = 0.597) domains. Pre-MBS patients were more likely to be physically inactive when perceiving barriers in the environmental (p = 0.048) and behavioral (p = 0.048) domains. In contrast, post-surgical patients were more likely to be physically inactive when perceiving barriers in the environmental (p = 0.027), social (p = 0.020), and behavioral (p = 0.037) domains. CONCLUSION: The results show that individuals who underwent metabolic and bariatric surgery have a lower prevalence of behavioral and physical PBPA compared to those awaiting the procedure. The perception of barriers to physical activity in the environmental and behavioral domains increases the likelihood of physical inactivity in both pre- and post-MBS patients, while in the social domain, it was only associated with physical activity in post-MBS patients.


Assuntos
Cirurgia Bariátrica , Obesidade Mórbida , Humanos , Estudos Transversais , Prevalência , Obesidade Mórbida/cirurgia , Exercício Físico
13.
Epidemiol. serv. saúde ; 33(spe2): e20231206, 2024. tab, graf
Artigo em Inglês | LILACS-Express | LILACS | ID: biblio-1574836

RESUMO

ABSTRACT Objective To evaluate vaccination coverage and delay in vaccine dose administration in infants in six municipalities in the Southern region of Brazil. Methodology National Vaccination Coverage Survey 2020, with infants born alive in 2017 and 2018, carried out from September 2020 to March 2022. Coverage of doses administered, doses administered on time and delay in dose administration were evaluated. Results For 4681 infants analyzed, coverage for vaccines recommended up to 24 months was 68.0% (95%CI 63.9;71.8%) for doses administered and 3.9% (95%CI 2.7%;5.7%) for doses administered on time. Delay time for the majority of late vaccinations was ≤ 3 months. For some boosters, 25% of vaccine administration was delayed by ≥ 6 months. Conclusion In addition to tracking vaccine defaulters, strategies are needed to encourage compliance with the vaccination schedule at the recommended ages.


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RESUMO Objetivo Avaliar as coberturas vacinais e o atraso nas doses de vacinas em lactentes em seis municípios da região Sul do Brasil. Metodologia Inquérito Nacional de Cobertura Vacinal 2020, com lactentes nascidos vivos em 2017 e 2018, realizado entre setembro de 2020 e março de 2022. Foram avaliadas as coberturas de doses aplicadas, doses em dia e o tempo de atraso da aplicação. Resultados Para 4.681 lactentes analisados, as coberturas para vacinas indicadas até os 24 meses foram de 68,0% (IC95% 63,9;71,8) para doses aplicadas e 3,9% (IC95% 2,7;5,7) para doses em dia. A maioria das aplicações em atraso foi ≤ 3 meses. Para alguns reforços, 25% das aplicações atrasaram ≥ 6 meses. Conclusão Além da busca de faltosos às vacinas, são necessárias estratégias para estímulo ao cumprimento do esquema de vacinação nas idades preconizadas.

14.
Epidemiol. serv. saúde ; 33(spe2): e20231162, 2024. tab, graf
Artigo em Inglês | LILACS-Express | LILACS | ID: biblio-1574837

RESUMO

ABSTRACT Objective To estimate hepatitis A vaccination coverage in 24-month-old children and identify factors associated with non-vaccination. Methods This was a survey involving a sample stratified by socioeconomic strata in capital cities (2020-2022), with coverage estimates and 95% confidence intervals (95%CI), the factor analysis was performed using the prevalence ratio (PR) by means of Poisson regression. Results Among 31,001 children, hepatitis A coverage was 88.1% (95%CI 86.8;89.2). Regarding socioeconomic strata (A/B), the variable immigrant parents/guardians was associated with non-vaccination (PR = 1.91; 95%CI 1.09;3.37); in strata C/D, children of Asian race/skin color (PR = 4.69; 95%CI 2.30;9.57), fourth-born child or later (PR = 1.68; 95%CI 1.06;2 .66), not attending daycare/nursery (PR = 1.67; 95%CI 1.24;2.24) and mother with paid work (PR = 1.42; 95%CI 1.16;1.74) were associated with non-vaccination. Conclusion Hepatitis A coverage was below the target (95%), suggesting that specificities of social strata should be taken into consideration.


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RESUMO Objetivo Estimar a cobertura vacinal da hepatite A em crianças de 24 meses e identificar fatores associados à ausência de vacinação. Métodos Inquérito em amostra estratificada por estratos socioeconômicos em capitais (2020-2022), com estimativa de cobertura e intervalos de confiança de 95% (IC95%) e análise de fatores pela razão de prevalência (RP) via regressão de Poisson. Resultados Nas 31.001 crianças, a cobertura da hepatite A foi de 88,1% (IC95% 86,8;89,2). Nos estratos socioeconômicos (A/B), a variável pais/responsáveis imigrantes foi associada à ausência de vacinação (RP = 1,91; IC95% 1,09;3,37); nos estratos C/D, crianças de cor amarela (RP = 4,69; IC95% 2,30;9,57), 4ª ordem de nascimento ou mais (RP = 1,68; IC95% 1,06;2,66), não frequentar creche/berçário (RP = 1,67; IC95% 1,24;2,24) e mãe com trabalho remunerado (RP = 1,42; IC95% 1,16;1,74) foram associadas à ausência de vacinação. Conclusão Cobertura da hepatite A abaixo da meta (95%), sugerindo-se considerar especificidades dos estratos sociais.

15.
Epidemiol. serv. saúde ; 33(spe2): e20231393, 2024. tab, graf
Artigo em Inglês | LILACS-Express | LILACS | ID: biblio-1574838

RESUMO

ABSTRACT Objective To analyze vaccination coverage according to social strata in children up to 24 months old, living in the municipality of Londrina (PR), Brazil. Methods This was a population-based survey conducted between 2021 and 2022, in which vaccination coverage and sociodemographic aspects of mothers and families were evaluated using Pearson's chi-square test. Results In a sample of 456 children, complete vaccination coverage varied according to social strata, being 36.0% (95%CI 26.8;57.8); in stratum A; 59.5% (95%CI 26.1;86); in stratum B; 66.2% (95%CI 51.7;78.1); in stratum C; and 70.0% (95%CI 56.1;81.0) in stratum D. Conclusion The analysis of vaccination coverage indicated that social stratum A is at highest risk for vaccine-preventable diseases.


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RESUMO Objetivo Analisar a cobertura vacinal segundo estrato social, em crianças até 24 meses de vida, residentes no município de Londrina (PR). Métodos Inquérito de base populacional, realizado entre em 2021 e 2022, em que se avaliou a cobertura vacinal e os aspectos sociodemográficos das mães e das famílias, através do teste qui-quadrado de Pearson. Resultados Em uma amostra de 456 crianças, a cobertura vacinal completa variou de acordo com o estrato social, sendo no estrato A de 36,0% (IC95% 26,8;57,8); no estrato B, de 59,5% (IC95% 26,1;86); no estrato C, de 66,2% (IC95% 51,7;78,1); e no estrato D, de 70,0% (IC95% 56,1;81,0). Conclusão A análise da cobertura vacinal indicou o estrato social A como o de maior risco para doenças prevenidas por vacinas.

16.
Epidemiol. serv. saúde ; 33(spe2): e20231309, 2024. tab, graf
Artigo em Inglês | LILACS-Express | LILACS | ID: biblio-1574839

RESUMO

ABSTRACT Objective To analyze the reliability of records held on the National Immunization Program Information System (SI-PNI) in a subsample of children included in the national vaccination coverage survey in Brazilian state capitals and Federal District in 2020. Methods This was a study of agreement between data recorded on vaccination cards (doses and dates) and on the SI-PNI for 4050 children with full coverage at 24 months. Results Data on 3587 children were held on the SI-PNI, with losses of 11% (95%CI: 10;12). Total agreement between doses and dates in the two sources was 86% (95%CI: 86;87), however taking each dose and vaccine individually, variation was greater, with 32% of data in only one source. Conclusion Part of the information was not recorded, but the discrepancy can be considered small. Nonetheless, underrecording of doses and children can compromise vaccination coverage estimates, altering the numerator and denominator data.


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RESUMO Objetivo Analisar a confiabilidade dos registros no Sistema de Informação do Programa Nacional de Imunizações (SI-PNI) em uma subamostra de crianças incluídas no inquérito nacional de cobertura vacinal nas capitais brasileiras e no Distrito Federal, em 2020. Método Estudo de concordância entre registros nas cadernetas (doses e datas) e no SI-PNI para 4.050 crianças com esquema completo aos 24 meses. Resultados Foram localizados registros de 3.587 crianças no SI-PNI, havendo 11% (IC95%10,0;12,0) de perdas. A concordância total entre doses e datas nas duas fontes foi de 86% (IC95% 86,0;87,0), porém para cada dose e vacina a variação foi maior, com 32% de dados só em uma fonte. Conclusão Parte das informações não vem sendo adequadamente registrada, mas para os dados existentes nas duas fontes a discordância pode ser considerada pequena. O sub-registro de doses e crianças pode comprometer as estimativas de cobertura vacinal, alterando os dados do numerador e do denominador.

17.
Epidemiol. serv. saúde ; 33(spe2): e20231188, 2024. tab, graf
Artigo em Inglês | LILACS-Express | LILACS | ID: biblio-1569170

RESUMO

ABSTRACT Objective To describe vaccination coverage and hesitation for the basic children's schedule in Belo Horizonte and Sete Lagoas, Minas Gerais state, Brazil. Methods Population-based epidemiological surveys performed from 2020 to 2022, which estimated vaccine coverage by type of immunobiological product and full schedule (valid and ministered doses), according to socioeconomic strata; and reasons for vaccination hesitancy. Results Overall coverage with valid doses and vaccination hesitancy for at least one vaccine were, respectively, 50.2% (95%CI 44.1;56.2) and 1.6% (95%CI 0.9;2.7), in Belo Horizonte (n = 1,866), and 64.9% (95%CI 56.9;72.1) and 1.0% (95%CI 0.3;2.8), in Sete Lagoas (n = 451), with differences between socioeconomic strata. Fear of severe reactions was the main reason for vaccination hesitancy. Conclusion Coverage was identified as being below recommended levels for most vaccines. Disinformation should be combated in order to avoid vaccination hesitancy. There is a pressing need to recover coverages, considering public health service access and socioeconomic disparities.


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RESUMO Objetivo Descrever as coberturas e hesitação das vacinas do calendário básico infantil em Belo Horizonte e Sete Lagoas, Minas Gerais. Métodos Inquéritos epidemiológicos de base populacional realizados de 2020 a 2022, para estimar coberturas vacinais por tipo de imunobiológico e esquema completo (doses válidas e aplicadas) segundo estratos socioeconômicos, e os motivos de hesitação vacinal. Resultados A cobertura global com doses válidas e a hesitação vacinal de pelo menos uma vacina foram, respectivamente, de 50,2% (IC95% 44,1;56,2) e 1,6% (IC95% 0,9;2,7), em Belo Horizonte (n = 1.866), e de 64,9% (IC95% 56,9;72,1) e 1,0% (IC95% 0,3;2,8), em Sete Lagoas (n = 451), com diferenças entre os estratos. O receio de reações graves foi o principal motivo de hesitação vacinal. Conclusão Identificou-se coberturas abaixo do preconizado para a maioria das vacinas. A desinformação deve ser combatida, evitando-se a hesitação vacinal. Há necessidade premente de recuperar as coberturas, considerando acesso ao SUS e disparidades socioeconômicas.

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Epidemiol. serv. saúde ; 33(spe2): e20231216, 2024. tab, graf
Artigo em Inglês | LILACS-Express | LILACS | ID: biblio-1569171

RESUMO

ABSTRACT Objective To describe timely vaccination completion and obstacles in the first 24 months of life in Brazil, examining associations with maternal race/skin color. Methods Study participants were 37,801 children born in 2017 and 2018 included in the National Immunization Coverage Survey. We calculated prevalence and 95% confidence intervals for timely vaccine completeness and obstacles at 5, 12 and 24 months of life, according to maternal race/skin color. Associations were analyzed using logistic regression. Results 7.2% (95%CI 6.3;8.2) of mothers faced difficulties in taking their children to be vaccinated, and 23.4% (95%CI 21.7;25.1) were not vaccinated when taken. These proportions were 75% (95%CI 1.25;2.45) and 97% (95%CI 1.57;2.48) higher, respectively, among Black mothers. At least one vaccination was delayed among 49.9% (95%CI 47.8;51.9) and 61.1% (95%CI 59.2;63.0) of children by 5 and 12 months, respectively. These rates were higher among Black/mixed race mothers. Conclusion There are racial inequalities in both the obstacles faced and in vaccination rates in Brazil.


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RESUMO Objetivo Descrever a completude vacinal em tempo oportuno nos primeiros 24 meses de vida no Brasil e os obstáculos para vacinação, testando-se associações com raça/cor da pele materna. Métodos Fez-se coleta de informações sobre os nascidos em 2017 e 2018, constantes no Inquérito Nacional de Cobertura Vacinal. Foram calculados prevalência e intervalos de confiança de 95% de obstáculos à vacinação e completude vacinal em tempo oportuno aos 5 meses, primeiro e segundo ano, segundo raça/cor da pele materna. Empregou-se regressão logística para análise de associações. Resultados Analisaram-se dados de 37.801 crianças. Do total, 7,2% (IC95% 6,3;8,2) dos responsáveis enfrentaram dificuldades para levar seus filhos para vacinação e 23,4% (IC95% 21,7;25,1) das crianças não foram vacinadas, mesmo sendo levadas. Essas proporções foram 75% (IC95% 1,25;2,45) e 97% (IC95% 1,57;2,48) mais elevadas, respectivamente, entre pretas; e 49,9% (IC95% 47,8;51,9) e 61,1% (IC95% 59,2;63,0) das crianças tiveram atraso em alguma vacina até os 5 meses e o primeiro ano, respectivamente. Tais valores foram maiores entre pardas/pretas. Conclusão Há desigualdades raciais nos obstáculos enfrentados e na vacinação no Brasil.

19.
Front Neurosci ; 17: 1210221, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37575303

RESUMO

Introduction: Vagus nerve stimulation (VNS) therapy is an established treatment for patients with drug-resistant epilepsy that reduces seizure frequency by at least 50% in approximately half of patients; however, the characteristics of the patients with the best response have not yet been identified. Thus, it is important to identify the profile of patients who would have the best response to guide early indications and better patient selection. Methods: This retrospective study evaluated vagus nerve stimulation (VNS) as an adjuvant therapy for patients with drug-resistant epilepsy from six epilepsy centers in Brazil. Data from 192 patients aged 2-66 years were analyzed, and all patients received at least 6 months of therapy to be included. Results: Included patients were aged 2-66 years (25.6 ± 14.3), 105 (54.7%) males and 87 (45.8%) females. Median follow-up interval was 5 years (range, 2005-2018). Overall, the response rate (≥50% seizure reduction) after VNS implantation was 65.6% (126/192 patients). Most patients had 50-90% seizure reduction (60.9%) and nine patients became seizure-free. There were no serious complications associated with VNS implantation. The rate of a ≥ 50% seizure reduction response was significantly higher in patients with no history of neurosurgery. The presence of focal without generalized seizures and focal discharges on interictal EEG was associated with better response. Overall, etiological predictors of a better VNS response profile were tumors while a worse response to VNS was related to the presence of vascular malformations and Lennox-Gastaut Syndrome. Discussion: We observed an association between a better response to VNS therapy no history of neurosurgery, focal interictal epileptiform activity, and focal seizure pattern. Additionally, it is important to highlight that age was not a determinant factor of the response, as children and adults had similar response rates. Thus, VNS therapy should be considered in both adults and children with DRE.

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Insects ; 14(7)2023 Jul 02.
Artigo em Inglês | MEDLINE | ID: mdl-37504605

RESUMO

Although the boll weevil (BW), Anthonomus grandis grandis (Coleoptera: Curculionidae) has been attributed to the significant losses caused to cotton yield in the Americas, the categorization as a quarentenary pest in places where it is still not occurring has increased its relevance worldwide. In areas where it is widespread, pest suppression relies on many broad-spectrum insecticide applications. However, other control tactics are sought. Considering that early-flowering cultivars escape from boll weevil infestation, we investigated if three different planting dates (November, December, and January) could alter the plant life cycle, allowing the plants to escape from boll weevil infestation. Field trials were run in two seasons (2014/2015 and 2017/2018), and variables (days required to reach each flowering stage, fruiting plant structures-undamaged and damaged by the BW, and totals-number of boll weevils on plants and that had emerged from fallen structures on the ground) were assessed over 29 and 33 weeks, respectively. Based on the number of days required to initiate and terminate the flowering stage, the time to reach the economic threshold (ET), the number of undamaged, damaged, and the total reproductive structures, we concluded that planting dates in December for the Central Cerrado of Brazil should be preferred over the other two tested dates. Cultivations run at this planting date, anticipating the flowering period initiation and termination, reduced infested flowering structures, and delayed the decision making to control the pest, when compared to the other two planting dates.

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