Grupo de Enfrentamento à Morte Materna e Infantil da Secretaria de Saúde do Estado de São Paulo: uma estratégia do Comitê Estadual de Vigilância à Morte Materna, Infantil e Fetal / Group to Combat Maternal and Child Death of the São Paulo State Health Department: a strategy of the State Committee for the Surveillance of Maternal, Child and Fetal Death

O Grupo de Enfrentamento à Morte Materna Infantil da Secretaria de Estado da Saúde de São Paulo, enquanto estratégia do O Comitê Estadual de Vigilância à Morte Materna, Infantil e Fetal, atua na ampliação e qualificação dos serviços ofertados e a produção do cuidado no âmbito do Ciclo gravídico, puerperal e neonatal. Está no escopo da Secretaria da Saúde do estado de São Paulo atuar na problemática da morte materna, infantil e fetal, que envolve diferentes atores que visam garantir que as políticas estaduais vigentes. O objetivo deste relato de experiência é apresentar a Nota Técnica que trata das Orientações para montagem das caixas de emergências obstétricas, nas instituições com atendimento a mulheres gestantes e puérperas (hospitais e maternidades), no âmbito do estado de São Paulo.

Risk Factors for Death Among 120,804 Hospitalized Patients with Confirmed COVID-19 in São Paulo, Brazil.

São Paulo is a state in Brazil with one of the highest numbers of confirmed and severe cases of coronavirus disease (COVID-19), with an incidence of 294 hospitalizations per 100,000 inhabitants. We report the clinical characteristics and outcomes of 120,804 hospitalized patients with confirmed COVID-19 from February 26 to October 10, 2020, in São Paulo. Characteristics of patients who died and survived were compared using a survival analysis. The median age was 60 years (interquartile range [IQR], 47-72), 67,821 (56.1%) were men, and 61,659 (51.0%) were white. Most hospitalized patients (79,812; 66.1%) reported one or more comorbidities, 41,708 (34.5%) hospitalized patients were admitted to intensive care units, and 33,079 (27.4%) died. Men (hazard ratio [HR], 1.22; 95% confidence interval [CI], 1.18-1.25), elderly individuals (HR, 3.85; 95% CI, 3.68-4.02), and patients with chronic cardiovascular disease including hypertension (HR, 1.05; 95% CI, 1.02-1.08), chronic lung disease (HR, 1.38; 95% CI, 1.31-1.45), diabetes mellitus (HR, 1.14; 95% CI, 1.11-1.18), and chronic neurological disease (HR, 1.48; 95% CI, 1.41-1.55) were at higher risk for death from COVID-19.

Risk Factors for Death Among 120,804 Hospitalized Patients with Confirmed COVID-19 in São Paulo, Brazil

São Paulo is a state in Brazil with one of the highest numbers of confirmed and severe cases of coronavirus disease (COVID-19), with an incidence of 294 hospitalizations per 100,000 inhabitants. We report the clinical characteristics and outcomes of 120,804 hospitalized patients with confirmed COVID-19 from February 26 to October 10, 2020, in São Paulo. Characteristics of patients who died and survived were compared using a survival analysis. The median age was 60 years (interquartile range [IQR], 47­72), 67,821 (56.1%) were men, and 61,659 (51.0%) were white. Most hospitalized patients (79,812; 66.1%) reported one or more comorbidities, 41,708 (34.5%) hospitalized patients were admitted to intensive care units, and 33,079 (27.4%) died. Men (hazard ratio [HR], 1.22; 95% confidence interval [CI], 1.18­1.25), elderly individuals (HR, 3.85; 95% CI, 3.68­4.02), and patients with chronic cardiovascular disease including hypertension (HR, 1.05; 95% CI, 1.02­1.08), chronic lung disease (HR, 1.38; 95% CI, 1.31­1.45), diabetes mellitus (HR, 1.14; 95% CI, 1.11­1.18), and chronic neurological disease (HR, 1.48; 95% CI, 1.41­1.55) were at higher risk for death from COVID-19.

Effectiveness of the CoronaVac vaccine in older adults during a gamma variant associated epidemic of covid-19 in Brazil: test negative case-control study

Objective To estimate the effectiveness of the inactivated whole virus vaccine, CoronaVac (Sinovac Biotech), against symptomatic covid-19 in the elderly population of São Paulo state, Brazil during widespread circulation of the gamma variant. Design Test negative case-control study. Setting Community testing for covid-19 in São Paulo state, Brazil. Participants 43 774 adults aged ≥70 years who were residents of São Paulo state and underwent reverse transcription polymerase chain reaction (RT-PCR) testing for SARS-CoV-2 from 17 January to 29 April 2021. 26 433 cases with symptomatic covid-19 and 17 622 test negative controls with covid-19 symptoms were formed into 13 283 matched sets, one case with to up to five controls, according to age, sex, self-reported race, municipality of residence, previous covid-19 status, and date of RT-PCR test (±3 days). Intervention Vaccination with a two dose regimen of CoronaVac. Main outcome measures RT-PCR confirmed symptomatic covid-19 and associated hospital admissions and deaths. Results Adjusted vaccine effectiveness against symptomatic covid-19 was 24.7% (95% confidence interval 14.7% to 33.4%) at 0-13 days and 46.8% (38.7% to 53.8%) at ≥14 days after the second dose. Adjusted vaccine effectiveness against hospital admissions was 55.5% (46.5% to 62.9%) and against deaths was 61.2% (48.9% to 70.5%) at ≥14 days after the second dose. Vaccine effectiveness ≥14 days after the second dose was highest for the youngest age group (70-74 years)­59.0% (43.7% to 70.2%) against symptomatic disease, 77.6% (62.5% to 86.7%) against hospital admissions, and 83.9% (59.2% to 93.7%) against deaths­and declined with increasing age. Conclusions Vaccination with CoronaVac was associated with a reduction in symptomatic covid-19, hospital admissions, and deaths in adults aged ≥70 years in a setting with extensive transmission of the gamma variant. Vaccine protection was, however, low until completion of the two dose regimen, and vaccine effectiveness was observe to decline with increasing age among this elderly population.

Panorama contemporâneo de Acidentes de Trânsito Terrestre em diferentes territórios / Contemporary Panorama of Land Traffic Accidents in different territories

Acidente de trânsito terrestre é um evento inesperado que ocorre em uma via envolvendo veículos ou entre veículos e pedestres ou animais, ou ainda, entre veículos e qualquer obstáculo presente nas proximidades desta via.1 Esses acidentes representam a oitava causa de morte no mundo, segundo o último Relatório Global sobre Segurança Viária, produzido pela OMS, chegando em 2016 à cifra de 1,35 milhão de vidas perdidas por ano e 50 milhões de feridos. As crianças e jovens de 5 a 29 anos correspondem a faixa etária com maior mortalidade devido às condições inseguras das vias.

The role of pregnant women with rash in the Zika virus sentinel surveillance.

INTRODUCTION: The state of São Paulo has been monitoring cases of microcephaly and pregnant women presenting with acute rash, through CeVeSP. METHODS: This was a descriptive study focusing on pregnant women with rash and the outcome of their pregnancy, based on the notifications through the CeVeSP. RESULTS: During 2016, 2,209 cases of pregnant women with rash were reported and investigated. Of these, 36.6% were confirmed. Of the pregnant women who tested positive for ZIKV, 6.4% did not have a favorable outcome. CONCLUSIONS: Our results allowed the characterization of pregnant women exposed to ZIKV and the outcome of pregnancy.

The role of pregnant women with rash in the Zika virus sentinel surveillance

Abstract INTRODUCTION: The state of São Paulo has been monitoring cases of microcephaly and pregnant women presenting with acute rash, through CeVeSP. METHODS: This was a descriptive study focusing on pregnant women with rash and the outcome of their pregnancy, based on the notifications through the CeVeSP. RESULTS: During 2016, 2,209 cases of pregnant women with rash were reported and investigated. Of these, 36.6% were confirmed. Of the pregnant women who tested positive for ZIKV, 6.4% did not have a favorable outcome. CONCLUSIONS Our results allowed the characterization of pregnant women exposed to ZIKV and the outcome of pregnancy.

The role of pregnant women with rash in the Zika virus sentinel surveillance

INTRODUCTION: The state of São Paulo has been monitoring cases of microcephaly and pregnant women presenting with acute rash, through CeVeSP. METHODS: This was a descriptive study focusing on pregnant women with rash and the outcome of their pregnancy, based on the notifications through the CeVeSP. RESULTS: During 2016, 2,209 cases of pregnant women with rash were reported and investigated. Of these, 36.6% were confirmed. Of the pregnant women who tested positive for ZIKV, 6.4% did not have a favorable outcome. CONCLUSIONS Our results allowed the characterization of pregnant women exposed to ZIKV and the outcome of pregnancy.

Detecção de infecção pelo vírus da hepatite B nos municípios brasileiros segundo cobertura dos serviços de hemoterapia, no período de 2001 a 2008 / Detection of infection by hepatitis B virus in the brazilian municipalities according to the coverage of hemotherapy services, in the period from 2001 to 2008

OBJETIVO: descrever a taxa de detecção de infecção pelo vírus da hepatite B no Brasil e a razão de taxas de detecção nos municípios segundo cobertura dos serviços de hemoterapia (SH) durante o período 2001-2008. MÉTODOS: estudo descritivo, compreendeu o cálculo da taxa de detecção de infecção pelo vírus da hepatite B por sexo, faixa etária, Regiões brasileiras e presença de SH; regressão linear para tendência; teste de qui-quadrado para comparação de proporções da detecção e razão de taxas; os dados foram coletados do Sistema de Informação de Agravos de Notificação (Sinan-NET). RESULTADOS: a taxa de detecção de infecção pelo vírus da hepatite B apresentou incremento no Brasil, sendo 2,4 vezes mais elevada nos municípios com SH. CONCLUSÃO: a detecção da infecção pelo vírus da hepatite B apresentou pequeno incremento no período estudado e em todas as Regiões brasileiras foram encontradas taxas mais elevadas em municípios com serviço de hemoterapia.

OBJECTIVE: to describe the detection rate of infection by hepatitis B virus in Brazil and detection rates ratio in municipalities regarding hemotherapy service (HS) during the period 2001-2008. METHODS: a descriptive study reached the detection rate of infection by hepatitis Bvirus by gender, age, Brazilian macro-regions and presence of HS; it was applied linear regression for trend, and chi-squared test to compare proportions of detection and ratio rates; data from the Reportable Diseases Database (Sinan-NET) was used. RESULTS: the detection rates of infection by hepatitis B virus showed increase in Brazil, and were 2.4 higherin municipalities with HS. CONCLUSION: the detection of infection by hepatitis B virus showed small increase during the study period, and all Brazilian regions presented higher rates in municipalities with hemotherapy service.