Psychological distress, low-income, and socio-economic vulnerability in the COVID-19 pandemic.

OBJECTIVES: Although literature broadly reports the impact of COVID-19 on global mental health, little is known about the extent of its deleterious impact on the most vulnerable individuals. The present study aimed to evaluate the level of psychological distress of adult's residents of two urban shantytown communities located in São Paulo city, Brazil. STUDY DESIGN: This was a cross-sectional study. METHODS: An online questionnaire was divided into four sections: (1) informed consent, (2) socio-economic data, (3) 12-item general health questionnaire, and (4) Brazilian food insecurity scale was applied. RESULTS: Of the 495 family headship (448 females and 47 males), the mean age was 36.1 years, 85% have an indication of psychological distress, 61.4% had a monthly income less than or equal to $70, and the incidence of households experiencing moderate or severe food insecurity was 40%. Multivariate logistic regression revealed that respondents who experienced moderate or severe food insecurity (odds ratio [OR] = 2.701, confidence interval [CI] 95% = 1.265-5.769; P = 0.010) and lower monthly income (OR = 2.031, CI 95% = 1.056-3.908; P = 0.034) had a higher risk of psychological distress. On the other hand, having an employment is a protective factor against the stressful situations caused by COVID-19 pandemic (P = 0.029). CONCLUSION: The present study identified low-income younger women residents of urban slums who suffer from food insecurity as high-risk groups to have psychological distress. Our findings are of particular importance because they showed the intersection of vulnerabilities during the COVID-19 outbreak.

Brazilian experience with two conditioning regimens in patients with multiple sclerosis: BEAM/horse ATG and CY/rabbit ATG.

Studies have shown that autologous hematopoietic SCT (HSCT) can be used as an intensive immunosuppressive therapy to treat refractory patients and to prevent the progression of multiple sclerosis (MS). This is a prospective multicentric Brazilian MS trial comparing two conditioning regimens: BEAM/horse ATG and CY/rabbit ATG. Most (80.4%) of the 41 subjects in the study had the secondary progressive MS subtype and the mean age was 42 years. The baseline EDSS score in 58.5% of the subjects was 6.5 and 78% had a score of 6.0 or higher, respectively. The complication rate during the intra-transplantation period was 56% for all patients: 71.4% of the patients in the BEAM/hATG group and 40% in the CY/rATG group (P=0.04). Three subjects (7.5%) died of cardiac toxicity, sepsis and alveolar hemorrhage, all of them in the BEAM/ATG group. EFS was 58.54% for all patients: 47% in the BEAM/hATG group and 70% in the CY/rATG group (P=0.288). In conclusion, the CY/rATG regimen seems to be associated with similar outcome results, but presented less toxicity when compared with the BEAM/hATG regimen. Long-term follow-up would be required to fully assess the differences in therapeutic effectiveness between the two regimens.

Anti-HCV related to HCV PCR and risck factors analysis in a blood donor population of central Brazil

Ainda sao raros os casos de infeccao por hepatite C (HCV)na regiao central do Brasil. Neste estudo, 2.350 doadores voluntarios de sangue foram avaliados, resultando em prevalencias para o anti-HCV de 2,2 (por cento), pelo ELISA de segunda geracao, e de 1,4 por cento, apos o ensaio confirmatorio "line immunoassay". Anticorpos contra os antigenos "core", NS4 e NS5 do HCV foi observada em 76,6 (por cento) dos doadores anti-HCV positivos. A positividade da reacao em cadeia da polimerase (PCR) mostrou-se relacionada a reatividade aos diferentes antigenos do HCV no "line immunoassay". A maioria dos doadores positivos tiveram historia previa de exposicao parenteral. A combinacao de ALT>50 UI/1 e positividade ao anti-HBc parece nao ser eficaz como marcadores indiretos para a infeccao pelo HCV, entretanto a dosagem do ALT e a deteccao de anti-HCV sao indicadas na triagem de doadores de sangue brasileiros.

Anti-HCV related to HCV PCR and risk factors analysis in a blood donor population of central Brazil.

Data concerning HCV infection in Central Brazil are rare. Upon testing 2,350 voluntary blood donors from this region, we found anti-HCV prevalence rates of 2.2% by a second generation ELISA and 1.4% after confirmation by a line immunoassay. Antibodies against core, NS4, and NS5 antigens of HCV were detected in 81.8%, 72.7%, and 57.5%, respectively, of the positive samples in the line immunoassay. HCV viremia was present in 76.6% of the anti-HCV-positive blood donors. A relation was observed between PCR positivity and serum reactivity in recognizing different HCV antigens in the line immunoassay. The majority of the positive donors had history of previous parenteral exposure. While the combination of ALT > 50 IU/l and anti-HBc positivity do not appear to be good surrogate markers for HCV infection, the use of both ALT anti-HCV tests is indicated in the screening of Brazilian blood donors.

[Serologic screening of infectious diseases in blood banks as an indicator of morbidity in the population]. / Rastreamento sorológico para doenças infecciosas em banco de sangue como indicador de morbidade populacional.

Screening tests of 62,814 blood donations carried out between October 85 and October 87 in all five blood banks of Goiânia, Central Brazil, were analysed. The private institutions (3 blood banks) collected 80% of all donations and the remaining were collected by public blood banks. Seroprevalence of HIV, HBsAg, Chagas' disease and syphilis were compared with data obtained in the surveillance system and from previous surveys in an attempt to validate this source of health information. A seroprevalence of 0.07% for AIDS (one ELISA test) was calculated, which may suggest the presence of 1900 infected individuals, in the population of the State of Goiás as a whole. This figure seems reasonably close to the official data obtained by compulsory notification. For Chagas' disease, hepatitis B and syphilis seroprevalence of 3.3%, 1.3% and 4.1% were obtained, respectively. The potential usefulness and the limitations of screening in blood banks as a source of reliable morbidity indicator is discussed.