Impact of a research-action on vaccination indicators in the state of Minas Gerais, Brazil.

OBJECTIVE: Analyze the impact of the state research-action project on immunization indicators (vaccination coverage - VC, homogeneity of vaccination coverage - HVC, dropout rate - DR, and risk rating) before and after the intervention in municipalities and priority Regional Health Administrations/Regional Health Superintendencies (RHA/RHS). METHODS: The state research-action project was a before-after community clinical trial conducted in 212 municipalities belonging to eight RHA/RHS in the state of Minas Gerais, Brazil. The study sample comprised RHA/RHS with a decreasing trend for routine vaccination coverage in children under one year from 2015 to 2020. This study used secondary VC and DR data from 10 immunobiologicals recommended for children younger than two years from January to December 2021 (pre-intervention period, prior to the state research-action project) and from January to December 2022 (post-intervention period). The categorical variables were presented in proportions, and initially, a comparison was made between those of DR, HVC, and the risk rating for the transmission of vaccine-preventable diseases, according to the two periods (2021 and 2022), using the McNemar test. RESULTS: All immunization indicators increased after conducting the research-action project. In 2021, 80.66% of the state's municipalities had a risk rating for the transmission of vaccine-preventable diseases as "high and very high." In 2022, the value reduced to 68.40%. CONCLUSIONS: Risk rating for the transmission of vaccine-preventable diseases is an important mechanism to assist managers in defining priorities. The state research-action project used a method that enabled the construction and execution of unique action plans for each municipality, directing the improvement of immunization indicators in the state.

Impact of a research-action on vaccination indicators in the state of Minas Gerais, Brazil / Impacto de uma pesquisa-ação nos indicadores vacinais em Minas Gerais

ABSTRACT OBJECTIVE Analyze the impact of the state research-action project on immunization indicators (vaccination coverage - VC, homogeneity of vaccination coverage - HVC, dropout rate - DR, and risk rating) before and after the intervention in municipalities and priority Regional Health Administrations/Regional Health Superintendencies (RHA/RHS). METHODS The state research-action project was a before-after community clinical trial conducted in 212 municipalities belonging to eight RHA/RHS in the state of Minas Gerais, Brazil. The study sample comprised RHA/RHS with a decreasing trend for routine vaccination coverage in children under one year from 2015 to 2020. This study used secondary VC and DR data from 10 immunobiologicals recommended for children younger than two years from January to December 2021 (pre-intervention period, prior to the state research-action project) and from January to December 2022 (post-intervention period). The categorical variables were presented in proportions, and initially, a comparison was made between those of DR, HVC, and the risk rating for the transmission of vaccine-preventable diseases, according to the two periods (2021 and 2022), using the McNemar test. RESULTS All immunization indicators increased after conducting the research-action project. In 2021, 80.66% of the state's municipalities had a risk rating for the transmission of vaccine-preventable diseases as "high and very high." In 2022, the value reduced to 68.40%. CONCLUSIONS Risk rating for the transmission of vaccine-preventable diseases is an important mechanism to assist managers in defining priorities. The state research-action project used a method that enabled the construction and execution of unique action plans for each municipality, directing the improvement of immunization indicators in the state.

RESUMO OBJETIVO Analisar o impacto do projeto estadual de pesquisa-ação nos indicadores de imunização (coberturas vacinais - CV, homogeneidade de cobertura vacinal - HCV, taxa de abandono - TA e classificação de risco) antes e após a intervenção em municípios e Gerências Regionais de Saúde/Superintendências Regionais de Saúde (GRS/SRS) prioritários. MÉTODOS O projeto estadual de pesquisa-ação foi um ensaio clínico comunitário, do tipo antes-depois, realizado em 212 municípios pertencentes a oito GRS/SRS do estado de Minas Gerais, Brasil. Compuseram a amostra do estudo as SRS/GRS com tendência decrescente para a cobertura vacinal de rotina em crianças menores de 1 ano, no período de 2015 a 2020. Neste estudo, foram utilizados dados secundários de CV e TA de 10 imunobiológicos recomendados para crianças menores de 2 anos, no período de janeiro a dezembro de 2021 (período pré-intervenção, anterior ao projeto estadual de pesquisa-ação) e de janeiro a dezembro de 2022 (período pós-intervenção). As variáveis categóricas foram apresentadas em proporções e, inicialmente, realizou-se a comparação entre as de TA, HCV e a classificação de risco para a transmissão de doenças imunopreveníveis, segundo os dois períodos (2021 e 2022), utilizando-se o teste McNemar. RESULTADOS Observou-se um aumento de todos os indicadores de imunização após a realização do projeto de pesquisa-ação. No ano de 2021, 80,66% dos municípios do estado tiveram a classificação de risco para transmissão de doenças imunopreveníveis como "alto e muito alto risco". Em 2022, o valor foi reduzido para 68,40%. CONCLUSÕES A classificação de risco para transmissão de doenças imunopreveníveis é um mecanismo importante para auxiliar os gestores na definição de prioridades. O projeto estadual de pesquisa-ação empregou um método que possibilitou a construção e a execução de planos de ação singulares a cada município, direcionando a melhoria dos indicadores de imunização no estado.

Adverse event following immunization or vaccination in children in Minas Gerais: 2015 to 2020.

OBJECTIVE: To describe adverse event following immunization or vaccination in children in Minas Gerais: 2015 to 2020, resulting from immunization errors in children from zero to nine years old. METHODS: An ecological, descriptive study with a quantitative approach, based on event notifications available in the National Immunization Program Information System. RESULTS: Among the 39,903,277 doses of immunobiologicals in children aged zero to nine, administered in the state of MG, 3,259 events of types of immunization errors were recorded, around 0.008% of the total and, of these, 91.86% did not result in adverse events and 56.02% were children under one year of age. The most frequent diagnosis was application outside the recommended age (29.12%). Among the manifestations, 71.91% were local and systemic, with fever being the most common (40.85%). CONCLUSION: The study demonstrated that immunization errors were rare and that most of them were not associated with adverse events, which reinforces the safety of the immunization process. This undoubtedly raises reflection on the need and relevance of continuing education for health professionals.

Repercussions of SARS-CoV-2 infection and the pandemic on birth routes: a cross-sectional study.

OBJECTIVE: To assess the repercussions of SARS-CoV-2 infection (suspected or confirmed) and the context of the pandemic on the birth route and humanized assistance during childbirth. METHOD: Cross-sectional epidemiological study, nested within a cohort and comparative with the research "Birth in Belo Horizonte: Survey on Childbirth and Delivery".The medical records of three reference maternity hospitals in Belo Horizonte were assessed, with a final sample of 1,682 pregnant women, in the months of May, June and July 2020. A descriptive analysis was carried out, with absolute and relative frequency, and a comparative one, with a Pearson's chi-square test. RESULTS: It was observed that 2.02% of pregnant women were infected with SARS-CoV-2.Before the pandemic, out of a total of 390 pregnant women, 74.10% gave birth vaginally.During a pandemic, among infected women, 51.61% gave birth via cesarean section and 48,39% via vaginal delivery;among uninfected, 26.99% cesarean sections and 73.01% vaginaldeliveries. CONCLUSION: There was an increase in the percentage of cesarean sections and a possible influence of the pandemic on the rates of indication of cesarean sections at the time of admission to the maternity ward.

Epidemiology of monkeypox notifications in the state of Minas Gerais, Brazil.

OBJECTIVES: to describe the epidemiological profile of suspected, confirmed, and probable cases of monkeypox in the state of Minas Gerais, Brazil. METHODS: a descriptive, retrospective study of reported suspected, confirmed, and probable cases of monkeypox infection in the state of Minas Gerais, Brazil. The study period was from the first notification, on June 11, to September 7, 2022. RESULTS: a total of 759 suspected, confirmed, and probable cases of monkeypox infection were reported, with 35.44% suspected, 53.75% confirmed, and 10.81% probable cases, respectively. As for the coexisting diseases within confirmed cases, 38.79% were related to people living with human immunodeficiency virus, and 13.74% had some active sexually transmitted infection. Regarding the evolution of confirmed cases, 47.43% were cured. CONCLUSIONS: the results contribute to greater knowledge and control of the infection by allowing better disease management and care offered in health services.

The association between multiple cardiovascular risk factors and overweight in Brazilian adolescents: an analysis based on the grade of membership.

The aim of the current research is to analyze the coexistence of modifiable risk behaviors for cardiovascular disease (CVD) in 12-to-17-year-old adolescents living in Brazil and their influence on overweight. National, cross-sectional, school-based epidemiological study focused on estimating the prevalence of cardiovascular risk factors and metabolic syndrome in 12 to 17 year old adolescents enrolled in public and private schools in Brazilian counties accounting for more than 100 thousand inhabitants. The grade of membership method was used to identify the coexistence of risk factors among adolescents. The analytical sample comprised 71,552 adolescents. According to the two herein generated profiles, adolescents classified under Profile 2 have shown behaviors such as smoking, alcohol consumption and diet rich in Ultra-processed food intake ≥ 80% of the percentage of total caloric value. In addition, adolescents presenting CVD risk profile have shown increased likelihood of being overweight. The study has found coexistence of risk factors for CVD in Brazilian adolescents, with emphasis on tobacco smoking and alcoholic beverage intake. In addition, it heads towards the analysis of the association between CVD risk factors and health outcomes, such as overweight.

The association between multiple cardiovascular risk factors and overweight in Brazilian adolescents: an analysis based on the grade of membership / A associação entre múltiplos fatores de risco cardiovascular e o excesso de peso em adolescentes brasileiros: uma análise baseada no grade of membership

Abstract The aim of the current research is to analyze the coexistence of modifiable risk behaviors for cardiovascular disease (CVD) in 12-to-17-year-old adolescents living in Brazil and their influence on overweight. National, cross-sectional, school-based epidemiological study focused on estimating the prevalence of cardiovascular risk factors and metabolic syndrome in 12 to 17 year old adolescents enrolled in public and private schools in Brazilian counties accounting for more than 100 thousand inhabitants. The grade of membership method was used to identify the coexistence of risk factors among adolescents. The analytical sample comprised 71,552 adolescents. According to the two herein generated profiles, adolescents classified under Profile 2 have shown behaviors such as smoking, alcohol consumption and diet rich in Ultra-processed food intake ≥ 80% of the percentage of total caloric value. In addition, adolescents presenting CVD risk profile have shown increased likelihood of being overweight. The study has found coexistence of risk factors for CVD in Brazilian adolescents, with emphasis on tobacco smoking and alcoholic beverage intake. In addition, it heads towards the analysis of the association between CVD risk factors and health outcomes, such as overweight.

Resumo O objetivo desta pesquisa é analisar a coexistência de comportamentos de risco modificáveis para doenças cardiovasculares (DCV) em adolescentes de 12 a 17 anos residentes no Brasil e sua influência no excesso de peso. Estudo epidemiológico nacional, transversal, de base escolar, com foco em estimar a prevalência de fatores de risco cardiovascular e síndrome metabólica em adolescentes de 12 a 17 anos matriculados em escolas públicas e privadas de municípios brasileiros que somam mais de 100 mil habitantes. O grade of membership foi utilizado para identificar a coexistência de fatores de risco entre os adolescentes. A amostra analítica foi composta por 71.552 adolescentes. De acordo com os dois perfis gerados, os adolescentes classificados no Perfil 2 mostraram comportamentos como fumar, consumo de álcool e dieta rica em alimentos ultraprocessados ≥ 80% da porcentagem do valor calórico total. Além disso, adolescentes com perfil de risco para DCV mostraram maior probabilidade de apresentar excesso de peso. O estudo encontrou coexistência de fatores de risco para DCV em adolescentes brasileiros, com destaque para tabagismo e consumo de bebidas alcoólicas. Além disso, demonstra associação entre fatores de risco para DCV e desfechos de saúde, como o excesso de peso.

Tendência temporal dos homicídios de mulheres nos estados da região Sudeste do Brasil, de 2007 a 2019 / Timeline trend of homicides of women in the states of the Southeast region of Brazil between 2007 and 2019

Resumo O objetivo deste artigo é analisar a tendência temporal de homicídios de mulheres no período de 2007 a 2019, na região Sudeste do Brasil. Trata-se de um estudo ecológico misto dos homicídios em mulheres, de 2007 a 2019, considerando-se como unidade de análise os anos do estudo e os estados que compõem a região Sudeste. Os dados foram obtidos via Sistema de Informação sobre Mortalidade (SIM) e tabulados pelo TABNET. Empregou-se o modelo de regressão de Prais-Winsten para verificação de tendência de homicídios. Foram registrados 18.415 homicídios de mulheres entre 2007 e 2019 na região Sudeste. Cerca de 9.691 (53,64%) eram mulheres pretas, 5.118 (27,80%) com escolaridade de 4 a 7 anos e 10.841 (58,87%) solteiras. As variações percentuais anuais foram: São Paulo -3,73; IC95% [-6,09; -1,32], Espírito Santo -5,67; IC95% [-7,11; -4,21], Rio de Janeiro -3,86; IC95% [-9,54; 2,17] e Minas Gerais -2,11; IC95% [-4,87; 0,73]. São Paulo e Espírito Santo apresentaram taxas de homicídios de mulheres decrescentes, enquanto Minas Gerais e Rio de Janeiro taxas estacionárias. As maiores taxas de homicídio no período ocorreram em mulheres solteiras, pretas e com escolaridade de quatro a sete anos. Faz-se necessária a construção de redes sociais que viabilizem a proteção integral das mulheres.

Abstract The scope of this article is to analyze the timeline trend of homicides of women between 2007 and 2019, in the Southeast region of Brazil. It is a mixed ecological study of homicides in women, from 2007 to 2019, considering the years of the study and the states that that make up the Southeast region as the unit of analysis. The data were obtained via the Mortality Information System (SIM) and tabulated by TABNET. The Prais-Winten regression model was used to verify the homicide trend. There were 18,415 homicides of women between 2007 and 2019 in the Southeast region. A total of 9,691 (53.64%) were black women, 5,118 (27.8%) had 4 to 7 years of schooling and 10,841 (58.87%) were single. The annual percentage variations were: São Paulo -3.73 ; 95%CI [-6.09; -1.32], Espírito Santo -5.67 ; 95%CI [-7.11;-4.21], Rio de Janeiro -3.86; 95%CI [-9.54; 2.17] and Minas Gerais -2.11 ; 95%CI [-4.87; 0.73]. São Paulo and Espírito Santo presented decreasing homicide rates for women, while Minas Gerais and Rio de Janeiro showed stationary rates. The highest homicide rates in the period were single women, black women and women with 4 to 7 years of schooling. It is necessary to build social networks that ensure the full protection of women.

[Timeline trend of homicides of women in the states of the Southeast region of Brazil between 2007 and 2019]. / Tendência temporal dos homicídios de mulheres nos estados da região Sudeste do Brasil, de 2007 a 2019.

The scope of this article is to analyze the timeline trend of homicides of women between 2007 and 2019, in the Southeast region of Brazil. It is a mixed ecological study of homicides in women, from 2007 to 2019, considering the years of the study and the states that that make up the Southeast region as the unit of analysis. The data were obtained via the Mortality Information System (SIM) and tabulated by TABNET. The Prais-Winten regression model was used to verify the homicide trend. There were 18,415 homicides of women between 2007 and 2019 in the Southeast region. A total of 9,691 (53.64%) were black women, 5,118 (27.8%) had 4 to 7 years of schooling and 10,841 (58.87%) were single. The annual percentage variations were: São Paulo -3.73 ; 95%CI [-6.09; -1.32], Espírito Santo -5.67 ; 95%CI [-7.11;-4.21], Rio de Janeiro -3.86; 95%CI [-9.54; 2.17] and Minas Gerais -2.11 ; 95%CI [-4.87; 0.73]. São Paulo and Espírito Santo presented decreasing homicide rates for women, while Minas Gerais and Rio de Janeiro showed stationary rates. The highest homicide rates in the period were single women, black women and women with 4 to 7 years of schooling. It is necessary to build social networks that ensure the full protection of women.

O objetivo deste artigo é analisar a tendência temporal de homicídios de mulheres no período de 2007 a 2019, na região Sudeste do Brasil. Trata-se de um estudo ecológico misto dos homicídios em mulheres, de 2007 a 2019, considerando-se como unidade de análise os anos do estudo e os estados que compõem a região Sudeste. Os dados foram obtidos via Sistema de Informação sobre Mortalidade (SIM) e tabulados pelo TABNET. Empregou-se o modelo de regressão de Prais-Winsten para verificação de tendência de homicídios. Foram registrados 18.415 homicídios de mulheres entre 2007 e 2019 na região Sudeste. Cerca de 9.691 (53,64%) eram mulheres pretas, 5.118 (27,80%) com escolaridade de 4 a 7 anos e 10.841 (58,87%) solteiras. As variações percentuais anuais foram: São Paulo -3,73; IC95% [-6,09; -1,32], Espírito Santo -5,67; IC95% [-7,11; -4,21], Rio de Janeiro -3,86; IC95% [-9,54; 2,17] e Minas Gerais -2,11; IC95% [-4,87; 0,73]. São Paulo e Espírito Santo apresentaram taxas de homicídios de mulheres decrescentes, enquanto Minas Gerais e Rio de Janeiro taxas estacionárias. As maiores taxas de homicídio no período ocorreram em mulheres solteiras, pretas e com escolaridade de quatro a sete anos. Faz-se necessária a construção de redes sociais que viabilizem a proteção integral das mulheres.

[Transmission risk classification for vaccine-preventable diseases in Minas Gerais, Brazil: two years since the onset of the COVID-19 pandemic]. / Classificação de risco para transmissão de doenças imunopreveníveis em Minas Gerais, Brasil: dois anos desde o início da pandemia de COVID-19.

The scope of this study is to analyze the risk classification of transmission of vaccine-preventable diseases (VPDs) in the 853 municipalities in the state of Minas Gerais (MG) two years after the onset of the COVID-19 pandemic. It is an epidemiological study with secondary data on vaccination coverage and dropout rate of ten immuno-biologicals recommended for under 2-year-old children in 2021 in MG. With respect to the dropout rate, this indicator was only evaluated for the multidose vaccines. After calculating all the indicators, the municipalities of the state were classified according to the transmission risk of VPDs into five categories: very low, low, medium, high, and very high risk. Minas Gerais had 80.9% of municipalities classified as high transmission risk for VPDs. Regarding the homogeneity of vaccination coverage (HCV), large municipalities had the highest percentage of HCV classified as very low, and 100% of these municipalities were classified as high or very high risk for transmission of VPDs, with statistical significance. The use of immunization indicators by municipality is effective for the classification of the scenario of each territory and the proposal of public policies seeking to increase vaccination coverage.

O objetivo é analisar a classificação de risco de transmissão de doenças imunopreveníveis nos 853 municípios de Minas Gerais (MG) após dois anos de início da pandemia de COVID-19. Estudo epidemiológico com dados secundários da cobertura vacinal e taxa de abandono de dez imunobiológicos recomendados para crianças menores de 2 anos, no ano de 2021, em MG. Em relação à taxa de abandono, este indicador foi avaliado somente para as vacinas multidoses. Após o cálculo de todos os indicadores, os municípios do estado foram classificados de acordo com o risco de transmissão de doenças imunopreveníveis em cinco estratos. Minas Gerais apresentou 80,9% dos municípios classificados como alto risco para transmissão de doenças imunopreveníveis. Em relação à homogeneidade das coberturas vacinais (HCV), os municípios de grande porte apresentaram a maior porcentagem de HCV classificada como muito baixa e 100% desses municípios foram classificados como de alto ou muito alto risco para transmissão de doenças imunopreveníveis, com significância estatística. A utilização de indicadores de imunização por município é efetiva para o delineamento do cenário de cada território e a proposição de políticas públicas em saúde visando o aumento das coberturas vacinais.

Classificação de risco para transmissão de doenças imunopreveníveis em Minas Gerais, Brasil: dois anos desde o início da pandemia de COVID-19 / Transmission risk classification for vaccine-preventable diseases in Minas Gerais, Brazil: two years since the onset of the COVID-19 pandemic

Resumo O objetivo é analisar a classificação de risco de transmissão de doenças imunopreveníveis nos 853 municípios de Minas Gerais (MG) após dois anos de início da pandemia de COVID-19. Estudo epidemiológico com dados secundários da cobertura vacinal e taxa de abandono de dez imunobiológicos recomendados para crianças menores de 2 anos, no ano de 2021, em MG. Em relação à taxa de abandono, este indicador foi avaliado somente para as vacinas multidoses. Após o cálculo de todos os indicadores, os municípios do estado foram classificados de acordo com o risco de transmissão de doenças imunopreveníveis em cinco estratos. Minas Gerais apresentou 80,9% dos municípios classificados como alto risco para transmissão de doenças imunopreveníveis. Em relação à homogeneidade das coberturas vacinais (HCV), os municípios de grande porte apresentaram a maior porcentagem de HCV classificada como muito baixa e 100% desses municípios foram classificados como de alto ou muito alto risco para transmissão de doenças imunopreveníveis, com significância estatística. A utilização de indicadores de imunização por município é efetiva para o delineamento do cenário de cada território e a proposição de políticas públicas em saúde visando o aumento das coberturas vacinais.

Abstract The scope of this study is to analyze the risk classification of transmission of vaccine-preventable diseases (VPDs) in the 853 municipalities in the state of Minas Gerais (MG) two years after the onset of the COVID-19 pandemic. It is an epidemiological study with secondary data on vaccination coverage and dropout rate of ten immuno-biologicals recommended for under 2-year-old children in 2021 in MG. With respect to the dropout rate, this indicator was only evaluated for the multidose vaccines. After calculating all the indicators, the municipalities of the state were classified according to the transmission risk of VPDs into five categories: very low, low, medium, high, and very high risk. Minas Gerais had 80.9% of municipalities classified as high transmission risk for VPDs. Regarding the homogeneity of vaccination coverage (HCV), large municipalities had the highest percentage of HCV classified as very low, and 100% of these municipalities were classified as high or very high risk for transmission of VPDs, with statistical significance. The use of immunization indicators by municipality is effective for the classification of the scenario of each territory and the proposal of public policies seeking to increase vaccination coverage.

Total cholesterol and low-density lipoprotein alterations in children and adolescents from Brazil: a prevalence meta-analysis

ABSTRACT Objective: The aim of the present study was to evaluate the prevalence of total cholesterol (TC) and low-density lipoprotein (LDL) alterations in children and adolescents in Brazil. Materials and methods: A systematic review and meta-analysis of prevalence. The search for articles was carried out in the databases: Medline (PubMed), Embase, Scientific Electronic Library Online (SciELO), Latin American and Caribbean Literature in Health Sciences (Lilacs). The meta-analysis was performed using the random effects model. The I² test was used to identify heterogeneity. Results: The present metanalysis revealed a significant prevalence of altered lipid profile in children and adolescents in Brazil. Regarding lipoprotein fractions, the prevalence of altered TC level was 27.47% (95% CI 24.36-30.82), and a smaller prevalence was observed for LDL cholesterol (19.29% - 95% CI 15.21-24.16). The models revealed high heterogeneity (I² = 99%; p < 0.01), however the precise source of it was not identified; although type of school, age group, year and the region of Brazil appeared to influence the estimations of altered lipid profiles. Conclusion: An important prevalence of lipid alterations was observed among Brazilian children and adolescents. Those results reinforce the importance of knowing the lipid profile of children and adolescents to perform early interventions for this public.

Environmental factors associated with excessive gestational weight gain: a meta-analysis and systematic review.

The aim is, systematically examine the scientific evidences that associated environmental factors (environment, social environment, environmental planning and spatial population distribution) with the excessive gestational weight gain. A meta-analysis and systematic review carried out as per the Cochrane Handbook recommendations and following the steps recommended by the Preferred Reporting Items for Systematic Reviews and Meta-Analyzes. The inclusion studies were done with the following PECO criteria: P-pregnant women, E-environmental factors, O-weight gain. The search procedure was conducted on the databases EMBASE, Web of Science, Cinahl, LILACS and MEDLINE (PubMed). The relationship between the socioeconomic factors of the micro-region of residence and gestational weight gain was evidenced by the linkage between residing in high-poverty neighborhoods and inadequate gestational weight gain. This study revealed the higher prevalence of excessive gestational weight gain in pregnant women those lives in urban areas. Environmental factors of the pregnant women's residence area implicated in the excessive gestational weight gain. Our findings can therefore contribute to the development of public policies to prevent inadequate gestational weight gain.

Environmental factors associated with excessive gestational weight gain: a meta-analysis and systematic review / Fatores ambientais associados ao ganho de peso gestacional excessivo: uma meta-análise e revisão sistemática

Abstract The aim is, systematically examine the scientific evidences that associated environmental factors (environment, social environment, environmental planning and spatial population distribution) with the excessive gestational weight gain. A meta-analysis and systematic review carried out as per the Cochrane Handbook recommendations and following the steps recommended by the Preferred Reporting Items for Systematic Reviews and Meta-Analyzes. The inclusion studies were done with the following PECO criteria: P-pregnant women, E-environmental factors, O-weight gain. The search procedure was conducted on the databases EMBASE, Web of Science, Cinahl, LILACS and MEDLINE (PubMed). The relationship between the socioeconomic factors of the micro-region of residence and gestational weight gain was evidenced by the linkage between residing in high-poverty neighborhoods and inadequate gestational weight gain. This study revealed the higher prevalence of excessive gestational weight gain in pregnant women those lives in urban areas. Environmental factors of the pregnant women's residence area implicated in the excessive gestational weight gain. Our findings can therefore contribute to the development of public policies to prevent inadequate gestational weight gain.

Resumo O objetivo é examinar sistematicamente as evidências científicas que associam fatores ambientais (meio ambiente, meio ambiente social, planejamento ambiental e distribuição espacial da população) com o excessivo ganho de peso gestacional. Trata-se de uma revisão sistemática e meta-análise realizada seguindo os passos recomendados pelo Preferred Reporting Items for Systematic Reviews and Meta-Analyzes. Os estudos de incluídos basearam-se nos seguintes critérios PECO: P-gestantes, E-fatores ambientais, O-ganho de peso gestacional. O procedimento de pesquisa foi conduzido nas bases de dados EMBASE, Web of Science, Cinahl, LILACS e MEDLINE (PubMed). A relação entre os fatores socioeconômicos da microrregião de residência e o ganho de peso gestacional foi evidenciada pela ligação entre a residência em bairros de alta pobreza e o ganho de peso gestacional inadequado. Este estudo revelou a maior prevalência de ganho de peso gestacional excessivo em gestantes que vivem em áreas urbanas. Fatores ambientais da área de residência das gestantes implicados no ganho de peso gestacional excessivo. As descobertas desse estudo podem, portanto, contribuir para o desenvolvimento de políticas públicas para evitar o ganho de peso gestacional inadequado.

Evaluation on the information about absolute and relative indications of cesarean sections available on popular websites / Avaliação das informações sobre indicações absolutas e relativas de cesarianas disponíveis em sites populares

Abstract Objectives: to evaluate the reliability of information available on popular websites, in other words, websites aimed lay pregnant women, about absolute and relative indications for cesarean sections. Methods: this was a descriptive/comparative study based on the popular websites most likely to be visited by lay pregnant women and that contained information about indications for absolute and relative cesarean sections. Cohen's Kappa index of agreement was used to analyze the reliability degree on the indications for cesarean sections presented on the websites and the scientific evidence. Results: there was a higher prevalence (62.63%) of information on the indications for cesarean sections that did not mention whether the indication was absolute or relative, and of these indications, 40.74% were not indications for cesarean sections. Low agreement was also observed among websites and the scientific evidence when the website mentioned the indication for cesarean section was absolute or relative. Conclusion: this study showed that the reliability of the information on absolute and relative indications for cesarean sections available in popular websites is questionable.

Resumo Objetivos: avaliar a confiabilidade das informações disponíveis em sites populares, ou seja, sites voltados para gestantes leigas, sobre indicações absolutas e relativas de cesarianas. Métodos: estudo descritivo/comparativo, baseado nos sites populares mais prováveis de serem visitados por gestantes leigas e que traziam informações sobre as indicações de cesarianas absolutas e relativas. Para analisar o grau de confiabilidade das indicações de cesarianas apresentadas pelos sites e a evidência cientifica, foi realizado o índice de concordância de Kappa de Cohen. Resultados: houve maior prevalência (62,63%) de informações de indicações de cesarianas que não mencionavam se a indicação apresentada era absoluta ou relativa, sendo que destas, 40,74% não eram indicações de cesarianas. Observou-se, concordância baixa entre os sites e a evidência cientifica quando o site mencionava que a indicação de cesariana era absoluta ou relativa. Conclusão: este estudo demonstrou que a confiabilidade das informações acerca das indicações absolutas e relativas de cesarianas disponíveis em sites populares é questionável

Epidemiology of monkeypox notifications in the state of Minas Gerais, Brazil / Epidemiología de las notificaciones de viruela del mono en el estado de Minas Gerais, Brasil / Epidemiologia das notificações de monkeypox no estado de Minas Gerais, Brasil

ABSTRACT Objectives: to describe the epidemiological profile of suspected, confirmed, and probable cases of monkeypox in the state of Minas Gerais, Brazil. Methods: a descriptive, retrospective study of reported suspected, confirmed, and probable cases of monkeypox infection in the state of Minas Gerais, Brazil. The study period was from the first notification, on June 11, to September 7, 2022. Results: a total of 759 suspected, confirmed, and probable cases of monkeypox infection were reported, with 35.44% suspected, 53.75% confirmed, and 10.81% probable cases, respectively. As for the coexisting diseases within confirmed cases, 38.79% were related to people living with human immunodeficiency virus, and 13.74% had some active sexually transmitted infection. Regarding the evolution of confirmed cases, 47.43% were cured. Conclusions: the results contribute to greater knowledge and control of the infection by allowing better disease management and care offered in health services.

RESUMEN Objetivos: describir perfil epidemiológico de casos sospechosos, confirmados y probables por viruela símica en Minas Gerais, Brasil. Métodos: estudio descriptivo, retrospectivo, con casos notificados sospechosos, confirmados y probables de infección por viruela símica en el estado de Minas Gerais, Brasil. El período del estudio fue desde la primera notificación, en 11 de junio, hasta 7 de septiembre de 2022. Resultados: fueron notificados 759 casos sospechosos, confirmados y probables de infección por viruela símica, siendo, respectivamente, 35,44% sospechosos, 53,75% confirmados y 10,81% probables. Cuanto a las enfermedades coexistentes en los casos confirmados, 38,79% referidos a personas viviendo con virus de la inmunodeficiencia humana, y 13,74% poseían alguna infección sexualmente transmisible activa. Sobre la evolución de casos confirmados, 47,43% evolucionaron para la cura. Conclusiones: los resultados contribuyen para mayor conocimiento y control de la infección, auxiliando en la mejor gestión de la enfermedad y cuidado ofrecidos en los servicios de salud.

RESUMO Objetivos: descrever o perfil epidemiológico dos casos suspeitos, confirmados e prováveis por monkeypox no estado de Minas Gerais, Brasil. Métodos: estudo descritivo, retrospectivo, com os casos notificados suspeitos, confirmados e prováveis de infecção pelo monkeypox no estado de Minas Gerais, Brasil. O período do estudo foi desde a primeira notificação, em 11 de junho, até 7 de setembro de 2022. Resultados: foram notificados 759 casos suspeitos, confirmados e prováveis de infecção pelo monkeypox, sendo, respectivamente, 35,44% suspeitos, 53,75% confirmados e 10,81% prováveis. Quanto às doenças coexistentes nos casos confirmados, 38,79% referiam-se a pessoas vivendo com vírus da imunodeficiência humana, e 13,74% possuíam alguma infecção sexualmente transmissível ativa. Sobre a evolução dos casos confirmados, 47,43% evoluíram para a cura. Conclusões: os resultados contribuem para maior conhecimento e controle da infecção, de modo a auxiliar no melhor gerenciamento da doença e cuidado ofertados nos serviços de saúde.

Repercussions of SARS-CoV-2 infection and the pandemic on birth routes: a cross-sectional study / Repercusiones de la infección por SARS-CoV-2y la pandemia en las vías de nacimiento: un estudio transversal / Repercussões da infecção por SARS-CoV-2 e da pandemia nas vias de nascimento: estudo transversal

ABSTRACT Objective: To assess the repercussions of SARS-CoV-2 infection (suspected or confirmed) and the context of the pandemic on the birth route and humanized assistance during childbirth. Method: Cross-sectional epidemiological study, nested within a cohort and comparative with the research "Birth in Belo Horizonte: Survey on Childbirth and Delivery".The medical records of three reference maternity hospitals in Belo Horizonte were assessed, with a final sample of 1,682 pregnant women, in the months of May, June and July 2020. A descriptive analysis was carried out, with absolute and relative frequency, and a comparative one, with a Pearson's chi-square test. Results: It was observed that 2.02% of pregnant women were infected with SARS-CoV-2.Before the pandemic, out of a total of 390 pregnant women, 74.10% gave birth vaginally.During a pandemic, among infected women, 51.61% gave birth via cesarean section and 48,39% via vaginal delivery;among uninfected, 26.99% cesarean sections and 73.01% vaginaldeliveries. Conclusion: There was an increase in the percentage of cesarean sections and a possible influence of the pandemic on the rates of indication of cesarean sections at the time of admission to the maternity ward.

RESUMEN Objetivo: Evaluar las repercusiones de la infección por SARS-CoV-2 (sospechosa o confirmada) y el contexto de la pandemia en la vía del parto y la asistencia humanizada durante el parto. Método: Estudio epidemiológico transversal, anidado en una cohorte y comparativo con la investigación "Nacimiento en Belo Horizonte: Encuesta sobre Parto y Parto".Se enviaron los prontuarios de tres maternidades de referencia en Belo Horizonte, con una muestra final de 1.682 gestantes, en los meses de mayo, junio y julio de 2020. Se realizó un análisis descriptivo, con frecuencia absoluta y relativa, y comparativo. uno, con una prueba de Chi, cuadrado de Pearson. Resultados: Tenga en cuenta que el 2,02% de las mujeres embarazadas estaban infectadas con SARS-CoV-2.Antes de la pandemia, en un total de 390 gestantes, el 74,10% daba a luz por vía vaginal.Durante una pandemia, entre las mujeres infectadas, el 51,61% dio a luz por cesárea y el 48,39% por parto vaginal;en las no infectadas, 26,99% cesáreas y 73,01% vaginales. Conclusión: Hubo un aumento en el porcentaje de cesáreas y una posible influencia de la pandemia en las tasas de indicación de cesáreas al momento del ingreso a la sala de maternidad.

RESUMO Objetivo: Avaliar as repercussões da infecção por SARS-CoV-2 (suspeita ou confirmada) e do contexto da pandemia na via de nascimento e na assistência humanizada ao parto. Método: Estudo epidemiológico transversal, aninhado a uma coorte e comparativo com a pesquisa "Nascer em Belo Horizonte: Inquérito sobre o Parto e Nascimento". Avaliou-se prontuários de três maternidades-referência em Belo Horizonte, com amostra final de 1.682 parturientes, nos meses de maio, junho e julho de 2020. Realizou-se análise descritiva, com frequência absoluta e relativa, e comparativa, com teste Qui-quadrado de Pearson. Resultados: Observou-se que, 2,02% das gestantes estavam infectadas por SARS-CoV-2. Antes da pandemia, em um total de 390 gestantes, 74,10% pariram via vaginal. Durante a pandemia, nas mulheres infectadas, 51,61% pariram pela via cesariana e 48,39% pela vaginal; nas não infectadas, 26,99% cesarianas e 73,01% vaginais. Conclusão: Observou-se aumento percentual de cesarianas e possível influência da pandemia nas taxas de indicação de cesarianas no momento da admissão na maternidade.

Adverse event following immunization or vaccination in children in Minas Gerais: 2015 to 2020 / Eventos supostamente atribuíveis à imunização ou vacinação em crianças de Minas Gerais: de 2015 a 2020

ABSTRACT Objective: To describe adverse event following immunization or vaccination in children in Minas Gerais: 2015 to 2020, resulting from immunization errors in children from zero to nine years old. Methods: An ecological, descriptive study with a quantitative approach, based on event notifications available in the National Immunization Program Information System. Results: Among the 39,903,277 doses of immunobiologicals in children aged zero to nine, administered in the state of MG, 3,259 events of types of immunization errors were recorded, around 0.008% of the total and, of these, 91.86% did not result in adverse events and 56.02% were children under one year of age. The most frequent diagnosis was application outside the recommended age (29.12%). Among the manifestations, 71.91% were local and systemic, with fever being the most common (40.85%). Conclusion: The study demonstrated that immunization errors were rare and that most of them were not associated with adverse events, which reinforces the safety of the immunization process. This undoubtedly raises reflection on the need and relevance of continuing education for health professionals.

RESUMO Objetivo: Descrever os eventos supostamente atribuíveis à imunização ou vacinação em crianças de Minas Gerais, de 2015 a 2020, decorrentes dos erros de imunização em crianças de 0 a 9 anos. Métodos: Estudo ecológico, descritivo, de abordagem quantitativa, fundamentado nas notificações de eventos disponíveis no Sistema de Informações do Programa Nacional de Imunizações. Resultados: Dentre os 39.903.277 de doses de imunobiológicos administrados em crianças de 0 a 9 anos, no estado de Minas Gerais, registraram-se 3.259 eventos do tipo erros de imunizaçõo, cerca de 0,008% do total e, destes, 91,86% não acarretaram eventos adversos e 56,02% ocorreram em crianças menores de 1 ano. O diagnóstico mais frequente foi a aplicação fora da idade recomendada (29,12%). Dentre as manifestações, 71,91% foram locais e, em relação às sistêmicas, a mais comum foi a febre (40,85%). Conclusão: O estudo demonstrou que os erros de imunização foram raros e a maioria deles não se associou aos eventos adversos, o que reitera a segurança no processo de imunização. Isso suscita, indubitavelmente, a reflexão sobre a necessidade e a relevância de educação permanente dos profissionais da saúde.

Estratégias cooperativas para melhorar a cobertura vacinal em crianças no estado de Minas Gerais, Brasil / Cooperative strategies to improve vaccination coverage in children in the state of Minas Gerais, Brazil / Estrategias cooperativas para mejorar la cobertura de vacunación infantil en el estado de Minas Gerais (Brasil)

Objetivo: relatar a experiência das oficinas de uma pesquisa-ação do tipo intervenção elaborada para aumento da cobertura vacinal de crianças em municípios do estado de Minas Gerais. Método: relato de experiência sobre a metodologia empregada nas oficinas organizadas com objetivo de aumentar a cobertura vacinal no estado de Minas Gerais, Brasil. As oficinas foram compostas em quatro etapas: momento motivacional, núcleo contextual, núcleo integrador/planejamento e núcleo integrador/resultados. Resultados: As oficinas mostraram-se potentes na sensibilização e na indução da discussão dos indicadores de cobertura vacinal, evidenciando, inconsistências entre o Sistema de Informação do Programa Nacional de Imunizações e os registros internos dos municípios. Para além dos indicadores, as oficinas, permitiram troca de experiências entre os representantes municipais, discussão de recursos financeiros, estruturação de salas de vacina, aquisição de veículos, contratação de profissionais, entre outros. Considerações Finais: As oficinas mostram-se capaz de evidenciar a realidade dos municípios, para além do reconhecimento das necessidades para melhoria dos processos de imunização, mas também no desenvolvimento de estratégias, capazes de promover aumento das coberturas vacinais.

Objective: to report the experience of workshops of an action research designed to increase vaccination coverage of children in municipalities of the state of Minas Gerais. Method: experience report on the methodology used in the workshops organized to increase vaccination coverage in the state of Minas Gerais, Brazil. The workshops were composed in four stages: motivational moment, contextual core, integrative core/planning and integrative core/results. Results: The workshops proved powerful in raising awareness and inducing discussion of vaccination coverage indicators, evidencing, inconsistencies between the National Immunization Program Information System and the internal records of the municipalities. In addition to the indicators, the workshops allowed the exchange of experiences among municipal representatives, discussion of financial resources, structuring of vaccine rooms, acquisition of vehicles, hiring of professionals, among others. Final Considerations: The workshops are able to highlight the reality of the municipalities, in addition to recognizing the needs for improvement of immunization processes, but also in developing strategies to promote increased vaccination coverage.

Objetivo: relatar la experiencia de los talleres de una investigación-acción diseñada para aumentar la cobertura de vacunación infantil en municipios del estado de Minas Gerais. Método: informe de experiencia sobre la metodología utilizada en los talleres organizados para aumentar la cobertura de vacunación en el estado de Minas Gerais, Brasil. Los talleres constaron de cuatro etapas: momento motivacional, núcleo contextual, núcleo integrador/planificación y núcleo integrador/resultados. Resultados: Los talleres demostraron ser potentes para sensibilizar e inducir la discusión de los indicadores de cobertura de vacunación, evidenciando, inconsistencias entre el Sistema de Información del Programa Nacional de Inmunizaciones y los registros internos de los municipios. Además de los indicadores, los talleres permitieron el intercambio de experiencias entre representantes municipales, discusión de recursos financieros, estructuración de salas de vacunas, adquisición de vehículos, contratación de profesionales, entre otros. Consideraciones Finales: Los talleres se mostraron capaces de evidenciar la realidad de los municipios, más allá del reconocimiento de las necesidades de mejora de los procesos de inmunización, pero también en el desarrollo de estrategias, capaces de promover el aumento de la cobertura de vacunación.

Environmental factors associated with human papillomavirus vaccine coverage in adolescents: 2016-2020 analysis.

OBJECTIVE: to analyze the association between the factors of the social environment and the coverage rates of the human papillomavirus (HPV) vaccine in adolescents, in the State of Minas Gerais, Brazil. METHOD: this is an epidemiological, ecological study, with panel and trend analysis from 2016 to 2020. The population consisted of adolescents aged 9 to 13 years. The environmental variables were coverage rates, the municipal index of human development, income, education, and longevity; and the rate of violence. The Prais-Winsten autoregression and the panel regression model were used, in addition to the estimate of the mean annual percentage variation. RESULTS: the vaccination coverage rates are below the goals recommended by the Ministry of Health for all regions analyzed. Moreover, these rates are associated with factors related to the application of the first dose and to aspects inherent to the social environment, such as the rate of violence. CONCLUSION: our findings showed that, although tenuous, aspects of the environment, in addition to individual characteristics, provide relevant information to understand the occurrence of health outcomes, since this vaccination campaign presents a strong influence of the environment and age as factors associated with the low rates. HIGHLIGHTS: (1) The coverage of human papillomavirus vaccination is below the target in Minas Gerais.(2) The rates are associated with aspects inherent to the social environment, such as violence.(3) The environment provides relevant information for understanding health outcomes.