Time trend analysis and impacts of the COVID-19 pandemic on mammography and Papanicolaou test coverage in Brazilian state capitals.

BACKGROUND: Breast and cervical cancer are major public health issues globally. The reduction in incidence and mortality rates of these cancers is linked to effective prevention, early detection, and appropriate treatment measures. This study aims to analyze the temporal trends in the prevalence of mammography and Papanicolaou test coverage among women living in Brazilian state capitals between 2007 and 2023, and to compare the coverage of these tests before and during the Covid-19 pandemic. METHODS: A time series study was conducted using data from the Surveillance System for Risk and Protective Factors for Chronic Diseases by Telephone Survey from 2007 to 2023. The variables analyzed included mammography and Papanicolaou test coverage according to education level, age group, race/skin color, regions, and Brazilian capitals. The Prais-Winsten regression model was used to analyze the time series, and Student's t-test was employed to compare the prevalence rates between 2019 and 2023. RESULTS: Between 2007 and 2023, mammography coverage showed a stationary trend (71.1% in 2007 and 73.1% in 2023; p-value = 0.75) with a declining trend observed among women with 12 years or more of education (APC= -0.52% 95%CI -1.01%; -0.02%). Papanicolaou test coverage for all women aged between 25 and 64 exhibited a downward trend from 82% in 2007 to 76.8% in 2023 (APC= -0.45% 95%CI -0.76%; -0.13%). This decline was also noticed among those with 9 years or more of education; in the 25 to 44 age group; among women with white and mixed race; and in the Northeast, Central-West, Southeast, and South regions. When comparing coverage before and during Covid-19 pandemic, a reduction was noted for both tests. CONCLUSIONS: Over the years, there has been stability in mammography coverage and a decline in Papanicolaou test. The COVID-19 pandemic negatively impacted the number of these tests carried out among women, highlighting the importance of actions aimed at increasing coverage, especially among the most vulnerable groups.

Environmental and individual factors associated with gestational weight gain.

BACKGROUND: Environmental factors have an impact on inappropriate food choices and sedentary lifestyle, and both individually and in combination these factors favour improper gestational weight gain (GWG) and consequent maternal and neonatal health problems. The objective of this study was to analyze the environmental and individual factors associated with GWG. METHODS: Data were from "Born in Belo Horizonte: Survey on childbirth and birth", a hospital-based retrospective cohort of 506 pregnant women with deliveries in public and private maternity hospitals in Belo Horizonte, Minas Gerais. Data were collected via face-to-face interviews from November 2011 to March 2013. The outcome variable of this study was the GWG categorized based on the Institute of Medicine Guidelines. Explanatory environmental variables included the availability and access to food environment and places available for physical activity in the neighborhood. Explanatory individual variables included socioeconomic and demographic, obstetric and childbirth variables. Generalized estimating equations examined the association of environmental and individual factors with insufficient or excessive GWG. RESULTS: The final sample consisted of 506 mothers. There was 36.4% pregnant women showing excessive GWG and 22.7% showing GWG below the recommended interval. Regarding excessive GWG, there was a positive association with the number of mixed food purchasing establishments close to the place of residence, pre-pregnancy body mass index in the categories of overweight and obesity, arterial hypertension and the private sector as the predominant place for prenatal consultations. CONCLUSION: GWG outside of the recommended interval was associated with individual and environmental factors, and most pregnant women had insufficient or excessive gestational weight gain. Such results can complement previously published evidence, important for creating more effective strategies for the prevention of excessive and inadequate GWG and the consequent problems related to it during pregnancy.

Common mental disorders in Brazilian adolescents: association with school characteristics, consumption of ultra-processed foods and waist-to-height ratio.

Half of all mental health problems diagnosed in adulthood have their onset before or during adolescence, especially common mental disorders (CMD). Thus, it is relevant to study the factors associated with these disorders. This study aimed to investigate the association of school characteristics, consumption of ultra-processed foods, and waist-to-height ratio with the presence of CMD in Brazilian adolescents. This is a school-based, cross-sectional study that analyzed data from 71,553 Brazilian adolescents aged 12-17 years. The prevalence of CMD in these adolescents was 17.1% (cut-off point 5 for the General Health Questionnaire-12). Associations were estimated using multilevel logistic models, with the presence of CMD as the dependent variable. The final model, adjusted for non-modifiable individual variables, modifiable individual variables and family characteristics, identified a positive association between private-funded schools (OR = 1.10; 95%CI: 1.07-1.14), advertisements for ultra-processed foods (OR = 1.13; 95%CI: 1.09-1.17), the second to fourth quartiles of ultra-processed food intake and waist-to-height ratio (OR = 2.26; 95%CI: 2.03-2.52). This study demonstrated that the private-funded schools , the presence of ultra-processed food advertisements, the consumption of ultra-processed food, and an increased waist-to-height ratio are risk factors for CMD in Brazilian adolescents.

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.

[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.

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.

[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.

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.

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.

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.

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.

Yellow fever vaccination before and during the covid-19 pandemic in Brazil.

OBJECTIVE: To analyze the number of yellow fever vaccine doses administered before and during the covid-19 pandemic in Brazil. METHODS: This is an ecological, time series study based on data from the National Immunization Program. Differences between the median number of yellow fever vaccine doses administered in Brazil and in its regions before (from April/2019 to March/2020) and after (from April/2020 to March/2021) the implementation of social distancing measures in the country were assessed via the Mann-Whitney test. Prais-Winsten regression models were used for time series analyses. RESULTS: We found a reduction in the median number of yellow fever vaccine doses administered in Brazil and in its regions: North (-34.71%), Midwest (-21.72%), South (-63.50%), and Southeast (-34.42%) (p < 0.05). Series showed stationary behavior in Brazil and in its five regions during the covid-19 pandemic (p > 0.05). Brazilian states also showed stationary trends, except for two states which recorded an increasing trend in the number of administered yellow fever vaccine doses, namely: Alagoas State (before: ß = 64, p = 0.081; after: ß = 897, p = 0.039), which became a yellow fever vaccine recommendation zone, and Roraima State (before: ß = 68, p = 0.724; after: ß = 150, p = 0.000), which intensified yellow fever vaccinations due to a yellow fever case confirmation in a Venezuelan State in 2020. CONCLUSION: The reduced number of yellow fever vaccine doses administered during the covid-19 pandemic in Brazil may favor the reemergence of urban yellow fever cases in the country.

[Vaccination coverage in children under one year of age in Minas Gerais state, Brazil]. / Cobertura vacinal em crianças menores de um ano no estado de Minas Gerais, Brasil.

The scope of this article is to analyze vaccination coverage rates in children under one year of age during the period from 2015 to 2020 in the state of Minas Gerais (MG). It involved an ecological, time-series study on vaccination coverage in children under 1 year of age, considering the 28 Regional Health Management/Superintendencies (GRS/SRS) of MG as the unit of analysis. The following immunobiological vaccine coverage was analyzed: Bacillus Calmette and Guérin, human rotavirus, pneumococcal 10, pentavalent, meningococcus C, yellow fever, and polio vaccines. The Prais-Winsten autoregressive model was employed for trend analysis. The year 2020 stands out, as it presented the lowest proportion of GRS and SRS that reached the recommended vaccine coverage goals for the immunobiologicals analyzed. Regarding the analysis of the coverage trend, 8 of the 28 GRS/SRS showed a decreasing trend for at least 5 of the 7 immunobiologicals evaluated. We observed a downward trend in the vaccination coverage of at least five immunobiologicals in eight of the GRS/SRS, with emphasis on the Pentavalent vaccine, which showed a downward trend in vaccination coverage in 60.71% of the GRS and SRS.

O objetivo deste artigo é analisar as taxas de coberturas vacinais em crianças menores de um ano durante o período de 2015 a 2020 no estado de Minas Gerais (MG). Estudo ecológico, de série temporal, sobre as coberturas vacinais em crianças menores de 1 ano, considerando-se como unidade de análise as 28 Gerências/Superintendências Regionais de Saúde (GRS/SRS) de MG. Analisaram-se as coberturas vacinais dos seguintes imunobiológicos vacinas: contra o Bacilo de Calmette e Guérin (BCG), contra rotavírus humano, contra pneumococo 10, pentavalente, contra meningococo C, contra febre amarela e contra a poliomielite. Empregou-se o modelo autorregressivo de Prais-Winsten para análise de tendência. Destaca-se o ano de 2020, que apresentou a menor proporção de GRS e SRS que alcançaram as metas preconizadas de cobertura vacinal para os imunobiológicos analisados. Quanto à análise de tendência da cobertura, 8 das 28 GRS/SRS apresentaram tendência decrescente de, pelo menos, 5 dos 7 imunobiológicos avaliados. Observou-se tendência decrescente na cobertura vacinal de pelo menos cinco imunobiológicos em oito das GRS /SRS, com destaque para a vacina Pentavalente, que apresentou tendência decrescente de cobertura vacinal em 60,71% das GRS e SRS.

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.

Trend in cases of gestational and congenital syphilis in Minas Gerais, Brazil, 2009-2019: an ecological study. / Tendência dos casos de sífilis gestacional e congênita em Minas Gerais, 2009-2019: um estudo ecológico.

OBJECTIVE: To analyze the trend of notifications of gestational and congenital syphilis in Minas Gerais, Brazil, from 2009 to 2019. METHODS: This was an ecological time series study which took the state of Minas Gerais as its unit of analysis, based on data reported on the Notifiable Health Conditions Information System (SINAN). The Prais-Winsten autoregressive model was used to verify trends. RESULTS: 20,348 cases of gestational syphilis and 11,173 cases of congenital syphilis were reported. Average percentage annual increase was 36.7% (95%CI 32.5;41.0), for gestational syphilis incidence rates, and 32.8% (95%CI 28.0;37.8) for congenital syphilis incidence rates (p<0.001). CONCLUSION: The temporal trend analysis showed that gestational and congenital syphilis incidence rates had significant increasing trends, which may be related to inadequate treatment or failure to treat syphilis during pregnancy.

Reliability of information available on popular websites about vaccination of pregnant women.

OBJECTIVE: To analyze the reliability of information available on popular websites about vaccination of pregnant women according to the recommendations of the Brazilian Ministry of Health. METHOD: Descriptive and comparative study. For data collection, a checklist composed of information on recommended, contraindicated, and indicated vaccines in special situations during pregnancy, according to the Ministry of Health, was elaborated. RESULTS: None of the analyzed websites presented all the recommended information. Contraindications, most common adverse events, simultaneous administration of vaccines, information on the DT vaccine, and recommended vaccines in special situations were presented by a minority of websites. CONCLUSION: Information available on websites about the vaccination of pregnant women is not always based on the recommendations and misinformation may interfere with the acceptance of this practice. The importance of the professionals of the multidisciplinary team as information mediators, particularly the nurse, is emphasized, as is the need for regulating the production and dissemination of information on the internet.

[Community food environment and presence of food swamps around schools in a Brazilian metropolis]. / O ambiente alimentar comunitário e a presença de pântanos alimentares no entorno das escolas de uma metrópole brasileira.

The study aimed to assess the community food environment and the existence of food swamps around schools in a Brazilian metropolis. This was an ecological study in public and private schools in Belo Horizonte, Minas Gerais State, Brazil, with a 250-meter buffer as the analytical unit. The study included all preschool, elementary, and middle schools. In relation to the schools, the study evaluated administrative regimen (public versus private), type of teaching, and per capita income in the schools' census tracts. Information was also compiled on the retail food establishments inside the buffer zone around the schools. The food environment was characterized only according to the establishments around the schools that sold food for immediate consumption. Analysis of the buffers revealed that 97.4% of the schools had at least one establishment in the vicinity that sold food for immediate consumption. The most available establishments around schools were snack bars, restaurants, and bars. Schools located in higher-income census tracts showed higher mean numbers of all establishments in their vicinity, except for grocery stores and supermarkets. In addition, 54.6% of the schools were in neighborhoods classified as food swamps. The results that the among the target categories, there was a predominance of establishments that mainly sell ultra-processed foods such as bars and snack bars in the vicinity of schools in Belo Horizonte, which exposes children and adolescents to an unhealthy food environment.

O objetivo foi avaliar o ambiente alimentar comunitário e a existência de pântanos alimentares no entorno das escolas de uma metrópole brasileira. Trata-se de um estudo ecológico realizado em escolas públicas e privadas de Belo Horizonte, Minas Gerais, Brasil, e teve como unidade de análise o buffer de 250m. Foram incluídas no estudo todas as escolas de Educação Infantil, de Ensinos Fundamental e Médio. Em relação às escolas, foram avaliadas a dependência administrativa e o tipo de ensino ofertado, bem como a renda per capita dos setores censitários das escolas. Contabilizou-se também as informações sobre os estabelecimentos de venda de alimentos para o consumo imediato que estavam dentro do buffer no entorno das escolas. Em relação ao ambiente alimentar foram avaliados apenas os estabelecimentos que comercializam alimentos para o consumo imediato no entorno escolar. A análise dos buffers revelou que 97,4% das escolas tinham ao menos um desses estabelecimentos no seu entorno. Os estabelecimentos mais disponíveis no entorno da escola foram lanchonetes, restaurantes e bares. As escolas localizadas em setores censitários de maior renda apresentavam maior média de todos os estabelecimentos no seu entorno, exceto das mercearias e supermercados. Ademais, 54,6% das escolas estavam em vizinhanças que são classificados como pântanos alimentares. Os resultados revelam que entre as categorias avaliadas ocorre um predomínio dos estabelecimentos que comercializam, predominantemente, alimentos ultraprocessados, como os bares e lanchonetes no entorno das escolas de Belo Horizonte, o que expõe as crianças e os adolescentes a um ambiente alimentar não saudável.

El objetivo fue evaluar el ambiente alimentario comunitario y la existencia de establecimientos de comida ultraprocesada en el entorno de las escuelas de una metrópoli brasileña. Se trata de un estudio ecológico, realizado en escuelas públicas y privadas de Belo Horizonte, Minas Gerais, Brasil, y tuvo como unidad de análisis una zona de influencia de 250m. Se incluyeron en el estudio todas las escuelas de educación infantil, enseñanza fundamental y media. En relación con las escuelas, se evaluó la dependencia administrativa y el tipo de enseñanza ofertada, así como la renta per cápita de los sectores censitarios de las escuelas. Se contabilizó también información sobre establecimientos de venta de alimentos para consumo inmediato que estaban dentro de la zona de influencia en el entorno de las escuelas. En relación con el ambiente alimentario, se evaluaron solamente los establecimientos que comercializan alimentos para consumo inmediato en el entorno escolar. El análisis de las zonas de influencia reveló que un 97,4% de las escuelas poseían al menos un establecimiento en su entorno que comercializa alimentos para el consumo inmediato. Los establecimientos más disponibles en el entorno de la escuela fueron cafeterías, restaurantes y bares. Las escuelas localizadas en sectores censitarios de mayor renta presentaban mayor media de todos los establecimientos en su entorno, excepto tiendas de alimentación y supermercados. Además, un 54,6% de las escuelas estaban en vecindarios que se clasifican como zonas con abundancia de locales con comida ultraprocesada. Los resultados revelan que entre las categorías evaluadas se produce un predominio de establecimientos que comercializan, predominantemente, alimentos ultraprocesados, como bares y cafeterías, en el entorno de las escuelas de Belo Horizonte, lo que expone a niños y adolescentes a un ambiente alimentario no saludable.

Association between early pregnant hospitalization and use of obstetric interventions and cesarean: a cross-sectional study.

OBJECTIVE: Evaluate the association between early pregnant hospitalization and the use of obstetric interventions and cesarean delivery route. METHODS: Cross-sectional study, with 758 women selected at the time of childbirth. It was assumed as early hospitalization when the woman was admitted to the hospital having less than 6 cm of cervical dilation. Logistic regression models were constructed in order to estimate the odds ratio for each obstetric intervention, adjusted by sociodemographic and obstetric variables. RESULTS: 73.22% of women were early hospitalized. On average, they had 1.97 times the chance to undergo Kristeller's maneuver, 2.59 and 1.80 times the chance to receive oxytocin infusion and analgesia, respectively, and 8 times more chances to having their children by cesarean delivery when compared to women that had timely hospitalization. CONCLUSION: Early hospitalized women were submitted to a higher number of obstetric intervention and had increased chances of undergoing cesarean sections.

Adverse events following immunization against SARS-CoV-2 (covid-19) in the state of Minas Gerais.

OBJECTIVE: To analyze adverse events following immunization (AEFI) against SARS-CoV-2 (covid-19) in the state of Minas Gerais (MG), Brazil. METHODS: Epidemiological, descriptive study, with data from e-SUS Notifica (e-SUS Notification) in the state of Minas Gerais from January 20 to March 5, 2021. All suspected cases of AEFI of the covid-19 vaccine in the state were analyzed, totaling 7,305 cases. In this study, we verified the possible correlation between AEFI and the possible immunobiological administered causalities. The variables analyzed for AEFI cases were the immunobiological agent administered (AstraZeneca or Coronavac), the type of event, the evolution of the case, and the time in days since the administration of the immunobiological agent and the onset of symptoms and causality. The incidence rate (IT) was calculated for 100,000 doses applied. RESULTS: The occurrence of AEFI as a result of the covid-19 vaccine was frequent (TI: 777.12) in the state. However, only 3% were classified as a severe AEFI, with a 20.85 IT, and 4.71% of them evolved to deaths (8.19 deaths per 100,000 doses applied). Among the deaths analyzed, 84.4% were classified as preexisting conditions caused by factors other than vaccines. Regarding non-serious AEFI, 1.11% occurred by immunization errors (TI: 8.62 EI for every 100 thousand doses applied). CONCLUSION: This work encourages the discussion about the importance of recording AEFI related to covid-19 vaccines, demonstrating its safety for the population.

Spatial analysis of vaccination against Hepatitis B in pregnant women in an urban Brazilian area. / Análise espacial da vacinação contra hepatite B em gestantes em área urbana no Brasil.

The objective of this article is to analyze the spatial distribution of Hepatitis B vaccine (HBVAC) of pregnant women. This is a cross-sectional study carried with 266 puerperae. The HBVAC record was obtained through the prenatal care booklet. The spatial scanning technique was used to detect a cluster of risk for the presence or absence of an HBVAC record. After this cluster identification, the individual and environmental variables were compared between the Coverage Areas of Basic Health Units (CAs-BHUs). The mean prevalence of non-HBVAC was 88.34%. Scan spatial scan analysis observed a cluster of a high prevalence of puerperae with a HBVAC record. Comparative analyses have shown that paid work and the number of prenatal visits are positively associated with an HBVAC record. Given the above, this work brings a reflection on possible disparities with other CAs-BHUs, besides the influence of the environmental perspective. It should be emphasized that the vaccination situation is influenced not only by factors intrinsic to the individuals. However, in this study, the results indicate that individual variables are predominantly mandatory in the decision of HBVAC uptake among pregnant women.

O objetivo deste artigo é analisar a distribuição espacial da vacina contra Hepatite B (VCHB) de gestantes. Estudo transversal, realizado com 266 puérperas. O registro da VCHB foi obtido por meio da caderneta de pré-natal. Para a detecção do cluster de risco para presença de registro ou ausência de VCHB foi utilizada a técnica de varredura espacial. Posteriormente a esta identificação do cluster, procedeu-se à comparação das variáveis individuais e ambientais entre as Áreas de Abrangência da Unidade Básica de Saúde (AA-UBS). A prevalência média de não VCHB foi de 88,34%. A análise de varredura espacial Scan observou-se um cluster de alta prevalência de puérperas que apresentava o registro da VCHB em suas cadernetas. Análises comparativas demonstraram que trabalho remunerado e o número de consultas realizadas no pré-natal estão associados positivamente a VCHB. Este trabalho suscita uma reflexão de possíveis disparidades com as demais AA-UBS, além da perspectiva a nível ambiental. Ressalta-se que a situação vacinal sofre influência não somente de fatores intrínsecos aos indivíduos, entretanto, nesse estudo, os resultados apontam que as variáveis individuais são majoritariamente mandatórias na decisão das gestantes em vacinarem.