Artigos e Materiais de Revistas Científicas - LIM/38
URI Permanente para esta coleção
A coleção de Artigos e Materiais de Revistas Científicas engloba artigos originais, artigos de revisão, artigos de atualização, artigos técnicos, relatos de experiências, resenhas, ensaios, editoriais, cartas ao editor, debates, notas científicas e técnicas, depoimentos, entrevistas e pontos de vista. Consideram-se como artigos científicos originais os trabalhos redigidos para divulgação de informações e resultados sobre determinada pesquisa científica, publicados em periódico científico após avaliação por outros pesquisadores.
Navegar
Submissões Recentes
- You knew you had to be there, it had to be done: Experiences of health professionals who faced the COVID-19 pandemic in one public hospital in Spain(2023) RODRIGUEZ-MADRID, Maria Nieves; PASTOR-MORENO, Guadalupe; ALBERT-LOPEZ, Enrique; PASTOR-VALERO, MariaIntroductionThe COVID-19 pandemic highlighted the lack of a government contingency plan for an effective response to an unexpected health crisis. This study uses a phenomenological approach to explore the experience of healthcare professionals during the first three waves of the COVID-19 pandemic in a public health hospital in the Valencia region, Spain. It assesses the impact on their health, coping strategies, institutional support, organizational changes, quality of care, and lessons learned. MethodsWe carried out a qualitative study with semi-structured interviews with doctors and nurses from the Preventive Medicine, Emergency, and Internal Medicine Services and the Intensive Care Unit, using the Colaizzi's 7-step data analysis method. ResultsDuring the first wave, lack of information and leadership led to feelings of uncertainty, fear of infection, and transmission to family members. Continuous organizational changes and lack of material and human resources brought limited results. The lack of space to accommodate patients, along with insufficient training in treating critical patients, and the frequent moving around of healthcare workers, reduced the quality of care. Despite the high levels of emotional stress reported, no sick leave was taken; the high levels of commitment and professional vocation helped in adapting to the intense work rhythms. Healthcare professionals in the medical services and support units reported higher levels of stress, and a greater sense of neglect by their institution than their colleagues in managerial roles. Family, social support, and camaraderie at work were effective coping strategies. Health professionals showed a strong collective spirit and sense of solidarity. This helped them cope with the additional stress and workload that accompanied the pandemic. ConclusionIn the wake of this experience, they highlight the need for a contingency plan adapted to each organizational context. Such a plan should include psychological counseling and continuous training in critical patient care. Above all, it needs to take advantage of the hard-won knowledge born of the COVID-19 pandemic.
- Beyond HIV prevention: Assessment of the benefits of pre-exposure prophylaxis for sexual quality of life(2024) BERTEVELLO, Daniel A.; VASCONCELOS, Ricardo; CERQUEIRA, Natalia B.; FREITAS, Angela C.; CUNHA, Ana; I, Vivian Avelino-SilvaBackground: Pre-exposure prophylaxis (PrEP) may favor sexual satisfaction by reducing the fear of HIV and promoting less restrictive sexual practices. These benefits may be even higher among PrEP users with mental health issues. Methods: We invited adult PrEP users to answer a questionnaire including demographics, questions on the sexual experience compared to the period before PrEP use, and the Hospital Anxiety and Depression Scale. Factors associated with improvements in the sexual experience were investigated using modified Poisson models. Results: We included 221 participants; most were white males. A large percentage of participants reported improvements in quality of sex after PrEP initiation; the composite outcome ""PrEP-associated improvement in the quality of sex"" was observed in 92 (42%), whereas the outcome ""PrEP-associated improvement in the fear of HIV acquisition"" was observed in 120 participants (54%). Demographics and depression/anxiety were not significantly associated with the outcomes. Conclusion: PrEP has positive effects beyond HIV prevention, improving several aspects of sexual quality of life. These benefits are valid incentives for PrEP use and prescription.
- Dimensions of harassment at school: dialogs about gender with young high school students in Sao Paulo/Brazil(2023) SILVA, Cristiane Goncalves da; LEITE, Vanessa Jorge; PONTES, Julia Clara deIn this article, we discuss uses of ""harassment"" as a category employed by young students from public high schools to make sense of violence and gender discrimination experiences that occur in and out of school. The analysis is based on fieldwork records produced within the scope of a multicenter, mixed -methods research carried out in nine schools located in Sao Paulo. Harassment appears as a polysemic category that, by naming violence, helps to face gender and generation hierarchies and inequalities. We infer that the young girls have questioned norms and attitudes that feed gender inequalities in schools; in addition, they have denounced the silence or inadequacy of the institution in facing the problem. This enables to identify convergences with a new sensibility regarding violence against women that globalized feminist discourses have brought to the surface.
- Promotion of ultra-processed foods in Brazil: combined use of claims and promotional features on packaging(2023) ANDRADE, Giovanna Calixto; MAIS, Lais Amaral; RICARDO, Camila Zancheta; DURAN, Ana Clara; MARTINS, Ana Paula BortolettoOBJECTIVE: To assess the availability of different promotional strategies applied for UPF sales in Brazilian food retailers. METHODS: Information available on food packaging was gathered from all packaged products sold in the five largest food retail chains in Brazil in 2017. UPF were identified using the NOVA food classification system. From this sample, data related to promotional characteristics, nutrition claims and health claims were collected and coded using the INFORMAS methodology. Additional claims referring to the Brazilian Dietary Guidelines were also collected. RESULTS: This study evaluated the packaging of 2,238 UPF, of which 59.8% presented at least one promotional strategy. Almost one third denoted a simultaneous use of different promotional strategies in the same packaging. Nutrition claims were the most commonly found promotional strategy, followed by health claims and the use of characters. The food subgroups comprising the highest prevalence of promotional strategies on their labels were: noncaloric sweeteners (100.0%), breakfast cereals and granola bars (96.2%), juices, nectars and fruit-flavoured drinks (92.9%), other unsweetened beverages (92.9%), and other sweetened beverages (92.6%). CONCLUSIONS: Considering the poor nutritional quality of UPF, the widespread presence of promotional features on their packaging highlights the need for marketing restrictions on this kind of product.
- Civil society and community social support initiatives for vulnerable groups in primary care center catchment areas: the role of the FHS during the pandemic(2023) MENDONCA, Maria Helena Magalhaes de; SOARES, Mariangela Uhlmann; SPADACIO, Cristiane; ALVES, Marcia Guimaraes de Mello; SCHENKMAN, Simone; BOUSQUAT, Aylene Emilia Moraes; GIOVANELLA, LigiaThe pandemic highlighted new and old health risks that require health actions and social support. This study analyzed the knowledge of health professionals working in primary health care centers (PHCCs) regarding civil society and health service separately or along with health promotion and social support initiatives targeting vulnerable groups. The article begins by discussing the concept of social support and then goes on to present an analysis of empirical data from the multidimensional cross-sectional study ""Challenges facing primary health care in the response to COVID-19 in the SUS"", conducted using a nationally representative sample of PHCCs. Scores were calculated for selected and aggregated variables, and we calculated percentages for selected actions together with 95% confidence intervals at national and regional level. The percentage of PHCCs that supported actions and where the local community developed initiatives in the catchment area varied across regions, with rates being significantly higher in the Northeast and in non-urban municipalities with low MHDI, which was associated with actions developed in the catchment area by community health workers. The findings reveal several gaps and challenges, including the need to amplify the magnitude and scope of intra and intersectoral actions, strengthen ties between different actors, reverse the effects of the pandemic on health inequities and promote further research.
- Safeguarding HIV prevention and care services amidst military conflict: experiences from Ukraine(2023) LOPATINA, Yaroslava; ZAKOWICZ, Anna Maria; SHABAROVA, Zoya; FORD, Terri; FONSECA, Fernanda F.; ODOKE, Wilfred; HOMBERGH, Jan van den; I, Vivian Avelino-Silva; BENZAKEN, Adele Schwartz; MILES, Ralph C.Ukraine stands out among European countries concerning HIV epidemiological data. Since February 2022, the military conflict with Russian forces has posed unprecedented challenges to HIV prevention and care. AIDS Healthcare Foundation (AHF), a global non-profit organisation with operations in Ukraine since 2009, implemented a preparedness plan to protect staff members and support local facilities in the continuity of care throughout the war. In this manuscript, we describe the strategies adopted by AHF to anticipate the risk of military conflict, steps to implement a preparedness plan, main challenges faced by local staff members and managers, adaptations needed as the conflict evolved, and indicators of HIV care 1 year before and 1 year after the onset of the conflict. Our experience shows that safeguarding the organisation's human resources has been a prerequisite to sustain services throughout the war.
- Ultra-processed food consumption deteriorates the profile of micronutrients consumed by Portuguese adults and elderly: the UPPER project(2023) ANTONIAZZI, Luiza; MIRANDA, Renata Costa de; RAUBER, Fernanda; MORAES, Milena Miranda de; AFONSO, Claudia; SANTOS, Cristina; LOPES, Carla; RODRIGUES, Sara; LEVY, Renata BertazziPurpose This study aims to describe micronutrient intake according to food processing degree and to investigate the association between the dietary share of ultra-processed foods and micronutrient inadequacies in a representative sample of Portuguese adult and elderly individuals. Methods Cross-sectional data from the National Food, Nutrition and Physical Activity Survey (2015/2016) were used. Food consumption data were collected through two 24-h food recalls, and food items were classified according to the NOVA system. Linear regression models were used to assess the association between the micronutrient density and the quintiles of ultra-processed food consumption-crude and adjusted. Negative Binomial regressions were performed to measure the prevalence ratio of micronutrient inadequacy according to ultra-processed food quintiles. Results For adults, all evaluated vitamins had significantly lower content in the fraction of ultra-processed foods compared to unprocessed or minimally processed foods, except vitamin B2. For the elderly, out of ten evaluated vitamins, seven presented significantly less content in ultra-processed foods compared to non-processed ones. The higher energy contribution of ultra-processed foods in adults was associated with a lower density of vitamins and minerals. This association was not observed in the elderly. For adults, compared with the first quintile of ultra-processed food consumption, the fifth quintile was positively associated with inadequate intakes of vitamin B6 (PR 1.51), vitamin C (PR 1.32), folate (PR 1.14), magnesium (PR 1.21), zinc (PR 1.33), and potassium (PR 1.19). Conclusion Our results corroborate the importance of public health actions that promote a reduction in the consumption of ultra-processed foods.
- Sensitivity and specificity of a syphilis rapid diagnostic test in blood donors' samples(2023) ARAI, Carolina; LEMOS-MACHADO, Juliano Alves; AUN, Marcelo Vivolo; BONET-BUB, Carolina; SANTOS, Leandro Dinalli; MIRANDA, Angelica Espinosa; AVELINO-SILVA, Vivian I.Rapid Diagnostic Tests (RDT) are useful to identify syphilis cases, particularly for hard-to-reach populations and if laboratory services are scarce. However, RDT performance may be subopti-mal. We aimed to assess the sensitivity and specificity of a syphilis RDT using well-characterized blood donors' samples. We categorized samples from 811 blood donors into five groups: 1 - Sam-ples with reactive Chemiluminescence (QML), FTA-Abs, and VDRL; 2 -Samples with reactive QML and FTA-Abs, and nonreactive VDRL; 3 -Samples with reactive QML, and nonreactive for other markers (false-positives); 4 -Controls with nonreactive QML; and 5 -Samples reactive for HIV, with nonreactive QML. Sensitivity was tested in groups 1 (overall and according to VDRL titers) and 2; specificity was tested in groups 3-5. The RDT had high specificity, even in samples reactive for HIV. The sensitivity was high (91.9%) in samples with reactive VDRL but varied between 75.0%-100% according to VDRL titers. The overall sensitivity was lower (81.3%) in sam-ples with reactive FTA-Abs and nonreactive VDRL. The RDT is a useful tool to detect active syph-ilis but may be more limited for cases with very early or remote infection, or those with prior treatment. When higher sensitivity is needed, additional strategies including recurrent testing or laboratory-based tests may be required.(c) 2023 Sociedade Brasileira de Infectologia.
- Nova diet quality scores and risk of weight gain in the NutriNet-Brasil cohort study(2023) SANTOS, Francine Silva dos; STEELE, Euridice Martinez; COSTA, Caroline dos Santos; GABE, Kamila Tiemman; LEITE, Maria Alvim; CLARO, Rafael Moreira; TOUVIER, Mathilde; SROUR, Bernard; LOUZADA, Maria Laura da Costa; LEVY, Renata Bertazzi; MONTEIRO, Carlos AugustoObjective:To assess the prospective association of two diet quality scores based on the Nova food classification with BMI gain. Design:The NutriNet-Brasil cohort is an ongoing web-based prospective study with continuous recruitment of participants aged & GE; 18 years since January 2020. A short 24-h dietary recall screener including 'yes/no' questions about the consumption of whole plant foods (WPF) and ultra-processed foods (UPF) was completed by participants at baseline. The Nova-WPF and the Nova-UPF scores were computed by adding up positive responses regarding the consumption of thirty-three varieties of WPF and twenty-three varieties of UPF, respectively. Participants reported their height at baseline and their weight at both baseline and after approximately 15 months of follow-up. A 15-month BMI (kg/m(2)) increase of & GE;5 % was coded as BMI gain. Setting:Brazil. Participants:9551 participants from the NutriNet-Brasil cohort. Results:Increasing quintiles of the Nova-UPF score were linearly associated with higher risk of BMI gain (relative risk Q5/Q1 = 1 & BULL;34; 95 % CI 1 & BULL;15, 1 & BULL;56), whereas increasing quintiles of the Nova-WPF score were linearly associated with lower risk (relative risk Q5/Q1 = 0 & BULL;80; 95 % CI 0 & BULL;69, 0 & BULL;94). We identified a moderate inverse correlation between the two scores (-0 & BULL;33) and a partial mediating effect of the alternative score: 15 % for the total effect of the Nova-UPF score and 25 % for the total effect of the Nova-WPF score. Conclusions:The Nova-UPF and Nova-WPF scores are independently associated with mid-term BMI gain further justifying their use in diet quality monitoring systems.
- Violence, discrimination, and sexual health practices among adolescent men who have sex with men, transgender women and travestis in three cities in Brazil(2023) RYNGELBLUM, Marcelo; GRANGEIRO, Alexandre; ZUCCHI, Eliana Miura; COUTO, Marcia Thereza; DOURADO, Ines; MAGNO, Laio; TUPINAMBAS, Unai; PERES, Maria Fernanda TourinhoThe HIV epidemic has a disproportionate impact on adolescent and young men who have sex with men (AMSM) and transgender women and travestis (ATGW), with an increased HIV prevalence over the last 10 years. Violence affects the lives of these populations, undermining their ability to self-care and making them more vulnerable to HIV infection. In this study, we aimed to examine the association between different types of victimization by violence and discrimination and sexual health practices of these adolescent populations in steady and casual relationships. We conducted a cross-sectional study using baseline data from the cohort of PrEP1519 project. We used the mean score of sexual health practices as our outcome and the cumulative score of discrimi-nati on (within family, community, education, religious, online and public spaces) and violence (physical, sexual and intimate partner) as our exposure variable. We performed linear regression analyses to estimate the association between exposure and outcome. We found that 90% of AMSM and 95% of ATGW experienced at least one form of violence in the three months prior to this study and about 45% of ATGW suffered sexual violence during the same period. Experiencing discrimination within healthcare settings (from facilities or providers) was negatively associated with sexual health practices. Discrimi-nation and violence negatively affect sexual health practices. HIV prevention and care of AMSM and ATGW people should involve listening to their experi-ences and addressing discrimination and violence in this population.
- Caregivers' perceptions on routine childhood vaccination: A qualitative study on vaccine hesitancy in a South Brazil state capital(2024) MATOS, Camila Carvalho de Souza Amorim; COUTO, Marcia Thereza; ODUWOLE, Elizabeth O.; WIYSONGE, Charles SheyImmunization programs worldwide have been facing challenges in keeping vaccination coverage high. Even though universally known for its robust National Immunization Program, Brazil has also faced significant challenges regarding vaccination coverage. One of the reasons for this is vaccine hesitancy, a complex, multi-causal, and context-specific phenomenon. This qualitative study aims to understand the factors associated with decision-making and the drivers of vaccine hesitancy in Florianopolis, Santa Catarina state capital, regarding caregivers' perceptions of routine childhood vaccination. In-depth interviews were conducted in the Capital city of Santa Catarina State. Families with children up to 6 years old were included. Data were analyzed based on thematic content analysis. Twenty-nine caregivers in 18 families were interviewed. These caregivers were mainly mothers and fathers. Three themes emerged: 1. Access to information and the decision-making process, where we discuss the role of social circles, healthcare workers, and the internet; 2. Individual-institutions power relationships: Perceptions about the State's role and the Health institutions: 3. Reasons and motivations: The senses and meanings behind non-vaccination, where we discuss the drivers of vaccine hesitancy related to risk perception, caregivers' opinions on the medical-pharmaceutical industry, vaccines' composition and their side effects, families' lifestyles and worldviews, and the childhood routine vaccination schedule. The results of this study reaffirm the complexity of the decision-making process in childhood vaccination and further enable a better contextual understanding of the complex and challenging phenomenon of vaccine hesitancy.
- Forty years of the Brazilian response to HIV: reflections on the need for a programmatic shift and policy as a common good(2023) GRANGEIRO, Alexandre; FERRAZ, Dulce; MAGNO, Laio; ZUCCHI, Eliana Miura; COUTO, Marcia Thereza; DOURADO, InesAgradecemos a Barreira & Alencar 1 e Paiva & Ayres 2 pelos comentarios apontando caminhos mais efetivos para a resposta ao HIV no Brasil. Neste 2023, que marca 40 anos das primeiras acoes brasileiras contra o HIV, inauguradas em 1983 pelo Grupo Somos, nosso objetivo e marcar a necessidade de retomar uma discussAo com a sociedade brasileira que permita ""acordar"" a politica de HIV e reforNo primeiro artigo deste debate 3, evidenciamos um desafio: se a variedade de metodos de prevencAo existente nos permite almejar a eliminacAo do HIV, a persistencia de barreiras de acesso e as
- HIV epidemic, prevention technologies, and the new generations: trends and opportunities for epidemic response(2023) GRANGEIRO, Alexandre; FERRAZ, Dulce; MAGNO, Laio; ZUCCHI, Eliana Miura; COUTO, Marcia Thereza; DOURADO, InesThe United Nations has underscored the possibility of ending the HIV epide-mic as a public health problem. However, an increase in the incidence among adolescents and youth has indicated a greater distance between HIV responses and the specificities of the new generations, which can maintain the epidemic for an extended period. Regards this matter, it is debated that the provision of a range of preventive methods, even if highly effective, and a conservatism that has internalized stigma within government policies, hinder the proper and essential dialogue between current preventive policies and the needs of the new generations. These generations are marked by a social representation of AIDS as a mild disease, by new gender and sexuality performances, and by the search for a more critical role in affective and sexual encounters, which inclu-des frequent use of dating apps and substances. The hierarchy of the delivery of prevention methods is presented as a proposal for a new policy, prioritizing pre-exposure prophylaxis (PrEP) and addressing the social determinants of the HIV epidemic, including strategies to mitigate stigma. The importance of the participation of adolescents and youth in constructing the policy and the need for an intersectoral response are also reinforced.
- Methodological issues in qualitative research on HIV prevention: an integrative review(2023) SPADACIO, Cristiane; SANTOS, Lorruan Alves dos; SORRENTINO, Isa da Silva; GOMES, Romeu; CASTELLANOS, Marcelo Eduardo Pfeiffer; ZUCCHI, Eliana Miura; GRANGEIRO, Alexandre; COUTO, Marcia TherezaIn view of the growing concern about the use of qualitative approach in health research, this article aims to analyze how the qualitative theoretical -method-ological framework of HIV prevention is presented in empirical research. We conducted an integrative literature review with the following guiding ques-tions: ""How is the qualitative theoretical-methodological framework expressed in empirical research on HIV prevention?""; ""What are the limits and poten-tials of the qualitative methodological designs employed?"". In the qualitative methodological discussion, five dimensions guided the methodological course and the presentation of findings, from the analysis of the characterization of qualitative studies to the contextualization of the studies and the methodologi-cal approaches used, highlighting the use of semi-structured interviews with thematic content analysis. We also examined social categories and analytical references, drawing attention to the plurality of these theoretical-conceptual references and to the authors' polyphony, and identified the limits and po-tentials of qualitative research. This study focuses on a scientific topic that is related to a wide variety of social groups and analyzes how they are af-fected by it, examining issues related to social inequality and other analytical possibilities surrounding HIV prevention, and providing resources for a com-prehensive methodological discussion. Hence, avoiding the risk of conducting qualitative research based on checklists that limit inventiveness and openness to different designs and forms of execution and analysis is as pivotal as ensur-ing that the research is consistent and detailed in publications.
- Talking about inequities: A comparative analysis of COVID-19 narratives in the UK, US, and Brazil(2023) EVERED, Jane A.; CASTELLANOS, Marcelo E. P.; DOWRICK, Anna; GERMANI, Ana Claudia Camargo Goncalves; RAI, Tanvi; SOUZA, Alicia Navarro de; QURESHI, Kaveri; CONCEICAO, Maria Ines Gandolfo; CABRAL, Ivone; GROB, RachelDisproportionate mortality and morbidity burdens of the COVID-19 pandemic and coinciding media coverage of public acts of violence perpetrated against people of color in 2020 precipitated reckonings with structural inequities in global, national, and local contexts. This cross-country comparative analysis aims to describe how people voice and make sense race, racism, and privilege in their experiences with COVID-19 infection in the United States, United Kingdom, and Brazil. Anchored by continuous reflection on our individual and collective positionality, we conducted an inductive comparative analysis conceptually situated in intersectionality and critical race theory. Countries used a shared qualitative methodology to collect and analyze 166 narratives of people with experience of COVID-19 infection from 2020 to 2023. We selected 19 cases that illustrate crossnational differences in peoples' acknowledgment and narration of structural privilege and disadvantage in their observations of COVID-19 in their countries and in their personal experiences. People in the US had the most fluency with voicing race directly. In Brazil, while some respondents (especially younger people) demonstrated high racial consciousness, others struggled to identify and talk about racial relationships. In the UK, people voiced racial identifications, though often within white norms of politeness and an accompanying sense of discomfort. The findings overall illustrate moments the interview becomes or does not become a space for voicing social categories and systemic underpinnings of difference in COVID-19 infections and healthcare experiences. We reflect on cross-country differences in historical and contemporary racialized discourse and elaborate on implications of focusing on voicing in qualitative research.
- Characterization of interprofessional education experiences in health education at the University of São Paulo(2023) COSTA, Jaqueline Bissolati; MAZZI, Nathalia Romeu de; PEDUZZI, Marina; GERMANI, Ana Claudia Camargo Gonsalves; SILVA, Jaqueline Alcantara Marcelino; AGRELI, Heloise Lima Fernandes; NASCIMENTO, Ariana Gomes; BELBER, Gisele Silvestre; LEONELLO, Valeria MarliObjective: To map the experiences of Interprofessional Education (IPE) in Health at the Sao Paulo campus of the University of Sao Paulo. Method: This is a descriptive, exploratory study with a quantitative approach and data collection through an online questionnaire addressed to teachers from eight teaching units and 14 health courses. The data was analyzed using absolute and percentage frequencies. Results: The majority of teachers do not take part in IPE experiences (70.4%). Most of the experiences are between six and ten years old, involving up to four teachers and small groups of students, mostly extracurricular or extension activities. The teaching and assessment strategies are diverse and open to students of all years. Conclusion: IPE experiences involve a small number of students and teachers and, although consolidated in terms of the time they have been offered, are limited to extracurricular spaces. Factors such as improvements in institutional support and teacher development are pointed out as important for making progress in strengthening IPE in the analyzed context.
- Population Prevalence of Trachoma in Nine Rural Non-Indigenous Evaluation Units of Brazil(2023) SZWARCWALD, Celia Landmann; LOPES, Maria de Fatima Costa; SOUZA JUNIOR, Paulo Roberto Borges de; GOMEZ, Daniela Vaz Ferreira; LUNA, Expedito Jose de Albuquerque; ALMEIDA, Wanessa da Silva de; DAMACENA, Giseli Nogueira; FAVACHO, Joana da Felidade Ribeiro; FRIAS, Paulo Germano de; BUTCHER, Robert; BOYD, Sarah; BAKHTIARI, Ana; WILLIS, Rebecca; JIMENEZ, Cristina; HARDING-ESCH, Emma; SABOYA-DIAZ, Martha Idali; SOLOMON, Anthony W.Purpose: To assess the contemporary prevalence of trachoma in Brazil's non-indigenous population, surveys of those thought to be at greatest risk of disease were conducted. Methods: Rural census tracts of non-indigenous population from nine mesoregions were selected to compose the survey evaluation units (EUs) by considering previously endemic municipalities at greatest risk of trachoma. In each of the nine EUs, we conducted a population-based prevalence survey. Every resident of selected households aged >= 1 year was examined for trachomatous inflammation - follicular (TF) and trachomatous trichiasis (TT). Additionally, data were collected on household-level access to water, sanitation, hygiene (WASH) and education. Results: A total of 27,962 individuals were examined across nine EUs. The age-adjusted TF prevalence in 1-9-year-olds was <5% in each EU. The age- and gender-adjusted prevalence of 7 unknown to the health system in >= 15-year-olds was <0.2% in eight EUs; in one EU, it was 0.22%. The median number of households surveyed per EU with access to an improved drinking water source within a 30-minute roundtrip of the house was 66%. School attendance was >99% of surveyed children. Conclusions: The prevalence of TF was well below the target for elimination as a public health problem in all EUs. Because EUs surveyed were selected to represent the highest-risk non-indigenous areas of the country, TF prevalence is unlikely to be >= 5% in non-indigenous populations elsewhere. In one EU, the prevalence of 7 was above the target threshold for elimination. Further investigation and possibly improvement in 7 surgical provision are required in that EU.
- Local protection bubbles: an interpretation of the slowdown in the spread of coronavirus in the city of São Paulo, Brazil, in July 2020(2023) PINTO, Jose Paulo Guedes; MAGALHAES, Patricia Camargo; FIGUEIREDO, Gerusa Maria; ALVES, Domingos; ANGEL, Diana Maritza SeguraAfter four months of fighting the pandemic, the city of Sao Paulo, Brazil, en-tered a phase of relaxed social distancing measures in July 2020. Simulta-neously, there was a decline in the social distancing rate and a reduction in the number of cases, fatalities, and hospital bed occupancy. To understand the pandemic dynamics in the city of Sao Paulo, we developed a multi-agent simulation model. Surprisingly, the counter-intuitive results of the model fol-lowed the city's reality. We argue that this phenomenon could be attributed to local bubbles of protection that emerged in the absence of contagion net-works. These bubbles reduced the transmission rate of the virus, causing short and temporary reductions in the epidemic curve - but manifested as an un-stable equilibrium. Our hypothesis aligns with the virus spread dynamics ob-served thus far, without the need for ad hoc assumptions regarding the natu-ral thresholds of collective immunity or the heterogeneity of the population's transmission rate, which may lead to erroneous predictions. Our model was designed to be user-friendly and does not require any scientific or program-ming expertise to generate outcomes on virus transmission in a given loca-tion. Furthermore, as an input to start our simulation model, we developed the COVID-19 Protection Index as an alternative to the Human Development Index, which measures a given territory vulnerability to the coronavirus and includes characteristics of the health system and socioeconomic development, as well as the infrastructure of the city of Sao Paulo.
- Malnutrition in mother-child dyads in the Brazilian National Survey on Child Nutrition (ENANI-2019)(2023) FARIAS, Dayana Rodrigues; ANJOS, Luiz Antonio dos; FREITAS, Maiara Brusco de; BERTI, Talita Lelis; ANDRADE, Pedro Gomes; ALVES-SANTOS, Nadya Helena; LEITE, Maria Alvim; RAYMUNDO, Carlos Eduardo; LACERDA, Elisa Maria de Aquino; BOCCOLINI, Cristiano Siqueira; CASTRO, Ines Rugani Ribeiro de; KAC, GilbertoMalnutrition affects billions of individuals worldwide and represents a global health challenge. This study aimed to determine the prevalence of malnutri-tion (undernutrition or overweight) among mother-child dyads in children under 5 years old in Brazil in 2019 and to estimate changes in this preva-lence from 2006 to 2019. Individual-level data from the Brazilian National Survey on Child Nutrition (ENANI-2019) and the Brazilian National Survey of Demography and Health of Women and Children carried out in 2006 (PNDS 2006) were analyzed. Malnutrition outcomes in mother-child dyads included overweight mother and child, undernourished mother and child, and the double burden of malnutrition, i.e., overweight mother and child having any form of undernourishment (stunting, wasting, or underweight). Prevalence and 95% confidence intervals (95%CI) were estimated. Most women (58.2%) and 9.7% of the children were overweight, 6.9% were stunted, and 3.1% of mothers and 2.9% of the children were underweight. The preva-lence of overweight in the mother-child dyad was 7.8% and was statistically higher in Southern Brazil (9.7%; 95%CI: 7.5; 11.9) than in the Central-West (5.4%; 95%CI: 4.3; 6.6). The prevalence of overweight mother and stunted child was 3.5%, with statistically significant difference between the extremes of the mother's education [0-7 vs. >= 12 years, 4.8% (95%CI: 3.2; 6.5) and 2.1%, (95%CI: 1.2; 3.0), respectively]. Overweight in the dyad increased from 5.2% to 7.8%, and the double burden of malnutrition increased from 2.7% to 5.2% since 2006. Malnutrition in Brazilian mother-child dyads seems to be a grow-ing problem, and dyads with lower formal education, higher maternal age, and from the South Region of Brazil were more vulnerable.
- Association between ultra-processed food consumption and the incidence of type 2 diabetes: the ELSA-Brasil cohort(2023) CANHADA, Scheine L.; VIGO, Alvaro; LEVY, Renata; LUFT, Vivian C.; FONSECA, Maria de Jesus M. da; GIATTI, Luana; MOLINA, Maria del Carmen B.; DUNCAN, Bruce B.; SCHMIDT, Maria InesBackground Ultra-processed food (UPF) consumption increases the risk of type 2 diabetes in various high-income countries, with some variation in the magnitude across studies. Our objective was to investigate the association of UPF consumption and specific subgroups with incident type 2 diabetes in Brazilian adults. Methods The Brazilian Longitudinal Study of Adult Health (ELSA-Brasil) is a multicenter cohort study of 15,105 adults (35-74 years) enrolled in public institutions in Brazil (2008-2010). We followed participants with two clinic visits (2012-2014; 2017-2019) and annual telephone surveillance. After excluding those with diabetes at baseline, who died or were lost in the follow-up, with missing data, with implausible energy food intake, or reporting bariatric surgery, there were 10,202 participants. We used the NOVA classification to assess UPF consumption based on a food frequency questionnaire. We defined type 2 diabetes by self-report, medication use, or comprehensive laboratory tests. We estimated relative risks (RR) and 95% confidence intervals (95% CI) using robust Poisson regression. Results Median UPF consumption was 372 g/day. Over 8.2 (0.7) years of follow-up, we detected 1799 (17.6%) incident cases. After adjustment for socio-demographics, family history of diabetes, and behavioral risk factors, comparing the fourth (>= 566 g/day) with the first (< 236 g/day) quartile of UPF distribution, RR was 1.24 (1.10-1.39); every 150 g/ day increments in UPF consumption resulted in a RR of 1.05 (1.03-1.07). Reclassifying natural beverages with added sweeteners as UPF increased risk (RR 1.40; 1.25-1.58). Among UPF subgroupings, consumption of processed meats and sweetened beverages increased diabetes risk, while yogurt and dairy sweets decreased the risk (p < 0.05). Conclusions UPF consumption increased the incidence of type 2 diabetes in Brazilian adults, with heterogeneity across specific food items. These findings add to previous evidence for the role of UPFs in the development of diabetes and other chronic diseases, supporting recommendations to avoid their intake in diabetes prevention and management.