Congenital Zika virus (ZIKV) infection may present with a broad spectrum of clinical manifestations. Some sequelae, particularly neurodevelopmental problems, may have a later onset. We conducted a prospective cohort study of 799 high-risk pregnant women who were followed up until delivery. Eighty-three women and/or newborns were considered ZIKV exposed and/or infected. Laboratory diagnosis was made by polymerase chain reaction in the pregnant mothers and their respective newborns, as well as Dengue virus, Chikungunya virus, and ZIKV serology. Serology for toxoplasmosis, rubella, cytomegalovirus, herpes simplex virus, and syphilis infections were also performed in microcephalic newborns. The newborns included in the study were followed up until their third birthday. Developmental delay was observed in nine patients (13.2%): mild cognitive delay in three patients, speech delay in three patients, autism spectrum disorder in two patients, and severe neurological abnormalities in one microcephalic patient; sensorineural hearing loss, three patients and dysphagia, six patients. Microcephaly due to ZIKV occurred in three patients (3.6%). Clinical manifestations can appear after the first year of life in children infected/exposed to ZIKV, emphasizing the need for long-term follow-up.

Recent outbreaks of Zika virus (ZIKV) infection highlight the urgent need to evaluate the efficacy of current public health measures to educate susceptible groups about how to prevent infection, modes of viral transmission, and consequences of infection. We performed a cross-sectional study in the city of Jundiaí, São-Paulo, from March 2016 to August 2017. In 315 high-risk pregnant women we evaluated the rate of ZIKV infection, knowledge of pathways of ZIKV transmission, and the use of protective measures. Data were analyzed and correlated with sociodemographic variables. The rate of ZIKV infection was 10.8%. ZIKV transmission by mosquitoes was the best-known means of virus acquisition, while transmission of ZIKV by sexual intercourse as well as mother–fetus transmission was known by less than half of the women. The use of insect repellent, reported by 53% of participants, was correlated with higher education and personal directives from health professionals. Condom use was reported by 19.5% of subjects. Improved strategies to increase awareness of ZIKV infection and its consequences, designed to appeal to specific, targeted populations, are clearly necessary to more accurately prevent the spread of this infection and diminish adverse consequences in the pregnant population.

Introdução: As doenças crônicas não transmissíveis (DCNT) — incluindo diabetes (DM) e hipertensão arterial sistêmica (HAS) — são responsáveis por grande parte das mortes mundiais atualmente, sendo a identificação de fatores associados uma ferramenta fundamental para sua prevenção e estratégias de promoção da saúde. Objetivo: Determinar a prevalência de HAS e DM na população adulta atendida pelo Projeto Vozes das Ruas (PVR) em Jundiaí (SP) e fatores associados. Métodos: Os participantes do estudo transversal, conduzido de março a novembro de 2019, foram adultos acima de 18 anos, voluntários das ações de promoção de saúde do PVR em 2019, que consistiram na aplicação de um questionário sociodemográfico e de comportamentos em saúde; na avaliação de glicemia capilar, pressão arterial, peso, altura e circunferência abdominal; e posterior aconselhamento em saúde. Realizou-se análise descritiva dos dados para verificar a associação dos desfechos DM e HAS com variáveis independentes. Utilizaram-se teste χ² e regressão logística multivariada para variáveis com p<0,20, adotando-se a significância de 5%. Resultados: A amostra foi composta de 580 participantes, 50% do sexo feminino e com idade média de 48,56 anos. A prevalência autodeclarada de DM foi 16,2% e de HAS, 30,2%. Os fatores associados em comum foram: faixa etária acima de 39 anos e uso de medicação contínua. Associados à DM foram: antecedente familiar de DM, uso de unidade básica de saúde, histórico de tabagismo. Em relação à HAS as associações foram: menos de oito anos de estudo, sobrepeso e obesidade. Conclusões: Na população estudada houve elevada prevalência de duas das principais DCNT — HAS e DM — que apresentaram fatores associados de extrema relevância para o planejamento de estratégias de promoção da saúde e prevenção de doenças.

Background: Rheumatoid arthritis (RA) is a chronic systemic inflammatory disease in which achieving remission is the most effective strategy to prevent progression and optimize long-term outcomes. The performance of commonly used disease activity indices has not been well validated in the Brazilian RA population. This study aimed to evaluate the agreement between CDAI/SDAI and the revised Boolean 2.0 remission criteria, which served as the reference standard, and to identify the most accurate CDAI and SDAI remission cut-offs in this population. Methods: We conducted a cross-sectional analysis of baseline data from a Brazilian Cohort study, which included 840 patients from 11 public hospitals in Brazil. Disease activity was assessed using DAS28-CRP, DAS28-ESR, SDAI, CDAI, and Boolean 1.0/2.0. Agreement was assessed using Cohen’s kappa, and optimal remission cut-offs were determined through ROC curve analysis. Results: The study population was predominantly female (89.8%), with a mean age of 57 years and a median disease duration of 12 years. DAS28-CRP showed the highest remission rate (39.2%), whereas Boolean 1.0 showed the lowest (15.1%). Strong agreement was found between Boolean 2.0, and both the SDAI (κ = 0.775) and CDAI (κ = 0.692). ROC analysis revealed that the most accurate remission cut-offs were SDAI ≤ 4.3 and CDAI ≤ 3.9, which increased remission detection by 5.9% and 6.2%, respectively. Conclusion: In our cohort, SDAI ≤ 4.3 and CDAI ≤ 3.9 were the values most closely aligned with Boolean 2.0 remission. These adjusted cut-offs may help minimize overtreatment in resource-limited settings. Prospective studies assessing function, radiographic progression, and quality of life are warranted to confirm their validity in the Brazilian population.