Parasitic infections are considered a major public health problem due to their associated morbimortality and negative impact on physical and intellectual development, especially in the at-risk pediatric group. Periodic prophylactic administration of antiparasitic agents against soil-transmitted helminths is recommended by the World Health Organization (WHO) to control parasitic infections and disease burden. We aimed to evaluate the prevalence of intestinal parasitic infections in Brazil. We performed a systematic review by searching the literature found in the PubMed, LILACS, and SciELO databases, followed by a meta-analysis of the proportions from studies published in English, Portuguese, and/or Spanish from January 2000 to May 2018. This systematic review was registered in the PROSPERO database (CRD42018096214). The prevalence of intestinal parasitic infections (protozoa and/or helminths) in Brazil was 46% (confidence interval: 39-54%), with 99% heterogeneity. Prevalence varied by region: 37%, 51%, 50%, 58%, and 41% in the Southeast, South, Northeast, North, and Central-West regions, respectively. Most studies (32/40) evaluated children (<18 years) and found an average prevalence of 51%. Children also had the highest prevalence in all four regions: Central-West (65%), South (65%), North (58%), Northeast (53%), and Southeast (37%). However, most studies evaluated specific populations, which may have created selection bias. Presumably, this review of intestinal parasitic diseases in Brazil includes the most studies and the largest population ever considered. The prevalence of intestinal parasitic infections is high in Brazil, and anthelmintic drugs should be administered periodically as a prophylactic measure, as recommended by the WHO.

OBJECTIVE: To evaluate the impact of mode of delivery on breastfeeding incentive practices and on neonatal and maternal short and long-term complications. METHODS: A cohort study was conducted between June 2015 and April 2016 with 768 puerperal women from 11 maternities in Sergipe, interviewed in the first 24 hours, 45–60 days and 6–8 months after delivery. Associations between breastfeeding incentive practices, neonatal and maternal, both short-term and late complications, and the exposure variables were evaluated by the relative risk (95%CI) and the Fisher exact test. RESULTS: The C-section newborns had less skin-to-skin contact immediately after delivery (intrapartum C-section: 0.18, 95%CI 0.1–0.31 and elective C-section: 0.36, 95%CI 0.27–0.47) and less breastfeeding within one hour of birth (intrapartum C-section: 0.43, 95%CI 0.29–0.63 and elective C-section: 0.44, 95%CI 0.33–0.59). Newborns from elective C-section were less frequently breastfed in the delivery room 0.42 (95%CI 0.2–0.88) and roomed-in less 0.85 (95%CI 0.77–0.95). Women submitted to intrapartum C-section had greater risk of early complications 1.3 (95%CI 1.04–1.64, p = 0.037) and sexual dysfunction 1.68 (95%CI 1.14–2.48, p = 0.027). The frequency of neonatal complications, urinary incontinence and depression according to the mode of delivery was similar. CONCLUSIONS: The C-section was negatively associated with breastfeeding incentive practices; in addition, C-section after labor increased the risk of early maternal complications and sexual dysfunction.

Jardim-Botelho A, et al. Pediatr Gastroenterol Hepatol Nutr. 2023 Nov;26(6):355-369. https://doi.org/10.5223/pghn.2023.26.6.355

O Brasil tem extensas formações vegetais ao longo do seu território que são afetadas por ocorrências de queimadas, necessitando de um monitoramento espaço-temporal e de estudos que relacionem a sua atuação nos biomas e nas áreas protegidas do país. Sendo assim, o objetivo do presente estudo foi analisar o comportamento temporal e espacial das ocorrências de fogo de 2003 a 2017 nos biomas brasileiros: Amazônia, Caatinga, Cerrado, Mata Atlântica, Pantanal e Pampa, incluindo as incidências nas áreas de Unidades de Conservação, verificando possíveis padrões da distribuição dos focos, assim como a tendência estatística das suas ocorrências. Foram utilizados dados geoespaciais de 2003 a 2017 do satélite de referência AQUA_M-T obtido no Instituto Nacional de Pesquisas Espaciais, e das Unidades de Conservação disponibilizados pelo Ministério do Meio Ambiente. Estatisticamente, foi aplicado o algoritmo Kernel para analisar a distribuição espacial a partir da média da série temporal estudada, e o teste não paramétrico de Mann-Kendall, considerando também a sua Persistência de Longo Alcance para verificar a tendência de ocorrência. Observou-se que os biomas Amazônia e Cerrado possuem, respectivamente, os maiores focos de fogo, com o Cerrado tendo maior área queimada. Consequentemente, as Unidades de Conservação localizadas nestes biomas tiveram maior quantidade de focos detectados. A análise da tendência estatística indicou que o crescimento da ocorrência de fogo possui sazonalidade em todos os biomas, com o Pampa sendo caracterizado por uma condição natural. Portanto, o estudo permitiu identificar e quantificar, espacialmente, os maiores focos de queimadas nos Biomas brasileiros, bem como nas Unidades de Conservação em cada respectivo bioma para a série estudada, servindo como base para medidas de prevenção e controle do fogo principalmente nas Unidades de Conservação que possuem maiores ocorrências no país.

Objective: This study aimed to analyse the clinical and epidemiological indicators, temporal trends and the spatial distribution of leprosy in patients under 15 years old in an endemic area of Northeast Brazil. Design: Regional surveillance study of all reported cases. Setting: State of Sergipe, endemic area of Northeast Brazil. Methods: An ecological and time series study was conducted, based on secondary data reported by the Brazilian Information System on Notifiable Diseases for leprosy cases diagnosed in Sergipe state (2002–2015). The analysis of temporal trends was performed using the Joinpoint Regression Programme through Poisson regression. We performed spatial analysis by Kernel estimator and Moran index. Results: The incidence rate was reduced from 6.29 to 3.78 cases per 100 000 inhabitants in 2002 and 2015, respectively. However, Sergipe was still classified as highly endemicity in 2015. The mean number of household contacts (HHC) examined was significantly lower than those registered. Clinical data indicated that 21.4% of the patients developed leprosy reactions, and 31.3% presented with some physical disability in the multibacillary groups. Patients diagnosed by examination within the HHC presented better indicators, such as lower percentage of leprosy reaction and physical disability. Spatial analysis showed the most risk areas distributed on the northeast and cities around the capital, Aracaju. Conclusion: The data indicate that there is a persistence of active Myobacterium leprae transmission and a delay in disease detection, following a pattern of high endemicity in many municipalities. The early detection by HHC examination is important to stop transmission and also to detect the cases in a less severe state.

COVID-19 pandemic has disrupted health services, including vaccination demand. We describe the impact of the COVID-19 pandemic on routine pediatric vaccination in Brazil.We conducted a retrospectiv...