VEGF is an important neurotrophic and vascular factor involved in mental disorders. The objective of this study was to verify the effect of genetic polymorphisms in the VEGF pathway on the risk for depression, symptom intensity, and suicide attempts. To examine the association between the VEGF pathway and depression, we genotyped polymorphisms and measured the plasma concentrations of VEGF, KDR, and FLT1 proteins. The participants were 160 patients with depression and 114 healthy controls. The questionnaires that assessed the clinical profile of the patients were the MINI-International Neuropsychiatric Interview, GRID-HAMD₂₁, CTQ, BSI, and the number of suicide attempts. Genotyping of participants was performed using the real-time PCR and protein measurements were performed using the enzyme-linked immunosorbent assay (ELISA). VEGF and its inhibitors were reduced in depression. Individuals with depression and displaying the homozygous AA of the rs699947 polymorphism had higher plasma concentrations of VEGF (p-value = 0.006) and were associated with a greater number of suicide attempts (p-value = 0.041). Individuals with depression that were homozygous for the G allele of the FLT1 polymorphism rs7993418 were associated with lower symptom severity (p-value = 0.040). Our results suggest that VEGF pathway polymorphisms are associated with the number of suicide attempts and the severity of depressive symptoms.

Background/Objectives: COVID-19 is an infectious disease whose prevention is significantly aided by vaccination, which reduces both case severity and mortality. Despite the safety and efficacy of vaccines, acceptance is not universal, and understanding of the factors influencing vaccination decisions and hesitancy remains limited. This review aims to identify and analyze studies addressing two key questions: what influences the decision to vaccinate and what factors are associated with vaccine hesitancy. Methods: This systematic review was conducted following the PRISMA guidelines. Data collection utilized descriptors related to vaccine adherence and hesitancy, based on the PEO strategy of the Joanna Briggs Institute (JBI). Searches were conducted in Embase, Scopus, PubMed, Lilacs, and Web of Science, focusing on publications from 2021, the year the first COVID-19 vaccine was approved. After excluding duplicates and selecting articles based on eligibility criteria, the analysis involved data extraction and methodological quality assessment using JBI tools. Results: A total of 5268 publications were identified, with 30 included in this study. Factors associated with vaccine hesitancy included low education levels, social media influence, confidence in vaccine safety, and fear of side effects. In contrast, factors linked to vaccine acceptance included higher education, higher income, older age, and existing comorbidities. Conclusions: The findings highlight the urgent need for targeted health communication and education strategies, particularly for vulnerable groups. Public health policies should incorporate these factors to enhance vaccination adherence and build public confidence in vaccine safety, which is essential for mitigating future health emergencies.

Background: Brazil’s Unified Health System (Sistema Único de Saúde—SUS) has played a crucial role in reducing health disparities by providing universal and free healthcare to a diverse population. However, the COVID-19 pandemic exposed significant barriers to healthcare access among vulnerable groups, particularly due to the intersection of multiple vulnerabilities. This study aimed to examine how intersectionality—specifically sex/gender, race/ethnicity, and education level—has influenced inequalities in healthcare service utilization among vulnerable populations during the COVID-19 pandemic in Brazil. Methods: This cross-sectional study is part of the “COVID-19 Social Thermometer in Brazil” project, conducted between May 2022 and October 2023 in Brazil’s state capitals and the Federal District, focusing on populations considered socially vulnerable during the pandemic. Participants were selected using sequential sampling and completed a structured questionnaire. Statistical analyses—performed using Excel, RStudio (version 4.3.2), and ArcGIS—included sociodemographic profiling, the construction of the Jeopardy Index (a measure of social vulnerability), and binary logistic regression to explore associations between Jeopardy Index and healthcare service utilization. Results: 3406 participants, the majority were men (60%), aged 30 to 59 years (65.1%), and identified as Black or Brown (72.2%). Most participants were concentrated in the Northeast (26.6%) and North (22.3%) macroregions. A high reliance on public healthcare services (SUS) was observed, particularly in the Southeast (96%). According to the Jeopardy Index, the most socially vulnerable groups—such as women, transgender individuals, Black people, and those with no formal education—were significantly more likely to rely on SUS (OR = 3.14; 95% CI: 1.34–7.35) and less likely to use private healthcare (OR = 0.07; 95% CI: 0.02–0.20), reflecting a 214% higher likelihood of SUS use and a 93% lower likelihood of private service utilization compared to the most privileged group. Conclusions: Our findings reveal that individuals experiencing intersecting social vulnerabilities face marked inequalities in healthcare access. Without SUS, these populations would likely have been excluded from essential care. Strengthening SUS and implementing inclusive public policies are critical to reducing disparities and ensuring equitable healthcare access for historically marginalized groups.

Background: International migration is a global phenomenon with significant implications on the health–disease process due to exposures along transit routes and local/destination epidemiological indicators. We aimed to analyze the transmission and spread of tuberculosis among international migrants and refugees from a spatiotemporal perspective and the associated factors. Method: This was an ecological study of cases of tuberculosis in international migrants in Brazil, between 2010 and 2021. Annual incidence rates were calculated and spatiotemporal scan techniques were used to identify municipalities at risk. Multiple logistic regression was used to identify factors associated with tuberculosis in international migrants. Results: A total of 4037 cases of tuberculosis were reported in Brazil in international migrants. Municipalities at risk for this event were identified using the spatiotemporal scan technique, and a cluster was identified with ITT: +52.01% and ETT: +25.60%. A higher probability of TB infection was identified in municipalities with a TB incidence rate >14.40 cases/100 inhabitants, population >11,042 inhabitants, Gini index >0.49, and illiteracy rate >13.12%. A lower probability was found in municipalities with average per capita household income >BRL 456.43. Conclusions: It is recommended that health authorities implement monitoring and rigorous follow-up in affected areas to ensure proper diagnosis and treatment completion for international migrants, preventing disease spread to other communities.

Background: Women in situations of vulnerability experience situations of violence aggravated by their social condition and which generate mental health problems, and these conditions have been further exacerbated by the COVID-19 pandemic. Objective: This study aims to scrutinize the frequency of violence against women and their mental health status within favelas during the COVID-19 pandemic in Brazil, exploring how the pandemic may have impacted these issues and identifying factors that contribute to these experiences. Methods: It is a cross-sectional and quantitative study in which data were obtained through the application of a questionnaire adapted and validated for the Brazilian context. The sample consisted of Brazilian women over 18 years old, who lived lived in favelas in the capital cities of Brazilian states. Sampling was carried out using a sequential approach, including participants as they were located and agreed to take part in the study. Descriptive analyses (absolute and relative frequency) were carried out to characterize the profile of the people who answered the questionnaire and logistic regression to identify the factors associated with mental health status and violence against women. Results: A total of 766 women living in favelas answered the questionnaire. The majority identified themselves as black/brown (75.8%), single, separated, or widowed (51.7%), had completed high school (43.1%), worked informally (47.1%) and did not receive government assistance (57.3%). Black/brown women (OR: 1,05; IC95% 4,55 − 2,53) who were married (OR: 2,45; IC95% 1,18 − 5,19) and exposed to drug trafficking (OR: 3,23; IC95% 1,36 − 7,97) were more likely to experience conjugal violence during the pandemic. In addition, women with informal employment (OR: 3,26; IC95%: 1,24 − 9,55) and complete higher education (OR: 4,47; IC95%: 1,68 − 1,21), were more likely to consider their mental health as precarious during the pandemic period. Conclusions: The pandemic has exacerbated the social vulnerability of these women, highlighting the need to incorporate a gender perspective into the formulation of public policies during health crises such as the COVID-19 pandemic.

The rapid spread of COVID-19 have overwhelmed health systems, especially in the care of chronic disease such as tuberculosis and diabetes. The objective of the study was to analyze the magnitude and relevance of tuberculosis-diabetes and diabetes-COVID-19 comorbidities in spatial risk areas and their factors associated with unfavorable outcomes in the Brazilian population between 2020 and 2022. An ecological study was carried out in Brazilian municipalities. The population was composed by cases of tuberculosis-diabetes and diabetes-COVID-19 comorbidities, registered in the Influenza Epidemiological Surveillance Information System (SIVEP-GRIPE) and in DATASUS from 2020 to 2022. The Scan Statistics technique was used to identify spatial risk clusters. Binary logistic regression was then employed to understand the relationship between outcomes and comorbidities, considering clinical and sociodemographic variables. A total of 24,750 cases of tuberculosis-diabetes comorbidity were identified, which consisted of an incidence of 3.2 cases per 100,000 inhabitants. Risk clusters were identified in the Central-West and North regions. 303,210 cases of diabetes- COVID-19 comorbidity were identified, resulting in an incidence of 0.4 cases per 100,000 inhabitants. São Paulo-SP, Rio de Janeiro-RJ and Belo Horizonte-MG were the municipalities with the highest spatial risk of illness. The analysis of the spatial risk areas revealed distinct patterns in the geographic distribution of comorbidities. Based on the findings, it is concluded that comorbidities between tuberculosis and diabetes, as well as between COVID-19 and diabetes, represent significant challenges for public health in Brazil, deserving attention from health authorities and the scientific community.