Objective: To describe COVID‐19 deaths among children and adolescents in Sergipe, Brazil.Methods: Ecological study of all COVID‐19 reported cases and deaths occurring in children and adolescents < 19 years of age in Sergipe reported by the health surveillance and mortality information systems of Sergipe’s Health Secretary and hospital records.Results: Of 37 deaths of children < 19 years old were reported up to 30 September 2020, corresponding to 4.87 deaths for 100 000 population < 19 years old. Most deaths occurred among infants (44.1/100 000), and this age group had the highest case fatality rate (15.3 %). Most children had comorbidities such as chronic neurological diseases (n = 7; 19%) and prematurity (n = 4; 11%). Most children who died (n = 18; 49%) were not admitted to intensive care units (ICUs).Conclusion: COVID‐19 mortality in children and adolescents in Sergipe was higher than in other Brazilian states and in high‐income countries. A large proportion of the deaths occurred among children with comorbidities and a minority of children were admitted to ICU, reflecting the limited provision of such beds in the State. Newborns and infants are a high‐risk group that must have priority in health public policy.

RESUMO Objetivo investigar a forma de oferta de dieta, conforme os diversos métodos de alimentação, e descrever o ganho de peso em recém-nascidos com microcefalia relacionada ao Zika Vírus, comparando-os com recém-nascidos sem microcefalia. Método estudo de coorte retrospectivo com caso controle aninhado. Informações sobre idade gestacional, peso e métodos de alimentação (seio materno, sonda nasogástrica/orogástrica, mamadeira e copo) foram coletadas em prontuários de 43 recém-nascidos com microcefalia por Zika Vírus, equiparados conforme idade gestacional com 43 recém-nascidos sem acometimentos (grupo controle), em uma maternidade de referência no Nordeste do Brasil. Os dados foram coletados desde o nascimento até a alta hospitalar. As medidas de desfecho foram pesos (ao nascer e na alta), velocidade de ganho de peso, tempo de internação e métodos de alimentação. Resultados O grupo com microcefalia apresentou menores pesos ao nascer (D=-1,67; p<0,001), inclusive com maior probabilidade de serem baixo peso (Phi=0,687; p<0,001), e no momento da alta (D=-0,87; p=0,006), do que o controle. O grupo com microcefalia também apresentou maior velocidade de ganho de peso (D=0,77; p=0,006), embora com métodos alimentares semelhantes ao grupo controle, incluindo a aceitação do seio materno, de forma exclusiva (34,9%) ou complementada (58,1%). Conclusão recém-nascidos com microcefalia relacionada ao Zika Vírus utilizaram métodos alimentares semelhantes, incluindo seio materno, aos do grupo sem acometimento. Quanto ao peso, apresentaram valores menores ao nascimento e na alta, apesar de terem um crescimento precoce pós-natal mais rápido que aqueles sem microcefalia.

Early-life mortality rates have significantly declined since 2000, and sustaining this progress could save over 11 million children's lives worldwide. Achieving uniform reductions in early-life mortality remains a critical public health challenge in Brazil. This study analyzed disaggregated trends in early-life mortality across Brazilian regions and assessed each region's progress toward meeting the Sustainable Development Goals (SDGs) and national targets for Brazil. This is a population-based analytical and ecological study. We analyzed data from official government information systems for Brazilian regions and states over five consecutive five-year periods between 1998 and 2022. The SDG targets considered were: an under-five mortality rate (U5MR) of 25 per 1000 live births, a neonatal mortality rate (NMR) of 12.0 per 1000 live births, and an infant mortality rate (IMR) of 15.7 per 1000 live births. Brazil's adjusted national targets were: U5MR of 8.3, NMR of 5.3, and IMR of 7.7 per 1000 live births, respectively. We calculated the absolute annual change (AAC) in mortality rates for each five-year interval to assess trends and infer the likelihood of meeting the 2030 targets. Between 1998 and 2022, U5MR in Brazil declined by 54%, from 32.5 to 15.1 deaths per 1000 live births. The national average met the SDG targets for all age strata, but no state achieved the stricter IPEA targets. From 2018 to 2022, under-five and infant mortality rates showed annual increases (AAC = +0.22 and + 0.10, respectively), while neonatal mortality remained stable (AAC = −0.02). Regional disparities persisted. In 2022, Santa Catarina (South region) had the lowest U5MR (11.5 deaths per 1000 live births), while Roraima (North region) had the highest (24.6 deaths per 1000 live births). Although most states are projected to meet the SDG targets for U5MR by 2030, none are on track to meet the IPEA goals. Despite national progress in meeting SDG targets for early-life mortality, recent increases in under-five and infant deaths and enduring regional inequalities threaten future gains. Sustained improvements will require focused, region-specific strategies to address the social and health determinants driving these disparities. This research received no specific grant from any funding agency.

One of the main gaps in characterizing the congenital Zika syndrome (CZS) up to now is the small number of participants in individual studies. Pooling the data together overcomes the sample size-related limitations of individual studies and provides an opportunity for investigating heterogeneity between studies and, as appropriate, to better characterize the CZS . This study aims to describe adverse anthropometric, clinical, and neuroimaging outcomes in Brazilian children with Zika-related microcephaly.Individual participant data meta-analysis of 12 cohorts of the Zika Brazilian Cohorts Consortium (ZBC-Consortium), using primary data from children with Zika-related microcephaly, born between January/2015 and July/2018. We included 843 children with microcephaly at birth, at first evaluation, or over follow-up. Of 601 children with microcephaly at birth, 217 (36.1%) had moderate and 384 (63.9%) had severe microcephaly. Postnatal microcephaly occurred in 172 (20.4%) children. There was heterogeneity across studies. Severe microcephaly ranged from 11-87.5%; prematurity from 10-20% in most sites; low birth weight from 10-43.8%. Deficit of social attention, hyperreflexia, and persistence of primitive reflexes were reported in at least 50% of the children in the larger cohorts. Epilepsy ranged from 30-80% of the children and dysphagia, from 22.2-67.7%. Calcifications and ventriculomegaly were the most consistent and frequent abnormality (around 80%). Cortical atrophy or other development disorders were reported in around 50% of the children. The frequency of fundal, optical nerve and hearing abnormalities ranged from 0-67.1%, 0-36.5% and 0–50%, respectively. This large sample size allowed us to describe the spectrum of severity and of manifestations of Congenital Zika Syndrome.

Objetivo: investigar a visão de puérperas sobre mitos que envolvem aleitamento materno e aspectos fonoaudiológicos, e avaliar a aceitabilidade de orientações sobre essas temáticas.

Purpose: to investigate the perception of postpartum women regarding myths related to breastfeeding and speech-language pathology aspects, and to evaluate th acceptability of guidance on these topics.