Vaccines are very important to reduce morbidity and mortality by preventable infectious diseases, especially during childhood. Optimal coverage is not always achieved, for several reasons. Here we assessed vaccine coverage for the first 12 months of age in children between 12 and 59 months old, residing in the urban area of a small Amazonian city, and factors associated with incomplete vaccination. A census was performed in the urban area of Assis Brasil, in the Brazilian Amazon, in January 2010, with mothers of 282 children aged 12 to 59 months old, using structured interviews and data from vaccination cards. Mixed logistic regression was used to determine factors associated with incomplete vaccination schemes. Only 82.6% of all children had a completed the basic vaccine scheme for the first year of life. Vaccine coverage ranged from 52.7% coverage (oral rotavirus vaccine) to 99.7% coverage (for Bacille Calmette-Guérin). The major deficiencies occurred in doses administered after the first six months of life. Incomplete vaccination was associated with not having enough income to buy a house (aOR = 2.12, 95% CI 1.06-4.21), low maternal schooling (aOR = 2.60, 95% CI 1.28 – 5.29) , and time of residence of the child in the urban area of the city (aOR = 0.73, 95% CI 0.55 – 0.95). This study showed that vaccine coverage in the first twelve months of life in Assis Brasil is similar to other areas in the Amazon and it is below the coverage postulated by the Brazilian Ministry of Health. Low vaccine coverage was associated with socioeconomic inequities that still prevail in the Brazilian Amazon. Short and long-term strategies must be taken to update child vaccines and increase vaccine coverage in the Amazon.

Estudo transversal com universitários realizado para analisar a prevalência e os fatores associados ao consumo regular de frutas e hortaliças por acadêmicos de uma universidade pública federal de Rio Branco, Acre, Brasil. Foram investigados 863 estudantes de cursos de graduação em 2010. A prevalência geral de consumo regular de frutas e hortaliças foi de 14,8%. Os fatores associados ao consumo regular de frutas e hortaliças foram: pertencer à classe econômica A/B (RP = 1,70; IC95%: 1,10-2,62), conviver com companheiro(a) (RP = 1,53; IC95%: 1,02-2,29), praticar atividade física (RP = 1,69; IC95%: 1,11-2,56) e consumo de fast food igual ou menor que 2 vezes na semana (RP = 1,49; IC95%: 1,04-2,13). Em conclusão, destaca-se que a minoria dos acadêmicos alcançou a recomendação de consumir frutas e hortaliças em 5 dias ou mais da semana. O consumo regular desses alimentos mostrou-se associado aos aspectos socioeconômicos e aos hábitos saudáveis relacionados à prática de atividade física e baixo consumo de fast food.

OBJETIVO: Caracterizar os padrões de amamentação nos primeiros seis meses de vida e fatores associados ao desmame precoce numa coorte de nascidos vivos em Rio Branco, Acre. MÉTODOS: Estudo prospectivo com nascidos vivos entre abril e junho de 2015. As entrevistas com as mães ocorreram logo após o nascimento e entre 6 e 15 meses pós-parto. Na alta hospitalar, o aleitamento foi definido em exclusivo (AME) e materno (AM). No seguimento, os padrões de amamentação foram AME, aleitamento materno predominante (AMP) e AM. A interrupção da amamentação nos primeiros seis meses foi classificada como desmame precoce. Utilizou-se o método de Kaplan Meier (log-rank: 95%) para estimar a probabilidade condicional de mudança no padrão de amamentação e risco de desmame. Os fatores associados ao desmame e seus intervalos de confiança de 95% (IC95%) foram analisados pela regressão proporcional de Cox bruta e ajustada. RESULTADOS: Participaram do estudo 833 lactentes que na alta hospitalar estavam em AME (95,4%) e AM (4,6%). A probabilidade do lactente em AME na alta hospitalar permanecer em AME, ou se tornar AMP ou AM, aos seis meses, foi de 16,4%, 32,3% e 56,5% respectivamente. A probabilidade de desmame aos seis meses foi estaticamente maior para lactentes em AM na alta hospitalar (47,4%) em comparação com aqueles em AME (26%). Mostraram-se associados ao desmame precoce: o AM na alta hospitalar (HR = 1,82; IC95% 1,06–3,11), ausência de amamentação cruzada praticada pela mãe (HR = 2,50; IC95% 1,59–3,94), usar chupeta (HR = 6,23; IC95% 4,52–8,60), pretender amamentar por menos de seis meses (HR = 1,93; IC95% 1,25–2,98), não amamentar na primeira hora de vida (HR = 1,45; IC95% 1,10–1,92) e consumir álcool na gestação (HR = 1,88; IC95% 1,34–2,90). CONCLUSÃO: Comparados aos lactentes em AME, aqueles em AM, na alta hospitalar, apresentaram maior probabilidade de desmame. Esforços em saúde pública devem priorizar o AME na alta hospitalar, promover amamentação na primeira hora de vida e orientar sobre os riscos do consumo de álcool na gestação, amamentação cruzada e uso de chupeta.

Hepatitis A is still a neglected health problem in the world. The most affected areas are the ones with disadvantaged socioeconomic conditions. In Brazil, seroprevalence studies showed that 64.7 % of the general population has antibodies against HAV (hepatitis A virus), and the Amazon region has the highest seroprevalence in the country. In the present study the seroprevalence of total HAV antibodies in children between 1 and 5 years old residing in the urban area of Assis Brasil, Acre was measured and spatial distribution of several socioeconomic inequities was evaluated. In the year of 2011, seroprevalence rate was 16.66 %. Factors associated with having a positive serology identified by multivariate analysis were being of indigenous ethnicity [adjusted Odds Ratio (aOR) = 3.27, CI 1.45–7.28], usage of water from the public system (aOR = 8.18, CI 1.07–62.53), living in a house not located in a street (aOR = 3.48, CI 1.54–7.87), and child age over 4 years old (aOR = 2.43, CI 1.23–4.79). The distribution of seropositive children was clustered in the eastern part of the city, where several socioeconomic inequities (lack of flushed toilets, lack of piped water inside the household and susceptibility of the household to flooding during rain, low maternal education, having wood or ground floor at home, and not owning a house, lack of piped water at home, and type of drinking water) also clustered. The findings highlight that sanitation and water treatment still need improvement in the Brazilian Amazon, and that socioeconomic development is warranted in order to decrease this and other infectious diseases.

Toxocara spp. infection and the seroconversion rate in the Amazon have been poorly investigated. This study analyzed individual and household-level risk factors for the presence of IgG antibodies to Toxocara spp. in urban Amazonian children over a period of 7 years and evaluated the seroconversion rates over a 1-year follow-up. In children < 59 months of age, the overall prevalence rate was 28.08% in 2003 and 23.35% in 2010. The 2010–2011 seroconversion rates were 13.90% for children 6–59 months of age and 12.30% for children 84–143 months of age. Multilevel logistic regression analysis identified child age, previous wheezing, and current infection with hookworm as significant associated factors for Toxocara spp. seropositivity in 2003. In 2010, age, previous helminthiasis, and having a dog were associated with seropositivity, whereas having piped water inside the household was a protective factor. Control programs mainly need to target at-risk children, water quality control, and animal deworming strategies.

Background: The aim of this study was to analyse the prevalence of undernutrition, overweight and associated factors, before and after the implementation of the Interoceanic Highway. Methods: A population-based cross-sectional study on children under 5 years of age was conducted in the municipality of Assis Brasil, AC, Brazil, in 2003 and 2010. Prevalence of undernutrition was observed by using height-for-age Z-scores (HAZ) and adopting a cut-off point equal to or lower than a -2 Z-score. Overweight prevalence was defined by a cut-off point equal to or greater than a +2 Z-score of the WHZ index. Z-scores were calculated relative to WHO 2006 reference data. Semi-structured questionnaires were applied to the children’s guardians, investigating family socio-economic and demographic characteristics, morbidities, access to services and child care. Associated factors were identified by hierarchical multiple logistic regression analysis. Results: The prevalence of low HAZ (undernutrition) was 7.0% in 2003 and 12.2% in 2010. The prevalence of high WHZ (overweight) was 1.0% and 6.6% for 2003 and 2010, respectively. It was not possible to adjust the multiple model for the year 2003. The factors associated with low HAZ in 2010 were: wealth index, the situation of living with biological parents, maternal height and presence of open sewage, whereas the factors associated with a high WHZ in the same year were: child’s age, mother’s time of residence in the location, mother’s body mass index. Conclusions: Overweight increase within this undernutrition scenario reveals that the process of nutritional transition began in this Amazonian city only in the last decade, and therefore, it is delayed when compared to overweight in other parts of Brazil. Such nutritional transition in Assis Brasil may have been facilitated by the construction of the Interoceanic Highway.