RESUMO
La seguridad alimentaria es cuando toda persona en todo momento tiene acceso económico y físico a suficientes alimentos inocuos y nutritivos para satisfacer sus necesidades alimentarias y preferencias en cuanto alimentos a fin de llevar una vida sana y activa. Por lo que el objetivo evaluar seguridad alimentaria y calidad de vida de la población vulnerable en la provincia Cusco, Perú. Para lo que se aplicó metodología con enfoque cuantitativo, con un diseño no experimental de corte transversal, basada en cuestionarios aplicados y entrevistas a una muestra de estudio (249 pobladores), la misma que previo a su aplicación superó las pruebas de validez y confiabilidad. Se realizó pruebas de frecuencia a los resultados de la opinión de los encuestados y correlación de Sperman's. Se evidencia que en un 65,9% la percepción de la población es que existe una inadecuada seguridad alimentaria, asimismo en un 85,1% que existe una mala calidad de vida, y desde una perspectiva estadística entre las citadas variables se obtuvo una significancia de 0,000 con un Rho de Sperman de 0,442, lo que demuestra la vulnerabilidad que se encuentra la población de Cusco. Concluyendo que entre las dos variables de estudio existe una relación directamente proporcional y de nivel moderado, denotando que en la media que se mejora los aspectos asociados a las dimensiones de la seguridad alimentaria, por consecuencia se tendría una mejora calidad de vida de la población de la provincia de Cusco, lo que evidencia que en la medida que se refuerce los aspectos asociados a la seguridad alimentaria, el bienestar físico y psicológico aspecto relacionado a la salud de dichas personas tendrá la oportunidad de mejorar.
Food security is when everyone at all times has economic and physical access to sufficient safe and nutritious food to meet their dietary needs and food preferences for a healthy and active life. Therefore, the objective is to evaluate food security and quality of life of the vulnerable population in the province of Cusco, Peru. For which a methodology with a quantitative approach was applied, with a non-experimental cross-sectional design, based on questionnaires applied and interviews to a study sample (249 residents), which, prior to its application, passed the validity and reliability tests. Frequency tests were carried out on the results of the respondents' opinion and Sperman's correlation. It is evident that in 65.9% the perception of the population is that there is inadequate food security, also in 85.1% that there is a poor quality of life, and from a statistical perspective, a significance was obtained between the aforementioned variables of 0.000 with a Sperman's Rho of 0.442, which demonstrates the vulnerability of the population of Cusco. Concluding that between the two study variables there is a directly proportional relationship and of a moderate level, denoting that on average the aspects associated with the dimensions of food security are improved, consequently there would be an improved quality of life for the population of the province of Cusco, which shows that to the extent that the aspects associated with food security are reinforced, the physical and psychological well-being, an aspect related to the health of these people, will have the opportunity to improve
A segurança alimentar é quando todos têm, em todos os momentos, acesso económico e físico a alimentos seguros e nutritivos suficientes para satisfazer as suas necessidades dietéticas e preferências alimentares para levar uma vida saudável e activa. Portanto, o objetivo é avaliar a segurança alimentar e a qualidade de vida da população vulnerável na província de Cusco, Peru. Para o qual foi aplicada uma metodologia de abordagem quantitativa, com desenho transversal não experimental, baseada na aplicação de questionários e entrevistas a uma amostra do estudo (249 residentes), que, antes da sua aplicação, passou em testes de validade e fiabilidade. Foram realizados testes de frequência sobre os resultados das opiniões dos entrevistados e correlação de Spearman. Evidencia-se que em 65,9% a percepção da população é que há segurança alimentar inadequada, também em 85,1% que há má qualidade de vida, e do ponto de vista estatístico obteve-se significância entre as variáveis citadas de 0,000, com um Speman Rho de 0,442, o que demonstra a vulnerabilidade da população de Cusco. Concluindo que entre as duas variáveis do estudo existe uma relação diretamente proporcional e moderada, denotando que em média os aspectos associados às dimensões da segurança alimentar são melhorados, consequentemente haveria uma melhoria na qualidade de vida da população do província de Cusco, o que mostra que à medida que se reforçam os aspectos associados à segurança alimentar, o bem-estar físico e psicológico, aspecto relacionado à saúde dessas pessoas, terá a oportunidade de melhorar
Assuntos
Abastecimento de AlimentosRESUMO
La seguridad alimentaria es "cuando toda persona en todo momento tiene acceso económico y físico a suficientes alimentos inocuos y nutritivos para satisfacer sus necesidades alimentarias y preferencias en cuanto alimentos a fin de llevar una vida sana y activa". Por lo que el objetivo evaluar seguridad alimentaria y calidad de vida de la población vulnerable en la provincia Cusco, Perú. Para lo que se aplicó metodología con enfoque cuantitativo, con un diseño no experimental de corte transversal, basada en cuestionarios aplicados y entrevistas a una muestra de estudio (249 pobladores), la misma que previo a su aplicación superó las pruebas de validez y confiabilidad. Se realizó pruebas de frecuencia a los resultados de la opinión de los encuestados y correlación de Sperman's. Se evidencia que en un 65,9% la percepción de la población es que existe una inadecuada seguridad alimentaria, asimismo en un 85,1% que existe una mala calidad de vida, y desde una perspectiva estadística entre las citadas variables se obtuvo una significancia de 0,000 con un Rho de Sperman de 0,442, lo que demuestra la vulnerabilidad que se encuentra la población de Cusco. Concluyendo que entre las dos variables de estudio existe una relación directamente proporcional y de nivel moderado, denotando que en la media que se mejora los aspectos asociados a las dimensiones de la seguridad alimentaria, por consecuencia se tendría una mejora calidad de vida de la población de la provincia de Cusco, lo que evidencia que en la medida que se refuerce los aspectos asociados a la seguridad alimentaria, el bienestar físico y psicológico aspecto relacionado a la salud de dichas personas tendrá la oportunidad de mejorar.
Food security is "when everyone at all times has economic and physical access to sufficient safe and nutritious food to meet their dietary needs and food preferences for a healthy and active life." Therefore, the objective is to evaluate food security and quality of life of the vulnerable population in the province of Cusco, Peru. For which a methodology with a quantitative approach was applied, with a non-experimental cross-sectional design, based on questionnaires applied and interviews to a study sample (249 residents), which, prior to its application, passed the validity and reliability tests. Frequency tests were carried out on the results of the respondents' opinion and Sperman's correlation. It is evident that in 65.9% the perception of the population is that there is inadequate food security, also in 85.1% that there is a poor quality of life, and from a statistical perspective, a significance was obtained between the aforementioned variables of 0.000 with a Sperman's Rho of 0.442, which demonstrates the vulnerability of the population of Cusco. Concluding that between the two study variables there is a directly proportional relationship and of a moderate level, denoting that on average the aspects associated with the dimensions of food security are improved, consequently there would be an improved quality of life for the population of the province of Cusco, which shows that to the extent that the aspects associated with food security are reinforced, the physical and psychological well-being, an aspect related to the health of these people, will have the opportunity to improve.
A segurança alimentar é "quando todos têm, em todos os momentos, acesso económico e físico a alimentos seguros e nutritivos suficientes para satisfazer as suas necessidades dietéticas e preferências alimentares para levar uma vida saudável e activa". Portanto, o objetivo é avaliar a segurança alimentar e a qualidade de vida da população vulnerável na província de Cusco, Peru. Para o qual foi aplicada uma metodologia de abordagem quantitativa, com desenho transversal não experimental, baseada na aplicação de questionários e entrevistas a uma amostra do estudo (249 residentes), que, antes da sua aplicação, passou em testes de validade e fiabilidade. Foram realizados testes de frequência sobre os resultados das opiniões dos entrevistados e correlação de Spearman. Evidencia-se que em 65,9% a percepção da população é que há segurança alimentar inadequada, também em 85,1% que há má qualidade de vida, e do ponto de vista estatístico obteve-se significância entre as variáveis citadas de 0,000, com um Speman Rho de 0,442, o que demonstra a vulnerabilidade da população de Cusco. Concluindo que entre as duas variáveis do estudo existe uma relação diretamente proporcional e moderada, denotando que em média os aspectos associados às dimensões da segurança alimentar são melhorados, consequentemente haveria uma melhoria na qualidade de vida da população do província de Cusco, o que mostra que à medida que se reforçam os aspectos associados à segurança alimentar, o bem-estar físico e psicológico, aspecto relacionado à saúde dessas pessoas, terá a oportunidade de melhorar.
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This study aimed to describe the prevalence of HTLV-1/2 in quilombola communities in the state of Pará and investigate the possible sociodemographic risk factors associated with the infection, as well as to trace the occurrence of the familial transmission of the virus. A total of 310 individuals living in eight quilombos located in the state of Pará (northern Brazil) were investigated for the presence of anti-HTLV-1/2 antibodies using an enzyme-linked immunosorbent assay (ELISA), and positive samples were confirmed using Western blot and/or real-time quantitative polymerase chain reaction (qPCR). Participants answered a questionnaire about sociodemographic aspects and risk factors for infection. Anti-HTLV-1/2 antibodies were detected in two individuals (one man and one woman), for an overall seroprevalence of 0.65%. Both individuals belonged to the community of São José de Icatú. The search for intrafamilial infection identified two other infected women, which increased the general prevalence of HTLV-1 among the Icatú to 6.25% (4/64). Western blot and qPCR confirmed their HTLV-1 infection, and phylogenetic analysis demonstrated that the isolates were of the cosmopolitan subtype and transcontinental subgroup. Epidemiological investigation of the cases revealed that the three women, at some point in their lives, had a relationship with the infected male individual. HTLV-1 is transmitted silently between individuals in the community of São José de Icatú with a present or past family relationship, stressing the need for screening and laboratory diagnosis to prevent further dissemination of the virus and surveillance of disease emergence.
Assuntos
Infecções por HTLV-I , Vírus Linfotrópico T Tipo 1 Humano , Filogenia , Humanos , Brasil/epidemiologia , Feminino , Masculino , Infecções por HTLV-I/epidemiologia , Infecções por HTLV-I/transmissão , Infecções por HTLV-I/virologia , Adulto , Vírus Linfotrópico T Tipo 1 Humano/genética , Vírus Linfotrópico T Tipo 1 Humano/isolamento & purificação , Vírus Linfotrópico T Tipo 1 Humano/classificação , Vírus Linfotrópico T Tipo 1 Humano/imunologia , Pessoa de Meia-Idade , Estudos Soroepidemiológicos , Adulto Jovem , Fatores de Risco , Prevalência , Adolescente , População Negra , Idoso , Vírus Linfotrópico T Tipo 2 Humano/genética , Vírus Linfotrópico T Tipo 2 Humano/isolamento & purificação , Vírus Linfotrópico T Tipo 2 Humano/imunologiaRESUMO
Introduction Congenital Syphilis (CS) is considered the second leading cause of preventable death in developing countries. The last report of the incidence rate of CS was made in 2017. Objective The objective of the study was to estimate the incidence of CS between 2019-2023. Materials and methods This is a retrospective study for which data were obtained from the new cases of CS reported in the Epidemiological Bulletin for 2019-2023 and from the newborn population records reported in the National Institute of Statistics and Geography and the National Population Council. Results In Mexico, the incidence rate of CS is 3.20 per 10,000 births. An increment of CS cases was observed between 2019-2023, with a higher number of cases in 2022. Conclusion A democratization of detection and prompt management is needed to reduce transmission, particularly among the most vulnerable population.
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OBJECTIVES: To understand how the perinatal care experiences among adolescents were impacted during the early years of the COVID-19 pandemic. STUDY DESIGN: Integrative review. METHODS: We performed a search in the literature focusing on qualitative studies regarding the perceptions of pregnant adolescents during the pandemic (2020-2023). We described the most frequent thematic axes observed in the included studies, and we synthesized the results. RESULTS: The selection involved 69 articles, resulting in 9 studies from 7 countries (Indonesia, Kenya, the United Kingdom, South Africa, the United States, Malawi, and India). The studies highlight six main thematic axes: 1. Economic impact: the pandemic adversely influenced personal and family conditions, leading to early marriages and violence and exacerbating pre-existing economic inequalities. 2. Mental health: increased anxiety, depression, isolation, and fear among pregnant adolescents, with a focus on concerns related to contamination and perinatal uncertainties. 3. Compromised perinatal care: restrictions during prenatal and delivery care and lack of emotional and professional support lead to negative impacts on care for pregnant adolescents. 4. Breakdown of family Support network: school closures, family losses, and increased domestic violence affected family dynamics, influencing the occurrence of early pregnancies. 5. Impact on sexual education: school closures hindered access to contraceptives, contributing to unplanned pregnancies. 6. Vaccine hesitancy: misinformation led to hesitancy among pregnant women, highlighting the need for better communication to increase confidence in vaccination. CONCLUSIONS: The review emphasizes the wide geographic variety of the studies and highlights the interconnection between economic, social, and mental health factors. The pandemic intensified preexisting challenges, underscoring the importance of comprehensive support for pregnant adolescents, including emotional and psychological support. The COVID-19 pandemic exacerbated social and economic inequalities, negatively impacting the perinatal experiences of pregnant adolescents. The emphasis is on the need for comprehensive support, considering psychosocial factors, highlights the importance of more inclusive and sensitive health policies addressing the specific needs of this group during public health crises. The identified thematic axes, spanning economic, mental health, perinatal care, family support networks, sexual education, and vaccine hesitancy, illuminate the intricate challenges faced by adolescents during the pandemic. The identification of these axes provided a comprehensive analysis of the diverse consequences experienced by adolescents during the COVID-19 pandemic. It also allows the proposition of tailored interventions to mitigate the adverse effects on adolescent well-being and inform public health strategies for future pandemics or crises.
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BACKGROUND: Cardiovascular disease (CVD) is one of the main causes of death and disability worldwide. The etiology of CVD is often associated with multiple risk factors, with environmental factors receiving considerable attention. Individuals with precarious jobs are among the groups most affected by chronic exposure to environmental pollutants. AIM: This study aimed to evaluate occupational exposure to heavy metals among individuals in precarious job settings and investigate atherogenic indices as biomarkers of cardiovascular risk. METHODS: A total of 137 workers participated in this cross-sectional study conducted in three work environments in San Luis Potosi, Mexico. Urine and blood samples were collected to assess metal exposure and biochemical profiles, including atherogenic indices. RESULTS: The results showed that workers in the brick sector exhibited the highest levels of metal exposure, particularly arsenic (44.06 µg/L), followed by stonecutters and garbage collectors (24.7 and 16.9 µg/L, respectively). Similarly, Castelli risk index (CRI) and the atherogenic index of plasma (AIP) were higher in brickmakers (3.883 and 0.499) compared to stonecutters (3.285 and 0.386) and garbage collectors (3.329 and 0.367). CONCLUSIONS: Evidence of exposure to heavy metals was observed in the three populations, in addition to the fact that individuals with greater exposure to arsenic also exhibited higher CRI and AIP.
Assuntos
Arsênio , Aterosclerose , Doenças Cardiovasculares , Metais Pesados , Humanos , Arsênio/toxicidade , Arsênio/urina , México/epidemiologia , Estudos Transversais , Metais Pesados/análise , Metais Pesados/urina , Doenças Cardiovasculares/epidemiologia , Doenças Cardiovasculares/etiologia , BiomarcadoresRESUMO
Introduction: Sexually transmitted infections (STIs) present significant global and national health challenges, particularly in India. Objective: To estimate the prevalence and characteristics of STIs among attendees at the Suraksha Clinic in the Apex Regional STD Centre, Safdarjung Hospital. Methods:Retrospective data from January 2018 to December 2022 were statistically analyzed using Excel and SPSS. The study included the examination for diagnosis of various STIs, such as syphilis, human immunodeficiency virus (HIV), gonorrhoea, chlamydiasis, trichomoniasis, candidiasis, bacterial vaginosis, chancroid, and genital herpes. Gender distribution and syndromic diagnoses, including vaginal/cervical discharge and genital ulcers, were also considered. Referrals to Integrated Counseling and Testing Centres for HIV testing were analyzed. Results: The outcomes reveal a substantial burden of STIs, with 3.06% showing reactivity to syphilis, 1.74% testing positive for HIV, 3.36% for gonorrhoea, 11.78% for chlamydiasis, 1.05% for trichomoniasis, 26.24% for candidiasis, 9.97% for bacterial vaginosis, 7.80% for chancroid, 11.64% for herpes genitalis, and 4.01% for other non-STIs. Attendees' interactions included 34.36% of referrals to Integrated Counseling and Testing Centres for HIV testing. The gender distribution showed 58.92% male and 40.94% female attendees. Conclusion: Syndromic diagnoses, including vaginal/cervical discharge (21.22%) and genital warts (8.00%), highlight prevalent conditions, necessitating routine screening, early detection, and targeted interventions for effective disease control and prevention. These findings underscore the significance of integrated screening, patient education, and proactive strategies to safeguard public health in the face of rising STI rates. (AU)
Introdução: As infecções sexualmente transmissíveis (IST) apresentam desafios de saúde globais e nacionais significativos, particularmente na Índia. Objetivo: Estimar a prevalência e as características das IST entre os pacientes atendidos na Clínica Suraksha do Centro Regional de doenças sexualmente transmissíveis (DST) Apex, Hospital Safdarjung. Métodos: Dados retrospectivos de janeiro de 2018 a dezembro de 2022 foram analisados estatisticamente utilizando Excel e Statistical Package for the Social Sciences (SPSS). O estudo inclui o exame para diagnóstico de diversas IST, como sífilis, HIV, gonorreia, clamídia, tricomoníase, candidíase, vaginose bacteriana, cancroide e herpes genital. A distribuição por gênero e os diagnósticos sindrômicos, incluindo corrimento vaginal/cervical e úlceras genitais, também foram considerados. Foram analisados encaminhamentos para Centros Integrados de Aconselhamento e Testagem para testagem de HIV. Resultados: Os resultados revelam uma carga substancial de IST, com 3,06% apresentando reatividade à sífilis, 1,74% testando positivo para HIV, 3,36% para gonorreia, 11,78% para clamídia, 1,05% para tricomoníase, 26,24% para candidíase, 9,97% para vaginose bacteriana, 7,80% para cancroide, 11,64% para herpes genital e 4,01% para outras infecções não IST. As interações dos participantes incluíram 34,36% de encaminhamentos para Centros Integrados de Aconselhamento e Testagem para testes de HIV. A distribuição por gênero mostrou 58,92% de participantes do sexo masculino e 40,94% do sexo feminino. Conclusão: Os diagnósticos sindrômicos, incluindo corrimento vaginal/cervical (21,22%) e verrugas genitais (8,00%), destacam condições prevalentes, necessitando de exames de rotina, detecção precoce e intervenções direcionadas para controle e prevenção eficazes de doenças. Estas conclusões sublinham a importância do rastreio integrado, da educação dos pacientes e de estratégias proativas para salvaguardar a saúde pública diante do aumento das taxas de IST. (AU)
Assuntos
Humanos , Masculino , Feminino , Infecções Sexualmente Transmissíveis , Sífilis , Educação de Pacientes como Assunto , Epidemiologia , HIVRESUMO
Introducción: El nuevo coronavirus comenzó en Wuhan, China, a fines de 2019 y se ha diseminado con rapidez por todo el mundo. Objetivo: Caracterizar el comportamiento de la COVID-19 en el Policlínico Ángel Machaco Ameijeiras de la semana estadística 11 a la 34, 2020. Métodos: Se realizó un estudio descriptivo, de corte transversal, con el universo fueron los casos atendidos Se utilizó el Programa EPIDAT 3.1, las variables definidas permitieron la creación una base de datos en Excel. Resultados: Se confirmaron 16 casos desde el inicio de la pandemia, todos son cubanos, con una fuente de infección conocida, La tasa de incidencia acumulada es de 4,6 POR 10 000 habitantes, predominaron los pacientes asintomáticos, las edades de 21 a 39 años y de 40 a 59 años, en el consejo popular Debeche Nalón predominaron los casos en el mes de abril y reaparecieron en julio y agosto. Conclusiones: Se confirmaron un 20,2 por ciento de los casos sospechosos de COVID-19, predominaron los casos en el consejo popular Debeche Nalón y el grupo de edades de 21 a 39 años. No se evidenciaron diferencias relacionadas con el sexo. Todos los casos tenían fuente de infección conocida, sobre todo los centros de trabajo. Al momento del ingreso la mayoría era asintomático. Las infecciones respiratorias agudas se encuentran en zona de éxito durante la etapa analizada y su tendencia era descendente, así como la tendencia de la COVID-19 ligeramente ascendente(AU)
Introduction: The new coronavirus began in Wuhan, China, in late 2019 and has spread rapidly throughout the world. Objective: To characterize the behavior of COVID-19 at Ángel Machaco Ameijeiras Polyclinic from statistical week 11 to 34, 2020. Methods: A descriptive, cross-sectional study was carried out in the universe made up of the cases assisted. EPIDAT 3.1 Program was used, the defined variables allowed the creation of a database in Excel. Results: Sixteen cases have been confirmed since the beginning of the pandemic, all are Cuban, with a known source of infection. The cumulative incidence rate is 4.6 per 10,000 inhabitants, asymptomatic patients, ages 21 to 39 years and 40 to 59 years predominated. In Debeche Nalón community, cases prevailed in the month of April and reappeared in July and August. Conclusions: 20.2percent of suspected COVID-19 cases were confirmed. No differences related to sex were evident. All cases had a known source of infection, especially those in workplaces. At the time of admission, the majority were asymptomatic. Acute respiratory infections are in the success zone during the stage analyzed and their trend was downward, while the trend of COVID-19 was slightly upward(AU)
Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Populações Vulneráveis , COVID-19/prevenção & controle , COVID-19/epidemiologiaRESUMO
Background: Despite significant progress in the areas of prevention, diagnosis, and treatment, HIV continues to result in a substantial number of fatalities on a global scale each year. Gaining insights from epidemiological data can prove instrumental in the development of health promotion strategies, particularly within vulnerable populations, such as indigenous groups. Consequently, our study aimed to investigate the prevalence of HIV infection within the indigenous population residing in the second-largest region of Brazil. Additionally, we sought to explore the subtypes of HIV-1 and detect any drug-resistance mutations present within this population. Methods: In this cross-sectional study, we aimed to evaluate the prevalence of HIV-1 infection and explore its associated characteristics within the indigenous population residing in the villages of Jaguapiru and Bororó, located in the Dourados area of Mato Grosso do Sul (MS), Brazil. Blood samples were collected for rapid HIV screening, serological tests, nucleic acid amplification, and HIV subtyping. Additionally, the HIV-1 viral load and CD4+ T lymphocyte count of the people living with HIV (PLHIV) were assessed at the time of recruitment and 24 weeks later. Findings: Out of the 2190 invited individuals, 1927 (88%) were included in this study. The average age of the participants was 34.2 (±13.8) years, with a majority of 74% being female. Moreover, 68.44% of the participants identified themselves as belonging to the Guarani-Kaiowa ethnic group. HIV seroprevalence was 0.93% (18/1927), and 73.22% (1411/1927) were unaware of their serological status. The prevalence of HIV-1 was higher in single indigenous people [10/617 (1.62%)], who received government benefits [14/1021 (1.37%)], had less than five years of formal education [11/685 (1.61%)], had sexual intercourse with users of injectable drugs [2/21 (9.52%)], with history of sexually transmitted infections (STIs) [10/62 (16.2%)] and incarceration [3/62 (4.84%)]. Of 18 positive samples, 44.4% (8/18) were successfully amplified, and HIV-1 subtype C was prevalent. Furthermore, we identified HIV-1 drug resistance mutations in four patients, specifically from the classes of Protease Inhibitor, Nucleoside Reverse Transcriptase Inhibitor, and Non-Nucleoside Reverse Transcriptase Inhibitor. Notably, three of these patients exhibited a high viral load even after 24 weeks of undergoing antiretroviral therapy. Out of the 18 PLHIV, 66.66% (12/18) had a viral load below 1000 copies/mL, while 50% (9/18) had a CD4+ T lymphocytes count greater than 350 cells/mL after 24 weeks of treatment. Interpretation: Despite the concerted efforts to control HIV infection, the prevalence observed in the indigenous population under study surpassed that reported in other Brazilian indigenous groups. This disparity highlights the disproportionate impact of the disease on this particular group. The detection of drug-resistance mutations further emphasizes the critical need to expand diagnostic coverage, closely monitor treatment strategies, and maintain ongoing molecular surveillance. These measures are imperative for enhancing HIV management within this vulnerable population. Funding: This study was partially funded by Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq), Fundação de Apoio ao Desenvolvimento do Ensino, Ciência e Tecnologia do Estado de Mato Grosso do Sul (FUNDECT), Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES), Secretaria do Estado de Saúde (SES) of Governo do Estado de Mato Grosso do Sul, and Universidade Federal da Grande Dourados (UFGD).
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Introduction: Human T-lymphotropic virus 2 (HTLV-2) has been described for more than 30 years as an endemic infection in Brazilian indigenous populations, with its occurrence varying by age and sex, maintained mainly by sexual intercourse and mother-to-child transmission, favoring intrafamilial aggregation. Methods: The epidemiological scenario of HTLV-2 infection has been described among communities of the Amazon region of Brazil (ARB), with the number of retrospective positive blood samples increasing for more than 50 years. Results: Five publications were selected that showed the presence of HTLV-2 in 24 of 41 communities; the prevalence of infection was described among 5,429 individuals at five points in time. Among the Kayapó villages, the prevalence rates were described according to age and sex and reached up to 41.2%. Three communities (Asurini, Araweté, and Kaapor) were kept virus free for 27 to 38 years of surveillance. Low, medium and high prevalence levels of infection were defined, and two pockets of high endemicity were shown in the state of Pará, pointing to the Kikretum and Kubenkokrê Kayapó villages as the epicenter of HTLV-2 in the ARB. Discussion: The prevalence rates over the years have shown a decline among the Kayapó (from 37.8 to 18.4%) and an apparent change to a higher prevalence among females, but not during the first decade of life, usually associated with transmission from mother to child. Sociocultural and behavioral aspects, as well as public health policies directed toward sexually transmitted infections, might have positively influenced the decline in HTLV-2 infections.
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Leptospirosis and toxoplasmosis are zoonoses of occupational character that are spread worldwide, mainly in tropical and socioeconomically vulnerable areas. Both diseases have vertebrate hosts, which spread the infectious agent to the environment and are potentially infectious to humans and can progress to fatal cases. The present study reinforces the importance of One Health for the control and prophylaxis of leptospirosis and toxoplasmosis using sentinel animals in areas of socioeconomic vulnerability based on a serological study. A total of 336 blood samples were obtained from the canine population of the urban district, which has high rates of poverty and sanitation. The results were analyzed based on seroreactivity animals and georeferencing by kernel spatial mapping. A total of 43.3% (52/120) of the animals were seroreagents for anti-Leptospira spp., with a predominance of Canicola (35/52 = 67.3%) and Pyrogenes (5/52 = 9.6%), while 52.97% (178/336) of the dogs were seroreactive for anti-Toxoplasma gondii. The presence of seroreagent dogs for both zoonosis alert to the inadequate hygienic-sanitary conditions of the studied region, and highlight the importance of a survey of the social, economic and environmental structure to identify factors related to the links in the epidemiological chain of pathogen transmission and necessary corrective actions.
Leptospirose e toxoplasmose são zoonoses de caráter ocupacional disseminadas mundialmente, principalmente em áreas tropicais e socioeconomicamente vulneráveis. Ambas as doenças têm hospedeiros vertebrados, que espalham o agente infeccioso para o meio ambiente e são potencialmente infecciosos para o homem, as quais podem evoluir para casos fatais. O presente estudo reforça a importância da saúde única para o controle e a profilaxia da leptospirose e da toxoplasmose, mediante a utilização de animais sentinela em áreas de vulnerabilidade socioeconômica, com base em estudo sorológico. Um total de 336 amostras de sangue foi obtido da população canina de um distrito urbano que apresenta altos índices de pobreza e ausência de saneamento básico. Os resultados foram analisados com base em animais sororreagentes e georreferenciados por mapeamento espacial de Kernel. Um total de 43,3% (52/120) dos animais foi sororreagente para anti-Leptospira spp., com predominância de Canicola (35/52 = 67,3%) e Pirogenes (5/52 = 9,6%), enquanto 52,97% (178/336) dos cães foram sororreagentes para anti-Toxoplasma gondii. A presença de cães sororreagentes para ambas as doenças alerta para as condições higiênico-sanitárias inadequadas da região estudada e evidencia a importância de um levantamento da estrutura social, econômica e ambiental para identificar fatores relacionados aos elos da cadeia epidemiológica de transmissão do patógeno e ações corretivas necessárias.
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Animais , Cães , Toxoplasma , Zoonoses , Toxoplasmose Animal , Doenças do Cão , LeptospiroseRESUMO
Genomics can reveal essential features about the demographic evolution of a population that may not be apparent from historical elements. In recent years, there has been a significant increase in the number of studies applying genomic epidemiological approaches to understand the genetic structure and diversity of human populations in the context of demographic history and for implementing precision medicine. These efforts have traditionally been applied predominantly to populations of European origin. More recently, initiatives in the United States and Africa are including more diverse populations, establishing new horizons for research in human populations with African and/or Native ancestries. Still, even in the most recent projects, the under-representation of genomic data from Latin America and the Caribbean (LAC) is remarkable. In addition, because the region presents the most recent global miscegenation, genomics data from LAC may add relevant information to understand population admixture better. Admixture in LAC started during the colonial period, in the 15th century, with intense miscegenation between European settlers, mainly from Portugal and Spain, with local indigenous and sub-Saharan Africans brought through the slave trade. Since, there are descendants of formerly enslaved and Native American populations in the LAC territory; they are considered vulnerable populations because of their history and current living conditions. In this context, studying LAC Native American and African descendant populations is important for several reasons. First, studying human populations from different origins makes it possible to understand the diversity of the human genome better. Second, it also has an immediate application to these populations, such as empowering communities with the knowledge of their ancestral origins. Furthermore, because knowledge of the population genomic structure is an essential requirement for implementing genomic medicine and precision health practices, population genomics studies may ensure that these communities have access to genomic information for risk assessment, prevention, and the delivery of optimized treatment; thus, helping to reduce inequalities in the Western Hemisphere. Hoping to set the stage for future studies, we review different aspects related to genetic and genomic research in vulnerable populations from LAC countries.
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Blood spotted onto filter paper can be easily collected outside healthcare facilities and shipped to a central laboratory for serological testing. However, dried blood testing generally requires manual processing for pre-analytical steps. In this study, we used a standardized blood collection device combined with an automated elution system to test illegal gold miners living in French Guiana for human immunodeficiency virus (HIV), hepatitis B virus (HBV), hepatitis C virus (HCV) and syphilis. We included 378 participants, 102 females and 266 males, in three illegal gold mining resting sites. Blood collected on the Ser-Col device (Labonovum) was eluted using an automated system (SCAUT Ser-Col automation, Blok System Supply) and an automated analyzer (Alinity i, Abbott). Ser-Col results were compared to both plasma results, considered the gold standard, and to Dried blood Spot (DBS) results, considered the reference sampling method using dried blood. In plasma samples, two participants (0.5%) tested positive for HIV, six (1.5%) tested positive for hepatitis B surface antigen (HBsAg), eight were weakly positive for anti-HCV antibodies but negative for HCV RNA, and 47 tested positive for treponemal antibodies (12.4%), including 20 females (19.6%) and 27 males (9.8%, p= 0.010179). We observed a full concordance of Ser-Col and DBS results for HIV diagnosis compared to plasma results. Ser-Col and DBS samples tested positive in five HBsAg carriers and negative for one participant with a low HBsAg level in plasma (0.5 IU/mL). All participants tested negative for HCV in Ser-Col and DBS samples, including the eight participants who tested low positive for HCV antibodies and HCV RNA negative in plasma. Among syphilis seropositive participants, 41 (87.2%) and 40 (85.1%) tested positive for treponemal antibodies in Ser-Col and DBS samples, respectively. The Ser-Col method allows automated dried blood testing of HIV, HBV, HCV and syphilis with performances comparable to DBS. Automated approaches to test capillary blood transported on dried blood devices may facilitate large-scale surveys and improve testing of populations living in remote areas.
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Infecções por HIV , Hepatite B , Hepatite C , Sífilis , Masculino , Feminino , Humanos , Hepacivirus , Vírus da Hepatite B/genética , HIV/genética , Antígenos de Superfície da Hepatite B , Sífilis/diagnóstico , Sífilis/epidemiologia , Guiana Francesa , Infecções por HIV/diagnóstico , Hepatite C/diagnóstico , Hepatite C/epidemiologia , RNA , Hepatite B/diagnóstico , Teste em Amostras de Sangue Seco/métodosRESUMO
Environmental pollutants are involved in the development and progression of numerous cancers, including cervical cancer (CC). One possible explanation for this is the ability of several pollutants to mimic natural hormones. This study aimed to evaluate the urinary concentrations of monoesters of phthalates and bisphenol A (BPA) in women with CC. A total of 45 women were included: 15 in the control group, 12 with CC diagnosis classified in early stages IA-IIB, and 18 in late stages III-IV. Urine samples were analyzed for BPA, mono-isobutyl phthalate (MiBP), mono-n-butyl phthalate (MBP), monobenzyl phthalate (MBzP), and mono 2-ethylhexyl phthalate (MEHP) using high-performance liquid chromatography coupled to a tandem mass detector. The detection rate of environmental pollutants was 100%, with a median concentration in the control group and early-, and late-stage groups of 10.4, 9.2, 4.3, 38.4, and 12.9 µg L-1; 3.1, 3.1, 151.1, 54.5, and 30.4 µg L-1 and 1.9, 92.8, 3.6, 31.0, and 9.3 µg L-1 for BPA, MEHP, MBzP, MBP, and MiBP, respectively This study reveals high levels of phthalates, particularly MEHP, in urine samples of women with CC associated with human papillomavirus (HPV) infection. Further studies are needed to evaluate the possible role of phthalates in synergy with HPV in progression to CC.
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Poluentes Ambientais , Infecções por Papillomavirus , Ácidos Ftálicos , Neoplasias do Colo do Útero , Humanos , Feminino , Ácidos Ftálicos/metabolismo , Poluentes Ambientais/metabolismo , Exposição Ambiental/análiseRESUMO
Introdução: A tuberculose (TB) é considerada uma doença bem desafiadora para o sistema de saúde no Brasil, devido ao número elevado de casos nas últimas décadas. Contudo, com a pandemia da COVID-19, foi observada uma redução significativa de casos de TB. Objetivo: O objetivo desse trabalho foi avaliar o comportamento da TB nas macrorregionais de saúde do estado do Paraná, bem como nas populações vulneráveis nos anos de 2011 a 2021, e sua associação com a ocorrências de casos de COVID-19 a partir de 2020. Metodologia: Trata-se de um estudo ecológico, com dados secundários de TB do Sistema de Informação de Agravos de Notificação (SINAN) e de COVID-19 no banco de dados público oficial da Secretaria de Estado da Saúde do Paraná (SESA) para o coronavírus. Principais resultados: Foi observada diferenças significativas de ocorrência de casos de TB entre as macrorregionais relacionadas à faixa etária da população e entre os períodos pré-pandêmico e pandêmico no Paraná. Os dados obtidos apontam também para uma associação significativa de casos de TB em populações em situação de rua, privadas de liberdade e portadores do vírus da imunodeficiência humana (HIV) no estado ao longo dos anos observados. Conclusão: As notificações de TB no estado do Paraná foram afetadas pela pandemia da COVID-19.
Introduction: Tuberculosis (TB) is considered a very challenging disease for the health system in Brazil, due to the high number of cases in recent decades. However, with the COVID-19 pandemic, a significant reduction in TB cases was observed. Objective: The objective of this study was to evaluate the behavior of TB in the macro-regional health regions of the state of Paraná, as well as in vulnerable populations in the years 2011 to 2021 and the association with the occurrence of COVID-19 cases from 2020. Methodology: Its an ecological study with secondary tuberculosis data from SINAN and data COVID-19 in the official public database of the Paraná State Health Department (SESA). Results: Results show significant differences of TB cases among the macro-regions related to the age group of the population and between the pre-pandemic and pandemic periods. A significant association of TB cases was also observed for the homeless, deprived of liberty and HIV-positive populations in the state over the years observed. Conclusion: TB notifications in the state of Paraná were affected by the COVID-19 pandemic.
Introducción: La tuberculosis (TB) es considerada una enfermedad muy desafiadora para el sistema de salud en Brasil, debido al elevado número de casos en las últimas décadas. Sin embargo, con la pandemia de COVID-19, se observó una reducción significativa de los casos de TB. Objetivo: El objetivo de este estudio fue evaluar el comportamiento de la TB en las macro regiones sanitarias del estado de Paraná, así como en poblaciones vulnerables en los años 2011 a 2021 y la asociación con la ocurrencia de casos de COVID-19 a partir de 2020. Metodología: Es un estudio ecológico con datos secundarios de tuberculosis del SINAN y datos COVID-19 en la base de datos pública oficial de la Secretaría de Salud del Estado de Paraná (SESA). Resultados: Los resultados muestran diferencias significativas de casos de TB entre las macrorregiones relacionadas con el grupo de edad de la población y entre los períodos prepandémico y pandémico. También se observó una asociación significativa de casos de TB para la población sin hogar, privada de libertad y seropositiva al VIH en el estado a lo largo de los años observados. Conclusiones: Las notificaciones de TB en el estado de Paraná fueron afectadas por la pandemia de COVID-19.
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ABSTRACT Objective: To describe the implementation of a compassionate community in Rocinha and Vidigal slums, located in the city of Rio de Janeiro. Method: Report on the experience of implementing a Compassionate Community based on the World Health Organization conceptual bases, supported by university extension guidelines. Results: Initially, local leaders and residents were recruited and trained in palliative care. Subsequently, health professionals from different specialties engaged in the project through volunteering. Home visits were instituted in the form of interconsultation and "sponsorships" by residents and health professionals to people in palliative care and family members. Finally, the health care network in the territory was integrated in order to recognize the project as a support network. Conclusion: We highlight the experience as living work in health, which involves relationships and creative processes, which mobilize structured technical knowledge and relationships between people and soft-hard and soft technologies, making it possible to recognize powers in the territory.
RESUMEN Objetivo: Describir la implementación de una comunidad compasiva en las favelas de Rocinha y Vidigal, ubicadas en la ciudad de Río de Janeiro. Método: Relato de la experiencia de implementación de una Comunidad Compasiva a partir de las bases conceptuales de la Organización Mundial de la Salud, sustentada en lineamientos de extensión universitaria. Resultados: Inicialmente, se reclutaron y capacitaron a líderes locales y residentes en cuidados paliativos. Posteriormente, profesionales de la salud de diferentes especialidades se involucraron en el proyecto a través del voluntariado. Se instituyeron visitas domiciliarias en la modalidad de interconsulta y "patrocinios" por parte de residentes y profesionales de salud a personas en cuidados paliativos y familiares. Finalmente, se integró la Red de Atención a la Salud del territorio para reconocer el proyecto como una red de apoyo. Conclusión: Destacamos la experiencia como trabajo vivo en salud, que involucra relaciones y procesos creativos, que movilizan saberes técnicos estructurados y relaciones entre personas y tecnologías ligeras-duras y ligeras, posibilitando el reconocimiento de poderes en el territorio.
RESUMO Objetivo: Descrever a implementação de uma comunidade compassiva nas favelas da Rocinha e Vidigal, localizadas na cidade do Rio de Janeiro. Método: Relato da experiência da implementação de uma Comunidade Compassiva a partir das bases conceituais da Organização Mundial da Saúde, amparada pelas diretrizes da extensão universitária. Resultados: Inicialmente, lideranças locais e moradores foram recrutados e receberam treinamento sobre cuidados paliativos. Posteriormente, profissionais de saúde de diferentes especialidades engajaram-se no projeto por meio da prática do voluntariado. Foram instituídas visitas domiciliares na modalidade interconsulta e "apadrinhamentos" por moradores e profissionais de saúde às pessoas em cuidados paliativos e familiares. Por fim, a Rede de Atenção à Saúde do território foi integrada de forma a reconhecer o projeto como rede de apoio. Conclusão: Destacamos a experiência como trabalho vivo em saúde, que envolve relações e processos criativos, os quais mobilizam o saber técnico estruturado e as relações entre as pessoas e as tecnologias leve-duras e leves, tornando factível o reconhecimento de potências no território.
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Cuidados Paliativos , Modelos de Assistência à Saúde , Visita Domiciliar , Pessoal de Saúde , Populações VulneráveisRESUMO
Resumen El COVID-19 ha visibilizado las inequidades sistémicas, multiplicado las condiciones de vulnerabilidad y descubierto la incapacidad de numerosas instituciones públicas para responder a la pandemia. El objetivo del presente trabajo fue analizar y contextualizar la gestión de la crisis sanitaria en Cuba, así como la atención a grupos vulnerables durante el primer año de la pandemia. La investigación se sustenta en un enfoque mixto que combina el análisis cualitativo de contenido con el de datos estadísticos procedentes de fuentes primarias y secundarias. Los hallazgos revelaron que más de la mitad de la población cubana es vulnerable ante COVID-19 por factores como edad, género, raza, salud física, condiciones del hogar y limitaciones para acceder a derechos básicos asociados a alimentación de calidad, vivienda digna y servicios de agua potable. Las estadísticas epidemiológicas recabadas entre marzo de 2020 y marzo de 2021 muestran una gestión de la crisis sanitaria adecuada a partir de la articulación gubernamental con la gestión científica y tecnológica y la infraestructura de salud pública y universal. Sin embargo, existen estrategias contradictorias en la atención a la población en riesgo, que profundizan desigualdades previamente existentes y dinamizan y amplían la condición de vulnerabilidad. COVID-19 constituye una ventana de oportunidad para pensar estrategias de desarrollo desde un modelo de política social integral.
Abstract COVID-19 has made visible systemic inequities, multiplied vulnerability conditions, and uncovered the lack of capacity of numerous public institutions to respond to the pandemic. The paper aims to analyze and contextualize the health crisis management, as well as vulnerable groups' care in Cuba during the first year of the pandemic. For this purpose, a mixed approach was selected, which combines qualitative content analysis with statistical data obtained from primary and secondary sources. Findings revealed that more than half of the Cuban population is vulnerable to COVID-19 due to factors such as age, gender, race, physical health, living conditions, and limitations to access to basic rights associated to quality food, dignified housing, and potable water rights. Epidemiological statistics collected between March 2020 and March 2021, show an adequate management of the sanitary contingency based on the coordination of governmental structures with scientific and technological sectors and public and universal health infrastructure. However, there are contradictory strategies in caring for vulnerable populations that deepen previously existing inequalities and dynamize and extend vulnerability conditions. COVID-19 constitutes a window of opportunity to rethink country development strategies from a comprehensive social policy model.
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From 2019 to 2020, the Mexican economy declined for two consecutive years, especially in the last one when it was hit by a decline of 8.4% before the COVID-19 pandemic impacts which was not only one of the worst in the OECD club, but also the deepest economic recession since 1932 in the national history. At the same time, both the number of people in poverty and poverty rate in 2020 have increased compared with those registered in 2018. Through the analysis, we can find that the current Mexican government has increased the intensity and scope of the implementation of social relief policies adhered to the principal of "for the good of all, first the poor (Por el bien de todos, Primero los pobres)." However, in the context of recession caused by the COVID-19, neither the general decrease in residents' income could be avoided, nor the number of people in poverty has been reduced. Besides, in accordance with the benefits obtained by the distinct household deciles based on the income and expenditure survey published by INEGI, it showed that the implementation of government relief measures has relatively reduced the support for the low-income people and further aggravated the deterioration of poverty due to its indifferent application with respect to high-income households and the low-income ones. Therefore, the deficiencies in the response implemented in the face of the epidemic, especially poverty alleviation actions and social relief policies, have further enhanced the poverty problem at least partially. In this sense, recover and improve the economic growth rate as soon as possible will not enough to reduce the poverty, and it should be accompanied by the necessary adjustments in the poverty alleviation measures and social relief policies, especially with a focalized approach inclined to the low-income segments of the population.
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COVID-19 , Humanos , COVID-19/epidemiologia , COVID-19/prevenção & controle , Fatores Socioeconômicos , Pandemias/prevenção & controle , Pobreza , Política PúblicaRESUMO
Higher rates of human immunodeficiency virus (HIV) infection have been detected in prisoners when compared with the general population, but research into HIV molecular epidemiology and its transmission network has been lacking among them. Thus, this study aimed to verify potential HIV molecular transmission networks among prisoners. In addition, we aimed to describe the mutations related to antiretroviral resistance in these isolates. Thus, we conducted a cross-sectional survey from 2013 to 2018 in prisons in Central-Western Brazil, and the final sampling composed of 84 prisoners. Proviral DNA was extracted from each whole blood sample followed by amplification of the partial polymerase gene and sequencing. Forty-nine sequences (58.3%) were classified as subtype B, followed by C (14.3%), D, and F1 (2.4% each). A complex and dynamic HIV-1 epidemic is observed in the prisons, as 25% of the sequences were recombinant forms. We detected 15 HIV transmission clusters composed of at least two sequences, that included not only prisoners but also individuals from the general population from the same State with a variety of risk behaviors. Thirty-two percent (32.0%) of treatment-experienced prisoners had at least one drug resistance mutation (DRM), while transmitted DRMs were found in 5.9% of the prisoners. We highlight the urgent need for routine surveillance of HIV-1 infection including resistance genotypic tests considering the high disease burden, risky behaviors inside prisons, and the dynamic relationship of prisoners with the outside community.
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Infecções por HIV , HIV-1 , Prisioneiros , Brasil/epidemiologia , Estudos Transversais , HIV-1/genética , Humanos , Epidemiologia MolecularRESUMO
Human T-lymphotropic viruses 1 and 2 (HTLV-1 and HTLV-2) are retroviruses that originated on the African continent and dispersed throughout other continents through human migratory flows. This study describes the prevalence of HTLV-1 and HTLV-2 infection in residents of 11 quilombo remnant communities in the state of Pará, Brazil, and the associated risk factors. A total of 859 individuals (334 men and 525 women), aged between 7 and 91 years, participated in the study. All subjects answered a questionnaire with questions on sociodemographic characteristics and on risk factors associated with HTLV infection, and blood samples were collected and separated into plasma and leukocytes. An immunoenzymatic assay (ELISA; Murex HTLV-I+II, DiaSorin, Dartford, UK) was used as a screening test, and positive samples were subjected to line immunoassay confirmatory tests (Inno-LIA HTLV I/II Score FUJIREBIO) and DNA extraction for subsequent real-time PCR to differentiate the viral type. Four of the 859 individuals were seropositive for HTLV. HTLV-1 infection was confirmed in one individual from the Itamoari community (0.92%), and HTLV-2 infection was confirmed in two individuals from São Benedito (3.17%) and in one individual from Arimandeua (2.22%). Blood transfusion was the only risk factor associated with HTLV infection in this study. This study reports the occurrence of HTLV-1 and HTLV-2 in quilombo remnant communities in the state of Pará. Considering the African origin of the virus and its introduction into Brazil from the slave trade, the continued evaluation of quilombola communities in the state of Pará is essential to better characterize the distribution of infections in these populations and to create public health policies for the control of the spread of the virus and associated diseases.