Systematic review of temporal trends of congenital syphilis in Brazil

The present study was aimed to retrieve and analyse the temporal trends of congenital syphilis (CS) in Brazil, as well as to list its main associated factors. Methods: In August 2019 a systematic review was developed in four electronic databases (Lilacs, Pubmed, Scielo and Web of Science) and in manual searches on reference lists. It was established that the synthesis of this review would be composed by ecological studies with CS temporal trends in the Brazilian territory, regardless of the population characteristics and data representativeness. More specifically, it was also established that the prevalence of CS of the first and last year of the time series would be presented in the descriptive synthesis. Results: Of the 2,157 initial studies, 14 adequately met the inclusion criteria and composed the synthesis. Twelve (85.7%) of these studies showed increases in time trends, with particular emphasis on the two nationwide studies, which showed positive trends between 2003–2008 (0.4) and 2010–2015 (3.7). Associations were found between CS and socioeconomic and ethnic factors, especially in the groups of women with low income, low education, brown / black skin colour and who had untreated partners. Conclusion: most of the available research showed an increase in the temporal trends of CS, highlighting that these data were observed at the national, state and municipal levels. Since mothers socioeconomic and ethnic factors are associated with higher CS frequencies, efforts are needed to increase the coverage of the Unified Health System to vulnerable women.

Frequency of food ingestion as a potential contributing of anemia in children and adolescent with malaria by P. vivax

Background and Objective: Nutrition, in addition to its physiological function, plays an important role in the recovery of individuals with malaria, a disease that still represents a serious public health problem in the world. The objective of this article is to evaluate the frequency of food intake and the occurrence of anemia in children and adolescent with vivax malaria. Methods: A cross-sectional analytical study was carried out between 2014 and 2015 in the Marajo island. The hemoglobin level was measured by the colorimetric enzymatic reaction and a questionnaire of food intake frequency was used to assess the consumption of foods. Results: A total of 67 patients met the criteria for the inclusion in the study, of which 62.7% were children. There is a high consumption of ultra-processed foods in both age groups. Anemia occurred in 52.2% of patients, and in most of them, it was moderate. There was no significant association between gender, age range, parasitemia at admission with anemia, but a significant association was found between anemia and the ingestion of ultra-processed foods. Conclusion: The ingestion of ultra-processed foods contributes to anemia in children and adolescent with malaria.

Molecular epidemiology of carbapenem-resistant Acinetobacter baumannii from Southern Brazil

Carbapenem resistance in Acinetobacter baumannii has reached extremely high levels worldwide and class D OXA-type carbapenemases are the main associated mechanism. The aim of this study was to evaluate the phenotypic and molecular profile of clinical carbapenem-resistant A. baumannii (CRAb) isolates from a southern Brazilian border region. A. baumannii species was identified by the presence of the blaOXA-51 gene and the susceptibility profile was determined by broth microdilution. The main carbapenemases were investigated by PCR and the typing of the CRAb isolates was performed by PFGE. During the study period, a total of 36 CRAb were recovered, 71.4% from respiratory tract samples from ICU patients. High level resistance to aminoglycosides and fluroquinolones were found in contrast to polymyxin B, for which all of CRAb were susceptible. The blaOXA-23 gene was present in 34 isolates and was the only one detected other than blaOXA-51. Molecular typing revealed the presence of four clonal strains, two of them endemic throughout the study period. To the best of our knowledge, our study brings the first data about resistance profile in Acinetobacter in the western border of south of Brazil and make aware of endemic clones of CRAb-producing-OXA-23 in this region of state, contributing for the construction of the national epidemiologic scenario of CRAb.

Covid-19 and prisons: Reflection on human rights and public health

Background: The epidemic of coronavirus disease 2019 (COVID-19) is a challenging public health problem. The identification of risk groups is essential for the establishment of prevention, screening, containment and treatment strategies. In Brazil, overcrowding and unsanitary conditions in prisons have been a problem for a long time that facilitates infection diseases. Objective: To reflect on the vulnerability of the prison population to COVID-19 and the implications of possible outbreaks in public health Method: Theoretical-reflective study. Results: The prison population has a high clinical vulnerability to contamination by COVID-19. This is aggravated by the structural conditions of prisons, which increases the spread of diseases, especially respiratory conditions, and hinders the establishment of preventive measures. The health care strategies of this population are still insufficient. Conclusion: Outbreaks of COVID-19 in prisons affect prisoners, staff and family members, and could lead the health system to an unprecedented collapse. Strategies to reduce the impact of COVID-19 in prisons and its impact on public health are urgent. Priority health measures, contingency protocols and coordinated actions between the health and justice sectors must be implemented in order to minimize the spread of the virus in this vulnerable and invisible population.