Detection of arboviruses in Aedes aegypti through transovarian analysis: A study in Goiânia, Goiás

Abstract Background: Arboviral diseases are a group of infectious diseases caused by viruses transmitted by arthropods, mainly mosquitoes. These diseases, such as those caused by the dengue (DENV), Zika (ZIKV), chikungunya (CHIKV), and yellow fever (YFV) viruses, have a significant impact worldwide. In this context, entomological surveillance plays a crucial role in the control and prevention of arboviruses by providing essential information on the presence, distribution, and activity of vector mosquitoes. Based on entomological surveillance, transovarian transmission provides information regarding the maintenance and dissemination of arboviruses. The objective of this study was to detect these arboviruses in Goiânia, Goiás, and analyze the occurrence of transovarian transmission. Methods: Aedes aegypti eggs were collected from different regions of Goiânia and cultivated under controlled laboratory conditions until the emergence of adult mosquitoes. Adult females were grouped into pools containing their heads and thoraxes. These pools were subsequently evaluated using reverse-transcription quantitative polymerase chain reaction (RT-qPCR) assay. Results: A total of 157 pools (N=1570) were analyzed, with two pools testing positive for CHIKV and one pool testing positive for ZIKV, indicating that the offspring resulting from transovarian transmission are potentially infectious. Conclusions: In summary, the demonstration of the vertical transmission mechanisms of CHIKV and ZIKV in A. aegypti serves as an alert to health authorities, as these diseases are still underreported, and their primary urban vector has likely acquired this capacity, contributing to the dissemination of these infections.

Transmissão vertical do HIV na rede de saúde: reflexões bioéticas sobre gênero e cuidado a partir de um caso emblemático / Vertical transmission of HIV in the health network: bioethics reflections on gender and care based on an emblematic case

Resumo Num cenário epidêmico ainda preocupante, a prevenção da Transmissão Vertical (TV) do HIV impõe problemas complexos, devido as vulnerabilidades individual, social e moral das mulheres vivendo com o vírus, somadas às fragilidades da rede de saúde. A partir de um caso emblemático, este estudo buscou compreender os desafios bioéticos do cuidado para a prevenção da TV do HIV no âmbito do Comitê de Porto Alegre/RS. Os eixos analíticos desenvolvidos refletem sobre como a produção do cuidado se articula, por um lado, com discursos e práticas relacionais pautadas no gênero e interseccionadas por raça e classe social e, por outro, com vulnerabilidades programáticas das políticas de saúde. Vislumbrou-se um processo de extrema estigmatização, em que as poucas ofertas para as mulheres cisgênero se dirigiam à regulação reprodutiva e perpetuavam dinâmicas de violência estrutural. Discute-se caminhos para a construção de um cuidado que incorpore a perspectiva decolonial e busque produzir equidade e justiça social ao reconhecer as trajetórias das mulheres.

Abstract In a still worrying epidemic scenario, the prevention of Vertical Transmission (VT) of HIV poses complex problems, due to the individual, social, and moral vulnerabilities of women living with the virus, in addition to the weaknesses of the health network. Based on an emblematic case, this study sought to understand the bioethical challenges of HIV VT prevention in the scope of the Porto Alegre/RS Committee. The analytical categories developed reflect on how the production of care is articulated, on the one hand, with relational discourses and practices based on gender and intersected by race and social class and, on the other, with programmatic vulnerabilities of health policies. A process of extreme stigmatization was revealed, in which the few offers for cisgender women were aimed toward reproductive regulation and perpetuated dynamics of structural violence. We discuss ways of building care that incorporates a decolonial perspective and seeks to produce equity and social justice by recognizing women's trajectories.

Caracterización de madres de pacientes con exposición perinatal al Virus de Inmunodeficiencia Humana

La mayor incidencia de la infección por el virus de inmunodeficiencia humana (VIH) en mujeres ha tenido un impacto directo en la transmisión vertical, situación que puede ser evitada con un adecuado control prenatal. Objetivo: Determinar características demográficas, epidemiológicas y obstétricas de madres de pacientes con exposición perinatal al VIH. Métodos: Se realizó un estudio retrospectivo, observacional, transversal y analítico. Se incluyeron madres con infección por VIH de transmisión horizontal, cuyos hijos con exposición perinatal, nacidos entre 2001 y 2020, fueron atendidos en la Unidad VIH del Hospital de Niños "J.M. de los Ríos" (Caracas-Venezuela). La información fue obtenida de la Base de Datos Interna. Las madres fueron agrupadas según la década de nacimiento del hijo (2001-2010 o 2011-2020). El análisis estadístico incluyó la prueba de Chi cuadrado. Resultados: Se estudiaron 805 madres. La edad promedio al nacer fue 26,4 años; el 8,6 % (n=69/803) era adolescente. El control prenatal fue inadecuado o inexistente en 59,7 % (n=463/776). La identificación de la infección materna fue obtenida durante o después del nacimiento en 36,4 % (n=280/769), con diferencias entre décadas: 26,7 % en la primera y 42,5 % en la segunda (p<0,01). En el 90,4 % (n=253/280) de este grupo el diagnóstico se obtuvo posterior al nacimiento. Conclusiones: La edad promedio de las madres fue 26,4 años. Aproximadamente 50 % tuvo control prenatal inadecuado o inexistente. Alrededor de un tercio obtuvo el diagnóstico después del embarazo, con significativo mayor porcentaje en la segunda década. Sólo en 1/10 madres de este grupo, la infección fue identificada al nacimiento.

The higher incidence of human immunodeficiency virus (HIV) infection in women has had a direct impact on vertical transmission, situation that can be avoided with an adequate prenatal control. Objective: To determine demographic, epidemiological, and obstetric characteristics of mothers of children with perinatal exposure to HIV. Methods: A retrospective, observational, cross-sectional and analytical study was carried out. It was included mothers, with horizontally transmitted HIV infection, whose children with perinatal exposure, born between 2001 and 2020, were treated at the HIV Unit of the Children's Hospital "J.M. de los Ríos" (Caracas-Venezuela). The information was obtained from the Unit Internal Database. The mothers were grouped according to the decade of her child's birth (2001-2010 or 2011-2020). Chi square test was performed for statistical analysis. Results: A total of 805 mothers were studied. The average age at birth was 26.4 years; 8.6 % (n=69/803) were adolescents. Prenatal care was inadequate or non-existent in 59.7 % (n=463/776). Identification of maternal infection was obtained during or after birth in 36.4 % (n=280/769), with differences between decades: 26.7 % in the first and 42.5 % in the second (p<0.01). In 90.4 % (n=253/280) of this group, the diagnosis was obtained after birth. Conclusions: The average age of the mothers was 26.4 years. Approximately 50 % had inadequate or nonexistent prenatal care. About a third were diagnosed after pregnancy, with a significantly higher percentage in the second decade. In only 1/10 mothers of this group the infection was identified at birth.

Seroprevalence of Toxoplasmosis in Puerperal Women Treated at a Tertiary Referral Hospital / Soroprevalência de toxoplasmose em puérperas atendidas em um hospital terciário de referência

Abstract Objective To evaluate the seroprevalence of toxoplasmosis among puerperal women cared for at a tertiary university hospital and the level of understanding of these puerperal women about toxoplasmosis, vertical transmission, and its prophylaxis. Methods For this cross-sectional study, we evaluated 225 patients using presential interviews, prenatal documentation, and electronic medical records. Data were stored using Research Electronic Data Capture (REDCap) software. Prevalence rates were estimated by the presence of reactive IgG antibodies against Toxoplasma gondii. Data analysis was performed using the chi-square test and calculation of the odds ratio (OR). Seroreactivity to T. gondii and exposure variables (age, educational level, and parity) were analyzed using a confidence interval (95%CI) and a significance level of 5% (p < 0.05). Results The seropositivity rate for T. gondii was 40%. There was no association between seroprevalence and age. Primiparity was a protective factor against seropositivity and low education was a risk factor. Conclusion Knowledge of T. gondii infection and its transmission forms was significantly limited, presenting a risk for acute maternal toxoplasmosis and vertical transmission of this protozoan. Increasing the education level regarding the risk of toxoplasmosis during pregnancy could reduce the rates of infection and vertical transmission of this parasite.

Resumo Objetivo Avaliar a soroprevalência de toxoplasmose entre puérperas atendidas em um hospital universitário terciário e o nível de compreensão dessas puérperas sobre toxoplasmose, transmissão vertical e sua profilaxia. Métodos Para esse estudo transversal, foram avaliadas 225 pacientes utilizando entrevistas presenciais, documentação de pré-natal e prontuário eletrônico. Os dados foram armazenados usando o software Research Electronic Data Capture (REDCap). As taxas de prevalência foram estimadas pela presença de anticorpos IgG reativos contra o Toxoplasma gondii. A análise dos dados foi realizada por meio do teste do qui-quadrado e cálculo do odds ratio (OR). A sororreatividade ao T. gondii e as variáveis de exposição (idade, escolaridade e paridade) foram analisadas, utilizando-se intervalo de confiança (IC95%) e nível de significância de 5% (p < 0,05). Resultados A taxa de soropositividade para T. gondii foi de 40%. Não houve associação entre soroprevalência e idade. A primiparidade foi fator de proteção contra a soropositividade e a baixa escolaridade foi fator de risco. Conclusão O conhecimento da infecção por T. gondii e suas formas de transmissão foi significativamente limitado, apresentando risco para toxoplasmose materna aguda e transmissão vertical desse protozoário. Aumentar o nível de escolaridade quanto ao risco de toxoplasmose durante a gravidez pode reduzir as taxas de infecção e transmissão vertical desse parasita.

Vozes silenciadas: vivências de pessoas que convivem com HIV na província de Gaza, Moçambique / Silenced voices: experiences of people living with HIV in the province of Gaza, Mozambique / Voces silenciadas: experiencias de personas que viven con el VIH en la provincia de Gaza, Mozambique

OBJETIVO: No mundo, cerca de 16 milhões de mulheres vivem com HIV, muitas delas em idade reprodutiva. Esses níveis de infecção e as taxas de transmissão vertical ainda trazem grandes preocupações, devido à pouca intervenção terapêutica precoce em muitos países africanos. Em Moçambique, país da África Subsaariana, os índices de prevalência do HIV são de 13,2%, colocando o país em segundo lugar na conta de novas infecções, atrás apenas da África do Sul. OBJETIVO: Conhecer as experiências e as principais dificuldades vivenciadas pelas gestantes ou lactantes soropositivas e seus parceiros sexuais no contexto específico. METODOLOGIA: Estudo qualitativo realizado em Chókwè na província de Gaza- Moçambique. Foram realizadas entrevistas semiestruturadas com mulheres gestantes ou lactantes que vivem com HIV, com seus parceiros sexuais e com profissionais de saúde. Foram realizados grupos focais com mães mentoras e entrevista em grupo com pais mentores, as quais ocorreram no segundo semestre de 2021. As entrevistas e os encontros foram gravados com gravador de voz e transcritas na íntegra. As informações passaram pelo processo de análise temática. RESULTADOS: Participaram do estudo dez mulheres gestantes ou lactantes soropositivas e um parceiro sexual; treze mães mentoras e dois pais mentores; duas enfermeiras de Saúde Materno Infantil e uma psicóloga. Os achados revelam que as participantes associam o diagnóstico do HIV ao teste de gravidez ou ao parto, e o período da gestação e da amamentação é marcado pelo medo de infectar o filho com o vírus. As mulheres escondem seu estado sorológico do marido, da família e da comunidade por medo das consequências relacionadas com normas sociais rígidas e interferência de fatores culturais. Os resultados dos profissionais de saúde trouxeram aspectos similares aos das mulheres vivendo com HIV, entretanto, ressaltam a falta de profissionais para oferecer atendimento de qualidade. Constatou-se que na unidade de saúde e na comunidade utilizam palestras como única estratégia de educação em saúde, apesar da pouca eficácia. CONCLUSÕES: Observou-se que ainda existem muitas barreiras para prevenção da transmissão vertical em Moçambique, em especial, a qualidade do aconselhamento e dificuldades de acesso ao serviço, seja por falta de recursos ou pelas normas sociais e familiares que não reconhecem a autonomia da mulher. É necessario apoiar as mães que não desejam amamentar e aquelas que tem maior vulnerabilidade socioeconômica. Recomenda-se maior investimento nas estratégias de apoio psicossocial e envolvimento comunitário, utilizando alternativas como a Terapia Comunitária Integrativa (TCI) e Educação Popular. Sugere-se o envolvimento de lideranças comunitárias no processo de desenvolvimento de um programa de intervenção e promoção de saúde mental para mulheres gestantes ou lactantes soropositivas.

OBJECTIVE: In the world, about 16 million women are living with HIV, many of them in reproductive age. These levels of infection and vertical transmission rates are still of great concern, due to the lack of early therapeutic intervention in many African countries. In Mozambique, a country in sub-Saharan Africa, HIV prevalence rates are 13.2%, placing the country in second place in terms of new infections, behind only South Africa. OBJECTIVE: To know the experiences and the main difficulties experienced by HIV-positive pregnant or lactating women and their sexual partners in the specific context. METHODOLOGY: Qualitative study carried out in Chókwè in the province of Gaza - Mozambique. Semi-structured interviews were conducted with pregnant or lactating women living with HIV, with their sexual partners and with health professionals. Focus groups were held with mentor mothers and group interviews with mentor fathers, which took place in the second half of 2021. The interviews and meetings were recorded with a voice recorder and transcribed in full. The information went through the thematic analysis process. RESULTS: Ten seropositive pregnant or lactating women and one sexual partner participated in the study; thirteen mentor mothers and two mentor fathers; two Maternal and Child Health nurses and a psychologist. The findings reveal that the participants associate the HIV diagnosis with the pregnancy test or childbirth, and the period of pregnancy and breastfeeding is marked by the fear of infecting the child with the virus. Women hide their serological status from their husband, family and community for fear of consequences related to rigid social norms and interference of cultural factors. The results of health professionals brought similar aspects to those of women living with HIV, however, they highlight the lack of professionals to offer quality care. It was found that the health unit and the community use lectures as the only health education strategy, despite its low effectiveness. CONCLUSIONS: It was observed that there are still many barriers to preventing mother-to-child transmission in Mozambique, in particular, the quality of counseling and difficulties in accessing the service, whether due to lack of resources or social and family norms that do not recognize women's autonomy. . It is necessary to support mothers who do not wish to breastfeed and those who are more socioeconomically vulnerable. Greater investment in psychosocial support and community involvement strategies is recommended, using alternatives such as Integrative Community Therapy (ICT) and Popular Education. It is suggested the involvement of community leaders in the process of developing a program of intervention and promotion of mental health for seropositive pregnant or lactating women.

OBJETIVO: En el mundo, alrededor de 16 millones de mujeres viven con el VIH, muchas de ellas en edad reproductiva. Estos niveles de infección y tasas de transmisión vertical siguen siendo motivo de gran preocupación, debido a la falta de una intervención terapéutica temprana en muchos países africanos. En Mozambique, un país del África subsahariana, las tasas de prevalencia del VIH son del 13,2%, lo que coloca al país en el segundo lugar en términos de nuevas infecciones, solo por detrás de Sudáfrica. OBJETIVO: Conocer las vivencias y las principales dificultades vividas por mujeres embarazadas o lactantes seropositivas y sus parejas sexuales en el contexto específico. METODOLOGÍA: Estudio cualitativo realizado en Chókwè en la provincia de Gaza-Mozambique. Se realizaron entrevistas semiestructuradas con mujeres embarazadas o lactantes que viven con el VIH, con sus parejas sexuales y con profesionales de la salud. Se realizaron grupos focales con madres mentoras y entrevistas grupales con padres mentores, que se realizaron en el segundo semestre de 2021. Las entrevistas y encuentros fueron grabados con una grabadora de voz y transcritas en su totalidad. La información pasó por el proceso de análisis temático. RESULTADOS: Participaron del estudio diez mujeres embarazadas o lactantes seropositivas y una pareja sexual; trece madres mentoras y dos padres mentores; dos enfermeras de Salud Materno Infantil y una psicóloga. Los hallazgos revelan que las participantes asocian el diagnóstico de VIH con la prueba de embarazo o el parto, y el período de embarazo y lactancia está marcado por el miedo a contagiar al niño con el virus. Las mujeres ocultan su estado serológico a su esposo, familia y comunidad por temor a las consecuencias relacionadas con las normas sociales rígidas y la interferencia de factores culturales. Los resultados de los profesionales de la salud trajeron aspectos similares a los de las mujeres que viven con el VIH, sin embargo, destacan la falta de profesionales para ofrecer una atención de calidad. Se constató que la unidad de salud y la comunidad utilizan las charlas como única estrategia de educación en salud, a pesar de su baja efectividad. CONCLUSIONES: Se observó que todavía existen muchas barreras para prevenir la transmisión maternoinfantil en Mozambique, en particular, la calidad de la consejería y las dificultades para acceder al servicio, ya sea por falta de recursos o por normas sociales y familiares que no reconocer la autonomía de la mujer. Es necesario apoyar a las madres que no desean amamantar ya aquellas que son más vulnerables socioeconómicamente. Se recomienda una mayor inversión en estrategias de apoyo psicosocial y participación comunitaria, utilizando alternativas como la Terapia Comunitaria Integrativa (TIC) y la Educación Popular. Se sugiere involucrar a los líderes comunitarios en el proceso de desarrollo de un programa de intervención y promoción de la salud mental para mujeres embarazadas o lactantes seropositivas.

Microdeletions and vertical transmission of the Y-chromosome azoospermia factor region / 亚洲男科学杂志(英文版)

Spermatogenesis is regulated by several Y chromosome-specific genes located in a specific region of the long arm of the Y chromosome, the azoospermia factor region (AZF). AZF microdeletions are the main structural chromosomal abnormalities that cause male infertility. Assisted reproductive technology (ART) has been used to overcome natural fertilization barriers, allowing infertile couples to have children. However, these techniques increase the risk of vertical transmission of genetic defects. Despite widespread awareness of AZF microdeletions, the occurrence of de novo deletions and overexpression, as well as the expansion of AZF microdeletion vertical transmission, remains unknown. This review summarizes the mechanism of AZF microdeletion and the function of the candidate genes in the AZF region and their corresponding clinical phenotypes. Moreover, vertical transmission cases of AZF microdeletions, the impact of vertical inheritance on male fertility, and the prospective direction of research in this field are also outlined.

Profile of pregnant women and children accompanied due to T. gondii exposure at a referred healthcare center: What has changed in 10 years? / Perfil de gestantes e crianças acompanhadas por exposição ao Toxoplasma gondii num centro de referência: O que mudou 10 anos depois?

Abstract Objectives: to characterize the profile of pregnant women and newborns accompanied at a reference center for infectious-parasitic diseases, after the exposure of T. gondii, establishing comparisons with a previous study, in the same location, ten years ago. Methods: this is a retrospective cohort study, with a follow-up of four years (2016 to 2019), using the previous study carried out from 2002 to 2010 as a comparative for the variables assessed. Mothers who presented tests suggestive of seroconversion for the disease during prenatal care and their respective concepts, followed up over a year, were included. The chi-square test was used, assuming a significance level of 5% for the comparison of the groups in the two periods. Results: during the period from 2016 to 2019, 79 binomials were studied, whereas 58 binomials were accompanied in the previous period. Comparing both periods, the findings showed lower proportions of adolescents (p<0.001), with low schooling (p<0.001), with low serological testing (p<0.001) and with late or postnatal diagnosis (p<0.001). As to the children, the findings showed fewer changes in fundoscopy (p<0.001), strabismus (p=0.002), hepatomegaly (p=0.026) and any sequelae (p<0.001). Conclusion: a positive advance was observed regarding the care provided for the mother-child binomial affected by T. gondii, with a reduction in negative outcomes for the child. However, there are still challenges concerning the diagnosis and proper management of the disease.

Resumo Objetivos: caracterizar o perfil de gestantes e neonatos acompanhadas em um centro de referência em doenças infecto-parasitárias, após exposição ao Toxoplasma gondii, estabelecendo comparações em relação a estudo prévio, no mesmo local, há dez anos. Métodos: trata-se de estudo de coorte retrospectivo, com seguimento de quatro anos (2016 a 2019), servindo o estudo prévio realizado de 2002 a 2010 como comparativo para as variáveis estudadas. Foram incluídas mães que apresentaram durante o pré-natal exames sugestivos soroconversão para a doença e seus respectivos conceptos, acompanhados ao longo de um ano. Utilizou-se o teste qui-quadrado, assumindo-se nível de significância de 5% para a comparação dos grupos nos dois períodos. Resultados: durante o período de 2016 a 2019, foram estudados 79 binômios, enquanto no período anterior foram acompanhados 58 binômios. Comparando-se os dois períodos, em relação às mães, registraram-se menores proporções de adolescentes (p<0,001), de baixa escolaridade (p<0,001), baixa realização de testes sorológicos (p<0,001) e com diagnóstico tardio ou pós-natal (p<0,001). Em relação às crianças, verificaram-se menores proporções de alterações de fundoscopia (p<0,001), estrabismo (p=0,002), hepatomegalia (p=0,026) e qualquer sequela (p<0,001). Conclusão: observou-se um avanço em relação aos cuidados para o binômio mãe-filho acometido pelo T. gondii, com redução de desfechos negativos sobre a criança. Todavia, ainda existem desafios para o diagnóstico e adequado manejo da doença.

Vertical transmission of HIV to neonates in a reference hospital in Northeastern Brazil from 2013 to 2017

ABSTRACT The aim of this study was to estimate the rate of Mother-to-child Transmission (MTCT) of HIV to neonates in a reference university hospital in Sao Luis city, the capital of Maranhao State (MA), evaluating MTCT-associated factors. A retrospective cohort study based on data from the Notifiable Diseases Data System (SINAN) was carried out and included all HIV-exposed neonates notified from 2013 to 2017 by the university hospital. The study population comprised 725 HIV-exposed neonates, of whom 672 neonates were exposed and uninfected, and 53 were exposed and infected. The estimated rate of MTCT in the period of 2013 to 2017 was 7.3%. Most pregnant women were ≥ 20 years old (86.9%), reported ≥ 8 years of schooling (53.2%), reported full-time or independent paid work (46.9%) and were residents in other cities of the state (61.7%). Regarding healthcare, 86.3% received prenatal care, 74.6% received Antiretroviral Therapy (ART) as prophylaxis during pregnancy, 81.8% received ART prophylaxis during childbirth and 78.1% underwent cesarean section. Among the neonates, 92.8% received ART prophylaxis and 94.3% were not breastfed. Despite these variables, the 7.3% MTCT rate found in this study makes it clear that the interventions recommended by the Ministry of Health were not fully adopted.

Detección clonal de cepas parentales de streptococcus agalactiae Lehmann y Neumann por amplificación aleatoria de ADN polimórfico / Clonal detection of streptococcus agalactiae Lehmann and Neumann parental strains by random amplification of polymorphic DNA

RESUMEN Streptococcus agalactiae (SGB) produce infecciones invasivas en neonatos siendo la transmisión materna la más frecuente. Estudios epidemiológicos utilizan técnicas moleculares que evalúan la diversidad genética, entre ellas la de amplificación aleatoria de ADN polimórfico (RAPD) que resulta ser accesible, sensible y utiliza cebadores arbitrarios para amplificar segmentos polimórficos de ADN mediante PCR. El objetivo fue determinar la relación clonal entre aislamientos de SGB recuperados de madres y sus respectivos recién nacidos. Se estudiaron por RAPD cuatro parejas de aislamientos de SGB obtenidos de hisopados vagino-rectales de madres y de hemocultivos de sus neonatos. Se utilizaron los cebadores OPS11, OPB17 y OPB18 para seleccionar uno con capacidad de discriminar entre cepas no relacionadas genéticamente. Se utilizó la fórmula de Hunter-Gaston que establece el índice de discriminación (D), cuando D>0,90 se considera que los aislamientos pertenecen a clones diferentes. Los perfiles de amplificación para los ocho aislamientos, empleando independientemente cada cebador, permitieron calcular un D=1 para OPS11, y D=0,84 para OPB17 y OPB18. Por lo tanto, OPS11 fue seleccionado para el estudio de la relación clonal de los aislamientos, encontrándose perfiles de amplificación similares por RAPD para cada par de cepas madre-recién nacido. Se observaron diferentes perfiles de amplificación entre los pares de cepas madre-recién nacido, lo que revela la discriminación entre cepas no relacionadas, resultados confirmados por electroforesis en campo pulsante (PFGE). Estos resultados indican transmisión vertical para cada caso estudiado y robustez del cebador OPS11. Se encontraron condiciones apropiadas del ensayo de RAPD, lo que es útil para estudios epidemiológicos.

ABSTRACT Streptococcus agalactiae (GBS) causes invasive infections in newborns, being the most frequent the maternal transmission. Epidemiological studies use molecular techniques that assess genetic diversity, including random amplification of polymorphic DNA (RAPD) that is found to be accessible, sensitive and uses arbitrary primers to amplify polymorphic segments of DNA by PCR. The objective was to determine the clonal relationship between GBS strains recovered from mothers and their respective newborns. Four pairs of GBS isolates obtained from vaginal-rectal swabs of mothers and blood cultures of their newborns were studied with RAPD. Primers OPS11, OPB17 and OPB18 were used to select one with the ability to discriminate between non-genetically related strains. The Hunter-Gaston formula that establishes the discrimination index (D) was used; when D>0.90, it is considered that the isolates belong to different clones. The amplification profiles for the eight isolates, using each primer independently, allowed to calculate a D=1 for OPS11, and D=0.84 for OPB17 and OPB18. Therefore, OPS11 was selected for the study of the clonal relationship of the isolates, and similar amplification profiles were found by RAPD for each mother-newborn pair of GBS isolates. Different amplification profiles were observed between pairs of mother-newborn strains, which reveals the discrimination between unrelated strains, confirmed by pulsating field electrophoresis (PFGE). These results indicated vertical transmission for each studied case and robustness of the OPS11 primer. Appropriate conditions of the RAPD trial were found, which is useful for epidemiological studies.

Virus linfotrópico humano de células T tipo 1 (HTLV-1) en el embarazo / Human lymphotropic virus in T-cell type 1 (HTLV-1) during pregnancy

El HTLV-1 es un retrovirus que afecta principalmente a los linfocitos T-CD4, causando enfermedades como paraparesia espástica o mielopatía, uveítis, dermatitis infecciosas, leucemia/linfoma de las células T del adulto, además de otras enfermedades. Causa una infección crónica de por vida en humanos y su transmisión ocurre a través de la lactancia materna, el contacto sexual y las transfusiones de sangre. En Chile actualmente ocupa el cuarto lugar en notificaciones entre el año 2014-2021, estimándose a nivel mundial más de 20 millones de portadores. El mayor riesgo de transmisión ocurre por lactancia mayor a seis meses y alta carga proviral y altos títulos de anticuerpos en la madre portadora. El objetivo consistió en analizar la situación de la portación del virus HTLV-1 durante el embarazo, determinando su prevalencia, vías de transmisión y complicaciones. Se realizó una revisión bibliográfica sistemática de artículos publicados en bases de datos científicas referidos al virus HTLV-1. Este virus está globalmente diseminado y se presenta en forma endémica en algunas regiones del mundo con prevalencias entre muy elevadas y bajas. En Chile la seroprevalencia en promedio es de 0,124% para HTLV-1. Esta infección no cuenta con tratamiento, solo se tratan los síntomas por lo que mientras esto no cambie, solo es factible reducir la transmisión, incidencia y la morbilidad del HTLV-1 incorporando medidas de control del virus en las intervenciones de control de enfermedades y estrategias de salud pública. La forma más eficiente de transmisión del virus madre-hijo es a través de la leche materna, es necesario implementar la detección prenatal de HTLV-1, en especial en las zonas endémicas, así como también asesorar a las madres HTVL-1 positivas sobre la lactancia materna.

HTLV-1 is a retrovirus that mainly affects CD4-T lymphocytes, causing diseases such as spastic paraparesis or myelopathy, uveitis, infectious dermatitis, adult T-cell leukemia/lymphoma, and other diseases. It causes a lifelong chronic infection in humans and its transmission occurs through breastfeeding, sexual contact and blood transfusions. In Chile, it currently ranks fourth in notifications between the years 2014-2021, with more than 20 million carriers being estimated worldwide. The greatest risk of transmission occurs by breastfeeding for more than six months and high proviral load and high antibody titers in the carrier mother. The objective consisted of analyzing the situation of the carriage of the HTLV-1 virus during pregnancy, determining its prevalence, transmission routes and complications. A systematic bibliographic review of articles published in scientific databases referring to the HTLV-1 virus was carried out. This virus is globally disseminated and occurs endemic in some regions of the world with prevalence between very high and low. In Chile, the average seroprevalence is 0.124% for HTLV-1. There is no treatment for this infection, only the symptoms are treated, so as long as this does not change, it is only feasible to reduce the transmission, incidence, and morbidity of HTLV-1 by incorporating virus control measures into disease control interventions and strategies. of public health. The most efficient form of mother-child transmission of the virus is through breast milk, it is necessary to implement prenatal screening for HTLV-1, especially in endemic areas, as well as counsel HTLV-1 positive mothers on breastfeeding

A maternidade e a transmissão vertical do HIV/ AIDS em gestantes adolescentes soropositivas: Revisão integrativa / Maternidad y transmisión vertical del VIH/SIDA en adolescentes embarazadas con VIH/SIDA: Revisión integrativa / Maternity and vertical transmission of HIV/AIDs in HIV/AIDS pregnant adolescents: Integrative review

Objetivo: analisar as percepções de mães adolescentes com HIV/Aids sobre a gestação e a transmissão vertical. Método: Estudo de revisão integrativa de literatura. As bases de informação utilizadas foram: Biblioteca Virtual de Saúde (BVS), Web of Science, PubMed e Science Direct, reunindo artigos do recorte temporal de 2012 a 2020. O período de coleta de dados se deu entre outubro de 2021 a dezembro de 2021. Resultados: Elencaram-se dois artigos que relataram a condição biopsicossocial da gestante adolescente, associada ao medo, insegurança, incapacidade e culpabilização. Os resultados foram agrupados em categorias, a saber: a maternidade sob ótica da adolescente soropositiva e a transmissão vertical do HIV durante a gestação na adolescência. Conclusão: Espera-se que a temática possa ser explorada a fim de contribuir para a assistência voltada para o público estudado e minimizar os riscos da transmissão vertical.(AU)

Objective: to analyze the perceptions of adolescent mothers with HIV/AIDS about pregnancy and vertical transmission. Method: Study of integrative literature review. The information bases used were: Virtual Health Library (VHL), Web of Science, PubMed and Science Direct, gathering articles from the time frame from 2012 to 2020. The data collection period took place between October 2021 and December 2021. Results: Two articles were reported on the biopsychosocial condition of pregnant adolescents, associated with fear, insecurity, disability and guilt. The results were grouped into categories, that is: maternity from the perspective of hiv-positive adolescents and vertical transmission of HIV during pregnancy in adolescence. Conclusion: It is expected that the theme can be explored in order to contribute to the assistance aimed at the studied public and minimize the risks of vertical transmission.(AU)

Objetivo: analizar las percepciones de las madres adolescentes con VIH/SIDA sobre el embarazo y la transmisión vertical. Método: Estudio de la revisión integradora de la literatura. Las bases de información utilizadas fueron: Biblioteca Virtual en Salud (BVS), Web of Science, PubMed y Science Direct, recopilando artículos del marco de tiempo de 2012 a 2020. El período de recolección de datos tuvo lugar entre octubre de 2021 y diciembre de 2021. Resultados: Se reportaron dos artículos sobre la condición biopsicosocial de adolescentes embarazadas, asociada con miedo, inseguridad, discapacidad y culpa. Los resultados se agruparon en categorías, es decir: maternidad desde la perspectiva de las adolescentes seropositivas y transmisión vertical del VIH durante el embarazo en la adolescencia. Conclusión: Se espera que el tema pueda ser explorado con el fin de contribuir a la asistencia dirigida al público estudiado y minimizar los riesgos de transmisión vertical.(AU)

COVID and Women’s Health in India

Background : COVID-19 disease surfaced in Wuhan in December, 2019 and rapidly spread in the World as a pandemic (March, 2020) Till date (10 August) COVID-19 has affected 20 million people. Many women have delivered and many conceived during this time. Till date very few adverse effects and vertical transmission is observed. WHO later changed the terminology to SARS-COV-2 and removed ’19’ from the name. Material and Method : We studied Maternal and Perinatal outcome of COVID confirmed pregnancies and the effects of CORONA infections on Women’s Health. Results : Most of the patients were asymptomatic. Majority 80% cases of our cases were delivered by Cesarean Section. Cesarean Section was done for Obstetric reasons along with early consideration due to COVID concerns. Meconium Stained Liquor and Fetal Distress was the indication of Cesarean in 14% cases. Previous Cesarean Sections was a major cause of repeat cesarean in our study. Preterm labour was reported in only one case of Twin Pregnancies. Premature Rupture of Membranes was not seen in any of the pregnancies. Maternal and Fetal outcome were favorable with only few cases of mild to moderate Pneumonia in mothers. Most of the women were psychological disturbed due to the Lockdown and had unwanted pregnancy (due to lack of contraceptive availability), domestic violence and also family disputes and child beating were reported by many in the survey. Due to lack of Medical Services by the GP’s and the friendly small Obstetrics Gynaecology clinics (closed due to Lockdown) small problems got aggravated and a lot of these women one now coming up with Anemia, Polycystic Ovarian Syndrome (PCOS), Fibroids, Abnormal Uterine Bleeding (AUB), Endometriosis, Pelvic Inflammatory Disease (PID), Cervical Crosiers, Vaginitis, Obesity etc. Conclusion : Coronavirus infection in pregnancy did not adversely affect the pregnancy and has a benign course. Pregnant women are not at higher risk of developing Pneumonia compared to non pregnant women. There is no evidence of increased risk of miscarriage or foetal losses with COVID-19 infection during pregnancy. But SARS-COV2 disease a lot of other Gynaecological problems and adversely affected Women’s Health.

Fatores preditores da transmissão vertical do vírus da imunodeficiência humana em recém-natos: Uma nova abordagem / Predictors of vertical hiv transmission in newborns: a new approach

Introdução: A transmissão materno-fetal do vírus da imunodeficiência humana, no Brasil, atinge ainda grandes proporções, levando a elevadas taxas de morbimortalidade na infância e vida adulta dos indivíduos afetados. O objetivo do presente estudo foi analisar o perfil epidemiológico dos pacientes pediátricos em tratamento ou que foram expostos ao vírus do HIV no município de Criciúma/SC. Métodos: Foi realizado um estudo observacional transversal, retrospectivo, descritivo e de abordagem quantitativa. Foram analisadas 110 crianças e adolescentes, entre 0 e 18 anos, no período de julho de 2016 a junho de 2018. Resultados: Totalizaram-se 23 (20,9%) pacientes que são soropositivos confirmados e 87 (79,1%) que estão em acompanhamento para possível infecção ou que tiveram alta do serviço por não terem adquirido o vírus. Quanto ao diagnóstico materno prévio, 24 (21,8%) mães não tinham o diagnóstico prévio e representaram 16 (69,6%) das infecções verticais, 86 (78,2%) sabiam de sua soropositividade, resultando em 7 (30,4%) crianças infectadas pelo HIV. Já entre os não infectados, 8 (9,2%) eram filhos de mães que não tinham o diagnóstico, e em 79 (90,8%) crianças, a mãe já tinha o diagnóstico. O uso profilático de terapia antirretroviral (TARV) materno foi observado em 82 (74,5%) e não utilizado em 28 (25,5%) crianças. Conclusão: A transmissão vertical do HIV foi vista com maior prevalência nas crianças em que não foram utilizadas medidas profiláticas, demonstrando que o diagnóstico materno prévio, a profilaxia com TARV durante a gestação e a amamentação têm valor significativo na transmissão vertical do HIV.

Introduction: Maternal-fetal transmission of HIV in Brazil is still high, with high morbidity and mortality rates during childhood and adulthood in affected individuals. The objective of this study was to analyze the epidemiological profile of pediatric patients undergoing treatment for or who were exposed to the HIV virus in the city of Criciúma, SC, Brazil. Methods: A cross-sectional, retrospective, descriptive, and quantitative analysis of 110 children and adolescents between birth and 18 years of age was conducted between July 2016 and June 2018. Results: A total of 23 (20.9%) patients were confirmed seropositive, while 87 (79.1%) are being followed up for possible infection or were released for seronegativity. Regarding previous diagnosis, 24 (21.8%) previously undiagnosed mothers had 16 (69.6%) vertically infected children, and 86 (78.2%) mothers knew they were seropositive, resulting in 7 (30.4%) vertical infections. Among the uninfected, 8 (9.2%) were children of previously undiagnosed mothers, while the mothers of 79 (90.8%) had been diagnosed. Prophylactic maternal antiretroviral therapy was applied in 82 (74.5%) cases and was not applied in 28 (25.5%) cases. Conclusions: There was a higher prevalence of vertical HIV transmission when prophylactic measures were not used, which demonstrates that prior maternal diagnosis and antiretroviral prophylaxis during pregnancy and breastfeeding have significant value in vertical HIV transmission.

Zika virus vertical transmission in mosquitoes A less understood mechanism

Zika virus disease is a great concern in different parts of the world, and it has become a Public Health Emergency of International Concern. The global pandemic of ZIKV in 2015 prompted concern among scientific community. Zika is a flavivirus of the family Flaviviridae transmitted by mosquitoes. Natural vertical transmission is an ecological strategy that arboviruses adopt to ensure their survival inside the mosquito vector during harsh conditions or interepidemic periods when horizontal transmission is difficult. ZIKV is vertically transmitted from infected females to its offspring. This review has concluded various studies regarding the vertical transmission ability of different mosquito species for ZIKV. Previously Aedes aegypti was considered to be a major vector, however Aedes albopictus and Culex quinquifasciatus are discovered to have the similar vertical transmission potential. Different studies shown that natural vertical transmission has been detected in mosquito species which are not implicated as possible vectors. It leads to the possibility that many other mosquito species may be potential ZIKV vectors.

Congenital syphilis: epidemiological analysis and sentinel event of the quality of care for the mother/newborn binomium / Sífilis congênita: análise epidemiológica e evento sentinela da qualidade da assistência ao binômio mãe/recém-nascido

Introduction: congenital syphilis remains a serious public health problem in Brazil and worldwide, being fetal and antenatal infections the main causes of global morbidity and mortality. Objective: to analyze the cases of congenital syphilis and an outcome indicator of the quality of care for the mother/newborn binomial in Vitória (ES), in the 2016-2019 quadrennium. Methods: study with a quantitative approach, which evaluated the indicator "congenital syphilis follow-up". Data were collected in the Notifiable Diseases Information System (SINAN), for the period from January 1, 2016 to December 31, 2019. The information regarding the follow-up of NB occurred by searching an electronic medical record, from August 1, 2020 to March 31, 2021. Results: in the 2016-2019 quadrennium, the municipality of Vitória had 169 cases of congenital syphilis, according to the year of diagnosis criterion. This indicator decreased over the quadrennium: 64 cases in 2016 (37.9%), 43 in 2017 (25.4%), 37 in 2018 (21.9%) and 25 in 2019 (14.8 %). The nontreponemal test was reactive in 62.7% of cases. In 10.7% there were alterations in the laboratory analysis of the CSF; 3%, alteration in the examination of long bones; 5.3%, non-treponemal CSF reagent test, and 11.8% were symptomatic at birth. The congenital syphilis incidence rate, which was 14.65/1000 live births in 2016, reached 5.58/1000 live births in 2019. The follow-up indicator for congenital syphilis cases that were born alive was 69.8 % in 2016, 79.5% in 2017, 84.4% in 2018 and 85.7% in 2019. Conclusion: there was a significant reduction in the number of cases of congenital syphilis, in the incidence rate of the disease and progressive improvement in the follow-up of congenital syphilis, having, as a guideline, the Plan to Eliminate Syphilis.

Introdução: a sífilis congênita continua sendo um grave problema de saúde pública no Brasil e no mundo, sendo as infecções fetais antenatais as principais causas de morbidade e mortalidade global. Objetivo: analisar os casos de sífilis congênita e um indicador de resultado da qualidade da assistência ao binômio mãe/recém nascido em Vitória (ES), no quadriênio 2016-2019. Método: estudo de abordagem quantitativa, que avaliou o indicador "seguimento da sífilis congênita". Os dados foram coletados no Sistema de Informação de Agravos de Notificação (SINAN), referentes ao período de 1.º de janeiro de 2016 a 31 de dezembro de 2019. As informações referentes ao seguimento dos RN com SC ocorreram mediante busca em prontuário eletrônico, no período de 1.º de agosto de 2020 a 31 de março de 2021. Resultados: no quadriênio 2016-2019, o município de Vitória teve 169 casos de sífilis congênita, pelo critério ano de diagnóstico. Esse indicador foi decrescente ao longo do quadriênio: 64 casos em 2016 (37,9%), 43 em 2017 (25,4%), 37 em 2018 (21,9%) e 25 em 2019 (14,8%). O teste não treponêmico foi reagente em 62,7% dos casos. Em 10,7%, houve alterações na análise laboratorial do líquor; 3%, alteração no exame de ossos longos; 5,3%, teste não treponêmico reagente no líquor; e 11,8% apresentaram-se sintomáticos ao nascimento. A taxa de incidência sífilis congênita, que em 2016 se encontrava em 14,65/1000 nascidos vivos, chegou a 5,58/1000 nascidos vivos em 2019. O indicador de seguimento dos casos de sífilis congênita que nasceram vivos foi de 69,8% em 2016, 79,5% em 2017, 84,4% em 2018 e 85,7% em 2019. Conclusão: houve significativa redução do número de casos de sífilis congênita, da taxa de incidência da doença e melhoria progressiva do seguimento da sífilis congênita, tendo, como diretriz, o Plano de Enfrentamento da Sífilis.

Gamma variant vertically transmitted from a mild symptomatic pregnant woman associated with fatal neonatal COVID

ABSTRACT Herein we describe a mild symptomatic real-time reverse transcriptase- polymerase chain reaction-confirmed coronavirus 2 (SARS-CoV-2) infection in a pregnant woman who gave birth to a preterm infant, 32 weeks gestational age. The neonate was immediately isolated after delivery and developed severe respiratory disease that progressed to multisystem inflammatory syndrome and death on the seventh day of life. Genome sequencing detected the P.1 (gamma) variant in samples obtained at hospital admission (mother) and on the first (10h) and 13th days of life (neonate). Complete homology (mother's and newborn's sequences) confirmed vertical transmission. To our knowledge, this is the first report of vertically-transmitted SARS-CoV-2 P.1 (gamma) variant in a mild symptomatic infection in pregnancy associated with fatal COVID in a neonate.

Análise espacial da mortalidade fetal por sífilis congênita no Município do Recife-PE-Brasil entre 2007 e 2016 / Análisis espacial de la mortalidad fetal por sífilis congénita en el municipio de Recife-PE-Brasil entre 2007 y 2016 / Spatial analysis of fetal mortality from congenital syphilis in the municipality of Recife-PE-Brazil between 2007 and 2016

Resumo Objetivo analisar a distribuição espacial da mortalidade fetal por sífilis congênita entre os bairros do Município do Recife-PE. Método estudo ecológico, realizado a partir do indicador epidemiológico taxa de mortalidade fetal por sífilis congênita, agregado ao nível dos bairros, em dois quinquênios: 2007 a 2011 e 2012 a 2016. O padrão de autocorrelação espacial foi determinado pelos Índices de Moran Global e Local, com significância estatística inferior a 5% e representado em mapas BoxMap e MoranMap que apontaram as áreas com taxas altas, baixas e em transição epidemiológica e os clusters de maior interesse epidemiológico. Resultados foram notificados 208 óbitos fetais. O Índice Global de Moran evidenciou autocorrelação espacial positiva em grau razoável, no primeiro quinquênio (I = 0,351 e p-valor = 0,01) e, em grau fraco, no segundo quinquênio (I = 0,189 e p-valor = 0,02). Os Distritos Sanitários I e VII obtiveram os maiores percentuais de bairros que formaram o cluster de altas taxas do indicador com 63,3% e 38,4% no primeiro e segundo quinquênios, respectivamente. Conclusões e implicações para a Prática a análise espacial apontou as áreas críticas para ocorrência do indicador, podendo contribuir para o investimento nas áreas prioritárias de prevenção da transmissão vertical da sífilis.

Resumen Objetivo Analizar la distribución espacial de la mortalidad fetal por sífilis congénita entre los barrios de Recife-PE. Método Estudio ecológico, basado en el indicador epidemiológico tasa de mortalidad fetal por sífilis congénita, agregada a nivel de barrio, en dos quinquenios: 2007 a 2011 y 2012 a 2016. El patrón de autocorrelación espacial fue determinado por los Índices Moran Global y Local, con significancia estadística menor al 5% y representados en mapas de BoxMap y MoranMap, que indicaron áreas con tasas de transición alta, baja y epidemiológica y conglomerados de mayor interés epidemiológico. Resultados Notificadas 208 muertes fetales. El Índice Global de Moran mostró un grado razonable de autocorrelación espacial positiva en el primer quinquenio (I = 0,351 y p-valor=0,01) y un grado débil en el segundo quinquenio (I = 0,189 y p-valor=0,02). Los Distritos Sanitarios I y VII presentaron los mayores porcentajes de barrios que formaron el cluster de tasas altas del indicador con 63,3% y 38,4% en el primer y segundo quinquenio, respectivamente. Conclusión e Implicación para la Práctica El análisis espacial señaló las áreas críticas para la ocurrencia del indicador, que podrían contribuir a la inversión en áreas prioritarias para la prevención de la transmisión vertical de sífilis.

Abstract Objective To analyze the spatial distribution of fetal mortality due to congenital syphilis among the neighborhoods of the city of Recife-PE. Method Ecological study, based on the epidemiological indicator fetal mortality rate due to congenital syphilis, aggregated at the neighborhood level, in two five-year periods: 2007 to 2011 and 2012 to 2016. The pattern of spatial autocorrelation was determined by the Moran Global and Local Indexes, with statistical significance lower than 5% and represented in BoxMap and MoranMap maps that indicated areas with high, low and epidemiological transition rates and clusters of greater epidemiological interest. Results It was reported 208 fetal deaths. The Moran Global Index showed a reasonable degree of positive spatial autocorrelation in the first five-year period (I = 0.351 and p-value = 0.01) and a weak degree in the second five-year period (I = 0.189 and p-value = 0.02). Sanitary Districts I and VII had the highest percentages of neighborhoods that formed the cluster of high rates of the indicator with 63.3% and 38.4% in the first and second five-year periods, respectively. Conclusions and Implications for Practice The spatial analysis pointed out the critical areas for the occurrence of the indicator, which could contribute to investment in priority areas for the prevention of vertical transmission of syphilis.

An excerpt of Society for Maternal-Fetal Medicine Consult Series #56: Hepatitis C in pregnancy—updated guidelines: Replaces Consult Number 43, November 2017 / 中国热带医学

@#Abstract: In the United States, it is estimated that 1% to 4% of pregnant women are infected with hepatitis C virus （HCV）, which carries approximately a 5% risk of transmission from mother to infant. Hepatitis C virus can be transmitted to the infant in utero or during the peripartum period, and infection during pregnancy is associated with an increased risk of adverse fetal outcomes, including fetal growth restriction and low birthweight. The purpose of an excerpt of Society for Maternal-Fetal Medicine Consult Series #56: Hepatitis C in pregnancy—updated guidelines: Replaces Consult Number 43, November 2017 is to discuss the current evidence, provide updated recommendations regarding screening, review treatment, and address management of hepatitis C virus during pregnancy.

Enfermedad por COVID-19 y embarazo / COVID-19 Illness and Pregnancy / Doença por COVID-19 e gravidez

Resumen: La presencia de COVID-19 en una mujer embarazada plantea una serie de inquietantes preocupaciones, ya que otros tipos de coronavirus se han asociado con resultados adversos. El objetivo de este artículo es realizar una búsqueda bibliográfica acerca del abordaje apropiado para pacientes embarazadas con COVID-19. Se realizó una búsqueda sistemática en las bases de datos: EMBASE (Elsevier), Lilacs (Biblioteca Virtual en Salud-BVS, interfaz iAHx), Medline (PubMed), Science Direct, Cochrane Database of Systematic Reviews (Wiley), DARE (Database of Abstracts of Reviews of Effects, Wiley), CENTRAL (Cochrane Central Register of Controlled Trials, Ovid), WHO, ICTRP (International Clinical Trials Registry Platform, ICTRP portal) y ClinicalTrials, entre mayo y junio del 2020. Además, se seleccionaron artículos originales, reportes de casos y artículos de revisión publicados en los últimos seis meses. No hubo restricción de idioma para permitir la recopilación de tantas publicaciones como fuera posible.

Abstract: The presence of COVID-19 in a pregnant woman raises a number of disturbing concerns, as other types of coronavirus have been associated with adverse outcomes. The objective of this article is to carry out a bibliographic search about the appropriate approach for pregnant patients with COVID-19. A systematic search was carried out in the following databases: EMBASE (Elsevier), Lilacs (Virtual Health Library-VHL, iAHx interface), Medline (PubMed), Science Direct, Cochrane Database of Systematic Reviews (Wiley), DARE (Database of Abstracts of Reviews of Effects, Wiley), CENTRAL (Cochrane Central Register of Controlled Trials, Ovid), WHO, ICTRP (International Clinical Trials Registry Platform, ICTRP portal) and ClinicalTrials, between May and June 2020. In addition, original articles, case reports and review articles published in the last six months were selected. There was no language restriction to allow the collection of as many posts as possible.

Resumo: A presenta de COVID-19 em urna mulher grávida levanta urna série de preocupares preocupantes, pois outros tipos de coronavírus foram associados a resultados adversos. O objetivo deste artigo é realizar urna pesquisa bibliográfica sobre a abordagem adequada para gestantes com COVID-19. Foi realizada urna busca sistemática ñas bases de dados: EMBASE (Elsevier), Lilacs (Biblioteca Virtual de Saúde-BVS, interface iAHx), Medline (PubMed), Science Direct, Cochrane Database of Systematic Reviews (Wiley), DARE (Banco de Dados de Resumos de Resenhas de Efeitos, Wiley), CENTRAL (Cochrane Central Register of Controlled Trials, Ovidio), QUIEN, ICTRP (Plataforma Internacional de Registro de Ensaios Clínicos, ICTRP portal) e Clinical Trials, entre maio e junho de 2020. Além disso, foram selecionados artigos originais, relatos de casos e artigos de revisão publicados nos últimos seis meses. Não houve restrição de idioma para permitir a coleta do maior número possível de postagens.

Experiências de mulheres vivendo com HIV gestantes ou lactantes num contexto de Moçambique: revisão integrativa / Experiences of pregnant or lactating women living with HIV in a Mozambican context: an integrative review

| OBJETIVO: Conhecer e documentar as experiências e as principais dificuldades vivenciadas pelas gestantes ou lactantes soropositivas. MÉTODO: Revisão integrativa da literatura com busca de produções sobre as experiências e principais dificuldades enfrentadas por mulheres vivendo com HIV/Aids, gestantes ou lactantes nas bases de dados BVS, periódicos da CAPES e SciELO, realizada em março de 2021. RESULTADOS: Foram identificadas 256 pesquisas, publicadas no período de 2016 a 2021. Destacou-se que dos 256; 70 resumos são da BVS, 181 resumos dos periódicos CAPES e 5 resumos são da SciELO; apenas 18 artigos publicados nos últimos 5 anos discutem a temática em causa. CONCLUSÃO: As mulheres HIV positivas gestantes ou lactantes podem vivenciar um sofrimento psíquico caracterizado pelo medo de infectar a criança durante a gestação, no parto ou durante a amamentação; referem ainda o receio de partilhar o diagnóstico de HIV positiva enquanto gestantes ou lactantes à família, e amigos para evitar a discriminação e estigmatização perante a sociedade que ainda não aceita que a mulher HIV positiva também tem o direito de ser mãe.

OBJECTIVE: Know and document the experiences and main difficulties experienced by HIV-positive pregnant or lactating women. METHOD: integrative literature review searching for productions on the experiences and main difficulties women face with HIV/AIDS, pregnant or lactating in the BVS databases, CAPEs, and SciELO periodicals, carried out in March 2021. RESULTS: there were identified 256 types of research published in the period from 2016 to 2021. It is highlighted that of the 256, 70 are BVS's researches, 181 are CAPES's researches, and 5 are SciELO's summaries; only 18 papers published in the past five years discussed the subject matter. CONCLUSION: The HIV positive pregnant or lactating women may experience psychic suffering characterized by the fear of infecting the children during pregnancy, on labor, or during breastfeeding; they also refer to be afraid of sharing the diagnosis of HIV-positive while pregnant or lactating to their family and friends to avoid the discrimination and stigmatization before the society that does not yet accept that HIV-positive women have the right to the motherhood.