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2.
Medicina (B.Aires) ; 81(2): 257-268, June 2021. graf
Article in Spanish | LILACS | ID: biblio-1287278

ABSTRACT

Resumen La transmisión vertical de la infección por Toxoplasma gondii ocurre cuando la madre se infecta por primera vez en el transcurso del embarazo. El diagnóstico de la infección materna y la del re cién nacido se logra con el conjunto de pruebas serológicas, hallazgos clínicos y ecográficos. El reconocimiento temprano de la infección materna permite un tratamiento que reduce la tasa de transmisión y el riesgo de daño en el producto de la concepción. El objetivo de este consenso de expertos fue revisar la literatura científica para actualizar las recomendaciones de práctica clínica respecto de la prevención, el diagnóstico y el tratamiento de la toxoplasmosis congénita en nuestro país.


Abstract Mother-to-child transmission in Toxoplasma gondii infection occurs only when the infection is acquired for the first time during pregnancy. Diag nosis of maternal infection and the newborn is achieved by a combination of serological tests, clinical features and ultrasound images. An early diagnosis of maternal infection allows treatment that offers a reduction both in transmission rate and risk of congenital damage. The aim of this expert consensus was to review the scientific literature which would enable an update of the clinical practice guideline of prevention, diagnosis and treatment of congenital toxoplasmosis in our country.


Subject(s)
Humans , Female , Pregnancy , Infant, Newborn , Child , Toxoplasma , Toxoplasmosis , Toxoplasmosis, Congenital/diagnosis , Toxoplasmosis, Congenital/prevention & control , Toxoplasmosis, Congenital/drug therapy , Pregnancy Complications, Parasitic , Infectious Disease Transmission, Vertical/prevention & control , Consensus , Medical History Taking
3.
Rev. Ciênc. Plur ; 7(2): 33-46, maio 2021. tab, graf
Article in Portuguese | LILACS, BBO | ID: biblio-1282571

ABSTRACT

Objetivo:Analisar a incidência, a mortalidade e o perfil dos casos de sífilis congênita no Rio Grande do Norte entre 2014 e 2018. Metodologia:Trata-se de um estudo epidemiológico, quantitativo, ecológico, realizado com dados de sífilis congênita registrados no Sinan. Resultados:A taxa de incidência e mortalidade por sífilis congênita duplicaram no Estado no período analisado. A maioria das crianças foi diagnosticada com menos de 7 dias após o nascimento, sendo mais predominante em filhos de mães com idade entre 20 e 29 anos, com baixa escolaridade e pardas, que foram diagnosticadas com sífilis recente e que tiveram acesso ao pré-natal. A maioria teve o diagnóstico da sífilis materna durante o pré-natal, mas não realizou tratamento adequado e o parceiro não recebeu tratamento. Conclusões:Os achados apontam para necessidade de estratégias para qualificação da atenção pré-natal com intuito de evitar a transmissão vertical, especialmente nesses grupos mais susceptíveis e vulneráveis (AU).


Objective:To analyze the incidence, mortality, and profile of cases of congenital syphilis at the Rio Grande do Norte between 2014 and 2018. Methodology:This is an epidemiological, quantitative, ecological study conducted with data on congenital syphilis registered at Sinan. Results:The incidence and mortality from congenital syphilis doubled in Rio Grande do Norte State during the analyzed period. Most children were diagnosed less than seven days after birth, being more prevalent in children of mothers aged 20 to 29 years, with low education and mixed-race, diagnosed with recent syphilis, and who had access to prenatal care. Most were diagnosed with maternal syphilis during prenatal care but did not receive adequate treatment, and the partner did not receive treatment. Conclusions:The findings show the need for strategies for quality prenatal care to avoid vertical transmission, especially in these most susceptible and vulnerable groups (AU).


Objetivo: Analizar la incidencia, la mortalidad y el perfil de los casos de sífilis congénita en el Río Grande del Norte entre 2014 y 2018.Metodología: Se trata de un estudio epidemiológico, cuantitativo y ecológico realizado con los datos de sífilis congénita registrados en el Sinan.Resultados: La incidencia y mortalidad por sífilis congénita se duplicó en el estado de Río Grande do Norte durante el período analizado. La mayoría de los niños fueron diagnosticados en menos de siete días después del nacimiento, siendo más prevalente en los hijos de madres de 20 a 29 años, con baja educación y mestizos, diagnosticados con sífilis reciente y que tuvieron acceso a la atención prenatal. La mayoría fueron diagnosticados de sífilis materna durante la atención prenatal pero no recibieron el tratamiento adecuado, y la pareja no recibió tratamiento.Conclusiones: Los hallazgos muestran la necesidad de estrategias de atención prenatal de calidad para evitar la transmisión vertical, especialmente en estos grupos más susceptibles y vulnerables (AU).


Subject(s)
Humans , Female , Child , Adolescent , Adult , Middle Aged , Prenatal Care , Syphilis, Congenital/pathology , Brazil/epidemiology , Infectious Disease Transmission, Vertical/prevention & control , Disease Notification/standards , Risk Groups , Epidemiologic Studies , Time Series Studies , Mothers
4.
Rev. Bras. Saúde Mater. Infant. (Online) ; 21(1): 207-215, Jan.-Mar. 2021. tab
Article in English | LILACS | ID: biblio-1250688

ABSTRACT

Abstract Objectives: to present an analysis of the follow-up of exposed children and pregnant women living with HIV who are assisted in a reference public healthcare service of a Brazilian capital. Methods: this is a cross-sectional study with sociodemographic and clinical data obtainedfrom physical and electronic medical records of women living with HIV and exposed children, treated between 2000 and 2018, in a secondary healthcare service. For associations, the chi-square test at 5% significance was used. Results: the data about 183 pregnancies and 214 children from the capital or other municipalities in the state were analyzed. The women have low schooling, are brown or black, single, multiparous, diagnosed with HIV during prenatal care, with the start of follow-up from the third trimester of pregnancy and the use of prophylaxis during childbirth. As for children, the associations were significant for notification on SINAN, admission to the health service, use of prophylaxis indicating better monitoring for those who live in the state capital. Conclusions: the prevention measures recommended by the Ministry of Health, in general, were followed, but children and pregnant women who live in other cities were worse off than those ones in the capital. Unnotified cases were identified on SINAN. These issues may contribute to new cases of vertical transmission of HIV.


Resumo Objetivos: apresentar uma análise do acompanhamento de crianças expostas e gestantes vivendo com HIV atendidas em um serviço público de referência de uma capital brasileira. Métodos: trata-se de estudo transversal, com dados sociodemográficos e clínicos obtidos em prontuários físicos e eletrônicos mulheres vivendo com HIV e crianças expostas, atendidas entre 2000 a 2018 em um serviço de atenção secundária à saúde. Para as associações foi utilizado o teste qui-quadrado, com significância de 5%. Resultados: foram analisados dados de 183 gestações de 150 mulheres e 214 crianças expostas a infecção pelo HIV As mulheres possuíam baixa escolaridade, eram pardas ou pretas, solteiras, multíparas, com diagnóstico de HIV durante o pré-natal, com início do acompanhamento a partir do terceiro trimestre de gestação e uso de profilaxia durante o parto. Quanto às crianças, as associações foram significativas para notificação no SINAN, admissão no serviço de saúde, uso de profilaxia indicando melhor acompanhamento para aquelas que moravam na capital do estado. Conclusões: as medidas de prevenção recomendadas pelo Ministério da Saúde, em geral, foram seguidas, porém apresentaram pior cenário as crianças e gestantes que residiam em outros munícipios quando comparadas as da capital. Foram identificados casos não notificados no SINAN. Essas questões podem contribuir para novos casos de transmissão vertical do HIV.


Subject(s)
Humans , Female , Pregnancy , Infant, Newborn , Infant , Child, Preschool , Child , Socioeconomic Factors , Secondary Care , HIV Infections/prevention & control , HIV Infections/epidemiology , Infectious Disease Transmission, Vertical/prevention & control , Epidemiological Monitoring , Underregistration , Brazil/epidemiology , Chi-Square Distribution , Cross-Sectional Studies , Pregnant Women , Maternal-Child Health Services
5.
Article in Chinese | WPRIM | ID: wpr-921533

ABSTRACT

Objective To evaluate the effects of antiretroviral therapy(ART)for the prevention of mother-to-child transmission(PMTCT)of acquired immune deficiency syndrome(AIDS)on the growth and development of 18-month-old children born by human immunodeficiency virus(HIV)-positive pregnant women in Lingshan County,Guangxi Zhuang Autonomous Region,and provide scientific evidence for improving the ART medication plan for PMTCT.Methods Lingshan County,ranking the first in the HIV-epidemic counties of Guangxi,was selected as the research site.According to the design of retrospective case-control study,we assigned all the subjects into the case group and the control group:(1)The case group included the HIV-positive pregnant women who had received ART for PMTCT and their HIV-negative infants in Lingshan County from 2010 to 2017.The historical cards and PMTCT data of them were collected from the national PMTCT database.(2)The control group included the healthy pregnant women and their healthy babies born in the Lingshan Maternity and Infant Hospital in 2017,and the children's growth and development data were collected.The stunted growth in children was defined as at least one of the three main indicators of body height,body weight,and head circumference below the normal range.Results The number of HIV-positive mothers and their infants in the case group was 391 and 368,respectively,and 87.21%(341/391)and 95.38%(351/368)of mothers and infants respectively received ART medication.The HIV positive rate,mortality rate,and mother-to-child transmission rate of 18-month-old children were 1.36%(5/368),4.35%(16/368),and 2.01%(5/249),respectively.The incidence of stunted growth of 18-month-old children in the case group and the control group was 42.12%(155/368)and 23.06%(101/438),respectively,with significant difference(


Subject(s)
Case-Control Studies , China/epidemiology , Female , Growth and Development , HIV , HIV Infections/prevention & control , Humans , Infant , Infectious Disease Transmission, Vertical/prevention & control , Mothers , Pregnancy , Pregnancy Complications, Infectious/drug therapy , Retrospective Studies
6.
Chinese Medical Journal ; (24): 2825-2831, 2021.
Article in English | WPRIM | ID: wpr-921162

ABSTRACT

Chronic hepatitis B virus (HBV) infection due to vertical transmission remains a critical concern with regards to eliminating HBV infection. Implementation of hepatitis B vaccine, the foundation to prevent perinatal and horizontal transmission, has reduced the prevalence of HBV by >80%. In countries where the hepatitis B immune globulin (HBIG) is available, such as China and the United States, the administration of HBIG and hepatitis B vaccine to the infants of mothers who are positive for hepatitis B surface antigen has become a standard practice and is effective in preventing vertical transmission. Accumulating evidence on the efficacy and safety of antiviral prophylaxis during pregnancy indicates the probability of attaining the goal of the World Health Organization to eliminate hepatitis by 2030. In this review, we discuss the transmission routes, diagnostic criteria, and preventive strategies for vertical transmission. A preventive program that includes screening before pregnancy, antiviral prophylaxis during pregnancy, and postpartum immunoprophylaxis provides "perfect strategies" to eliminate vertical transmission. However, there is still a notable gap between "perfect strategies" and real-world application, including insufficient coverage of timely birth dose vaccine and the efficacy and necessity of HBIG, especially in mothers who are negative for hepatitis B envelope antigen. In particular, there is a clear need for a comprehensive long-term safety profile of antiviral prophylaxis. Therefore, feasible and cost-effective preventive strategies need to be determined across regions. Access also needs to be scaled up to meet the demands for prophylaxis and prevalence targets.


Subject(s)
Female , Hepatitis B Surface Antigens , Hepatitis B Vaccines , Hepatitis B virus , Hepatitis B, Chronic , Humans , Infant , Infectious Disease Transmission, Vertical/prevention & control , Pregnancy
7.
Chinese Medical Journal ; (24): 2818-2824, 2021.
Article in English | WPRIM | ID: wpr-921161

ABSTRACT

Chronic hepatitis B virus (HBV) infection is a serious health issue because of its severe sequelae. Prevention of mother-to-child transmission (MTCT) of HBV is critical to eliminate chronic HBV infection. Here, we reviewed the progress toward the elimination of HBV infection in children in China in the recent decade. A universal hepatitis B vaccination program started from 2002 has been intensified, with the coverage of timely birth dose >95% of all newborn infants from 2012. Since 2011, China has taken a nationwide program to administer hepatitis B immunoglobulin (HBIG) with free of charge in all neonates of HBV-infected mothers, leading to a significant increment of timely use of HBIG. The prevalence of hepatitis B surface antigen (HBsAg) was declined from around 10% among children in 1980s to 2 × 105 U/mL during the third trimester is increasing, which will further reduce MTCT of HBV. However, there are some challenges in the elimination of HBV infection in children, which need to overcome by the concerted efforts. Nevertheless, it is anticipated that China will achieve the goal set by the World Health Organization that the prevalence of HBsAg in children aged <5 years is ≤0.1% by 2030.


Subject(s)
China/epidemiology , Female , Hepatitis B/prevention & control , Hepatitis B Surface Antigens , Hepatitis B virus , Hepatitis B, Chronic/prevention & control , Humans , Infant , Infant, Newborn , Infectious Disease Transmission, Vertical/prevention & control , Pregnancy , Pregnancy Complications, Infectious/epidemiology
8.
Chinese Journal of Hepatology ; (12): 313-318, 2021.
Article in Chinese | WPRIM | ID: wpr-879637

ABSTRACT

The World Health Organization (WHO) has set the goal of eliminating viral hepatitis as a threat to public health by 2030. Blocking mother-to-child transmission (MTCT) of hepatitis B virus (HBV) is the key step for eliminating viral hepatitis, at the same time, it is the hotspot in the field of hepatitis B prevention and control as well. The China Foundation of Hepatitis Prevention and Control (CFHPC) organized a team of specialists to develop an algorithm for preventing MTCT of HBV, based on the most recent hepatitis B guidelines and the latest evidence. The algorithm covers 10 continuous steps from pregnant management to follow-up postpartum. Among the 10 steps, screening, antiviral therapy during pregnancy, and infant's immunization are the core components in the algorithm.


Subject(s)
Algorithms , Antiviral Agents/therapeutic use , Child , China , Female , Hepatitis B/prevention & control , Hepatitis B Surface Antigens , Hepatitis B e Antigens , Hepatitis B virus , Humans , Infant , Infectious Disease Transmission, Vertical/prevention & control , Pregnancy , Pregnancy Complications, Infectious/prevention & control
9.
Cad. Saúde Pública (Online) ; 37(3): e00069820, 2021. tab, graf
Article in Portuguese | LILACS | ID: biblio-1285811

ABSTRACT

Resumo: A transmissão vertical do HIV ainda representa um importante problema de saúde pública no mundo. O objetivo deste estudo foi verificar a transmissão vertical do HIV em Rio Branco, Acre, Brasil, e avaliar a possibilidade de eliminação. Foi realizado estudo transversal dos casos de HIV em gestante e longitudinal sobre a incidência da transmissão vertical do HIV na base populacional de gestantes residentes no Município de Rio Branco, no período de 2007-2015. As coortes de gestantes foram formadas por mulheres que tiveram filhos nascidos vivos, mortos ou abortos. Os dados foram obtidos do Sistema de Informação de Agravos de Notificação (SINAN), Sistema de Informações sobre Nascidos Vivos (SINASC), Sistema de Informação sobre Mortalidade (SIM) e Sistema de Informações Hospitalares (SIH). Foi realizado o relacionamento entre as bases de dados utilizando o software OpenRecLink. Foram calculadas as prevalências de HIV em gestante, a taxa de transmissão vertical e os principais fatores associados. A prevalência de HIV em gestante apresentou tendência de aumento, e a prevalência média foi de 0,18%, as variáveis estatisticamente associadas à ocorrência de HIV em gestantes foram idade materna ≥ 20 anos (p = 0,007), menor escolaridade (p = 0,054) e não ter companheiro (p = 0,001). A transmissão vertical foi de 6,9%. O uso de terapia antirretroviral (TARV) no pré-natal, mesmo entre as gestantes que já sabiam ser portadoras do vírus, foi menor que 90%. A realização de cesáreas eletivas ficou abaixo de 60%, e o uso de TARV no parto e pelo recém nascido nas primeiras 24 horas apresentou variações, dependendo do período em que o diagnóstico materno foi realizado. Embora as estratégias de eliminação da transmissão vertical do HIV estejam bem estabelecidas, os resultados deste estudo ainda apontam falhas importantes na cascata de cuidados das gestantes infectadas em Rio Branco.


Abstract: Vertical HIV transmission is still an important global public health problem. This study aimed to verify vertical HIV transmission in Rio Branco, Acre, Brazil, and to assess the possibility of its elimination. A cross-sectional study was conducted of HIV in pregnant women and a longitudinal study on the incidence of vertical HIV transmission in pregnant women living in the municipality (county) of Rio Branco in 2007-2015. The cohorts of pregnant women consisted of women who had liveborn children, stillbirths, or abortions. The data were obtained from the Brazilian Information System for Notificable Diseases (SINAN), Brazilian Information System on Live Births (SINASC), Brazilian Mortality Information System (SIM), and Brazilian Hospital Information Systems (SIH). Databases. Probabilistic database linkage was performed with the OpenRecLink software. The authors calculated the HIV prevalence rate in pregnant women, the vertical transmission rate, and the principal associated factors. HIV prevalence in pregnant women showed an upward trend, and the mean prevalence was 0.18%. Variables statistically associated with the occurrence of HIV in pregnant women were maternal age ≥ 20 years (p = 0.007), lower schooling (p = 0.054), and unmarried conjugal status/without partner (p = 0.001). Vertical HIV transmission was 6.9%. Use of antiretroviral therapy (ART) during prenatal care, even among pregnant women that already knew they were HIV-positive, was less than 90%. The elective cesarean rate was less than 60%, and the use of ART during delivery and by the newborn in the first 24 hours showed variations, depending on the period in which the maternal diagnosis was made. Although the strategies for the elimination of vertical HIV transmission are well established, this study's results point to important flaws in the cascade of care for HIV-infected pregnant women in Rio Branco.


Resumen: La transmisión vertical del VIH todavía representa un importante problema de salud pública en el mundo. El objetivo de este estudio fue verificar la transmisión vertical del VIH en Río Branco-Acre y evaluar la posibilidad de su eliminación. Se realizó un estudio transversal de los casos de VIH en gestantes y longitudinal sobre la incidencia de la transmisión vertical del VIH en la base poblacional de gestantes residentes en el municipio de Río Branco, durante el período de 2007-2015. Las cohortes de gestantes estuvieron formadas por mujeres que tuvieron hijos nacidos vivos, muertos o abortos. Los datos se obtuvieron del Sistema Brasileño de Información de Enfermedades de Notificación (SINAN), Sistema de Información sobre Nacidos Vivos (SINASC), Sistema de Información sobre Mortalidad (SIM) y Sistema de Informaciones Hospitalarias (SIH). Se realizó la relación entre las bases de datos, utilizando el software OpenRecLink. Se calcularon las prevalencias de VIH en gestantes, la tasa de transmisión vertical y sus principales factores asociados. La prevalencia de VIH en gestantes presentó una tendencia de aumento y la prevalencia media fue de 0,18%, las variables estadísticamente asociadas a la ocurrencia de VIH en gestantes fueron: edad materna ≥ 20 años (p = 0,007), menor escolaridad (p = 0,054) y no contar con compañero (p = 0,001). La transmisión vertical fue de un 6,9%. El uso de terapia antirretroviral viral (TARV) durante el período prenatal, incluso entre las gestantes que ya se sabían portadoras del virus, fue menor de un 90%. La realización de cesáreas electivas quedó por debajo de un 60% y el uso de TARV en el parto y por el recién nacido en las primeras 24 horas presentó variaciones, dependiendo del período en que el diagnóstico materno fue realizado. A pesar de que las estrategias de eliminación de la transmisión vertical del HIV estén bien establecidas, los resultados de este estudio todavía apuntan fallos importantes en la cascada de cuidados de las gestantes infectadas en Río Branco.


Subject(s)
Humans , Female , Pregnancy , Infant, Newborn , Child , Adult , Young Adult , Pregnancy Complications, Infectious/prevention & control , Pregnancy Complications, Infectious/epidemiology , HIV Infections/prevention & control , HIV Infections/epidemiology , Brazil/epidemiology , Cross-Sectional Studies , Longitudinal Studies , Infectious Disease Transmission, Vertical/prevention & control
10.
Rev. Soc. Bras. Med. Trop ; 54(supl.1): e2020834, 2021. graf
Article in English | LILACS | ID: biblio-1250844

ABSTRACT

Abstract This article discusses viral hepatitis, a theme addressed by the Clinical Protocol and Therapeutic Guidelines to Comprehensive Care for People with Sexually Transmitted Infections and, more precisely, by the Clinical Protocols and Therapeutic Guidelines for Hepatitis B and Hepatitis C and Coinfections, published by the Brazilian Ministry of Health. Besides the broad spectrum of health impairment, hepatitis A, B, and C viruses also present different transmission forms, whether parenteral, sexual, vertical, or fecal-oral. Among the strategies suggested for the control of viral hepatitis, in addition to behavioral measures, are expanded diagnosis, early vaccination against hepatitis A and hepatitis B viruses, and access to available therapeutic resources. Considering vertical transmission of the hepatitis B and hepatitis C viruses, screening for pregnant women with chronic hepatitis B and C is an essential perinatal health strategy, indicating with precision those who can benefit from the prophylactic interventions.


Subject(s)
Humans , Female , Pregnancy , Sexually Transmitted Diseases/diagnosis , Sexually Transmitted Diseases/prevention & control , Hepatitis C/diagnosis , Hepatitis C/prevention & control , Hepatitis B/diagnosis , Hepatitis B/prevention & control , Brazil , Infectious Disease Transmission, Vertical/prevention & control
11.
Rev. Bras. Saúde Mater. Infant. (Online) ; 20(4): 985-995, Oct-Dec. 2020. tab
Article in English | LILACS | ID: biblio-1155289

ABSTRACT

Abstract Objectives: to analyze the association of socioeconomic, obstetric, pediatric and prophylactic factors to the vertical transmission of HIV in children followed at a reference service in Recife between 2010 and 2015. Methods: case-control nested the cohort of children exposed to vertical transmission of HIV. A univariate and multivariate statistical analysis was performed on the association of socioeconomic, obstetric, pediatric and prophylactic measures with the outcome. We considered two multivariate approaches, conventional and hierarchical, the latter made it possible to consider different levels of determination. Results: 46.5% of the mothers had low schooling, 69.6% without work-related wages and 35.7% received a family grant. Women with postpartum diagnosis and less than 6 prenatal appointments had a greater chance of vertical transmission. Prophylactic measures were statistically associated with prevention of transmission (p<0.1%). Conclusions: vertical risk factors for HIV transmission were identified: no sewage system, at least six prenatal consultations, first care of the child with more than two months and no prophylaxis in pregnancy and childbirth. Determining factors for which specific policies and programs exist and their non-access social determination evidence of HIV vertical transmission.


Resumo Objetivos: analisar a associação dos fatores socioeconómicos, obstétricos, pediátricos e medidas profiláticas à transmissão vertical do HIV em crianças acompanhadas em um serviço de referência no Recife, entre 2010 e 2015. Métodos: caso-controle aninhado a coorte de crianças expostas à transmissão vertical do HIV. Realizou-se análise estatística uni e multivariada da associação das características socioeconômicas, obstétricas, pediátricas e das medidas profiláticas com o desfecho. Considerou-se duas abordagens multivariadas, convencional e hierarquizada, esta última possibilita considerar diferentes níveis de determinação. Resultados: observou-se 46,5% de mães com baixa escolaridade, 69,6% sem remuneração advinda do trabalho e 35,7% recebendo bolsa família. Mulheres com diagnóstico pós-parto e menos de 6 consultas de pré-natal apresentaram maior chance de transmissão vertical. As medidas profiláticas estiveram estatisticamente associadas à prevenção da transmissão (p<0,1%). Conclusões: identificaram-se como fatores de risco para a transmissão vertical do HIV: não possuir rede coletora de esgoto, não ter realizado no mínimo seis consultas de pré-natal, primeiro atendimento da criança com mais de dois meses e não ter realizado as profilaxias na gestação e no parto. Fatores determinantes para os quais existem políticas e programas específicos e o seu não acesso evidencia a determinação social da transmissão vertical do HIV.


Subject(s)
Humans , Child , Socioeconomic Factors , Risk Factors , HIV , Infectious Disease Transmission, Vertical/prevention & control , Infectious Disease Transmission, Vertical/statistics & numerical data , Brazil/epidemiology , Case-Control Studies , Multivariate Analysis , Observational Study
12.
Rev. Bras. Saúde Mater. Infant. (Online) ; 20(4): 1165-1172, Oct-Dec. 2020. tab
Article in English | LILACS | ID: biblio-1155297

ABSTRACT

Abstract Objectives: to estimate the prevalence and the factors associated with the colonization by group B streptococcus (GBS) in pregnant women from the urban area attended at health units in a municipality in northeastern Brazil. Methods: it is a cross-sectional study conducted from January 2017 to March 2018. Vagino-rectal swabs were collected from 210 pregnant women between 32 and 40 weeks of gestation. The swabs were seeded on 5% sheep blood agar and on chromogenic agar. For confirmatory identification of GBS, the CAMP test and latex agglutination were used. Descriptive analysis and univariate and multivariate association analysis were performed using a multinomial logistic model. Results: the prevalence of GBS colonization among pregnant women was 18.1% (n = 38), and a statistically significant association (p<0.05) was found for income and parity variables in the group of older women in the univariate analysis, and for skin color, age and parity in the final multivariate analysis. Conclusions: the prevalence of maternal colonization by GBS was similar to that described in other studies. Although some risk factors, such as skin color, age and parity, were associated with colonization, other studies are essential to establish more information on pregnant women more likely to be colonized by GBS.


Resumo Objetivos: estimar a prevalência e apontar fatores associados à colonização por estreptococos do grupo B (EGB) em gestantes da zona urbana atendidas em unidades de saúde de um município do nordeste do Brasil. Métodos: trata-se de um estudo transversal realizado entre janeiro de 2017 a março de 2018. Foram coletados swabs vaginorretais de 210 gestantes entre a 32 e 40 semanas de gestação. As amostras foram semeadas em ágar sangue de carneiro 5% e ágar cromogênico. Para identificação confirmatoria de EGB foram utilizados o teste de CAMP e aglutinação em látex. Foram realizadas análise descritiva, de associação univariada e multivariada utilizando modelo logístico multinomial. Resultados: a prevalência de colonização por EGB entre as gestantes foi de 18,1% (n=38), e as variáveis renda e paridade no grupo de mulheres mais velhas na análise univariada além de cor da pele, idade e paridade na análise multivariada final estiveram estatisticamente associadas ao desfecho (p<0,05). Conclusões: a prevalência da colonização materna pelo EGB mostrou-se semelhante às descritas em outros estudos. Apesar de alguns fatores de risco como cor da pele, idade e paridade estarem associados à colonização, outros estudos são fundamentais para se estabelecer maiores informações sobre as gestantes mais passíveis de colonização pelo EGB.


Subject(s)
Humans , Female , Pregnancy , Prenatal Diagnosis , Streptococcus agalactiae , Prevalence , Risk Factors , Infectious Disease Transmission, Vertical/prevention & control , Urban Area , Primary Health Care , Socioeconomic Factors , Streptococcal Infections/epidemiology , Brazil/epidemiology , Infectious Disease Transmission, Vertical/statistics & numerical data
13.
Rev. chil. pediatr ; 91(5): 672-683, oct. 2020. tab
Article in Spanish | LILACS | ID: biblio-1144265

ABSTRACT

La prevención de la transmisión vertical de VIH es un desafío para todos los países del mundo. Esto se ve complejizado por la construcción permanente de sociedades globales, con grado variable de población migrante internacional. Las políticas, programas y acciones sanitarias para la prevención de transmisión vertical de VIH en gestantes migrantes demandan una perspectiva intercultural, en donde se aborden todas las dimensiones sociales, culturales y de género asociadas a la infección. El entender la realidad local en cuanto a la prevención de transmisión vertical de VIH en población migrante internacional en Chile es esencial para llevar acciones concretas que favorezcan la prevención de transmisión madre-hijo de VIH. En este artículo se presentan algunos conceptos esenciales relacionados a esta temática. También se expone información internacional y nacional sobre riesgos de transmisión vertical de VIH en migrantes gestantes, la importancia del plan nacional de preven ción de transmisión vertical de VIH en nuestro país, y algunos esfuerzos que se están realizando para adaptar dicho plan a la realidad de diversidad social y cultural que migrantes gestantes presentan hoy en Chile, como un valioso insumo de salud pública con perspectiva intercultural.


Preventing vertical transmission of HIV is a challenge for all countries worldwide. The permanent construction of global societies with a variable degree of international migrant population has made it more complex. Health policies, programs, and actions for preventing vertical transmission of HIV in pregnant migrants demand an intercultural perspective, where social, cultural, and gender dimen sions associated with the infection are addressed. Understanding the local reality regarding the pre vention of vertical transmission in the international migrant population in Chile is essential to carry out concrete actions that favor the prevention of mother-to-child transmission of HIV. This article presents some essential concepts related to this topic. It also presents international and national in formation on risks of vertical transmission in pregnant migrants, the importance of the national plan for preventing vertical transmission of HIV in our country, and some ongoing efforts to adapt such plan to the reality of social and cultural diversity that pregnant migrants currently present in Chile, as a useful public health instrument with an intercultural perspective.


Subject(s)
Humans , Female , Pregnancy , Infant, Newborn , Pregnancy Complications, Infectious/diagnosis , Pregnancy Complications, Infectious/ethnology , Pregnancy Complications, Infectious/therapy , Prenatal Care/methods , Transients and Migrants , HIV Infections/transmission , Infectious Disease Transmission, Vertical/prevention & control , Emigrants and Immigrants , Culturally Competent Care/methods , HIV Infections/diagnosis , HIV Infections/ethnology , HIV Infections/therapy , Chile/epidemiology , Social Determinants of Health , Health Policy
14.
Rev. bras. ginecol. obstet ; 42(9): 562-568, Sept. 2020.
Article in English | LILACS | ID: biblio-1137873

ABSTRACT

Abstract Objective The present comprehensive review aims to show the full extent of what is known to date and provide a more thorough view on the effects of SARS-CoV2 in pregnancy. Methods Between March 29 and May, 2020, the words COVID-19, SARS-CoV2, COVID- 19 and pregnancy, SARS-CoV2 and pregnancy, and SARS and pregnancy were searched in the PubMed and Google Scholar databases; the guidelines from well-known societies and institutions (Royal College of Obstetricians and Gynaecologists [RCOG], American College of Obstetricians and Gynecologists [ACOG], International Society of Ultrasound in Obstetrics & Gynecology [ISUOG], Centers for Disease Control and Prevention [CDC], International Federation of Gynecology and Obstetrics [FIGO]) were also included. Conclusion The COVID-19 outbreak resulted in a pandemic with > 3.3 million cases and 230 thousand deaths until May 2nd. It is caused by the SARS-CoV2 virus and may lead to severe pulmonary infection and multi-organ failure. Past experiences show that unique characteristics in pregnancy make pregnant women more susceptible to complications from viral infections. Yet, this has not been reported with this new virus. There are risk factors that seem to increase morbidity in pregnancy, such as obesity (body mass index [BMI] > 35), asthma and cardiovascular disease. Current reports describe an increased rate of pretermbirth and C-section. Vertical transmission


Resumo Objetivo A presente revisão detalhada busca fornecer dados objetivos para avaliar o que se sabe até o momento e possibilitar uma visãomais ampla dos efeitos do SARSCoV2 na gravidez. Métodos Entre 29 demarço e 2 de maio de 2020, foi realizada uma busca nos bancos de dados PubMed e Google Scholar com as palavras COVID-19, SARS-CoV2, COVID-19 e gravidez, SARS-CoV2 e gravidez, e SARS e gravidez. As recomendações dos principais órgãos sobre o tema também foram acessadas. Conclusão O surto de COVID-19 resultou em uma pandemia com> 3.3 milhões de casos e 230 mil mortes até 2 de maio. É uma condição causada pelo vírus SARS-CoV2 e pode levar ao acometimento pulmonar difuso e à falência de múltiplos órgãos. Características únicas da gestante tornam essa população mais propensas a complicações de infecções virais. Até o momento, essa tendência não foi observada para esse novo vírus. Os fatores que parecem estar associados à maior morbidade materno-fetal são obesidade (índice demassa corporal [IMC] > 35), asma e doença cardiovascular. Há descrição de aumento de parto prematuro e parto cesáreo. Não se pode descartar a possibilidade de transmissão vertical da doença, devido a relatos de positividade de reação em cadeia de polimerase (RT-PCR) de swab nasal, RT-PCR de líquido amniótico e imunoglobulina M (IgM) de recém-nascidos. Tratamentos devem ser analisados caso a caso, dada a falta de qualidade de estudos que comprovem a sua eficácia e segurança na gravidez. O corpo clínico deve utilizar equipamentos de proteção individual (EPI) ao manusear pacientes suspeitos ou confirmados e ficar atento aos sinais de descompensação respiratória.


Subject(s)
Humans , Female , Pregnancy , Pneumonia, Viral/diagnosis , Pneumonia, Viral/therapy , Pneumonia, Viral/transmission , Pneumonia, Viral/epidemiology , Pregnancy Complications, Infectious/diagnosis , Pregnancy Complications, Infectious/therapy , Pregnancy Complications, Infectious/epidemiology , Coronavirus Infections/diagnosis , Coronavirus Infections/therapy , Coronavirus Infections/transmission , Coronavirus Infections/epidemiology , Pandemics , Betacoronavirus/isolation & purification , Cesarean Section/statistics & numerical data , Global Health , Risk Factors , Infection Control/methods , Infectious Disease Transmission, Patient-to-Professional/prevention & control , Perinatal Care/methods , Infectious Disease Transmission, Vertical/prevention & control , Premature Birth/epidemiology , Premature Birth/virology , SARS-CoV-2 , COVID-19
17.
Rev. Col. méd. cir ; 159(1): 10-17, abr 2020. graf
Article in Spanish | LILACS, LIGCSA | ID: biblio-1223158

ABSTRACT

La presentación de la infección por SARS-CoV2 en neonatos nacidos de madres positivas no está clara, pues aún no hay evidencia definitiva de transmisión vertical. El objetivo es presentar cinco casos de recién nacidos, hijos de madres con infección perinatal a SARS-CoV-2, describir las características clínicas y el éxito del uso de técnicas de aislamiento de contacto y gotas al momento de realizar apego madre-hijo y alimentación a seno materno para evitar transmisión horizontal. Se analizaron 5 neonatos durante el mes de abril 2020, obteniendo datos clínicos y de laboratorio del expediente y entrevista. Todas las madres fueron asintomáticas a SARS-Cov-2, con antecedentes de ruptura prematura de membranas, sufrimiento fetal, oligohidramnios y preeclampsia. En 3 recién nacidos, se evidenció alteración clínica secundaria a procesos aún no asociados a infección por SARS-CoV-2. Las pruebas de RT-PCR para SARS-CoV-2 realizadas en neonatos, en diferentes tipos de muestra, fueron negativas. Todos los neonatos recibieron leche materna y realizaron apego madre-hijo con medidas de aislamiento por transmisión de gotas y contacto con supervisión médica. En este reporte de casos, se demostró que, con el uso correcto de las técnicas de aislamiento por gotas y contacto, información, supervisión y acompañamiento a las madres, se disminuye considerablemente el riesgo de contagio al recién nacido. Se necesitan más estudios para determinar si existe transmisión vertical.


The presentation of SARS-CoV-2 infection in neonates born to positive mothers is not clear, there is still no definitive evidence of vertical transmission. The objective is to present five cases of neonate born to SARS-CoV-2 mothers with perinatal infection, in addition to describing the clinical characteristics and the success of using contact and drop isolation techniques at the time of motherchild attachment and maternal feeding to avoid horizontal transmission. Five infants were analyzed in April 2020, obtaining clinical and laboratory data from the clinical records and interviews. All mothers were asymptomatic to SARS-Cov-2 and had a history of premature rupture of membranes, fetal distress, oligohydramnios, and preeclampsia. In 3 newborns, clinical alterations not yet documented as related to SARS-CoV-2 infection were evident. RT-PCR tests for SARS-CoV-2 performed in neonates, on different types of samples, were negative. All neonates received breast milk and had mother-child attachment with isolation measures by drop transmission and contact with medical supervision. In this case report, it was demonstrated that, with the correct use of the techniques of isolation from drops and contact, information, supervision and accompaniment to the mothers, the risk of contact to the newborn was diminished. More studies are needed to determine if there is vertical transmission.


Subject(s)
Humans , Female , Infant, Newborn , Breast Feeding , Infant, Newborn , Coronavirus Infections/prevention & control , Betacoronavirus , Infectious Disease Transmission, Vertical/prevention & control , Disease Transmission, Infectious/prevention & control , Fetal Distress/diagnosis , Mothers
18.
s.l; IETSI; mar. 2020.
Non-conventional in Spanish | LILACS, BRISA | ID: biblio-1096593

ABSTRACT

INTRODUCCIÓN: Los coronavirus humanos comunes; 229E (alfa coronavirus), NL63 (alfacoronavirus), OC43 (beta coronavirus) y HKU1 (beta coronavirus) causan el resfriado común(1). Sin embargo, existen tres coronavirus humanos que causan enfermedades más graves y agudas; MERS-CoV que causa elsíndrome respiratorio de medio oriente, MERS, SARS-CoV que causa el síndrome respiratorio agudo severo o SARS y el coronavirus SARS-CoV-2 que causa COVID-19(2). Las mujeres embarazadas tienen un alto riesgo de desarrollar una infección grave durante esta pandemia actual de SARS-CoV-2, ya que las gestantes presentan mayor alteración de su sistema inmune como disminución de la respuesta proliferativa de linfocitos, especialmente en el segundo y tercer trimestres(3) y cursan con cambios fisiológicos maternos en la función pulmonar(4). Existe información limitada que evalue el impacto de SARS-CoV-2 en las mujeres durante el embarazo y en el feto o neonato. Dado que además, es fundamental determinar si existe trasmisión del SARS-CoV2 de madre a feto, realizamos una revisión rápida para guiar el manejo de las mujeres afectadas por COVID-19 durante el embarazo. MÉTODOS: Criterios de Inclusion: Relacionados con el tema a tratar: trasmisión de SARS-CoV-2 madre-feto. Tipos de estudio: Revisiones sistemáticas, ECAs, estudios observacionales, reportes de casos o Idioma: Aquellos publicados en inglés, español. Criterios de Exclusion: Tipo de estudio: cartas al director, editoriales, comentarios, fichas técnicas. Fuentes de Información: Se revisó la base de datos de MEDLINE/PUBMED. Adicionalmente, se revisó manualmente las publicaciones que citaron los artículos de interés, así como publicaciones citadas de los mismos estudios. Estrategia de Búsqueda: La estrategia de búsqueda se basó en los términos MeSH (Medical Subject Headings). Se revisó literatura en inglés y español. La fecha de búsqueda fue el 21 de marzo del 2020. RESULTADOS: De acuerdo con nuestra estrategia de búsqueda identificamos 36 estudios. Dos revisores (YHR y JTM) evaluaron la elegibilidad de los estudios según títulos y resúmenes aplicando los objetivos de esta revisión y la pregunta de investigación (PICO). Las referencias que cumplieron con los criterios de búsqueda fueron exportadas al software de manejo de referencias Zoter. CONCLUSIONES: La infección perinatal SARS-CoV-2 podría tener efectos adversos, causando problemas como sufrimiento fetal, parto prematuro, dificultad respiratoria, trombocitopenia acompañada de una función hepática anormal e incluso la muerte. Sin embargo, los datos clínicos sobre la infección por SARS-CoV-2 en recién nacidos aún son muy limitados y la evidencia no es suficiente para atribuir estos eventos a SARS-CoV-2 o a la neumonía causada por esta. La neumonía producida por SARS-COV-2 en las gestantes, pueden verse incrementada por la inmunosupresión y cambios respiratorios fisiológicos que causa el embarazo en la mujer. Hasta el momento, no se ha reportado evidencia sólida respecto a la trasmisión de SARS-CoV-2 madrefeto en muestras de placenta, sangre de cordón umbilical, líquido amniótico y leche materna. Por lo tanto, es sería importante mantener todas las muestras de mujeres embarazadas infectadas y sospechosas de SARSCoV-2 y sus recién nacidos, para un estudio a profundidad y un seguimiento continuo de los recién nacidos para valorar su daño a corto y largo plazo. Todos los estudios revisados corresponden a reportes de caso, por ello, los datos deben interpretarse con cautela y no considerarse como evidencia concluyente. Pero, dado que estamos frente a una enfermedad emergente, estos datos son útiles para una primera aproximación sobre la relación del SARS-CoV-2 y la transmisión madre-feto.


Subject(s)
Coronavirus Infections/transmission , Infectious Disease Transmission, Vertical/prevention & control , Technology Assessment, Biomedical
19.
Article in English | WPRIM | ID: wpr-878292

ABSTRACT

Objective@#To calculate the number of pregnant women who receive standardized prevention of mother-to-child transmission (PMTCT) services for HIV annually.@*Methods@#HIV-positive pregnant women in six counties of Liangshan Prefecture in 2017 were selected as study subjects. The entire process, from when the subjects first received the PMTCT of HIV services to the end, was divided into four stages, which were further divided into 25 phases. The equivalent coefficient was used to indicate the weight of workload in each phase. Seven experts were invited to score the equivalent coefficient; the number of pregnant women who received standardized services to prevent the transmission of HIV was calculated.@*Results@#A total of 663 HIV-positive pregnant women were registered in six Liangshan Prefecture counties in 2017. This figure was converted into 7,780 person-months devoted to HIV-positive pregnant women, with 260 person-months (3.34%) spent on the first antenatal care, 1,510 person-months (19.41%) during pregnancy, 378 person-months (4.86%) on delivery, and 5,632 person-months (72.39%) on post-partum period. The equivalent coefficient calculation showed that 314 HIV-positive pregnant women received standardized PMTCT services.@*Conclusion@#The number of pregnant women receiving standardized services for the PMTCT of HIV can be calculated accurately using the equivalent method to identify the gap between the level of PMTCT of HIV intervention services needed and the actual workload.


Subject(s)
Anti-HIV Agents/therapeutic use , Female , HIV Infections/virology , Humans , Infectious Disease Transmission, Vertical/prevention & control , Pregnancy , Pregnant Women
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