Your browser doesn't support javascript.
loading
Show: 20 | 50 | 100
Results 1 - 20 de 299
Filter
1.
Med. infant ; 31(1): 44-50, Marzo 2024. Ilus, Tab
Article in Spanish | LILACS, UNISALUD, BINACIS | ID: biblio-1553048

ABSTRACT

El uso de antirretrovirales (ARV) en el embarazo, el parto y el recién nacido y la aplicación de tratamientos combinados en los niños se han asociado con una disminución del sida en pediatría y el aumento de la sobrevida. La introducción de los inhibidores de integrasa en una dosis diaria ha eliminado barreras para la adherencia, pero los medicamentos orales diarios continúan planteando problemas de privacidad y estigma. Las nuevas tecnologías de administración de los medicamentos y las nuevas drogas junto con la combinación de ARV y los anticuerpos ampliamente neutralizantes (bNAb), ofrecen un potencial de opciones futuras para el tratamiento pediátrico del HIV. Los bNAb son anticuerpos que pueden reconocer diferentes tipos de HIV, bloquear su entrada en las células sanas y ayudar a destruir las células ya infectadas, pueden administrarse por vía parenteral y constituyen un enfoque novedoso y seguro con potencial para el tratamiento y la prevención del HIV, incluida la transmisión vertical. En los lactantes que contraen HIV, los bNAb podrían ofrecer ventajas terapéuticas al reducir el reservorio del virus, mejorar la inmunidad adquirida y, en el futuro, proporcionar un camino hacia la cura funcional. Dentro de los ARV inyectables de acción prolongada, cabotegravir/ rilpivirina se ha incorporado en las guías internacionales de adultos y adolescentes tanto para el tratamiento como para la prevención. A medida que el tratamiento del HIV en adultos va evolucionando, es fundamental asegurar que los neonatos, lactantes, niños y adolescentes tengan acceso a las mejores opciones de tratamiento y prevención a lo largo de su vida (AU)


The use of antiretrovirals (ARVs) during pregnancy, delivery, and in the newborn and the use of combination therapy in children have been associated with a decrease in pediatric AIDS and increased survival. The introduction of once-daily integrase inhibitors has removed barriers to adherence, but daily oral medications continue to pose privacy and stigma issues. New drug delivery technologies and new drugs along with the combination of ARVs and broadly neutralizing antibodies (bNAbs) offer potential future options for pediatric HIV treatment. bNAbs are antibodies that can recognize different types of HIV, block their entry into healthy cells and help destroy already infected cells, can be delivered parenterally, and represent a novel and safe approach with potential for the treatment and prevention of HIV, including mother-to-child transmission. In infants who contract HIV, bNBAs could offer therapeutic advantages by reducing the viral reservoir, enhancing acquired immunity and, in the future, providing a pathway to a functional cure. Within the long-acting injectable ARVs, cabotegravir/rilpivirine has been incorporated into international guidelines for adults and adolescents for both treatment and prevention. As adult HIV treatment evolves, it is critical to ensure that newborns, infants, children and adolescents have access to the best treatment and prevention options throughout their lives (AU)


Subject(s)
HIV Infections/prevention & control , HIV Infections/drug therapy , Anti-Retroviral Agents/administration & dosage , Anti-Retroviral Agents/therapeutic use , Infectious Disease Transmission, Vertical/prevention & control , Drug Compounding
3.
Chinese Journal of Contemporary Pediatrics ; (12): 534-540, 2023.
Article in Chinese | WPRIM | ID: wpr-981990

ABSTRACT

Currently, the main strategy for preventing neonatal group B Streptococcus (GBS) infection is prenatal screening combined with intrapartum antibiotic prophylaxis, which has effectively reduced the incidence of neonatal GBS early-onset disease. However, the burden of GBS infection is still significant. The intrapartum antibiotic prophylaxis strategy has limitations such as inducing antibiotic resistance and inability to effectively prevent GBS late-onset disease. It is crucial to develop and evaluate other prevention strategies, while paying close attention to assessing penicillin allergy in pregnant women and how to prevent GBS infection in neonates with negative maternal GBS screening. In recent years, there has been some progress in GBS vaccines and related immunological research, and the use of specific vaccines is expected to significantly reduce GBS infection in neonates.


Subject(s)
Female , Humans , Infant, Newborn , Pregnancy , Anti-Bacterial Agents/therapeutic use , Antibiotic Prophylaxis , Infectious Disease Transmission, Vertical/prevention & control , Pregnancy Complications, Infectious/epidemiology , Streptococcal Infections/drug therapy , Streptococcus agalactiae
4.
Arch. argent. pediatr ; 120(6): e264-e267, dic. 2022.
Article in Spanish | LILACS, BINACIS | ID: biblio-1399710

ABSTRACT

La infección por estreptococo ß-hemolítico del grupo B o Streptococcus agalactiae puede causar morbilidad grave y mortalidad en los recién nacidos, especialmente en prematuros. Las estrategias de prevención actuales han sido eficaces en reducir la frecuencia de sepsis neonatal temprana ocasionada por transmisión vertical. La incidencia de sepsis tardía por dicho microrganismo no se ha modificado y la vía de infección es menos clara. En niños amamantados, la transmisión a través de la leche materna es posible. Se presentan tres casos de infección tardía por estreptococo ß-hemolítico del grupo B en recién nacidos prematuros alimentados con leche materna cuyas madres tenían mastitis. En todos los casos, tanto en el cultivo de la leche materna como en los hemocultivos de los neonatos se desarrolló el mismo microrganismo.


Group B ß-hemolytic Streptococcus or Streptococcus agalactiae is a major cause of morbidity and mortality in neonates, especially in premature infants. Current prevention strategies have been effective in reducing the frequency of early onset neonatal sepsis caused by vertical transmission. The incidence of late onset sepsis due to this microorganism has not changed and the route of infection is less clear. In breastfed infants, transmission through breast milk is possible. We report three cases of late group B ß-hemolytic streptococcal infection in breastfed preterm infants whose mothers had mastitis. In all cases, both the breast milk culture and the blood cultures of the neonates developed the same microorganism.


Subject(s)
Humans , Female , Infant, Newborn , Streptococcal Infections/diagnosis , Streptococcal Infections/epidemiology , Streptococcus agalactiae , Infant, Premature , Infectious Disease Transmission, Vertical/prevention & control , Milk, Human
5.
Rev. Bras. Saúde Mater. Infant. (Online) ; 22(4): 823-831, Oct.-Dec. 2022. tab
Article in English | LILACS | ID: biblio-1422685

ABSTRACT

Abstract Objectives: to estimate the detection rate of syphilis in pregnant women, the occurrence of congenital syphilis, and the rate of mother-to-child transmission of syphilis, in addition to analyzing missed opportunities in the prevention of mother-to-child transmission in the indigenous population. Methods: descriptive study of cases of pregnant indigenous women with syphilis resulting or not in a case of congenital syphilis. The data were obtained from the Sistema de Informação de Agravos de Notificação (Information System of Notifable Diseases), the records of the Infecções Sexualmente Transmissíveis do Distrito Sanitário Especial Indígena (Sexually Transmitted Infections in the Special Indigenous Health District), and the medical records of pregnant indigenous women in 2015. The database and the calculation of syphilis rates in pregnant women, congenital syphilis, and mother-to-child transmission were carried out. Data on prenatal, diagnosis and treatment of syphilis during pregnancy were collected from the medical records. Results: the detection rate of syphilis in pregnant women reached 35.2/1,000 live births (LB), the occurrence of congenital syphilis encompassed 15.7/1.000 LB, and the rate of mother-to-child transmission was 44.8%. Six (24%) pregnant women started prenatal care in the first trimester and seven (28%) attended seven or more consultations. The diagnosis of syphilis was late and only nine (36%) women were properly treated. Conclusions: failures in the diagnosis and the adequate treatment of pregnant women with syphilis compromised the prevention of mother-to-child transmission of the disease.


Resumo Objetivos: estimar a taxa de detecção de sífilis em gestantes, a incidência de sífilis congênita e a taxa de transmissão verticalda sífilis e analisar as oportunidades perdidas na prevenção da transmissão vertical na população indígena. Métodos: estudo descritivo de casos de gestantes indígenas com sífilis que tiveram ou não como desfecho um caso de sífilis congênita. Os dados foram obtidos do Sistema de Informação de Agravos de Notificação, dos registros da área de Infecções Sexualmente Transmissíveis do Distrito Sanitário Especial Indígena e dos prontuários de gestantes indígenas, no ano de 2015. Realizou-se o relacionamento da base de dados e cálculo de taxas de sífilis em gestantes, sífilis congênita e de transmissão vertical. Nos prontuários, coletaram-se dados do pré-natal, diagnóstico e tratamento da sífilis na gestação. Resultados: a taxa de detecção de sífilis em gestantes foi de 35,2/1.000 nascidos vivos (NV), a incidência de sífilis congênita, 15,7/1.000 NV e a taxa de transmissão vertical, 44,8%. Evidenciou-se que seis (24%) gestantes iniciaram o pré-natal no primeiro trimestre e sete (28%) realizaram sete ou mais consultas. O diagnóstico de sífilis foi tardio e apenas nove (36%) realizaram adequadamente o tratamento. Conclusões: falhas no diagnóstico e no tratamento adequado de gestantes com sífilis comprometeram a prevenção da transmissão vertical da doença.


Subject(s)
Humans , Female , Pregnancy , Syphilis, Congenital/prevention & control , Syphilis, Congenital/epidemiology , Syphilis/prevention & control , Syphilis/epidemiology , Infectious Disease Transmission, Vertical/prevention & control , Infectious Disease Transmission, Vertical/statistics & numerical data , Health of Indigenous Peoples , Prenatal Care , Underregistration , Brazil/epidemiology , Pregnant Women , Health Vulnerability
8.
Buenos Aires; GCBA. Gerencia Operativa de Epidemiología; 8 jul. 2022. f:12 l:19 p. tab, graf.(Boletín Epidemiológico Semanal: Ciudad Autónoma de Buenos Aires, 7, 307).
Monography in Spanish | LILACS, InstitutionalDB, BINACIS, UNISALUD | ID: biblio-1391790

ABSTRACT

La hepatitis B es una infección vírica que afecta al hígado, puede dar lugar tanto a un cuadro agudo como a una enfermedad crónica, y se transmite por la vía sexual, vertical y parenteral. En este informe, se describe la situación mundial y nacional de esta patología, y su transmisión vertical, así como la caracterización de niños expuestos al virus durante el embarazo, nacidos en el Hospital Materno Infantil Ramón Sardá entre 2018 y 2021.


Subject(s)
Humans , Female , Pregnancy , Infant, Newborn , Infectious Disease Transmission, Vertical/prevention & control , Infectious Disease Transmission, Vertical/statistics & numerical data , Hepatitis B/transmission , Hepatitis B/epidemiology , Epidemiological Monitoring , Infant, Newborn, Diseases/epidemiology
9.
Ciudad de Buenos Aires; GCBA. Ministerio de Salud; jul. 2022. 79 p. tab, graf.
Monography in Spanish | LILACS, InstitutionalDB, BINACIS, UNISALUD | ID: biblio-1513101

ABSTRACT

Nueva edición de la Situación epidemiológica del VIH en la Ciudad de Buenos Aires, que presenta información actualizada y sistematizada sobre el estado actual de la epidemia y sobre las líneas de trabajo desarrolladas para responder a ella en los terrenos preventivo y asistencial. Se aspira a que esta información contribuya a la planificación de acciones en el nivel central, así como en los efectores responsables de la atención e implementación de estrategias preventivas. (AU)


Subject(s)
Sexually Transmitted Diseases/prevention & control , Epidemiologic Studies , Acquired Immunodeficiency Syndrome/diagnosis , Acquired Immunodeficiency Syndrome/prevention & control , Acquired Immunodeficiency Syndrome/epidemiology , Infectious Disease Transmission, Vertical/prevention & control
10.
Poblac. salud mesoam ; 19(2)jun. 2022.
Article in Spanish | LILACS, SaludCR | ID: biblio-1386952

ABSTRACT

Resumen Introducción: se busca cuantificar los retornos de la inversión asociados a una intervención en el sistema público de salud de un municipio de la Provincia de Buenos Aires, Argentina, consistente en el fortalecimiento de la estrategia denominada Eliminación de la Transmisión Maternoinfantil de la Infección por VIH, Sífilis, enfermedad de Chagas Congénita e Infección Perinatal por Hepatitis B (ETMI-PLUS). Metodología: el estudio (cuantitativo) se basa en la metodología de Retorno Social de la Inversión (RSI). Se establecieron definiciones ad-hoc para la medición de los retornos sobre la base de los datos disponibles provenientes de diversas fuentes: información primaria de la Secretaría de Salud del MAB; tasas de transmisión congénita de cada enfermedad notificados al Sistema Nacional de Vigilancia de Salud; presupuestos detallados de los recursos asignados al proyecto por parte de la Fundación Mundo Sano y costos de tratamientos e insumos de nomencladores oficiales. Resultados: por cada peso invertido para reforzar la ETMI-PLUS en el MAB, se obtuvo un retorno de casi 4 pesos, gracias a las mejoras en la eliminación vertical de las cuatro enfermedades y al descenso de las complicaciones cardiacas en las mujeres embarazadas diagnosticadas con chagas y tratadas oportunamente. Conclusiones: estos resultados sugieren la existencia de una relación retorno-inversión favorable, analizada bajo una perspectiva conservadora, ya que, se incluyen exclusivamente los ahorros para el sistema de salud y se excluyen otras dimensiones de los retornos vinculadas con las mejoras en los resultados alcanzados.


Abstract Introduction: we seek to quantify the returns on investment associated with an intervention in the public health system of a Municipality of the Province of Buenos Aires, Argentina. This intervention consists of strengthening the strategy for the Elimination of Mother-to-Child Transmission of HIV Infection, Syphilis, Congenital Chagas Disease and Perinatal Hepatitis B Infection, a strategy called ETMI-PLUS. Methodology: the study (quantitative) is based on the Social Return on Investment (RSI) methodology. Ad-hoc definitions are established for the measurement of returns based on the information available from various sources: primary information from the Ministry of Health of the MAB; rates of congenital transmission of each disease reported to the National Health Surveillance System; detailed budgets of the resources assigned to the project by Fundación Mundo Sano and costs of treatments and supplies from official nomenclators. Results: for each argentinean peso invested in strengthening the ETMI-PLUS in the MAB, a return of almost 4 pesos would have been obtained thanks to the improvements in the vertical elimination of the 4 diseases and the reduction of cardiac complications in pregnant women.Conclusions: these results suggest the existence of a return / investment relationship favorable to the intervention, analyzed under a conservative analysis since savings for the health system are exclusively included and other dimensions of returns associated with improvements in results are excluded.


Subject(s)
Humans , Syphilis/prevention & control , HIV , Chagas Disease/prevention & control , Hepatitis B/prevention & control , Argentina , Infectious Disease Transmission, Vertical/prevention & control
11.
Chinese Journal of Contemporary Pediatrics ; (12): 49-53, 2022.
Article in English | WPRIM | ID: wpr-928565

ABSTRACT

OBJECTIVES@#To study the effect of intrapartum antibiotic prophylaxis (IAP) of group B streptococcus (GBS) infection on the incidence and bacteriological profile of early-onset neonatal sepsis (EONS).@*METHODS@#A retrospective analysis was performed on the medical data of 494 pregnant women with positive GBS screening results and 526 neonates born by these women. According to whether the pregnant woman received IAP, the neonates were divided into two groups: IAP (n=304) and control (n=222). The two groups were compared in terms of clinical indices, incidence rate of EONS, and distribution of pathogenic bacteria in blood culture.@*RESULTS@#Compared with the control group, the IAP group had a significantly lower proportion of children with abnormal clinical manifestations (P<0.001) and a significantly lower incidence rate of EONS (P=0.022). In the IAP group, Escherichia coli (2.3%) was the most common type of pathogenic bacteria in blood culture of the neonates with EONS, while GBS (3.2%) was the most common type of pathogenic bacteria in the control group. The IAP group had a significantly higher detection rate of ampicillin-resistant Escherichia coli than the control group (P=0.029).@*CONCLUSIONS@#Although IAP can significantly reduce the incidence rate of EONS in neonates born to pregnant women with positive GBS screening results, the infection rate of ampicillin-resistant Escherichia coli may increase after IAP treatment. Therefore, it is needed to enhance the monitoring of blood culture results of neonates with EONS and timely adjust treatment plan according to drug susceptibility test results.


Subject(s)
Child , Female , Humans , Infant, Newborn , Pregnancy , Anti-Bacterial Agents/therapeutic use , Antibiotic Prophylaxis , Incidence , Infectious Disease Transmission, Vertical/prevention & control , Neonatal Sepsis/prevention & control , Pregnancy Complications, Infectious , Retrospective Studies , Streptococcal Infections/prevention & control , Streptococcus agalactiae
12.
Santos, SP; s.n; 2022. 170 p.
Thesis in Portuguese | LILACS, InstitutionalDB, ColecionaSUS | ID: biblio-1526451

ABSTRACT

A exposição a um fator de risco (biológico, estabelecido ou ambiental) ou a associação entre risco biológico e/ou ambiental, pode resultar em um impacto cumulativo, aumentando a probabilidade de atraso para o desenvolvimento infantil. Neste sentido, são apresentados três estudos em formato de artigos para compreender o desenvolvimento de lactentes com risco biológico para exposição ao HIV e as oportunidades domiciliares. Objetivo: avaliar e comparar o desempenho motor, cognitivo e de linguagem, e as oportunidades no ambiente domiciliar de lactentes expostos e não expostos ao HIV em situação de vulnerabilidade social em duas regiões distintas do Brasil. Os objetivos específicos por artigo foram: (I) verificar o desempenho motor, cognitivo e de linguagem e as oportunidades no ambiente domiciliar de lactentes expostos e não expostos ao HIV durante os primeiros 18 meses de vida na cidade de Santos/SP; (II) comparar o desempenho motor, cognitivo e de linguagem e verificar as oportunidades domiciliares na cidade de Belém e Benevides/PA em lactentes expostos e não expostos ao HIV; e (III) identificar o contexto familiar, social e as oportunidades presentes no ambiente domiciliar de lactentes expostos e não expostos ao HIV em duas diferentes regiões do Brasil. Método: o estudo I foi observacional e longitudinal, e os estudos II e III foram observacionais e transversais. Participantes por artigo foram: (I) 17 lactentes da cidade de Santos/SP, ambos os sexos, idades de 4, 8, 12 e 18 meses, sendo 10 lactentes do grupo exposto ao HIV; (II) 80 lactentes (43 com risco biológico para o HIV) de 4 a 18 meses de idade, das cidades de Belém e Benevides/PA; e (III) 104 lactentes da Região Sudeste (Santos/SP) e 80 da Região Norte (Belém e Benevides/PA). Instrumentos utilizados nos três estudos foram a Escala Bayley III, a versão brasileira do questionário Affordances no Ambiente Domiciliar para o Desenvolvimento Motor ­ Escala Bebê, e o Critério de Classificação Econômica Brasil. Dados foram analisados estatisticamente utilizando-­se dos seguintes testes, por artigo: (I) ANOVA com medidas repetidas e post hoc de Bonferroni; (II) teste t-­Student para amostras independentes; (III) ANOVA e teste Exato de Fisher. Resultados: Estudo (I), não houve diferenças entre ser ou não exposto ao HIV em relação às características familiares, desenvolvimento motor, cognitivo e de linguagem, tampouco nos resultados do questionário AHEMD­IS. Contudo, houve diferença em relação ao momento da avaliação no domínio cognitivo e linguagem e nos resultados do AHEMD­IS. Estudo (II), os resultados indicaram que não houve diferença entre os lactentes expostos e não expostos ao HIV no desempenho motor, cognitivo e de linguagem, e nas oportunidades do ambiente domiciliar. Estudo (III), os resultados indicaram haver diferença entre as regiões Norte e Sudeste no desenvolvimento cognitivo e oportunidades domiciliares; associações significativas foram encontradas entre desenvolvimento da linguagem e idade, oportunidade do ambiente para a dimensão da motricidade fina e o tipo de domicílio e classificação do ambiente. Não houve diferença entre os grupos com risco biológico para o HIV o sem risco. Conclusão: (I) lactentes expostos ao HIV e à terapia antirretroviral não apresentaram atraso o desenvolvimento em relação aos lactentes não expostos ao HIV nos primeiros 18 meses de vida; (II) quando comparados com seus pares não expostos e até os 18 meses de idade lactentes não apresentam diferenças no desempenho motor, cognitivo e de linguagem, e nem em relação às oportunidades do ambiente domiciliar; e (III) existe diferença regional no desenvolvimento cognitivo e para as oportunidade domiciliares ­ confirmando a vulnerabilidade social entre a Região Norte e Sudeste do Brasil. Os fatores biológicos para exposição ao HIV e os fatores ambientais podem impactar os componentes da funcionalidade, sendo necessário um reforço do acompanhamento e da vigilância de lactentes com risco, especialmente avaliações que contemplem o modelo biopsicossocial. Neste sentido, a tese traz contribuições cientificas, clínicas e sociais sobre a identificação precoce dos fatores de risco biológico e ambiental


Exposure to a risk factor (biological, established or environmental) or the association between biological and/or environmental risk can result in a cumulative impact, increasing the likelihood of delay in child development. In this sense, three studies are presented in the form of articles to understand the development of infants at biological risk for exposure to HIV and the opportunities at home. Aim: to evaluate and compare the motor, cognitive and language performance, and opportunities in the home environment of infants exposed and not exposed to HIV in situations of social vulnerability in two different regions of Brazil. The specific objectives per article were: (I) to verify the motor, cognitive and language performance and opportunities in the home environment of infants exposed and not exposed to HIV during the first 18 months of life in the city of Santos/SP; (II) to compare the motor, cognitive and language performance and verify the home opportunities in the city of Belém and Benevides/PA in infants exposed and not exposed to HIV; and (III) to identify the family and social context and the opportunities present in the home environment of infants exposed and not exposed to HIV in two different regions of Brazil. Method: Study I was observational and longitudinal, and studies II and III were observational and cross­sectional. Participants per article were: (I) 17 infants from the city of Santos/SP, both sexes, aged 4, 8, 12 and 18 months; being, 10 infants in the group exposed to HIV; (II) 80 infants (43 at biological risk for HIV) aged 4 to 18 months, from the cities of Belém and Benevides/PA; and (III) 104 infants from the Southeast Region (Santos/SP) and 80 from the North Region (Belém and Benevides/PA). Instruments used in the three studies were the Bayley III Scale, the Brazilian version of the Affordances in the Home Environment for Motor Development ­ Baby Scale, and the Brazil Economic Classification Criterion. Data were statistically analyzed using the following tests, per article: (I) ANOVA with repeated measures and Bonferroni's post hoc; (II) Student's t test for independent samples; (III) ANOVA and Fisher's exact test. Results: Study (I), there were no differences between being or not exposed to HIV in relation to family characteristics, motor, cognitive and language development, nor in relation to the AHEMD­IS questionnaire. There was a difference between the time of assessment for the cognitive and language domain and in the results of the AHEMDIS. Study (II), results indicated that there was no difference between HIV­exposed and nonexposed infants in motor, cognitive and language performance, and in home environment opportunities. Study (III), results indicated that there is a difference between the North and Southeast regions in cognitive development and home opportunities; Significant associations were found between language development and age, environmental opportunity for fine motor skills, and type of household and environmental classification. There were no differences between groups with biological risk for HIV and those without risk. Conclusion: (I) infants exposed to HIV and antiretroviral therapy showed no developmental delay in relation to infants not exposed to HIV in the first 18 months of life; (II) when compared with their unexposed peers and up to 18 months of age, they do not show differences in motor, cognitive and language performance, nor in relation to opportunities in the home environment; and (III) there are regional differences in cognitive development and for household opportunities, confirming the social vulnerability between the North and Southeast regions of Brazil. Biological factors for exposure to HIV and environmental factors can impact the components of functionality, and it is necessary to reinforce the monitoring and surveillance of infants at risk, especially assessments that include the biopsychosocial model. In this sense, the thesis brings scientific, clinical and social contributions on the early identification of biological and environmental risk factors


Subject(s)
Humans , Male , Female , Infectious Disease Transmission, Vertical/prevention & control
14.
Washington; OPS; jul. 2020. 64 p.
Non-conventional in Spanish | BIGG, LILACS | ID: biblio-1393166

ABSTRACT

Según estimaciones de la Organización Mundial de la Salud (OMS), en el 2015 257 millones de personas en el mundo tenían la infección crónica por el virus de la hepatitis B (VHB) y 900 000 fallecieron a causa de ella, en la mayor parte de los casos de cirrosis o carcinoma hepatocelular. La mayoría de las defunciones asociadas con el VHB en personas adultas obedecen a infecciones contraídas al nacer o en los cinco primeros años de vida. En mayo del 2016, la Asamblea Mundial de la Salud aprobó la Estrategia mundial del sector de la salud contra las hepatitis víricas 2016-2021, en la que se hace un llamado a eliminar las hepatitis virales como amenaza de salud pública ­definida como una reducción de 90% de la incidencia de infecciones y una reducción de 65% de la mortalidad­ para el 2030. La eliminación de la infección por el VHB como amenaza de salud pública conlleva la necesidad de reducir la prevalencia del antígeno de superficie del virus de la hepatitis B (HBsAg) a menos de 0,1% en los niños de 5 años de edad. Esta meta se puede lograr mediante la vacunación de todos los recién nacidos contra la hepatitis B y otras intervenciones orientadas a prevenir la transmisión maternoinfantil del VHB


Subject(s)
Humans , Female , Pregnancy , Infectious Disease Transmission, Vertical/prevention & control , Hepatitis B/drug therapy , Antiviral Agents/therapeutic use , Pregnancy/drug effects , Tenofovir/pharmacology , Hepatitis B e Antigens/analysis
15.
Bol. micol. (Valparaiso En linea) ; 36(1): 7-12, jun. 2021.
Article in Spanish | LILACS | ID: biblio-1380383

ABSTRACT

Las mujeres embarazadas o en período de lactancia han sido excluidas de los ensayos clínicos sobre vacunas contra SARS-CoV-2, evitando así la obtención de datos sólidos que permitan determinar la seguridad e inmunogenicidad de las vacunas en esta población, a la vez que se han asociado peores resultados maternos ­ fetales. La evidencia acerca de la seguridad e inmunogenicidad en esta población es limitada, en base a estudios observacionales, con pocos casos y en mujeres vacunadas con plataformas ARNm, en las cuales no se ha descrito por ahora una mayor asociación a eventos adversos relacionados a vacunas, como tampoco, variaciones significativas en la respuesta inmunológica en comparación a la población no embarazada. También existen datos que documentan la adquisición de anticuerpos transplacentarios, considerándose de bajo riesgo la posibilidad de transmisión vertical. Se hacen necesarios ensayos clínicos que permitan precisar recomendaciones basadas en evidencia para esta población, en un contexto de utilización de emergencia de vacunas contra SARS-CoV-2. (AU)


Pregnant or breastfeeding women have been excluded from clinical trials on vaccines against SARSCoV-2, thus avoiding obtaining solid data to determine the safety and immunogenicity of vaccines in this population, as well as being associated worse maternal-fetal outcomes. The evidence about safety and immunogenicity in this population is limited, based on observational studies, with few cases and in women vaccinated with mRNA platforms, in which a greater association to adverse events related to vaccines has not been described or significant variations in the immune response compared to the non-pregnant population. There are also data that document the acquisition of transplacental antibodies, considering the possibility of vertical transmission as low risk. Clinical trials are necessary to evidence-based recommendations for this population, in a context of emergency use of vaccines against SARSCoV-2. (AU)


Subject(s)
Humans , Female , Pregnancy , Breast Feeding , Pregnancy/immunology , COVID-19 Vaccines/adverse effects , Infectious Disease Transmission, Vertical/prevention & control , COVID-19/prevention & control , COVID-19/transmission
16.
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
17.
Rev. chil. infectol ; 38(3): 401-409, jun. 2021. ilus, tab, graf
Article in Spanish | LILACS | ID: biblio-1388240

ABSTRACT

Resumen La transmisión vertical de hepatitis B es responsable de 50% de las infecciones en el mundo e implica 90% de riesgo de evolucionar a hepatitis crónica y sus complicaciones. La inmunoprofilaxis postparto (inmunoglobulina más vacuna) es la medida de prevención más efectiva. Sin embargo, puede existir fracaso a pesar de dicha intervención, debido a factores como alta carga viral o la presencia de HBeAg en la madre, los que sólo pueden evitarse si se hace el diagnóstico y tratamiento durante la gestación. En Chile, en el año 2019 se incorporó la vacunación en los recién nacidos, pero no existe aún cribado durante el embarazo, a diferencia de los países desarrollados. En los últimos años se ha experimentado un aumento acelerado de inmigración proveniente principalmente de América latina y el Caribe, con prevalencias altas en algunos de ellos. Chile debiese avanzar prontamente hacia el cribado de hepatitis B en embarazo.


Abstract Half of cases of hepatitis B around the world are produced from vertical transmission; and 90% of them can evolve to chronic hepatitis and their long term complications. Postpartum immunoprophylaxis (immunoglobulin and vaccine) is the most effective preventive measure. However, despite this prophylaxis, vertical transmission is possible if the mother presents a high viral load or e-antigen. This risk can be reduced only if screening during pregnancy and treatment if needed, are incorporated. In 2019, vaccination for hepatitis B in newborn was incorporated in Chile, but not yet prenatal screening, unlike developed countries. Chile has experienced a growth in immigration from Latin America and Caribbean, some countries with high endemicity included. Prenatal screening in Chile should be promptly incorporated.


Subject(s)
Humans , Female , Pregnancy , Infant, Newborn , Pregnancy Complications, Infectious/diagnosis , Pregnancy Complications, Infectious/prevention & control , Pregnancy Complications, Infectious/drug therapy , Hepatitis B/diagnosis , Hepatitis B/prevention & control , Hepatitis B/transmission , Antiviral Agents/therapeutic use , Chile , Neonatal Screening , Hepatitis B Vaccines , Infectious Disease Transmission, Vertical/prevention & control , Hepatitis B Surface Antigens
18.
Rev. Ciênc. Plur ; 7(2): 33-46, maio 2021. tab, graf
Article in Portuguese | BBO, LILACS | 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
19.
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
20.
Acta Academiae Medicinae Sinicae ; (6): 743-748, 2021.
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)
Female , Humans , Infant , Pregnancy , Case-Control Studies , China/epidemiology , Growth and Development , HIV , HIV Infections/prevention & control , Infectious Disease Transmission, Vertical/prevention & control , Mothers , Pregnancy Complications, Infectious/drug therapy , Retrospective Studies
SELECTION OF CITATIONS
SEARCH DETAIL