Prevalência e Fatores Associados de Doenças Infecciosas na Gestação em uma Coorte no Município de Palhoça/SC / Prevalence and Associated Factors of Infectious Diseases in Pregnancy in a Cohort in the Municipality of Palhoça/SC

Introdução: A gestação é um período em que o corpo das gestantes passa por alterações fisiológicas, entre elas maior suscetibilidade à ação de doenças infecciosas. Essas doenças são distintas quanto à prevalência, fatores associados, forma de transmissão, curso e quadro clínico, mas possuem em comum a possível manifestação de desfechos obstétricos negativos ao feto e recém-nascido quando presentes durante a gravidez. As principais doenças associadas a esses desfechos adversos são: sífilis, toxoplasmose, rubéola, citomegalovírus, HIV/Aids, tétano, infecções vaginais e do trato urinário. Objetivo: Determinar a prevalência de relato de determinadas doenças infecciosas na gestação e fatores associados em uma coorte no município de Palhoça/SC. Métodos: Estudo transversal aninhado a um estudo de coorte denominado Coorte Brasil Sul. Participarão do estudo as 558 mães de crianças cadastradas no banco de dados que contenham as informações necessárias para realização deste estudo. A análise bivariada será realizada por meio do teste do qui-quadrado, com valores de p<0,05. Já a análise multivariada será feita com todas as variáveis com valores de p<0,28 por meio da regressão de Poisson, com valor de p<0,05. Será utilizada como medida de associação a razão de prevalência com intervalo de confiança de 95%. Resultados: Entre os diversos fatores associados às infecções gestacionais, verificou-se associação estatisticamente significativa entre o relato de doenças infecciosas gestacionais e menor escolaridade materna (p=0,043) nas gestantes incluídas no estudo (n = 558). Conclusão: Gestantes com menor escolaridade apresentam maior vulnerabilidade quanto à sua saúde, sendo mais suscetíveis às infecções gestacionais.

Introduction: During pregnancy, the pregnant woman's body undergoes physiological changes, among them a greater susceptibility to infectious diseases. These diseases are distinct as to prevalence, associated factors, the form of transmission, course, and clinical picture, but they have in common the possible manifestation of negative obstetric outcomes to the fetus and newborn when present during pregnancy. The main diseases associated with these adverse outcomes are syphilis, toxoplasmosis, rubella, cytomegalovirus, HIV/AIDS, tetanus, and vaginal and urinary tract infections. Objective: To determine the prevalence of reports of certain infectious diseases in pregnancy and associated factors in a cohort in the municipality of Palhoça/SC. Methods: Cross-sectional study nested within a cohort study called the Brasil Sul Cohort. The 558 mothers of children registered in the database containing the information necessary for this study will participate in the study. The bivariate analysis will use the chi-square test, with p-values <0.05. The multivariate analysis will be done with all variables with p-values <0.28 through the Poisson regression, with p-value <0.05. The measure of association is the prevalence ratio with a 95% confidence interval. Results: Among the various factors associated with gestational infections, the study showed a statistically significant association between the report of gestational infectious diseases and lower maternal education (p=0.043) in the pregnant women included in the study (n = 558). Conclusion: Pregnant women with less education have greater vulnerability to their health, being more susceptible to gestational infections.

Fatores perinatais associados à sepse neonatal precoce em uma maternidade-escola do sul do Brasil / Perinatal factors associated with early neonatal sepsis in the maternity ward of a teaching hospital in southern brazil

Introdução: Sepse neonatal é uma condição potencialmente fatal, que constitui um problema de saúde pública de impacto global e é responsável por taxas expressivas de morbidade e mortalidade. O objetivo deste artigo é estimar os fatores associados à sepse neonatal precoce em uma maternidade-escola do sul do Brasil. Métodos: Realizou-se estudo de caso-controle para observar eventual associação entre fatores relacionados à sepse neonatal precoce e características clínicas e sociodemográficas maternas e fatores perinatais dos recém-nascidos, utilizando-se dados de prontuários de pacientes no período entre 2014 e 2017. A amostra foi composta por 293 binômios mãe/recém-nascido, sendo 1 caso para 2 controles. Todas as variáveis com valores de p< 0,05 na análise bivariada foram incluídas em uma análise multivariada por meio de Regressão Logística. Resultados: Idade gestacional menor que 37 semanas (OR 19,6 IC 95% 5,3; 73,0) (p<00,1) e presença de fator de risco para Streptococcus agalactiae beta hemolítico (SGB) (OR 5,1 IC 95% 1,2; 21,8) (p=0,027) foram as exposições independentemente associadas à sepse neonatal precoce. Conclusão: Identificou-se maior chance de desenvolver sepse neonatal precoce quando prematuridade e fatores de risco maternos para SGB estão presentes. Assim, medidas mais eficazes de prevenção e controle desses fatores são de extrema importância.

Introduction: Neonatal sepsis is a potentially fatal condition that constitutes a public health problem worldwide, being responsible for significant rates of morbidity and mortality. The objective of this study was to identify factors associated with early neonatal sepsis in the maternity ward of a teaching hospital in Southern Brazil. Methods: We conducted a case-control study to identify if factors related to early neonatal sepsis are associated with maternal clinical and sociodemographic characteristics and perinatal factors of infants, using data from patient records between 2014 and 2017. The sample consisted of 293 mother/newborn binomials, 1 case for 2 controls. All variables with p-values < 0.05 in the bivariate analysis were included in a multivariate analysis using logistic regression. Results: A gestational age < 37 weeks (odds ratio [OR] 19.6; 95%CI 5.3; 73.0) (p < 00.1) and the presence of a risk factor for beta-hemolytic Streptococcus agalactiae (GBS) (OR 5.1; 95%CI 1.2; 21.8) (p = 0.027) were independently associated with early neonatal sepsis. Conclusions: Prematurity and the presence of maternal risk factors for GBS increase the likelihood of developing early neonatal sepsis. Thus, more effective measures to prevent and control these factors are extremely important.

burden of infectious diseases in the Brazilian Southern state of Santa Catarina

Infectious diseases are still significant causes of deaths in Brazil. The objective of this study was to estimate the burden of selected infectious diseases in the Brazilian Southern state of Santa Catarina in 2011. An ecological study was conducted. The infectious diseases included were HIV/AIDS, tuberculosis, hepatitis B, hepatitis C, Chagas disease, diarrheal diseases and other infectious diseases. Data were collected from official health information systems. Disability Adjusted Life Years [DALY] were estimated by the sum of Years of Life Lost [YLL] and Years Lived with Disability [YLD]. 45,237.33 DALYs were estimated, with a rate of 685.46 DALYs per 100,000 population. 92.9% was due to YLL and 7.1% to YLD. Men and the age range of 0-4 years presented higher burden. The highest burden was attributed to HIV/AIDS. There was a high concentration of burden rates in the coast regions of the state. It could be concluded that more than 90% of the burden was attributed to the early mortality component. The highest burden was observed among men, children under 5 years of age and at the coast regions of the state. The highest levels of burden were due to HIV/AIDS

Burden of AIDS in a Brazilian State

Background: To estimate the burden of a disease implies the simultaneous quantification of the impact of early mortality and the health problems that affect the individual's quality of life, and this evaluation can be particularly important in a disease such as AIDS that has become a long-term disease. The purpose of this study was to determine the burden of disease due to AIDS in the Brazilian Southern State of Santa Catarina

Methods: An ecological designed study was performed using death and AIDS notifications data for 2009. The disability adjusted life years [DALYs] were estimated by the sum of years of life lost [YLL] and the years lived with disability [YLD]. The YLL was estimated as the difference between the life expectancy from birth and the age at death with the application of a discount rate of 3% per year. The YLD was estimated as the product of the Burden of Disease Study's weight for AIDS of 0.167 and its average duration of 108 months in Brazil for the incident cases. The YLL, YLD and DALY rates were calculated per 100,000 inhabitants by sex and age groups

Results: There were 2034 notified cases and 689 deaths due to AIDS reported. There were 15,756.5 YLLs estimated, resulting in 257.5 YLLs/100,000 inhabitants, and 4554.1 YLDs were estimated, resulting in 74.4 YLDs/100,000 inhabitants. The DALY was estimated at 20,310.6, with a rate of 331.9 DALYs/100,000 inhabitants. The highest rates were observed in males in the age groups 30-44 and 45-59 years

Conclusions: The burden of AIDS was high and was observed mainly in adults, with a predominance in males