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1.
Lancet Reg Health Am ; 13: 100311, 2022 Sep.
Article in English | MEDLINE | ID: covidwho-2211074

ABSTRACT

Background: Data regarding the geographical distribution of cases and risk factors for COVID-19 death in children and adolescents are scarce. We describe the spatial distribution of COVID-19 cases and deaths in paediatric population and their association with social determinants of health in Brazil. Methods: This is a population-based ecological study with a spatial analysis of all cases and deaths due to COVID-19 in Brazil among children and adolescents aged 0-19 years from March 2020 to October 2021. The units of analysis were the 5570 municipalities. Data on COVID-19 cases and deaths, social vulnerability, health inequities, and health system capacity were obtained from publicly available databases. Municipalities were stratified from low to very high COVID-19 incidence and mortality using K-means clustering procedures, and spatial clusters and relative risks were estimated using spatial statistics with Poisson probability models. The relationship between COVID-19 estimates and social determinants of health was explored by using multivariate Beta regression techniques. Findings: A total of 33,991 COVID-19 cases and 2424 deaths among children and adolescents aged 0-19 years were recorded from March 2020 to October 2021. There was a spatial dependence for the crude mortality coefficient per 100,000 population in the paediatric population aged 0-19 years (I Moran 0·10; P < 0·001). Forty municipalities had higher mortality rates, of which 20 were in states from the Northeast region. Seven spatial clusters were identified for COVID-19 mortality, with four clusters in the Northeast region and three in the North region. Municipalities with higher social inequality and vulnerability had higher COVID-19 mortality in the paediatric population. Interpretation: The main clusters of risk for mortality among children and adolescents were identified in municipalities in the North and Northeast regions, which are the regions with the worst socioeconomic indicators and greatest health disparities in the country. Our findings confirmed the higher burden of COVID-19 for Brazilian paediatric population in municipalities with higher social inequality and vulnerability and worse socioeconomic indicators. To reduce the burden of COVID-19 on children, mass immunisation is necessary. Funding: None.

2.
Pharmacy Education ; 20(2):39-40, 2020.
Article in English | EMBASE | ID: covidwho-2218219

ABSTRACT

The abrupt interruption of planned activities at the University Pharmacy (UP) in the Federal University of Santa Catarina forced a rapid change in routine services with the aim of ensuring continued access to medicines. Since March 2020, the UP has not been able to provide dispensing services or consultations inside its facility because of safety concerns around the spread of COVID-19. Internships are now dedicated to management tasks such as preparing documents to advise patients about particular medicines' utilisation. Virtual communication with the patients was established. This allowed students to be put in charge of keeping in touch with special groups of patients by telephone to track health outcomes, COVID-19 symptoms, and other particular needs. The Global Competency Framework and the National Pharmaceutical Education Guidelines were used as guides to develop the study. Three domains were affected by gains and losses: organisation and management competencies, professional/personal competencies, and pharmaceutical care. Copyright © 2020, International Pharmaceutical Federation. All rights reserved.

3.
Journal of Information Technology Education-Research ; 22:1-24, 2023.
Article in English | Web of Science | ID: covidwho-2218053

ABSTRACT

Aim/Purpose The objective of this study is threefold: (i) investigate how a group of subjects see the relationship between the integration of content, pedagogical and technological knowledge of their chemistry teaching in light of the teaching practices developed during the pandemic;(ii) present a framework for the integration of digital technologies in chemical education;and (iii) integrate empirical research on teachers' relationship with technology in the remote classroom during the pandemic.Background The COVID-19 pandemic has imposed changes in the ways of teaching and learning and has affected educational contexts at all levels of education. While technology has been instrumental in providing access to education during the pandemic, it has also revealed a picture of serious technological inequality, especially among students. The adoption of technology in education is an old topic in Brazil but still requires studies and advances in the implementation of Information and Communication Technologies (ICT) in education. With regard to teaching Chemical Science, the study of the skills and knowledge that teachers need to carry out an effective and efficient integration of ICT in education is still a priority at any educational level.Methodology The research method used was qualitative with an interpretive paradigm that involved 324 Licentiate and Baccalaureate students in Chemistry from public educational institutions in the five regions that make up the Brazilian territory. Data were collected through an online survey and, after being exported it was analyzed using Python software. In order to reduce the number of variables, exploratory factor analysis was carried out followed by a reliability analysis of the adopted factors, in addition to subsequent comparisons between the means related to the three factors for each of the categorical variables present in this work (Gender, Age, Region, Teacher Education, Period, and Course).Contribution This article analyzes the perceptions of these chemistry students in Brazil regarding the effective integration of content, pedagogical and technological knowledge of their chemistry teachers during the pandemic. It also proposes a framework of a model constituted from the amalgamation between Johnstone's triangle and the conceptual structure TPACK whose aim is to teach chemistry by interrelating the macroscopic, symbolic, and submicroscopic levels incorporated into technologies.Findings The results of this research allow us to conclude that of the three main knowledge areas proposed in the TPACK model, the field of Knowledge mostly Scientific of chemistry teachers (Factor 1) was pointed out as the most deficient when investigated in the light of the perceptions of the students. The model developed and presented in this study, which integrates TPACK into the Johnstone Triangle, proposed a theoretical framework that explains the integration of technology into the chemistry curriculum and gives teachers a very important role in its use and appropriation to facilitate the integration of technology in an effective way, thus adding improvements to the construction of chemical knowledge of their students. Recommendations for Practitioners Recommendations for Researchers This study found that it is necessary for chemistry teachers to carry out training courses to improve the development of ICT-related skills and, consequently, to use the knowledge that composes the TPACK structure in interrelated ways so that chemical instructions can be used in a pedagogically appropriate manner and effectively to improve students' chemistry learning experience. This study involved only higher education chemistry professors and students;therefore, future research is needed involving chemistry teachers from different levels of education to expand our results. In addition, the proposed model that integrates TPACK and Johnstone's Triangle can be reapplied and improved, and new theoretical and epistemological contributions can be added to the framework to improve the teaching and learning process of c emistry with the support of technologies.Impact on Society The understanding of the TPACK of higher education chemistry teachers in Brazil can demonstrate weaknesses in the process of incorporating ICT in the classroom during the process of teaching and learning chemistry. Therefore, this research typology can be useful in supporting the development of ICT- related skills, consequently improving teachers' TPACK. On the other hand, such understanding, by promoting reflections on university chemistry curricula, endorses the need for teachers' continuing education as a healthy mechanism for a growing integration of technologies in their teaching practices. The proposed model has the potential to align discussions on the use of technology in teaching chemistry, considering the specificities that are inherent and indispensable to the understanding of chemical knowledge.Future Research Future research should be to further improve the use of the proposed model that integrates Johnstone's triangle and the TPACK conceptual framework in teacher training, using it fully to guide the development and promotion of teacher training courses regarding the insertion of teaching technologies in a pedagogical way to teach chemistry in its different dimensions.

4.
Revista Panamericana de Salud Publica/Pan American Journal of Public Health ; 46 (no pagination), 2022.
Article in Portuguese | EMBASE | ID: covidwho-2218029

ABSTRACT

Objective. To describe the trends in suicide rates in Brazil from 2011 to 2020 and determine whether these rates are associated with COVID-19 pandemic-related variables. Method. This ecological time series study analyzed mortality from suicide with a focus on 2020, the first year of the COVID-19 pandemic. The suicide mortality rate per 100,000 population was the primary outcome. The trends in suicide rates were estimated using generalized Prais-Winsten regression. An autoregressive integrated moving average (ARIMA) model was used to predict suicide rates in 2020. The association between suicide rates and death rates from COVID-19, unemployment, receiving emergency financial aid, and rates of social distancing was investigated. Results. From 2011 to 2020, 115 469 deaths by suicide were recorded in Brazil (60.5 deaths/100 000 population). The suicide rate in 2020 was 6.68/100 000 population. An increasing trend in suicide rates was observed from 2011 to 2020 in both sexes, with annual percent change of 0.23 (95%CI: 0.141;0.322) in women;and 1.19 (95%CI: 0.714;1.810) in men. Mortality by suicide increased in all regions, with the highest increase recorded in the South. There was no evidence of increase in deaths by suicide in relation to the expected number during the first year of the COVID-19 pandemic. Conclusions. Suicide rates increased for both sexes and in all Brazilian states. In the first pandemic year, the number of deaths by suicide did not increase in relation to the expected number, with a stability trend during the months of 2020. Copyright © 2022 Authors. All rights reserved.

5.
Revista Panamericana de Salud Publica/Pan American Journal of Public Health ; 46 (no pagination), 2022.
Article in Portuguese | EMBASE | ID: covidwho-2218028

ABSTRACT

Objective. To present the experience and results of the reregistration of residents in Foz do Iguacu, a border town located in the state of Parana, Brazil, to meet the guidelines of the national Primary Health Care (PHC) Policy and its new financing model (Programa Previne Brasil). Method. A scanning strategy (convenience sample) was used for data collection, with 52 263 households visited and 22 710 interviews conducted from September to November 2019. The interviews were conducted face-to-face by 54 community health workers. Data were collected on the household (ownership status, urban or rural location, type of household, construction material, availability of electrical and sewage networks, water supply and waste disposal). Demographic and health information on the residents was also collected. Results. The reregistration process revealed that most residents were home owners and lived in well-constructed homes, located mostly in urban areas, served by electricity, with access to water supply and garbage collection. Of the reregistered population, 52.8% were women, 62.5% were aged between 15 and 59 years and 60.0% declared themselves white. Among respondents aged 15 or over, 90.0% had completed elementary school. The main occupation was "formal salaried job". Additionally, 18.6% of the interviewees declared themselves to be hypertensive and 7.0%, diabetic. Conclusions. The reregistration process uncovered relevant information to support both PHC planning as well as social assistance, work and housing initiatives;it was also fundamental to define health care strategies in this border town during the COVID-19 pandemic. Copyright © 2022 Authors. All rights reserved.

6.
Tropical Medicine and Infectious Disease ; 8(1):38, 2023.
Article in English | ProQuest Central | ID: covidwho-2216875

ABSTRACT

The Zika virus is a mosquito-borne virus spread primarily by Aedes mosquitoes. Zika cases have been detected throughout the mosquito's range, with an epidemic occurring from 2015 to 2017 in Brazil. Many Zika cases are mild or asymptomatic, but infections in pregnant women can cause microcephaly in children, and a small percentage of cases result in Guillan–Barré syndrome. There is currently little systematic information surrounding the municipal spread of the Zika Virus in Brazil. This article uses coarsened exact matching with negative binomial estimation and ordinary least squares estimation to assess the determinants of Zika incidence across the ~280,000 cases confirmed and recorded by Brazil's Ministry of Health in 2016 and 2017. These data come from Freedom of Information Act (FOIA) requests in Brazil and have not been published. We use data on the universe of individual Zika cases in Brazil and Geographic Information Systems (GIS) software to examine the virus at the municipal level across 5570 municipalities and construct a unique, unusually rich dataset covering daily Zika transmission. Additionally, our dataset includes corresponding local data on democratic governance, mosquito control efforts, and environmental conditions to estimate their relationship to Zika transmission. The results demonstrate that the presence of subnational democratic, participatory policymaking institutions and high levels of local state capacity are associated with low rates of Zika contraction. These models control for local healthcare spending and economic conditions, among other factors, that also influence Zika contraction rates. In turn, these findings provide a better understanding of what works for local health governance and mosquito control and makes important data public so that scholars and practitioners can perform their own analyses. Stronger models of Zika transmission will then inform mosquito abatement efforts across the Global South, as well as provide a blueprint for combatting Dengue fever, which is also transmitted by Aedes mosquitoes.

7.
Hormone Research in Paediatrics ; 95(Supplement 2):241, 2022.
Article in English | EMBASE | ID: covidwho-2214137

ABSTRACT

Lockdown and school closure related to COVID-19 pandemic increased sedentary time and greater consumption of ultra-processed foods, an environment that may exacerbate the childhood obesity epidemic. In Brazil, public schools remained closed for more than 40 weeks. In Brazil, prior to the current pandemic, 15.9% of children under 5 yr.-old, 29.3% of those between 5 and 9 yr.-old and 30.8% of adolescents were overweight. Aim(s): To verify the impact of school closure on the weight, body mass index (BMI), changing lifestyle habits and increasing the prevalence of obesity in children and adolescents at the pediatric obesity clinic of a public tertiary hospital in Southern Brazil. Method(s): Cross-sectional observational study of overweight/ obese patients aged 6 to 15 years who attended a medical appointment from November 2019 to May 2021. Patients with an organic or endocrine cause of obesity, monogenic obesity and genetic syndromes were excluded. The study protocol was approved by the Ethics Committee. Data of the last pre-pandemic visit were extracted from the clinical records and anthropometric measurements were assessed in the first visit during the pandemic. A survey was aimed to assess whether nutritional and consumer habits have been affected under quarantine conditions. Result(s): 50 patients (31 girls) aged 11.6+/-2.4 yr.-old were included. All of them were from low-income families and had not been returned to school. The interval between visits was 382.7+/-76.6 days. Over 58% reported snacking more, greater consumption of ultra-processed foods and increased sedentary time. Forty-five patients (88%) experienced weight gain [9 kg (-3.6 to 25.5)] and there was a gain of 19.6% compared to pre-pandemic weight. The median BMI and its z-score variation between visits were +1.9 kg/ m2 (-2.9 to +7.7) and +0.07 (-0.93 to +1.47), respectively. The change in adjusted BMI to the median for sex and age was +1.65 kg/m2 (-3.60 to +6.90). There was an increase in the prevalence of obesity of 12% in this group. Conclusion(s): Defining the longitudinal change in BMI in the pediatric age group is a challenge. This study showed an unhealthy weight gain in a group of previously overweight pediatric patients, increased sedentary time and some difficulties faced by children during quarantine in Brazil. The study highlights that lockdown imposed by SARS-CoV-2 affected eating behaviors, dietary and sedentary habits, and advocates for organized nutritional support during future epidemic-related quarantines, particularly for the most vulnerable groups, including children with overweight or obesity.

8.
Journal of Clinical Nursing (John Wiley & Sons, Inc.) ; : 1, 2023.
Article in English | Academic Search Complete | ID: covidwho-2213745

ABSTRACT

Aims and objectives Background Design Methods Results Conclusions Relevance to clinical practice Patient or Public Contribution This paper aims to: (a) determine the personal, sociodemographic, clinical, behavioural, and social characteristics of older Brazilians with clinical evidence of long COVID;(b) evaluate perceived quality of life and determine its association with personal, sociodemographic, behavioural, clinical and social variables;and (c) assess significant predictors of high perceived QoL.Given the inherent vulnerabilities of the ageing process, the older people are an at‐risk group for both contagion of SARS‐CoV‐2 and the perpetuation of residual symptoms after infection, the so‐called long COVID or post‐COVID syndrome.A cross‐sectional survey design using the STROBE checklist.Brazilian older people with long COVID syndrome (n = 403) completed a phone survey measuring personal, sociodemographic, behavioural, clinical, and social characteristics, and perceived Quality of Life (QoL). Data were collected from June 2021–March 2022. A multiple linear regression model was performed to identify salient variables associated with high perceived QoL.The mean age of participants was 67.7 ± 6.6 years old. The results of the multivariate regression model showed that race, home ownership, daily screen time, musculoskeletal and anxiety symptoms, and work situation were the significant predictors of QoL among COVID‐19 survivors.Knowledge about the persistence of physical, emotional, and social symptoms of COVID‐19 can help nurses and other healthcare providers to improve the management of survivors, bringing benefits to the whole society.Given the novelty of long‐COVID and its heterogeneous trajectory, interventions focusing on the repercussions and requirements unique to more vulnerable older persons should be developed and these aspects should be included in public health recommendations and policymakers' concerns.No patient or public contribution was required to design, to outcome measures or undertake this research. Patients/members of the public contributed only to the data collection. [ FROM AUTHOR]

9.
Policing: An International Journal ; 2023.
Article in English | Web of Science | ID: covidwho-2213104

ABSTRACT

PurposeThe authors investigated the effect of basic human values in the prediction of COVID-19 vaccination behavior amongst public security agents in Brazil.Design/methodology/approachA sample of 15,313 Brazilian public security agents responded to the portrait values questionnaire and a COVID vaccination behavior measure. Multidimensional scaling analysis (MDS) was used to observe the order of the predicted by the theory. For hypotheses, the authors ran a series of Structural equation modeling (SEM) with direct effects between values and vaccination rate.FindingsResults suggest that the values of conservation and self-transcendence positively predicted vaccination. A nonsignificative negative prediction was obtained for openness to change and self-enhancement values on vaccination behavior.Research limitations/implicationsData were collected using self-report questionnaires.Practical implicationsInstitutional management should encourage capacitation campaigns aimed at public security agents, enabling a significant increase in vaccine protection for the public security institutions.Social implicationsThe reinforcement of conservation and self-transcendence values lead to the perception of the vaccine as a measure of caring for people in general and for the members of the ingroup, hence motivating the vaccination behavior.Originality/valueThe findings confirm that values encourage individuals to be vaccinated, due to their intrinsic motivation. This relationship did not appear to be clearly tested by previous empirical studies.

10.
Social Science & Medicine ; : 115712, 2023.
Article in English | ScienceDirect | ID: covidwho-2211475

ABSTRACT

Rationale From the earliest days of the COVID-19 pandemic, public health officials and news organizations reported pervasive racial disparities in the infection, morbidity, and mortality of the virus. In both the U.S. and Brazil, Black, Native, and mixed-race individuals were more negatively impacted by COVID-19 than White people. Simultaneously, significant social factions downplayed the threat and insisted on living "normally”. We examined how these two factors coexisted. Objective We sought to establish whether Whites' anti-Black attitudes predicted their concern about the pandemic and tendency to behave in ways that exacerbated the pandemic. Methods and Results: In five studies, conducted in two countries (total N = 3425), we found that anti-Black attitudes (above and beyond political orientation, White racial identification, and perceptions of racial disparities) were associated with less concern about COVID-19, lower adoption of health and social distancing behaviors, and greater interest in returning to normalcy. Discussion We discuss how efforts to combat anti-Blackness may improve the health of the general population.

11.
Journal of Veterinary Behavior ; 60:37-43, 2023.
Article in English | EMBASE | ID: covidwho-2211014

ABSTRACT

The COVID-19 pandemic changed the routines of people, consequently changing the daily lives of their pets. Behavioral and emotional changes caused by the stress resulting from restrictions of social isolation and their consequences in the human-animal relationship have been discussed. However, there are still no studies that identify the factors that affect behavior and which are the most susceptible groups. The purpose of this study is to identify behavioral and emotional changes on dogs during the COVID-19 pandemic and their effects on the quality of life of animals and their owners. The methodology used was online questionnaires, which were posted on social networks aimed to dog owners in Rio de Janeiro state, Brazil. The results showed that age, sex, dog size, type of home, and restrictions imposed differently affected the type of behavioral change. However, the most frequent type of change was the worsening of previous conditions. Neutered behaviors directly interfered in the lives of owners and their pets, as owners managed the situation and sought information without guidance from a veterinarian, with the possibly consequence of worsening the situation in the future. Veterinarians should actively investigate behavioral changes that have occurred through anamnesis to avoid abandonment and instability in the human-animal relationship. Copyright © 2022 Elsevier Inc.

12.
Rev Panam Salud Publica ; 46: e104, 2022.
Article in Spanish | MEDLINE | ID: covidwho-2205515

ABSTRACT

This analysis compares and systematizes some of the milestones (between December 2020 and October 2021) in the approval by Brazil and Chile of the CoronaVac vaccine made by the Chinese laboratory Sinovac, with regard to how the efficacy and immunogenicity of the vaccine was determined. To this end, a comprehensive analysis was conducted of official public documentation of the vaccine's approval in both countries; likewise, relevant technical articles on the subject, as well as dissemination and discussion in the media were considered. In both cases, a wide range of private and public actors expressed clearly competing interests in the measurement and dissemination of figures on the vaccine's efficacy. This reveals the challenges that middle-income countries face-and will continue to face-when certifying the quality of products in a pandemic period, and the need to institutionally strengthen regulatory authorities to ensure a sound and accurate evaluation of vaccine quality, in terms of safety and efficiency.


Esta análise compara e sistematiza alguns marcos da aprovação, no Brasil e no Chile, da vacina CoronaVac, do laboratório chinês Sinovac, de dezembro de 2020 a outubro de 2021, especificamente sobre como sua eficácia e imunogenicidade foram fundamentadas. Para tanto, foi realizada uma análise exaustiva da documentação pública oficial sobre a aprovação da vacina em ambos os países. Da mesma forma, foram considerados artigos técnicos pertinentes sobre o assunto, e divulgações e discussões realizadas na mídia. Em ambos os casos, uma disputa de interesses de uma ampla gama de atores privados e públicos em torno da medição e divulgação dos números referentes à eficácia foi claramente expressa. Isso permite visualizar os enormes desafios que os países de renda média enfrentam e enfrentarão para certificar a qualidade dos produtos em um contexto epidemiológico de pandemia e a necessidade de fortalecer institucionalmente as autoridades reguladoras para viabilizar uma avaliação íntegra e acertada da qualidade das vacinas em relação a sua segurança e eficiência.

13.
Front Cell Infect Microbiol ; 12: 932563, 2022.
Article in English | MEDLINE | ID: covidwho-2198700

ABSTRACT

In Brazil, the coronavirus disease 2019 (COVID-19) epidemic spread rapidly in a heterogeneous way, mainly due to the different socioeconomic and behavioral characteristics of different regional populations and different evaluation periods. We performed a cross-sectional study including 1,337 individuals (first wave = 736/second wave = 601) after the first two waves of COVID-19 in the city of Belém, the capital of the state of Pará. The detection of IgG anti-SARS-CoV-2 antibodies was performed using an enzyme-linked immunosorbent assay test followed by statistical analysis using the RStudio program. Our results showed an increase in the seroprevalence (first wave= 39.1%/second wave= 50.1%) of anti-severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) IgG antibodies in the population of Belém from the first to the second pandemic wave. Advanced age, primary or secondary education level, lack of social isolation, and a low frequency of protective mask use were considered risk factors for SARS-CoV-2 infection during the first wave compared to the second wave. This study is one of the firsts to provide important information about the dynamics of virus circulation and the groups vulnerable to exposure in the two major periods. Our data emphasize the socioeconomic characteristics of the affected population and that nonpharmacological prevention measures are crucial for combating the pandemic.


Subject(s)
COVID-19 , Antibodies, Viral , Brazil/epidemiology , COVID-19/epidemiology , Cross-Sectional Studies , Humans , Immunoglobulin G , Risk Factors , SARS-CoV-2 , Seroepidemiologic Studies
14.
Glob Public Health ; 17(11): 3216-3223, 2022 Nov.
Article in English | MEDLINE | ID: covidwho-2187598

ABSTRACT

This article approaches the emergence of social subjects - associativism - and the formation of horizontal circuits of solidarity, both of which were decisive processes for saving lives in favelas and suburbs in Rio de Janeiro during the Covid-19 pandemic.The impact of the pandemic has been enormous collective trauma that accentuated the collapse of health surveillance systems and generated a catastrophe and humanitarian crisis in the city. Solidarity and local collective cooperation processes had decisive effects as a new protagonism, generating synergy with health actions and social programmes. They contributed decisively to actions that made forms of immunological protection, food security, and access to basic care possible in adverse contexts with weak policies and severe limitations for social isolation.Highlighting the importance of collective health surveillance and assistance actions from local associations, this paper discusses public health actions in the favela territories that demonstrate how communities, universities, public officials, and public health networks can develop policies and projects to confront Covid-19 in the favelas.


Subject(s)
COVID-19 , Humans , Brazil/epidemiology , COVID-19/epidemiology , Pandemics , Public Health , Government Programs
15.
Int J Infect Dis ; 2023.
Article in English | PubMed | ID: covidwho-2179542

ABSTRACT

OBJECTIVES: We assessed whether combining (pooling) four individual's samples and testing with Xpert Ultra has the same accuracy as testing samples individually, as a more efficient testing method. METHODS: We conducted a cross-sectional study of individuals with presumptive TB attending primary health care or general hospital facilities in Alagoas, Brazil. Sputum samples of four consecutive individuals were pooled and the pool and individual samples were tested with Xpert Ultra. The agreement of the tests was compared using kappa statistics. We estimated the sensitivity and specificity of pooling using the individual test as the reference standard and potential cartridge savings. RESULTS: Three hundred and ninety-six participants were tested. Ninety-five (24.0%) individual samples were MTB-positive, 300 (75.8%) MTB-not detected, including 20 MTB-trace, and one reported an error. Ninety-nine pools of four samples were tested, of which 62 (62.6%) had MTB-detected and 37 (37.4%) MTB-not detected, including six (6.1%) with MTB-trace. The agreement of individual and pooled testing was 96.0%. Pooling had sensitivity of 95.0% (95%CI 86.9%-99%), specificity of 97.1% (95%CI 85.1%-99.9%) and Kappa of 0.913. The method saved 12.4% of cartridge costs. CONCLUSION: The pooled testing of specimens had a high level of agreement with individual testing. Pooling of samples for testing improves the efficiency of testing, potentially enabling the screening and testing of larger numbers of people more cost-effectively.

16.
Hematology, Transfusion and Cell Therapy ; 44(Supplement 2):S681, 2022.
Article in English | EMBASE | ID: covidwho-2179248

ABSTRACT

Objetivos: A COVID-19 e uma doenca infecciosa, onde a maioria dos infectados desenvolve quadros leves, no entanto, idosos e individuos com comorbidades estao relacionados aos casos mais graves. A fim de conter a propagacao da doenca, foram desenvolvidas vacinas com a finalidade de inducao de memoria imunologica. Entretanto, estudos sobre a efetividade da imunizacao em idosos ainda sao escassos e nao se sabe exatamente como sera o comportamento nessa populacao. Dessa forma, o objetivo desta pesquisa foi avaliar esta resposta imune celular em idosos de Instituicoes de Longa Permanencia (ILPS) no estado de Sergipe, Brasil, induzida pela vacina CoronaVac. Material e Metodos: Este estudo prospectivo foi realizado com idosos (grupo idosos-GI) e profissionais (grupo controle-GC) de ILPS. Todos receberam a vacina CoronaVac e as analises foram feitas 30 dias apos a administracao da segunda dose da vacina. Respeitando-se os aspectos eticos e legais, os participantes foram submetidos a um questionario estruturado, e foram coletadas amostras de sangue periferico para analise das populacoes de linfocitos T CD4+ e CD8+ e os subtipos de memoria que foram avaliados por citometria de fluxo multiparametrica. Resultados: Foram avaliados 28 individuos, sendo 23 idosos (GI) e cinco profissionais (GC). No GI, nove eram do sexo feminino e 14 do masculino, com medias de idade 81,6 (67-89) e 74,1 (64-89), respectivamente. O grupo GC foi composto por duas mulheres e tres homens, e as medias de idades foram de 36,5 (24 e 49) para as mulheres e 45,0 (30-64) para os homens. Foi observado aumento da expressao dos linfocitos TCD3+ e TCD4+ nos idosos vacinados (p=0,0010 e p=0,0383) em comparacao ao GC. Os idosos tambem apresentaram aumento de LTCD4+ e LTCD8+, ambos de memoria efetora (CD45RA-CCR7-) demonstrando p=0,0471 e 0,0138, respectivamente. Avaliando as diferencas entre os sexos dos idosos, observou-se que os homens apresentaram aumento no numero total de LTCD8+ (p=0,0464) e LTCD8+ de memoria efetora (p=0,0199);e diminuicao nos LTCD4+ de memoria central (CD45RA-CCR7+) quando comparados com as mulheres (p= 0,0440). Discussao: Apesar de todos os avancos no controle da doenca e melhoria nos desfechos dos pacientes mais graves, inumeras questoes ainda permanecem sem resposta: As vacinas conferem a mesma protecao da infeccao ou sao fatores sinergicos? Idosos apresentam a mesma resposta aos imunizantes que os jovens? Nas infeccoes por SARS-CoV-2, as respostas dos LT sao detectadas em quase todos os casos, sendo as respostas das LT CD4+ mais proeminentes do que as respostas dos LT CD8+. Diferentemente das situacoes relatadas apos a infecao pelo SARS-CoV-2, avaliando a resposta ao imunizante CoronaVac, o presente trabalho demonstrou que idosos apresentaram maior producao de LTCD4+ quando comparados aos jovens. Entretanto, apesar de os LTCD8+ nao terem respostas diferentes entre os grupos (idosos e jovens), apresentaram maior resposta nos idosos do sexo masculino. Conclusao: Neste trabalho, foi observado que os homens parecem apresentar memoria efetora rapida maior que das mulheres, entretanto, as mulheres apresentaram memoria central maior, sugerindo imunidade prologada maior nas mulheres idosas do que nos homens. Copyright © 2022

17.
Hematology, Transfusion and Cell Therapy ; 44(Supplement 2):S679-S680, 2022.
Article in English | EMBASE | ID: covidwho-2179246

ABSTRACT

Background: In the COVID-19 pandemic, individuals may be asymptomatic, with mild or severe symptoms associated with respiratory tract infections. Patients with COVID-19 have IgG antibodies on average two weeks after infection and persist at stable levels for a few months. The influence of the levels of these antibodies and the time in circulation, protection, and severity of the disease in reinfections, has not yet been completely elucidated. The objective of this work was to evaluate the titers of anti-SARS-CoV-2 IgG antibodies in asymptomatic patients or with mild symptoms in a period of six months. Method(s): In this longitudinal study, we selected 62 individuals (median age 42.5 years;IQR 33.3-52.0;59.7% female) tested positive for SARS-CoV-2 Immunoglobulin G (IgG) antibodies using a Fluorescence Immunoassay (FIA) (iChroma II, BioSys + Kovalent) from July 2020 (peak of the first wave) to March 2021 (begging of the second wave associated with transmission of the Gamma variant) in the state of Sergipe, Northeast Brazil. All participants included in the present study had a history of asymptomatic or mild COVID-19, were not vaccinated against the disease, and were selected from the EpiSERGIPE Project conducted in the state of Sergipe. An in-house indirect Enzyme-Linked Immunosorbent assay (ELISA)-based method was used to evaluate the serum titers of anti-nucleocapsid SARS-CoV-2 antibodies in three moments: baseline (D0), 90 days (D90), and 180 days (D180). Briefly, 96-microwell plates (Nunc, Thermo Fisher Scientific). Result(s): In D0, 79% (49 of 62) of individuals had a positive result for the presence of anti-nucleocapsid SARS-CoV-2 antibodies. In D90 and D180, the percentage of positive results was 69.3% (43 of 62) and 53.2% (33 of 62), respectively. We found a progressive decline in the levels of anti-nucleocapsid SARS-CoV-2 antibodies over time, ranging from 26.2 (Interquartile Range [IQR] 12.4-37.7) in D0 to 11.7 (IQR 5.6-18.2) in D180 (p<0.001). In addition, we found that individuals over 40 years old had higher levels of IgG antibodies to the SARS-CoV-2 nucleocapsid in D90, regardless of sex. However, an influence of sex and age was not observed on D0 and D180. Discussion(s): Studies describe that IgG levels remain for only 3-4 months in the body of individuals who have had previous contact with SARS-CoV-2, however in this study it was observed that most individuals had a significant and gradual decrease in anti-nucleocapsid SARS-CoV-2 antibodies circulating, even before completing three months after exposure to the virus. Conclusion(s): This study showed a progressive decline in the levels of anti-nucleocapsid SARS-CoV-2 antibodies during the first six months after SARS-CoV-2 infection among individuals with asymptomatic or mild COVID-19. Approximately 50% of individuals have no detectable antibodies six months after infection. Moreover, we found a potential influence of age on the humoral response against SARS-CoV-2. Copyright © 2022

18.
Hematology, Transfusion and Cell Therapy ; 44(Supplement 2):S677-S678, 2022.
Article in English | EMBASE | ID: covidwho-2179243

ABSTRACT

Introducao: Quando a Pandemia do COVID-19 chegou ao Brasil, pacientes com doenca falciforme foram considerados uma populacao de alto risco. Ware et al. (2017), em seu estudo, levantou algumas questoes que contribuiam com essa hipotese. A Sociedade Americana de Doenca Falciforme produziu um guia de orientacoes para esses pacientes durante a pandemia., (Sickle Cell Society, 2020). Isso fez com que nossa equipe elaborasse uma estrategia para fornecer informacoes a esses pacientes de maneira remota. Aproveitando a tecnologia e a colaboracao de varios profissionais de diferentes areas, gravamos sete "lives" que, na linguagem da internet, sao transmissoes ao vivo feitas por meio de redes sociais. Objetivo: Transmitir informacoes sobre cuidados em saude durante a pandemia do COVID-19 para pacientes com Doenca Falciforme. Metodologia: Os profissionais da saude foram convidados pela coordenadora da plataforma digital @melhoreviversemdor para realizacao das "lives" com temas especificos de suas areas de atuacao. Foram convidados dez profissionais, porem apenas nove puderam participar. As "lives" aconteceram entre os meses de junho e junho do corrente ano, em horarios previamente combinados e dentro da unidade de saude, no caso o Instituto Estadual de Hematologia Arthur de Siqueira Cavalcante (HEMORIO). Ao termino, as "lives" foram salvas e adicionadas a rede social Instagram no endereco @melhoreviversemdor. Resultados: Abaixo relacionamos os temas das "lives", os profissionais que realizaram a mesma e numero de visualizacoes obtidas no dia da postagem. Essas visualizacoes foram registradas no Instagram. 1) Tratamento domiciliar da dor na Doenca Falciforme - Enfermeira Elvira Carvalho - 233 visualizacoes. 2) Direitos e Beneficios Sociais no contexto da Pandemia do COVID-19 - Assistente Social Marcia Pereira - 299 visualizacoes. 3) Orientacoes de Atividade para a memoria durante a Pandemia do COVID-19 - fonoaudiologa Marcia Baima - 162 visualizacoes. 4) O fantasma do coronavirus no Universo Infantil - psicologas Daniella Gouget e Joanna D'Arc Bastos - 282 visualizacoes. 5) Cuidados com o seu bebe durante a Pandemia do COVID-19 - Enfermeira Disleine Xavier - 200 visualizacoes. 6) Orientacoes do armazenamento de medicamentos durante a Pandemia do COVID-19 - 263 visualizacoes. 7) Aspectos juridicos do doente cronico durante a Pandemia do COVID-19 - Com a advogada e enfermeira Delaine Fidlarczyk e o advogado Andre Baiseredo - 169 visualizacoes. 8) Abordagem odontologica nas gestantes com Doenca Falciforem - Destistas Larissa Melo e Thais Xavier - 198 visualizacoes. 9) A Importancia da boa alimentacao na Doenca Falciforme em tempos de pandemia do COVID-19 - Nutricionista Karen Cordovil - 236 visualizacoes. Conclusao: A educacao em saude e um processo continuo que envolve o fornecimento de informacoes nao apenas aos profissionais de saude, mas tambem aos pacientes. Esse trabalho teve o objetivo de transmitir conhecimentos de boas praticas em saude para pessoas que vivem com Doenca Falciforme. Todas as "lives" obtiveram mais de 100 visualizacoes, o que consideramos um resultado positivo, ja que foi a primeira vez que a plataforma @melhoreviversemdor executou esse tipo de proposta como veiculo de informacao. Seguir tendencias atuais como o uso de ferramentas virtuais e apostar na modernizacao da assistencia sem perder o profissionalismo e a constante preocupacao na melhoria da assistencia. Copyright © 2022

19.
Hematology, Transfusion and Cell Therapy ; 44(Supplement 2):S676, 2022.
Article in English | EMBASE | ID: covidwho-2179240

ABSTRACT

Objetivo: Descrever o perfil clinico-epidemiologico de pacientes com COVID-19 atendidos em hospitais de Uberaba - MG. Material e Metodos: Trabalho aprovado pelo Comite de Etica em Pesquisa do Hospital de Clinicas da Universidade Federal do Triangulo Mineiro (CAAE ndegree 31328220.8.0000.8667). Foram coletados dados de 371 individuos com COVID-19, atendidos entre maio/2020 e junho/2021. As variaveis analisadas foram: genero, idade, sintomatologia, comorbidades, medicamentos e desfecho (alta/obito). Utilizou-se o programa SPSS, versao 20.0 para o tratamento dos dados coletados. Considerou-se estatisticamente significantes valores de p < 0,05. Resultados: Dentre os 371 pacientes, 39,9% eram mulheres e 60,1%, homens. Os sintomas predominantes foram dispneia (70%), tosse (60%) e febre (50%). Acerca das comorbidades, HAS (44,6% M e 49,8% H), DM (29% M e 24,7% H) e obesidade (16,2% M e 12,1% H) foram as mais prevalentes. Os medicamentos mais utilizados foram heparina (87,2% M e 86,1% H) e corticoide (81,1% M e 80,7% H). Houve pior desfecho entre os pacientes mais velhos;sendo a presenca de comorbidades e o tempo de internacao significativamente maiores para homens que foram a obito se comparados aos que receberam alta (p = 0,004 e p = 0,002, respectivamente). Discussao: No presente estudo, houve um predominio de pacientes do sexo masculino, o que diverge de um estudo realizado no estado de Pernambuco, que relatou um predominio do sexo feminino. Por outro lado, esse mesmo estudo aponta achados semelhantes aos nossos em relacao aos sintomas apresentados pelos pacientes, como dispneia, tosse e febre sendo os mais frequentes nos dois estudos, demonstrando um comportamento semelhante da sintomatologia da doenca no Brasil. Alem disso, a literatura tambem vem demonstrando que a presenca de comorbidades, em especial HAS e DM, sao importantes fatores de risco para o agravamento e pior prognostico em individuos com COVID-19. No presente trabalho, a prevalencia de comorbidades foi maior no grupo de individuos do sexo masculino que foram a obito e observamos maior incidencia de hipertensao, diabetes e obesidade em toda a nossa casuistica, corroborando os dados da literatura. No tocante a medicacao, foi observado o uso de heparina e corticoide, independentemente da gravidade. Estudos demonstram que o tratamento com corticosteroides reduz o risco de morte em pacientes graves, incluindo aqueles em ventilacao mecanica. Em relacao a heparina, um ensaio clinico demonstrou que o farmaco reduz o risco de mortes por complicacoes da doenca, se administrada aos primeiros sinais de insuficiencia respiratoria. Conclusao: Conclui-se que a idade mais avancada e comorbidades previas estao relacionadas a um pior prognostico em individuos infectados pelo SARS-CoV-2 na amostra analisada. Copyright © 2022

20.
Hematology, Transfusion and Cell Therapy ; 44(Supplement 2):S673, 2022.
Article in English | EMBASE | ID: covidwho-2179236

ABSTRACT

Resumo: O transplante de medula ossea traz bons resultados em sua terapeutica para tratamento de doencas onco-hematologicas. Contudo, encontram-se alguns pacientes com indicacao de transplante de medula ossea que nao possuem doadores compativeis em sua familia, que dependem de doadores voluntarios. A doacao voluntaria se da atraves de cadastro no Redome. Com a pandemia do COVID-19 os cadastros foram afetados, impactando no numero de doadores. Portanto, faz-se necessario demonstrar os impactos causados pela pandemia no numero de doadores de medula ossea. Logo, realizou-se estudo de dados fornecidos pelo REDOME entre 2019 a 2020, relacionados as coletaS e cadastro na Fundacao Hemocentro de Ribeirao Preto junto ao Laboratorio de HLA. Autores: Santos VT, Deghaide NHS, Martins GV, Correa APB, Domeneghetti MS, Roque ACM, Sartori LG. Instituicao: Fundacao Hemocentro de Ribeirao Preto. Justificativa: Frente a pandemia(COVID-19), o Laboratorio de HLA se adaptou as medidas de prevencao e recomendacoes do Hospital das Clinicas de Ribeirao Preto e protocolos do Ministerio da Saude, com reducao no cadastro de doadores voluntarios de medula ossea. O objetivo deste trabalho foi identificar o numero de doadores voluntarios que foram cadastrados como doadores de medula ossea antes da pandemia, e analisar os cadastros durante esta. Materiais e Metodos: Utilizou-se um estudo observacional de criterio longitudinal e retrospectivo, do tipo serie temporal, utilizando a base dados fornecidos pelo REDOME, referentes ao numero de cadastro de novos doadores de medula ossea no Hemocentro de Ribeirao Preto, entre 2019 e 2020. Os cadastros de janeiro a dezembro de 2020 foram comparados ao ano de 2019. Resultados: Segundo o REDOME, o numero de doadores no Brasil e de 5.522.346. O numero de doadores cadastrados a Fundacao Hemocentro de Ribeirao Preto esta acima de 265.000, o que corresponde a 4,8% do total de doadores cadastrados no pais. Os total doadores em Ribeirao Preto em 2019 foi 24.130 e 18.737 em 2020. Em 2019, no Brasil foram 291.361 novos doadores, onde o Hemocentro representa 8,28% do pais. A pandemia influenciou essa reducao frente isolamento social e dificultou a realizacao de campanhas. Discussao: O transplante de medula ossea e uma terapeutica de resultados positivos em sua terapeutica, no entanto, necessita-se de doadores compativeis. O numero de doadores de transplante de medula ossea aumenta e no Brasil, ha locais de cadastro e de coleta, chamado de hemocentro. A educacao em saude e recurso importante para informar e atualizar a populacao quanto a relevancia do cadastro para formacao do banco de doadores. Conforme dados do Ministerio da Saude, as doacoes de medula ossea e transplantes nao chegaram a ser interrompidos na pandemia, porem foram aplicadas restricoes de seguranca, publicadas no portal da Agencia Nacional de Vigilancia Sanitaria. O decrescimo de cadastros de doadores de medula ossea no Hemocentro de Ribeirao Preto e em todo o Brasil, pode estar fortemente relacionado com a interrupcao de campanhas em virtude da pandemia. Conclusao: Ao comparar o registro de doadores de medula ossea no Hemocentro com dados de cadastro no Brasil, entre 2019 e 2020, nota-se que houve reducao nos registros. No estado de Sao Paulo, a reducao foi de 12,7%, passando de 69.567 para 60.744 o numero de cadastros. No Brasil, de 25,66%, total de 291.361 em 2019 para 170.287 ate dezembro de 2020. As restricoes do periodo de isolamento social devido COVID-19 impactaram nos registros de doadores, assim como a nao realizacao de cadastro e campanhas do Hemocentro, que foram suspensas em 2020. Copyright © 2022

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