Compliance with the vaccination schedule in children hospitalized with pneumonia and associated factors.

OBJECTIVE: To verify the adequacy and factors associated with compliance with the immunization schedule (BCG, DTP-Hib, MMR, PCV-10) in children hospitalized with pneumonia at a pediatric referral hospital in Northeast Brazil. METHODS: This is a cross-sectional, descriptive study with an analytical component, with a sample of 452 children hospitalized with pneumonia at the Instituto de Medicina Integral Prof. Fernando Figueira, between 2010 and 2013. The inclusion criterion was children aged from one month to less than five years of age with proof in the immunization record. The exclusion criterion was the presence of hospital-acquired pneumonia or concomitant disease. We have evaluated the adequacy of the immunization schedule for the BCG, tetravalent, MMR, and 10-valent pneumococcal conjugate (PCV-10) vaccines. We used the chi-square test and Fisher's exact test followed by multivariate Poisson regression, estimating the crude and adjusted prevalence ratios and respective 95% confidence intervals. The variables with p < 0.20 in the univariate analysis were included in the multivariate analysis. RESULTS: There was good adequacy in the immunization schedule, except for PCV-10, which presented a percentage lower than 85%. We have observed an association between adequate compliance with the immunization schedule and education level of the mother (89.9% complete high school), sex of the child (87.2% female), age of the child (94.2% younger than six months), and breastfeeding (84.3% breastfed). CONCLUSIONS: Given the high rate of education level of the mother and the high percentage of breastfeeding, we can understand that there is a better understanding of the health of the child by the mothers studied in this study, showing the effectiveness of public policies for infant feeding. However, children did not have good adequacy of the immunization schedule of PCV-10, one of the main vaccines against pneumonia, which can be one of the main factors in the causes of hospitalization, with no influence on the classification of the severity of the disease. In this way, we emphasize that the causes of pneumonia morbidity are not associated with a single factor.

Compliance with the vaccination schedule in children hospitalized with pneumonia and associated factors / Cumprimento do esquema vacinal em crianças internadas por pneumonia e fatores associados

ABSTRACT OBJECTIVE: To verify the adequacy and factors associated with compliance with the immunization schedule (BCG, DTP-Hib, MMR, PCV-10) in children hospitalized with pneumonia at a pediatric referral hospital in Northeast Brazil. METHODS: This is a cross-sectional, descriptive study with an analytical component, with a sample of 452 children hospitalized with pneumonia at the Instituto de Medicina Integral Prof. Fernando Figueira, between 2010 and 2013. The inclusion criterion was children aged from one month to less than five years of age with proof in the immunization record. The exclusion criterion was the presence of hospital-acquired pneumonia or concomitant disease. We have evaluated the adequacy of the immunization schedule for the BCG, tetravalent, MMR, and 10-valent pneumococcal conjugate (PCV-10) vaccines. We used the chi-square test and Fisher's exact test followed by multivariate Poisson regression, estimating the crude and adjusted prevalence ratios and respective 95% confidence intervals. The variables with p < 0.20 in the univariate analysis were included in the multivariate analysis. RESULTS: There was good adequacy in the immunization schedule, except for PCV-10, which presented a percentage lower than 85%. We have observed an association between adequate compliance with the immunization schedule and education level of the mother (89.9% complete high school), sex of the child (87.2% female), age of the child (94.2% younger than six months), and breastfeeding (84.3% breastfed). CONCLUSIONS: Given the high rate of education level of the mother and the high percentage of breastfeeding, we can understand that there is a better understanding of the health of the child by the mothers studied in this study, showing the effectiveness of public policies for infant feeding. However, children did not have good adequacy of the immunization schedule of PCV-10, one of the main vaccines against pneumonia, which can be one of the main factors in the causes of hospitalization, with no influence on the classification of the severity of the disease. In this way, we emphasize that the causes of pneumonia morbidity are not associated with a single factor.

RESUMO OBJETIVO: Verificar a adequação e os fatores associados ao cumprimento do esquema vacinal (BCG, DTP-Hib, SCR, VCP-10) em crianças internadas com pneumonia em um hospital de referência pediátrica no Nordeste do Brasil. MÉTODOS: Estudo transversal, descritivo com componente analítico, composto por 452 crianças hospitalizadas por pneumonia no Instituto de Medicina Integral Prof. Fernando Figueira, entre 2010 e 2013. Critérios de inclusão: idade de um mês a menores de cinco anos; com comprovação do cartão vacinal. Critérios de exclusão: pneumonia hospitalar ou doença de base concomitante. Avaliamos a adequação do esquema vacinal da BCG, tetravalente, tríplice viral e pneumocócica conjugada 10 valente (VPC-10). Foram utilizados os testes qui-quadrado e exato de Fisher seguidos de regressão multivariada de Poisson, estimando-se as razões de prevalência brutas, ajustadas e os respectivos intervalos de confiança de 95%. Participaram da análise multivariada as variáveis que na análise univariada apresentaram valor p < 0,20. RESULTADOS: Houve boa adequação no calendário vacinal, exceto a vacina VPC-10, que apresentou percentual inferior a 85%. Observou-se associação entre o adequado cumprimento do esquema vacinal e escolaridade materna (89,9% ensino médio completo), sexo da criança (87,2% feminino), idade da criança (94,2% menor que seis meses) e aleitamento materno (84,3% amamentaram). CONCLUSÕES: Pela elevada taxa na escolaridade materna e pelo elevado percentual de alimentação por leite materno, pode-se entender que há uma melhor compreensão no cuidado da saúde da criança pelas genitoras estudadas nesta pesquisa, apresentando a eficácia das políticas públicas de alimentação infantil. Porém, as crianças não tiveram uma boa adequação do esquema vacinal da VPC-10, uma das principais vacinas contra a pneumonia, podendo ser esse um dos principais fatores nas causas do internamento, não apresentando influência com a classificação da gravidade da doença. Enfatiza-se dessa maneira que as causas de morbidade por pneumonia não são associadas a um único fator.

Intervenções educativas sobre o HIV/AIDS para adolescentes de escolas públicas / Educational interventions on HIV/AIDS for teenagers in public schools / Intervenciones educativas sobre el VIH/SIDA para adolescentes de escuelas públicas

Objetivos: identificar o uso e aceitação dos preservativos entre estudantes; realizar intervenções educativas sobre o HIV/aids. Método: estudo de intervenção, de abordagem quantitativa entre os estudantes na faixa etária entre 10 e 15 anos, em uma escola pública do Recife-PE. A amostra foi de 30 alunos, distribuídos em duas salas, sendo 16 alunos da 7º série do 8º ano e 14 do 8º série do 9º ano. Para a seleção da amostra foram levados em consideração critérios de inclusão e exclusão. A coleta de dados foi realizada com o uso de questionário e análise pelo Epi-Info versão 3.5. Em seguida,foram realizadas intervenções educativas por meio de palestras. Tudo isso após a aprovação do projeto de pesquisa pelo Comitê de Ética em Pesquisas do Centro de Ciências da Saúde, da Universidade Federal de Pernambuco/CCS/UFPE, sob n°191/10, com a assinatura do Termo de Consentimento Livre e Esclarecido pelos pais/responsáveis. Resultados: dentre os principais resultados, observou-se que 66,7% dos estudantes concordaram que o uso de preservativos reduz o risco de contrair HIV/AIDS; 63,3% concordaram que para reduzir os riscos de contrair o HIV/AIDS é usar preservativos,independente do número de parceiros; 56,7% dos jovens opinaram que discordam em realizar atividade sexual sem preservativo; 36,7% usarão preservativos com todos os parceiros sexuais. Conclusão: houve índice satisfatório de aceitação no uso de preservativos. (AU)

Objectives: to identify the use and acceptance of condoms among students; executing educational interventions on HIV/AIDS. Method: quantitative approach intervention study among students between the ages of 10 and 15 years, in a public school in Recife-PE, Brazil. The sample consisted of 30 students divided into two rooms, with 16 students in 7th and 8th grade 14 in the 8th and 9th grade. For the sample selection, inclusion and exclusion criteria were taken into consideration. Data collection was performed with the use of a questionnaire and the analysis by the Epi-Info version 3.5, software. Then educational interventions were carried out through lectures. All this after the approval of the research project by the Research Ethics Committee of the Center for Health Sciences, Federal University of Pernambuco/CCS/UFPE, under protocol No. 191/10, with the signing of the free and informed consent by parents/guardians. Results: among the main results, it was noted that 66.7% of the students agreed that the use of condoms reduces the risk of contracting HIV/AIDS; 63.3% agreed that to reduce the risks of contracting HIV/AIDS is to use condoms, regardless of the number of partners; 56.7% of young people gave their opinions that they disagree about performing sexual activity without a condom; 36.7% use condoms with all sexual partners. Conclusion: There was a satisfactory index of acceptance for the use of condoms.(AU)

Objetivos: identificar el uso y aceptación de los preservativos entre estudiantes; realizar intervenciones educativas sobre el VIH/SIDA. Método: estudio de intervención, de abordaje cuantitativo entre los estudiantes de entre diez y quince años, en una escuela pública de Recife (PE, Brasil). El universo fue de 30 alumnos, distribuidos en dos clases, dieciséis alumnos del 7ºcurso y catorce del 8º curso de educación primaria. Para la selección del muestreo se tuvieron en cuenta criterios de inclusión y exclusión. La recogida de datos se realizó mediante empleo de cuestionario y análisis por la versión Epi-Info. Seguidamente se realizaron intervenciones educativas por medio de conferencias. Todo ello tras la aprobación del proyecto de investigación por el Comité de Ética en Investigaciones del Centro de Ciencias de la Sanidad de la Universidad Federal de Pernambuco/CCS/UFPE. bajo nº 191/10, con la firma del Término de Libre y Espontánea Voluntad por parte de los padres/tutores. Resultados: entre los principales resultados, se observó que el 66,7% de los estudiantes estuvieron de acuerdo con que el empleo de preservativos reduce el riesgo de contraer VIH/SIDA; el 63,3% aceptaron que para reducir el riesgo de adquirir el VIH/SIDA hay que usar preservativos, independientemente del número de compañeros sexuales; 56,7% de los jóvenes opinaron que no aceptan realizar actividades sexuales sin preservativo; el 36,7% utilizarán preservativos con todos sus compañeros sexuales. (AU)