Estudo transversal do perfil das infecções congênitas atendidas entre 2012 e 2014 em um centro de referência em Belo Horizonte, Minas Gerais / Cross-sectional study of clinical and laboratorial aspects of congenital infections attended at a reference Center in Belo Horizonte, MG, 2012-2014

Introdução: as infecções congênitas são resultantes da transmissão vertical de microrganismos de gestantes infectadas para seus conceptos. Apesar dessas infecções, em geral, cursarem com pouca ou nenhuma manifestação clínica nas gestantes, a infecção fetal pode trazer morbimortalidade perinatal e na infância. Objetivo: identificar a prevalência das infecções congênitas encaminhadas ao Centro de Referência e Treinamento em Doenças Infecciosas e Parasitárias Orestes Diniz (CTR/DIP Orestes Diniz) e avaliar os métodos laboratoriais usados para o diagnóstico. Métodos: estudo transversal realizado em ambulatório de referência em doenças infecciosas, a partir de coleta de dados de prontuários de crianças com diagnóstico suspeito de infecção congênita. A confirmação diagnóstica baseou-se em testes sorológicos ou de biologia molecular, além de descrição de sintomatologia da criança. Resultados: um total de 513 crianças foram identificadas, sendo que 41,3% tiveram o diagnóstico confirmado, a maioria foi de toxoplasmose (45,35%) e sífilis (15,98%). Entre as crianças com diagnóstico confirmado, 28,85% apresentaram manifestações clínicas, enquanto que no grupo com diagnóstico indeterminado ou suspeito o percentual foi de 16,38%. As principais manifestações identificadas foram acometimento do sistema nervoso central (n=39) e alterações visuais (n=30). Conclusão: a confirmação de infecção foi definida em aproximadamente metade dos pacientes avaliados e a maioria das crianças foi assintomática ao nascimento. O pré-natal de qualidade e a propedêutica e tratamento precoce das crianças identificadas podem reduzir o impacto dessas infecções no nosso meio.(AU)

Introduction: congenital infections are results of microorganisms transmitted to the fetus by the infected pregnant. Most newborn infants infected during pregnancy or labor have no sings of congenital disease. However, these infections may cause perinatal and infancy morbidity and mortality. Objective: to determine the prevalence of congenital infections in newborns and infants attended at the CTR/DIP Orestes Diniz (Centro de Treinamento e Referência em Doenças Infecciosas e Parasitárias Orestes Diniz) and to analyse the laboratorial methods used for diagnosis of congenital disease of assisted children. Methods: cross-sectional study conducted in an Infectious Diseases Reference Center where it was evaluated the charts of infants with suspected congenital infection. Diagnosis confirmation was based on serological tests, molecular biology and signs and symptoms described in the charts. Results: A total of 41,3% of the 513 children identified have had a defined diagnosis. Most of them had toxoplasmosis (45,35%) and syphilis (15,98%). Clinical manifestations was observed in 28,85% of children with defined diagnosis of congenital infection, and in 16,38% of children with uncertain diagnosis. Central Nervous System (n=39) and ocular (n=30) manifestations were the most frequent findings. Conclusions: Defined diagnosis was possible in about half of cases and most of them were asymptomatic at birth. An appropriate prenatal care and early diagnosis and treatment of congenital infections may reduce the impact of disease in the population.(AU)

Seroprevalence of HIV, hepatitis B, and syphilis among pregnant women at the general hospital, Guatemala City, 2005-2009.

BACKGROUND: sexually transmitted infection (STI) screening in pregnancy provides an excellent opportunity for secondary prevention. OBJECTIVE: to document the epidemiology of HIV, hepatitis B, and syphilis among pregnant women at a Guatemalan national hospital. RESULTS: from 2004 to 2009, 118 (0.76%) of 15 563 of women tested in the prenatal clinic had HIV infection, 29 (0.22%) of 13 028 women tested had hepatitis B virus infection, and 78 (0.60%) of 13 027 had a positive test for syphilis. From August 1, 2007 through December 31, 2009, 29 482 women were tested in the obstetrical emergency room. A total of 63 were HIV positive (0.21%), 48 had hepatitis B (0.16%), and 196 had syphilis (0.66%). Of the 9196 births between August 2007 and July of 2008, 33 (0.36%) were to HIV-infected mothers. CONCLUSION: these 3 STIs were uncommon in our population and did not increase in incidence during the study period. HIV maternal-to-child transmission (MTCT) prevention programs were feasible in our setting.

Seroprevalence of hepatitis B in pregnant women in Mexico.

OBJECTIVE: To determine the seroprevalence of hepatitis B in pregnant women from several regions of Mexico, as well as the risk factors associated with its occurrence. MATERIAL AND METHODS: A cross-sectional study was conducted between May and August 2000. It included 9,992 pregnant women attending the health services of the Mexican Institute of Social Security (Instituto Mexicano del Seguro Social-IMSS) in five cities: Tijuana, Ciudad Juarez, Acapulco, Cancun, and Mexico City (northeast and southeast regions). RESULTS: The overall prevalence for confirmed cases was 1.65% (165/9,992). The prevalences for individual cities were as follows: Tijuana, 1.27%; Ciudad Juarez, 1.46%; Acapulco, 2.47%; Cancun, 0.93%; northeastern Mexico City, 1.20%, and southeastern Mexico City, 2.52%. The risk factors found to be associated with HBsAg were: age, age at first sexual intercourse, city (Acapulco and southeastern Mexico City), and marital status (single or divorced). CONCLUSIONS: The prevalence of HBsAg in pregnant women (1.65%) was greater than that reported in previous studies and showed geographical differences. This high prevalence suggests that a considerable amount of cases of hepatitis B occurs perinatally and through contact with carriers in the general population. Vaccination of newborns of high-risk pregnant women should be considered.

Seroprevalence of hepatitis B in pregnant women in Mexico

OBJECTIVE: To determine the seroprevalence of hepatitis B in pregnant women from several regions of Mexico, as well as the risk factors associated with its occurrence. MATERIAL AND METHODS: A cross-sectional study was conducted between May and August 2000. It included 9 992 pregnant women attending the health services of the Mexican Institute of Social Security (Instituto Mexicano del Seguro Social-IMSS) in five cities: Tijuana, Ciudad Juarez, Acapulco, Cancun, and Mexico City (northeast and southeast regions). RESULTS: The overall prevalence for confirmed cases was 1.65 percent (165/9 992). The prevalences for individual cities were as follows: Tijuana, 1.27 percent; Ciudad Juarez, 1.46 percent; Acapulco, 2.47 percent; Cancun, 0.93 percent; northeastern Mexico City, 1.20 percent, and southeastern Mexico City, 2.52 percent. The risk factors found to be associated with HBsAg were: age, age at first sexual intercourse, city (Acapulco and southeastern Mexico City), and marital status (single or divorced). CONCLUSIONS: The prevalence of HBsAg in pregnant women (1.65 percent) was greater than that reported in previous studies and showed geographical differences. This high prevalence suggests that a considerable amount of cases of hepatitis B occurs perinatally and through contact with carriers in the general population. Vaccination of newborns of high-risk pregnant women should be considered

Vacunación en la hepatitis B / Vaccination in hepatitis B

La infección de la hepatitis B es endémica en muchas partes del mundo y en los países desarrollados es el agente que con mayor frecuencia infecta el hígado del hombre; el modo más común de adquirir la infección es a través de madres infectadas crónicamente, las cuales transmiten el virus a sus productos con una probabilidad del 70 al 90 por ciento. Asimismo, muchos adolescentes y adultos quedan infectados al quedar expuestos percutáneamente y por transmisión de sangre y sus derivados contaminados por el virus. La única forma disponible de prevención pasiva para la hepatitis por HVB es el uso de inmunoglobulina para hepatitis B que confiere inmunidad temporal. La inmunización activa contra hepatitis B ha sido incluída en el esquema rutinario de vacunación infantil en los Estados Unidos desde 1991. En los países donde la vacunación contra el HVB aún no es general, se recomienda siempre que sea posible en los recién nacidos y para grupos que están en alto riesgo de adquirir esta infección. El primero de estos grupos lo constituyen los individuos que requieren transfusiones repetidas de sangre o de sus derivados como parte de un tratamiento prolongado, pacientes que requieren operaciones frecuentes o intervenciones en el aparato circulatorio, sujetos con inmunidad deficiente natural o adquirida y en pacientes con enfermedades malignas. Otro grupo en alto riesgo está formado por los trabajadores de la salud, personal de instituciones para insuficientes mentales y en algunas instituciones semicerradas donde se considera que la hepatitis B es un riego ocupacional. El esquema de vacunación varía en relación al tipo de vacuna empleada, sin embargo se recomienda la aplicación de tres dosis intramusculares (músculo deltoides en adultos y niños y músculo anterolateral en neonatos e infantes), en cuyo caso brinda protección hasta por 5 años. Cualquiera de las vacunas contra la hepatitis puede aplicarse simultáneamente con cualquier otra vacuna