Effects of the COVID-19 pandemic on routine pediatric vaccination in Brazil.

BACKGROUND: COVID-19 pandemic has disrupted health services, including vaccination demand. We describe the impact of the COVID-19 pandemic on routine pediatric vaccination in Brazil. METHODS: We conducted a retrospective analysis of all vaccine doses provided to children aged 0-6 years from January 2019 to December 2020. We obtained data stratified by age group (0 to 2 years and >2 to 6 years) and Brazilian region. Difference-in-difference (DiD) analyses were performed to compare vaccine uptake in the pre-pandemic (January-February), stay-at-home (March-June), and reopening (July-December) periods. RESULTS: The number of vaccine doses administered declined in the stay-at-home period. For children aged 0 to 2 years, the highest reductions were recorded in the North (-25.3%), Northeast (-16.8%) and Central-West (-10.2%) regions. For children aged >2 to 6 years, the highest decline was observed in the North (DiD = -27.2%) and South (DiD = -14.0%) regions. The number of vaccine doses administered in the reopening period has slightly increased in all regions. CONCLUSIONS: Vaccination decreased during the COVID-19 pandemic. Although the number of doses recovered in part during the reopening phase, additional strategies, such as increased public awareness and vaccination booster campaigns are required.

Prevalence of intestinal parasitic infections in Brazil: a systematic review.

INTRODUCTION: Parasitic infections are considered a major public health problem due to their associated morbimortality and negative impact on physical and intellectual development, especially in the at-risk pediatric group. Periodic prophylactic administration of antiparasitic agents against soil-transmitted helminths is recommended by the World Health Organization (WHO) to control parasitic infections and disease burden. We aimed to evaluate the prevalence of intestinal parasitic infections in Brazil. METHODS: We performed a systematic review by searching the literature found in the PubMed, LILACS, and SciELO databases, followed by a meta-analysis of the proportions from studies published in English, Portuguese, and/or Spanish from January 2000 to May 2018. This systematic review was registered in the PROSPERO database (CRD42018096214). RESULTS: The prevalence of intestinal parasitic infections (protozoa and/or helminths) in Brazil was 46% (confidence interval: 39-54%), with 99% heterogeneity. Prevalence varied by region: 37%, 51%, 50%, 58%, and 41% in the Southeast, South, Northeast, North, and Central-West regions, respectively. Most studies (32/40) evaluated children (<18 years) and found an average prevalence of 51%. Children also had the highest prevalence in all four regions: Central-West (65%), South (65%), North (58%), Northeast (53%), and Southeast (37%). However, most studies evaluated specific populations, which may have created selection bias. Presumably, this review of intestinal parasitic diseases in Brazil includes the most studies and the largest population ever considered. CONCLUSIONS: The prevalence of intestinal parasitic infections is high in Brazil, and anthelmintic drugs should be administered periodically as a prophylactic measure, as recommended by the WHO.

Prevalence of intestinal parasitic infections in Brazil: a systematic review

Abstract INTRODUCTION: Parasitic infections are considered a major public health problem due to their associated morbimortality and negative impact on physical and intellectual development, especially in the at-risk pediatric group. Periodic prophylactic administration of antiparasitic agents against soil-transmitted helminths is recommended by the World Health Organization (WHO) to control parasitic infections and disease burden. We aimed to evaluate the prevalence of intestinal parasitic infections in Brazil. METHODS: We performed a systematic review by searching the literature found in the PubMed, LILACS, and SciELO databases, followed by a meta-analysis of the proportions from studies published in English, Portuguese, and/or Spanish from January 2000 to May 2018. This systematic review was registered in the PROSPERO database (CRD42018096214). RESULTS: The prevalence of intestinal parasitic infections (protozoa and/or helminths) in Brazil was 46% (confidence interval: 39-54%), with 99% heterogeneity. Prevalence varied by region: 37%, 51%, 50%, 58%, and 41% in the Southeast, South, Northeast, North, and Central-West regions, respectively. Most studies (32/40) evaluated children (<18 years) and found an average prevalence of 51%. Children also had the highest prevalence in all four regions: Central-West (65%), South (65%), North (58%), Northeast (53%), and Southeast (37%). However, most studies evaluated specific populations, which may have created selection bias. Presumably, this review of intestinal parasitic diseases in Brazil includes the most studies and the largest population ever considered. CONCLUSIONS The prevalence of intestinal parasitic infections is high in Brazil, and anthelmintic drugs should be administered periodically as a prophylactic measure, as recommended by the WHO.