Decline in Vaccination Coverage against Poliomyelitis in the municipalities of Vale do Paraíba (SP) under a spatial approach.

OBJECTIVE: To analyze vaccination coverage (VC) for polio in the municipalities of Vale do Paraíba in the State of São Paulo. METHODS: This is an ecological and exploratory study of VC in 35 municipalities using a spatial approach; VC data were obtained from the IT Department of the Unified Health System (DATASUS), for the years 2015 and 2019, and categorized into Low (VC<95%) and ideal (≥95%). Information was obtained on gross domestic product (GDP), professional rates and number of basic health units (UBS) and maternal data such as age, marital status (MS) and education. Univariate and bivariate Moran indices were estimated for the years 2015 and 2019, and thematic maps were created for CV values. RESULTS: The average VC values were 107.7%±27.2 in 2015, and 94.2%±27.8 in 2019 (p<0.05). In 2015 vs. 2019, there were 10 vs. 25 municipalities in the Low category. In 2015, the variables VC, number of UBS, age, education, and MS were spatially correlated, but in 2019 only maternal age and education were spatially correlated. The bivariate Moran was significant and negative for VC in 2019 with maternal education. There was an increase in municipalities with worsening VC values. CONCLUSIONS: The spatial approach identified a decrease in polio vaccination coverage in the studied region.

Association between exposure to air pollutants and hospitalization for SARS-Cov-2: an ecological time-series study

ABSTRACT BACKGROUND: Exposure to air pollutants and illness by severe acute respiratory syndrome coronavirus 2 (SARS-Cov-2) infection can cause serious pulmonary impairment. OBJECTIVE: To identify a possible association between exposure to air pollutants and hospitalizations due to SARS-Cov-2. DESIGN AND SETTING: Ecological time-series study carried out in Taubaté, Tremembé, and Pindamonhangaba in 2020 and 2021. METHODS: Study with Sars-Cov-2 hospitalizations with information on hospitalization date, sex and age of the subjects, duration of hospitalization, type of discharge, and costs of these hospitalizations. Statistical analysis was performed through a negative binomial regression, with data on pollutant concentrations, temperature, air relative humidity, and hospitalization date. Coefficients obtained by the analysis were transformed into relative risk for hospitalization, which estimated hospitalizations excess according to an increase in pollutant concentrations. RESULTS: There were 1,300 hospitalizations and 368 deaths, with a predominance of men (61.7%). These data represent an incidence rate of 250.4 per 100,000 inhabitants and 28.4% hospital lethality. Significant exposure (P value < 0.05) occurred seven days before hospital admission (lag 7) for nitrogen dioxide (NO2) (relative risk, RR = 1.0124) and two days before hospital admission for PM2.5 (RR = 1.0216). A 10 μg/m3 in NO2 concentration would decrease by 320 hospitalizations and ¼ US $ 240,000 in costs; a 5 μg/m3 in PM2.5 concentration would decrease by 278 hospitalizations and ¼ US $ 190,000 in costs. CONCLUSION: An association between exposure to air pollutants and hospital admission due to Sars-Cov-2 was observed with excess hospitalization and costs for the Brazilian public health system.

Association between exposure to air pollutants and hospitalization for SARS-Cov-2: an ecological time-series study.

BACKGROUND: Exposure to air pollutants and illness by severe acute respiratory syndrome coronavirus 2 (SARS-Cov-2) infection can cause serious pulmonary impairment. OBJECTIVE: To identify a possible association between exposure to air pollutants and hospitalizations due to SARS-Cov-2. DESIGN AND SETTING: Ecological time-series study carried out in Taubaté, Tremembé, and Pindamonhangaba in 2020 and 2021. METHODS: Study with Sars-Cov-2 hospitalizations with information on hospitalization date, sex and age of the subjects, duration of hospitalization, type of discharge, and costs of these hospitalizations. Statistical analysis was performed through a negative binomial regression, with data on pollutant concentrations, temperature, air relative humidity, and hospitalization date. Coefficients obtained by the analysis were transformed into relative risk for hospitalization, which estimated hospitalizations excess according to an increase in pollutant concentrations. RESULTS: There were 1,300 hospitalizations and 368 deaths, with a predominance of men (61.7%). These data represent an incidence rate of 250.4 per 100,000 inhabitants and 28.4% hospital lethality. Significant exposure (P value < 0.05) occurred seven days before hospital admission (lag 7) for nitrogen dioxide (NO2) (relative risk, RR = 1.0124) and two days before hospital admission for PM2.5 (RR = 1.0216). A 10 µg/m3 in NO2 concentration would decrease by 320 hospitalizations and ¼ US $ 240,000 in costs; a 5 µg/m3 in PM2.5 concentration would decrease by 278 hospitalizations and ¼ US $ 190,000 in costs. CONCLUSION: An association between exposure to air pollutants and hospital admission due to Sars-Cov-2 was observed with excess hospitalization and costs for the Brazilian public health system.

SARS-CoV-2 infection in children and adolescents: a Brazilian experience.

OBJECTIVE: To describe clinical and epidemiological aspects of children and adolescents infected with the SARS-CoV-2 in the Municipality of Taubaté, SP, from March to November 2020. METHODS: Cross-sectional study with secondary data obtained from the Epidemiological Surveillance System about confirmed cases in city residents and from medical records of patients who were treated in hospitals in Taubaté, aged between 0 and 19 years. Chi-square and Student's t tests were used for comparisons. RESULTS: 677 cases in the studied age range were reported during the study period, corresponding to 10.1% of cases reported in the municipality. The rapid antibody test was the most used to confirm infection, followed by RT-PCR and serology. Symptoms were described in 57.7% of the cases, mainly fever and cough. Diarrhea was associated with age below 4 years, while fever, cough, headache, odynophagia, ageusia, anosmia, myalgia, and dyspnea were associated with an age ranging from 10 to 19 years. In the study period, there were no deaths from COVID-19 of residents of the municipality in the age group from 0 to 19 years. CONCLUSIONS: The study was able to identify the proportion of involvement of COVID-19 in children and adolescents in the city, and the disease had a mild evolution. The main symptoms were fever and cough, but mainly diarrhea in younger children, and headache, odynophagia, anosmia, ageusia, and myalgia in adolescents.

SARS-CoV-2 infection in children and adolescents: a Brazilian experience / Infecção pelo SARS-CoV-2 em crianças e adolescentes: uma experiência brasileira

Abstract Objective: To describe clinical and epidemiological aspects of children and adolescents infected with the SARS-CoV-2 in the Municipality of Taubaté, SP, from March to November 2020. Methods: Cross-sectional study with secondary data obtained from the Epidemiological Surveillance System about confirmed cases in city residents and from medical records of patients who were treated in hospitals in Taubaté, aged between 0 and 19 years. Chi-square and Student's t tests were used for comparisons. Results: 677 cases in the studied age range were reported during the study period, corresponding to 10.1% of cases reported in the municipality. The rapid antibody test was the most used to confirm infection, followed by RT-PCR and serology. Symptoms were described in 57.7% of the cases, mainly fever and cough. Diarrhea was associated with age below 4 years, while fever, cough, headache, odynophagia, ageusia, anosmia, myalgia, and dyspnea were associated with an age ranging from 10 to 19 years. In the study period, there were no deaths from COVID-19 of residents of the municipality in the age group from 0 to 19 years. Conclusions: The study was able to identify the proportion of involvement of COVID-19 in children and adolescents in the city, and the disease had a mild evolution. The main symptoms were fever and cough, but mainly diarrhea in younger children, and headache, odynophagia, anosmia, ageusia, and myalgia in adolescents.

RESUMO Objetivo: Descrever aspectos clínicos e epidemiológicos de crianças e adolescentes infectados pelo SARS-CoV-2 no município de Taubaté (SP) de março a novembro de 2020. Métodos: Estudo transversal com dados secundários obtidos no Setor de Vigilância Epidemiológica de casos confirmados em residentes do município e consulta de prontuários de pacientes que foram atendidos em hospitais de Taubaté, com idade entre 0 e 19 anos. Realizaram-se os testes de qui-quadrado, comparação de proporções e t de Student, sendo considerados nível de significância alfa <5%. Resultados: Notificaram-se 677 casos no período estudado, correspondendo a 10,1% do total de casos notificados no município. O teste rápido de anticorpos foi o teste mais utilizado, seguido de RT-PCR e sorologia. Sintomas foram descritos em 57,7% dos casos, sendo febre e tosse os mais frequentes. Diarreia apresentou associação com faixa etária < 4 anos, e febre, tosse, cefaleia, odinofagia, ageusia, anosmia, mialgia e dispneia tiveram associação com faixa etária de 10 a 19 anos. No período estudado, não ocorreu nenhum óbito por COVID-19 na faixa etária de 0 a 19 anos de residentes do município. Conclusões: O estudo conseguiu identificar a proporção de acometimento da COVID-19 em crianças e adolescentes no município, e a doença teve comportamento leve e boa evolução. Os principais sintomas foram febre e tosse, destacando-se diarreia nas crianças mais jovens e cefaleia, odinofagia, anosmia, ageusia e mialgia nos adolescentes.