Epidemiologia e Servicos de Saude最新文献

Objective: To compare child health booklet (CHB) use and filling out among mothers who were or were not Bolsa Família Program (BFP) beneficiaries.

Methods: Cross-sectional study with mothers of children <6years attending health centers in Salvador, Bahia, Brazil, between January-February/2023. The CHB was evaluated regarding its use (having a CHB, having it in hand, and having read it) and filling out (growth curves, development monitoring forms, and vaccination completeness). Descriptive statistics and the chi-square test were used.

Results: Of the 411 study participants, 66% were BFP beneficiaries. Significant differences were found between the groups regarding CHB use: having a CHB (p < 0.001), having it in hand (p = 0.037), and having read it (p < 0.001). Significant difference in vaccination completeness was found (p = 0.005).

Conclusion: There was a significant difference in CHB use and vaccination completeness when comparing mothers who were BFP beneficiaries and those who were not.

Objective: To investigate factors associated with tuberculosis deaths in Mato Grosso state, Brazil, from 2011 to 2020.

Methods: Retrospective cohort study with data obtained from the Notifiable Health Conditions Information System and the Mortality Information System. Deaths were qualified using probabilistic linkage and analyzed using Poisson regression.

Results: 12,331 cases and 525 deaths were identified over 10 years. The factors associated with death were: age ≥60 years (RR: 7.70; 95%CI 1.91;31.04), incomplete elementary and high school education (RR: 3.66; 95%CI 1.34;9.96), illiteracy (RR: 4.50; 95%CI 1.60;12.66), homeless population (RR: 2.41; 95%CI 1.34;4.35), alcohol use (RR: 1.45; 95%CI 1.04;2.02), male sex (RR: 1.48; 95%CI 1.04;2.09) and tobacco use (RR: 1.32; 95%CI 0.98;1.77). Laboratory confirmation was a protective factor.

Conclusion: Risk of death was higher in men over 60 years old, with low education levels, in vulnerable situations, and who used alcohol/tobacco.

Objective: To describe the distribution of nutritional status and food insecurity among the adult transgender population in the Baixada Santista region of the state of São Paulo and to identify associated factors.

Methods: This was a cross-sectional study using data from the research project entitled Mapping the Transgender Population in Baixada Santista of the state of São Paulo, conducted through a structured questionnaire administered between August and December 2023. The outcomes were nutritional status and food and nutrition insecurity (FNI). The association analysis was performed using Fisher's exact test.

Results: A total of 237 people took part in the study. High prevalence of FNI was associated with an income of less than 2 minimum wages (p < 0.001), difficulty finding a job (p < 0.001) and lack of family support related to gender (p = 0.001). Difficulty reading/writing (p = 0.025) and proximity to an open-air market (p = 0.033) were negatively or positively associated with adequate nutritional status, respectively.

Conclusion: The high prevalence of FNI among the most vulnerable population and the adequate nutritional status associated with proximity to open-air markets indicate the need for policies aimed at reducing inequities and expand access to adequate food.

Objective: To analyze the sociodemographic and access profile of trans men and transmasculine individuals linked to the Transgender Outpatient Clinic in Porto Alegre, capital city of the state of Rio Grande do Sul.

Methods: This was a descriptive cross-sectional study based on data from users registered with the service between 2019 and 2021.

Results: Of the 418 people included, 384 (91.2%) identified as trans men and 34 (8.8%) as transmasculine individuals. The majority were of White race/skin color (77.9%) and 16.4% had a right to name and gender rectification. Scheduled appointments were the predominant mode of access (84.0%). Among the trans men, 188 (49.0%) had utilized primary healthcare services prior to receiving care at the outpatient clinic.

Conclusion: The users were predominantly young, White, with higher levels of education, and were minimally engaged in the formal labor market. The existence of a service staffed with qualified and sensitized professionals can enhance the access of this population to the Brazilian National Health System (Sistema Único de Saúde - SUS).

Objective: To estimate vaccination coverage, identify barriers and hesitancy to vaccinating children up to 24 months, born between 2017-2018, living in the urban area of Rio Branco, Acre, Brazil.

Methods: Population survey carried out from 2020 to 2021, which assessed sociodemographic characteristics and vaccination status among children.

Results: Among 451 included children, vaccination coverage was below 80%. Meningococcal C vaccine had the lowest coverage for administered doses (76.3%; 95%CI 70.5;81.3) and doses on time (27.4%; 95%CI 23.1;32.1). The statements "vaccines cause serious adverse reactions" (26.4%; 95%CI 18.1;36.8) and "you don't need vaccination for diseases that no longer exist" (22%; 95%CI 15.7;29.8) were the most frequent regarding vaccination hesitancy. Lack of vaccines was the main barrier to care (86.6%; 95%CI 71.8;94.3).

Conclusion: Vaccination coverage in children born in 2017-2018 was below the target recommended for the full schedule of administered doses, both valid and timely administered.

Objective: To estimate vaccination coverage in children born between 2017-2018, living in urban areas of state capitals, the Federal District and 12 inland municipalities in Brazil, and to identify associated factors.

Methods: This was a household survey conducted between 2020-2022, among children up to 24 months old. Vaccination coverage was estimated according to family, maternal and child characteristics.

Results: Among the 37,801 children in the sample, complete coverage (doses administered) was 60.1% (95%CI 58.6;61.6) and 6.1% (95%CI 5.4;7.0) had not received any vaccines. Coverage was lower among children of mothers with lower level of education (OR = 0.70; 95%CI 0.54;0.90) and in those who experienced delays in receiving any vaccine by 6 months old (OR = 0.28; 95%CI 0.24;0.32).

Conclusion: Vaccination coverage is below the expected levels. Effective communication strategies are needed to reinforce the importance of routine vaccination, prevent delays and abandonment of the vaccination schedule, in order to recover the high coverage levels achieved in past decades.

Objective: To analyze full vaccination coverage in live births in 2017 and 2018 in the capitals of the Midwest region of Brazil, according to social strata.

Methods: Population-based household survey with cluster sampling. Full coverage in children at 12 and 24 months of age and sociodemographic factors were analyzed.

Results: 5,715 children were analyzed. Full coverage at 12 months of age was 67.9% (95%CI 65.4;70.4), while at 24 months it was 48.2% (95%CI 45.3;51.1). Pneumococcal vaccine had the highest vaccination coverage (91.3%), while the second dose of rotavirus vaccine had the lowest (74.2%). In Campo Grande, no vaccine reached coverage above 90%, with BCG (82.9%) and hepatitis B (82.1%) standing out. Campo Grande and Brasília had the worst vaccination coverage in the high social stratum (24 months of age).

Conclusion: Vaccination coverage in the Midwest was below 80%, falling short of the recommended target and associated with socioeconomic factors.

Objective: To estimate vaccination coverage and analyze sociodemographic factors associated with non-vaccination in children born in 2017 and 2018 in the state capitals of Northeast Brazil.

Methods: A household survey using cluster sampling was conducted from 2020-2022 to estimate vaccination coverage and hesitancy. Factors associated with non-vaccination were analyzed using logistic regression to calculate Odds Ratios (OR) and their Confidence Intervals (95%CI).

Results: Natal was the capital with the lowest vaccination coverage, below 75.0% for most immunizers. Teresina had rates equal to or greater than 90.0% for all vaccines. Among those interviewed, 99.1% (95%CI 98.9;99.3) believe that vaccines are important for health; 95.4% (95%CI 95.0;95.8) trust immunobiologicals and 79.6% (95%CI% 78.8;80.3) are not afraid of reactions. Belonging to the highest socioeconomic stratum (adjusted OR: 1.34 - 95%CI 1.20;1.50) was as a factor associated with non-vaccination.

Conclusion: Low coverage highlights the need for a better understanding of regional specificities and social inequalities.

Objective: To characterize the use of private services in infant vaccination and assess vaccination coverage according to the service used.

Methods: : This was a national vaccination survey conducted in 2020 that estimated the use of private vaccination services and vaccination coverage among infants residing in state capitals and 12 inland municipalities.

Results: : Of the 37,801 participants, 25.1% (95%CI 23.2;27.2) used private services at least once, with higher proportions in capitals, larger cities and in the South and Southeast regions. Socioeconomic and demographic differences were identified among families, based on the service used. The coverage for the set of vaccines administered up to 24 months was 60.3% (95%CI 58.6;62.0) in the public service and 59.5% (95%CI 55.9;63.0) in private services, and up-to-date vaccines, 10.3% (95%CI 9.1;11.6) and 9.4% (95%CI 7.4;11.8), respectively.

Conclusion: The use of private services was frequent, with low coverage for the set of vaccines, regardless of the type of service used, especially for up-to-date vaccines.

Objective: To estimate hepatitis A vaccination coverage in 24-month-old children and identify factors associated with non-vaccination.

Methods: This was a survey involving a sample stratified by socioeconomic strata in capital cities (2020-2022), with coverage estimates and 95% confidence intervals (95%CI), the factor analysis was performed using the prevalence ratio (PR) by means of Poisson regression.

Results: Among 31,001 children, hepatitis A coverage was 88.1% (95%CI 86.8;89.2). Regarding socioeconomic strata (A/B), the variable immigrant parents/guardians was associated with non-vaccination (PR = 1.91; 95%CI 1.09;3.37); in strata C/D, children of Asian race/skin color (PR = 4.69; 95%CI 2.30;9.57), fourth-born child or later (PR = 1.68; 95%CI 1.06;2 .66), not attending daycare/nursery (PR = 1.67; 95%CI 1.24;2.24) and mother with paid work (PR = 1.42; 95%CI 1.16;1.74) were associated with non-vaccination.

Conclusion: Hepatitis A coverage was below the target (95%), suggesting that specificities of social strata should be taken into consideration.

Main results: Hepatitis A vaccination coverage was 88%. Non-vaccination was greater in children with immigrant guardians (strata A/B); of Asian race/skin color, fourth-born child or later, those not attending daycare/nursery and mother with paid work (C/D strata).

Implications for services: The results of this study contributed to the Ministry of Health and Health Departments in monitoring vaccination coverage and identifying factors that may negatively impact hepatitis A vaccination coverage.

Perspectives: Further research is needed on the impact of migration on hepatitis A vaccination and vaccination in general. Health managers should be attentive to the different factors affecting vaccination among social strata.