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We conducted a systematic review to assess the impact of the COVID-19 pandemic on measles vaccination coverage. We searched for articles published between January 2021 and December 2023 in Portuguese, English, and Spanish in the Web of Science, ScienceDirect, PubMed, and LILACS databases. The final sample consisted of 32 studies, which demonstrated that most countries had a 1% to 10% decrease on measles vaccination coverage during the pandemic. However, the influence of the pandemic varied worldwide, ranging from 1% to 60% based on the region. The COVID-19 pandemic has had a relatively modest impact on measles immunization, with a complex intersection of several factors associated with the decrease in measles vaccination coverage.

Human infection by Leptospira results from direct exposure or indirect contact with soil or water contaminated by the urine of carrier mammals. Despite the current knowledge about the modes of infection, there are still gaps in understanding the factors that contribute to the disease lethality. Aiming to identify factors associated with death from leptospirosis in Brazil, a retrospective exploratory cross-sectional study was conducted using data from the Brazilian Information System for Notificable Diseases of the Brazilian Ministry of Health, from 2007 to 2019. From an initial total of 50,640 confirmed cases, 38,206 (75.45%) cases were selected for analysis, of which 10.39% (3,968) represented deaths. Among the sociodemographic factors associated with death from leptospirosis, notable ones included contact with trash/rubble, work-related infection, male gender, non-white skin color, and increased risk with age. Among the clinical factors, notable ones included the presence of respiratory alterations, clinical-epidemiological confirmation criteria, pulmonary hemorrhage, kidney failure, jaundice, cardiac alterations, and vomiting. Regarding geographical distribution, residing in the Southeast increased the chance of death by 83% compared to individuals residing in the North, which had the lowest proportion of deaths (5.68%). The results found in this study provide an overview of the lethality of leptospirosis in humans in Brazil. Regional differences should be better investigated to guide health policies.

This article analyzes the continuity of care in the relational domain based on user experience. This is a qualitative case study based on 45 interviews with person living with HIV (PLH) followed-up in polyclinics and 38 interviews with users diagnosed with systemic arterial hypertension (SAH) registered in basic health units (BHU) in a large city in the state of Rio de Janeiro, Brazil. The results were analyzed according to two dimensions of relational continuity: trust-based relationship and availability of personalized information. The strongest trust-based relationships and the protagonism in the availability of health information were established with the family health team (FHT) physician and the infectious disease specialist in the polyclinics. Among the differences, according to users with SAH, the relationship bonds were broken by health care provider turnover. In the absence of relationships with other FHT professionals, continuity and access were simultaneously affected. Among PLH users, nursing professionals played an important role in care. In both cases, the results showed a care with little concern for interprofessional practices, collective actions and promotional initiatives to strengthen continuity. The lack of technology-mediated communication required users to attend health care services to solve their demands and contact professionals. The results indicate the importance of a regular point of care for establishment of the bond and consequent relational continuity. However, health care work management-related problems in the Brazilian Unified National Health System aggravate health care provider turnover and favor disruptions in therapeutic follow-up.

This study aimed to evaluate the mental health, quality of life, social support, and activities by community health workers (CHW) during and after a health crisis under a gender perspective. This multicenter, quantitative, longitudinal study was carried out in eight municipalities in the Brazilian Northeast in 2021 and 2023 with 705 CHW who were paired by propensity score matching, answered a validated questionnaire, and were analyzed under the focus of gender (men and women), time (during and after the COVID-19 pandemic), and interactions between them. The effect of time stemmed from the violence in the territories, developed activities, anxiety about the virus, mental health, and quality of life. The effect of gender stemmed from the reduction of social support (friends) in female CHW and greater performance of home visits and activities of the health in schools program by CHW. The interaction between gender and time stemmed from the reduction of violence against female CHW and an increase in the male gender between the studied periods. Although men and women share the same dilemmas and difficulties in exercising CHW, gender implications fall on female professionals, who show greater physical and emotional exhaustion and susceptibility to illness, especially in times of health crises.

This study aimed to develop and validate a logical model of the components of comprehensive care for children with congenital Zika syndrome (CZS) in the municipality of Rio de Janeiro, Brazil, in three stages: (1) search in the scientific literature and official documents to elaborate the logical model, (2) improvement of the model by incorporating the suggestions of specialists in child health, people with disabilities, health evaluation, and health care network, and (3) validation of the logical model by the Delphi consensus in two phases: evaluation of the relevance of the model items by the percentage of agreement (PA), Cronbach's alpha coefficient, medians, and interquartile values. The logical model contains all the necessary components to admit and follow up CZS cases from conception to the third year of life. A total of 136 items of the model were classified as relevant (phase 1: PA 96-97% and 0.76-0.93; phase 2: PA 98% and 0.88-0.97), 98% very relevant and 2% relevant. The elaboration and validation of the logical model could graphically represent the components necessary for comprehensive health care for children with CZS and organize care flows with the necessary elements to assist local management in planning, structuring, and evaluating the health care network. Despite the unique characteristics of the municipality, this model may serve other locations with contextual factors resembling those in Rio de Janeiro.

This essay seeks to reflect on the enormous potential of the legacy of black feminist thought as a critical social theory to alleviate the theoretical, methodological, political, and ethical challenges for Public Health. Focusing on Social and Human Sciences in Health seeks to empirically analyze the contributions of the field in view of the historical trajectory of the development of public debates on women's health care or reproductive policies in their epistemological, social, and political displacements up to the implementation of the perspective of reproductive justice, claimed as a primordial dimension of the intersectional matrix. Anchored in a reflection on a certain academic trajectory of research in this field, this essay sheds light on the ethical-political confrontation of the expressive social inequalities in Brazil.

This study describes the 1964 measles epidemic among the Hitnü people of Arauca, Colombia, based on the perspective of this Indigenous people. For this, a Historical Anthropology study was carried out with field diaries based on two ethnographic approaches (1976-1982 and 2023-2024). The data were collected for over about 50 years from the survivors of the epidemic, and the most recent records refer to older Hitnü who knew the facts from the oral tradition of their parents. Results show that the Hitnü recognize the characteristics of a measles epidemic ("romé"). Moreover, symbolic questions followed explanations about the epidemic, and this study argues that their interpretations suffered the influence of the historical and sociopolitical context of the time, characterized by struggles between Indigenous and non-Indigenous people. This experience shows the value of Ethnography to reconstruct facts related to epidemics and explore health emergencies based on the perspective of the affected people to be reported by ethnographers who distance themselves from the often hegemonic narratives that reinforce inequalities, delegitimizing or ignoring the knowledge and resolution capacities of Indigenous people regarding this type of event and their interpretations, which, as with Hitnü and other South American groups, are linked to their relationship with non-Indigenous people over time.

This study aims to analyze the relationship between precarious employment and the presence and number of functional limitations controlled by sociodemographic variables based on data from the 2018 Mexican National Health and Nutrition Survey. This is a population-based cross-sectional study using the linear hurdle model adjusted by robust standard error estimates. A count variable was constructed to measure the number of functional limitations of each person, while the main independent variable is a summative index that classifies unsafety in the current job into four items. The results show that the level of unsafe labor conditions has significant associations with the probability of having at least one functional limitation and also with the increase in the number of functional limitations, and this association is still maintained with the control for theoretically relevant variables such as gender, age and marital status.