Sedentary behavior in Brazilian children and adolescents: a systematic review

ABSTRACT OBJECTIVE To describe the methodological characteristics of the studies selected and assess variables associated with sedentary behavior in Brazilian children and adolescents. METHODS For this systematic review, we searched four electronic databases: PubMed, Web of Knowledge, LILACS, SciELO. Also, electronic searches were applied in Google Scholar. A supplementary search was conducted in the references lists of the included articles and in non-indexed journals. We included observational studies with children and adolescents aged from three to 19 years developed in Brazil, presenting analyses of associations based on regression methods and published until September 30, 2014. RESULTS Of the 255 potential references retrieved by the searches, 49 met the inclusion criteria and composed the descriptive synthesis. In this set, we identified a great number of cross-sectional studies (n = 43; 88.0%) and high methodological variability on the types of sedentary behavior assessed, measurement tools and cut-off points used. The variables most often associated with sedentary behavior were “high levels of body weight” (in 15 out of 27 studies; 55.0%) and “lower level of physical activity” (in eight out of 16 studies; 50.0%). CONCLUSIONS The findings of this review raise the following demands to the Brazilian agenda of sedentary behavior research geared to children and adolescents: development of longitudinal studies, validation of measuring tools, establishment of risk cut-offs, measurement of sedentary behavior beyond screen time and use of objective measures in addition to questionnaires. In the articles available, the associations between sedentary behavior with “high levels of body weight” and “low levels of physical activity” were observed in different regions of Brazil.

Occurrence of campylobacter jejuni in diarrhoeic and non-diarrhoeic children in Sao Paulo, Brazil

Campylobacter jejuni was looked for in the feaces of 262 children, beeing 189 with acute diarrhoea, 31 with chronic diarrhoea and 42 controls. The organism was isolated from 14 (7.4%), 2 (6.5%) and 6 (14.3%) of the children, and each group, respectively.

Paracoccidioidomycosis in children with different skeletal involvement

The rarity of paracoccidioidomycosis in childhood prompted us to report two cases with different clinical and radiological skeletal involvement. The number of osteolytic lesions, the presence of periosteal reaction and the finding of Paracoccidioides brasiliensis in biopsy specimens, were distinctive features in both cases.

Fifth disease in children living in Belém, Brazil

Acute sera from two children suffering from an illness with an erythematous rash were positive for B 19 virus specific IgM antibody, as tested by a capture radioimmunoassay. The first patient, a two year old boy, presented with a cutaneous rash of six days duration, the second was a four year old girl, sister of the first patient, who was examined at the same time and had a three day history of cutaneous rash.

Immunization aganist hepatitis B in children from endemic zone: evaluation of the antibody response against the DNA recombinant vaccine (Engerix B-20 mcg)

A previous seroepidemiological study in the rural zone of Vargem Alta (ES) SouthEast of Brazil, showed a prevalence of up to 9% of hepatitis B surface antigen (HBsAg) in some areas. One hundred susceptible children aging 1 to 5 years old were selected and immunized with a recombinant DNA hepatitis B vaccine (Smith-Kline 20 mcg) using the 0-1-6 months vaccination schedule. Blood samples were collected at the time of the first vaccine dose (month 0) in order to confirm susceptible individuals and 1,3,6 and 8 months after the first dose , to evaluate the antibody response. Our results showed that two and five months after the second dose, 79% and 88% of children seroconverted respectively, reaching 97% after the third dose. The levels of anti-HBs were calculated in milli International Units/ml (mIU/ml) and demonstrated the markedly increase of protective levels of antibodies after the third dose. These data showed a good immunogenicity of the DNA recombinant hepatitis B vaccine when administered in children of endemic areas.

Acute respiratory infections in children from a deprived urban population from Uruguay

To obtain base line data on incidence, duration, clinical characteristics and etiology of acute respiratory infections (ARI), 276 children from deprived families living in Montevideo were followed during 32 months. The target population was divided into two groups for the analysis of the results: children aged less than 12 months and those older than this age. During the follow-up period 1.056 ARI episodes were recorded. ARI incidence was 5.2 per child/year. It was 87% higher in infants than in the older group, as was the duration of the episodes. Most of the diseases were mild. Tachypnea and retractions were seldom observed, but 12 children were refered to the hospital, and 2 infants died. Viral etiology was identified in 15.3% of the episodes. RSV was the predominant agent producing annual outbreaks. Moderate to heavy colonization of the upper respiratory tract by Streptococcus pneumoniae (32.3%) and Hemophilus sp. (18.9%) was recorded during ARI episodes. This community-based study furnish original data on ARI in Uruguay. It enabled to asses the impact of these infections on childhood.

Etiology and severity of community acquired pneumonia in children from Uruguay: a 4-year study

The 4-year study (1987-1990) covered the major clinical-epidemiological characteristics of pneumonia in children as diagnosed at the emergency service of the Children's Hospital, as well as etiologies, and factors involved in the most severe cases. Etiology was determined in 47.7% of the 541 pneumonia cases, involving 283 pathogens of which 38.6% were viruses and 12.6% bacteria. Viral and mixed etiologies were more frequent in children under 12 months of age. Bacteria predominated in ages between 6 and 23 months. Among the viruses, respiratory syncytial virus predominated (66%). The bacterial pneumonias accounted for 12.2% of the recognized etiologies. The most important bacterial agents were S. pneumoniae (64%) and H. influenzae (19%). H. influenzae and mixed infections had a relevant participation during the 1988 season, pointing to annual variations in the relative participation of pathogens and its possible implication in severity of diseases. Correlation of severity and increased percentage of etiological diagnosis was assessed: patients with respiratory rates over 70 rpm, or pleural effusion and/or extensive pulmonary parenchyma compromise yielded higher positive laboratory results. Various individual and family risk factors were recognized when comparing pneumonia children with healthy controls.

A prospective study with children whose mothers had dengue during pregnancy

Dengue congenital disease was not confirmed in 10 children whose mothers had the infection during pregnancy. The fetal sera presented anti-dengue IgG antibodies which progressively declined, and disappeared after 8 months. IgM antibodies to dengue were not observed in the sera. Other normal data suggesting the healthy state of the children included: absence of malformations, pregnancy time, Apgar index, weight, and placenta aspect

Prevalence of thermotolerant species of Campylobacter and their biotypes in children and domestic birds and dogs in Southern Chile

The prevalence of thermotolerant Campylobacter in diarrhoeic and healthy children as well as in dogs, hens, ducks and pigeons was determined in Southern Chile. Campylobacter were found in 34.5% of the faecal samples examined. The isolation rate of Campylobacter in diarrhoeic and healthy children was 16.3% and 6.4% respectively. Despite C.jejuni was always more frequent than C. coli, the latter was isolated with a high frequency (29%) from patients with diarrhoea. C.jejuni and C. coli biotypes I and II were found in healthy and diarrhoeic children and were predominant in all the animals species studied. This may point out towards the possible origin of strains infecting children.

Aspergillosis in immunocompromised children acute myeloid leukemia and bone marrow aplasia.: Report of two cases

Two cases of Aspergillosis in immunocompromised children are reported. Both were caused by Aspergillns flavus. Early diagnosis and treatment led to the remission of the process. One patient had acute myeloid leukemia; the fungus was isolated from the blood. The other patient with bone marrow aplasia, presented an invasive aspergillosis of the paranasal sinuses with dissemination of fungal infection; the diagnosis was obtained by histology and culture of biopsied tissue from a palatal ulceration.

Lysotypes and plasmidial profile of Salmonella Serovar Typhimurium isolated from children with enteric processes in the cities of Rio de Janeiro, RJ, and Salvador, BA - Brazil

The lysotypes, plasmidial profiles, and profiles of resistance to antimicrobial agents were determined in 111 Salmonella Typhimurium strains isolated from feces and blood of children treated in Rio de Janeiro and in Salvador. Six distinct lysotypes (19, 41, 97, 105, 120 and 193) were recognized, with a predominance of lysotype 193 (59.7%) in Rio de Janeiro and of phage type 105 (38.4) in Salvador. Approximately 86.7% of the lysotype 193 strains presented multiple resistance to more than six antimicrobial agents, whereas 93% of lysotype 105 strains were fully susceptible. More than 90% of the strains presented plasmids distributed into 36 different profiles in Rio de Janeiro and into 10 profiles in Salvador. A 40 MDa plasmid was the most frequent (47%) in the strains from Rio de Janeiro, whereas a 61 MDa plasmid predominated (14.5%) in Salvador. Combined analysis of plasmid profile and classification into lysotypes (especially those belonging to types 105 and 103, proved to be more discriminatory than the other methods applied).

A comparative study of severe scorpion envenomation in children caused by Tityus bahiensis and Tityus serrulatus

From January 1984 to May 1994, 17 of 239 children under 15 years old stung by Tityus serrulatus (15.1%) or Tityus bahiensis (84.9%) presented severe envenoming. Of these 17 patients (1-11 years old; median=2 yr) 14 were stung by T.serrulatus and three by T.bahiensis. All of them received scorpion antivenom i.v. at times ranging from 45 min. to 5 h after the accident (median=2h). On admission, the main clinical manifestations and laboratory and electrocardiographic changes were: vomiting (17), diaphoresis (15), tachycardia (14), prostration (10), tachypnea (8), arterial hypertension (7), arterial hypotension (5), tremors (5), hypothermia (4), hyperglycemia (17), leukocytosis (16/16), hypokalemia (13/17), increased CK-MB enzyme activity (>6% of the total CK, 11/12), hyperamylasemia (11/14), sinusal tachycardia (16/17) and a myocardial infarction-like pattern (11/17). Six patients stung by T.serrulatus had depressed left ventricular systolic function assessed by means of echocardiography. Of these, five presented pulmonary edema and four had shock. A child aged two-years old presented severe respiratory failure and died 65 h after being stung by T.serrulatus. Severe envenomations caused by T.serrulatus were 26.2 times more frequent than those caused by T.bahiensis (p<0.001).

Risk factors and prevalence of antibodies against hepatitis A virus (HAV) in children from day-care centers, in Goiania, Brazil

A seroepidemiologic survey about hepatitis A virus (HAV) infection was carried out in a group comprising 310 children, ranging in age from 3 months to 9 years, from day-care centers, in Goiania, a middle sized city in the central region of Brazil. The biomarkers employed in the investigation of previous infection include total IgG and IgM anti-HAV antibodies, and for the detection of more recent infection, IgM anti-HAV antibodies were analyzed. The study was performed in 1991 and 1992. According to the results, 69.7% of the children presented total IgG/IgM anti-HAV antibodies, with 60% of the group in the age range of 1 to 3 years. Among 10 day-care centers analyzed, the prevalence of the biomarker IgM anti-HAV was 3.2%, with an uniform distribution of the cases in the group of children ranging in age from 1 to 4 years. Multi-variate analysis was performed to investigate the sociodemographic factors that could influence the results. It was verified that the risk for the infection increased with the length of the attendance in the day-care centers, i.e., the risk for children with attendance of one year or more was 4.7 times higher, when compared with children with one month attendance (CI 95% 2.3-9.9). According to the results, hepatitis A is an endemic infection in day-care centers in the study area. The length of attendance in the day-care settings was demonstrated to be a risk factor for the HAV infection. Such findings suggest that if hepatits A vaccination becomes available as a routine policy in our region, the target group should be children under one year. Moreover, those children should receive the vaccine before they start to attend the day-care centers.