Subsequent pregnancies: who has them and who wants them? Observations from an urban center in Southern Brazil

Subsequent pregnancies in mothers of a birth cohort from Pelotas, Southern Brazil, were studied in relation to maternal and socio-economic factors. Within about 3 1/2 years of the cohort child's birth, 39% of mothers had experienced at least one further pregnancy. This proportion decreased with increasing maternal age, years of schooling and family income. A U-shaped trend was observed with respect to parity. Mothers who had delivered the cohort child by caesarean section were also less likely to have another pregnancy within that time. Logistic regression analysis showed that each of these factors remained significantly associated with further pregnancies after controlling for the remaining variables. Analysis of the first subsequent pregnancy showed that a high proportion of mothers had not wanted the pregnancy. Unwanted pregnancies were also significantly associated with older women, low educational status, higher parity and low family income.

Bullying among adolescents in a Brazilian urban center – “Health in Beagá” Study

OBJECTIVE To analyze the prevalence of bullying and its associated factors in Brazilian adolescents.METHODS Data were used from a population-based household survey conducted by the Urban Health Observatory (OSUBH) utilizing probability sampling in three stages: census tracts, residences, and individuals. The survey included 598 adolescents (14-17 years old) who responded questions on bullying, sociodemographic characteristics, health-risk behaviors, educational well-being, family structure, physical activity, markers of nutritional habits, and subjective well-being (body image, personal satisfaction, and satisfaction with their present and future life). Univariate and multivariate analysis was done using robust Poisson regression.RESULTS The prevalence of bullying was 26.2% (28.0% among males, 24.0% among females). The location of most bullying cases was at or on route to school (70.5%), followed by on the streets (28.5%), at home (9.8%), while practicing sports (7.3%), at parties (4.6%), at work (1.7%), and at other locations (1.6%). Reports of bullying were associated with life dissatisfaction, difficulty relating to parents, involvement in fights with peers and insecurity in the neighborhood.CONCLUSIONS A high prevalence of bullying among participating adolescents was found, and the school serves as the main bullying location, although other sites such as home, parties and workplace were also reported. Characteristics regarding self-perception and adolescent perceptions of their environment were also associated with bullying, thus advancing the knowledge of this type of violence, especially in urban centers of developing countries.

FIRST CASE OF AUTOCHTHONOUS HUMAN VISCERAL LEISHMANIASIS IN THE URBAN CENTER OF RIO DE JANEIRO: CASE REPORT

Visceral leishmaniasis is an anthropozoonosis that is caused by protozoa of the genus Leishmania, especially Leishmania (Leishmania) infantum, and is transmitted to humans by the bite of sandflies of the genus Lutzomyia, such as Lutzomyia longipalpis. There are many reservoirs, including Canis familiaris. It is a chronic infectious disease with systemic involvement that is characterized by three phases: the initial period, the state period and the final period. The main symptoms are fever, malnutrition, hepatosplenomegaly, and pancytopenia. This article reports a case of a patient diagnosed with visceral leishmaniasis in the final period following autochthonous transmission in the urban area of Rio de Janeiro. The case reported here is considered by the Municipal Civil Defense and Health Surveillance of Rio de Janeiro to be the first instance of autochthonous visceral leishmaniasis in humans in the urban area of this city. The patient was discharged and is undergoing a follow-up at the outpatient clinic, demonstrating clinical improvement.

Factors associated with Leptospira sp infection in a large urban center in northeastern Brazil

Leptospirosis is a zoonotic disease that has emerged to cause epidemics in urban communities in developing countries. However, little is known about the infection in the general population. A seroprevalence survey was performed on a random sample of 1,390 subjects in Salvador, Brazil. Data on environmental and socioeconomic factors were collected. The microagglutination test of serum samples was used to show any prior Leptospira infection. The overall seroprevalence was 12.4%. Among the seropositive individuals, 111 (61%) had high titers for serovars of the Icterohaemorrhagiae serogroup. Seroprevalence increased with age and was similar for males and females. A positive correlation between Leptospira infection and low educational level was found. These findings indicate that a significant proportion of this urban population is exposed to pathogenic Leptospira. Public health actions for leptospirosis control will need to target not only the traditional groups at risk of infection with severe forms of this disease, but also the general population that is at risk.

Detection of caliciviruses associated with acute infantile gastroenteritis in Salvador, an urban center in Northeast Brazil

Acute gastroenteritis caused by viruses is one of the leading causes of infantile morbidity. The aim of the present study was to investigate the presence of human caliciviruses of the genera norovirus and sapovirus in children up to 3 years of age with acute gastroenteritis from low-income communities in the city of Salvador, Brazil. This study is an extension of previous work carried out to establish the profile of the most prevalent enteric pathogens present in these communities. In this report, 139 fecal samples, collected from July 2001 to January 2002 were analyzed by RT-PCR and 13 (9%) were positive for human caliciviruses. By sequencing, seven isolates were characterized as norovirus genogroup GII and one as sapovirus genotype GII/1. Sequencing of the previously detected group-A rotaviruses and human astroviruses was also performed and revealed the circulation of rotavirus group A genotypes G1P[8] and G9P[8], and human astrovirus genotypes 6, 7, and 8. No mixed infection was observed. Community-based studies provide geographically representative information on disease burden. However, there are only a few reports in developing countries concerning the genotypes of the most important gastroenteric viruses detected in such communities. The present findings demonstrate the wide diversity of genotypes of the most important viruses responsible for acute gastroenteritis circulating in low-income communities.

A novel association between Rhodnius neglectus and the Livistona australis palm tree in an urban center foreshadowing the risk of Chagas disease transmission by vectorial invasions in Monte Alto City, Sao Paulo, Brazil

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Mutagenicity profile of atmospheric particulate matter in a small urban center subjected to airborne emission from vehicle traffic and sugar cane burning

Atmospheric particulate matter (PM) is genotoxic and recently was classified as carcinogenic to humans by the International Agency for Research on Cancer. PM chemical composition varies depending on source and atmospheric conditions. The Salmonella/microsome assay is the most used mutagenicity test and can identify the major chemical classes responsible for observed mutagenicity. The objective of this work was to characterize the mutagenicity of PM samples from a countryside city, Limeira, Brazil, which is influenced by heavy traffic and sugar cane biomass burning. Six samples of total PM were collected. Air mass backward trajectories were calculated. Organic extracts were assayed using the Salmonella/microsome microsuspension mutagenicity assay using TA98, YG1041, and TA1538, with and without metabolic activation (S9). YG1041 was the most sensitive strain and mutagenicity reached 9,700 revertants per m(3) without metabolic activation. Potency for TA1538 was higher than TA98, indicating that this strain should be considered in air mutagenicity studies. The increased response to YG1041 relative to TA98, and the decreased response with S9, suggests that nitroaromatics are the major contributors. Limeira is among the most mutagenic cities in the world. High mutagenicity in Limeira seems to occur when the air mass from the area of sugarcane production is mixed with air from the region impacted by anthropogenic activities such as traffic. An increase in the formation of nitro-polycyclic aromatic hydrocarbons may result from longer contact time between the aromatic compounds and the atmosphere with high NOx and ozone concentration, although more studies are required to confirm this hypothesis. Environ. Mol. Mutagen., 2015. © 2015 Wiley Periodicals, Inc.

The participation of the nutritionist in Primary Health Care in a large urban center

Nutritionists are important professionals for ensuring the implementation of health promotion, treatment and rehabilitation. However, their participation in primary healthcare from a quantitative standpoint is limited. The city of Sao Paulo has experienced an uneven urbanization process triggering new problems of insecurity in terms of food and nutrition. This article analyzes the performance of the primary healthcare nutritionist in a large urban center. It is a quantitative study that used data from the Municipal Health Department, population data of Sao Paulo and a semi-structured questionnaire applied in individual interviews. All regions of the city are found to have fewer nutritionists than the recommendation of the Federal Council of Nutritionists. There are 123 nutritionists in the basic healthcare network and 51 in the Family Health Support Nuclei (FHSN) (57.3%). Each nutritionist from the FHSN accompanies 7.1 family health strategy teams on average. The age groups corresponding to children are less frequently seen by nutritionists. Comparing the activities, the transition from a model of primary health care focused on individual care to a model that prioritizes group care was observed.

Un desafío pendiente para el próximo quinquenio : Los objetivos de desarrollo del milenio

En el año 2000, los gobiernos de 189 países se comprometieron a alcanzar dieciocho metas para combatir la desigualdad y mejorar el desarrollo humano en el mundo a través del cumplimiento de los denominados Objetivos de Desarrollo del Milenio (ODM) de la Organización de las Naciones Unidas (ONU), todo ello con un horizonte para el año 2015. Los ODM deben ser monitoreados por los institutos de estadística existentes en la mayoría de los países que calculan indicadores económicos. En la Argentina, el Instituto Nacional de Estadística y Censos tiene una larga experiencia en la creación y cálculo de índices, específicamente, del índice de Precios al Consumidor el cual ha sido considerado como el mejor índice de precios de toda América Latina. Sin embargo, desde el año 2007 se ha implementado una nueva metodología para su cálculo. En esta comunicación se presentan resultados de trabajos realizados desde diferentes puntos de vista que aportan los métodos exploratorios y confirmatorios tendientes a conocer la situación de pobreza e indigencia y la distribución de los ingresos de los habitantes del Aglomerado Gran Rosario. Los análisis exploratorios y confirmatorios aplicados presentan incuestionables resultados que reflejan la coherencia de las conclusiones a que se ha arribado. Los datos primarios de calidad utilizados permitieron plasmar análisis dinámicos con la información homogénea disponible. Finalmente y a la luz de estas circunstancias, ¿se podrá saber fehacientemente si se alcanzarán los Objetivos de Desarrollo del Milenio en el año 2015?

La necesidad de una herramienta para medir el hambre en los hogares de la región

En septiembre del año 2000, los gobiernos de 189 países adoptaron en Naciones Unidas un acuerdo global para combatir la desigualdad y mejorar el desarrollo humano en el mundo, con un horizonte puesto en el año 2015. Una de sus metas en este compromiso, llamado ?Los Objetivos de Desarrollo del Milenio?, consiste en reducir la pobreza extrema a la mitad. Específicamente, las autoridades de la República Argentina acordaron ?erradicar la indigencia y el hambre? entre 1990 y 2015, con una meta adicional consistente en ?reducir la pobreza a menos del 20 ?. En tiempos de grandes diferencias entre las estadísticas oficiales ?que están indicando mejores condiciones de vida en estos últimos años??y los informes de la oposición, de las consultoras privadas y de la Iglesia ?los cuales exhiben una posición contraria?, se desprende que la preocupación por erradicar el hambre está implícitamente presente en todos los sectores. Dada la cercanía de la fecha establecida como límite, se considera de interés la posibilidad de construir un nuevo instrumento de medición: un indicador del hambre para el próximo quinquenio. Por la complejidad del tema, esta propuesta innovadora presenta lineamientos básicos tendientes a la elaboración de un indicador que pueda brindar un seguimiento del fenómeno del hambre en la región, como una alternativa ante la inexistencia de estadísticas oficiales actualizadas que lo midan. Para ello se sugiere un marco teórico inexistente, hasta donde se conoce, obligando a definir aspectos conceptuales de variables relevantes. Tener un conocimiento más riguroso sobre los hogares argentinos que padecen el flagelo del hambre y poder identificarlos permitirá una mejor distribución de los recursos y procurar, a no muy largo plazo, que ningún habitante se encuentre en situación de pobreza extrema

Un desafío pendiente para el próximo quinquenio : Los objetivos de desarrollo del milenio

En el año 2000, los gobiernos de 189 países se comprometieron a alcanzar dieciocho metas para combatir la desigualdad y mejorar el desarrollo humano en el mundo a través del cumplimiento de los denominados Objetivos de Desarrollo del Milenio (ODM) de la Organización de las Naciones Unidas (ONU), todo ello con un horizonte para el año 2015. Los ODM deben ser monitoreados por los institutos de estadística existentes en la mayoría de los países que calculan indicadores económicos. En la Argentina, el Instituto Nacional de Estadística y Censos tiene una larga experiencia en la creación y cálculo de índices, específicamente, del índice de Precios al Consumidor el cual ha sido considerado como el mejor índice de precios de toda América Latina. Sin embargo, desde el año 2007 se ha implementado una nueva metodología para su cálculo. En esta comunicación se presentan resultados de trabajos realizados desde diferentes puntos de vista que aportan los métodos exploratorios y confirmatorios tendientes a conocer la situación de pobreza e indigencia y la distribución de los ingresos de los habitantes del Aglomerado Gran Rosario. Los análisis exploratorios y confirmatorios aplicados presentan incuestionables resultados que reflejan la coherencia de las conclusiones a que se ha arribado. Los datos primarios de calidad utilizados permitieron plasmar análisis dinámicos con la información homogénea disponible. Finalmente y a la luz de estas circunstancias, ¿se podrá saber fehacientemente si se alcanzarán los Objetivos de Desarrollo del Milenio en el año 2015?

La necesidad de una herramienta para medir el hambre en los hogares de la región

En septiembre del año 2000, los gobiernos de 189 países adoptaron en Naciones Unidas un acuerdo global para combatir la desigualdad y mejorar el desarrollo humano en el mundo, con un horizonte puesto en el año 2015. Una de sus metas en este compromiso, llamado ?Los Objetivos de Desarrollo del Milenio?, consiste en reducir la pobreza extrema a la mitad. Específicamente, las autoridades de la República Argentina acordaron ?erradicar la indigencia y el hambre? entre 1990 y 2015, con una meta adicional consistente en ?reducir la pobreza a menos del 20 ?. En tiempos de grandes diferencias entre las estadísticas oficiales ?que están indicando mejores condiciones de vida en estos últimos años??y los informes de la oposición, de las consultoras privadas y de la Iglesia ?los cuales exhiben una posición contraria?, se desprende que la preocupación por erradicar el hambre está implícitamente presente en todos los sectores. Dada la cercanía de la fecha establecida como límite, se considera de interés la posibilidad de construir un nuevo instrumento de medición: un indicador del hambre para el próximo quinquenio. Por la complejidad del tema, esta propuesta innovadora presenta lineamientos básicos tendientes a la elaboración de un indicador que pueda brindar un seguimiento del fenómeno del hambre en la región, como una alternativa ante la inexistencia de estadísticas oficiales actualizadas que lo midan. Para ello se sugiere un marco teórico inexistente, hasta donde se conoce, obligando a definir aspectos conceptuales de variables relevantes. Tener un conocimiento más riguroso sobre los hogares argentinos que padecen el flagelo del hambre y poder identificarlos permitirá una mejor distribución de los recursos y procurar, a no muy largo plazo, que ningún habitante se encuentre en situación de pobreza extrema