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Pinheiro GSMA, Lemos SMA, Martins IDA, Januário GC, Cintra ML, Farias AVSR, Oliveira RMDS, Januário JN, Azevedo VMGDO, Bentes AA, Alves CRL. Effects of SARS-CoV-2 gestational exposure and risk factors on neurodevelopment until 12 months: A prospective cohort study in Brazil. Early Hum Dev 2024; 188:105918. [PMID: 38104363 DOI: 10.1016/j.earlhumdev.2023.105918] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Revised: 11/26/2023] [Accepted: 12/07/2023] [Indexed: 12/19/2023]
Abstract
BACKGROUND The effects of SARS-CoV-2 gestational exposure on child development remain inconclusive. AIMS To analyze the effects of SARS-CoV-2 gestational exposure on neurodevelopment until 12 months. STUDY DESIGN Prospective cohort study conducted in five municipalities in Southeast Brazil from August 2021 to September 2022. SUBJECTS Infants were recruited from a serological survey performed during neonatal screening and followed up to 12 months old. We included 224 infants exposed to SARS-CoV-2 during pregnancy and 225 non-exposed, according to the serology results of the newborn as well as their mothers and the maternal antenatal RT-PCR results. OUTCOME MEASURES Developmental assessments were performed at 6 and 12 months using the Survey of Wellbeing of Young Children-Brazilian Version (SWYC-BR). Children with suspected developmental delay (SDD) at 6 and 12 months were considered at high risk for developmental delay (HRDD). Additionally, risk factors associated with SDD were examined. RESULTS There were 111 children identified with SDD and 52 with HRDD. SARS-CoV-2 gestational exposure was not associated with SDD. Exposure in the first gestational trimester increased SDD risk by 2.15 times compared to the third. Cesarean delivery predicted SDD (OR 1.56; 95%CI 1.01-2.42) and HRDD (OR 1.91; 95%CI 1.04-3.48). Additionally, suspected maternal depression predicted SDD (OR 1.76; 95%CI 1.01-3.10). CONCLUSION SARS-CoV-2 gestational exposure did not increase the developmental delay risk. However, our findings suggest that the earlier the gestational exposure, the greater the developmental delay risk at 12 months. Cesarean delivery and suspected maternal depression increased the developmental delay risk, independent of virus exposure.
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Affiliation(s)
| | - Stela Maris Aguiar Lemos
- Universidade Federal de Minas Gerais, Av. Prof. Alfredo Balena, 190 - Santa Efigênia, Belo Horizonte, MG 30130-100, Brazil
| | - Isadora de Araújo Martins
- Universidade Federal de Minas Gerais, Av. Prof. Alfredo Balena, 190 - Santa Efigênia, Belo Horizonte, MG 30130-100, Brazil
| | - Gabriela Cintra Januário
- Secretaria de Estado de Saúde de Minas Gerais, Rodovia Papa João Paulo II, 4143. Cidade Administrativa - Serra Verde, Belo Horizonte, MG 31630-900, Brazil
| | - Mila Lemos Cintra
- Universidade Federal de Minas Gerais, Av. Prof. Alfredo Balena, 190 - Santa Efigênia, Belo Horizonte, MG 30130-100, Brazil
| | | | | | - José Nélio Januário
- Universidade Federal de Minas Gerais, Av. Prof. Alfredo Balena, 190 - Santa Efigênia, Belo Horizonte, MG 30130-100, Brazil.
| | | | - Aline Almeida Bentes
- Universidade Federal de Minas Gerais, Av. Prof. Alfredo Balena, 190 - Santa Efigênia, Belo Horizonte, MG 30130-100, Brazil.
| | - Claudia Regina Lindgren Alves
- Universidade Federal de Minas Gerais, Av. Prof. Alfredo Balena, 190 - Santa Efigênia, Belo Horizonte, MG 30130-100, Brazil.
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Petrowski N, de Castro F, Davis-Becker S, Gladstone M, Lindgren Alves CR, Becher Y, Grisham J, Donald K, van den Heuvel M, Kandawasvika G, Maqbool S, Tofail F, Xin T, Zeinoun P, Cappa C. Establishing performance standards for child development: learnings from the ECDI2030. J Health Popul Nutr 2023; 42:140. [PMID: 38087377 PMCID: PMC10717755 DOI: 10.1186/s41043-023-00483-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Accepted: 12/02/2023] [Indexed: 12/18/2023]
Abstract
BACKGROUND Standards of early childhood development (ECD) are needed to determine whether children living in different contexts are developmentally on track. The Early Childhood Development Index 2030 (ECDI2030) is a population-level measure intended to be used in household surveys to collect globally comparable data on one of the indicators chosen to monitor progress toward target 4.2 of the Sustainable Development Goals: The proportion of children aged 24-59 months who are developmentally on track in health, learning and psychosocial well-being. METHODS To define performance cut-scores for the ECDI2030 we followed a criterion-referenced standard setting exercise using the modified Angoff method. The exercise gauged the expectations from 15 global experts in ECD and was informed by representative population data collected in Mexico and the State of Palestine. The final calibrated age-specific performance cut-scores were applied to these data to estimate the proportion of children developmentally on track, disaggregated by background characteristics, including the child's sex and attendance to early childhood education. RESULTS Through a process of standard setting, we generated robust performance standards for the ECDI2030 by establishing five age-specific cut-scores to identify children as developmentally on track. CONCLUSIONS This paper demonstrated how the standard setting methodology, typically applied to measures in the health and education fields, could be applied to a measure of child development. By creating robust criterion-referenced standards, we have been able to ensure that the cut-scores related to age for the ECDI2030 are based on performance standards set by global experts in the ECD field for defining on and off track development.
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Affiliation(s)
- Nicole Petrowski
- UNICEF, Data and Analytics Section, 3 UN Plaza, New York, NY, 10017, USA.
| | - Filipa de Castro
- Formerly with UNICEF, Data and Analytics Section, 3 UN Plaza, New York, NY, 10017, USA
| | - Susan Davis-Becker
- ACS Ventures, 11035 Lavender Hill Drive #160-433, Las Vegas, NV, 89135, USA
| | - Melissa Gladstone
- Department of Women and Children's Health, Liverpool School of Tropical Medicine, University of Liverpool, Pembroke Place, Liverpool, L3 5QA, UK
| | | | - Yvonne Becher
- The Child Development Centre, 4/F Prime Mansion, 183-187 Johnston Road, Wan Chai, Hong Kong
| | - Jennifer Grisham
- Early Childhood Laboratory, University of Kentucky, 621 S. Limestone, Lexington, KY, 40506-0657, USA
| | - Kirsten Donald
- Division of Developmental Pediatrics, Red Cross War Memorial Children's Hospital and Neuroscience Institute, University of Cape Town, Cape Town, South Africa
| | - Meta van den Heuvel
- Hospital for Sick Children, 555 University Ave, Toronto, ON, M5G 1X8, Canada
| | - Gwendoline Kandawasvika
- Primary Health Sciences Department, Faculty of Medicine and Health Sciences, University of Zimbabwe, Mt Pleasant, P.O. Box MP167, Harare, Zimbabwe
| | - Shazia Maqbool
- Developmental-Behavioral Pediatrics Department, The Children's Hospital and Institute of Child Health, Lahore, Pakistan
| | - Fahmida Tofail
- International Centre for Diarrhoeal Disease Research, GPO Box 128, Dhaka, 1000, Bangladesh
| | - Tao Xin
- National Assessment Center for Education Quality, Ministry of Education, Beijing, China
| | | | - Claudia Cappa
- UNICEF, Data and Analytics Section, 3 UN Plaza, New York, NY, 10017, USA
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Sato HI, Costa MS, Takahashi RHC, Lourenço KL, Guimarães NS, Alves CRL, Machado EL, Tupinambás U, Fonseca FGD, Teixeira SMR. RT-qPCR-based pool testing for the diagnosis of COVID-19. Einstein (Sao Paulo) 2023; 21:eAE0115. [PMID: 37436266 DOI: 10.31744/einstein_journal/2023ae0115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Accepted: 02/07/2023] [Indexed: 07/13/2023] Open
Abstract
This study proposes a strategy for large-scale testing among a large number of people for the early diagnosis of COVID-19 to elucidate the epidemiological situation. Pool testing involves the analysis of pooled samples. This study aimed to discuss a reverse transcription technique followed by quantitative real-time polymerase chain reaction using pool testing to detect SARS-CoV-2 in nasopharyngeal swab samples. The study proposes an innovative diagnostic strategy that contributes to resource optimization, cost reduction, and improved agility of feedback from results. Pool testing is simultaneously performed on multiple samples to efficiently and cost-effectively detect COVID-19. Pool testing can optimize resource utilization and expand diagnostic access, and is a viable alternative for developing countries with limited access to testing. To optimize resources, the pool size was determined by estimating COVID-19 prevalence in the study population.
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Affiliation(s)
- Hugo Itaru Sato
- Vaccine Technology Center, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | - Murilo Soares Costa
- Postgraduate Program in Infectious Diseases and Tropical Medicine, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | | | - Karine Lima Lourenço
- Vaccine Technology Center, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | | | | | - Elaine Leandro Machado
- Department of Preventive and Social Medicine, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | - Unaí Tupinambás
- Medical Clinic Department, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
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Chiari APG, Senna MIB, Gomes VE, Freire MDSM, Soares ARDS, Alves CRL, Cury GC, Ferreira RC. Intersectoral Collaboration to Promote Child Development: The Contributions of the Actor-Network Theory. Qual Health Res 2023; 33:451-467. [PMID: 37010148 PMCID: PMC10126467 DOI: 10.1177/10497323231153534] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
An integrated intersectoral care model promises to meet complex needs to promote early child development and address health determinants and inequities. Nevertheless, there is a lack of understanding of actors' interactions in producing intersectoral collaboration networks. The present study aimed to analyze the intersectoral collaboration in the social protection network involved in promoting early child growth and development in Brazilian municipalities. Underpinned by the tenets of actor-network theory, a case study was conducted with data produced from an educational intervention, entitled "Projeto Nascente." Through document analysis (ecomaps), participant observation (in Projeto Nascente seminars), and interviews (with municipal management representatives), our study explored and captured links among actors; controversies and resolution mechanisms; the presence of mediators and intermediaries; and an alignment of actors, resources, and support. The qualitative analysis of these materials identified three main themes: (1) agency fragility for intersectoral collaboration, (2) attempt to form networks, and (3) incorporation of fields of possibilities. Our findings revealed that intersectoral collaboration for promoting child growth and development is virtually non-existent or fragile, and local potential is missed or underused. These results emphasized the scarcity of action by mediators and intermediaries to promote enrollment processes to intersectoral collaboration. Likewise, existing controversies were not used as a mechanism for triggering changes. Our research supports the need to mobilize actors, resources, management, and communication tools that promote processes of interessement and enrollment in favor of intersectoral collaboration policies and practices for child development.
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Affiliation(s)
- Antônio Paulo Gomes Chiari
- Universidade Federal de Minas
Gerais, Belo Horizonte, Brazil
- Antônio Paulo Gomes Chiari, Department of Social
and Preventive Dentistry, Universidade Federal de Minas Gerais, Av. Presidente Antônio
Carlos, 6627, Belo Horizonte 31270-901, Brazil.
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Pinheiro GSMA, de Souza RC, de Oliveira Azevedo VMG, Guimarães NS, Pires LG, Lemos SMA, Alves CRL. Effects of intrauterine exposure to SARS-CoV-2 on infants' development: a rapid review and meta-analysis. Eur J Pediatr 2023; 182:2041-2055. [PMID: 36899144 PMCID: PMC10005921 DOI: 10.1007/s00431-023-04910-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Revised: 02/22/2023] [Accepted: 02/26/2023] [Indexed: 03/12/2023]
Abstract
Potential medium- and long-term neurodevelopmental sequelae of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection during pregnancy have not been ruled out. We aimed to systematically review and summarize the evidence regarding the effects of intrauterine exposure to SARS-CoV-2 on infant development and behavior. Scopus, PubMed, Web of Science, CINAHL, and PsycNet databases were searched for studies published up to February 6, 2023, investigating the effects of gestational SARS-CoV-2 on infant development and behavior. We performed narrative synthesis according to updated protocols. Studies using comparison groups and with the Ages and Stages Questionnaires-Third Edition (ASQ-3) scores available were included in a meta-analysis performed according to Cochrane protocols. We used the Newcastle-Ottawa Quality Assessment Scale to analyze the risk of bias. Heterogeneity was calculated using the I2 statistic. The search identified 2,782 studies. After removing duplicates and applying the eligibility criteria, we performed a narrative synthesis of 10 included studies and a meta-analysis of three. There was no evidence of higher developmental delay rates in infants exposed to SARS-CoV-2 during pregnancy compared to non-exposed infants. However, the exposed infants scored lower than either the non-exposed children or pre-pandemic cohorts in some domains. Pooled results from the random-effects model indicated that SARS-CoV-2-exposed infants had lower scores on fine motor (mean difference [MD] = -4.70, 95% confidence interval [CI]: -8.76; -0.63), and problem-solving (MD = -3.05, 95% CI: -5.88; -0.22) domains than non-exposed infants (heterogeneity: I2 = 69% and 88%, respectively). There was no difference between the exposed and non-exposed infants in the communication, gross motor, and personal-social ASQ-3 domains. Conclusion: We did not find evidence confirming the association between SARS-CoV-2 gestational exposure and neurodevelopmental delays. However, the meta-analysis indicated that gestational exposure negatively affected fine motor and problem-solving skills. Robust evidence on this topic is still incipient, and the available studies present methodological inconsistencies that limit the drawing of clear-cut conclusions. PROSPERO registration: #CRD42022308002; March 14, 2022. What is Known: • COVID-19 is associated with adverse pregnancy outcomes potentially linked to neurodevelopmental delays. • SARS-CoV-2 vertical transmission is rare; however, infections during pregnancy can be deleterious to the fetus, possibly mediated by maternal immune activation and other inflammatory mechanisms. What is New: • No evidence of increased developmental delay rates among SARS-CoV-2 gestational-exposed infants was found. However, a meta-analysis of three studies showed lower scores in fine motor and personal social ASQ-3 domains among exposed infants. • SARS-CoV-2 gestational exposure and the pandemic can affect child development via many mechanisms. Potential neurodevelopmental sequelae of SARS-CoV-2 exposure during gestation have not been ruled out.
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Affiliation(s)
| | - Rayany Cristina de Souza
- Postgraduate Program in Health Sciences, Medicine School, Universidade Federal de Uberlândia (UFU), Uberlândia, Brazil
| | | | | | - Laura Gregório Pires
- Medicine School, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, Brazil
| | - Stela Maris Aguiar Lemos
- Speech Therapy and Audiology Department, Medicine School, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, Brazil
| | - Claudia Regina Lindgren Alves
- Pediatrics Department, Medicine School, Universidade Federal de Minas Gerais (UFMG), Av. Alfredo Balena, 190/247, Belo Horizonte, Minas Gerais, 30130100, Brazil.
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Gontijo ML, Moreira JM, Silva TR, Alves CRL. Impact of adverse childhood experiences (ACE) on the development of 18-months-old children. Journal of Affective Disorders Reports 2022. [DOI: 10.1016/j.jadr.2022.100401] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2022] Open
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Pinheiro GSMA, Azevedo VMGDO, Bentes AA, Januário GC, Januário JN, Cintra ML, Souza ABAD, Pires LG, Lemos SMA, Alves CRL. Serological survey for IgG antibodies against SARS-CoV-2 from newborns and their mothers. CAD SAUDE PUBLICA 2022; 38:e00021022. [PMID: 36102379 DOI: 10.1590/0102-311xen021022] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Accepted: 07/22/2022] [Indexed: 11/21/2022] Open
Abstract
This serological survey, conducted in five Brazilian municipalities, evaluated the use of dried blood spots (DBS), obtained from newborns and their mothers, to detect SARS-CoV-2 IgG antibodies. DBS were obtained from 4,803 neonates aged up to seven days and their mothers, both asymptomatic, at public health care clinics during newborn screening. DBS were processed by ELISA to detect IgG antibodies against SARS-CoV-2 nucleocapsid antigen. Mothers of seropositive neonates were interviewed about sociodemographic characteristics and clinical and laboratory antecedents. Non-satisfactory samples, dyads with incomplete data, and vaccinated mothers were excluded. Of the 1,917 DBS dyads samples analyzed, 14.7% of neonates showed IgG antibodies against SARS-CoV-2. Among seropositive neonates, 73.2% of their mothers were also seropositive. More than half of the mothers with seropositive neonates denied clinical or laboratory suspicion of COVID-19 during pregnancy. Suspicion occurred in the third trimester for 24.6% of the mothers. This study tested an innovative strategy to improve the understanding of COVID-19 antibody dynamics during pregnancy and suggests the feasibility of a universal serological survey in puerperal women and neonates.
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8
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Scherrer IRS, Moreira JM, Alves CRL. Maternal care and child physical health: Impact of the exposure to adverse experiences during the first year of life of vulnerable children. Child Care Health Dev 2022; 48:503-511. [PMID: 34964153 DOI: 10.1111/cch.12951] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Revised: 12/05/2021] [Accepted: 12/20/2021] [Indexed: 11/28/2022]
Abstract
INTRODUCTION Adverse childhood experiences (ACEs) can negatively affect children's current and future health. OBJECTIVES This study aims to analyse the impact of ACE on the health of 12-month-old infants assessed by a Physical Health and Maternal Care Indicator (ISCM). METHODS We conducted a retrospective cohort including 170 infants born in two public services for high-risk births in Brazil. ISCM gathers information that reflects maternal care and the child's health throughout the first year of life, such as vaccination, nutrition, growth, illnesses and accidents. The ACE impact on ISCM was analysed by multiple linear regression, and the d-Cohen test estimated its effect size. Spearman's correlation was used to analyse the cumulative ACE effect, measured by a score reflecting events such as family dysfunction, maternal mental health, poverty and exposure to violence. RESULTS Most infants were born prematurely (71.7%), had low birthweight (64.7%) and were exposed to three ACEs on average. The ISCM was lower in children exposed to maternal depression (P < 0.001, d-Cohen = 0.08), substance abuse by family members (P = 0.02, d-Cohen = 0.6) and marital conflicts (P = 0.03, d-Cohen = 0.7). The Spearman's correlation showed that the greater the exposure to ACEs, the lower the ISCM (r = -0.40, P < 0.0001). CONCLUSION Exposure to ACE, especially in the family environment, had negative effect on maternal care and child health. The impact could be detected in the first year of life and had cumulative effect. Our findings indicate the need for a broader approach to child health to minimize ACE's impacts.
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Affiliation(s)
| | - Janaina Matos Moreira
- School of Medicine, Department of Pediatrics, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
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9
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Guimarães NS, Costa MS, Machado EL, Sato HI, Amaral EDCME, Arivabene RG, Lourenço KL, Tupinambás U, Fonseca FGD, Takahashi RHC, Teixeira SMR, Alves CRL. Autocoleta de swab nasofaríngeo e teste molecular em pool testing como estratégias para detecção de coronavírus da síndrome respiratória aguda grave 2 (SARS-CoV-2): viabilidade em estudantes de medicina da Universidade Federal de Minas Gerais, 2021. Epidemiol Serv Saúde 2022; 31:e2021409. [DOI: 10.1590/s1679-49742022000100002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2021] [Accepted: 12/20/2021] [Indexed: 11/22/2022] Open
Abstract
Resumo Objetivo Demonstrar a viabilidade da utilização combinada da autocoleta de swab nasofaríngeo e pool testing para detecção do SARS-CoV-2 em inquéritos epidemiológicos. Métodos A experiência envolveu amostra de 154 estudantes da Universidade Federal de Minas Gerais, que realizaram a autocoleta do swab nasofaríngeo em cabines individuais e sem supervisão. O teste molecular foi realizado utilizando-se a técnica de pool testing. Resultados A obtenção de amostras durou cerca de 5 minutos por pessoa. Realizou-se análise para detecção de RNA endógeno em 40 amostras e os resultados indicaram que não houve falhas decorrentes da autocoleta. Nenhum dos pools detectou presença de RNA viral. O custo da realização do teste molecular (RT-PCR) por pool testing com amostras obtidas por autocoleta foi cerca de dez vezes menor do que nos métodos habituais. Conclusão As estratégias investigadas mostraram-se economicamente viáveis e válidas para a pesquisa de SARS-CoV-2 em inquéritos epidemiológicos.
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Costa MS, Guimarães NS, de Andrade AB, Vaz-Tostes LP, Oliveira RB, Simões MDS, Gelape GDO, Alves CRL, Machado EL, da Fonseca FG, Teixeira SMR, Sato HI, Takahashi RHC, Tupinambás U. Detection of SARS-CoV-2 through pool testing for COVID-19: an integrative review. Rev Soc Bras Med Trop 2021; 54:e0276. [PMID: 34787261 PMCID: PMC8582953 DOI: 10.1590/0037-8682-0276-2021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2021] [Accepted: 08/19/2021] [Indexed: 12/18/2022] Open
Abstract
INTRODUCTION The pool testing technique optimizes the number of tests performed and reduces the delivery time of results, which is an interesting strategy for the health crisis caused by the COVID-19 pandemic. This integrative review investigated studies in which pool testing was carried out for epidemiological or screening purposes to analyze its clinical or cost effectiveness and assessed the applicability of this method in high-, middle-, and low-income countries. METHODS This integrative review used primary studies published in the MEDLINE, EMBASE, Literatura Latino-Americana e do Caribe em Ciências da Saúde (LILACS), and Cochrane Library databases. RESULTS A total of 435 studies were identified: 35.3% were carried out in Asia, 29.4% in Europe, 29.4% in North America, and 5.9% in Oceania. CONCLUSIONS This review suggests that pool testing in the general population may be a useful surveillance strategy to detect new variants of SARS-CoV-2 and to evaluate the period of immunogenicity and global immunity from vaccines.
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Affiliation(s)
- Murilo Soares Costa
- Universidade Federal de Minas Gerais, Programa de Pós-Graduação em Ciências da Saúde: Infectologia e Medicina Tropical, Belo Horizonte, MG, Brasil
| | - Nathalia Sernizon Guimarães
- Universidade Federal de Minas Gerais, Programa de Pós-Graduação em Ciências da Saúde: Infectologia e Medicina Tropical, Belo Horizonte, MG, Brasil
| | | | | | - Rhuan Braga Oliveira
- Universidade Federal de Minas Gerais, Faculdade de Medicina, Belo Horizonte, MG, Brasil
| | | | | | | | - Elaine Leandro Machado
- Universidade Federal de Minas Gerais, Departamento de Medicina Preventiva e Social, Belo Horizonte, MG, Brasil
| | | | | | - Hugo Itaru Sato
- Universidade Federal de Minas Gerais, Centro de Tecnologia de Vacinas, Belo Horizonte, MG, Brasil
| | | | - Unaí Tupinambás
- Universidade Federal de Minas Gerais, Programa de Pós-Graduação em Ciências da Saúde: Infectologia e Medicina Tropical, Belo Horizonte, MG, Brasil
- Universidade Federal de Minas Gerais, Departamento de Clínica Médica, Belo Horizonte , MG, Brasil
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Chiari APG, Soares ARS, Cury GC, Alves CRL, Senna MIB, Ferreira RC. Intersectoral collaboration to promote child development: mapping the relationships. Eur J Public Health 2020. [DOI: 10.1093/eurpub/ckaa166.892] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Integrated and intersectoral interventions early in life have the greatest potential to address social inequities, ensuring better opportunities for access to child development support services. The “Projeto Nascente” (Universidade Federal de Minas Gerais and Ministry of Health, Brazil) sought to qualify health and other sectors professionals in actions to promote and monitor early child development, in primary health care. One of its focuses was to stimulate the intersectoral actions to promote child development. The research analyzed the intersectoral network in 31 municipalities in the State of Minas Gerais, Brazil, participating in the 'Projeto Nascente'.
A case study with a qualitative approach was developed using document research on the professionals' perception regarding intersectoral networking. The material was ecomaps elaborated by professionals during the training of the “Projeto Nascente”. The ecomaps represented the local intersectoral networks.
Initially, 29 ecomaps from eleven municipalities were analyzed. Social Protection, Education, Sports, Culture, churches and non-governmental organizations were cited. Other health services were also included. All ecomaps were represented with the family health team in a central position with the other services around them. In municipalities with more than one ecomap, there was no uniformity neither in the services nor in the quality of the relationships represented.
A closer relationship between Education and Social Protection was noticed. However, the quality of the relationships often seemed stressful. Health professionals reported that they invest more energy in relationships than other sectors. Sport and Culture, although less mentioned, seem to be potential partners for new collaborations. The emergence of other health services seems to reflect the fragmentation of the health sector, as well as evidence of the conceptual confusion surrounding intersectoral collaboration.
Key messages
The identification and mapping of the services networking aimed at promoting child development are essential steps in the process of stimulating and reflecting on intersectoral collaboration. The centrality and self-perceived protagonism of the health professionals may not be the best way to involve and count on the participation of other sectors in intersectoral collaboration.
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Affiliation(s)
- A P G Chiari
- Faculty of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - A R S Soares
- Faculty of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - G C Cury
- Faculty of Medicine, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - C R L Alves
- Faculty of Medicine, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - M I B Senna
- Faculty of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - R C Ferreira
- Faculty of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
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Duczmal LH, Almeida ACL, Duczmal DB, Alves CRL, Magalhães FCO, Lima MSD, Silva IR, Takahashi RHC. Vertical social distancing policy is ineffective to contain the COVID-19 pandemic. CAD SAUDE PUBLICA 2020; 36:e00084420. [PMID: 32428075 DOI: 10.1590/0102-311x00084420] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Accepted: 04/28/2020] [Indexed: 11/21/2022] Open
Abstract
Considering numerical simulations, this study shows that the so-called vertical social distancing health policy is ineffective to contain the COVID-19 pandemic. We present the SEIR-Net model, for a network of social group interactions, as a development of the classic mathematical model of SEIR epidemics (Susceptible-Exposed-Infected (symptomatic and asymptomatic)-Removed). In the SEIR-Net model, we can simulate social contacts between groups divided by age groups and analyze different strategies of social distancing. In the vertical distancing policy, only older people are distanced, whereas in the horizontal distancing policy all age groups adhere to social distancing. These two scenarios are compared to a control scenario in which no intervention is made to distance people. The vertical distancing scenario is almost as bad as the control, both in terms of people infected and in the acceleration of cases. On the other hand, horizontal distancing, if applied with the same intensity in all age groups, significantly reduces the total infected people "flattening the disease growth curve". Our analysis considers the city of Belo Horizonte, Minas Gerais State, Brazil, but similar conclusions apply to other cities as well. Code implementation of the model in R-language is provided in the supplementary material.
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Affiliation(s)
- Luiz Henrique Duczmal
- Departamento de Estatística, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | | | | | | | | | - Max Sousa de Lima
- Departamento de Estatística, Universidade Federal do Amazonas, Manaus, Brazil
| | - Ivair Ramos Silva
- Departamento de Estatística, Universidade Federal de Ouro Preto, Ouro Preto, Brazil
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Ferreira RDC, Alves CRL, Guimarães MAP, Menezes KKPD, Magalhães LDC. Effects of early interventions focused on the family in the development of children born preterm and/or at social risk: a meta‐analysis. Jornal de Pediatria (Versão em Português) 2020. [DOI: 10.1016/j.jpedp.2019.05.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Ferreira RDC, Alves CRL, Guimarães MAP, Menezes KKPD, Magalhães LDC. Effects of early interventions focused on the family in the development of children born preterm and/or at social risk: a meta-analysis. J Pediatr (Rio J) 2020; 96:20-38. [PMID: 31254528 PMCID: PMC9432118 DOI: 10.1016/j.jped.2019.05.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2018] [Revised: 04/11/2019] [Accepted: 05/06/2019] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVE To verify whether early intervention focused on the family improves the cognitive, motor, and language development of children born preterm and/or at social risk in the first 3 years of life. SOURCE OF DATA Meta-analysis of clinical trials published between 2008 and 2018, in the following databases: CINAHL, MEDLINE - PubMed, MEDLINE - BVS, LILACS - BVS, IBECS - BVS, PEDro and Cochrane Reviews. Experimental studies on early interventions focused on the family, whose target groups were children born preterm and/or at social risk, with assessment of cognitive and/or motor and/or language development up to 3 years were included. The studies were rated using the PEDro Scale. DATA SYNTHESIS Twelve studies were included from a total of 3378 articles. Early intervention focused on the family contributed to the development of the cognitive (Standardized Mean Difference - SMD=0.48, 95% CI: 0.34-0.61) and motor (SMD=0.76, 95% CI: 0.55-0.96) domains of preterm infants. Regarding cognitive development, performance improvement was observed at 12, 24 and 36 months, while in the motor domain, the effect was observed only at 12 months in preterm infants. There was no benefit of the intervention in the cognitive, motor, and language outcomes of children with the social risk factor associated to biological risk. CONCLUSION Early intervention focused on the family has a positive effect on the cognition of preterm infants. The effect on motor development was lower, possibly due to the emphasis on interventions in family-child interaction. The effect of interventions on the development of children at social risk and on the language domain was inconclusive, due to the scarcity of studies in the area.
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Affiliation(s)
| | - Claudia Regina Lindgren Alves
- Universidade Federal de Minas Gerais (UFMG), Faculdade de Medicina, Departamento de Pediatria, Belo Horizonte, MG, Brazil
| | - Marina Aguiar Pires Guimarães
- Universidade Federal de Minas Gerais (UFMG), Programa de Pós-Graduação em Ciências da Saúde - Saúde da Criança e do Adolescente, Belo Horizonte, MG, Brazil
| | - Kênia Kiefer Parreiras de Menezes
- Universidade Federal de Minas Gerais (UFMG), Escola Educação Física, Fisioterapia e Terapia Ocupacional (EEFFTO), Departamento de Fisioterapia, Belo Horizonte, MG, Brazil
| | - Lívia de Castro Magalhães
- Universidade Federal de Minas Gerais (UFMG), Escola Educação Física, Fisioterapia e Terapia Ocupacional (EEFFTO), Departamento de Terapia Ocupacional, Belo Horizonte, MG, Brazil
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Silva GS, Alves CRL. Avaliação do grau de implantação dos atributos da atenção primária à saúde como indicador da qualidade da assistência prestada às crianças. CAD SAUDE PUBLICA 2019; 35:e00095418. [DOI: 10.1590/0102-311x00095418] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2018] [Accepted: 10/18/2018] [Indexed: 11/22/2022] Open
Abstract
O objetivo deste artigo foi avaliar o grau de implantação dos atributos da atenção primária à saúde (APS) como indicador da qualidade da assistência prestada às crianças. Realizou-se estudo transversal em um município de médio porte de Minas Gerais, Brasil. Foram entrevistados 707 cuidadores de crianças de 0 a 4 anos (498 da área urbana e 209 da rural) e 22 profissionais das equipes de saúde da família, utilizando o Primary Care Assessment Tool, o critério Brasil de classificação socioeconômica e um questionário elaborado pelos pesquisadores. Foram calculados os escores dos atributos da APS a partir da opinião de usuários e profissionais. Escores ≥ 6,6 foram considerados indicativos de alto grau de implantação dos atributos. O teste de Mann-Whitney foi utilizado para comparar os resultados das áreas urbana e rural. Os profissionais avaliaram melhor os serviços da APS do que os usuários. Para os profissionais, os componentes com maiores escores foram “sistemas de informação” e “orientação familiar” (ambos 8,9). Para os usuários, os componentes melhor avaliados foram “sistemas de informação” (7,8) e “utilização” (6,8), e os pior avaliados foram “integração de cuidados” (4,0) e “serviços disponíveis” (4,6). Os escores dos atributos essencial e geral dos serviços da área rural foram mais altos do que os da área urbana na opinião dos usuários, mas não na dos profissionais. Há divergências importantes entre as avaliações de profissionais e usuários. Os serviços da área rural foram melhor avaliados do que os da área urbana, embora os atributos da APS não estejam devidamente implantados no município como um todo, indicando que a qualidade da assistência à criança se encontra aquém da necessária.
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Moreira RS, Magalhães LC, Siqueira CM, Alves CRL. "Survey of Wellbeing of Young Children (SWYC)": how does it fit for screening developmental delay in Brazilian children aged 4 to 58 months? Res Dev Disabil 2018; 78:78-88. [PMID: 29793101 DOI: 10.1016/j.ridd.2018.05.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/04/2017] [Revised: 03/01/2018] [Accepted: 05/08/2018] [Indexed: 06/08/2023]
Abstract
OBJECTIVE To replicate the original normative study of the SWYC's Milestones Questionnaires for children in Brazil. Our goals were to compare the performance of Brazilian and North American children using this screening tool and to verify the reliability and validity of the Brazilian version. STUDY DESIGN AND SETTING Cross-sectional study with children aged 1-65 months and their guardians, recruited in southern Brazil. Parents were interviewed using the Developmental Milestones questionnaire, which contains 10 questions about cognitive, motor, social, and language abilities. Item response theory was used to examine item validity. RESULTS We interviewed 415 parents. SWYC provided the most information on the children's development between 10 and 30 months. The performance of Brazilian and North American children was quite similar when children are younger than 36 months old. Above 36 months, North American children performed almost all items earlier than Brazilians. Convergent validity was 0.73 and internal consistency 0.97. CONCLUSION The Brazilian version of the Developmental Milestones questionnaire presented acceptable measurement qualities that support the SWYĆs potential as a developmental screening tool. As we found important differences between North American and Brazilian children in achieving the milestones, especially among the oldest children, additional normative studies are needed.
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Affiliation(s)
- R S Moreira
- Department of Health Sciences at the Federal University of Santa Catarina/Araranguá, Rod. Gov. Jorge Lacerda, 3201 Jardim das Avenidas, Araranguá, SC, ZIP CODE: 88.906-072, Brazil.
| | - L C Magalhães
- Department of Occupational Therapy at theFederal University of Minas Gerais, Av. Pres. Antônio Carlos, 6627 Campus, Pampulha, Belo Horizonte, MG, ZIP CODE 31270-901, Brazil.
| | - C M Siqueira
- Department of Pediatrics at the Federal University of Minas Gerais, Av. Prof. Alfredo Balena, 190-room 267, Belo Horizonte, MG. ZIP CODE 30130100, Brazil.
| | - C R L Alves
- Department of Pediatrics at the Federal University of Minas Gerais, Av. Prof. Alfredo Balena, 190-room 267, Belo Horizonte, MG. ZIP CODE 30130100, Brazil.
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Guimarães MAP, Alves CRL, Cardoso AA, Penido MG, Magalhães LDC. Clinical application of the Newborn Behavioral Observation (NBO) System to characterize the behavioral pattern of newborns at biological and social risk. J Pediatr (Rio J) 2018; 94:300-307. [PMID: 28850813 DOI: 10.1016/j.jped.2017.05.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2017] [Revised: 04/28/2017] [Accepted: 05/02/2017] [Indexed: 11/28/2022] Open
Abstract
OBJECTIVE To compare the behavior of preterm newborns and full-term newborns using the Newborn Behavioral Observation and to evaluate the mothers' experience when participating in this observation. METHOD This was a cross-sectional study performed at a referral hospital for high-risk births, involving mothers and neonates before hospital discharge. The mothers answered the sociodemographic questionnaire, participated in the Newborn Behavioral Observation session, and evaluated the experience by answering the parents' questionnaire at the end. The characteristics of the preterm newborn and full-term newborn groups and the autonomic, motor, organization of states, and responsiveness scores were compared. Linear regression was performed to test the association of the characteristics of mothers and neonates with the scores in the autonomic, motor, organization of states, and responsiveness domains. RESULTS The Newborn Behavioral Observation was performed with 170 newborns (eight twins and 77% preterm newborns). Approximately 15% of the mothers were adolescents and had nine years of schooling, on average. The groups differed regarding weight for gestational age, age at observation, APGAR score, feeding, and primiparity. The linear regression adjusted for these variables showed that only prematurity remained associated with differences in the scores of the motor (p=0.002) and responsiveness (p=0.02) domains. No statistical difference was observed between the groups in the score attributed to one's own knowledge prior to the session (p=0.10). After the session, these means increased in both groups. This increase was significantly higher in the preterm newborn group (p=0.02). CONCLUSIONS The Newborn Behavioral Observation increased the mothers' knowledge about the behavior of their children, especially in mothers of preterm newborns, and identified differences in the behavior of preterm newborns and full-term newborns regarding the motor and responsiveness domains.
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Affiliation(s)
| | - Claudia Regina Lindgren Alves
- Universidade Federal de Minas Gerais (UFMG), Faculdade de Medicina, Departamento de Pediatria, Belo Horizonte, MG, Brazil
| | - Ana Amélia Cardoso
- Universidade Federal de Minas Gerais (UFMG), Departamento de Terapia Ocupacional, Belo Horizonte, MG, Brazil
| | - Márcia Gomes Penido
- Universidade Federal de Minas Gerais (UFMG), Faculdade de Medicina, Departamento de Pediatria, Belo Horizonte, MG, Brazil
| | - Lívia de Castro Magalhães
- Universidade Federal de Minas Gerais (UFMG), Programa de Pós Graduação em Ciências da Reabilitação, Belo Horizonte, MG, Brazil
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Guimarães MAP, Alves CRL, Cardoso AA, Magalhães LDC. OBSERVAÇÃO DO COMPORTAMENTO NEONATAL: ADAPTAÇÃO TRANSCULTURAL DO NEWBORN BEHAVIORAL OBSERVATIONS. Rev paul pediatr 2017; 36:8. [PMID: 29091131 PMCID: PMC5849381 DOI: 10.1590/1984-0462/;2018;36;1;00017] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/08/2017] [Accepted: 04/04/2017] [Indexed: 11/22/2022]
Abstract
Objective: To conduct the cross-cultural adaptation for Brazilian Portuguese of the Newborn Behavioral Observations (NBO), a new resource for observing neonatal behavior and sharing information with parents. Methods: Methodological study of translation and cultural adaptation of the NBO system, which includes the Recording Form, with 18 items, the Recording Guidelines, with instructions to score each item, the Summary Form, to record suggestions based on the observation, and the Parent Questionnaire, to record the parents’ experiences. The adaptation process followed international recommendations for cross-cultural adaptation of health care protocols, which included requesting permission from the authors, translation, back translation and pre-test, followed by external evaluators who scored the quality of the adaptation, which was analyzed quantitatively. The quality of the adaptation of the instruments’ items was evaluated by the index of agreement between evaluators for conceptual and cultural equivalence. Results: Expert panel evaluation showed that the cross-cultural adaptation of the NBO protocols was both well understood conceptually and culturally appropriate, with 140 (77.8%) items presenting concordance index higher than 90% for conceptual and cultural equivalence. Items that did not reach adequate level of agreement were revised according to experts’ suggestions. Conclusions: The Brazilian version of the NBO system can be safely used, since the methodology was rigorous enough to ensure equivalence between the original and translated versions. The NBO should be tried in clinical practice, as it can contribute to improve the quality of maternal and child care.
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Januário GC, Alves CRL, Lemos SMA, Almeida MCDM, Cruz RC, Friche AADL. Health Vulnerability Index and newborn hearing screening: urban inequality. Codas 2016; 28:567-574. [PMID: 27849250 DOI: 10.1590/2317-1782/20162015182] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2015] [Accepted: 11/05/2015] [Indexed: 11/22/2022] Open
Abstract
Purpose To analyze the intra-urban differentials related to the outcome of the Newborn Hearing Screening (NHS) of children living in Belo Horizonte tested in a reference service using the Health Vulnerability Index (HVI). Methods cross-sectional study with children living in Belo Horizonte evaluated by a Newborn Hearing Screening Reference Service (NHSRS) between 2010 and 2011. The HVI of the census tract of each child was obtained by the georeferencing of their respective addresses. Multivariate analysis was conducted using the decision tree technique, considering a statistical model for each response. A thematic map of points representing the geographic distribution of the children evaluated by the NHS program was also developed. Results The NHS failure rate for children living in areas with very high HVI, or without HVI data, was 1.5 times higher than that for children living in other census tracts. For children living in areas of low, medium, and high HVI, who underwent NHS after 30 days of life, the NHS failure rate was 2.1 times higher in children that presented Risk Indicator for Hearing Loss (RIHL) (17.2%) than in those who did not (8.1%). Uneven distribution was observed between areas for children that underwent the NHS and those who failed it. Conclusion Significant intra-urban differentials were found in Belo Horizonte, indicating correlation between health vulnerability and NHS outcomes.
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Affiliation(s)
| | | | | | | | - Ramon Costa Cruz
- Secretaria de Estado de Saúde de Minas Gerais - Belo Horizonte (MG), Brasil
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Januário GC, Lemos SMA, de Lima Friche AA, Alves CRL. Quality indicators in a newborn hearing screening service. Braz J Otorhinolaryngol 2015; 81:255-63. [PMID: 25596650 PMCID: PMC9452237 DOI: 10.1016/j.bjorl.2014.08.008] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2013] [Accepted: 05/24/2014] [Indexed: 11/26/2022] Open
Abstract
Introduction Newborn hearing screening (NHS) programs are implemented across the globe to detect early hearing impairment. In order to meet this objective, the quality of these programs should be monitored using internationally recognized indicators. Objective To evaluate a newborn hearing screening service (NHSS) using international quality indicators. Methods A retrospective cohort study on the NHSS of Minas Gerais was conducted, analyzing the services performed between 2010 and 2011. Results were analyzed according to criteria from the American Academy of Pediatrics and the Joint Committee on Infant Hearing. Results This study assessed 6987 children. The proportions of cases that were referred for a retest, that followed through with retest, and that were referred for diagnosis were 8.0%, 71.9%, and 2.1%, respectively. The proportion of assessed newborn children in the first 30 days of life in this study was 65%. The median age of those children who failed both the NHS and the retest was significantly higher than the other children. The chance of a child with a hearing impairment risk indicator to fail the NHS was 2.4 times higher than of those without a risk indicator. Conclusion NHSS achieved three of four evaluated indicators. Despite this, it is still necessary to perform NHS earlier and to ensure that the subsequent steps are followed.
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Campos FR, Rabelo ATV, Friche CP, Silva BSVD, Friche AADL, Alves CRL, Goulart LMHDF. Alterações da linguagem oral no nível fonológico/fonético em crianças de 4 a 6 anos residentes em belo horizonte. Rev CEFAC 2014. [DOI: 10.1590/1982-021620141713] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Objetivo estudar a prevalência de alterações da linguagem oral em crianças de quatro a seis anos e verificar sua associação com as variáveis idade, sexo, presença de alterações de motricidade orofacial e presença de alterações de processamento auditivo. Métodos realizou-se avaliação da linguagem oral (teste de avaliação de linguagem ABFW – Fonologia), avaliação de motricidade orofacial e avaliação simplificada do processamento auditivo. Os dados foram armazenados em formato eletrônico para análise estatística. Para comparação de proporções foi empregado o Teste Qui-Quadrado e para comparação de médias foi empregada a análise de variância. Foi considerado valor de 5% (p< 0,05) como limiar de significância estatística. Resultados foram avaliadas 242 crianças de 4 anos a 6 anos e 11 meses de idade. Observou-se prevalência de 36,0% (n=87) de alterações de linguagem oral, e associação com faixa etária com significância estatística (p=0,009). Verificou-se associação entre desvio fonológico e faixa etária (p<0,001); entre a presença de desvio fonético e alterações de motricidade orofacial (p<0,001) e presença de desvio fonológico e alterações do processamento auditivo (p<0,001). Conclusão a alta prevalência de alterações verificada aponta para a necessidade de elaboração de ações em atenção primária à saúde, de maneira a prevenir o aparecimento destas alterações, melhorar o acesso à intervenção e possibilitar a prevenção de problemas escolares mais graves. A maior ocorrência de alterações da linguagem oral na faixa etária de quatro a cinco anos sugere que esta seja uma boa fase para identificação e prevenção destes desvios.
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Abstract
OBJETIVO: Descrever alterações de fala em escolares de 1ª a 4ª série e investigar a existência de associação entre essas alterações e os distúrbios de motricidade orofacial (MO) e de processamento auditivo. MÉTODOS: Estudo transversal com amostra aleatória e estratificada composta por 288 escolares, calculada com base num universo de 1.189 crianças matriculadas em escolas públicas da área de abrangência de um centro de saúde de Belo Horizonte. A idade mediana foi de 8,9 anos, sendo 49,7% meninos. Foram utilizados: protocolo de MO adaptado do Roteiro para Avaliação Miofuncional; prova de Fonologia do Teste de Linguagem Infantil ABFW; e avaliação simplificada do processamento auditivo. Os dados foram analisados estatisticamente. RESULTADOS: Das crianças avaliadas, 31,9% apresentaram alteração de fala. Destas, 18% apresentaram desvio fonético, 9,7% desvio fonológico e 4,2% fonético e fonológico. Observou-se variação linguística na fala de 38,5% das crianças. Houve maior proporção de crianças com desvio fonético isolado na 1ª série e de crianças menores de 8 anos com desvio fonético e fonológico. Verificou-se associação entre desvio fonético e alterações de motricidade orofacial e entre desvio fonológico e alterações de processamento auditivo. CONCLUSÃO: A prevalência de alterações de fala em escolares de 1ª a 4ª série é considerada alta. Além disso, estas são associadas a outras alterações fonoaudiológicas, o que sugere que uma pode ser consequência de outra, apontando para a necessidade de diagnóstico e intervenções precoces.
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Rabelo ATV, Alves CRL, Goulart LMHF, Friche AADL, Lemos SMA, Campos FR, Friche CP. Speech disorders in students in Belo Horizonte. J Soc Bras Fonoaudiol 2011; 23:344-350. [PMID: 22231055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Received: 05/02/2011] [Accepted: 07/19/2011] [Indexed: 05/31/2023]
Abstract
PURPOSE To describe speech disorders in students from 1st to 4th grades, and to investigate possible associations between these disorders and stomatognathic system and auditory processing disorders. METHODS Cross-sectional study with stratified random sample composed of 288 students, calculated based on an universe of 1,189 children enrolled in public schools from the area covered by a health center in Belo Horizonte. The median age was 8.9 years, and 49.7% were male. Assessment used a stomatognathic system protocol adapted from the Myofunctional Evaluation Guidelines, the Phonology task of the ABFW - Child Language Test, and a simplified auditory processing evaluation. Data were statistically analyzed. RESULTS From the subjects studied, 31.9% had speech disorder. From these, 18% presented phonetic deviation, 9.7% phonological deviation, and 4.2% phonetic and phonological deviation. Linguistic variation was observed in 38.5% of the children. There was a higher proportion of children with phonetic deviation in 1st grade, and a higher proportion of children younger than 8 years old with both phonetic and phonological deviations. Phonetic deviation was associated to stomatognathic system disorder, and phonological deviation was associated to auditory processing disorder. CONCLUSION The prevalence of speech disorders in 1st to 4th grade students is considered high. Moreover, these disorders are associated to other Speech-Language Pathology and Audiology alterations, which suggest that one disorder may be a consequence of the other, indicating the need for early diagnosis and intervention.
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Affiliation(s)
- Alessandra Terra Vasconcelos Rabelo
- Graduate Program in Health Sciences: Child and Adolescent Health, School of Medicine, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil.
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Alves CRL, Lasmar LMDLBF, Goulart LMHF, Alvim CG, Maciel GVR, Viana MRDA, Colosimo EA, Carmo GAAD, Costa JGDD, Magalhães MEN, Mendonça MLD, Beirão MMDV, Moulin ZS. Qualidade do preenchimento da Caderneta de Saúde da Criança e fatores associados. CAD SAUDE PUBLICA 2009; 25:583-95. [DOI: 10.1590/s0102-311x2009000300013] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2008] [Accepted: 09/29/2008] [Indexed: 11/21/2022] Open
Abstract
A Caderneta de Saúde da Criança (CSC) é um documento imprescindível para a promoção da saúde infantil. Foi realizado um estudo transversal com amostra aleatória simples de crianças acompanhadas no Sistema Único de Saúde (SUS), visando analisar os fatores associados à qualidade do preenchimento da CSC. Foram realizadas entrevistas e verificação direta das cadernetas de 365 crianças das nove regionais de saúde de Belo Horizonte, Minas Gerais, Brasil. Foi criado um sistema de escore para classificar as CSC quanto à qualidade do seu preenchimento e relacioná-la às variáveis explicativas. O odds ratio foi calculado por regressão logística. O preenchimento dos vinte itens do escore variou de 3,1% (uso de ferruginoso) a 99,7% (data de nascimento). Os fatores associados aos piores escores foram: crianças > 12 meses de idade (OR = 1,77), mães < 6 anos de estudo (OR = 1,97), crianças não acompanhadas por médicos generalistas (OR = 3,18) e mães que não receberam explicações sobre a CSC na maternidade (OR = 1,77). Os resultados apontam a precária utilização da CSC, reforçando a necessidade de investimentos em capacitação dos profissionais e organização dos serviços para que ela cumpra seu papel na promoção da saúde infantil.
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Alves CRL, Goulart EMA, Colosimo EA, Goulart LMHF. Fatores de risco para o desmame entre usuárias de uma unidade básica de saúde de Belo Horizonte, Minas Gerais, Brasil, entre 1980 e 2004. CAD SAUDE PUBLICA 2008; 24:1355-67. [DOI: 10.1590/s0102-311x2008000600016] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2007] [Accepted: 10/19/2007] [Indexed: 11/21/2022] Open
Abstract
O objetivo foi analisar comparativamente os fatores que interferiram na duração do aleitamento materno entre usuárias do Centro de Saúde São Marcos, Belo Horizonte, Estado de Minas Gerais, Brasil, em 1980, 1986, 1992, 1998 e 2004. Foram realizados cinco estudos longitudinais retrospectivos (coortes históricas), utilizando o mesmo questionário. Foram entrevistadas, no total, 790 mães de menores de 24 meses. A análise estatística foi feita, ano a ano, pelo método de Kaplan-Meier e modelo de Cox. Entre 1980 e 2004, as condições significativamente associadas ao risco de desmame foram: primiparidade, dificuldade para amamentar após o parto, conceito de tempo ideal de aleitamento materno menor que seis meses, início do aleitamento materno após a alta da maternidade, não reconhecimento das vantagens da amamentação para a criança e opinião paterna desfavorável, indiferente ou desconhecida sobre o aleitamento materno. Em quatro dos cinco estudos, ter tido dificuldade para amamentar (RR: 1,70-3,97) e considerar ideal amamentar por menos de seis meses (RR: 1,67-3,27) representaram maior risco de desmame. A duração mediana do aleitamento materno foi cinco meses em 1980 e 11 meses em 2004.
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Guerra AFM, Gonçalves DU, Werneck Côrtes MDCJ, Alves CRL, Lima TMA. [Pediatric Otolaryngology at the Public Health System of a city in Southeastern Brazil]. Rev Saude Publica 2008; 41:719-25. [PMID: 17923892 DOI: 10.1590/s0034-89102007000500005] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2006] [Accepted: 05/08/2007] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE To assess the suitability of referral from primary to secondary care in pediatric Otolaryngology. METHODS The study was performed in the city of Belo Horizonte, in the state of Minas Gerais, from March 2004 to May 2005. A total of 408 pre-school children referred from primary care to secondary care in the department of Otolaryngology presenting with otitis, tonsillitis, sinusitis, allergic rhinitis, and tonsillar/adenoidal hypertrophy was assessed. The studied variables were: agreement between diagnoses in primary and secondary care; waiting time for doctor's appointment; follow-up, and professional (pediatrician or family physician) that examined children in primary care. Agreement of diagnoses was assessed using kappa statistics. RESULTS Patients were five years old on average, 214 (52.5%) were boys, mean waiting time for appointment was 3.7 months. Diagnoses in primary and secondary care were respectively: otitis (44%, 49%), tonsillar/adenoidal hypertrophy (22%, 33%), tonsillitis (18%, 23%), sinusitis (13%, 21%), allergic rhinitis (3%, 33%). Agreement analysis of kappa was 0.15 for otitis with effusion, 0.35 for recurrent otitis, 0.04 for tonsillar/adenoidal hypertrophy, 0.43 for tonsillitis, 0.05 for allergic rhinitis, and 0.2 for sinusitis. Diagnoses in primary care referred to secondary care were in agreement when given either by pediatrician or family physician. CONCLUSIONS Unsuitability of referrals from primary to secondary care in otolaryngology was expressed by the long time waiting for appointments and by the low agreement between diagnoses in different level of care for the same patients. Primary health care could be more efficient if professionals were better qualified in Otolaryngology.
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Affiliation(s)
- Angela Francisca Marques Guerra
- Programa de Pós-graduação em Ciências da Saúde, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brasil
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