BackgroundBrazil has at least 800,000 HTLV-1 infected individuals. HTLV-1 can be transmitted via sexual intercourse, contact with blood and from mother to child, mainly by breastfeeding. Treatments for the high morbidity/mortality associated diseases (ATL and HAM/TSP) are limited, therefore, infection prevention is of utmost importance. However, antenatal screening is not routinely performed in Brazil. A lack of data regarding the number of individuals infected via breastfeeding impairs the development of government policies. The objective is to estimate the number of HTLV-1 infections occurring annually due to mother to child transmission (MTCT) in Brazil, nationally and regionally.MethodologyTo estimate HTLV-1 MTCT in Brazil the following variables are modelled: number of births, prevalence of HTLV-1 infection in pregnant women, breastfeeding duration rate and transmission risk according to breastfeeding period. The number of cases of HAM/TSP and ATL attributable to MTCT are also estimated.Principal findingsIn 2008, there were 2,934,828 live births in Brazil. HTLV prevalence in pregnant women in Brazil ranges between 0.1–1.05% by region. An estimated 16,548 HTLV-1 infected women are pregnant each year. According to the breastfeeding pattern and HTLV-1 prevalence of each region there are an estimated 3,024 new cases of HTLV-1 infection due to MTCT annually of which 2,610 are preventable through infant feeding advice. These 3,024 transmissions will result in 120–604 cases of ATL and 8–272 of HAM/TSP. North-East region comprises the high number of MTCT cases, followed by South-East.Conclusions/significanceA high number of new HTLV-1 infections due to MTCT occur every year in Brazil. Antenatal screening and avoiding breastfeeding are essential to prevent subsequent development of HTLV-1-associated diseases.

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ObjectivesA teaching curriculum in health policy may be well established in medical school; however, an emphasis on applying taught principles via participation in health policy roles is less defined. We undertook a study to explore medical student participation in health policy roles.Design and settingAn anonymous online survey via convenience sampling was conducted in the UK.ParticipantsA total of 112 students from six medical schools participated in the study.Outcome measuresThe outcome measures were as follows: medical students’ beliefs about their current knowledge of health policy and their desire to learn more; their current, past and future involvement in a health policy role, and perceived barriers to involvement.ResultsForty-seven percent of participants reported previous teaching on health policy, with the majority scoring themselves 2 out of 5 for knowledge about the topic (38%). Seventy-seven percent of participants expressed a desire to be taught health policy while 73% agreed with compulsory teaching. Ninety-six percent of participants reported no current or previous activity in a health policy role, with 61% willing to undertake a role in the future. The three main barriers to student involvement were: a lack of knowledge about health policy (57%), an unawareness of opportunities available (56%), and a lack of time (43%).ConclusionIn addition to already established teaching programs within medical school, implementation of community-based experiences could improve knowledge of health policy, while providing an opportunity for students to gain experience in health policy committee roles.

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