In Brazil, National Immunization Days (NIDs) are held twice a year to maintain the elimination of poliomyelitis and to provide routine immunization for children younger than five years of age. Few studies have examined factors associated with participation in National Immunization Days among Brazilian children, or the contribution of immunization days to the coverage of recommended vaccines. Methods: We conducted a household cluster survey in 26 state capitals and the Federal District among children aged 19 to 35 months. Vaccination histories, including dates of vaccination, participation in the most recent NID or reasons for non-participation were obtained. Survey estimates were compared with official estimates based on doses administered. Results: Among the 17,749 children surveyed, 16,213 (91%) participated in the most recent NID. Children who received vaccination in the private sector had the lowest participation (84%) in NIDs. In 13 capitals, official coverage estimates were higher than those from the survey. The main reasons given for non-participation the most recent NID included parent's decision not to participate, doctor's advice, child's illness, and factors associated with the organization of the NID. Overall, 15% of the children surveyed had received at least one immunization in addition to oral polio vaccine in the most recent NID, including yellow fever, hepatitis B, measles-mumps-rubella (MMR) and combined diphtheria-tetanus-pertussisHaemophilus influenzae type b vaccines. Conclusions: In Brazilian capitals, National Immunization Days continue to enjoy high levels of acceptance by the population and offer opportunities to complete recommended immunization schedules. Reasons for non-participation suggest the need for different communication strategies to reach parents who do not bring their children for vaccination on NIDs. Keywords:Poliomyelitis. Healthcare surveys. Mass vaccination. Immunization programs. IntroductionNational Immunization Days (NIDs) are considered essential strategies for polio eradication, to reach children who are not covered by routine vaccination programs, as well as to maintain the necessary visibility and political commitment for eradication. [1,2] In 1980, Brazil implemented National Immunization Days against infantile paralysis as part of the long-term strategy to eliminate poliomyelitis [3]. The initial objective was to achieve high coverage to interrupt transmission of poliovirus, with an established target of vaccinating 95% of children younger than five years with oral poliovirus vaccine. Following the identification of the last confirmed case of poliomyelitis in Brazil in 1989 and the certification of elimination of poliomyelitis from the Americas in 1994, [4] two NIDs per year were maintained to ensure high levels of protection against poliomyelitis while polioviruses circulated in other parts of the world. Currently, with high coverage in the routine immunization program and many years without cases of infantile paralysis, the National Immunization Progra...
Background There is a renewed interest in including men who have sex with men (MSM) in global HIV surveillance. A multicenter study of 10 Brazilian cities was designed to generate a national-level estimate the prevalence of HIV and syphilis among MSM. This abstracts presents the results of one of the participating cities. Objectives To establish a baseline among MSM in Manaus to continuously monitor the prevalence of HIV and syphilis infection, level of knowledge about STI/HIV/AIDS, prevailing sexual attitudes and practices, and frequency of acts of discrimination against MSM. Methodology A cross-sectional study of 824 MSM (>18 years old) was conducted from October to May 2008 using respondent-driven sampling (RDS)-a chain-link and snowball sampling method that generates probability-based samples and is systematic, so it can be used to develop comparable surveillance data. Results The weighted prevalence obtained with the use of Respondent-Driven Sampling Analysis Tool (RDSAT) software were 6.8% (CI 4.9 to 9.8) for HIV and 4.0% (CI 2.6 to 5.8) for syphilis. A number of participants reported sex with both men and women (47.8% of HIV positive and 56.1% of syphilis cases), while 20% of HIV positive and 30% of syphilis cases classified themselves as gay or homosexual. A previous infection of syphilis was the main predictive variables associated with HIV. The average age of first intercourse was 13.25 (with a range 5À23). This pattern of early sex suggests abuse. Fifty four point five per cent of participants had their first sexual intercourse with men, 42.6% with women, and 2.2% with transvestites. Participants also reportedd41% (CI 37 to 47) used condoms in their first relationship, 73.1% (CI 69.7 to 77.2) had at least one casual sex partner during the previous 12 months, 31.6% (CI 27.7 to 35.9) used condoms consistently with casual relationships if they were with men and 15.5% (CI 11.9 to 18.9) with a woman. Nineteen per cent of MSM said they had been the target of direct physical aggression due to their sexual identity, 10% reported being forced to have sex against their will, and over 30% reported being humiliated or disrespected because of their sexual orientation.
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