Control of mother-to-child transmission of infectious diseases in Brazil: progress in HIV/AIDS and failure in congenital syphilis

Ramos, Alberto Novaes; Matida, Luiza Harunari; Saraceni, Valéria; Veras, Maria Amélia; Pontes, Ricardo José Soares

doi:10.1590/s0102-311x2007001500005

Cited by 56 publications

(47 citation statements)

References 24 publications

(33 reference statements)

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“…Expanded further actions for the prevention of MTCT have occurred since 1999 [6]. Despite these advances in national policy for control of HIV [13,30], there are indications of operational failures in these procedures [30-32]. Additionally, regional differences are important factors that contribute in Brazil to sustain a non-favorable outcome [16,17,30].…”

Section: Discussionmentioning

confidence: 99%

“…Despite these advances in national policy for control of HIV [13,30], there are indications of operational failures in these procedures [30-32]. Additionally, regional differences are important factors that contribute in Brazil to sustain a non-favorable outcome [16,17,30]. Our study points to a statistically significant association between non-performance of any measure aimed at the prevention of MTCT (prenatal or childbirth or child) and the occurrence of these clinical events.…”

Section: Discussionmentioning

confidence: 99%

“…We identified a positive association between the occurrences of opportunistic illnesses in all regions of the country compared with the North region, mainly in the Southeast where the epidemic is consolidated since the very beginning [30]. It is noteworthy that the North region had the lowest proportion of AIDS cases in the two periods (2% vs. 9%).…”

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Opportunistic illnesses in Brazilian children with AIDS: results from two national cohort studies, 1983-2007

Ramos

Matida²,

Hearst

et al. 2011

AIDS Res Ther

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BackgroundHAART has significantly reduced AIDS-related morbidity in children. However, limited evidence is available from developing countries regarding patterns of opportunistic illnesses. We describe these events and their associated factors in children with AIDS in Brazil.MethodsThis study is based on two representative retrospective multi-center cohorts including a total 1,859 children with AIDS, infected via mother-to-child transmission (MTCT), between 1983-2002. Opportunistic illnesses were described and analyzed over time. The association of demographic, clinical and operational data with the occurrence of opportunistic diseases was assessed.ResultsIn total, 1,218 (65.5%) had at least one event of an opportunistic disease. Variables significantly associated with occurrence of these events included: region of residence (OR 2.68-11.33, as compared to the Northern region), age < 1 year at diagnosis (OR 2.56, 95% CI 1.81-3.61, p < 0.001), and non-performance of MTCT prevention measures (OR 1.58, 95% CI 1.21-2.07, p < 0.001). Protective factors included year of HIV diagnosis in the HAART era (OR 0.34, 95% CI 0.15-0.76, p = 0.009) and ART use (OR 0.58, 95% CI 0.44-0.77, p < 0.001). In both periods bacterial infections represented the most common opportunistic events (58.6 vs. 34.7%; p < 0.001), followed by Pneumocystis jirovecii pneumonia (21.9 vs. 13.2%; p < 0.001), and bacterial meningitis/sepsis (16.8 vs. 7.4%; p < 0.001).ConclusionsDespite the significant reduction in recent years, opportunistic illnesses are still common in Brazilian children with AIDS in the HAART era, especially bacterial diseases. The data reinforce the need for scaling up prevention of MTCT, early diagnosis of infection, and improvement of comprehensive pediatric care.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Opportunistic illnesses in Brazilian children with AIDS: results from two national cohort studies, 1983-2007

Ramos

Matida²,

Hearst

et al. 2011

AIDS Res Ther

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“…Atualmente, observa-se o aumento proporcional de casos de AIDS de transmissão heterossexual e taxas de incidência crescentes no gênero feminino. Este fenômeno, chamado "feminização", é acompanhado por um número cada vez maior de crianças atingidas 7,8 . A transmissão vertical do HIV pode ocorrer durante a gestação (35%), o trabalho de parto e o parto propriamente dito (65%), ou através da amamentação, com risco acrescido de transmissão entre 7% e 22% a cada exposição (mamada) 9 .…”

Section: Introductionunclassified

Transmissão vertical do HIV, da sífilis e da hepatite B no município de maior incidência de AIDS no Brasil: um estudo populacional no período de 2002 a 2007

Kupek

Oliveira

2012

Rev. bras. epidemiol.

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“…Portanto, a compreensão do que ocorre com esses parceiros é de extrema importância para a eliminação da SC, uma vez que esse problema é um dos maiores empecilhos para que a gestante seja considerada adequadamente tratada 12 , tendo como consequência a necessidade de tratamento do bebê, o que pode gerar transtornos para a família. A maior parte dos trabalhos relacionados à sífilis gestacional analisa variáveis das gestantes 13,14 e as poucas informações referentes aos parceiros limitam-se à adequação ou não do tratamento recebido 13 .…”

Section: Discussionunclassified

Sífilis em parturientes: aspectos relacionados ao parceiro sexual

Campos¹,

Araújo²,

Melo³

et al. 2012

Rev. Bras. Ginecol. Obstet.

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PURPOSES:To analyze the sociodemographic and behavioral profile of sex partners, the proportion of those inadequately treated as well as to verify how many of them were inadequately treated and why some were not treated. METHODS: Quantitative study with data collected from May to October, 2008 at five public maternities in Fortaleza, Ceará. A survey was carried out with parturients who were hospitalized with syphilis and had a stable sex partner. We analyzed sociodemographic variables and those related to communication, diagnosis and treatment of sex partners. The data were entered into the Statistical Package for the Social Sciences and were analyzed using frequency distributions, measures of central tendency and dispersion. RESULTS: The study included 56 pregnant women. Most sexual partners were young adults aged on average 29 years, 50% of them had studied for less than seven years, 82.1 worked and 46.4% had a family income of less than a minimum wage. Of all the partners, 92.9% were the child's father and 69.6% lived with the women. Fifty percent and 12% were alcohol and drug users, respectively. Most partners (75.0%) were told about the diagnosis by the women, and in 78.6% of cases they were aware of the VDRL result before or during the prenatal period. However, 25.0% of the women did not communicate the result to their partners for the following reasons: not knowing the importance of the partner's treatment (50.0%), not being together after the diagnosis (42.9%) and having a quarrel (7.1%). Of the partners who were informed about the result before or during the prenatal period, 56.0% were treated and six (42.8%) were considered to have been

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Control of mother-to-child transmission of infectious diseases in Brazil: progress in HIV/AIDS and failure in congenital syphilis

Abstract: In Brazil, syphilis and HIV infection are considered serious public health problems. However, in practice, epidemiological surveillance, prevention measures, and prenatal

Cited by 56 publications

References 24 publications

Opportunistic illnesses in Brazilian children with AIDS: results from two national cohort studies, 1983-2007

Opportunistic illnesses in Brazilian children with AIDS: results from two national cohort studies, 1983-2007

Transmissão vertical do HIV, da sífilis e da hepatite B no município de maior incidência de AIDS no Brasil: um estudo populacional no período de 2002 a 2007

Sífilis em parturientes: aspectos relacionados ao parceiro sexual

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