Andréia Moreira de Andrade

Introdução: A triagem auditiva neonatal universal – TANU, consiste em avaliar todos os recém-nascidos de uma determinada região, independentemente da presença de fatores de risco ou da necessidade de internação na UTI neonatal. Objetivo: Realizar uma revisão sistemática, para estimar a prevalência da perda auditiva em recém-nascidos. Métodos: A inclusão para a revisão foi: Estudos publicados com a população de recém-nascidos; Desfecho: perda auditiva infantil avaliadas por meio dos exames padrão-ouro; Tipo de estudo: Estudos transversais e de coorte, que avaliaram prevalência e incidência da perda auditiva, por meio da TANU. As bases de dados que foram pesquisadas na busca eletrônica estão listadas a seguir: EMBASE, Literatura Latino Americana e do Caribe em Ciências da Saúde e Scielo via Biblioteca Virtual de Saúde, Medline via Pubmed, Web of Science, Scopus e Proquest (fonte da literatura cinzenta) via web of Science. Dois autores realizarão a extração dos dados, ainda com cegamento. Os dados extraídos serão: Título, autores, ano de publicação, critérios de diagnóstico para perda auditiva, população e amostra, faixa etária e resultados; os dados extraídos dos estudos serão descritos e apresentados em tabelas, exibindo as variáveis selecionadas. Para apresentação do rastreamento dos dados será utilizado o fluxograma prisma. Para síntese quantitativa dos dados será conduzida uma metanálise de prevalência. Conclusão: Este protocolo estabelece diretrizes metodológicas para a realização de uma revisão sistemática e metanálise sobre a prevalência da perda auditiva infantil por meio da triagem auditiva neonatal universal. A síntese dos dados esperados poderá fornecer evidências robustas para embasar a prática clínica e orientar futuras pesquisas. A adoção de metodologias rigorosas garantirá a transparência e reprodutibilidade dos achados. Ao concluir a revisão, espera-se obter a prevalência sumária da perda auditiva em neonatos, proporcionando uma visão abrangente da distribuição desse fenômeno em nível global. Esse conhecimento será fundamental para a implementação de intervenções estratégicas e baseadas em evidências, especialmente no período crítico do desenvolvimento da linguagem e da audição, favorecendo ações preventivas e terapêuticas mais eficazes para essa população.

Introdução: A perda auditiva prejudica a comunicação interpessoal, a linguagem e diversas atividades diárias de aprendizagem, resultando em consequências psicológicas e de desenvolvimento significativas para as pessoas afetadas. Objetivo: Promover a transparência e confiabilidade na construção do estudo, que propõe estimar a prevalência da perda auditiva de crianças em idade escolar, por meio de uma revisão sistemática da literatura. Métodos: A revisão sistemática, foi registrada no PROSPERO 2025 CRD: 42025644090. A busca por artigos, foi realizada nas bases de dados eletrônicas MEDLINE, SciELO, LILACS, Scopus, Web of Science, pró-quest, via Web of Science, Pubmed e BVS. Os descritores utilizados no processo de revisão foram selecionados com os Descritores em Ciências da Saúde (DeCS) da Bireme. A busca foi realizada em inglês, organizando os conceitos em três blocos: o primeiro incluiu termos relacionados à população, o segundo, termos associados ao desfecho que era a perda auditiva, e o terceiro, um termo referente ao tipo de estudo. Os dados extraídos dos estudos serão sistematizados e exibidos em tabelas. Metanálise de prevalência, baseada no modelo de efeitos aleatórios, será realizada para a síntese quantitativa. Resultados Esperados: Espera-se contribuir para o conhecimento do cenário de saúde auditiva em menores de 12 anos de idade, através do estudo da ocorrência de perdas auditivas no público infantil, na busca de identificar essas alterações e proporcionar o tratamento e intervenções adequadas e precoces, bem como propor políticas públicas que visem o desenvolvimento adequado de audição, linguagem e aprendizagem.

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The Brazilian Association of Collective Health (Abrasco) has played a leading role in consolidating collective health in Brazil since its foundation. After 19 years, Abrasco's Epidemiology Committee resumed its planning with the development of the Fifth Strategic Plan for the Development of Epidemiology in Brazil (2025–2029). This plan emerged in a challenging context marked by social inequalities, scientific denialism, the COVID-19 pandemic, the climate crisis, and disinvestment in public policies, reinforcing the need to update Brazilian epidemiology. The plan's development occurred in multiple stages, including online surveys, debates, and in-person workshops. Workshop I (Brasília, 2023) identified priority challenges, and Workshop II (Rio de Janeiro, 2024) defined strategies to address them. The construction process was guided by the qualified participation of epidemiologists from all regions of the country and was based on principles of plurality, diversity, gender equity, and race/ethnicity. The plan highlights epidemiology across three thematic areas: education, research, and health policies, programs, and services. The Strategic Plan Working Group of the Epidemiology Committee, supported by the Secretariat of Health and Environment Surveillance of the Ministry of Health, led the process. This supplement of the Brazilian Journal of Epidemiology presents the Fifth Strategic Plan for the Development of Epidemiology in Brazil (2025–2029), contributions to the discussion of some central topics, and a deepening of strategic and operational dimensions. The Fifth Strategic Plan for the Development of Epidemiology in Brazil (2025–2029) presents a collective vision for the future, aiming to strengthen epidemiology as a central discipline within the field of collective health. It reaffirms its commitment to equity, social justice, and the consolidation of the Sistema Único de Saúde in Brazil.

Background: Continued breastfeeding reduces infant mortality and provides nutritional, immunological, and developmental benefits for the child. Objectives: A prospective cohort study conducted in 2015 followed 608 children who were breastfed between 6 and 24 months. The study assessed the risk of breastfeeding interruption at 12, 18, and 24 months, as well as the factors associated with this outcome, in a cohort of newborns in Rio Branco, using the life table method. Methods: The factors associated with breastfeeding cessation and their 95% confidence intervals (CI95%) were analyzed using both crude and adjusted Cox proportional hazards regression in a hierarchical model. The risks of breastfeeding cessation at 12, 18, and 24 months were 19%, 65%, and 71%, respectively. Results: Factors positively associated with the risk of breastfeeding cessation include the use of a pacifier before 6 weeks of age (HR = 1.62; CI: 95% 1.24–2.11) and the use of a bottle during the first year of life (HR = 1.41; CI: 95% 1.11–1.78). Maternal return to work after the birth of the baby (HR = 0.78; CI: 95% 0.62–0.97) was found to be negatively associated with the risk of breastfeeding interruption. Conclusions: Early pacifier use before 6 weeks and the introduction of a bottle in the first year affect continued breastfeeding. Maternal employment was associated with reduced risk of breastfeeding cessation, contrary to most studies.

Introduction: Food insecurity (FI) experienced during pregnancy represents a relevant public health problem, as it negatively affects maternal and child health. Objective: To investigate the prevalence of FI among pregnant women during the COVID-19 pandemic and determine associated factors. Methods: A cross-sectional study was carried out in the period from 2021 to 2022, with a representative sample of 423 women resulting from a sample calculation based on the average (2912 births) that occurred in the years 2016 to 2020 in the only maternity hospital in the municipality. After analyzing the medical records, interviews were carried out with the postpartum women using a standardized questionnaire and the Brazilian Food Insecurity Scale. Poisson regression with robust variance was used to calculate prevalence ratios and 95% confidence intervals to measure associations. Results: FI was observed in 57.0% of cases and was associated with age under 20 years (PR = 1.52; 95% CI 1.29; 1.79), receipt of government assistance (PR = 1.31; 95% CI 1.10; 1.55), loss of family employment (PR = 1.40; 95% CI 1.20; 1.64), greater number of residents (PR = 1.17; 95% CI 1.00; 1.37), and prenatal care in a public institution (PR = 1.53; 95% CI 1.04; 2.26). Conclusion: There was a high prevalence of FI cases, associated with socioeconomic, demographic, and prenatal care characteristics during the COVID-19 pandemic.

The aim of the present study was to propose a quality prenatal (PN) care assessment model combining use and visit content (both adjusted for the weeks of gestation) to estimate inadequate PN care and associated factors in Rio Branco, Acre. A cross-sectional study was conducted using a population-based cohort of 1030 women in the city of Rio Branco in 2015. The use of PN care was classified according to the adapted Kotelchuck index by combining the performance of clinical-obstetric procedures adjusted for weeks of gestation. Levels of adequacy were built according to PN care use and content. Gross and adjusted odds ratios were estimated by using a logistic regression. The prevalence rates of inadequate prenatal care quality were 25.9% (Level-1), 54.8% (Level-2), 68.8% (Level-3), and 78.6% (Level-4). The factors associated with Level-1 were age ≤ 34 years (ORaj:3.74), not having a partner (ORaj:1.62), unplanned pregnancy (ORaj:1.73), and multiparity (ORaj:2.25); those for Level-2 comprised not having a partner (ORaj:1.82) and multiparity (ORaj:1.33); those for Level-3 were age ≤ 34 years (ORaj:3.31), not having a partner (Oraj:1.71), unplanned pregnancy (Oraj:1.45), PN in the private sector (Oraj:3.08), and multiparity (ORaj:2.17); those for Level 4 comprised not having a partner (ORaj:2.33), family income < 1 MW (ORaj:2.05), unplanned pregnancy (ORaj:1.41), PN in the private sector (ORaj:6.80), and multiparity (ORaj:1.49). The Kotelchuck index was proven efficient in assessing the combined effect of use and content in assessing PN care quality.

Background: Averse birth-outcomes still affect newborns worldwide. Although high-quality prenatal care is the main strategy to prevent these outcomes, the effect of prenatal care based on Kotelchuck index combined with consultation contents is still unclear. Thus, this article to evaluate the effect of the quality of prenatal care (PC) process on birth indicators in a cohort of puerperaes who attended maternity hospitals in Brazilian western Amazon, city of Rio Branco, in the state of Acre, Brazil, in 2015. Methods: This research was a hospital-based cohort study. The sample consisted of 1,030 women who gave birth in maternity hospitals in the city between April 6 and June 30, 2015. This research was a hospital-based cohort study. The sample consisted of 1,030 women who gave birth in maternity hospitals in Rio Branco between April 6^th. and June 30^th., 2015. Prenatal care was classified as fully adequate when started ≤4th month; ≥80.0–109% expected consultations for GA according to the Kotelchuck Index; ≥5 records of blood pressure, weight, GA, fundal height, ≥4 records of fetal heart rate, fetal movements or equivalent to 75% of the number of consultations; in addition to recording ABO/RH, hemoglobin, VDRL, urine, glucose, anti-HIV and anti-toxoplamosis during the 1st trimester. The evaluated outcomes were low birth weight (LBW), preterm birth and vertical transmission of human immunodeficiency virus (HIV)/hepatitis/syphilis. Differences between proportions were assessed using the X² test, and the crude and adjusted odds ratios (OR) (95% CI) were estimated using unconditional logistic regression. Results: Overall cohort, the outcomes incidences were 8.8% for LBW, 9.2% for preterm birth, and 1.1% for vertical transmission (syphilis/HIV/hepatitis). Crude and adjusted OR showed that inadequate PC increased the risk statistically significant of LBW (ORcrude: 1.84; 95%CI: 0.99–3.44; ORadjusted: 1.87; 95%CI: 1.00–3.52), and preterm birth (ORcrude: 1.79; 95%CI: 1.00–3.29; ORadjusted: 3.98; 95%CI: 1.40–11.29). Conclusion: The results draw attention to the importance of quality PC in reducing the risks of LBW, preterm birth, and vertical transmission of syphilis/HIV/hepatitis. Moreover, using this proposed quality prenatal care indicator based on Kotelchuck index combined with consultations contents adjusted by GA may accurately predict unfavorable outcomes.

This study aimed to analyze overweight trend and obesity in adults from Rio Branco, Acre, Western Brazilian Amazon, from 2006 to 2020. This is a time series study, with data from Surveillance System for Risk and Protective Factors for Chronic Diseases by Telephone Survey (VIGITEL). To estimate annual percentage change (APC) and 95% confidence intervals, the software Jointpoint Regression Analysis v.4.6.0.0., was used. In Rio Branco, overweight prevalence ranged from 44.0% in 2006 to 58.9% in 2020, with a bigger frequency among men than that among women. Obesity prevalence has increased from 12.5% in 2006 to 21.4% in 2020, similar between both sexes. From 2006 to 2020, overweight APC was 5.2% (95% CI: 1.4; 9.1) by 2010, and decreased to 1.3% by 2020. Public policies to control obesity and its risks must be both, implemented as strengthened.

Resumo Objetivo Identificar o perfil epidemiológico dos pacientes que evoluíram para óbito, caracterizar essas mortes segundo variáveis sociodemográficas e clínicas e analisar a relação entre a causa básica e a causa imediata do óbito em um hospital de ensino. Métodos Estudo quantitativo, transversal retrospectivo, com componentes descritivos, utilizando como principal fonte de dados os atestados de óbitos do Sistema de Informações do Sistema Único de Saúde e das declarações de óbitos ocorridos em 2016 da instituição pesquisada. Resultados Dos 634 [...] Resumo Objetivo Identificar o perfil epidemiológico dos pacientes que evoluíram para óbito, caracterizar essas mortes segundo variáveis sociodemográficas e clínicas e analisar a relação entre a causa básica e a causa imediata do óbito em um hospital de ensino. Métodos Estudo quantitativo, transversal retrospectivo, com componentes descritivos, utilizando como principal fonte de dados os atestados de óbitos do Sistema de Informações do Sistema Único de Saúde e das declarações de óbitos ocorridos em 2016 da instituição pesquisada. Resultados Dos 634