Euclides Ayres de Castilho

RESUMO Objetivo: Descrever os procedimentos metodológicos utilizados para a coleta e análise de dados em inquérito online realizado no período de julho a dezembro de 2023 e verificar a se a amostra alcançada na pesquisa é representativa da população brasileira. Métodos: Estudo epidemiológico de corte transversal realizado pelas redes sociais virtuais, utilizando-se a metodologia Respondent-Driven Sampling (RDS) para a coleta de informações na população adulta brasileira. Para a ponderação da amostra, utilizou-se um procedimento de pós-estratificação com base nos dados sociodemográficos da Pesquisa Nacional de Amostra por Domicílios 2022 (PNADC-2022). As prevalências de doenças crônicas não transmissíveis (DCNT), autoavaliação de saúde e comportamentos de saúde estimadas na ConVid-2 foram comparadas às estimativas da Pesquisa Nacional de Saúde, 2019. Resultados: O total de 3.805 indivíduos participou da pesquisa ConVid-2. A comparação das variáveis sociodemográficas da ConVid-2 com as da PNADC mostrou proporções muito semelhantes nas duas pesquisas. Quanto às DCNT, a comparação com a PNS-2019 mostrou discrepâncias apenas nas prevalências de asma e depressão. Em relação aos hábitos, os percentuais de fumo atual, atividade física adequada no lazer e consumo de alimentos saudáveis e não saudáveis foram próximos nas duas pesquisas. A maior diferença ocorreu no uso de telas após a pandemia de COVID-19. Conclusão: O uso do método RDS com o registro dos pares recrutador-recrutado possibilitou obter estimativas mais fidedignas. As mudanças nos estilos de vida salientam a necessidade de ações voltadas à promoção de comportamentos saudáveis e ao controle das DCNT.

Objective: To describe the methodological procedures used to collect and analyze data from an online survey carried out from July to December 2023 and to verify whether the obtained sample is representative of the Brazilian population. Methods: A cross-sectional epidemiological study was carried out through social media, using the Respondent-Driven Sampling methodology to collect information from the Brazilian adult population. For sample weighting, a post-stratification procedure was used based on sociodemographic data of the 2022 Continuous National Household Sample Survey (PNADC-2022). Prevalence estimates of chronic noncommunicable diseases, self-rated health, and health behaviors estimated in the ConVid-2 survey were compared with the estimates from the 2019 National Health Survey (PNS-2019). Results: A total of 3,805 individuals participated in the ConVid-2 survey. When comparing sociodemographic variables from ConVid-2 with those from the PNADC, we verified very similar proportions in both surveys. Regarding chronic noncommunicable diseases, we found discrepancies only in prevalence of asthma and depression in comparison with PNS-2019. As for lifestyle habits, the percentages of current smoking, adequate leisure-time physical activity, and consumption of healthy and unhealthy foods were similar in both surveys. The greatest difference was observed in screen use after the COVID-19 pandemic. Conclusion: The use of the Respondent-Driven Sampling method with the inclusion of recruiter-recruitee pairs enabled us to obtain more reliable estimates. Concerning lifestyle changes and the findings of this study, we highlight the need for actions aimed at promoting healthy behaviors and achieving greater advances in the control of chronic noncommunicable diseases.

RESUMO Objetivo: Analisar a morbidade por COVID-19 segundo as características sociodemográficas e condições de saúde preexistentes, com base nos dados de um inquérito realizado em 2023 pela internet denominado de "ConVid-2: Pesquisa de Comportamentos". Métodos: Estudo transversal epidemiológico realizado pelo método respondent driven sampling (RDS). Foram estimados as prevalências e os respectivos intervalos de confiança de cinco indicadores relacionados à COVID-19. Para testar a hipótese de associação dos desfechos com as características sociodemográficas, foram utilizados modelos de regressão logística. Resultados: O total da amostra foi de 3.805 indivíduos de 18 anos ou mais. Aproximadamente, 50% dos participantes tomaram quatro doses ou mais de vacina antiCOVID-19. A prevalência estimada de COVID-19 foi de 49,5%, com gradientes significativos e crescentes para a idade e decrescentes por grau de instrução. A COVID-longa foi identificada em 32% dos indivíduos que tiveram COVID-19 confirmada, com as maiores proporções entre as mulheres (38,3%; odds ratio — OR=0,52; p=0,002), com dificuldades financeiras (38,9%; OR=1,68; p=0,02) e com alguma doença crônica não transmissível (36,3%; OR=1,58; p=0,03). O maior percentual de internação hospitalar ocorreu entre os que tiveram COVID-longa (12,7%). O falecimento de algum morador do domicílio por COVID-19 foi relatado por 5,1% dos participantes. Conclusão: Os achados revelaram grandes desigualdades socioeconômicas em todos os indicadores relacionados à morbidade por COVID-19. A idade avançada, as condições preexistentes de saúde e a COVID-longa interferiram na gravidade da doença e no aumento de internações. Esses achados são relevantes para fornecer subsídios às políticas públicas dirigidas aos cuidados dedicados ao diagnóstico e manejo das complicações relacionadas à COVID-19 no sistema público de saúde.

Objective: To analyze COVID-19 morbidity according to sociodemographic characteristics and preexisting health conditions, based on data from a survey conducted in 2023 online called "ConVid-2 Behavior Survey".

In 2021, an RDS survey was conducted among Venezuelan migrant women of reproductive age who migrated to two Brazilian cities (Manaus and Boa Vista) from 2018 to 2021. To start the RDS recruitment, we chose seeds non-randomly in both cities. The study variables were age, educational level, self-rated health, pregnancy, migratory status and use of health services. We estimated the prevalence, confidence intervals and homophily effects by variable category. We used a multivariate logistic regression model to identify the main factors associated with healthcare use. A total of 761 women were recruited in Manaus and 1268 in Boa Vista. Manaus showed more irregular migrants than Boa Vista. The main reasons for using health services were as follows: illness, disease prevention and prenatal care. The logistic regression model showed the use of health services was associated with educational level and healthcare needs but not with migratory status. The social inclusion of Venezuelan migrants is extremely relevant, although many challenges must be overcome. The strategy of the Brazilian Federal Government for providing humanitarian assistance to Venezuelan migrants should be expanded to include and facilitate their integration into labor markets, access to healthcare and education, benefiting both migrants and the Brazilian people by reducing social inequality.

The lack of information regarding the burden of acute bacterial meningitis in Latin America leads to a reduction in the estimated incidence rates of the disease, and impairs public health decisions on the use and follow-up of preventive interventions, particularly, the evaluation of existing vaccination policies. The use of the real-time PCR in diagnostic routine procedures has resulted in a substantial increase in confirmed bacterial meningitis cases. However, in resource-poor countries, these assays are only available in reference laboratories. Sample transportation to these laboratories is a critical constraint, as it requires specialized, high cost courier services. To overcome this barrier we evaluated the use of FTA^TM Elute filter paper cards for the conservation and processing of samples under normal environmental conditions, as they would be when transported from remote and under-equipped healthcare facilities to the reference centers. A total of 401 samples received in 2015 as part of Sao Paulo’s national surveillance for routine diagnosis were selected for this study. The sensitivity and specificity of real-time PCR were evaluated using fresh serum and cerebrospinal fluid (CSF) samples processed using our laboratory’s standard DNA extraction, and processing the same samples after being dried and stored on FTA^TM card, and DNA extracted following the manufacturer’s instructions. The sensitivities for detection of Neisseria meningitidis, Streptococcus pneumoniae, and Haemophilus influenzae from CSF dried and stored on FTA^TM cards were 98%, 92%, and 100%, respectively, and with serum samples were 73%, 88%, and 100%, respectively. When compared to our laboratory’s standard methodology, results showed high concordance, with Kappa index ranges of 0.9877–1.00 for CSF, and 0.8004–1.00 for serum samples. The use of FTA^TM cards for CSF and serum conservation and transport represents a rapid, reliable, and cost-effective alternative that will allow obtaining valuable epidemiological information that would otherwise be lost.

Of these studies, health surveys stand out for having various modalities and widespread use in several countries, whether of household base aimed at population groups or morbidities. In Brazil, we highlight the institutionalization of national or regional surveys, whose regularity has offered important information for knowing the health status of our population and thus providing substantial elements to follow the evolutionary trends and subsidize the managers in their decision-making process.

Context • Worldwide, 35 million people suffer from obesity. Mental disorders have been associated with being overweight or obese. Considerable evidence has shown a correlation between stress and the use of homeopathy and stress and obesity. However, few studies have examined the relationship between weight loss and homeopathic treatment of obesity. Objective • The study intended to evaluate the efficacy of a homeopathic treatment in preventing excessive weight gain during pregnancy in overweight or obese women who were suspected of having a common mental disorder. Design • The study was a randomized, controlled, double-blinded clinical trial. Setting • The study took place at the Center for the Social Support of Motherhood (São Paulo, Brazil). Participants • Participants were pregnant women who were enrolled at the center. Intervention • For the homeopathic group, 9 drugs were preselected, including (1) Pulsatilla nigricans, (2) Sepia succus, (3) Lycopodium clavatum, (4) sulphur, (5) Lachesis trigonocephalus, (6) Nux vomica, (7) Calcarea carbonica, (8) phosphorus; and (9) Conium maculatum. From those 9 drugs, 1 was prioritized for administration for each participant. After the first appointment, a reselection or selection of a new, more appropriate drug occurred, using the list of preselected drugs. The dosage was 6 drops orally 2 ×/d, in the morning and at night, on 4 consecutive days each wk, with an interval of 3 d between doses, up until the next appointment medical appointment. The control group received the equivalent placebo drug. Both groups also received a diet orientation. Outcome Measures • We evaluated pregnant women who were overweight or had class 1 or 2 obesity and were suspected of having a common mental disorder, with no concomitant diseases, in 2 groups: those receiving a placebo (control group, n = 72); and those receiving homeopathic treatment (homeopathy group, n = 62). Weight change during pregnancy was defined as the difference between the body mass index (BMI) at the initial evaluation and that recorded at the final evaluation, adjusted for 40 wk of gestation. In addition, the APGAR index in the newborn was evaluated as a possible complication. Results • The mean variation between baseline BMI and BMI at week 40 of gestation was +4.95 kg/m2 in the control group and +5.05 kg/m2 in the homeopathy group. The difference between the 2 groups was not significant (P = .815; 95% confidence interval [CI], -0.916 to 0.722). APGAR 10 at 5 min (59.6%in homeopathy group and 36.4% among control) was statistically significant (P = .016). Conclusions • Homeopathy does not appear to prevent excessive body mass gain in pregnant women who are overweight or obese and suspected of having a common mental disorder. Homeopathy did not change the APGAR score to modified clinical attention at delivery room. However, the evidence observed at APGAR 10 at minute 5 suggests that homeopathy had a modulating effect on the vitality of newborns, warranting further studies designed to investigate it.