Abstract The aim of this study was to analyze the connections between the Sendai Framework for Disaster Risk Reduction, the Sustainable Development Goals (SDGs), and the principles of Brazil’s Unified Health System (SUS) in the context of the public health emergency caused by the COVID-19 pandemic and its potential implications for population health. This qualitative, cross-sectional, exploratory study collected data from health professionals with experience in emergency and disaster risk management and treatment practices, which were then processed using the Iramuteq software for lexical analysis. The textual corpus was presented through a descending hierarchical classification that resulted in seven classes grouped into three categories: disaster response in the context of SUS; prevention of future disaster risks; and preparedness and recovery actions based on the Sendai Framework and the SDGs. The study highlighted aspects related to the direct and indirect effects of the COVID-19 pandemic and the challenges related to disaster risk reduction as advocated by the Sendai Framework, emphasizing the need to strengthen the culture of safety and sustainability within the SUS, which aligns with the ODS and social determinants of health.

Resumo O objetivo foi analisar os nexos entre o Marco de Sendai para a Redução do Risco de Desastres, os Objetivos de Desenvolvimento Sustentável (ODS) e os princípios do Sistema Único de Saúde (SUS), no contexto da emergência de saúde pública da pandemia de COVID-19, e suas potenciais implicações para a saúde da população. O estudo é qualitativo, transversal, exploratório, com dados coletados junto a profissionais de saúde com experiência em práticas assistenciais e de gestão de risco de emergências e desastres, e tratados pelo software Iramuteq para análise lexical. O corpus textual foi apresentado através da classificação hierárquica descendente, que originou sete classes aglutinadas em três categorias denominadas: resposta a desastres no contexto do SUS; prevenção de futuros riscos de desastres; e ações de preparação e recuperação a partir do Marco de Sendai e dos ODS. Ressaltou-se aspectos sobre os efeitos diretos e indiretos da pandemia de COVID-19 e os desafios relacionados à redução do risco de desastres preconizados no Marco de Sendai, apontando a necessidade de fortalecer a cultura de segurança e sustentabilidade no âmbito do SUS, o que se coaduna com os ODS, bem como aos determinantes sociais da saúde.

Abstract The aim of this study was to analyze the connections between the Sendai Framework for Disaster Risk Reduction, the Sustainable Development Goals (SDGs), and the principles of Brazil’s Unified Health System (SUS) in the context of the public health emergency caused by the COVID-19 pandemic and its potential implications for population health. This qualitative, cross-sectional, exploratory study collected data from health professionals with experience in emergency and disaster risk management and treatment practices, which were then processed using the Iramuteq software for lexical analysis. The textual corpus was presented through a descending hierarchical classification that resulted in seven classes grouped into three categories: disaster response in the context of SUS; prevention of future disaster risks; and preparedness and recovery actions based on the Sendai Framework and the SDGs. The study highlighted aspects related to the direct and indirect effects of the COVID-19 pandemic and the challenges related to disaster risk reduction as advocated by the Sendai Framework, emphasizing the need to strengthen the culture of safety and sustainability within the SUS, which aligns with the ODS and social determinants of health.

Resumo O objetivo foi analisar os nexos entre o Marco de Sendai para a Redução do Risco de Desastres, os Objetivos de Desenvolvimento Sustentável (ODS) e os princípios do Sistema Único de Saúde (SUS), no contexto da emergência de saúde pública da pandemia de COVID-19, e suas potenciais implicações para a saúde da população. O estudo é qualitativo, transversal, exploratório, com dados coletados junto a profissionais de saúde com experiência em práticas assistenciais e de gestão de risco de emergências e desastres, e tratados pelo software Iramuteq para análise lexical. O corpus textual foi apresentado através da classificação hierárquica descendente, que originou sete classes aglutinadas em três categorias denominadas: resposta a desastres no contexto do SUS; prevenção de futuros riscos de desastres; e ações de preparação e recuperação a partir do Marco de Sendai e dos ODS. Ressaltou-se aspectos sobre os efeitos diretos e indiretos da pandemia de COVID-19 e os desafios relacionados à redução do risco de desastres preconizados no Marco de Sendai, apontando a necessidade de fortalecer a cultura de segurança e sustentabilidade no âmbito do SUS, o que se coaduna com os ODS, bem como aos determinantes sociais da saúde.

ABSTRACT Background: Coronavirus disease (COVID-19) serology testing evaluates the prevalence of COVID-19 cases. Methods: A seroepidemiological survey of COVID-19 among healthcare workers was performed (June 2020 to November 2020) in Ribeirão Preto, São Paulo, Brazil. Overall, 10,172 and 2,129 workers participated in the first and second phases, respectively. Results: First phase: 12.7% tested positive for COVID-19 (73.5% females and 35.2% aged 30-39 years), and 29.6% were nursing technicians. Second phase: 12.1% tested positive for COVID-19 (65.5% females and 33.3% aged 40-49 years), and 24.8% were nursing assistants. Conclusions: In 2020, healthcare workers in Ribeirão Preto had COVID-19 in a similar way.

ABSTRACT Background: An outbreak of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) Omicron variant was detected in the psychiatric ward of a general hospital in Brasília, Brazil. Methods: We report the investigation, clinical outcomes, viral sequencing, and control measures applied to outbreak containment. Results: The overall attack rate was 95% (23/24) in a period of 13 days. Among the cases, 78% (18/23) were vaccinated and 17% (4/23) required intensive care. The Omicron variant was isolated from the 19 sequenced samples. Conclusions: The findings highlight the potential harm that highly transmissible variants may generate among hospitalized populations, particularly those with comorbidities.

Abstract INTRODUCTION: Chikungunya virus (CHIKV) can negatively influence outcomes in patients with pre-existing conditions. We investigated the association between the recent CHIKV outbreak and increased type 2 diabetes (T2D)-attributable deaths. METHODS: Monthly averages of T2D-attributable deaths between 2001 and 2016 were determined and compared to the equivalent data for 2017 and the recent CHIKV outbreak. RESULTS: CHKV outbreak peaked in April 2017 with 4,394.4 cases/100,000 inhabitants, while T2D-attributable deaths in the same period increased by 35.2%. CONCLUSIONS: T2D-attributable deaths significantly increased compared to the previous data, which overlapped with CHIKV incidence. The pathophysiology of this association warrants further investigations.

Resumo: O objetivo deste trabalho foi determinar a digestibilidade de nutrientes e a energia metabolizável (EM) da silagem de pescado, bem como avaliar o efeito da inclusão de farinha de silagem de pescado (FSP) nas dietas sobre o desempenho, as características de carcaça, a qualidade da carne, a análise sensorial da carne e da mortadela, e a viabilidade econômica de suínos em crescimento e terminação. No ensaio de digestibilidade, 16 suínos machos castrados (33,20±4,93 kg) receberam dietas com e sem FSP. A silagem de pescado apresentou 39,01% de proteína bruta e 4.032 kcal kg-1de EM. No ensaio de desempenho, 32 suínos machos castrados (26,00±1,68 kg) foram alimentados com rações contendo diferentes níveis de inclusão de FSP (0, 25, 50 e 75%). A FSP, obtida a partir da mistura (1:1) da silagem de pescado com milho, apresentou efeito quadrático sobre o ganho diário de peso, e o melhor resultado foi obtido com a inclusão de 25,83%. Os resultados de conversão alimentar e da viabilidade econômica indicam que até 25% de FSP, que corresponde a 5,87% de silagem com base na matéria seca, pode ser utilizada nas fases de crescimento e terminação de suínos.

Abstract: The objective of this work was to determine the nutrient digestibility and metabolizable energy (ME) of fish silage, as well as to evaluate the effect of the dietary inclusion of fish silage meal (FSM) in diets on the performance, carcass characteristics, meat quality, sensory analysis of meat and mortadella, and economic viability of growing and finishing pigs. In the digestibility assay, 16 barrows (33.20±4.93 kg) received diets with and without FSM. The fish silage had 39.01% crude protein and 4,032 kcal kg-1 ME. In the performance assay, 32 barrows (26.00±1.68 kg) were fed diets containing different inclusion levels of FSM (0, 25, 50, and 75%). FSM, obtained from the mixture (1:1) of fish silage with corn, showed a quadratic effect on average daily gain, and the best result was obtained with the inclusion level of 25.83%. The results for feed conversion and economic viability indicate that up to 25% FSM, corresponding to 5.87% of fish silage based on dry matter, can be used in the pig growing and finishing phases.

RESUMO Objetivou-se, com este trabalho, determinar o tamanho de amostra para análise de caracteres físicos e químicos de frutos maduros de maracujá-fedorento (Passiflora foetida). Foram colhidos, aleatoriamente, 150 frutos de plantas cultivadas em casa de vegetação. Em laboratório, esses frutos foram mensurados quanto a 12 caracteres (comprimento longitudinal; diâmetro equatorial; massa de fruto; massa de casca; massa de polpa; rendimento de polpa; peso de sementes por fruto; número de sementes por fruto; massa de sementes por fruto; acidez titulável; sólidos solúveis e ratio), sendo calculadas as medidas de tendência central e de dispersão e verificada sua normalidade. Determinou-se o intervalo de confiança bootstrap percentil, a partir da simulação de tamanho 4.000, para 150 tamanhos de amostra (1, 2, ..., 150 frutos) de cada caractere mensurado. Os caracteres físicos e químicos analisados em frutos maduros de P. foetida apresentam diferentes precisões experimentais e requerem diferentes tamanhos de amostra. Para o comprimento longitudinal, por exemplo, o diâmetro equatorial e a relação entre estes, seis frutos são suficientes para a estimação da média com um erro de estimação de 5% da média. Se forem considerados todos os caracteres físicos e químicos de frutos maduros, analisados neste trabalho, são necessários no mínimo 39 frutos, assumindo-se erro de 10% da estimativa da média.

ABSTRACT The objective of this study was to determine the sample size required to evaluate physical and chemical characters of Passiflora foetida fruits. A hundred and fifty fruits were randomly harvested from plants grown in a greenhouse. In the laboratory, these fruits were measured for 12 characters (length, equatorial diameter, fruit mass, bark mass, pulp mass, pulp yield, seed weight per fruit, number of seeds per fruit, seed mass per fruit, titratable acidity, soluble solids, and ratio) and the measures of central tendency and dispersion were calculated and checked for normality. The bootstrap percentile confidence interval was determined, from the simulation of 4,000, for 150 sample sizes (1, 2, ..., 150 fruits) measured for each character. The physical and chemical characteristics evaluated in mature fruits of P. foetida exhibit different experimental accuracies and require different sample sizes. To measure only the longitudinal length, equatorial diameter and the relationship among these six fruits are sufficient to estimate the average estimation error with a 5% average. If we consider all the physical and chemical characters of ripe fruit in this work, at least 39 fruits are required, assuming 10% error of the estimated average.

Abstract: The benign characteristics formerly attributed to Plasmodium vivax infections have recently changed owing to the increasing number of reports of severe vivax malaria resulting in a broad spectrum of clinical complications, probably including undernutrition. Causal inference is a complex process, and arriving at a tentative inference of the causal or non-causal nature of an association is a subjective process limited by the existing evidence. Applying classical epidemiology principles, such as the Bradford Hill criteria, may help foster an understanding of causality and lead to appropriate interventions being proposed that may improve quality of life and decrease morbidity in neglected populations. Here, we examined these criteria in the context of the available data suggesting that vivax malaria may substantially contribute to childhood malnutrition. We found the data supported a role for P. vivax in the etiology of undernutrition in endemic areas. Thus, the application of modern causal inference tools, in future studies, may be useful in determining causation.

In Brazil, more than 99% of malaria cases are reported in the Amazon, and the State of Amazonas accounts for 40% of this total. However, the accumulated experience and challenges in controlling malaria in this region in recent decades have not been reported. Throughout the first economic cycle during the rubber boom (1879 to 1912), malaria was recorded in the entire state, with the highest incidence in the villages near the Madeira River in the Southern part of the State of Amazonas. In the 1970s, during the second economic development cycle, the economy turned to the industrial sector and demanded a large labor force, resulting in a large migratory influx to the capital Manaus. Over time, a gradual increase in malaria transmission was observed in peri-urban areas. In the 1990s, the stimulation of agroforestry, particularly fish farming, led to the formation of permanent Anopheline breeding sites and increased malaria in settlements. The estimation of environmental impacts and the planning of measures to mitigate them, as seen in the construction of the Coari-Manaus gas pipeline, proved effective. Considering the changes occurred since the Amsterdam Conference in 1992, disease control has been based on early diagnosis and treatment, but the development of parasites that are resistant to major antimalarial drugs in Brazilian Amazon has posed a new challenge. Despite the decreased lethality and the gradual decrease in the number of malaria cases, disease elimination, which should be associated with government programs for economic development in the region, continues to be a challenge.

Plasmodium vivax radical cure requires the use of primaquine (PQ), a drug that induces haemolysis in glucose-6-phosphate dehydrogenase deficient (G6PDd) individuals, which further hampers malaria control efforts. The aim of this work was to study the G6PDd prevalence and variants in Latin America (LA) and the Caribbean region. A systematic search of the published literature was undertaken in August 2013. Bibliographies of manuscripts were also searched and additional references were identified. Low prevalence rates of G6PDd were documented in Argentina, Bolivia, Mexico, Peru and Uruguay, but studies from Curaçao, Ecuador, Jamaica, Saint Lucia, Suriname and Trinidad, as well as some surveys carried out in areas of Brazil, Colombia and Cuba, have shown a high prevalence (> 10%) of G6PDd. The G6PD A-202A mutation was the variant most broadly distributed across LA and was identified in 81.1% of the deficient individuals surveyed. G6PDd is a frequent phenomenon in LA, although certain Amerindian populations may not be affected, suggesting that PQ could be safely used in these specific populations. Population-wide use of PQ as part of malaria elimination strategies in LA cannot be supported unless a rapid, accurate and field-deployable G6PDd diagnostic test is made available.

Plasmodium vivax is the most widespread parasite causing malaria, being especially prevalent in the Americas and Southeast Asia. Children are one of the most affected populations, especially in highly endemic areas. However, there are few studies evaluating the therapeutic response of infants with vivax malaria. This study retrospectively evaluated the parasitaemia clearance in children diagnosed with vivax malaria during the first five days of exclusive treatment with chloroquine (CQ). Infants aged less than six months old had a significantly slower parasitaemia clearance time compared to the group of infants and children between six months and 12 years old (Kaplan-Meier survival analysis; Wilcoxon test; p = 0.004). The impaired clearance of parasitaemia in younger children with vivax malaria is shown for the first time in Latin America. It is speculated that CQ pharmacokinetics in young children with vivax malaria is distinct, but this specific population may also allow the detection of CQ-resistant parasites during follow-up, due to the lack of previous immunity.

Malaria is the most important parasitic disease worldwide, responsible for an estimated 225 million clinical cases each year. It mainly affects children, pregnant women and non-immune adults who frequently die victims of cerebral manifestations and anaemia. Although the contribution of the American continent to the global malaria burden is only around 1.2 million clinical cases annually, there are 170 million inhabitants living at risk of malaria transmission in this region. On the African continent, where Plasmodium falciparum is the most prevalent human malaria parasite, anaemia is responsible for about half of the malaria-related deaths. Conversely, in Latin America (LA), malaria-related anaemia appears to be uncommon, though there is a limited knowledge about its real prevalence. This may be partially explained by several factors, including that the overall malaria burden in LA is significantly lower than that of Africa, that Plasmodium vivax, the predominant Plasmodium species in the region, appears to display a different clinical spectrus and most likely because better health services in LA prevent the development of severe malaria cases. With the aim of contributing to the understanding of the real importance of malaria-related anaemia in LA, we discuss here a revision of the available literature on the subject and the usefulness of experimental animal models, including New World monkeys, particularly for the study of the mechanisms involved in the pathogenesis of malaria.

Apresentamos o caso de uma paciente do sexo feminino, que apresentou quadro de febre hemorrágica da dengue, evoluindo com icterícia e importantes alterações da coagulação. O diagnóstico de dengue foi realizado pela presença de anticorpos IgM antidengue (MAC-ELISA). Esta doença deveria ser considerada no diagnóstico diferencial das icterícias febris agudas.

We describe the case of a female patient who presented a condition of dengue hemorrhagic fever that evolved with jaundice and significant coagulation abnormalities. Dengue was diagnosed through the presence of anti-dengue IgM antibodies (MAC-ELISA). This disease needs to be taken into consideration in the differential diagnosis for acute febrile jaundice.