Resumo Objetivo Avaliar a qualidade de vida de pessoas que vivem com HIV/AIDS (PVHA) e fazem seguimento ambulatorial em um hospital universitário na região amazônica (Belém, PA). Métodos Este foi um estudo descritivo transversal. Os dados foram coletados em novembro e dezembro de 2019 aplicando um formulário com variáveis sociodemográficas e usando o instrumento específico WHOQOL-HIV Bref. As variáveis sociodemográficas foram analisadas usando estatística descritiva. A análise inferencial do instrumento WHOQOL-HIV Bref foi realizada usando o teste de correlação de Spearman entre os domínios da qualidade de vida. Resultados Foram entrevistados 208 pacientes, sendo 66,3% nascidos com o sexo biológico masculino, 67,3% heterossexuais e 57,2% com faixa etária de 36-55 anos. O maior escore médio foi encontrado no domínio espiritual (17,1±2,8) e o menor no domínio nível de independência (4,2±2,8). Em geral, foram observadas correlações moderadas positivas; só a correlação entre os domínios nível de independência e espiritual não foi estatisticamente significante (p>0,05). Conclusão Os resultados sugerem que os apoios social e religioso, emprego e acesso a serviços de saúde podem melhorar a qualidade de vida de PVHA na região amazônica. São necessárias mais pesquisas sobre a qualidade de vida de PVHA para aprimorar as políticas públicas igualitariamente e equanimemente no Brasil, especialmente na Amazônia Brasileira que tem tido um aumento contínuo no número de PVHA. HIVAIDS HIV AIDS (PVHA Belém, Belém (Belém PA. PA . PA) transversal 201 WHOQOLHIV WHOQOL descritiva 20 pacientes 663 66 3 66,3 masculino 673 67 67,3 572 57 2 57,2 3655 36 55 36-5 anos 17,1±2,8 17128 17 1 8 (17,1±2,8 4,2±2,8. 4228 4,2±2,8 4 (4,2±2,8) geral positivas p>0,05. p005 p p>0,05 0 05 (p>0,05) religioso Brasil 6 66, 67, 5 57, 365 36- 17,1±2, 1712 (17,1±2, 422 4,2±2, (4,2±2,8 p00 p>0,0 (p>0,05 17,1±2 171 (17,1±2 42 4,2±2 (4,2±2, p0 p>0, (p>0,0 17,1± (17,1± 4,2± (4,2±2 p>0 (p>0, 17,1 (17,1 4,2 (4,2± p> (p>0 17, (17, 4, (4,2 (p> (17 (4, (p (1 (4 (

Abstract Objective To evaluate the quality of life of people living with HIV/AIDS (PLWHA) and undergoing outpatient follow-up at a university hospital in the Amazon region (Belém, PA). Methods This was a cross-sectional descriptive study. Data were collected in November and December 2019 using a form with sociodemographic variables and the specific WHOQOL-HIV Bref instrument. Sociodemographic variables were analyzed using descriptive statistics. The inferential analysis of the WHOQOL-HIV Bref instrument was performed using the Spearman correlation test between the quality-of-life domains. Results A total of 208 patients were interviewed. They were born with male biological sex (66.3%), heterosexual (67.3%), and aged 36-55 years (57.2%). The highest mean score was found in the spiritual domain (17.1±2.8) and the lowest in the independence-level domain (4.2±2.8). In general, moderate positive correlations were observed; only the correlation between the independence level and spirituality domains was not statistically significant (p>0.05). Conclusion The results suggest that social and religious support, employment, and access to health services can improve the quality of life of PLWHA in the Amazon region. More research on the quality of life of PLWHA is necessary to improve public policies equitably and equally in Brazil, especially in the Brazilian Amazon where a continuous increase in the number of PLWHA has occurred. HIVAIDS HIV AIDS (PLWHA followup follow up Belém, Belém (Belém PA. PA . PA) crosssectional cross sectional study 201 WHOQOLHIV WHOQOL statistics qualityoflife 20 interviewed 66.3%, 663 66.3% , 66 3 (66.3%) 67.3%, 673 67.3% 67 (67.3%) 3655 36 55 36-5 57.2%. 572 57.2% 57 2 (57.2%) 17.1±2.8 17128 17 1 8 (17.1±2.8 independencelevel 4.2±2.8. 4228 4.2±2.8 4 (4.2±2.8) general observed p>0.05. p005 p p>0.05 0 05 (p>0.05) support employment Brazil occurred 66.3 6 (66.3% 67.3 (67.3% 365 5 36- 57.2 (57.2% 17.1±2. 1712 (17.1±2. 422 4.2±2. (4.2±2.8 p00 p>0.0 (p>0.05 66. (66.3 67. (67.3 57. (57.2 17.1±2 171 (17.1±2 42 4.2±2 (4.2±2. p0 p>0. (p>0.0 (66. (67. (57. 17.1± (17.1± 4.2± (4.2±2 p>0 (p>0. (66 (67 (57 17.1 (17.1 4.2 (4.2± p> (p>0 (6 (5 17. (17. 4. (4.2 (p> ( (17 (4. (p (1 (4

Resumen Objetivo Evaluar la calidad de vida de personas que viven con el VIH/SIDA (PVVS) y que realizan seguimiento ambulatorio en un hospital universitario de la región amazónica (Belém, estado de Pará). Métodos Se trató de un estudio descriptivo transversal. Los datos se recopilaron en noviembre y diciembre de 2019 mediante la aplicación de un formulario con variables sociodemográficas y la utilización del instrumento específico WHOQOL-HIV Bref. Se utilizó la estadística descriptiva para analizar las variables sociodemográficas. El análisis inferencial del instrumento WHOQOL-HIV Bref se realizó con la prueba de correlación de Spearman entre los dominios de la calidad de vida. Resultados Se entrevistaron 208 pacientes, de los cuales el 66,3 % era de sexo biológico masculino, el 67,3 % era heterosexual y el 57,2 % estaba dentro del grupo de edad de 36 a 55 años. La puntuación promedio más alta fue en el dominio espiritual (17,1±2,8) y la más baja en el dominio nivel de independencia (4,2±2,8). En general, se observaron correlaciones moderadas positivas. La única correlación que no fue estadísticamente significativa fue entre el dominio nivel de independencia y espiritual (p>0,05). Conclusión Los resultados sugieren que el apoyo social y religioso, el empleo y el acceso a los servicios de salud pueden mejorar la calidad de vida de PVVS en la región amazónica. Es necesario realizar más estudios sobre la calidad de vida de PVVS para mejorar las políticas públicas de forma igualitaria y ecuánime en Brasil, especialmente en la Amazonia brasileña que presenta un aumento continuo del número de PVVA. VIHSIDA VIH SIDA (PVVS Belém, Belém (Belém Pará. Pará . Pará) transversal 201 WHOQOLHIV WHOQOL HIV 20 pacientes 663 66 3 66, masculino 673 67 67, 572 57 2 57, 5 años 17,1±2,8 17128 17 1 8 (17,1±2,8 4,2±2,8. 4228 4,2±2,8 4 (4,2±2,8) general positivas p>0,05. p005 p p>0,05 0 05 (p>0,05) religioso Brasil PVVA 6 17,1±2, 1712 (17,1±2, 422 4,2±2, (4,2±2,8 p00 p>0,0 (p>0,05 17,1±2 171 (17,1±2 42 4,2±2 (4,2±2, p0 p>0, (p>0,0 17,1± (17,1± 4,2± (4,2±2 p>0 (p>0, 17,1 (17,1 4,2 (4,2± p> (p>0 17, (17, 4, (4,2 (p> (17 (4, (p (1 (4 (

Abstract Respiratory Syncytial Virus (RSV) poses a global health concern, particularly affecting young children, the elderly, and immunosuppressed individuals. RSV viral load is essential for understanding transmission, disease severity, prevention, and treatment. This retrospective study aimed to analyze the frequency rates and viral loads of RSV infections in different patient cohorts and age groups over an eight-year period in a university hospital in São Paulo, Brazil. This study analyzed 1380 Immunocompetent (IC) and Immunosuppressed (IS) patients with acute respiratory tract infections. IC included patients with chronic Heart Disease (HD), Primary Care service recipients (PC), and a subgroup suspected of having Severe Acute Respiratory Syndrome caused by Influenza A (H1N1)pdm09 virus (SARS H1N1). IS comprised transplant patients and those with HIV infection. Respiratory samples were collected between February 2005 and October 2013, with RSV detection and viral load quantification (Log10 copies of RNA/mL) using RT-qPCR. Overall RSV infection rate was 17.3 %, with higher rates in children (23.9 %) than in adults (12.9 %), particularly in children under two years of age (28.2 %). Children in the SARS H1N1 and PC subgroups had higher infection rates (16.4 % and 34.9 %, respectively), with the highest rate in PC children aged 1 to < 2 years (45.45 %). Adults with HD had a significantly higher frequency rate (27.83 %) than those in the SARS H1N1 (2.65 %) and IS (15.16 %) subgroups and higher hospitalization rate among adults under 65 years. RSV viral load ranged from 2.43 to 10.15 Log10 RNA copies/mL (mean ± SD 5.82 ± 2.19), with hospitalized patients exhibiting significantly higher viral loads (7.34 ± 1.9) than outpatients (4.38 ± 1.89). Elderly bone marrow transplant patients also had significantly higher viral loads (7.57 ± 2.41) than younger adults (5.12 ± 1.87). This study provides insights into the RSV infection patterns in different patient cohorts in Brazil. Further investigations are needed to understand susceptibility and risk factors associated with RSV infection. In conclusion, high RSV viral load among hospitalized patients could serve as a surrogate marker of disease severity. Additionally, patients with chronic heart disease deserve greater attention regarding complications associated with RSV infection. (RSV concern elderly individuals transmission severity prevention treatment eightyear eight year Paulo Brazil 138 (IC (IS HD, , (HD) PC, (PC) H1N1pdm09 HNpdm pdm09 H N pdm (H1N1)pdm0 H1N1. HN . H1N1) 200 2013 Log (Log1 RNA/mL RNAmL mL RTqPCR. RTqPCR RT qPCR. qPCR RT-qPCR 173 17 3 17. 23.9 239 23 9 (23. 12.9 129 12 (12. 28.2 282 28 (28. %. H1N 16.4 164 16 4 (16. 349 34 34. respectively, respectively respectively) 45.45 4545 45 (45.4 27.83 2783 27 83 (27.8 2.65 265 (2.6 15.16 1516 15 (15.1 6 243 43 2.4 1015 10 10.1 Log1 copiesmL mean 582 5 82 5.8 2.19, 219 2.19 19 2.19) 7.34 734 7 (7.3 1.9 4.38 438 38 (4.3 1.89. 189 1.89 89 1.89) 7.57 757 57 (7.5 2.41 241 41 5.12 512 (5.1 1.87. 187 1.87 87 1.87) conclusion Additionally 13 (HD (PC H1N1pdm0 pdm0 (H1N1)pdm 20 201 (Log 23. (23 12. (12 28. (28 16. (16 45.4 454 (45. 27.8 278 8 (27. 2.6 26 (2. 15.1 151 (15. 24 2. 101 10. 58 5. 21 2.1 7.3 73 (7. 1. 4.3 (4. 18 1.8 7.5 75 5.1 51 (5. H1N1pdm (2 (1 45. (45 27. (27 15. (15 7. (7 4. (4 (5 (

ABSTRACT Background: Some studies have suggested the importance of vitamin D [25(OH)D] in malaria clinical practice. The prevalence of 25(OH)D deficiency in the Amazon population is not well known, and there are few studies in patients with malaria. This study aimed to evaluate 25(OH)D serum levels in patients with malaria and determine their relationships with epidemiological, clinical, laboratory, and parasitemia data. Methods: An analytical cross-sectional study of 123 patients with malaria and 122 individuals without malaria was performed in Itaituba, Pará, Brazil, from January 2018 to October 2019, by evaluating sociodemographic, clinical-epidemiological, parasitological, and laboratory data and adopting a 5% significance level. Parametric tests (Student's t-test), non-parametric tests (Mann-Whitney U), and Spearman’s correlation ([rs], for non-parametric variables) were used according to the nature of the distribution of the variables. For the qualitative variables, Pearson's chi-square test, Fisher's exact test, and the G test were used. Spearman's correlation was used to compare the results of the 25(OH)D levels and blood counts performed among patients and the control group. Results: Malaria patients residing in a mining area had 25(OH)D serum levels that were significantly lower than those in the control group residing in the mining area, though both were within normal levels. Red blood cell counts had an inverse correlation with parasitemia (Plasmodium falciparum), and platelet levels had an inverse correlation with parasitemia (Plasmodium vivax). 25(OH)D deficiency was evidenced in Itaituba, in the state of Pará, which is an endemic area of malaria in the Amazon region.

ABSTRACT Objective: to describe the clinical-epidemiological profile of the care service at the Reference Center for Special Immunobiologicals of Hospital in the Amazon. Method: a descriptive study, of a quantitative approach and analyzed by means of the descriptive and inferential statistics. The Information System of the Reference Center for Special Immunobiologicals (former) and the Information System of the National Immunization Program (current) were the databases used, between 2006 and 2016. Results: 77,077 doses of immunobiological vaccines were administered; 25.2% corresponded to the inactivated influenza vaccine; chronic renal failure was the main indication (19%). The current system recorded 18,267 doses of immunobiological vaccines administered between the years 2014 to 2016; 37.8% of which were inactivated influenza vaccines; 42.5% of the indications were not reported, with HIV/AIDS being 18.2%. Infectologia foi a especialidade que mais encaminhou para vacinação (18,3%). Conclusion: the data accuracy has been compromised by the incompleteness in the information systems. We observed underutilization of the service by the local population.

RESUMEN: Objetivo: describir el perfil clínico-epidemiológico de la atención brindada por el Centro de Referencia para Inmunobiológicos Especiales de un Hospital de la Amazonía. Método: descriptivo con enfoque cuantitativo y analizado mediante estadística descriptiva e inferencial. El Sistema de Información del Centro de Referencia para Inmunobiológicos Especiales (antiguo) y el Sistema de Información del Programa Nacional de Inmunización (actual) se utilizaron como base de datos entre 2006 y 2016. Resultados: se administraron 77,077 dosis de inmunobiológicos; el 25,2% correspondió a la vacuna inactivada contra la influenza; La insuficiencia renal crónica fue la indicación principal (19%). El sistema actual registró 18.267 dosis de inmunobiológicos administradas entre los años 2014 y 2016; siendo que el 37,8% correspondió a la vacuna inactivada contra la influenza; El 42,5% de las indicaciones no fueron informadas, y el porcentaje informado de VIH / SIDA fue de 18,2%. La especialidad que más derivaciones realizó para vacunación fue la de infectología (18,3%). Conclusión: la precisión de los datos se vio comprometida por la falta de integridad en los sistemas de información. Se observó la subutilización del servicio por la población local.

RESUMO Objetivo: descrever o perfil clínico-epidemiológico do atendimento no Centro de Referência em Imunobiológicos Especiais de Hospital na Amazônia. Método: descritivo de abordagem quantitativa e analisado por meio da estatística descritiva e inferencial. O Sistema de Informação do Centro de Referência para Imunobiológicos Especiais (antigo) e Sistema de Informação do Programa Nacional de Imunização (atual) foram as bases utilizadas, entre 2006 e 2016. Resultados: foram administradas 77.077 doses de imunobiológicos; 25,2% corresponderam à vacina influenza inativada; insuficiência renal crônica foi a principal indicação (19%). O sistema atual registrou 18.267 doses de imunobiológicos administrados entre os anos de 2014 a 2016; sendo 37,8% correspondente à vacina influenza inativada; não foram informadas 42,5% das indicações, sendo HIV/AIDS 18,2%. Infectologia foi a especialidade que mais encaminhou para vacinação (18,3%). Conclusão: a acurácia dos dados foi comprometida pela falta de completude nos sistemas de informação. Observou-se subutilização do serviço pela população local.

ABSTRACTINTRODUCTION:This study aimed to evaluate basic sanitation and socioeconomic indicators, reported cases of malaria, and risk of contracting malaria in the Ananindeua municipality, State of Pará.METHODS:Data on basic sanitation and socioeconomic dimensions were taken from the Brazilian Institute of Geography and Statistics [ Instituto Brasileiro de Geografia e Estatística (IBGE)] 2010 census. Epidemiological malaria information was taken from the Epidemiological Malaria Surveillance Information System [ Sistema de Informação de Vigilância Epidemiológica de Malária (SIVEP/Malaria)], between 2003 and 2013 of the Ministry of Health and from the SIVEP/Malaria forms of the municipality's Endemic Diseases Unit for 2,013 cases.RESULTS:Our data do not confirm the correlation among indicators of basic sanitation, socioeconomic conditions, and water supply with malaria cases. Of the 1,557 cases evaluated, most were caused by Plasmodium vivax , with rare cases of Plasmodium falciparum and mixed infections. There were 756 notifications in 2003. The number of reported cases was sharply reduced between 2006 and 2012, but a 142-case outbreak occurred in 2013. Ananindeua municipality's Annual Parasite Index indicated low risk in 2003 and no risk in other years, and the 2,013 cases were predominantly male individuals aged ≥40 years.CONCLUSIONS:Our data confirm the non-endemicity of malaria in the Ananindeua municipality, as the Annual Parasite Indices described for the years 2004-2013 classify it as a risk-free area. However, the 2013 outbreak indicates the need to strengthen prevention, surveillance, and control activities to reduce the risk of new outbreaks and consequent economic and social impacts on the population.

Malaria remains a major public health problem in Brazil where Plasmodium vivax is the predominant species, responsible for 82% of registered cases in 2013. Though benign, P. vivax infection may sometimes evolve with complications and a fatal outcome. Here, we report a severe case of P. vivax malaria in a 35-year-old Brazilian man from a malaria endemic area, who presented with reversible myocarditis.

INTRODUÇÃO: Esse estudo avaliou a resposta à revacinação contra hepatite B (HB) entre profissionais de saúde (PS) com anti-HBs negativo após esquema de vacinação completo. MÉTODOS: PS cujo anti-HBs foi realizado > 90 dias após a última dose do esquema vacinal receberam 4ª dose da vacina. O anti-HBs foi repetido 30-90 dias após. RESULTADOS: Entre 170 PS, 126 (74,1%) tiveram anti-HBs positivo após a 4ª dose. CONCLUSÕES: Repetir o teste sorológico após a 4ª dose é estratégia prática caso o anti-HBs tenha sido realizado > 90 dias após a última dose da vacina.

INTRODUCTION: This study aimed to evaluate the response to hepatitis B (HB) revaccination of healthcare workers (HCW) who are negative for antibodies to HB surface antigen (anti-HBs) after a complete vaccination series. METHODS: HCW whose anti-HBs test was performed > 90 days after a HB vaccination course were given a 4th dose. A post-vaccination test was done within 30 to 90 days. RESULTS: One hundred and seventy HCW were enrolled: 126 (74.1%) were anti-HBs-positive after the 4th dose. CONCLUSIONS: Rechecking anti-HBs after the 4th HB vaccine dose is a practical approach in case of post-vaccination tests performed >90 days after the full vaccination course.

O perfil dos indivíduos, a situação vacinal e as vacinas recomendadas aos viajantes que procuram o serviço médico de orientação pré-viagem do Ambulatório dos Viajantes do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo foram analisados no presente estudo. Dos 445 viajantes estudados, 51% eram mulheres; a mediana de idade foi de 33,5 anos; 51% viajavam a trabalho e 39,5% por lazer. Destinos mais procurados: África (47%); Ásia (31,7%); América do Sul (21,4%). Trezentos e oitenta e cinco (86,5%) viajantes tiveram indicação de vacinação para viagem. Principais vacinas recomendadas: febre tifóide (55,7%), difteria-tétano (54,1%), hepatite A (46,1%), hepatite B (44,2%), febre amarela (24,7%). A orientação pré-viagem mostrou-se importante não só para indicar as vacinas recomendadas para a viagem, mas também como oportunidade para atualização das vacinas de rotina.

TThe profile and vaccination status of travelers seeking pre-travel medical advice at the Travelers' Clinic of Hospital das Clínicas, University of São Paulo School of Medicine, and the vaccines recommended for them, were analyzed in the present study. Among the 445 travelers who were studied, 51% were women, the median age was 33.5 years, 51% were traveling on business and 39.5% were traveling for leisure purposes. The destinations most sought were Africa (47%), Asia (31.7%) and South America (21.4%). Vaccination before traveling was recommended for 385 (86.5%) of the travelers. The main vaccines recommended were against typhoid fever (55.7%), diphtheria-tetanus (54.1%), hepatitis A (46.1%), hepatitis B (44.2%) and yellow fever (24.7%). The pre-travel guidance was shown to be important not only for indicating the vaccines recommended for the trip, but also as an opportunity to update routine vaccinations.