Autor: projetomina

Malaria causes significant morbidity and mortality in children under 5 years of age in sub-Saharan Africa and the Asia-Pacific region. Neonates and young infants remain relatively protected from clinical disease and the transplacental transfer of maternal antibodies is hypothesized as one of the protective factors. The adverse health effects of Plasmodium vivax malaria in early childhood–traditionally viewed as a benign infection–remain largely neglected in relatively low-endemicity settings across the Amazon. Overall, 1,539 children participating in a birth cohort study in the main transmission hotspot of Amazonian Brazil had a questionnaire administered, and blood sampled at the two-year follow-up visit. Only 7.1% of them experienced malaria confirmed by microscopy during their first 2 years of life– 89.1% of the infections were caused by P. vivax. Young infants appear to be little exposed to, or largely protected from infection, but children >12 months of age become as vulnerable to vivax malaria as their mothers. Few (1.4%) children experienced ≥4 infections during the 2-year follow-up, accounting for 43.4% of the overall malaria burden among study participants. Antenatal malaria diagnosed by microscopy during pregnancy or by PCR at delivery emerged as a significant correlate of subsequent risk of P. vivax infection in the offspring (incidence rate ratio, 2.58; P = 0.002), after adjusting for local transmission intensity. Anti-P. vivax antibodies measured at delivery do not protect mothers from subsequent malaria; whether maternal antibodies transferred to the fetus reduce early malaria risk in children remains undetermined. Finally, recent and repeated vivax malaria episodes in early childhood are associated with increased risk of anemia at the age of 2 years in this relatively low-endemicity setting. Antenatal infection increases the risk of vivax malaria in the offspring and repeated childhood P. vivax infections are associated with anemia at the age of 2 years. Read the article.

This article aims to examine agreement of pre-pregnancy weight, pregnancy weight, height and systolic (SBP) and diastolic (DBP) blood pressure measurements recorded on antenatal record cards with the same information obtained in the MINA-Brazil longitudinal study. 428 pregnant women who participated in the MINA-Brazil study and had an antenatal card at time of childbirth were selected. Concordance analysis
of the data used Lin’s correlation coefficient and Bland-Altman analysis. There was moderate agreement on self-reported pre-pregnancy weight (0.935) and height (0.913) information, and substantial agreement on the pregnant women’s weight in the second (0.993) and third (0.988) trimesters of pregnancy. Little agreement was found on SBP and DBP measured in the second (SBP = 0.447; DBP = 0.409) and third (SBP = 0.436; DBP = 0.332) trimesters of pregnancy. Anthropometric measurements showed strong agreement. There was weak agreement between blood pressure measurements, which may relate both to the variability and the standardisation of these measurements, suggesting the need for continued training of antenatal teams in primary health care. Read the article.

This article examines constitutive elements of contemporary domestic cooking practices among women who live in the urban area of Cruzeiro do Sul, Acre, Brazil. We conducted semi-structured interviews with 16 self-identified women and mothers, who cook at home at least once a day. Here, we offer an in-depth analysis of our qualitative data, having coded our interviews with attention to the elements of cooking practices (i.e., understandings, procedures, engagements, materials, competencies, and meanings). Our findings reveal that cooking practices are not only gendered but also play a vital part in the construction and affirmation of these Brazilian women’s identity, as indicated by how they negotiate elements of their domestic culinary practices regarding financial availability (materials), time availability (procedures), sociocultural gender norms (competences), and aspirations and personal desires (understandings). Read from a feminist perspective, we conclude that tensions surrounding the performance of femininity occurred when buying food at the supermarket or participating in the practice of “comprar fiado” in small neighborhood markets; preparing menus to meet familial preferences; preparing meals quickly and with little effort; offering the best foods to her children and husband; and showing affection and appreciation to those they feed. Read the article.

To investigate the factors associated with continued breastfeeding (BF). All the parturients at a local maternity from July 2015 to June 2016 were invited to participate in a cohort study in Cruzeiro do Sul, Acre. Data on socioeconomic, demographic, obstetric and neonatal of the babies were obtained for the interview. Multiple Poisson regression models with robust variance were used to estimate the prevalence ratio (PR) and 95% confidence intervals (95%CI). Among the 1551 mothers contacted, 305 lived in the rural area, leaving 1,246 eligible mothers living in urban area. For the 1-year cohort follow-up, 74 non-twin babies were assessed. Most of the mothers reported to have mixed skin color (79%), are over 21 years old (72°%o), more than 10 years of schooling (72%>) and with unpaying job (54%). The children’s age ranged from 10 to 15 months. The frequency of continued breastfeeding was 69,4%> (95%oCI=66.0-72.6). The factors negatively associated with continued breastfeeding were the use of bottle feeding (PR=1.44; CI95%> =1,33-1.56) and pacifier (PR=2.54; CI95%> =1.98-3.27), after adjusting for maternal age and socioeconomic variables. The frequency of continued breastfeeding in Cruzeiro do Sul was higher than the national estimates, but below the WHO recommendations for breastfeeding up to two years of age. Read the article.

This article aims to assess the consumption of ultra-processed foods (UPFs) during the first year of life and associated factors. We analyzed data from the one-year follow-up of the MINA-Brazil birth cohort. Socioeconomic, demographic and obstetric data were collected in the baseline study and at one-year follow-up (n = 774). Dietary intake during the previous day was assessed using a food frequency questionnaire to determine UPF consumption. Multiple Poisson regression with robust variance was performed to estimate prevalence ratios (PR) and confidence intervals (95%CI) for factors associated with the consumption of ≥ 3 UPFs. Prevalence of UPF consumption and consumption of ≥ 3 UPFs was 87.5% and 40.5%, respectively. Consumption of ≥ 3 UPFs was associated with lower maternal education (≤ 9 years of schooling [PR: 2.02 95%CI 1.42; 2.87] and between 10-12 years of schooling [PR: 1.55, 95%CI 1, 11; 2.14]), below-average wealth index (PR: 1.26, 95%CI 1.04; 1.53), and having a teenage mother (PR:1.19, 95%CI 1.00; 1.49). Lack of dietary diversity was inversely associated with the outcome (RP: 0,65, IC95% 0,51; 0,81). The consumption of ≥ 3 UPFs was associated with lower wealth index, education and maternal age. Dietary diversity was associated with higher levels of UPF consumption. Read the article.

Brazil is among the top ten countries in preterm delivery worldwide. This study assesses the factors associated with preterm birth in the Western Brazilian Amazon. A population-based cross-sectional study was held between July 2015 to June 2016 in Cruzeiro do Sul, Brazilian Amazon. A total of 1525 births were included in this analysis. Preterm birth was defined as births at gestational age < 37 weeks. A stepwise multiple logistic regression was used to identify factors associated with preterm delivery. The prevalence rate of preterm birth was 7.9% (n = 120; 95% CI: 6.5–9.3). After adjusting for confounding factors, a positive association with preterm birth was observed for pregnant women who completed less than six antenatal care visits (OR: 2.93; 95% CI: 1.89–4.56), who had a birth interval of < 18 months (OR: 2.65; 95% CI: 1.04–6.75), and who experienced bleeding (OR: 2.17; 95% CI: 1.39–3.38) and hypertension during pregnancy (OR: 1.74; 95% CI: 1.07–2.82). Factors associated with preterm birth in the Western Brazilian Amazon were mostly related to the aspects of health care provided to women, and thus could be prevented. Proper, timely, and regular antenatal care visits can help reduce adverse outcomes, such as hypertension and bleeding. Read the article.

This study investigated the HC predictors in the first year using data from the Maternal and Child Health and Nutrition in Acre (MINA-Brazil) study carried out in Cruzeiro do Sul, Acre State, Western Brazilian Amazon. We enrolled 1246 mother-infant pairs at birth, as previously described, and 774 (52% female) took part in the 1-year follow-up study from August 2016 to July 2017, when they were 10-15 months of age. The baseline survey at birth provided data on the mother’s and infant’s health conditions. The follow-up visit detailed the child’s health profile and anthropometric status. Structured questionnaires, administered by trained researchers, collected data on the participants’ sociodemographic information, the child’s health conditions and morbidity and feeding practices in early childhood. Perinatal and birth data were collected from hospital records. The participants, and those lost to follow-up at 1 year, had similar profiles with regard to maternal education, primiparous mothers, delivery methods, low birthweight and the children’s sex. Read the article.

O objetivo deste estudo foi investigar os fatores associados aos níveis pressóricos em gestantes participantes do Estudo MINA-Brasil, inscritas no pré-natal da Estratégia de Saúde da Família em Cruzeiro do Sul, Acre, Amazônia Ocidental Brasileira. Modelos múltiplos de regressão linear foram utilizados, adotando-se nível de significância de 5%. A maioria das gestantes participantes tinha média de idade de 24 anos (DP 6,3), 44,0% eram primigestas e 59,1% das gestantes apresentaram ganho de peso gestacional semanal excessivo. A ocorrência de hipertensão arterial foi de 0,7%. Os fatores associados positivamente aos níveis de pressão arterial sistólica foram: índice de massa corporal pré-gestacional (β = 0,984, IC95%: 0,768-1,200) e ganho de peso gestacional semanal (β = 6,816, IC95%: 3,368-10,264). Para os níveis de pressão arterial diastólica foram positivamente associados idade da gestante (β = 0,111, IC95%: 0,002-0,221), escolaridade (β = 2,194, IC95%: 0,779-3,609), índice de massa corporal pré-gestacional (β = 0,589, IC95%: 0,427-0,751) e ganho de peso gestacional semanal (β = 3,066, IC95%: 0,483-5,650). Esses resultados reforçam a necessidade de maior atenção pré-natal no cuidado materno para prevenção de distúrbios hipertensivos no final da gravidez. Leia o artigo.