Alanderson Alves Ramalho

Consumo regular de frutas e hortaliças por estudantes universitários em Rio Branco, Acre, Brasil: prevalência e fatores associados

This cross-sectional study with university students examined the prevalence of regular consumption of fruits and vegetables and associated factors among students at a Federal university in Rio Branco, Acre State, Brazil. 863 undergraduates were interviewed in 2010. Overall prevalence of regular consumption of fruits and vegetables was 14.8%. Factors associated with regular consumption of fruits and vegetables were: socioeconomic classes A and B (PR = 1.70; 95%CI: 1.10-2.62), living with a partner (PR = 1.53; 95%CI: 1.02-2.29), regular physical activity (PR = 1.69; 95%CI: 1.11-2.56), and consumption of fast food twice a week or less (PR = 1.49; 95%CI: 1.04-2.13). A minority of the students met the recommendation to consume fruits and vegetables 5 or more days a week. Regular fruit and vegetable consumption was associated with socioeconomic status and healthy habits such as physical exercise and low consumption of fast food.

Epidemiology and Control of Child Toxocariasis in the Western Brazilian Amazon – A Population-Based Study

Toxocara spp. infection and the seroconversion rate in the Amazon have been poorly investigated. This study analyzed individual and household-level risk factors for the presence of IgG antibodies to Toxocara spp. in urban Amazonian children over a period of 7 years and evaluated the seroconversion rates over a 1-year follow-up. In children < 59 months of age, the overall prevalence rate was 28.08% in 2003 and 23.35% in 2010. The 2010-2011 seroconversion rates were 13.90% for children 6-59 months of age and 12.30% for children 84-143 months of age. Multilevel logistic regression analysis identified child age, previous wheezing, and current infection with hookworm as significant associated factors for Toxocara spp. seropositivity in 2003. In 2010, age, previous helminthiasis, and having a dog were associated with seropositivity, whereas having piped water inside the household was a protective factor. Control programs mainly need to target at-risk children, water quality control, and animal deworming strategies.

Seroprevalence and Seroconversion of Dengue and Implications for Clinical Diagnosis in Amazonian Children

This study aimed to evaluate the prevalence of serum IgG dengue in children in an Amazonian population, to assess the seroconversion rate in 12 months, and to estimate how many seropositive children had a prior clinical diagnosis of dengue. We conducted a population-based study between 2010 and 2011, with children aged 6 months to 12 years that were living in the urban area of a small town in the Brazilian Amazon. The prevalence of IgG antibodies against dengue antigens was determined by indirect ELISA technique, and seronegative children were reexamined after 12 months to determine seroconversion rates. Results showed seroprevalence of IgG antibodies against dengue type of 2.9%, with no significant association between age, race, and sex. In seropositive children, only 8.4% had received a clinical diagnosis of dengue, and the ratio of clinically diagnosed cases and subclinical cases was 1 : 11. The seroconversion rate between 2010 and 2011 was 1.4% (CI 3.8% to 35.1%). The seroprevalence of dengue in this pediatric population was low, and the vast majority of cases were not clinically detected, suggesting a difficulty in making the clinical diagnosis in children and a high frequency of asymptomatic infections.

Evolution of Socioeconomic Conditions and Its Relation to Spatial-Temporal Changes of Giardiasis and Helminthiasis in Amazonian Children.

This study analyzed the evolution of socioeconomic, sanitary, and personal factors as well as spatiotemporal changes in the prevalence of helminthiasis and giardiasis in urban Amazonian children between 2003 and 2011. Child age, lack of sanitation, and lack of access to bottled water were identified as significant associated factors for helminthiasis and giardiasis. There was an overall improvement in socioeconomic and sanitary conditions in the city resulting in decreased helminth prevalences from 12.42 to 9.63% between 2003 and 2010, but the prevalence increased to 15.03% in 2011 due to migratory movement and unstable sanitary conditions. As for Giardiasis, socioeconomic and environmental changes were not enough to reduce prevalence (16% in 2003 and 23% in 2011). Spatial analysis identified a significant cluster for helminthiasis in an area of poor housing conditions. Control programs in the Amazon need to target high-risk areas focusing changes in sanitation, water usage, and health education.

Fatores associados ao uso de medicamentos na gestação em primigestas no Município de Rio Branco, Acre, Brasil

Estudio transversal con 887 primigestas para analizar los factores asociados al consumo de medicamentos durante el embarazo en Rio Branco, Acre, Brasil. La informacion se baso en entrevistas y tarjeta prenatal. Los medicamentos se calificaron de acuerdo con el sistema anatomico terapeutico quimico (ATC), de la Organizacion Mundial de la Salud y con la categoria de riesgo del Food and Drug Administration (Estados Unidos). La media de edad fue de 21 anos; la media del uso de medicamentos fue de un 2,42; los medicamentos mas consumidos fueron los antianemicos (47,5%), los suplementos y vitaminas (18,7%), analgesicos (13,8%) y antibioticos (10,5%). En la clasificacion de riesgo, un 69,3% pertenecian a la categoria A; 22,3% a B; 7,6% a C y 0,8% a la D. La posibilidad de haber estado expuestas al riesgo en el consumo de medicamentos fue mayor en primigestas en la unidad B (OR = 2,10, IC95%: 1,26-3,50), con edades entre 19 y 24 anos (OR = 2,79, IC95%: 1,58-4,93) y con prescripcion (OR = 1,86, IC95%: 1,18-2,95). Los medicamentos esenciales fueron utilizados con menos frecuencia en las mujeres con mayores ingresos de los hogares (OR = 0,63, IC95%: 0,42-0,96) y que realizaron el cuidado prenatal en una red clinica privada (OR = 0,53, IC95%: 0,38- 0,74).This cross-sectional study in a sample of 887 primigravidae in Rio Branco, Acre State, Brazil aimed to analyze factors associated with the use of medicines during the first pregnancy. Information was obtained from interviews and prenatal cards. Medicines were classified according to the Anatomical Therapeutic Chemical (ATC) Classification System of the World Health Organization and risk categories according to the U.S. Food and Drug Administration. Mean age was 21 years and mean number of medicines used was 2.42. The most frequently consumed medicines were antianemics (47.5%), supplements and vitamins (18.7%), analgesics (13.8%), and antibiotics (10.5%). In the risk categorization, 69.3% belonged to category A, 22.3% to B, 7.6% to C, and 0.8% to D. The odds of having used risky medicines were higher among primigravidae in unit B (OR = 2.10; 95%CI: 1.26-3.50), in the 19 to 24-year age bracket (OR = 2.79; 95%CI: 1.58-4.93), and in the presence of a medical prescription (OR = 1.86; 95%CI: 1.18-2.95). Essential drugs were less used by women with higher family income (OR = 0.63; 95%CI: 0.42-0.96) and those who had received private prenatal care (OR = 0.53; 95%CI: 0.38-0.74).Estudo transversal, envolvendo 887 primigestas com o objetivo de analisar os fatores associados ao uso de medicamentos na gestacao no Municipio de Rio Branco, Acre, Brasil. As informacoes tiveram como base uma entrevista e o cartao de pre-natal. Os medicamentos foram classificados de acordo com o Sistema Anatomico Terapeutico Quimico (ATC), da Organizacao Mundial da Saude, e com a categoria de risco do Food and Drug Administration (Estados Unidos). A media de idade foi 21 anos, a media do uso de medicamentos foi 2,42; os medicamentos mais consumidos foram os antianemicos (47,5%), suplementos e vitaminas (18,7%), analgesicos (13,8%) e antibioticos (10,5%). Na categorizacao de risco, 69,3% pertenciam a categoria A; 22,3% a B; 7,6% a C e 0,8% a D. A chance de ter sido exposta a utilizacao de medicamentos de risco foi maior nas primigestas na unidade B (RC = 2,10; IC95%: 1,26-3,50), na faixa etaria de 19 a 24 anos (RC = 2,79; IC95%: 1,58-4,93) e com prescricao medica (RC = 1,86; IC95%: 1,18-2,95). Os medicamentos essenciais foram menos utilizados entre as mulheres com maior renda familiar (RC = 0,63; IC95%: 0,42-0,96), e que realizaram o pre-natal na rede privada (RC = 0,53; IC95%: 0,38-0,74).

Anomalias congênitas em nascidos vivos

Objective: To analyze the prevalence and factors potentially associated with congenital anomalies in a municipality of the State of Acre. Methods: Descriptive cross-sectional study of data from the Live Birth Information System (Sistema de Informacoes sobre Nascidos Vivos – SINASC) of the municipality of Rio Branco, Acre, Brazil, from 2001 to 2013. The outcome variable was the presence of congenital anomalies and the independent variables were related to the mother and the live birth. Odds Ratios (OR) and Confidence Intervals of 95% were estimated by logistic regression. Results: The prevalence of congenital anomalies was 0.2% in live births in the analyzed period, and the most frequent were musculoskeletal deformities (41.3%) followed by malformations of the nervous system (17.9%); they were associated with the age of the mother <15 and ≥35 years old (OR 1.72, 95%CI 1.03, 2.87), cesarean section (OR 1.85, 95%CI 1.29, 2.65), lower Apgar score at 1 (OR 3.54, 95%CI 1.69, 7.42) and 5 minutes (OR 13.65, 95%CI 4.00, 46.61) and birth weight ≤1.499g (OR 5.09; 95%CI 2.32, 11.19). Conclusion: The chance of having congenital anomaly was higher in the live births of mothers aged <15 and ≥35 years old; preterm births with less than 32 gestational weeks; cesarean births; live births who presented a degree of severe difficulty for Apgar 1 and for Apgar 5, and neonates who presented extreme low weight.

FARMACOCINÉTICA E MECANISMOS DE TERATOGENICIDADE DOS MEDICAMENTOS NA GESTAÇÃO: UMA REVISÃO DA LITERATURA.

The presence of emerging contaminants in surface Physiological changes that occur during a gestational period on a female organism are greatly explored by researchers and it is well elucidated by scientific literature, however, the theme: pharmacokinetics and mechanisms of teratogenicity by medicines on female organisms passing by physiological changes, it is still poorly explored. The research’s purpose was to review and contribute to adding scientific knowledge about pharmacokinetics and mechanisms of teratogenicity by drugs used during gestation.

Stunting in children under five years old is still a health problem in the Western Brazilian Amazon: a population-based study in Assis Brasil, Acre, Brazil

Despite the process of nutritional transition in Brazil, in some places, such as the Amazon region, stunting is still an important public health problem. We identified the prevalence and factors associated with stunting in children under five years old residing in the urban area of Assis Brasil. A survey was conducted in which a questionnaire on socioeconomic, maternal and childrens conditions was applied, and height or length was measured. The children with height for age index below -2 Z-scores were considered stunted, according to the criteria by the World Health Organization. Four hundred and twenty-eight children were evaluated. Of these, 62 were stunted. Factors associated with stunting, according to adjusted models, were: the presence of open sewer, the wealth index for households, the receipt of governmental financial aid and the mothers height, age and education. Therefore, it was observed that family and the mothers characteristics as well as environmental and socioeconomic factors were closely related to the occurrence of stunting in the population studied, and such nutritional disturbance is still a health problem in the Brazilian Amazon.

Association between malaria and anemia in an urban area with Plasmodium transmission: Mâncio Lima, Acre State, Brazil

El objetivo de este trabajo es analizar la prevalencia de anemia atribuible a la malaria en una poblacion urbana, residente en el Municipio de Mâncio Lima, Acre, Brasil. Se trata de un estudio de cohorte no-concurrente con 1.167 personas acompanadas por tres meses anteriores a la fecha de la entrevista a traves de datos del SIVEP-Malaria. Se calcularon las medidas de frecuencia y la prevalencia de anemia en pacientes con y sin historial de malaria reciente, conforme las variables de interes. Los resultados mostraron que un 50,2% de los individuos eran de sexo masculino y 67,96% se encontraban en la franja de edad de 15 anos o mas. La prevalencia general de anemia fue de un 7,1%, siendo mayor en la franja de edad de 6 meses hasta 5 anos de edad. En relacion con el historial de malaria reciente, se verifico que un 8,3% de los hombres que tuvieron malaria presentaron anemia. En general, la prevalencia de anemia atribuible a la malaria fue nula, excepto para los hombres (2,4%) y en el barrio Cobal (51,4%). Los resultados demuestran baja prevalencia de anemia y que la contribucion de la malaria a la anemia existe solamente en hombres y areas geograficas especificas.The aim of this study was to analyze the prevalence of malaria-attributable anemia in the urban population of Mâncio Lima, Acre State, Brazil. This was a non-concurrent cohort study of 1,167 persons followed for the three months prior to the interview using data from the SIVEP-Malaria database. Anemia frequency and prevalence rates were calculated in patients with and without a recent history of malaria, according to target variables. 50.2% of the individuals were males, and 67.96% were 15 years or older. Overall anemia prevalence was 7.1%, higher in the 6 months to 5 years age bracket. Some 8.3% of men with a recent history of malaria presented anemia. Overall, prevalence of malaria-attributable anemia was negligible, except in men (2.4%) and the Cobal neighborhood (51.4%). The results showed that anemia prevalence was low and that malarias contribution to anemia only existed in men and in specific geographic areas.

Asociación entre malaria y anemia en un área urbana de transmisión del Plasmodium : Mâncio Lima, Acre, Brasil

El objetivo de este trabajo es analizar la prevalencia de anemia atribuible a la malaria en una poblacion urbana, residente en el Municipio de Mâncio Lima, Acre, Brasil. Se trata de un estudio de cohorte no-concurrente con 1.167 personas acompanadas por tres meses anteriores a la fecha de la entrevista a traves de datos del SIVEP-Malaria. Se calcularon las medidas de frecuencia y la prevalencia de anemia en pacientes con y sin historial de malaria reciente, conforme las variables de interes. Los resultados mostraron que un 50,2% de los individuos eran de sexo masculino y 67,96% se encontraban en la franja de edad de 15 anos o mas. La prevalencia general de anemia fue de un 7,1%, siendo mayor en la franja de edad de 6 meses hasta 5 anos de edad. En relacion con el historial de malaria reciente, se verifico que un 8,3% de los hombres que tuvieron malaria presentaron anemia. En general, la prevalencia de anemia atribuible a la malaria fue nula, excepto para los hombres (2,4%) y en el barrio Cobal (51,4%). Los resultados demuestran baja prevalencia de anemia y que la contribucion de la malaria a la anemia existe solamente en hombres y areas geograficas especificas.The aim of this study was to analyze the prevalence of malaria-attributable anemia in the urban population of Mâncio Lima, Acre State, Brazil. This was a non-concurrent cohort study of 1,167 persons followed for the three months prior to the interview using data from the SIVEP-Malaria database. Anemia frequency and prevalence rates were calculated in patients with and without a recent history of malaria, according to target variables. 50.2% of the individuals were males, and 67.96% were 15 years or older. Overall anemia prevalence was 7.1%, higher in the 6 months to 5 years age bracket. Some 8.3% of men with a recent history of malaria presented anemia. Overall, prevalence of malaria-attributable anemia was negligible, except in men (2.4%) and the Cobal neighborhood (51.4%). The results showed that anemia prevalence was low and that malarias contribution to anemia only existed in men and in specific geographic areas.