Victor Delpizzo Castagno

Prevalence of Chagas disease among pregnant women in the southern region of Rio Grande do Sul

Anti-Trypanosoma cruzi antibodies in the umbilical cord of 351 parturients in the city of Pelotas, Rio Grande do Sul were investigated to determine the prevalence of Chagas disease among pregnant women. One case was identified (0.3%), without detection of congenital transmission. This highlights the importance of investigating Chagas disease among pregnant women living in or originating from endemic areas.

Prevalence of asthenopia in children: a systematic review with meta-analysis☆

OBJECTIVE To estimate the prevalence of asthenopia in 0-18 year-old children through a systematic review and meta-analysis of prevalence studies. SOURCES Inclusion criteria were population-based studies from 1960 to May of 2014 reporting the prevalence of asthenopia in children. The search was performed independently by two reviewers in the PubMed, EMBASE, and LILACS databases, with no language restriction. This systematic review was performed in accordance with the Cochrane Collaboration guidelines and the PRISMA Statement. Downs and Black score was used for quality assessment. SUMMARY OF FINDINGS Out of 1692 potentially relevant citations retrieved from electronic databases and searches of reference lists, 26 were identified as potentially eligible. Five of these studies met the inclusion criteria, comprising a total of 2465 subjects. Pooled prevalence of asthenopia was 19.7% (12.4-26.4%). The majority of children with asthenopia did not present visual acuity or refraction abnormalities. The largest study evaluated 1448 children aged 6 years and estimated a prevalence of 12.6%. Associated risk factors were not clearly established. CONCLUSION Although asthenopia is a frequent and relevant clinical problem in childhood, with potential consequences for learning, the scarcity of studies about the prevalence and clinical impact of asthenopia hinders the effective planning of public health measures.

Shortage of ocular health care in the public system: a population-based study

This cross-sectional population-based study investigated the prevalence of eye care services utilization and the association with socioeconomic and demographic factors, need for health care, and type of service payment. The study evaluated 2,960 adults aged 20 and older. In the previous 5 years, 46% of the sample and 30% of those aged 50 and older had not visited an eye care service. Among the persons who used a service, 18% went to an optical store and only 17% used the public health system. The main reason for using eye care services was poor vision (69.5%). Lack of money (29%) and time (24.6%) were the most frequently cited reasons for non-utilization. Age, education, and economic status were directly associated with the outcome. Female gender, cataract, glaucoma, prescription eyewear, and private appointments were also associated with the outcome. It is necessary to increase the public health systems role, integrating ocular health with all levels of health care, expanding participation by other health professionals, and intensifying screening and prevention of eye problems.

Asthenopia in schoolchildren

Objective To assess asthenopia prevalence and associated factors in schoolchildren aged 6–16. Methods This was a cross-sectional study of all children attending the first to eighth grades at two public schools in the urban region of a medium-sized town in Southern Brazil between April and December 2012. A questionnaire on socioeconomic and cultural matters was answered by parents, while the children answered a questionnaire on asthenopia-related symptoms. The children underwent a complete visual function examination, including measurement of visual acuity, refraction test, cover test, stereopsis, heterophoria assessment, near point of convergence, and accommodative convergence/accommodation ratio. Results Asthenopia prevalence was 24.7% in a total sample of 964 children. Visual acuity of 20/25 or better in both eyes was found in 92.8% of the children. The stereopsis test was normal in 99.4% of them, and some kind of strabismus was found in 3.5%. About 37.8% had astigmatism, 71.6% had mild hyperopia, 13.6% had moderate hyperopia, and 6.1% were myopic. Near point of convergence was abnormal in 14.0% of the children, and the accommodative convergence/accommodation ratio was found to be altered in 17.1% of them. Conclusion Children and adolescents have expressive prevalence of asthenopia. The prevalence of visual function alterations does not differ from the general population, and, therefore, they are not prerequisites. It is very important that its mechanisms and risk factors be better defined. Health professionals need to be on the lookout for complaints of visual fatigue because of its potential to influence learning and school performance.

Hyperopia: a meta-analysis of prevalence and a review of associated factors among school-aged children

BackgroundStudies show great variability in the prevalence of hyperopia among children. This study aimed to synthesize the existing knowledge about hyperopia prevalence and its associated factors in school children and to explore the reasons for this variability.MethodsThis systematic review followed PRISMA guidelines. Searching several international databases, the review included population- or school-based studies assessing hyperopia through cycloplegic autorefraction or cycloplegic retinoscopy. Meta-analysis of hyperopia prevalence was performed following MOOSE guidelines and using the random effects model.ResultsThe review included 40 cross-sectional studies. The prevalence of hyperopia ranged from 8.4% at age six, 2-3% from 9 to 14 years and approximately 1% at 15 years. With regard to associated factors, age has an inverse association with hyperopia. The frequency of hyperopia is higher among White children and those who live in rural areas. There is no consensus about the association between hyperopia and gender, family income and parental schooling.ConclusionFuture studies should use standardized methods to classify hyperopia and sufficient sample size when evaluating age-specific prevalence. Furthermore, it is necessary to deepen the understanding about the interactions among hyperopic refractive error and accommodative and binocular functions as a way of identifying groups of hyperopic children at risk of developing visual, academic and even cognitive function sequelae.

Moderate hyperopia prevalence and associated factors among elementary school students

Hyperopia is the most common refractive condition in childhood. There are few studies on moderate hyperopia and associated factors. This study aims to investigate the prevalence of moderate hyperopia and associated factors among school children. A cross-sectional study comprising 1,032 students attending 1st to 8th grades at two public schools was conducted in a Southern Brazilian urban area in 2012. Cycloplegia was used to examine both eyes and refractive error was measured through auto-refraction. A socioeconomic and cultural questionnaire was administered. Multivariable analysis was performed through Poisson regression. Moderate hyperopia prevalence was 13.4% (95% CI, 11.2-15.4) and 85% of these did not wear glasses. Age was inversely associated with moderate hyperopia, while female gender RP = 1.39 (95%CI, 1.02 - 1.90) and white skin RP = 1.66 (95%CI, 1.04 - 2.66) were risk factors for this outcome. This study makes progress in estimating mild and moderate hyperopia prevalence both by age range and specific age. It emphasizes how the lack of this condition being corrected in southern Brazil is a serious problem. It highlights the importance of detailing and characterizing the amount of time spent on close-range, long-range and outdoor activities.

Amplitude of Accommodation in Schoolchildren.

ABSTRACT Purpose: Hofstetter’s equations are based on studies of Amplitude of Accommodation (AA) with methodological limitations, particularly in the case of children younger than 10 years of age. The aim of this study is to evaluate AA by age, gender, economic status, and time of day as well as accommodative insufficiency prevalence. Methods: A cross-sectional study was conducted with 867 schoolchildren aged 6–16 years attending two public schools in the urban area of the South Brazilian city of Pelotas. Subjective refraction was performed using a monocular fogging method to standard end point of maximum plus for best visual acuity (20/25). AA was assessed using the push-up method. Results: The median AA value was 14.3D (P25 13.3–P75 16.7) among children aged 6–16 years, being 15.5D (P25 14.3D–P75 16.7) among children aged 6–10 years, 14.2D (P25 12.5D–P75 15.4) among 11–13-year-olds, 13.3D (P25 12.5D–P75 15.4) among children aged 14–15 and 12.9D (P25 11.1D–P75 14.3) among those aged 16. AA variability was 2.4D in those aged 6–8, 3.4D in children aged 9–12, and 2.9D in those aged 13–16. There was no significant difference in median AA according to gender, time of examination, or economic status; 2.8% of children showed AA of less than 2D lower than Hofstetter’s minimum reference value. Conclusions: This study reports AA in a large sample of children and therefore may contribute to current knowledge on AA norms. In order to avoid the impact of outliers, it proposes the use of the median and percentiles to define AA standards by specific age. A set of studies using precise AA measurement and large sample size are needed to determine clinical standards for AA.

Prevalência e fatores associados à prática de esportes individuais e coletivos em adolescentes pertencentes a uma coorte de nascimentos

O presente estudo investigou a pratica de esportes individuais e coletivos e fatores associados em jovens com idade media de 11 anos, pertencentes a uma coorte de nascimentos. Informacoes dos jovens e de suas maes foram coletadas por meio de questionarios. O desfecho foi dividido em pratica de esportes individuais e coletivos. Uma analise por meio de regressao de Poisson foi conduzida para estabelecer os fatores associados a pratica esportiva, obedecendo a um modelo conceitual de analise com as variaveis independentes hierarquizadas. Um total de 4350 jovens foi estudado. A pratica de esportes coletivos foi menor nas meninas - 68,1% (IC95% 66,2 - 70,0) em comparacao aos meninos - 82,1% (IC95% 80,5 - 83,7). Nos esportes individuais, a prevalencia foi de 12,9% (IC95% 11,6 - 14,4) e 18,9% (IC95% 17,3 - 20,6) em meninas e meninos, respectivamente. Entre as meninas, a pratica de esportes individuais relacionou-se diretamente com nivel economico e inversamente com assistir televisao. Nos meninos este desfecho associou-se com estudar em escolas privadas e ter maes fisicamente ativas. Em esportes coletivos, a pratica foi menor naqueles que despendem maior tempo assistindo TV. Em ambos os sexos houve uma relacao direta entre o uso regular do video-game e a pratica de esportes. Politicas publicas devem considerar os diferentes aspectos relacionados a pratica esportiva e atender a disparidades socioeconomicas no acesso a diferentes modalidades esportivas. Alem disso, o maior acesso a diferentes locais de praticas esportivas, bem como o incentivos de pais, amigos e ambiente escolar devem ser fortalecidos.