Predictive model for cocaine use in prisons in Rio de Janeiro, Brazil

OBJECTIVE: To identify predictors of and groups vulnerable to cocaine use in prison. METHODS: We selected 376 inmates with history of cocaine use in prison (cases) and 938 inmates with no history of drug use (controls) serving sentences in the Rio de Janeiro State prison system in 1998. The analysis included exposure variables divided into three hierarchical levels: distal, intermediate, and proximal. We performed bivariate analysis using logistic regression and multivariate analysis using hierarchized regression; results are given in odds ratios. RESULTS: Variables associated with cocaine use in prison in the proximal level were use of alcohol and marijuana and duration of imprisonment in years. The effect of social vulnerability variables (distal level) was intermediated by variables in the next levels. Considering only the distal and intermediate levels, use of marijuana prior to imprisonment (OR=4.50; 95% CI: 3.17-6.41) and offence in order to obtain drugs (OR=2.96; 95% CI: 1.79-4.90) showed the strongest association with the outcome. For every additional year spent in prison, the odds of cocaine use increase by 13% (OR=1.13; 95% CI: 1.06-1.21). CONCLUSIONS: Considering the distal and intermediate levels, use of marijuana prior to imprisonment and perpetration of offence in order to obtain drugs were the variables with greatest predictive value. The final model showed alcohol and marijuana use in prison and duration of imprisonment as important predictors of the outcome. The prison environment appears as a factor stimulating drug use.     

Risk factors for hepatitis B virus infection in Rio de Janeiro,Brazil

Background  

Despite international efforts to prevent hepatitis B virus (HBV) infection through global vaccination programs, new cases are still being reported throughout the world.     

Cat-transmitted sporotrichosis, Rio de Janeiro, Brazil

Sporotrichosis is an emerging zoonosis in Rio de Janeiro, Brazil. From 1998 to 2003, 497 humans and 1,056 cats with culture-proven sporotrichosis were studied. A total of 421 patients, 67.4% with a history of a scratch or bite, reported contact with cats that had sporotrichosis.     

Congenital malformations in Rio de Janeiro, Brazil: prevalence and associated factors

This study aims to estimate the prevalence of congenital malformations and their correlation with socioeconomic and maternal variables. The design was cross-sectional, based on a sample of 9,386 postpartum women after admission for childbirth in maternity hospitals in the city of Rio de Janeiro, Brazil. Data were collected through interviews with mothers in the immediate postpartum, as well as by consulting the patient records of both the mothers and newborn infants. Prevalence of congenital malformations at birth was 1.7%, and minor malformations were the most frequent. Neural tube defects were the most frequent major malformations. According to multivariate analysis, congenital malformations were statistically associated with: maternity hospitals belonging to or outsourced by the Unified National Health System (SUS) and inadequate prenatal care (相似文献   

Neonatal screening for hemoglobinopathies in Rio de Janeiro, Brazil]

OBJECTIVE: To describe the main results obtained in the first 15 months of neonatal screening for sickle cell disease in the state of Rio de Janeiro, Brazil, from August 2000 to November 2001. METHODS: Starting in August 2000, blood samples began to be collected for sickle cell disease screening from all newborns receiving care in primary health care clinics in the state of Rio de Janeiro. The samples were submitted to high-resolution liquid chromatography. If the resulting chromatogram was compatible with sickle cell disease, the child and the parents were referred for diagnostic confirmation and treatment. RESULTS: Between August 2000 and November 2001, 99 260 newborns were screened. There was one case of homozygous Hb C. On average, one of every 27 newborns who were screened presented sickle cell trait (Hb AS). Sickle cell disease was observed in 83 cases, or one new case in each 1 196 births. The 83 consisted of: 62 Hb S, 18 Hb SC, and 3 Hb SD. One child did not appear for diagnostic confirmation. The 82 children who were followed up by the program presented 15 intercurrent illnesses (upper respiratory infections, fever, splenic sequestration crises, hand-foot syndrome, and vascular occlusion), resulting in seven hospital admissions. Blood transfusions were necessary with 15 children, but none developed alloimmunization. All the other babies were doing well with the use of prophylactic penicillin. CONCLUSIONS: Our data show the importance of early diagnosis for sickle cell disease, so as to prevent the frequent infectious complications faced by these patients.     

Hemophilia care in the state of Rio de Janeiro, Brazil.

In the developing countries of the world, few people with hemophilia receive adequate care. Nevertheless, Brazil has made significant advances in the treatment of hemophilia over the last decade. The provision of factor concentrates imported by the Government of Brazil is gradually increasing, and patients receive the concentrates for free. A national register was established as well as a coordinated program for comprehensive care. Of the 6 297 persons with hemophilia in Brazil who were registered as of January 2001, 689 of them (11.1%) were registered in the state of Rio de Janeiro. Of those 689, 664 of them were being monitored at the state's coordinating blood transfusion center, which is located in the city of Rio de Janeiro. Among those 664, factor VIII inhibitors were identified in 81 of them (12.2%). Among 653 of the Rio de Janeiro patients who were tested for transfusion-transmitted diseases, the overall prevalence found was 41.5%, with the specific rates being 13.3% for human immunodeficiency virus (HIV), 2.9% for hepatitis B virus (HBV), and 39.4% for hepatitis C virus (HCV). The state of Rio de Janeiro has adopted a comprehensive hemophilia management approach that includes medical, psychological, and social care. As a result, the quality of life of hemophilia patients has improved noticeably. For example, the rate of hospitalization among patients fell by 30% between 1998 and 2001, and there has also been a decline in the school and work activities that they have missed.     

HIV vaccine evaluation center in Rio de Janeiro, Brazil

We conducted an HIV seroincidence study among high-risk men who have sex with men in Rio de Janeiro to determine whether this population would be suitable for vaccine and non-vaccine HIV prevention studies. There were 34 HIV seroconversions during the follow-up period, for a seroincidence of 3.1 per 100 person-years. The incidence among the youngest members of our cohort was over 8%, an extraordinarily high transmission rate for a homosexual male population. We have used the sensitive/less sensitive ELISA assay to identify a high-risk heterosexual population for intervention studies in Brazil. The estimated seroincidence was 1.9 and 2.8 per 100 person-years among heterosexual females and males, respectively. We are presently conducting a study to investigate behavior changes among 202 participants of a post-sexual-exposure chemoprophylaxis (PEP) study. During a median follow-up of 24 months, there were 11 HIV seroconversions, 10 of which were among non-PEP users. Additionally, we are conducting a phase 2 HIV vaccine trial of the ALVAC-HIV vector vCP1452 alone and in combination with a subunit vaccine, MN rgp120, in healthy adult volunteers. The primary goal of this trial is to define the immunogenicity and confirm the safety of the most promising vector-based vaccine alone and in combination with a recombinant envelope protein vaccine with an established safety and immunogenicity profile. A phase 3 HIV vaccine trial is planned to begin in the next 18-24 months.     

Income inequality and homicide rates in Rio de Janeiro, Brazil.

OBJECTIVES: This study determined the effect of income inequality on homicide rates in the state of Rio de Janeiro, Brazil. METHODS: We conducted an ecological study at 2 geographical levels, municipalities in the state of Rio de Janeiro and administrative regions in the municipality of Rio de Janeiro. The association between homicide and income inequality was tested by multiple regression procedures, with adjustment for other socioeconomic indicators. RESULTS: For the municipalities of Rio de Janeiro State, no association between homicide and income concentration was found an outcome that can be explained by the municipalities' different degrees of urbanization. However, for the administrative regions in the city of Rio de Janeiro, the 2 income inequality indicators were strongly correlated with the outcome variable (P < .01). Higher homicide rates were found precisely in the sector of the city that has the greatest concentration of slum residents and the highest degree of income inequality. CONCLUSIONS: The findings suggest that social policies specifically aimed at low-income urban youth, particularly programs to reduce the harmful effects of relative deprivation, may have an important impact on the homicide rate.     

Analysis of some virulence factors of Vibrio vulnificus isolated from Rio de Janeiro, Brazil.

Twenty strains of V. vulnificus isolated from the environment were investigated for characteristics related to their infectivity such as colonial morphology, enzymatic activity and animal assays. The presence of DNase, chitinase, amylase, lecithinase and gelatinase was observed in 100% of the strains, haemolytic activity was absent, and variable results were obtained in elastase, collagenase and chondroitinase. In the animal assays, 70% of the strains were lethal to adult mice, while 45% caused fluid accumulation in suckling mice. Although all strains had opaque colonies, only 3 of the 20 had the three enzymes elastase, collagenase and gelatinase, and only one of these was virulent in animal assays.     

Food consumption by pregnant adolescents in Rio de Janeiro, Brazil

The increase in teenage pregnancy has been viewed with concern by public health experts. Food consumption to help maintain high nutrient demands has been identified as one of the most relevant components. This study aims to present the habitual consumption of food and energy-specific nutrients by pregnant adolescents. A total of 1,180 adolescent mothers were interviewed in maternity hospitals in the City of Rio de Janeiro, and a simplified questionnaire on semi-quantitative frequency of food consumption was applied. Lower consumption of fruit juice, vegetables, and fruits was observed among adolescent mothers over 15. Adolescent mothers classified in the lowest quartile of consumption lack the minimum recommended consumption of energy and nutrients. An inverse association was found between the number of household members and energy and nutrient consumption. Adolescent mothers who received dietary information and changed their eating habits during pregnancy showed better results concerning the consumption of energy and nutrients. Prenatal care was a key factor for improving the results of pregnancy, emphasizing the importance of providing dietary information.     

Middle-class teenage sexuality and pregnancy in Rio de Janeiro, Brazil

The subject of this paper is teenage pregnancy among middle-class youth, a topic not sufficiently studied in Brazil. The paper is based on a qualitative, socio-anthropological study of 14 middle-class families in Rio de Janeiro, Brazil, whose children have remained single, living with their parents after the child's birth. A total of 25 in-depth interviews were conducted with 6 young men and 7 young women, ages 18 to 24, and their parents (11 mothers, one father), to examine the event in retrospect and its impact on these young people and their families. Three aspects are analyzed: difficulties young people face in internalizing contraception as a norm; late discovery of pregnancy; and how the decision to either have an abortion or give birth is made by young people and their parents. This research allows seeing teenage pregnancy as an event that hinges on the process of constructing a young person's autonomy, in which sexuality plays a prominent role. Concluding, the phenomenon should be analyzed in a specific historical and cultural context, with changes over the decades in the rules underlying the process of individualization among young people.     

Serological surveillance of measles in blood donors in Rio de Janeiro, Brazil.

OBJECTIVES: To estimate the proportion of individuals seronegative for measles antibody among blood donors from a blood bank in the city of Rio de Janeiro, Brazil, and to describe their social and demographic characteristics, with the goal of exploring the potential use of plasma banks to supplement serological surveillance with relevant data in order to support the program of measles elimination in the city of Rio de Janeiro and elsewhere. METHODS: Plasma samples from 1 101 consecutive blood donations made in November 2000 at HEMORIO, the largest blood bank in the state of Rio de Janeiro, were tested for measles immunoglobulin G, using a commercial enzyme immunoassay and a plaque reduction neutralization test. We calculated the proportion (and 95% confidence interval (CI)) of samples seronegative for measles antibody for the total sample of blood donors and also for subgroups categorized by age, sex, neighborhood of residence, education, and occupation. We used the chi-square test to assess the statistical significance of differences in proportions and linear trends in proportions. RESULTS: Of the total group of blood donors, 6.9% of them (95% CI: 5.4%-8.4%) were seronegative for measles. Women had a higher proportion (10.1%; 95% CI: 6.8%-13.4%) of seronegative results than did men (5.6%; 95% CI: 4.0%-7.2%). In terms of age, 86.8% of seronegative individuals were born between 1971 and 1982. Seronegativity was inversely proportional to age (chi-square = 58.0; P < 0.0001). With regard to occupation, students had the highest proportion of seronegative individuals (17.8%). In terms of education, most of the susceptible persons were in the categories of "incomplete university degree" or "incomplete high school." For the various areas of residence the proportions ranged from 2.1% to 11.4%. CONCLUSIONS: Blood bank plasma may constitute a useful and convenient source of complementary data for serological surveillance in adults of measles and other infections for which immunization and surveillance activities are implemented. This approach could be beneficial to other areas in Brazil and other countries where plasma from blood donors is available for surveillance. The use of residual sera from patients and plasma from blood donors represents a tradeoff between representativeness and timeliness as well as economy of resources.     

Risk assessment of yellow fever urbanization in Rio de Janeiro, Brazil

Yellow fever (YF), an arthropod-borne viral disease, occurs in regions of tropical America and Africa. Sylvatic YF is endemic in the north and west of Brazil. Urban YF, on the other hand, has not been reported in the country since 1942. However, the widespread presence of the YF urban vector in Brazil has lead to concern about the potential re-emergence of YF in urban centres. Here, we assess the risk of YF emergence in the city of Rio de Janeiro, Brazil, by estimating the probability of infected individuals arriving from YF-endemic areas, and the probability of infective individuals triggering an epidemic. We found that the risk of urban YF emergence may reach values as high as 29% during the epizootic periods but the precision of the estimate is low.     

Intestinal parasitic helminths in institutionalized dogs of Rio de Janeiro, Brazil

The occurrence of intestinal parasitic helminths in dogs from a public institute of veterinary medicine in Rio de Janeiro was assessed. Samples of fresh feces were collected in March 2004 and analyzed by Willis and centrifugal-flotation in sucrose solution methods. Of 204 samples, 45.6% were positive for helminths.     

Surveillance of risk factors for non-communicable diseases among adolescents: the experience in Rio de Janeiro, Brazil

This paper presents the methodology and results of the implementation of a Surveillance System for Non-Communicable Disease Risk Factors in Adolescents. A random sample of 8th-grade students (n = 1,684) enrolled in municipal schools in Rio de Janeiro, Brazil, was studied. Students were asked to complete a confidential questionnaire on food consumption, physical activity, sedentary leisure-time activities, and tobacco consumption. Prevalence estimates of risk factors were calculated for the entire sample and by gender. Non-response rates ranged from 1.1 to 8.9%. The findings included low consumption of fruits (45.8%) and vegetables (20.0% and 16.5% for salads and cooked vegetables, respectively), regular consumption of soft drinks (36.7%) and candies (46.7%), extensive time on TV, computer, and videogames (71.7% spend at least 4h/day at these activities), low frequency of regular physical activity (40%), and 6.4% prevalence of smoking. Girls showed less physical activity and more smoking. The system appeared to be feasible and indicated high prevalence of risk factors for non-communicable diseases.     

Occurrence of human fascioliasis in Volta Redonda, Rio de Janeiro, Brazil

Through the result of coprologics exams, accomplished in patients assisted in Volta Redonda hospitals, the first occurrence of the human fascioliasis is marked in the State of Rio de Janeiro, Brazil.