Southeast Region Research Articles

Factors associated with early childhood development: results from the Brazilian National Survey on Child Nutrition (ENANI-2019)

IntroductionThe full achievement of early childhood development (ECD) is a human right and adhering to the nurturing care framework may facilitate it.ObjectiveTo evaluate the association between distal and proximal variables...

Human papillomavirus (HPV) type 16 E6 seroprevalence among men living with HIV without HPV-driven malignancies.

Individuals living with HIV are at a higher risk for developing human papillomavirus-driven oropharyngeal squamous cell carcinoma (HPV+OPSCC). There are no methods for early detection; however, HPV16 E6 antibodies have been identified as a promising early marker. The objective of this study was to evaluate the prevalence of HPV16 E6 antibodies among men living with HIV, with secondary objectives of analyzing clinical and serologic predictors of HPV16 E6 seropositivity. Banked blood specimens from 2,320 men aged 40+ living with HIV in Tennessee were evaluated for the following HPV16 antibodies: L1, E1, E2, E4, E6, E7. HPV16 E6 antibody levels were further categorized as moderate or high. Demographic, clinical, and serologic determinants of HPV16 E6 seropositivity were evaluated using logistic regression. HPV16 L1 antibodies were most common (22.8%), followed by E4 (10.5%), E6 (5.6%), E2 (4.8%), and E7 (4.0%). Of the 130 HPV16 E6 seropositives, 55 (2.4%) had moderate seropositivity and 75 (3.2%) had high. HPV16 E6 seropositive men had nearly 2-fold greater odds of seropositivity against one additional HPV16 E antigen (OR: 1.67 [95% CI: 1.10-2.52]; P=0.015) and over 3-fold greater odds of seroreactivity against two additional HPV16 E antigens (OR: 3.21 [95% CI: 1.40-7.33]; P=0.006). HPV16 E6 seropositivity was not associated with the clinical or demographic factors evaluated. In the largest study to date, HPV16 E6 seroprevalence was elevated compared to prior studies in HIV populations (range: 1.1% to 3.2%) and likely reflects the high incidence of HPV+OPSCC in the southeast region of the United States.

Population characteristics, prescription patterns and glycemic control of users of flash glucose monitoring systems in Brazil: a real-world evidence study

BackgroundTo date, there is a lack of information on the use of flash glucose monitoring system (fCGM) in low-middle income countries, such as Brazil, as well as on digital health platforms most used to calculate the bolus insulin dose. In this study, we aimed to describe the population characteristics, prescription patterns and glycemic control of fCGM users compared to blood glucose monitoring (BGM) system in those who use Glic™, a digital health platform in Brazil, and to assess factors associated with better glycemic control in this population.MethodsThis study is a cross-sectional retrospective study using anonymized aggregated data manually inputted by Glic™ users who self-reported a diagnosis of type 1 diabetes (T1DM), type 2 diabetes (T2DM), gestational diabetes (GDM) and latent autoimmune diabetes in adults (LADA).ResultsOf the 12,727 individuals included in this study, 11,007 (86.5%) reported their glucose monitoring method to be BGM, while 1720 (13.5%) reported using fCGM. Most individuals (70.5%) had T1DM. Compared to BGM, fCGM users were significantly younger, had a higher proportion of males, resided more frequently in the Southeast region of Brazil, had a lower BMI, a longer time since diagnosis, and used Glic™ platform more frequently. fCGM users were prescribed significantly more ultra-long and ultra-rapid acting insulins as their basal and bolus insulin, respectively, and less oral anti-diabetics drugs compared to BGM users. Considering only the T1DM and LADA individuals and their manual glucose inputs, fCGM users had non-significant lower glucose levels than BGM. Use of Glic™ platform and a higher percentage of basal insulin dose were associated with a better glycemic control.ConclusionThis is the first and largest real-world evidence study that describe and compare fCGM and BGM in users of a digital health patient support platform in Brazil. fCGM users were significantly different from those who perform BGM, in terms of population characteristics and treatment patterns. Glycemic control was better in fCGM users, although not statistically significant due to a restricted sample size. Importantly, a higher frequency of Glic™ use was associated with a higher glucose time in range.

When Separatists Secure the Homeland: The Neglected Role of Securitisation in Ethnonationalist Violence in Southeastern Nigeria

ABSTRACT The resurgent Biafran separatism in Nigeria has been analysed through three theoretical models: relative marginalisation; material deprivation; and state violence. These conventional perspectives, however cogent, are structure-based and sidestep the agency of Biafran separatists as ethnopolitical entrepreneurs who draw on ethnic fear to securitise the state, employ inflammatory language to mobilise their followers, and resort to emergency measures to stamp out perceived threats with the aim of establishing a state. I underscore the agency and political strategy of Biafran separatists and identify distinct causal pathways that do not fit well within the structure-based models conventionally applied to separatism in Nigeria. The aims and objectives of this article are twofold. First, I contribute to the existing literature on ethnonationalist conflicts in the southeast region by foregrounding political agency whilst transcending the structure-based explanations that neither capture nor comprehend the lifeworlds of political actors―that is, separatists―who contest the state’s monopoly of legitimate violence. Second, I contribute empirically to the broader literature on securitisation beyond the state by accentuating how non-state actors are not invariably passive receptacles of security discourses fashioned by state actors―presidents and prime ministers, for example―but active agents of securitisation in the face of perceived threats to societal security.

Monitoring Virulence Phenotypes of Bremia lactucae in South and Southeast Brazil

ABSTRACTLettuce downy mildew (Bremia lactucae) is one of the most important diseases of lettuce, especially in conditions of mild temperatures and high humidity. The great variability of B. lactucae makes the use of genetic control complex, as resistance to different virulence phenotypes requires different resistance factors. Dm (“Downy mildew”) genes or resistance factors, have been widely used in lettuce cultivars, providing a high level of resistance to downy mildew. The objective of this work was to monitor and study the virulence phenotypes of B. lactucae in the south and southeast regions of Brazil. Samples with downy mildew symptoms were collected in the main producing areas of the states of São Paulo, Rio de Janeiro, Rio Grande do Sul, Santa Catarina and Paraná. Subsequently, a race differentiation test was carried out by inoculating differentiating cultivars and observing the pathogen's response, and a sextet code was assigned to each isolate according to its virulence phenotype (EU‐C). Frequency (%), virulence complexity index by isolate and by phenotype, and Gleason index were calculated. A total of 117 isolates were evaluated and 61 virulence phenotypes were identified. The sextet code 31‐00‐00 was the most frequent and could be used for the evaluation of resistant cultivars in the states of the south and southeast regions of Brazil. The resistance factor of lettuce cultivar Balesta provided resistance to all evaluated isolates, while RYZ2164 was resistant to all isolates except those from Paraná. Additionally, Kibrille conferred resistance to isolates from Santa Catarina.

Spacetime modeling of mortality by infectious and parasitic diseases in Brazil: a 20-year ecological and population-based study.

Infectious and parasitic diseases (IPDs) encompass a broad range of illnesses predominantly associated with poverty. They are more prevalent in low- and middle-income countries, including Brazil, where they continue to be among the leading causes of mortality. This study aims to analyze the spatiotemporal dynamics of mortality due to IPDs in Brazil from 2000 to 2019. We conducted an ecological study using data on mortality by IPDs from the Brazilian Mortality Information System. We applied the segmented log-linear regression model to assess temporal trends. For spatial analysis, we used the local empirical Bayesian estimator and Moran indices. Retrospective spatiotemporal scan statistics were performed using the Poisson Probability Distribution Model. Between 2000 and 2019, there were 2,155,513 deaths related to IPDs in Brazil. The leading causes of death included acute respiratory infections (n = 1,130,069; 52.49%), septicemia (n = 289,817; 13.46%), human immunodeficiency virus/acquired immunodeficiency syndrome (n = 232,892; 10.82%), tuberculosis (n = 104,121; 4.84%), and neglected tropical diseases such as Chagas disease (n = 94,788; 4.40%) and schistosomiasis (n = 10,272; 0.48%). An increasing temporal trend in the mortality rate from IPDs was observed in Brazil and across all its regions. Additionally, our spatiotemporal scan identified high-risk clusters of death in the Southeast and Northeast regions. Mortality from IPDs remains a significant public health concern in Brazil, with an increasing trend observed in all regions. Our findings underscore the urgent need for comprehensive intersectoral public policies. These policies should focus on a greater allocation of resources and investments in the most critical areas, aiming to significantly reduce the number of deaths, particularly in the most vulnerable regions.

‘My Life Matters Here’: black undergraduate students’ experiences of attending historically Black colleges and universities during a time of racial reckoning

ABSTRACT Despite robust literature on the role of historically Black colleges and universities (HBCUs) in promoting upward mobility for Black college students, little is known about the impact of these institutions on the well-being of Black college students exposed to high-profile anti-Black violence. This qualitative study explored the experiences of 30 Black undergraduate college students exposed to anti-Black violence during 2020. Students were recruited from four HBCUs in the Southeast region of the US. Thematic analysis revealed four major themes: (a) HBCUs as places of refuge, (b) grounds for social activism, (c) Black excellence as a counternarrative to anti-Blackness, and (d) perceptions of personal safety at historically white institutions. Findings suggest HBCUs are essential for supporting the well-being of Black college students in the wake of anti-Black violence and serve as a buffer against the race-related trauma and adverse effects of anti-Black violence exposure. Implications for research and policy are discussed.

Impact of the COVID-19 pandemic on small vulnerable newborns: an interrupted time series analysis in Peru and Brazil.

We examined COVID-19's impact on the number of small vulnerable newborns (SVN) at national and regional levels in Peru and Brazil. Using national birth registries, we examined monthly numbers of preterm (PT), low birthweight (LBW), and small for gestational age (SGA) newborns. We analysed COVID-19's impact on SVN using two interrupted time series models. We estimated SVN's expected numbers in the absence of the pandemic using mixed-effects regressions and calculated percent changes by comparing these estimates to observed during the pandemic. Incidence rate ratios (IRR) were estimated using Poisson regression. In Peru, the average percent changes in PT, LBW, and SGA births were -17%, -11%, and -3% in 2020, and -10%, -4%, and +2% in 2021, respectively. The IRR of PT and LBW declined throughout the pandemic, while SGA IRR increased in August 2020-November 2020 and May 2021-December 2021. The Coast region experienced the greatest drop in PT, LBW, and SGA IRR in 2020, followed by a slight increase in 2021, whereas the Highlands and Amazon regions had increased LBW and SGA IRR. In Brazil, the percent changes in PT, LBW, and SGA births were +1%, -3%, and -8% in 2020, and +1%, 0%, and -1% in 2021, respectively. Most PT, LBW, and SGA IRRs decreased during the pandemic, except in the Northeast and Southeast regions, where PT increased in 2020. All regions experienced declines in LBW and SGA in 2020, with the Central-West and South regions showing the greatest LBW declines and Central-West region the highest SGA decrease. No significant worsening of neonatal outcomes were observed during the COVID-19 pandemic. In Peru, PT and LBW births declined, while SGA increased from August 2020. In Brazil, PT births slightly increased, while LBW and SGA births declined in 2020, remaining stable in 2021.

Mental disorders related to psychosocial factors among delivery workers: results of a web survey in Brazil.

The number of delivery workers (DW) has grown significantly with the rise of the platform economy. Evidence suggests that the working conditions faced by these workers are precarious, however, less is known about the health implications among workers. This study aims to investigate the prevalence of mental disorders (MD) and occupational factors related to this condition among DW. This is a cross-sectional study, a web survey with DW in Brazil. Data collection lasted four months, starting in February 2022. Anxiety, panic disorder, and depression were measured based on self-reported medical diagnosis. Those with at least one of the three diagnoses were considered to have MD. Cox regression analysis, presenting prevalence ratios, showed the factors related to MD. A total of 563 DW participated in the study. The overall prevalence of MD was 25.6%. Lack of support from the company (PR = 1.71), accelerated work pace (PR = 1.55) and experience of conflicts with company customers (PR-1.48) were psychosocial factors associated to MD. In addition, working in the South, Southeast or Central-West regions is related to a higher prevalence of MD (PR = 2.10). The high prevalence of MD and its association with psychosocial stressors at work require regulation of the practices of companies operating in the platform economy, aiming to control the intensification of work. In addition to health and social security policies, it is crucial to ensure fair remuneration to reduce the pace of work in a non-strenuous workday, protecting workers from conflicts with dissatisfied customers of the company.

P-151. Cutaneous Larva Migrans Within the United States Military Health System and Association with International Travel

Abstract Background Cutaneous larva migrans (CLM) is a parasitic dermatitis which occurs after zoonotic hookworm larva from the soil penetrate the skin. CLM is most common in tropical and sub-tropical regions of the world and in returning travelers from those regions. Within the United States (U.S.) autochthonous cases of CLM have been reported, however the epidemiology is not well-described. We seek to describe the epidemiology of CLM and association with geographic location and international travel within the U.S. military health system. Methods We performed a retrospective cohort study of active duty service members and their family members who had a diagnosis code of hookworm between October 2012 and September 2018. Of the initial cohort (n = 272), 61 (22.4%) were diagnosed with CLM. Results Most patients in this study were male (65.5%), active duty (55.7%), and white (45.9%) [Table 1]. Patients’ ages ranged from 1 to 56 years (mean 24.6) with 80.3% of patients 18 years of age or older. All the patients were born within the United States. Most were diagnosed by their primary care manager, however 19.7% were diagnosed via emergency or urgent care. Patients reported preceding travel to tropical and subtropical world regions in 32.8% of cases: Caribbean (13.1%), Africa (6.6%), Mexico and Central America (6.6%), South America (3.3%) and Japan (3.3%) [Figure 1]. After excluding those with preceding international travel, 67.2% of patients had autochthonous CLM. Of the autochthonous cases, more patients were diagnosed or had preceding travel in the southeast U.S. (68.3%) compared with the western U.S. (19.5%), southwest U.S. (9.8%), or northeast U.S. (2.4%) [Figure 2]. States with the highest number of cases were Florida (26.7%), Georgia (14.6%), North Carolina (9.8%), Texas (9.8%), Washington (7.3%) and Hawaii (7.3%). Based on the reported literature, we found a lower number of cases with preceding international travel than expected. Most autochthonous cases within the U.S. were from the southeast and coastal regions. Conclusion CLM should be considered in the U.S. even in patients without recent international travel. These findings are useful in providing nationwide data on the epidemiology of CLM and allowing for informed preventative counseling to travelers and non-travelers within the U.S. Disclosures Alison Helfrich, DO, MPH, Moderna: Stocks/Bonds (Public Company)|Sanofi: Stocks/Bonds (Public Company)

Interrogating Economic Re-Birth and Economic Integration of the Southeast States of Nigeria: Problems and Prospects

What is now known as the Southeast region of Nigeria emerged as an outcome of the National Constitutional Conference convened by the late Nigeria Military leader, General Sani Abacha’s administration, and held from June 1994 to June 1995. The Southeast region is currently home to five core-Igbo-speaking states of Abia, Anambra, Ebonyi, Enugu, and Imo. These five states were major parts of the old Eastern Region of Nigeria, which witnessed sustained growth in diverse sectors of its economy before the outbreak of the Nigerian Civil War in 1967. Specifically, from the mid-1950s, small, medium and large scale industries had sprouted up in many parts of the region, particularly in the major towns of Aba, Enugu, Umuahia and Onitsha (mostly inhabited by the Igbo). The Golden Guinea Breweries located in Aba; the Cement Company located at Nkalagu, near Enugu; and many other enterprises (mainly private sector-driven) had commenced manufacturing of goods, as trade and services flourished, but the outbreak of the Nigerian Civil war in July 1967 aborted the visible economic growth in Igboland. However, although the Igbo (who lost the war) were “reintegrated into Nigeria” when the war ended in January 1970, they have found it very difficult till date to recreate their glorious economic past. Since 1970, most Igbo-owned industries, investments and firms are located in areas outside Igboland, which has impacted negatively on the economic growth of the region. It is against this background that this paper interrogates the question of economic rebirth and economic integration of the southeast region of Nigeria. Adopting the eclectic research method, it highlights the problems inhibiting the trend, examines the prospects, and proffers solutions, which, if implemented, could lead to the economic resurgence and integration of states in the Southeast region of Nigeria by 2030.

The Early Steps to Transplant Access Registry (E-STAR) dashboard: center-specific reporting on prewaitlisting data to improve access to kidney transplantation.

The 2022 National Academies of Sciences, Engineering, and Medicine report highlighted inequities in access to kidney transplantation and called for a comprehensive dashboard highlighting early transplant steps, yet data on steps such as referral and evaluation start are limited. Addressing this gap is crucial for improving equity in access to transplantation. The Early Steps to Transplant Access Registry (E-STAR) provides a model for how prewaitlisting data can be used to inform quality improvement to drive equity in access to transplantation. E-STAR includes data from 37 transplant centers across 13 states and four regions (Southeast, New York, New England, and the Ohio River Valley), representing ∼217 000 adults with end-stage kidney disease (ESKD) treated in 4365 dialysis facilities, in addition to patients preemptively referred. Similar to the Scientific Registry of Transplant Recipients center-specific reports, the E-STAR dashboard was developed as an interactive website offering center-specific and regional insights into pretransplant access measures within and across centers with the intention to improve access to transplantation. Publicly available de-identified reports illustrate trends in referral, evaluation, and waitlisting by subgroup (e.g., race, sex, age, insurance status), while password-protected features enable transplant centers to benchmark their performance against anonymized peers. The E-STAR dashboard demonstrates how centralized, standardized data collection can support transplant centers, policymakers, community partners, and regional organizations to identify disparities, drive quality improvement, and develop interventions for the advancement of equity in transplant access. This work may inform future center-specific reports once prewaitlisting data are collected nationally.

Determination of highly hazardous pesticides in fruits and vegetables in the Maya region of southeast of Mexico

Highly Hazardous Pesticides (HHPs) have been identified as substances with severe adverse effects, including carcinogenicity, endocrine disruption, and reproductive toxicity. The aim of this study was to evaluate pesticide residues in fruits and vegetables from Hopelchén to provide evidence for policy recommendations on pesticide regulation. A total of 25 samples were collected and analyzed using the QuEChERS method with GC-MS/MS and LC-MS techniques. Of the 156 pesticides screened, 25 were detected, with tebuconazole, chlorantraniliprole, imidacloprid and carbendazim among the most frequent. Approximately 20% of the pesticides identified qualified as HHPs based on WHO/FAO criteria, while 60% were categorized as HHPs according to the more comprehensive criteria outlined by Pesticide Action Network International. Many of these pesticides exhibited toxicity to bees and high environmental persistence. Furthermore, 33% of the samples exceeded the European Union’s Maximum Residue Limits, particularly for pesticides in papayas and bell peppers. Our findings show the presence of HHPs in the region, which represent critical hazards to ecosystem, pollinator populations, and public health. This work may contribute to the development of specific HHPs classification criteria for Mexico, thus advancing the transition toward safer, with special emphasis on vulnerable regions such as the Mayan zone in southeastern Mexico.

Transforming Voter Behaviour in Nigeria’s South-East Region: Analysing the Impact of Socio-Economic Conditions, Electoral Irregularities and Sustainable Voters’ Education

Transforming Voter Behaviour in Nigeria’s South-East Region: Analysing the Impact of Socio-Economic Conditions, Electoral Irregularities and Sustainable Voters’ Education

Genetic characterization of measles virus circulating in Iran, 2021–2023

BackgroundMeasles, an ongoing public health concern, demands continuous molecular surveillance and virus characterization for elimination. Despite Iran achieving measles elimination status in 2019 through robust molecular testing and vaccination, the COVID-19 pandemic disrupted global vaccination efforts, leading to increased measles-related morbidity and mortality. This study aims to overview measles virus serological and molecular traits in Iran from 1st January 2021 to 30th April 2023.MethodsFollowing World Health Organization and Center for Diseases and Control protocols, serological tests were performed on suspected cases and the nucleoprotein (N) gene of confirmed cases were subsequently amplified using molecular methods and were sequenced afterwards for measles genotyping. Phylogenetic analysis was performed with the obtained sequences.ResultsAnalyzing 17,343 suspected cases from 1st January 2021 to 30th April 2023, 936, 177, and 164 samples were positive using ELISA, quantitative Reverse transcription PCR, and Reverse transcription PCR, respectively. The B3 genotype predominated, notably in Iran’s South East (41%), Central (28%), and South (13%) regions. Provinces bordering countries with measles outbreaks exhibited higher risk of virus importation. Genetic comparisons with measles sequences submitted to NCBI and MeaNS databases revealed direct importation and contact transmission.ConclusionRegular surveillance and genetic analysis are critical for understanding measles transmission and reacting to outbreaks. The COVID-19 pandemic yielded mixed effects on measles cases, enhancing hygiene measures while causing underreporting and vaccination gaps. Vigilance against measles resurgence is crucial, requiring cross-border transmission studies, improving cross-border surveillance and adaptable vaccination strategies.

Identification of distinct pesticide poisoning patterns in Brazil: a cross-sectional cluster analysis of epidemiological data.

This study aimed to identify distinct patterns of pesticide poisoning in Brazil through the cluster analysis of epidemiological data from 2011 to 2019. A cross-sectional analysis of 49,233 confirmed pesticide poisoning cases was conducted using multiple correspondence analysis and hierarchical clustering. Data from the Brazilian Notifiable Diseases Information System were analyzed by region, demographics, and exposure types. Three distinct clusters were identified. Cluster 1 was characterized by severe cases, predominantly involving suicide attempts (~90%), required treatment (99.1%) and fatality rates (93.2% of all cases). Exposures were mostly domestic and occurred via ingestion, with a strong prevalence in the Northeast. Cluster 2 consisted mainly of pediatric cases, marked by accidental and acute domestic exposures, and showed minimal representation in the Southeast and South regions. Cluster 3 had a male predominance (80.1%) and was strongly associated with occupational and chronic exposures, involving cutaneous and respiratory routes, and was most prevalent in the Central-West. The study reveals significant regional and demographic disparities in pesticide poisoning across Brazil. These findings underscore the urgent need for targeted public health interventions and stricter pesticide regulations to address regional vulnerabilities and mitigate pesticide-related harm.

WASH-friendly schools for whom? Integrating the perception of different school stakeholders in Brazil.

Ensuring that schools are water, sanitation and hygiene (WASH) friendly requires WASH to be visibly implemented, inclusive and sustainable, engaging the entire school community, including direct and indirect stakeholders (school staff, students and their families). However, students, staff, and parents are often overlooked in the design of WASH solutions. This study aims to contrast different school stakeholders' perspectives on WASH and evaluate the extent to which the Human Right to Water and Sanitation (HRtWS) and its normative contents are being realized in schools within the basic education system, covering students aged 0 to 18. For that purpose, a mixed-method study was conducted involving seven schools located in a small municipality in the southeast region of Brazil. Data collection methods included on-site observations in schools, in-depth interviews with school staff and parents/legal guardians of students, and a one-day art-based research workshop with students around drinking water, sanitation, solid waste management and COVID-19. Several inconsistencies were identified when comparing primary findings with the schools' information previously provided by the Brazilian Government, including differences in the number of schools and levels of education offered, water sources, absence of bathrooms, and waste burning instead of solid waste collection. A clear violation of all the normative contents of the HRtWS was observed, which, in turn, were triggering and exposing students to incidents of violence such as bullying and verbal abuse. There was a misalignment among stakeholders about which interventions implemented amidst the COVID-19 pandemic are still in place. Moreover, discrepancies among school stakeholders' perceptions of WASH suggest insufficient communication among actors. As a result of this research, a list of recommendations formulated by stakeholders and the involvement and alignment of all stakeholders are the first steps in successfully co-creating solutions.

A Retrospective Observational Study on Post-Pandemic Effects of Endogenous and Exogenous Factors on Prematurity in Pregnant Women Under 18 Years of Age.

Background/Objectives: This research investigates the impact of exogenous and endogenous factors on fetal health in pregnant women under the age of 18, with a special focus on the influence of educational level, adherence to vices (smoking and alcohol), comorbidities (diabetes and hypertension), and poor sanitary conditions. Methods: The study uses retrospective data collected from a medical institution in the Southeast region of Romania, including a sample of 3639 births during the post-pandemic period (2022-2023). This period was considered to be a reference period for the study because, as a result of measures to combat the spread of COVID-19 disease in the pandemic, there was an increase in the birth rate among patients under 18 years of age. The APGAR clinical score was evaluated at 5, 10, and 20 min after birth and measured on an inverted scale to reflect the increased risk to fetal health. Results: The results indicate that lack of education is a significant exogenous factor associated with an increased risk of preterm births and a lower APGAR score. Additionally, adherence to vices is more pronounced among pregnant women with low educational levels and smoking and alcohol consumption negatively impact fetal health. Regarding comorbidities, diabetes did not significantly affect the short-term APGAR score, while hypertension had a complex effect, though medical interventions mitigated the associated risks. Conclusions: The conclusions of the research emphasize the need for appropriate educational and medical interventions to reduce the risks associated with preterm births and newborn health in adolescent pregnancies, especially in disadvantaged environments. The study suggests future research directions to expand the analysis to other geographical regions and for long-term monitoring of newborn health.

Strengthening National Immunization Technical Advisory Groups: Twelve Years of Progress (2012-2023).

Well-functioning National Immunization Technical Advisory Groups (NITAGs) are valuable contributors to decision-making processes in the complex immunization policy arena. This paper describes the progress made globally on the establishment and strengthening of these key advisory groups and discusses some of their strengths, challenges, and opportunities. The data submitted annually by countries to the World Health Organization (WHO) via the WHO/UNICEF Joint Reporting Form (JRF) were analyzed, comparing the NITAG functionality criteria in 2012 and 2023. In 2023 and 2012, 88% and 61% of countries, respectively, reported having a NITAG. A total of 77% of NITAGs met all six NITAG process criteria in 2023 compared to 33% in 2012. This progress was most notable in the WHO African Region, increasing from 7% (2012) to 77% (2023), and the South-East Asia Region, increasing from 45% (2012) to 91% (2023). In 2023, 84% of NITAGs issued a vaccine-policy recommendation that was adopted by decision-makers. Marked progress has been made since 2012 on establishing and maintaining NITAGs, with a small number of countries yet to form an advisory committee. Supporting and sustaining NITAG functions remains an important means for countries to foster independent and transparent expert advice on vaccine and immunization policy. Setbacks in countries facing instability or political turmoil are a reminder of the reversibility of progress. WHO and partners play an important role in supporting countries in strengthening these advisory committees. Continuous commitment by countries to the function and involvement of NITAGs in policy recommendations is essential for enhancing the strength and resilience of immunization programs.

Mammals in urban centers: a dataset from the perspective of the media in Brazil.

The continuous growth of the urban population, coupled with habitat loss, has resulted in unanticipated interactions between animals and humans in urban centers. In this study, we investigated the presence of mammals in urban centers through newspaper reports on websites. Specifically, we examined: i) the frequency of photographic records, ii) the temporal trends (2001 to 2021) and spatial trends (Brazilian Federative regions and states) of the records, and iii) the orders, families, and species most frequently reported in urban centers. On the Google platform (http://www.google.com.br), we used combinations of the keywords "mammals in urban centers," "mammals found in the city", and "mammals found in the municipality" to survey mammal records. We excluded repeated news items, sites that experienced technical problems during the search period, and those that did not cover the topic. We compiled a total of 733 websites. The records spanned from 2002 to 2021, with 73% occurring in the last four years. The Southeast, South, and Midwest regions stood out. The animals recorded belonged to 55 mammal species (16 vulnerable and 3 endangered), distributed in 22 families and 10 orders. The data indicate that the majority of mammal sightings in urban areas occur on streets, with some conflictual interactions. This is the first study that utilizes websites for diagnosing the mammal fauna present in urban centers in Brazil. The dataset generated here could aid in understanding the occurrence of mammal species in the urban environment.