We report the early growth and neurologic findings of 48 infants in Brazil diagnosed with probable congenital Zika virus syndrome and followed to age 1–8 months. Most of these infants had microcephaly (86.7%) and craniofacial disproportion (95.8%). The clinical pattern included poor head growth with increasingly negative z-scores, pyramidal/extrapyramidal symptoms, and epilepsy.

Processed and ultra-processed food consumption among children aged 13 to 35 months and associated factors Consumo de alimentos processados e ultraprocessados e fatores associados em crianças entre 13 e 35 meses de idade Consumo de alimentos procesados y ultraprocesados y factores asociados en niños entre 13 y 35 meses de edad

This study estimated the percentages of incomplete immunization with new vaccines and old vaccines and associated factors in children 13 to 35 months of age belonging to a birth cohort in São Luís, the capital of Maranhão State, Brazil. The sample was probabilistic, with 3,076 children born in 2010. Information on vaccination was obtained from the Child's Health Card. The new vaccines, namely those introduced in 2010, were meningococcal C and 10-valent pneumococcal, and the old vaccines, or those already on the childhood immunization schedule, were BCG, hepatitis B, human rotavirus, polio, tetravalent (diphtheria, tetanus, pertussis, Haemophilus influenzae b), yellow fever, and triple viral (measles, mumps, rubella). The study used hierarchical modeling and Poisson regression with robust variance. Prevalence ratios (PR) and 95% confidence intervals (95%CI) were calculated. Incomplete immunization was higher with new vaccines (51.1%) than with old vaccines (33.2%). Children 25 to 35 months of age (PR = 1.27; 95%CI: 1.14-1.41) and those in economic classes D/E (PR = 1.20; 95%CI: 1.06-1.35) were only significantly associated with new vaccines; low maternal schooling (PR = 1.58; 95%CI: 1.21-2.06), unavailability of outpatient and/or hospital care for the child (PR = 1.20; 95%CI: 1.04-1.38), and unavailability of the vaccine in health services (PR: 1.28; 95%CI: 1.12-1.46) were only associated with old vaccines. Immunization strategies should consider the vulnerability of older preschool-age children and those belonging to classes D and E, especially when new vaccines are introduced, as well as children of mothers with low schooling. Strategies should also address problems with the availability of health services and vaccines.

RESUMO: Introdução: O acesso à mamografia, principal exame de detecção precoce do câncer de mama, não é igualitário entre as mulheres brasileiras. Objetivou-se analisar os fatores associados à não realização desse exame num período inferior a dois anos no Brasil e por macrorregião, considerando-se características sociodemográficas, condições de saúde, hábitos de vida e uso dos serviços de saúde. Método: Estudo transversal que utilizou dados da Pesquisa Nacional de Saúde (PNS). A amostra consiste de 10.571 mulheres (≥ 40 anos) residentes em todas as regiões brasileiras. Modelo de regressão de Poisson com abordagem hierarquizada foi utilizado para estimar razões de prevalência. Resultados: As características associadas à não realização de mamografia foram: idade ≥ 60 anos, baixa escolaridade, viver sem companheiro, avaliar negativamente o próprio estado de saúde, possuir alguma doença crônica, não praticar exercício físico, não realizar o exame clínico da mama até um ano, ou o exame de Papanicolaou até três anos, não ter consultado com médico no último ano, não possuir plano de saúde, sentir-se discriminada por profissional de saúde e ter cadastro em uma unidade de saúde da família. Variáveis sociodemográficas se sobressaíram no Norte e Nordeste; e nas outras regiões, condições de saúde e hábitos de vida. Conclusão: Variáveis relacionadas ao uso dos serviços de saúde tiveram destaque na não realização da mamografia. Ações que reduzam a desigualdade no acesso ao exame devem ser adotadas em cada macrorregião do Brasil.

OBJECTIVE: To estimate the effect of being a beneficiary of the Bolsa Família Program (BFP) in the vaccination of children aged 13 to 35 months. METHODS: Our study was based on all birth records of residents of Ribeirão Preto (SP) and probabilistic sampling with 1/3 of the births of residents of São Luís (MA), selecting low-income children, born in 2010, belonging to the cohorts Brazilian Ribeirão Preto and São Luís Birth Cohort Studies and eligible for the Bolsa Família program. The information of Cadastro Único (CadÚnico – Single Registry) was used to categorize the receipt of benefit from the BFP (yes or no). The final sample consisted of 532 children in Ribeirão Preto and 1,229 in São Luís. The outcome variable was a childhood vaccine regimen, constructed with BCG, tetravalent, triple viral, hepatitis B, poliomyelitis, rotavirus and yellow fever vaccines. The adjustment variables were: economic class, mother’s schooling and mother’s skin color. Children with monthly per capita family income of up to R$ 280.00 and/or economic class D/E were considered eligible for the benefit of the BFP. A theoretical model was constructed using a directed acyclic graph to estimate the effect of being a beneficiary of the BFP in the vaccination of low-income children. In the statistical analyses, weighing was used by the inverse of the probability of exposure and pairing by propensity score. RESULTS: Considering a monthly per capita family income of up to R$ 280.00, being a beneficiary of the BFP had no effect on the childhood vaccination schedule, according to weighing by the inverse of the probability of exposure (SL-coefficient: −0.01; 95%CI −0.07 to 0.04; p = 0.725 and RP-coefficient: 0.04; 95%CI −0.02 to 0.10; p = 0.244) and pairing by propensity score (SL-coefficient: −0.01; 95%CI −0.07 to 0.05; p = 0.744 and RP-coefficient: 0.04; 95%CI −0.02 to 0.10; p = 0.231). CONCLUSIONS: The receipt of the benefit of the BFP did not influence childhood vaccination, which is one of the conditionalities of the program. This may indicate that this conditionality is not being adequately monitored.