Objective: To describe the repercussions, from the perspectives of caregiver mothers, of confirmed congenital Zika syndrome (CZS) in their offspring. Methods:A descriptive-exploratory study with a qualitative approach was carried out in the state of Espírito Santo in southeastern Brazil, with 25 women who had a child diagnosed with CZS.Results: Emerging themes from the content analysis were grouped into two categories:(1) inequalities experienced by mothers, including social inequality, poverty, and gender inequality; (2) the impact of a child with CZS on mothering, including feelings at the time of diagnosis, maternal isolation and mental health, experiences of stigma and prejudice, and exhausting itineraries searching for therapeutic care. Conclusion:The repercussions of CZS were a huge burden on already vulnerable women, and social inequalities and poverty were important markers in the mothers' reports.Many of the families affected by CZS already lived in precarious social conditions and these conditions were exacerbated further. Robust public and social policies to support these mothers need effective implementation given that babies born with CZS need long-term care and support.

Introduction:This proof-of-concept study aims to demonstrate that quantitative texture analysis of magnetic resonance imaging (MRI) of orbital tumours can produce a unique footprint as an adjunct to histology and as a reference guide.Methods:‘MaZda’ texture analysis software programme version 4.6 and MedCalc software (18.10.2) were used for data procuring and analysis. The following statistical analyses were performed: analysis of variance (ANOVA) to compare histogram means; Wilcoxon signed rank sum test to compare intra-lesion variability; Mann-Whitney U test to compare inter-lesion feature differences; area under curve to test sensitivity and specificity in differentiating abnormal from normal tissue; and Fisher’s coefficient and linear discriminant analysis to reduce data vector dimensions.Results:Thirteen cases were assessed. Eleven cases were imaged with similar protocols. The software produced characteristic histograms and other quantitative parameters for a variety of orbital pathologies. The mean of histograms differed significantly between pathologies as well as other texture features and there were significant minimal misclassifications on inter-tumour analysis. Though the test showed 100% sensitivity in detecting abnormal tissues, it was not specific in differentiating some of the adnexal normal tissues from certain types of orbital tumours.Conclusions:This proof-of-concept study confirms that the non-invasive classification of orbital tumours is achievable. Further studies are needed to create a larger reference framework.

Objective: To perform spatial distribution analysis of reported cases of Zika virus and congenital Zika syndrome (CZS) in the state of Espírito Santo, Brazil, by neighborhood, and relate the results to sociodemographic indicators and implications for the health process. Methods: An ecological study using data from the 2016 National Notifiable Diseases Surveillance System, epidemiological records, and information on neighborhoods of families confirmed with CZS from qualitative field research. Results: Sociodemographic indicators were analyzed in three distinct groups: general population with Zika virus, pregnant women with Zika virus, and cases of CZS visited.For the three groups, average literacy rates were 71.1%, 71.0%, and 68.3%; the average income per minimum wage was 1.4, 1.1, and 1.4; sanitary sewage coverage was 75.6%, 76.1%, and 71.4%; garbage coverage was 90.8%, 91.2%, and 89.2%; and water supply was 93.8%, 94.1% and 93.8%, respectively. Socioeconomic indicators showed no significant differences between groups, although they were above the national average. A nonsignificant variation of 68.3%-71.1% was seen in the average literacy level above 15 years of age. Conclusion: Socioeconomic and demographic indicators of cases of Zika virus infectionand CZS may indicate that the outbreak had different impacts according to class, social group, or gender, reflecting the persistence and social geography of inequality in Brazil.

Background The provision of care and monitoring of health are essential for indigenous Venezuelans from the Warao ethnic group, who are at risk of decimation. Objective Analyze a Local Action Plan (LAP) to promote access to the health system of indigenous Venezuelans from the Warao ethnic group (IVWEG) in Manaus, Brazil. Method A mixed-methods study was performed. Quantitative data were collected to assess the provision of care and monitoring of health conditions in IVWEG through a survey that was self-completed by healthcare providers. Qualitative narrative data were collected to gain insight into IVWEG that seek care. We applied descriptive statistics, grouping analysis (GA) by hierarchical levels, and multiple correspondence analysis (MCA). Content analysis was applied to qualitative data. Results 106 healthcare providers participated in the study, with the following characteristics: 94 (88.7%) females, 67 (63.2%) pardo race/color, 40 (37.7%) working in primary healthcare, and 49 (46.2%) nurses. In addition, 43 (40.6%) of the healthcare providers reported providing care to IVWEG. Among the providers, 89 (84%) had received training for assisting IVWEG. Additionally, 30 IVWEG were enrolled for interviews in the qualitative phase. The barriers to seeking care were language, distance to health units, and lack of money for transportation. The LAP proved to facilitate access to the health system by indigenous Venezuelans from the Warao ethnic group in Manaus. The study contributed to knowledge on a LAP addressed to IVWEG and helped improved their access to the health system, providing appropriate training for healthcare providers and other relevant actors by implementing a coherent and consistent public health policy at the local level.

Introduction: Human infection caused by the new Coronavirus is a public health emergency of international importance, whose clinical spectrum ranges from mild symptoms to severe acute respiratory syndrome. However, there is weak information about the clinical presentations of Coronavirus in newborns and children. Objective: To describe the recommendations about breastfeeding during SARS-CoV-2 infection. Methods: Scope review study. Results: The discussion on viral transmission through breastfeeding is controversial and the recommendations vary according to experts of different countries. Conclusion: The scientific knowledge currently available does not allow to accurately inform the best conduct in the breastfeeding process, making each country decide the strategy that best adapts to its reality. Implications for the practice: It is important that the health team has a close eye to identify atypical signs and symptoms during this process to act preventively in the face of possible complications.