Ana Paula Sayuri Sato

Universidade de São Paulo

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Elizabeth Fujimori

Universidade de São Paulo

Ana Luíza Vilela Borges

Universidade de São Paulo

Eliseu Alves Waldman

Departamento de Epidemiología

Sophia Cornblüth Szarfarc

Instituto de Saúde

Maria Alice Tsunechiro

Universidade de São Paulo

Kelly Polido Kaneshiro Olympio

Instituto de Saúde

Gisela Soares Brunken

Universidade Federal de Mato Grosso

Maria Aparecida Munhóz Gaíva

Universidade Federal de Mato Grosso

Christiane Borges do Nascimento Chofakian

Universidade de São Paulo

Ana Paula Sacone da Silva Ferreira

Universidade de São Paulo

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Universidade de São Paulo

126

Secretaria Municipal de Saúde

Instituto de Saúde

Secretaria da Saúde

Universidade Brasil

Fundação Oswaldo Cruz

Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo

Departamento de Epidemiología

Universidade Federal do Rio de Janeiro

Instituto Adolfo Lutz

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Vaccine coverage and factors associated with influenza vaccination in the elderly in the city of São Paulo, Brazil: SABE Study 2015

Figshare (2021)

Ana Paula Sayuri Sato Fabíola Bof de Andrade Yeda A. O. Duarte José Leopoldo Ferreira Antunes

Abstract: This study evaluated influenza vaccine coverage among elderly individuals (≥ 60 years) living in the city of São Paulo, Brazil, in 2015, and analyzed associated factors. This was a cross-sectional population-based study of data from the SABE Study (Health, Well-Being, and Aging). The dependent variable was influenza vaccination in the 12 months prior to the interview, and the independent variables were sociodemographic and behavioral characteristics, self-reported health status, and use of health services. Data analysis considered the complex study sample, respecting the sampling weight. Poisson’s regression was used, with significance set at 5%. Vaccine coverage was 79.7% (95%CI: 76.8-82.5). Influenza vaccination was associated with marital status (PR single/without partner = 0.84; 95%CI: 0.77-0.93), physical activity (PR yes = 1.08; 95%CI: 1.01-1.17), and medical appointment in the previous 12 months (PR yes = 1.22; 95%CI: 1.07-1.39). There were no differences between sociodemographic strata. Influenza vaccination in the elderly had already reached the target for universal coverage in the city of São Paulo. The results are relevant for planning the immunization program, pointing to priority groups to motivate for vaccination and valuing interaction between the elderly and health services.

10.6084/m9.figshare.14280904

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Fertility rates among very young adolescent women: temporal and spatial trends in Brazil

BMC Pregnancy and Childbirth (2016)

Ana Luíza Vilela Borges Christiane Borges do Nascimento Chofakian Ana Paula Sayuri Sato Elizabeth Fujimori Luciane Simões Duarte

We assessed whether the reported decrease in fertility rates among 15 to 19 years old Brazilian adolescents has met with a parallel decrease in very young adolescent (10 to 14 years old) fertility rates. So we explored temporal trends for fertility rates among very young adolescents between 2000 and 2012 for Brazil as a whole, its regions and states; and also analyzed the spatial distribution of fertility rates among Brazilian municipalities in the years 2000 and 2012.We used data from the Information System on Live Births to calculate the rates. To examine the temporal trends, we used linear regression for time series with Prais-Winsten estimation, including the annual percentage change, for the country, regions, and states. To analyze the spatial distribution among Brazilian municipalities, we calculated the Global Moran Index and created a local Moran significance and cluster map through Local Indicators of Spatial Association (LISA). We also elaborated a thematic map with the rates using empirical Bayesian estimation.Brazilian very young adolescent fertility rates remained high and stable throughout the 2000 to 2012 period, and significantly decreased in three out of 26 states, and in the federal district. On the other hand, an increase was observed in two Northern and Northeastern states. The rates were spatially dependent in Brazilian municipalities (Moran Index = 0.22 in 2012; p = 0.05). The maps indicated a heterogeneous distribution of the rates, with high-rate clusters predominant in the North and low-rate clusters predominant in the South, Southeast, and Midwest.Our findings indicate that Brazilian very young adolescent fertility rates have not decreased in parallel with adolescent fertility rates as they remain high and did not decrease from 2000 and 2012, even though a few states presented a decrease. Thus, these phenomena probably have distinct underlying causes that warrant further elucidation. Progress in this field is crucial for the development of specific policies and programs focused on very young adolescents.

Total fertility rate

10.1186/s12884-016-0843-x

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Equal access to vaccines: lessons learned and future perspectives

Saúde e Sociedade (2023)

Ariane de Jesus Lopes de Abreu Ana Paula Sayuri Sato Eliseu Alves Waldman

Abstract Vaccination is an essential component of primary health care and coping with health emergencies. However, despite the progress from the last decades, important barriers persist resulting in lower access and disparities between the countries in the access to new vaccines. In this scenario, the World Health Organization (WHO) launched, in 2020, the Immunization Agenda for the 2021-2030 decade (AI2030). This article aims to discuss the main factors that affect access to vaccines and strategies to promote equity in access to them at global and national levels. These factors are multi-sectoral and need to be considered in both levels, with emphasis on financial and geographic barriers, infrastructure challenges, socioeconomic and cultural factors, public policies, and governance. The text points the need to remodel the global architecture of production chains and research and innovation centers, creating and/or strengthening existing ones in low- and middle-income countries. In addition, establishing new mechanisms and models for the production and commercialization of vaccines is necessary. The strategies adopted for accessing vaccines and other health technologies are at the center of the global health agenda debate.

Equity

Global Health

10.1590/s0104-12902023230486en

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Association Between Gestational Weight Gain According to Three International Charts and Child Adverse Outcomes in Brazil: Results from Multiple Cohort Data (P11-126-19)

Current Developments in Nutrition (2019)

Thaís Rangel Bousquet Carrilho Dayana Rodrigues Farias Mônica Araújo Batalha Ronaldo Fernandes Santos Alves Nathalia Costa

To evaluate the association between gestational weight gain (GWG) classified according to three international charts and adverse child outcomes in the Brazilian population. Data from 12 cohorts conducted in Brazil (1990-2018) were combined in a pooled dataset of 15,066 women. Weight and gestational age were measured. Adult (18-48 years) women with singleton pregnancies and free of hypertension and diabetes were included. Selected centiles of three international charts were used [Life-cycle project – L charts, Intergrowth-21st - I chart and Hutcheon – H charts]. Total GWG was calculated as: difference between the weight measured up to 14 days before delivery and the weight measured in the 1st trimester (I chart) or the pre-pregnancy self-reported weight (L and H charts). The outcomes were small and large for gestational age infants (SGA/LGA, < 10th/ > 90th - Intergrowth centile), low birth weight (LBW, < 2500g) and macrosomia (> 4000g). Multinomial logistic regressions were fitted for selected centiles (lowest: 3rd, 5th, 10th, 25th; highest: 75th, 90th, 95th, 97th) to evaluate the charts' performance in the prediction of the outcomes. A total of 7,456 women were included in the analysis. Total GWG was 12.1 kg (SD = 5.9) and GWG from the 1st trimester to delivery 10.9 kg (SD = 4.8). The prevalence of SGA was 6.6%, LGA, 14.9%, LBW, 6.5% and macrosomia, 4.7%. For all charts, women who gained weight in the lowest centiles presented higher prevalences of SGA and LBW in comparison to those on the highest centiles, while women with gains in the highest centiles, presented higher prevalences of LGA and macrosomia. L charts presented a better performance to predict outcomes, i.e., women with gains in the highest centiles were associated with increased odds of LGA and macrosomia and those in the lowest centiles with increased odds for SGA and LBW. Analysis based on H charts provided similar results. The poorest performance was observed for I charts, in which only women with gains on the higher centiles were associated with the occurrence of LGA (Figure). L charts seem to better predict the occurrence of child outcomes. Further investigation is needed to decide the most appropriate chart and cutoffs for GWG recommendations for the Brazilian population, considering maternal and child adverse outcomes. The Brazilian National Council for Scientific and Technological Development and Bill and Melinda Gates Foundation.

Growth chart

10.1093/cdn/nzz048.p11-126-19

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Anemia em gestantes brasileiras antes e após a fortificação das farinhas com ferro Anemia en gestantes brasileñas antes y después de la fortificación de harinas con hierro Anemia in Brazilian pregnant women before and after flour fortification with iron

DOAJ (DOAJ: Directory of Open Access Journals) (2011)

Elizabeth Fujimori Ana Paula Sayuri Sato Sophia Cornblüth Szarfarc Glória Valéria da Veiga Valterlinda Alves de Oliveira Queiroz

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Hemoglobin curves during pregnancy before and after fortification of flours with iron

Revista da Escola de Enfermagem da USP (2014)

Ana Paula Sayuri Sato Elizabeth Fujimori Sophia Cornblüth Szarfarc

Objective: To assess the level of hemoglobin-Hb during pregnancy before and after fortification of flours with iron. Method: A cross-sectional study with data from 12,119 pregnant women attended at a public prenatal from five macro regions of Brazil. The sample was divided into two groups: Before-fortification (birth before June/2004) and After-fortification (last menstruation after June/2005). Hb curves were compared with national and international references. Polynomial regression models were built, with a significance level of 5%. Results: Although the higher levels of Hb in all gestational months after-fortification, the polynomial regression did not show the fortification effect (p=0.3). Curves in the two groups were above the references in the first trimester, with following decrease and stabilization at the end of pregnancy. Conclusion: Although the fortification effect was not confirmed, the study presents variation of Hb levels during pregnancy, which is important for assistencial practice and evaluation of public policies.

10.1590/s0080-623420140000300004

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389. Ultrasound Evidence of the Difference between Male and Female Fetus Size during Pregnancy

日本産科婦人科學會雜誌 (1982)

Ana Paula Sayuri Sato Seung‐Kwon Koh Chika Kakuta

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The environmental impact of informal and home productive arrangement in the jewelry and fashion jewelry chain on sanitary sewer system

Environmental Science and Pollution Research (2018)

Fernanda Junqueira Salles Ana Paula Sayuri Sato Maciel Santos Luz D. I. T. Fávaro Francisco Jorge Ferreira

Mercury

Sewage sludge

10.1007/s11356-018-1357-z

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Does the knowledge of emergency contraception affect its use among high school adolescents?

Cadernos de Saúde Pública (2016)

Christiane Borges do Nascimento Chofakian Ana Luíza Vilela Borges Ana Paula Sayuri Sato Gizelton Pereira Alencar Osmara Alves dos Santos

This study aimed to test how knowledge on emergency contraception (according to age at sexual initiation, type of school, and knowing someone that has already used emergency contraception) influences the method's use. This was a cross-sectional study in a probabilistic sample of students 15-19 years of age enrolled in public and private middle schools in a medium-sized city in Southeast Brazil (n = 307). Data were collected in 2011 using a self-administered questionnaire. A structural equations model was used for the data analysis. Considering age at sexual initiation and type of school, knowledge of emergency contraception was not associated with its use, but knowing someone that had used the method showed a significant mean effect on use of emergency contraception. Peer group conversations on emergency contraception appear to have greater influence on use of the method than knowledge itself, economic status, or sexual experience.

Emergency Contraception

Affect

10.1590/0102-311x00188214

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O conhecimento da contracepção de emergência afeta seu uso entre adolescentes do Ensino Médio do Brasil

Christiane Borges do Nascimento Chofakian Ana Luíza Vilela Borges Ana Paula Sayuri Sato Gizelton Pereira Alencar Osmara Alves dos Santos

O objetivo do trabalho foi testar como o conhecimento da anticoncepcao de emergencia, na presenca da idade de iniciacao sexual, tipo de escola e conhecer alguem que ja usou a anticoncepcao de emergencia, influencia no uso deste metodo. Estudo transversal realizado com uma amostra probabilistica com estudantes de 15-19 anos, matriculados no Ensino Medio de escolas publicas e privadas em uma cidade de porte medio do Sudeste do Brasil (n = 307). Os dados foram coletados em 2011, por meio de um questionario autoadministrado. Modelo de equacoes estruturais foi usado para analise de dados. Considerando a idade de iniciacao sexual e o tipo de escola, o conhecimento da anticoncepcao de emergencia nao foi associado com o seu uso, no entanto, conhecer alguem que ja tinha usado o metodo mostrou um efeito medio significativo no uso da anticoncepcao de emergencia. Parece que as conversas a respeito do uso da anticoncepcao de emergencia nas relacoes sociais, como o grupo de pares, tem maior influencia sobre a utilizacao do metodo do que o proprio conhecimento, situacao economica ou experiencia sexual.

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