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Introduction: Treatment for multiple sclerosis should focus on relapse prevention and treatment, as well as symptom and disease progression control, which require the use of multiple medications. Objective: To evaluate the association of polypharmacy and related clinical, epidemiological factors in multiple sclerosis patient cohorts. Methods: It was conducted a prospective study of multiple sclerosis patients that held a prescription of disease-modifying drugs between January and December 2017. The medications were analyzed and classified as either long-term or as-needed medications for therapeutic objective and prescription status purposes. Results: During 2017, 124 patients were attended, 106 were eligible for the study, and 81 agreed to participate. The average age was 40.95±11.69 years. The disease duration varied between 6 months and 30 years, with a median of 7 years. More than half of the multiple sclerosis patients suffered from comorbidities (54.32%), and 76.54% were categorized as polypharmacy. The comparison of polypharmacy between the groups yielded significant differences for comorbidities and employment status and regarding age between patients with polypharmacy and patients without polypharmacy of long-term medications. Conclusion: The age of the patient and the presence of comorbidities are important factors related to polypharmacy.

ObjectiveTo determine the incidence of medication discrepancies in transition points of care of hospitalised children.DesignA prospective observational multicentre study was carried out between February and August 2019. Data collection consisted of the following steps: sociodemographic data collection, clinical interview with the patient’s caregiver, review of patient prescriptions and evaluation of medical records. Medication discrepancies were classified as intentional (documented or undocumented) and unintentional. In addition, discrepancies identified were categorised according to the medication discrepancy taxonomy. Unintentional discrepancies were assessed for potential clinical harm to the patient.SettingPaediatric clinics of four teaching hospitals in Brazil.PatientsChildren aged 1 month–12 years.FindingsA total of 248 children were included, 77.0% (n=191) patients had at least one intentional discrepancy; 20.2% (n=50) patients had at least one unintended discrepancy and 15.3% (n=38) patients had at least one intentional discrepancy and an unintentional one. The reason for the intentional discrepancy was not documented in 49.6% (n=476) of the cases. The most frequent unintentional discrepancy was medication omission (54.1%; n=66). Low potential to cause discomfort was found in 53 (43.4%) unintentional discrepancies, while 55 (45.1%) had the potential to cause moderate discomfort and 14 (11.5%) could potentially cause severe discomfort.ConclusionsAlthough most medication discrepancies were intentional, the majority of these were not documented by the healthcare professionals. Unintentional discrepancies were often related to medication omission and had a potential risk of causing harm to hospitalised children.

This study aimed to evaluate the influence of Integrated Continuous Care on the functional independence of the elderly. This cohort study included participants aged 60 years or older who had experienced a disabling event or disease, and were admitted to rehabilitation in a Brazilian Integrated Continuous Care Unit. The functional gain was evaluated by the Barthel index. Fifty-nine elderly individuals admitted due to a disabling event or disease at the ICCU were assisted from March 2014 to February 2015. Since twenty-two of these were excluded, only 37 participants were evaluated. The mean age of the elderly that were included was 70.41 years (± 1.40) and most of them presented an ischemic stroke diagnosis (64.9%). The total functional gain was 24.05 (± 3.84) points, with an average stay of 32.32 (± 2.18) days. When compared with the degree of dependence on the admission and at discharge, total or severe dependence was identified in 62.2% on admission and mild dependence or total independence was identified in 54.1% at discharge, with a significant decrease in the percentage of the elderly with total dependence between admission and discharge (McNemar test, p = 0.001). At hospital discharge, 70.3% of the elderly had better individual performance in their Activities of Daily Living than at hospital admission and none of them got worse. The multi-professional team-based approach in the Integrated Continuous Care assistance model favors the elderly with gain in functionality and independence. The social network involvement of the elderly lead to their empowerment and co-responsibility along with their family/caregiver in pursuit of the therapeutic goals established together. Investigar a influência dos Cuidados Continuados Integrados na independência funcional de idosos. Este estudo de coorte incluiu participantes com 60 anos ou mais que sofreram algum evento ou doença incapacitante e que foram internados para reabilitação em Unidade Brasileira de Cuidados Continuados Integrados. O ganho funcional foi avaliado pelo índice de Barthel. Cinquenta e nove idosos admitidos por um evento ou doença incapacitante na UCCI foram atendidos de março de 2014 a fevereiro de 2015. Como vinte e dois deles foram excluídos, apenas 37 participantes foram avaliados. A média de idade dos pacientes incluídos foi de 70,41 anos (± 1,40) e a maioria apresentou AVC isquêmico como diagnóstico (64,9%). O ganho funcional total foi de 24,05 (± 3,84) pontos, com tempo médio de permanência de 32,32 (± 2,18) dias. Quando comparados o grau de dependência na admissão e na alta, a dependência total ou grave foi identificada em 62,2% na admissão e a dependência leve ou independência total foi identificada em 54,1% na alta, com uma diminuição significativa no percentual de pacientes com dependência total entre admissão e alta (teste de McNemar, p = 0,001). Na alta hospitalar, 70,3% dos pacientes apresentaram melhor desempenho individual em suas Atividades de Vida Diária do que no momento da admissão hospitalar e nenhum paciente piorou. A abordagem multiprofissional baseada em equipe no modelo assistencial do Cuidado Integrado Contínuo beneficia o idoso, com ganho de funcionalidade e independência. O envolvimento do paciente na rede social leva ao empoderamento e corresponsabilidade deste e da família/cuidador na busca dos objetivos terapêuticos estabelecidos em conjunto.

Rationale: Necrotizing fasciitis is a destructive tissue infection with rapid progression and high mortality. Thus, it is necessary that high-performance dressings be introduced as possibilities of treatment. Patient concerns: Female patient, 44 years of age, admitted to hospital unit complaining of lesion in the gluteal region and drainage of purulent secretion in large quantity followed by necrosis. Diagnoses: The diagnosis of necrotizing fasciitis was carried out with the computerized tomography examination result and its association with the patient's clinical condition. Interventions: Initially, successive debridements were carried out in lower limbs as well as primary dressing with enzymatic debriding action until indication of negative pressure wound therapy, for the period of 2 weeks in the right lower limb and for 5 weeks in the left lower limb, with changes every 72 h. Dressing with saline gauze was used at the end of this therapy until hospital discharge. Outcomes: After the use of negative pressure wound therapy, we observed the presence of granulation tissue, superficialization and reduction of lesion extension. The patient presented good tolerance and absence of complications. Lessons: Negative pressure wound therapy constituted a good option for the treatment of necrotizing fasciitis, despite the scarcity of protocols published on the subject.

Pharmacovigilance encompasses the detection, evaluation, understanding, and prevention of adverse effects or any other drug-related problems. Knowledge of real and independent pharmacovigilance data is essential because clinical trials with medicinal products are limited and do not reveal all adverse effects of a product. The spontaneous notification system is one of the main tools used in pharmacovigilance. However, important remaining challenges for health professionals are the accurate recognition of adverse drug reactions and reporting routinely and systematically during their work. Once low notification rates make it harder to detect and monitor potential safety issues, it is needed risk assessment, and regulatory actions to safeguard patient safety. The objective of this study is to present the challenges of pharmacovigilance in Brazil. The implementation of computerized active search tools significantly improves the identification of possible adverse drug effects. Effective pharmacovigilance is crucial to ensure the safety and integrity of healthcare systems, to avoid lengthy hospital stays and to optimize healthcare spending. However, pharmacovigilance tools remain underused, undervalued, or even unknown in Brazil.

The Specialized Component of Pharmaceutical Care is the Brazilian Unified Health System strategy that aims to ensure comprehensive drug treatment at an outpatient level and improve access to high complexity, high cost treatments, such as multiple sclerosis. Given the diversity of treatments available and the differences in financing and dispensing in different countries, the objective of this study was to present the workings of the model of care for patients with multiple sclerosis through the public health system in Brazil in the state of Mato Grosso do Sul. In Campo Grande, the registration and dispensation of drugs for the treatment of multiple sclerosis is the responsibility of the Pharmacy School Professor Ana Maria Cervantes Baraza of the Federal University of Mato Grosso do Sul. In this center, all patients receive pharmaceutical advice on the administration of injectable drugs and oral medications; the storage, preservation, and transportation of refrigerated drugs; and information on the disease and management of adverse reactions. Clinical pharmacy services are also available to patients in a pharmaceutical office, ensuring patient privacy and comfort and enabling the creation of a bond with the pharmacist. The model of care provided by the Pharmacy School allows for the development of pharmaceutical services, encourages the rational use of medicines, and emphasizes the importance of self-care, adherence to therapy, and the co-responsibility of patients and their families.

Objective: To evaluate the health service and the satisfaction of patients and their caregivers in relation to the therapeutic ride, in Integrated Continuous Care. Methods: Cross-sectional, descriptive study, conducted between January 2017 and January 2018, using a specific form for data collection and interview conducted before hospital discharge. Results: The study included 23 patients and 27 caregivers. Regarding the evaluation of the service related to the therapeutic ride, 95.6% (22/23) of the patients and 70.4% (19/27) of the caregivers confirmed that they understood the objectives of this practice. The duration of the therapeutic ride was considered sufficient by 69.6% (16/23) of patients and 70.4% (19/27) of caregivers. Most patients (52.2%) and caregivers (70.4%) declared to be very satisfied with the result of the therapeutic ride. Conclusion: The therapeutic ride demonstrates its differential aspect by adding training, contributing greatly to the safe transition from the hospital to the home.

Objectives: to evaluate the maternalfetal outcomes of thromboprophylaxis with enoxa parin based on scoring system in women with serum markers for hereditary thrombophilia and previous obstetric complications. Methods: a retrospective study was undertaken based on data collected from clinical records. We included 54 pregnant women with serum markers for hereditary thrombophilia undergoing therapeutic intervention with enoxaparin in the period from November 2009 to December 2013. The initial dose of low molecular weight heparin was guided by a scoring system. The maternalfetal outcomes of previous pregnancies and, subsequently, the treatment were compared using the chisquare (χ2) test with the Yates correction and Fisher's Exact Test; p

Objectives: to determine the frequency of serum markers for hereditary and acquired thrombophilia and their association with pregnancy in women with Systemic Lupus Erythematosus (SLE). Methods: a case-control study was conducted among 25 pregnant women with SLE (study group) and 32 pregnant women without known disease and with at least one previous pregnancy (control group). The presence of antiphospholipid antibodies and hereditary thrombophilia were examined in both groups. We used the y2 Test with Yates correction or Fisher's Exact Test to verify the associations and calculate the relative risk. Results: thrombophilia was present in 72.0% of pregnant women with SLE and in 6.0% of patients in the control group. A significant association was found between the presence of SLE and serum markers for hereditary thrombophilia / antiphospholipid antibodies (p

Purpose: To evaluate the effects of enoxaparin and unfractionated heparin (UFH) administered in prophylactic and therapeutic doses on fetal vessels in healthy pregnant Wistar rats, according to Doppler velocimetry measurements. Methods: Fifty animals were assigned to one of five groups: controls (saline), prophylactic and therapeutic enoxaparin (1 and 2 mg/kg/day, respectively), and prophylactic and therapeutic UFH (72 and 400 UI/kg/day, respectively). Uterine horns were examined by ultrasound for identification of live fetuses. A sample of these fetuses underwent Doppler velocimetry. Spectral curves, peak systolic velocity (PSV), pulsatility index (PI), and resistance index (RI) of the middle cerebral artery, ductus venosus, and umbilical artery were investigated. Differences were considered statistically significant when p

PURPOSE: To investigate the association of perinatal variables with the birth of very low birth weight (VLBW) preterm newborns. METHODS: It was a retrospective study of the medical records of infants born after spontaneous preterm labor with admission to a neonatal intensive care unit. Preterm infants were divided into two groups: very low birth weight (VLBW) group (weight 4 weeks (p=0.02; RR=1.8) and early neonatal death (p=0.0001; RR=2.9). CONCLUSIONS: Factors such as hypertension and bleeding comorbidities during delivery and management of gestational age of less than 33 weeks were associated with the birth of VLBW newborns. This group of infants also showed higher RR for the occurrence of early neonatal death.

OBJETIVO: Verificar a frequência e a associação de marcadores séricos para trombofilias hereditárias e adquiridas em gestantes com histórico de pré-eclâmpsia grave em gestação anterior. MÉTODOS: Estudo tipo caso-controle composto por 81 gestantes com histórico de pré-eclâmpsia grave em gestação anterior (grupo de estudo) e 32 gestantes sem antecedente de pré-eclâmpsia grave em gestação anterior (grupo controle). Foi rastreada a presença de anticorpos antifosfolípides e trombofilias hereditárias em ambos os grupos. Foi utilizado o teste χ² com correção de Yates para verificar as associações e calcular os riscos relativos. RESULTADOS: Verificou-se a presença de trombofilias em 60,0% das pacientes com histórico de pré-eclâmpsia e em 6,0% das pacientes do grupo controle. Encontrou-se significante associação entre pré-eclâmpsia grave em gestação anterior e presença de marcadores para trombofilias hereditárias/anticorpos antifosfolípides (p

PURPOSE: To evaluate the effects of exposure of enoxaparin and unfractionated heparin (UFH) in prophylactic and therapeutic doses on the fertility rates of pregnant healthy Wistar rats.METHODS:Enoxaparin and UFH were administered in prophylactic doses 1 mg/Kg/day 72 UI/Kg/day, and in therapeutic doses at 2 mg/kg/day 400UI/Kg/day. The rats were divided into five groups. The number of live and dead foetuses was quantified. The uterine horns were dissected and the presence of early and late reabsorptions (abortions) was determined. A p

Objective We performed an individual participant data (IPD) metaanalysis to calculate the recurrence risk of hypertensive disorders of pregnancy (HDP) and recurrence of individual hypertensive syndromes. Study Design We performed an electronic literature search for cohort studies that reported on women experiencing HDP and who had a subsequent pregnancy. The principal investigators were contacted and informed of our study; we requested their original study data. The data were merged to form one combined database. The results will be presented as percentages with 95% confidence interval (CI) and odds ratios with 95% CI. Results Of 94 eligible cohort studies, we obtained IPD of 22 studies, including a total of 99,415 women. Pooled data of 64 studies that used published data (IPD where available) showed a recurrence rate of 18.1% (n = 152,213; 95% CI, 17.9–18.3%). In the 22 studies that are included in our IPD, the recurrence rate of a HDP was 20.7% (95% CI, 20.4–20.9%). Recurrence manifested as preeclampsia in 13.8% of the studies (95% CI,13.6–14.1%), gestational hypertension in 8.6% of the studies (95% CI, 8.4–8.8%) and hemolysis, elevated liver enzymes and low platelets (HELLP) syndrome in 0.2% of the studies (95% CI, 0.16–0.25%). The delivery of a small-for-gestational-age child accompanied the recurrent HDP in 3.4% of the studies (95% CI, 3.2–3.6%). Concomitant HELLP syndrome or delivery of a small-for-gestational-age child increased the risk of recurrence of HDP. Recurrence increased with decreasing gestational age at delivery in the index pregnancy. If the HDP recurred, in general it was milder, regarding maximum diastolic blood pressure, proteinuria, the use of oral antihypertensive and anticonvulsive medication, the delivery of a small-for-gestational-age child, premature delivery, and perinatal death. Normotensive women experienced chronic hypertension after pregnancy more often after experiencing recurrence (odds ratio, 3.7; 95% CI, 2.3–6.1). Conclusion Among women that experience hypertension in pregnancy, the recurrence rate in a next pregnancy is relatively low, and the course of disease is milder for most women with recurrent disease. These reassuring data should be used for shared decision-making in women who consider a new pregnancy after a pregnancy that was complicated by hypertension.

OBJETIVO: Verificar a associação de variáveis perinatais com o nascimento de recém-nascidos pré-termo de muito baixo peso ao nascer (MBPN). MÉTODOS: Foi um estudo retrospectivo com análise de prontuários de recém-nascidos (RN) de parto pré-termo espontâneo com admissão em unidade de terapia intensiva neonatal. Os RN pré-termo foram distribuídos em dois grupos: grupo muito baixo peso ao nascer (MBPN; peso 4 semanas (p=0,02; RR=1,8) e óbito neonatal precoce (p=0,001; RR=2,9). CONCLUSÕES: Fatores como comorbidades hipertensivas e hemorrágicas durante a gestação e parto com idade gestacional inferior a 33 semanas foram associadas ao nascimento de recém-nascidos de MBPN. Esse grupo de recém-natos também apresentou RR elevado para a ocorrência de óbito neonatal precoce. PURPOSE: To investigate the association of perinatal variables with the birth of very low birth weight (VLBW) preterm newborns. METHODS: It was a retrospective study of the medical records of infants born after spontaneous preterm labor with admission to a neonatal intensive care unit. Preterm infants were divided into two groups: very low birth weight (VLBW) group (weight 4 weeks (p=0.02; RR=1.8) and early neonatal death (p=0.0001; RR=2.9). CONCLUSIONS: Factors such as hypertension and bleeding comorbidities during delivery and management of gestational age of less than 33 weeks were associated with the birth of VLBW newborns. This group of infants also showed higher RR for the occurrence of early neonatal death.

To investigate the association of perinatal variables with the birth of very low birth weight (VLBW) preterm newborns.It was a retrospective study of the medical records of infants born after spontaneous preterm labor with admission to a neonatal intensive care unit. Preterm infants were divided into two groups: very low birth weight (VLBW) group (weight1,500 g) and low birth weight (LBW) group (weight ≥1,500 g and2,500 g). Prenatal variables such as maternal complications during pregnancy and childbirth/postpartum, and fetal/neonatal complications were investigated. Statistical analysis was performed using the Fisher exact test or χ2 test, with calculation of relative risk (RR), and the Student t test for comparison of group means, with the level of significance set at p≤0.05.Hemorrhagic comorbidities (p=0.006; RR=1.2) and hypertension (p=0.04; RR=1.5), surgical delivery (p=0.001; RR=0.5), gestational age33 weeks (p0.001; RR=16.7) and Apgar score at 1st and 5th minute (p=0.006; RR=1.6; p=0.01; RR=1.9) were associated with the occurrence of VLBW. Infants with VLBW had a significant association with the occurrence of metabolic comorbidities (p=0.01; RR=1.8), neurological (p=0.01; RR=1.7) and infectious diseases (p=0.001; RR=1.9), hospitalization4 weeks (p=0.02; RR=1.8) and early neonatal death (p=0.0001; RR=2.9).Factors such as hypertension and bleeding comorbidities during delivery and management of gestational age of less than 33 weeks were associated with the birth of VLBW newborns. This group of infants also showed higher RR for the occurrence of early neonatal death.

Background: In this study, we aimed to verify the frequency of urinary tract infection (UTI) in pregnant women, the main etiologic agents and their antibiotic susceptibilities. Moreover, to confirm UTI as a risk factor for maternal and fetal complications. Methodology: Data collection was performed using medical records from pregnant women suffering from UTIs (the Study Group) and pregnant women without UTIs (the Control Group). Both groups of patients visited the Department of High Risk Pregnancy, University Hospital, Federal University of Mato Grosso do Sul during the period of April 2005 to April 2010. Results: Of the 864 pregnant women studied, 15.6% (135/864) had a UTI. Escherichia coli was the most frequent cause of urinary tract infections, with a frequency of 34.8% (47/135). The E. coli strains were most sensitive to norfloxacin (91.4%), nitrofurantoin (80.8%) and ceftriaxone (74.4%) and most resistant to ampicillin (42.5%), trimethoprim-sulfamethoxazole (31.1%) and first-generation cephalosporins (14.8%). There was a significant association between preterm delivery, low birth weight and UTI in pregnant women. There was no significant association with premature rupture of membranes, admission to Neonatal Intensive Care Unit (Neo ICU) and Apgar of less than 7 at 5 min. Conclusion: The use of urine culture as routine prenatal laboratorial screening allows for the early diagnosis and treatment of UTIs in pregnant women, thereby providing better perinatal conditions.

OBJETIVO: Avaliar se a intervenção com heparina de baixo peso molecular (HBPM) - enoxaparina sódica - foi eficaz na melhora dos desfechos perinatais de mulheres com trombofillias com base em sistema de pontuação. MÉTODOS: Estudo prospectivo, não randomizado, não controlado, realizado em um Ambulatório de Gestação de Alto Risco, durante o período de novembro de 2009 a novembro de 2011. Foram incluídas gestantes com diagnóstico e intervenção terapêutica para trombofilias adquiridas e/ou hereditárias na gestação atual. Os dados obstétricos e perinatais das gestantes anteriores à intervenção foram comparados com os desfechos subsequentes à intervenção, sendo analisados estatisticamente através do teste do χ², com correção de Yates, considerando significativos quando p

To assess whether an enoxaparin-based intervention using a score system was effective in improving perinatal outcome in women with thrombophilia.Prospective, not randomized, uncontrolled, performed at a Clinic of High-Risk Pregnancy from November 2009 to November 2011. We included women with a diagnosis and therapeutic intervention for thrombophilia acquired and/or inherited in the current pregnancy. The obstetric and perinatal outcomes of pregnant women before the intervention were compared with outcomes after the intervention, and statistically analyzed using the χ2 test with Yates correction, considered significant when p0.05. The initial dose of low-molecular-weight Heparin (LMWH) was guided by a scoring system based on the clinical and gestational history of the patients and screening tests for acquired and/or inherited thrombophilia.We included 84 pregnant women with 175 pregnancies before diagnosis, 20.0% of which resulted in fetal ou perinatal death, 40.0% resulted in abortion, 17.7% developed preeclampsia/eclampsia, 10.3% resulted in full-term births, and 29.7% in premature births. In the 84 pregnancies after intervention, 6.0% resulted in fetal ou perinatal death, 1.2% in abortion, 4.8% developed preeclampsia/eclampsia, 22.6% resulted in premature birth, and 70.2% in full-term birth. A significant reduction in the rate of stillbirths/perinatal death (p0.05) and abortion (p0.0001) and a significant increase (p0.05) in the number of live births were observed after intervention.Enoxaparin-based intervention using a score system in pregnant women with thrombophilia is effective in improving perinatal outcome.

To determine the frequency and the association of serum markers for inherited and acquired thrombophilias in pregnant women with a history of severe pre-eclampsia in previous pregnancies.Case-control study consisting of 81 pregnant women with a history of severe pre-eclampsia in previous pregnancies (study group) and 32 women with no history of severe pre-eclampsia in previous pregnancies (control group). The presence of inherited thrombophilia and antiphospholipid antibodies was screened in both groups. We used the chi-square test with Yates correction to assess associations and calculate the relative risks.The presence of thrombophilia was detected in 60.0% of patients with a previous history of pre-eclampsia and in 6.0% of the control patients. A significant association was found between pre-eclampsia in a previous pregnancy and the presence of markers for hereditary thrombophilia/antiphospholipid antibodies (p0.05). The relative risk to develop pre-eclampsia was found to be 1.57 (1.34RR1.84) for pregnant women with antiphospholipid antibodies, 1.53 (1.26RR1.86) for women with hereditary thrombophilia markers and 1.86 (1.45RR2.38) considering the presence of hereditary thrombophilia and/or antiphospholipid antibodies.Women with serum markers for inherited or acquired thrombophilia showed a high relative risk to develop pre-eclampsia.

AIMS: To verify the perinatal outcomes in pregnant women with acute toxoplasmosis, and to determine if there was association between the results of Toxoplasma gondii-specific IgG avidity test and the presence or absence of fetal/neonatal infection. METHODS: A cross-sectional study included pregnant women with serological diagnosis of acute toxoplasmosis (presenting a positive Toxoplasma gondii-specific IgM test) attended at the outpatient unit for high-risk pregnancy of the Faculty of Medicine, Federal University of Mato Grosso do Sul, Brazil, in the period from November 2002 to November 2007. Test results demonstrating IgG avidity index above 30% were considered high avidity, while values below 30% were considered low avidity. Fetal and/or neonatal infection was defined by positive result for the polymerase chain reaction in amniotic fluid, or by a positive Toxoplasma gondii-specific IgM test in the newborn's serum. RESULTS: Considering all pregnant women referred to the outpatient unit for high-risk pregnancy in the period of study, frequency of pregnant women with positive Toxoplasma gondii-specific IgM was 10.8% (176/1.634). The rate of congenital infection in these patients was 4% (7/176). The IgG avidity test was performed in 162 patients (92% of the 176 pregnant women with positive IgM), and the avidity was high in 144 (88.9%). There was an association (p=0.003) between high avidity and no fetal/neonatal toxoplasmosis in our sample, with a prevalence ratio of 13.4 (confidence interval [CI] 95% 2.2-86.6). The positive predictive value of the avidity test (probability of congenital infection with a low avidity) was 22% (95% 6%-47%), while the negative predictive value (probability of absence of congenital infection with a high avidity) was 98% (95% CI 94% -99%). CONCLUSIONS: In this study the rate of congenital infection in pregnant women diagnosed with acute toxoplasmosis was 4%. In pregnant women with positive Toxoplasma gondii-specific IgM, results of Toxoplasma gondii-specific IgG avidity test were associated with the presence or absence of congenital infection, with a high negative predictive value (no fetal/neonatal infection when avidity was high).

Objectives: To estimate vertical HIV transmission rate in a capital city of the Midwest region of Brazil and describe the factors related to transmission. Methods: A descriptive epidemiological study based on the analysis of secondary data from the Notifiable Diseases Information System (SINAN). The analysis considered all HIV-infected pregnant women with delivery in Campo Grande-MS in the years 2007–2013 and their HIV-exposed infants. Results: A total of 218 births of 176 HIV-infected pregnant women were identified during the study period, of which 187 infants were exposed and uninfected, 19 seroconverted, and 12 were still inconclusive in July 2015. Therefore, the overall vertical HIV transmission rate in the period was 8.7%. Most (71.6%) of HIV-infected pregnant women were less than 30 years at delivery, housewives (63.6%) and studied up to primary level (61.9%). Prenatal information was described in 75.3% of the notification forms and approximately 80% of pregnant women received antiretroviral prophylaxis. Among infants, 86.2% received prophylaxis, but little more than half received it during the whole period recommended by the Brazilian Ministry of Health. Among the exposed children, 11.3% were breastfed. Conclusion: The vertical HIV transmission rate has increased over the years and the recommended interventions have not been fully adopted. HIV-infected pregnant women need adequate prophylactic measures in prenatal, intrapartum and postpartum, requiring greater integration among health professionals. Keywords: Vertical transmission, HIV, Disease prevention, Antiretroviral therapy, Prenatal follow-up, Health services, Social environment