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Impacto da vacina antipneumocócica 10‐valente na redução de hospitalização por pneumonia adquirida na comunidade em crianças
Impact of the pneumococcal 10‐valent vaccine on reducing hospitalization for community‐acquired pneumonia in children
Sandra Rodrigues da Silvaa, Luane Marques de Mellob, Anderson Soares da Silvab, Altacílio Aparecido Nunesb,
Autor para correspondencia
altacilio@fmrp.usp.br
altacilio@gmail.com

Autor para correspondência.
a Superintendência Regional de Saúde de Alfenas, Alfenas, MG, Brasil
b Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo (FMRP‐USP), São Paulo, SP, Brasil
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    "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0065">Introdu&#231;&#227;o</span><p id="par0005" class="elsevierStylePara elsevierViewall">Entre os v&#225;rios agentes etiol&#243;gicos bacterianos envolvidos na g&#234;nese da pneumonia adquirida na comunidade &#40;PAC&#41;&#44; o <span class="elsevierStyleItalic">Streptococcus pneumoniae</span> &#233; o principal causador da doen&#231;a em crian&#231;as e adultos&#46; Atualmente s&#227;o relatados 91&#160;sorotipos<a class="elsevierStyleCrossRefs" href="#bib0105"><span class="elsevierStyleSup">1&#44;2</span></a> associados a essa e outras doen&#231;as&#46; No entanto&#44; as PAC s&#227;o as que provocam maior morbidade&#44; estima&#8208;se a ocorr&#234;ncia de 13&#44;8&#160;milh&#245;es de novos casos em todo o mundo a cada ano&#46;<a class="elsevierStyleCrossRefs" href="#bib0115"><span class="elsevierStyleSup">3&#44;4</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">Entre 6&#8208;16&#37; dos casos de PAC necessitam de hospitaliza&#231;&#227;o e em crian&#231;as abaixo dos cinco anos&#44; a doen&#231;a&#44; sobretudo de etiologia bacteriana&#44; &#233; respons&#225;vel por 20&#8208;40&#37; das interna&#231;&#245;es apenas no continente americano&#46;<a class="elsevierStyleCrossRef" href="#bib0120"><span class="elsevierStyleSup">4</span></a> No Brasil&#44; entre 2004 e 2006&#44; as doen&#231;as pneumoc&#243;cicas foram respons&#225;veis por cerca de 34&#46;000&#160;interna&#231;&#245;es&#46;</p><p id="par0015" class="elsevierStylePara elsevierViewall">A estimativa mundial da incid&#234;ncia de PAC nos pa&#237;ses em desenvolvimento entre crian&#231;as de 1&#8208;5&#160;anos &#233; de 0&#44;29&#160;epis&#243;dios&#47;crian&#231;a&#47;ano&#46; Isso equivale a uma incid&#234;ncia de anual de cerca de 150&#160;milh&#245;es de casos da doen&#231;a&#59; 11&#8208;20&#37; desses precisam de interna&#231;&#227;o hospitalar&#46;<a class="elsevierStyleCrossRef" href="#bib0120"><span class="elsevierStyleSup">4</span></a> No Brasil&#44; segundo o Sistema de Informa&#231;&#227;o Hospitalar &#40;SIH&#8208;SUS&#41;&#44; de janeiro de 2005 a mar&#231;o de 2006 a PAC foi a causa de interna&#231;&#227;o de cerca de 20&#37; nos menores de cinco&#160;anos&#46;<a class="elsevierStyleCrossRefs" href="#bib0125"><span class="elsevierStyleSup">5&#8211;7</span></a></p><p id="par0025" class="elsevierStylePara elsevierViewall">Medidas preventivas s&#227;o consensualmente a melhor maneira de reduzir a ocorr&#234;ncia das doen&#231;as pneumoc&#243;cicas e de suas consequ&#234;ncias&#44; como a hospitaliza&#231;&#227;o e a morte prematura&#46;<a class="elsevierStyleCrossRef" href="#bib0125"><span class="elsevierStyleSup">5</span></a> Dentre tais medidas&#44; a imuniza&#231;&#227;o ativa contra os principais agentes causadores&#44; em especial alguns sorotipos do <span class="elsevierStyleItalic">Streptococcus pneumoniae</span>&#44; se mostra&#44; ao longo dos anos&#44; altamente eficiente na redu&#231;&#227;o do aparecimento de formas graves da doen&#231;a&#46;<a class="elsevierStyleCrossRefs" href="#bib0125"><span class="elsevierStyleSup">5&#44;6</span></a></p><p id="par0030" class="elsevierStylePara elsevierViewall">No Brasil&#44; com a incorpora&#231;&#227;o de vacinas pneumoc&#243;cicas&#44; especialmente a 10&#8208;valente&#44; a partir de 2010&#44;<a class="elsevierStyleCrossRefs" href="#bib0130"><span class="elsevierStyleSup">6&#44;7</span></a> observa&#8208;se a redu&#231;&#227;o de doen&#231;as pneumoc&#243;cicas&#44; como as meningites e as PAC&#44;<a class="elsevierStyleCrossRefs" href="#bib0140"><span class="elsevierStyleSup">8&#8211;10</span></a> em crian&#231;as abaixo dos dois&#160;anos&#44; com queda do n&#250;mero de interna&#231;&#245;es&#44; de desnutri&#231;&#227;o&#44; de mortes e absente&#237;smo no trabalho dos pais&#44; al&#233;m de diminui&#231;&#227;o de custos&#44; entre outras&#46;<a class="elsevierStyleCrossRefs" href="#bib0155"><span class="elsevierStyleSup">11&#44;12</span></a></p><p id="par0035" class="elsevierStylePara elsevierViewall">O presente estudo teve como objetivo avaliar o impacto da vacina conjugada pneumoc&#243;cica 10&#8208;valente &#40;PCV&#8208;10&#41;&#44; antes da dose de refor&#231;o vacinal&#44; em crian&#231;as menores de um ano hospitalizadas com PAC antes e ap&#243;s a sua introdu&#231;&#227;o no Programa Nacional de Imuniza&#231;&#227;o &#40;PNI&#41; em munic&#237;pios pertencentes &#224; Superintend&#234;ncia Regional de Sa&#250;de de Alfenas &#40;SRS&#47;Alfenas&#44; MG&#44; Brasil&#41;&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">M&#233;todo</span><p id="par0040" class="elsevierStylePara elsevierViewall">Trata&#8208;se de um estudo ecol&#243;gico que incluiu registros de crian&#231;as vacinadas e n&#227;o vacinadas com a PCV&#8208;10&#44; no per&#237;odo pr&#233; e p&#243;s&#8208;inclus&#227;o no PNI&#44; e considerou&#8208;se a vacina&#231;&#227;o o fator de exposi&#231;&#227;o e a hospitaliza&#231;&#227;o por PAC o desfecho&#46; O estudo usou dados anuais secund&#225;rios por munic&#237;pio para c&#225;lculo da cobertura vacinal e das taxas de morbidade por pneumonia em menores de um ano de 2007 a 2013&#46; Procedeu&#8208;se &#224; compara&#231;&#227;o dos n&#250;meros brutos&#44; ou seja&#44; n&#250;meros n&#227;o proporcionais&#44; de hospitaliza&#231;&#227;o por PAC de 2007 a 2013 nos munic&#237;pios pertencentes &#224; SRS&#47;Alfenas&#46;</p><p id="par0045" class="elsevierStylePara elsevierViewall">Foram investigados registros de crian&#231;as com at&#233; um ano&#44; residentes nos 26&#160;munic&#237;pios sob a jurisdi&#231;&#227;o da SRS&#47;Alfenas &#8211; Secretaria Estadual de Sa&#250;de de Minas Gerais&#44; Brasil&#46; Os dados foram coletados por meio de busca no sistema de informa&#231;&#227;o do SI&#8208;PNI &#40;Sistema de Informa&#231;&#227;o do Programa Nacional de Imuniza&#231;&#227;o&#41;<a class="elsevierStyleCrossRef" href="#bib0165"><span class="elsevierStyleSup">13</span></a> e do banco de dados do Tabwin dispon&#237;vel no N&#250;cleo de Regula&#231;&#227;o da SRS&#47;Alfenas&#44; MG&#46; Os munic&#237;pios pertencentes &#224; SRS&#47;Alfenas s&#227;o&#58; Alfenas&#44; Alterosa&#44; Arceburgo&#44; Areado&#44; Bandeira do Sul&#44; Botelhos&#44; Cabo Verde&#44; Campestre&#44; Campo do Meio&#44; Campos Gerais&#44; Carmo do Rio Claro&#44; Carvalh&#243;polis&#44; Concei&#231;&#227;o da Aparecida&#44; Divisa Nova&#44; Fama&#44; Guaran&#233;sia&#44; Guaxup&#233;&#44; Juruaia&#44; Machado&#44; Monte Belo&#44; Muzambinho&#44; Nova Resende&#44; Paragua&#231;u&#44; Po&#231;o Fundo&#44; S&#227;o Pedro da Uni&#227;o e Serrania&#46;</p><p id="par0050" class="elsevierStylePara elsevierViewall">Foi inclu&#237;da toda a popula&#231;&#227;o infantil no per&#237;odo j&#225; definido&#46; Para verificar a associa&#231;&#227;o entre vari&#225;veis &#40;independentes e resposta&#41;&#44; foram usadas an&#225;lises univariadas e empregaram&#8208;se a raz&#227;o de preval&#234;ncia relativa &#40;RP&#41; e seu respectivo intervalo de confian&#231;a a 95&#37; &#40;IC95&#37;&#41; como estimadores de associa&#231;&#227;o&#46; Posteriormente&#44; foi feita an&#225;lise multivariada por regress&#227;o log&#237;stica&#44; inseriram&#8208;se todas as vari&#225;veis explicativas no modelo &#40;n&#250;mero de hospitaliza&#231;&#245;es por PAC&#44; idade ajustada&#44; sexo&#44; munic&#237;pio de resid&#234;ncia&#44; estado vacinal&#44; cobertura vacinal&#41;&#46; Para an&#225;lise de diferen&#231;as entre propor&#231;&#245;es foi usado o teste qui&#8208;quadrado e para diferen&#231;as entre m&#233;dias o teste <span class="elsevierStyleItalic">t</span> de <span class="elsevierStyleItalic">Student</span> para amostras independentes&#46; Em todas as an&#225;lises considerou&#8208;se um n&#237;vel de signific&#226;ncia de 5&#37;&#46; No armazenamento e na an&#225;lise dos dados foi empregado o <span class="elsevierStyleItalic">software</span> estat&#237;stico SPSS 20&#46;0<span class="elsevierStyleSup">&#174;</span> &#40;IBM SPSS Statistics for Windows&#44; Version&#160;20&#46;0&#44; Armonk&#44; NY&#44; USA&#41;&#46;</p><p id="par0055" class="elsevierStylePara elsevierViewall">O projeto de pesquisa foi submetido ao Comit&#234; de &#201;tica e Pesquisa do Hospital das Cl&#237;nicas da Faculdade de Medicina de Ribeir&#227;o Preto da USP e foi aprovado em 19&#160;de mar&#231;o de 2013 &#40;n&#176;&#160;CAAE&#58; 12487113&#46;5&#46;0000&#46;5440&#41;&#46;</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Resultados</span><p id="par0060" class="elsevierStylePara elsevierViewall">O estudo pretendeu avaliar o n&#250;mero de interna&#231;&#245;es por PAC em menores de um ano&#44; portanto antes do refor&#231;o vacinal&#44; que deve ocorrer entre 12 e 15&#160;meses&#44; e a cobertura vacinal&#44; que ocorreram no per&#237;odo que compreendeu a fase pr&#233; &#40;2007&#44; 2008 e 2009&#41; e p&#243;s &#40;2011&#44; 2012 e 2013&#41; introdu&#231;&#227;o da PCV&#8208;10 no calend&#225;rio vacinal do PNI preconizado pelo Minist&#233;rio da Sa&#250;de&#46; A <a class="elsevierStyleCrossRef" href="#tbl0005">tabela 1</a> mostra o n&#250;mero de crian&#231;as em cada um dos anos nos per&#237;odos pr&#233; e p&#243;s&#8208;vacinal&#44; bem como o n&#250;mero de crian&#231;as inclu&#237;das no estudo&#46; Nota&#8208;se que&#44; no per&#237;odo anterior &#224; introdu&#231;&#227;o da PCV&#8208;10&#44; as perdas foram de 11&#44;3&#37;&#44; enquanto&#44; no per&#237;odo p&#243;s&#8208;vacinal&#44; foram de 8&#44;3&#37;&#46; Todas as perdas se deveram a registros inconsistentes&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0065" class="elsevierStylePara elsevierViewall">O n&#250;mero bruto de registros de crian&#231;as do sexo masculino e do feminino entre 2007 e 2009&#44; foi&#44; respectivamente de 2&#46;632 e 2&#46;459 &#40;<span class="elsevierStyleItalic">p</span>&#60;0&#44;05&#41;&#44; com m&#233;dia de nove&#160;meses&#160;&#40;&#177;1&#41;&#160;para o sexo feminino e de 10&#160;meses &#40;&#177;1&#41; para o masculino &#40;<span class="elsevierStyleItalic">p</span>&#60;0&#44;05&#41;&#46; Considerando&#8208;se o per&#237;odo de 2011 a 2013&#44; foram 2&#46;737&#160;registros de crian&#231;as do sexo masculino e 2&#46;476 do feminino &#40;<span class="elsevierStyleItalic">p</span>&#60;0&#44;05&#41;&#44; com respectivas m&#233;dias de 9&#44;5&#177;1&#160;meses e 10&#177;1&#44;2&#160;meses&#46; Houve diferen&#231;a significativa &#40;<span class="elsevierStyleItalic">p</span>&#60;0&#44;05&#41;&#46;</p><p id="par0070" class="elsevierStylePara elsevierViewall">O n&#250;mero de interna&#231;&#245;es durante o per&#237;odo analisado pode ser verificado na <a class="elsevierStyleCrossRef" href="#fig0005">figura 1</a>&#46; Como pode ser observado&#44; o n&#250;mero de interna&#231;&#245;es por PAC na faixa et&#225;ria menor de um ano passou de 828&#160;em 2007 para 624 em 2013&#46; Foram 5&#46;044&#160;casos de interna&#231;&#245;es por PAC durante o per&#237;odo de an&#225;lise&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0075" class="elsevierStylePara elsevierViewall">Em mar&#231;o de 2010 ocorreu a implanta&#231;&#227;o da vacina pneumoc&#243;cica 10&#8208;valente &#40;conjugada&#41; no calend&#225;rio de vacina&#231;&#227;o da crian&#231;a no PNI&#46; Assim&#44; a cobertura vacinal desse ano n&#227;o alcan&#231;ou os 95&#37; de cobertura preconizada &#40;<a class="elsevierStyleCrossRef" href="#tbl0010">tabela 2</a>&#41;&#46; N&#227;o foi avaliado 2010 em rela&#231;&#227;o &#224; cobertura vacinal&#44; pois poderia introduzir vi&#233;s na an&#225;lise&#44; tanto pela baixa cobertura quanto pela possibilidade de retardo na soroconvers&#227;o vacinal&#46;</p><elsevierMultimedia ident="tbl0010"></elsevierMultimedia><p id="par0080" class="elsevierStylePara elsevierViewall">Na <a class="elsevierStyleCrossRef" href="#fig0010">figura 2</a> &#233; apresentada a quantidade global de interna&#231;&#245;es por PAC nos per&#237;odos pr&#233; e p&#243;s&#8208;incorpora&#231;&#227;o da vacina no PNI&#44; considerando&#8208;se todos os munic&#237;pios da SRS&#47;Alfenas&#46; Ao se considerar o conjunto de munic&#237;pios que comp&#245;e a SRS&#47;Alfenas&#44; houve uma diferen&#231;a significativa de &#8208;13&#44;20&#37; &#40;IC95&#37;&#58;&#160;&#8208;44&#44;08&#37;&#160;a&#160;&#8208;15&#44;31&#37;&#59; <span class="elsevierStyleItalic">p</span>&#60;0&#44;05&#41; na ocorr&#234;ncia de casos de interna&#231;&#227;o por PAC em crian&#231;as entre os per&#237;odos estudados&#46;</p><elsevierMultimedia ident="fig0010"></elsevierMultimedia><p id="par0085" class="elsevierStylePara elsevierViewall">A an&#225;lise multivariada entre o estado vacinal e a ocorr&#234;ncia de interna&#231;&#227;o por PAC em cada um dos 26&#160;munic&#237;pios&#44; ajustada para vari&#225;veis de confus&#227;o&#44; bem como da SRS como um todo&#44; pode ser observada na <a class="elsevierStyleCrossRef" href="#tbl0015">tabela 3</a>&#46;</p><elsevierMultimedia ident="tbl0015"></elsevierMultimedia><p id="par0090" class="elsevierStylePara elsevierViewall">Nos munic&#237;pios de Alfenas&#44; Areado&#44; Bandeira do Sul&#44; Botelhos&#44; Cabo Verde&#44; Campestre&#44; Carmo do Rio Claro&#44; Carvalh&#243;polis&#44; Concei&#231;&#227;o da Aparecida&#44; Divisa Nova&#44; Fama&#44; Muzambinho&#44; Nova Resende&#44; Paragua&#231;u&#44; S&#227;o Pedro da Uni&#227;o e Serrania n&#227;o foram observadas diferen&#231;as de preval&#234;ncia de PAC&#44; entre crian&#231;as vacinadas e n&#227;o vacinadas&#46; Nos munic&#237;pios de Alterosa&#44; Arceburgo&#44; Campo do Meio&#44; Campos Gerais&#44; Guaran&#233;sia&#44; Juruaia&#44; Machado&#44; Monte Belo e Po&#231;o Fundo houve diminui&#231;&#227;o nas interna&#231;&#245;es por PAC em crian&#231;as vacinadas&#44; quando comparadas com as n&#227;o vacinadas&#44; conforme pode ser visto na <a class="elsevierStyleCrossRef" href="#fig0015">figura 3</a>&#46; J&#225; no munic&#237;pio de Guaxup&#233;&#44; houve um aumento significativo de 27&#37; no registro de hospitaliza&#231;&#227;o por PAC entre os dois per&#237;odos estudados &#40;pr&#233; e p&#243;s&#8208;vacinal&#41;&#46; Tal fen&#244;meno necessita de melhor esclarecimento&#46; No conjunto dos 26&#160;munic&#237;pios&#44; a vacina&#231;&#227;o pode ter sido respons&#225;vel por uma redu&#231;&#227;o de 19&#37; nas hospitaliza&#231;&#245;es decorrentes de casos PAC em crian&#231;as menores de um ano&#46; Durante esse per&#237;odo n&#227;o houve mortalidade causada por PAC em menores de um ano no conjunto dos munic&#237;pios da SRS&#47;Alfenas&#46;</p><elsevierMultimedia ident="fig0015"></elsevierMultimedia></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Discuss&#227;o</span><p id="par0095" class="elsevierStylePara elsevierViewall">Este estudo mostrou uma redu&#231;&#227;o de 19&#37; em PAC&#44; em crian&#231;as menores que do um ano&#44; entre 2007&#8208;2009 e 2011&#8208;2013&#44; correspondente aos per&#237;odos antes e ap&#243;s a implanta&#231;&#227;o do Calend&#225;rio Vacinal da PCV&#8208;10 em 2010 no PNI&#44; em 26&#160;munic&#237;pios sob a jurisdi&#231;&#227;o da SRS&#47;Alfenas&#46;</p><p id="par0100" class="elsevierStylePara elsevierViewall">O Minist&#233;rio da Sa&#250;de preconiza como 95&#37; a taxa ideal de cobertura vacinal capaz de dar efici&#234;ncia &#224; vacina pneumoc&#243;cica 10&#8208;valente na redu&#231;&#227;o de casos de PAC e outras doen&#231;as pneumoc&#243;cicas invasivas&#46;<a class="elsevierStyleCrossRefs" href="#bib0155"><span class="elsevierStyleSup">11&#44;12&#44;14</span></a> No presente estudo&#44; a taxa m&#233;dia de cobertura no ano da incorpora&#231;&#227;o da vacina foi de apenas 52&#44;7&#37;&#59; no entanto&#44; em 2011&#44; 2012 e 2013 as taxas foram respectivamente 104&#44;0&#37;&#44; 102&#44;9&#37; e 103&#44;1&#37;&#44; ou seja&#44; acima do preconizado&#46; Espera&#8208;se&#44; portanto&#44; uma redu&#231;&#227;o no n&#250;mero de casos de PAC e de suas consequ&#234;ncias como a hospitaliza&#231;&#227;o e a mortalidade&#44; a qual realmente foi observada&#46; Esse achado &#233; semelhante ao estudo publicado por Afonso et al&#46;&#44;<a class="elsevierStyleCrossRef" href="#bib0175"><span class="elsevierStyleSup">15</span></a> no qual se notou que&#44; em cidades onde a cobertura vacinal foi superior a 95&#37;&#44; houve redu&#231;&#227;o dos casos de pneumonia&#44; ao contr&#225;rio das cidades com menor cobertura&#44; como S&#227;o Paulo&#44; com 75&#37;&#44; e Porto Alegre&#44; com 85&#37;&#44; onde tal redu&#231;&#227;o n&#227;o foi observada No presente estudo&#44; conforme demonstrado nos dados da <a class="elsevierStyleCrossRef" href="#tbl0010">tabela 2</a>&#44; muitos munic&#237;pios apresentaram cobertura vacinal superior a 100&#37;&#46; Isso aconteceu provavelmente devido a dois fatos importantes&#46; O primeiro se refere &#224; intensa migra&#231;&#227;o sazonal nos munic&#237;pios no per&#237;odo de colheita do caf&#233;&#46; Os trabalhadores rurais e suas fam&#237;lias que procuram os postos de vacina&#231;&#227;o s&#227;o vacinados em suas respectivas faixas et&#225;rias&#46; O outro fato seria a extensa zona rural que muitos munic&#237;pios possuem&#46; Assim&#44; para muitas fam&#237;lias fica mais perto ir ao posto de vacina&#231;&#227;o de outra cidade do que em sua pr&#243;pria cidade de resid&#234;ncia&#46;</p><p id="par0105" class="elsevierStylePara elsevierViewall">Al&#233;m dos aspectos diretamente ligados &#224; morbidade e mortalidade das PAC&#44; com impacto na qualidade de vida das crian&#231;as e seus parentes&#44; h&#225; ainda a quest&#227;o econ&#244;mica associada &#224; doen&#231;a&#44; por exemplo&#44; o custo atrelado ao seu manejo&#44; como gastos com antibi&#243;ticos&#44; interna&#231;&#227;o&#44; feitura de exames&#44; falta ao trabalho por parte dos pais&#44; entre outros&#46; Diante disso&#44; alguns estudos t&#234;m mostrado que a vacina&#231;&#227;o para o pneumococo em crian&#231;as &#233; custo&#8208;efetiva sob a perspectiva da sociedade&#44; reduz os encargos totais decorrentes das doen&#231;as pneumoc&#243;cicas&#44; incluindo as PAC&#46; Mart&#237; et al&#46;&#44;<a class="elsevierStyleCrossRef" href="#bib0155"><span class="elsevierStyleSup">11</span></a> em an&#225;lise da custo&#8208;efetividade que tomou por base os anos de vida ganhos com qualidade &#40;QALY&#41; da PCV&#8208;10 em seis pa&#237;ses latino&#8208;americanos&#44; incluindo o Brasil&#44; mostraram que a incorpora&#231;&#227;o dessa imuniza&#231;&#227;o &#233; uma estrat&#233;gia custo&#8208;efetiva na melhoria dos padr&#245;es de sa&#250;de da popula&#231;&#227;o infantil&#46;</p><p id="par0110" class="elsevierStylePara elsevierViewall">Ao se analisarem os per&#237;odos anteriores e posteriores &#224; introdu&#231;&#227;o PCV&#8208;10 no PNI&#44; conforme pode ser visto na <a class="elsevierStyleCrossRef" href="#fig0005">figura 1</a>&#44; o n&#250;mero de interna&#231;&#245;es por PAC nos 26&#160;munic&#237;pios selecionados j&#225; havia apresentado um decl&#237;nio a partir de 2009 &#40;per&#237;odo pr&#233;&#8208;vacinal&#41;&#44; fato que certamente pode ser explicado pelas melhores condi&#231;&#245;es sanit&#225;rias&#44; aumento da renda das fam&#237;lias&#44; bem como aos ganhos na assist&#234;ncia &#224; sa&#250;de das crian&#231;as observados nos &#250;ltimos anos em todo Brasil&#46; Assim&#44; a vacina&#231;&#227;o contra o pneumococo trouxe um incremento &#224; queda observada no per&#237;odo p&#243;s&#8208;introdu&#231;&#227;o da mesma&#44; a partir de 2010&#46;<a class="elsevierStyleCrossRefs" href="#bib0180"><span class="elsevierStyleSup">16&#8211;19</span></a></p><p id="par0120" class="elsevierStylePara elsevierViewall">Uma das limita&#231;&#245;es deste estudo &#233; o fato de se tratar de um estudo ecol&#243;gico&#44; em que a unidade observada n&#227;o &#233; o indiv&#237;duo&#44; mas um conjunto de pessoas que representa uma parcela da popula&#231;&#227;o que est&#225; sob a jurisdi&#231;&#227;o da SRS&#47;Alfenas &#40;crian&#231;as menores de um ano&#41;&#44; por&#233;m foram usadas fontes oficiais que t&#234;m controle de qualidade &#8211; Datasus&#44; SI&#8208;PNI e Tabwin &#8211; dispon&#237;veis no N&#250;cleo de Regula&#231;&#227;o da SRS&#47;Alfenas&#44; mas ainda assim podem apresentar falhas&#44; fato que foi observado nas perdas de registros em pelo menos 8&#44;3&#37; dos casos no per&#237;odo p&#243;s&#8208;vacinal&#46; Outros aspectos limitantes no presente estudo relacionam&#8208;se a poss&#237;veis fatores de confundimento&#44; como&#44; por exemplo&#44; a melhoria nos padr&#245;es nutricionais das crian&#231;as&#44; observados na &#250;ltima d&#233;cada&#44; que contribui para a queda de ocorr&#234;ncia de casos graves de PAC&#44; al&#233;m da vacina&#231;&#227;o&#44; bem como a presen&#231;a de algumas comorbidades e as diferen&#231;as na preval&#234;ncia de PAC entre os g&#234;neros masculino e feminino&#46;<a class="elsevierStyleCrossRefs" href="#bib0190"><span class="elsevierStyleSup">18&#44;20</span></a> Finalmente&#44; outra limita&#231;&#227;o reside no fato de se ter estudado apenas crian&#231;as antes do refor&#231;o vacinal preconizado entre 12 e 15&#160;meses&#46;</p><p id="par0125" class="elsevierStylePara elsevierViewall">No per&#237;odo p&#243;s&#8208;advento da PCV&#8208;10 houve diminui&#231;&#227;o do n&#250;mero de PAC em crian&#231;as menores de 12&#160;meses nas crian&#231;as da regi&#227;o da SRS&#47;Alfenas&#44; MG&#44; Brasil&#46; Em pa&#237;ses em que foram implantadas vacinas antipneumoc&#243;cicas conjugadas e mesmo polissacar&#237;dicas e que se mant&#234;m com altas coberturas vacinais&#44; a redu&#231;&#227;o das doen&#231;as pneumoc&#243;cicas invasivas &#233; significativa&#59; o mesmo resultado foi encontrado neste estudo&#44; que mostrou redu&#231;&#227;o do n&#250;mero de crian&#231;as internadas por PAC&#44; no per&#237;odo estudado&#46;</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Financiamento</span><p id="par0130" class="elsevierStylePara elsevierViewall">O estudo n&#227;o recebeu financiamento&#46;</p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">Conflitos de interesse</span><p id="par0135" class="elsevierStylePara elsevierViewall">Os autores declaram n&#227;o haver conflitos de interesse&#46;</p></span></span>"
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            0 => "Pneumonia"
            1 => "<span class="elsevierStyleItalic">Streptococcus pneumoniae</span>"
            2 => "Imuniza&#231;&#227;o"
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            1 => "<span class="elsevierStyleItalic">Streptococcus pneumoniae</span>"
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    "resumen" => array:2 [
      "pt" => array:3 [
        "titulo" => "Resumo"
        "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Objetivo</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Descrever e analisar a ocorr&#234;ncia de interna&#231;&#245;es por pneumonia adquirida na comunidade em crian&#231;as antes e ap&#243;s a implanta&#231;&#227;o&#44; no Programa Nacional de Imuniza&#231;&#227;o&#44; da vacina pneumoc&#243;cica 10&#8208;valente &#40;conjugada&#41;&#46;</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">M&#233;todos</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Trata&#8208;se de um estudo ecol&#243;gico que incluiu registros de crian&#231;as menores de um ano&#44; vacinadas e n&#227;o vacinadas com a vacina antipneumoc&#243;cica 10&#8208;valente conjugada&#44; no per&#237;odo pr&#233; e p&#243;s&#8208;inclus&#227;o da vacina no Programa Nacional de Imuniza&#231;&#227;o na &#225;rea de abrang&#234;ncia da Superintend&#234;ncia Regional de Sa&#250;de de Alfenas&#44; MG&#44; Brasil&#46; A vacina&#231;&#227;o foi considerada como fator de exposi&#231;&#227;o e a hospitaliza&#231;&#227;o por pneumonia adquirida na comunidade como desfecho&#44; com o uso de dados anuais secund&#225;rios por munic&#237;pio&#46; Para verificar a associa&#231;&#227;o entre as vari&#225;veis foi empregada a raz&#227;o de preval&#234;ncia e seu intervalo de confian&#231;a 95&#37; &#40;IC95&#37;&#41;&#46; Para o c&#225;lculo de diferen&#231;a entre propor&#231;&#245;es empregou&#8208;se o teste Z&#46;</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Resultados</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Considerando os 26&#160;munic&#237;pios da Superintend&#234;ncia Regional de Sa&#250;de de Alfenas&#44; houve redu&#231;&#227;o significativa do n&#250;mero de hospitaliza&#231;&#227;o por pneumonia adquirida na comunidade em crian&#231;as abaixo de um ano&#44; com raz&#227;o de preval&#234;ncia &#40;RP&#41;&#61;0&#44;81 &#40;IC95&#37;&#160;0&#44;74&#8208;0&#44;89&#59; <span class="elsevierStyleItalic">p</span>&#60;0&#44;05&#41;&#44; o que indica uma preval&#234;ncia de interna&#231;&#227;o por pneumonia adquirida na comunidade 19&#37; menor no per&#237;odo p&#243;s&#8208;vacinal&#46;</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Conclus&#245;es</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Os resultados sugerem a efetividade da vacina pneumoc&#243;cica 10&#8208;valente &#40;conjugada&#41; na preven&#231;&#227;o de casos graves da pneumonia adquirida na comunidade em crian&#231;as menores de um ano&#46;</p></span>"
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          0 => array:2 [
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            "titulo" => "M&#233;todos"
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        "titulo" => "Abstract"
        "resumen" => "<span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Objective</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">To describe and analyze the occurrence of hospitalizations for community&#8208;acquired pneumonia in children before and after the pneumococcal 10&#8208;valent conjugate vaccine implementation into the National Immunization Program&#46;</p></span> <span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Methods</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">This is an ecological study that includes records of children younger than one year old&#44; vaccinated and not vaccinated with the pneumococcal 10&#8208;valent conjugate vaccine in the periods pre&#8208; and post&#8208;inclusion of the vaccine in the National Immunization Program in the area covered by the Regional Health Superintendence of Alfenas&#44; state of Minas Gerais&#44; Brazil&#46; Vaccination was considered as the exposure factor and hospitalization for community&#8208;acquired pneumonia as the endpoint&#44; using secondary annual data by municipality&#46; The prevalence ratio and its 95&#37; confidence interval &#40;95&#37;CI&#41; were used to verify the association between variables&#46; The Z test was used to calculate the difference between proportions&#46;</p></span> <span id="abst0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Results</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">Considering the 26 municipalities of the Regional Health Superintendence of Alfenas&#44; there was a significant reduction in hospitalizations for community&#8208;acquired pneumonia in children younger than one year of age&#44; with prevalence ratio &#40;PR&#41;&#61;0&#46;81 &#40;95&#37;CI&#58; 0&#46;74 to 0&#46;89&#59; <span class="elsevierStyleItalic">p</span>&#60;0&#46;05&#41;&#44; indicating a 19&#37; lower prevalence of hospitalization for community&#8208;acquired pneumonia in the post&#8208;vaccination period&#46;</p></span> <span id="abst0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Conclusions</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">The results suggest the effectiveness of the pneumococcal 10&#8208;valent conjugate vaccine in preventing severe cases of community&#8208;acquired pneumonia in children younger than one year of age&#46;</p></span>"
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          "pt" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">N&#250;mero de interna&#231;&#245;es por pneumonia adquirida na comunidade &#40;PAC&#41; em menores de um ano em 26 munic&#237;pios de 2007 a 2013&#46; Coordenadoria de Regula&#231;&#227;o da SRS&#47;Alfenas&#44; MG&#44; Brasil&#46;</p>"
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          "pt" => "<p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">Distribui&#231;&#227;o total de casos de PAC em crian&#231;as&#44; registrados nos munic&#237;pios da SRS de Alfenas&#44; MG&#44; Brasil &#8211; no per&#237;odo anterior &#40;2007&#8208;2009&#41; e ap&#243;s o in&#237;cio da imuniza&#231;&#227;o &#40;2011&#8208;2013&#41; com a vacina pneumoc&#243;cica 10&#8208;valente &#40;conjugada&#41;&#46;</p>"
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          "pt" => "<p id="spar0060" class="elsevierStyleSimplePara elsevierViewall">Representa&#231;&#227;o dos valores pontuais da raz&#227;o de preval&#234;ncia &#40;RP&#41; relativos &#224;s interna&#231;&#245;es por PAC em crian&#231;as com at&#233; um ano&#44; em cada um dos 26&#160;munic&#237;pios e considerando&#8208;se o valor total da SRS&#8208;Alfenas&#44; MG&#44; Brasil&#44; ap&#243;s a introdu&#231;&#227;o da vacina PCV&#8208;10&#46; As colunas representam os valores da raz&#227;o de preval&#234;ncia de hospitaliza&#231;&#227;o por PAC&#44; ap&#243;s a introdu&#231;&#227;o da vacina PCV&#8208;10&#46; A linha horizontal representa a raz&#227;o de preval&#234;ncia&#61;1&#44; ou seja&#44; a linha de n&#227;o altera&#231;&#227;o na preval&#234;ncia de PAC ap&#243;s introdu&#231;&#227;o da vacina PCV&#8208;10&#46;</p>"
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                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " colspan="7" align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Per&#237;odos</th></tr><tr title="table-row"><th class="td" title="table-head  " colspan="3" align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Pr&#233;&#8208;vacinal</th><th class="td" title="table-head  " align="left" valign="top" scope="col">Introdu&#231;&#227;o da PCV&#8208;10&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " colspan="3" align="center" valign="top" scope="col" style="border-bottom: 2px solid black">P&#243;s&#8208;vacinal</th></tr><tr title="table-row"><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">2007&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">2008&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">2009&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">2010&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">2011&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">2012&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">2013&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">5969&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">5622&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">5628&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">5765&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">5669&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">5723&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">5667&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="3" align="center" valign="top">M&#233;dia &#40;A&#41;</td><td class="td" title="table-entry  " align="left" valign="top">&#8211;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="center" valign="top">M&#233;dia &#40;B&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="3" align="center" valign="top">5740</td><td class="td" title="table-entry  " align="left" valign="top">5765&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="center" valign="top">5686&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " colspan="7" align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Registros &#40;PNI&#41; &#8211; SRS&#47;Alfenas&#44; MG</th></tr><tr title="table-row"><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">2007&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">2008&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">2009&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">2010&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">2011&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">2012&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">2013&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">5107&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">5088&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">5080&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">5765&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">5215&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">5212&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">5213&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="3" align="center" valign="top">M&#233;dia &#40;C&#41;</td><td class="td" title="table-entry  " align="left" valign="top">&#8211;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " colspan="3" align="center" valign="top">M&#233;dia &#40;D&#41;</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="3" align="center" valign="top">5091</td><td class="td" title="table-entry  " align="left" valign="top">&#8211;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " colspan="3" align="center" valign="top">5213</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="3" align="center" valign="top">Perdas A&#8208;C &#40;&#37;&#41;</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " colspan="3" align="center" valign="top">Perdas B&#8208;D &#40;&#37;&#41;</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="3" align="center" valign="top">11&#44;3</td><td class="td" title="table-entry  " align="left" valign="top">&#8211;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " colspan="3" align="center" valign="top">8&#44;3</td></tr></tbody></table>
                  """
              ]
              "imagenFichero" => array:1 [
                0 => "xTab1250833.png"
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        ]
        "descripcion" => array:1 [
          "pt" => "<p id="spar0070" class="elsevierStyleSimplePara elsevierViewall">Distribui&#231;&#227;o de crian&#231;as menores de um ano de idade cadastradas nos 26 munic&#237;pios da SRS&#47;Alfenas&#44; MG&#59; nos per&#237;odos p&#233; e p&#243;s&#8208;vacinal&#44; bem como&#44; n&#250;mero bruto e m&#233;dia de crian&#231;as inclu&#237;das no estudo com respectivas perdas por per&#237;odo</p>"
        ]
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        "etiqueta" => "Tabela 2"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
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          0 => array:3 [
            "identificador" => "at2"
            "detalle" => "Tabela "
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          ]
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        "tabla" => array:1 [
          "tablatextoimagen" => array:1 [
            0 => array:2 [
              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " rowspan="2" align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Munic&#237;pio</th><th class="td" title="table-head  " colspan="2" align="center" valign="top" scope="col" style="border-bottom: 2px solid black">2010</th><th class="td" title="table-head  " colspan="2" align="center" valign="top" scope="col" style="border-bottom: 2px solid black">2011</th><th class="td" title="table-head  " colspan="2" align="center" valign="top" scope="col" style="border-bottom: 2px solid black">2012</th><th class="td" title="table-head  " colspan="2" align="center" valign="top" scope="col" style="border-bottom: 2px solid black">2013</th></tr><tr title="table-row"><th class="td-with-role" title="table-head ; entry_with_role_rowhead " align="center" valign="top" scope="col" style="border-bottom: 2px solid black">n&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="center" valign="top" scope="col" style="border-bottom: 2px solid black">&#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="center" valign="top" scope="col" style="border-bottom: 2px solid black">n&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="center" valign="top" scope="col" style="border-bottom: 2px solid black">&#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="center" valign="top" scope="col" style="border-bottom: 2px solid black">n&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="center" valign="top" scope="col" style="border-bottom: 2px solid black">&#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="center" valign="top" scope="col" style="border-bottom: 2px solid black">n&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="center" valign="top" scope="col" style="border-bottom: 2px solid black">&#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Alfenas&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">524&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">54&#44;24&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">937&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">100&#44;64&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">843&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">90&#44;55&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">927&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">99&#44;57&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Alterosa&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">85&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">49&#44;13&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">150&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">88&#44;24&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">184&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">108&#44;24&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">165&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">97&#44;06&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Arceburgo&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">23&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">22&#44;55&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">76&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">73&#44;08&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">117&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">112&#44;50&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">99&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">95&#44;19&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Areado&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">94&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">45&#44;41&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">171&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">97&#44;16&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">169&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">96&#44;02&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">199&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">113&#44;07&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Bandeira do Sul&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">12&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">19&#44;35&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">46&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">75&#44;41&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">80&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">131&#44;15&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">92&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">150&#44;82&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Botelhos&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">53&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">34&#44;42&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">185&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">156&#44;78&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">164&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">138&#44;98&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">177&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">150&#44;00&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Cabo Verde&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">86&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">49&#44;14&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">199&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">125&#44;16&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">140&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">88&#44;05&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">141&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">88&#44;68&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Campestre&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">115&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">49&#44;36&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">215&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">101&#44;90&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">184&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">87&#44;20&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">235&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">111&#44;37&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">C&#46; do Meio&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">52&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">45&#44;22&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">142&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">112&#44;70&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">161&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">127&#44;78&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">121&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">96&#44;03&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">C&#46; Gerais&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">183&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">55&#44;62&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">330&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">100&#44;30&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">291&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">88&#44;45&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">332&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">100&#44;91&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">C&#46; Rio Claro&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">100&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">54&#44;35&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">168&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">83&#44;17&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">195&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">96&#44;53&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">195&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">96&#44;53&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Carvalh&#243;polis&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">23&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">46&#44;00&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">43&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">107&#44;50&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">43&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">107&#44;50&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">42&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">105&#44;00&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Conc&#46; Aparecida&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">74&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">57&#44;81&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">145&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">131&#44;82&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">144&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">130&#44;91&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">103&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">93&#44;64&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Divisa Nova&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">60&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">71&#44;43&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">84&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">123&#44;53&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">82&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">120&#44;59&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">77&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">113&#44;24&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Fama&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">20&#44;00&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">20&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">86&#44;96&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">24&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">104&#44;35&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">31&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">134&#44;78&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Guaran&#233;sia&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">95&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">45&#44;89&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">236&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">95&#44;16&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">244&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">98&#44;39&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">243&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">97&#44;98&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Guaxup&#233;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">387&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">61&#44;23&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">645&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">105&#44;56&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">708&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">115&#44;88&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">633&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">103&#44;60&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Juruaia&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">73&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">89&#44;02&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">90&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">84&#44;11&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">128&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">119&#44;63&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">131&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">122&#44;43&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Machado&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">285&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">58&#44;52&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">519&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">102&#44;57&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">463&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">91&#44;50&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">461&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">91&#44;11&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Monte Belo&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">68&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">62&#44;39&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">116&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">84&#44;67&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">150&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">109&#44;49&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">146&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">106&#44;57&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Muzambinho&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">120&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">50&#44;21&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">264&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">112&#44;34&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">243&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">103&#44;40&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">253&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">107&#44;66&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Nova Resende&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">107&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">56&#44;02&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">234&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">121&#44;88&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">206&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">107&#44;29&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">208&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">108&#44;33&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Paragua&#231;u&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">107&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">47&#44;35&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">254&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">102&#44;01&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">271&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">108&#44;84&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">245&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">98&#44;39&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Po&#231;o Fundo&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">103&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">65&#44;19&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">157&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">95&#44;15&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">176&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">106&#44;67&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">182&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">110&#44;30&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">S&#46; P&#46; da Uni&#227;o&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">14&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">33&#44;33&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">52&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">130&#44;00&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">59&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">147&#44;50&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">57&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">142&#44;50&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Serrania&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">30&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">30&#44;30&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">104&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">101&#44;96&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">107&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">104&#44;90&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">93&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">91&#44;18&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleBold">Total</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top"><span class="elsevierStyleBold">2878</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top"><span class="elsevierStyleBold">52&#44;72</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top"><span class="elsevierStyleBold">5582</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top"><span class="elsevierStyleBold">102&#44;99</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top"><span class="elsevierStyleBold">5576</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top"><span class="elsevierStyleBold">102&#44;88</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top"><span class="elsevierStyleBold">5588</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top"><span class="elsevierStyleBold">103&#44;10</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
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          "pt" => "<p id="spar0075" class="elsevierStyleSimplePara elsevierViewall">Distribui&#231;&#227;o da cobertura vacinal da vacina pneumoc&#243;cica 10&#8208;valente &#40;conjugada&#41; em crian&#231;as em 2010&#44; 2011&#44; 2012 e 2013&#44; na SRS&#47;Alfenas&#44; MG&#44; Brasil</p>"
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          "leyenda" => "<p id="spar0085" class="elsevierStyleSimplePara elsevierViewall">RP&#44; raz&#227;o de preval&#234;ncia&#59; IC95&#37;&#44; intervalo de confian&#231;a 95&#37;&#46;</p>"
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                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Munic&#237;pio&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="center" valign="top" scope="col" style="border-bottom: 2px solid black">RP&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="center" valign="top" scope="col" style="border-bottom: 2px solid black">IC95&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="center" valign="top" scope="col" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">p</span>&#8208;valor&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Alfenas&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#44;07&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;81&#8208;1&#44;42&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#62;0&#44;05&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Alterosa&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;36&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;13&#8208;0&#44;95&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#60;0&#44;05<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Arceburgo&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;22&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;05&#8208;0&#44;90&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#60;0&#44;05<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Areado&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;59&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;24&#8208;1&#44;47&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#62;0&#44;05&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">B&#46;do Sul&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;33&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;07&#8208;1&#44;65&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#62;0&#44;05&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Botelhos&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#44;02&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;44&#8208;2&#44;38&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#62;0&#44;05&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Cabo Verde&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#44;26&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;79&#8208;1&#44;99&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#62;0&#44;05&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Campestre&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;71&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;35&#8208;1&#44;41&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#62;0&#44;05&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Campo do Meio&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;48&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;30&#8208;0&#44;77&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#60;0&#44;05<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Campos Gerais&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;59&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;41&#8208;0&#44;87&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#60;0&#44;05<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Carmo do Rio Claro&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;86&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;54&#8208;1&#44;37&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#62;0&#44;05&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Carvalh&#243;polis&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;90&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;30&#8208;2&#44;70&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#62;0&#44;05&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Concei&#231;&#227;o da Aparecida&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;53&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;21&#8208;1&#44;35&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#62;0&#44;05&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Divisa Nova&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#44;88&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;32&#8208;10&#44;90&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#62;0&#44;05&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Fama&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;41&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;04&#8208;4&#44;20&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#62;0&#44;05&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Guaran&#233;sia&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;23&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;15&#8208;0&#44;36&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#60;0&#44;05<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Guaxup&#233;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#44;27&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#44;08&#8208;1&#44;50&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#60;0&#44;05<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Juruaia&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;57&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;37&#8208;0&#44;88&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#60;0&#44;05<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Machado&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;63&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;40&#8208;0&#44;90&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#60;0&#44;05<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Monte Belo&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;48&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;24&#8208;0&#44;97&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#60;0&#44;05<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Muzambinho&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;88&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;41&#8208;1&#44;91&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#62;0&#44;05&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Nova Resende&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;72&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;44&#8208;1&#44;19&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#62;0&#44;05&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Paragua&#231;u&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#44;04&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;54&#8208;1&#44;89&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#62;0&#44;05&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Po&#231;o Fundo&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;37&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;15&#8208;0&#44;89&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#60;0&#44;05<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">3&#44;15&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;67&#8208;14&#44;70&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#62;0&#44;05&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Serrania&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#44;14&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;44&#8208;2&#44;90&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#62;0&#44;05&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">SRS Alfenas &#40;Global&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top"><span class="elsevierStyleBold">0&#44;81</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top"><span class="elsevierStyleBold">0&#44;74&#8208;0&#44;89</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top"><span class="elsevierStyleBold">&#60;0&#44;05</span><a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
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          "pt" => "<p id="spar0080" class="elsevierStyleSimplePara elsevierViewall">An&#225;lise de associa&#231;&#227;o entre vacina&#231;&#227;o e ocorr&#234;ncia de PAC em crian&#231;as dos 26 munic&#237;pios da SRS&#47;Alfenas&#44; MG&#44; Brasil&#44; comparando 2007&#8208;2009 &#40;antes da imuniza&#231;&#227;o antipneumoc&#243;cica&#41; com 2011&#8208;2013 &#40;ap&#243;s introdu&#231;&#227;o da vacina pneumoc&#243;cica&#41;</p>"
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                      "titulo" => "Serotype distribution of <span class="elsevierStyleItalic">Streptococcus pneumoniae</span> isolated from patients with invasive pneumococcal disease in Brazil before and after ten&#8208;pneumococcal conjugate vaccine implementation"
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                            2 => "E&#46;H&#46; Takagi"
                            3 => "C&#46;M&#46; Fujii"
                            4 => "C&#46;R&#46; Yoshioka"
                            5 => "A&#46;E&#46; Gilio"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.vaccine.2013.05.042"
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                        "tituloSerie" => "Vaccine"
                        "fecha" => "2013"
                        "volumen" => "31"
                        "paginaInicial" => "6150"
                        "paginaFinal" => "6154"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23747454"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            1 => array:3 [
              "identificador" => "bib0110"
              "etiqueta" => "2"
              "referencia" => array:1 [
                0 => array:1 [
                  "referenciaCompleta" => "World Health Organization &#91;homepage on the Internet&#93;&#46; Acute respiratory infections &#91;cited 2014 Jan 10&#93;&#46; Available from&#58; http&#58;&#47;&#47;www&#46;who&#46;it&#47;vacine&#95;research&#47;diseases&#47;ari&#47;en&#47;print&#46;html&#46;"
                ]
              ]
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              "identificador" => "bib0115"
              "etiqueta" => "3"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The burden of pneumonia in children in the developed world"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "T&#46; Farha"
                            1 => "A&#46;H&#46; Thomson"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Paediatr Respir Rev&#46;"
                        "fecha" => "2005"
                        "volumen" => "6"
                        "paginaInicial" => "411"
                        "paginaFinal" => "421"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            3 => array:3 [
              "identificador" => "bib0120"
              "etiqueta" => "4"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Hospitalization rates for pneumococcal disease in Brazil&#44; 2004&#8208;2006"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "H&#46;M&#46; Novaes"
                            1 => "A&#46;M&#46; Sartori"
                            2 => "P&#46;C&#46; So&#225;rez"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Rev Saude Publica"
                        "fecha" => "2011"
                        "volumen" => "45"
                        "paginaInicial" => "539"
                        "paginaFinal" => "547"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21519721"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            4 => array:3 [
              "identificador" => "bib0125"
              "etiqueta" => "5"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Bacterial pneumonia vaccines and childhood pneumonia&#58; are we winning&#44; refining&#44; or redefining&#63;"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "S&#46;K&#46; Obaro"
                            1 => "S&#46;A&#46; Madhi"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/S1473-3099(06)70411-X"
                      "Revista" => array:6 [
                        "tituloSerie" => "Lancet Infect Dis&#46;"
                        "fecha" => "2006"
                        "volumen" => "6"
                        "paginaInicial" => "150"
                        "paginaFinal" => "161"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16500596"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            5 => array:3 [
              "identificador" => "bib0130"
              "etiqueta" => "6"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Serotype distribution and antimicrobial resistance of streptococcus pneumoniae prior to introduction of the 10&#8208;valent pneumococcal conjugate vaccine in Brazil&#44; 2000&#8208;2007"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "A&#46;P&#46; De Menezes"
                            1 => "L&#46;C&#46; Campos"
                            2 => "M&#46;S&#46; dos Santos"
                            3 => "J&#46; Azevedo"
                            4 => "R&#46;C&#46; Santos"
                            5 => "M&#46;G&#46; Carvalho"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.vaccine.2010.12.021"
                      "Revista" => array:6 [
                        "tituloSerie" => "Vaccine"
                        "fecha" => "2011"
                        "volumen" => "29"
                        "paginaInicial" => "1139"
                        "paginaFinal" => "1144"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21182994"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            6 => array:3 [
              "identificador" => "bib0135"
              "etiqueta" => "7"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Impacto da vacina pneumoc&#243;cica conjugada 10&#8208;valente na meningite pneumoc&#243;cica em crian&#231;as com at&#233; dois anos de idade no Brasil"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "I&#46;M&#46; Grando"
                            1 => "C&#46; Moraes"
                            2 => "B&#46; Flannery"
                            3 => "W&#46;M&#46; Ramalho"
                            4 => "M&#46;A&#46; Horta"
                            5 => "D&#46;L&#46; Pinho"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Cad Saude Publica"
                        "fecha" => "2015"
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                        "paginaInicial" => "276"
                        "paginaFinal" => "284"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25760162"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
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              "identificador" => "bib0140"
              "etiqueta" => "8"
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                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Impact of the antipneumococcal conjugate vaccine on the occurrence of infectious respiratory diseases and hospitalization rates in children"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "W&#46;M&#46; Abr&#227;o"
                            1 => "L&#46;M&#46; Mello"
                            2 => "A&#46;S&#46; Silva"
                            3 => "A&#46;A&#46; Nunes"
                          ]
                        ]
                      ]
                    ]
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                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1590/0037-8682-0007-2015"
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                        "tituloSerie" => "Rev Soc Bras Med Trop&#46;"
                        "fecha" => "2015"
                        "volumen" => "48"
                        "paginaInicial" => "44"
                        "paginaFinal" => "49"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25860463"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
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              "identificador" => "bib0145"
              "etiqueta" => "9"
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                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Pneumococcal meningitis&#58; epidemiological profile pre&#8208;and post&#8208;introduction of the pneumococcal 10&#8208;valent conjugate vaccine"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "T&#46;E&#46; Hirose"
                            1 => "E&#46;M&#46; Maluf"
                            2 => "C&#46;O&#46; Rodrigues"
                          ]
                        ]
                      ]
                    ]
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                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "J Pediatr &#40;Rio J&#41;&#46;"
                        "fecha" => "2015"
                        "volumen" => "91"
                        "paginaInicial" => "130"
                        "paginaFinal" => "135"
                      ]
                    ]
                  ]
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                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Pneumococcal conjugate vaccine and changing epidemiology of childhood bacterial meningitis"
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                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "S&#46;A&#46; Madhi"
                          ]
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                  "host" => array:1 [
                    0 => array:1 [
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                        "tituloSerie" => "J Pediatr &#40;Rio J&#41;&#46;"
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                        "volumen" => "91"
                        "paginaInicial" => "108"
                        "paginaFinal" => "110"
                      ]
                    ]
                  ]
                ]
              ]
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              "identificador" => "bib0155"
              "etiqueta" => "11"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "A cost&#8208;effectiveness analysis of a 10&#8208;valent pneumococcal conjugate vaccine in children in six Latin American countries"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "S&#46;G&#46; Mart&#237;"
                            1 => "L&#46; Colantonio"
                            2 => "A&#46; Bardach"
                            3 => "J&#46; Galante"
                            4 => "A&#46; Lopez"
                            5 => "J&#46; Caporale"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1186/1478-7547-11-21"
                      "Revista" => array:5 [
                        "tituloSerie" => "Cost Eff Resour Alloc&#46;"
                        "fecha" => "2013"
                        "volumen" => "11"
                        "paginaInicial" => "21"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24004943"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
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              "identificador" => "bib0160"
              "etiqueta" => "12"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Impact of 10&#8208;valent pneumococcal non&#8208;typeable Haemophilus influenzae protein D conjugate vaccine &#40;PHiD&#8208;CV&#41; on childhood pneumonia hospitalizations in Brazil two years after introduction"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "M&#46;C&#46; Scotta"
                            1 => "T&#46;N&#46; Veras"
                            2 => "P&#46;C&#46; Klein"
                            3 => "V&#46; Tronco"
                            4 => "F&#46;P&#46; Polack"
                            5 => "R&#46; Mattiello"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.vaccine.2014.06.042"
                      "Revista" => array:6 [
                        "tituloSerie" => "Vaccine"
                        "fecha" => "2014"
                        "volumen" => "32"
                        "paginaInicial" => "4495"
                        "paginaFinal" => "4499"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24958703"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            12 => array:3 [
              "identificador" => "bib0165"
              "etiqueta" => "13"
              "referencia" => array:1 [
                0 => array:1 [
                  "referenciaCompleta" => "Brasil &#8211; Minist&#233;rio da Sa&#250;de &#8211; DATASUS &#91;homepage on the Internet&#93;&#46; Sistema Informa&#231;&#245;es do PNI&#93;&#46; Sistema de informa&#231;&#227;o do Programa Nacional de Imuniza&#231;&#227;o SI&#8208;PNI &#91;cited 2015 Dec 14&#93;&#46; Available from&#58; http&#58;&#47;&#47;pni&#46;datasus&#46;gov&#46;br&#46;"
                ]
              ]
            ]
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              "identificador" => "bib0170"
              "etiqueta" => "14"
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                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Decline in pneumonia admissions after routine childhood immunisation with pneumococcal conjugate vaccine in the USA&#58; a time&#8208;series analysis"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "C&#46;G&#46; Grijalva"
                            1 => "J&#46;P&#46; Nuorti"
                            2 => "P&#46;G&#46; Arbogast"
                            3 => "S&#46;W&#46; Martin"
                            4 => "K&#46;M&#46; Edwards"
                            5 => "M&#46;R&#46; Griffin"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/S0140-6736(07)60564-9"
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                        "tituloSerie" => "Lancet"
                        "fecha" => "2007"
                        "volumen" => "369"
                        "paginaInicial" => "1179"
                        "paginaFinal" => "1186"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17416262"
                            "web" => "Medline"
                          ]
                        ]
                        "itemHostRev" => array:3 [
                          "pii" => "S0967586812001701"
                          "estado" => "S300"
                          "issn" => "09675868"
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            14 => array:3 [
              "identificador" => "bib0175"
              "etiqueta" => "15"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Effect of 10&#8208;valent pneumococcal vaccine on pneumonia among children Brazil"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "E&#46;T&#46; Afonso"
                            1 => "R&#46; Minamisava"
                            2 => "A&#46;L&#46; Bierrenbach"
                            3 => "J&#46;J&#46; Escalante"
                            4 => "A&#46;P&#46; Alencar"
                            5 => "C&#46;M&#46; Domingues"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.3201/eid1904.121198"
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                        "tituloSerie" => "Emerg Infect Dis&#46;"
                        "fecha" => "2013"
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                        "paginaInicial" => "589"
                        "paginaFinal" => "597"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23628462"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
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              "identificador" => "bib0180"
              "etiqueta" => "16"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Appropriateness of administrative data for vaccine impact evaluation&#58; the case of pneumonia hospitalizations and pneumococcal vaccine in Brazil"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "S&#46; Sgambatti"
                            1 => "R&#46; Minamisava"
                            2 => "E&#46;T&#46; Afonso"
                            3 => "C&#46;M&#46; Toscano"
                            4 => "A&#46;L&#46; Bierrenbach"
                            5 => "A&#46;L&#46; Andrade"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1017/S0950268814000922"
                      "Revista" => array:6 [
                        "tituloSerie" => "Epidemiol Infect&#46;"
                        "fecha" => "2015"
                        "volumen" => "143"
                        "paginaInicial" => "334"
                        "paginaFinal" => "342"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24759601"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
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              "identificador" => "bib0185"
              "etiqueta" => "17"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Effectiveness of ten&#8208;valent pneumococcal conjugate vaccine against invasive pneumococcal disease in Brazil&#58; a matched case&#8208;control study"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "C&#46;M&#46; Domingues"
                            1 => "J&#46;R&#46; Verani"
                            2 => "E&#46;I&#46; Montenegro Renoiner"
                            3 => "M&#46;C&#46; de Cunto Brandileone"
                            4 => "B&#46; Flannery"
                            5 => "L&#46;H&#46; de Oliveira"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/S2213-2600(14)70060-8"
                      "Revista" => array:6 [
                        "tituloSerie" => "Lancet Respir Med&#46;"
                        "fecha" => "2014"
                        "volumen" => "2"
                        "paginaInicial" => "464"
                        "paginaFinal" => "471"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24726406"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            17 => array:3 [
              "identificador" => "bib0190"
              "etiqueta" => "18"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The worldwide impact of the seven&#8208;valent pneumococcal conjugate vaccine"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "S&#46;P&#46; Fitzwater"
                            1 => "A&#46; Chandran"
                            2 => "M&#46; Santosham"
                            3 => "H&#46;L&#46; Johnson"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1097/INF.0b013e31824de9f6"
                      "Revista" => array:6 [
                        "tituloSerie" => "Pediatr Infect Dis J&#46;"
                        "fecha" => "2012"
                        "volumen" => "31"
                        "paginaInicial" => "501"
                        "paginaFinal" => "508"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22327872"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            18 => array:3 [
              "identificador" => "bib0195"
              "etiqueta" => "19"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Choosing between 7&#8208;&#44; 10&#8208; and 13&#8208;valent pneumococcal conjugate vaccines in childhood&#58; a review of economic evaluations &#40;2006&#8208;2014&#41;"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "D&#46;B&#46; Wu"
                            1 => "N&#46; Chaiyakunapruk"
                            2 => "H&#46;Y&#46; Chong"
                            3 => "P&#46; Beutels"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.vaccine.2015.01.081"
                      "Revista" => array:6 [
                        "tituloSerie" => "Vaccine"
                        "fecha" => "2015"
                        "volumen" => "33"
                        "paginaInicial" => "1633"
                        "paginaFinal" => "1658"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25681663"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            19 => array:3 [
              "identificador" => "bib0200"
              "etiqueta" => "20"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
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Información del artículo
ISSN: 01030582
Idioma original: Portugués
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