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de Sá Couto-Pereira N, Nexha A, Boff Borges R, Amando GR, Francisco AP, Amaral FG, Frey BN, Calcagnotto ME, Hidalgo MP, Pilz LK. Routine regularity during a global pandemic: Impact on mental health outcomes and influence of chronotype. Chronobiol Int 2024; 41:456-472. [PMID: 38380627 DOI: 10.1080/07420528.2024.2314216] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Accepted: 01/26/2024] [Indexed: 02/22/2024]
Abstract
Among the public health recommendations for supporting mental health during the COVID-19 pandemic, many strategies had an impact on biological rhythms, like sleep hygiene, physical exercise and healthy eating habits. Considering the known relationship between circadian organization and mental health, our aim was to test the association between behavioral regularity and mental health, and its interaction with chronotype, in a large sample surveyed in Brazil. We collected longitudinal data using online questionnaires that assessed sociodemographic characteristics, behavioral routines, mental health (PHQ-9, GAD-7, WHO-5 scales), and chronotype estimation based on midpoint of sleep on free days - MSF (μMCTQ), in a sample of 1390 participants (81% females). We computed a Routine Regularity Score (RRS) that reflects regularity across four behaviors: sleep, eating, working, exercising. There was a strong negative association between RRS and the severity of anxiety and depressive symptoms (GAD-7 and PHQ-9 scores), which was weaker among participants with late MSF, and a strong positive association with well-being (WHO-5 scores). RRS was a mediator of the MSF-mental health association and a predictor of mental health states. This study provides empirical evidence that maintaining behavioral routines during times of hardship may serve as tools to alleviate the negative impact on mental health.
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Affiliation(s)
- Natividade de Sá Couto-Pereira
- Neurophysiology and Neurochemistry of Neuronal Excitability and Synaptic Plasticity Laboratory (NNNESP Lab.), Department of Biochemistry, Instituto de Ciências Básicas da Saúde, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
- Graduate Program in Neuroscience, Instituto de Ciências Básicas da Saúde, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
- Psychological Neuroscience Laboratory, Psychology Research Centre, School of Psychology, University of Minho, Braga, Portugal
| | - Adile Nexha
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada
| | - Rogério Boff Borges
- Unidade de Bioestatística - Diretoria de Pesquisa (DIPE), Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
- Department of Statistics, Institute of Mathematics and Statistics, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Guilherme Rodriguez Amando
- Laboratório de Cronobiologia e Sono, Hospital de Clínicas de Porto Alegre/Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
- Graduate Program in Psychiatry and Behavioral Sciences, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Ana Paula Francisco
- Laboratório de Cronobiologia e Sono, Hospital de Clínicas de Porto Alegre/Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Fernanda G Amaral
- Laboratório de Neurobiologia da Pineal, Department of Physiology, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Benicio N Frey
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada
- Mood Disorders Program, Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada
- Women's Health Concerns Clinic, St. Joseph's Healthcare Hamilton, Hamilton, Ontario, Canada
| | - Maria Elisa Calcagnotto
- Neurophysiology and Neurochemistry of Neuronal Excitability and Synaptic Plasticity Laboratory (NNNESP Lab.), Department of Biochemistry, Instituto de Ciências Básicas da Saúde, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
- Graduate Program in Neuroscience, Instituto de Ciências Básicas da Saúde, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
- Graduate Program in Psychiatry and Behavioral Sciences, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
- Graduate Program in Biological Sciences: Biochemistry, Department of Biochemistry, Instituto de Ciências Básicas da Saúde, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Maria Paz Hidalgo
- Laboratório de Cronobiologia e Sono, Hospital de Clínicas de Porto Alegre/Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
- Graduate Program in Psychiatry and Behavioral Sciences, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Luísa K Pilz
- Laboratório de Cronobiologia e Sono, Hospital de Clínicas de Porto Alegre/Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
- Graduate Program in Psychiatry and Behavioral Sciences, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
- Department of Anesthesiology and Intensive Care Medicine CCM / CVK, Charité - Universitätsmedizin Berlin, Berlin, Germany
- ECRC Experimental and Clinical Research Center, Charité - Universitätsmedizin Berlin, Berlin, Germany
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Alonso MS, Lima MCP, Dias A, Camacho-Vega JC, García-Iglesias JJ, Ruiz-Frutos C, Bernardes JM, Gómez-Salgado J. Psychological distress among Brazilian workers during the initial stage of the COVID-19 pandemic: a descriptive study. Front Public Health 2024; 12:1283310. [PMID: 38439755 PMCID: PMC10910103 DOI: 10.3389/fpubh.2024.1283310] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Accepted: 01/31/2024] [Indexed: 03/06/2024] Open
Abstract
Background COVID-19 pandemic imposed drastic and abrupt changes to working environment and organization and that might have caused additional negative effects on mental health. Thus, this study aimed to quantify and assess the severity of psychological distress experienced by Brazilian essential and nonessential workers during the first months of the COVID-19 pandemic. Methods This descriptive study included 2,903 participants who answered an online questionnaire between April and May 2020. The research questionnaire was translated and culturally adapted to the Brazilian population from a questionnaire developed and validated for the Spanish population. Variables were analyzed using simple and cumulative percentage distributions and measures of central tendency and dispersion. The Wilson score interval was used to calculate confidence interval (CI) for the main outcome, psychological distress. Results It was observed a high prevalence (72.6%) of psychological distress among the study's participants. They also presented a median risk perception score of 60 (out of a maximum of 90), and their greatest concern was transmitting the virus to family members, close contacts or patients. Furthermore, it was found a lower sense of coherence and work engagement among the participants than those observed in previous studies conducted in other countries. Conclusion Almost three quarters of the study's participants were classified as presenting psychological distress. Thus, it is imperative to provide mental health remotely delivered interventions to workers during public health events that require prolonged social distancing measures.
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Affiliation(s)
- Melissa Spröesser Alonso
- Public/Collective Health Graduate Program, Botucatu Medical School, São Paulo State University (UNESP), Botucatu, Brazil
| | - Maria Cristina Pereira Lima
- Public/Collective Health Graduate Program, Botucatu Medical School, São Paulo State University (UNESP), Botucatu, Brazil
| | - Adriano Dias
- Public/Collective Health Graduate Program, Botucatu Medical School, São Paulo State University (UNESP), Botucatu, Brazil
| | - Juan Carlos Camacho-Vega
- Department of Architectural Construction II, Higher Technical School of Building Engineering, University of Seville, Seville, Spain
| | - Juan Jesus García-Iglesias
- Faculty of Labour Sciences, Department of Sociology, Social Work, and Public Health, University of Huelva, Huelva, Spain
| | - Carlos Ruiz-Frutos
- Faculty of Labour Sciences, Department of Sociology, Social Work, and Public Health, University of Huelva, Huelva, Spain
- Safety and Health Postgraduate Programme, Universidad Espíritu Santo, Guayaquil, Ecuador
| | - João Marcos Bernardes
- Public/Collective Health Graduate Program, Botucatu Medical School, São Paulo State University (UNESP), Botucatu, Brazil
| | - Juan Gómez-Salgado
- Faculty of Labour Sciences, Department of Sociology, Social Work, and Public Health, University of Huelva, Huelva, Spain
- Safety and Health Postgraduate Programme, Universidad Espíritu Santo, Guayaquil, Ecuador
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Griesi JM, Bernardes JM, Alonso M, Gómez-Salgado J, Ruiz-Frutos C, Fagundo-Rivera J, López-López D, Camacho-Vega JC, Dias A. Risk perception of healthcare workers in the first wave of the COVID-19 pandemic in Brazil. Heliyon 2024; 10:e25297. [PMID: 38352759 PMCID: PMC10861974 DOI: 10.1016/j.heliyon.2024.e25297] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2023] [Revised: 01/23/2024] [Accepted: 01/24/2024] [Indexed: 02/16/2024] Open
Abstract
Objectives To validate the items of the Emotional Impact Questionnaire coronavirus disease-2019 (COVID-19) related to risk perception, estimating its degree, among healthcare workers in the first wave of COVID-19 pandemic, identifying possible associated factors.Methods: cross-sectional study in 1872 healthcare workers of Brazil. The population was characterized by sociodemographic and occupational information, knowledge about COVID-19, quality of information received, risk perception and preventive measures about the disease, and sense of coherence. Results Being divorced, having a chronic disease, spending more than 1 h per day getting informed about COVID-19, and always or almost always wearing a mask regardless of symptoms, as well as self-perception of health were associated with high-risk perception. An inverse association was found between risk perception, sense of coherence and not knowing if one has had occasional contact with confirmed COVID-19 cases. Conclusion Risk perception is influenced by emotions, experiences, and knowledge. Sense of coherence and resilience have a role in reducing risk perception. Understanding risk perception is crucial for developing effective strategies to mitigate the impact of the COVID-19 pandemic and other similar scenarios.
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Affiliation(s)
- Joana Muraguti Griesi
- Department of Public Health, Botucatu Medical School, São Paulo State University/UNESP, Botucatu, 18618-687, Brazil
| | - João Marcos Bernardes
- Department of Public Health, Botucatu Medical School, São Paulo State University/UNESP, Botucatu, 18618-687, Brazil
- Public (Collective) Health Graduate Program, Botucatu Medical School, São Paulo State University/UNESP, Botucatu, 18618-687, Brazil
| | - Melissa Alonso
- Public (Collective) Health Graduate Program, Botucatu Medical School, São Paulo State University/UNESP, Botucatu, 18618-687, Brazil
| | - Juan Gómez-Salgado
- Department of Sociology, Social Work and Public Health, Faculty of Labour Sciences, University of Huelva, 21007, Huelva, Spain
- Safety and Health Graduate Program, Universidad Espíritu Santo, Guayaquil, 092301, Ecuador
| | - Carlos Ruiz-Frutos
- Department of Sociology, Social Work and Public Health, Faculty of Labour Sciences, University of Huelva, 21007, Huelva, Spain
- Safety and Health Graduate Program, Universidad Espíritu Santo, Guayaquil, 092301, Ecuador
| | | | - Daniel López-López
- Health and Podiatry Group, Department of Health Sciences, Faculty of Nursing and Podiatry. Industrial Campus of Ferrol, Universidade da Coruña, 15403, Ferrol, Spain
| | - Juan Carlos Camacho-Vega
- Department of Building Construction II, Higher Technical School of Building Engineering, University of Seville, Seville, Spain
| | - Adriano Dias
- Department of Public Health, Botucatu Medical School, São Paulo State University/UNESP, Botucatu, 18618-687, Brazil
- Public (Collective) Health Graduate Program, Botucatu Medical School, São Paulo State University/UNESP, Botucatu, 18618-687, Brazil
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Castillo AP, Miranda JVO, Fonseca PLC, Silva SDO, Lopes REN, Spanhol VC, Moreira RG, Nicolino RR, Queiroz DC, de Araújo E Santos LCG, Dos Santos APS, Rivetti HAA, Martins-Duarte ES, de Almeida Vitor RW, Dos Reis JKP, Aguiar RS, da Silveira JAG. Evidence of SARS-CoV-2 infection and co-infections in stray cats in Brazil. Acta Trop 2024; 249:107056. [PMID: 37913970 DOI: 10.1016/j.actatropica.2023.107056] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2023] [Revised: 10/20/2023] [Accepted: 10/29/2023] [Indexed: 11/03/2023]
Abstract
The zoonotic virus SARS-CoV-2, which causes severe acute respiratory syndrome in humans (COVID-19), has been identified in cats. Notably, most positive cases were in cats that had close contact with infected humans, suggesting a role for humans in animal transmission routes. Previous studies have suggested that animals with immune depletion are more susceptible to SARS-CoV-2 infection. To date, there is limited evidence of SARS-CoV-2 infections in stray and free-range cats affected by other pathogens. In this study, we investigated infections caused by SARS-CoV-2, Leishmania spp., Toxoplasma gondii, Mycoplasma spp., Bartonella spp., Feline leukemia virus (FeLV), and Feline immunodeficiency virus (FIV) in stray cats from an urban park in Brazil during the COVID-19 pandemic. From February to September 2021, 78 mixed-breed cats were tested for SARS-CoV-2 and hemopathogens using molecular analysis at Américo Renné Giannetti Municipal Park, Belo Horizonte, Minas Gerais, Brazil. An enzyme-linked immunosorbent assay (ELISA) was used to detect IgG in T. gondii. None of the animals in this study showed any clinical signs of infections. The SARS-CoV-2 virus RNA was detected in 7.7 % of cats, and a whole virus genome sequence analysis revealed the SARS-CoV-2 Delta lineage (B.1.617.2). Phylogenetic analysis showed that SARS-CoV-2 isolated from cats was grouped into the sublineage AY.99.2, which matches the epidemiological scenario of COVID-19 in the urban area of our study. Leishmania infantum was detected and sequenced in 9 % of cats. The seroprevalence of T. gondii was 23.1 %. Hemotropic Mycoplasma spp. was detected in 7.7 % of the cats, with Mycoplasma haemofelis and Candidatus Mycoplasma haemominutum being the most common. Bartonella henselae and Bartonella clarridgeiae were detected in 38.5 % of the cats, FeLV was detected in 17,9 %, and none of the cats studied tested positive for FIV. This study reports, for the first time, the SARS-CoV-2 infection with whole-genome sequencing in stray cats in southeastern Brazil and co-infection with other pathogens, including Bartonella spp. and Feline leukemia virus. Our study observed no correlation between SARS-CoV-2 and the other detected pathogens. Our results emphasize the importance of monitoring SARS-CoV-2 in stray cats to characterize their epidemiological role in SARS-CoV-2 infection and reinforce the importance of zoonotic disease surveillance.
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Affiliation(s)
- Anisleidy Pérez Castillo
- Departamento de Parasitologia, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Av. Pres. Antônio Carlos, 6627 - Pampulha, Belo Horizonte, MG 31270-901, Brazil; Laboratório de PROTOVET, Departamento de Medicina Veterinária Preventiva, Escola de Veterinária da Universidade Federal de Minas Gerais, Av. Pres. Antônio Carlos, 6627 - Pampulha, Belo Horizonte, MG 31270-901, Brazil
| | - Joao Victor Oliveira Miranda
- Laboratório de Biologia Integrativa, Departamento de Genética, Ecologia e Evolução, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Av. Pres. Antônio Carlos, 6627 - Pampulha, Belo Horizonte, MG 31270-901, Brazil
| | - Paula Luize Camargos Fonseca
- Laboratório de Biologia Integrativa, Departamento de Genética, Ecologia e Evolução, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Av. Pres. Antônio Carlos, 6627 - Pampulha, Belo Horizonte, MG 31270-901, Brazil
| | - Soraia de Oliveira Silva
- Departamento de Parasitologia, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Av. Pres. Antônio Carlos, 6627 - Pampulha, Belo Horizonte, MG 31270-901, Brazil
| | - Rosálida Estevam Nazar Lopes
- Departamento de Parasitologia, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Av. Pres. Antônio Carlos, 6627 - Pampulha, Belo Horizonte, MG 31270-901, Brazil
| | - Viviane Campos Spanhol
- Laboratório de Retroviroses, Departamento de Medicina Veterinária Preventiva, Escola de Veterinária da Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Rennan Garcias Moreira
- Centro de Laboratórios Multiusuários, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Av. Pres. Antônio Carlos, 6627 - Pampulha, Belo Horizonte, MG 31270-901, Brazil
| | - Rafael Romero Nicolino
- Departamento de Epidemiologia e Defesa Sanitária Animal, Escola de Veterinária da Universidade Federal de Minas Gerais, Av. Pres. Antônio Carlos, 6627 - Pampulha, Belo Horizonte, MG 31270-901, Brazil
| | - Daniel Costa Queiroz
- Laboratório de Biologia Integrativa, Departamento de Genética, Ecologia e Evolução, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Av. Pres. Antônio Carlos, 6627 - Pampulha, Belo Horizonte, MG 31270-901, Brazil
| | - Luiza Campos Guerra de Araújo E Santos
- Laboratório de Biologia Integrativa, Departamento de Genética, Ecologia e Evolução, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Av. Pres. Antônio Carlos, 6627 - Pampulha, Belo Horizonte, MG 31270-901, Brazil
| | - Anna Pio Soares Dos Santos
- Departamento de Parasitologia, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Av. Pres. Antônio Carlos, 6627 - Pampulha, Belo Horizonte, MG 31270-901, Brazil
| | - Hugo Adriano Araújo Rivetti
- Centro de Controle de Zoonoses, Prefeitura de Belo Horizonte, R. Édna Quintel, 173 - São Bernardo, Belo Horizonte, MG 31270-705, Brazil
| | - Erica S Martins-Duarte
- Departamento de Parasitologia, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Av. Pres. Antônio Carlos, 6627 - Pampulha, Belo Horizonte, MG 31270-901, Brazil
| | - Ricardo Wagner de Almeida Vitor
- Departamento de Parasitologia, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Av. Pres. Antônio Carlos, 6627 - Pampulha, Belo Horizonte, MG 31270-901, Brazil
| | - Jenner Karlisson Pimenta Dos Reis
- Laboratório de Retroviroses, Departamento de Medicina Veterinária Preventiva, Escola de Veterinária da Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Renato Santana Aguiar
- Laboratório de Biologia Integrativa, Departamento de Genética, Ecologia e Evolução, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Av. Pres. Antônio Carlos, 6627 - Pampulha, Belo Horizonte, MG 31270-901, Brazil
| | - Júlia Angélica Gonçalves da Silveira
- Laboratório de PROTOVET, Departamento de Medicina Veterinária Preventiva, Escola de Veterinária da Universidade Federal de Minas Gerais, Av. Pres. Antônio Carlos, 6627 - Pampulha, Belo Horizonte, MG 31270-901, Brazil.
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Martins JP, Siqueira BA, Sansone NMS, Marson FAL. COVID-19 in Brazil: a 3-year update. Diagn Microbiol Infect Dis 2023; 107:116074. [PMID: 37729718 DOI: 10.1016/j.diagmicrobio.2023.116074] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Revised: 08/23/2023] [Accepted: 08/24/2023] [Indexed: 09/22/2023]
Abstract
Three years into the coronavirus disease (COVID)-19 pandemic and the world is still struggling with the aftermath of this global health crisis. In Brazil, we are witnessing serious economic, health, social, and political problems. The rapid spread of the virus in our country was the result of a shortage of vaccines and the lack of an effective national campaign to identify and report cases. This health crisis also intensified social inequalities, hitting Indigenous peoples hard due to the lack of access to health services. In addition, rising unemployment and overcrowding of the health system made contagion possible, especially among the most vulnerable, increasing the number of serious cases of the disease. It is important to highlight that emotional problems worsened, the educational system was severely affected, and domestic violence increased during the confinement period, in addition to the fact that the pandemic exposed the great disparities of regional inequalities that exist across the country, mainly concerning health management.
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Affiliation(s)
- Jéssica Paula Martins
- Laboratory of Molecular Biology and Genetics, São Francisco University, Bragança Paulista, São Paulo, Brazil
| | - Bianca Aparecida Siqueira
- Laboratory of Molecular Biology and Genetics, São Francisco University, Bragança Paulista, São Paulo, Brazil
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Hotez PJ. Global Vaccine Access Demands Combating Both Inequity And Hesitancy. Health Aff (Millwood) 2023; 42:1681-1688. [PMID: 38048497 DOI: 10.1377/hlthaff.2023.00775] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/06/2023]
Abstract
The world's population suffered from lack of access to COVID-19 vaccines. Although inequities in vaccine availability for low- and middle-income countries are widely cited as a component of this lack of access, there is a related but less discussed component: vaccine refusal or hesitancy. Regarding the first component (global vaccine inequities), there are multiple dimensions to this topic and its causes, but for low- and middle-income countries, the most glaring one resulted from upstream science policies that prioritized speed and innovation at the expense of technologies that could be produced by low- and middle-income country vaccine producers. Regarding the second component (vaccine refusal or hesitancy), as COVID-19 waves swept across the United States in 2021, thousands of unvaccinated Americans perished from refusing COVID-19 immunizations. These deaths occurred because of an expanding antiscience ecosystem that now extends into low- and middle-income countries and could block the uptake of new vaccines or routine childhood immunizations. Future vaccine policies must address both elements of global access and their political identities. This recommendation reflects the author's experiences as a vaccine scientist who both develops affordable COVID-19 and neglected disease vaccines and lives on the front lines combating vaccine refusal.
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Affiliation(s)
- Peter J Hotez
- Peter J. Hotez , Baylor College of Medicine, Houston, Texas
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Ferreira Furtado LM, Da Costa Val Filho JA, Da Silva Pereira V, Coimbra YS, Caldas VHR, Magalhães AR, De Carvalho BAS, Moreira SG, Teixeira AL, De Miranda AS. Effect of the COVID-19 Pandemic on the Epidemiology of Pediatric Traumatic Brain Injury in Brazil. Cureus 2023; 15:e48896. [PMID: 38024051 PMCID: PMC10653551 DOI: 10.7759/cureus.48896] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/16/2023] [Indexed: 12/01/2023] Open
Abstract
Aim In response to the coronavirus 2019 disease (COVID-19) pandemic, governments worldwide implemented measures to prevent infection, resulting in restricted school activities, restricted children's freedom of movement, and increased risk of violence and injuries at home, including traumatic brain injury (TBI), among children. In Brazil, the consequences of the COVID-19 pandemic on the causes, severity, and mortality of pediatric TBI have not yet been investigated. Thus, our study aimed to determine whether the COVID-19 pandemic has affected the epidemiology of pediatric TBI among Brazilian children. Materials and methods We investigated the patients with TBI aged <18 years who visited a tertiary trauma center in Brazil in 2019 and 2020. TBI-related variables, such as classification, mechanism, clinical manifestations, need for intervention, morbidity, and mortality, were recorded. Furthermore, we used a nationwide databank to collect information on mortality from external causes of trauma and violence in the pediatric population in 2019 and 2020. The Mann-Whitney test was used to compare quantitative variables related to the mechanisms and severity of TBI in both periods in order to determine the impact of the COVID-19 pandemic. Results Of the patients with traumatic brain injury, 1371 visited the trauma center in 2019 and 1052 in 2020. No difference was noted in the incidence rate of abusive head trauma between these periods (p=0.142) or in mortality from violence in Brazil. Recreational causes of pediatric TBI increased during the first year of the COVID-19 pandemic in Brazil and falls from bicycles significantly increased during the pandemic (p<0.001). Conclusion A global reduction in pediatric admissions to emergency rooms as well as no impact on mortality and severity of pediatric TBI were observed during the COVID-19 pandemic in Brazil. Additionally, a public education program regarding child safety during recreational activities, particularly how to avoid falls from bicycles was recommended.
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Affiliation(s)
| | | | - Victor Da Silva Pereira
- Department of Neurological Surgery, Pontifícia Universidade Católica de Minas Gerais, Contagem, BRA
| | - Yasmin S Coimbra
- Department of Neurological Surgery, Faculdade de Ciências Médicas de Minas Gerais, Belo Horizonte, BRA
| | - Vitor Hugo R Caldas
- Department of Neurological Surgery, Faculdade de Ciências Médicas de Minas Gerais, Belo Horizonte, BRA
| | - Anne R Magalhães
- Department of Neurological Surgery, Pontifícia Universidade Católica de Minas Gerais, Contagem, BRA
| | - Bruna Athayde S De Carvalho
- Department of Neurological Surgery, João XXIII Hospital / Fundação Hospitalar do Estado de Minas Gerais (FHEMIG), Belo Horizonte, BRA
| | - Saulo G Moreira
- Department of Neurological Surgery, Faculdade de Ciências Médicas de Minas Gerais, Belo Horizonte, BRA
| | - Antônio L Teixeira
- Neuropsychiatry, The University of Texas Health Science Center at Houston, Houston, USA
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de Oliveira FDCE, Silva MFS, Fernandes MDCR, Garcia MML, Dinelly Pinto ACM, Severino FG, Alves JSM, Fonseca CAG, de Carvalho Araújo FM, de Andrade LOM, Gambim Fonseca MH. SARS CoV-2 infection among Healthcare Workers from different public health units in Brazil. Mol Immunol 2023; 163:13-19. [PMID: 37717421 DOI: 10.1016/j.molimm.2023.09.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Revised: 08/23/2023] [Accepted: 09/04/2023] [Indexed: 09/19/2023]
Abstract
Understanding COVID-19 exposure differences among Healthcare Workers (HCWs) across various healthcare units is crucial for their protection and effective management of future outbreaks. However, comparative data on COVID-19 among HCWs in different healthcare units are scarce in Brazil. This study evaluated the relationship between SARS-CoV-2 infection and workplaces in HCWs from three distinct healthcare settings in Brazil. It also examined COVID-19 symptom dynamics reported by them. The cohort comprised 464 HCWs vaccinated with two doses of CoronaVac and a BNT162b2 booster from different institutions: Primary Health Care Units (PHCUs), Emergency Care Units (ECUs), and Hospitals. Participants answered a questionnaire and underwent blood collection at various time points after vaccinations. RT-PCR data and post-vaccination antibody responses were utilized as indicators of SARS-CoV-2 infection. We found that most infected HCWs worked in ECUs, where positive RT-PCR percentages were higher compared to PHCUs and Hospitals. ECUs also showed the highest seropositivity and antibody levels, especially after the first CoronaVac dose. The second dose of CoronaVac diminished the differences in the antibody levels among HCWs from ECUS, PHCUs, and Hospitals, indicating the benefit of the second dose to equalize the antibody levels between previously exposed and unexposed persons. Moreover, COVID-19 symptoms appeared to evolve over time.
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Cohen M, Cardoso RB, Kerr LRFS, Kendall C, Almeida RLF, Schneider NB, Viera CM, Zaduchliver JG, Castro AA, Pinheiro FML, Albuquerque MFPM, Lima LNGC, Veras MASM, Martelli CMT, Cruz LN, Camey SA. Mental health outcomes in frontline healthcare workers in Brazil during the COVID-19 epidemic: Results of an online survey in four regions using respondent-driven sampling (RDS). Compr Psychiatry 2023; 126:152402. [PMID: 37647781 DOI: 10.1016/j.comppsych.2023.152402] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Revised: 06/16/2023] [Accepted: 07/11/2023] [Indexed: 09/01/2023] Open
Abstract
BACKGROUND The COVID-19 pandemic overwhelmed health facilities and presented healthcare workers (HCWs) with a new infectious disease threat. In addition to a sanitary crisis, Brazil still had to face major political, economic, and social challenges. This study aimed to investigate mental health outcomes in frontline HCWs in different regions of the country and at different epidemic times. We also sought to identify the main risk factors associated with these outcomes. METHODS A cross-sectional online survey using respondent-driven sampling was conducted to recruit physicians (n = 584), nurses (n = 997), and nurse technicians (n = 524) in 4 regions of Brazil (North, Northeast, Southeast, and South) from August 2020 to July 2021. We used standardized instruments to screen for common mental disorders (CMD)(SRQ-20), alcohol misuse (AUDIT-C), depression (PHQ-9), anxiety (GAD-7), and post-traumatic stress disorder (PTSD)(PCL-5). Gile's successive sampling estimator was used to produce weighted estimates. We created a three-cluster data set for each HCW category and developed a hierarchical regression model with three levels: individual characteristics; workplace-related aspects; COVID-19 personal experience. The impact of the epidemic moment on the outcomes was also studied. RESULTS The prevalence of probable CMD was 26.8-36.9%, alcohol misuse 8.7-13.6%, depression 16.4-21.2%, anxiety 10.8-14.2%, and PTSD 5.9-8.0%. We found a stronger association between mental health outcomes and the following factors: history of psychiatric disorders, female gender, and clinical comorbidities (level 1); work overload and family isolation (level 2); sick leave (level 3). Epidemic variables, such as the number of deaths and trend of deaths by COVID-19, had almost no impact on the outcomes. CONCLUSION An alarmingly high prevalence of depression and anxiety was found in Brazilian frontline HCWs. Individual factors were the most strongly associated with mental health outcomes. These findings indicate the need to develop programs that provide emotional support, identify professionals at risk and refer them to specialized treatment when necessary.
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Affiliation(s)
- Mírian Cohen
- Graduate Program in Epidemiology, Federal University of Rio Grande do Sul (UFRGS), Ramiro Barcelos St, 2400, 2nd fl, Porto Alegre, Rio Grande do Sul, Brazil; National Institute of Science and Technology for Health Technology Assessment (IATS), Ramiro Barcelos St, 2350, BLDG 21, Unit 507, Porto Alegre, Rio Grande do Sul, Brazil.
| | - Ricardo B Cardoso
- Graduate Program in Epidemiology, Federal University of Rio Grande do Sul (UFRGS), Ramiro Barcelos St, 2400, 2nd fl, Porto Alegre, Rio Grande do Sul, Brazil; National Institute of Science and Technology for Health Technology Assessment (IATS), Ramiro Barcelos St, 2350, BLDG 21, Unit 507, Porto Alegre, Rio Grande do Sul, Brazil
| | - Ligia R F S Kerr
- Department of Community Health, Federal University of Ceará (UFC), Prof Costa Mendes St, 1608, 5(th) fl, Fortaleza, Ceará, Brazil
| | - Carl Kendall
- Department of Community Health, Federal University of Ceará (UFC), Prof Costa Mendes St, 1608, 5(th) fl, Fortaleza, Ceará, Brazil; Tulane University School of Public Health and Tropical Medicine, 1440 Canal St, New Orleans, Louisiana, USA
| | - Rosa L F Almeida
- Graduate Program in Public Health, Fortaleza University (UNIFOR), Washington Soares Ave, 1321 Fortaleza, Ceará, Brazil
| | - Nayê B Schneider
- Graduate Program in Epidemiology, Federal University of Rio Grande do Sul (UFRGS), Ramiro Barcelos St, 2400, 2nd fl, Porto Alegre, Rio Grande do Sul, Brazil; National Institute of Science and Technology for Health Technology Assessment (IATS), Ramiro Barcelos St, 2350, BLDG 21, Unit 507, Porto Alegre, Rio Grande do Sul, Brazil
| | - Carolina M Viera
- Medical School, Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), Ipiranga Ave, 6681 Porto Alegre, Rio Grande do Sul, Brazil
| | - Jorge G Zaduchliver
- Hospital Moinhos de Vento (HMV), Ramiro Barcelos St, 910, Porto Alegre, Rio Grande do Sul, Brazil
| | - Andriele A Castro
- Hospital Moinhos de Vento (HMV), Ramiro Barcelos St, 910, Porto Alegre, Rio Grande do Sul, Brazil
| | - Francisco M L Pinheiro
- Department of Community Health, Federal University of Ceará (UFC), Prof Costa Mendes St, 1608, 5(th) fl, Fortaleza, Ceará, Brazil
| | - Maria F P M Albuquerque
- Insitute Aggeu Magalhães, FIOCRUZ-PE, Prof. Moraes Rego Ave, s/n, UFPE Campus, Recife, Pernambuco, Brazil
| | - Luana N G C Lima
- Evandro Chagas Institute, BR-316 Hwy, km 7, Ananindeua, Pará, Brazil
| | - Maria A S M Veras
- School of Medical Sciences, Santa Casa de São Paulo, Dr Cesário Mota Jr. St, 61, São Paulo, São Paulo, Brazil
| | - Celina M T Martelli
- Insitute Aggeu Magalhães, FIOCRUZ-PE, Prof. Moraes Rego Ave, s/n, UFPE Campus, Recife, Pernambuco, Brazil
| | - Luciane N Cruz
- National Institute of Science and Technology for Health Technology Assessment (IATS), Ramiro Barcelos St, 2350, BLDG 21, Unit 507, Porto Alegre, Rio Grande do Sul, Brazil; Hospital Moinhos de Vento (HMV), Ramiro Barcelos St, 910, Porto Alegre, Rio Grande do Sul, Brazil
| | - Suzi A Camey
- Statistics Department, Federal University of Rio Grande do Sul (UFRGS), Bento Gonçalves Ave, 9500 Porto Alegre, Rio Grande do Sul, Brazil; Hospital de Clínicas de Porto Alegre (HCPA), Ramiro Barcelos St, 2350 Porto Alegre, Rio Grande do Sul, Brazil
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Russo G, de Oliveira BLCAL, Cassenote AJF, Scheffer MC. What happened to health labour markets during COVID-19? Insights from the analysis of cross-sectional survey data on the perceptions of medical doctors in Brazil. BMJ Open 2023; 13:e075458. [PMID: 37558455 PMCID: PMC10414124 DOI: 10.1136/bmjopen-2023-075458] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Accepted: 07/24/2023] [Indexed: 08/11/2023] Open
Abstract
OBJECTIVES To examine physicians' perceptions of changing employment opportunities in Brazil, and gain an insight into labour markets in low/middle-income countries (LMICs) during the pandemic. STUDY DESIGN Descriptive and inferential analysis of a quantitative dataset from a representative cross-sectional survey of physicians of two Brazilian states. SETTINGS São Paulo and Maranhão states in Brazil. PARTICIPANTS Representative sample of 1183 physicians. OUTCOME MEASURES We estimated prevalence and 95% CIs for physicians' perceptions of changes in demand and supply of doctors, as well as changes in prices of medical services for facilities of practice in the two states, stratified by public, private and dual-practice physicians. RESULTS Most doctors reported increased job opportunities in the public sector (54.9%, 95% CI 52.0% to 57.7%), particularly in Maranhão state (65.0%, 95% CI 60.9% to 68.9%). For the private sector, increased opportunities were reported only in large private hospitals (46.7%, 95% CI 43.9% to 49.6%) but not in smaller clinics. We recorded perceptions of slight increases in availability of doctors in Maranhão, particularly in the public sector (51.4%, 95% CI 43.2% to 59.5%). Younger doctors recounted increased vacancies in the public sector (64%, 95% CI 58.1% to 68.1%), older doctors only in walk-in clinics in Maranhão (47.5%, 95% CI 39.9% to 55.1%). Those working directly with patients with COVID-19 saw opportunities in public hospitals (65%, 95% CI 62.3% to 68.4%) and in large private ones (55%, 95% CI 51.8% to 59.1%). CONCLUSIONS Our findings hint that health labour markets in LMICs may not necessarily shrink during epidemics, and that impacts will depend on the balance of public and private services in national health systems.
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Affiliation(s)
- Giuliano Russo
- Wolfson Institute of Population Health, Queen Mary University of London, London, UK
| | | | - Alex J Flores Cassenote
- Departamento da Medicina Preventiva, Universidade de São Paulo Hospital das Clínicas, Sao Paulo, Brazil
| | - Mário C Scheffer
- Preventative Medicine, Universidade de Sao Paulo Faculdade de Medicina, Sao Paulo, Brazil
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11
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Silva MFS, de Oliveira FDCE, Pinto ACMD, Luciano MCDS, Garcia MML, Araújo FMDC, Fonseca MHG. Antibody response following the fourth SARS-CoV-2 vaccine dose during the Omicron wave in Brazil. J Med Virol 2023; 95:e29055. [PMID: 37641396 DOI: 10.1002/jmv.29055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Revised: 08/03/2023] [Accepted: 08/14/2023] [Indexed: 08/31/2023]
Abstract
We investigated the impact of the fourth dose with ChAdOx1 nCoV-19 (AstraZeneca) in the humoral immune response to SARS-CoV-2 during a 9-month follow-up period in which Omicron was the predominant variant in Brazil. IgG for the SARS-CoV-2 spike protein (S) and nucleocapsid (N) proteins were analyzed in samples collected before and after the fourth dose. All participants were tested monthly for SARS-CoV-2 infection by RT-qPCR. The antibody response induced by the fourth dose of the coronavirus disease 2019 vaccine was evaluated and compared with the response induced by the second and third doses. The additional antibody response to the viral S protein after the fourth dose was smaller than those after the third vaccine dose. In contrast, an increase in the N IgG levels could be observed after the fourth dose compared to other vaccine doses. In the comparison of the antibody response before and after the fourth dose, an increase in both S-and-N IgG was noted, mainly in the positive qPCR group. We did not observe a significant decline in IgG levels after the fourth dose, as observed after the second and third doses, therefore, a sustained humoral response to both S and N proteins seems to be achieved.
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12
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Zaildo T, Santino TA, Chaves G, da Silva BAK, Alchieri JC, Patino CM, Leite S, Luz KG, Guerra RO, da Penha THS, da Silva GR, Jácome AC, Monteiro KS, de Mendonça KMPP. Barriers to and facilitators of populational adherence to prevention and control measures of COVID-19 and other respiratory infectious diseases: a qualitative evidence synthesis. Eur Respir Rev 2023; 32:220238. [PMID: 37343960 DOI: 10.1183/16000617.0238-2022] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Accepted: 04/03/2023] [Indexed: 06/23/2023] Open
Abstract
AIMS To summarise the evidence on barriers to and facilitators of population adherence to prevention and control measures for coronavirus disease 2019 (COVID-19) and other respiratory infectious diseases. METHODS A qualitative synthesis was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis and the Cochrane Effective Practice and Organization of Care: Qualitative Evidence Synthesis. We performed an electronic search on MEDLINE, Embase and PsycINFO from their inception to March 2023. RESULTS We included 71 studies regarding COVID-19, pneumonia, tuberculosis, influenza, pertussis and H1N1, representing 5966 participants. The measures reported were vaccinations, physical distancing, stay-at-home policy, quarantine, self-isolation, facemasks, hand hygiene, contact investigation, lockdown, infection prevention and control guidelines, and treatment. Tuberculosis-related measures were access to care, diagnosis and treatment completion. Analysis of the included studies yielded 37 barriers and 23 facilitators. CONCLUSIONS This review suggests that financial and social support, assertive communication, trust in political authorities and greater regulation of social media enhance adherence to prevention and control measures for COVID-19 and infectious respiratory diseases. Designing and implementing effective educational public health interventions targeting the findings of barriers and facilitators highlighted in this review are key to reducing the impact of infectious respiratory diseases at the population level.
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Affiliation(s)
- Tácito Zaildo
- Department of Physical Therapy, Graduate Program in Physical Therapy, Federal University of Rio Grande do Norte, Natal, RN, Brazil
| | - Thayla Amorim Santino
- Department of Physical Therapy, State University of Paraiba, Campina Grande, PB, Brazil
| | | | | | - João Carlos Alchieri
- Department of Psychology, Graduate Program in Science, Federal University of Rio Grande do Norte, Natal, RN, Brazil
| | - Cecilia M Patino
- Department of Population and Public Health Sciences, University of Southern California Keck School of Medicine, Los Angeles, CA, USA
| | - Sarah Leite
- Department of Physical Therapy, Graduate Program in Physical Therapy, Federal University of Rio Grande do Norte, Natal, RN, Brazil
| | - Kleber Giovanni Luz
- Department of Infectious Diseases, Federal University of Rio Grande do Norte, Natal, RN, Brazil
| | - Ricardo Oliveira Guerra
- Department of Physical Therapy, Graduate Program in Physical Therapy, Federal University of Rio Grande do Norte, Natal, RN, Brazil
| | - Tito Hugo Soares da Penha
- Department of Physical Therapy, Graduate Program in Physical Therapy, Federal University of Rio Grande do Norte, Natal, RN, Brazil
| | - Gabriel Rodrigues da Silva
- Department of Physical Therapy, Graduate Program in Physical Therapy, Federal University of Rio Grande do Norte, Natal, RN, Brazil
| | - Ada Cristina Jácome
- Public Health Department of the State of Rio Grande do Norte, Natal, RN, Brazil
| | - Karolinne Souza Monteiro
- Faculty of Health Sciences of Trairi, Federal University of Rio Grande do Norte, Natal, RN, Brazil
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Martins AF, de Souza DRV, de Rezende Neto JM, Santos AA, da Invenção GB, Matos ILS, dos Santos KA, de Jesus PC, da Silva FA, de Almeida FHO, do Vale FYN, Fonseca DLM, Schimke LF, Matos SS, Oliveira BM, Ferreira CS, de Paula Dias B, dos Santos SMSA, Barbosa CC, de Carvalho Barreto ID, Moreno AKM, Gonçalves RL, de Mello Silva B, Cabral-Marques O, Borges LP. A higher number of SARS-COV-2 infections in quilombola communities than in the local population in Brazil. Front Public Health 2023; 11:1095162. [PMID: 37304100 PMCID: PMC10253171 DOI: 10.3389/fpubh.2023.1095162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Accepted: 05/11/2023] [Indexed: 06/13/2023] Open
Abstract
The historical and social vulnerability of quilombola communities in Brazil can make them especially fragile in the face of COVID-19, considering that several individuals have precarious health systems and inadequate access to water. This work aimed to characterize the frequency of SARS-COV-2 infections and the presence of IgM and IgG SARS-CoV-2 antibodies in quilombola populations and their relationship with the presence of risk factors or preexisting chronic diseases in the quilombola communities. We analyzed the sociodemographic and clinical characteristics, serological status, comorbidities, and symptoms of 1,994 individuals (478 males and 1,536 females) from 18 Brazilian municipalities in the State of Sergipe of quilombola communities, which were evaluated at different epidemiological weeks, starting at the 32nd (August 6th) and ending at the 40th (October 3rd) epidemiological week. More than 70% of studied families live in rural areas and they have an extreme poverty social status. Although we found a higher number of SARS-COV-2 infections in quilombola communities than in the local population, their SARS-CoV-2 reactivity and IgM and IgG positivity varied across the communities investigated. Arterial hypertension was the most risk factor, being found in 27.8% of the individuals (9.5% in stage 1, 10.8% in stage 2, and 7.5% in stage 3). The most common COVID-19 symptoms and comorbidities were headache, runny nose, flu, and dyslipidemia. However, most individuals were asymptomatic (79.9%). Our data indicate that mass testing must be incorporated into public policy to improve the health care system available to quilombola populations during a future pandemic or epidemic.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | - Fernando Yuri Nery do Vale
- Department of Clinical and Toxicological Analyses, School of Pharmaceutical Sciences University of São Paulo, São Paulo, Brazil
| | - Dennyson Leandro M. Fonseca
- Interunit Postgraduate Program on Bioinformatics, Institute of Mathematics and Statistics (IME), University of São Paulo (USP), São Paulo, SP, Brazil
| | - Lena F. Schimke
- Department of Immunology, Institute of Biomedical Sciences, University of São Paulo, São Paulo, SP, Brazil
| | - Saulo Santos Matos
- Department of Pharmacy, Federal University of Sergipe, São Cristóvão, SE, Brazil
| | | | - Cyntia Silva Ferreira
- Department of Biological Sciences, Federal University of Ouro Preto, Ouro Preto, Minas Gerais, Brazil
| | - Bruna de Paula Dias
- Department of Biological Sciences, Federal University of Ouro Preto, Ouro Preto, Minas Gerais, Brazil
| | | | - Camila Cavadas Barbosa
- Department of Biological Sciences, Federal University of Ouro Preto, Ouro Preto, Minas Gerais, Brazil
| | | | - Ana Karolina Mendes Moreno
- Postgraduate Program in Animal Biodiversity, Institute of Biological Sciences, Federal University of Goiás, Goiânia, Brazil
| | - Ricardo Lemes Gonçalves
- Department of Biological Sciences, Federal University of Ouro Preto, Ouro Preto, Minas Gerais, Brazil
| | - Breno de Mello Silva
- Department of Biological Sciences, Federal University of Ouro Preto, Ouro Preto, Minas Gerais, Brazil
| | - Otavio Cabral-Marques
- Department of Clinical and Toxicological Analyses, School of Pharmaceutical Sciences University of São Paulo, São Paulo, Brazil
- Interunit Postgraduate Program on Bioinformatics, Institute of Mathematics and Statistics (IME), University of São Paulo (USP), São Paulo, SP, Brazil
- Department of Immunology, Institute of Biomedical Sciences, University of São Paulo, São Paulo, SP, Brazil
- Department of Pharmacy and Postgraduate Program of Health and Science, Federal University of Rio Grande do Norte, Natal, Brazil
- Department of Medicine, Division of Molecular Medicine, University of São Paulo School of Medicine, São Paulo, Brazil
- Laboratory of Medical Investigation 29, University of São Paulo School of Medicine, São Paulo, Brazil
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Boing AF, Boing AC, Barberia L, Borges ME, Subramanian SV. Uncovering inequities in Covid-19 vaccine coverage for adults and elderly in Brazil: A multilevel study of 2021-2022 data. Vaccine 2023:S0264-410X(23)00569-8. [PMID: 37221119 DOI: 10.1016/j.vaccine.2023.05.030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Revised: 05/11/2023] [Accepted: 05/12/2023] [Indexed: 05/25/2023]
Abstract
Vaccination is crucial for reducing severe COVID-19 cases, hospitalizations, and deaths. However, vaccine access disparities within countries, particularly in low- and middle-income nations, may leave disadvantaged regions and populations behind. This study aimed to investigate potential inequalities in vaccine coverage among Brazilian aged 18 years and older based on demographic, geographic, and socioeconomic characteristics at the municipal level. A total of 389 million vaccination records from the National Immunization Program Information System were analyzed to calculate vaccine coverage rates for the first, second, and booster doses among adults (18-59 years) and elderly (60 + years) vaccinated between January 2021 and December 2022. We analyzed the data by gender and used a three-level (municipalities, states, regions) multilevel regression analysis to assess the association between vaccine coverage and municipal characteristics. Vaccination coverage was higher among the elderly than among adults, particularly for the second and booster doses. Adult women showed higher coverage rates than men (ranging from 118 % to 25 % higher along the analyzed period). Significant inequalities were observed when analyzing the evolution of vaccination coverage by sociodemographic characteristics of municipalities. In the early stages of the vaccination campaign, municipalities with higher per capita Gross Domestic Product (pGDP), educational level, and fewer Black residents reached higher population coverages earlier. In December 2022, adult and elderly booster vaccine coverage was 43 % and 19 %, respectively, higher in municipalities in the highest quintile of educational level. Higher vaccine uptake was also observed in municipalities with fewer Black residents and higher pGDP. Municipalities accounted for most of the variance in vaccine coverage (59.7 %-90.4 % depending on the dose and age group). This study emphasizes the inadequate booster coverage and the presence of socioeconomic and demographic disparities in COVID-19 vaccination rates. These issues must be addressed through equitable interventions to avoid potential disparities in morbidity and mortality.
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Affiliation(s)
- Antonio Fernando Boing
- Federal University of Santa Catarina, Eng. Agronômico Andrei Cristian Ferreira Street, Florianópolis, SC 88040-900, Brazil
| | - Alexandra Crispim Boing
- Federal University of Santa Catarina, Eng. Agronômico Andrei Cristian Ferreira Street, Florianópolis, SC 88040-900, Brazil
| | - Lorena Barberia
- University of Sao Paulo, 1280 Prof. Almeida Prado Avenue, São Paulo, SP 05508-070, Brazil
| | | | - S V Subramanian
- Harvard T. H. Chan School of Public Health, Department of Society, Human Development and Health, 677 Huntington Ave, Boston, MA 02115, USA
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15
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Yang J, Cordeiro G, Longato M, Vaghela S, Kyaw MH, Mendoza CF, Dantas A, Senna T, Holanda P, Spinardi JR. Burden of COVID-19 during the omicron predominance in Brazil: a nationwide retrospective database study. J Med Econ 2023; 26:1201-1211. [PMID: 37735817 DOI: 10.1080/13696998.2023.2262323] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Accepted: 09/20/2023] [Indexed: 09/23/2023]
Abstract
BACKGROUND The coronavirus disease 2019 (COVID-19) pandemic has imposed significant burden on Brazil's health system. This study aimed to examine clinical characteristics, overall vaccine uptake, and to assess healthcare resource utilization (HCRU) and costs associated with acute COVID-19 in Brazil during the Omicron predominant period. METHODS A nationwide retrospective study was conducted using various Brazilian databases including, COVID-19 related databases, public health systems, and other surveillance/demographic datasets. Individuals with positive COVID-19 test results between January 1 2022 and April 30 2022, during Omicron BA.1/BA.2 wave, were identified. Patients' demographics, vaccine uptake, HCRU and corresponding costs were described by age groups. RESULTS A total of 8,160,715 (3.80%) COVID-19 cases were identified in the study cohort, ranging from 2.43% in <5 years to 62.05% in 19-49 years. The uptake of partial (Dose 1) or full immunization (Dose 2) was less than 0.1% in children aged <5 years, whereas in individuals ≥ 19 years, it exceeded 89.78% for Dose 1 and 84.07% for Dose 2. Overall booster vaccine uptake was 38.06%, which was significantly higher among individuals aged ≥ 65 years, surpassing 74.79%. Regardless of vaccination status, 87.2% cases were symptomatic, and 1.48% were hospitalized due to acute COVID-19 (<5 years: 2.33%, 5-11 years: 0.99%, 12-18 years: 0.32%, 19-49 years: 0.40%; 50-64 years: 1.50%, 65-74 years: 5.43%, and ≥ 75 years: 17.89%). Among the hospitalized patients (n = 120,450), 32.57% were admitted to ICU, of whom 31,283 (79.75%) individuals required mechanical ventilation (MV) support. The average cost per day in normal ward and ICU without MV in public/general hospital settings was $104.36 and $302.81, respectively. While average cost per day in normal ward and ICU with MV was $75.91 and $301.22 respectively. CONCLUSIONS This study quantified the burden of COVID-19 in Brazil, suggesting substantial healthcare resources required to manage the COVID-19 pandemic.
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Affiliation(s)
- Jingyan Yang
- Pfizer Inc., New York, NY, USA
- Institute for Social and Economic Research and Policy, Columbia University, New York, NY, USA
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Pre-Pandemic Cross-Reactive Immunity against SARS-CoV-2 among Central and West African Populations. Viruses 2022; 14:v14102259. [PMID: 36298814 PMCID: PMC9611584 DOI: 10.3390/v14102259] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Revised: 10/06/2022] [Accepted: 10/11/2022] [Indexed: 11/06/2022] Open
Abstract
For more than two years after the emergence of COVID-19 (Coronavirus Disease-2019), significant regional differences in morbidity persist. These differences clearly show lower incidence rates in several regions of the African and Asian continents. The work reported here aimed to test the hypothesis of a pre-pandemic natural immunity acquired by some human populations in central and western Africa, which would, therefore, pose the hypothesis of an original antigenic sin with a virus antigenically close to the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2). To identify such pre-existing immunity, sera samples collected before the emergence of COVID-19 were tested to detect the presence of IgG reacting antibodies against SARS-CoV-2 proteins of major significance. Sera samples from French blood donors collected before the pandemic served as a control. The results showed a statistically significant difference of antibodies prevalence between the collected samples in Africa and the control samples collected in France. Given the novelty of our results, our next step consists in highlighting neutralizing antibodies to evaluate their potential for pre-pandemic protective acquired immunity against SARS-CoV-2. In conclusion, our results suggest that, in the investigated African sub-regions, the tested populations could have been potentially and partially pre-exposed, before the COVID-19 pandemic, to the antigens of a yet non-identified Coronaviruses.
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