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Cardona-Arias JA, Carmona-Fonseca J. Prospective study of malaria in pregnancy, placental and congenital malaria in Northwest Colombia. Malar J 2024; 23:116. [PMID: 38664687 PMCID: PMC11044305 DOI: 10.1186/s12936-024-04948-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2024] [Accepted: 04/13/2024] [Indexed: 04/29/2024] Open
Abstract
BACKGROUND Pregnancy Associated Malaria (PAM) include malaria in pregnancy (MiP), placental malaria (PM), and congenital malaria (CM). The evidence available in Colombia on PAM focuses on one of the presentations (MiP, PM or CM), and no study longitudinally analyses the infection from the pregnant woman, passing through the placenta, until culminating in the newborn. This study determined the frequency of MiP, PM, and CM caused by Plasmodium vivax, Plasmodium falciparum, or mixed infections, according to Thick Blood Smear (TBS) and quantitative Polymerase Chain Reaction (qPCR). Identifying associated factors of PAM and clinical-epidemiological outcomes in northwestern Colombia. METHODS Prospective study of 431 pregnant women, their placenta, and newborns registered in the data bank of the research Group "Salud y Comunidad César Uribe Piedrahíta" which collected information between 2014 and 2020 in endemic municipalities of the departments of Córdoba and Antioquia. The frequency of infection was determined with 95% confidence intervals. Comparisons were made with the Chi-square test, Student t-test, prevalence ratios, and control for confounding variables by log-binomial regression. RESULTS The frequency of MiP was 22.3% (4.6% using TBS), PM 24.8% (1.4% using TBS), and CM 11.8% (0% using TBS). Using TBS predominated P. vivax. Using qPCR the proportions of P. vivax and P. falciparum were similar for MiP and PM, but P. falciparum predominated in CM. The frequency was higher in nulliparous, and women with previous malaria. The main clinical effects of PAM were anaemia, low birth weight, and abnormal APGAR score. CONCLUSIONS The magnitude of infections was not detected with TBS because most cases were submicroscopic (TBS-negative, qPCR-positive). This confirmed the importance of improving the molecular detection of cases. PAM continue being underestimated in the country due to that in Colombia the control programme is based on TBS, despite its outcomes on maternal, and congenital health.
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Affiliation(s)
| | - Jaime Carmona-Fonseca
- School of Medicine, University of Antioquia UdeA., Research Group Coordinator "Salud y Comunidad-César Uribe Piedrahíta", Medellín, Colombia
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Cardona-Arias JA, Salas-Zapata W, Carmona-Fonseca J. A systematic review of mixed studies on malaria in Colombia 1980-2022: what the "bifocal vision" discovers. BMC Public Health 2023; 23:1169. [PMID: 37330477 PMCID: PMC10276438 DOI: 10.1186/s12889-023-16098-5] [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: 07/29/2022] [Accepted: 06/10/2023] [Indexed: 06/19/2023] Open
Abstract
Mixed methods are essential in public health research and malaria control, because they allow grasping part of the complexity and diversity of the factors that determine health-disease. This study analyzes the mixed studies on malaria in Colombia, 1980-2022, through a systematic review in 15 databases and institutional repositories. The methodological quality was assessed with Mixed Methods Appraisal Tool (MMAT), STrengthening the Reporting of OBservational studies in Epidemiology (STROBE), and Standards for Reporting Qualitative Research (SRQR). The qualitative and quantitative findings were grouped into a four-level hierarchical matrix. The epidemiological profile of malaria morbidity, from traditional epidemiology, has been sustained by environmental problems, armed conflict, individual risk behaviors, and low adherence to recommendations from health institutions. However, the qualitative component reveals deeper causes that are less studied, of greater theoretical complexity, and that reflect challenges to design and implement health interventions, such as socioeconomic and political crises, poverty, and the neoliberal orientation in the malaria control policy; the latter reflected in the change in the role of the State, the fragmentation of control actions, the predominance of insurance over social assistance, the privatization of the provision of health services, the individualistic and economistic predominance of health, and low connection with popular tradition and community initiatives. The above confirms the importance of expanding mixed studies as a source of evidence to improve malaria research and control models in Colombia, and to identify the underlying causes of the epidemiological profile.
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Affiliation(s)
| | | | - Jaime Carmona-Fonseca
- Research group "Salud y Comunidad César Uribe Piedrahíta" School of Medicine, University of Antioquia, Medellín, Colombia
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Gonçalves NV, de Souza BC, Araújo MDS, Morais EC, de Melo BG, de Brito SR, Carrera MDFP, da Costa SBN, Alves TMK, Bastos TDR, de Melo JS, Miranda CDSC. Malaria and environmental, socioeconomics and public health conditions in the municipality of São Félix do Xingu, Pará, Eastern Amazon, Brazil: An ecological and cross-sectional study. Rev Soc Bras Med Trop 2023; 56:e0502. [PMID: 37075452 PMCID: PMC10109341 DOI: 10.1590/0037-8682-0502-2022] [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: 10/20/2022] [Accepted: 03/08/2023] [Indexed: 04/21/2023] Open
Abstract
BACKGROUND Malaria is a parasitosis conditioned by several factors. This study sought to analyze the spatial distribution of malaria considering environmental, socioeconomic, and political variables in São Félix do Xingu, Pará, Brazil, from 2014 to 2020. METHODS Epidemiological, cartographic, and environmental data were obtained from the Ministry of Health, Brazilian Geographical and Statistical Institute, and National Space Research Institute. Statistical and spatial distribution analyses were performed using chi-squared tests of expected equal proportions and the kernel and bivariate global Moran's techniques with Bioestat 5.0 and ArcGIS 10.5.1. RESULTS The highest percentage of cases occurred in adult males with brown skin color, mainly placer miners, with a primary education level, living in rural areas, who were infected with Plasmodium vivax and with parasitemia of two or three crosses as diagnosed by the thick drop/smear test. The disease had a non-homogeneous distribution, with distinct annual parasite indices associated with administrative districts and clusters of cases in locations with deforestation, mining, and pastures close to Conservation Units and Indigenous Lands. Thus, a direct relationship between areas with cases and environmental degradation associated with land use was demonstrated, along with the precarious availability of health services. Pressure on protected areas and epidemiological silence in Indigenous Lands were also noted. CONCLUSIONS Environmental and socioeconomic circuits were identified for development of diseases associated with precarious health services in the municipality. These findings highlight the need to intensify malaria surveillance and contribute to the systematic knowledge of malaria's epidemiology by considering the complexity of its conditioning factors.
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Affiliation(s)
- Nelson Veiga Gonçalves
- Universidade do Estado do Pará, Laboratório de Epidemiologia e Geoprocessamento da Amazônia, Belém, PA, Brasil
- Universidade Federal Rural da Amazônia, Instituto Ciberespacial, Belém, PA, Brasil
| | - Bruna Costa de Souza
- Universidade do Estado do Pará, Laboratório de Epidemiologia e Geoprocessamento da Amazônia, Belém, PA, Brasil
- Universidade Federal Rural da Amazônia, Instituto Ciberespacial, Belém, PA, Brasil
| | | | | | - Bruma Gouveia de Melo
- Universidade do Estado do Pará, Laboratório de Epidemiologia e Geoprocessamento da Amazônia, Belém, PA, Brasil
| | | | | | | | - Taiana Moita Koury Alves
- Universidade do Estado do Pará, Laboratório de Epidemiologia e Geoprocessamento da Amazônia, Belém, PA, Brasil
| | - Thalita da Rocha Bastos
- Universidade do Estado do Pará, Laboratório de Epidemiologia e Geoprocessamento da Amazônia, Belém, PA, Brasil
| | - João Simão de Melo
- Universidade Federal do Pará, Instituto de Ciências da Saúde, Belém, PA, Brasil
| | - Claudia do Socorro Carvalho Miranda
- Universidade do Estado do Pará, Laboratório de Epidemiologia e Geoprocessamento da Amazônia, Belém, PA, Brasil
- Centro Universitário da Amazônia, Belém, PA, Brasil
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Costa EM, Rocha NCDS, Rocha TAH, Lima HLO, Vissoci JRN, Queiroz RCDS, Fonseca Thomaz EBA. Bolsa Família Program and deaths from oral cancer in Brazil: an ecological study. Rev Panam Salud Publica 2022; 46:e208. [PMID: 36569580 PMCID: PMC9767244 DOI: 10.26633/rpsp.2022.208] [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: 05/03/2022] [Accepted: 08/25/2022] [Indexed: 12/24/2022] Open
Abstract
Objective To assess the effect of coverage of the Bolsa Família Program (BFP) on oral cancer mortality rates in Brazil between 2005 and 2017, adjusting for health care coverage and socioeconomic characteristics of the Brazilian federative units. Methods This is an ecological study using annual data (2005-2017) from all the Brazilian federative units. The dependent variable for this study was the oral cancer mortality rate, standardized by gender and age using the direct standardization technique. BFP coverage was the main independent variable, calculated as the ratio of the number of BFP beneficiaries to those families that should potentially be entitled to this conditional cash transfer. Socioeconomic background and health care coverage were covariables. Choropleth maps were drawn, and space-time cube analysis was used to assess changes in the spatiotemporal distribution of BFP and oral cancer mortality rates. Mixed-effects linear regression analysis estimated the coefficients (β) and 95% confidence intervals (CI) for the association between BFP coverage and oral cancer mortality rates. Results BFP coverage trends increased and oral cancer mortality rate trends stabilized in Brazilian federative units, except for Maranhão, Goiás, and Minas Gerais, where the oral cancer mortality rates have increased. In the adjusted model, greater BFP coverage was associated with lower oral cancer mortality rates (β -2.10; 95% CI [-3.291, -0.919]). Conclusions Egalitarian strategies such as BFP can reduce the oral cancer mortality rate. We recommend the follow-up of families benefiting from conditional cash transfer program by oral health teams to reduce the oral cancer mortality rate.
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Affiliation(s)
- Elisa Miranda Costa
- Federal University of MaranhãoSão LuísMaranhãoBrazilFederal University of Maranhão, São Luís, Maranhão, Brazil,Elisa Miranda Costa,
| | - Núbia Cristina da Silva Rocha
- Methods, Analytics and Technology for Health (M.A.T.H. Consortium)Belo HorizonteMinas GeraisBrazilMethods, Analytics and Technology for Health (M.A.T.H. Consortium), Belo Horizonte, Minas Gerais, Brazil
| | - Thiago Augusto Hernandes Rocha
- Pan American Health OrganizationWashington, D.C.United States of AmericaPan American Health Organization, Washington, D.C., United States of America
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Sironi AP, Bertoldo J, Sampaio V, Coimbra D, Rasella D, Barreto ME. Malaria-VisAnalytics: a tool for visual exploratory analysis of Brazilian public malaria data. Malar J 2022; 21:232. [PMID: 35915484 PMCID: PMC9344676 DOI: 10.1186/s12936-022-04248-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/22/2022] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Data integration and visualisation techniques have been widely used in scientific research to allow the exploitation of large volumes of data and support highly complex or long-lasting research questions. Integration allows data from different sources to be aggregated into a single database comprising variables of interest for different types of studies. Visualisation allows large and complex data sets to be manipulated and interpreted in a more intuitive way.
Methods
Integration and visualisation techniques were applied in a malaria surveillance ecosystem to build an integrated database comprising notifications, deaths, vector control and climate data. This database is accessed through Malaria-VisAnalytics, a visual mining platform for descriptive and predictive analysis supporting decision and policy-making by governmental and health agents.
Results
Experimental and validation results have proved that the visual exploration and interaction mechanisms allow effective surveillance for rapid action in suspected outbreaks, as well as support a set of different research questions over integrated malaria electronic health records.
Conclusion
The integrated database and the visual mining platform (Malaria-VisAnalytics) allow different types of users to explore malaria-related data in a user-friendly interface. Summary data and key insights can be obtained through different techniques and dimensions. The case study on Manaus can serve as a reference for future replication in other municipalities. Finally, both the database and the visual mining platform can be extended with new data sources and functionalities to accommodate more complex scenarios (such as real-time data capture and analysis).
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