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Zhang H, Yin L, Mao L, Mei S, Chen T, Liu K, Feng S. Combinational Recommendation of Vaccinations, Mask-Wearing, and Home-Quarantine to Control Influenza in Megacities: An Agent-Based Modeling Study With Large-Scale Trajectory Data. Front Public Health 2022; 10:883624. [PMID: 35719665 PMCID: PMC9204335 DOI: 10.3389/fpubh.2022.883624] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Accepted: 03/31/2022] [Indexed: 11/15/2022] Open
Abstract
The outbreak of COVID-19 stimulated a new round of discussion on how to deal with respiratory infectious diseases. Influenza viruses have led to several pandemics worldwide. The spatiotemporal characteristics of influenza transmission in modern cities, especially megacities, are not well-known, which increases the difficulty of influenza prevention and control for populous urban areas. For a long time, influenza prevention and control measures have focused on vaccination of the elderly and children, and school closure. Since the outbreak of COVID-19, the public's awareness of measures such as vaccinations, mask-wearing, and home-quarantine has generally increased in some regions of the world. To control the influenza epidemic and reduce the proportion of infected people with high mortality, the combination of these three measures needs quantitative evaluation based on the spatiotemporal transmission characteristics of influenza in megacities. Given that the agent-based model with both demographic attributes and fine-grained mobility is a key planning tool in deploying intervention strategies, this study proposes a spatially explicit agent-based influenza model for assessing and recommending the combinations of influenza control measures. This study considers Shenzhen city, China as the research area. First, a spatially explicit agent-based influenza transmission model was developed by integrating large-scale individual trajectory data and human response behavior. Then, the model was evaluated across multiple intra-urban spatial scales based on confirmed influenza cases. Finally, the model was used to evaluate the combined effects of the three interventions (V: vaccinations, M: mask-wearing, and Q: home-quarantining) under different compliance rates, and their optimal combinations for given control objectives were recommended. This study reveals that adults were a high-risk population with a low reporting rate, and children formed the lowest infected proportion and had the highest reporting rate in Shenzhen. In addition, this study systematically recommended different combinations of vaccinations, mask-wearing, and home-quarantine with different compliance rates for different control objectives to deal with the influenza epidemic. For example, the "V45%-M60%-Q20%" strategy can maintain the infection percentage below 5%, while the "V20%-M60%-Q20%" strategy can maintain the infection percentage below 15%. The model and policy recommendations from this study provide a tool and intervention reference for influenza epidemic management in the post-COVID-19 era.
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Affiliation(s)
- Hao Zhang
- Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China
- University of Chinese Academy of Sciences, Beijing, China
| | - Ling Yin
- Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China
| | - Liang Mao
- Department of Geography, University of Florida, Gainesville, FL, United States
| | - Shujiang Mei
- Shenzhen Center for Disease Control and Prevention, Shenzhen, China
| | - Tianmu Chen
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Public Health, Xiamen University, Xiamen, China
| | - Kang Liu
- Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China
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Murray-Tuite P, Hotle S. How do Parents Manage Symptomatic Children? Social-Distancing Insights for COVID-19 and Seasonal Influenza. JOURNAL OF HUMAN BEHAVIOR IN THE SOCIAL ENVIRONMENT 2020; 31:3-26. [PMID: 34239285 PMCID: PMC8259535 DOI: 10.1080/10911359.2020.1817224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Strategies for controlling pandemics include social distancing. Using data from a 2016 nation-wide survey pertaining to influenza, (generalized) ordered logit models are developed to identify the factors associated with the relative frequency (never/sometimes/always) a household (a) isolates a sick child from others in the household, (b) keeps the sick child out of school/daycare, (c) stops the child's social activities, (d) has a parent stay home to care for the child, and (e) has another adult care for the child. Marital status is non-significant for isolation practices but is significant in caregiving. Married individuals are 25% more likely to report a parent always staying home with a sick child. Males are more likely to report never isolating a sick child (6%, 3%, and 2% for actions a, b, and c, respectively) and 3% more likely to never have a parent stay home. Individuals knowledgeable about the disease are 10% more likely to always keep a sick child home from school/daycare. Parents are 27% more likely to always stay home with an infant. Individuals who had never worn masks (before the survey) are less likely to isolate a child within the household, but do not act significantly differently with respect to school/daycare.
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Affiliation(s)
| | - Susan Hotle
- Department of Civil and Environmental Engineering, Virginia
Tech, Blacksburg, VA, USA
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Fong MW, Gao H, Wong JY, Xiao J, Shiu EYC, Ryu S, Cowling BJ. Nonpharmaceutical Measures for Pandemic Influenza in Nonhealthcare Settings-Social Distancing Measures. Emerg Infect Dis 2020; 26:976-984. [PMID: 32027585 PMCID: PMC7181908 DOI: 10.3201/eid2605.190995] [Citation(s) in RCA: 294] [Impact Index Per Article: 58.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Influenza virus infections are believed to spread mostly by close contact in the community. Social distancing measures are essential components of the public health response to influenza pandemics. The objective of these mitigation measures is to reduce transmission, thereby delaying the epidemic peak, reducing the size of the epidemic peak, and spreading cases over a longer time to relieve pressure on the healthcare system. We conducted systematic reviews of the evidence base for effectiveness of multiple mitigation measures: isolating ill persons, contact tracing, quarantining exposed persons, school closures, workplace measures/closures, and avoiding crowding. Evidence supporting the effectiveness of these measures was obtained largely from observational studies and simulation studies. Voluntary isolation at home might be a more feasible social distancing measure, and pandemic plans should consider how to facilitate this measure. More drastic social distancing measures might be reserved for severe pandemics.
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Chu Y, Wu Z, Ji J, Sun J, Sun X, Qin G, Qin J, Xiao Z, Ren J, Qin D, Zheng X, Wang XL. Effects of school breaks on influenza-like illness incidence in a temperate Chinese region: an ecological study from 2008 to 2015. BMJ Open 2017; 7:e013159. [PMID: 28264827 PMCID: PMC5353286 DOI: 10.1136/bmjopen-2016-013159] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVE To assess the effects of winter/summer school breaks on occurrences of influenza-like illness (ILI). METHODS We jointly analysed ILI surveillance data with the timing of school breaks in a temperate district in Beijing, China from 2008 to 2015. ILI incidence rate ratios (IRRs) of schoolchildren (5-14 and 15-24 years of age) to adults (25-59 and >60 years of age) were used to measure the age shift of ILI incidence before, during and after the 4-week winter/7-week summer breaks. Serfling-based Poisson regression model with adjustment for unmeasured confounders was built to further assess the effect of winter school breaks. RESULTS ILI incidences were consistently lower during winter breaks than before winter breaks for all age groups. IRRs of younger schoolchildren aged 5-14 to adults were higher during winter school breaks than before breaks, while the opposite was true for the IRRs of older schoolchildren aged 15-24 to adults. Schoolchildren-to-adults IRRs during summer breaks were significantly lower than before or after school breaks (p<0.001). CONCLUSIONS Both winter and summer breaks were associated with reductions of ILI incidences among schoolchildren and adults. Our study contributes additional evidence on the effects of school breaks on ILI incidence, suggesting school closure could be effective in controlling influenza transmission in developing countries.
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Affiliation(s)
- Yanhui Chu
- Centers for Disease Control and Prevention in Xicheng District, Beijing, China
| | - Zhenyu Wu
- Department of Biostatistics, School of Public Health, Key Laboratory of Public Health Safety and Collaborative Innovation Center of Social Risks Governance in Health, Fudan University, Shanghai, China
| | - Jiayi Ji
- Department of Biostatistics, School of Public Health, Key Laboratory of Public Health Safety and Collaborative Innovation Center of Social Risks Governance in Health, Fudan University, Shanghai, China
| | - Jingyi Sun
- Centers for Disease Control and Prevention in Xicheng District, Beijing, China
| | - Xiaoyu Sun
- Centers for Disease Control and Prevention in Xicheng District, Beijing, China
| | - Guoyou Qin
- Department of Biostatistics, School of Public Health, Key Laboratory of Public Health Safety and Collaborative Innovation Center of Social Risks Governance in Health, Fudan University, Shanghai, China
| | - Jingning Qin
- Centers for Disease Control and Prevention in Xicheng District, Beijing, China
| | - Zheng Xiao
- Centers for Disease Control and Prevention in Xicheng District, Beijing, China
| | - Jian Ren
- Centers for Disease Control and Prevention in Xicheng District, Beijing, China
| | - Di Qin
- Centers for Disease Control and Prevention in Xicheng District, Beijing, China
| | - Xueying Zheng
- Department of Biostatistics, School of Public Health, Key Laboratory of Public Health Safety and Collaborative Innovation Center of Social Risks Governance in Health, Fudan University, Shanghai, China
| | - Xi-Ling Wang
- Department of Biostatistics, School of Public Health, Key Laboratory of Public Health Safety and Collaborative Innovation Center of Social Risks Governance in Health, Fudan University, Shanghai, China
- Shanghai Key Laboratory of Meteorology and Health, Shanghai, China
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Kraut RY, Snedeker KG, Babenko O, Honish L. Influence of School Year on Seasonality of Norovirus Outbreaks in Developed Countries. THE CANADIAN JOURNAL OF INFECTIOUS DISEASES & MEDICAL MICROBIOLOGY = JOURNAL CANADIEN DES MALADIES INFECTIEUSES ET DE LA MICROBIOLOGIE MEDICALE 2017; 2017:9258140. [PMID: 28167970 PMCID: PMC5266842 DOI: 10.1155/2017/9258140] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/10/2016] [Accepted: 11/24/2016] [Indexed: 11/17/2022]
Abstract
Factors affecting the seasonal distribution of norovirus outbreaks are not well understood. This study examined whether grade school settings at the start of the school year may be a factor. We searched Ovid Medline from January 2002 to June 2014 for studies that provided all reported norovirus outbreaks in a developed country by month for a minimum of three years. Historical school years were obtained from verifiable sources. The start of the norovirus seasonal outbreak peak and peak outbreak month were determined for each study and compared to the start month of school. Northern hemisphere and southern hemisphere countries had a different norovirus seasonality and different school year structures (traditional compared to year round). In the two studies that provided outbreaks by age, outbreaks among children started several months before outbreaks in the adult population. The median number of months between school start and start of the seasonal outbreak peak was two months (interquartile range [IQR] = 2.0-3.0), while the median number of months between school start and peak outbreak month was four months (IQR = 3.0-4.0). These findings suggest the possibility the school setting at the start of the school year may be a factor in the seasonality of norovirus.
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Affiliation(s)
- Roni Y. Kraut
- Department of Family Medicine, University of Alberta, Edmonton, AB, Canada T6G 2T4
| | - Kate G. Snedeker
- Department of Public Health Sciences, University of Alberta, Edmonton, AB, Canada T6G 1C9
- Surveillance and Reporting, Alberta Health Services, Edmonton, AB, Canada T2W 3N2
| | - Oksana Babenko
- Department of Family Medicine, University of Alberta, Edmonton, AB, Canada T6G 2T4
| | - Lance Honish
- Environmental Public Health, Alberta Health Services, Edmonton, AB, Canada T5J 2Y2
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Waiboci LW, Mott JA, Kikwai G, Arunga G, Xu X, Mayieka L, Emukule GO, Muthoka P, Njenga MK, Fields BS, Katz MA. Which influenza vaccine formulation should be used in Kenya? A comparison of influenza isolates from Kenya to vaccine strains, 2007-2013. Vaccine 2016; 34:2593-601. [PMID: 27079931 DOI: 10.1016/j.vaccine.2016.03.095] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2015] [Revised: 03/11/2016] [Accepted: 03/29/2016] [Indexed: 10/22/2022]
Abstract
INTRODUCTION Every year the World Health Organization (WHO) recommends which influenza virus strains should be included in a northern hemisphere (NH) and a southern hemisphere (SH) influenza vaccine. To determine the best vaccine formulation for Kenya, we compared influenza viruses collected in Kenya from April 2007 to May 2013 to WHO vaccine strains. METHODS We collected nasopharyngeal and oropharyngeal (NP/OP) specimens from patients with respiratory illness, tested them for influenza, isolated influenza viruses from a proportion of positive specimens, tested the isolates for antigenic relatedness to vaccine strains, and determined the percentage match between circulating viruses and SH or NH influenza vaccine composition and schedule. RESULTS During the six years, 7.336 of the 60,072 (12.2%) NP/OP specimens we collected were positive for influenza: 30,167 specimens were collected during the SH seasons and 3717 (12.3%) were positive for influenza; 2903 (78.1%) influenza A, 902 (24.2%) influenza B, and 88 (2.4%) influenza A and B positive specimens. We collected 30,131 specimens during the NH seasons and 3978 (13.2%) were positive for influenza; 3181 (80.0%) influenza A, 851 (21.4%) influenza B, and 54 (1.4%) influenza A and B positive specimens. Overall, 362/460 (78.7%) isolates from the SH seasons and 316/338 (93.5%) isolates from the NH seasons were matched to the SH and the NH vaccine strains, respectively (p<0.001). Overall, 53.6% and 46.4% SH and NH vaccines, respectively, matched circulating strains in terms of vaccine strains and timing. CONCLUSION In six years of surveillance in Kenya, influenza circulated at nearly equal levels during the SH and the NH influenza seasons. Circulating viruses were matched to vaccine strains. The vaccine match decreased when both vaccine strains and timing were taken into consideration. Either vaccine formulation could be suitable for use in Kenya but the optimal timing for influenza vaccination needs to be determined.
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Affiliation(s)
- Lilian W Waiboci
- US Centers for Disease Control and Prevention-Kenya, P.O. Box 606-00621, Nairobi, Kenya; Department of Biochemistry, University of Nairobi, P.O. Box 30197-00100, Nairobi, Kenya.
| | - Joshua A Mott
- US Centers for Disease Control and Prevention-Kenya, P.O. Box 606-00621, Nairobi, Kenya; US Centers for Disease Control and Prevention, 1600 Clifton Road, Atlanta, GA 30329-4027, USA
| | - Gilbert Kikwai
- Kenya Medical Research Institute/Centers for Diseases Control and Prevention, P.O. Box 54840-00200, Nairobi, Kenya
| | - Geoffrey Arunga
- Kenya Medical Research Institute/Centers for Diseases Control and Prevention, P.O. Box 54840-00200, Nairobi, Kenya
| | - Xiyan Xu
- US Centers for Disease Control and Prevention, 1600 Clifton Road, Atlanta, GA 30329-4027, USA
| | - Lilian Mayieka
- Kenya Medical Research Institute/Centers for Diseases Control and Prevention, P.O. Box 54840-00200, Nairobi, Kenya
| | - Gideon O Emukule
- US Centers for Disease Control and Prevention-Kenya, P.O. Box 606-00621, Nairobi, Kenya
| | - Phillip Muthoka
- Kenya Ministry of Health, Afya House, P.O. Box 30016-00100, Nairobi, Kenya
| | - M Kariuki Njenga
- US Centers for Disease Control and Prevention-Kenya, P.O. Box 606-00621, Nairobi, Kenya; Kenya Medical Research Institute/Centers for Diseases Control and Prevention, P.O. Box 54840-00200, Nairobi, Kenya
| | - Barry S Fields
- US Centers for Disease Control and Prevention-Kenya, P.O. Box 606-00621, Nairobi, Kenya; US Centers for Disease Control and Prevention, 1600 Clifton Road, Atlanta, GA 30329-4027, USA
| | - Mark A Katz
- US Centers for Disease Control and Prevention-Kenya, P.O. Box 606-00621, Nairobi, Kenya; US Centers for Disease Control and Prevention, 1600 Clifton Road, Atlanta, GA 30329-4027, USA
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Oliveira CR, Costa GSR, Paploski IAD, Kikuti M, Kasper AM, Silva MMO, Tavares AS, Cruz JS, Queiroz TL, Lima HCAV, Calcagno J, Reis MG, Weinberger DM, Shapiro ED, Ko AI, Ribeiro GS. Influenza-like illness in an urban community of Salvador, Brazil: incidence, seasonality and risk factors. BMC Infect Dis 2016; 16:125. [PMID: 26975185 PMCID: PMC4791800 DOI: 10.1186/s12879-016-1456-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2015] [Accepted: 03/07/2016] [Indexed: 11/11/2022] Open
Abstract
BACKGROUND Our understanding of the epidemiology of influenza is limited in tropical regions, which in turn has hampered identifying optimal region-specific policy to diminish disease burden. Influenza-like illness (ILI) is a clinical diagnosis that can be used as a surrogate for influenza. This study aimed to define the incidence and seasonality of ILI and to assess its association with climatic variables and school calendar in an urban community in the tropical region of Salvador, Brazil. METHODS Between 2009 and 2013, we conducted enhanced community-based surveillance for acute febrile illnesses (AFI) among patients ≥ 5 years of age in a slum community emergency unit in Salvador, Brazil. ILI was defined as a measured temperature of ≥ 37.8 °C or reported fever in a patient with cough or sore throat for ≤ 7 days, and negative test results for dengue and leptospirosis. Seasonality was analyzed with a harmonic regression model. Negative binomial regression models were used to correlate ILI incidence with rainfall, temperature, relative humidity and the number of days per month that schools were in session while controlling for seasonality. RESULTS There were 2,651 (45.6% of 5,817 AFI patients) ILI cases with a mean annual incidence of 60 cases/1,000 population (95% CI 58-62). Risk of ILI was highest among 5-9 year olds with an annual incidence of 105 cases/1,000 population in 2009. ILI had a clear seasonal pattern with peaks between the 35-40th week of the year. ILI peaks were higher and earlier in 5-9 year olds compared with > 19 year olds. No association was seen between ILI and precipitation, relative humidity or temperature. There was a significant association between the incidence of ILI in children 5-9 years of age and number of scheduled school days per month. CONCLUSIONS We identified a significant burden of ILI with distinct seasonality in the Brazilian tropics and highest rates among young school-age children. Seasonal peaks of ILI in children 5-9 years of age were positively associated with the number of school days, indicating that children may play a role in the timing of seasonal influenza transmission.
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Affiliation(s)
- Carlos R. Oliveira
- Department of Pediatrics, School of Medicine, Yale University, New Haven, USA
| | - Gisela S. R. Costa
- Centro de Pesquisas Gonçalo Moniz, Fundação Oswaldo Cruz, Ministério da Saúde, Rua Waldemar Falcão, 121, Candeal, 40296-710 Salvador, Brazil
| | - Igor A. D. Paploski
- Centro de Pesquisas Gonçalo Moniz, Fundação Oswaldo Cruz, Ministério da Saúde, Rua Waldemar Falcão, 121, Candeal, 40296-710 Salvador, Brazil
- Instituto de Saúde Coletiva, Universidade Federal da Bahia, Salvador, Brazil
| | - Mariana Kikuti
- Centro de Pesquisas Gonçalo Moniz, Fundação Oswaldo Cruz, Ministério da Saúde, Rua Waldemar Falcão, 121, Candeal, 40296-710 Salvador, Brazil
- Instituto de Saúde Coletiva, Universidade Federal da Bahia, Salvador, Brazil
| | - Amelia M. Kasper
- Centro de Pesquisas Gonçalo Moniz, Fundação Oswaldo Cruz, Ministério da Saúde, Rua Waldemar Falcão, 121, Candeal, 40296-710 Salvador, Brazil
| | - Monaise M. O. Silva
- Centro de Pesquisas Gonçalo Moniz, Fundação Oswaldo Cruz, Ministério da Saúde, Rua Waldemar Falcão, 121, Candeal, 40296-710 Salvador, Brazil
| | - Aline S. Tavares
- Centro de Pesquisas Gonçalo Moniz, Fundação Oswaldo Cruz, Ministério da Saúde, Rua Waldemar Falcão, 121, Candeal, 40296-710 Salvador, Brazil
| | - Jaqueline S. Cruz
- Centro de Pesquisas Gonçalo Moniz, Fundação Oswaldo Cruz, Ministério da Saúde, Rua Waldemar Falcão, 121, Candeal, 40296-710 Salvador, Brazil
| | - Tássia L. Queiroz
- Instituto de Saúde Coletiva, Universidade Federal da Bahia, Salvador, Brazil
| | - Helena C. A. V. Lima
- Centro de Pesquisas Gonçalo Moniz, Fundação Oswaldo Cruz, Ministério da Saúde, Rua Waldemar Falcão, 121, Candeal, 40296-710 Salvador, Brazil
| | - Juan Calcagno
- Centro de Pesquisas Gonçalo Moniz, Fundação Oswaldo Cruz, Ministério da Saúde, Rua Waldemar Falcão, 121, Candeal, 40296-710 Salvador, Brazil
| | - Mitermayer G. Reis
- Centro de Pesquisas Gonçalo Moniz, Fundação Oswaldo Cruz, Ministério da Saúde, Rua Waldemar Falcão, 121, Candeal, 40296-710 Salvador, Brazil
- Department of Epidemiology of Microbial Diseases, School of Public Health, Yale University, New Haven, USA
- Faculdade de Medicina, Universidade Federal da Bahia, Salvador, Brazil
| | - Daniel M. Weinberger
- Department of Epidemiology of Microbial Diseases, School of Public Health, Yale University, New Haven, USA
| | - Eugene D. Shapiro
- Department of Pediatrics, School of Medicine, Yale University, New Haven, USA
- Department of Epidemiology of Microbial Diseases, School of Public Health, Yale University, New Haven, USA
- Department of Investigative Medicine, School of Medicine, Yale University, New Haven, USA
| | - Albert I. Ko
- Centro de Pesquisas Gonçalo Moniz, Fundação Oswaldo Cruz, Ministério da Saúde, Rua Waldemar Falcão, 121, Candeal, 40296-710 Salvador, Brazil
- Department of Epidemiology of Microbial Diseases, School of Public Health, Yale University, New Haven, USA
| | - Guilherme S. Ribeiro
- Centro de Pesquisas Gonçalo Moniz, Fundação Oswaldo Cruz, Ministério da Saúde, Rua Waldemar Falcão, 121, Candeal, 40296-710 Salvador, Brazil
- Instituto de Saúde Coletiva, Universidade Federal da Bahia, Salvador, Brazil
- Department of Epidemiology of Microbial Diseases, School of Public Health, Yale University, New Haven, USA
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