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Brazete C, Caveiro D, Neto ML, Dinis JP, Rocha LC, Sá L, Carvalhido R. Validation of a Questionnaire on Sexual and Reproductive Health Among Immigrant Vocational Education Students in Portugal from São Tomé and Príncipe. J Community Health 2023; 48:847-856. [PMID: 37160528 PMCID: PMC10469261 DOI: 10.1007/s10900-023-01230-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/24/2023] [Indexed: 05/11/2023]
Abstract
Sexual and reproductive health interventions' effectiveness should be evaluated using a valid instrument. This study aimed to validate a questionnaire on sexual and reproductive health in adolescents and young adults from São Tomé and Príncipe who voluntarily enrolled in a vocational school in Portugal to complete their 12th school year and obtain a professional card.A questionnaire consisting of perception and knowledge sections was adapted from previous questionnaires. We followed the steps of psychometric analysis. Firstly, we assessed face validity and content validity. We used factorial analysis to validate the perceptions section (which included Likert-type questions). For the knowledge section (which consisted of multiple-choice questions), we used the key check, discrimination index, and difficulty index. We evaluated internal consistency through Cronbach's alpha for the perceptions section and the Kuder-Richardson score for the knowledge section.Out of 105 invited students, a total of ninety students were enrolled in this study, of whom 88 completed most of the questions. The exploratory analysis showed that most students agreed with the right to refuse intercourse. However, while approximately 23% disagreed that consensual sex among adult women or men is always wrong, around the same proportion agreed. A considerable number of students recognized condoms and pills as effective methods of contraception. However, most students were unfamiliar with other methods. Most knowledge questions showed acceptable difficulty levels, and the discrimination index varied among questions. The knowledge questions demonstrated good consistency levels. This study enabled us to develop an appropriate instrument for evaluating the effectiveness of public health interventions and identifying specific knowledge gaps in migrant populations from low-income countries. This will help prioritise topics to be addressed in sexual health education sessions.
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Affiliation(s)
- Cátia Brazete
- Unidade Local de Saúde do Alto Minho, Unidade de Saúde Pública, Viana do Castelo, Portugal.
- Universidade do Porto, Instituto de Saúde Pública, Porto, Portugal.
| | - Diogo Caveiro
- Unidade Local de Saúde do Alto Minho, Unidade de Saúde Pública, Viana do Castelo, Portugal
- Universidade do Porto, Instituto de Saúde Pública, Porto, Portugal
| | - Marisa Lopes Neto
- Unidade Local de Saúde do Alto Minho, Unidade de Saúde Pública, Viana do Castelo, Portugal
| | - João Pedro Dinis
- Unidade Local de Saúde do Alto Minho, Unidade de Saúde Pública, Viana do Castelo, Portugal
| | - Luís Castro Rocha
- Unidade Local de Saúde do Alto Minho, Unidade de Saúde Pública, Viana do Castelo, Portugal
| | - Lígia Sá
- Unidade Local de Saúde do Alto Minho, Unidade de Saúde Pública, Viana do Castelo, Portugal
| | - Ricardo Carvalhido
- SWITCH ON - Academia de Formação Profissional, Viana do Castelo, Portugal
- Escola Superior de Educação, Instituto Politécnico de Viana do Castelo, Viana do Castelo, Portugal
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Brazete C, Brazete J, Alves F, Aguiar A, Gonçalves AM, Cardoso M, Sá L, Gonçalves E, Pinto M, Duarte R. COVID-19 vaccine effectiveness against symptomatic disease and severe outcomes, 2021-2022: a test-negative case-control study. Public Health 2023; 218:84-91. [PMID: 36989570 PMCID: PMC9943732 DOI: 10.1016/j.puhe.2023.02.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2022] [Revised: 02/04/2023] [Accepted: 02/17/2023] [Indexed: 02/24/2023]
Abstract
Objectives This study evaluated the effectiveness of COVID-19 vaccines in preventing symptomatic and severe disease. Study design This was an observational test-negative case-control study. Methods Study participants were adults with at least one symptom included in the World Health Organization COVID-19 definition who sought healthcare in a public emergency department between 1 November 2021 and 2 March 2022 (corresponding with the fifth pandemic wave in Portugal dominated by the Omicron variant). This study used multivariable logistic regression models to estimate and compare the odds ratio of vaccination between test-positive cases and test-negative controls to calculate the absolute and relative vaccine effectiveness. Results The study included 1059 individuals (522 cases and 537 controls) with a median age of 56 years and 58% were women. Compared with the relative effectiveness of the primary vaccination scheme that had been completed ≥180 days earlier, the effectiveness against symptomatic infection of a booster administered between 14 and 132 days earlier was 71% (95% confidence interval [CI]: 57%, 81%; p < 0.001). The effectiveness of the primary series against symptomatic infection peaked at 85% (95% CI: 56%, 95%) between 14 and 90 days after the last inoculation and decreased to 34% (95% CI: −42.6%, 49.5%) after ≥180 days. Conclusions Despite the known immunological evasion characteristics of the Omicron variant, results from this study show that vaccine effectiveness increases after booster administration. COVID-19 vaccine effectiveness decreases to less than 50% between 3 and 6 months after completion of the primary cycle; therefore, this would be an appropriate time to administer a booster to restore immunity.
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Affiliation(s)
- Cátia Brazete
- Unidade de Saúde Pública Do Alto Minho, Viana Do Castelo, Portugal,EPIUnit - Instituto de Saúde Pública da Universidade Do Porto, Porto, Portugal,Corresponding author. , Rua José Espregueira, 96, 4904-459 Viana do Castelo, Portugal, +351 969147639
| | - João Brazete
- Faculdade de Medicina da Universidade Do Porto, Porto, Portugal
| | - Filipe Alves
- Unidade de Investigação Clínica da Administração Regional de Saúde Do Norte, Porto, Portugal
| | - Ana Aguiar
- EPIUnit - Instituto de Saúde Pública da Universidade Do Porto, Porto, Portugal,Laboratório para a Investigação Integrativa e Translacional da Universidade Do Porto, Porto, Portugal,Instituto de Ciências Biomédicas Abel Salazar, Universidade Do Porto, Porto, Portugal
| | | | - Marta Cardoso
- Unidade de Saúde Pública Do Alto Minho, Viana Do Castelo, Portugal
| | - Lígia Sá
- Unidade de Saúde Pública Do Alto Minho, Viana Do Castelo, Portugal
| | - Eugénio Gonçalves
- Serviço de Medicina Física e Reabilitação, Centro Hospitalar de Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
| | - Marta Pinto
- Faculdade de Psicologia e Ciências da Educação da Universidade Do Porto, Porto, Portugal
| | - Raquel Duarte
- EPIUnit - Instituto de Saúde Pública da Universidade Do Porto, Porto, Portugal,Unidade de Investigação Clínica da Administração Regional de Saúde Do Norte, Porto, Portugal,Laboratório para a Investigação Integrativa e Translacional da Universidade Do Porto, Porto, Portugal,Instituto de Ciências Biomédicas Abel Salazar, Universidade Do Porto, Porto, Portugal,Serviço de Pneumologia, Centro Hospitalar de Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
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Gonçalves EM, Beirão TM, Brazete C, Andrade I, Costa F, Pinto P, Campolargo A. Setting an interdisciplinary framework to improve functional outcomes in axial spondyloarthritis: comment on the article by Barnett and Sengupta. Arthritis Care Res (Hoboken) 2023; 75:445-446. [PMID: 36063394 PMCID: PMC9538957 DOI: 10.1002/acr.25012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Revised: 07/26/2022] [Accepted: 07/28/2022] [Indexed: 11/06/2022]
Affiliation(s)
- Eugénio Moita Gonçalves
- Physical Medicine and Rehabilitation DepartmentCentro Hospitalar de Vila Nova de Gaia/Espinho EPEVila Nova de GaiaPortugal
| | - Tiago Melo Beirão
- Rheumatology Department, Centro Hospitalar de Vila Nova de Gaia/Espinho EPEVila Nova de GaiaPortugal
| | - Cátia Brazete
- Public Health Unit, Unidade de Local de Saúde do Alto MinhoViana do CasteloPortugal
| | - Inês Andrade
- Centro de Medicina de Reabilitação de AlcoitãoAlcabidechePortugal
| | - Flávio Costa
- Rheumatology Department, Centro Hospitalar de Vila Nova de Gaia/Espinho EPEVila Nova de GaiaPortugal
| | - Patrícia Pinto
- Rheumatology Department, Centro Hospitalar de Vila Nova de Gaia/Espinho EPEVila Nova de GaiaPortugal
| | - Ana Campolargo
- Physical Medicine and Rehabilitation DepartmentCentro Hospitalar de Vila Nova de Gaia/Espinho EPEVila Nova de GaiaPortugal
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Brazete C, Pinto M, Sá L, Aguiar A, Alves F, Duarte R. Evaluation of the Real-World Effectiveness of Vaccines against COVID-19 at a Local Level: Protocol for a Test-Negative Case-Control Study. Vaccines (Basel) 2022; 10:vaccines10050822. [PMID: 35632578 PMCID: PMC9147572 DOI: 10.3390/vaccines10050822] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2022] [Revised: 05/15/2022] [Accepted: 05/19/2022] [Indexed: 12/04/2022] Open
Abstract
Vaccines against COVID-19 approved for use in the EU/EEA have been shown to be highly effective against wild-type SARS-CoV-2. However, their effectiveness against new variants may be reduced. This study aims to evaluate the effectiveness of vaccines against COVID-19 in the prevention of symptomatic and severe disease, during pre- and post-omicron phases. Individuals who sought treatment at the emergency department of a Portuguese hospital with COVID-19-like disease and were tested for SARS-CoV-2 are the subjects of the study. Patients who received a positive result are considered cases, while those with negative results are the controls. The test-negative case–control method is one of the study designs recommended by WHO to estimate the effectiveness of vaccines against COVID-19. The main advantage of this design is that it controls for the healthcare seeking bias, commonly present in traditional cohort and case–control designs. This study may have broad implications for understanding the real-world performance of the COVID-19 vaccines at the local level, which may play a key role in promoting adherence to vaccination. Moreover, this study may contribute to inform decisions regarding booster doses and variant-specific vaccine formulations leading to the control of this and future pandemics.
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Affiliation(s)
- Cátia Brazete
- EPIUnit—Instituto de Saúde Pública, Universidade do Porto, 4050-600 Porto, Portugal; (A.A.); (R.D.)
- Unidade de Saúde Pública do Alto Minho, 4904-459 Viana do Castelo, Portugal;
- Correspondence:
| | - Marta Pinto
- Unidade de Investigação Clínica da ARS Norte, 4000-477 Porto, Portugal; (M.P.); (F.A.)
- Faculdade de Psicologia e Ciências da Educação, Universidade do Porto, 4200-135 Porto, Portugal
| | - Lígia Sá
- Unidade de Saúde Pública do Alto Minho, 4904-459 Viana do Castelo, Portugal;
| | - Ana Aguiar
- EPIUnit—Instituto de Saúde Pública, Universidade do Porto, 4050-600 Porto, Portugal; (A.A.); (R.D.)
- Laboratório Para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), 4050-600 Porto, Portugal
| | - Filipe Alves
- Unidade de Investigação Clínica da ARS Norte, 4000-477 Porto, Portugal; (M.P.); (F.A.)
| | - Raquel Duarte
- EPIUnit—Instituto de Saúde Pública, Universidade do Porto, 4050-600 Porto, Portugal; (A.A.); (R.D.)
- Unidade de Investigação Clínica da ARS Norte, 4000-477 Porto, Portugal; (M.P.); (F.A.)
- Laboratório Para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), 4050-600 Porto, Portugal
- Instituto de Ciências Biomédicas Abel Salazar, Universidade do Porto, 4050-303 Porto, Portugal
- Serviço de Pneumologia, Centro Hospitalar de Vila Nova de Gaia/Espinho, 4434-502 Vila Nova de Gaia, Portugal
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Abstract
COVID-19 vaccines are considered promising agents in the control of the pandemic. Although their safety was assessed in randomised clinical trials, severe adverse events (AEs) have been reported after large-scale administration. This study aims to evaluate thromboembolic AEs reported after vaccination in a real-world context and how they led to the interruption of vaccination campaigns. We also review the benefits and risks of the vaccines approved in the European Union and provide recommendations. A review of the literature was performed using Medline/PubMed electronic database as well as institutional and pharmacovigilance official reports. Our findings show that vaccine-induced prothrombotic immune thrombocytopenia has been suggested as a very rare AE associated with viral vector vaccines. Unusual thrombotic events combined with moderate-to-severe thrombocytopenia were reported mainly in women under 60 years of age. As safety signals emerged, Vaxzevria and Janssen´s COVID-19 vaccine campaigns have been paused while investigations proceed. On the other hand, the number of deep vein thrombosis and pulmonary embolism reports have not increased. Post-marketing surveillance indicated that mRNA vaccines are safe and should continue to be used. The thrombotic events report rate is not increased in people over 60 years. As they are at greater risk for COVID-19 complications and death, no vaccine restrictions are recommended in this group. Risk factors for vaccine-induced prothrombotic immune thrombocytopenia should be established so that evidence-based decisions can be made. Systematic monitoring of COVID-19 vaccine safety is essential to ensure that the benefits of vaccination outweigh the risks.
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Affiliation(s)
- C Brazete
- Instituto de Saúde Pública da Universidade do Porto, Porto, Portugal, Unidade de Saúde Pública do Alto Minho, Viana do Castelo, Portugal
| | - A Aguiar
- EPIUnit, Instituto de Saúde Pública da Universidade do Porto, Porto, Portugal, Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Porto, Portugal
| | - I Furtado
- Serviço de Infeciologia, Centro Hospitalar e Universitário do Porto, Porto, Portugal
| | - R Duarte
- EPIUnit, Instituto de Saúde Pública da Universidade do Porto, Porto, Portugal, Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Porto, Portugal, Unidade de Investigação Clínica da Administração Regional de Saúde do Norte, Porto, Portugal, Departamento de Ciências da Saúde Pública, Ciências Forenses e Educação Médica, Universidade do Porto, Porto, Portugal, Serviço de Pneumologia, Centro Hospitalar de Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
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