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Preto C, Maron de Mello A, Cesário Pereira Maluf EM, Teixeira Krainski E, Graeff G, de Sousa GA, da Silva LR, Vieira da Costa-Ribeiro MC, da Cruz Magalhães Buffon M, Shimakura SE, Raboni SM, Siqueira de Carvalho D, Luhm KR. Vaccination coverage and adherence to a dengue vaccination program in the state of Paraná, Brazil. Vaccine 2020; 39:711-719. [PMID: 33386178 DOI: 10.1016/j.vaccine.2020.12.030] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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: 09/20/2020] [Revised: 12/05/2020] [Accepted: 12/09/2020] [Indexed: 10/22/2022]
Abstract
The success of vaccination programs depends on the level of acceptance of the vaccine to achieve high vaccine coverage rates (VCR). Vaccine hesitancy is a challenge, especially concerning new vaccines. Dengue vaccine, Dengvaxia®, was licensed in Brazil in 2015 and implemented, in a pioneering publicly-funded initiative in the state of Paraná, between 2016 and 2018. The vaccination program took place in five phases in the 30 municipalities most affected by dengue in the state, targeting individuals from nine to 44 years-old in two cities and from 15 to 27 years-old in the other 28 municipalities, totaling a target population of 500,000 individuals. A cross-sectional descriptive study was carried out to assess VCR and adherence to the dengue vaccine in this program. VCR, dropout ratio (DR), and compliance with the vaccination schedule (CVS) were analyzed by sex, age group, and municipality size. A total of 302,603 individuals (60.5%) received ≥ 1 dose, 44.2% received ≥ 2 doses, and 28.6% 3 doses. The DR was 52.8%. Among individuals who started vaccination, 40.6% achieved CVS. The highest VCR, highest CVS, and lowest DR occurred in the age group from 9 to 14 years old and from 28 to 44 years old and in smaller municipalities. A greater proportion of men started vaccination (male 64.0%; female 57.1%) however, the DR was higher in men (male 55.4%; female 49.9%), and a higher percentage of women completed the vaccination schedule according to the recommendations (CVS male 37.8%; female 43.6%). Differences were noted in the CVS according to the initial phase of the program (first phase 50.8%; second phase 18.8%). The heterogeneity in vaccine uptake and compliance according to sex, age, and municipality size suggests the need for differentiated strategies to address challenges with new and multiple-dose vaccines.
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Affiliation(s)
- Clara Preto
- Universidade Federal do Paraná (UFPR), Postgraduate Program in Public Health - Curitiba, Rua Padre Camargo, 280 - Alto da Glória, Curitiba, PR 80060-240, Brazil.
| | - Angela Maron de Mello
- National Audit Department of Brazilian Public Health/Health Ministry, Rua Cândido Lopes, 208 - Centro, Curitiba, PR 80020-060, Brazil
| | - Eliane Mara Cesário Pereira Maluf
- Universidade Federal do Paraná (UFPR), Public Health Department, Rua Padre Camargo, 280 - Alto da Glória, Curitiba, PR 80060-240, Brazil
| | - Elias Teixeira Krainski
- Universidade Federal do Paraná (UFPR), Statistics Department, Rua Padre Camargo, 280 - Alto da Glória, Curitiba, PR 80060-240, Brazil
| | - Gabriel Graeff
- Fundação de Apoio da Universidade Federal do Paraná (FUNPAR), Rua João Negrão, 280 - Centro, Curitiba, PR 80010-200, Brazil
| | - Gabriela Amanda de Sousa
- Universidade Federal do Paraná (UFPR), Postgraduate Program in Public Health - Curitiba, Rua Padre Camargo, 280 - Alto da Glória, Curitiba, PR 80060-240, Brazil
| | - Lineu Roberto da Silva
- Universidade Federal do Paraná (UFPR), Public Health Department, Rua Padre Camargo, 280 - Alto da Glória, Curitiba, PR 80060-240, Brazil
| | - Magda Clara Vieira da Costa-Ribeiro
- Universidade Federal do Paraná (UFPR), Postgraduate Program in Public Health - Curitiba, Rua Padre Camargo, 280 - Alto da Glória, Curitiba, PR 80060-240, Brazil
| | - Marilene da Cruz Magalhães Buffon
- Universidade Federal do Paraná (UFPR), Postgraduate Program in Public Health - Curitiba, Rua Padre Camargo, 280 - Alto da Glória, Curitiba, PR 80060-240, Brazil
| | - Silvia Emiko Shimakura
- Universidade Federal do Paraná (UFPR), Postgraduate Program in Public Health - Curitiba, Rua Padre Camargo, 280 - Alto da Glória, Curitiba, PR 80060-240, Brazil
| | - Sonia Mara Raboni
- Universidade Federal do Paraná (UFPR), Public Health Department, Rua Padre Camargo, 280 - Alto da Glória, Curitiba, PR 80060-240, Brazil
| | - Denise Siqueira de Carvalho
- Universidade Federal do Paraná (UFPR), Postgraduate Program in Public Health - Curitiba, Rua Padre Camargo, 280 - Alto da Glória, Curitiba, PR 80060-240, Brazil
| | - Karin Regina Luhm
- Universidade Federal do Paraná (UFPR), Postgraduate Program in Public Health - Curitiba, Rua Padre Camargo, 280 - Alto da Glória, Curitiba, PR 80060-240, Brazil
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Svoboda WK, Soares MDCP, Alves MM, Rocha TC, Gomes EC, Menoncin F, Batista PM, Silva LRD, Headley SA, Hilst CLS, Aguiar LM, Ludwig G, Passos FDC, Souza JCD, Navarro IT. SEROLOGICAL DETECTION OF HEPATITIS A VIRUS IN FREE-RANGING NEOTROPICAL PRIMATES (Sapajus spp., Alouatta caraya) FROM THE PARANÁ RIVER BASIN, BRAZIL. Rev Inst Med Trop Sao Paulo 2016; 58:9. [PMID: 26910453 PMCID: PMC4793950 DOI: 10.1590/s1678-994658009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2014] [Accepted: 05/18/2015] [Indexed: 12/02/2022] Open
Abstract
Nonhuman primates are considered as the natural hosts of Hepatitis A virus (HAV), as
well as other pathogens, and can serve as natural sentinels to investigate epizootics
and endemic diseases that are of public health importance. During this study, blood
samples were collected from 112 Neotropical primates (NTPs) (Sapajus nigritus and S.
cay, n = 75; Alouatta caraya, n = 37) trap-captured at the Paraná River basin,
Brazil, located between the States of Paraná and Mato Grosso do Sul. Anti-HAV IgG
antibodies were detected in 4.5% (5/112) of NTPs, specifically in 6.7% (5/75) of
Sapajus spp. and 0% (0/37) of A. caraya. In addition, all samples were negative for
the presence of IgM anti-HAV antibodies. These results suggest that free-ranging NTPs
were exposed to HAV within the geographical regions evaluated.
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Affiliation(s)
| | | | | | | | | | | | - Paulo Mira Batista
- Secretaria de Estado de Saúde do Mato Grosso do Sul, Campo Grande, Mato Grosso do Sul, Brasil
| | | | - Selwyn Arlington Headley
- Departamento de Medicina Veterinária e Preventiva e Clínica de Pequenos Animais, Universidade Estadual de Londrina, Paraná, Brasil
| | - Carmen Lúcia Scortecci Hilst
- Departamento de Medicina Veterinária e Preventiva e Clínica de Pequenos Animais, Universidade Estadual de Londrina, Paraná, Brasil
| | - Lucas M Aguiar
- Universidade Federal da Integração Latino-Americana, Foz do Iguaçu, Paraná, Brasil
| | - Gabriela Ludwig
- Centro Nacional de Pesquisa e Conservação de Primatas Brasileiros, Instituto Chico Mendes de Conservação da Biodiversidade, João Pessoa, Paraíba, Brasil
| | | | | | - Italmar Teodorico Navarro
- Departamento de Medicina Veterinária e Preventiva e Clínica de Pequenos Animais, Universidade Estadual de Londrina, Paraná, Brasil
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Svoboda WK, Martins LC, Malanski LDS, Shiozawa MM, Spohr KAH, Hilst CLS, Aguiar LM, Ludwig G, Passos FDC, Silva LRD, Headley SA, Navarro IT. Serological evidence for Saint Louis encephalitis virus in free-ranging New World monkeys and horses within the upper Paraná River basin region, Southern Brazil. Rev Soc Bras Med Trop 2014; 47:280-6. [PMID: 25075477 DOI: 10.1590/0037-8682-0083-2014] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2014] [Accepted: 06/30/2014] [Indexed: 11/22/2022] Open
Abstract
INTRODUCTION Saint Louis encephalitis virus (SLEV) primarily occurs in the Americas and produces disease predominantly in humans. This study investigated the serological presence of SLEV in nonhuman primates and horses from southern Brazil. METHODS From June 2004 to December 2005, sera from 133 monkeys (Alouatta caraya, n=43; Sapajus nigritus, n=64; Sapajus cay, n=26) trap-captured at the Paraná River basin region and 23 blood samples from farm horses were obtained and used for the serological detection of a panel of 19 arboviruses. All samples were analyzed in a hemagglutination inhibition (HI) assay; positive monkey samples were confirmed in a mouse neutralization test (MNT). Additionally, all blood samples were inoculated into C6/36 cell culture for viral isolation. RESULTS Positive seroreactivity was only observed for SLEV. A prevalence of SLEV antibodies in sera was detected in Alouatta caraya (11.6%; 5/43), Sapajus nigritus (12.5%; 8/64), and S. cay (30.8%; 8/26) monkeys with the HI assay. Of the monkeys, 2.3% (1/42) of A. caraya, 6.3% 94/64) of S. nigritus, and 15.4% (4/26) of S. cay were positive for SLEV in the MNT. Additionally, SLEV antibodies were detected by HI in 39.1% (9/23) of the horses evaluated in this study. Arboviruses were not isolated from any blood sample. CONCLUSIONS These results confirmed the presence of SLEV in nonhuman primates and horses from southern Brazil. These findings most likely represent the first detection of this virus in nonhuman primates beyond the Amazon region. The detection of SLEV in animals within a geographical region distant from the Amazon basin suggests that there may be widespread and undiagnosed dissemination of this disease in Brazil.
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Affiliation(s)
- Walfrido Kühl Svoboda
- Instituto Latino-Americano de Ciências da Vida e da Natureza (ILACVN), Universidade Federal da Integração Latino-Americana (UNILA), Foz do Iguaçu, PR, Brasil
| | - Lívia Carício Martins
- Departamento de Arbovirologia e Febres Hemorrágicas, Instituto Evandro Chagas, Ananindeua, PA, Brazil
| | | | | | | | | | - Lucas M Aguiar
- Universidade Federal da Integração Latino-Americana, Foz do Iguaçu, PR
| | - Gabriela Ludwig
- Centro Nacional de Pesquisa e Conservação de Primatas Brasileiros, Instituto Chico Mendes de Conservação da Biodiversidade, João Pessoa, PB
| | | | | | - Selwyn Arlington Headley
- Departamento de Medicina Veterinária Preventiva, Universidade Estadual de Londrina, Londrina, PR, Basil
| | - Italmar Teodorico Navarro
- Departamento de Medicina Veterinária Preventiva, Universidade Estadual de Londrina, Londrina, PR, Basil
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Tranquilin MV, Lehmkuhl RC, Maron A, Silva LRD, Ziliotto L, Seki MC, Salomon GR, Carrasco ADOT. First report of yellow fever virus in non-human primates in the State of Paraná, Brazil. Rev Soc Bras Med Trop 2014; 46:522-4. [PMID: 23982102 DOI: 10.1590/0037-8682-0106-2013] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2013] [Accepted: 07/02/2013] [Indexed: 11/22/2022] Open
Abstract
Sylvatic yellow fever is a zoonosis associated mainly with wild animals, especially those in the genus Alouatta, that act as the source of infection. Once infected, these animals pass the disease on to humans by way of an infected mosquito belonging to the genera Aedes, Haemagogus, or Sabethes. The present study is the first report of a case of yellow fever in non-human primates (NHP) in the State of Paraná, Brazil. After the case was diagnosed, several prophylactic measures were adopted to prevent outbreaks of the disease in humans.
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Lenzi L, Silva LRD, Mello AMD, Grochocki MHC, Pontarolo R. [Factors related to death by the Pandemic Influenza A (H1N1) 2009 in patients treated with oseltamivir]. Rev Bras Enferm 2013; 66:715-21. [PMID: 24217756 DOI: 10.1590/s0034-71672013000500012] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2012] [Accepted: 07/23/2013] [Indexed: 11/22/2022] Open
Abstract
This study aimed to identify factors related to death in Pandemic Influenza A(H1N1)2009 in patients treated with Oseltamivir. It is an observational and retrospective study, carried out with data of patients who had presented laboratorial diagnosis of the illness. Data were collected from the notification forms of the disease, belonging to a database of the Ministry of Health. Statistical analysis was performed by chi-square, Student t test and logistic regression, considering significant p values <0,05. The highest mortality was observed in patients aged between 20 and 59 years, low schooling, with the presence of comorbidities, not vaccinated, treated late and had more severe symptoms of infection. The identification of risk factors for death reinforces the need for prevention and early care, especially in the presence of factors that increase the clinical severity of disease.
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Lenzi L, Mello ÂMD, Silva LRD, Grochocki MHC, Pontarolo R. Manifestações clínicas, desfechos e fatores prognósticos da influenza pandêmica A (H1N1) de 2009 em crianças. Rev paul pediatr 2012. [DOI: 10.1590/s0103-05822012000300007] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
OBJETIVO: Descrever as características clínicas e a letalidade, além de analisar os fatores prognósticos da infecção pela influenza pandêmica A (H1N1), em crianças do estado do Paraná. MÉTODOS: Estudo observacional e retrospectivo. Os dados foram coletados a partir do Sistema Nacional de Agravos de Notificação (Sinan), do Ministério da Saúde, entre março e dezembro de 2010. Foram incluídas as crianças com idade entre zero e 12 anos, com confirmação laboratorial da infecção. As variáveis referentes às características demográficas e clínicas e aos desfechos foram avaliadas estatisticamente a fim de comparar as taxas de letalidade na presença e na ausência desses fatores. Os fatores prognósticos foram identificados por regressão logística. Consideraram-se como significativos os valores de p<0,05. RESULTADOS: Foram incluídas 1.307 crianças, das quais 19 foram a óbito. Os fatores de risco para o óbito foram cardiopatias (OR 7,1; IC95% 1,5 - 32,7), imunodepressão (OR 14,9; IC95% 3,9 - 56,2), dispneia (OR 9,5; IC95% 2,8 - 32,9), pneumonia (OR 23,8; IC95% 2,4 - 239,8), presença de sibilos (OR 11,9; IC95% 1,4 - 103,7) e tempo para o início do tratamento a partir do início dos sintomas (OR 1,3; IC95% 1,2 - 1,5). O tratamento precoce com o antiviral oseltamivir foi um fator de proteção ao óbito (OR 0,012; IC95% 0,003 - 0,05). CONCLUSÕES: Os fatores de risco subjacentes apresentaram papel fundamental na determinação dos desfechos. O diagnóstico e o tratamento precoce foram importantes para a diminuição dos óbitos pela influenza A (H1N1) 2009 em crianças.
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Lenzi L, Mello ÂMD, Silva LRD, Grochocki MHC, Pontarolo R. Influenza pandêmica A (H1N1) 2009: fatores de risco para o internamento. J Bras Pneumol 2012; 38:57-65. [DOI: 10.1590/s1806-37132012000100009] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2011] [Accepted: 10/14/2011] [Indexed: 11/21/2022] Open
Abstract
OBJETIVO: Avaliar os aspectos da influenza pandêmica A (H1N1) 2009 em pacientes hospitalizados a fim de identificar os fatores de risco para o internamento e, consequentemente, para o agravamento da doença. MÉTODOS: Estudo observacional e retrospectivo realizado entre março e dezembro de 2010. Os dados foram coletados a partir do Sistema Nacional de Agravos de Notificação do Ministério da Saúde. Foram incluídos somente os pacientes hospitalizados e não hospitalizados com confirmação laboratorial da infecção durante o período de estudo. As variáveis referentes às características demográficas e clínicas foram avaliadas estatisticamente a fim de comparar as taxas de internamento na presença ou na ausência desses fatores. Os fatores de risco foram identificados por regressão logística. RESULTADOS: Foram incluídos no estudo 4.740 pacientes com confirmação laboratorial da infecção. Desses, 1.911 foram internados, e 258 (13,5%) foram a óbito. Os fatores de risco para o internamento foram idade (faixa etária de 20 a 29 anos), etnia negra ou indígena, presença de algumas comorbidades (cardiopatias, pneumopatias, nefropatias, hemoglobinopatia, imunodepressão, diabetes, obesidade, puerpério e tabagismo), número alto de comorbidades associadas, e alguns sintomas (dispneia, diarreia, vômito, dor torácica, hemoptise, pneumonia e sibilos). Níveis maiores de escolaridade e uso precoce do oseltamivir foram relacionados a fatores de proteção. A hospitalização contribuiu para o aumento da sobrevida. CONCLUSÕES: O conhecimento das características epidemiológicas que podem estar associadas a internação, gravidade da doença e mortalidade podem ser úteis na adoção de medidas preventivas e no diagnóstico e tratamento precoce da doença, colaborando para a diminuição dos óbitos e da necessidade de hospitalização.
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Garcia JL, Svoboda WK, Chryssafidis AL, de Souza Malanski L, Shiozawa MM, de Moraes Aguiar L, Teixeira GM, Ludwig G, da Silva LR, Hilst C, Navarro IT. Sero-epidemiological survey for toxoplasmosis in wild New World monkeys (Cebus spp.; Alouatta caraya) at the Paraná river basin, Paraná State, Brazil. Vet Parasitol 2005; 133:307-11. [PMID: 16006040 DOI: 10.1016/j.vetpar.2005.06.004] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2005] [Revised: 06/06/2005] [Accepted: 06/07/2005] [Indexed: 12/01/2022]
Abstract
In this study, we captured 60 wild New World monkeys (Cebus spp.; Alouatta caraya) at the Paraná river basin, Paraná State, Brazil, and modified agglutination test (MAT) was performed to evaluate anti-Toxoplasma gondii antibodies. Prevalence was 30.2% (13/43) in Cebus spp. (capuchin monkeys) and 17.6% (3/17) for A. caraya (black and golden howler monkeys). MAT showed antibody titers of 16 (15/16) and 64 (1/16). Herein, we have observed an odds ratio (OR)=4.67 (1.06<OR<21.42, p<0.01) among monkeys with presumed risk of human contact. There were not any statistical differences among age, species and sex (p>0.05). The present work is the first report on serum occurrence of anti-T. gondii antibodies in wild capuchin monkeys and in wild black and golden howler monkeys.
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Affiliation(s)
- João Luis Garcia
- Microbiology and Immunology Laboratory, Departamento de Biologia, Universidade Estadual do Centro Oeste-UNICENTRO, R. Simeão Camargo Varela de Sá, 03, Bairro Cascavel, 85040-080 Guarapuava, PR, Brazil.
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