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Duguay C, Niles-Robin RA, Thickstun CR, Cox H, Sampson A, Alexandre JSF, Caleb-Mars N, Goss CW, Morice A, Carvalho Scholte RG, Krentel A. Factors associated with never treatment and acceptability of mass drug administration for the elimination of lymphatic filariasis in Guyana, 2021. PLOS Glob Public Health 2024; 4:e0001985. [PMID: 38662738 PMCID: PMC11045083 DOI: 10.1371/journal.pgph.0001985] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Accepted: 03/25/2024] [Indexed: 04/28/2024]
Abstract
Guyana remains one of four countries in the Americas endemic for lymphatic filariasis (LF). Elimination of LF requires repeated annual mass drug administration (MDA) with sufficient levels of coverage for success. This study assesses the acceptability and never treatment of LF MDA using data from a routine assessment survey in 2021. A subset of individuals, over 20 years of age (n = 2498), were selected to receive an expanded questionnaire to examine factors associated with acceptability and never treatment. Assessed factors include respondent demographics, knowledge, risk perceptions of LF, and opinions on the MDA programme. The majority (73%) of those with scores above the acceptability threshold (score ≥22.5) reported participating in MDA two or more times. Factors strongly and positively associated with scoring above the acceptability threshold include beliefs in importance of participation in MDA for their community (aOR = 2.8, 95%CI (1.1-7.2)), perception of importance of LF treatment (6.9 (3.2-14.7)), receiving treatment in 2021 (2.9 (1.5-5.4)), and the number of self-reported times taking treatment for LF (2.2 (1.1-4.4)). Ten percent of respondents participated in the MDA for the first time in 2021, while 15% reported never treatment during any round of LF MDA. Three factors were statistically associated with participation in MDA across the two levels of the models (level 1: took LF treatment once versus never, and level 2: took LF treatment twice versus never) included: 1) scoring above the acceptability threshold (aOR = 6.2, 95%CI(3.8-10.0)), 2) self-reported importance of participation in MDA for their community (7.1 (2.9-17.8)), and 3) personal beliefs that they should take LF treatment even if they are not sick (2.6 (1.7-3.9)). As Guyana moves closer to LF elimination, these results provide further insight and understanding into programmatic results and could inform further action following MDA activities-particularly if an approach is needed to address never treatment during MDA.
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Affiliation(s)
- Claudia Duguay
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada
| | - Reza A. Niles-Robin
- Neglected Tropical Diseases Programme-Vector control Services, Ministry of Health, Georgetown, Guyana
| | - Charles R. Thickstun
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada
- Bruyère Research Institute, Ottawa, Ontario, Canada
| | - Horace Cox
- Neglected Tropical Diseases Programme-Vector control Services, Ministry of Health, Georgetown, Guyana
| | - Annastacia Sampson
- Neglected Tropical Diseases Programme-Vector control Services, Ministry of Health, Georgetown, Guyana
| | - Jean Seme-Fils Alexandre
- Neglected, Tropical, and Vector Borne Diseases, Pan American Health Organization, Washington, DC, United States of America
| | - Nathely Caleb-Mars
- Neglected, Tropical, and Vector Borne Diseases, Pan American Health Organization, Washington, DC, United States of America
| | - Charles W. Goss
- Division of Biostatistics, Washington University in St. Louis School of Medicine, St. Louis, Missouri, United States of America
| | - Ana Morice
- Neglected, Tropical, and Vector Borne Diseases, Pan American Health Organization, Washington, DC, United States of America
| | - Ronaldo G. Carvalho Scholte
- Neglected, Tropical, and Vector Borne Diseases, Pan American Health Organization, Washington, DC, United States of America
| | - Alison Krentel
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada
- Bruyère Research Institute, Ottawa, Ontario, Canada
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Nigenda G, Serván-Mori E. Human resources for health and maternal mortality in Latin America and the Caribbean over the last three decades: a systemic-perspective reflections. Int J Equity Health 2024; 23:67. [PMID: 38561759 PMCID: PMC10983735 DOI: 10.1186/s12939-024-02154-y] [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] [Received: 12/08/2023] [Accepted: 03/18/2024] [Indexed: 04/04/2024] Open
Abstract
BACKGROUND The role of human resources for health in the operation of health systems is crucial. However, training and incorporating them into institutions is a complex process due to the continuous misalignment between the supply and demand of health personnel. Taking the case of the Latin American and Caribbean region countries, this comment discusses the relationship between the availability of human resources for health and the maternal mortality ratio for the period 1990-2021. It proposes the need to resume planning exercises from a systemic perspective that involves all areas of government and the private sector linked to the training and employment of health workers. MAIN TEXT We used secondary data from a global source to show patterns in the relationship between these two aspects and identify gaps in the Latin American and Caribbean regions. The results show enormous heterogeneity in the response of regional health systems to the challenge of maternal mortality in the region. Although most countries articulated specific programs to achieve the reduction committed by all countries through the Millennium Development Goals, not all had the same capacity to reduce it, and practically none met the target. In addition, in the English Caribbean countries, we found significant increases in the number of health personnel that do not explain the increases in the maternal mortality rate during the period. CONCLUSIONS The great lesson from the data shown is that some countries could articulate responses to the problem using available resources through effective strategies, considering the specific needs of their populations. Although variations in maternal mortality rate cannot be explained solely through the provision of health personnel, it is important to consider that it is critical to find new modalities on how human resources for health could integrate and create synergies with other resources to increase systems capacity to deliver care according to conditions in each country.
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Affiliation(s)
- Gustavo Nigenda
- Faculty of Nursing and Obstetrics, National Autonomous University of Mexico, Mexico City, Mexico
| | - Edson Serván-Mori
- Center for Health Systems Research, National Institute of Public Health of Mexico, Universidad Av. 655, Cuernavaca, Morelos, Mexico.
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Rojas-Andrade R, Aranguren Zurita S, Prosser Bravo G, Vargas B. Intrinsic Motivation and Institutional Limitations: Key Implementation Determinants of Psychological First Aid Training. Community Ment Health J 2024:10.1007/s10597-024-01261-y. [PMID: 38489127 DOI: 10.1007/s10597-024-01261-y] [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] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2023] [Accepted: 02/25/2024] [Indexed: 03/17/2024]
Abstract
Psychological first aid (PFA) trainings are conducted to train frontline care workers in practical and emotional support to people who have been recently affected by stressful events. The aim of this study was to describe the determinants of the implementation behavior of a PFA training strategy in Chile and to provide theoretical information on the factors that influence trainers' self-efficacy. For this purpose, the Determinants of Implementation Behavior Questionnaire, administered online to a sample of 117 PFA trainers throughout Chile, was used. The results indicate that the main facilitators for implementation originate in the intrinsic motivation of the trainers, while the barriers are mainly found in the limited institutional opportunities offered by the context. Evidence was also found on the effect of motivation and context on trainer self-efficacy. PFA trainers may need to invest a lot of psychological resources to overcome the barriers encountered during implementation.
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Affiliation(s)
- Rodrigo Rojas-Andrade
- Escuela de Psicología, Universidad Santiago de Chile, Ecuador 3650, Estación Central, Santiago, Región Metropolitana, Chile.
| | | | | | - Belén Vargas
- Universidad de Chile, Núcleo Milenio para Mejorar la Salud Mental de Adolescentes y Jóvenes, Ministerio de Salud, Santiago, Imhay, Santiago, Chile
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Bruhn FRP, Werneck GL, Barbosa DS, Câmara DCP, Simões TC, Buzanovsky LP, Duarte AGS, de Melo SN, Cardoso DT, Donato LE, Maia-Elkhoury ANS, Belo VS. Spatio-temporal dynamics of visceral leishmaniasis in Brazil: A nonlinear regression analysis. Zoonoses Public Health 2024; 71:144-156. [PMID: 37984837 DOI: 10.1111/zph.13092] [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] [Received: 05/22/2023] [Revised: 10/06/2023] [Accepted: 10/29/2023] [Indexed: 11/22/2023]
Abstract
AIMS This study describes the spatio-temporal dynamics of new visceral leishmaniasis (VL) cases notified in Brazil between 2001 and 2020. METHODS AND RESULTS Data on the occurrence of the disease were obtained by means of the Notifiable Diseases Information System of the Brazilian Ministry of Health. Joinpoint, temporal generalized additive models and conditional autoregressive (CAR) models were used to analyse the temporal evolution of the rates in Brazil, states and regions. Spatio-temporal generalized additive and CAR models were used to identify the distribution of annual risks of VL occurrence in the Brazilian territory in relation to variation in the spatial average. There were 63,966 VL cases in the target period (3.198 cases/year), corresponding to a mean incidence rate of 1.68 cases/100,000 inhabitants. Of these, 4451 resulted in deaths, which gives a mean mortality rate of 0.12 deaths/100,000 inhabitants and a case fatality of 6.96%. The highest incidence rate was found in the North region, followed closely by the Northeast region, which presented the second and first highest mortality rates, respectively. For all of Brazil, and in the Northeast region, there were stability in the incidence rates, while the other regions showed an increasing trend in different time segments in the period: Central-West up to 2011, North up to 2008, Southeast up to 2004, and South up to 2010. On the other hand, all regions experienced a reduction in incidence rate during the last years of the series. The Northeast region had the highest number of municipalities with statistically significant elevated relative risks. The spatio-temporal analysis showed the highest risk area predominantly in the Northeast region in the beginning of the time series. From 2002 to 2018, this area expanded to the interior of the country. CONCLUSIONS The present study has shown that VL has expanded in Brazil. However, the North and Northeast regions continue to have the highest incidence, and the risk of infection has decreased in recent years.
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Affiliation(s)
- Fábio Raphael Pascoti Bruhn
- Laboratório de Epidemiologia Veterinária, Departamento de Veterinária Preventiva, Universidade Federal de Pelotas, Capão do Leão, Rio Grande do Sul, Brazil
| | - Guilherme Loureiro Werneck
- Departamento de Epidemiologia, Instituto de Medicina Social, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | - David Soeiro Barbosa
- Departamento de Parasitologia, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | | | - Taynãna César Simões
- NESPE - Núcleo de Estudos em Saúde Pública e Envelhecimento, Instituto Rene Rachou (Fiocruz-Minas), Belo Horizonte, Minas Gerais, Brazil
| | | | | | - Saulo Nascimento de Melo
- Universidade Federal de São João del-Rei, Campus Centro-Oeste Dona Lindu, Divinópolis, MG, Brazil
| | - Diogo Tavares Cardoso
- Departamento de Parasitologia, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | | | | | - Vinícius Silva Belo
- Universidade Federal de São João del-Rei, Campus Centro-Oeste Dona Lindu, Divinópolis, MG, Brazil
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Béhague DP, Gonçalves H, da Cruz SH, de Cruz L, Horta BL, Lima NP. The politicizing clinic: insights on 'the social' for mental health policy and practice. Soc Psychiatry Psychiatr Epidemiol 2024; 59:523-536. [PMID: 38108834 PMCID: PMC10944422 DOI: 10.1007/s00127-023-02573-2] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Accepted: 09/28/2023] [Indexed: 12/19/2023]
Abstract
PURPOSE In this paper, we explore how Brazilian socially sensitive therapy can respond to care-users' desire to change the social and political forces shaping their lives. We use this case to demonstrate the limits of the "social determinants of health" agenda which, when operationalized, tends to leave questions of lasting structural change aside. METHODS We report on mixed methods ethnographic and epidemiological results from the 1982 Pelotas (Brazil) birth cohort study, a prospective study of 5914 children. Ethnographic analysis explored the cyclical relationship between schooling, mental health care, conceptualizations of mental distress, social and political engagement, and experiences with diverse forms of discrimination. Epidemiological bivariate and multivariate analyses examined differences in socio-political participation and the reporting of discrimination at different time-points for participants who used therapy with those who did not. Effect modification analysis tested the hypothesis that the socially empowering effects of therapy were greater for marginalized and minoritized youth. RESULTS Most young people living in situations of precarity experienced therapy, particularly when based in schools, to be a blame-inducing process. A more fulfilling and impactful therapeutic experience took shape when young people were able to shift the focus away from symptom reduction and behavioral management toward narrative life analyses, social debate, and political agency. Use of socially sensitive therapy was statistically associated with increased political participation and reporting of discrimination after controlling for confounders. The empowering effects of therapy were greater for those with less formal education and family income, but not for young people who identified as black, brown, or non-white. CONCLUSION The findings underscore the importance of considering agency, sociality, and politics when theorizing "the social" in clinical practice, and health and social policy.
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Affiliation(s)
- Dominique P Béhague
- Vanderbilt University, Medicine Health, and Society, Nashville, Tennessee, USA.
- Kings College London, Social Medicine & Global Health, London, UK.
| | - Helen Gonçalves
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil
| | | | - Larissa de Cruz
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil
| | - Bernardo L Horta
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil
| | - Natália P Lima
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil
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Espinosa O, Mora L, Sanabria C, Ramos A, Rincón D, Bejarano V, Rodríguez J, Barrera N, Álvarez-Moreno C, Cortés J, Saavedra C, Robayo A, Franco OH. Predictive models for health outcomes due to SARS-CoV-2, including the effect of vaccination: a systematic review. Syst Rev 2024; 13:30. [PMID: 38229123 PMCID: PMC10790449 DOI: 10.1186/s13643-023-02411-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Accepted: 12/04/2023] [Indexed: 01/18/2024] Open
Abstract
BACKGROUND The interaction between modelers and policymakers is becoming more common due to the increase in computing speed seen in recent decades. The recent pandemic caused by the SARS-CoV-2 virus was no exception. Thus, this study aims to identify and assess epidemiological mathematical models of SARS-CoV-2 applied to real-world data, including immunization for coronavirus 2019 (COVID-19). METHODOLOGY PubMed, JSTOR, medRxiv, LILACS, EconLit, and other databases were searched for studies employing epidemiological mathematical models of SARS-CoV-2 applied to real-world data. We summarized the information qualitatively, and each article included was assessed for bias risk using the Joanna Briggs Institute (JBI) and PROBAST checklist tool. The PROSPERO registration number is CRD42022344542. FINDINGS In total, 5646 articles were retrieved, of which 411 were included. Most of the information was published in 2021. The countries with the highest number of studies were the United States, Canada, China, and the United Kingdom; no studies were found in low-income countries. The SEIR model (susceptible, exposed, infectious, and recovered) was the most frequently used approach, followed by agent-based modeling. Moreover, the most commonly used software were R, Matlab, and Python, with the most recurring health outcomes being death and recovery. According to the JBI assessment, 61.4% of articles were considered to have a low risk of bias. INTERPRETATION The utilization of mathematical models increased following the onset of the SARS-CoV-2 pandemic. Stakeholders have begun to incorporate these analytical tools more extensively into public policy, enabling the construction of various scenarios for public health. This contribution adds value to informed decision-making. Therefore, understanding their advancements, strengths, and limitations is essential.
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Affiliation(s)
- Oscar Espinosa
- Directorate of Analytical, Economic and Actuarial Studies in Health, Instituto de Evaluación Tecnológica en Salud (IETS) & Economic Models and Quantitative Methods Research Group, Centro de Investigaciones para el Desarrollo, Universidad Nacional de Colombia, Bogotá, D.C., Colombia.
| | - Laura Mora
- Directorate of Analytical, Economic and Actuarial Studies in Health, Instituto de Evaluación Tecnológica en Salud (IETS), Bogotá, Colombia
| | - Cristian Sanabria
- Directorate of Analytical, Economic and Actuarial Studies in Health, Instituto de Evaluación Tecnológica en Salud (IETS), Bogotá, Colombia
| | - Antonio Ramos
- Directorate of Analytical, Economic and Actuarial Studies in Health, Instituto de Evaluación Tecnológica en Salud (IETS) & Economic Models and Quantitative Methods Research Group, Centro de Investigaciones para el Desarrollo, Universidad Nacional de Colombia, Bogotá, D.C., Colombia
| | - Duván Rincón
- Directorate of Analytical, Economic and Actuarial Studies in Health, Instituto de Evaluación Tecnológica en Salud (IETS), Bogotá, Colombia
| | - Valeria Bejarano
- Directorate of Analytical, Economic and Actuarial Studies in Health, Instituto de Evaluación Tecnológica en Salud (IETS) & Economic Models and Quantitative Methods Research Group, Centro de Investigaciones para el Desarrollo, Universidad Nacional de Colombia, Bogotá, D.C., Colombia
| | - Jhonathan Rodríguez
- Directorate of Analytical, Economic and Actuarial Studies in Health, Instituto de Evaluación Tecnológica en Salud (IETS) & Economic Models and Quantitative Methods Research Group, Centro de Investigaciones para el Desarrollo, Universidad Nacional de Colombia, Bogotá, D.C., Colombia
| | - Nicolás Barrera
- Directorate of Analytical, Economic and Actuarial Studies in Health, Instituto de Evaluación Tecnológica en Salud (IETS), Bogotá, Colombia
| | | | - Jorge Cortés
- Faculty of Medicine, Universidad Nacional de Colombia, Bogotá, D.C., Colombia
| | - Carlos Saavedra
- Faculty of Medicine, Universidad Nacional de Colombia, Bogotá, D.C., Colombia
| | - Adriana Robayo
- Directorate of Analytical, Economic and Actuarial Studies in Health, Instituto de Evaluación Tecnológica en Salud (IETS), Bogotá, Colombia
| | - Oscar H Franco
- University Medical Center Utrecht, Utrecht University & Harvard T.H. Chan School of Public Health, Harvard University, Cambridge, USA
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Haby MM, Barreto JOM, Kim JYH, Peiris S, Mansilla C, Torres M, Guerrero-Magaña DE, Reveiz L. What are the best methods for rapid reviews of the research evidence? A systematic review of reviews and primary studies. Res Synth Methods 2024; 15:2-20. [PMID: 37696668 DOI: 10.1002/jrsm.1664] [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] [Received: 05/08/2023] [Revised: 07/09/2023] [Accepted: 08/07/2023] [Indexed: 09/13/2023]
Abstract
Rapid review methodology aims to facilitate faster conduct of systematic reviews to meet the needs of the decision-maker, while also maintaining quality and credibility. This systematic review aimed to determine the impact of different methodological shortcuts for undertaking rapid reviews on the risk of bias (RoB) of the results of the review. Review stages for which reviews and primary studies were sought included the preparation of a protocol, question formulation, inclusion criteria, searching, selection, data extraction, RoB assessment, synthesis, and reporting. We searched 11 electronic databases in April 2022, and conducted some supplementary searching. Reviewers worked in pairs to screen, select, extract data, and assess the RoB of included reviews and studies. We included 15 systematic reviews, 7 scoping reviews, and 65 primary studies. We found that several commonly used shortcuts in rapid reviews are likely to increase the RoB in the results. These include restrictions based on publication date, use of a single electronic database as a source of studies, and use of a single reviewer for screening titles and abstracts, selecting studies based on the full-text, and for extracting data. Authors of rapid reviews should be transparent in reporting their use of these shortcuts and acknowledge the possibility of them causing bias in the results. This review also highlights shortcuts that can save time without increasing the risk of bias. Further research is needed for both systematic and rapid reviews on faster methods for accurate data extraction and RoB assessment, and on development of more precise search strategies.
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Affiliation(s)
- Michelle M Haby
- Science and Knowledge Unit, Evidence and Intelligence for Action in Health Department, Pan American Health Organization, Washington, DC, USA
- Department of Chemical and Biological Sciences, University of Sonora, Hermosillo, Mexico
- Melbourne School of Population and Global Health, The University of Melbourne, Parkville, Victoria, Australia
| | | | - Jenny Yeon Hee Kim
- Science and Knowledge Unit, Evidence and Intelligence for Action in Health Department, Pan American Health Organization, Washington, DC, USA
| | - Sasha Peiris
- Science and Knowledge Unit, Evidence and Intelligence for Action in Health Department, Pan American Health Organization, Washington, DC, USA
| | - Cristián Mansilla
- McMaster Health Forum, McMaster University, Hamilton, Ontario, Canada
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada
| | - Marcela Torres
- Science and Knowledge Unit, Evidence and Intelligence for Action in Health Department, Pan American Health Organization, Washington, DC, USA
| | - Diego Emmanuel Guerrero-Magaña
- Doctoral Program in Chemical and Biological Sciences and Health, Department of Chemical and Biological Sciences, University of Sonora, Hermosillo, Mexico
| | - Ludovic Reveiz
- Science and Knowledge Unit, Evidence and Intelligence for Action in Health Department, Pan American Health Organization, Washington, DC, USA
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Benavides JA, Megid J, Castilho JG, Macedo CI, Mourão Fuches RM, Frazatti Gallina NM, Boere V, Zalafon-Silva B, da Silva RM, Coutinho JFV, Arruda MDF, de Oliveira E Silva I, Valença-Montenegro MM, Cordeiro JF, Leal S, Higashi CDS, Medeiros FDS, Uchoa de Castro A, Rizzo R, Sena FA, Gonçalves PDC, Rocha SM, Wada M, Vargas A, Carrieri ML, Kotait I. No Evidence of Rabies Exposure in Wild Marmosets (Callithrix jacchus) of Northeast Brazil. Ecohealth 2023; 20:355-361. [PMID: 38236519 DOI: 10.1007/s10393-023-01663-6] [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] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Accepted: 09/29/2023] [Indexed: 01/19/2024]
Abstract
Rabies transmitted by wildlife is the main source of human rabies mortality in Latin America and considered an emerging disease. The common marmoset Callithrix jacchus of Brazil is the only known primate reservoir of rabies worldwide. We tested whether alive free-ranging C. jacchus were exposed to rabies in four northeast states that have previously reported rabies-positive dead C. jacchus (Pernambuco and Bahia) or not (Paraíba and Rio Grande do Norte). Our results show no evidence of rabies antibodies or infection in the sampled C. jacchus, suggesting that apparently healthy marmosets are not widely exposed to rabies over their natural range.
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Affiliation(s)
- Julio A Benavides
- MIVEGEC, IRD, CNRS, Université de Montpellier, UMR IRD-CNRS-UM MIVEGEC, Centre Montpellier. 911, Avenue Agropolis, BP 64501, 34394, Montpellier Cedex 5, France.
- Centro de Investigación para la Sustentabilidad y Doctorado en Medicina de la Conservación, Facultad de Ciencias de la Vida, Universidad Andrés Bello, República 440, Santiago, Chile.
| | - Jane Megid
- Faculdade de Medicina Veterinária e Zootecnia, Departamento de Higiene Veterinária e Saúde Pública, Universidade Estadual Paulista "Júlio de Mesquita Filho", Botucatu, São Paulo, Brazil
| | | | - Carla I Macedo
- Pasteur Institute, Av. Paulista 393, São Paulo, SP, CEP 01311-000, Brazil
| | - Regina Maria Mourão Fuches
- Centro de Desenvolvimento e Inovação, Instituto Butantan, Laboratório Piloto de Vacinas Virais, São Paulo, Brazil
| | - Neuza Maria Frazatti Gallina
- Centro de Desenvolvimento e Inovação, Instituto Butantan, Laboratório Piloto de Vacinas Virais, São Paulo, Brazil
| | - Vanner Boere
- Universidade Federal do Sul da Bahia, BR 415, Itabuna, BA, Brazil
| | | | - Ramiro Monã da Silva
- Faculdade de Medicina Veterinária e Zootecnia, Departamento de Higiene Veterinária e Saúde Pública, Universidade Estadual Paulista "Júlio de Mesquita Filho", Botucatu, São Paulo, Brazil
| | | | - Maria de Fatima Arruda
- Setor de Psicobiologia, Departamento de Fisiología, Universidade Federal do Río Grande do Norte, Natal, Brazil
| | | | - Mônica Mafra Valença-Montenegro
- Centro Nacional de Pesquisa e Conservação de Primatas Brasileiro, Instituto Chico Mendes de Conservação da Biodiversidade, João Pessoa, Brazil
| | | | - Silvana Leal
- Secretaria de Estado de Saúde de Pernambuco, Recife, Brazil
| | | | | | | | - Rodrigo Rizzo
- Centro de Desenvolvimento e Inovação, Instituto Butantan, Laboratório Piloto de Vacinas Virais, São Paulo, Brazil
| | - Fabio Antonio Sena
- Centro de Desenvolvimento e Inovação, Instituto Butantan, Laboratório Piloto de Vacinas Virais, São Paulo, Brazil
| | | | | | - Marcelo Wada
- Secretaria de Vigilância em Saúde (SVS), Ministério da Saúde, Brasilia, Brazil
| | - Alexander Vargas
- Secretaria de Vigilância em Saúde (SVS), Ministério da Saúde, Brasilia, Brazil
| | - Maria Luiza Carrieri
- Centro de Desenvolvimento e Inovação, Instituto Butantan, Laboratório Piloto de Vacinas Virais, São Paulo, Brazil
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Ferranna M, Cadarette D, Chen S, Ghazi P, Ross F, Zucker L, Bloom DE. The macroeconomic burden of noncommunicable diseases and mental health conditions in South America. PLoS One 2023; 18:e0293144. [PMID: 37862345 PMCID: PMC10588886 DOI: 10.1371/journal.pone.0293144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2023] [Accepted: 10/05/2023] [Indexed: 10/22/2023] Open
Abstract
Noncommunicable diseases and mental health conditions (referred to collectively as NMHs) are the greatest cause of preventable death, illness, and disability in South America and negatively affect countries' economic performance through their detrimental impacts on labor supply and capital investments. Sound, evidence-based policy-making requires a deep understanding of the macroeconomic costs of NMHs and of their distribution across countries and diseases. The paper estimates and projects the macroeconomic burden of NMHs over the period 2020-2050 in 10 South American countries. We estimate the impact of NMHs on gross domestic product (GDP) through a human capital-augmented production function approach, accounting for mortality and morbidity effects of NMHs on labor supply, for the impact of treatment costs on physical capital accumulation, and for variations in human capital by age. Our central estimates suggest that the overall burden of NMHs in these countries amounts to $7.3 trillion (2022 international $, 3% discount rate, 95% confidence interval: $6.8-$7.8 trillion). Overall, the macroeconomic burden of NMHs is around 4% of total GDP over 2020-2050, with little variation across countries (from 3.2% in Peru to 4.5% in Brazil). In other words, without NMHs, annual GDP over 2020-2050 would be about 4% larger. In most countries, the largest macroeconomic burden is associated with cancers. Results from the paper point to a significant macroeconomic burden of NMHs in South America and provide a strong justification for investment in NMH prevention, early detection, treatment, and formal and informal care.
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Affiliation(s)
- Maddalena Ferranna
- Department of Pharmaceutical and Health Economics, Alfred E. Mann School of Pharmacy and Pharmaceutical Sciences, University of Southern California, Los Angeles, United States of America
- Schaeffer Center for Health Policy and Economics, University of Southern California, Los Angeles, United States of America
| | - Daniel Cadarette
- Harvard Kennedy School, Cambridge, Massachusetts, United States of America
| | - Simiao Chen
- Heidelberg Institute of Global Health, Faculty of Medicine and University Hospital, Heidelberg University, Heidelberg, Germany
| | - Parastou Ghazi
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, United States of America
| | - Faith Ross
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, United States of America
| | - Leo Zucker
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, United States of America
| | - David E. Bloom
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, United States of America
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Ledien J, Cucunubá ZM, Parra-Henao G, Rodríguez-Monguí E, Dobson AP, Adamo SB, Castellanos LG, Basáñez MG, Nouvellet P. From serological surveys to disease burden: a modelling pipeline for Chagas disease. Philos Trans R Soc Lond B Biol Sci 2023; 378:20220278. [PMID: 37598701 PMCID: PMC10440172 DOI: 10.1098/rstb.2022.0278] [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] [Received: 11/20/2022] [Accepted: 06/29/2023] [Indexed: 08/22/2023] Open
Abstract
In 2012, the World Health Organization (WHO) set the elimination of Chagas disease intradomiciliary vectorial transmission as a goal by 2020. After a decade, some progress has been made, but the new 2021-2030 WHO roadmap has set even more ambitious targets. Innovative and robust modelling methods are required to monitor progress towards these goals. We present a modelling pipeline using local seroprevalence data to obtain national disease burden estimates by disease stage. Firstly, local seroprevalence information is used to estimate spatio-temporal trends in the Force-of-Infection (FoI). FoI estimates are then used to predict such trends across larger and fine-scale geographical areas. Finally, predicted FoI values are used to estimate disease burden based on a disease progression model. Using Colombia as a case study, we estimated that the number of infected people would reach 506 000 (95% credible interval (CrI) = 395 000-648 000) in 2020 with a 1.0% (95%CrI = 0.8-1.3%) prevalence in the general population and 2400 (95%CrI = 1900-3400) deaths (approx. 0.5% of those infected). The interplay between a decrease in infection exposure (FoI and relative proportion of acute cases) was overcompensated by a large increase in population size and gradual population ageing, leading to an increase in the absolute number of Chagas disease cases over time. This article is part of the theme issue 'Challenges and opportunities in the fight against neglected tropical diseases: a decade from the London Declaration on NTDs'.
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Affiliation(s)
- Julia Ledien
- School of Life Sciences, University of Sussex, Falmer, Brighton BN1 9RH, UK
| | - Zulma M. Cucunubá
- Departamento de Epidemiología Clínica y Bioestadística, Facultad de Medicina, Universidad Pontificia Javeriana, 110231 Bogotá, Colombia
| | - Gabriel Parra-Henao
- Centro de Investigación en Salud para el Trópico, Universidad Cooperativa de Colombia, 470002, Santa Marta, Colombia
- National Institute of Health, 111321 Bogotá, Colombia
| | - Eliana Rodríguez-Monguí
- Departamento de Epidemiología Clínica y Bioestadística, Facultad de Medicina, Universidad Pontificia Javeriana, 110231 Bogotá, Colombia
- Independent consultant to the Neglected, Tropical and Vector Borne Diseases Program, Pan American Health Organization (PAHO), Colombia
| | - Andrew P. Dobson
- Department of Ecology and Evolutionary Biology, Princeton University, Princeton, NJ 08544, USA
| | - Susana B. Adamo
- Center for International Earth Science Information Network (CIESIN), Columbia Climate School, Columbia University, New York, NY 10025, USA
| | - Luis Gerardo Castellanos
- Department of Communicable Diseases and Environmental Determinants of Health, Pan American Health Organization (PAHO), Washington, DC 20037, USA
| | - María-Gloria Basáñez
- London Centre for Neglected Tropical Disease Research (LCNTDR) & MRC Centre for Global Infectious Disease Analysis (GIDA), Department of Infectious Disease Epidemiology, School of Public Health, Imperial College London, London SW7 2AZ, UK
| | - Pierre Nouvellet
- School of Life Sciences, University of Sussex, Falmer, Brighton BN1 9RH, UK
- London Centre for Neglected Tropical Disease Research (LCNTDR) & MRC Centre for Global Infectious Disease Analysis (GIDA), Department of Infectious Disease Epidemiology, School of Public Health, Imperial College London, London SW7 2AZ, UK
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11
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Maruyama JM, Valente JY, Tovo-Rodrigues L, Santos IS, Barros AJD, Munhoz TN, Barros FC, Murray J, Matijasevich A. Maternal depression trajectories in childhood, subsequent maltreatment, and adolescent emotion regulation and self-esteem: the 2004 Pelotas birth cohort. Eur Child Adolesc Psychiatry 2023; 32:1935-1945. [PMID: 35731302 PMCID: PMC9214189 DOI: 10.1007/s00787-022-02022-6] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Accepted: 06/01/2022] [Indexed: 11/26/2022]
Abstract
This study aimed to examine the impact of maternal depressive symptoms trajectories on 15-year-old adolescents' self-esteem and emotion regulation and test the mediating role of child maltreatment in this association. The 2004 Pelotas Birth Cohort is an ongoing cohort study originally comprised of 4231 live births in a southern Brazilian city. We examined a subsample of 1949 adolescents at age 15 years. Maternal depressive symptoms were assessed using the Edinburgh Postnatal Depression Scale. Trajectories of maternal depression from 3 months until the 11-year follow-up were calculated using a group-based modeling approach. Child maltreatment at age 11 years was measured using the parent-report version of the Parent-Child Conflict Tactics Scale. Adolescent outcomes at age 15 years were assessed by the self-report version of the Rosenberg Self-esteem Scale and the Emotion Regulation Index for Children and Adolescents. Path model analysis was conducted using a structural equation modeling framework in Mplus software. All maternal depression trajectories were negatively associated with offspring self-esteem and emotion regulation compared to the reference group (low depression trajectory). There was a significant indirect effect of maternal depression trajectories on emotion regulation mediated via child maltreatment. No evidence of moderation by sex was found for any pathway. The effects of maternal depression on adolescents' emotion regulation are partly mediated by child maltreatment at age 11.
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Affiliation(s)
- Jessica Mayumi Maruyama
- Departamento de Medicina Preventiva, Faculdade de Medicina FMUSP, Universidade de São Paulo, Av. Dr. Arnaldo 455, 2nd Floor, São Paulo, SP, CEP 01246-903, Brazil.
| | - Juliana Y Valente
- Departamento de Psiquiatria, Universidade Federal de São Paulo, São Paulo, Brazil
| | | | - Iná S Santos
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil
- Postgraduate Program in Pediatrics and Child Health, Pontifical Catholic University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Aluísio J D Barros
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil
| | - Tiago N Munhoz
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil
- Faculty of Psychology, Federal University of Pelotas, Pelotas, Brazil
| | - Fernando C Barros
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil
- Programa de Pós-graduação em Saúde e Comportamento, Universidade Católica de, Pelotas, Brazil
| | - Joseph Murray
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil
- Human Development and Violence Research Centre, Federal University of Pelotas, Pelotas, Brazil
| | - Alicia Matijasevich
- Departamento de Medicina Preventiva, Faculdade de Medicina FMUSP, Universidade de São Paulo, Av. Dr. Arnaldo 455, 2nd Floor, São Paulo, SP, CEP 01246-903, Brazil
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil
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12
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Rivera T, Brustrom J, Vera Antelo M, Puertas EB, Rhoda DA, Velandia-Gonzalez M. Understanding COVID-19 Vaccine Acceptance among Latin American Health Workers: Implications for Designing Interventions. Vaccines (Basel) 2023; 11:1471. [PMID: 37766147 PMCID: PMC10536662 DOI: 10.3390/vaccines11091471] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2023] [Revised: 08/30/2023] [Accepted: 09/04/2023] [Indexed: 09/29/2023] Open
Abstract
Health workers (HWs) have a key role in promoting vaccine acceptance. This study draws on the Behavioral and Social Drivers of Vaccination (BeSD) model and our team's investigation of vaccine hesitancy in a sample of 1197 HWs across 14 Caribbean countries in 2021. We conducted a cross-sectional Internet survey of 6718 HWs across 16 countries in Latin America in spring 2022, after the COVID-19 vaccine had recently become widely available in the region. The survey assessed HWs' attitudes regarding COVID-19 vaccines and vaccines in general. As a proxy measure of COVID-19 vaccine acceptance, we used the willingness to recommend the COVID-19 vaccine to eligible people. Ninety-seven percent of respondents were COVID-19 vaccine acceptant. Although nearly all respondents felt that the COVID-19 vaccine was safe and effective, 59% expressed concerns about potential adverse effects. Despite uniformly high acceptance of the COVID-19 vaccine overall and across Latin American subregions, acceptance differed by sex, HW profession, and COVID-19 history. Social processes, including actions and opinions of friends, family, and colleagues; actions and opinions of religious leaders; and information seen on social networks shaped many respondents' opinions of vaccines, and the magnitude of these effects differed across both demographic and geographic subgroups. Information campaigns designed for HWs should underscore the importance of vaccine safety. Messages should be tailored to specific audiences according to the information source each is most likely to consult and trust.
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Affiliation(s)
- Tamara Rivera
- Comprehensive Immunization Program, Pan American Health Organization, 525 23rd Street, NW, Washington, DC 20037, USA
| | - Jennifer Brustrom
- Biostat Global Consulting, 330 Blandford Drive, Worthington, OH 43085, USA
| | - Maite Vera Antelo
- Comprehensive Immunization Program, Pan American Health Organization, 525 23rd Street, NW, Washington, DC 20037, USA
| | - E Benjamin Puertas
- Human Resources for Health Unit, Pan American Health Organization, 525 23rd Street, NW, Washington, DC 20037, USA
| | - Dale A Rhoda
- Biostat Global Consulting, 330 Blandford Drive, Worthington, OH 43085, USA
| | - Martha Velandia-Gonzalez
- Comprehensive Immunization Program, Pan American Health Organization, 525 23rd Street, NW, Washington, DC 20037, USA
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de Carvalho RHDSBF, Alves MTSSDBE, da Silva-Junior AG, Alexandre GC, Coimbra TRS, Moraes M, de Menezes LO, de Oliveira SS, Thomaz EBAF, Lamy ZC, Barreira LSG. Maternal health during the COVID-19 pandemic: Experiences of health workers in three Brazilian municipalities. PLoS One 2023; 18:e0290068. [PMID: 37643204 PMCID: PMC10464980 DOI: 10.1371/journal.pone.0290068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Accepted: 08/01/2023] [Indexed: 08/31/2023] Open
Abstract
OBJECTIVE To analyze the experiences of maternal health workers in three Brazilian cities, located in the Northeast (São Luís), Southeast (Niterói), and South (Pelotas) regions during the first year of the COVID-19 pandemic. METHODS Qualitative research carried out between December 2020 and February 2021. Interviews were conducted, in person or remotely, with 30 health workers, doctors and nurses, working in maternity hospitals of different degrees of complexity. RESULTS Sociodemographic characteristics, employment relationships and professional qualification of the interviewees were described. Two thematic axes were identified: 1) changes in hospital organization and dynamics in the pandemic; 2) Illness and suffering of health workers. The majority of respondents were women. Most physicians had work relationships in the public and private sectors. In Niterói, health workers had better professional qualifications and more precarious work relationships (as temporary hires), compared to São Luís and Pelotas. In the context of the uncertainties resulting from the pandemic, this situation generated even more insecurity for those workers. The statements at the beginning of the pandemic covered topics such as changes in the organizational dynamics of services, healthcare, telemedicine, and interaction between health workers and users. In the health workers' perception, the initial period of the health emergency, which resulted in intense changes in the provision of services, was marked by an increase in preterm births, perinatal mortality, and fetal losses. Work overload, fear of contamination, concern for family members and uncertainties regarding the new disease caused intense suffering in health workers who had little institutional support in the cities studied. The suffering experienced by health workers went beyond the work dimension, reaching their private life. CONCLUSION Changes caused by the pandemic required immediate adjustments in professional practices, generating insecurities in healthcare regardless of the location studied. The method of hiring health workers remained the same as the previously practiced one in each city. Due to the risk of disease transmission, measures contrary to humanization practices, and more restrictive in São Luís, were reported as harmful to obstetric care. The Covid-19 pandemic was a huge challenge for the Brazilian health system, aggravating the working conditions experienced by health workers. In addition to the work environment, it was possible to briefly glimpse its effects on private life.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | - Zeni Carvalho Lamy
- Public Health Department, Federal University of Maranhão, São Luís, MA, Brazil
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14
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Mujica OJ, Sanhueza A, Carvajal-Velez L, Vidaletti LP, Costa JC, Barros AJD, Victora CG. Recent trends in maternal and child health inequalities in Latin America and the Caribbean: analysis of repeated national surveys. Int J Equity Health 2023; 22:125. [PMID: 37393277 PMCID: PMC10314462 DOI: 10.1186/s12939-023-01932-4] [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] [Received: 01/30/2023] [Accepted: 06/07/2023] [Indexed: 07/03/2023] Open
Abstract
BACKGROUND Although most Latin American and the Caribbean (LAC) countries made important progress in maternal and child health indicators from the 1990s up to 2010, little is known about such progress in the last decade. This study aims at documenting progress for each country as a whole, and to assess how within-country socioeconomic inequalities are evolving over time. METHODS We identified LAC countries for which a national survey was available between 2011-2015 and a second comparable survey in 2018-2020. These included Argentina, Costa Rica, Cuba, the Dominican Republic, Guyana, Honduras, Peru, and Suriname. The 16 surveys included in the analysis collected nationally representative data on 221,989 women and 152,983 children using multistage sampling. Twelve health-related outcomes were studied, seven of which related to intervention coverage: the composite coverage index, demand for family planning satisfied with modern methods, antenatal care (four or more visits and eight or more visits), skilled attendant at birth, postnatal care for the mother and full immunization coverage. Five additional impact indicators were also investigated: stunting prevalence among under-five children, tobacco use by women, adolescent fertility rate, and under-five and neonatal mortality rates. For each of these indicators, average annual relative change rates were calculated between the baseline and endline national level estimates, and changes in socioeconomic inequalities over time were assessed using the slope index of inequality. RESULTS Progress over time and the magnitude of inequalities varied according to country and indicator. For countries and indicators where baseline levels were high, as Argentina, Costa Rica and Cuba, progress was slow and inequalities small for most indicators. Countries that still have room for improvements, such as Guyana, Honduras, Peru and Suriname, showed faster progress for some but not all indicators, although also had wider inequalities. Among the countries studied, Peru was the top performer in terms of increasing coverage and reducing inequalities over time, followed by Honduras. Declines in family planning and immunization coverage were observed in some countries, and the widest inequalities were present for adolescent fertility and antenatal care coverage with eight or more visits. CONCLUSIONS Although LAC countries are well placed in terms of current levels of health indicators compared to most low- and middle-income countries, important inequalities remain, and reversals are being observed in some areas. More targeted efforts and actions are needed in order to leave no one behind. Monitoring progress with an equity lens is essential, but this will require further investment in conducting surveys routinely.
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Affiliation(s)
- Oscar J Mujica
- Pan American Health Organization (PAHO), 525 23Rd Street NW, Washington, DC, 20037, USA.
| | - Antonio Sanhueza
- Pan American Health Organization (PAHO), 525 23Rd Street NW, Washington, DC, 20037, USA
| | - Liliana Carvajal-Velez
- United Nations International Children Emergency Fund (UNICEF), New York City, USA
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
| | - Luis Paulo Vidaletti
- International Center for Equity in Health (ICEH), Federal University of Pelotas, Pelotas, Brazil
| | - Janaína C Costa
- International Center for Equity in Health (ICEH), Federal University of Pelotas, Pelotas, Brazil
| | - Aluísio J D Barros
- International Center for Equity in Health (ICEH), Federal University of Pelotas, Pelotas, Brazil
| | - Cesar G Victora
- International Center for Equity in Health (ICEH), Federal University of Pelotas, Pelotas, Brazil
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López-Olmedo N, Muciño-Sandoval K, Canto-Osorio F, Vargas-Flores A, Quiroz-Reyes A, Sabines A, Malo-Serrano M, Bautista-Arredondo S, Colchero MA, Barrientos-Gutiérrez T. Warning labels on alcoholic beverage containers: a pilot randomized experiment among young adults in Mexico. BMC Public Health 2023; 23:1156. [PMID: 37322503 PMCID: PMC10268389 DOI: 10.1186/s12889-023-16069-w] [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] [Received: 01/03/2023] [Accepted: 06/07/2023] [Indexed: 06/17/2023] Open
Abstract
BACKGROUND Little is known about the potential impacts of visible and up-to-date health warning labels on alcoholic beverage containers on a range of outcomes in low- and middle-income countries. We conducted an experimental study to test the potential impacts of visible health warning labels (on the principal panel of the package) on thinking about health risks, product attractiveness, visual avoidance, and intention to change alcohol use among students in Mexico aged 18-30 years. METHODS A double-blind, parallel-group, online randomized trial was conducted from November 2021 to January 2022 in 11 states in Mexico. In the control group, participants were presented with the image of a conventional beer can with a fictional design and brand. In the intervention groups, the participants observed pictograms with a red font and white backgrounds (health warning label in red-HWL red) or with a black font and yellow backgrounds (health warning label in yellow-HWL yellow), located at the top, covering around one-third of the beer can. We used Poisson regression models -unadjusted and adjusted for covariates- to assess differences in the outcomes across study groups. RESULTS Using intention-to-treat analysis (n = 610), we found more participants in groups HWL red and HWL yellow thought about the health risks from drinking beer compared to the control group [Prevalence Ratio (PR) = 1.43, CI95%:1.05,1.93 for HWL red; PR = 1.25, CI95%: 0.91, 1.71 for HWL yellow]. A lower percentage of young adults in the interventions vs control group considered the product attractive (PR 0.74, 95%CI 0.51, 1.06 for HWL red; PR 0.56, 95%CI 0.38, 0.83 for HWL yellow). Although not statistically significant, a lower percentage of participants in the intervention groups considered buying or consuming the product than the control group. Results were similar when models were adjusted for covariates. CONCLUSIONS Visible health warning labels could lead individuals to think about the health risks of alcohol, reducing the attractiveness of the product and decreasing the intention to purchase and consume alcohol. Further studies will be required to determine which pictograms or images and legends are most contextually relevant for the country. TRIAL REGISTRATION The protocol of this study was retrospectively registered on 03/01/2023: ISRCTN10494244.
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Affiliation(s)
- Nancy López-Olmedo
- Center for Population Health Research, National Institute of Public Health, Cuernavaca, Morelos, Mexico
| | - Karla Muciño-Sandoval
- Center for Population Health Research, National Institute of Public Health, Cuernavaca, Morelos, Mexico
| | - Francisco Canto-Osorio
- Center for Population Health Research, National Institute of Public Health, Cuernavaca, Morelos, Mexico
| | - Adriana Vargas-Flores
- Center for Health Systems Research, National Institute of Public Health, Cuernavaca, Morelos, Mexico
| | - Alai Quiroz-Reyes
- Center for Health Systems Research, National Institute of Public Health, Cuernavaca, Morelos, Mexico
| | - Arturo Sabines
- Pan American Health Organization in Mexico, Mexico City, Mexico
| | | | - Sergio Bautista-Arredondo
- Center for Health Systems Research, National Institute of Public Health, Cuernavaca, Morelos, Mexico
| | - MArantxa Colchero
- Center for Health Systems Research, National Institute of Public Health, Cuernavaca, Morelos, Mexico
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Becerril-Montekio V, Torres-Pereda P, García-Bello LA, Alcalde-Rabanal J. Replacement of core team members on embedded implementation research teams: experiences from Latin America and the Caribbean. Rev Panam Salud Publica 2023; 47:e82. [PMID: 37223326 PMCID: PMC10202338 DOI: 10.26633/rpsp.2023.82] [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] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Accepted: 02/10/2023] [Indexed: 05/25/2023] Open
Abstract
Objective To understand how replacement of decision-makers (DMs) serving as principal investigators (PI) or co-PIs on research teams may affect the feasibility and value of embedded implementation research (EIR) used to improve health policies, programs, and services in Latin America and the Caribbean. Methods This was a descriptive qualitative study based on 39 semistructured interviews with 13 embedded research teams selected by financing agencies to explore team composition, interaction among members, and research results. Interviews were conducted at three points during the study period from September 2018 to November 2019; data were analyzed from 2020 to 2021. Results Research teams were found to be operating in one of three situations: (i) permanent core team (no change) with either active DM or inactive DM participation; (ii) replacement of DM-PI or co-PI that did not affect EIR research; and (iii) replacement of DM-PI that affected EIR. Conclusions To ensure EIR continuity and stability, research teams should include high-level DMs together with more technical staff performing essential implementation activities. This structure could improve collaboration among professional researchers and ensure greater embeddedness of EIR to strengthen the health system.
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Affiliation(s)
- Victor Becerril-Montekio
- Centro de Investigación en Sistemas de SaludInstituto Nacional de Salud PúblicaCuernavacaMorelosMexicoCentro de Investigación en Sistemas de Salud, Instituto Nacional de Salud Pública, Cuernavaca, Morelos, Mexico.
| | - Pilar Torres-Pereda
- Centro de Investigación en Sistemas de SaludInstituto Nacional de Salud PúblicaCuernavacaMorelosMexicoCentro de Investigación en Sistemas de Salud, Instituto Nacional de Salud Pública, Cuernavaca, Morelos, Mexico.
| | - Luis Alberto García-Bello
- Dirección de Salud MentalInstituto de Salud Pública del Estado de GuanajuatoLeónGuanajuatoMexicoDirección de Salud Mental, Instituto de Salud Pública del Estado de Guanajuato, León, Guanajuato, Mexico.
| | - Jacqueline Alcalde-Rabanal
- Centro de Investigación en Sistemas de SaludInstituto Nacional de Salud PúblicaCuernavacaMorelosMexicoCentro de Investigación en Sistemas de Salud, Instituto Nacional de Salud Pública, Cuernavaca, Morelos, Mexico.
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Lamy ZC, Thomaz EBAF, da Silva-Junior AG, Alexandre GC, Alves MTSSDBE, de Carvalho RHDSBF, de Menezes LO, de Oliveira SS, Moraes M, Magalhães YB, Coimbra TRS, Guzman-Barrera LS. Experiences of women in prenatal, childbirth, and postpartum care during the COVID-19 pandemic in selected cities in Brazil: The resignification of the experience of pregnancy and giving birth. PLoS One 2023; 18:e0284773. [PMID: 37146073 PMCID: PMC10162534 DOI: 10.1371/journal.pone.0284773] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2022] [Accepted: 04/06/2023] [Indexed: 05/07/2023] Open
Abstract
The COVID-19 pandemic has impacted public and private health systems around the world, impairing good practices in women's health care. However, little is known about the experiences, knowledge, and feelings of Brazilian women in this period. The objective was to analyze the experiences of women, seen at maternity hospitals accredited by the Brazilian Unified Health System (SUS, acronym in Portuguese), regarding health care during pregnancy, childbirth, and postpartum periods, their interpersonal relationships, and perceptions and feelings about the pandemic. This was a qualitative, exploratory research, carried out in three Brazilian municipalities with women hospitalized in 2020, during pregnancy, childbirth, or postpartum period, with COVID-19 or not. For data collection, semi-structured individual interviews (in person, by telephone, or by digital platform) were conducted, recorded and transcribed. The content analysis of thematic modalities was displayed as per the following axes: i) Knowledge about the disease; ii) Search for health care in prenatal, childbirth, and postpartum periods; iii) Experience of suffering from COVID-19; iv) Income and work; and v) Family dynamics and social support network. A total of 46 women were interviewed in São Luís-MA, Pelotas-RS, and Niterói-RJ. Use of media was important to convey information and fight fake news. The pandemic negatively impacted access to health care in the prenatal, childbirth, and postpartum periods, contributing to worsening of the population's social and economic vulnerabilities. Women experienced diverse manifestations of the disease, and psychic disorders were very frequent. Social isolation during the pandemic disrupted the support network of these women, who found social support strategies in communication technologies. Women-centered care-including qualified listening and mental health support-can reduce the severity of COVID-19 cases in pregnant, parturient, and postpartum women. Sustainable employment and income maintenance policies are essential to mitigate social vulnerabilities and reduce risks for these women.
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Affiliation(s)
- Zeni Carvalho Lamy
- Public Health Department, Universidade Federal do Maranhão, São Luís, MA, Brazil
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Kim JYH, Ragusa M, Tortosa F, Torres A, Gresh L, Méndez-Rico JA, Alvarez-Moreno CA, Lisboa TC, Valderrama-Beltrán SL, Aldighieri S, Reveiz L. Viral reactivations and co-infections in COVID-19 patients: a systematic review. BMC Infect Dis 2023; 23:259. [PMID: 37101275 PMCID: PMC10131452 DOI: 10.1186/s12879-023-08117-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [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] [Received: 12/13/2022] [Accepted: 02/24/2023] [Indexed: 04/28/2023] Open
Abstract
BACKGROUND Viral reactivations and co-infections have been reported among COVID-19 patients. However, studies on the clinical outcomes of different viral reactivations and co-infections are currently in limit. Thus, the primary purpose of this review is to perform an overarching investigation on the cases of latent virus reactivation and co-infection in COVID-19 patients to build collective evidence contributing to improving patient health. The aim of the study was to conduct a literature review to compare the patient characteristics and outcomes of reactivations and co-infections of different viruses. METHODS Our population of interest included confirmed COVID-19 patients who were diagnosed with a viral infection either concurrently or following their COVID-19 diagnosis. We extracted the relevant literature through a systematic search using the key terms in the online databases including the EMBASE, MEDLINE, Latin American Caribbean Health Sciences Literature (LILACS), from inception onwards up to June 2022. The authors independently extracted data from eligible studies and assessed the risk of bias using the Consensus-based Clinical Case Reporting (CARE) guidelines and the Newcastle-Ottawa Scale (NOS). Main patient characteristics, frequency of each manifestation, and diagnostic criteria used in studies were summarized in tables. RESULTS In total, 53 articles were included in this review. We identified 40 reactivation studies, 8 coinfection studies, and 5 studies where concomitant infection in COVID-19 patients was not distinguished as either reactivation or coinfection. Data were extracted for 12 viruses including IAV, IBV, EBV, CMV, VZV, HHV-1, HHV-2, HHV-6, HHV-7, HHV-8, HBV, and Parvovirus B19. EBV, HHV-1, and CMV were most frequently observed within the reactivation cohort, whereas IAV and EBV within the coinfection cohort. In both reactivation and coinfection groups, patients reported cardiovascular disease, diabetes, and immunosuppression as comorbidities, acute kidney injury as complication, and lymphopenia and elevated D-dimer and CRP levels from blood tests. Common pharmaceutical interventions in two groups included steroids and antivirals. CONCLUSION Overall, these findings expand our knowledge on the characteristics of COVID-19 patients with viral reactivations and co-infections. Our experience with current review indicates a need for further investigations on virus reactivation and coinfection among COVID-19 patients.
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Affiliation(s)
- Jenny Yeon Hee Kim
- Knowledge Translation Program, Evidence and Intelligence for Action in Health Department, Pan American Health Organization, Washington, DC USA
| | - Martin Ragusa
- Knowledge Translation Program, Evidence and Intelligence for Action in Health Department, Pan American Health Organization, Washington, DC USA
- Incident Management System for the COVID-19 Response, Pan American Health Organization, Washington, DC USA
| | - Fernando Tortosa
- Knowledge Translation Program, Evidence and Intelligence for Action in Health Department, Pan American Health Organization, Washington, DC USA
- Incident Management System for the COVID-19 Response, Pan American Health Organization, Washington, DC USA
| | - Ana Torres
- Knowledge Translation Program, Evidence and Intelligence for Action in Health Department, Pan American Health Organization, Washington, DC USA
- Incident Management System for the COVID-19 Response, Pan American Health Organization, Washington, DC USA
| | - Lionel Gresh
- Incident Management System for the COVID-19 Response, Pan American Health Organization, Washington, DC USA
- Department of Health Emergencies, Pan American Health Organization, Washington, DC USA
| | - Jairo Andres Méndez-Rico
- Incident Management System for the COVID-19 Response, Pan American Health Organization, Washington, DC USA
- Department of Health Emergencies, Pan American Health Organization, Washington, DC USA
| | | | - Thiago Costa Lisboa
- Critical Care Department, Hospital de Clinicas de Porto Alegre, PPG Ciencias Pneumologicas, Universidade Federal do Rio Grande do Sul, UFRGS, Porto Alegre, Brazil
| | - Sandra Liliana Valderrama-Beltrán
- Ph.D. Program in Clinical Epidemiology, Department of Clinical Epidemiology and Biostatistics, Faculty of Medicine, Pontificia Universidad Javeriana, Bogotá, Colombia
- Internal Medicine Department, Hospital Universitario San Ignacio, Pontificia Universidad Javeriana, Bogotá, Colombia
| | - Sylvain Aldighieri
- Incident Management System for the COVID-19 Response, Pan American Health Organization, Washington, DC USA
- Department of Health Emergencies, Pan American Health Organization, Washington, DC USA
| | - Ludovic Reveiz
- Knowledge Translation Program, Evidence and Intelligence for Action in Health Department, Pan American Health Organization, Washington, DC USA
- Incident Management System for the COVID-19 Response, Pan American Health Organization, Washington, DC USA
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Sahadeo NSD, Nicholls S, Moreira FRR, O’Toole Á, Ramkissoon V, Whittaker C, Hill V, McCrone JT, Mohammed N, Ramjag A, Brown Jordan A, Hill SC, Singh R, Nathaniel-Girdharrie SM, Hinds A, Ramkissoon N, Parag KV, Nandram N, Parasram R, Khan-Mohammed Z, Edghill L, Indar L, Andrewin A, Sealey-Thomas R, McMillan P, Oyinloye A, George K, Potter I, Lee J, Johnson D, Charles S, Singh N, Bisesor-McKenzie J, Laws H, Belmar-George S, Keizer-Beache S, Greenaway-Duberry S, Ashwood N, Foster JE, Georges K, Naidu R, Ivey M, Giddings S, Haraksingh R, Ramsubhag A, Jayaraman J, Chinnadurai C, Oura C, Pybus OG, St. John J, Gonzalez-Escobar G, Faria NR, Carrington CVF. Implementation of genomic surveillance of SARS-CoV-2 in the Caribbean: Lessons learned for sustainability in resource-limited settings. PLOS Glob Public Health 2023; 3:e0001455. [PMID: 36963002 PMCID: PMC10022082 DOI: 10.1371/journal.pgph.0001455] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/21/2022] [Accepted: 01/26/2023] [Indexed: 02/24/2023]
Abstract
The COVID-19 pandemic highlighted the importance of global genomic surveillance to monitor the emergence and spread of SARS-CoV-2 variants and inform public health decision-making. Until December 2020 there was minimal capacity for viral genomic surveillance in most Caribbean countries. To overcome this constraint, the COVID-19: Infectious disease Molecular epidemiology for PAthogen Control & Tracking (COVID-19 IMPACT) project was implemented to establish rapid SARS-CoV-2 whole genome nanopore sequencing at The University of the West Indies (UWI) in Trinidad and Tobago (T&T) and provide needed SARS-CoV-2 sequencing services for T&T and other Caribbean Public Health Agency Member States (CMS). Using the Oxford Nanopore Technologies MinION sequencing platform and ARTIC network sequencing protocols and bioinformatics pipeline, a total of 3610 SARS-CoV-2 positive RNA samples, received from 17 CMS, were sequenced in-situ during the period December 5th 2020 to December 31st 2021. Ninety-one Pango lineages, including those of five variants of concern (VOC), were identified. Genetic analysis revealed at least 260 introductions to the CMS from other global regions. For each of the 17 CMS, the percentage of reported COVID-19 cases sequenced by the COVID-19 IMPACT laboratory ranged from 0·02% to 3·80% (median = 1·12%). Sequences submitted to GISAID by our study represented 73·3% of all SARS-CoV-2 sequences from the 17 CMS available on the database up to December 31st 2021. Increased staffing, process and infrastructural improvement over the course of the project helped reduce turnaround times for reporting to originating institutions and sequence uploads to GISAID. Insights from our genomic surveillance network in the Caribbean region directly influenced non-pharmaceutical countermeasures in the CMS countries. However, limited availability of associated surveillance and clinical data made it challenging to contextualise the observed SARS-CoV-2 diversity and evolution, highlighting the need for development of infrastructure for collecting and integrating genomic sequencing data and sample-associated metadata.
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Affiliation(s)
- Nikita S. D. Sahadeo
- Department of Preclinical Sciences, Faculty of Medical Sciences, The University of the West Indies, St. Augustine, Republic of Trinidad and Tobago
| | - Soren Nicholls
- Department of Preclinical Sciences, Faculty of Medical Sciences, The University of the West Indies, St. Augustine, Republic of Trinidad and Tobago
| | - Filipe R. R. Moreira
- MRC Centre for Global Infectious Disease Analysis, Department for Infectious Disease Epidemiology, Imperial College London, London, United Kingdom
| | - Áine O’Toole
- Institute of Evolutionary Biology, University of Edinburgh, Edinburgh, United Kingdom
| | - Vernie Ramkissoon
- Department of Preclinical Sciences, Faculty of Medical Sciences, The University of the West Indies, St. Augustine, Republic of Trinidad and Tobago
| | - Charles Whittaker
- MRC Centre for Global Infectious Disease Analysis, Department for Infectious Disease Epidemiology, Imperial College London, London, United Kingdom
| | - Verity Hill
- Institute of Evolutionary Biology, University of Edinburgh, Edinburgh, United Kingdom
| | - John T. McCrone
- Institute of Evolutionary Biology, University of Edinburgh, Edinburgh, United Kingdom
| | - Nicholas Mohammed
- Department of Preclinical Sciences, Faculty of Medical Sciences, The University of the West Indies, St. Augustine, Republic of Trinidad and Tobago
| | - Anushka Ramjag
- Department of Preclinical Sciences, Faculty of Medical Sciences, The University of the West Indies, St. Augustine, Republic of Trinidad and Tobago
| | - Arianne Brown Jordan
- Department of Preclinical Sciences, Faculty of Medical Sciences, The University of the West Indies, St. Augustine, Republic of Trinidad and Tobago
| | - Sarah C. Hill
- Department of Zoology, University of Oxford, Oxford, United Kingdom
- Department of Pathobiology and Population Sciences, The Royal Veterinary College, London, United Kingdom
| | - Risha Singh
- Caribbean Public Health Agency (CARPHA), Headquartered in Port of Spain, Republic of Trinidad and Tobago
| | | | - Avery Hinds
- Ministry of Health, Port of Spain, Republic of Trinidad and Tobago
| | - Nuala Ramkissoon
- Ministry of Health, Port of Spain, Republic of Trinidad and Tobago
| | - Kris V. Parag
- MRC Centre for Global Infectious Disease Analysis, Department for Infectious Disease Epidemiology, Imperial College London, London, United Kingdom
| | - Naresh Nandram
- Ministry of Health, Port of Spain, Republic of Trinidad and Tobago
| | - Roshan Parasram
- Ministry of Health, Port of Spain, Republic of Trinidad and Tobago
| | | | - Lisa Edghill
- Caribbean Public Health Agency (CARPHA), Headquartered in Port of Spain, Republic of Trinidad and Tobago
| | - Lisa Indar
- Caribbean Public Health Agency (CARPHA), Headquartered in Port of Spain, Republic of Trinidad and Tobago
| | | | | | | | | | | | - Irad Potter
- Ministry of Health and Social Development, Road Town, Tortola, British Virgin Islands
| | - John Lee
- Ministry of Health and Wellness, George Town, Grand Cayman, Cayman Islands
| | - David Johnson
- Ministry of Health, Wellness and New Health Investment, Roseau, Dominica
| | | | | | | | - Hazel Laws
- Ministry of Health, Basseterre, Saint Kitts and Nevis
| | | | - Simone Keizer-Beache
- Ministry of Health, Wellness and the Environment, Kingstown, Saint Vincent and the Grenadines
| | | | - Nadia Ashwood
- Ministry of Health, Agriculture, Sports and Human Services, Grand Turk, Turks and Caicos Islands
| | - Jerome E. Foster
- Department of Preclinical Sciences, Faculty of Medical Sciences, The University of the West Indies, St. Augustine, Republic of Trinidad and Tobago
| | - Karla Georges
- School of Veterinary Medicine, Faculty of Medical Sciences, The University of the West Indies, St. Augustine, Republic of Trinidad and Tobago
| | - Rahul Naidu
- School of Dentistry, Faculty of Medical Sciences, The University of the West Indies, St. Augustine, Republic of Trinidad and Tobago
| | - Marsha Ivey
- Department of Clinical Medical Sciences, Faculty of Medical Sciences, The University of the West Indies, St. Augustine, Republic of Trinidad and Tobago
| | - Stanley Giddings
- Department of Clinical Medical Sciences, Faculty of Medical Sciences, The University of the West Indies, St. Augustine, Republic of Trinidad and Tobago
| | - Rajini Haraksingh
- Department of Life Sciences, Faculty of Sciences of Technology, The University of the West Indies, St. Augustine, Republic of Trinidad and Tobago
| | - Adesh Ramsubhag
- Department of Life Sciences, Faculty of Sciences of Technology, The University of the West Indies, St. Augustine, Republic of Trinidad and Tobago
| | - Jayaraj Jayaraman
- Department of Life Sciences, Faculty of Sciences of Technology, The University of the West Indies, St. Augustine, Republic of Trinidad and Tobago
| | - Chinnaraja Chinnadurai
- Department of Life Sciences, Faculty of Sciences of Technology, The University of the West Indies, St. Augustine, Republic of Trinidad and Tobago
| | - Christopher Oura
- School of Veterinary Medicine, Faculty of Medical Sciences, The University of the West Indies, St. Augustine, Republic of Trinidad and Tobago
| | - Oliver G. Pybus
- Department of Zoology, University of Oxford, Oxford, United Kingdom
- Department of Pathobiology and Population Sciences, The Royal Veterinary College, London, United Kingdom
| | - Joy St. John
- Caribbean Public Health Agency (CARPHA), Headquartered in Port of Spain, Republic of Trinidad and Tobago
| | - Gabriel Gonzalez-Escobar
- Caribbean Public Health Agency (CARPHA), Headquartered in Port of Spain, Republic of Trinidad and Tobago
| | - Nuno R. Faria
- MRC Centre for Global Infectious Disease Analysis, Department for Infectious Disease Epidemiology, Imperial College London, London, United Kingdom
- Departamento de Moléstias Infecciosas e Parasitárias e Instituto de Medicina Tropical da Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| | - Christine V. F. Carrington
- Department of Preclinical Sciences, Faculty of Medical Sciences, The University of the West Indies, St. Augustine, Republic of Trinidad and Tobago
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20
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Rodrigues LS, Pizato N, Carvalho KMB, Dutra ES, Botelho PB, Andrade LS, Moraes VD, Gonçalves VSS. Validation of a dietary advice protocol for adults with obesity in primary health care according to the Brazilian Dietary Guidelines. Fam Pract 2022:cmac132. [PMID: 36416351 DOI: 10.1093/fampra/cmac132] [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] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Obesity is a non-communicable chronic disease which carries a high cost for the Brazilian Unified Health System. Standardized protocols can help primary health care (PHC) professionals manage the disease. OBJECTIVES To describe the validation process of a protocol concerning dietary guidelines for adults with obesity in PHC by non-nutrition professionals. METHODS A validation study of a dietary advice protocol consisting of 6 recommendations was conducted according to Brazilian Dietary Guidelines. The topics incorporated into the recommendations were submitted to a panel of judges for content validity and achieved a Scale Content Validity Index (S-CVI) score >0.80. Subsequently, an online workshop was held and consisted of guiding questions to adequately improve current protocols. Face validity was assessed in a mediation workshop conducted with PHC non-nutrition professionals. Following the validation process, necessary adjustments were made to the eating protocol. RESULTS The validation process was conducted by a panel of 20 judges and 10 PHC professionals. The content was validated using a 0.98 S-CVI. The online workshop expert panel agreed the instrument provides a trustworthy foundation for appropriate dietary guidelines. Moreover, the judges suggested changes to the flowchart designed to support the professionals' decisions, discussed the absence of quantitative prescription guidelines, and offered additional suggestions to strengthen equity and encourage autonomy in non-nutrition healthcare professionals in PHC. CONCLUSION This study describes the validation process of a dietary advice protocol for people with obesity, as well as the importance of its integration into PHC.
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Affiliation(s)
| | - Nathalia Pizato
- Graduate Program in Human Nutrition, University of Brasilia, Brasilia, Brazil
| | - Kenia M B Carvalho
- Graduate Program in Public Health, University of Brasilia, Brasilia, Brazil
- Graduate Program in Human Nutrition, University of Brasilia, Brasilia, Brazil
| | - Eliane S Dutra
- Graduate Program in Human Nutrition, University of Brasilia, Brasilia, Brazil
| | - Patrícia B Botelho
- Graduate Program in Human Nutrition, University of Brasilia, Brasilia, Brazil
| | - Laila S Andrade
- Nutrition and Health Research Group-PENSA/UnB, University of Brasilia, Brasilia, Brazil
| | - Verena D Moraes
- Laboratory of Regional Endemic Situations, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
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21
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Braule Pinto ALDC, Guatimosim RF, Loureiro FF, Serpa ALDO, Costa DS, Diaz AP, Joaquim RM, Baldaçara LR, Alves Maria GDS, da Silva AG, de Miranda DM, Malloy-Diniz LF. Longitudinal invariance and validity of the Impact of Event Scale-Revised under COVID-19 pandemic in a Brazilian sample. Psychol Assess 2022; 34:791-802. [PMID: 35708924 DOI: 10.1037/pas0001152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Although the Impact Event Scale-Revised is widely used, its factor structure is still controversial. In addition, its longitudinal measurement invariance (LMI) remains uninvestigated. In this sense, we carried out three studies to investigate its psychometric properties. In Study 1, we evaluated the factorial structure of the scale comparing the different models existing in the literature in Brazilian samples who responded to the instrument during the COVID-19 pandemic. In Study 2, we provide support for a five-factor model throughout convergent validity with psychological distress and sleep problems, and criterion validity between people with diagnostic of mental disorders. Finally, we evaluated the LMI over a 6-month interval. The results indicated that the five-factor model has excellent goodness of fit and holds strict longitudinal invariance. Additionally, internal consistency and stability coefficients indicate that the scale is appropriate to measure posttraumatic stress symptomatology) in nonclinical samples across multiple assessments. (PsycInfo Database Record (c) 2022 APA, all rights reserved).
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Affiliation(s)
| | - Rafaela Ferreira Guatimosim
- Instituto de Saude Mental Baseada em Evidencias (SAMBE), Department of Mental Health, Universidade Federal de Minas Gerais
| | - Fabiano Franca Loureiro
- Instituto de Saude Mental Baseada em Evidencias (SAMBE), Department of Mental Health, Universidade Federal de Minas Gerais
| | | | - Danielle Souza Costa
- Instituto de Saude Mental Baseada em Evidencias (SAMBE), Department of Mental Health, Universidade Federal de Minas Gerais
| | - Alexandre Paim Diaz
- Instituto de Saude Mental Baseada em Evidencias (SAMBE), Department of Mental Health, Universidade Federal de Minas Gerais
| | - Rui Mateus Joaquim
- Instituto de Saude Mental Baseada em Evidencias (SAMBE), Department of Mental Health, Universidade Federal de Minas Gerais
| | - Leonardo Rodrigo Baldaçara
- Instituto de Saude Mental Baseada em Evidencias (SAMBE), Department of Mental Health, Universidade Federal de Minas Gerais
| | - Gustavo Dos Santos Alves Maria
- Instituto de Saude Mental Baseada em Evidencias (SAMBE), Department of Mental Health, Universidade Federal de Minas Gerais
| | - Antônio Geraldo da Silva
- Instituto de Saude Mental Baseada em Evidencias (SAMBE), Department of Mental Health, Universidade Federal de Minas Gerais
| | - Débora Marques de Miranda
- Instituto de Saude Mental Baseada em Evidencias (SAMBE), Department of Mental Health, Universidade Federal de Minas Gerais
| | - Leandro Fernandes Malloy-Diniz
- Instituto de Saude Mental Baseada em Evidencias (SAMBE), Department of Mental Health, Universidade Federal de Minas Gerais
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22
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Grijalva MJ, Moncayo AL, Yumiseva CA, Ocaña-Mayorga S, Baus EG, Villacís AG. Evaluation of Selective Deltamethrin Application with Household and Community Awareness for the Control of Chagas Disease in Southern Ecuador. J Med Entomol 2022; 59:1421-1433. [PMID: 35604412 PMCID: PMC9278838 DOI: 10.1093/jme/tjac050] [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] [Subscribe] [Scholar Register] [Received: 10/03/2021] [Indexed: 05/25/2023]
Abstract
Chagas disease is endemic in ~70% of Ecuador. Rhodnius ecuadoriensis and Triatoma carrioni (Hemiptera: Reduviidae) are the primary vectors of Chagas disease in Southern Ecuador. This study tested the effectiveness of selective deltamethrin application of Domiciliary Units (DUs) infested with triatomines, coupled with community education activities and a community-based surveillance system. Ten communities were selected in Loja Province, 466 DUs were examined, of these, 5.6% were infested with R. ecuadoriensis (Density [D] = 4 triatomines/DUs searched, Crowding [CR] = 71 triatomines/infested house, Colonization Index [CI] = 77% infested DUs with nymphs) and 8% with T. carrioni (D = 0.6, CR = 7, CI = 64%). Infested DUs were sprayed with deltamethrin. Subsequent visits were conducted at 6 and 12 mo after spraying. At each time point, new entomological searches were carried out in all DUs. All entomological indexes dropped significantly for the primary vector species one year after the initial intervention (R. ecuadoriensis: I = 2%, D = 0.1, CR = 7, CI = 100%; T. carrioni: I = 1.6%, D = 0.1, CR = 5.5, CI = 50%). Fifteen min educational talks were conducted in every DUs and workshops for schoolchildren were organized. Community-based surveillance system was established. However, there is a high risk of DUs reinfestation, possibly from sylvatic habitats (especially of R. ecuadoriensis) and reinforcing educational and surveillance activities are necessary.
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Affiliation(s)
- Mario J Grijalva
- Centro de Investigación para la Salud en América Latina, Escuela de Ciencias Biológicas, Facultad de Ciencias Exactas y Naturales, Pontificia Universidad Católica del Ecuador, Quito, Ecuador
- Infectious and Tropical Disease Institute, Department of Biomedical Sciences, Heritage College of Osteopathic Medicine, Ohio University, Athens, OH, USA
| | - Ana L Moncayo
- Centro de Investigación para la Salud en América Latina, Escuela de Ciencias Biológicas, Facultad de Ciencias Exactas y Naturales, Pontificia Universidad Católica del Ecuador, Quito, Ecuador
| | - Cesar A Yumiseva
- Centro de Investigación para la Salud en América Latina, Escuela de Ciencias Biológicas, Facultad de Ciencias Exactas y Naturales, Pontificia Universidad Católica del Ecuador, Quito, Ecuador
| | - Sofia Ocaña-Mayorga
- Centro de Investigación para la Salud en América Latina, Escuela de Ciencias Biológicas, Facultad de Ciencias Exactas y Naturales, Pontificia Universidad Católica del Ecuador, Quito, Ecuador
- Infectious and Tropical Disease Institute, Department of Biomedical Sciences, Heritage College of Osteopathic Medicine, Ohio University, Athens, OH, USA
| | - Esteban G Baus
- Centro de Investigación para la Salud en América Latina, Escuela de Ciencias Biológicas, Facultad de Ciencias Exactas y Naturales, Pontificia Universidad Católica del Ecuador, Quito, Ecuador
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Saboyá-Díaz MI, Carey Angeles CA, Avellaneda Yajahuanca RDS, Meléndez Ruíz SK, Cabrera R, Honorio Morales HA, Pachas PE, Guardo M, Renneker KK, Muñoz BE, West SK. Associated factors of the co-occurrence of trachoma and soil-transmitted helminthiases in children 1 to 9 years old in rural communities of the Amazon basin in Loreto Department, Peru: Results from a population-based survey. PLoS Negl Trop Dis 2022; 16:e0010532. [PMID: 35877683 PMCID: PMC9312473 DOI: 10.1371/journal.pntd.0010532] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Accepted: 05/24/2022] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND There is evidence of the occurrence of trachoma in Peru, and studies have shown that soil-transmitted helminthiases (STH) are affecting rural communities in the Amazon basin in Loreto Department. This study was done to estimate trachoma prevalence, STH prevalence, and the associated factors for both diseases in children aged 1-9 years in rural communities of Peru. METHODOLOGY A population-based cross-sectional survey was carried out in rural communities of Loreto. A standardized survey questionnaire with individual and household risk factors related to both diseases was used. Ocular examination was done for all participants aged one year and above, and eye swab samples were collected from children with follicular trachoma (TF). Anthropometric measurements, stool samples for STH, and blood samples for hemoglobin measurement were taken from children. PRINCIPAL FINDINGS TF prevalence was 7.74% (95% CI 5.08-11.63%), STH prevalence was 49.49% (95% CI 25.00-52.43%), and prevalence of co-occurrence of both diseases was 5.06% (95% CI 2.80-8.98%) in children aged 1-9 years. Being at age 3-8 years old (AOR = 6.76; 95% CI 1.346-33.947), have an unclean face (AOR = 24.64; 95% CI 6.787-89.444), and having been dewormed in the last six months (AOR = 2.47; 95% CI 1.106-5.514), were risk factors of TF. Being a female (AOR = 0.22; 95% CI 0.103-0.457) was associated with decreased odds of TF. Having been dewormed in the last six months (AOR = 0.30; 95% CI 0.139-0.628) was a preventative factor for STH. Risk factors for children with both diseases mirrored the findings for risk factors for individual diseases. CONCLUSIONS Neglected tropical diseases and associated risk factors overlap in communities living in vulnerable conditions in the Amazon basin of Peru. These findings support the need to implement integrated interventions, including mass drug administration, water, sanitation, and hygiene for both diseases in the study area.
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Affiliation(s)
- Martha Idalí Saboyá-Díaz
- Communicable Diseases and Environmental Determinants of Health Department, Pan American Health Organization, Washington, District of Columbia, United States of America
| | | | | | | | | | | | - Paul E. Pachas
- National Center of Public Health, National Institute of Health of Peru, Lima, Peru
| | - Monica Guardo
- Health Surveillance, Disease Prevention, and Control, Pan American Health Organization, Guatemala City, Guatemala
| | - Kristen K. Renneker
- International Trachoma Initiative, The Task Force for Global Health, Decatur, Georgia, United States of America
| | - Beatriz E. Muñoz
- Dana Center for Preventive Ophthalmology, Wilmer Eye Institute, Johns Hopkins University, Baltimore, Maryland, United States of America
| | - Sheila K. West
- Dana Center for Preventive Ophthalmology, Wilmer Eye Institute, Johns Hopkins University, Baltimore, Maryland, United States of America
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24
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Benavides JA, Raghavan RK, Boere V, Rocha S, Wada MY, Vargas A, Voietta F, de Oliveira e Silva I, Leal S, de Castro A, Arruda MDF, Peterson AT, Megid J, Carrieri ML, Kotait I. Spatio-temporal dynamics of rabies and habitat suitability of the common marmoset Callithrix jacchus in Brazil. PLoS Negl Trop Dis 2022; 16:e0010254. [PMID: 35358179 PMCID: PMC8970506 DOI: 10.1371/journal.pntd.0010254] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Accepted: 02/11/2022] [Indexed: 11/18/2022] Open
Abstract
Rabies transmitted by wildlife is now the main source of human rabies in the Americas. The common marmoset, Callithrix jacchus, is considered a reservoir of rabies causing sporadic and unpredictable human deaths in Brazil, but the extent of the spillover risk to humans remains unknown. In this study, we described the spatiotemporal dynamics of rabies affecting C. jacchus reported to Brazil’s Ministry of Health passive surveillance system between 2008 and 2020, and combined ecological niche modelling with C. jacchus occurrence data to predict its suitable habitat. Our results show that 67 outbreaks (91 cases) of rabies affecting C. jacchus were reported by 41 municipalities between January 2008 and October 2020, with a mean of 5 outbreaks/year [range: 1–14]. The maximum number of outbreaks and municipalities reporting cases occurred in 2018, coinciding with higher surveillance of primate deaths due to Yellow Fever. A mean of 3 [1–9] new municipalities reported outbreaks yearly, suggesting potential spatial expansions of the C. jacchus variant in northeastern Brazil and emerging rabies spillover from vampire bat Desmodus rotundus to C. jacchus in the north and south. Outbreaks were concentrated in the states of Ceará (72%) and Pernambuco (16%) up to 2012, but are now reported in Piauí since 2013, in Bahia since 2017 (D. rotundus’ antigenic variant, AgV3) and in Rio de Janeiro since 2019 (AgV3). Besides confirming suitable habitat for this primate in the northeast and the east coast of Brazil, our Maximum Entropy model also predicted suitable habitat on the north and the west states of the country but predicted low habitat suitability among inland municipalities of the Caatinga biome reporting rabies. Our findings revealed new areas reporting rabies infecting C. jacchus, highlighting the need to implement strategies limiting spillover to humans and to better understand the drivers of C. jacchus rabies dynamics. Rabies virus is the deadliest virus affecting mammals. In Brazil, rabies transmitted by the common marmoset primate is emerging and causing unpredictable human deaths. This primate once endemic to the northeast of the country has now invaded regions in the south throughout human-mediated introductions. However, the dynamics of rabies in this primate and the extend of spillover risk to humans remain unknown. We found that outbreaks of rabies in this marmoset reported to the Ministry of Health are continuously reported in new areas, including three new states since 2012 and three states reporting rabies originated from the common vampire bat. We also showed that this primate has suitable habitat to invade other states in the north and west of Brazil. Preventive strategies should be implemented to limit further rabies spillover to humans in new areas.
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Affiliation(s)
- Julio A. Benavides
- Doctorado en Medicina de la Conservación y Centro de Investigación para la Sustentabilidad, Facultad de Ciencias de la Vida, Universidad Andres Bello, República 440 Santiago, Chile
- MIVEGEC, IRD, CNRS, Université de Montpellier, Montpellier, France
- Departamento Higiene Veterinária e Saúde Pública, Faculdade de Medicina Veterinária e Zootecnia, Universidade Estadual Júlio de Mesquita Filho, Botucatu, Brazil
- * E-mail:
| | - Ram K. Raghavan
- Department of Veterinary Pathobiology, College of Veterinary Medicine, University of Missouri, Columbia, Missouri, United States of America
- Department of Public Health, School of Health Professions, University of Missouri, Columbia, Missouri, United States of America
| | - Vanner Boere
- Institute of Humanities, Arts and Sciences, Federal University of Southern Bahia -UFSB, Itabuna, Brazil
| | - Silene Rocha
- Secretaria de Vigilância em Saúde (SVS), Ministério da Saúde, Brasilia, Brazil
| | - Marcelo Y. Wada
- Secretaria de Vigilância em Saúde (SVS), Ministério da Saúde, Brasilia, Brazil
| | - Alexander Vargas
- Secretaria de Vigilância em Saúde (SVS), Ministério da Saúde, Brasilia, Brazil
| | - Fernanda Voietta
- Secretaria de Vigilância em Saúde (SVS), Ministério da Saúde, Brasilia, Brazil
| | - Ita de Oliveira e Silva
- Institute of Humanities, Arts and Sciences, Federal University of Southern Bahia -UFSB, Itabuna, Brazil
| | - Silvana Leal
- Secretaria de saúde de Pernambuco, Recife, Brazil
| | - Alene de Castro
- Programa Estadual de Vigilância de Epizootia, Secretaria de saúde de Rio Grande do Norte, Natal, Brazil
| | - Maria de Fatima Arruda
- Setor de Psicobiologia, Departamento de Fisiología Universidade Federal do Río Grande do Norte, Natal, Brazil
| | - A. Townsend Peterson
- Biodiversity Institute, University of Kansas, Lawrence, Kansas, United States of America
| | - Jane Megid
- Departamento Higiene Veterinária e Saúde Pública, Faculdade de Medicina Veterinária e Zootecnia, Universidade Estadual Júlio de Mesquita Filho, Botucatu, Brazil
| | | | - Ivanete Kotait
- Retired Researcher, Instituto Biológico, São Paulo, Brazil
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Lopes FT, de Sousa RS, Carvalho Gomes JL, Vallinoto MC, de Lima ACR, Lima SS, Freitas FB, Feitosa RNM, Rangel da Silva ANM, Machado LFA, Aben-Athar CYP, Maia da Silva EL, Cayres Vallinoto IMV, Vallinoto ACR. The Relevance of a Diagnostic and Counseling Service for People Living With HTLV-1/2 in a Metropolis of the Brazilian Amazon. Front Public Health 2022; 10:864861. [PMID: 35419336 PMCID: PMC8995423 DOI: 10.3389/fpubh.2022.864861] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Accepted: 02/16/2022] [Indexed: 11/13/2022] Open
Abstract
Introduction To identify the prevalence of infection in the urban area of the capital city of Belém, Brazil, the Laboratory of Virology of the Federal University of Pará implemented, as a public service, serological screening for human T-lymphotropic viruses 1 and 2 (HTLV-1/2) infection and, if necessary, counseling service and referral to specialized medical care. The project is funded by the National Council of Science and Technology, the Ministry of Health of Brazil and the Pan American Health Organization. Methods From January 2020 to June 2021, 1,572 individuals of both sexes were approached to answer a questionnaire and were tested using an enzyme immunoassay (Murex HTLV-I+II, DiaSorin, Dartford, UK). Seropositive samples were confirmed as HTLV-1 and HTLV-2 infection by line immunoassay (INNO-LIA® HTLV I/II Score, Fujirebio, Japan) and/or by real-time polymerase chain reaction. G and Fisher's exact tests were applied to identify the association between epidemiological characteristics and HTLV-1/2 infection. Results Of the 1,572 screened individuals, 63.74% were females between the ages of 30 and 59 years (49.04%). Infection was confirmed in six individuals (0.38%), among whom three (0.19%) were infected with HTLV-1 and three with HTLV-2 (0.19%). Blood transfusion before 1993 was the main risk factor associated with the route of exposure to the virus (p = 0.0442). The infected individuals were referred to a counseling session with a nursing professional, and two patients who manifested signs and symptoms suggestive of myelopathy associated with HTLV were referred to a neurologist. Conclusion The implementation of the screening service revealed the occurrence of moderate endemicity of HTLV-1/2 in Belém, reinforcing the importance of continuing the service as a means of establishing an early diagnosis and providing counseling as a measure to prevent and control viral transmission in the general population.
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Affiliation(s)
- Felipe Teixeira Lopes
- Laboratory of Virology, Institute of Biological Sciences, Federal University of Pará, Belém, Brazil
| | - Renata Santos de Sousa
- Laboratory of Virology, Institute of Biological Sciences, Federal University of Pará, Belém, Brazil
| | | | - Mariana Cayres Vallinoto
- Laboratory of Virology, Institute of Biological Sciences, Federal University of Pará, Belém, Brazil
| | - Aline Cecy Rocha de Lima
- Laboratory of Virology, Institute of Biological Sciences, Federal University of Pará, Belém, Brazil
| | - Sandra Souza Lima
- Laboratory of Virology, Institute of Biological Sciences, Federal University of Pará, Belém, Brazil
| | | | | | | | - Luiz Fernando A. Machado
- Laboratory of Virology, Institute of Biological Sciences, Federal University of Pará, Belém, Brazil
| | - Cintia Y. P. Aben-Athar
- Laboratory of Virology, Institute of Biological Sciences, Federal University of Pará, Belém, Brazil
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Servadio JL, Muñoz-Zanzi C, Convertino M. Environmental determinants predicting population vulnerability to high yellow fever incidence. R Soc Open Sci 2022; 9:220086. [PMID: 35316947 PMCID: PMC8889195 DOI: 10.1098/rsos.220086] [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] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/22/2022] [Accepted: 02/07/2022] [Indexed: 06/14/2023]
Abstract
Yellow fever (YF) is an endemic mosquito-borne disease in Brazil, though many locations have not observed cases in recent decades. Some locations with low disease burden may resemble locations with higher disease burden through environmental and ecohydrological characteristics, which are known to impact YF burden, motivating increased or continued prevention measures such as vaccination, mosquito control or surveillance. This study aimed to use environmental characteristics to estimate vulnerability to observing high YF burden among all Brazilian municipalities. Vulnerability was defined in three categories based on yearly incidence between 2000 and 2017: minimal, low and high vulnerability. A cumulative logit model was fit to these categories using environmental and ecohydrological predictors, selecting those that provided the most accurate model fit. Per cent of days with precipitation, mean temperature, biome, population density, elevation, vegetation and nearby disease occurrence were included in best-fitting models. Model results were applied to estimate vulnerability nationwide. Municipalities with highest probability of observing high vulnerability was found in the North and Central-West (2000-2016) as well as the Southeast (2017) regions. Results of this study serve to identify specific locations to prioritize new or ongoing surveillance and prevention of YF based on underlying ecohydrological conditions.
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Affiliation(s)
- Joseph L. Servadio
- Division of Environmental Health Sciences, School of Public Health, University of Minnesota, Minneapolis, MN, USA
- Center for Infectious Disease Dynamics and Department of Biology, Pennsylvania State University, University Park, PA, USA
| | - Claudia Muñoz-Zanzi
- Division of Environmental Health Sciences, School of Public Health, University of Minnesota, Minneapolis, MN, USA
| | - Matteo Convertino
- Future Ecosystems Lab, Tsinghua SIGS, Tsinghua University, Shenzhen, People's Republic of China
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da Silva Carvalho VK, da Silva EN, Barreto JOM. Public engagement in health technology assessment in Brazil: the case of the public consultation on National Clinical Guidelines for Care in Normal Birth. BMC Public Health 2021; 21:1825. [PMID: 34627182 PMCID: PMC8502292 DOI: 10.1186/s12889-021-11855-w] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Accepted: 09/24/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND There is a growing body of literature that recognizes the importance of public engagement in health technology assessment. However, there is still uncertainty regarding how the results should be recorded, analyzed, and used by decision makers. OBJECTIVE Synthesize the contributions of the Brazilian public (women, health professionals, managers, educational institutions, and companies) about the implementation of the National Clinical Guidelines for Care in Normal Birth from the public consultation carried out in Brazil. METHOD IRaMuTeQ software was used to organize and summarize the corpus based on three types of analysis: descriptive statistics; descending hierarchical classification; and specificities analysis. The public consultation was conducted in 2016 by the National Committee for Health Technology Incorporation (CONITEC) in the Brazilian public health system as part of the guideline development process. RESULTS The corpus consisted of 303 texts, separated into 1233 text segments, 1081 of which were used, corresponding to retention of 87.67%. Five classes emerged from our analyses: mandatory presence of an obstetrician during labor and delivery in hospital settings; barriers and facilitators for guideline implementation; use of evidence-based practices by health professionals; progression of labor and delivery and women's rights; and mobilization to promote the guideline For each class, the most frequent words and sentences with the highest chi-squared scores were presented. Barriers were associated with lack of financial resources, training and professional motivation, and facilitators with training to change the practices of health professionals. Obstetric nurses emerged as an alternative for supervising normal births as well as the mandatory presence of an obstetrician during childbirth in hospital settings. CONCLUSION Our findings summarize the contributions provided by the Brazilian public and shed some light on the barriers and facilitators of clinical guidelines for care in normal birth. These topics are not typically explored by quantitative studies. Including this information in the decision-making process would not only increase public engagement, but provide greater evidence for implementing the clinical guidelines nationwide.
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Sanhueza A, Carvajal-Vélez L, Mújica OJ, Vidaletti LP, Victora CG, Barros AJ. SDG3-related inequalities in women's, children's and adolescents' health: an SDG monitoring baseline for Latin America and the Caribbean using national cross-sectional surveys. BMJ Open 2021; 11:e047779. [PMID: 34413102 PMCID: PMC8378377 DOI: 10.1136/bmjopen-2020-047779] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
OBJECTIVES Latin America and the Caribbean (LAC) countries have made important progress towards achieving the Sustainable Development Goal (SDG) targets related to health (SDG3) at the national level. However, vast within-country health inequalities remain. We present a baseline of health inequalities in the region, against which progress towards the SDGs can be monitored. SETTING We studied 21 countries in LAC using data from Demographic and Health Surveys and Multiple Indicator Cluster Survey carried out from 2011 to 2016 PARTICIPANTS: The surveys collect nationally representative data on women and children using multistage sampling. In total, 288 207 women and 195 092 children made part of the surveys in the 21 countries. OUTCOME MEASURES Five health intervention indicators were studied, related to reproductive and maternal health, along with adolescent fertility and neonatal and under-five mortality rates. Inequalities in these indicators were assessed through absolute and relative measures. RESULTS In most countries, subnational geographical health gradients were observed for nearly all women, child, and adolescent (WCA) indicators. Coverage of key interventions was higher in urban areas and among the richest, compared with rural areas and poorer quintiles. Analyses by woman's age showed that coverage was lower in adolescent girls than older women for family planning indicators. Pro-urban and pro-rich inequalities were also seen for mortality in most countries. CONCLUSIONS Regional averages hide important health inequalities between countries, but national estimates hide still greater inequalities between subgroups of women, children and adolescents. To achieve the SDG3 targets and leave no one behind, it is essential to close health inequality gaps within as well as between countries.
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Affiliation(s)
- Antonio Sanhueza
- Evidence and Intelligence for Action in Health, Pan American Health Organization, PAHO/WHO, Washington, DC, USA
| | - Liliana Carvajal-Vélez
- Data, Research and Policy, United Nations Children's Fund (UNICEF), New York, New York, USA
| | - Oscar J Mújica
- Evidence and Intelligence for Action in Health, Pan American Health Organization, PAHO/WHO, Washington, DC, USA
| | - Luis Paulo Vidaletti
- International Center for Equity in Health, Federal University of Pelotas, Pelotas, Brazil
| | - Cesar G Victora
- International Center for Equity in Health, Federal University of Pelotas, Pelotas, Brazil
| | - Aluisio Jd Barros
- International Center for Equity in Health, Federal University of Pelotas, Pelotas, Brazil
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Magnago C, Pierantoni CR. Situational analysis and reflections on the introduction of advanced practice nurses in Brazilian primary healthcare. Hum Resour Health 2021; 19:90. [PMID: 34294088 PMCID: PMC8296671 DOI: 10.1186/s12960-021-00632-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Accepted: 07/09/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND The shortage of doctors and their unequal distribution serve as challenges to advancing primary healthcare (PHC) and achieving effective universal healthcare coverage in Brazil. In an effort to use nurses' potential more efficiently, the country is investigating the introduction of the advanced practice nurse (APN) into PHC. This paper presents a situational analysis of the practices of Brazilian nurses based on the following components: regulation, practice, and education. METHODS This is a national multi-method study with triangulated data from a documentary study, a scoping review, and an exploratory study. The regulation component involved the analysis of official normative documents on the regulation of nursing education and nurses' scope of practice. The practice component aimed to identify the practices performed by nurses in Brazilian PHC based on primary studies. The education component intended to identify the practices taught in nursing training based on a survey and interviews with directors of undergraduate nursing programs. RESULTS Federal legislation in Brazil authorizes nursing graduates to perform a set of advanced practices as part of the PHC nurse's daily routine. They can request and interpret complementary tests and prescribe medication. However, in the local context, municipalities define the scope of this assistance based on technical norms or nursing protocols. Furthermore, this study indicates that undergraduate nursing programs do not fully prepare students to adequately execute these tasks. CONCLUSIONS In the context of Brazilian PHC, advanced practices have already been implemented and respond to main healthcare demands. Therefore, it is unnecessary to introduce the APN as a new professional category. Upon detecting deficiencies in the training process, the current education model should undergo reforms that seek to incorporate the skills compatible with the regulated advanced practices and in-service training for practicing nurses. Regarding the introduction of APN along international lines, this article presents recommendations that may support the operationalization of a Brazilian APN model.
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Affiliation(s)
- Carinne Magnago
- Department of Policy, Management and Health, School of Public Health, University of São Paulo (FSP/USP), Av. Dr. Arnaldo, 715, São Paulo, SP, 01246-904, Brazil.
| | - Celia Regina Pierantoni
- Institute of Social Medicine, Rio de Janeiro State University (IMS/Uerj), Rio de Janeiro, Brazil
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30
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Costa ÉA, Giovanetti M, Silva Catenacci L, Fonseca V, Aburjaile FF, Chalhoub FLL, Xavier J, Campos de Melo Iani F, da Cunha e Silva Vieira MA, Freitas Henriques D, Medeiros DBDA, Guedes MIMC, Senra Álvares da Silva Santos B, Gonçalves Silva AS, de Pino Albuquerque Maranhão R, da Costa Faria NR, Farinelli de Siqueira R, de Oliveira T, Ribeiro Leite Jardim Cavalcante K, Oliveira de Moura NF, Pecego Martins Romano A, Campelo de Albuquerque CF, Soares Feitosa LC, Martins Bayeux JJ, Bertoni Cavalcanti Teixeira R, Lisboa Lobato O, da Costa Silva S, Bispo de Filippis AM, Venâncio da Cunha R, Lourenço J, Alcantara LCJ. West Nile Virus in Brazil. Pathogens 2021; 10:896. [PMID: 34358046 PMCID: PMC8308589 DOI: 10.3390/pathogens10070896] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Revised: 05/20/2021] [Accepted: 05/21/2021] [Indexed: 01/04/2023] Open
Abstract
Background: West Nile virus (WNV) was first sequenced in Brazil in 2019, when it was isolated from a horse in the Espírito Santo state. Despite multiple studies reporting serological evidence suggestive of past circulation since 2004, WNV remains a low priority for surveillance and public health, such that much is still unknown about its genomic diversity, evolution, and transmission in the country. Methods: A combination of diagnostic assays, nanopore sequencing, phylogenetic inference, and epidemiological modeling are here used to provide a holistic overview of what is known about WNV in Brazil. Results: We report new genetic evidence of WNV circulation in southern (Minas Gerais, São Paulo) and northeastern (Piauí) states isolated from equine red blood cells. A novel, climate-informed theoretical perspective of the potential transmission of WNV across the country highlights the state of Piauí as particularly relevant for WNV epidemiology in Brazil, although it does not reject possible circulation in other states. Conclusion: Our output demonstrates the scarceness of existing data, and that although there is sufficient evidence for the circulation and persistence of the virus, much is still unknown on its local evolution, epidemiology, and activity. We advocate for a shift to active surveillance, to ensure adequate preparedness for future epidemics with spill-over potential to humans.
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Affiliation(s)
- Érica Azevedo Costa
- Departamento de Medicina Veterinária Preventiva, Universidade Federal de Minas Gerais, Belo Horizonte 31270-901, Brazil; (É.A.C.); (M.I.M.C.G.); (B.S.Á.d.S.S.); (A.S.G.S.)
| | - Marta Giovanetti
- Laboratório de Flavivírus, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro 21040-360, Brazil; (M.G.); (F.L.L.C.); (N.R.d.C.F.); (A.M.B.d.F.)
- Laboratório de Genética Celular e Molecular, Universidade Federal de Minas Gerais, Belo Horizonte 31270-901, Brazil; (V.F.); (F.F.A.); (J.X.)
| | - Lilian Silva Catenacci
- Departamento De Morfofisiologia Veterinária, Universidade Federal do Piauí, Teresina 64049-550, Brazil;
| | - Vagner Fonseca
- Laboratório de Genética Celular e Molecular, Universidade Federal de Minas Gerais, Belo Horizonte 31270-901, Brazil; (V.F.); (F.F.A.); (J.X.)
- KwaZulu-Natal Research Innovation and Sequencing Platform (KRISP), School of Laboratory Medicine and Medical Sciences, College of Health Sciences, University of KwaZulu-Natal, Durban 4041, South Africa;
- Coordenação Geral dos Laboratórios de Saúde Pública/Secretaria de Vigilância em Saúde, Ministério da Saúde (CGLAB/SVS-MS), Brasília 70719-040, Brazil
| | - Flávia Figueira Aburjaile
- Laboratório de Genética Celular e Molecular, Universidade Federal de Minas Gerais, Belo Horizonte 31270-901, Brazil; (V.F.); (F.F.A.); (J.X.)
| | - Flávia L. L. Chalhoub
- Laboratório de Flavivírus, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro 21040-360, Brazil; (M.G.); (F.L.L.C.); (N.R.d.C.F.); (A.M.B.d.F.)
| | - Joilson Xavier
- Laboratório de Genética Celular e Molecular, Universidade Federal de Minas Gerais, Belo Horizonte 31270-901, Brazil; (V.F.); (F.F.A.); (J.X.)
| | | | | | - Danielle Freitas Henriques
- Seção de Arbovirologia e Febres Hemorrágicas, Instituto Evandro Chagas, Ministério da Saúde, Ananindeua 70058-900, Brazil; (D.F.H.); (D.B.d.A.M.)
| | - Daniele Barbosa de Almeida Medeiros
- Seção de Arbovirologia e Febres Hemorrágicas, Instituto Evandro Chagas, Ministério da Saúde, Ananindeua 70058-900, Brazil; (D.F.H.); (D.B.d.A.M.)
| | - Maria Isabel Maldonado Coelho Guedes
- Departamento de Medicina Veterinária Preventiva, Universidade Federal de Minas Gerais, Belo Horizonte 31270-901, Brazil; (É.A.C.); (M.I.M.C.G.); (B.S.Á.d.S.S.); (A.S.G.S.)
| | - Beatriz Senra Álvares da Silva Santos
- Departamento de Medicina Veterinária Preventiva, Universidade Federal de Minas Gerais, Belo Horizonte 31270-901, Brazil; (É.A.C.); (M.I.M.C.G.); (B.S.Á.d.S.S.); (A.S.G.S.)
| | - Aila Solimar Gonçalves Silva
- Departamento de Medicina Veterinária Preventiva, Universidade Federal de Minas Gerais, Belo Horizonte 31270-901, Brazil; (É.A.C.); (M.I.M.C.G.); (B.S.Á.d.S.S.); (A.S.G.S.)
| | - Renata de Pino Albuquerque Maranhão
- Setor de Clínica de Equinos, Hospital Veterinário, Campus Pampulha, Universidade Federal de Minas Gerais Escola de Veterinária, Belo Horizonte 31270-901, Brazil;
| | - Nieli Rodrigues da Costa Faria
- Laboratório de Flavivírus, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro 21040-360, Brazil; (M.G.); (F.L.L.C.); (N.R.d.C.F.); (A.M.B.d.F.)
| | | | - Tulio de Oliveira
- KwaZulu-Natal Research Innovation and Sequencing Platform (KRISP), School of Laboratory Medicine and Medical Sciences, College of Health Sciences, University of KwaZulu-Natal, Durban 4041, South Africa;
| | - Karina Ribeiro Leite Jardim Cavalcante
- Coordenacao Geral das Arboviroses, Secretaria de Vigilância em Saúde/Ministério da Saúde, Brasília 70058-900, Brazil; (K.R.L.J.C.); (N.F.O.d.M.); (A.P.M.R.)
| | - Noely Fabiana Oliveira de Moura
- Coordenacao Geral das Arboviroses, Secretaria de Vigilância em Saúde/Ministério da Saúde, Brasília 70058-900, Brazil; (K.R.L.J.C.); (N.F.O.d.M.); (A.P.M.R.)
| | - Alessandro Pecego Martins Romano
- Coordenacao Geral das Arboviroses, Secretaria de Vigilância em Saúde/Ministério da Saúde, Brasília 70058-900, Brazil; (K.R.L.J.C.); (N.F.O.d.M.); (A.P.M.R.)
| | | | - Lauro César Soares Feitosa
- Centro de Ciências Agrárias, Departamento de Clínica e Cirurgia Veterinária, Universidade Federal do Piauí, Teresina 64049-550, Brazil;
| | - José Joffre Martins Bayeux
- Faculdade de Ciências da Saúde, Medicina Veterinária, Urbanova, São José Dos Campos, UNIVAP-Universidade Vale do Paraíba, São Paulo 12245-720, Brazil;
| | | | - Osmaikon Lisboa Lobato
- Laboratório de Genética e Conservação de Germoplasma, Campus Prof. Cinobelina Elvas, Universidade Federal do Piauí, Bom Jesus, Piauí 64049-550, Brazil; (O.L.L.); (S.d.C.S.)
| | - Silvokleio da Costa Silva
- Laboratório de Genética e Conservação de Germoplasma, Campus Prof. Cinobelina Elvas, Universidade Federal do Piauí, Bom Jesus, Piauí 64049-550, Brazil; (O.L.L.); (S.d.C.S.)
| | - Ana Maria Bispo de Filippis
- Laboratório de Flavivírus, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro 21040-360, Brazil; (M.G.); (F.L.L.C.); (N.R.d.C.F.); (A.M.B.d.F.)
| | - Rivaldo Venâncio da Cunha
- Coordenacao dos Laboratorios de Referencia, Oswaldo Cruz Foundation, Rio de Janeiro 21040-360, Brazil;
| | - José Lourenço
- Department of Zoology, University of Oxford, Oxford OX1 3PS, UK;
| | - Luiz Carlos Junior Alcantara
- Laboratório de Flavivírus, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro 21040-360, Brazil; (M.G.); (F.L.L.C.); (N.R.d.C.F.); (A.M.B.d.F.)
- Laboratório de Genética Celular e Molecular, Universidade Federal de Minas Gerais, Belo Horizonte 31270-901, Brazil; (V.F.); (F.F.A.); (J.X.)
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Arcêncio RA, Berra TZ, Terena NDFM, Rocha MP, Ferraz de Araújo Alecrim T, de Souza Kihara FM, Mascarello KC, Martins Sales CM, Maciel ELN. Spatial clustering and temporal trend analysis of international migrants diagnosed with tuberculosis in Brazil. PLoS One 2021; 16:e0252712. [PMID: 34106968 PMCID: PMC8189475 DOI: 10.1371/journal.pone.0252712] [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] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2021] [Accepted: 05/20/2021] [Indexed: 11/18/2022] Open
Abstract
Background Tuberculosis (TB) in migrants is of concern to health authorities worldwide and is even more critical in Brazil, considering the country´s size and long land borders. The aim of the study was to identify critical areas in Brazil for migrants diagnosed with TB and to describe the temporal trend in this phenomenon in recent years. Methods This is an ecological study that used spatial analysis and time series analysis. As the study population, all cases of migrants diagnosed with TB from 2014 to 2019 were included, and Brazilian municipalities were considered as the unit of ecological analysis. The Getis-Ord Gi* technique was applied to identify critical areas, and based on the identified clusters, seasonal-trend decomposition based on loess (STL) and Prais-Winsten autoregression were used, respectively, to trace and classify temporal trend in the analyzed series. In addition, several municipal socioeconomic indicators were selected to verify the association between the identified clusters and social vulnerability. Results 2,471 TB cases were reported in migrants. Gi* analysis showed that areas with spatial association with TB in immigrants coincide with critical areas for TB in the general population (coast of the Southeast and North regions). Four TB clusters were identified in immigrants in the states of Amazonas, Roraima, São Paulo, and Rio de Janeiro, with an upward trend in most of these clusters. The temporal trend in TB in immigrants was classified as increasing in Brazil (+ 60.66% per year [95% CI: 27.21–91.85]) and in the clusters in the states of Amazonas, Roraima, and Rio de Janeiro (+1.01, +2.15, and + 2.90% per year, respectively). The cluster in the state of São Paulo was the only one classified as stationary. The descriptive data on the municipalities belonging to the clusters showed evidence of the association between TB incidence and conditions of social vulnerability. Conclusions The study revealed the critical situation of TB among migrants in the country. Based on the findings, health authorities might focus on actions in regions identified, stablishing an intensive monitoring and following up, ensuring that these cases concluded their treatment and avoiding that they could spread the disease to the other regions or scenarios. The population of migrants are very dynamic, therefore strategies for following up them across Brazil are really urgent to manage the tuberculosis among international migrants in an efficient and proper way.
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Affiliation(s)
- Ricardo Alexandre Arcêncio
- Department of Maternal-Infant and Public Health Nursing, University of São Paulo at Ribeirão Preto School of Nursing, Ribeirão Preto, São Paulo, Brazil
- * E-mail:
| | - Thaís Zamboni Berra
- Department of Maternal-Infant and Public Health Nursing, University of São Paulo at Ribeirão Preto School of Nursing, Ribeirão Preto, São Paulo, Brazil
| | | | - Matheus Piumbini Rocha
- Epidemiology Laboratory, Health Sciences Center, Universidade Federal do Espírito Santo, Vitoria, Brazil
| | | | | | - Keila Cristina Mascarello
- Department of Health Sciences, Centro Universitário Norte do Espírito Santo, Universidade Federal do Espírito Santo, Vitoria, Brazil
| | | | - Ethel Leonor Noia Maciel
- Epidemiology Laboratory, Health Sciences Center, Universidade Federal do Espírito Santo, Vitoria, Brazil
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Pinotti F, Wikramaratna PS, Obolski U, Paton RS, Damineli DSC, Alcantara LCJ, Giovanetti M, Gupta S, Lourenço J. Potential impact of individual exposure histories to endemic human coronaviruses on age-dependent severity of COVID-19. BMC Med 2021; 19:19. [PMID: 33430856 PMCID: PMC7801230 DOI: 10.1186/s12916-020-01887-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2020] [Accepted: 12/11/2020] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Cross-reactivity to SARS-CoV-2 from exposure to endemic human coronaviruses (eHCoV) is gaining increasing attention as a possible driver of both protection against infection and COVID-19 severity. Here we explore the potential role of cross-reactivity induced by eHCoVs on age-specific COVID-19 severity in a mathematical model of eHCoV and SARS-CoV-2 transmission. METHODS We use an individual-based model, calibrated to prior knowledge of eHCoV dynamics, to fully track individual histories of exposure to eHCoVs. We also model the emergent dynamics of SARS-CoV-2 and the risk of hospitalisation upon infection. RESULTS We hypothesise that primary exposure with any eHCoV confers temporary cross-protection against severe SARS-CoV-2 infection, while life-long re-exposure to the same eHCoV diminishes cross-protection, and increases the potential for disease severity. We show numerically that our proposed mechanism can explain age patterns of COVID-19 hospitalisation in EU/EEA countries and the UK. We further show that some of the observed variation in health care capacity and testing efforts is compatible with country-specific differences in hospitalisation rates under this model. CONCLUSIONS This study provides a "proof of possibility" for certain biological and epidemiological mechanisms that could potentially drive COVID-19-related variation across age groups. Our findings call for further research on the role of cross-reactivity to eHCoVs and highlight data interpretation challenges arising from health care capacity and SARS-CoV-2 testing.
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Affiliation(s)
| | | | - Uri Obolski
- School of Public Health, Tel Aviv University, Tel Aviv, Israel
- Porter School of the Environment and Earth Sciences, Tel Aviv University, Tel Aviv, Israel
| | | | - Daniel S C Damineli
- Department of Pediatrics, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | - Luiz C J Alcantara
- Laboratório de Genética Celular e Molecular, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
- Laboratório de Flavivírus, Instituto Oswaldo Cruz Fiocruz, Rio de Janeiro, Brazil
| | - Marta Giovanetti
- Laboratório de Genética Celular e Molecular, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
- Laboratório de Flavivírus, Instituto Oswaldo Cruz Fiocruz, Rio de Janeiro, Brazil
| | - Sunetra Gupta
- Department of Zoology, University of Oxford, Oxford, UK
| | - José Lourenço
- Department of Zoology, University of Oxford, Oxford, UK
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Gomes JM, Silva BM, Santos EFDS, Kelly PJ, Costa ADS, Takiuti AD, de Abreu LC, Soares Júnior JM, Baracat EC, Sorpreso ICE. Human Papillomavirus (HPV) and the quadrivalent HPV Vaccine among Brazilian adolescents and parents: Factors associated with and divergences in knowledge and acceptance. PLoS One 2020; 15:e0241674. [PMID: 33180790 PMCID: PMC7660498 DOI: 10.1371/journal.pone.0241674] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2020] [Accepted: 10/19/2020] [Indexed: 11/25/2022] Open
Abstract
Background Low national immunization coverage (44.64%) requires strengthening the vaccination campaign to improve knowledge about HPV and its vaccine among adolescents and parents/guardians. Our aim is to evaluate factors related to knowledge about HPV, its vaccine, acceptability and divergences among Brazilian adolescents and parents/guardians. Methods A cross-sectional study was performed at a health unit of Sao Paulo University, Brazil, from 2015 to 2016. The convenience sample comprised 1047 individuals, including 74% (n = 776) adolescents and 26% (n = 271) parents/guardians, who answered a survey (knowledge about HPV, its vaccine, barriers and acceptability). Results The main source of information for adolescents was school (39%, n = 298); for parents/guardians, it was health professionals (55%, n = 153). Parents/guardians were 2.48 times more likely than adolescents to know that HPV caused changes in the Pap smear test [RR 2.48, 95% CI 2.03–3.01 (p < 0.001)], 1.43 times likely to be aware that HPV was a sexually transmitted infection [RR 1.43, 95% CI 1.22–1.68 (p < 0.001)], and 2.77 times likely to be informed that the HPV vaccine decreased the chance of having genital warts [RR 2.77, 95% CI 2.22–2.47 (p < 0.001)]. Girls knew more about the topic than boys (RR 1.67; 95% CI 1.10–2.60); education increased parents’ knowledge [(RR 3.38; 95% CI 1.71–6.69)]. Conclusion Female adolescents and parents/guardians with a higher level of education are factors related to suitable knowledge about HPV and its vaccine among Brazilian respondents. There were differences between parents/guardians and adolescents in HPV awareness, clinical implications, vaccine knowledge and vaccine acceptance.
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Affiliation(s)
- Jéssica Menezes Gomes
- Disciplina de Ginecologia, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, Brazil
| | - Beatriz Machado Silva
- Disciplina de Ginecologia, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, Brazil
| | | | - Patricia Jane Kelly
- School of Nursing and Health Studies, University of Missouri—Kansas City, Kansas City, MO, United States of America
| | - Annielson de Souza Costa
- Disciplina de Ginecologia, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, Brazil
| | - Albertina Duarte Takiuti
- Disciplina de Ginecologia, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, Brazil
| | - Luiz Carlos de Abreu
- Study Design and Scientific Writing Laboratory at ABC Medical School, Santo André, SP, Brazil
| | - José Maria Soares Júnior
- Disciplina de Ginecologia, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, Brazil
| | - Edmund Chada Baracat
- Disciplina de Ginecologia, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, Brazil
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Lawson A, Boaz R, Corberán-Vallet A, Arezo M, Larrieu E, Vigilato MA, Del Rio Vilas VJ. Integration of animal health and public health surveillance sources to exhaustively inform the risk of zoonosis: An application to echinococcosis in Rio Negro, Argentina. PLoS Negl Trop Dis 2020; 14:e0008545. [PMID: 32841252 PMCID: PMC7473527 DOI: 10.1371/journal.pntd.0008545] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2020] [Revised: 09/04/2020] [Accepted: 06/30/2020] [Indexed: 11/19/2022] Open
Abstract
The analysis of zoonotic disease risk requires the consideration of both human and animal geo-referenced disease incidence data. Here we show an application of joint Bayesian analyses to the study of echinococcosis granulosus (EG) in the province of Rio Negro, Argentina. We focus on merging passive and active surveillance data sources of animal and human EG cases using joint Bayesian spatial and spatio-temporal models. While similar spatial clustering and temporal trending was apparent, there appears to be limited lagged dependence between animal and human outcomes. Beyond the data quality issues relating to missingness at different times, we were able to identify relations between dog and human data and the highest ‘at risk’ areas for echinococcosis within the province. This work focuses on utilizing animal disease data to try and inform our understanding of the spread of diseases in humans. We implement predictive models to estimate the relationship between the distribution of disease in animal populations and the distribution of disease in human populations. Development of a better understanding of this relationship could inform animal and public health interventions aiming to mitigate against human disease before it spreads. Missing data and limited data resources made discovery of these relationships difficult, but we fit multiple model types to try and identify any connection between these two populations. We found specific areas with elevated risk of human disease and changes in disease risk over time. Finally, there was some indication of an association between previous years’ levels of animal disease and human disease when using animals as covariables.
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Affiliation(s)
- Andrew Lawson
- Medical University of South Carolina, Charleston, South Carolina, United States of America
- * E-mail:
| | - R Boaz
- Medical University of South Carolina, Charleston, South Carolina, United States of America
| | | | - Marcos Arezo
- Ministerio de Salud, Viedma, Rio Negro, Argentina
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Ke C, Persaud S, Singh K, Ostrow B, Lebovic G, Hincapié C, Lowe J. Interaction between sex and rurality on the prevalence of diabetes in Guyana: a nationally representative study. BMJ Open Diabetes Res Care 2020; 8:e001349. [PMID: 32699107 PMCID: PMC7380853 DOI: 10.1136/bmjdrc-2020-001349] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2020] [Revised: 05/14/2020] [Accepted: 06/02/2020] [Indexed: 12/25/2022] Open
Abstract
INTRODUCTION Diabetes prevalence has never been measured in Guyana. We conducted a nationally representative cross-sectional study to estimate the prevalence of diabetes and pre-diabetes, and the association between sex and diabetes. RESEARCH DESIGN AND METHODS In 2016, the Ministry of Public Health led Guyana's first national STEPS survey among adults aged 18-69 years. Half of the participants were randomly selected for hemoglobin A1c and fasting blood glucose testing. We estimated the prevalence of diabetes and pre-diabetes and measured the association between sex and diabetes prevalence using logistic regression to compute adjusted ORs. RESULTS We included 805 adults (511 women, 294 men, mean age 41.8 (SD 14.4) years). The national prevalence of diabetes was 18.1% (95% CI: 15.4% to 20.8%), with higher rates among women (21.4%, 95% CI: 18.0% to 24.7%) than men (15.1%, 95% CI: 10.9% to 19.3%). Sex-specific diabetes prevalence varied significantly across urban and rural areas (p=0.002 for interaction). In rural areas, diabetes was twice as common among women (24.1%, 95% CI: 20.1% to 28.2%) compared with men (11.8%, 95% CI: 7.7% to 15.9%). After adjusting for prespecified covariates, rural women had double the odds of diabetes compared with rural men (OR 2.1, 95% CI: 1.20 to 3.82). This prevalence pattern was reversed in urban areas (diabetes prevalence, women: 13.9%, 95% CI: 8.7% to 19.0%; men: 22.0%, 95% CI: 12.9% to 31.1%), with urban women having half the odds of diabetes compared with urban men (OR 0.4, 95% CI: 0.20 to 0.99). We estimated that nearly one-third of women and over a quarter of men had diabetes or pre-diabetes. CONCLUSIONS The burden of diabetes in Guyana is considerably higher than previously estimated, with an unexpectedly high prevalence among women-particularly in rural areas.
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Affiliation(s)
- Calvin Ke
- Division of Enodcrinology and Metabolism, Department of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Shamdeo Persaud
- Chief Medical Officer, Ministry of Public Health, Georgetown, Guyana
| | - Kavita Singh
- Chronic Diseases Unit, Ministry of Public Health, Georgetown, Guyana
| | - Brian Ostrow
- Department of Surgery, University of Toronto, Toronto, Ontario, Canada
| | - Gerald Lebovic
- Applied Health Research Centre, Li Ka Shing Knowledge Institute, Unity Health Toronto, Toronto, Ontario, Canada
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada
| | - Cesar Hincapié
- Applied Health Research Centre, Li Ka Shing Knowledge Institute, Unity Health Toronto, Toronto, Ontario, Canada
- Department of Chiropractic Medicine, Faculty of Medicine, University of Zurich, Zurich, Switzerland
| | - Julia Lowe
- Division of Enodcrinology and Metabolism, Department of Medicine, University of Toronto, Toronto, Ontario, Canada
- School of Medicine and Public Health, Faculty of Health and Medicine, The University of Newcastle, Callaghan, New South Wales, Australia
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Almonte M, Murillo R, Sánchez GI, González P, Ferrera A, Picconi MA, Wiesner C, Cruz-Valdez A, Lazcano-Ponce E, Jerónimo J, Ferreccio C, Kasamatsu E, Mendoza L, Rodríguez G, Calderón A, Venegas G, Villagra V, Tatti S, Fleider L, Terán C, Baena A, Hernández MDLL, Rol ML, Lucas E, Barbier S, Ramírez AT, Arrossi S, Rodríguez MI, González E, Celis M, Martínez S, Salgado Y, Ortega M, Beracochea AV, Pérez N, Rodríguez de la Peña M, Ramón M, Hernández-Nevarez P, Arboleda-Naranjo M, Cabrera Y, Salgado B, García L, Retana MA, Colucci MC, Arias-Stella J, Bellido-Fuentes Y, Bobadilla ML, Olmedo G, Brito-García I, Méndez-Herrera A, Cardinal L, Flores B, Peñaranda J, Martínez-Better J, Soilán A, Figueroa J, Caserta B, Sosa C, Moreno A, Mural J, Doimi F, Giménez D, Rodríguez H, Lora O, Luciani S, Broutet N, Darragh T, Herrero R. Multicentric study of cervical cancer screening with human papillomavirus testing and assessment of triage methods in Latin America: the ESTAMPA screening study protocol. BMJ Open 2020; 10:e035796. [PMID: 32448795 PMCID: PMC7252979 DOI: 10.1136/bmjopen-2019-035796] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2019] [Revised: 03/18/2020] [Accepted: 04/03/2020] [Indexed: 12/20/2022] Open
Abstract
INTRODUCTION Human papillomavirus (HPV) testing is replacing cytology in primary screening. Its limited specificity demands using a second (triage) test to better identify women at high-risk of cervical disease. Cytology represents the immediate triage but its low sensitivity might hamper HPV testing sensitivity, particularly in low-income and middle-income countries (LMICs), where cytology performance has been suboptimal. The ESTAMPA (EStudio multicéntrico de TAMizaje y triaje de cáncer de cuello uterino con pruebas del virus del PApiloma humano; Spanish acronym) study will: (1) evaluate the performance of different triage techniques to detect cervical precancer and (2) inform on how to implement HPV-based screening programmes in LMIC. METHODS AND ANALYSIS Women aged 30-64 years are screened with HPV testing and Pap across 12 study centres in Latin America. Screened positives have colposcopy with biopsy and treatment of lesions. Women with no evident disease are recalled 18 months later for another HPV test; those HPV-positive undergo colposcopy with biopsy and treatment as needed. Biological specimens are collected in different visits for triage testing, which is not used for clinical management. The study outcome is histological high-grade squamous intraepithelial or worse lesions (HSIL+) under the lower anogenital squamous terminology. About 50 000 women will be screened and 500 HSIL+ cases detected (at initial and 18 months screening). Performance measures (sensitivity, specificity and predictive values) of triage techniques to detect HSIL+ will be estimated and compared with adjustment by age and study centre. ETHICS AND DISSEMINATION The study protocol has been approved by the Ethics Committee of the International Agency for Research on Cancer (IARC), of the Pan American Health Organisation (PAHO) and by those in each participating centre. A Data and Safety Monitoring Board (DSMB) has been established to monitor progress of the study, assure participant safety, advice on scientific conduct and analysis and suggest protocol improvements. Study findings will be published in peer-reviewed journals and presented at scientific meetings. TRIAL REGISTRATION NUMBER NCT01881659.
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Affiliation(s)
- Maribel Almonte
- Prevention and Implementation Group, International Agency for Research on Cancer, Lyon, Rhône-Alpes, France
| | - Raúl Murillo
- Pontificia Universidad Javeriana, Bogotá, Colombia
| | | | - Paula González
- Agencia Costarricense de Investigaciones Biomédicas (ACIB), Fundación Inciensa, Guanacaste, Costa Rica
| | - Annabelle Ferrera
- Instituto de Investigaciones en Microbiología, Universidad Nacional Autónoma de Honduras (UNAH), Tegucigalpa, Honduras
| | | | | | | | | | | | - Catterina Ferreccio
- Advanced Center for Chronic Diseases, ACCDiS, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Elena Kasamatsu
- Instituto de Investigaciones en Ciencias de la Salud, Universidad Nacional de Asunción, San Lorenzo, Paraguay
| | - Laura Mendoza
- Instituto de Investigaciones en Ciencias de la Salud, Universidad Nacional de Asunción, San Lorenzo, Paraguay
| | | | - Alejandro Calderón
- Caja Costarricense de Seguro Social (CCSS), Región Pacífico Central, San José, Costa Rica
| | - Gino Venegas
- Clínica Angloamericana, Lima, Perú
- Escuela de Medicina Humana, Universidad de Piura, Lima, Perú
| | | | - Silvio Tatti
- Hospital de Clínicas José de San Martín, Buenos Aires, Argentina
| | - Laura Fleider
- Hospital de Clínicas José de San Martín, Buenos Aires, Argentina
| | - Carolina Terán
- Facultad de Medicina, Universidad Mayor, Real y Pontificia de San Francisco Xavier de Chuquisaca, Sucre, Bolivia
| | - Armando Baena
- Prevention and Implementation Group, International Agency for Research on Cancer, Lyon, Rhône-Alpes, France
| | - María de la Luz Hernández
- Prevention and Implementation Group, International Agency for Research on Cancer, Lyon, Rhône-Alpes, France
- SMS-Oncology, Amsterdam, The Netherlands
| | - Mary Luz Rol
- Prevention and Implementation Group, International Agency for Research on Cancer, Lyon, Rhône-Alpes, France
| | - Eric Lucas
- Screening Group, International Agency for Research on Cancer, Lyon, Rhône-Alpes, France
| | - Sylvaine Barbier
- Prevention and Implementation Group, International Agency for Research on Cancer, Lyon, Rhône-Alpes, France
| | - Arianis Tatiana Ramírez
- Prevention and Implementation Group, International Agency for Research on Cancer, Lyon, Rhône-Alpes, France
| | - Silvina Arrossi
- Centro de Estudios de Estado y Sociedad/Consejo Nacional de Investigaciones Científicas y Técnicas, Buenos Aires, Argentina
| | - María Isabel Rodríguez
- Instituto de Investigaciones en Ciencias de la Salud, Universidad Nacional de Asunción, San Lorenzo, Paraguay
| | | | - Marcela Celis
- Instituto Nacional de Cancerología, Bogotá, Colombia
| | | | - Yuly Salgado
- Instituto Nacional de Cancerología, Bogotá, Colombia
| | - Marina Ortega
- Hospital Nacional, Ministerio de Salud Pública y Bienestar Social, Itauguá, Paraguay
- Instituto Nacional del Cáncer, Ministerio de Salud Pública y Bienestar Social, Capiatá, Paraguay
| | - Andrea Verónica Beracochea
- Centro de Salud Ciudad de la Costa, ASSE, Ciudad de la Costa, Uruguay
- Hospital Policial, DNASS, Montevideo, Uruguay
| | - Natalia Pérez
- Hospital de Clínicas, Facultad de Medicina, UDELAR, Montevideo, Uruguay
| | | | | | | | | | - Yessy Cabrera
- Instituto de Investigaciones en Microbiología, Universidad Nacional Autónoma de Honduras (UNAH), Tegucigalpa, Honduras
| | | | - Laura García
- Laboratorio de Biología Molecular, Departamento de Patología Clínica, Centro Hospitalario Pereira Rossell, Montevideo, Uruguay
| | | | - María Celeste Colucci
- Instituto Nacional de Enfermedades Infecciosas - ANLIS Malbrán, Buenos Aires, Argentina
| | | | | | | | - Gladys Olmedo
- Laboratorio Central de Salud Pública, Asunción, Paraguay
| | | | | | - Lucía Cardinal
- Hospital de Clínicas José de San Martín, Buenos Aires, Argentina
| | - Betsy Flores
- Facultad de Medicina, Universidad Mayor, Real y Pontificia de San Francisco Xavier de Chuquisaca, Sucre, Bolivia
| | - Jhacquelin Peñaranda
- Facultad de Medicina, Universidad Mayor, Real y Pontificia de San Francisco Xavier de Chuquisaca, Sucre, Bolivia
| | | | - Ana Soilán
- Hospital Nacional, Ministerio de Salud Pública y Bienestar Social, Itauguá, Paraguay
- Hospital Materno Infantil de San Lorenzo, Ministerio de Salud Pública y Bienestar Social, San Lorenzo, Paraguay
| | | | - Benedicta Caserta
- Departamento de Anatomía Patológica y Citología, Hospital de la Mujer, Centro Hospitalario Pereira Rossell, Montevideo, Uruguay
| | - Carlos Sosa
- Hospital Monseñor Víctor Manuel Sanabria Martínez, CCSS, Puntarenas, Costa Rica
| | - Adrián Moreno
- Hospital Nacional Profesor Alejandro Posadas, Buenos Aires, Argentina
| | - Juan Mural
- Hospital Nacional Profesor Alejandro Posadas, Buenos Aires, Argentina
| | | | - Diana Giménez
- Hospital Materno Infantil de Trinidad, Ministerio de Salud Pública y Bienestar Social, Asunción, Paraguay
| | - Hernando Rodríguez
- Hospital Materno Infantil de Trinidad, Ministerio de Salud Pública y Bienestar Social, Asunción, Paraguay
| | - Oscar Lora
- Facultad de Medicina, Universidad Mayor, Real y Pontificia de San Francisco Xavier de Chuquisaca, Sucre, Bolivia
- Hospital Gineco-Obstétrico y Neonatal "Dr Jaime Sánchez Porcel", Sucre, Bolivia
| | - Silvana Luciani
- Pan American Health Organization (PAHO), Washington, District of Columbia, USA
| | - Nathalie Broutet
- Department of Sexual and Reproductive Health and Research, World Health Organization, Geneva, Switzerland
| | - Teresa Darragh
- Department of Pathology, University of California, San Francisco, California, USA
| | - Rolando Herrero
- Prevention and Implementation Group, International Agency for Research on Cancer, Lyon, Rhône-Alpes, France
- Agencia Costarricense de Investigaciones Biomédicas (ACIB), Fundación Inciensa, Guanacaste, Costa Rica
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Colpani V, Soares Falcetta F, Bacelo Bidinotto A, Kops NL, Falavigna M, Serpa Hammes L, Schwartz Benzaken A, Kalume Maranhão AG, Domingues CMAS, Wendland EM. Prevalence of human papillomavirus (HPV) in Brazil: A systematic review and meta-analysis. PLoS One 2020; 15:e0229154. [PMID: 32084177 PMCID: PMC7034815 DOI: 10.1371/journal.pone.0229154] [Citation(s) in RCA: 42] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2019] [Accepted: 01/30/2020] [Indexed: 12/16/2022] Open
Abstract
OBJECTIVES This study aimed to estimate the prevalence of genital, anal and oral HPV infection in Brazil through systematic review and meta-analysis. METHODS We searched EMBASE, LILACS, MEDLINE, Web of Science and SciELO from inception to December 2018. Original research articles that assessed the prevalence of genital (i.e., cervical, penile), anal and oral HPV infection in Brazil were selected in pairs by independent authors. No sex, age, HPV vaccination, language or date restrictions were applied. HPV prevalence was estimated and stratified according to risk factors population and by geographic area throughout the country. The study prevalence was pooled using a random effects model. Analysis was performed using R (version 3.5.2), packages meta version 4.9-4 and metaphor 2.0-0. This review is registered on PROSPERO under protocol number CRD42016032751. RESULTS We identified 3,351 references. After the screening process, 139 of them were eligible for this systematic review (57,513 total participants). Prevalence of cervical HPV was 25.41% (95% CI 22.71-28.32). Additionally, prevalence was 36.21% (95% CI 23.40, 51.33) in the penile region, 25.68% (95%CI 14.64, 41.04) in the anal region, and 11.89% (95%CI 6.26, 21.43) in the oral region. Subgroup analysis showed prevalence in each anatomic site was higher in high-risk populations. CONCLUSION The prevalence of HPV is high in the Brazilian population and varies by population risk and anatomic body site, with lower rates in the oral cavity compared to that in the cervical, penile and anal region. Studies on HPV have primarily been developed to evaluate infection and cancer in the cervical region. There is a profound lack of HPV data in many geographic regions of Brazil and for different anatomic sites.
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Affiliation(s)
- Verônica Colpani
- Hospital Moinhos de Vento, Porto Alegre, Rio Grande do Sul, Brazil
| | | | | | | | - Maicon Falavigna
- Hospital Moinhos de Vento, Porto Alegre, Rio Grande do Sul, Brazil
| | | | - Adele Schwartz Benzaken
- Tropical Medicine Foundation Heitor Vieira Dourado, Manaus, Amazonas, Brazil
- Aids Health Care Foundation, Manaus, Amazonas, Brazil
| | | | | | - Eliana Márcia Wendland
- Hospital Moinhos de Vento, Porto Alegre, Rio Grande do Sul, Brazil
- Department of Community Health, Federal University of Health Science of Porto Alegre, Porto Alegre, Rio Grande do Sul, Brazil
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Haby MM, Sosa Leon LA, Luciañez A, Nicholls RS, Reveiz L, Donadeu M. Systematic review of the effectiveness of selected drugs for preventive chemotherapy for Taenia solium taeniasis. PLoS Negl Trop Dis 2020; 14:e0007873. [PMID: 31945055 PMCID: PMC6964831 DOI: 10.1371/journal.pntd.0007873] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2019] [Accepted: 10/25/2019] [Indexed: 01/21/2023] Open
Abstract
Background Preventive chemotherapy is a useful tool for the control of Taenia solium taeniasis and cysticercosis. The aim of this systematic review is to assess the scientific evidence concerning the effectiveness and safety of different drugs in preventive chemotherapy for T. solium taeniasis in endemic populations. Methods A systematic review was conducted of controlled and uncontrolled studies, assessing the efficacy and adverse effects (among other outcomes) of albendazole, niclosamide and/or praziquantel for preventive chemotherapy of T. solium taeniasis. A comprehensive search was conducted for published and unpublished studies. Two reviewers screened articles, completed the data extraction and assessment of risk of bias. A meta-analysis of cure rate and relative reduction in prevalence was performed. The protocol for this review was registered on the International prospective register of systematic reviews (PROSPERO), number CRD42018112533. Results We identified 3555 records, of which we included 20 primary studies reported across 33 articles. Meta-analyses of drug and dose showed that a single dose of praziquantel 10mg/kg, albendazole 400mg per day for three consecutive days, or niclosamide 2g, resulted in better cure rates for T. solium taeniasis (99.5%, 96.4% and 84.3%, respectively) than praziquantel 5mg/kg or single dose albendazole 400mg (89.0% and 52.0%, respectively). These findings have a low certainty of evidence due to high risk of bias in individual studies and heterogeneity in combined estimates. In relation to side-effects, most studies reported either no or only mild and transient side-effects within the first three days following drug administration for all drugs and doses. Conclusion Evidence indicated that praziquantel 10mg/kg, niclosamide 2g, and triple dose albendazole 400mg were effective as taenicides and could be considered for use in mass drug administration programs for the control of T. solium taeniasis. Evidence was not found that any of these drugs caused severe side effects at the indicated doses, although the extent of the available evidence was limited. Taeniasis and cysticercosis caused by Taenia solium are considered, by the WHO, to be neglected tropical diseases. Preventive chemotherapy for taeniasis in endemic populations is a useful tool for control of the parasite. Preventive chemotherapy can be implemented by treating the whole population in endemic areas at regular intervals (known as mass drug administration). While different drugs, doses and regimes have been used there were still uncertainties about which drugs and dose have the best efficacy while considering adverse effects. We conducted a systematic review of the best available literature to inform a WHO guideline for preventive chemotherapy. We found that praziquantel 10mg/kg, niclosamide 2g, and triple dose albendazole 400mg (400mg per day for three consecutive days) are all effective. Proven side-effects were mild and short-lived, when they did occur.
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Affiliation(s)
- Michelle M. Haby
- Department of Chemical and Biological Sciences, University of Sonora, Hermosillo, Sonora, Mexico
- Centre for Health Policy, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia
- * E-mail:
| | | | - Ana Luciañez
- Neglected Infectious Diseases, Communicable Diseases and Environmental Determinants of Health, Pan American Health Organization/World Health Organization, Washington DC, United States of America
| | - Ruben Santiago Nicholls
- Neglected Infectious Diseases, Communicable Diseases and Environmental Determinants of Health, Pan American Health Organization/World Health Organization, Washington DC, United States of America
| | - Ludovic Reveiz
- Department of Evidence and Intelligence for Action in Health, Pan American Health Organization/World Health Organization, Washington DC, United States of America
| | - Meritxell Donadeu
- Faculty of Veterinary and Agricultural Sciences, The University of Melbourne, Melbourne, Victoria, Australia
- Initiative for Neglected Animal Diseases (INAND), Midrand, South Africa
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Keys HM, Noland GS, De Rochars MB, Blount S, Gonzales M. Prevalence of malaria and lymphatic filariasis in bateyes of the Dominican Republic. Infect Dis Poverty 2019; 8:39. [PMID: 31130142 PMCID: PMC6535845 DOI: 10.1186/s40249-019-0547-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2018] [Accepted: 05/07/2019] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND The island of Hispaniola, shared by Haiti and the Dominican Republic (DR), is the only remaining malaria-endemic island in the Caribbean and accounts for 95% of the lymphatic filariasis (LF) burden in the Americas. Both countries aim to eliminate the diseases by 2020. Migration from Haiti, where both diseases are more prevalent, may promote transmission in the DR. Historically, Haitian migrant labourers live in rural Dominican agricultural 'company towns' called bateyes, many of which received mass drug administration (MDA) for LF elimination. This study sought to determine the prevalence of malaria and LF in bateyes of the DR and to describe related risk factors for disease. METHODS From March to April 2016, a cross-sectional, cluster survey was conducted across Dominican bateyes stratified into three regions: southwest, north and east. A household questionnaire (n = 776), captured demographics, ethnic origin, mobility patterns, malaria intervention coverage, and knowledge, and recent fever and treatment-seeking. Two individuals per household (n = 1418) were tested for malaria parasites by microscopy and rapid diagnostic test (RDT) and LF antigen by filariasis test strip (FTS). Population-level estimates and confidence intervals (CI) were computed adjusting for the survey design. Two-sided t-tests compared differences in knowledge scores. RESULTS No (0%) blood sample was Plasmodium-positive by microscopy or RDT. Six individuals were FTS-positive (0.5%; 95% CI: 0.2-1.5), but none (0%) of these were microfilariae-positive. Most batey residents were born in the DR (57.8%), documented (85.0%), and permanent residents (85.1%). Very few respondents (9.4%) reported travel to Haiti in the past year. Overall, half (53.8%) of respondents owned a bed net, and 82.3% of net owners reported using it the previous night. Indoor residual spraying (IRS) differed by region (range: 4.7%-61.2%). Most of those with recent fever sought care (56.0%), yet only 30.5% of those seeking care were tested for malaria. Compared to Dominican-born populations, Haitian-born respondents more frequently reported recent fever, did not seek care for the fever, had not heard of malaria, and could not name symptoms or prevention methods. CONCLUSIONS Malaria and LF transmission appear absent or extremely low in Dominican bateyes, which are a mixture of Haitian and Dominican residents. Travel to Haiti is rare, meaning risk of malaria and LF importation is low. Addressing identified gaps in intervention coverage, malaria knowledge, treatment seeking and service delivery will improve the quality of surveillance for these diseases, particularly among marginalized populations and promote island-wide elimination.
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Affiliation(s)
- Hunter M. Keys
- Department of Anthropology, University of Amsterdam, Building B-REC B 8.01, Nieuwe Achtergracht 166, 1018 WV Amsterdam, The Netherlands
| | | | - Madsen Beau De Rochars
- Health Services Research, Management and Policy Department, University of Florida, 1225 Center Drive, HPNP 3101, Gainesville, FL 32611 USA
| | - Stephen Blount
- The Carter Center, 453 Freedom Parkway, Atlanta, GA 30307 USA
| | - Manuel Gonzales
- Center for Prevention and Control of Vector-borne and Zoonotic Diseases, Av. Juan Pablo Duarte No. 269, 10301 Santo Domingo, Dominican Republic
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Castanha PMS, Souza WV, Braga C, de Araújo TVB, Ximenes RAA, Albuquerque MDFPM, Montarroyos UR, Miranda-Filho DB, Cordeiro MT, Dhalia R, Marques ETA, Rodrigues LC, Martelli CMT. Perinatal analyses of Zika- and dengue virus-specific neutralizing antibodies: A microcephaly case-control study in an area of high dengue endemicity in Brazil. PLoS Negl Trop Dis 2019; 13:e0007246. [PMID: 30856223 PMCID: PMC6428350 DOI: 10.1371/journal.pntd.0007246] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2018] [Revised: 03/21/2019] [Accepted: 02/14/2019] [Indexed: 01/12/2023] Open
Abstract
Laboratory confirmation of Zika virus (ZIKV) infection during pregnancy is challenging due to cross-reactivity with dengue virus (DENV) and limited knowledge about the kinetics of anti-Zika antibody responses during pregnancy. We described ZIKV and DENV serological markers and the maternal-fetal transfer of antibodies among mothers and neonates after the ZIKV microcephaly outbreak in Northeast Brazil (2016). We included 89 microcephaly cases and 173 neonate controls at time of birth and their mothers. Microcephaly cases were defined as newborns with a particular head circumference (2 SD below the mean). Two controls without microcephaly were matched by the expected date of delivery and area of residence. We tested maternal serum for recent (ZIKV genome, IgM and IgG3 anti-NS1) and previous (ZIKV and DENV neutralizing antibodies [NAbs]) markers of infection. Multiple markers of recent or previous ZIKV and DENV infection in mothers were analyzed using principal component analysis (PCA). At delivery, 5.6% of microcephaly case mothers and 1.7% of control mothers were positive for ZIKV IgM. Positivity for ZIKV IgG3 anti-NS1 was 8.0% for case mothers and 3.5% for control mothers. ZIKV NAbs was slightly higher among mothers of cases (69.6%) than that of mothers of controls (57.2%; p = 0.054). DENV exposure was detected in 85.8% of all mothers. PCA discriminated two distinct components related to recent or previous ZIKV infection and DENV exposure. ZIKV NAbs were higher in newborns than in their corresponding mothers (p<0.001). We detected a high frequency of ZIKV exposure among mothers after the first wave of the ZIKV outbreak in Northeast Brazil. However, we found low sensitivity of the serological markers to recent infection (IgM and IgG3 anti-NS1) in perinatal samples of mothers of microcephaly cases. Since the neutralization test cannot precisely determine the time of infection, testing for ZIKV immune status should be performed as early as possible and throughout pregnancy to monitor acute Zika infection in endemic areas.
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Affiliation(s)
- Priscila M. S. Castanha
- Aggeu Magalhães Institute, Oswaldo Cruz Foundation (FIOCRUZ), Recife, Pernambuco, Brazil
- School of Medical Science, University of Pernambuco, Recife, Pernambuco, Brazil
| | - Wayner V. Souza
- Aggeu Magalhães Institute, Oswaldo Cruz Foundation (FIOCRUZ), Recife, Pernambuco, Brazil
| | - Cynthia Braga
- Aggeu Magalhães Institute, Oswaldo Cruz Foundation (FIOCRUZ), Recife, Pernambuco, Brazil
| | - Thalia Velho Barreto de Araújo
- Aggeu Magalhães Institute, Oswaldo Cruz Foundation (FIOCRUZ), Recife, Pernambuco, Brazil
- Federal University of Pernambuco, Recife, Pernambuco, Brazil
| | - Ricardo A. A. Ximenes
- School of Medical Science, University of Pernambuco, Recife, Pernambuco, Brazil
- Federal University of Pernambuco, Recife, Pernambuco, Brazil
| | | | | | | | - Marli T. Cordeiro
- Aggeu Magalhães Institute, Oswaldo Cruz Foundation (FIOCRUZ), Recife, Pernambuco, Brazil
| | - Rafael Dhalia
- Aggeu Magalhães Institute, Oswaldo Cruz Foundation (FIOCRUZ), Recife, Pernambuco, Brazil
| | - Ernesto T. A. Marques
- Aggeu Magalhães Institute, Oswaldo Cruz Foundation (FIOCRUZ), Recife, Pernambuco, Brazil
- Department of Infectious Diseases and Microbiology, University of Pittsburgh, Pittsburgh, Pennsylvania, United States of America
| | - Laura C. Rodrigues
- Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Celina M. T. Martelli
- Aggeu Magalhães Institute, Oswaldo Cruz Foundation (FIOCRUZ), Recife, Pernambuco, Brazil
- * E-mail:
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Fuller TL, Calvet G, Genaro Estevam C, Rafael Angelo J, Abiodun GJ, Halai UA, De Santis B, Carvalho Sequeira P, Machado Araujo E, Alves Sampaio S, Lima de Mendonça MC, Fabri A, Ribeiro RM, Harrigan R, Smith TB, Raja Gabaglia C, Brasil P, Bispo de Filippis AM, Nielsen-Saines K. Behavioral, climatic, and environmental risk factors for Zika and Chikungunya virus infections in Rio de Janeiro, Brazil, 2015-16. PLoS One 2017; 12:e0188002. [PMID: 29145452 PMCID: PMC5690671 DOI: 10.1371/journal.pone.0188002] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2017] [Accepted: 10/30/2017] [Indexed: 12/20/2022] Open
Abstract
The burden of arboviruses in the Americas is high and may result in long-term sequelae with infants disabled by Zika virus infection (ZIKV) and arthritis caused by infection with Chikungunya virus (CHIKV). We aimed to identify environmental drivers of arbovirus epidemics to predict where the next epidemics will occur and prioritize municipalities for vector control and eventual vaccination. We screened sera and urine samples (n = 10,459) from residents of 48 municipalities in the state of Rio de Janeiro for CHIKV, dengue virus (DENV), and ZIKV by molecular PCR diagnostics. Further, we assessed the spatial pattern of arbovirus incidence at the municipal and neighborhood scales and the timing of epidemics and major rainfall events. Lab-confirmed cases included 1,717 infections with ZIKV (43.8%) and 2,170 with CHIKV (55.4%) and only 29 (<1%) with DENV. ZIKV incidence was greater in neighborhoods with little access to municipal water infrastructure (r = -0.47, p = 1.2x10-8). CHIKV incidence was weakly correlated with urbanization (r = 0.2, p = 0.02). Rains began in October 2015 and were followed one month later by the largest wave of ZIKV epidemic. ZIKV cases markedly declined in February 2016, which coincided with the start of a CHIKV outbreak. Rainfall predicted ZIKV and CHIKV with a lead time of 3 weeks each time. The association between rainfall and epidemics reflects vector ecology as the larval stages of Aedes aegypti require pools of water to develop. The temporal dynamics of ZIKV and CHIKV may be explained by the shorter incubation period of the viruses in the mosquito vector; 2 days for CHIKV versus 10 days for ZIKV.
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Affiliation(s)
- Trevon L. Fuller
- Institute of the Environment and Sustainability, University of California Los Angeles, Los Angeles, California, United States of America
- * E-mail:
| | - Guilherme Calvet
- Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
| | | | | | - Gbenga J. Abiodun
- Foundation for Professional Development, Pretoria, Gauteng, South Africa
| | - Umme-Aiman Halai
- David Geffen UCLA School of Medicine, Los Angeles, California, United States of America
| | - Bianca De Santis
- Laboratorio de Referência de Flavivirus, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
| | - Patricia Carvalho Sequeira
- Laboratorio de Referência de Flavivirus, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
| | - Eliane Machado Araujo
- Laboratorio de Referência de Flavivirus, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
| | - Simone Alves Sampaio
- Laboratorio de Referência de Flavivirus, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
| | | | - Allison Fabri
- Laboratorio de Referência de Flavivirus, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
| | - Rita Maria Ribeiro
- Laboratorio de Referência de Flavivirus, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
| | - Ryan Harrigan
- Institute of the Environment and Sustainability, University of California Los Angeles, Los Angeles, California, United States of America
| | - Thomas B. Smith
- Institute of the Environment and Sustainability, University of California Los Angeles, Los Angeles, California, United States of America
- Department of Ecology and Evolutionary Biology, University of California Los Angeles, Los Angeles, California, United States of America
| | - Claudia Raja Gabaglia
- Biomedical Research Institute of Southern California, Oceanside, California, United States of America
| | - Patrícia Brasil
- Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
| | - Ana Maria Bispo de Filippis
- Laboratorio de Referência de Flavivirus, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
| | - Karin Nielsen-Saines
- David Geffen UCLA School of Medicine, Los Angeles, California, United States of America
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Vinholes DB, Bassanesi SL, Chaves Junior HDC, Machado CA, Melo IMF, Fuchs FD, Fuchs SC. Association of workplace and population characteristics with prevalence of hypertension among Brazilian industry workers: a multilevel analysis. BMJ Open 2017; 7:e015755. [PMID: 28827245 PMCID: PMC5724203 DOI: 10.1136/bmjopen-2016-015755] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Exposure to risk factors for hypertension may be influenced by the characteristics of the workplace, where workers spend most of their daily time. OBJECTIVES To evaluate the association between features of the companies, particularly the presence of facilities to provide meals, and of population characteristics and the prevalence of hypertension, taking into account individual risk factors for hypertension. MATERIAL AND METHODS This multilevel analysis was based on a cross-sectional study with individual and company data from the SESI (Serviço Social da Indústria-Social Service of Industries) study and population-based data from the national census statistics. Workers aged ≥15 years were randomly selected from small (20-99), medium (100-499) and large (≥500 employees) companies per state using multistage sampling. Logistic regression was used to analyse the association between hypertension and individual, workplace and population variables, with odds ratios (ORs; 95% CI) adjusted for three-level variables. RESULTS 4818 Workers from 157 companies were interviewed and their blood pressure, weight and height were measured. Overall, 77% were men, aged 35.4 ±10.7 years, with 8.7 ±4.1 years of schooling and mostly worked in companies with a staff canteen (66%). Besides individual characteristics-being male, ageing, low schooling, alcohol abuse and higher BMI-a workplace with no staff canteen (OR=1.28; 95% CI 1.08 to 1.52), small companies (OR=1.31; 95% CI 1.07 to 1.60) and living in cities with higher economic inequality (OR=1.47; 95% CI 1.23 to 1.76) were associated with a higher risk for hypertension. CONCLUSION Among Brazilian workers, the prevalence of hypertension is associated with individual risk factors, lack of a canteen at the workplace, small companies and higher economic inequalities of cities. These three-level characteristics help to interpret differences in the prevalence of hypertension between regions or countries.
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Affiliation(s)
- Daniele B Vinholes
- Postgraduate Studies Program in Epidemiology, School of Medicine, Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
| | - Sérgio L Bassanesi
- Postgraduate Studies Program in Epidemiology, School of Medicine, Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
| | | | - Carlos Alberto Machado
- Department of Cardiology, School of Medicine, Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil
| | - Ione M F Melo
- Formerly at Unit of Health and Safety of Work, Serviço Social da Indústria (SESI), Brasilia, Brazil
| | - Flavio Danni Fuchs
- Postgraduate Studies Program in Cardiology, School of Medicine, Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
- Division of Cardiology, Hospital de Clínicas de Porto Alegre, Porto Alegre, Rio Grande do Sul, Brazil
| | - Sandra Costa Fuchs
- Postgraduate Studies Program in Epidemiology, School of Medicine, Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
- Postgraduate Studies Program in Cardiology, School of Medicine, Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
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Marques-Toledo CDA, Degener CM, Vinhal L, Coelho G, Meira W, Codeço CT, Teixeira MM. Dengue prediction by the web: Tweets are a useful tool for estimating and forecasting Dengue at country and city level. PLoS Negl Trop Dis 2017; 11:e0005729. [PMID: 28719659 PMCID: PMC5533462 DOI: 10.1371/journal.pntd.0005729] [Citation(s) in RCA: 44] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2016] [Revised: 07/28/2017] [Accepted: 06/20/2017] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND Infectious diseases are a leading threat to public health. Accurate and timely monitoring of disease risk and progress can reduce their impact. Mentioning a disease in social networks is correlated with physician visits by patients, and can be used to estimate disease activity. Dengue is the fastest growing mosquito-borne viral disease, with an estimated annual incidence of 390 million infections, of which 96 million manifest clinically. Dengue burden is likely to increase in the future owing to trends toward increased urbanization, scarce water supplies and, possibly, environmental change. The epidemiological dynamic of Dengue is complex and difficult to predict, partly due to costly and slow surveillance systems. METHODOLOGY / PRINCIPAL FINDINGS In this study, we aimed to quantitatively assess the usefulness of data acquired by Twitter for the early detection and monitoring of Dengue epidemics, both at country and city level at a weekly basis. Here, we evaluated and demonstrated the potential of tweets modeling for Dengue estimation and forecast, in comparison with other available web-based data, Google Trends and Wikipedia access logs. Also, we studied the factors that might influence the goodness-of-fit of the model. We built a simple model based on tweets that was able to 'nowcast', i.e. estimate disease numbers in the same week, but also 'forecast' disease in future weeks. At the country level, tweets are strongly associated with Dengue cases, and can estimate present and future Dengue cases until 8 weeks in advance. At city level, tweets are also useful for estimating Dengue activity. Our model can be applied successfully to small and less developed cities, suggesting a robust construction, even though it may be influenced by the incidence of the disease, the activity of Twitter locally, and social factors, including human development index and internet access. CONCLUSIONS Tweets association with Dengue cases is valuable to assist traditional Dengue surveillance at real-time and low-cost. Tweets are able to successfully nowcast, i.e. estimate Dengue in the present week, but also forecast, i.e. predict Dengue at until 8 weeks in the future, both at country and city level with high estimation capacity.
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Affiliation(s)
- Cecilia de Almeida Marques-Toledo
- Departamento de Bioquimica e Imunologia do Instituto de Ciencias Biologicas, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
- Consultoria Tecnica, Ecovec LTDA, Belo Horizonte, Minas Gerais, Brazil
| | - Carolin Marlen Degener
- Programa de Computacao Cientifica, Fundacao Oswaldo Cruz, Rio de Janeiro, Rio de Janeiro, Brazil
| | - Livia Vinhal
- Secretaria de Vigilancia em Saude, Ministerio da Saude, Brasilia, Brazil
| | - Giovanini Coelho
- Secretaria de Vigilancia em Saude, Ministerio da Saude, Brasilia, Brazil
| | - Wagner Meira
- Departamento de Ciencia da Computacao do Instituto de Ciencias Exatas, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Claudia Torres Codeço
- Programa de Computacao Cientifica, Fundacao Oswaldo Cruz, Rio de Janeiro, Rio de Janeiro, Brazil
| | - Mauro Martins Teixeira
- Departamento de Bioquimica e Imunologia do Instituto de Ciencias Biologicas, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
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Clavijo A, Freire de Carvalho MH, Orciari LA, Velasco-Villa A, Ellison JA, Greenberg L, Yager PA, Green DB, Vigilato MA, Cosivi O, Del Rio-Vilas VJ. An inter- laboratory proficiency testing exercise for rabies diagnosis in Latin America and the Caribbean. PLoS Negl Trop Dis 2017; 11:e0005427. [PMID: 28369139 PMCID: PMC5391118 DOI: 10.1371/journal.pntd.0005427] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2016] [Revised: 04/13/2017] [Accepted: 02/21/2017] [Indexed: 12/02/2022] Open
Abstract
The direct fluorescent antibody test (DFA), is performed in all rabies reference laboratories across Latin America and the Caribbean (LAC). Despite DFA being a critical capacity in the control of rabies, there is not a standardized protocol in the region. We describe the results of the first inter-laboratory proficiency exercise of national rabies laboratories in LAC countries as part of the regional efforts towards dog-maintained rabies elimination in the American region. Twenty three laboratories affiliated to the Ministries of Health and Ministries of Agriculture participated in this exercise. In addition, the laboratories completed an online questionnaire to assess laboratory practices. Answers to the online questionnaire indicated large variability in the laboratories throughput, equipment used, protocols availability, quality control standards and biosafety requirements. Our results will inform actions to improve and harmonize laboratory rabies capacities across LAC in support for the regional efforts towards elimination of dog-maintained rabies.
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Affiliation(s)
- Alfonso Clavijo
- Pan American Foot-and-Mouth Disease Center, Pan American Health Organization, Rio de Janeiro, Brazil
| | | | - Lillian A. Orciari
- National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Andres Velasco-Villa
- National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - James A. Ellison
- National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Lauren Greenberg
- National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Pamela A. Yager
- National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Douglas B. Green
- National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Marco A. Vigilato
- Pan American Foot-and-Mouth Disease Center, Pan American Health Organization, Rio de Janeiro, Brazil
| | - Ottorino Cosivi
- Pan American Foot-and-Mouth Disease Center, Pan American Health Organization, Rio de Janeiro, Brazil
| | - Victor J. Del Rio-Vilas
- Pan American Foot-and-Mouth Disease Center, Pan American Health Organization, Rio de Janeiro, Brazil
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de Oliveira LH, Camacho LAB, Coutinho ESF, Martinez-Silveira MS, Carvalho AF, Ruiz-Matus C, Toscano CM. Impact and Effectiveness of 10 and 13-Valent Pneumococcal Conjugate Vaccines on Hospitalization and Mortality in Children Aged Less than 5 Years in Latin American Countries: A Systematic Review. PLoS One 2016; 11:e0166736. [PMID: 27941979 PMCID: PMC5152835 DOI: 10.1371/journal.pone.0166736] [Citation(s) in RCA: 93] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2016] [Accepted: 11/02/2016] [Indexed: 12/22/2022] Open
Abstract
Background Several Latin American and Caribbean (LAC) countries have introduced pneumococcal conjugate vaccine (PCV-10 or PCV-13) in their routine national immunization programs. Objectives We aimed to summarize the evidence of PCV impact and effectiveness in children under 5 years old in the LAC Region. Methods We conducted a systematic review of the literature on impact or effectiveness of PCVs on deaths or hospitalizations due to invasive pneumococcal disease (IPD), pneumonia, meningitis and sepsis. We searched Medline, WoS, Lilacs, Scopus, Central and gray literature published in any language from 2009 to January 2016. We included studies addressing the outcomes of interest in children in the target age group, and with the following designs: randomized trials, cohort or case-control, interrupted time series with at least three data points before and after the intervention, and before-after studies. Screening of citations, data extraction, and risk of bias assessment were conducted in duplicate by independent reviewers, according to the study protocol registered on PROSPERO. Descriptive analysis of the effectiveness measurements and sensitivity analysis were conducted. Effectiveness is reported as 1-OR or 1-RR for case control or cohort/clinical trials, and as percent change of disease incidence rates for before-after studies. Results We identified 1,085 citations, 892 from databases and 193 from other sources. Of these, 22 were further analyzed. Studies were from Brazil, Chile, Uruguay, Argentina, Peru and Nicaragua. Effectiveness ranged from 8.8–37.8% for hospitalizations due to X-ray confirmed pneumonia, 7.4–20.6% for clinical pneumonia, and 13.3–87.7% for meningitis hospitalizations, and 56–83.3% for IPD hospitalization, varying by age, outcome definition, type of vaccine and study design. Conclusions Available evidence to date indicates significant impact of both PCV-10 and PCV-13 in the outcomes studied, with no evidence of the superiority of one vaccine over the other on pneumonia, IPD or meningitis hospitalization reduction in children under 5 years old.
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Affiliation(s)
- Lucia Helena de Oliveira
- Immunization Unit/FGL, Pan American Health Organization, World Health Organization (PAHO), Washington DC, United States of America
- * E-mail:
| | - Luiz Antonio B. Camacho
- Department of Epidemiology and Quantitative Methods in Health, National Public Health School (ENSP), Oswaldo Cruz Foundation (Fiocruz), Rio de Janeiro, Brazil
| | - Evandro S. F. Coutinho
- Department of Epidemiology and Quantitative Methods in Health, National Public Health School (ENSP), Oswaldo Cruz Foundation (Fiocruz), Rio de Janeiro, Brazil
| | | | - Ana Flavia Carvalho
- Vaccine Advocacy and Education, Sabin Vaccine Institute, Washington DC, United States of America
| | - Cuauhtemoc Ruiz-Matus
- Immunization Unit/FGL, Pan American Health Organization, World Health Organization (PAHO), Washington DC, United States of America
| | - Cristiana M. Toscano
- Institute of Tropical Pathology and Public Health (IPTSP), Federal University of Goias (UFG), Goiânia, Goiás, Brazil
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Barbosa RM, Cabral CDS, do Lago TDG, Pinho ADA. Differences in the Access to Sterilization between Women Living and Not Living with HIV: Results from the GENIH Study, Brazil. PLoS One 2016; 11:e0164887. [PMID: 27812146 PMCID: PMC5094764 DOI: 10.1371/journal.pone.0164887] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2016] [Accepted: 10/03/2016] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND In many countries, young women of reproductive age have been especially affected by the HIV epidemic, which have fostered research to better understand how HIV infection influences and shapes women´s fertility and reproductive and sexual decisions. In Brazil, few studies have focused on the impact of the HIV epidemic on contraceptive choices among women living with HIV (WLHIV). OBJECTIVE This study evaluates the impact HIV infection may have in the access to female sterilization in Brazil, using a time-to-event analysis. METHODS A cross-sectional quantitative study (GENIH study) was conducted between February 2013 and April 2014 in the city of São Paulo, comparing two probabilistic samples of 975 WLHIV and 1,003 women not living with HIV (WNLHIV) aged 18 to 49. Sexual and reproductive data was collected retrospectively in order to reconstruct women's reproductive trajectories. Given the objectives of this study, the analysis was restricted to women with parity one or more and, in case of WLHIV, to those sterilized after HIV diagnosis and not infected through vertical transmission. The final sample analysis included 683 WNLHIV and 690 WLHIV. A series of multivariable-adjusted Cox models estimated the probability of being sterilized after HIV diagnosis, compared with WNLHIV. Models were adjusted for schooling, race/color, and stratified by parity at last delivery (1-2, 3+). Hazard ratios were calculated for female sterilization, and separately for interval and postpartum procedures (performed in conjunction with caesarean section or immediately after vaginal delivery). Additionally, information regarding unmet demand for female sterilization was also explored. FINDINGS No statistical difference in the overall risk of sterilization between WLHIV and WNLHIV in the two parity-related groups is observed: HR = 0.88 (0.54-1.43) and 0.94 (0.69-1.29), respectively, among women with 1-2 children and those with three and more. However, significant differences regarding the impact of HIV infection at sterilization are observed depending on the timing and the type of sterilization procedure. The probability of obtaining an interval sterilization is significantly lower for WLHIV compared to those not living with HIV. The reverse occurs regarding postpartum sterilization. Although sterilization is mainly performed in conjunction with caesarean section in Brazil, it is evident that caesarean sections are not the sole factor increasing the risk of sterilization among WLHIV. CONCLUSION The results indicate barriers in the access to services offering interval sterilization for WLHIV and certain facilitation in obtaining the procedure in conjunction with caesarean section. Health policy makers at local and national levels should promote institutional changes in order to facilitate access to interval sterilization and to confront the sensitive discussion of WLHIV's eligibility for postpartum sterilization. It is also urgent to increase access to a wider range of contraceptive methods for WLHIV and promote dual method protection strategies. Moreover, since condom use may decrease in the future in the context of the preventive effect of antiretroviral therapy, promoting dual methods will expand the choices regarding the reproductive rights of women living with HIV.
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Affiliation(s)
- Regina Maria Barbosa
- Núcleo de Estudos da População Elza Berquó –Universidade Estadual de Campinas–Campinas, Brazil
- Centro de Referêcia e Treinamento em DST/AIDS–Secretaria de Estado da Saúde de São Paulo–São Paulo, Brazil
| | - Cristiane da Silva Cabral
- Departamento de Saúde Materno-Infantil–Faculdade de Saúde Pública–Universidade de São Paulo–São Paulo, Brazil
| | | | - Adriana de Araujo Pinho
- Laboratório de Educação em Ambiente e Saúde–Instituto Oswaldo Cruz–Fiocruz–Rio de Janeiro, Brazil
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Beltrán-Alzate C, López Díaz F, Romero-Montoya M, Sakamuri R, Li W, Kimura M, Brennan P, Cardona-Castro N. Leprosy Drug Resistance Surveillance in Colombia: The Experience of a Sentinel Country. PLoS Negl Trop Dis 2016; 10:e0005041. [PMID: 27706165 PMCID: PMC5051701 DOI: 10.1371/journal.pntd.0005041] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2016] [Accepted: 09/14/2016] [Indexed: 12/02/2022] Open
Abstract
An active search for Mycobacterium leprae drug resistance was carried out, 243 multibacillary patients from endemic regions of Colombia were included from 2004 to 2013 in a surveillance program. This program was a World Health Organization initiative for drug resistance surveillance in leprosy, where Colombia is a sentinel country. M. leprae DNA from slit skin smear and/or skin biopsy samples was amplified and sequenced to identify mutations in the drug resistance determining region (DRDR) in rpoB, folP1, gyrA, and gyrB, the genes responsible for rifampicin, dapsone and ofloxacin drug-resistance, respectively. Three isolates exhibited mutations in the DRDR rpoB gene (Asp441Tyr, Ser456Leu, Ser458Met), two in the DRDR folP1 gene (Thr53Ala, Pro55Leu), and one isolate exhibited mutations in both DRDR rpoB (Ser456Met) and DRDR folP1 (Pro55Leu), suggesting multidrug resistance. One isolate had a double mutation in folP1 (Thr53Ala and Thr88Pro). Also, we detected mutations outside of DRDR that required in vivo evaluation of their association or not with drug resistance: rpoB Arg505Trp, folP1 Asp91His, Arg94Trp, and Thr88Pro, and gyrA Ala107Leu. Seventy percent of M. leprae mutations were related to drug resistance and were isolated from relapsed patients; the likelihood of relapse was significantly associated with the presence of confirmed resistance mutations (OR range 20.1-88.7, p < 0.05). Five of these relapsed patients received dapsone monotherapy as a primary treatment. In summary, the current study calls attention to M. leprae resistance in Colombia, especially the significant association between confirmed resistance mutations and relapse in leprosy patients. A high frequency of DRDR mutations for rifampicin was seen in a region where dapsone monotherapy was used extensively.
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Affiliation(s)
- Camilo Beltrán-Alzate
- Instituto Colombiano de Medicina Tropical–Universidad CES Sabaneta, Antioquia, Colombia
| | | | | | - Rama Sakamuri
- Department of Microbiology, Immunology and Pathology, Colorado State University, Fort Collins, Colorado, United States of America
| | - Wei Li
- Department of Microbiology, Immunology and Pathology, Colorado State University, Fort Collins, Colorado, United States of America
| | - Miyako Kimura
- Department of Microbiology, Immunology and Pathology, Colorado State University, Fort Collins, Colorado, United States of America
| | - Patrick Brennan
- Department of Microbiology, Immunology and Pathology, Colorado State University, Fort Collins, Colorado, United States of America
| | - Nora Cardona-Castro
- Instituto Colombiano de Medicina Tropical–Universidad CES Sabaneta, Antioquia, Colombia
- Facultad de Medicina. Universidad CES, Medellín, Colombia
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Kuan G, Ramirez S, Gresh L, Ojeda S, Melendez M, Sanchez N, Collado D, Garcia N, Mercado JC, Gordon A, Balmaseda A, Harris E. Seroprevalence of Anti-Chikungunya Virus Antibodies in Children and Adults in Managua, Nicaragua, After the First Chikungunya Epidemic, 2014-2015. PLoS Negl Trop Dis 2016; 10:e0004773. [PMID: 27322692 PMCID: PMC4913910 DOI: 10.1371/journal.pntd.0004773] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2015] [Accepted: 05/20/2016] [Indexed: 01/25/2023] Open
Abstract
Chikungunya is a viral disease transmitted by Aedes aegypti and Ae. albopictus mosquitoes. In late 2013, chikungunya virus (CHIKV) was introduced into the Caribbean island of St. Martin. Since then, approximately 2 million chikungunya cases have been reported by the Pan American Health Organization, and most countries in the Americas report autochthonous transmission of CHIKV. In Nicaragua, the first imported case was described in July 2014 and the first autochthonous case in September 2014. Here, we conducted two studies to analyze the seroprevalence of anti-CHIKV antibodies after the first chikungunya epidemic in a community-based cohort study (ages 2-14 years) and in a cross-sectional survey of persons aged ≥15 years in the same area of Managua, Nicaragua. Routine annual serum samples collected from 3,362 cohort participants in March/April 2014 and 2015, and 848 age-stratified samples collected from persons ≥15 years old at the end of May-beginning of June 2015 were used to estimate the seroprevalence of anti-CHIKV antibodies after the first epidemic (October 2014 to February 2015 in the study population). Using an Inhibition ELISA assay that measures total anti-CHIKV antibodies, the seroprevalence was significantly higher in those aged ≥15 (13.1% (95%CI: 10.9, 15.5)) than in the pediatric population (6.1% (95%CI: 5.3, 6.9)). The proportion of inapparent infections was 58.3% (95%CI: 51.5, 65.1) in children and 64.9% (95%CI: 55.2, 73.7) in the ≥15 study population. We identified age, water availability, household size, and socioeconomic status as factors associated with the presence of anti-CHIKV antibodies. Overall, this is the first report of CHIKV seropositivity in continental Latin America and provides useful information for public health authorities in the region.
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Affiliation(s)
- Guillermina Kuan
- Centro de Salud Sócrates Flores Vivas, Ministry of Health, Managua, Nicaragua
| | - Stephania Ramirez
- Sustainable Sciences Institute, Managua, Nicaragua
- Division of Infectious Diseases and Vaccinology, School of Public Health, University of California, Berkeley, Berkeley, United States of America
| | - Lionel Gresh
- Sustainable Sciences Institute, Managua, Nicaragua
| | - Sergio Ojeda
- Sustainable Sciences Institute, Managua, Nicaragua
| | | | - Nery Sanchez
- Sustainable Sciences Institute, Managua, Nicaragua
| | - Damaris Collado
- National Virology Laboratory, Centro Nacional de Diagnóstico y Referencia, Ministry of Health, Managua, Nicaragua
| | - Nadezna Garcia
- National Virology Laboratory, Centro Nacional de Diagnóstico y Referencia, Ministry of Health, Managua, Nicaragua
| | - Juan Carlos Mercado
- National Virology Laboratory, Centro Nacional de Diagnóstico y Referencia, Ministry of Health, Managua, Nicaragua
| | - Aubree Gordon
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, United States of America
| | - Angel Balmaseda
- National Virology Laboratory, Centro Nacional de Diagnóstico y Referencia, Ministry of Health, Managua, Nicaragua
| | - Eva Harris
- Division of Infectious Diseases and Vaccinology, School of Public Health, University of California, Berkeley, Berkeley, United States of America
- * E-mail:
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