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Vieira-Meyer A, Guimarães JMX, Morais APP, Dias MSA, Vieira NFC, Farias SF, Oliveira ALS, Meyer CHC, Vasconcelos MIO, Yousafzai A. Readiness of Community Health Agents for COVID19. Eur J Public Health 2022. [PMCID: PMC9593920 DOI: 10.1093/eurpub/ckac129.546] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Brazil is one of the countries with the highest COVID19 mortality numbers. COVID19 deaths affected disproportionally different populations/communities, tending to be higher among more vulnerable ones. Brazil has a public-funded unified health system (SUS) built on the aegis of equity and social control. Its Primary Health Care (PHC) is organized by the Family Health Strategy (FHS) through Family Health Teams (FHT), which comprise a family doctor, a nurse, a dentist, nurse auxiliaries and Community Health Agents (CHAs). CHAs are individuals from the community trained to provide a range of services in the territories, including home visits, health promotion activities, and serve as liaisons between health units and communities. In this context, CHAs have the potential to play an important role in fighting the pandemic by working on contact tracing, collecting information on infected people, and providing guidance to them and the community in order to contain community transmission. However, not much is known about their readiness regarding the COVID19 pandemic in one of the Brazil's poorest regions. Thus, this study evaluated, though CHA perspective, aspects related to their preparedness for COVID19 in Brazil's northeast region. Questionnaires were applied to CHAs from 8 different municipalities - 4 capitals and 4 country-side municipalities. A total of 1935 CHAs were interviewed at their workplace in 2021. 77.8% said that they were acting in the COVID19 frontline, but only 16% referred to have received training for this function. Furthermore, only 13.7% mention to have had access to adequate individual protective equipment during their work, and 91.6% believe that they can get infected by SAR-COV-2 during their work duties. Additionally, 93.9% considered themselves a transmission vehicle due to work. Despite their potential in the fight against COVID19, CHAs did not received enough training, nor were equipped adequately during the COVID19 pandemic. Key messages • CHAs did not received enough training, nor were equipped adequately during the COVID19 pandemic. • Addequate trainning and work environment are essencial for proper work development.
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Affiliation(s)
- A Vieira-Meyer
- Family Health, Oswaldo Cruz Foundation Ceará , Eusébio, Brazil
- Dentistry, Unichristus , Fortaleza, Brazil
| | - JMX Guimarães
- Universidade Estadual do Ceará Nursing, , Fortaleza, Brazil
| | - APP Morais
- Universidade Estadual do Ceará Nursing, , Fortaleza, Brazil
| | - MSA Dias
- Centro de Ciências da Saúde, Universidade Estadual do Ceará , Sobral, Brazil
| | - NFC Vieira
- FFOE, Universidade Federal do Ceará , Fortaleza, Brazil
| | - SF Farias
- Public Health, Oswaldo Cruz Foundation Pernambuco , Recife, Brazil
| | - ALS Oliveira
- Public Health, Oswaldo Cruz Foundation Pernambuco , Recife, Brazil
| | - CHC Meyer
- Justiça Federal do Ceará , Fortaleza, Brazil
| | - MIO Vasconcelos
- Centro de Ciências da Saúde, Universidade Estadual do Ceará , Sobral, Brazil
| | - A Yousafzai
- Department of Global Health and Population, Harvard University , Boston, USA
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Magalhaes T, Morais CNL, Jacques IJAA, Azevedo EAN, Brito AM, Lima PV, Carvalho GMM, Lima ARS, Castanha PMS, Cordeiro MT, Oliveira ALS, Jaenisch T, Lamb MM, Marques ETA, Foy BD. Erratum to: Follow-Up Household Serosurvey in Northeast Brazil for Zika Virus: Sexual Contacts of Index Patients Have the Highest Risk for Seropositivity. J Infect Dis 2020; 223:736. [PMID: 33332568 DOI: 10.1093/infdis/jiaa725] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- Tereza Magalhaes
- Arthropod-borne and Infectious Diseases Laboratory, Department of Microbiology, Pathology and Immunology, Colorado State University, Fort Collins, Colorado, USA
| | - Clarice N L Morais
- Department of Virology, Aggeu Magalhaes Institute, Oswaldo Cruz Foundation, Recife, Brazil
| | - Iracema J A A Jacques
- Department of Collective Health, Aggeu Magalhaes Institute, Oswaldo Cruz Foundation, Recife, Brazil
| | - Elisa A N Azevedo
- Department of Virology, Aggeu Magalhaes Institute, Oswaldo Cruz Foundation, Recife, Brazil
| | - Ana M Brito
- Department of Collective Health, Aggeu Magalhaes Institute, Oswaldo Cruz Foundation, Recife, Brazil
| | - Priscilla V Lima
- Department of Virology, Aggeu Magalhaes Institute, Oswaldo Cruz Foundation, Recife, Brazil
| | - Gabriella M M Carvalho
- Department of Virology, Aggeu Magalhaes Institute, Oswaldo Cruz Foundation, Recife, Brazil
| | - Andreza R S Lima
- Department of Virology, Aggeu Magalhaes Institute, Oswaldo Cruz Foundation, Recife, Brazil
| | - Priscila M S Castanha
- Infectious Disease and Microbiology Department, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.,Faculty of Medical Science, University of Pernambuco, Recife, Brazil
| | - Marli T Cordeiro
- Department of Virology, Aggeu Magalhaes Institute, Oswaldo Cruz Foundation, Recife, Brazil
| | - Andre L S Oliveira
- Statistics and Geoprocessing Laboratory, Aggeu Magalhaes Institute, Oswaldo Cruz Foundation, Recife, Brazil
| | - Thomas Jaenisch
- Center for Global Health, University of Colorado School of Public Health, Aurora, Colorado, USA.,Department of Epidemiology, University of Colorado School of Public Health, Aurora, Colorado, USA.,Heidelberg Institute of Global Health, Heidelberg University Hospital, Heidelberg, Germany
| | - Molly M Lamb
- Center for Global Health, University of Colorado School of Public Health, Aurora, Colorado, USA.,Department of Epidemiology, University of Colorado School of Public Health, Aurora, Colorado, USA
| | - Ernesto T A Marques
- Infectious Disease and Microbiology Department, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Brian D Foy
- Arthropod-borne and Infectious Diseases Laboratory, Department of Microbiology, Pathology and Immunology, Colorado State University, Fort Collins, Colorado, USA
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Magalhaes T, Morais CNL, Jacques IJAA, Azevedo EAN, Brito AM, Lima PV, Carvalho GMM, Lima ARS, Castanha PMS, Cordeiro MT, Oliveira ALS, Jaenisch T, Lamb MM, Marques ETA, Foy BD. Follow-Up Household Serosurvey in Northeast Brazil for Zika Virus: Sexual Contacts of Index Patients Have the Highest Risk for Seropositivity. J Infect Dis 2020; 223:673-685. [PMID: 32888023 DOI: 10.1093/infdis/jiaa563] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Accepted: 09/01/2020] [Indexed: 01/14/2023] Open
Abstract
BACKGROUND Zika virus (ZIKV) is a mosquito-borne virus that is also transmitted sexually; however, the epidemiological relevance of ZIKV sexual transmission in endemic regions is unclear. METHODS We performed a household-based serosurvey in Northeast Brazil to evaluate the differential exposure to ZIKV and chikungunya virus (CHIKV) among households. Individuals who participated in our previous arboviral disease cohort (indexes) were recontacted and enrolled, and their household members were newly enrolled. RESULTS The relative risk of sexual partners being ZIKV-seropositive when living with a ZIKV-seropositive index participant was significantly higher, whereas this was not observed among nonsexual partners of the index. For CHIKV, both sexual and nonsexual partner household members living with a CHIKV-seropositive index had a significantly higher risk of being seropositive. In the nonindex-based dyadic and generalized linear mixed model analyses, the odds of sexual dyads having a concordant ZIKV plaque reduction neutralization test result was significantly higher. We have also analyzed retrospective clinical data according to the participants' exposure to ZIKV and CHIKV. CONCLUSIONS Our data suggest that ZIKV sexual transmission may be a key factor for the high ZIKV seroprevalence among households in endemic areas and raises important questions about differential disease from the 2 modes of transmission.
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Affiliation(s)
- Tereza Magalhaes
- Arthropod-borne and Infectious Diseases Laboratory, Department of Microbiology, Pathology and Immunology, Colorado State University, Fort Collins, Colorado, USA
| | - Clarice N L Morais
- Department of Virology, Aggeu Magalhaes Institute, Oswaldo Cruz Foundation, Recife, Brazil
| | - Iracema J A A Jacques
- Department of Collective Health, Aggeu Magalhaes Institute, Oswaldo Cruz Foundation, Recife, Brazil
| | - Elisa A N Azevedo
- Department of Virology, Aggeu Magalhaes Institute, Oswaldo Cruz Foundation, Recife, Brazil
| | - Ana M Brito
- Department of Collective Health, Aggeu Magalhaes Institute, Oswaldo Cruz Foundation, Recife, Brazil
| | - Priscilla V Lima
- Department of Virology, Aggeu Magalhaes Institute, Oswaldo Cruz Foundation, Recife, Brazil
| | - Gabriella M M Carvalho
- Department of Virology, Aggeu Magalhaes Institute, Oswaldo Cruz Foundation, Recife, Brazil
| | - Andreza R S Lima
- Department of Virology, Aggeu Magalhaes Institute, Oswaldo Cruz Foundation, Recife, Brazil
| | - Priscila M S Castanha
- Infectious Disease and Microbiology Department, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.,Faculty of Medical Science, University of Pernambuco, Recife, Brazil
| | - Marli T Cordeiro
- Department of Virology, Aggeu Magalhaes Institute, Oswaldo Cruz Foundation, Recife, Brazil
| | - Andre L S Oliveira
- Statistics and Geoprocessing Laboratory, Aggeu Magalhaes Institute, Oswaldo Cruz Foundation, Recife, Brazil
| | - Thomas Jaenisch
- Center for Global Health, University of Colorado School of Public Health, Aurora, Colorado, USA.,Department of Epidemiology, University of Colorado School of Public Health, Aurora, Colorado, USA.,Heidelberg Institute of Global Health, Heidelberg University Hospital, Heidelberg, Germany
| | - Molly M Lamb
- Center for Global Health, University of Colorado School of Public Health, Aurora, Colorado, USA.,Department of Epidemiology, University of Colorado School of Public Health, Aurora, Colorado, USA
| | - Ernesto T A Marques
- Infectious Disease and Microbiology Department, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Brian D Foy
- Arthropod-borne and Infectious Diseases Laboratory, Department of Microbiology, Pathology and Immunology, Colorado State University, Fort Collins, Colorado, USA
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Magalhaes T, Braga C, Cordeiro MT, Oliveira ALS, Castanha PMS, Maciel APR, Amancio NML, Gouveia PN, Peixoto-da-Silva VJ, Peixoto TFL, Britto H, Lima PV, Lima ARS, Rosenberger KD, Jaenisch T, Marques ETA. Zika virus displacement by a chikungunya outbreak in Recife, Brazil. PLoS Negl Trop Dis 2017; 11:e0006055. [PMID: 29108009 PMCID: PMC5697888 DOI: 10.1371/journal.pntd.0006055] [Citation(s) in RCA: 43] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2017] [Revised: 11/21/2017] [Accepted: 10/19/2017] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Several arboviruses, including dengue virus (DENV), Zika virus (ZIKV) and chikungunya virus (CHIKV), transmitted by Aedes mosquitoes, circulate in northeast Brazil. Diseases caused by these viruses are of great public health relevance, however, their epidemiological features in areas where the three viruses co-circulate are scarce. Here, we present analyses of molecular and serological diagnostics in a prospective study of acute febrile patients recruited from May 2015 to May 2016 in Recife, Brazil. METHODS Two hundred sixty-three acute febrile patients with symptoms suggestive of an arboviral disease who attended an urgent heath care clinic in the Recife Metropolitan Region in northeast Brazil were enrolled. Acute and convalescent blood samples were collected and tested using molecular and serological assays for infection with DENV, ZIKV and CHIKV. RESULTS Quantitative real-time reverse-transcriptase polymerase chain reactions (qRTPCR) performed on acute phase sera detected no patients positive for DENV, but 26 (9.9%) positive for ZIKV and 132 (50.2%) positive for CHIKV. There were a few suspected and only one confirmed dengue case. Specific serological assays for ZIKV and CHIKV confirmed the qRTPCR data. Analyses of DENV IgM and IgG ELISAs in the context of qRTPCR results suggested high levels of cross reactive antibodies in ZIKV-positive samples. Results from neutralization assays highly corroborated those from qRTPCR and ZIKV ELISA, indicating very few positive DENV cases. ZIKV infections were temporally clustered in the first months of the study and started to decrease concomitantly with an increase in CHIKV infections in August 2015. The proportion of CHIKV infections increased significantly in September 2015 and remained high until the end of the study period, with an average of 84.7% of recruited patients being diagnosed from August 2015 to May 2016. ZIKV infections exhibited a female bias and the cases were spread over the study site, while CHIKV cases had a male bias and were spatially clustered in each month. CONCLUSIONS In 2015-2016 in the Recife Metropolitan Region, we detected the tail end of a Zika epidemic, which was displaced by a chikungunya epidemic. Few dengue cases were identified despite a high number of official dengue notifications in the area during this period. We show here important epidemiological features of these cases.
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Affiliation(s)
- Tereza Magalhaes
- Laboratory of Virology and Experimental Therapeutics, Aggeu Magalhaes Institute (Instituto Aggeu Magalhães-IAM), Oswaldo Cruz Foundation (Fundação Oswaldo Cruz-FIOCRUZ), Recife, Brazil.,Arthropod-borne and infectious Diseases Laboratory (AIDL), Department of Microbiology, Immunology and Pathology, Colorado State University (CSU), Fort Collins, United States of America
| | - Cynthia Braga
- Department of Parasitology, IAM, FIOCRUZ, Recife, Brazil.,Institute of Integral Medicine Professor Fernando Figueira (Instituto de Medicina Integral Professor Fernando Figueira-IMIP), Recife, Brazil
| | - Marli T Cordeiro
- Laboratory of Virology and Experimental Therapeutics, Aggeu Magalhaes Institute (Instituto Aggeu Magalhães-IAM), Oswaldo Cruz Foundation (Fundação Oswaldo Cruz-FIOCRUZ), Recife, Brazil
| | | | - Priscila M S Castanha
- Laboratory of Virology and Experimental Therapeutics, Aggeu Magalhaes Institute (Instituto Aggeu Magalhães-IAM), Oswaldo Cruz Foundation (Fundação Oswaldo Cruz-FIOCRUZ), Recife, Brazil.,Faculty of Medical Science, University of Pernambuco (Universidade de Pernambuco-UPE), Recife, Brazil
| | - Ana Paula R Maciel
- Urgent Health Care Unit (Unidade de Pronto Atendimento-UPA) of Paulista, IMIP, Paulista, Brazil
| | - Nathalia M L Amancio
- Urgent Health Care Unit (Unidade de Pronto Atendimento-UPA) of Paulista, IMIP, Paulista, Brazil
| | - Pollyanne N Gouveia
- Urgent Health Care Unit (Unidade de Pronto Atendimento-UPA) of Paulista, IMIP, Paulista, Brazil
| | | | - Thaciana F L Peixoto
- Urgent Health Care Unit (Unidade de Pronto Atendimento-UPA) of Paulista, IMIP, Paulista, Brazil
| | - Helena Britto
- Institute of Integral Medicine Professor Fernando Figueira (Instituto de Medicina Integral Professor Fernando Figueira-IMIP), Recife, Brazil
| | - Priscilla V Lima
- Laboratory of Virology and Experimental Therapeutics, Aggeu Magalhaes Institute (Instituto Aggeu Magalhães-IAM), Oswaldo Cruz Foundation (Fundação Oswaldo Cruz-FIOCRUZ), Recife, Brazil
| | - Andreza R S Lima
- Laboratory of Virology and Experimental Therapeutics, Aggeu Magalhaes Institute (Instituto Aggeu Magalhães-IAM), Oswaldo Cruz Foundation (Fundação Oswaldo Cruz-FIOCRUZ), Recife, Brazil
| | - Kerstin D Rosenberger
- Section Clinical Tropical Medicine, Department of Infectious Diseases, Heidelberg University Hospital, Heidelberg, Germany
| | - Thomas Jaenisch
- Section Clinical Tropical Medicine, Department of Infectious Diseases, Heidelberg University Hospital, Heidelberg, Germany.,German Centre for Infection Research (DZIF), partner site Heidelberg, Heidelberg, Germany
| | - Ernesto T A Marques
- Laboratory of Virology and Experimental Therapeutics, Aggeu Magalhaes Institute (Instituto Aggeu Magalhães-IAM), Oswaldo Cruz Foundation (Fundação Oswaldo Cruz-FIOCRUZ), Recife, Brazil.,Center for Vaccine Research, University of Pittsburgh, Pittsburgh, United States of America
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