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de Oliveira LA, de Rezende IM, Navarini VJ, Marchioro SB, Torres AJL, Croda J, Croda MG, Gonçalves CCM, Xavier J, de Castro E, Lima M, Iani F, Adelino T, Aburjaile F, Ferraz Demarchi LH, Taira DL, Zardin MCSU, Fonseca V, Giovanetti M, Andrews J, Alcantara LCJ, Simionatto S. Genomic characterization of SARS-CoV-2 from an indigenous reserve in Mato Grosso do Sul, Brazil. Front Public Health 2023; 11:1195779. [PMID: 37965526 PMCID: PMC10641392 DOI: 10.3389/fpubh.2023.1195779] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Accepted: 09/04/2023] [Indexed: 11/16/2023] Open
Abstract
Background The COVID-19 pandemic had a major impact on indigenous populations. Understanding the viral dynamics within this population is essential to create targeted protection measures. Methods A total of 204 SARS-CoV-2 positive samples collected between May 2020 and November 2021 from an indigenous area in Mato Grosso do Sul (MS), Midwestern Brazil, were screened. Samples were submitted to whole genome sequencing using the Nanopore sequencing platform. Clinical, demographic, and phylogenetic data were analyzed. Results We found the co-circulation of six main SARS-CoV-2 lineages in the indigenous population, with the Zeta lineage being the most prevalent (27.66%), followed by B.1.1 (an ancestral strain) (20.21%), Gamma (14.36%) and Delta (13.83%). Other lineages represent 45.74% of the total. Our phylogenetic reconstruction indicates that multiple introduction events of different SARS-CoV-2 lineages occurred in the indigenous villages in MS. The estimated indigenous population mortality rate was 1.47%. Regarding the ethnicity of our cohort, 64.82% belong to the Guarani ethnicity, while 33.16% belong to the Terena ethnicity, with a slightly higher prevalence of males (53.43%) among females. Other ethnicities represent 2.01%. We also observed that almost all patients (89.55%) presented signs and symptoms related to COVID-19, being the most prevalent cough, fever, sore throat, and headache. Discussion Our results revealed that multiple independent SARS-CoV-2 introduction events had occurred through time, probably due to indigenous mobility, since the villages studied here are close to urban areas in MS. The mortality rate was slightly below of the estimation for the state in the period studied, which we believe could be related to the small number of samples evaluated, the underreporting of cases and deaths among this population, and the inconsistency of secondary data available for this study. Conclusion In this study, we showed the circulation of multiple SARS-CoV-2 variants in this population, which should be isolated and protected as they belong to the most fragile group due to their socioeconomic and cultural disparities. We reinforce the need for constant genomic surveillance to monitor and prevent the spread of new emerging viruses and to better understand the viral dynamics in these populations, making it possible to direct specific actions.
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Affiliation(s)
- Laís Albuquerque de Oliveira
- Health Sciences Research Laboratory, Federal University of Grande Dourados, Dourados, Mato Grosso do Sul, Brazil
| | - Izabela Mauricio de Rezende
- Stanford Pandemic Preparedness Hub, Department of Medicine, Division of Infectious Diseases and Geographic Medicine, Stanford University School of Medicine, Stanford, CA, United States
| | - Vinicius João Navarini
- Health Sciences Research Laboratory, Federal University of Grande Dourados, Dourados, Mato Grosso do Sul, Brazil
| | - Silvana Beutinger Marchioro
- Laboratory of Immunology and Molecular Biology, Institute of Health Sciences, Federal University of Bahia, Salvador, Bahia, Brazil
| | - Alex José Leite Torres
- Laboratory of Immunology and Molecular Biology, Institute of Health Sciences, Federal University of Bahia, Salvador, Bahia, Brazil
| | - Julio Croda
- Oswaldo Cruz Foundation, Campo Grande, Mato Grosso do Sul, Brazil
- Faculdade de Medicina (FAMED), Universidade Federal do Mato Grosso do Sul, Campo Grande, Mato Grosso do Sul, Brazil
| | - Mariana Garcia Croda
- Faculdade de Medicina (FAMED), Universidade Federal do Mato Grosso do Sul, Campo Grande, Mato Grosso do Sul, Brazil
| | - Crhistinne Cavalheiro Maymone Gonçalves
- School of Medicine, Federal University of Mato Grosso do Sul, Campo Grande, Mato Grosso do Sul, Brazil
- State Secretariat of Health of Mato Grosso do Sul, Campo Grande, Mato Grosso do Sul, Brazil
| | - Joilson Xavier
- Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Emerson de Castro
- Ezequiel Dias Foundation (FUNED), Belo Horizonte, Minas Gerais, Brazil
| | - Mauricio Lima
- Ezequiel Dias Foundation (FUNED), Belo Horizonte, Minas Gerais, Brazil
| | - Felipe Iani
- Ezequiel Dias Foundation (FUNED), Belo Horizonte, Minas Gerais, Brazil
| | - Talita Adelino
- Ezequiel Dias Foundation (FUNED), Belo Horizonte, Minas Gerais, Brazil
| | - Flávia Aburjaile
- Preventive Veterinary Medicine Departament, Veterinary School, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | | | - Deborah Ledesma Taira
- State Secretariat of Health of Mato Grosso do Sul, Campo Grande, Mato Grosso do Sul, Brazil
| | | | - Vagner Fonseca
- Pan American Health Organization - PAHO, Brasília, Distrito Federal, Brazil
| | - Marta Giovanetti
- Rene Rachou, Fundação Oswaldo Cruz, Belo Horizonte, Minas Gerais, Brazil
- Sciences and Technologies for Sustainable Development and One Health, Università Campus Bio-Medico di Roma, Rome, Italy
- Climate-Amplified Diseases and Epidemics (CLIMADE) Rio de Janeiro, Rio de Janeiro, Brazil
| | - Jason Andrews
- Stanford Pandemic Preparedness Hub, Department of Medicine, Division of Infectious Diseases and Geographic Medicine, Stanford University School of Medicine, Stanford, CA, United States
| | - Luiz Carlos Junior Alcantara
- Rene Rachou, Fundação Oswaldo Cruz, Belo Horizonte, Minas Gerais, Brazil
- Climate-Amplified Diseases and Epidemics (CLIMADE) Rio de Janeiro, Rio de Janeiro, Brazil
| | - Simone Simionatto
- Health Sciences Research Laboratory, Federal University of Grande Dourados, Dourados, Mato Grosso do Sul, Brazil
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Pescarini JM, Cardoso AM, Santos RV, Scaff PF, Paixao ES, Ranzani OT, Cerqueira-Silva T, Boaventura VS, Bertoldo-Junior J, de Oliveira VA, Werneck GL, Barreto ML, Barral-Netto M. Vaccine coverage and effectiveness against laboratory-confirmed symptomatic and severe Covid-19 in indigenous people in Brazil: a cohort study. BMC Public Health 2023; 23:1267. [PMID: 37386490 PMCID: PMC10311776 DOI: 10.1186/s12889-023-16196-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Accepted: 06/27/2023] [Indexed: 07/01/2023] Open
Abstract
BACKGROUND Indigenous people have historically suffered devastating impacts from epidemics and continue to have lower access to healthcare and be especially vulnerable to respiratory infections. We estimated the coverage and effectiveness of Covid-19 vaccines against laboratory-confirmed Covid-19 cases among indigenous people in Brazil. METHODS We linked nationwide Covid-19 vaccination data with flu-like surveillance records and studied a cohort of vaccinated indigenous people aged ≥ 5 years between 18th January 2021 and 1st March 2022. We considered individuals unexposed from the date they received the first dose of vaccine until the 13th day of vaccination, partially vaccinated from the 14th day after the first dose until the 13th day after receiving the second dose, and fully vaccinated onwards. We estimated the Covid-19 vaccination coverage and used Poisson regression to calculate the relative risks (RR) and vaccine effectiveness (VE) of CoronaVac, ChAdOx1, and BNT162b2 against Covid-19 laboratory-confirmed cases incidence, mortality, hospitalisation, and hospital-progression to Intensive Care Unit (ICU) or death. VE was estimated as (1-RR)*100, comparing unexposed to partially or fully vaccinated. RESULTS By 1st March 2022, 48.7% (35.0-62.3) of eligible indigenous people vs. 74.8% (57.9-91.8) overall Brazilians had been fully vaccinated for Covid-19. Among fully vaccinated indigenous people, we found a lower risk of symptomatic cases (RR: 0.47, 95%CI: 0.40-0.56) and mortality (RR: 0.47, 95%CI: 0.14-1.56) after the 14th day of the second dose. VE for the three Covid-19 vaccines combined was 53% (95%CI:44-60%) for symptomatic cases, 53% (95%CI:-56-86%) for mortality and 41% (95%CI:-35-75%) for hospitalisation. In our sample, we found that vaccination did not reduce Covid-19 related hospitalisation. However, among hospitalised patients, we found a lower risk of progression to ICU (RR: 0.14, 95%CI: 0.02-0.81; VE: 87%, 95%CI:27-98%) and Covid-19 death (RR: 0.04, 95%CI:0.01-0.10; VE: 96%, 95%CI: 90-99%) after the 14th day of the second dose. CONCLUSIONS Lower coverage but similar Covid-19 VE among indigenous people than overall Brazilians suggest the need to expand access, timely vaccination, and urgently offer booster doses to achieve a great level of protection among this group.
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Affiliation(s)
- Julia M Pescarini
- Center of Data and Knowledge Integration for Health (Cidacs), Fiocruz, Salvador, BA, Brazil.
- London School of Hygiene and Tropical Medicine, London, UK.
| | - Andrey M Cardoso
- Escola Nacional de Saúde Pública (ENSP), Fundação Oswaldo Cruz, Rio de Janeiro, RJ, Brazil.
| | - Ricardo Ventura Santos
- Escola Nacional de Saúde Pública (ENSP), Fundação Oswaldo Cruz, Rio de Janeiro, RJ, Brazil
- Museu Nacional, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Priscila F Scaff
- Center of Data and Knowledge Integration for Health (Cidacs), Fiocruz, Salvador, BA, Brazil
| | - Enny S Paixao
- Center of Data and Knowledge Integration for Health (Cidacs), Fiocruz, Salvador, BA, Brazil
- London School of Hygiene and Tropical Medicine, London, UK
| | - Otavio T Ranzani
- Barcelona Institute for Global Health, Universitat Pompeu Fabra (UPF), CIBER Epidemiología y Salud Pública (CIBERESP), ISGlobal, Barcelona, Spain
- Pulmonary Division, Heart Institute, Faculty of Medicine, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | - Thiago Cerqueira-Silva
- Universidade Federal da Bahia (UFBA), Salvador, BA, Brazil
- LIB and LEITV Laboratories, Instituto Gonçalo Moniz, Fiocruz, Salvador, BA, Brazil
| | - Viviane S Boaventura
- Universidade Federal da Bahia (UFBA), Salvador, BA, Brazil
- LIB and LEITV Laboratories, Instituto Gonçalo Moniz, Fiocruz, Salvador, BA, Brazil
| | - Juracy Bertoldo-Junior
- Center of Data and Knowledge Integration for Health (Cidacs), Fiocruz, Salvador, BA, Brazil
- Barcelona Institute for Global Health, Universitat Pompeu Fabra (UPF), CIBER Epidemiología y Salud Pública (CIBERESP), ISGlobal, Barcelona, Spain
- Universidade Federal da Bahia (UFBA), Salvador, BA, Brazil
| | - Vinicius A de Oliveira
- Center of Data and Knowledge Integration for Health (Cidacs), Fiocruz, Salvador, BA, Brazil
- Universidade Federal da Bahia (UFBA), Salvador, BA, Brazil
- LIB and LEITV Laboratories, Instituto Gonçalo Moniz, Fiocruz, Salvador, BA, Brazil
| | - Guilherme L Werneck
- Universidade do Estado do Rio de Janeiro, Rio de Janeiro, RJ, Brazil
- Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, RJ, Brazil
| | - Mauricio L Barreto
- Center of Data and Knowledge Integration for Health (Cidacs), Fiocruz, Salvador, BA, Brazil
| | - Manoel Barral-Netto
- Center of Data and Knowledge Integration for Health (Cidacs), Fiocruz, Salvador, BA, Brazil
- Universidade Federal da Bahia (UFBA), Salvador, BA, Brazil
- LIB and LEITV Laboratories, Instituto Gonçalo Moniz, Fiocruz, Salvador, BA, Brazil
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3
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Lucas PCC, Lorenz C, Florez-Montero GL, Palasio RGS, Portella TP, Monteiro PCM, Yu ALF, Carvalhanas TRMP. Institutional outbreaks of influenza-like illnesses in the state of São Paulo: an analysis of the epidemiological profile during the COVID-19 pandemic. Public Health 2023; 221:142-149. [PMID: 37454404 DOI: 10.1016/j.puhe.2023.06.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Revised: 05/22/2023] [Accepted: 06/13/2023] [Indexed: 07/18/2023]
Abstract
OBJECTIVES This study aimed to spatiotemporally analyze the profile of influenza-like illness (ILI) outbreaks in the state of São Paulo, Brazil, between 2020 and 2022. STUDY DESIGN This was a cross-sectional retrospective study. METHODS Outbreaks of ILI with final diagnoses of COVID-19, influenza, or other respiratory viruses (ORVs) recorded between January 2020 and November 2022, obtained from the Notifiable Diseases Information System (SINAN NET) Outbreak module, were analyzed. Kernel density estimates and Getis-Ord Gi∗ statistics were performed to identify spatial clusters. RESULTS A total of 13,314 ILI outbreaks were identified, involving 130,568 cases and 2649 deaths. Of these, 104,399 (80%) were confirmed as COVID-19, 15,861 (12%) were confirmed as ORV, and 10,308 (8%) were confirmed as influenza. The year 2021 had the highest number of outbreaks and cases. Schools recorded the most outbreaks and cases, followed by long-term care facilities for older adults (LTCs). The highest average number of cases per outbreak and the highest attack rates occurred at social gatherings and prisons. Prisoners were three times more likely to contract COVID-19 during outbreaks than people in other institutions. The highest hospitalization and mortality rates for all virus types occurred in the LTC group. The occurrence and intensity of outbreaks were highly heterogeneous among the different institutions after the introduction of new SARS-CoV-2 variants in the state. CONCLUSIONS ILI outbreaks were not randomly distributed; they clustered in specific areas. Transmissibility varied among different institutions with different responses to the COVID-19 pandemic. These results can be used as a basis for prioritizing actions and allocating resources during future pandemics.
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Affiliation(s)
- P C C Lucas
- Secretaria de Saúde do Estado de São Paulo, Coordenadoria de Controle de Doenças, Centro de Vigilância Epidemiológica "Prof. Alexandre Vranjac", Divisão de Doenças de Transmissão Respiratória, São Paulo, São Paulo, Brazil
| | - C Lorenz
- Secretaria de Saúde do Estado de São Paulo, Coordenadoria de Controle de Doenças, Centro de Vigilância Epidemiológica "Prof. Alexandre Vranjac", Divisão de Doenças de Transmissão Respiratória, São Paulo, São Paulo, Brazil.
| | - G L Florez-Montero
- Secretaria de Saúde do Estado de São Paulo, Coordenadoria de Controle de Doenças, Centro de Vigilância Epidemiológica "Prof. Alexandre Vranjac", Divisão de Doenças de Transmissão Respiratória, São Paulo, São Paulo, Brazil
| | - R G S Palasio
- Secretaria de Saúde do Estado de São Paulo, Coordenadoria de Controle de Doenças, Centro de Vigilância Epidemiológica "Prof. Alexandre Vranjac", Divisão de Doenças de Transmissão Respiratória, São Paulo, São Paulo, Brazil
| | - T P Portella
- Secretaria de Saúde do Estado de São Paulo, Coordenadoria de Controle de Doenças, Centro de Vigilância Epidemiológica "Prof. Alexandre Vranjac", Divisão de Doenças de Transmissão Respiratória, São Paulo, São Paulo, Brazil
| | - P C M Monteiro
- Secretaria de Saúde do Estado de São Paulo, Coordenadoria de Controle de Doenças, Centro de Vigilância Epidemiológica "Prof. Alexandre Vranjac", Divisão de Doenças de Transmissão Respiratória, São Paulo, São Paulo, Brazil
| | - A L F Yu
- Secretaria de Saúde do Estado de São Paulo, Coordenadoria de Controle de Doenças, Centro de Vigilância Epidemiológica "Prof. Alexandre Vranjac", Divisão de Doenças de Transmissão Respiratória, São Paulo, São Paulo, Brazil
| | - T R M P Carvalhanas
- Secretaria de Saúde do Estado de São Paulo, Coordenadoria de Controle de Doenças, Centro de Vigilância Epidemiológica "Prof. Alexandre Vranjac", Divisão de Doenças de Transmissão Respiratória, São Paulo, São Paulo, Brazil
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4
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Muruganandam N, Roy A, Sivanandan N, Vins A, Beniwal N, Kaur H, Potdar V, Parvez R. Respiratory viruses among ethnic Nicobarese during COVID-19 pandemic. BMC Infect Dis 2022; 22:463. [PMID: 35568797 PMCID: PMC9107012 DOI: 10.1186/s12879-022-07435-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Accepted: 04/25/2022] [Indexed: 11/24/2022] Open
Abstract
Background Acute respiratory infections (ARIs) and severe acute respiratory illness (SARI) are public health burdens globally. The percentage of non-SARS CoV-2 respiratory viruses among patients having ARI and SARI who visit Car Nicobar's hospital settings is undocumented. Changes in the epidemiology of other respiratory viruses during COVID19 pandemic is being reported worldwide. Methods Inpatient and outpatient settings at BJR hospital, Car Nicobar Island, India, were used to conduct prospective monitoring for ARI and SARI among Nicobarese tribal members. The patients with ARI and SARI were enlisted in BJR hospital from June 2019 to May 2021. At the ICMR-NIV in Pune, duplex RT-PCR assays were used to test the presence of respiratory viruses. The prevalence of non- SARS CoV-2 respiratory viruses was measured by comparing here between pandemic and pre-pandemic periods. Results During the COVID19 pandemic, Influenza A (H3N2) and rhinovirus were predominantly reported non-SARS CoV-2 respiratory viruses while Human metapneumovirusand influenza A (H1N1)pdm09were most commonly reported in the prepandemic period. This result indicates the altered circulation of non-SARS CoV-2 during pandemic. Conclusions A considerable proportion of respiratory infection was correlated with respiratory viruses. Prevalence of non-SARS CoV-2 respiratory viruses was high at the time of infection when compared with pre-pandemic period, at Car Nicobar Island. This study enlightened the change in circulation of other respiratory viruses among the indigenous Nicobarese tribes. Clinicians and allied medical staff should be more prudent of these respiratory infections. Supplementary Information The online version contains supplementary material available at 10.1186/s12879-022-07435-x.
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Affiliation(s)
- Nagarajan Muruganandam
- Indian Council of Medical Research (ICMR)-Regional Medical Research Centre, Port Blair, Andaman and Nicobar Islands, 744103, India
| | - Avijit Roy
- Directorate of Health Services, Port Blair, Andaman and Nicobar Islands, 744101, India
| | - Nimisha Sivanandan
- Indian Council of Medical Research (ICMR)-Regional Medical Research Centre, Port Blair, Andaman and Nicobar Islands, 744103, India
| | - Alwin Vins
- Indian Council of Medical Research (ICMR)-Regional Medical Research Centre, Port Blair, Andaman and Nicobar Islands, 744103, India
| | - Nisha Beniwal
- Indian Council of Medical Research (ICMR)-Regional Medical Research Centre, Port Blair, Andaman and Nicobar Islands, 744103, India
| | - Harpreet Kaur
- Indian Council of Medical Research, New Delhi, 110029, India
| | - Varsha Potdar
- Indian Council of Medical Research (ICMR)-National Institute of Virology (NIV), Pune, Maharashtra, 411021, India.
| | - Rehnuma Parvez
- Indian Council of Medical Research (ICMR)-Regional Medical Research Centre, Port Blair, Andaman and Nicobar Islands, 744103, India.
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5
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Freitas D, Silva R, Costa J, Markus D, Soares H, Minervino A, Lima J, Gennari S, Marcili A. First molecular-based detection study of Leishmania infantum in the Tapirapé indigenous population in the Brazilian Amazon. Braz J Med Biol Res 2022; 55:e11654. [PMID: 35137853 PMCID: PMC8851902 DOI: 10.1590/1414-431x2021e11654] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Accepted: 12/09/2021] [Indexed: 11/22/2022] Open
Abstract
Species of the genus Leishmania parasitize mammals and have life cycles that alternate between vertebrate and invertebrate hosts. Most species develop in a hematophagous arthropod and infect a specific vertebrate host that may belong to diverse orders and families. Visceral leishmaniasis is a chronic zoonosis with a wide geographic distribution, affecting 350 million people globally, mostly in areas with a high risk of infection. In Brazil, this disease not only has a high incidence but is also expanding to new areas, both in urban centers and rural areas, including territories with tribal communities, due to increasing human intervention. The objective of this study was to perform cathepsin L-like gene-based molecular diagnosis of Leishmania infantum in the indigenous Tapirapé ethnic group in the state of Mato Grosso. From the 372 individuals assessed, only 0.8% (3/372) tested positive for L. infantum, all from the same village (Urubu Branco). Despite the small number of infected individuals, this study demonstrates the first human cases of Leishmania infantum infection in this population, suggesting the need for regular monitoring of visceral leishmaniasis in the area and leading to a broad discussion on the planning and implementation of public health measures for the indigenous population, while respecting their distinctive territories and culture.
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Affiliation(s)
| | | | | | | | - H.S. Soares
- Universidade de Santo Amaro, Brasil; Universidade de São Paulo, Brasil
| | | | | | - S.M. Gennari
- Universidade de Santo Amaro, Brasil; Universidade de São Paulo, Brasil
| | - A. Marcili
- Universidade de Santo Amaro, Brasil; Universidade de São Paulo, Brasil
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6
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Lana RM, Freitas LP, Codeço CT, Pacheco AG, Carvalho LMFD, Villela DAM, Coelho FC, Cruz OG, Niquini RP, Porto VBG, Gava C, Gomes MFDC, Bastos LS. Identification of priority groups for COVID-19 vaccination in Brazil. CAD SAUDE PUBLICA 2021; 37:e00049821. [PMID: 34644749 DOI: 10.1590/0102-311x00049821] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Accepted: 07/29/2021] [Indexed: 12/15/2022] Open
Abstract
In a context of community transmission and shortage of vaccines, COVID-19 vaccination should focus on directly reducing the morbidity and mortality caused by the disease. It was thus essential to define priority groups for vaccination by the Brazilian National Immunization Program (PNI in Portuguese), based on the risk of hospitalization and death from the disease. We calculated overrisk according to sex, age group, and comorbidities using hospitalization and death records from severe acute respiratory illness with confirmation of COVID-19 (SARI-COVID) in all of Brazil in the first 6 months of the epidemic. Higher overrisk was associated with male sex (hospitalization = 1.1 and death = 1.2), age over 45 years for hospitalization (OvRag ranging from 1.1 to 8.5), and age over 55 year for death (OvRag ranging from 1.5 to 18.3). In the groups with comorbidities, chronic kidney disease, diabetes mellitus, cardiovascular disease, and chronic lung disease were associated with overrisk, while there was no such evidence for asthma. Chronic kidney disease or diabetes and age over 60 showed an even stronger association, reaching overrisk of death 14 and 10 times greater than in the general population, respectively. For all the comorbidities, there was higher overrisk at older ages, with a downward gradient in the oldest age groups. This pattern was reversed when examining overrisk in the general population, for both hospitalization and death. The current study provided evidence of overrisk of hospitalization and death from SARI-COVID, assisting the definition of priority groups for COVID-19 vaccination.
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Affiliation(s)
- Raquel Martins Lana
- Programa de Computação Científica, Fundação Oswaldo Cruz, Rio de Janeiro, Brasil
| | | | | | | | | | | | - Flávio Codeço Coelho
- Fundação Getúlio Vargas, Rio de Janeiro, Brasil.,Institute of Global Health, University of Geneva, Geneva, Switzerland
| | | | - Roberta Pereira Niquini
- Instituto Federal de Educação, Ciência e Tecnologia do Rio de Janeiro, Rio de Janeiro, Brasil
| | | | - Caroline Gava
- Coordenação-geral do Programa Nacional de Imunizações, Ministério da Saúde, Brasília, Brasil
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7
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Liu H, Gong YN, Shaw-Saliba K, Mehoke T, Evans J, Liu ZY, Lewis M, Sauer L, Thielen P, Rothman R, Chen KF, Pekosz A. Differential disease severity and whole-genome sequence analysis for human influenza A/H1N1pdm virus in 2015-2016 influenza season. Virus Evol 2021; 7:veab044. [PMID: 34040796 PMCID: PMC8135377 DOI: 10.1093/ve/veab044] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
During the 2015–16 winter, the US experienced a relatively mild influenza season compared to Taiwan, which had a higher number of total and severe cases. While H1N1pdm viruses dominated global surveillance efforts that season, the global distribution of genetic variants and their contributions to disease severity have not been investigated. Samples collected from influenza A-positive patients by the Johns Hopkins Center of Excellence for Influenza Research and Surveillance active surveillance in the emergency rooms in Baltimore, Maryland, USA, and northern Taiwan between November 2015 and April 2016, were processed for influenza A virus whole-genome sequencing. In Baltimore, the majority of the viruses were the H1N1pdm clade 6B.1 and no H1N1pdm clade 6B.2 viruses were detected. In northern Taiwan, more than half of the H1N1pdm viruses were clade 6B.1 and 38% were clade 6B.2, consistent with the global observation that most 6B.2 viruses circulated in Asia and not North America. Whole virus genome sequence analysis identified two genetic subgroups present in each of the 6B.1 and 6B.2 clades and one 6B.1 interclade reassortant virus. Clinical data showed 6B.2 patients had more disease symptoms including higher crude and inverse probability weighted odds of pneumonia than 6B.1 patients, suggesting 6B.2 circulation may be one of the reasons for the severe flu season in Taiwan. Local surveillance efforts linking H1N1pdm virus sequences to patient clinical and demographic data improve our understanding of influenza circulation and disease potential.
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Affiliation(s)
- Hsuan Liu
- W. Harry Feinstone Department of Molecular Microbiology and Immunology, The Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland 21205, USA
| | - Yu-Nong Gong
- Research Center for Emerging Viral Infections, College of Medicine, Chang Gung University, Taoyuan, Taiwan.,Department of Laboratory Medicine, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Kathryn Shaw-Saliba
- W. Harry Feinstone Department of Molecular Microbiology and Immunology, The Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland 21205, USA.,Department of Emergency Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland 21205, USA
| | - Thomas Mehoke
- Research and Exploratory Development Department, Johns Hopkins Applied Physics Laboratory, Laurel, Maryland, 20723, USA
| | - Jared Evans
- Research and Exploratory Development Department, Johns Hopkins Applied Physics Laboratory, Laurel, Maryland, 20723, USA
| | - Zhen-Ying Liu
- Department of Emergency Medicine, Chang Gung Memorial Hospital, Keelung, Taiwan
| | - Mitra Lewis
- Department of Emergency Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland 21205, USA
| | - Lauren Sauer
- Department of Emergency Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland 21205, USA
| | - Peter Thielen
- Research and Exploratory Development Department, Johns Hopkins Applied Physics Laboratory, Laurel, Maryland, 20723, USA
| | - Richard Rothman
- Department of Emergency Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland 21205, USA
| | - Kuan-Fu Chen
- Department of Emergency Medicine, Chang Gung Memorial Hospital, Keelung, Taiwan.,Clinical Informatics and Medical Statistics Research Center, Chang Gung University, Taoyuan, Taiwan.,Community Medicine Research Center, Chang Gung Memorial Hospital, Keelung, Taiwan
| | - Andrew Pekosz
- W. Harry Feinstone Department of Molecular Microbiology and Immunology, The Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland 21205, USA.,Department of Emergency Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland 21205, USA.,Department of Environmental Health and Engineering, The Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland 21205, USA
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8
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Ribeiro AA, Rossi LA. Covid-19 pandemic and the motivations for demanding health service in indigenous villages. Rev Bras Enferm 2020; 73:e20200312. [PMID: 33111778 DOI: 10.1590/0034-7167-2020-0312] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2020] [Accepted: 08/09/2020] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE To discuss the fundamental aspects in the establishment of preventive measures to tackle covid-19 among indigenous people in view of the motivations for seeking health care in villages of the Terra Indígena Buriti, Mato Grosso do Sul, Brazil. METHODS Theoretical-reflective study based on assumptions of the National Health System and previous ethnographic research that enabled the identification of the motivations to seek health care in Buriti villages. RESULTS Indigenous people seek health centers for health care programs assistance, treatment of cases they cannot resolve and to chat. Such motivations were the basis for discussing the indigenization process in the confrontation of the new coronavirus pandemic in indigenous lands. FINAL CONSIDERATIONS The motivations for seeking health care show the physical and social vulnerability of the Terena ethnicity. The effectiveness of the social isolation measure in the villages depends on the dialogue with indigenous leaders, professional engagement and intersectoral actions.
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Palamim CVC, Ortega MM, Marson FAL. COVID-19 in the Indigenous Population of Brazil. J Racial Ethn Health Disparities 2020; 7:1053-1058. [PMID: 33025421 PMCID: PMC7537979 DOI: 10.1007/s40615-020-00885-6] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2020] [Revised: 09/22/2020] [Accepted: 09/28/2020] [Indexed: 12/22/2022]
Abstract
Brazil has 896,917 Indigenous individuals distributed among 505 Indigenous lands. There are 274 different Indigenous languages within 305 Indigenous ethnic groups. The Indigenous population is susceptible to pandemics, especially to the current pandemic of COVID-19, which has spread rapidly. In Brazil, after the first COVID-19-confirmed Indigenous case on 05th June 2020, more 420 suspected cases, 1727 confirmed cases being 934 active cases, 715 cases with clinical cure, and 70 cases of death were accounted through the first week of June. The number of cases is underestimated, according to the Special Secretariat for Indigenous Health (SESAI) database, since the deaths are due to respiratory failure, possibly caused by COVID-19, but not confirmed. The first COVID-19-caused death was a 15-year-old Indigenous Yanomami teenage from Roraima State without known previous diseases history and/or comorbidities. In the present study, the importance of social isolation, especially for Indigenous people who are more vulnerable to the COVID-19, was highlighted by the identification of the infection community. An Indigenous of the Kokama ethnicity was infected after coming in contact with a Medical Doctor who was infected with the disease. Later, it was noticed that both, Indigenous and doctor, were responsible for COVID-19’s transmission to 43 other Indigenous individuals (30 in Alto Rio Solimões and 13 in Parintis), causing possibly other confirmed deaths. The impact of COVID-19 for Indigenous population might be an unprecedented tragedy, and the government in Brazil must take emergency measures as the social isolation.
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Affiliation(s)
- Camila Vantini Capasso Palamim
- Laboratory of Cell and Molecular Tumor Biology and Bioactive Compounds, São Francisco University, Avenida São Francisco de Assis, 218. Jardim São José, Bragança Paulista, 12916-000, São Paulo, Brazil.,Laboratory of Human and Medical Genetics, São Francisco University, Avenida São Francisco de Assis, 218. Jardim São José, Bragança Paulista, São Paulo, 12916-900, Brazil
| | - Manoela Marques Ortega
- Laboratory of Cell and Molecular Tumor Biology and Bioactive Compounds, São Francisco University, Avenida São Francisco de Assis, 218. Jardim São José, Bragança Paulista, 12916-000, São Paulo, Brazil.,Laboratory of Human and Medical Genetics, São Francisco University, Avenida São Francisco de Assis, 218. Jardim São José, Bragança Paulista, São Paulo, 12916-900, Brazil
| | - Fernando Augusto Lima Marson
- Laboratory of Cell and Molecular Tumor Biology and Bioactive Compounds, São Francisco University, Avenida São Francisco de Assis, 218. Jardim São José, Bragança Paulista, 12916-000, São Paulo, Brazil. .,Laboratory of Human and Medical Genetics, São Francisco University, Avenida São Francisco de Assis, 218. Jardim São José, Bragança Paulista, São Paulo, 12916-900, Brazil.
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