1
|
da Costa VG, Saivish MV, Sinhorini PF, Nogueira ML, Rahal P. A meta-analysis of Chikungunya virus in neurological disorders. Infect Dis Now 2024:104938. [PMID: 38885813 DOI: 10.1016/j.idnow.2024.104938] [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: 11/22/2023] [Revised: 03/17/2024] [Accepted: 06/13/2024] [Indexed: 06/20/2024]
Abstract
Chikungunya disease typically presents with the fever-arthralgia-rash symptom triad. However, an increase in the number of atypical clinical manifestations, particularly neurological disorders, has occurred. The current evidence regarding the pooled prevalence of Chikungunya virus (CHIKV)-associated neurological cases (CANCs) suspected of having an arboviral aetiology is not well-understood. Therefore, this meta-analysis included 19 studies (n = 7319 patients) and aimed to determine the pooled rate of exposure to CANC. The pooled positivity rate of CANC was 12 % (95 % CI: 6-19), and Brazil was overrepresented (11/19). These estimations varied between 3 and 14 % based on the diagnostic method (real-time PCR vs. ELISA-IgM) and biological samples (cerebrospinal fluid or blood specimens) used for detection of CHIKV. Regarding the frequency of CHIKV in neurological clinical subgroups, the rates were higher among patients with myelitis (27 %), acute disseminated encephalomyelitis (27 %), Guillain-Barré syndrome (15 %), encephalitis (12 %), and meningoencephalitis (7 %). Our analysis highlights the significant burden of CANC. However, the data must be interpreted with caution due to the heterogeneity of the results, which may be related to the location of the studies covering endemic periods and/or outbreaks of CHIKV. Current surveillance resources should also focus on better characterizing the epidemiology of CHIKV infection in neurological disorders. Additionally, future studies should investigate the interactions between CHIKV and neurological diseases with the aim of gaining deeper insight into the mechanisms underlying the cause-and-effect relationship between these two phenomena.
Collapse
Affiliation(s)
- Vivaldo G da Costa
- Laboratório de Estudos Genômicos, Departamento de Biologia, Instituto de Biociências Letras e Ciências Exatas, Universidade Estadual Paulista Júlio de Mesquita Filho (UNESP), São José do Rio Preto 15054-000, SP, Brazil.
| | - Marielena V Saivish
- Laboratório de Pesquisas em Virologia, Departamento de Doenças Dermatológicas, Infecciosas e Parasitárias, Faculdade de Medicina de São José do Rio Preto, São José do Rio Preto 15090‑000, SP, Brazil; Laboratório Nacional de Biociências, Centro Nacional de Pesquisa em Energia e Materiais (CNPEM), Campinas 13083‑100, SP, Brazil
| | - Paola F Sinhorini
- Laboratório de Estudos Genômicos, Departamento de Biologia, Instituto de Biociências Letras e Ciências Exatas, Universidade Estadual Paulista Júlio de Mesquita Filho (UNESP), São José do Rio Preto 15054-000, SP, Brazil
| | - Maurício L Nogueira
- Laboratório de Pesquisas em Virologia, Departamento de Doenças Dermatológicas, Infecciosas e Parasitárias, Faculdade de Medicina de São José do Rio Preto, São José do Rio Preto 15090‑000, SP, Brazil; Laboratório Nacional de Biociências, Centro Nacional de Pesquisa em Energia e Materiais (CNPEM), Campinas 13083‑100, SP, Brazil; Department of Pathology, The University of Texas Medical Branch, Galveston, TX 77555-0609, USA
| | - Paula Rahal
- Laboratório de Estudos Genômicos, Departamento de Biologia, Instituto de Biociências Letras e Ciências Exatas, Universidade Estadual Paulista Júlio de Mesquita Filho (UNESP), São José do Rio Preto 15054-000, SP, Brazil
| |
Collapse
|
2
|
de Freitas DA, Wakimoto MD, Dias S, Souza-Santos R. High-Risk Areas for Congenital Zika Syndrome in Rio de Janeiro: Spatial Cluster Detection. Trop Med Infect Dis 2024; 9:105. [PMID: 38787038 PMCID: PMC11125739 DOI: 10.3390/tropicalmed9050105] [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: 03/18/2024] [Revised: 04/16/2024] [Accepted: 04/17/2024] [Indexed: 05/25/2024] Open
Abstract
Brazil reported 18,282 suspected congenital Zika syndrome (CZS) cases up to 2018 and accounts for 61.4% of the total reported Zika cases in the Americas in the period. To detect high-risk areas for children with CZS in the city of Rio de Janeiro, we used cluster detection and thematic maps. We analyzed data using a Poisson model in Satscan 10.1.3 software. We also analyzed the records of children with CZS from 2015 to 2016 to describe the clinical and epidemiological maternal and child profile, as well as live births in 2016 and the social development index (SDI) by neighborhood. In 2015 and 2016, the incidence rates of CZS were 8.84 and 46.96 per 100,000 live births in the city, respectively. Severe congenital findings such as microcephaly and brain damage, osteoarticular impairment, ocular abnormalities, and hearing loss were observed in 47 children. The spatial distribution of CZS was concentrated in the north and west zones in heterogeneous neighborhoods. The neighborhoods with the highest occurrence of CZS cases were found to have the worst SDIs. Stascan detected three spatial clusters in the north zone, where the SDI is lower. The clusters presented high relative risks for CZS (7.86, 1.46, and 2.08), although they were not statistically significant. Our findings highlight a higher occurrence of CZS in areas with less favorable socioeconomic conditions.
Collapse
Affiliation(s)
- Danielle Amaral de Freitas
- Escola Nacional de Saúde Pública, Fundação Oswaldo Cruz, Rua Leopoldo Bulhões, Rio de Janeiro 1480, RJ, Brazil;
| | - Mayumi Duarte Wakimoto
- Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz, Av. Brasil, Rio de Janeiro 4365, RJ, Brazil;
| | - Sónia Dias
- National School of Public Health, Public Health Research Centre, Comprehensive Health Research Center (CHRC), REAL, NOVA University of Lisbon, Avenida Padre Cruz, 1600-560 Lisboa, Portugal;
| | - Reinaldo Souza-Santos
- Escola Nacional de Saúde Pública, Fundação Oswaldo Cruz, Rua Leopoldo Bulhões, Rio de Janeiro 1480, RJ, Brazil;
| |
Collapse
|
3
|
Sena BF, Herrera BB, Bruneska Gondim Martins D, Lima Filho JL. Advancing arbovirus diagnosis in Brazil: strengthening diagnostic strategies and public health data collection. Braz J Infect Dis 2024; 28:103766. [PMID: 38802065 PMCID: PMC11153883 DOI: 10.1016/j.bjid.2024.103766] [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: 11/19/2023] [Revised: 04/16/2024] [Accepted: 05/12/2024] [Indexed: 05/29/2024] Open
Abstract
BACKGROUND The last five decades have seen a surge in viral outbreaks, particularly in tropical and subtropical regions like Brazil, where endemic arboviruses such as Dengue (DENV), Zika (ZIKV), and Chikungunya (CHIKV) pose significant threats. However, current diagnostic strategies exhibit limitations, leading to gaps in infection screening, arbovirus differential diagnoses, DENV serotyping, and life-long infection tracking. This deficiency impedes critical information availability regarding an individual's current infection and past infection history, disease risk assessment, vaccination needs, and policy formulation. Additionally, the availability of point-of-care diagnostics and knowledge regarding immune profiles at the time of infection are crucial considerations. OBJECTIVES This review underscores the urgent need to strengthen diagnostic methods for arboviruses in Brazil and emphasizes the importance of data collection to inform public health policies for improved diagnostics, surveillance, and policy formulation. METHODS We evaluated the diagnostic landscape for arboviral infections in Brazil, focusing on tailored, validated methods. We assessed diagnostic methods available for sensitivity and specificity metrics in the context of Brazil. RESULTS Our review identifies high-sensitivity, high-specificity diagnostic methods for arboviruses and co-infections. Grifols transcription-mediated amplification assays are recommended for DENV, CHIKV, and ZIKV screening, while IgG/IgM ELISA assays outperform Rapid Diagnostic Tests (RDTs). The Triplex real-time RT-PCR assay is recommended for molecular screening due to its sensitivity and specificity. CONCLUSION Enhanced diagnostic methods, on-going screening, and tracking are urgently needed in Brazil to capture the complex landscape of arboviral infections in the country. Recommendations include nationwide arbovirus differential diagnosis for DENV, ZIKV, and CHIKV, along with increased DENV serotyping, and lifelong infection tracking to combat enduring viral threats and reduce severe presentations.
Collapse
Affiliation(s)
- Brena F Sena
- Keizo Asami Institute, Universidade Federal de Pernambuco, Recife, PE, Brazil.
| | - Bobby Brooke Herrera
- Rutgers Robert Wood Johnson Medical School, Department of Medicine, Division of Allergy, Immunology, and Infectious Diseases, and Child Health Institute of New Jersey, Rutgers University, NJ, USA; Rutgers University, Rutgers Global Health Institute, NJ, USA
| | - Danyelly Bruneska Gondim Martins
- Keizo Asami Institute, Universidade Federal de Pernambuco, Recife, PE, Brazil; Department of Biochemistry, Universidade Federal de Pernambuco, Recife, PE, Brazil
| | - José Luiz Lima Filho
- Keizo Asami Institute, Universidade Federal de Pernambuco, Recife, PE, Brazil; Department of Biochemistry, Universidade Federal de Pernambuco, Recife, PE, Brazil
| |
Collapse
|
4
|
Pereira SH, Sá Magalhães Serafim M, Moraes TDFS, Zini N, Abrahão JS, Nogueira ML, Coelho dos Reis JGA, Bagno FF, da Fonseca FG. Design, development, and validation of multi-epitope proteins for serological diagnosis of Zika virus infections and discrimination from dengue virus seropositivity. PLoS Negl Trop Dis 2024; 18:e0012100. [PMID: 38635656 PMCID: PMC11025737 DOI: 10.1371/journal.pntd.0012100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2023] [Accepted: 03/22/2024] [Indexed: 04/20/2024] Open
Abstract
Zika virus (ZIKV), an arbovirus from the Flaviviridae family, is the causative agent of Zika fever, a mild and frequent oligosymptomatic disease in humans. Nonetheless, on rare occasions, ZIKV infection can be associated with Guillain-Barré Syndrome (GBS), and severe congenital complications, such as microcephaly. The oligosymptomatic disease, however, presents symptoms that are quite similar to those observed in infections caused by other frequent co-circulating arboviruses, including dengue virus (DENV). Moreover, the antigenic similarity between ZIKV and DENV, and even with other members of the Flaviviridae family, complicates serological testing due to the high cross-reactivity of antibodies. Here, we designed, produced in a prokaryotic expression system, and purified three multiepitope proteins (ZIKV-1, ZIKV-2, and ZIKV-3) for differential diagnosis of Zika. The proteins were evaluated as antigens in ELISA tests for the detection of anti-ZIKV IgG using ZIKV- and DENV-positive human sera. The recombinant proteins were able to bind and detect anti-ZIKV antibodies without cross-reactivity with DENV-positive sera and showed no reactivity with Chikungunya virus (CHIKV)- positive sera. ZIKV-1, ZIKV-2, and ZIKV-3 proteins presented 81.6%, 95%, and 66% sensitivity and 97%, 96%, and 84% specificity, respectively. Our results demonstrate the potential of the designed and expressed antigens in the development of specific diagnostic tests for the detection of IgG antibodies against ZIKV, especially in regions with the circulation of multiple arboviruses.
Collapse
Affiliation(s)
- Samille Henriques Pereira
- Laboratório de Virologia Básica e Aplicada, Departamento de Microbiologia, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Mateus Sá Magalhães Serafim
- Laboratório de Vírus, Departamento de Microbiologia, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Thaís de Fátima Silva Moraes
- Laboratório de Virologia Básica e Aplicada, Departamento de Microbiologia, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Nathalia Zini
- Laboratório de Pesquisa em Virologia, Faculdade de Medicina de São José do Rio Preto, São José do Rio Preto, São Paulo, Brazil
- Centro de Tecnologia em Vacinas, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Jônatas Santos Abrahão
- Laboratório de Vírus, Departamento de Microbiologia, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Maurício Lacerda Nogueira
- Laboratório de Pesquisa em Virologia, Faculdade de Medicina de São José do Rio Preto, São José do Rio Preto, São Paulo, Brazil
| | | | - Flávia Fonseca Bagno
- Centro de Tecnologia em Vacinas, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Flávio Guimarães da Fonseca
- Laboratório de Virologia Básica e Aplicada, Departamento de Microbiologia, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
- Centro de Tecnologia em Vacinas, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| |
Collapse
|
5
|
Serafim MSM, Kronenberger T, Rocha REO, Rosa ADRA, Mello TLG, Poso A, Ferreira RS, Abrahão JS, Kroon EG, Mota BEF, Maltarollo VG. Aminopyrimidine Derivatives as Multiflavivirus Antiviral Compounds Identified from a Consensus Virtual Screening Approach. J Chem Inf Model 2024; 64:393-411. [PMID: 38194508 DOI: 10.1021/acs.jcim.3c01505] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2024]
Abstract
Around three billion people are at risk of infection by the dengue virus (DENV) and potentially other flaviviruses. Worldwide outbreaks of DENV, Zika virus (ZIKV), and yellow fever virus (YFV), the lack of antiviral drugs, and limitations on vaccine usage emphasize the need for novel antiviral research. Here, we propose a consensus virtual screening approach to discover potential protease inhibitors (NS3pro) against different flavivirus. We employed an in silico combination of a hologram quantitative structure-activity relationship (HQSAR) model and molecular docking on characterized binding sites followed by molecular dynamics (MD) simulations, which filtered a data set of 7.6 million compounds to 2,775 hits. Lastly, docking and MD simulations selected six final potential NS3pro inhibitors with stable interactions along the simulations. Five compounds had their antiviral activity confirmed against ZIKV, YFV, DENV-2, and DENV-3 (ranging from 4.21 ± 0.14 to 37.51 ± 0.8 μM), displaying aggregator characteristics for enzymatic inhibition against ZIKV NS3pro (ranging from 28 ± 7 to 70 ± 7 μM). Taken together, the compounds identified in this approach may contribute to the design of promising candidates to treat different flavivirus infections.
Collapse
Affiliation(s)
- Mateus Sá Magalhães Serafim
- Departamento de Microbiologia, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG 31270-901, Brazil
| | - Thales Kronenberger
- Institute of Pharmacy, Pharmaceutical/Medicinal Chemistry and Tübingen Center for Academic Drug Discovery (TüCAD2), Eberhard Karls University Tübingen, Auf der Morgenstelle 8, Tübingen 72076, Germany
- Excellence Cluster "Controlling Microbes to Fight Infections" (CMFI), Tübingen 72076, Germany
- School of Pharmacy, Faculty of Health Sciences, University of Eastern Finland, Kuopio 70211, Finland
| | - Rafael Eduardo Oliveira Rocha
- Departamento de Bioquímica e Imunologia, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG 31270-901, Brazil
| | - Amanda Del Rio Abreu Rosa
- Departamento de Bioquímica e Imunologia, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG 31270-901, Brazil
| | - Thaysa Lara Gonçalves Mello
- Departamento de Produtos Farmacêuticos, Faculdade de Farmácia, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG 31270-901, Brazil
| | - Antti Poso
- Institute of Pharmacy, Pharmaceutical/Medicinal Chemistry and Tübingen Center for Academic Drug Discovery (TüCAD2), Eberhard Karls University Tübingen, Auf der Morgenstelle 8, Tübingen 72076, Germany
- School of Pharmacy, Faculty of Health Sciences, University of Eastern Finland, Kuopio 70211, Finland
- Department of Medical Oncology and Pneumology, University Hospital of Tübingen, Tübingen 70211, Germany
| | - Rafaela Salgado Ferreira
- Departamento de Bioquímica e Imunologia, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG 31270-901, Brazil
| | - Jonatas Santos Abrahão
- Departamento de Microbiologia, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG 31270-901, Brazil
| | - Erna Geessien Kroon
- Departamento de Microbiologia, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG 31270-901, Brazil
| | - Bruno Eduardo Fernandes Mota
- Departamento de Análises Clínicas e Toxicológicas, Faculdade de Farmácia, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG 31270-901, Brazil
| | - Vinícius Gonçalves Maltarollo
- Departamento de Produtos Farmacêuticos, Faculdade de Farmácia, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG 31270-901, Brazil
| |
Collapse
|
6
|
Rodrigues CDS, Souza RKS, Rocha Neto CV, Otani RH, Batista DDM, Maia AKNDO, Filho KPDO, de Andrade TD, de Andrade Almeida E, Maciel LHG, Castro LDFAAP, Abtibol-Bernardino MR, Baia-da-Silva DC, Benzecry SG, Castilho MDC, Martínez-Espinosa FE, Alecrim MDGC, Santos RS, Botto-Menezes C. Clinical and Acoustic Alterations of Swallowing in Children Exposed to Zika Virus during Pregnancy in a Cohort in Amazonas, Brazil: A Case Series Study. Viruses 2023; 15:2363. [PMID: 38140604 PMCID: PMC10747239 DOI: 10.3390/v15122363] [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: 09/15/2023] [Revised: 11/13/2023] [Accepted: 11/13/2023] [Indexed: 12/24/2023] Open
Abstract
Oropharyngeal dysphagia (OD) is a swallowing disorder that involves difficulty in safely passing the food bolus from the oral cavity to the stomach. OD is a common problem in children with congenital Zika virus syndrome (CZS). In this case series, we describe the clinical and acoustic alterations of swallowing in children exposed to the Zika virus during pregnancy in a cohort from Amazonas, Brazil. From July 2019 to January 2020, 22 children were evaluated, 6 with microcephaly and 16 without microcephaly. The mean age among the participants was 35 months (±4.6 months). All children with microcephaly had alterations in oral motricity, mainly in the lips and cheeks. Other alterations were in vocal quality, hard palate, and soft palate. Half of the children with microcephaly showed changes in cervical auscultation during breast milk swallowing. In children without microcephaly, the most frequently observed alteration was in lip motricity, but alterations in auscultation during the swallowing of breast milk were not observed. Regarding swallowing food of a liquid and pasty consistency, the most frequent alterations were incomplete verbal closure, increased oral transit time, inadequacy in capturing the spoon, anterior labial leakage, and increased oral transit time. Although these events are more frequent in microcephalic children, they can also be seen in non-microcephalic children, which points to the need for an indistinct evaluation of children exposed in utero to ZIKV.
Collapse
Affiliation(s)
- Cristina de Souza Rodrigues
- Postgraduate Program in Tropical Medicine (PPGMT), University of Amazonas State (UEA), Manaus 69040-000, Brazil; (C.d.S.R.); (L.H.G.M.); (L.d.F.A.A.P.C.); (M.R.A.-B.); (F.E.M.-E.); (M.d.G.C.A.)
| | | | - Cosmo Vieira Rocha Neto
- School of Health Sciences, University of Amazonas State, Manaus 69065-001, Brazil; (C.V.-R.N.); (R.H.O.); (D.d.M.B.); (A.K.N.d.O.M.); (S.G.B.)
| | - Rodrigo Haruo Otani
- School of Health Sciences, University of Amazonas State, Manaus 69065-001, Brazil; (C.V.-R.N.); (R.H.O.); (D.d.M.B.); (A.K.N.d.O.M.); (S.G.B.)
| | - Daniel de Medeiros Batista
- School of Health Sciences, University of Amazonas State, Manaus 69065-001, Brazil; (C.V.-R.N.); (R.H.O.); (D.d.M.B.); (A.K.N.d.O.M.); (S.G.B.)
| | - Ana Karla Nelson de Oliveira Maia
- School of Health Sciences, University of Amazonas State, Manaus 69065-001, Brazil; (C.V.-R.N.); (R.H.O.); (D.d.M.B.); (A.K.N.d.O.M.); (S.G.B.)
| | | | | | | | - Luiz Henrique Gonçalves Maciel
- Postgraduate Program in Tropical Medicine (PPGMT), University of Amazonas State (UEA), Manaus 69040-000, Brazil; (C.d.S.R.); (L.H.G.M.); (L.d.F.A.A.P.C.); (M.R.A.-B.); (F.E.M.-E.); (M.d.G.C.A.)
| | | | - Marília Rosa Abtibol-Bernardino
- Postgraduate Program in Tropical Medicine (PPGMT), University of Amazonas State (UEA), Manaus 69040-000, Brazil; (C.d.S.R.); (L.H.G.M.); (L.d.F.A.A.P.C.); (M.R.A.-B.); (F.E.M.-E.); (M.d.G.C.A.)
- Department of Maternal and Child Health, Medical School, Federal University of Amazonas, Manaus 69020-160, Brazil
| | - Djane Clarys Baia-da-Silva
- Postgraduate Program in Tropical Medicine (PPGMT), University of Amazonas State (UEA), Manaus 69040-000, Brazil; (C.d.S.R.); (L.H.G.M.); (L.d.F.A.A.P.C.); (M.R.A.-B.); (F.E.M.-E.); (M.d.G.C.A.)
- School of Health Sciences, University of Amazonas State, Manaus 69065-001, Brazil; (C.V.-R.N.); (R.H.O.); (D.d.M.B.); (A.K.N.d.O.M.); (S.G.B.)
- Faculty of Pharmacy, University Nilton Lins, Manaus 69058-030, Brazil; (K.P.d.O.F.); (T.D.d.A.)
- Leônidas & Maria Deane Institute, Fiocruz Amazonia, Manaus 69057-070, Brazil
| | - Silvana Gomes Benzecry
- School of Health Sciences, University of Amazonas State, Manaus 69065-001, Brazil; (C.V.-R.N.); (R.H.O.); (D.d.M.B.); (A.K.N.d.O.M.); (S.G.B.)
| | | | - Flor Ernestina Martínez-Espinosa
- Postgraduate Program in Tropical Medicine (PPGMT), University of Amazonas State (UEA), Manaus 69040-000, Brazil; (C.d.S.R.); (L.H.G.M.); (L.d.F.A.A.P.C.); (M.R.A.-B.); (F.E.M.-E.); (M.d.G.C.A.)
- Leônidas & Maria Deane Institute, Fiocruz Amazonia, Manaus 69057-070, Brazil
- Tropical Medicine Foundation Doutor Heitor Vieira Dourado (FMT-HVD), Manaus 69040-000, Brazil;
| | - Maria das Graças Costa Alecrim
- Postgraduate Program in Tropical Medicine (PPGMT), University of Amazonas State (UEA), Manaus 69040-000, Brazil; (C.d.S.R.); (L.H.G.M.); (L.d.F.A.A.P.C.); (M.R.A.-B.); (F.E.M.-E.); (M.d.G.C.A.)
- Medical Course Coordination at Manaus Metropolitan College/FAMETRO, Manaus 69050-000, Brazil
| | - Rosane Sampaio Santos
- Postgraduate Program in Communication Disorders (PPGDIC), University of Tuiuti do Paraná (UTP), Paraná 82010-210, Brazil;
| | - Camila Botto-Menezes
- Postgraduate Program in Tropical Medicine (PPGMT), University of Amazonas State (UEA), Manaus 69040-000, Brazil; (C.d.S.R.); (L.H.G.M.); (L.d.F.A.A.P.C.); (M.R.A.-B.); (F.E.M.-E.); (M.d.G.C.A.)
- School of Health Sciences, University of Amazonas State, Manaus 69065-001, Brazil; (C.V.-R.N.); (R.H.O.); (D.d.M.B.); (A.K.N.d.O.M.); (S.G.B.)
- Tropical Medicine Foundation Doutor Heitor Vieira Dourado (FMT-HVD), Manaus 69040-000, Brazil;
| |
Collapse
|
7
|
Andrade GKSD, Marcon SS, Batiston AP, Neves ET, Vieira VCDL, Sá JSD, Benedito JCDS, Teston EF. Health care network for children with zika virus from the perspective of professionals. Rev Gaucha Enferm 2023; 44:e20230043. [PMID: 37971110 DOI: 10.1590/1983-1447.2023.20230043.en] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Accepted: 06/26/2023] [Indexed: 11/19/2023] Open
Abstract
OBJECTIVE To know the perspective of health professionals working in specialized care regarding the assistance offered to children with Congenital Zika Virus Syndrome in the Health Care Network. METHOD Qualitative study carried out in Campo Grande-MS through semi-structured interviews, between September and October 2020, with 12 professionals working in a reference service for people with physical and intellectual disabilities. Minayo's thematic analysis and the theoretical subsidies of the care model for chronic conditions were used for interpretation. RESULTS Assistance in the network is weakened by aspects related to access, monitoring and integration between different professionals/services. The potential involves the implementation of the referral and counter-referral system, the communication/integration between these services and the training of professionals. FINAL CONSIDERATIONS The participants perceive that assistance is influenced by the availability of trained professionals to work in a network and the optimization of access and follow-up at different points of care.
Collapse
Affiliation(s)
- Gleice Kelli Santana de Andrade
- Universidade Federal de Mato Grosso do Sul (UFMS). Instituto Integrado de Saúde. Mestrado em Enfermagem. Campo Grande, Mato Grosso do Sul, Brasil
| | - Sonia Silva Marcon
- Universidade Estadual de Maringá (UEM). Departamento de Enfermagem. Programa de Pós-Graduação em Enfermagem. Maringá, Paraná, Brasil
| | - Adriane Pires Batiston
- Universidade Federal de Mato Grosso do Sul (UFMS). Instituto Integrado de Saúde. Mestrado em Saúde da Família. Campo Grande, Mato Grosso do Sul, Brasil
| | - Eliane Tatsch Neves
- Universidade Federal de Santa Maria (UFSM). Centro de Ciências da Saúde. Programa de Pós-Graduação em enfermagem. Santa Maria, Rio Grande do Sul, Brasil
| | - Viviane Cazetta de Lima Vieira
- Universidade Estadual de Maringá (UEM). Departamento de Enfermagem. Programa de Pós-Graduação em Enfermagem. Maringá, Paraná, Brasil
| | - Jennyfer Soares de Sá
- Universidade Federal de Mato Grosso do Sul (UFMS). Instituto Integrado de Saúde. Mestrado em Enfermagem. Campo Grande, Mato Grosso do Sul, Brasil
| | - Júnior Cezar de Souza Benedito
- Universidade Federal de Mato Grosso do Sul (UFMS). Instituto Integrado de Saúde. Mestrado em Saúde da Família. Campo Grande, Mato Grosso do Sul, Brasil
| | - Elen Ferraz Teston
- Universidade Federal de Mato Grosso do Sul (UFMS). Instituto Integrado de Saúde. Mestrado em Enfermagem. Campo Grande, Mato Grosso do Sul, Brasil
| |
Collapse
|
8
|
Bezerra ACD, Vasconcelos MLD, Lima LMA, Cunha DAD, Alves GÂDS, Pernambuco L. Relationship between microcephaly and indicators of social inequality in the state of Paraíba, Brazil. EINSTEIN-SAO PAULO 2023; 21:eAO0043. [PMID: 37075460 PMCID: PMC10118366 DOI: 10.31744/einstein_journal/2023ao0043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Accepted: 09/15/2022] [Indexed: 04/03/2023] Open
Abstract
OBJECTIVE • Seventy-four (33.18%) municipalities in the state of Paraíba registered live births with microcephaly. • The highest proportion of cases (23.03%) was concentrated in the capital, João Pessoa. • Number of inhabitants, number of cases of Zika virus, water supply, and average household income were associated with a higher proportion of new cases. To analyze the relationship between microcephaly and social inequality indicators in the state of Paraíba during the biennium January 2015 and December 2016. METHODS Ecological study with data from newborn microcephaly records and municipal socioeconomic, environmental, and demographic indicators was conducted using two health information systems from the Brazilian Ministry of Health (SINASC and SINAN) and the Brazilian Institute of Geography and Statistics. A Poisson multiple regression model was applied with a significance level of 5%. RESULTS Among 223 municipalities in Paraíba, 74 registered new cases of microcephaly. The number of Zika virus cases, number of inhabitants, number of households without adequate water supply, and household income were predictor variables of the number of new cases of microcephaly in Paraíba. CONCLUSION Microcephaly is associated with indicators of social inequality in Paraíba. Zika virus cases, water supply, and family income are the indicators that best explain the increase in microcephaly cases. Therefore, these variables must be monitored by health professionals and authorities.
Collapse
|
9
|
Marques FJP, Carvalho ALD, Borigato EVM, Oliveira LFVD, Duarte LMR, Silva AGD, Amarante CLD, Pereira LJDM, Tavares EF, Costa LGDSD, Alcântara CAR, Salinas AN, Pinto FDLDC, Alcântara GCD, Utsch F, Silva CRD, Reis DAD, Bessa WM, Dutra RC, Ventura P, Oliveira TS. Health-related quality of life in children with cerebral palsy associated with congenital Zika infection. REVISTA PAULISTA DE PEDIATRIA : ORGAO OFICIAL DA SOCIEDADE DE PEDIATRIA DE SAO PAULO 2023; 41:e2022016. [PMID: 37042942 PMCID: PMC10088476 DOI: 10.1590/1984-0462/2023/41/2022016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/23/2022] [Accepted: 05/29/2022] [Indexed: 04/13/2023]
Abstract
OBJECTIVE To describe the health-related quality of life (QOL) in children with cerebral palsy (CP) associated with congenital Zika infection. METHODS Cross-sectional study of a consecutive series of children, followed in a referral multicentric rehabilitation network in Brazil. We invited the caregivers to respond to the Brazilian version of the Caregiver Priorities & Child Health Index of Life with Disabilities (CPCHILDTM) questionnaire. Statistical analysis was performed with the Statistical Package for the Social Sciences (SPSS) 26.0™. We used absolute and relative frequencies for categorical variables and mean and standard deviation for continuous variables. RESULTS The sample consisted of 193 children, at mean age of 50.3±7.6 months. We observed a predominance of children with cerebral palsy (CP) with Gross Motor Function Classification System (GMFCS) level V (93.7%). Epilepsy (88.4%) was the most common comorbidity. CPCHILDTM mean scores were activities of daily living (ADL)/personal care 43.2±12.6; positioning, transferring and mobility 33.7±16.5; comfort and emotions 84.4±15.2; communication and social interaction (CoSI) 48.2±24.3; health 70.9±17.1; and overall quality of life (OQOL) 72.1±17.1. Total score was 54.8±11.3. CONCLUSIONS Among children with cerebral palsy (CP) related to congenital Zika syndrome, the quality of life (QOL) scores were very similar to other populations with cerebral palsy (CP). The activities of positioning, transferring and mobility had the greatest impact on health-related quality of life (QOL). Rehabilitation strategies and public policies should prioritize aspects related to mobility for this population.
Collapse
Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | | | | | - Fabiana Utsch
- Rede SARAH de Hospitais de Reabilitação, Belo Horizonte, MG, Brazil
| | | | | | | | | | - Paloma Ventura
- Rede SARAH de Hospitais de Reabilitação, Salvador, BA, Brazil
| | | |
Collapse
|
10
|
Gomez SA, Rojas-Valencia N, Gomez S, Lans I, Restrepo A. Initial recognition and attachment of the Zika virus to host cells: A molecular dynamics and quantum interaction approach. Chembiochem 2022; 23:e202200351. [PMID: 35951472 DOI: 10.1002/cbic.202200351] [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: 06/19/2022] [Revised: 08/02/2022] [Indexed: 11/08/2022]
Abstract
The zika virus (ZIKV), transmitted to humans from the bites of Aedes Aegypti and Aedes Albopictus mosquitoes produces Zika fever and neurodegenerative disorders that despite affecting millions of people, most recently in Africa and the Americas, has been declared a neglected tropical disease by the World Health Organization. In this work, atomistic molecular dynamics simulations followed by rigorous analysis of the intermolecular interactions reveal crucial aspects of the initial virus···cell molecular recognition and attachment, events that trigger the infectious cycle. Previous experimental studies have shown that Dermatan Sulphate (DS) and Chondroitin Sulphate A (CSA), two glycosaminoglycans which are actually epimers to each other and that are structural constituents of receptors expressed in cell membranes, are the preferred anchorage sites, with a marked preference for DS. Our calculations rationalize this preference from a molecular perspective as follows: when free of the virus, DS has one sulfate group that does not participate in intramolecular strong hydrogen bonds, thus, it is readily available to interact with the envelope protein of the virus (Zika-E), then, after formation of the complexes, Zika-E···DS exhibits ten strong salt brides connecting the two fragments against only six salt bridges and two hydrogen bonds in Zika-E···CSA.
Collapse
Affiliation(s)
- Santiago A Gomez
- University of Antioquia: Universidad de Antioquia, Chemistry, COLOMBIA
| | | | - Sara Gomez
- Scuola Normale Superiore Classe di Scienze, Chemistry, COLOMBIA
| | - Isaias Lans
- University of Antioquia: Universidad de Antioquia, Chemistry, COLOMBIA
| | - Albeiro Restrepo
- Universidad de Antioquia, Chemistry, AA 1226, 00000, Medellin, COLOMBIA
| |
Collapse
|
11
|
Schuler-Faccini L, Del Campo M, García-Alix A, Ventura LO, Boquett JA, van der Linden V, Pessoa A, van der Linden Júnior H, Ventura CV, Leal MC, Kowalski TW, Rodrigues Gerzson L, Skilhan de Almeida C, Santi L, Beys-da-Silva WO, Quincozes-Santos A, Guimarães JA, Garcez PP, Gomes JDA, Vianna FSL, Anjos da Silva A, Fraga LR, Vieira Sanseverino MT, Muotri AR, Lopes da Rosa R, Abeche AM, Marcolongo-Pereira C, Souza DO. Neurodevelopment in Children Exposed to Zika in utero: Clinical and Molecular Aspects. Front Genet 2022; 13:758715. [PMID: 35350244 PMCID: PMC8957982 DOI: 10.3389/fgene.2022.758715] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2021] [Accepted: 01/27/2022] [Indexed: 12/15/2022] Open
Abstract
Five years after the identification of Zika virus as a human teratogen, we reviewed the early clinical manifestations, collectively called congenital Zika syndrome (CZS). Children with CZS have a very poor prognosis with extremely low performance in motor, cognitive, and language development domains, and practically all feature severe forms of cerebral palsy. However, these manifestations are the tip of the iceberg, with some children presenting milder forms of deficits. Additionally, neurodevelopment can be in the normal range in the majority of the non-microcephalic children born without brain or eye abnormalities. Vertical transmission and the resulting disruption in development of the brain are much less frequent when maternal infection occurs in the second half of the pregnancy. Experimental studies have alerted to the possibility of other behavioral outcomes both in prenatally infected children and in postnatal and adult infections. Cofactors play a vital role in the development of CZS and involve genetic, environmental, nutritional, and social determinants leading to the asymmetric distribution of cases. Some of these social variables also limit access to multidisciplinary professional treatment.
Collapse
Affiliation(s)
- Lavínia Schuler-Faccini
- Universidade Federal do Rio Grande do Sul, UFRGS, Porto Alegre, Brazil.,Medical Genetics Service, Hospital de Clinicas de Porto Alegre, HCPA, Porto Alegre, Brazil
| | - Miguel Del Campo
- Department of Pediatrics, School of Medicine, University of California San Diego, and Rady Children's Hospital San Diego, San Diego, CA, United States
| | | | - Liana O Ventura
- Department of Ophthalmology, Fundação Altino Ventura, FAV, Recife, Brazil
| | | | | | - André Pessoa
- Hospital Infantil Albert Sabin, Fortaleza, Brazil.,Universidade Estadual do Ceará, Fortaleza, Brazil
| | | | - Camila V Ventura
- Department of Ophthalmology, Fundação Altino Ventura, FAV, Recife, Brazil
| | | | - Thayne Woycinck Kowalski
- Universidade Federal do Rio Grande do Sul, UFRGS, Porto Alegre, Brazil.,CESUCA-Centro Universitário, Cachoeirinha, Brazil
| | | | | | - Lucélia Santi
- Universidade Federal do Rio Grande do Sul, UFRGS, Porto Alegre, Brazil.,Medical Genetics Service, Hospital de Clinicas de Porto Alegre, HCPA, Porto Alegre, Brazil
| | - Walter O Beys-da-Silva
- Universidade Federal do Rio Grande do Sul, UFRGS, Porto Alegre, Brazil.,Medical Genetics Service, Hospital de Clinicas de Porto Alegre, HCPA, Porto Alegre, Brazil
| | | | - Jorge A Guimarães
- Medical Genetics Service, Hospital de Clinicas de Porto Alegre, HCPA, Porto Alegre, Brazil
| | | | | | - Fernanda Sales Luiz Vianna
- Universidade Federal do Rio Grande do Sul, UFRGS, Porto Alegre, Brazil.,Medical Genetics Service, Hospital de Clinicas de Porto Alegre, HCPA, Porto Alegre, Brazil
| | - André Anjos da Silva
- School of Medicine, Graduate Program in Medical Sciences-Universidade do Vale do Taquari-UNIVATES, Lajeado, Brazil.,School of Medicine, Universidade do Vale do Rio dos Sinos-UNISINOS, São Leopoldo, Brazil
| | - Lucas Rosa Fraga
- Universidade Federal do Rio Grande do Sul, UFRGS, Porto Alegre, Brazil.,Medical Genetics Service, Hospital de Clinicas de Porto Alegre, HCPA, Porto Alegre, Brazil
| | - Maria Teresa Vieira Sanseverino
- Medical Genetics Service, Hospital de Clinicas de Porto Alegre, HCPA, Porto Alegre, Brazil.,Pontifícia Universidade Católica do Rio Grande do Sul, PUCRS, Porto Alegre, Brazil
| | - Alysson R Muotri
- Department of Pediatrics, School of Medicine, University of California San Diego, and Rady Children's Hospital San Diego, San Diego, CA, United States
| | | | - Alberto Mantovani Abeche
- Universidade Federal do Rio Grande do Sul, UFRGS, Porto Alegre, Brazil.,Medical Genetics Service, Hospital de Clinicas de Porto Alegre, HCPA, Porto Alegre, Brazil
| | | | - Diogo O Souza
- Universidade Federal do Rio Grande do Sul, UFRGS, Porto Alegre, Brazil
| |
Collapse
|
12
|
Targeting Zika Virus with New Brain- and Placenta-Crossing Peptide–Porphyrin Conjugates. Pharmaceutics 2022; 14:pharmaceutics14040738. [PMID: 35456572 PMCID: PMC9032516 DOI: 10.3390/pharmaceutics14040738] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Revised: 03/16/2022] [Accepted: 03/25/2022] [Indexed: 02/06/2023] Open
Abstract
Viral disease outbreaks affect hundreds of millions of people worldwide and remain a serious threat to global health. The current SARS-CoV-2 pandemic and other recent geographically- confined viral outbreaks (severe acute respiratory syndrome (SARS), Ebola, dengue, zika and ever-recurring seasonal influenza), also with devastating tolls at sanitary and socio-economic levels, are sobering reminders in this respect. Among the respective pathogenic agents, Zika virus (ZIKV), transmitted by Aedes mosquito vectors and causing the eponymous fever, is particularly insidious in that infection during pregnancy results in complications such as foetal loss, preterm birth or irreversible brain abnormalities, including microcephaly. So far, there is no effective remedy for ZIKV infection, mainly due to the limited ability of antiviral drugs to cross blood–placental and/or blood–brain barriers (BPB and BBB, respectively). Despite its restricted permeability, the BBB is penetrable by a variety of molecules, mainly peptide-based, and named BBB peptide shuttles (BBBpS), able to ferry various payloads (e.g., drugs, antibodies, etc.) into the brain. Recently, we have described peptide–porphyrin conjugates (PPCs) as successful BBBpS-associated drug leads for HIV, an enveloped virus in which group ZIKV also belongs. Herein, we report on several brain-directed, low-toxicity PPCs capable of targeting ZIKV. One of the conjugates, PP-P1, crossing both BPB and BBB, has shown to be effective against ZIKV (IC50 1.08 µM) and has high serum stability (t1/2 ca. 22 h) without altering cell viability at all tested concentrations. Peptide–porphyrin conjugation stands out as a promising strategy to fill the ZIKV treatment gap.
Collapse
|
13
|
Bancroft D, Power GM, Jones RT, Massad E, Iriat JB, Preet R, Kinsman J, Logan JG. Vector control strategies in Brazil: a qualitative investigation into community knowledge, attitudes and perceptions following the 2015-2016 Zika virus epidemic. BMJ Open 2022; 12:e050991. [PMID: 35105618 PMCID: PMC8808399 DOI: 10.1136/bmjopen-2021-050991] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
OBJECTIVE The World Health Organization declared a Public Health Emergency of International Concern following the rapid emergence of neonatal microcephaly in Brazil during the 2015-2016 Zika virus (ZIKV) epidemic. In response, a national campaign sought to control Aedes mosquito populations and reduce ZIKV transmission. Achieving adherence to vector control or mosquito-bite reduction behaviours, including the use of topical mosquito repellents, is challenging. Coproduction of research at the community level is needed to understand and mitigate social determinants of lower engagement with Aedes preventive measures, particularly within disempowered groups. DESIGN In 2017, the Zika Preparedness Latin America Network (ZikaPLAN) conducted a qualitative study to understand individual and community level experiences of ZIKV and other mosquito-borne disease outbreaks. Presented here is a thematic analysis of 33 transcripts from community focus groups and semistructured interviews, applying the Health Belief Model (HBM) to elaborate knowledge, attitudes and perceptions of ZIKV and vector control strategies. PARTICIPANTS 120 purposively sampled adults of approximate reproductive age (18-45); 103 women participated in focus groups and 17 men in semistructured interviews. SETTING Two sociopolitically and epidemiologically distinct cities in Brazil: Jundiaí (57 km north of São Paolo) and Salvador (Bahia state capital). RESULTS Four key and 12 major themes emerged from the analysis: (1) knowledge and cues to action; (2) attitudes and normative beliefs (perceived threat, barriers, benefits and self-efficacy); (3) behaviour change (household prevention and community participation); and (4) community preferences for novel repellent tools, vector control strategies and ZIKV messaging. CONCLUSIONS Common barriers to repellent adherence were accessibility, appearance and effectiveness. A strong case is made for the transferability of the HBM to inform epidemic preparedness for mosquito-borne disease outbreaks at the community level. Nationally, a health campaign targeting men is recommended, in addition to local mobilisation of funding to strengthen surveillance, risk communication and community engagement.
Collapse
Affiliation(s)
- Dani Bancroft
- Department of Public Health, Environments and Society, London School of Hygiene and Tropical Medicine, London, UK
| | - Grace M Power
- Department of Disease Control, London School of Hygiene & Tropical Medicine, London, UK
| | - Robert T Jones
- Department of Disease Control, London School of Hygiene & Tropical Medicine, London, UK
| | - Eduardo Massad
- School of Medicine, University of São Paulo, São Paulo, SP, Brazil
- School of Applied Mathematics, Fundação Getulio Vargas, Rio de Janeiro, RJ, Brazil
| | | | - Raman Preet
- Department of Epidemiology and Global Health, Umeå University, Umeå, Sweden
| | - John Kinsman
- Department of Epidemiology and Global Health, Umeå University, Umeå, Sweden
| | - James G Logan
- Department of Disease Control, London School of Hygiene & Tropical Medicine, London, UK
| |
Collapse
|
14
|
Disparities in Excess Mortality Between Indigenous and Non-Indigenous Brazilians in 2020: Measuring the Effects of the COVID-19 Pandemic. J Racial Ethn Health Disparities 2022; 9:2227-2236. [PMID: 34581998 PMCID: PMC8477716 DOI: 10.1007/s40615-021-01162-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2021] [Revised: 09/23/2021] [Accepted: 09/23/2021] [Indexed: 12/29/2022]
Abstract
This study aimed to estimate the number of excess deaths among Indigenous Peoples associated with the COVID-19 pandemic in 2020 and to assess the disparities in excess mortality between Indigenous and non-Indigenous Brazilians. A time series analysis of weekly mortality data including all deaths from January 2015 to December 2020 was conducted. The number of expected deaths for 2020 was estimated using an over-dispersed Poisson model that accounts for demographic changes, temporal trends, and seasonal effects in mortality. Weekly excess deaths were calculated as the difference between the number of observed deaths and the expected deaths. Regional differences in Indigenous mortality were investigated. A significant increase in Indigenous mortality was observed from April 1 to December 31, 2020. An estimated 1149 (95% CI 1018-1281) excess deaths was found among Indigenous Brazilians in 2020, representing a 34.8% increase from the expected deaths for this population. The overall increase in non-Indigenous mortality was 18.1%. The Indigenous population living in the Brazilian Amazon area was the earliest-affected Indigenous group, with one of the highest proportional increases in mortality. Disparities in excess mortality revealed a disproportionate burden of COVID-19 among Indigenous Brazilians compared to their non-Indigenous counterparts. Findings highlight the importance of implementing an effective emergency plan that addresses the increased vulnerability of Indigenous Peoples to COVID-19.
Collapse
|
15
|
Dias FM, Berger SMD, Lovisi GM. O cuidado em saúde às crianças com a Síndrome Congênita do Zika. SAÚDE EM DEBATE 2022. [DOI: 10.1590/0103-11042022e608] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/08/2023] Open
Abstract
RESUMO Este artigo teve como objetivo analisar o cuidado ofertado às crianças com a Síndrome Congênita do Zika, a partir das experiências dos profissionais participantes de um projeto de pesquisa clínica de um hospital público e universitário no estado do Rio de Janeiro. Foi realizado um estudo de caso exploratório, qualitativo, por meio de observação participante e entrevistas semiestruturadas com 11 profissionais de saúde. Os dados foram conduzidos por análise de conteúdo, modalidade temática. Sob a perspectiva do cuidado como uma das dimensões da integralidade em saúde, percebeu-se que os profissionais, em sua maioria mulheres e médicas, são sensíveis às questões das famílias, consideradas também como unidade de cuidado, e reconhecem a diferença no atendimento que prestam ante o modelo biomédico ainda hegemônico na área da saúde. No entanto, apontam seus limites perante uma rede fragmentada e ineficiente. Tais limites parecem inviabilizar uma assistência que acolha as dimensões afetivas e sociais dessas famílias, em especial, das mulheres, legitimadas na centralidade do cuidado de seus filhos. Foi constatada a importância de pensar em uma formação em saúde interdisciplinar, crítica e reflexiva que possibilite um olhar ampliado às vulnerabilidades e necessidades dessas famílias, incluindo uma perspectiva de gênero interseccional que compreenda o complexo processo de determinação social em saúde.
Collapse
|
16
|
Andrade GKSD, Teston EF, Marcon SS, Giacon-Arruda BCC, Amorim MD, Sato DM, Werle JE, Silva JLD. Congenital Zika Virus Syndrome: care in light of the Brazilian Unified Health System principles. Rev Bras Enferm 2021; 75:e20210146. [PMID: 34614105 DOI: 10.1590/0034-7167-2021-0146] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2021] [Accepted: 05/09/2021] [Indexed: 12/19/2022] Open
Abstract
OBJECTIVE to know health professionals' perceptions about care actions provided to children with Congenital Zika Virus Syndrome and their families. METHODS this is a qualitative study, carried out in a capital of center-western Brazil, based on the Unified Health System theoretical precepts. Data were collected in September and October 2020, through audio-recorded interviews with 12 health professionals from a specialized service and submitted to analysis of content, thematic modality. RESULTS the implementation of care actions with these children occurs through multidimensional assessment of children and their families, use of the Unique Therapeutic Project, therapeutic interventions for the development of children and the communication and exchange of interprofessional and family experiences, in addition to considering professionals' prior knowledge and their search for it. FINAL CONSIDERATIONS children with CZS and their families need individualized, frequent, integrated and continuous care.
Collapse
Affiliation(s)
| | - Elen Ferraz Teston
- Universidade Federal de Mato Grosso do Sul. Campo Grande, Mato Grosso do Sul, Brazil
| | | | | | | | - Daniela Miyuki Sato
- Universidade Federal de Mato Grosso do Sul. Campo Grande, Mato Grosso do Sul, Brazil
| | | | | |
Collapse
|
17
|
Kameda K, Kelly AH, Lezaun J, Löwy I. Imperfect diagnosis: The truncated legacies of Zika testing. SOCIAL STUDIES OF SCIENCE 2021; 51:683-706. [PMID: 34461777 PMCID: PMC8474320 DOI: 10.1177/03063127211035492] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
When the Zika virus burst onto the international scene in the second half of 2015, the development of diagnostic tools was seen as an urgent global health priority. Diagnostic capacity was restricted to a small number of reference laboratories, and none of the few available molecular or serological tests had been validated for extensive use in an outbreak setting. In the early weeks of the crisis, key funders stepped in to accelerate research and development efforts, and the WHO took responsibility for steering diagnostic standardization, a role it had successfully played during the West Africa Ebola virus outbreak. Yet when the WHO declared the end of the Zika Public Health Emergency of International Concern in November 2016, diagnostic capacity remained patchy, and few tools were available at the scale required in the countries that bore the brunt of the epidemic, particularly Brazil. This article analyses the limited impact of global R&D efforts on the availability of Zika diagnostic options where they were most needed and for those most vulnerable: women who might have been exposed to the virus during their pregnancy and children born with suspected congenital Zika syndrome. The truncated legacies of testing during the Zika crisis reveal some of the fault lines in the global health enterprise, particularly the limits of 'emergency R&D' to operate in geopolitical contexts that do not conform to the ideal type of a humanitarian crisis, or to tackle technical issues that are inextricably linked to domestic struggles over the scope and distribution of biological citizenship. Diagnostic shortcomings, we argue, lie at the heart of the stunning transformation, in less than two years, in the status of Zika: from international public health emergency to neglected disease.
Collapse
Affiliation(s)
- Koichi Kameda
- Institute for Research and
Innovation in Society (IFRIS), Paris, France
| | - Ann H Kelly
- Department of Global Health and
Social Medicine, King’s College London, London, UK
| | - Javier Lezaun
- Institute for Science, Innovation
and Society, University of Oxford, Oxford, UK
| | | |
Collapse
|
18
|
Vancamp P, Spirhanzlova P, Sébillot A, Butruille L, Gothié JD, Le Mével S, Leemans M, Wejaphikul K, Meima M, Mughal BB, Roques P, Remaud S, Fini JB, Demeneix BA. The pyriproxyfen metabolite, 4'-OH-PPF, disrupts thyroid hormone signaling in neural stem cells, modifying neurodevelopmental genes affected by ZIKA virus infection. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2021; 285:117654. [PMID: 34289950 DOI: 10.1016/j.envpol.2021.117654] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Revised: 05/25/2021] [Accepted: 06/11/2021] [Indexed: 06/13/2023]
Abstract
North-Eastern Brazil saw intensive application of the insecticide pyriproxyfen (PPF) during the microcephaly outbreak caused by the Zika virus (ZIKV). ZIKV requires the neural RNA-binding protein Musashi-1 to replicate. Thyroid hormone (TH) represses MSI1. PPF is a suspected TH disruptor. We hypothesized that co-exposure to the main metabolite of PPF, 4'-OH-PPF, could exacerbate ZIKV effects through increased MSI1 expression. Exposing an in vivo reporter model, Xenopus laevis, to 4'-OH-PPF decreased TH signaling and increased msi1 mRNA and protein, confirming TH-antagonistic properties. Next, we investigated the metabolite's effects on mouse subventricular zone-derived neural stem cells (NSCs). Exposure to 4'-OH-PPF dose-dependently reduced neuroprogenitor proliferation and dysregulated genes implicated in neurogliogenesis. The highest dose induced Msi1 mRNA and protein, increasing cell apoptosis and the ratio of neurons to glial cells. Given these effects of the metabolite alone, we considered if combined infection with ZIKV worsened neurogenic events. Only at the fourth and last day of incubation did co-exposure of 4'-OH-PPF and ZIKV decrease viral replication, but viral RNA copies stayed within the same order of magnitude. Intracellular RNA content of NSCs was decreased in the combined presence of 4'-OH-PPF and ZIKV, suggesting a synergistic block of transcriptional machinery. Seven out of 12 tested key genes in TH signaling and neuroglial commitment were dysregulated by co-exposure, of which four were unaltered when exposed to 4'-OH-PPF alone. We conclude that 4'-OH-PPF is an active TH-antagonist, altering NSC processes known to underlie correct cortical development. A combination of the TH-disrupting metabolite and ZIKV could aggravate the microcephaly phenotype.
Collapse
Affiliation(s)
- Pieter Vancamp
- Laboratory Molecular Physiology and Adaptation, CNRS UMR 7221, Muséum National d'Histoire Naturelle, Department Adaptations of Life, F-75005, Paris, France
| | - Petra Spirhanzlova
- Laboratory Molecular Physiology and Adaptation, CNRS UMR 7221, Muséum National d'Histoire Naturelle, Department Adaptations of Life, F-75005, Paris, France
| | - Anthony Sébillot
- Laboratory Molecular Physiology and Adaptation, CNRS UMR 7221, Muséum National d'Histoire Naturelle, Department Adaptations of Life, F-75005, Paris, France
| | - Lucile Butruille
- Laboratory Molecular Physiology and Adaptation, CNRS UMR 7221, Muséum National d'Histoire Naturelle, Department Adaptations of Life, F-75005, Paris, France
| | - Jean-David Gothié
- Laboratory Molecular Physiology and Adaptation, CNRS UMR 7221, Muséum National d'Histoire Naturelle, Department Adaptations of Life, F-75005, Paris, France
| | - Sébastien Le Mével
- Laboratory Molecular Physiology and Adaptation, CNRS UMR 7221, Muséum National d'Histoire Naturelle, Department Adaptations of Life, F-75005, Paris, France
| | - Michelle Leemans
- Laboratory Molecular Physiology and Adaptation, CNRS UMR 7221, Muséum National d'Histoire Naturelle, Department Adaptations of Life, F-75005, Paris, France
| | - Karn Wejaphikul
- Department of Internal Medicine, Academic Center for Thyroid Diseases, Erasmus Medical Center, Rotterdam, the Netherlands; Department of Pediatrics, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Marcel Meima
- Department of Internal Medicine, Academic Center for Thyroid Diseases, Erasmus Medical Center, Rotterdam, the Netherlands
| | - Bilal B Mughal
- Laboratory Molecular Physiology and Adaptation, CNRS UMR 7221, Muséum National d'Histoire Naturelle, Department Adaptations of Life, F-75005, Paris, France
| | - Pierre Roques
- Immunology of Viral Infections and Autoimmune Diseases, IDMIT Department, IBFJ, CEA, Université Paris Sud, INSERM U1184, 92265, Fontenay-aux-Roses, France
| | - Sylvie Remaud
- Laboratory Molecular Physiology and Adaptation, CNRS UMR 7221, Muséum National d'Histoire Naturelle, Department Adaptations of Life, F-75005, Paris, France
| | - Jean-Baptiste Fini
- Laboratory Molecular Physiology and Adaptation, CNRS UMR 7221, Muséum National d'Histoire Naturelle, Department Adaptations of Life, F-75005, Paris, France
| | - Barbara A Demeneix
- Laboratory Molecular Physiology and Adaptation, CNRS UMR 7221, Muséum National d'Histoire Naturelle, Department Adaptations of Life, F-75005, Paris, France.
| |
Collapse
|
19
|
Costa J, Ferreira EC, Santos C. COVID-19, Chikungunya, Dengue and Zika Diseases: An Analytical Platform Based on MALDI-TOF MS, IR Spectroscopy and RT-qPCR for Accurate Diagnosis and Accelerate Epidemics Control. Microorganisms 2021; 9:microorganisms9040708. [PMID: 33808104 PMCID: PMC8066533 DOI: 10.3390/microorganisms9040708] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Revised: 02/26/2021] [Accepted: 03/03/2021] [Indexed: 12/23/2022] Open
Abstract
COVID-19 and arboviruses (ARBOD) epidemics co-occurrence is a great concern. In tropical and subtropical regions, ARBOD diseases such as chikungunya, dengue, and Zika are frequent. In both COVID-19 and ARBOD cases, an accurate diagnosis of infected patients is crucial to promote adequate treatment and isolation measures in COVID-19 cases. Overlap of clinical symptoms and laboratory parameters between COVID-19 and ARBOD present themselves as an extra challenge during diagnosis. COVID-19 diagnosis is mainly performed by quantitative reverse polymerase chain reaction (RT-qPCR), while ARBOD diagnosis is performed by serology, detection of antigen or antibody, and molecular diagnosis. In this review, the epidemiologic profile of arboviruses and SARS-CoV-2 is analyzed, and potential risks of symptom overlap is addressed. The implementation of an analytical platform based on infrared (IR) spectroscopy, MALDI-TOF mass spectrometry, and RT-qPCR is discussed as an efficient strategy for a fast, robust, reliable, and cost-effective diagnosis system even during the co-occurrence of virus outbreaks. The spectral data of IR spectroscopy and MALDI-TOF MS obtained from COVID-19 infected and recovered patients can be used to build up an integrated spectral database. This approach can enable us to determine quickly the groups that have been exposed and have recovered from COVID-19 or ARBOD, avoiding misdiagnoses.
Collapse
Affiliation(s)
- Jéssica Costa
- Programa de Doctorado en Ciencias de Recursos Naturales, Universidad de La Frontera, Temuco 4811-230, Chile;
| | - Eugénio C. Ferreira
- CEB-Centre of Biological Engineering, Universidade do Minho, Campus of Gualtar, 4710-057 Braga, Portugal;
| | - Cledir Santos
- Department of Chemical Science and Natural Resources, Universidad de La Frontera, Temuco 4811-230, Chile
- Correspondence: ; Tel.: +56-45-259-6726
| |
Collapse
|
20
|
da Silva Sobrinho AR, Ramos LFS, Maciel YL, Maurício HDA, Cartaxo RDO, Ferreira SJ, Sette-de-Souza PH. Orofacial features in children with microcephaly associated with Zika virus: A scoping review. Oral Dis 2021; 28:1022-1028. [PMID: 33590546 DOI: 10.1111/odi.13804] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2020] [Revised: 02/05/2021] [Accepted: 02/11/2021] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To analyze published scientific evidence about the most common orofacial disorders in children with microcephaly associated with ZIKV infection. METHODS Through a scoping review, we respond to the search question was formulated: "What are the orofacial alterations in children with microcephaly associated with ZIKV?" It was performed a search in PubMed, EMBASE, Scopus, and Health Virtual Library. It was selected papers wrote in English, Portuguese, or Spanish. An evidence quality analysis was performed using the Agency for Healthcare Research and Quality classification. RESULTS It was included 11 studies performed in the Brazilian Northeast region. The studies were carried out between 2018 and 2020. The main related alterations were delay in the tooth-eruption and deformation in the oral structures. CONCLUSION The results observed in our work show moderate scientific evidence regarding the association of ZIKV with orofacial alterations in children with microcephaly due to the classifications of the quality of evidence of each one of the included studies. The main changes reported were in the chronology of tooth eruption, alteration in teeth, and oral structures.
Collapse
Affiliation(s)
| | | | | | - Herika de Arruda Maurício
- School of Dentistry of Pernambuco, Universidade de Pernambuco, Campus Camaragibe, Camaragibe, PE, Brazil
| | | | - Stefânia Jeronimo Ferreira
- School of Dentistry, Universidade de Pernambuco, Arcoverde, PE, Brazil.,Graduate Program in Health and Socioambiental Development, Universidade de Pernambuco, Campus Garanhuns, Garanhuns, PE, Brazil
| | - Pedro Henrique Sette-de-Souza
- School of Dentistry, Universidade de Pernambuco, Arcoverde, PE, Brazil.,Graduate Program in Health and Socioambiental Development, Universidade de Pernambuco, Campus Garanhuns, Garanhuns, PE, Brazil
| |
Collapse
|