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Oliveira MDS, Carvalho RF, Meurer CM, Rodrigues ÉM, Dias BP, Santos IGCD, Nascimento CA, Rodrigues YM, Santos AJFD, Almeida KDS, de Souza UJB, Campos FS, Ribeiro J, Soares CMDA, Ribeiro Júnior JC. Prevalence, under-reporting, and epidemiological surveillance of COVID-19 in the Araguaína City of Brazil. PLoS One 2024; 19:e0300191. [PMID: 38838042 DOI: 10.1371/journal.pone.0300191] [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: 08/13/2022] [Accepted: 02/19/2024] [Indexed: 06/07/2024] Open
Abstract
Asymptomatic and underreported individuals remain a source of coronafig disease 2019 (COVID-19) transmission to others. Data on the prevalence and epidemiological factors influencing transmission are fundamental for establishing control measures, especially in vulnerable regions such as the Amazon. This study aimed to determine the point prevalence and active infection of COVID-19 among the population in Araguaína, a Brazilian city located in the Amazon region, analyzed the socioeconomic and behavioral variables of a statistically representative sample of this population using an epidemiological survey, and identify the viral genomic diversity in the region. During the sixth epidemiological week of 2021 (February 8 to 12), samples of 497 inhabitants of the municipality asymptomatic for respiratory syndromes underwent reverse transcription-quantitative polymerase chain reaction and serological tests (immunoglobulin M and immunoglobulin G). A questionnaire collated data on socioeconomic factors, prevention measures, and health status history. The active infection rate was 6.2%, and the prevalence was 13.5% of the study population. Active infection cases were under-reported; each reported positive case represented 14-28 under-reported cases. Lineages P.2, P.1, and B.1.1 were detected. Working from home was a protective factor against the infection, and clinical signs of fever, dry cough, and loss of taste or smell were associated with testing positive (p <0.05). A descriptive analysis of the indicators revealed that the entire population was susceptible to the disease. Intensified vaccination strategies are required regardless of socioeconomic factors, health conditions, and preventive measures. Implementation of objective, comprehensive, and efficient management tools to minimize the spread of COVID-19 in this municipality can serve as a model for other regions of Brazil.
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Affiliation(s)
- Monike da Silva Oliveira
- Molecular Biology Laboratory, Institute of Biological Sciences, Federal University of Goiás, Goiânia, Goiás, Brazil
- Microbiology Laboratory, Federal University of North Tocantins, Araguaína, Tocantins, Brazil
| | | | - Carolina Merlin Meurer
- Microbiology Laboratory, Federal University of North Tocantins, Araguaína, Tocantins, Brazil
| | - Ézio Machado Rodrigues
- Microbiology Laboratory, Federal University of North Tocantins, Araguaína, Tocantins, Brazil
| | - Bianca Pereira Dias
- Microbiology Laboratory, Federal University of North Tocantins, Araguaína, Tocantins, Brazil
| | | | | | - Yron Moreira Rodrigues
- Microbiology Laboratory, Federal University of North Tocantins, Araguaína, Tocantins, Brazil
| | | | | | | | - Fabrício Souza Campos
- Bioinformatics and Biotechnology Laboratory, Federal University of Tocantins, Gurupi, Tocantins, Brazil
- Institute of Basic Health Sciences, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Juliane Ribeiro
- Molecular Biology and Animal Virology Laboratory, State University of Londrina, Londrina, Paraná, Brazil
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2
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Curtis E, Loring B, Latham K, Jordan A, Chee N, Hunia R, Snowden K, Tari K, Murupaenga P, Tipene R, Whitcombe S, Embers K, McKree Jansen R. An innovative Indigenous-led model for integrated COVID-19 case management in Auckland, New Zealand: lessons from implementation. Front Public Health 2024; 12:1324239. [PMID: 38406495 PMCID: PMC10884302 DOI: 10.3389/fpubh.2024.1324239] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Accepted: 01/17/2024] [Indexed: 02/27/2024] Open
Abstract
In Aotearoa/New Zealand (NZ), the Indigenous Māori population have been more severely impacted than non-Māori throughout the COVID-19 pandemic, and less well served by NZ's COVID-19 response. This case-study describes an innovative Indigenous-led service delivery model, which was designed and implemented to improve the case and contact management of Māori with COVID-19 in Auckland. We outline the context in which the conventional public health case and contact management was failing Māori and the factors which enabled Indigenous innovation and leadership. We describe the details of the model and how the approach fundamentally differed to the conventional approach to care. Qualitative and quantitative data on impact of the model are shared, along with the key barriers and enablers in the implementation of the model. The Māori Regional Coordination Hub (MRCH) model offers a valuable alternative to the conventional public health case and contact management approach, and this case study highlights lessons which may be applicable to improving the design and delivery of public health services to other Indigenous and marginalized groups.
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Affiliation(s)
- Elana Curtis
- Te Kupenga Hauora Māori, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - Belinda Loring
- Te Kupenga Hauora Māori, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - Kadin Latham
- Te Aka Whai Ora – Māori Health Authority, Auckland, New Zealand
| | - Anthony Jordan
- Te Whatu Ora - Te Toka Tumai Auckland, Auckland, New Zealand
| | - Nigel Chee
- Te Aka Whai Ora – Māori Health Authority, Auckland, New Zealand
| | | | - Karl Snowden
- Te Aka Whai Ora – Māori Health Authority, Auckland, New Zealand
| | | | - Paora Murupaenga
- Te Whatu Ora – Health New Zealand Counties Manukau, Auckland, New Zealand
| | - Roimata Tipene
- Te Whatu Ora - Te Toka Tumai Auckland, Auckland, New Zealand
| | - Stevie Whitcombe
- Te Whatu Ora – Health New Zealand Counties Manukau, Auckland, New Zealand
| | - Kelleigh Embers
- Te Whatu Ora - Te Toka Tumai Auckland, Auckland, New Zealand
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3
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Santos Silva L, da Conceição Barbosa RB, Lima JP, Castro-Alves J, Ribeiro-Alves M. Racial Inequalities in the Health Establishment Access to the Treatment of COVID-19 in Brazil in 2020. J Racial Ethn Health Disparities 2024:10.1007/s40615-023-01866-1. [PMID: 38189902 DOI: 10.1007/s40615-023-01866-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Revised: 11/02/2023] [Accepted: 11/04/2023] [Indexed: 01/09/2024]
Abstract
The Brazilian health system simultaneously allows for the existence of the public and private sectors, which often imposes financial barriers to access to services and affects the health of exposed groups. Studies have shown evidence of higher lethality risks among Black/Biracial and Indigenous People admitted to hospitals due to COVID-19 during the pandemic when compared to White People. This paper evaluated the association between access to treatment for COVID-19, race, and COVID-19-related deaths among the five macro-regions of Brazil in 2020. We conducted a retrospective, cross-sectional observational, and population-wide study. Logistical models were used including first-order interactions between race and the health establishment administration sector using deaths as outcome, adjusted for covariates. The lethality risk, defined as the percentage of deaths among hospitalized patients, of Black/Biracial and Indigenous People was up to 78% (in the Midwest) and 29% (in the South) higher when compared to White People, respectively. The association of the race/access interaction with COVID-19-related deaths suggested the possibility of institutional racism in health establishments. The results highlight the need to guarantee adequate funding to the public health sector to improve equity in access to healthcare and the constant development of educational activities and increased participation of racialized minorities in the healthcare workforce at influential positions for health workers on topics such as racism.
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Affiliation(s)
- Lídia Santos Silva
- National Institute of Infectology Evandro Chagas (INI), Oswaldo Cruz Foundation (FIOCRUZ), Rio de Janeiro, RJ, Brazil
| | | | - João Paulo Lima
- National Institute of Infectology Evandro Chagas (INI), Oswaldo Cruz Foundation (FIOCRUZ), Rio de Janeiro, RJ, Brazil
| | - Julio Castro-Alves
- National Institute of Infectology Evandro Chagas (INI), Oswaldo Cruz Foundation (FIOCRUZ), Rio de Janeiro, RJ, Brazil.
| | - Marcelo Ribeiro-Alves
- Laboratory of Clinical Research On STD/AIDS, National Institute of Infectology Evandro Chagas (INI), Oswaldo Cruz Foundation (FIOCRUZ), Rio de Janeiro, RJ, Brazil
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4
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Basta PC. Gold mining in the Amazon: the origin of the Yanomami health crisis. CAD SAUDE PUBLICA 2023; 39:e00111823. [PMID: 38126561 PMCID: PMC10740397 DOI: 10.1590/0102-311xpt111823] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Revised: 09/21/2023] [Accepted: 10/10/2023] [Indexed: 12/23/2023] Open
Affiliation(s)
- Paulo Cesar Basta
- Escola Nacional de Saúde Pública Sergio Arouca, Fundação Oswaldo Cruz, Rio de Janeiro, Brasil
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5
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de Oliveira LA, dos Santos Barbosa M, Leite Torres AJ, Croda MG, Oliveira da Silva B, dos Santos PCP, Rossoni R, Machado LOCL, Croda J, Maymone Gonçalves CC, Marques MF, da Silva Ferreira T, Sardi SI, Campos GS, de Almeida GB, Alves Gomes MM, Marchioro SB, Simionatto S. Seroprevalence Of SARS-COV-2 infection in asymptomatic indigenous from the largest Brazilian periurban area. PLoS One 2023; 18:e0295211. [PMID: 38134187 PMCID: PMC10745159 DOI: 10.1371/journal.pone.0295211] [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: 08/24/2023] [Accepted: 11/15/2023] [Indexed: 12/24/2023] Open
Abstract
This study assessed the seroprevalence of SARS-CoV-2 in 496 asymptomatic individuals from Mato Grosso do Sul, located in Dourados, the largest periurban indigenous area in Brazil, from January 25 to February 4, 2021. The volunteers participated before receiving their first dose of the CoronaVac inactivated vaccine. For screening, blood samples were collected and analyzed using SARS-CoV-2 rapid tests and the enzyme-linked immunosorbent assay (ELISA). We observed varying trends in total anti-SARS-CoV-2 antibodies across different variables. Seropositivity among the participants tested was 63.70% (316/496) using the rapid test and 52.82% (262/496) were positive using the ELISA method. The majority of participants identified with the Guarani-Kaiowá ethnic group, with 66.15% (217/328), and other ethnic groups with 58.84% (193/328). The median age of the subjects was 30.5 years, with 79.57% (261/328) being femaleThis research showed the elevated seroprevalence of SARS-CoV-2 antibodies in asymptomatic Brazilians. The findings indicate a high seropositivity rate among the asymptomatic indigenous population of Midwest Brazil. This underscores the overlooked status of these communities and underscores the need for targeted national initiatives that emphasize the protection of vulnerable ethnic groups in the fight against COVID-19.
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Affiliation(s)
| | - Marcelo dos Santos Barbosa
- Health Science Research Laboratory, Federal University of Grande Dourados, Dourados, Mato Grosso do Sul, Brazil
| | - Alex José Leite Torres
- Laboratory of Immunology and Molecular Biology, Institute of Health Sciences, Federal University of Bahia, Salvador, Bahia, Brazil
| | - Mariana Garcia Croda
- School of Medicine, Federal University of Mato Grosso do Sul, Campo Grande, Mato Grosso do Sul, Brazil
| | - Bruna Oliveira da Silva
- Health Science Research Laboratory, Federal University of Grande Dourados, Dourados, Mato Grosso do Sul, Brazil
| | | | - Regina Rossoni
- Health Science Research Laboratory, Federal University of Grande Dourados, Dourados, Mato Grosso do Sul, Brazil
| | | | - Julio Croda
- School of Medicine, Federal University of Mato Grosso do Sul, Campo Grande, Mato Grosso do Sul, Brazil
- Oswaldo Cruz Foundation, 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
| | - Michele Ferreira Marques
- Health Science Research Laboratory, Federal University of Grande Dourados, Dourados, Mato Grosso do Sul, Brazil
| | - Tiago da Silva Ferreira
- Health Science Research Laboratory, Federal University of Grande Dourados, Dourados, Mato Grosso do Sul, Brazil
| | - Silvia Inês Sardi
- Laboratory of Immunology and Molecular Biology, Institute of Health Sciences, Federal University of Bahia, Salvador, Bahia, Brazil
| | - Gubio Soares Campos
- Laboratory of Immunology and Molecular Biology, Institute of Health Sciences, Federal University of Bahia, Salvador, Bahia, Brazil
| | - Gabriel Barroso de Almeida
- Laboratory of Immunology and Molecular Biology, Institute of Health Sciences, Federal University of Bahia, Salvador, Bahia, Brazil
| | - Marilia Maria Alves Gomes
- Health Science 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
| | - Simone Simionatto
- Health Science Research Laboratory, Federal University of Grande Dourados, Dourados, Mato Grosso do Sul, Brazil
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6
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Da Luz Scherf E, Viana da Silva MV. Brazil's Yanomami health disaster: addressing the public health emergency requires advancing criminal accountability. Front Public Health 2023; 11:1166167. [PMID: 37265517 PMCID: PMC10229808 DOI: 10.3389/fpubh.2023.1166167] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Accepted: 04/28/2023] [Indexed: 06/03/2023] Open
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7
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Lamarca AP, Souza UJBD, Moreira FRR, Almeida LGPD, Menezes MTD, Souza ABD, Ferreira ACDS, Gerber AL, Lima ABD, Guimarães APDC, Cavalcanti AC, Silva ABPE, Lima BI, Lobato C, Silva CGD, Mendonça CPTB, Queiroz DC, Zauli DAG, Menezes D, Possebon FS, Cardoso FDP, Malta FSV, Braga-Paz I, Silva JDP, Ferreira JGG, Galvão JD, Souza LMD, Ferreira L, Possuelo LG, Cavalcante LTDF, Alvim LB, Souza LFAD, Santos LCGDAE, Dias RC, Souza RB, Castro TRY, Valim ARDM, Campos FS, Araujo JP, Trindade PDA, Aguiar RS, Michael Delai R, Vasconcelos ATRD. The Omicron Lineages BA.1 and BA.2 ( Betacoronavirus SARS-CoV-2) Have Repeatedly Entered Brazil through a Single Dispersal Hub. Viruses 2023; 15:888. [PMID: 37112869 PMCID: PMC10146814 DOI: 10.3390/v15040888] [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: 02/13/2023] [Revised: 03/20/2023] [Accepted: 03/27/2023] [Indexed: 04/03/2023] Open
Abstract
Brazil currently ranks second in absolute deaths by COVID-19, even though most of its population has completed the vaccination protocol. With the introduction of Omicron in late 2021, the number of COVID-19 cases soared once again in the country. We investigated in this work how lineages BA.1 and BA.2 entered and spread in the country by sequencing 2173 new SARS-CoV-2 genomes collected between October 2021 and April 2022 and analyzing them in addition to more than 18,000 publicly available sequences with phylodynamic methods. We registered that Omicron was present in Brazil as early as 16 November 2021 and by January 2022 was already more than 99% of samples. More importantly, we detected that Omicron has been mostly imported through the state of São Paulo, which in turn dispersed the lineages to other states and regions of Brazil. This knowledge can be used to implement more efficient non-pharmaceutical interventions against the introduction of new SARS-CoV variants focused on surveillance of airports and ground transportation.
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Affiliation(s)
- Alessandra P Lamarca
- Laboratório de Bioinformática, Laboratório Nacional de Computação Científica, Petrópolis 25651-075, Brazil
| | - Ueric José Borges de Souza
- Laboratório de Bioinformática e Biotecnologia, Universidade Federal do Tocantins, Campus de Gurupi, Palmas 77410-570, Brazil
| | - Filipe Romero Rebello Moreira
- Laboratório de Virologia Molecular, Departamento de Genética, Instituto de Biologia, Universidade Federal do Rio de Janeiro, Rio de Janeiro 21941-901, Brazil
| | - Luiz G P de Almeida
- Laboratório de Bioinformática, Laboratório Nacional de Computação Científica, Petrópolis 25651-075, Brazil
| | - Mariane Talon de Menezes
- Laboratório de Virologia Molecular, Departamento de Genética, Instituto de Biologia, Universidade Federal do Rio de Janeiro, Rio de Janeiro 21941-901, Brazil
| | | | | | - Alexandra L Gerber
- Laboratório de Bioinformática, Laboratório Nacional de Computação Científica, Petrópolis 25651-075, Brazil
| | - Aline B de Lima
- Departamento de Pesquisa & Desenvolvimento, Instituto Hermes Pardini, Belo Horizonte 30140-070, Brazil
| | - Ana Paula de C Guimarães
- Laboratório de Bioinformática, Laboratório Nacional de Computação Científica, Petrópolis 25651-075, Brazil
| | | | - Aryel B Paz E Silva
- Departamento de Genética, Ecologia e Evolução, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte 31270-901, Brazil
| | - Bruna Israel Lima
- Laboratório de Biologia Molecular, Parque Científico e Tecnológico Regional, Universidade de Santa Cruz do Sul, Santa Cruz do Sul 96815-900, Brazil
| | - Cirley Lobato
- Centro de Ciências de Saúde e do Desporto, Universidade Federal do Acre, Rio Branco 69920-900, Brazil
| | | | - Cristiane P T B Mendonça
- Departamento de Pesquisa & Desenvolvimento, Instituto Hermes Pardini, Belo Horizonte 30140-070, Brazil
| | - Daniel Costa Queiroz
- Departamento de Genética, Ecologia e Evolução, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte 31270-901, Brazil
| | | | - Diego Menezes
- Departamento de Genética, Ecologia e Evolução, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte 31270-901, Brazil
| | - Fábio Sossai Possebon
- Instituto de Biotecnologia, Universidade Estadual Paulista, Botucatu 18618-689, Brazil
| | | | | | - Isabela Braga-Paz
- Departamento de Genética, Ecologia e Evolução, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte 31270-901, Brazil
| | - Joice do Prado Silva
- Departamento de Pesquisa & Desenvolvimento, Instituto Hermes Pardini, Belo Horizonte 30140-070, Brazil
| | - Jorge Gomes Goulart Ferreira
- Departamento de Genética, Ecologia e Evolução, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte 31270-901, Brazil
| | | | | | - Leonardo Ferreira
- Centro de Medicina Tropical da Tríplice Fronteira, Foz do Iguaçu 85866-010, Brazil
| | - Lia Gonçalves Possuelo
- Departmento de Ciências da Vida, Universidade de Santa Cruz do Sul, Santa Cruz do Sul 96815-900, Brazil
| | | | - Luige B Alvim
- Departamento de Pesquisa & Desenvolvimento, Instituto Hermes Pardini, Belo Horizonte 30140-070, Brazil
| | - Luiz Fellype Alves de Souza
- Centro de Infectologia Charles Mérieux and Laboratório Rodolphe Mérieux, Hospital das Clínicas do Acre, Rio Branco 69920-223, Brazil
| | - Luiza C G de Araújo E Santos
- Departamento de Genética, Ecologia e Evolução, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte 31270-901, Brazil
| | - Rillery Calixto Dias
- Departamento de Genética, Ecologia e Evolução, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte 31270-901, Brazil
| | - Rutilene Barbosa Souza
- Centro de Infectologia Charles Mérieux and Laboratório Rodolphe Mérieux, Hospital das Clínicas do Acre, Rio Branco 69920-223, Brazil
| | - Thaís Regina Y Castro
- Laboratório de Biologia Molecular e Bioinformática Aplicadas a Microbiologia Clínica, Universidade Federal de Santa Maria, Santa Maria 97105-900, Brazil
| | | | - Fabrício Souza Campos
- Laboratório de Virologia, Departamento de Microbiologia, Imunologia e Parasitologia, Instituto de Ciências Básicas da Saúde, Universidade Federal do Rio Grande do Sul, Porto Alegre 90010-150, Brazil
| | - João Pessoa Araujo
- Instituto de Biotecnologia, Universidade Estadual Paulista, Botucatu 18618-689, Brazil
| | - Priscila de Arruda Trindade
- Laboratório de Biologia Molecular e Bioinformática Aplicadas a Microbiologia Clínica, Universidade Federal de Santa Maria, Santa Maria 97105-900, Brazil
| | - Renato S Aguiar
- Departamento de Genética, Ecologia e Evolução, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte 31270-901, Brazil
| | - Robson Michael Delai
- Centro de Medicina Tropical da Tríplice Fronteira, Foz do Iguaçu 85866-010, Brazil
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8
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Pickering K, Galappaththi EK, Ford JD, Singh C, Zavaleta-Cortijo C, Hyams K, Miranda JJ, Arotoma-Rojas I, Togarepi C, Kaur H, Arvind J, Scanlon H, Namanya DB, Anza-Ramirez C. Indigenous peoples and the COVID-19 pandemic: a systematic scoping review. ENVIRONMENTAL RESEARCH LETTERS : ERL [WEB SITE] 2023; 18:033001. [PMID: 36798651 PMCID: PMC9923364 DOI: 10.1088/1748-9326/acb804] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Revised: 10/17/2022] [Accepted: 02/01/2023] [Indexed: 05/06/2023]
Abstract
Past influenza pandemics including the Spanish flu and H1N1 have disproportionately affected Indigenous Peoples. We conducted a systematic scoping review to provide an overview of the state of understanding of the experience of Indigenous peoples during the first 18 months of the COVID-19 pandemic, in doing so we capture the state of knowledge available to governments and decision makers for addressing the needs of Indigenous peoples in these early months of the pandemic. We addressed three questions: (a) How is COVID-19 impacting the health and livelihoods of Indigenous peoples, (b) What system level challenges are Indigenous peoples experiencing, (c) How are Indigenous peoples responding? We searched Web of Science, Scopus, and PubMed databases and UN organization websites for publications about Indigenous peoples and COVID-19. Results were analyzed using descriptive statistics and content analysis. A total of 153 publications were included: 140 peer-reviewed articles and 13 from UN organizations. Editorial/commentaries were the most (43%) frequent type of publication. Analysis identified Indigenous peoples from 19 different countries, although 56% of publications were centered upon those in Brazil, United States, and Canada. The majority (90%) of articles focused upon the general adult population, few (<2%) used a gender lens. A small number of articles documented COVID-19 testing (0.04%), incidence (18%), or mortality (16%). Five themes of system level challenges affecting exposure and livelihoods evolved: ecological, poverty, communication, education and health care services. Responses were formal and informal strategies from governments, Indigenous organizations and communities. A lack of ethnically disaggregated health data and a gender lens are constraining our knowledge, which is clustered around a limited number of Indigenous peoples in mostly high-income countries. Many Indigenous peoples have autonomously implemented their own coping strategies while government responses have been largely reactive and inadequate. To 'build back better' we must address these knowledge gaps.
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Affiliation(s)
- Kerrie Pickering
- University of the Sunshine Coast, Sippy Downs, Queensland, Australia
| | - Eranga K Galappaththi
- Department of Geography, Virginia Polytechnic Institute and State University, Blacksburg, VA, United States of America
| | - James D Ford
- Priestley International Centre for Climate, University of Leeds, Leeds, United Kingdom
| | - Chandni Singh
- School of Environment and Development, Indian Institute for Human Settlements, Bangalore, India
| | - Carol Zavaleta-Cortijo
- Unidad de Ciudadanía Intercultural y Salud Indígena (UCISI), Facultad de Salud Pública y Administración, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Keith Hyams
- Department of Politics and International Studies, University of Warwick, Coventry, United Kingdom
| | - J Jaime Miranda
- CRONICAS Center of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Ingrid Arotoma-Rojas
- Priestley International Centre for Climate, University of Leeds, Leeds, United Kingdom
| | - Cecil Togarepi
- Department of Animal Production, Agribusiness and Economics, School of Agriculture and Fisheries Sciences, University of Namibia, Windhoek, Namibia
| | - Harpreet Kaur
- Indian Institute for Human Settlements, Bangalore, India
| | | | - Halena Scanlon
- University of the Sunshine Coast, Sippy Downs, Queensland, Australia
| | - Didacus B Namanya
- Ministry of Health, Uganda National Health Research Organisation, Entebbe, Uganda
| | - Cecilia Anza-Ramirez
- CRONICAS Center of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima, Peru
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9
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Apolonio JS, da Silva Júnior RT, Cuzzuol BR, Araújo GRL, Marques HS, Barcelos IDS, Santos LKDS, Malheiro LH, Lima de Souza Gonçalves V, Freire de Melo F. Syndemic aspects between COVID-19 pandemic and social inequalities. World J Methodol 2022; 12:350-364. [PMID: 36186746 PMCID: PMC9516541 DOI: 10.5662/wjm.v12.i5.350] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2022] [Revised: 06/22/2022] [Accepted: 07/25/2022] [Indexed: 02/08/2023] Open
Abstract
Although the coronavirus disease 2019 (COVID-19) pandemic has reached all over the world population, it has demonstrated a heterogeneous impact on different populations. The most vulnerable communities which coexist daily with the social inequalities like low access to hygiene and personal protection products, crowded residences, and higher levels of chronic diseases have a higher risk of contact and the spread of infection, beyond unfavorable clinical outcomes. The elevation of the risk of infection exposure can be related to gender due to the presence of a larger contingent of women in essential services, as well as frontline and cleaning professionals who regardless of gender have the greatest exposure to the virus. Such exposures can contribute to the development of fear of contaminating themselves or their family members associated also with the work stress, both of which are related to the emergence of mental disturbances in these populations. Furthermore, conditions of unsanitary living and low socioeconomic status, populations at war, pre-existing social barriers, and ethnicity have contributed to more impact of the pandemic both in the exposure to the virus and access to health services, COVID-19 management, and management of other pathologies. At the same time, factors such as the closing of non-essential services, the loss of jobs, and the increase in household spending aggravated the social vulnerabilities and impacted the family economy. Lastly, the COVID-19 pandemic contributed still more to the impact on women's health since it propitiated a favorable environment for increasing domestic violence rates, through the segregation of women from social life, and increasing the time of the victims with their aggressors.
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Affiliation(s)
- Jonathan Santos Apolonio
- Universidade Federal da Bahia, Instituto Multidisciplinar em Saúde, Vitória da Conquista 45029-094, Bahia, Brazil
| | | | - Beatriz Rocha Cuzzuol
- Universidade Federal da Bahia, Instituto Multidisciplinar em Saúde, Vitória da Conquista 45029-094, Bahia, Brazil
| | - Glauber Rocha Lima Araújo
- Universidade Federal da Bahia, Instituto Multidisciplinar em Saúde, Vitória da Conquista 45029-094, Bahia, Brazil
| | - Hanna Santos Marques
- Universidade Estadual do Sudoeste da Bahia, Campus Vitória da Conquista, Vitória da Conquista 45083-900, Bahia, Brazil
| | - Isadora de Souza Barcelos
- Universidade Federal da Bahia, Instituto Multidisciplinar em Saúde, Vitória da Conquista 45029-094, Bahia, Brazil
| | - Luana Kauany de Sá Santos
- Universidade Federal da Bahia, Instituto Multidisciplinar em Saúde, Vitória da Conquista 45029-094, Bahia, Brazil
| | - Luciano Hasimoto Malheiro
- Universidade Federal da Bahia, Instituto Multidisciplinar em Saúde, Vitória da Conquista 45029-094, Bahia, Brazil
| | | | - Fabrício Freire de Melo
- Universidade Federal da Bahia, Instituto Multidisciplinar em Saúde, Vitória da Conquista 45029-094, Bahia, Brazil
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Dahal S, Mamelund SE, Luo R, Sattenspiel L, Self-Brown S, Chowell G. Investigating COVID-19 transmission and mortality differences between indigenous and non-indigenous populations in Mexico. Int J Infect Dis 2022; 122:910-920. [PMID: 35905949 PMCID: PMC9357430 DOI: 10.1016/j.ijid.2022.07.052] [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: 05/11/2022] [Revised: 07/19/2022] [Accepted: 07/21/2022] [Indexed: 01/25/2023] Open
Abstract
OBJECTIVES Indigenous populations have been disproportionately affected during pandemics. We investigated COVID-19 mortality estimates among indigenous and non-indigenous populations at national and sub-national levels in Mexico. METHODS We obtained data from the Ministry of Health, Mexico, on 2,173,036 laboratory-confirmed RT-PCR positive COVID-19 cases and 238,803 deaths. We estimated mortality per 1000 person-weeks, mortality rate ratio (RR) among indigenous vs. non-indigenous groups, and hazard ratio (HR) for COVID-19 deaths across four waves of the pandemic, from February 2020 to March 2022. We also assessed differences in the reproduction number (Rt). RESULTS The mortality rate among indigenous populations of Mexico was 68% higher than that of non-indigenous groups. Out of 32 federal entities, 23 exhibited higher mortality rates among indigenous groups (P < 0.05 in 13 entities). The fourth wave showed the highest RR (2.40). The crude HR was 1.67 (95% CI: 1.62, 1.72), which decreased to 1.08 (95% CI: 1.04, 1.11) after controlling for other covariates. During the intense fourth wave, the Rt among the two groups was comparable. CONCLUSION Indigenous status is a significant risk factor for COVID-19 mortality in Mexico. Our findings may reflect disparities in non-pharmaceutical (e.g., handwashing and using facemasks), and COVID-19 vaccination interventions among indigenous and non-indigenous populations in Mexico.
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Affiliation(s)
- Sushma Dahal
- School of Public Health, Georgia State University, Atlanta, USA,Correspondence to: Sushma Dahal, School of Public Health, Georgia State University, P.O. Box 3995, Atlanta, Georgia, 30302-3995
| | - Svenn-Erik Mamelund
- Centre for Research on Pandemics & Society, Oslo Metropolitan University, Oslo, Norway
| | - Ruiyan Luo
- School of Public Health, Georgia State University, Atlanta, USA
| | - Lisa Sattenspiel
- College of Arts and Science, University of Missouri, Columbia, USA
| | | | - Gerardo Chowell
- School of Public Health, Georgia State University, Atlanta, USA
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11
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Pereira FM, Salomão de Araujo A, Catarina Martins Reis A, Santos da Hora A, Pinotti F, Paton RS, Vilas Boas Figueiredo C, Lopes Damasceno C, Carlos dos Santos D, Souza de Santana D, Freitas Sales D, Ariana Andrade Brandão E, da Silva Batista E, Campos de Sousa FS, Santana Menezes G, Silveira dos Santos J, Gomes Lima J, Tadeu Brito J, Dandara dos Santos L, Reboredo L, Santana Santos M, Kelly Astete Gomez M, Freitas da Cruz M, Rosa Ampuero M, Guerra Lemos da Silva M, S. da Paixão Melo M, Ferreira da Silva M, de Jesus Gonçalves dos Santos N, de Souza Pessoa N, Silva de Araujo R, de Macedo Godim T, Fraga de Oliveira Tosta S, Brandão Nardy V, Cristina Faria E, Frederico de Carvalho Dominguez Souza B, Laís Almeida dos Santos J, Wikramaratna P, Giovanetti M, Alcântara LCJ, Lourenço J, Leal e Silva de Mello A. Dynamics and Determinants of SARS-CoV-2 RT-PCR Testing on Symptomatic Individuals Attending Healthcare Centers during 2020 in Bahia, Brazil. Viruses 2022; 14:v14071549. [PMID: 35891528 PMCID: PMC9321627 DOI: 10.3390/v14071549] [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] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Revised: 07/03/2022] [Accepted: 07/05/2022] [Indexed: 02/05/2023] Open
Abstract
RT-PCR testing data provides opportunities to explore regional and individual determinants of test positivity and surveillance infrastructure. Using Generalized Additive Models, we explored 222,515 tests of a random sample of individuals with COVID-19 compatible symptoms in the Brazilian state of Bahia during 2020. We found that age and male gender were the most significant determinants of test positivity. There was evidence of an unequal impact among socio-demographic strata, with higher positivity among those living in areas with low education levels during the first epidemic wave, followed by those living in areas with higher education levels in the second wave. Our estimated probability of testing positive after symptom onset corroborates previous reports that the probability decreases with time, more than halving by about two weeks and converging to zero by three weeks. Test positivity rates generally followed state-level reported cases, and while a single laboratory performed ~90% of tests covering ~99% of the state's area, test turn-around time generally remained below four days. This testing effort is a testimony to the Bahian surveillance capacity during public health emergencies, as previously witnessed during the recent Zika and Yellow Fever outbreaks.
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Affiliation(s)
- Felicidade Mota Pereira
- Laboratório Central de Saúde Pública Professor Gonçalo Muniz, Salvador 40295-010, Brazil; (F.M.P.); (A.S.d.A.); (A.C.M.R.); (A.S.d.H.); (C.V.B.F.); (C.L.D.); (D.C.d.S.); (D.S.d.S.); (D.F.S.); (E.A.A.B.); (E.d.S.B.); (F.S.C.d.S.); (G.S.M.); (J.S.d.S.); (J.G.L.); (J.T.B.); (L.D.d.S.); (L.R.); (M.S.S.); (M.K.A.G.); (M.F.d.C.); (M.R.A.); (M.G.L.d.S.); (M.S.d.P.M.); (M.F.d.S.); (N.d.J.G.d.S.); (N.d.S.P.); (R.S.d.A.); (T.d.M.G.); (V.B.N.); (E.C.F.); (B.F.d.C.D.S.); (J.L.A.d.S.); (A.L.e.S.d.M.)
| | - Aline Salomão de Araujo
- Laboratório Central de Saúde Pública Professor Gonçalo Muniz, Salvador 40295-010, Brazil; (F.M.P.); (A.S.d.A.); (A.C.M.R.); (A.S.d.H.); (C.V.B.F.); (C.L.D.); (D.C.d.S.); (D.S.d.S.); (D.F.S.); (E.A.A.B.); (E.d.S.B.); (F.S.C.d.S.); (G.S.M.); (J.S.d.S.); (J.G.L.); (J.T.B.); (L.D.d.S.); (L.R.); (M.S.S.); (M.K.A.G.); (M.F.d.C.); (M.R.A.); (M.G.L.d.S.); (M.S.d.P.M.); (M.F.d.S.); (N.d.J.G.d.S.); (N.d.S.P.); (R.S.d.A.); (T.d.M.G.); (V.B.N.); (E.C.F.); (B.F.d.C.D.S.); (J.L.A.d.S.); (A.L.e.S.d.M.)
| | - Ana Catarina Martins Reis
- Laboratório Central de Saúde Pública Professor Gonçalo Muniz, Salvador 40295-010, Brazil; (F.M.P.); (A.S.d.A.); (A.C.M.R.); (A.S.d.H.); (C.V.B.F.); (C.L.D.); (D.C.d.S.); (D.S.d.S.); (D.F.S.); (E.A.A.B.); (E.d.S.B.); (F.S.C.d.S.); (G.S.M.); (J.S.d.S.); (J.G.L.); (J.T.B.); (L.D.d.S.); (L.R.); (M.S.S.); (M.K.A.G.); (M.F.d.C.); (M.R.A.); (M.G.L.d.S.); (M.S.d.P.M.); (M.F.d.S.); (N.d.J.G.d.S.); (N.d.S.P.); (R.S.d.A.); (T.d.M.G.); (V.B.N.); (E.C.F.); (B.F.d.C.D.S.); (J.L.A.d.S.); (A.L.e.S.d.M.)
| | - Anadilton Santos da Hora
- Laboratório Central de Saúde Pública Professor Gonçalo Muniz, Salvador 40295-010, Brazil; (F.M.P.); (A.S.d.A.); (A.C.M.R.); (A.S.d.H.); (C.V.B.F.); (C.L.D.); (D.C.d.S.); (D.S.d.S.); (D.F.S.); (E.A.A.B.); (E.d.S.B.); (F.S.C.d.S.); (G.S.M.); (J.S.d.S.); (J.G.L.); (J.T.B.); (L.D.d.S.); (L.R.); (M.S.S.); (M.K.A.G.); (M.F.d.C.); (M.R.A.); (M.G.L.d.S.); (M.S.d.P.M.); (M.F.d.S.); (N.d.J.G.d.S.); (N.d.S.P.); (R.S.d.A.); (T.d.M.G.); (V.B.N.); (E.C.F.); (B.F.d.C.D.S.); (J.L.A.d.S.); (A.L.e.S.d.M.)
| | - Francesco Pinotti
- Department of Zoology, University of Oxford, Oxford OX1 3SZ, UK; (F.P.); (R.S.P.)
| | - Robert S. Paton
- Department of Zoology, University of Oxford, Oxford OX1 3SZ, UK; (F.P.); (R.S.P.)
| | - Camylla Vilas Boas Figueiredo
- Laboratório Central de Saúde Pública Professor Gonçalo Muniz, Salvador 40295-010, Brazil; (F.M.P.); (A.S.d.A.); (A.C.M.R.); (A.S.d.H.); (C.V.B.F.); (C.L.D.); (D.C.d.S.); (D.S.d.S.); (D.F.S.); (E.A.A.B.); (E.d.S.B.); (F.S.C.d.S.); (G.S.M.); (J.S.d.S.); (J.G.L.); (J.T.B.); (L.D.d.S.); (L.R.); (M.S.S.); (M.K.A.G.); (M.F.d.C.); (M.R.A.); (M.G.L.d.S.); (M.S.d.P.M.); (M.F.d.S.); (N.d.J.G.d.S.); (N.d.S.P.); (R.S.d.A.); (T.d.M.G.); (V.B.N.); (E.C.F.); (B.F.d.C.D.S.); (J.L.A.d.S.); (A.L.e.S.d.M.)
| | - Caroline Lopes Damasceno
- Laboratório Central de Saúde Pública Professor Gonçalo Muniz, Salvador 40295-010, Brazil; (F.M.P.); (A.S.d.A.); (A.C.M.R.); (A.S.d.H.); (C.V.B.F.); (C.L.D.); (D.C.d.S.); (D.S.d.S.); (D.F.S.); (E.A.A.B.); (E.d.S.B.); (F.S.C.d.S.); (G.S.M.); (J.S.d.S.); (J.G.L.); (J.T.B.); (L.D.d.S.); (L.R.); (M.S.S.); (M.K.A.G.); (M.F.d.C.); (M.R.A.); (M.G.L.d.S.); (M.S.d.P.M.); (M.F.d.S.); (N.d.J.G.d.S.); (N.d.S.P.); (R.S.d.A.); (T.d.M.G.); (V.B.N.); (E.C.F.); (B.F.d.C.D.S.); (J.L.A.d.S.); (A.L.e.S.d.M.)
| | - Daiana Carlos dos Santos
- Laboratório Central de Saúde Pública Professor Gonçalo Muniz, Salvador 40295-010, Brazil; (F.M.P.); (A.S.d.A.); (A.C.M.R.); (A.S.d.H.); (C.V.B.F.); (C.L.D.); (D.C.d.S.); (D.S.d.S.); (D.F.S.); (E.A.A.B.); (E.d.S.B.); (F.S.C.d.S.); (G.S.M.); (J.S.d.S.); (J.G.L.); (J.T.B.); (L.D.d.S.); (L.R.); (M.S.S.); (M.K.A.G.); (M.F.d.C.); (M.R.A.); (M.G.L.d.S.); (M.S.d.P.M.); (M.F.d.S.); (N.d.J.G.d.S.); (N.d.S.P.); (R.S.d.A.); (T.d.M.G.); (V.B.N.); (E.C.F.); (B.F.d.C.D.S.); (J.L.A.d.S.); (A.L.e.S.d.M.)
| | - Daniele Souza de Santana
- Laboratório Central de Saúde Pública Professor Gonçalo Muniz, Salvador 40295-010, Brazil; (F.M.P.); (A.S.d.A.); (A.C.M.R.); (A.S.d.H.); (C.V.B.F.); (C.L.D.); (D.C.d.S.); (D.S.d.S.); (D.F.S.); (E.A.A.B.); (E.d.S.B.); (F.S.C.d.S.); (G.S.M.); (J.S.d.S.); (J.G.L.); (J.T.B.); (L.D.d.S.); (L.R.); (M.S.S.); (M.K.A.G.); (M.F.d.C.); (M.R.A.); (M.G.L.d.S.); (M.S.d.P.M.); (M.F.d.S.); (N.d.J.G.d.S.); (N.d.S.P.); (R.S.d.A.); (T.d.M.G.); (V.B.N.); (E.C.F.); (B.F.d.C.D.S.); (J.L.A.d.S.); (A.L.e.S.d.M.)
| | - Danielle Freitas Sales
- Laboratório Central de Saúde Pública Professor Gonçalo Muniz, Salvador 40295-010, Brazil; (F.M.P.); (A.S.d.A.); (A.C.M.R.); (A.S.d.H.); (C.V.B.F.); (C.L.D.); (D.C.d.S.); (D.S.d.S.); (D.F.S.); (E.A.A.B.); (E.d.S.B.); (F.S.C.d.S.); (G.S.M.); (J.S.d.S.); (J.G.L.); (J.T.B.); (L.D.d.S.); (L.R.); (M.S.S.); (M.K.A.G.); (M.F.d.C.); (M.R.A.); (M.G.L.d.S.); (M.S.d.P.M.); (M.F.d.S.); (N.d.J.G.d.S.); (N.d.S.P.); (R.S.d.A.); (T.d.M.G.); (V.B.N.); (E.C.F.); (B.F.d.C.D.S.); (J.L.A.d.S.); (A.L.e.S.d.M.)
| | - Evelyn Ariana Andrade Brandão
- Laboratório Central de Saúde Pública Professor Gonçalo Muniz, Salvador 40295-010, Brazil; (F.M.P.); (A.S.d.A.); (A.C.M.R.); (A.S.d.H.); (C.V.B.F.); (C.L.D.); (D.C.d.S.); (D.S.d.S.); (D.F.S.); (E.A.A.B.); (E.d.S.B.); (F.S.C.d.S.); (G.S.M.); (J.S.d.S.); (J.G.L.); (J.T.B.); (L.D.d.S.); (L.R.); (M.S.S.); (M.K.A.G.); (M.F.d.C.); (M.R.A.); (M.G.L.d.S.); (M.S.d.P.M.); (M.F.d.S.); (N.d.J.G.d.S.); (N.d.S.P.); (R.S.d.A.); (T.d.M.G.); (V.B.N.); (E.C.F.); (B.F.d.C.D.S.); (J.L.A.d.S.); (A.L.e.S.d.M.)
| | - Everton da Silva Batista
- Laboratório Central de Saúde Pública Professor Gonçalo Muniz, Salvador 40295-010, Brazil; (F.M.P.); (A.S.d.A.); (A.C.M.R.); (A.S.d.H.); (C.V.B.F.); (C.L.D.); (D.C.d.S.); (D.S.d.S.); (D.F.S.); (E.A.A.B.); (E.d.S.B.); (F.S.C.d.S.); (G.S.M.); (J.S.d.S.); (J.G.L.); (J.T.B.); (L.D.d.S.); (L.R.); (M.S.S.); (M.K.A.G.); (M.F.d.C.); (M.R.A.); (M.G.L.d.S.); (M.S.d.P.M.); (M.F.d.S.); (N.d.J.G.d.S.); (N.d.S.P.); (R.S.d.A.); (T.d.M.G.); (V.B.N.); (E.C.F.); (B.F.d.C.D.S.); (J.L.A.d.S.); (A.L.e.S.d.M.)
| | - Fulvia Soares Campos de Sousa
- Laboratório Central de Saúde Pública Professor Gonçalo Muniz, Salvador 40295-010, Brazil; (F.M.P.); (A.S.d.A.); (A.C.M.R.); (A.S.d.H.); (C.V.B.F.); (C.L.D.); (D.C.d.S.); (D.S.d.S.); (D.F.S.); (E.A.A.B.); (E.d.S.B.); (F.S.C.d.S.); (G.S.M.); (J.S.d.S.); (J.G.L.); (J.T.B.); (L.D.d.S.); (L.R.); (M.S.S.); (M.K.A.G.); (M.F.d.C.); (M.R.A.); (M.G.L.d.S.); (M.S.d.P.M.); (M.F.d.S.); (N.d.J.G.d.S.); (N.d.S.P.); (R.S.d.A.); (T.d.M.G.); (V.B.N.); (E.C.F.); (B.F.d.C.D.S.); (J.L.A.d.S.); (A.L.e.S.d.M.)
| | - Gabriela Santana Menezes
- Laboratório Central de Saúde Pública Professor Gonçalo Muniz, Salvador 40295-010, Brazil; (F.M.P.); (A.S.d.A.); (A.C.M.R.); (A.S.d.H.); (C.V.B.F.); (C.L.D.); (D.C.d.S.); (D.S.d.S.); (D.F.S.); (E.A.A.B.); (E.d.S.B.); (F.S.C.d.S.); (G.S.M.); (J.S.d.S.); (J.G.L.); (J.T.B.); (L.D.d.S.); (L.R.); (M.S.S.); (M.K.A.G.); (M.F.d.C.); (M.R.A.); (M.G.L.d.S.); (M.S.d.P.M.); (M.F.d.S.); (N.d.J.G.d.S.); (N.d.S.P.); (R.S.d.A.); (T.d.M.G.); (V.B.N.); (E.C.F.); (B.F.d.C.D.S.); (J.L.A.d.S.); (A.L.e.S.d.M.)
| | - Jackeline Silveira dos Santos
- Laboratório Central de Saúde Pública Professor Gonçalo Muniz, Salvador 40295-010, Brazil; (F.M.P.); (A.S.d.A.); (A.C.M.R.); (A.S.d.H.); (C.V.B.F.); (C.L.D.); (D.C.d.S.); (D.S.d.S.); (D.F.S.); (E.A.A.B.); (E.d.S.B.); (F.S.C.d.S.); (G.S.M.); (J.S.d.S.); (J.G.L.); (J.T.B.); (L.D.d.S.); (L.R.); (M.S.S.); (M.K.A.G.); (M.F.d.C.); (M.R.A.); (M.G.L.d.S.); (M.S.d.P.M.); (M.F.d.S.); (N.d.J.G.d.S.); (N.d.S.P.); (R.S.d.A.); (T.d.M.G.); (V.B.N.); (E.C.F.); (B.F.d.C.D.S.); (J.L.A.d.S.); (A.L.e.S.d.M.)
| | - Jaqueline Gomes Lima
- Laboratório Central de Saúde Pública Professor Gonçalo Muniz, Salvador 40295-010, Brazil; (F.M.P.); (A.S.d.A.); (A.C.M.R.); (A.S.d.H.); (C.V.B.F.); (C.L.D.); (D.C.d.S.); (D.S.d.S.); (D.F.S.); (E.A.A.B.); (E.d.S.B.); (F.S.C.d.S.); (G.S.M.); (J.S.d.S.); (J.G.L.); (J.T.B.); (L.D.d.S.); (L.R.); (M.S.S.); (M.K.A.G.); (M.F.d.C.); (M.R.A.); (M.G.L.d.S.); (M.S.d.P.M.); (M.F.d.S.); (N.d.J.G.d.S.); (N.d.S.P.); (R.S.d.A.); (T.d.M.G.); (V.B.N.); (E.C.F.); (B.F.d.C.D.S.); (J.L.A.d.S.); (A.L.e.S.d.M.)
| | - Jean Tadeu Brito
- Laboratório Central de Saúde Pública Professor Gonçalo Muniz, Salvador 40295-010, Brazil; (F.M.P.); (A.S.d.A.); (A.C.M.R.); (A.S.d.H.); (C.V.B.F.); (C.L.D.); (D.C.d.S.); (D.S.d.S.); (D.F.S.); (E.A.A.B.); (E.d.S.B.); (F.S.C.d.S.); (G.S.M.); (J.S.d.S.); (J.G.L.); (J.T.B.); (L.D.d.S.); (L.R.); (M.S.S.); (M.K.A.G.); (M.F.d.C.); (M.R.A.); (M.G.L.d.S.); (M.S.d.P.M.); (M.F.d.S.); (N.d.J.G.d.S.); (N.d.S.P.); (R.S.d.A.); (T.d.M.G.); (V.B.N.); (E.C.F.); (B.F.d.C.D.S.); (J.L.A.d.S.); (A.L.e.S.d.M.)
| | - Lenisa Dandara dos Santos
- Laboratório Central de Saúde Pública Professor Gonçalo Muniz, Salvador 40295-010, Brazil; (F.M.P.); (A.S.d.A.); (A.C.M.R.); (A.S.d.H.); (C.V.B.F.); (C.L.D.); (D.C.d.S.); (D.S.d.S.); (D.F.S.); (E.A.A.B.); (E.d.S.B.); (F.S.C.d.S.); (G.S.M.); (J.S.d.S.); (J.G.L.); (J.T.B.); (L.D.d.S.); (L.R.); (M.S.S.); (M.K.A.G.); (M.F.d.C.); (M.R.A.); (M.G.L.d.S.); (M.S.d.P.M.); (M.F.d.S.); (N.d.J.G.d.S.); (N.d.S.P.); (R.S.d.A.); (T.d.M.G.); (V.B.N.); (E.C.F.); (B.F.d.C.D.S.); (J.L.A.d.S.); (A.L.e.S.d.M.)
| | - Luciana Reboredo
- Laboratório Central de Saúde Pública Professor Gonçalo Muniz, Salvador 40295-010, Brazil; (F.M.P.); (A.S.d.A.); (A.C.M.R.); (A.S.d.H.); (C.V.B.F.); (C.L.D.); (D.C.d.S.); (D.S.d.S.); (D.F.S.); (E.A.A.B.); (E.d.S.B.); (F.S.C.d.S.); (G.S.M.); (J.S.d.S.); (J.G.L.); (J.T.B.); (L.D.d.S.); (L.R.); (M.S.S.); (M.K.A.G.); (M.F.d.C.); (M.R.A.); (M.G.L.d.S.); (M.S.d.P.M.); (M.F.d.S.); (N.d.J.G.d.S.); (N.d.S.P.); (R.S.d.A.); (T.d.M.G.); (V.B.N.); (E.C.F.); (B.F.d.C.D.S.); (J.L.A.d.S.); (A.L.e.S.d.M.)
| | - Maiara Santana Santos
- Laboratório Central de Saúde Pública Professor Gonçalo Muniz, Salvador 40295-010, Brazil; (F.M.P.); (A.S.d.A.); (A.C.M.R.); (A.S.d.H.); (C.V.B.F.); (C.L.D.); (D.C.d.S.); (D.S.d.S.); (D.F.S.); (E.A.A.B.); (E.d.S.B.); (F.S.C.d.S.); (G.S.M.); (J.S.d.S.); (J.G.L.); (J.T.B.); (L.D.d.S.); (L.R.); (M.S.S.); (M.K.A.G.); (M.F.d.C.); (M.R.A.); (M.G.L.d.S.); (M.S.d.P.M.); (M.F.d.S.); (N.d.J.G.d.S.); (N.d.S.P.); (R.S.d.A.); (T.d.M.G.); (V.B.N.); (E.C.F.); (B.F.d.C.D.S.); (J.L.A.d.S.); (A.L.e.S.d.M.)
| | - Marcela Kelly Astete Gomez
- Laboratório Central de Saúde Pública Professor Gonçalo Muniz, Salvador 40295-010, Brazil; (F.M.P.); (A.S.d.A.); (A.C.M.R.); (A.S.d.H.); (C.V.B.F.); (C.L.D.); (D.C.d.S.); (D.S.d.S.); (D.F.S.); (E.A.A.B.); (E.d.S.B.); (F.S.C.d.S.); (G.S.M.); (J.S.d.S.); (J.G.L.); (J.T.B.); (L.D.d.S.); (L.R.); (M.S.S.); (M.K.A.G.); (M.F.d.C.); (M.R.A.); (M.G.L.d.S.); (M.S.d.P.M.); (M.F.d.S.); (N.d.J.G.d.S.); (N.d.S.P.); (R.S.d.A.); (T.d.M.G.); (V.B.N.); (E.C.F.); (B.F.d.C.D.S.); (J.L.A.d.S.); (A.L.e.S.d.M.)
| | - Marcia Freitas da Cruz
- Laboratório Central de Saúde Pública Professor Gonçalo Muniz, Salvador 40295-010, Brazil; (F.M.P.); (A.S.d.A.); (A.C.M.R.); (A.S.d.H.); (C.V.B.F.); (C.L.D.); (D.C.d.S.); (D.S.d.S.); (D.F.S.); (E.A.A.B.); (E.d.S.B.); (F.S.C.d.S.); (G.S.M.); (J.S.d.S.); (J.G.L.); (J.T.B.); (L.D.d.S.); (L.R.); (M.S.S.); (M.K.A.G.); (M.F.d.C.); (M.R.A.); (M.G.L.d.S.); (M.S.d.P.M.); (M.F.d.S.); (N.d.J.G.d.S.); (N.d.S.P.); (R.S.d.A.); (T.d.M.G.); (V.B.N.); (E.C.F.); (B.F.d.C.D.S.); (J.L.A.d.S.); (A.L.e.S.d.M.)
| | - Mariana Rosa Ampuero
- Laboratório Central de Saúde Pública Professor Gonçalo Muniz, Salvador 40295-010, Brazil; (F.M.P.); (A.S.d.A.); (A.C.M.R.); (A.S.d.H.); (C.V.B.F.); (C.L.D.); (D.C.d.S.); (D.S.d.S.); (D.F.S.); (E.A.A.B.); (E.d.S.B.); (F.S.C.d.S.); (G.S.M.); (J.S.d.S.); (J.G.L.); (J.T.B.); (L.D.d.S.); (L.R.); (M.S.S.); (M.K.A.G.); (M.F.d.C.); (M.R.A.); (M.G.L.d.S.); (M.S.d.P.M.); (M.F.d.S.); (N.d.J.G.d.S.); (N.d.S.P.); (R.S.d.A.); (T.d.M.G.); (V.B.N.); (E.C.F.); (B.F.d.C.D.S.); (J.L.A.d.S.); (A.L.e.S.d.M.)
| | - Mariele Guerra Lemos da Silva
- Laboratório Central de Saúde Pública Professor Gonçalo Muniz, Salvador 40295-010, Brazil; (F.M.P.); (A.S.d.A.); (A.C.M.R.); (A.S.d.H.); (C.V.B.F.); (C.L.D.); (D.C.d.S.); (D.S.d.S.); (D.F.S.); (E.A.A.B.); (E.d.S.B.); (F.S.C.d.S.); (G.S.M.); (J.S.d.S.); (J.G.L.); (J.T.B.); (L.D.d.S.); (L.R.); (M.S.S.); (M.K.A.G.); (M.F.d.C.); (M.R.A.); (M.G.L.d.S.); (M.S.d.P.M.); (M.F.d.S.); (N.d.J.G.d.S.); (N.d.S.P.); (R.S.d.A.); (T.d.M.G.); (V.B.N.); (E.C.F.); (B.F.d.C.D.S.); (J.L.A.d.S.); (A.L.e.S.d.M.)
| | - Mariza S. da Paixão Melo
- Laboratório Central de Saúde Pública Professor Gonçalo Muniz, Salvador 40295-010, Brazil; (F.M.P.); (A.S.d.A.); (A.C.M.R.); (A.S.d.H.); (C.V.B.F.); (C.L.D.); (D.C.d.S.); (D.S.d.S.); (D.F.S.); (E.A.A.B.); (E.d.S.B.); (F.S.C.d.S.); (G.S.M.); (J.S.d.S.); (J.G.L.); (J.T.B.); (L.D.d.S.); (L.R.); (M.S.S.); (M.K.A.G.); (M.F.d.C.); (M.R.A.); (M.G.L.d.S.); (M.S.d.P.M.); (M.F.d.S.); (N.d.J.G.d.S.); (N.d.S.P.); (R.S.d.A.); (T.d.M.G.); (V.B.N.); (E.C.F.); (B.F.d.C.D.S.); (J.L.A.d.S.); (A.L.e.S.d.M.)
| | - Marta Ferreira da Silva
- Laboratório Central de Saúde Pública Professor Gonçalo Muniz, Salvador 40295-010, Brazil; (F.M.P.); (A.S.d.A.); (A.C.M.R.); (A.S.d.H.); (C.V.B.F.); (C.L.D.); (D.C.d.S.); (D.S.d.S.); (D.F.S.); (E.A.A.B.); (E.d.S.B.); (F.S.C.d.S.); (G.S.M.); (J.S.d.S.); (J.G.L.); (J.T.B.); (L.D.d.S.); (L.R.); (M.S.S.); (M.K.A.G.); (M.F.d.C.); (M.R.A.); (M.G.L.d.S.); (M.S.d.P.M.); (M.F.d.S.); (N.d.J.G.d.S.); (N.d.S.P.); (R.S.d.A.); (T.d.M.G.); (V.B.N.); (E.C.F.); (B.F.d.C.D.S.); (J.L.A.d.S.); (A.L.e.S.d.M.)
| | - Nadja de Jesus Gonçalves dos Santos
- Laboratório Central de Saúde Pública Professor Gonçalo Muniz, Salvador 40295-010, Brazil; (F.M.P.); (A.S.d.A.); (A.C.M.R.); (A.S.d.H.); (C.V.B.F.); (C.L.D.); (D.C.d.S.); (D.S.d.S.); (D.F.S.); (E.A.A.B.); (E.d.S.B.); (F.S.C.d.S.); (G.S.M.); (J.S.d.S.); (J.G.L.); (J.T.B.); (L.D.d.S.); (L.R.); (M.S.S.); (M.K.A.G.); (M.F.d.C.); (M.R.A.); (M.G.L.d.S.); (M.S.d.P.M.); (M.F.d.S.); (N.d.J.G.d.S.); (N.d.S.P.); (R.S.d.A.); (T.d.M.G.); (V.B.N.); (E.C.F.); (B.F.d.C.D.S.); (J.L.A.d.S.); (A.L.e.S.d.M.)
| | - Núbia de Souza Pessoa
- Laboratório Central de Saúde Pública Professor Gonçalo Muniz, Salvador 40295-010, Brazil; (F.M.P.); (A.S.d.A.); (A.C.M.R.); (A.S.d.H.); (C.V.B.F.); (C.L.D.); (D.C.d.S.); (D.S.d.S.); (D.F.S.); (E.A.A.B.); (E.d.S.B.); (F.S.C.d.S.); (G.S.M.); (J.S.d.S.); (J.G.L.); (J.T.B.); (L.D.d.S.); (L.R.); (M.S.S.); (M.K.A.G.); (M.F.d.C.); (M.R.A.); (M.G.L.d.S.); (M.S.d.P.M.); (M.F.d.S.); (N.d.J.G.d.S.); (N.d.S.P.); (R.S.d.A.); (T.d.M.G.); (V.B.N.); (E.C.F.); (B.F.d.C.D.S.); (J.L.A.d.S.); (A.L.e.S.d.M.)
| | - Ramile Silva de Araujo
- Laboratório Central de Saúde Pública Professor Gonçalo Muniz, Salvador 40295-010, Brazil; (F.M.P.); (A.S.d.A.); (A.C.M.R.); (A.S.d.H.); (C.V.B.F.); (C.L.D.); (D.C.d.S.); (D.S.d.S.); (D.F.S.); (E.A.A.B.); (E.d.S.B.); (F.S.C.d.S.); (G.S.M.); (J.S.d.S.); (J.G.L.); (J.T.B.); (L.D.d.S.); (L.R.); (M.S.S.); (M.K.A.G.); (M.F.d.C.); (M.R.A.); (M.G.L.d.S.); (M.S.d.P.M.); (M.F.d.S.); (N.d.J.G.d.S.); (N.d.S.P.); (R.S.d.A.); (T.d.M.G.); (V.B.N.); (E.C.F.); (B.F.d.C.D.S.); (J.L.A.d.S.); (A.L.e.S.d.M.)
| | - Taiane de Macedo Godim
- Laboratório Central de Saúde Pública Professor Gonçalo Muniz, Salvador 40295-010, Brazil; (F.M.P.); (A.S.d.A.); (A.C.M.R.); (A.S.d.H.); (C.V.B.F.); (C.L.D.); (D.C.d.S.); (D.S.d.S.); (D.F.S.); (E.A.A.B.); (E.d.S.B.); (F.S.C.d.S.); (G.S.M.); (J.S.d.S.); (J.G.L.); (J.T.B.); (L.D.d.S.); (L.R.); (M.S.S.); (M.K.A.G.); (M.F.d.C.); (M.R.A.); (M.G.L.d.S.); (M.S.d.P.M.); (M.F.d.S.); (N.d.J.G.d.S.); (N.d.S.P.); (R.S.d.A.); (T.d.M.G.); (V.B.N.); (E.C.F.); (B.F.d.C.D.S.); (J.L.A.d.S.); (A.L.e.S.d.M.)
| | | | - Vanessa Brandão Nardy
- Laboratório Central de Saúde Pública Professor Gonçalo Muniz, Salvador 40295-010, Brazil; (F.M.P.); (A.S.d.A.); (A.C.M.R.); (A.S.d.H.); (C.V.B.F.); (C.L.D.); (D.C.d.S.); (D.S.d.S.); (D.F.S.); (E.A.A.B.); (E.d.S.B.); (F.S.C.d.S.); (G.S.M.); (J.S.d.S.); (J.G.L.); (J.T.B.); (L.D.d.S.); (L.R.); (M.S.S.); (M.K.A.G.); (M.F.d.C.); (M.R.A.); (M.G.L.d.S.); (M.S.d.P.M.); (M.F.d.S.); (N.d.J.G.d.S.); (N.d.S.P.); (R.S.d.A.); (T.d.M.G.); (V.B.N.); (E.C.F.); (B.F.d.C.D.S.); (J.L.A.d.S.); (A.L.e.S.d.M.)
| | - Elaine Cristina Faria
- Laboratório Central de Saúde Pública Professor Gonçalo Muniz, Salvador 40295-010, Brazil; (F.M.P.); (A.S.d.A.); (A.C.M.R.); (A.S.d.H.); (C.V.B.F.); (C.L.D.); (D.C.d.S.); (D.S.d.S.); (D.F.S.); (E.A.A.B.); (E.d.S.B.); (F.S.C.d.S.); (G.S.M.); (J.S.d.S.); (J.G.L.); (J.T.B.); (L.D.d.S.); (L.R.); (M.S.S.); (M.K.A.G.); (M.F.d.C.); (M.R.A.); (M.G.L.d.S.); (M.S.d.P.M.); (M.F.d.S.); (N.d.J.G.d.S.); (N.d.S.P.); (R.S.d.A.); (T.d.M.G.); (V.B.N.); (E.C.F.); (B.F.d.C.D.S.); (J.L.A.d.S.); (A.L.e.S.d.M.)
| | - Breno Frederico de Carvalho Dominguez Souza
- Laboratório Central de Saúde Pública Professor Gonçalo Muniz, Salvador 40295-010, Brazil; (F.M.P.); (A.S.d.A.); (A.C.M.R.); (A.S.d.H.); (C.V.B.F.); (C.L.D.); (D.C.d.S.); (D.S.d.S.); (D.F.S.); (E.A.A.B.); (E.d.S.B.); (F.S.C.d.S.); (G.S.M.); (J.S.d.S.); (J.G.L.); (J.T.B.); (L.D.d.S.); (L.R.); (M.S.S.); (M.K.A.G.); (M.F.d.C.); (M.R.A.); (M.G.L.d.S.); (M.S.d.P.M.); (M.F.d.S.); (N.d.J.G.d.S.); (N.d.S.P.); (R.S.d.A.); (T.d.M.G.); (V.B.N.); (E.C.F.); (B.F.d.C.D.S.); (J.L.A.d.S.); (A.L.e.S.d.M.)
| | - Jessica Laís Almeida dos Santos
- Laboratório Central de Saúde Pública Professor Gonçalo Muniz, Salvador 40295-010, Brazil; (F.M.P.); (A.S.d.A.); (A.C.M.R.); (A.S.d.H.); (C.V.B.F.); (C.L.D.); (D.C.d.S.); (D.S.d.S.); (D.F.S.); (E.A.A.B.); (E.d.S.B.); (F.S.C.d.S.); (G.S.M.); (J.S.d.S.); (J.G.L.); (J.T.B.); (L.D.d.S.); (L.R.); (M.S.S.); (M.K.A.G.); (M.F.d.C.); (M.R.A.); (M.G.L.d.S.); (M.S.d.P.M.); (M.F.d.S.); (N.d.J.G.d.S.); (N.d.S.P.); (R.S.d.A.); (T.d.M.G.); (V.B.N.); (E.C.F.); (B.F.d.C.D.S.); (J.L.A.d.S.); (A.L.e.S.d.M.)
| | | | - Marta Giovanetti
- Laboratório de Flavivírus, Instituto Oswaldo Cruz Fiocruz, Rio de Janeiro 21045-900, Brazil;
- Department of Science and Technology for Humans and the Environment, University of Campus Bio-Medico di Roma, 00128 Rome, Italy
| | - Luiz Carlos Junior Alcântara
- Laboratório de Flavivírus, Instituto Oswaldo Cruz Fiocruz, Rio de Janeiro 21045-900, Brazil;
- Correspondence: (L.C.J.A.); (J.L.)
| | - José Lourenço
- Biosystems and Integrative Sciences Institute, Faculdade de Ciências, 1749-016 Lisboa, Portugal
- Correspondence: (L.C.J.A.); (J.L.)
| | - Arabela Leal e Silva de Mello
- Laboratório Central de Saúde Pública Professor Gonçalo Muniz, Salvador 40295-010, Brazil; (F.M.P.); (A.S.d.A.); (A.C.M.R.); (A.S.d.H.); (C.V.B.F.); (C.L.D.); (D.C.d.S.); (D.S.d.S.); (D.F.S.); (E.A.A.B.); (E.d.S.B.); (F.S.C.d.S.); (G.S.M.); (J.S.d.S.); (J.G.L.); (J.T.B.); (L.D.d.S.); (L.R.); (M.S.S.); (M.K.A.G.); (M.F.d.C.); (M.R.A.); (M.G.L.d.S.); (M.S.d.P.M.); (M.F.d.S.); (N.d.J.G.d.S.); (N.d.S.P.); (R.S.d.A.); (T.d.M.G.); (V.B.N.); (E.C.F.); (B.F.d.C.D.S.); (J.L.A.d.S.); (A.L.e.S.d.M.)
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Brizzi A, Whittaker C, Servo LMS, Hawryluk I, Prete CA, de Souza WM, Aguiar RS, Araujo LJT, Bastos LS, Blenkinsop A, Buss LF, Candido D, Castro MC, Costa SF, Croda J, de Souza Santos AA, Dye C, Flaxman S, Fonseca PLC, Geddes VEV, Gutierrez B, Lemey P, Levin AS, Mellan T, Bonfim DM, Miscouridou X, Mishra S, Monod M, Moreira FRR, Nelson B, Pereira RHM, Ranzani O, Schnekenberg RP, Semenova E, Sonabend R, Souza RP, Xi X, Sabino EC, Faria NR, Bhatt S, Ratmann O. Spatial and temporal fluctuations in COVID-19 fatality rates in Brazilian hospitals. Nat Med 2022; 28:1476-1485. [PMID: 35538260 PMCID: PMC9307484 DOI: 10.1038/s41591-022-01807-1] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Accepted: 03/31/2022] [Indexed: 02/07/2023]
Abstract
The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) Gamma variant of concern has spread rapidly across Brazil since late 2020, causing substantial infection and death waves. Here we used individual-level patient records after hospitalization with suspected or confirmed coronavirus disease 2019 (COVID-19) between 20 January 2020 and 26 July 2021 to document temporary, sweeping shocks in hospital fatality rates that followed the spread of Gamma across 14 state capitals, during which typically more than half of hospitalized patients aged 70 years and older died. We show that such extensive shocks in COVID-19 in-hospital fatality rates also existed before the detection of Gamma. Using a Bayesian fatality rate model, we found that the geographic and temporal fluctuations in Brazil's COVID-19 in-hospital fatality rates were primarily associated with geographic inequities and shortages in healthcare capacity. We estimate that approximately half of the COVID-19 deaths in hospitals in the 14 cities could have been avoided without pre-pandemic geographic inequities and without pandemic healthcare pressure. Our results suggest that investments in healthcare resources, healthcare optimization and pandemic preparedness are critical to minimize population-wide mortality and morbidity caused by highly transmissible and deadly pathogens such as SARS-CoV-2, especially in low- and middle-income countries.
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Affiliation(s)
- Andrea Brizzi
- Department of Mathematics, Imperial College London, London, UK
| | - Charles Whittaker
- MRC Centre for Global Infectious Disease Analysis, Jameel Institute, School of Public Health, Imperial College London, London, UK
| | | | - Iwona Hawryluk
- MRC Centre for Global Infectious Disease Analysis, Jameel Institute, School of Public Health, Imperial College London, London, UK
| | - Carlos A Prete
- Departamento de Engenharia de Sistemas Eletrônicos, Escola Politécnica, Universidade de São Paulo, São Paulo, Brazil
| | - William M de Souza
- World Reference Center for Emerging Viruses and Arboviruses and Department of Microbiology and Immunology, University of Texas Medical Branch, Galveston TX, USA
| | - Renato S Aguiar
- Departamento de Genética, Ecologia e Evolução, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
- Instituto D'Or de Pesquisa e Ensino (IDOR), Rio de Janeiro, Brazil
| | - Leonardo J T Araujo
- Laboratory of Quantitative Pathology, Center of Pathology, Adolfo Lutz Institute, São Paulo, Brazil
| | - Leonardo S Bastos
- Programa de Computação Científica, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
| | | | - Lewis F Buss
- MRC Centre for Global Infectious Disease Analysis, Jameel Institute, School of Public Health, Imperial College London, London, UK
- Departamento de Moléstias Infecciosas e Parasitárias e Instituto de Medicina Tropical da Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| | | | - Marcia C Castro
- Department of Global Health and Population, Harvard T. H. Chan School of Public Health, Boston MA, USA
| | - Silvia F Costa
- Departamento de Moléstias Infecciosas e Parasitárias e Instituto de Medicina Tropical da Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| | - Julio Croda
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven CT, USA
| | | | | | - Seth Flaxman
- Department of Computer Science, University of Oxford, Oxford, UK
| | - Paula L C Fonseca
- Departamento de Genética, Ecologia e Evolução, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Victor E V Geddes
- Departamento de Genética, Ecologia e Evolução, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | | | - Philippe Lemey
- Department of Microbiology, Immunology and Transplantation, Rega Institute, KU Leuven - University of Leuven, Leuven, Belgium
| | - Anna S Levin
- Departamento de Moléstias Infecciosas e Parasitárias e Instituto de Medicina Tropical da Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| | - Thomas Mellan
- MRC Centre for Global Infectious Disease Analysis, Jameel Institute, School of Public Health, Imperial College London, London, UK
| | - Diego M Bonfim
- Departamento de Genética, Ecologia e Evolução, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | | | - Swapnil Mishra
- MRC Centre for Global Infectious Disease Analysis, Jameel Institute, School of Public Health, Imperial College London, London, UK
- Section of Epidemiology, School of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Mélodie Monod
- Department of Mathematics, Imperial College London, London, UK
| | - Filipe R R Moreira
- Departamento de Genética, Instituto de Biologia, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Bruce Nelson
- Environmental Dynamics, INPA, National Institute for Amazon Research, Manaus, Brazil
| | | | - Otavio Ranzani
- Barcelona Institute for Global Health, ISGlobal, Barcelona, Spain
| | | | | | - Raphael Sonabend
- MRC Centre for Global Infectious Disease Analysis, Jameel Institute, School of Public Health, Imperial College London, London, UK
| | - Renan P Souza
- Departamento de Genética, Ecologia e Evolução, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Xiaoyue Xi
- Department of Mathematics, Imperial College London, London, UK
| | - Ester C Sabino
- Departamento de Moléstias Infecciosas e Parasitárias e Instituto de Medicina Tropical da Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil.
| | - Nuno R Faria
- MRC Centre for Global Infectious Disease Analysis, Jameel Institute, School of Public Health, Imperial College London, London, UK.
- Departamento de Moléstias Infecciosas e Parasitárias e Instituto de Medicina Tropical da Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil.
- Department of Zoology, University of Oxford, Oxford, UK.
- Department of Infectious Disease Epidemiology, Imperial College London, London, UK.
| | - Samir Bhatt
- MRC Centre for Global Infectious Disease Analysis, Jameel Institute, School of Public Health, Imperial College London, London, UK.
- Section of Epidemiology, School of Public Health, University of Copenhagen, Copenhagen, Denmark.
| | - Oliver Ratmann
- Department of Mathematics, Imperial College London, London, UK.
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Sansone NMS, Boschiero MN, Marson FAL. Epidemiologic Profile of Severe Acute Respiratory Infection in Brazil During the COVID-19 Pandemic: An Epidemiological Study. Front Microbiol 2022; 13:911036. [PMID: 35854935 PMCID: PMC9288583 DOI: 10.3389/fmicb.2022.911036] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Accepted: 05/26/2022] [Indexed: 01/08/2023] Open
Abstract
BackgroundThe COVID-19 is a significant public health issue, and monitoring confirmed cases and deaths is an essential epidemiologic tool. We evaluated the features in Brazilian hospitalized patients due to severe acute respiratory infection (SARI) during the COVID-19 pandemic in Brazil. We grouped the patients into the following categories: Influenza virus infection (G1), other respiratory viruses' infection (G2), other known etiologic agents (G3), SARS-CoV-2 infection (patients with COVID-19, G4), and undefined etiological agent (G5).MethodsWe performed an epidemiological study using data from DataSUS (https://opendatasus.saude.gov.br/) from December 2019 to October 2021. The dataset included Brazilian hospitalized patients due to SARI. We considered the clinical evolution of the patients with SARI during the COVID-19 pandemic according to the SARI patient groups as the outcome. We performed the multivariate statistical analysis using logistic regression, and we adopted an Alpha error of 0.05.ResultsA total of 2,740,272 patients were hospitalized due to SARI in Brazil, being the São Paulo state responsible for most of the cases [802,367 (29.3%)]. Most of the patients were male (1,495,416; 54.6%), aged between 25 and 60 years (1,269,398; 46.3%), and were White (1,105,123; 49.8%). A total of 1,577,279 (68.3%) patients recovered from SARI, whereas 701,607 (30.4%) died due to SARI, and 30,551 (1.3%) did not have their deaths related to SARI. A major part of the patients was grouped in G4 (1,817,098; 66.3%) and G5 (896,207; 32.7%). The other groups account for <1% of our sample [G1: 3,474 (0.1%), G2: 16,627 (0.6%), and G3: 6,866 (0.3%)]. The deaths related to SARI were more frequent in G4 (574,887; 34.7%); however, the deaths not related to SARI were more frequent among the patients categorized into the G3 (1,339; 21.3%) and G5 (25,829; 4.1%). In the multivariate analysis, the main predictors to classify the patients in the G5 when compared with G4 or G1-G4 were female sex, younger age, Black race, low educational level, rural place of residence, and the use of antiviral to treat the clinical signs. Furthermore, several features predict the risk of death by SARI, such as older age, race (Black, Indigenous, and multiracial background), low educational level, residence in a flu outbreak region, need for intensive care unit, and need for mechanical ventilatory support.ConclusionsThe possible COVID-19 underreporting (G5) might be associated with an enhanced mortality rate, more evident in distinct social groups. In addition, the patients' features are unequal between the patients' groups and can be used to determine the risk of possible COVID-19 underreporting in our population. Patients with a higher risk of death had a different epidemiological profile when compared with patients who recovered from SARI, like older age, Black, Indigenous, and multiracial background races, low educational level, residence in a flu outbreak region, need for intensive care unit and need for mechanical ventilatory support.
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Affiliation(s)
- Nathália Mariana Santos Sansone
- Laboratory of Cell and Molecular Tumor Biology and Bioactive Compounds, São Francisco University, Bragança Paulista, Brazil
- Laboratory of Human and Medical Genetics, São Francisco University, Bragança Paulista, Brazil
| | - Matheus Negri Boschiero
- Laboratory of Cell and Molecular Tumor Biology and Bioactive Compounds, São Francisco University, Bragança Paulista, Brazil
| | - Fernando Augusto Lima Marson
- Laboratory of Cell and Molecular Tumor Biology and Bioactive Compounds, São Francisco University, Bragança Paulista, Brazil
- Laboratory of Human and Medical Genetics, São Francisco University, Bragança Paulista, Brazil
- *Correspondence: Fernando Augusto Lima Marson ; ; orcid.org/0000-0003-4955-4234
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Alves DE, Mamelund SE, Dimka J, Simonsen L, Mølbak M, Ørskov S, Sattenspiel L, Tripp L, Noymer A, Chowell-Puente G, Dahal S, Van Doren TP, Wissler A, Heffernan C, Renfree Short K, Battles H, Baker MG. Indigenous peoples and pandemics. Scand J Public Health 2022; 50:662-667. [PMID: 35546099 PMCID: PMC9361406 DOI: 10.1177/14034948221087095] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022]
Affiliation(s)
- Daniele E Alves
- Centre for Research on Pandemics & Society, Oslo Metropolitan University, Norway
| | - Svenn-Erik Mamelund
- Centre for Research on Pandemics & Society, Oslo Metropolitan University, Norway
| | - Jessica Dimka
- Centre for Research on Pandemics & Society, Oslo Metropolitan University, Norway
| | | | | | | | | | - Lianne Tripp
- Department of Anthropology, University of Northern British Columbia, Canada
| | - Andrew Noymer
- Program in Public Health, University of California, Irvine, USA
| | | | - Sushma Dahal
- Department of Population Health Sciences, Georgia State University, USA
| | | | - Amanda Wissler
- School of Human Evolution and Social Change, Arizona State University, USA
| | - Courtney Heffernan
- Tuberculosis Program Evaluation and Research Unit, University of Alberta, Canada
| | - Kirsty Renfree Short
- School of Chemistry and Molecular Biosciences, University of Queensland, Australia
| | - Heather Battles
- Department of Anthropology, University of Auckland, New Zealand
| | - Michael G Baker
- Health Environment Infection Research Unit, University of Otago, New Zealand
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15
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Wang P, Hu T, Liu H, Zhu X. Exploring the impact of under-reported cases on the COVID-19 spatiotemporal distributions using healthcare workers infection data. CITIES (LONDON, ENGLAND) 2022; 123:103593. [PMID: 35068649 PMCID: PMC8761553 DOI: 10.1016/j.cities.2022.103593] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/16/2021] [Revised: 12/16/2021] [Accepted: 01/08/2022] [Indexed: 05/07/2023]
Abstract
A timely understanding of the spatiotemporal pattern and development trend of COVID-19 is critical for timely prevention and control. However, the under-reporting of casesis widespread in fields associated with public health. It is also possible to draw biased inferences and formulate inappropriate prevention and control policies if the phenomenon of under-reporting is not taken into account. Therefore, in this paper, a novel framework was proposed to explore the impact of under-reporting on COVID-19 spatiotemporal distributions, and empirical analysis was carried out using infection data of healthcare workers in Wuhan and Hubei (excluding Wuhan). The results show that (1) the lognormal distribution was the most suitable to describe the evolution of epidemic with time; (2) the estimated peak infection time of the reported cases lagged the peak infection time of the healthcare worker cases, and the estimated infection time interval of the reported cases was smaller than that of the healthcare worker cases. (3) The impact of under-reporting cases on the early stages of the pandemic was greater than that on its later stages, and the impact on the early onset area was greater than that on the late onset area. (4) Although the number of reported cases was lower than the actual number of cases, a high spatial correlation existed between the cumulatively reported cases and healthcare worker cases. The proposed framework of this study is highly extensible, and relevant researchers can use data sources from other counties to carry out similar research.
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Affiliation(s)
- Peixiao Wang
- State Key Laboratory of Information Engineering in Surveying, Mapping and Remote Sensing, Wuhan University, Wuhan 430079, China
| | - Tao Hu
- Department of Geography, Oklahoma State University, OK 74078, USA
- Center for Geographic Analysis, Harvard University, Cambridge, MA 02138, USA
| | - Hongqiang Liu
- College of Geodesy and Geomatics, Shandong University of Science and Technology, Qingdao 266590, China
| | - Xinyan Zhu
- State Key Laboratory of Information Engineering in Surveying, Mapping and Remote Sensing, Wuhan University, Wuhan 430079, China
- Collaborative Innovation Center of Geospatial Technology, Wuhan 430079, China
- Key Laboratory of Aerospace Information Security and Trusted Computing, Ministry of Education, Wuhan University, Wuhan 430079, China
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16
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Sansone NMS, Boschiero MN, Ortega MM, Ribeiro IA, Peixoto AO, Mendes RT, Marson FAL. Severe Acute Respiratory Syndrome by SARS-CoV-2 Infection or Other Etiologic Agents Among Brazilian Indigenous Population: An Observational Study from the First Year of Coronavirus Disease (COVID)-19 Pandemic. LANCET REGIONAL HEALTH. AMERICAS 2022; 8:100177. [PMID: 35018359 PMCID: PMC8739500 DOI: 10.1016/j.lana.2021.100177] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Background Indigenous peoples are vulnerable to pandemics, including to the coronavirus disease (COVID)-19, since it causes high mortality and specially, the loss of elderly Indigenous individuals. Methods The epidemiological data of severe acute respiratory syndrome (SARS) by SARS-CoV-2 infection or other etiologic agents (OEA) among Brazilian Indigenous peoples during the first year of COVID-19 pandemic was obtained from a Brazilian Ministry of Health open-access database to perform an observational study. Considering only Indigenous individuals diagnosed with SARS by COVID-19, the epidemiology data were also evaluated as risk of death. The type of sample collection for virus screening, demographic profile, clinical symptoms, comorbidities, and clinical evolution were evaluated. The primary outcome was considered the death in the Brazilian Indigenous individuals and the secondary outcome, the characteristics of Brazilian Indigenous infected by SARS-CoV-2 or OEA, as the need for intensive care unit admission or the need for mechanical ventilation support. The statistical analysis was done using Logistic Regression Model. Alpha of 0.05. Findings A total of 3,122 cases of Indigenous individuals with SARS in Brazil were reported during the first year of the COVID-19 pandemic. Of these, 1,994 were diagnosed with COVID-19 and 730/1,816 (40.2%) of them died. The death rate among individuals with SARS-CoV-2 was three-fold increased when compared to the group of individuals with OEA. Several symptoms (myalgia, loss of smell, and sore throat) and comorbidities (cardiopathy, systemic arterial hypertension, and diabetes mellitus) were more prevalent in the COVID-19 group when compared to Indigenous individuals with OEA. Similar profile was observed considering the risk of death among the Indigenous individuals with COVID-19 who presented several symptoms (oxygen saturation <95%, dyspnea, and respiratory distress) and comorbidities (renal disorders, cardiopathy, and diabetes mellitus). The multivariate analysis was significant in differentiating between the COVID-19-positive and non-COVID-19 patients [X2(7)=65.187; P-value<0.001]. Among the patients’ features, the following contributed in relation to the diagnosis of COVID-19: age [≥43 years-old [y.o.]; OR=1.984 (95%CI=1.480-2.658)]; loss of smell [OR=2.373 (95%CI=1.461-3.854)]; presence of previous respiratory disorders [OR=0.487; 95%CI=0.287-0.824)]; and fever [OR=1.445 (95%CI=1.082-1.929)]. Also, the multivariate analysis was able to predict the risk of death [X2(9)=293.694; P-value<0.001]. Among the patients’ features, the following contributed in relation to the risk of death: male gender [OR=1.507 (95%CI=1.010-2.250)]; age [≥60 y.o.; OR=3.377 (95%CI=2.292-4.974)]; the need for ventilatory support [invasive mechanical ventilation; OR=24.050 (95%CI=12.584-45.962) and non-invasive mechanical ventilation; OR=2.249 (95%CI=1.378-3.671)]; dyspnea [OR=2.053 (95%CI=1.196-3.522)]; oxygen saturation <95% [OR=1.691 (95%CI=1.050-2.723)]; myalgia [OR=0.423 (95%CI=0.191-0.937)]; and the presence of kidney disorders [OR=3.135 (95%CI=1.144-8.539)]. Interpretation The Brazilian Indigenous peoples are in a vulnerable situation during the COVID-19 pandemic and presented an increased risk of death due to COVID-19. Several factors were associated with enhanced risk of death, as male sex, older age (≥60 y.o.), and need for ventilatory support; also, other factors might help to differentiate SARS by COVID-19 or by OEA, as older age (≥43 y.o.), loss of smell, and fever. Funding Fundação de Amparo à Pesquisa do Estado de São Paulo (Foundation for Research Support of the State of São Paulo; #2021/05810-7).
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Key Words
- %, Percentage
- 95%CI, 95% Confidence Interval
- COVID-19
- COVID-19, Coronavirus Disease (2019)
- Ethnicity
- H1N1, H1N1 Strain of the Flu (Influenzae) virus
- HRCT, High-Resolution Computed Tomography
- ICU, Intensive Care Unit
- Indigenous
- Intensive Care Unit
- MV, Mechanical Ventilation
- NA, Not Applicable
- OEA, Other Etiologic Agents
- OR, Odds Ratio
- Pandemic
- RT-PCR, Real Time-Polymerase Chain Reaction
- Race
- Respiratory Disease
- SAH, Systemic Arterial Hypertension
- SARS, Severe Acute Respiratory Syndrome
- SARS-CoV, Severe Acute Respiratory Syndrome Coronavirus
- SARS-CoV-2, Severe Acute Respiratory Syndrome Coronavirus 2
- SIVEP-Gripe, Information System for Epidemiological Surveillance of Influenza (Sistema de Informação de Vigilância Epidemiológica da Gripe)
- SUS, Sistema Único de Saúde (Brazilian Public Health System)
- Severe Acute Respiratory Syndrome
- Virus
- y.o., Years Old
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Affiliation(s)
- Nathália M S Sansone
- Laboratory of Cell and Molecular Tumor Biology and Bioactive Compounds, São Francisco University, Bragança Paulista, SP, Brazil.,Laboratory of Human and Medical Genetics, São Francisco University, Bragança Paulista, SP, Brazil
| | - Matheus N Boschiero
- Laboratory of Cell and Molecular Tumor Biology and Bioactive Compounds, São Francisco University, Bragança Paulista, SP, Brazil
| | - Manoela M Ortega
- Laboratory of Cell and Molecular Tumor Biology and Bioactive Compounds, São Francisco University, Bragança Paulista, SP, Brazil.,Laboratory of Human and Medical Genetics, São Francisco University, Bragança Paulista, SP, Brazil
| | - Isadora A Ribeiro
- Laboratory of Cell and Molecular Tumor Biology and Bioactive Compounds, São Francisco University, Bragança Paulista, SP, Brazil.,Laboratory of Human and Medical Genetics, São Francisco University, Bragança Paulista, SP, Brazil
| | - Andressa O Peixoto
- Laboratory of Translational Medicine, Center for Investigation in Pediatrics, School of Medical Sciences, University of Campinas. Campinas, SP, Brazil
| | - Roberto T Mendes
- Laboratory of Translational Medicine, Center for Investigation in Pediatrics, School of Medical Sciences, University of Campinas. Campinas, SP, Brazil
| | - Fernando A L Marson
- Laboratory of Cell and Molecular Tumor Biology and Bioactive Compounds, São Francisco University, Bragança Paulista, SP, Brazil.,Laboratory of Human and Medical Genetics, São Francisco University, Bragança Paulista, SP, Brazil
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Impact of the COVID-19 Pandemic on Infectious Diseases in Brazil: A Case Study on Dengue Infections. EPIDEMIOLGIA (BASEL, SWITZERLAND) 2022; 3:97-115. [PMID: 36417270 PMCID: PMC9620889 DOI: 10.3390/epidemiologia3010009] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Revised: 02/14/2022] [Accepted: 02/17/2022] [Indexed: 12/14/2022]
Abstract
Brazil is known for being a breeding ground for emerging infectious diseases (EIDs), such as Zika, dengue, and chikungunya. Given that it has been one of the countries most affected by the SARS-CoV-2 pandemic, this article aims to analyze the impact that the COVID-19 pandemic has had on the burden of infectious diseases in Brazil, especially that of dengue. Brazil is a unique territory with a heterogeneous population living in a tropical, wet climate favorable to infectious diseases. In addition, despite being one of the largest emerging economies in the world, the country has been exposed to political instability and a public health system that suffers from large funding shortfalls and a lack of coherent regulation. The findings from this study are multilayered. Firstly, as cases of COVID-19 rose at the start of the pandemic, cases of dengue declined drastically. This may be due, in part, to factors such as seasonal climate and distancing measures. Furthermore, the findings indicate that the diversion of resources away from dengue and other infectious diseases, and mobilization for COVID-19 testing and treatment, likely resulted in a serious underreporting of dengue. While Brazil has incorporated some of the lessons learned from past EID experience in responding to the COVID-19 pandemic, the analysis highlights how the country's structural problems present pitfalls in the epidemiological fight. It was concluded that in a country such as Brazil, where infectious disease outbreaks are only a matter of time, pandemic preparedness should be prioritized over pandemic response.
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Deciphering Multifactorial Correlations of COVID-19 Incidence and Mortality in the Brazilian Amazon Basin. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19031153. [PMID: 35162177 PMCID: PMC8834595 DOI: 10.3390/ijerph19031153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/03/2021] [Revised: 12/31/2021] [Accepted: 01/18/2022] [Indexed: 12/10/2022]
Abstract
Amazonas suffered greatly during the COVID-19 pandemic. The mortality and fatality rates soared and scarcity of oxygen and healthcare supplies led the health system and funerary services to collapse. Thus, we analyzed the trends of incidence, mortality, and lethality indicators of COVID-19 and the dynamics of their main determinants in the state of Amazonas from March 2020 to June 2021. This is a time-series ecological study. We calculated the lethality, mortality, and incidence rates with official and public data from the Health Department. We used the Prais-Winsten regression and trends were classified as stationary, increasing, or decreasing. The effective reproduction number (Rt) was also estimated. Differences were considered significant when p < 0.05. We extracted 396,772 cases of and 13,420 deaths from COVID-19; 66% of deaths were in people aged over 60; 57% were men. Cardiovascular diseases were the most common comorbidity (28.84%), followed by diabetes (25.35%). Rural areas reported 53% of the total cases and 31% of the total deaths. The impact of COVID-19 in the Amazon is not limited to the direct effects of the pandemic itself; it may present characteristics of a syndemic due to the interaction of COVID-19 with pre-existing illnesses, endemic diseases, and social vulnerabilities.
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19
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Croda MG, Barbosa MDS, Marchioro SB, Nascimento DDGD, Melo ECP, Cruz OG, Torres AJL, Oliveira LAD, Ganem F, Simionatto S. The first year of the COVID-19 pandemic in an indigenous population in Brazil: an epidemiological study. Rev Inst Med Trop Sao Paulo 2022; 64:e69. [DOI: 10.1590/s1678-9946202264069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Accepted: 09/22/2022] [Indexed: 11/16/2022] Open
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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.
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21
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Vitorino LC, de Souza UJB, Oliveira Reis MN, Bessa LA. The impact of COVID-19 on the indigenous peoples related to air and road networks and habitat loss. PLOS GLOBAL PUBLIC HEALTH 2022; 2:e0000166. [PMID: 36962276 PMCID: PMC10021690 DOI: 10.1371/journal.pgph.0000166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Accepted: 02/13/2022] [Indexed: 11/18/2022]
Abstract
The vegetation loss in the Brazil's Legal Amazon (BLA) in 2020 corresponds to the highest loss observed in a decade, caused by the intensification of fires, mineral extraction activities, and other pressures. The possibility of earning from illegal activities such as deforestation and mining attracts the population to indigenous territories, while fires aggravate respiratory problems and enhance the current COVID-19 crisis. Furthermore, the BLA's road network is usually related to increased deforestation and fires in its areas of influence, and airports are known to contribute to spreading COVID-19 infections worldwide. Therefore, we decided to evaluate the effect of characteristics of Special Indigenous Health Districts (DSEIs) (including population, number of airports, and extent of the road network) and vegetation loss rates (deforestation, and area of vegetation lost by fires and mining) on the number of COVID-19 cases and deaths among the indigenous population in DSEIs in the BLA. We observed a positive correlation between the number of cases and deaths and the number of Indigenous Primary Healthcare Units, suggesting that many of these units did not increase appropriate activities for prevention and protection from COVID-19 in the DSEIs. The DSEIs with larger air transport and road networks were more affected by COVID-19. These networks constituted critical mechanisms for facilitating the spread of SARS-CoV-2 in the BLA. Additionally, we noted that changes that impact the landscape of DSEIs, such as fires and mining, also impact legal indigenous areas (IAs). Thus, IAs are not spared from exploratory processes in the district's landscape. Models that associate the air transport and road networks with the transformation of the landscape in IAs from burning or mining can explain the number of indigenous people who died due to COVID-19. These results are particularly important given the current disruptive scenario imposed by the Brazilian government on critical institutions that detect and fight fires in indigenous lands and the policies enacted to combat COVID-19 in Brazil, which are based on denying isolation measures and delaying vaccinations.
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Affiliation(s)
| | | | | | - Layara Alexandre Bessa
- Laboratory of Plant Mineral Nutrition and Center of Excellence in Exponential Agriculture-CEAGRE, Goiano Federal Institute, Rio Verde-GO, Brasil
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22
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Brizzi A, Whittaker C, Servo LMS, Hawryluk I, Prete CA, de Souza WM, Aguiar RS, Araujo LJT, Bastos LS, Blenkinsop A, Buss LF, Candido D, Castro MC, Costa SF, Croda J, de Souza Santos AA, Dye C, Flaxman S, Fonseca PLC, Geddes VEV, Gutierrez B, Lemey P, Levin AS, Mellan T, Bonfim DM, Miscouridou X, Mishra S, Monod M, Moreira FRR, Nelson B, Pereira RHM, Ranzani O, Schnekenberg RP, Semenova E, Sonnabend R, Souza RP, Xi X, Sabino EC, Faria NR, Bhatt S, Ratmann O. Report 46: Factors driving extensive spatial and temporal fluctuations in COVID-19 fatality rates in Brazilian hospitals. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2021:2021.11.01.21265731. [PMID: 34751273 PMCID: PMC8575144 DOI: 10.1101/2021.11.01.21265731] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
The SARS-CoV-2 Gamma variant spread rapidly across Brazil, causing substantial infection and death waves. We use individual-level patient records following hospitalisation with suspected or confirmed COVID-19 to document the extensive shocks in hospital fatality rates that followed Gamma's spread across 14 state capitals, and in which more than half of hospitalised patients died over sustained time periods. We show that extensive fluctuations in COVID-19 in-hospital fatality rates also existed prior to Gamma's detection, and were largely transient after Gamma's detection, subsiding with hospital demand. Using a Bayesian fatality rate model, we find that the geographic and temporal fluctuations in Brazil's COVID-19 in-hospital fatality rates are primarily associated with geographic inequities and shortages in healthcare capacity. We project that approximately half of Brazil's COVID-19 deaths in hospitals could have been avoided without pre-pandemic geographic inequities and without pandemic healthcare pressure. Our results suggest that investments in healthcare resources, healthcare optimization, and pandemic preparedness are critical to minimize population wide mortality and morbidity caused by highly transmissible and deadly pathogens such as SARS-CoV-2, especially in low- and middle-income countries. NOTE The following manuscript has appeared as 'Report 46 - Factors driving extensive spatial and temporal fluctuations in COVID-19 fatality rates in Brazilian hospitals' at https://spiral.imperial.ac.uk:8443/handle/10044/1/91875 . ONE SENTENCE SUMMARY COVID-19 in-hospital fatality rates fluctuate dramatically in Brazil, and these fluctuations are primarily associated with geographic inequities and shortages in healthcare capacity.
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Affiliation(s)
- Andrea Brizzi
- Department of Mathematics, Imperial College London, London, United Kingdom
| | - Charles Whittaker
- MRC Centre for Global Infectious Disease Analysis, Jameel Institute, School of Public Health, Imperial College London, United Kingdom
| | | | - Iwona Hawryluk
- MRC Centre for Global Infectious Disease Analysis, Jameel Institute, School of Public Health, Imperial College London, United Kingdom
| | - Carlos A Prete
- Departamento de Engenharia de Sistemas Eletrônicos, Escola Politécnica da Universidade de São Paulo, São Paulo, Brazil
| | - William M de Souza
- World Reference Center for Emerging Viruses and Arboviruses and Department of Microbiology and Immunology, University of Texas Medical Branch, Galveston, TX, USA
| | - Renato S Aguiar
- Departamento de Genética, Ecologia e Evolução, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
- Instituto D'Or de Pesquisa e Ensino (IDOR), Rio de Janeiro, Brazil
| | - Leonardo J T Araujo
- Laboratory of Quantitative Pathology, Center of Pathology, Adolfo Lutz Institute, São Paulo, Brazil
| | - Leonardo S Bastos
- Programa de Computação Científica, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
| | | | - Lewis F Buss
- Departamento de Moléstias Infecciosas e Parasitárias e Instituto de Medicina Tropical da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brasil
| | - Darlan Candido
- Department of Zoology, University of Oxford, Oxford, United Kingdom
| | - Marcia C Castro
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, United States
| | - Silvia F Costa
- Departamento de Moléstias Infecciosas e Parasitárias e Instituto de Medicina Tropical da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brasil
| | - Julio Croda
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, United States
| | | | - Christopher Dye
- Department of Zoology, University of Oxford, Oxford, United Kingdom
| | - Seth Flaxman
- Department of Computer Science, University of Oxford, Oxford, United Kingdom
| | - Paula L C Fonseca
- Departamento de Genética, Ecologia e Evolução, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Victor E V Geddes
- Departamento de Genética, Ecologia e Evolução, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | | | - Philippe Lemey
- Department of Microbiology, Immunology and Transplantation, KU Leuven - University of Leuven, Leuven, Belgium
| | - Anna S Levin
- Department of Infectious Disease Epidemiology, Imperial College London, London, United Kingdom
| | - Thomas Mellan
- MRC Centre for Global Infectious Disease Analysis, Jameel Institute, School of Public Health, Imperial College London, United Kingdom
| | - Diego M Bonfim
- Departamento de Genética, Ecologia e Evolução, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Xenia Miscouridou
- Department of Mathematics, Imperial College London, London, United Kingdom
| | - Swapnil Mishra
- MRC Centre for Global Infectious Disease Analysis, Jameel Institute, School of Public Health, Imperial College London, United Kingdom
- Section of Epidemiology, School of Public Health, University of Copenhagen, Denmark, Copenhagen
| | - Mélodie Monod
- Department of Mathematics, Imperial College London, London, United Kingdom
| | - Filipe R R Moreira
- Departamento de Genética, Instituto de Biologia, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Bruce Nelson
- Environmental Dynamics, INPA, National Institute for Amazon Research, Bairro Petropolis, Brazil
| | | | - Otavio Ranzani
- Barcelona Institute for Global Health, ISGlobal, Barcelona, Spain
| | - Ricardo P Schnekenberg
- Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, United Kingdom
| | - Elizaveta Semenova
- Department of Mathematics, Imperial College London, London, United Kingdom
| | - Raphael Sonnabend
- MRC Centre for Global Infectious Disease Analysis, Jameel Institute, School of Public Health, Imperial College London, United Kingdom
| | - Renan P Souza
- Departamento de Genética, Ecologia e Evolução, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Xiaoyue Xi
- Department of Mathematics, Imperial College London, London, United Kingdom
| | - Ester C Sabino
- Programa de Computação Científica, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
| | - Nuno R Faria
- MRC Centre for Global Infectious Disease Analysis, Jameel Institute, School of Public Health, Imperial College London, United Kingdom
- Department of Zoology, University of Oxford, Oxford, United Kingdom
- Department of Infectious Disease Epidemiology, Imperial College London, London, United Kingdom
- Instituto de Medicina Tropical, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | - Samir Bhatt
- MRC Centre for Global Infectious Disease Analysis, Jameel Institute, School of Public Health, Imperial College London, United Kingdom
- Section of Epidemiology, School of Public Health, University of Copenhagen
| | - Oliver Ratmann
- Department of Mathematics, Imperial College London, London, United Kingdom
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Increased vulnerability to SARS-CoV-2 infection among indigenous people living in the urban area of Manaus. Sci Rep 2021; 11:17534. [PMID: 34475438 PMCID: PMC8413354 DOI: 10.1038/s41598-021-96843-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Accepted: 08/17/2021] [Indexed: 01/19/2023] Open
Abstract
The COVID-19 pandemic threatens indigenous peoples living in suburban areas of large Brazilian cities and has thus far intensified their pre-existing socio-economic inequalities. We evaluated the epidemiological situation of SARS-CoV-2 infection among residents of the biggest urban multiethnic indigenous community of the Amazonas state, Brazil. Blood samples of 280 indigenous people living in the surrounding area of Manaus were tested for the presence of anti-SARS-CoV-2 IgA or IgG antibodies. The risk factors and sociodemographic information were assessed through an epidemiological questionnaire. We found a total positivity rate of 64.64% (95% CI 59.01–70.28) for SARS-CoV-2 infection. IgA and IgG were detected in 55.71% (95% CI 49.89–61.54) and 60.71% (95% CI 54.98–66.45) of the individuals, respectively. Over 80% of positive individuals were positive for both IgA and IgG.No significant difference in positivity rates between genders or age groups was observed. Moreover, the age group ≥ 60 years old showed the highest antibody ratios (IgA mean ratio = 3.080 ± 1.623; IgG mean ratio = 4.221 ± 1.832), while the age groups 13–19 and 20–29 showed the lowest IgA (mean ratio = 2.268 ± 0.919) and IgG ratios (mean ratio = 2.207 ± 1.246), respectively. Individuals leaving the home more frequently were at higher risk of infection (Odds ratio (OD) 2.61; 95% CI 1.00–1.49; p = 0.048). Five or more individuals per household increased fivefold the risk of virus transmission (OR 2.56; 95% CI 1.09–6.01; p = 0.019). The disproportionate dissemination of SARS-CoV-2 infection observed among the study population might be driven by typical cultural behavior and socioeconomic inequalities. Despite the pandemic threat, this population is not being targeted by public policies and appears to be chronically invisible to the Brazilian authorities.
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Intergenerational Association of Short Maternal Stature with Stunting in Yanomami Indigenous Children from the Brazilian Amazon. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18179130. [PMID: 34501720 PMCID: PMC8430951 DOI: 10.3390/ijerph18179130] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Revised: 08/18/2021] [Accepted: 08/24/2021] [Indexed: 12/13/2022]
Abstract
To describe the factors associated to stunting in <5-year-old Yanomami Brazilian children, and to evaluate the association of short maternal stature to their offspring’s stunting. A cross-sectional study carried out in three villages in the Yanomami territory. We performed a census, in which all households with children < 5-years-old were included. The length/height-for-age z-score <−2 standard deviations was used to classify the children as stunted. Short maternal height was defined as <145 cm for adult women, and <−2 standard deviations of the height-for-age z-score for adolescent women. We used adjusted Poisson regression models to estimate prevalence ratios (PR) along the 90% confidence interval. We evaluated 298 children. 81.2% of children suffered from stunting and 71.9% of the mothers from short stature. In the bivariate analysis, a significant association of stunting with short maternal stature, gestational malaria and child’s place of birth were observed. Considering the variables of the children under five years of age, there were significant associations with age group, the child’s caregiver, history of malaria, pneumonia, and malnutrition treatment. In the adjusted hierarchical model, stunting was 1.22 times greater in the offspring of women with a short stature (90% CI: 1.07–1.38) compared to their counterparts. Brazilian Amazonian indigenous children living in a remote area displayed an alarming prevalence of stunting, and this was associated with short maternal height, reinforcing the hypothesis of intergenerational chronic malnutrition transmission in this population. In addition, children above 24 months of age, who were born in the village healthcare units and who had had previous treatment in the past for stunting presented higher rates of stunting in this study.
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