1
|
Sirivichayakul C, Biswal S, Saez-Llorens X, López-Medina E, Borja-Tabora C, Bravo L, Kosalaraksa P, Alera MT, Reynales H, Rivera L, Watanaveeradej V, Yu D, Espinoza F, Dietze R, Fernando L, Wickramasinghe VP, Moreira ED, Fernando AD, Gunasekera D, Luz K, Venâncio da Cunha R, Oliveira AL, Rauscher M, Fan H, Borkowski A, Escudero I, Tuboi S, Lloyd E, Tricou V, Folschweiller N, LeFevre I, Vargas LM, Wallace D. Efficacy and Safety of a Tetravalent Dengue Vaccine (TAK-003) in Children With Prior Japanese Encephalitis or Yellow Fever Vaccination. J Infect Dis 2024:jiae222. [PMID: 38682569 DOI: 10.1093/infdis/jiae222] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Revised: 04/22/2024] [Accepted: 04/25/2024] [Indexed: 05/01/2024] Open
Abstract
BACKGROUND We explored the impact of prior Yellow fever (YF) or Japanese encephalitis (JE) vaccination on the efficacy of Takeda's dengue vaccine candidate, TAK-003 (NCT02747927). METHODS Children 4-16 years of age were randomized 2:1 to receive TAK-003 or placebo and were under active febrile surveillance. Symptomatic dengue was confirmed by serotype-specific RT-PCR. YF and JE vaccination history was recorded. RESULTS Of the 20,071 children who received TAK-003 or placebo, 21.1% had a YF and 23.9% had a JE vaccination history at randomization. Fifty-seven months after vaccination, vaccine efficacy was 55.7% (95% CI, 39.7%-67.5%) in those with YF vaccination, 77.8% (70.8%-83.1%) for JE vaccination, and 53.5% (45.4%-60.4%) for no prior YF/JE vaccination. Regional differences in serotype distribution confound these results. The apparent higher vaccine efficacy in the JE vaccination subgroup could be largely explained by serotype-specific efficacy of TAK-003. Within 28 days of any vaccination, the proportions of participants with serious adverse events in the YF/JE prior vaccination population were comparable between the TAK-003 and placebo groups. CONCLUSIONS The available data do not suggest a clinically relevant impact of prior JE or YF vaccination on TAK-003 performance. Overall, TAK-003 was well-tolerated and efficacious in different epidemiological settings.
Collapse
Affiliation(s)
- Chukiat Sirivichayakul
- Department of Tropical Pediatrics, Faculty of Tropical Medicine, Mahidol University, Thailand
| | | | - Xavier Saez-Llorens
- Hospital del Niño Dr José Renán Esquivel, Sistema Nacional de Investigación at SENACYT, Centro de Vacunación Internacional (Cevaxin), Panama City, Panama
| | - Eduardo López-Medina
- Centro de Estudios en Infectologia Pediátrica (CEIP), Universidad del Valle and Clínica Imbanaco Grupo Quironsalud, Cali, Colombia
| | | | - Lulu Bravo
- University of the Philippines Manila, Ermita, Philippines
| | | | | | | | - Luis Rivera
- Hospital Maternidad Nuestra Senora de Altagracia, Santo Domingo, Dominican Republic
| | | | - Delia Yu
- De La Salle Health Sciences Institute, Dasmariñas, Philippines
| | - Felix Espinoza
- National Autonomous University of Nicaragua, León, Nicaragua
| | - Reynaldo Dietze
- Núcleo de Doenças Infecciosas, Centro de Ciências da Saúde, Universidade Federal do Espirito Santo, Vitória, Brazil
| | - LakKumar Fernando
- Centre for Clinical Management of Dengue & Dengue Haemorrhagic Fever, Negombo General Hospital, Negombo, Sri Lanka
| | | | - Edson Duarte Moreira
- Associação Obras Sociais Irmã Dulce Hospital Santo Antônio and Oswaldo Cruz Foundation, Bahia, Brazil
| | | | - Dulanie Gunasekera
- Faculty of Medical Sciences, University of Sri Jayawardenenpura, Sri Lanka
| | - Kleber Luz
- Instituto de Medicina Tropical da Universidade Federal do Rio Grande do Norte, Brazil
| | | | | | | | - Huihao Fan
- Clinchoice Inc, Fort Washington, PA, USA
| | | | | | | | | | | | | | | | | | | |
Collapse
|
2
|
Xavier J, Fonseca V, Adelino T, Iani FCM, Pereira GC, Duarte MM, Lima M, Castro E, Oliveira C, Fritsch H, Guimarães N, Lamounier LO, Barreto FK, Braga de Oliveira CMM, Maymone Gonçalves CC, Malta Lima D, de Oliveira EC, de Castro Lichs GG, Gomes I, Mazaro J, Rodrigues JTN, Abrantes J, Colares JKB, Luz KG, Barbosa da Silva L, Demarchi L, Câmara MCB, Umaki Zardin MCS, Sabatini Mello Pinheiro R, Barbosa Souza R, Haddad SK, Figueiredo da Silva S, Slavov SN, Rocha T, Morel N, Chiparelli H, Burgueño A, Bórmida V, Cortinas MN, Martín RS, Pereira AC, dos Santos MF, André Júnior W, Mendez Rico J, Franco L, Rosewell A, do Carmo Said RF, de Albuquerque CFC, Noia Maciel EL, Santini de Oliveira M, Venâncio da Cunha R, Vinhal Frutuoso LC, de Filippis AMB, Giovanetti M, Carlos Junior Alcantara L. A Multiplex Nanopore Sequencing Approach for the Detection of Multiple Arboviral Species. Viruses 2023; 16:23. [PMID: 38257724 PMCID: PMC10821003 DOI: 10.3390/v16010023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2023] [Revised: 12/08/2023] [Accepted: 12/10/2023] [Indexed: 01/24/2024] Open
Abstract
The emergence and continued geographic expansion of arboviruses and the growing number of infected people have highlighted the need to develop and improve multiplex methods for rapid and specific detection of pathogens. Sequencing technologies are promising tools that can help in the laboratory diagnosis of conditions that share common symptoms, such as pathologies caused by emerging arboviruses. In this study, we integrated nanopore sequencing and the advantages of reverse transcription polymerase chain reaction (RT-PCR) to develop a multiplex RT-PCR protocol for the detection of Chikungunya virus (CHIKV) and several orthoflaviviruses (such as dengue (Orthoflavivirus dengue), Zika (Orthoflavivirus zikaense), yellow fever (Orthoflavivirus flavi), and West Nile (Orthoflavivirus nilense) viruses) in a single reaction, which provides data for sequence-based differentiation of arbovirus lineages.
Collapse
Affiliation(s)
- Joilson Xavier
- Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte 31270-901, Brazil
| | - Vagner Fonseca
- Organização Pan-Americana da Saúde, Organização Mundial da Saúde, Brasília 70800-400, Brazil
| | - Talita Adelino
- Laboratorio Central de Saúde Pública do Estado de Minas Gerais, Fundação Ezequiel Dias, Belo Horizonte 30510-010, Brazil (F.C.M.I.)
| | - Felipe C. M. Iani
- Laboratorio Central de Saúde Pública do Estado de Minas Gerais, Fundação Ezequiel Dias, Belo Horizonte 30510-010, Brazil (F.C.M.I.)
| | - Glauco C. Pereira
- Laboratorio Central de Saúde Pública do Estado de Minas Gerais, Fundação Ezequiel Dias, Belo Horizonte 30510-010, Brazil (F.C.M.I.)
| | - Myrian M. Duarte
- Laboratorio Central de Saúde Pública do Estado de Minas Gerais, Fundação Ezequiel Dias, Belo Horizonte 30510-010, Brazil (F.C.M.I.)
| | - Mauricio Lima
- Instituto Rene Rachou, Fundação Oswaldo Cruz, Belo Horizonte 30190-002, Brazil
| | - Emerson Castro
- Instituto Rene Rachou, Fundação Oswaldo Cruz, Belo Horizonte 30190-002, Brazil
| | - Carla Oliveira
- lnstituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro 21040-900, Brazil
| | - Hegger Fritsch
- Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte 31270-901, Brazil
| | - Natalia Guimarães
- Laboratorio Central de Saúde Pública do Estado de Minas Gerais, Fundação Ezequiel Dias, Belo Horizonte 30510-010, Brazil (F.C.M.I.)
| | - Ludmila O. Lamounier
- Laboratorio Central de Saúde Pública do Estado de Minas Gerais, Fundação Ezequiel Dias, Belo Horizonte 30510-010, Brazil (F.C.M.I.)
| | - Fernanda Khouri Barreto
- Instituto Multidisciplinar em Saúde, Universidade Federal da Bahia, Vitória da Conquista 45029-094, Brazil
| | | | | | - Danielle Malta Lima
- Faculty of the Graduate Program in Biotechnology (Renorbio), Universidade de Fortaleza, Fortaleza 60811-905, Brazil
| | | | | | - Iago Gomes
- Laboratório Central de Saúde Pública do Rio Grande do Norte, Natal 59037-170, Brazil
| | - Janaina Mazaro
- Secretaria Estadual de Saúde do estado do Acre, Rio Branco 69900-064, Brazil
| | | | - Jayra Abrantes
- Laboratório Central de Saúde Pública do Rio Grande do Norte, Natal 59037-170, Brazil
| | - Jeová K. B. Colares
- Faculty of the Graduate Program in Biotechnology (Renorbio), Universidade de Fortaleza, Fortaleza 60811-905, Brazil
| | - Kleber G. Luz
- Department of Infectious Diseases, Universidade Federal do Rio Grande do Norte, Natal 59078-900, Brazil
| | | | - Luiz Demarchi
- Laboratorio Central de Saúde Pública do Mato Grosso do Sul, Campo Grande 79074-460, Brazil
| | - Magaly C. B. Câmara
- Laboratório Central de Saúde Pública do Rio Grande do Norte, Natal 59037-170, Brazil
| | | | | | | | - Simone K. Haddad
- Fundação Hemocentro de Ribeirão Preto, Ribeirão Preto 14051-140, Brazil
| | | | | | - Themis Rocha
- Laboratório Central de Saúde Pública do Rio Grande do Norte, Natal 59037-170, Brazil
| | - Noelia Morel
- Departamento de Laboratorios de Salud Pública, Ministerio de Salud Pública, Montevideo 11200, Uruguay
| | - Hector Chiparelli
- Departamento de Laboratorios de Salud Pública, Ministerio de Salud Pública, Montevideo 11200, Uruguay
| | - Analía Burgueño
- Departamento de Laboratorios de Salud Pública, Ministerio de Salud Pública, Montevideo 11200, Uruguay
| | - Victoria Bórmida
- Departamento de Laboratorios de Salud Pública, Ministerio de Salud Pública, Montevideo 11200, Uruguay
| | - María N. Cortinas
- Departamento de Laboratorios de Salud Pública, Ministerio de Salud Pública, Montevideo 11200, Uruguay
| | - Rosario S. Martín
- Departamento de Laboratorios de Salud Pública, Ministerio de Salud Pública, Montevideo 11200, Uruguay
| | | | | | | | | | - Leticia Franco
- Pan American Health Organization, Washington, DC 20037, USA
| | - Alexander Rosewell
- Organização Pan-Americana da Saúde, Organização Mundial da Saúde, Brasília 70800-400, Brazil
| | | | | | - Ethel L. Noia Maciel
- Secretaria de Vigilância em Saúde e Ambiente, Ministério da Saúde, Brasília 70058-900, Brazil
| | | | | | | | | | - Marta Giovanetti
- Instituto Rene Rachou, Fundação Oswaldo Cruz, Belo Horizonte 30190-002, Brazil
- Sciences and Technologies for Sustainable Development and One Health, Universita Campus Bio-Medico di Roma, 00128 Roma, Italy
- Climate Amplified Diseases and Epidemics (CLIMADE), Fundação Oswaldo Cruz, Belo Horizonte 30190-002, Brazil
| | - Luiz Carlos Junior Alcantara
- Instituto Rene Rachou, Fundação Oswaldo Cruz, Belo Horizonte 30190-002, Brazil
- Climate Amplified Diseases and Epidemics (CLIMADE), Fundação Oswaldo Cruz, Belo Horizonte 30190-002, Brazil
| |
Collapse
|
3
|
Giovanetti M, Pinotti F, Zanluca C, Fonseca V, Nakase T, Koishi AC, Tscha M, Soares G, Dorl GG, Marques AEM, Sousa R, Adelino TER, Xavier J, de Oliveira C, Patroca S, Guimaraes NR, Fritsch H, Mares-Guia MA, Levy F, Passos PH, da Silva VL, Pereira LA, Mendonça AF, de Macêdo IL, Ribeiro de Sousa DE, Rodrigues de Toledo Costa G, Botelho de Castro M, de Souza Andrade M, de Abreu FVS, Campos FS, Iani FCDM, Pereira MA, Cavalcante KRLJ, de Freitas ARR, Campelo de Albuquerque CF, Macário EM, dos Anjos MPD, Ramos RC, Campos AAS, Pinter A, Chame M, Abdalla L, Riediger IN, Ribeiro SP, Bento AI, de Oliveira T, Freitas C, Oliveira de Moura NF, Fabri A, dos Santos Rodrigues CD, Dos Santos CC, Barreto de Almeida MA, dos Santos E, Cardoso J, Augusto DA, Krempser E, Mucci LF, Gatti RR, Cardoso SF, Fuck JAB, Lopes MGD, Belmonte IL, Mayoral Pedroso da Silva G, Soares MRF, de Castilhos MDMS, de Souza e Silva JC, Bisetto Junior A, Pouzato EG, Tanabe LS, Arita DA, Matsuo R, dos Santos Raymundo J, Silva PCL, Santana Araújo Ferreira Silva A, Samila S, Carvalho G, Stabeli R, Navegantes W, Moreira LA, Ferreira AGA, Pinheiro GG, Nunes BTD, de Almeida Medeiros DB, Cruz ACR, Venâncio da Cunha R, Van Voorhis W, Bispo de Filippis AM, Almiron M, Holmes EC, Ramos DG, Romano A, Lourenço J, Alcantara LCJ, Duarte dos Santos CN. Genomic epidemiology unveils the dynamics and spatial corridor behind the Yellow Fever virus outbreak in Southern Brazil. Sci Adv 2023; 9:eadg9204. [PMID: 37656782 PMCID: PMC10854437 DOI: 10.1126/sciadv.adg9204] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Accepted: 07/26/2023] [Indexed: 09/03/2023]
Abstract
Despite the considerable morbidity and mortality of yellow fever virus (YFV) infections in Brazil, our understanding of disease outbreaks is hampered by limited viral genomic data. Here, through a combination of phylogenetic and epidemiological models, we reconstructed the recent transmission history of YFV within different epidemic seasons in Brazil. A suitability index based on the highly domesticated Aedes aegypti was able to capture the seasonality of reported human infections. Spatial modeling revealed spatial hotspots with both past reporting and low vaccination coverage, which coincided with many of the largest urban centers in the Southeast. Phylodynamic analysis unraveled the circulation of three distinct lineages and provided proof of the directionality of a known spatial corridor that connects the endemic North with the extra-Amazonian basin. This study illustrates that genomics linked with eco-epidemiology can provide new insights into the landscape of YFV transmission, augmenting traditional approaches to infectious disease surveillance and control.
Collapse
Affiliation(s)
- Marta Giovanetti
- Laboratório de Flavivírus, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
- Instituto Rene Rachou, Fundação Oswaldo Cruz, Belo Horizonte, Minas Gerais, Brazil
- Department of Science and Technology for Humans and the Environment, Università of Campus Bio-Medico di Roma, Italy
| | | | - Camila Zanluca
- Laboratório de Virologia Molecular, Instituto Carlos Chagas/Fiocruz-PR, Curitiba, Paraná, Brazil
| | - Vagner Fonseca
- Organização Pan-Americana da Saúde/Organização Mundial da Saúde, Brasília, Distrito Federal, Brazil
| | - Taishi Nakase
- Nuffield Department of Medicine, University of Oxford, Oxford, OX3 7BN, UK
| | - Andrea C. Koishi
- Laboratório de Virologia Molecular, Instituto Carlos Chagas/Fiocruz-PR, Curitiba, Paraná, Brazil
| | - Marcel Tscha
- Laboratório de Virologia Molecular, Instituto Carlos Chagas/Fiocruz-PR, Curitiba, Paraná, Brazil
| | - Guilherme Soares
- Laboratório de Virologia Molecular, Instituto Carlos Chagas/Fiocruz-PR, Curitiba, Paraná, Brazil
| | - Gisiane Gruber Dorl
- Laboratório de Virologia Molecular, Instituto Carlos Chagas/Fiocruz-PR, Curitiba, Paraná, Brazil
| | | | - Renato Sousa
- Laboratório de Patologia Veterinária, Hospital Veterinário UFPR, PR Brazil
| | - Talita Emile Ribeiro Adelino
- Laboratório Central de Saúde Pública do Estado de Minas Gerais, Fundação Ezequiel Dias, Belo Horizonte, Minas Gerais, Brazil
| | - Joilson Xavier
- Instituto Rene Rachou, Fundação Oswaldo Cruz, Belo Horizonte, Minas Gerais, Brazil
- Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Carla de Oliveira
- Laboratório de Flavivírus, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
- Instituto Rene Rachou, Fundação Oswaldo Cruz, Belo Horizonte, Minas Gerais, Brazil
| | | | - Natalia Rocha Guimaraes
- Laboratório Central de Saúde Pública do Estado de Minas Gerais, Fundação Ezequiel Dias, Belo Horizonte, Minas Gerais, Brazil
| | - Hegger Fritsch
- Instituto Rene Rachou, Fundação Oswaldo Cruz, Belo Horizonte, Minas Gerais, Brazil
- Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | | | - Flavia Levy
- Laboratório de Flavivírus, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
| | - Pedro Henrique Passos
- Coordenação Geral das Arboviroses, Secretaria de Vigilância em Saúde/Ministério da Saúde (CGARB/SVS-MS), Brasília, Distrito Federal, Brazil
| | | | - Luiz Augusto Pereira
- Laboratório Central de Saúde Pública Dr Giovanni Cysneiros, Goiânia, Goiás, Brazil
| | - Ana Flávia Mendonça
- Laboratório Central de Saúde Pública Dr Giovanni Cysneiros, Goiânia, Goiás, Brazil
| | - Isabel Luana de Macêdo
- Veterinary Pathology Laboratory, Campus Darcy Ribeiro, University of Brasília, Brasília, DF 70636- 200, Brazil
| | | | | | - Marcio Botelho de Castro
- Veterinary Pathology Laboratory, Campus Darcy Ribeiro, University of Brasília, Brasília, DF 70636- 200, Brazil
- Graduate Program in Animal Sciences, College of Agronomy and Veterinary Medicine, University of Brasília, Brasília, DF 70910-900, Brazil
| | - Miguel de Souza Andrade
- Baculovirus Laboratory, Department of Cell Biology, Institute of Biological Sciences, University of Brasilia, Brasília 70910-900, DF, Brazil
| | | | - Fabrício Souza Campos
- Institute of Basic Health Sciences, Federal University of Rio Grande do Sul, Porto Alegre 90035-003, RS, Brazil
| | - Felipe Campos de Melo Iani
- Laboratório Central de Saúde Pública do Estado de Minas Gerais, Fundação Ezequiel Dias, Belo Horizonte, Minas Gerais, Brazil
| | - Maira Alves Pereira
- Laboratório Central de Saúde Pública do Estado de Minas Gerais, Fundação Ezequiel Dias, Belo Horizonte, Minas Gerais, Brazil
| | | | | | | | | | - Marlei Pickler Debiasi dos Anjos
- Laboratorio central de Saude Publica de Santa Catarina, Superintendência de Vigilância em Saúde – SES – Santa Catarina, South Brazil
| | - Rosane Campanher Ramos
- Laboratório Central de Saúde Pública do Estado do Rio Grande do Sul, Superintendência de Vigilância em Saúde – SES – Santa Catarina, South Brazil
| | | | - Adriano Pinter
- Departamento de Medicina Veterinária Preventiva e Saúde Animal, Faculdade de Medicina Veterinária e Zootecnia, Universidade de São Paulo, São Paulo, 05508-000, Brazil
| | - Marcia Chame
- Oswaldo Cruz Foundation, Biodiversity, Wildlife Health Institutional Platform (PIBSS/Fiocruz), Rio de Janeiro, Brazil
| | - Livia Abdalla
- Oswaldo Cruz Foundation, Biodiversity, Wildlife Health Institutional Platform (PIBSS/Fiocruz), Rio de Janeiro, Brazil
| | | | - Sérvio Pontes Ribeiro
- Laboratory of Ecology of Diseases & Forests, NUPEB/ICEB, Federal University of Ouro Preto, Minas Gerais, Brazil
| | - Ana I. Bento
- Pandemic Prevention Initiative, The Rockefeller Foundation, Washington DC, USA
| | - Tulio de Oliveira
- School for Data Science and Computational Thinking, Faculty of Science and Faculty of Medicine and Health Sciences, Stellenbosch University, South Africa
| | - Carla Freitas
- Secretaria de Vigilância em Saúde, SVS, Brazilian Ministry of Health, Brasilia, Federal District, Brazil
| | | | - Allison Fabri
- Laboratório de Flavivírus, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
| | | | | | | | - Edmilson dos Santos
- Secretaria Estadual de Saúde do Rio Grande do Sul, Centro Estadual de Vigilância em Saúde, Porto Alegre, RS, Brazil
| | - Jader Cardoso
- Secretaria Estadual de Saúde do Rio Grande do Sul, Centro Estadual de Vigilância em Saúde, Porto Alegre, RS, Brazil
| | - Douglas Adriano Augusto
- Plataforma Institucional Biodiversidade e Saúde Silvestre - Centro de Informação em Saúde Silvestre (CISS) - Fiocruz/RJ, Avenida Brasil, 4365. Manguinhos - Rio de Janeiro - RJ Cep: 21.040-360
| | - Eduardo Krempser
- Plataforma Institucional Biodiversidade e Saúde Silvestre - Centro de Informação em Saúde Silvestre (CISS) - Fiocruz/RJ, Avenida Brasil, 4365. Manguinhos - Rio de Janeiro - RJ Cep: 21.040-360
| | - Luís Filipe Mucci
- Secretaria da Saúde (São Paulo - Estado), Av Dr. Enéas Carvalho de Aguiar, 188 - Cerqueira César, São Paulo - SP, 05403-000, Brazil
- Coordenadoria de Controle de Doenças (CCD), Av. Dr. Enéas Carvalho de Aguiar, 188 - Cerqueira César, São Paulo - SP, 05403-000, Brazil
- Instituto Pasteur (IP), Av. Paulista, 363 Cerqueira Cesar – São Paulo- SP – CEP:01311-000
| | - Renata Rispoli Gatti
- Secretaria de Estado da Saude de Santa Catarina, R. Esteves Júnior, 160 - Centro, Florianópolis - SC, 88015-130, Brazil
| | - Sabrina Fernandes Cardoso
- Secretaria de Estado da Saude de Santa Catarina, R. Esteves Júnior, 160 - Centro, Florianópolis - SC, 88015-130, Brazil
- Department of Cell Biology, Embryology and Genetics, Federal University of Santa Catarina (UFSC), Florianópolis, Brazil
| | - João Augusto Brancher Fuck
- Diretoria de Vigilância Epidemiológica da Secretaria de Estado da Saúde de Santa Catarina, R. Esteves Júnior, 160 - Centro, Florianópolis - SC, 88015-130, Brazil
| | - Maria Goretti David Lopes
- Secretaria de Estado da Saúde do Paraná, Brazil, R. Piquiri, 170 - Rebouças, Curitiba - PR, 80230-140
| | - Ivana Lucia Belmonte
- Secretaria de Estado da Saúde do Paraná, Brazil, R. Piquiri, 170 - Rebouças, Curitiba - PR, 80230-140
| | | | | | | | | | - Alceu Bisetto Junior
- Secretaria de Estado da Saúde do Paraná, Brazil, R. Piquiri, 170 - Rebouças, Curitiba - PR, 80230-140
| | - Emanuelle Gemin Pouzato
- Secretaria de Estado da Saúde do Paraná, Brazil, R. Piquiri, 170 - Rebouças, Curitiba - PR, 80230-140
| | - Laurina Setsuko Tanabe
- Secretaria de Estado da Saúde do Paraná, Brazil, R. Piquiri, 170 - Rebouças, Curitiba - PR, 80230-140
| | - Daniele Akemi Arita
- Secretaria de Estado da Saúde do Paraná, Brazil, R. Piquiri, 170 - Rebouças, Curitiba - PR, 80230-140
| | - Ricardo Matsuo
- Secretaria de Estado da Saúde do Paraná, Brazil, R. Piquiri, 170 - Rebouças, Curitiba - PR, 80230-140
| | | | | | | | - Sandra Samila
- Secretaria de Estado da Saúde do Paraná, Brazil, R. Piquiri, 170 - Rebouças, Curitiba - PR, 80230-140
| | - Glauco Carvalho
- Laboratório Central de Saúde Pública do Estado de Minas Gerais, Fundação Ezequiel Dias, Belo Horizonte, Minas Gerais, Brazil
| | - Rodrigo Stabeli
- Organização Pan-Americana da Saúde/Organização Mundial da Saúde, Brasília, Distrito Federal, Brazil
| | - Wildo Navegantes
- Organização Pan-Americana da Saúde/Organização Mundial da Saúde, Brasília, Distrito Federal, Brazil
| | - Luciano Andrade Moreira
- Mosquitos Vetores: Endossimbiontes e Interação Patógeno-Vetor, Instituto René Rachou–Fiocruz, Belo Horizonte 30190-002, MG, Brazil
| | - Alvaro Gil A. Ferreira
- Mosquitos Vetores: Endossimbiontes e Interação Patógeno-Vetor, Instituto René Rachou–Fiocruz, Belo Horizonte 30190-002, MG, Brazil
| | | | | | | | | | | | - Wes Van Voorhis
- Center for Emerging and Re-emerging Infectious Diseases (CERID), University of Washington, Seattle, WA, USA
| | | | - Maria Almiron
- Pan American Health Organization/World Health Organization, Washington, DC, USA
| | - Edward C. Holmes
- Marie Bashir Institute for Infectious Diseases and Biosecurity, School of Life and Environmental Sciences and School of Medical Sciences, University of Sydney, Sydney, NSW, Australia
| | - Daniel Garkauskas Ramos
- Coordenação Geral das Arboviroses, Secretaria de Vigilância em Saúde/Ministério da Saúde (CGARB/SVS-MS), Brasília, Distrito Federal, Brazil
| | - Alessandro Romano
- Coordenação Geral das Arboviroses, Secretaria de Vigilância em Saúde/Ministério da Saúde (CGARB/SVS-MS), Brasília, Distrito Federal, Brazil
| | - José Lourenço
- BioISI (Biosystems and Integrative Sciences Institute), Faculdade de Ciências da Universidade de Lisboa, Campo Grande, 1749-016 Lisboa Portugal
| | - Luiz Carlos Junior Alcantara
- Laboratório de Flavivírus, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
- Instituto Rene Rachou, Fundação Oswaldo Cruz, Belo Horizonte, Minas Gerais, Brazil
| | | |
Collapse
|
4
|
Cerbino-Neto J, Peres IT, Varela MC, Brandão LGP, de Matos JA, Pinto LF, da Costa MD, Garcia MHDO, Soranz D, Maia MDLDS, Krieger MA, da Cunha RV, Camacho LAB, Ranzani O, Hamacher S, Bozza FA, Penna GO. Seroepidemiology of SARS-CoV-2 on a partially vaccinated island in Brazil: Determinants of infection and vaccine response. Front Public Health 2022; 10:1017337. [PMID: 36457326 PMCID: PMC9706255 DOI: 10.3389/fpubh.2022.1017337] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Accepted: 10/25/2022] [Indexed: 11/16/2022] Open
Abstract
Background A vaccination campaign targeted adults in response to the pandemic in the City of Rio de Janeiro. Objective We aimed to evaluate the seroprevalence of SARS-CoV-2 antibodies and identify factors associated with seropositivity on vaccinated and unvaccinated residents. Methods We performed a seroepidemiologic survey in all residents of Paquetá Island, a neighborhood of Rio de Janeiro city, during the COVID-19 vaccine roll-out. Serological tests were performed from June 16 to June 19, 2021, and adjusted seropositivity rates were estimated by age and epidemiological variables. Logistic regression models were used to estimate adjusted ORs for risk factors to SARS-CoV-2 seropositivity in non-vaccinated individuals, and potential determinants of the magnitude of antibody responses in the seropositive population. Results We included in the study 3,016 residents of Paquetá (83.5% of the island population). The crude seroprevalence of COVID-19 antibodies in our sample was 53.6% (95% CI = 51.0, 56.3). The risk factors for SARS-CoV-2 seropositivity in non-vaccinated individuals were history of confirmed previous COVID-19 infection (OR = 4.74; 95% CI = 3.3, 7.0), being a household contact of a case (OR = 1.93; 95% CI = 1.5, 2.6) and in-person learning (OR = 2.01; 95% CI = 1.4, 3.0). Potential determinants of the magnitude of antibody responses among the seropositive were hybrid immunity, the type of vaccine received, and time since the last vaccine dose. Being vaccinated with Pfizer or AstraZeneca (Beta = 2.2; 95% CI = 1.8, 2.6) determined higher antibody titers than those observed with CoronaVac (Beta = 1.2; 95% CI = 0.9, 1.5). Conclusions Our study highlights the impact of vaccination on COVID-19 collective immunity even in a highly affected population, showing the difference in antibody titers achieved with different vaccines and how they wane with time, reinforcing how these factors should be considered when estimating effectiveness of a vaccination program at any given time. We also found that hybrid immunity was superior to both infection-induced and vaccine-induced immunity alone, and online learning protected students from COVID-19 exposure.
Collapse
Affiliation(s)
- José Cerbino-Neto
- Municipal Health Department of Rio de Janeiro, Rio de Janeiro City Government, Rio de Janeiro, Brazil,National Institute of Infectious Disease Evandro Chagas, Oswaldo Cruz Foundation (FIOCRUZ), Rio de Janeiro, Brazil,D'Or Institute for Research and Education, Rio de Janeiro, Brazil,*Correspondence: José Cerbino-Neto
| | - Igor Tona Peres
- Department of Industrial Engineering and Tecgraf Institute, Pontifical Catholic University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Margareth Catoia Varela
- National Institute of Infectious Disease Evandro Chagas, Oswaldo Cruz Foundation (FIOCRUZ), Rio de Janeiro, Brazil
| | - Luciana Gomes Pedro Brandão
- National Institute of Infectious Disease Evandro Chagas, Oswaldo Cruz Foundation (FIOCRUZ), Rio de Janeiro, Brazil
| | - Juliana Arruda de Matos
- National Institute of Infectious Disease Evandro Chagas, Oswaldo Cruz Foundation (FIOCRUZ), Rio de Janeiro, Brazil,National Institute of Traumatology and Orthopedics Jamil Haddad, Rio de Janeiro, Brazil
| | - Luiz Felipe Pinto
- School of Medicine, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Marcellus Dias da Costa
- National Institute of Infectious Disease Evandro Chagas, Oswaldo Cruz Foundation (FIOCRUZ), Rio de Janeiro, Brazil
| | | | - Daniel Soranz
- Municipal Health Department of Rio de Janeiro, Rio de Janeiro City Government, Rio de Janeiro, Brazil,National School of Public Health, Oswaldo Cruz Foundation (FIOCRUZ), Rio de Janeiro, Brazil
| | | | - Marco Aurélio Krieger
- Vice Presidency of Production and Innovation in Health (VPPIS), Oswaldo Cruz Foundation (FIOCRUZ), Rio de Janeiro, Brazil
| | - Rivaldo Venâncio da Cunha
- Coordination of Health Surveillance and Reference Laboratories, Oswaldo Cruz Foundation (FIOCRUZ), Rio de Janeiro, Brazil
| | | | - Otavio Ranzani
- Barcelona Institute for Global Health (ISGlobal), CIBER Epidemiología y Salud Pública, Universitat Pompeu Fabra, Barcelona, Spain,Pulmonary Division, Hospital das Clínicas (HCFMUSP), Heart Institute (InCor), Universidade de Sáo Paulo, Sáo Paulo, Brazil
| | - Silvio Hamacher
- Department of Industrial Engineering and Tecgraf Institute, Pontifical Catholic University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Fernando Augusto Bozza
- National Institute of Infectious Disease Evandro Chagas, Oswaldo Cruz Foundation (FIOCRUZ), Rio de Janeiro, Brazil,D'Or Institute for Research and Education, Rio de Janeiro, Brazil
| | - Gerson Oliveira Penna
- Tropical Medicine Centre - University of Brasília and Fiocruz School of Government, Brasília, Brazil
| |
Collapse
|
5
|
Fritsch H, Giovanetti M, Xavier J, Adelino TER, Fonseca V, de Jesus JG, de Jesus R, Freitas C, Peterka CRL, Campelo de Albuquerque CF, Bispo de Filippis AM, da Cunha RV, Silva EC, Alcantara LCJ, Iani FCDM. Retrospective Genomic Surveillance of Chikungunya Transmission in Minas Gerais State, Southeast Brazil. Microbiol Spectr 2022; 10:e0128522. [PMID: 36005767 PMCID: PMC9602355 DOI: 10.1128/spectrum.01285-22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Accepted: 07/13/2022] [Indexed: 12/30/2022] Open
Abstract
Brazil accounted for a total number of 1,276,194 reported cases of chikungunya fever between 2014 and 2022. Additionally, since 2015, the country has experienced an increasing death toll, in which the Northeast and Southeast regions appear to report the worst scenarios. Although the CHIKV transmission dynamics have been studied in many parts of the country since its introduction in 2014, little is still known about chikungunya virus (CHIKV) transmission and genetic diversity in the state of Minas Gerais, located in southeast Brazil. Moreover, no studies have been published characterizing CHIKV genomic surveillance in this state. Thus, to retrospectively explore the CHIKV epidemic in Minas Gerais, we generated 40 genomes from clinical samples using Nanopore sequencing. Phylogenetic analysis indicated that multiple introductions of CHIKV occurred, likely from the northeastern Brazilian states, with the most recent common ancestral strain dating to early March 2016, which is in agreement with local epidemiological reports. Additionally, epidemiological data reveals a decline in the number of reported cases from 2017 to 2021, indicating that population immunity or changes in vector activity may have contributed to the decreasing waves of CHIKV infection. Together, our results shed light on the dispersion dynamics of CHIKV and show that infections decreased from March 2017 to January 2021 despite multiple introductions into Minas Gerais State. In conclusion, our study highlights the importance of combining genomic and epidemiological data in order to assist public health laboratories in monitoring and understanding the patterns and diversity of mosquito-borne viral epidemics. IMPORTANCE Arbovirus infections in Brazil, including chikungunya, dengue, yellow fever, and Zika, result in considerable morbidity and mortality and are pressing public health concerns. However, our understanding of these outbreaks is hampered by the limited availability of genomic data. In this study, we combine epidemiological analysis and portable genome sequencing to retrospectively describe the CHIKV epidemic in Minas Gerais between 2017 and 2021. Our results indicate that the East/Central/South African (ECSA) CHIKV lineage was introduced into Minas Gerais by three distinct events, likely from the North and Northeast regions of Brazil. Our study provides an understanding of how CHIKV initiates transmission in the region and illustrates that genomics in the field can augment traditional approaches to infectious disease surveillance and control.
Collapse
Affiliation(s)
- Hegger Fritsch
- Laboratorio de Flavivírus, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
- Laboratório Central de Saúde Pública do Estado de Minas Gerais, Fundação Ezequiel Dias, Belo Horizonte, Minas Gerais, Brazil
| | - Marta Giovanetti
- Laboratorio de Flavivírus, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
- Department of Science and Technology for Humans and the Environment, Campus Bio-Medico University of Rome, Rome, Italy
| | - Joilson Xavier
- Laboratorio de Flavivírus, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
| | - Talita Emile Ribeiro Adelino
- Laboratório Central de Saúde Pública do Estado de Minas Gerais, Fundação Ezequiel Dias, Belo Horizonte, Minas Gerais, Brazil
| | - Vagner Fonseca
- Organização Pan-Americana da Saúde, Organização Mundial da Saúde, Brasília, Distrito Federal, Brazil
| | - Jaqueline Góes de Jesus
- Laboratório de Patologia Experimental, Instituto Gonçalo Moniz, Fundacão Oswaldo Cruz, Salvador, Brazil
| | - Ronaldo de Jesus
- Coordenação Geral dos Laboratórios de Saúde Pública, Secretaria de Vigilância em Saúde, Ministério da Saúde, Brasília, Distrito Federal, Brazil
| | - Carla Freitas
- Coordenação Geral dos Laboratórios de Saúde Pública, Secretaria de Vigilância em Saúde, Ministério da Saúde, Brasília, Distrito Federal, Brazil
| | - Cassio Roberto Leonel Peterka
- Coordenação Geral das Arboviroses, Secretaria de Vigilância em Saúde, Ministério da Saúde (CGARB/SVS-MS), Brasília, Distrito Federal, Brazil
| | | | | | | | - Erniria Carvalhais Silva
- Coordenadoria Estadual de Vigilância das Arboviroses, Secretaria de Estado de Saúde de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | | | - Felipe Campos de Melo Iani
- Laboratório Central de Saúde Pública do Estado de Minas Gerais, Fundação Ezequiel Dias, Belo Horizonte, Minas Gerais, Brazil
| |
Collapse
|
6
|
Fritsch H, Pereira FM, Costa EA, Fonseca V, Tosta S, Xavier J, Levy F, de Oliveira C, Menezes G, Lima J, Santos L, Silva L, Nardy V, Astete MKG, Santos BSÁDS, Aguiar NR, Guedes MIMC, de Faria GC, Furtini R, Drumond SRM, Cunha GM, Souza MSPL, de Jesus R, Guimarães SAF, Nuno IC, de Santana ICB, de Sá JEU, Santos GR, Silva WS, Guedes TF, Araújo ELL, Said RFDC, de Albuquerque CFC, Peterka CRL, Romano APM, da Cunha RV, de Filippis AMB, Leal e Silva de Mello A, Giovanetti M, Alcantara LCJ. Retrospective Investigation in Horses with Encephalitis Reveals Unnoticed Circulation of West Nile Virus in Brazil. Viruses 2022; 14:v14071540. [PMID: 35891521 PMCID: PMC9316658 DOI: 10.3390/v14071540] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2022] [Revised: 07/10/2022] [Accepted: 07/11/2022] [Indexed: 12/10/2022] Open
Abstract
During these past years, several studies have provided serological evidence regarding the circulation of West Nile virus (WNV) in Brazil. Despite some reports, much is still unknown regarding the genomic diversity and transmission dynamics of this virus in the country. Recently, genomic monitoring activities in horses revealed the circulation of WNV in several Brazilian regions. These findings on the paucity of genomic data reinforce the need for prompt investigation of WNV infection in horses, which may precede human cases of encephalitis in Brazil. Thus, in this study, we retrospectively screened 54 suspicious WNV samples collected between 2017 and 2020 from the spinal cord and brain of horses with encephalitis and generated three new WNV genomes from the Ceará and Bahia states, located in the northeastern region of Brazil. The Bayesian reconstruction revealed that at least two independent introduction events occurred in Brazil. The first introduction event appears to be likely related to the North American outbreak, and was estimated to have occurred in March 2013.The second introduction event appears to have occurred in September 2017 and appears to be likely related to the South American outbreak. Together, our results reinforce the importance of increasing the priority of WNV genomic monitoring in equines with encephalitis in order to track the dispersion of this emerging pathogen through the country.
Collapse
Affiliation(s)
- Hegger Fritsch
- Universidade Federal de Minas Gerais, Belo Horizonte 31270-901, Brazil; (H.F.); (E.A.C.); (S.T.); (J.X.); (B.S.Á.d.S.S.); (N.R.A.); (M.I.M.C.G.)
| | - Felicidade Mota Pereira
- Laboratório Central de Saúde Pública Prof Goncalo Moniz, Salvador 41745-900, Brazil; (F.M.P.); (G.M.); (J.L.); (L.S.); (L.S.); (V.N.); (M.K.G.A.); (S.A.F.G.); (I.C.N.); (I.C.B.d.S.); (J.E.U.d.S.); (G.R.S.); (W.S.S.)
| | - Erica Azevedo Costa
- Universidade Federal de Minas Gerais, Belo Horizonte 31270-901, Brazil; (H.F.); (E.A.C.); (S.T.); (J.X.); (B.S.Á.d.S.S.); (N.R.A.); (M.I.M.C.G.)
| | - Vagner Fonseca
- Organização Pan-Americana de Saúde/Organização Mundial de Saúde, Brasilia 37650-000, Brazil; (V.F.); (R.F.d.C.S.); (C.F.C.d.A.)
| | - Stephane Tosta
- Universidade Federal de Minas Gerais, Belo Horizonte 31270-901, Brazil; (H.F.); (E.A.C.); (S.T.); (J.X.); (B.S.Á.d.S.S.); (N.R.A.); (M.I.M.C.G.)
| | - Joilson Xavier
- Universidade Federal de Minas Gerais, Belo Horizonte 31270-901, Brazil; (H.F.); (E.A.C.); (S.T.); (J.X.); (B.S.Á.d.S.S.); (N.R.A.); (M.I.M.C.G.)
| | - Flavia Levy
- Laboratorio de Flavivirus, lnstituto Oswaldo Cruz/Fundação Oswaldo Cruz, Rio de Janeiro 21040-360, Brazil; (F.L.); (C.d.O.); (A.M.B.d.F.)
| | - Carla de Oliveira
- Laboratorio de Flavivirus, lnstituto Oswaldo Cruz/Fundação Oswaldo Cruz, Rio de Janeiro 21040-360, Brazil; (F.L.); (C.d.O.); (A.M.B.d.F.)
| | - Gabriela Menezes
- Laboratório Central de Saúde Pública Prof Goncalo Moniz, Salvador 41745-900, Brazil; (F.M.P.); (G.M.); (J.L.); (L.S.); (L.S.); (V.N.); (M.K.G.A.); (S.A.F.G.); (I.C.N.); (I.C.B.d.S.); (J.E.U.d.S.); (G.R.S.); (W.S.S.)
| | - Jaqueline Lima
- Laboratório Central de Saúde Pública Prof Goncalo Moniz, Salvador 41745-900, Brazil; (F.M.P.); (G.M.); (J.L.); (L.S.); (L.S.); (V.N.); (M.K.G.A.); (S.A.F.G.); (I.C.N.); (I.C.B.d.S.); (J.E.U.d.S.); (G.R.S.); (W.S.S.)
| | - Lenisa Santos
- Laboratório Central de Saúde Pública Prof Goncalo Moniz, Salvador 41745-900, Brazil; (F.M.P.); (G.M.); (J.L.); (L.S.); (L.S.); (V.N.); (M.K.G.A.); (S.A.F.G.); (I.C.N.); (I.C.B.d.S.); (J.E.U.d.S.); (G.R.S.); (W.S.S.)
| | - Luciana Silva
- Laboratório Central de Saúde Pública Prof Goncalo Moniz, Salvador 41745-900, Brazil; (F.M.P.); (G.M.); (J.L.); (L.S.); (L.S.); (V.N.); (M.K.G.A.); (S.A.F.G.); (I.C.N.); (I.C.B.d.S.); (J.E.U.d.S.); (G.R.S.); (W.S.S.)
| | - Vanessa Nardy
- Laboratório Central de Saúde Pública Prof Goncalo Moniz, Salvador 41745-900, Brazil; (F.M.P.); (G.M.); (J.L.); (L.S.); (L.S.); (V.N.); (M.K.G.A.); (S.A.F.G.); (I.C.N.); (I.C.B.d.S.); (J.E.U.d.S.); (G.R.S.); (W.S.S.)
| | - Marcela Kelly Gómez Astete
- Laboratório Central de Saúde Pública Prof Goncalo Moniz, Salvador 41745-900, Brazil; (F.M.P.); (G.M.); (J.L.); (L.S.); (L.S.); (V.N.); (M.K.G.A.); (S.A.F.G.); (I.C.N.); (I.C.B.d.S.); (J.E.U.d.S.); (G.R.S.); (W.S.S.)
| | | | - Nágila Rocha Aguiar
- Universidade Federal de Minas Gerais, Belo Horizonte 31270-901, Brazil; (H.F.); (E.A.C.); (S.T.); (J.X.); (B.S.Á.d.S.S.); (N.R.A.); (M.I.M.C.G.)
| | - Maria Isabel Maldonado Coelho Guedes
- Universidade Federal de Minas Gerais, Belo Horizonte 31270-901, Brazil; (H.F.); (E.A.C.); (S.T.); (J.X.); (B.S.Á.d.S.S.); (N.R.A.); (M.I.M.C.G.)
| | - Guilherme Canhestro de Faria
- Laboratório de Saúde Animal, Instituto Mineiro de Agropecuária, Belo Horizonte 30110-005, Brazil; (G.C.d.F.); (R.F.); (S.R.M.D.)
| | - Ronaldo Furtini
- Laboratório de Saúde Animal, Instituto Mineiro de Agropecuária, Belo Horizonte 30110-005, Brazil; (G.C.d.F.); (R.F.); (S.R.M.D.)
| | - Safira Rachel Milanez Drumond
- Laboratório de Saúde Animal, Instituto Mineiro de Agropecuária, Belo Horizonte 30110-005, Brazil; (G.C.d.F.); (R.F.); (S.R.M.D.)
| | - Gabriel Muricy Cunha
- Secretary of Health of the State of Bahia (SESAB), Salvador 40301-110, Brazil; (G.M.C.); (M.S.P.L.S.)
| | | | - Ronaldo de Jesus
- Coordenação Geral dos Laboratórios de Saúde Pública, Secretaria de Vigilância em Saúde-Brazil, Brasília 70719-040, Brazil; (R.d.J.); (T.F.G.); (E.L.L.A.)
| | - Sara A. Franco Guimarães
- Laboratório Central de Saúde Pública Prof Goncalo Moniz, Salvador 41745-900, Brazil; (F.M.P.); (G.M.); (J.L.); (L.S.); (L.S.); (V.N.); (M.K.G.A.); (S.A.F.G.); (I.C.N.); (I.C.B.d.S.); (J.E.U.d.S.); (G.R.S.); (W.S.S.)
| | - Italo Coelho Nuno
- Laboratório Central de Saúde Pública Prof Goncalo Moniz, Salvador 41745-900, Brazil; (F.M.P.); (G.M.); (J.L.); (L.S.); (L.S.); (V.N.); (M.K.G.A.); (S.A.F.G.); (I.C.N.); (I.C.B.d.S.); (J.E.U.d.S.); (G.R.S.); (W.S.S.)
| | - Ian Carlos Brito de Santana
- Laboratório Central de Saúde Pública Prof Goncalo Moniz, Salvador 41745-900, Brazil; (F.M.P.); (G.M.); (J.L.); (L.S.); (L.S.); (V.N.); (M.K.G.A.); (S.A.F.G.); (I.C.N.); (I.C.B.d.S.); (J.E.U.d.S.); (G.R.S.); (W.S.S.)
| | - José Eduardo Ungar de Sá
- Laboratório Central de Saúde Pública Prof Goncalo Moniz, Salvador 41745-900, Brazil; (F.M.P.); (G.M.); (J.L.); (L.S.); (L.S.); (V.N.); (M.K.G.A.); (S.A.F.G.); (I.C.N.); (I.C.B.d.S.); (J.E.U.d.S.); (G.R.S.); (W.S.S.)
| | - George Roma Santos
- Laboratório Central de Saúde Pública Prof Goncalo Moniz, Salvador 41745-900, Brazil; (F.M.P.); (G.M.); (J.L.); (L.S.); (L.S.); (V.N.); (M.K.G.A.); (S.A.F.G.); (I.C.N.); (I.C.B.d.S.); (J.E.U.d.S.); (G.R.S.); (W.S.S.)
| | - Willadesmon Santos Silva
- Laboratório Central de Saúde Pública Prof Goncalo Moniz, Salvador 41745-900, Brazil; (F.M.P.); (G.M.); (J.L.); (L.S.); (L.S.); (V.N.); (M.K.G.A.); (S.A.F.G.); (I.C.N.); (I.C.B.d.S.); (J.E.U.d.S.); (G.R.S.); (W.S.S.)
| | - Thiago Ferreira Guedes
- Coordenação Geral dos Laboratórios de Saúde Pública, Secretaria de Vigilância em Saúde-Brazil, Brasília 70719-040, Brazil; (R.d.J.); (T.F.G.); (E.L.L.A.)
| | - Emerson Luiz Lima Araújo
- Coordenação Geral dos Laboratórios de Saúde Pública, Secretaria de Vigilância em Saúde-Brazil, Brasília 70719-040, Brazil; (R.d.J.); (T.F.G.); (E.L.L.A.)
| | - Rodrigo Fabiano do Carmo Said
- Organização Pan-Americana de Saúde/Organização Mundial de Saúde, Brasilia 37650-000, Brazil; (V.F.); (R.F.d.C.S.); (C.F.C.d.A.)
| | | | - Cassio Roberto Leonel Peterka
- Coordenação Geral das Arboviroses, Secretaria de Vigilância em Saúde (CGARB/SVS-MS), Brasilia 37650-000, Brazil; (C.R.L.P.); (A.P.M.R.)
| | - Alessandro Pecego Martins Romano
- Coordenação Geral das Arboviroses, Secretaria de Vigilância em Saúde (CGARB/SVS-MS), Brasilia 37650-000, Brazil; (C.R.L.P.); (A.P.M.R.)
| | | | - Ana Maria Bispo de Filippis
- Laboratorio de Flavivirus, lnstituto Oswaldo Cruz/Fundação Oswaldo Cruz, Rio de Janeiro 21040-360, Brazil; (F.L.); (C.d.O.); (A.M.B.d.F.)
| | - Arabela Leal e Silva de Mello
- Laboratório Central de Saúde Pública Prof Goncalo Moniz, Salvador 41745-900, Brazil; (F.M.P.); (G.M.); (J.L.); (L.S.); (L.S.); (V.N.); (M.K.G.A.); (S.A.F.G.); (I.C.N.); (I.C.B.d.S.); (J.E.U.d.S.); (G.R.S.); (W.S.S.)
- Correspondence: (A.L.e.S.d.M.); (M.G.); (L.C.J.A.)
| | - Marta Giovanetti
- Laboratorio de Flavivirus, lnstituto Oswaldo Cruz/Fundação Oswaldo Cruz, Rio de Janeiro 21040-360, Brazil; (F.L.); (C.d.O.); (A.M.B.d.F.)
- Department of Science and Technology for Humans and the Environment, University of Campus Bio-Medico, 00128 Rome, Italy
- Correspondence: (A.L.e.S.d.M.); (M.G.); (L.C.J.A.)
| | - Luiz Carlos Junior Alcantara
- Laboratorio de Flavivirus, lnstituto Oswaldo Cruz/Fundação Oswaldo Cruz, Rio de Janeiro 21040-360, Brazil; (F.L.); (C.d.O.); (A.M.B.d.F.)
- Correspondence: (A.L.e.S.d.M.); (M.G.); (L.C.J.A.)
| |
Collapse
|
7
|
Demarchi LHF, Bandeira LM, Taira DL, Zardin MCSU, Ibanhes ML, Esposito AOP, de Arruda LDC, Gonçalves CCM, Weis-Torres SMDS, Cesar GA, da Cunha RV, Tanaka TSO, Puga MAM, de Rezende GR, Lopes RB, Uehara SNDO, Pinho JRR, Carrilho FJ, Gomes-Gouvêa MS, Motta-Castro ARC. Hepatitis B Virus Infection among Japanese Immigrants and Descendants: The Need to Strengthen Preventive and Control Measures. Viruses 2022; 14:v14051085. [PMID: 35632826 PMCID: PMC9145874 DOI: 10.3390/v14051085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Revised: 03/03/2022] [Accepted: 03/04/2022] [Indexed: 02/01/2023] Open
Abstract
This cross-sectional study aimed to investigate the prevalence and risk factors of Hepatitis B virus infection among Japanese immigrants and their descendants from São Paulo (SP), and to verify the occurrence of occult hepatitis B and coinfection with HCV, Delta, and HTLV. All samples (n = 2.127) were tested for HBV serological markers by electrochemiluminescence. HBsAg and/or total anti-HBc positive samples were tested for HBV DNA by real-time PCR, and genotyped by sequencing using the Sanger methodology. The prevalence rate of HBV exposure was 13.4% (CI 95%: 11.9–14.9%), and 22 (1.1%) were HBsAg positive. A high rate of susceptibility to HBV infection was found (67.4%; CI 95%: 65.4–69.4%). In contrast, only 19.2% (CI 95%: 17.6–20.9%) presented a serological profile analogous to that elicited by Hepatitis B vaccination. HBV isolates (n = 8) were classified as genotypes HBV/B1 (62.5%), HBV/C2 (12.5%), HBV/F1b (12.5%), and HBV/A1 (12.5%). Hepatitis B vaccination strategies and educational measures to control this infection should be considered.
Collapse
Affiliation(s)
- Luiz Henrique Ferraz Demarchi
- Laboratório Central de Saúde Pública de Mato Grosso do Sul/SES/MS, Campo Grande 79080-320, Brazil; (D.L.T.); (M.C.S.U.Z.); (M.L.I.); (A.O.P.E.)
- Correspondence: (L.H.F.D.); (L.M.B.); (A.R.C.M.-C.)
| | - Larissa Melo Bandeira
- Laboratory of Clinical Immunology, Federal University of Mato Grosso do Sul, Campo Grande 79070-900, Brazil; (S.M.d.S.W.-T.); (G.A.C.); (T.S.O.T.); (M.A.M.P.); (G.R.d.R.); (S.N.d.O.U.)
- Correspondence: (L.H.F.D.); (L.M.B.); (A.R.C.M.-C.)
| | - Deborah Ledesma Taira
- Laboratório Central de Saúde Pública de Mato Grosso do Sul/SES/MS, Campo Grande 79080-320, Brazil; (D.L.T.); (M.C.S.U.Z.); (M.L.I.); (A.O.P.E.)
| | - Marina Castilhos Souza Umaki Zardin
- Laboratório Central de Saúde Pública de Mato Grosso do Sul/SES/MS, Campo Grande 79080-320, Brazil; (D.L.T.); (M.C.S.U.Z.); (M.L.I.); (A.O.P.E.)
| | - Mary Luizia Ibanhes
- Laboratório Central de Saúde Pública de Mato Grosso do Sul/SES/MS, Campo Grande 79080-320, Brazil; (D.L.T.); (M.C.S.U.Z.); (M.L.I.); (A.O.P.E.)
| | - Ana Olivia Pascoto Esposito
- Laboratório Central de Saúde Pública de Mato Grosso do Sul/SES/MS, Campo Grande 79080-320, Brazil; (D.L.T.); (M.C.S.U.Z.); (M.L.I.); (A.O.P.E.)
| | | | | | - Sabrina Moreira dos Santos Weis-Torres
- Laboratory of Clinical Immunology, Federal University of Mato Grosso do Sul, Campo Grande 79070-900, Brazil; (S.M.d.S.W.-T.); (G.A.C.); (T.S.O.T.); (M.A.M.P.); (G.R.d.R.); (S.N.d.O.U.)
| | - Gabriela Alves Cesar
- Laboratory of Clinical Immunology, Federal University of Mato Grosso do Sul, Campo Grande 79070-900, Brazil; (S.M.d.S.W.-T.); (G.A.C.); (T.S.O.T.); (M.A.M.P.); (G.R.d.R.); (S.N.d.O.U.)
| | | | - Tayana Serpa Ortiz Tanaka
- Laboratory of Clinical Immunology, Federal University of Mato Grosso do Sul, Campo Grande 79070-900, Brazil; (S.M.d.S.W.-T.); (G.A.C.); (T.S.O.T.); (M.A.M.P.); (G.R.d.R.); (S.N.d.O.U.)
| | - Marco Antonio Moreira Puga
- Laboratory of Clinical Immunology, Federal University of Mato Grosso do Sul, Campo Grande 79070-900, Brazil; (S.M.d.S.W.-T.); (G.A.C.); (T.S.O.T.); (M.A.M.P.); (G.R.d.R.); (S.N.d.O.U.)
| | - Grazielli Rocha de Rezende
- Laboratory of Clinical Immunology, Federal University of Mato Grosso do Sul, Campo Grande 79070-900, Brazil; (S.M.d.S.W.-T.); (G.A.C.); (T.S.O.T.); (M.A.M.P.); (G.R.d.R.); (S.N.d.O.U.)
| | - Roberta Barbosa Lopes
- Secretaria Nacional de Vigilância em Saúde SVS, Ministério da Saúde, Brasília, Distrito Federal 70740-610, Brazil;
| | - Silvia Naomi de Oliveira Uehara
- Laboratory of Clinical Immunology, Federal University of Mato Grosso do Sul, Campo Grande 79070-900, Brazil; (S.M.d.S.W.-T.); (G.A.C.); (T.S.O.T.); (M.A.M.P.); (G.R.d.R.); (S.N.d.O.U.)
| | - João Renato Rebello Pinho
- Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo 05403-000, Brazil; (J.R.R.P.); (F.J.C.); (M.S.G.-G.)
| | - Flair Jose Carrilho
- Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo 05403-000, Brazil; (J.R.R.P.); (F.J.C.); (M.S.G.-G.)
| | - Michele Soares Gomes-Gouvêa
- Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo 05403-000, Brazil; (J.R.R.P.); (F.J.C.); (M.S.G.-G.)
| | - Ana Rita Coimbra Motta-Castro
- Laboratory of Clinical Immunology, Federal University of Mato Grosso do Sul, Campo Grande 79070-900, Brazil; (S.M.d.S.W.-T.); (G.A.C.); (T.S.O.T.); (M.A.M.P.); (G.R.d.R.); (S.N.d.O.U.)
- Fiocruz Mato Grosso do Sul, Fundação Oswaldo Cruz, Campo Grande 79081-746, Brazil
- Correspondence: (L.H.F.D.); (L.M.B.); (A.R.C.M.-C.)
| |
Collapse
|
8
|
López-Medina E, Biswal S, Saez-Llorens X, Borja-Tabora C, Bravo L, Sirivichayakul C, Vargas LM, Alera MT, Velásquez H, Reynales H, Rivera L, Watanaveeradej V, Rodriguez-Arenales EJ, Yu D, Espinoza F, Dietze R, Fernando LK, Wickramasinghe P, Duarte Moreira E, Fernando AD, Gunasekera D, Luz K, da Cunha RV, Tricou V, Rauscher M, Liu M, LeFevre I, Wallace D, Kosalaraksa P, Borkowski A. Efficacy of a Dengue Vaccine Candidate (TAK-003) in Healthy Children and Adolescents 2 Years after Vaccination. J Infect Dis 2022; 225:1521-1532. [PMID: 33319249 PMCID: PMC9071282 DOI: 10.1093/infdis/jiaa761] [Citation(s) in RCA: 34] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2020] [Accepted: 12/10/2020] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND Takeda's dengue vaccine is under evaluation in an ongoing phase 3 efficacy study; we present a 2-year update. METHODS Children (20 099, 4-16 years old) were randomized to receive 2 doses of TAK-003 or placebo 3 months apart and are under surveillance to detect dengue by serotype-specific RT-PCR. RESULTS Cumulative efficacy against dengue approximately 27 months since first dose was 72.7% (95% confidence interval [CI], 67.1%-77.3%), including 67.0% (95% CI, 53.6%-76.5%) in dengue-naive and 89.2% (95% CI, 82.4%-93.3%) against hospitalized dengue. In the second year, decline in efficacy was observed (56.2%; 95% CI, 42.3%-66.8%) with the largest decline in 4-5 year olds (24.5%; 95% CI, -34.2% to 57.5%); efficacy was 60.6% (95% CI, 43.8%-72.4%) in 6-11 year and 71.2% (95% CI, 41.0%-85.9%) in 12-16 year age groups. As TAK-003 efficacy varies by serotype, changes in serotype dominance partially contributed to efficacy differences in year-by-year analysis. No related serious adverse events occurred during the second year. CONCLUSIONS TAK-003 demonstrated continued benefit independent of baseline serostatus in reducing dengue with some decline in efficacy during the second year. Three-year data will be important to see if efficacy stabilizes or declines further.Clinical Trials Registration. NCT02747927.Takeda's tetravalent dengue vaccine (TAK-003) continued to demonstrate benefit in reducing dengue independent of baseline serostatus up to 2 years after completing vaccination with some decline in efficacy during the second year in 4-16 year olds in dengue-endemic countries.
Collapse
Affiliation(s)
- Eduardo López-Medina
- Centro de Estudios en Infectología Pediátrica, Universidad del Valle and Centro Médico Imbanaco, Cali, Colombia
| | | | - Xavier Saez-Llorens
- Hospital del Niño Dr José Renán Esquivel, Sistema Nacional de Investigación, Secretaria Nacional de Ciencia y Tecnologia, Centro de Vacunación Internacional, Panama City, Panama
| | | | - Lulu Bravo
- University of the Philippines Manila, Ermita, Philippines
| | - Chukiat Sirivichayakul
- Department of Tropical Pediatrics, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
| | - Luis Martinez Vargas
- Centro de Atención e Investigación Médica Dominicana, Santo Domingo, Dominican Republic
| | - Maria Theresa Alera
- Philippines-Armed Forces Research Institute of Medical Sciences Virology Research Unit, Cebu City, Philippines
| | | | | | - Luis Rivera
- Hospital Maternidad Nuestra Senora de Altagracia, Santo Domingo, Dominican Republic
| | | | | | - Delia Yu
- De La Salle Medical and Health Sciences Institute, Dasmariñas, Philippines
| | - Felix Espinoza
- National Autonomous University of Nicaragua, León, Nicaragua
| | - Reynaldo Dietze
- Universidade Federal Do Espirito Santo, Hospital Universitário Cassiano Antônio de Moraes, Vitória, Brazil
| | - Lak Kumar Fernando
- Centre for Clinical Management of Dengue and Dengue Haemorrhagic Fever, Negombo General Hospital, Negombo, Sri Lanka
| | | | - Edson Duarte Moreira
- Associação Obras Sociais Irmã Dulce Hospital Santo Antônio and Oswaldo Cruz Foundation, Bahia, Brazil
| | | | - Dulanie Gunasekera
- Faculty of Medical Sciences, University of Sri Jayawardenenpura, Nugegoda, Sri Lanka
| | - Kleber Luz
- Instituto de Medicina Tropical da Universidade Federal do Rio Grande do Norte, Natal, Brazil
| | | | - Vianney Tricou
- Takeda Pharmaceuticals International AG, Zurich, Switzerland
| | | | - Mengya Liu
- Takeda Vaccines, Inc., Boston, Massachusetts, USA
| | - Inge LeFevre
- Takeda Pharmaceuticals International AG, Zurich, Switzerland
| | | | | | | |
Collapse
|
9
|
Graeff SVB, Pícoli RP, Arantes R, Cunha RVD. [Evolution of HIV infection in indigenous peoples in Central Brazil]. CAD SAUDE PUBLICA 2021; 37:e00062920. [PMID: 34932617 DOI: 10.1590/0102-311x00062920] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Accepted: 06/07/2021] [Indexed: 11/22/2022] Open
Abstract
Distribution of the AIDS epidemic in Brazil is associated with a wide range of factors that determine different population groups' greater or lesser vulnerability. The study's objective was to analyze clinical and laboratory characteristics of HIV/AIDS in individuals 13 years or older and the evolution to death in the indigenous population assisted by the Special Indigenous Health District of the State of Mato Grosso do Sul, Brazil. A descriptive and retrospective study was performed on the clinical conditions and evolution of the disease from 2001 to 2014, based on three secondary databases. The study assessed time in progression to AIDS, time in progression to death, viral load, CD4+ T-lymphocyte count, and survival time. A total of 103 cases of HIV infection were identified, of which 48.5% progressed to AIDS, 60% in less than a year since diagnosis. Forty deaths were recorded, 77.5% of which due to HIV infection. Of those who died, only 30% had survived for more than a year. The study suggests that diagnosis of HIV infection occurred in advanced stages of the disease (i.e., late), and points to deficient diagnostic coverage. Rapid progression to death and short survival time are indicative of insufficient access to specialized health services, as well as disconnection and deficient collaboration between the Indigenous Health District, municipalities, and the state.
Collapse
Affiliation(s)
| | | | - Rui Arantes
- Fundação Oswaldo Cruz, Campo Grande, Brasil.,Escola Nacional de Saúde Pública Sergio Arouca, Fundação Oswaldo Cruz, Rio de Janeiro, Brasil
| | - Rivaldo Venâncio da Cunha
- Fundação Oswaldo Cruz, Campo Grande, Brasil.,Faculdade de Medicina, Universidade Federal de Mato Grosso do Sul, Campo Grande, Brasil
| |
Collapse
|
10
|
Rivera L, Biswal S, Sáez-Llorens X, Reynales H, López-Medina E, Borja-Tabora C, Bravo L, Sirivichayakul C, Kosalaraksa P, Martinez Vargas L, Yu D, Watanaveeradej V, Espinoza F, Dietze R, Fernando L, Wickramasinghe P, Duarte Moreira E, Fernando AD, Gunasekera D, Luz K, Venâncio da Cunha R, Rauscher M, Zent O, Liu M, Hoffman E, LeFevre I, Tricou V, Wallace D, Alera MT, Borkowski A. Three years efficacy and safety of Takeda's dengue vaccine candidate (TAK-003). Clin Infect Dis 2021; 75:107-117. [PMID: 34606595 PMCID: PMC9402653 DOI: 10.1093/cid/ciab864] [Citation(s) in RCA: 76] [Impact Index Per Article: 25.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Indexed: 11/13/2022] Open
Abstract
Background Takeda’s live attenuated tetravalent dengue vaccine candidate (TAK-003) is under evaluation in a long-term clinical trial across 8 dengue-endemic countries. Previously, we have reported its efficacy and safety in both seronegative and seropositive participants and that its performance varies by serotype, with some decline in efficacy from first to second year postvaccination. This exploratory analysis provides an update with cumulative and third-year data. Methods Healthy 4–16 year olds (n = 20099) were randomized 2:1 to receive TAK-003 or placebo (0, 3 month schedule). The protocol included baseline serostatus testing of all participants and detection of all symptomatic dengue throughout the trial with a serotype specific reverse transcriptase-polymerase chain reaction. Results Cumulative efficacy after 3 years was 62.0% (95% confidence interval, 56.6–66.7) against virologically confirmed dengue (VCD) and 83.6% (76.8–88.4) against hospitalized VCD. Efficacy was 54.3% (41.9–64.1) against VCD and 77.1% (58.6–87.3) against hospitalized VCD in baseline seronegatives, and 65.0% (58.9–70.1) against VCD and 86.0% (78.4–91.0) against hospitalized VCD in baseline seropositives. Efficacy against VCD during the third year declined to 44.7% (32.5–54.7), whereas efficacy against hospitalized VCD was sustained at 70.8% (49.6–83.0). Rates of serious adverse events were 2.9% in TAK-003 group and 3.5% in placebo group during the ongoing long-term follow-up (ie, second half of the 3 years following vaccination), but none were related. No important safety risks were identified. Conclusions TAK-003 was efficacious against symptomatic dengue over 3 years. Efficacy declined over time but remained robust against hospitalized dengue. A booster dose evaluation is planned.
Collapse
Affiliation(s)
- Luis Rivera
- Hospital Maternidad Nuestra Senora de Altagracia, Santo Domingo, Dominican Republic
| | | | - Xavier Sáez-Llorens
- Hospital del Niño Dr. José Renán Esquivel, Sistema Nacional de Investigación at SENACYT, Centro de Vacunación Internacional (Cevaxin), Panama City, Panama
| | | | - Eduardo López-Medina
- Centro de Estudios en Infectología Pediátrica, Universidad del Valle and Centro Medico Imbanaco, Cali, Colombia
| | | | - Lulu Bravo
- University of the Philippines Manila, Ermita, Philippines
| | - Chukiat Sirivichayakul
- Department of Tropical Pediatrics, Faculty of Tropical Medicine, Mahidol University, Thailand
| | | | | | - Delia Yu
- De La Salle Medical and Health Sciences Institute, Dasmariñas, Philippines
| | | | - Felix Espinoza
- National Autonomous University of Nicaragua, León, Nicaragua
| | - Reynaldo Dietze
- Núcleo de Doenças Infecciosas, Centro de Ciencias da Saude-UFES, Vitória, Brazil
| | - LakKumar Fernando
- Centre for Clinical Management of Dengue & Dengue Haemorrhagic Fever, Negombo General Hospital, Negombo, Sri Lanka
| | | | - Edson Duarte Moreira
- Associação Obras Sociais Irmã Dulce Hospital Santo Antônio and Oswaldo Cruz Foundation, Bahia, Brazil
| | | | - Dulanie Gunasekera
- Faculty of Medical Sciences, University of Sri Jayawardenenpura, Sri Lanka
| | - Kleber Luz
- Instituto de Medicina Tropical da Universidade Federal do Rio Grande do Norte, Brazil
| | | | | | - Olaf Zent
- Takeda Pharmaceuticals International AG., Zurich, Switzerland
| | | | | | - Inge LeFevre
- Takeda Pharmaceuticals International AG., Zurich, Switzerland
| | - Vianney Tricou
- Takeda Pharmaceuticals International AG., Zurich, Switzerland
| | | | - Maria Theresa Alera
- Philippines-Armed Forces Research Institute of Medical Sciences Virology Research Unit, Cebu City, Philippines
| | | | | |
Collapse
|
11
|
Costa ÉA, Giovanetti M, Silva Catenacci L, Fonseca V, Aburjaile FF, Chalhoub FLL, Xavier J, Campos de Melo Iani F, da Cunha e Silva Vieira MA, Freitas Henriques D, Medeiros DBDA, Guedes MIMC, Senra Álvares da Silva Santos B, Gonçalves Silva AS, de Pino Albuquerque Maranhão R, da Costa Faria NR, Farinelli de Siqueira R, de Oliveira T, Ribeiro Leite Jardim Cavalcante K, Oliveira de Moura NF, Pecego Martins Romano A, Campelo de Albuquerque CF, Soares Feitosa LC, Martins Bayeux JJ, Bertoni Cavalcanti Teixeira R, Lisboa Lobato O, da Costa Silva S, Bispo de Filippis AM, Venâncio da Cunha R, Lourenço J, Alcantara LCJ. West Nile Virus in Brazil. Pathogens 2021; 10:896. [PMID: 34358046 PMCID: PMC8308589 DOI: 10.3390/pathogens10070896] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Revised: 05/20/2021] [Accepted: 05/21/2021] [Indexed: 01/04/2023] Open
Abstract
Background: West Nile virus (WNV) was first sequenced in Brazil in 2019, when it was isolated from a horse in the Espírito Santo state. Despite multiple studies reporting serological evidence suggestive of past circulation since 2004, WNV remains a low priority for surveillance and public health, such that much is still unknown about its genomic diversity, evolution, and transmission in the country. Methods: A combination of diagnostic assays, nanopore sequencing, phylogenetic inference, and epidemiological modeling are here used to provide a holistic overview of what is known about WNV in Brazil. Results: We report new genetic evidence of WNV circulation in southern (Minas Gerais, São Paulo) and northeastern (Piauí) states isolated from equine red blood cells. A novel, climate-informed theoretical perspective of the potential transmission of WNV across the country highlights the state of Piauí as particularly relevant for WNV epidemiology in Brazil, although it does not reject possible circulation in other states. Conclusion: Our output demonstrates the scarceness of existing data, and that although there is sufficient evidence for the circulation and persistence of the virus, much is still unknown on its local evolution, epidemiology, and activity. We advocate for a shift to active surveillance, to ensure adequate preparedness for future epidemics with spill-over potential to humans.
Collapse
Affiliation(s)
- Érica Azevedo Costa
- Departamento de Medicina Veterinária Preventiva, Universidade Federal de Minas Gerais, Belo Horizonte 31270-901, Brazil; (É.A.C.); (M.I.M.C.G.); (B.S.Á.d.S.S.); (A.S.G.S.)
| | - Marta Giovanetti
- Laboratório de Flavivírus, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro 21040-360, Brazil; (M.G.); (F.L.L.C.); (N.R.d.C.F.); (A.M.B.d.F.)
- Laboratório de Genética Celular e Molecular, Universidade Federal de Minas Gerais, Belo Horizonte 31270-901, Brazil; (V.F.); (F.F.A.); (J.X.)
| | - Lilian Silva Catenacci
- Departamento De Morfofisiologia Veterinária, Universidade Federal do Piauí, Teresina 64049-550, Brazil;
| | - Vagner Fonseca
- Laboratório de Genética Celular e Molecular, Universidade Federal de Minas Gerais, Belo Horizonte 31270-901, Brazil; (V.F.); (F.F.A.); (J.X.)
- KwaZulu-Natal Research Innovation and Sequencing Platform (KRISP), School of Laboratory Medicine and Medical Sciences, College of Health Sciences, University of KwaZulu-Natal, Durban 4041, South Africa;
- Coordenação Geral dos Laboratórios de Saúde Pública/Secretaria de Vigilância em Saúde, Ministério da Saúde (CGLAB/SVS-MS), Brasília 70719-040, Brazil
| | - Flávia Figueira Aburjaile
- Laboratório de Genética Celular e Molecular, Universidade Federal de Minas Gerais, Belo Horizonte 31270-901, Brazil; (V.F.); (F.F.A.); (J.X.)
| | - Flávia L. L. Chalhoub
- Laboratório de Flavivírus, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro 21040-360, Brazil; (M.G.); (F.L.L.C.); (N.R.d.C.F.); (A.M.B.d.F.)
| | - Joilson Xavier
- Laboratório de Genética Celular e Molecular, Universidade Federal de Minas Gerais, Belo Horizonte 31270-901, Brazil; (V.F.); (F.F.A.); (J.X.)
| | | | | | - Danielle Freitas Henriques
- Seção de Arbovirologia e Febres Hemorrágicas, Instituto Evandro Chagas, Ministério da Saúde, Ananindeua 70058-900, Brazil; (D.F.H.); (D.B.d.A.M.)
| | - Daniele Barbosa de Almeida Medeiros
- Seção de Arbovirologia e Febres Hemorrágicas, Instituto Evandro Chagas, Ministério da Saúde, Ananindeua 70058-900, Brazil; (D.F.H.); (D.B.d.A.M.)
| | - Maria Isabel Maldonado Coelho Guedes
- Departamento de Medicina Veterinária Preventiva, Universidade Federal de Minas Gerais, Belo Horizonte 31270-901, Brazil; (É.A.C.); (M.I.M.C.G.); (B.S.Á.d.S.S.); (A.S.G.S.)
| | - Beatriz Senra Álvares da Silva Santos
- Departamento de Medicina Veterinária Preventiva, Universidade Federal de Minas Gerais, Belo Horizonte 31270-901, Brazil; (É.A.C.); (M.I.M.C.G.); (B.S.Á.d.S.S.); (A.S.G.S.)
| | - Aila Solimar Gonçalves Silva
- Departamento de Medicina Veterinária Preventiva, Universidade Federal de Minas Gerais, Belo Horizonte 31270-901, Brazil; (É.A.C.); (M.I.M.C.G.); (B.S.Á.d.S.S.); (A.S.G.S.)
| | - Renata de Pino Albuquerque Maranhão
- Setor de Clínica de Equinos, Hospital Veterinário, Campus Pampulha, Universidade Federal de Minas Gerais Escola de Veterinária, Belo Horizonte 31270-901, Brazil;
| | - Nieli Rodrigues da Costa Faria
- Laboratório de Flavivírus, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro 21040-360, Brazil; (M.G.); (F.L.L.C.); (N.R.d.C.F.); (A.M.B.d.F.)
| | | | - Tulio de Oliveira
- KwaZulu-Natal Research Innovation and Sequencing Platform (KRISP), School of Laboratory Medicine and Medical Sciences, College of Health Sciences, University of KwaZulu-Natal, Durban 4041, South Africa;
| | - Karina Ribeiro Leite Jardim Cavalcante
- Coordenacao Geral das Arboviroses, Secretaria de Vigilância em Saúde/Ministério da Saúde, Brasília 70058-900, Brazil; (K.R.L.J.C.); (N.F.O.d.M.); (A.P.M.R.)
| | - Noely Fabiana Oliveira de Moura
- Coordenacao Geral das Arboviroses, Secretaria de Vigilância em Saúde/Ministério da Saúde, Brasília 70058-900, Brazil; (K.R.L.J.C.); (N.F.O.d.M.); (A.P.M.R.)
| | - Alessandro Pecego Martins Romano
- Coordenacao Geral das Arboviroses, Secretaria de Vigilância em Saúde/Ministério da Saúde, Brasília 70058-900, Brazil; (K.R.L.J.C.); (N.F.O.d.M.); (A.P.M.R.)
| | | | - Lauro César Soares Feitosa
- Centro de Ciências Agrárias, Departamento de Clínica e Cirurgia Veterinária, Universidade Federal do Piauí, Teresina 64049-550, Brazil;
| | - José Joffre Martins Bayeux
- Faculdade de Ciências da Saúde, Medicina Veterinária, Urbanova, São José Dos Campos, UNIVAP-Universidade Vale do Paraíba, São Paulo 12245-720, Brazil;
| | | | - Osmaikon Lisboa Lobato
- Laboratório de Genética e Conservação de Germoplasma, Campus Prof. Cinobelina Elvas, Universidade Federal do Piauí, Bom Jesus, Piauí 64049-550, Brazil; (O.L.L.); (S.d.C.S.)
| | - Silvokleio da Costa Silva
- Laboratório de Genética e Conservação de Germoplasma, Campus Prof. Cinobelina Elvas, Universidade Federal do Piauí, Bom Jesus, Piauí 64049-550, Brazil; (O.L.L.); (S.d.C.S.)
| | - Ana Maria Bispo de Filippis
- Laboratório de Flavivírus, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro 21040-360, Brazil; (M.G.); (F.L.L.C.); (N.R.d.C.F.); (A.M.B.d.F.)
| | - Rivaldo Venâncio da Cunha
- Coordenacao dos Laboratorios de Referencia, Oswaldo Cruz Foundation, Rio de Janeiro 21040-360, Brazil;
| | - José Lourenço
- Department of Zoology, University of Oxford, Oxford OX1 3PS, UK;
| | - Luiz Carlos Junior Alcantara
- Laboratório de Flavivírus, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro 21040-360, Brazil; (M.G.); (F.L.L.C.); (N.R.d.C.F.); (A.M.B.d.F.)
- Laboratório de Genética Celular e Molecular, Universidade Federal de Minas Gerais, Belo Horizonte 31270-901, Brazil; (V.F.); (F.F.A.); (J.X.)
| |
Collapse
|
12
|
Adelino TÉR, Giovanetti M, Fonseca V, Xavier J, de Abreu ÁS, do Nascimento VA, Demarchi LHF, Oliveira MAA, da Silva VL, de Mello ALES, Cunha GM, Santos RH, de Oliveira EC, Júnior JAC, de Melo Iani FC, de Filippis AMB, de Abreu AL, de Jesus R, de Albuquerque CFC, Rico JM, do Carmo Said RF, Silva JA, de Moura NFO, Leite P, Frutuoso LCV, Haddad SK, Martínez A, Barreto FK, Vazquez CC, da Cunha RV, Araújo ELL, de Oliveira Tosta SF, de Araújo Fabri A, Chalhoub FLL, da Silva Lemos P, de Bruycker-Nogueira F, de Castro Lichs GG, Zardin MCSU, Segovia FMC, Gonçalves CCM, Grillo ZDCF, Slavov SN, Pereira LA, Mendonça AF, Pereira FM, de Magalhães JJF, Dos Santos Júnior ADCM, de Lima MM, Nogueira RMR, Góes-Neto A, de Carvalho Azevedo VA, Ramalho DB, Oliveira WK, Macario EM, de Medeiros AC, Pimentel V, Holmes EC, de Oliveira T, Lourenço J, Alcantara LCJ. Field and classroom initiatives for portable sequence-based monitoring of dengue virus in Brazil. Nat Commun 2021; 12:2296. [PMID: 33863880 PMCID: PMC8052316 DOI: 10.1038/s41467-021-22607-0] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2020] [Accepted: 03/17/2021] [Indexed: 12/17/2022] Open
Abstract
Brazil experienced a large dengue virus (DENV) epidemic in 2019, highlighting a continuous struggle with effective control and public health preparedness. Using Oxford Nanopore sequencing, we led field and classroom initiatives for the monitoring of DENV in Brazil, generating 227 novel genome sequences of DENV1-2 from 85 municipalities (2015-2019). This equated to an over 50% increase in the number of DENV genomes from Brazil available in public databases. Using both phylogenetic and epidemiological models we retrospectively reconstructed the recent transmission history of DENV1-2. Phylogenetic analysis revealed complex patterns of transmission, with both lineage co-circulation and replacement. We identified two lineages within the DENV2 BR-4 clade, for which we estimated the effective reproduction number and pattern of seasonality. Overall, the surveillance outputs and training initiative described here serve as a proof-of-concept for the utility of real-time portable sequencing for research and local capacity building in the genomic surveillance of emerging viruses.
Collapse
Affiliation(s)
- Talita Émile Ribeiro Adelino
- Laboratório Central de Saúde Pública do Estado de Minas Gerais, Fundação Ezequiel Dias, Belo Horizonte, Minas Gerais, Brazil
| | - Marta Giovanetti
- Laboratório de Flavivírus, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro, Rio de Janeiro, Brazil.
| | - Vagner Fonseca
- Laboratório de Flavivírus, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro, Rio de Janeiro, Brazil
| | - Joilson Xavier
- Laboratório de Flavivírus, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro, Rio de Janeiro, Brazil
| | - Álvaro Salgado de Abreu
- Laboratório de Flavivírus, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro, Rio de Janeiro, Brazil
| | - Valdinete Alves do Nascimento
- Laboratório de Ecologia de Doenças Transmissíveis na Amazônia, Instituto Leônidas e Maria Deane, Fiocruz, Manaus, Amazonas, Brazil
| | | | | | | | | | | | - Roselene Hans Santos
- Laboratório Central de Saúde Pública Dr. Milton Bezerra Sobral, Recife, Pernambuco, Brazil
| | | | | | - Felipe Campos de Melo Iani
- Laboratório Central de Saúde Pública do Estado de Minas Gerais, Fundação Ezequiel Dias, Belo Horizonte, Minas Gerais, Brazil
| | - Ana Maria Bispo de Filippis
- Laboratório de Flavivírus, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro, Rio de Janeiro, Brazil
| | - André Luiz de Abreu
- Coordenação Geral dos Laboratórios de Saúde Pública, Secretaria de Vigilância em Saúde, Ministério da Saúde, Brasília, Distrito Federal, Brazil
| | - Ronaldo de Jesus
- Coordenação Geral dos Laboratórios de Saúde Pública, Secretaria de Vigilância em Saúde, Ministério da Saúde, Brasília, Distrito Federal, Brazil
| | | | - Jairo Mendez Rico
- Organização Pan-Americana da Saúde/Organização Mundial da Saúde, Brasília, Distrito Federal, Brazil
| | | | - Joscélio Aguiar Silva
- Coordenação Geral das Arboviroses, Secretaria de Vigilância em Saúde/Ministério da Saúde, Brasília, Distrito Federal, Brazil
| | - Noely Fabiana Oliveira de Moura
- Coordenação Geral das Arboviroses, Secretaria de Vigilância em Saúde/Ministério da Saúde, Brasília, Distrito Federal, Brazil
| | - Priscila Leite
- Coordenação Geral das Arboviroses, Secretaria de Vigilância em Saúde/Ministério da Saúde, Brasília, Distrito Federal, Brazil
| | - Lívia Carla Vinhal Frutuoso
- Coordenação Geral das Arboviroses, Secretaria de Vigilância em Saúde/Ministério da Saúde, Brasília, Distrito Federal, Brazil
| | | | | | | | | | | | - Emerson Luiz Lima Araújo
- Coordenação Geral dos Laboratórios de Saúde Pública, Secretaria de Vigilância em Saúde, Ministério da Saúde, Brasília, Distrito Federal, Brazil
| | | | - Allison de Araújo Fabri
- Laboratório de Flavivírus, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro, Rio de Janeiro, Brazil
| | - Flávia Löwen Levy Chalhoub
- Laboratório de Flavivírus, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro, Rio de Janeiro, Brazil
| | | | | | | | | | | | | | | | | | - Luiz Augusto Pereira
- Laboratório Central de Saúde Pública Dr. Giovanni Cysneiros, Goiânia, Goiás, Brazil
| | - Ana Flávia Mendonça
- Laboratório Central de Saúde Pública Dr. Giovanni Cysneiros, Goiânia, Goiás, Brazil
| | | | | | | | | | - Rita Maria Ribeiro Nogueira
- Laboratório de Flavivírus, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro, Rio de Janeiro, Brazil
| | - Aristóteles Góes-Neto
- Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | | | - Dario Brock Ramalho
- Secretaria de Saúde do Estado de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | | | | | | | - Victor Pimentel
- Instituto de Higiene e Medicina Tropical, Universidade Nova de Lisboa, Lisboa, Portugal
| | - Edward C Holmes
- Marie Bashir Institute for Infectious Diseases and Biosecurity, School of Life and Environmental Sciences and School of Medical Sciences, University of Sydney, Sydney, NSW, Australia
| | - Tulio de Oliveira
- KwaZulu-Natal Research Innovation and Sequencing Platform (KRISP), College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa
| | - José Lourenço
- Department of Zoology, Peter Medawar Building, University of Oxford, Oxford, UK.
| | - Luiz Carlos Junior Alcantara
- Laboratório de Flavivírus, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro, Rio de Janeiro, Brazil.
| |
Collapse
|
13
|
Torres MC, Lima de Mendonça MC, Damasceno dos Santos Rodrigues C, Fonseca V, Ribeiro MS, Brandão AP, Venâncio da Cunha R, Dias AI, Santos Vilas Boas L, Felix AC, Alves Pereira M, de Oliveira Pinto LM, Sakuntabhai A, Bispo de Filippis AM. Dengue Virus Serotype 2 Intrahost Diversity in Patients with Different Clinical Outcomes. Viruses 2021; 13:v13020349. [PMID: 33672226 PMCID: PMC7926750 DOI: 10.3390/v13020349] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2020] [Revised: 02/07/2021] [Accepted: 02/13/2021] [Indexed: 02/07/2023] Open
Abstract
Intrahost genetic diversity is thought to facilitate arbovirus adaptation to changing environments and hosts, and it might also be linked to viral pathogenesis. Dengue virus serotype 2 (DENV-2) has circulated in Brazil since 1990 and is associated with severe disease and explosive outbreaks. Intending to shed light on the viral determinants for severe dengue pathogenesis, we sought to analyze the DENV-2 intrahost genetic diversity in 68 patient cases clinically classified as dengue fever (n = 31), dengue with warning signs (n = 19), and severe dengue (n = 18). Unlike previous DENV intrahost diversity studies whose approaches employed PCR, here we performed viral whole-genome deep sequencing from clinical samples with an amplicon-free approach, representing the real intrahost diversity scenario. Striking differences were detected in the viral population structure between the three clinical categories, which appear to be driven mainly by different infection times and selection pressures, rather than being linked with the clinical outcome itself. Diversity in the NS2B gene, however, showed to be constrained, irrespective of clinical outcome and infection time. Finally, 385 non-synonymous intrahost single-nucleotide variants located along the viral polyprotein, plus variants located in the untranslated regions, were consistently identified among the samples. Of them, 124 were exclusively or highly detected among cases with warning signs and among severe cases. However, there was no variant that by itself appeared to characterize the cases of greater severity, either due to its low intrahost frequency or the conservative effect on amino acid substitution. Although further studies are necessary to determine their real effect on viral proteins, this heightens the possibility of epistatic interactions. The present analysis represents an initial effort to correlate DENV-2 genetic diversity to its pathogenic potential and thus contribute to understanding the virus’s dynamics within its human host.
Collapse
Affiliation(s)
- Maria Celeste Torres
- Laboratório de Flavivírus, Instituto Oswaldo Cruz, Fiocruz, 21040-360 Rio de Janeiro, Brazil; (M.C.L.d.M.); (C.D.d.S.R.); (A.M.B.d.F.)
- Correspondence:
| | - Marcos Cesar Lima de Mendonça
- Laboratório de Flavivírus, Instituto Oswaldo Cruz, Fiocruz, 21040-360 Rio de Janeiro, Brazil; (M.C.L.d.M.); (C.D.d.S.R.); (A.M.B.d.F.)
| | | | - Vagner Fonseca
- KwaZulu-Natal Research Innovation and Sequencing Platform (KRISP), School of Laboratory Medicine and Medical Sciences, Nelson R Mandela School of Medicine, College of Health Sciences, University of KwaZulu-Natal, 4041 Durban, South Africa;
- Laboratório de Genética Celular e Molecular, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, 31270-901 Belo Horizonte, Brazil
- Coordenação Geral dos Laboratórios de Saúde Pública/Secretaria de Vigilância em Saúde, Ministério da Saúde, (CGLAB/SVS-MS) Brasília, 70719-040 Distrito Federal, Brazil
| | - Mario Sergio Ribeiro
- Superintendência Secretaria de Vigilância em Saúde do Estado do Rio de Janeiro, 20031-142 Rio de Janeiro, Brazil;
| | - Ana Paula Brandão
- Laboratório Central Noel Nutels/LACEN, 20231-092 Rio de Janeiro, Brazil;
| | - Rivaldo Venâncio da Cunha
- Coordenação de Vigilância em Saúde e Laboratórios de Referência da Fundação Oswaldo Cruz, FIOCRUZ, 21040-360 Rio de Janeiro, Brazil;
| | - Ana Isabel Dias
- Instituto de Medicina Tropical, Faculdade de Medicina, Universidade de São Paulo, 05403-000 São Paulo, Brazil; (A.I.D.); (L.S.V.B.); (A.C.F.)
| | - Lucy Santos Vilas Boas
- Instituto de Medicina Tropical, Faculdade de Medicina, Universidade de São Paulo, 05403-000 São Paulo, Brazil; (A.I.D.); (L.S.V.B.); (A.C.F.)
| | - Alvina Clara Felix
- Instituto de Medicina Tropical, Faculdade de Medicina, Universidade de São Paulo, 05403-000 São Paulo, Brazil; (A.I.D.); (L.S.V.B.); (A.C.F.)
| | | | | | - Anavaj Sakuntabhai
- Functional Genetics of Infectious Diseases, Department of Global Health, Institut Pasteur, 75015 Paris, France;
| | - Ana Maria Bispo de Filippis
- Laboratório de Flavivírus, Instituto Oswaldo Cruz, Fiocruz, 21040-360 Rio de Janeiro, Brazil; (M.C.L.d.M.); (C.D.d.S.R.); (A.M.B.d.F.)
| | - on behalf of ZikAction Consortium
- Laboratório de Flavivírus, Instituto Oswaldo Cruz, Fiocruz, 21040-360 Rio de Janeiro, Brazil; (M.C.L.d.M.); (C.D.d.S.R.); (A.M.B.d.F.)
| |
Collapse
|
14
|
Xavier J, Fonseca V, Bezerra JF, do Monte Alves M, Mares-Guia MA, Claro IM, de Jesus R, Adelino T, Araújo E, Cavalcante KRLJ, Tosta S, de Souza TR, Moreira da Cruz FE, de Araújo Fabri A, de Oliveira EC, de Moura NFO, do Carmo Said RF, de Albuquerque CFC, Azevedo V, de Oliveira T, de Filippis AMB, Venâncio da Cunha R, Luz KG, Giovanetti M, Alcantara LCJ. Chikungunya virus ECSA lineage reintroduction in the northeasternmost region of Brazil. Int J Infect Dis 2021; 105:120-123. [PMID: 33476757 DOI: 10.1016/j.ijid.2021.01.026] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2021] [Accepted: 01/13/2021] [Indexed: 12/16/2022] Open
Abstract
The Northeast region of Brazil registered the second-highest incidence proportion of Chikungunya fever in 2019. In that year, an outbreak consisting of patients presenting with febrile disease associated with joint pain was reported by the public primary health care service in the city of Natal, in the state of Rio Grande do Norte, in March 2019. At first, the aetiological agent of the disease was undetermined. Since much is still unknown about chikungunya virus' (CHIKV) genomic diversity and evolutionary history in this northeasternmost state, we used a combination of portable whole-genome sequencing, molecular clock, and epidemiological analyses that revealed the reintroduction of the CHIKV East-Central-South-African (ECSA) lineage into Rio Grande do Norte. We estimated that the CHIKV ECSA lineage was first introduced into Rio Grande do Norte in early June 2014, while the 2019 outbreak clade diverged around April 2018, during a period of increased Chikungunya incidence in the Southeast region, which might have acted as a source of virus dispersion towards the Northeast region. Together, these results confirm that the ECSA lineage continues to spread across the country through interregional importation events, likely mediated by human mobility.
Collapse
Affiliation(s)
- Joilson Xavier
- Laboratório de Genética Celular e Molecular, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Vagner Fonseca
- Laboratório de Genética Celular e Molecular, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil; Secretaria de Vigilância em Saúde, Ministério da Saúde, Brasília, Distrito Federal, Brazil; KwaZulu-Natal Research Innovation and Sequencing Platform (KRISP), University of KwaZuluNatal, Durban, South Africa
| | - Joao Felipe Bezerra
- Laboratório Central de Saúde Pública do Rio Grande do Norte Dr. Almino Fernandes, Natal, Brazil; Escola Técnica de Saúde, Universidade Federal da Paraíba, Brazil
| | | | | | - Ingra Morales Claro
- Instituto de Medicina Tropical e Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | - Ronaldo de Jesus
- Laboratório de Genética Celular e Molecular, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Talita Adelino
- Laboratório de Genética Celular e Molecular, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Emerson Araújo
- Secretaria de Vigilância em Saúde, Ministério da Saúde, Brasília, Distrito Federal, Brazil
| | | | - Stephane Tosta
- Laboratório de Genética Celular e Molecular, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | | | | | - Allison de Araújo Fabri
- Laboratório de Flavivírus, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
| | | | | | | | | | - Vasco Azevedo
- Laboratório de Genética Celular e Molecular, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Tulio de Oliveira
- KwaZulu-Natal Research Innovation and Sequencing Platform (KRISP), University of KwaZuluNatal, Durban, South Africa
| | | | | | - Kleber Giovanni Luz
- Departamento de Infectologia, Universidade Federal do Rio Grande do Norte, Natal, Brazil
| | - Marta Giovanetti
- Laboratório de Genética Celular e Molecular, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil; Laboratório de Flavivírus, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
| | - Luiz Carlos Junior Alcantara
- Laboratório de Genética Celular e Molecular, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil; Laboratório de Flavivírus, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil.
| |
Collapse
|
15
|
Brito CAAD, Freitas ARR, Said RF, Falcão MB, Cunha RVD, Siqueira AM, Teixeira MG, Ribeiro GS, Brito MCMD, Cavalcanti LPDG. Classification of chikungunya cases: a proposal. Rev Soc Bras Med Trop 2020; 53:e20200529. [PMID: 33263689 PMCID: PMC7723373 DOI: 10.1590/0037-8682-0529-2020] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Accepted: 09/29/2020] [Indexed: 12/28/2022] Open
Affiliation(s)
- Carlos Alexandre Antunes de Brito
- Universidade Federal de Pernambuco, Departamento de Medicina Clínica, Recife, PE, Brasil.,Instituto de Pesquisa Autoimune, Recife, PE, Brasil.,Ministério da Saúde do Brasil, Comitê Técnico de Arboviroses, Brasília, DF, Brasil
| | | | | | - Melissa Barreto Falcão
- Universidade Estadual de Feira de Santana, Núcleo de Pesquisa e Extensão em Vigilância à Saúde, Feira de Santana, BA, Brasil
| | - Rivaldo Venâncio da Cunha
- Fundação Oswaldo Cruz, Campo Grande, MS, Brasil.,Universidade Federal do Mato Grosso do Sul, Escola de Medicina, Campo Grande, MS, Brasil
| | - André Machado Siqueira
- Fundação Oswaldo Cruz, Instituto Nacional de Infectologia Evandro Chagas, Rio de Janeiro, RJ, Brasil
| | | | - Guilherme Sousa Ribeiro
- Universidade Federal da Bahia, Escola de Medicina, Salvador, BA, Brasil.,Fundação Oswaldo Cruz, Instituto Gonçalo Moniz, Salvador, BA, Brasil
| | - Marina Coelho Moraes de Brito
- Instituto de Pesquisa Autoimune, Recife, PE, Brasil.,Universidade Federal de Pernambuco, Centro de Ciências Médicas, Recife, PE, Brasil
| | | |
Collapse
|
16
|
de Brito CAA, Marques CDL, Falcão MB, da Cunha RV, Simon F, Valadares LDDA, Luz KG, Melo CFCDAE, Albuquerque DDO, de Brito MCM, Duarte ALBP. Update on the treatment of musculoskeletal manifestations in chikungunya fever: a guideline. Rev Soc Bras Med Trop 2020; 53:e20190517. [PMID: 32756797 PMCID: PMC7405653 DOI: 10.1590/0037-8682-0517-2019] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2019] [Accepted: 05/29/2020] [Indexed: 03/09/2023] Open
Abstract
Since the emergence of the chikungunya virus in Brazil in 2014, more than 700,000 cases have been reported throughout the country, corresponding to one-third of all cases reported in the Americas. In addition to its high attack rates, resulting in hundreds of thousands of cases, the disease has high chronicity rates with persistent joint manifestations for more than 3 months, which can spread to more than half of the patients affected in the acute phase. Pain associated with musculoskeletal manifestations, often disabling, has an effect on patients' quality of life at different stages of the disease. Currently, the challenge faced by specialists is identifying the best therapy to be instituted for symptom relief despite the limited number of published intervention studies. In 2016, a multidisciplinary group published pharmacological treatment protocols for pain in patients with chikungunya, which was incorporated into the guidelines for clinical management of the Brazilian Ministry of Health in 2017; in that same year, a consensus was published by the Brazilian Society of Rheumatology about diagnosis and treatment. After 5 years of experience with chikungunya epidemics, in 2019, specialists involved in the protocols of the Brazilian Society of Rheumatology and Brazilian Ministry of Health prepared an update with the main objective of developing flowcharts for the therapeutic approach of musculoskeletal manifestations in adult patients to enable specialists at different levels of healthcare to spread and apply this guideline in a systematic and simplified manner.
Collapse
Affiliation(s)
| | - Cláudia Diniz Lopes Marques
- Universidade Federal de Pernambuco, Departamento de Medicina
Clínica, Recife, PE, Brasil
- Universidade Federal de Pernambuco, Hospital das Clínicas, Serviço
de Reumatologia, Recife, PE, Brasil
| | - Melissa Barreto Falcão
- Universidade Estadual de Feira de Santana, Núcleo de Pesquisa e
Extensão em Vigilância da Saúde, Feira de Santana, BA, Brasil
| | | | - Fabrice Simon
- Unité des Virus Émergents, Aix-Marseille Uniy-IRD 190-Inserm
1207-IHU Méditerranée Infection, 13015 Marseille, France
| | | | - Kleber Giovanni Luz
- Universidade Federal do Rio Grande do Norte, Instituto de Medicina
Tropical, Natal, RN, Brasil
| | | | | | | | - Angela Luzia Branco Pinto Duarte
- Universidade Federal de Pernambuco, Departamento de Medicina
Clínica, Recife, PE, Brasil
- Universidade Federal de Pernambuco, Hospital das Clínicas, Serviço
de Reumatologia, Recife, PE, Brasil
| |
Collapse
|
17
|
de Moraes L, Cerqueira-Silva T, Nobrega V, Akrami K, Santos LA, Orge C, Casais P, Cambui L, Rampazzo RDCP, Trinta KS, Montalbano CA, Teixeira MJ, Cavalcante LP, Andrade BB, da Cunha RV, Krieger MA, Barral-Netto M, Barral A, Khouri R, Boaventura VS. A clinical scoring system to predict long-term arthralgia in Chikungunya disease: A cohort study. PLoS Negl Trop Dis 2020; 14:e0008467. [PMID: 32693402 PMCID: PMC7373495 DOI: 10.1371/journal.pntd.0008467] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2019] [Accepted: 06/09/2020] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Chikungunya virus (CHIKV) has caused worldwide epidemics that impose a major burden on health systems. Approximately half of infected individuals develop chronic debilitating arthralgia, affecting their quality of life. Here, we identified the relevant clinical and demographic variables in the acute phase of CHIKV infection prospectively linked to chronic arthralgia to elaborate a prognostic scoring system. METHODS Acute CHIKV infection cases (n = 134) confirmed by serology or molecular test were examined <10 days of disease onset and followed for one year to evaluate for disease progression. Potential risk factors for chronic arthralgia were evaluated by multivariate analysis to develop a prognostic scoring system, which was subsequently tested in an independent validation cohort consisting of 42 individuals. RESULTS A total of 107 out of 134 (80%) acute CHIKV-confirmed cases from the derivation cohort were re-examined one year after enrollment. Chronic arthralgia post-CHIKV infection was diagnosed in 64 (60%). Five of the 12 parameters evaluated in the acute phase were statistically associated with persistent arthralgia and were further tested by Bayesian analysis. These variables were weighted to yield a prognosis score denominated SHERA (Sex, Hypertension, Edema, Retroocular pain, Age), which exhibited 81.3% accuracy in predicting long-term arthralgia post-CHIKV infection in the derivation cohort, and 76.5% accuracy in the validation cohort. CONCLUSIONS The simplified and externally validated prognostic scoring system, SHERA, is a useful method to screen acutely CHIKV-infected patients at elevated risk of chronic arthralgia who will benefit from specific interventions. This tool could guide public health policies, particularly in resource-constrained settings.
Collapse
Affiliation(s)
- Laise de Moraes
- Instituto Gonçalo Moniz (IGM)—Fundação Oswaldo Cruz (Fiocruz) Bahia
- Faculdade de Medicina da Bahia—Universidade Federal da Bahia, Salvador-BA, Brazil
| | - Thiago Cerqueira-Silva
- Instituto Gonçalo Moniz (IGM)—Fundação Oswaldo Cruz (Fiocruz) Bahia
- Faculdade de Medicina da Bahia—Universidade Federal da Bahia, Salvador-BA, Brazil
| | - Victor Nobrega
- Instituto Gonçalo Moniz (IGM)—Fundação Oswaldo Cruz (Fiocruz) Bahia
- Faculdade de Medicina da Bahia—Universidade Federal da Bahia, Salvador-BA, Brazil
| | - Kevan Akrami
- Instituto Gonçalo Moniz (IGM)—Fundação Oswaldo Cruz (Fiocruz) Bahia
- University of California, San Diego, Division of Infectious Disease, Department of Medi- cine, San Diego, California, United States of America
| | | | - Cibele Orge
- Instituto Gonçalo Moniz (IGM)—Fundação Oswaldo Cruz (Fiocruz) Bahia
- Faculdade de Medicina da Bahia—Universidade Federal da Bahia, Salvador-BA, Brazil
| | - Paula Casais
- Instituto Gonçalo Moniz (IGM)—Fundação Oswaldo Cruz (Fiocruz) Bahia
- Faculdade de Medicina da Bahia—Universidade Federal da Bahia, Salvador-BA, Brazil
| | - Lais Cambui
- Instituto Gonçalo Moniz (IGM)—Fundação Oswaldo Cruz (Fiocruz) Bahia
- Faculdade de Medicina da Bahia—Universidade Federal da Bahia, Salvador-BA, Brazil
| | | | | | | | | | | | - Bruno B. Andrade
- Instituto Gonçalo Moniz (IGM)—Fundação Oswaldo Cruz (Fiocruz) Bahia
| | - Rivaldo Venâncio da Cunha
- Faculdade de Medicina, Universidade do Mato Grosso do Sul, Campo Grande- MS, Brazil
- Fiocruz, Campo Grande, MS, Brazil
| | - Marco Aurélio Krieger
- Instituto de Biologia Molecular do Paraná, Curitiba, PR, Brasil
- Instituto Carlos Chagas—ICC/Fiocruz, Curitiba-PR, Brazil
| | - Manoel Barral-Netto
- Instituto Gonçalo Moniz (IGM)—Fundação Oswaldo Cruz (Fiocruz) Bahia
- Faculdade de Medicina da Bahia—Universidade Federal da Bahia, Salvador-BA, Brazil
- Instituto Nacional de Ciência e Tecnologia de Investigação em Imunologia, São Paulo- SP, Brazil
| | - Aldina Barral
- Instituto Gonçalo Moniz (IGM)—Fundação Oswaldo Cruz (Fiocruz) Bahia
- Faculdade de Medicina da Bahia—Universidade Federal da Bahia, Salvador-BA, Brazil
- Instituto Nacional de Ciência e Tecnologia de Investigação em Imunologia, São Paulo- SP, Brazil
| | - Ricardo Khouri
- Instituto Gonçalo Moniz (IGM)—Fundação Oswaldo Cruz (Fiocruz) Bahia
- Faculdade de Medicina da Bahia—Universidade Federal da Bahia, Salvador-BA, Brazil
- Rega Institute for Medical Research, KU Leuven, Leuven, Belgium
| | - Viviane Sampaio Boaventura
- Instituto Gonçalo Moniz (IGM)—Fundação Oswaldo Cruz (Fiocruz) Bahia
- Faculdade de Medicina da Bahia—Universidade Federal da Bahia, Salvador-BA, Brazil
- Serviço de Otorrinolaringologia do Hospital Santa Izabel/Santa Casa de Misericórdia da Bahia (HIS/SCMBa), Salvador, Brazil
- * E-mail:
| |
Collapse
|
18
|
Goes de Jesus J, da Luz Wallau G, Lima Maia M, Xavier J, Oliveira Lima MA, Fonseca V, Salgado de Abreu A, Fraga de Oliveira Tosta S, Ramos do Amaral H, Andrade Barbosa Lima I, Viana Silva P, Carlos dos Santos D, Sousa de Oliveira A, Campos de Souza S, Barreto Falcão M, Cerqueira E, Ceschini Machado L, Sobral MC, Teodoro Rezende TM, Ribeiro Pereira M, Mota Pereira F, Pereira Gusmão Maia Z, Freitas de Oliveira França R, Luiz de Abreu A, Campelo de Albuquerque e Melo CF, Rodrigues Faria N, Venâncio da Cunha R, Giovanetti M, Alcantara LCJ. Persistence of chikungunya ECSA genotype and local outbreak in an upper medium class neighborhood in Northeast Brazil. PLoS One 2020; 15:e0226098. [PMID: 31914137 PMCID: PMC6948741 DOI: 10.1371/journal.pone.0226098] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2019] [Accepted: 11/18/2019] [Indexed: 12/29/2022] Open
Abstract
The chikungunya East/Central/South/Africa virus lineage (CHIKV-ECSA) was first detected in Brazil in the municipality of Feira de Santana (FS) by mid 2014. Following that, a large number of CHIKV cases have been notified in FS, which is the second-most populous city in Bahia state, northeastern Brazil, and plays an important role on the spread to other Brazilian states due to climate conditions and the abundance of competent vectors. To better understand CHIKV dynamics in Bahia state, we generated 5 complete genome sequences from a local outbreak raised in Serraria Brasil, a neighbourhood in FS, by next-generation sequencing using Illumina approach. Phylogenetic reconstructions revealed that the new FS genomes belongs to the ECSA genotype and falls within a single strongly supported monophyletic clade that includes other older CHIKV sequences from the same location, suggesting the persistence of the virus during distinct epidemic seasons. We also performed minor variants analysis and found a small number of SNPs per sample (b_29L and e_45SR = 16 SNPs, c_29SR = 29 and d_45PL and f_45FL = 21 SNPs). Out of the 93 SNPs found, 71 are synonymous, 21 are non-synonymous and one generated a stop codon. Although those mutations are not related to the increase of virus replication and/or infectivity, some SNPs were found in non-structural proteins which may have an effect on viral evasion from the mammal immunological system. These findings reinforce the needing of further studies on those variants and of continued genomic surveillance strategies to track viral adaptations and to monitor CHIKV epidemics for improved public health control.
Collapse
Affiliation(s)
- Jaqueline Goes de Jesus
- Laboratório de Patologia Experimental, Instituto Gonçalo Moniz, Fundação Oswaldo Cruz, Salvador, Brazil
| | - Gabriel da Luz Wallau
- Departamento de Entomologia, Instituto Aggeu Magalhães, Fundação Oswaldo Cruz, Recife, Brazil
| | - Maricelia Lima Maia
- Universidade Estadual de Feira de Santana, Feira de Santana, Brazil
- Secretaria de Saúde de Feira de Santana, Ministério da Saúde, Feira de Santana, Brazil
| | - Joilson Xavier
- Laboratório de Genética Celular e Molecular, ICB, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | | | - Vagner Fonseca
- Laboratório de Genética Celular e Molecular, ICB, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
- KwaZulu-Natal Research Innovation and Sequencing Platform (KRISP), College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa
| | - Alvaro Salgado de Abreu
- Laboratório de Genética Celular e Molecular, ICB, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | | | | | | | - Paloma Viana Silva
- Laboratório de Patologia Experimental, Instituto Gonçalo Moniz, Fundação Oswaldo Cruz, Salvador, Brazil
| | - Daiana Carlos dos Santos
- Laboratório de Patologia Experimental, Instituto Gonçalo Moniz, Fundação Oswaldo Cruz, Salvador, Brazil
| | - Aline Sousa de Oliveira
- Laboratório de Patologia Experimental, Instituto Gonçalo Moniz, Fundação Oswaldo Cruz, Salvador, Brazil
| | - Siane Campos de Souza
- Laboratório de Patologia Experimental, Instituto Gonçalo Moniz, Fundação Oswaldo Cruz, Salvador, Brazil
| | | | | | - Laís Ceschini Machado
- Departamento de Entomologia, Instituto Aggeu Magalhães, Fundação Oswaldo Cruz, Recife, Brazil
| | - Mariana Carolina Sobral
- Departamento de Entomologia, Instituto Aggeu Magalhães, Fundação Oswaldo Cruz, Recife, Brazil
| | | | - Mylena Ribeiro Pereira
- Departamento de Virologia, Instituto Aggeu Magalhaes, Fundação Oswaldo Cruz, Recife, Brazil
| | | | | | | | - André Luiz de Abreu
- Secretaria de Vigilância em Saúde, Coordenação Geral de Laboratórios de Saúde Pública, Ministério da Saúde, Brasília, Brazil
| | | | | | - Rivaldo Venâncio da Cunha
- Departamento de Clínica Médica, Faculdade de Medicina, Universidade Federal do Mato Grosso do Sul, Campo Grande, Brazil
- Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
| | - Marta Giovanetti
- Laboratório de Genética Celular e Molecular, ICB, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
- Laboratório de Flavivírus, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
| | - Luiz Carlos Junior Alcantara
- Laboratório de Genética Celular e Molecular, ICB, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
- Laboratório de Flavivírus, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
| |
Collapse
|
19
|
Biswal S, Reynales H, Saez-Llorens X, Lopez P, Borja-Tabora C, Kosalaraksa P, Sirivichayakul C, Watanaveeradej V, Rivera L, Espinoza F, Fernando L, Dietze R, Luz K, Venâncio da Cunha R, Jimeno J, López-Medina E, Borkowski A, Brose M, Rauscher M, LeFevre I, Bizjajeva S, Bravo L, Wallace D. Efficacy of a Tetravalent Dengue Vaccine in Healthy Children and Adolescents. N Engl J Med 2019; 381:2009-2019. [PMID: 31693803 DOI: 10.1056/nejmoa1903869] [Citation(s) in RCA: 179] [Impact Index Per Article: 35.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
BACKGROUND Dengue, a mosquito-borne viral disease, was designated a World Health Organization top 10 threat to global health in 2019. METHODS We present primary efficacy data from part 1 of an ongoing phase 3 randomized trial of a tetravalent dengue vaccine candidate (TAK-003) in regions of Asia and Latin America in which the disease is endemic. Healthy children and adolescents 4 to 16 years of age were randomly assigned in a 2:1 ratio (stratified according to age category and region) to receive two doses of vaccine or placebo 3 months apart. Participants presenting with febrile illness were tested for virologically confirmed dengue by serotype-specific reverse-transcriptase polymerase chain reaction. The primary end point was overall vaccine efficacy in preventing virologically confirmed dengue caused by any dengue virus serotype. RESULTS Of the 20,071 participants who were given at least one dose of vaccine or placebo (safety population), 19,021 (94.8%) received both injections and were included in the per-protocol analysis. The overall vaccine efficacy in the safety population was 80.9% (95% confidence interval [CI], 75.2 to 85.3; 78 cases per 13,380 [0.5 per 100 person-years] in the vaccine group vs. 199 cases per 6687 [2.5 per 100 person-years] in the placebo group). In the per-protocol analyses, vaccine efficacy was 80.2% (95% CI, 73.3 to 85.3; 61 cases of virologically confirmed dengue in the vaccine group vs. 149 cases in the placebo group), with 95.4% efficacy against dengue leading to hospitalization (95% CI, 88.4 to 98.2; 5 hospitalizations in the vaccine group vs. 53 hospitalizations in the placebo group). Planned exploratory analyses involving the 27.7% of the per-protocol population that was seronegative at baseline showed vaccine efficacy of 74.9% (95% CI, 57.0 to 85.4; 20 cases of virologically confirmed dengue in the vaccine group vs. 39 cases in the placebo group). Efficacy trends varied according to serotype. The incidence of serious adverse events was similar in the vaccine group and placebo group (3.1% and 3.8%, respectively). CONCLUSIONS TAK-003 was efficacious against symptomatic dengue in countries in which the disease is endemic. (Funded by Takeda Vaccines; TIDES ClinicalTrials.gov number, NCT02747927.).
Collapse
Affiliation(s)
- Shibadas Biswal
- From Takeda Vaccines, Singapore (S. Biswal); Centro de Atención e Investigación Médica, Bogota (H.R.), and Centro de Estudios en Infectología Pediatrica, Centro Médico Imbanaco and Department of Pediatrics, Universidad del Valle, Cali (P.L., E.L.-M.) - both in Colombia; the Department of Infectious Diseases at Hospital del Niño Dr. José Renán Esquivel, Sistema Nacional de Investigación at Secretaria Nacional de Ciencia y Tecnologia (SENACYT), Centro de Vacunación Internacional (Cevaxin), Panama City, Panama (X.S.-L., J.J.); the Research Institute for Tropical Medicine, Muntinlupa (C.B.-T.), and the University of the Philippines Manila, Ermita (L.B.) - both in the Philippines; Srinagarind Hospital, Khon Kaen University, Khon Kaen (P.K.), and the Department of Tropical Pediatrics, Faculty of Tropical Medicine, Mahidol University (C.S.), and Phramongkutklao Hospital (V.W.), Bangkok - all in Thailand; Hospital Maternidad Nuestra Senora de Altagracia, Santo Domingo, Dominican Republic (L.R.); National Autonomous University of Nicaragua, Leon (F.E.); Center for Clinical Management of Dengue and Dengue Haemorrhagic Fever, Negombo General Hospital, Negombo, Sri Lanka (L.K.F.); Universidade Federal Do Espirito Santo, Hospital Universitário Cassiano Antônio de Moraes, Vitória (R.D.), Instituto de Medicina Tropical da Universidade Federal do Rio Grande do Norte, Natal (K.L.), and Universidade Federal de Mato Grosso do Sul, Campo Grande (R.V.C.) - all in Brazil; Takeda Pharmaceuticals International, Zurich, Switzerland (A.B., M.B., M.R., I.L., S. Bizjajeva); and Takeda Vaccines, Boston (D.W.)
| | - Humberto Reynales
- From Takeda Vaccines, Singapore (S. Biswal); Centro de Atención e Investigación Médica, Bogota (H.R.), and Centro de Estudios en Infectología Pediatrica, Centro Médico Imbanaco and Department of Pediatrics, Universidad del Valle, Cali (P.L., E.L.-M.) - both in Colombia; the Department of Infectious Diseases at Hospital del Niño Dr. José Renán Esquivel, Sistema Nacional de Investigación at Secretaria Nacional de Ciencia y Tecnologia (SENACYT), Centro de Vacunación Internacional (Cevaxin), Panama City, Panama (X.S.-L., J.J.); the Research Institute for Tropical Medicine, Muntinlupa (C.B.-T.), and the University of the Philippines Manila, Ermita (L.B.) - both in the Philippines; Srinagarind Hospital, Khon Kaen University, Khon Kaen (P.K.), and the Department of Tropical Pediatrics, Faculty of Tropical Medicine, Mahidol University (C.S.), and Phramongkutklao Hospital (V.W.), Bangkok - all in Thailand; Hospital Maternidad Nuestra Senora de Altagracia, Santo Domingo, Dominican Republic (L.R.); National Autonomous University of Nicaragua, Leon (F.E.); Center for Clinical Management of Dengue and Dengue Haemorrhagic Fever, Negombo General Hospital, Negombo, Sri Lanka (L.K.F.); Universidade Federal Do Espirito Santo, Hospital Universitário Cassiano Antônio de Moraes, Vitória (R.D.), Instituto de Medicina Tropical da Universidade Federal do Rio Grande do Norte, Natal (K.L.), and Universidade Federal de Mato Grosso do Sul, Campo Grande (R.V.C.) - all in Brazil; Takeda Pharmaceuticals International, Zurich, Switzerland (A.B., M.B., M.R., I.L., S. Bizjajeva); and Takeda Vaccines, Boston (D.W.)
| | - Xavier Saez-Llorens
- From Takeda Vaccines, Singapore (S. Biswal); Centro de Atención e Investigación Médica, Bogota (H.R.), and Centro de Estudios en Infectología Pediatrica, Centro Médico Imbanaco and Department of Pediatrics, Universidad del Valle, Cali (P.L., E.L.-M.) - both in Colombia; the Department of Infectious Diseases at Hospital del Niño Dr. José Renán Esquivel, Sistema Nacional de Investigación at Secretaria Nacional de Ciencia y Tecnologia (SENACYT), Centro de Vacunación Internacional (Cevaxin), Panama City, Panama (X.S.-L., J.J.); the Research Institute for Tropical Medicine, Muntinlupa (C.B.-T.), and the University of the Philippines Manila, Ermita (L.B.) - both in the Philippines; Srinagarind Hospital, Khon Kaen University, Khon Kaen (P.K.), and the Department of Tropical Pediatrics, Faculty of Tropical Medicine, Mahidol University (C.S.), and Phramongkutklao Hospital (V.W.), Bangkok - all in Thailand; Hospital Maternidad Nuestra Senora de Altagracia, Santo Domingo, Dominican Republic (L.R.); National Autonomous University of Nicaragua, Leon (F.E.); Center for Clinical Management of Dengue and Dengue Haemorrhagic Fever, Negombo General Hospital, Negombo, Sri Lanka (L.K.F.); Universidade Federal Do Espirito Santo, Hospital Universitário Cassiano Antônio de Moraes, Vitória (R.D.), Instituto de Medicina Tropical da Universidade Federal do Rio Grande do Norte, Natal (K.L.), and Universidade Federal de Mato Grosso do Sul, Campo Grande (R.V.C.) - all in Brazil; Takeda Pharmaceuticals International, Zurich, Switzerland (A.B., M.B., M.R., I.L., S. Bizjajeva); and Takeda Vaccines, Boston (D.W.)
| | - Pio Lopez
- From Takeda Vaccines, Singapore (S. Biswal); Centro de Atención e Investigación Médica, Bogota (H.R.), and Centro de Estudios en Infectología Pediatrica, Centro Médico Imbanaco and Department of Pediatrics, Universidad del Valle, Cali (P.L., E.L.-M.) - both in Colombia; the Department of Infectious Diseases at Hospital del Niño Dr. José Renán Esquivel, Sistema Nacional de Investigación at Secretaria Nacional de Ciencia y Tecnologia (SENACYT), Centro de Vacunación Internacional (Cevaxin), Panama City, Panama (X.S.-L., J.J.); the Research Institute for Tropical Medicine, Muntinlupa (C.B.-T.), and the University of the Philippines Manila, Ermita (L.B.) - both in the Philippines; Srinagarind Hospital, Khon Kaen University, Khon Kaen (P.K.), and the Department of Tropical Pediatrics, Faculty of Tropical Medicine, Mahidol University (C.S.), and Phramongkutklao Hospital (V.W.), Bangkok - all in Thailand; Hospital Maternidad Nuestra Senora de Altagracia, Santo Domingo, Dominican Republic (L.R.); National Autonomous University of Nicaragua, Leon (F.E.); Center for Clinical Management of Dengue and Dengue Haemorrhagic Fever, Negombo General Hospital, Negombo, Sri Lanka (L.K.F.); Universidade Federal Do Espirito Santo, Hospital Universitário Cassiano Antônio de Moraes, Vitória (R.D.), Instituto de Medicina Tropical da Universidade Federal do Rio Grande do Norte, Natal (K.L.), and Universidade Federal de Mato Grosso do Sul, Campo Grande (R.V.C.) - all in Brazil; Takeda Pharmaceuticals International, Zurich, Switzerland (A.B., M.B., M.R., I.L., S. Bizjajeva); and Takeda Vaccines, Boston (D.W.)
| | - Charissa Borja-Tabora
- From Takeda Vaccines, Singapore (S. Biswal); Centro de Atención e Investigación Médica, Bogota (H.R.), and Centro de Estudios en Infectología Pediatrica, Centro Médico Imbanaco and Department of Pediatrics, Universidad del Valle, Cali (P.L., E.L.-M.) - both in Colombia; the Department of Infectious Diseases at Hospital del Niño Dr. José Renán Esquivel, Sistema Nacional de Investigación at Secretaria Nacional de Ciencia y Tecnologia (SENACYT), Centro de Vacunación Internacional (Cevaxin), Panama City, Panama (X.S.-L., J.J.); the Research Institute for Tropical Medicine, Muntinlupa (C.B.-T.), and the University of the Philippines Manila, Ermita (L.B.) - both in the Philippines; Srinagarind Hospital, Khon Kaen University, Khon Kaen (P.K.), and the Department of Tropical Pediatrics, Faculty of Tropical Medicine, Mahidol University (C.S.), and Phramongkutklao Hospital (V.W.), Bangkok - all in Thailand; Hospital Maternidad Nuestra Senora de Altagracia, Santo Domingo, Dominican Republic (L.R.); National Autonomous University of Nicaragua, Leon (F.E.); Center for Clinical Management of Dengue and Dengue Haemorrhagic Fever, Negombo General Hospital, Negombo, Sri Lanka (L.K.F.); Universidade Federal Do Espirito Santo, Hospital Universitário Cassiano Antônio de Moraes, Vitória (R.D.), Instituto de Medicina Tropical da Universidade Federal do Rio Grande do Norte, Natal (K.L.), and Universidade Federal de Mato Grosso do Sul, Campo Grande (R.V.C.) - all in Brazil; Takeda Pharmaceuticals International, Zurich, Switzerland (A.B., M.B., M.R., I.L., S. Bizjajeva); and Takeda Vaccines, Boston (D.W.)
| | - Pope Kosalaraksa
- From Takeda Vaccines, Singapore (S. Biswal); Centro de Atención e Investigación Médica, Bogota (H.R.), and Centro de Estudios en Infectología Pediatrica, Centro Médico Imbanaco and Department of Pediatrics, Universidad del Valle, Cali (P.L., E.L.-M.) - both in Colombia; the Department of Infectious Diseases at Hospital del Niño Dr. José Renán Esquivel, Sistema Nacional de Investigación at Secretaria Nacional de Ciencia y Tecnologia (SENACYT), Centro de Vacunación Internacional (Cevaxin), Panama City, Panama (X.S.-L., J.J.); the Research Institute for Tropical Medicine, Muntinlupa (C.B.-T.), and the University of the Philippines Manila, Ermita (L.B.) - both in the Philippines; Srinagarind Hospital, Khon Kaen University, Khon Kaen (P.K.), and the Department of Tropical Pediatrics, Faculty of Tropical Medicine, Mahidol University (C.S.), and Phramongkutklao Hospital (V.W.), Bangkok - all in Thailand; Hospital Maternidad Nuestra Senora de Altagracia, Santo Domingo, Dominican Republic (L.R.); National Autonomous University of Nicaragua, Leon (F.E.); Center for Clinical Management of Dengue and Dengue Haemorrhagic Fever, Negombo General Hospital, Negombo, Sri Lanka (L.K.F.); Universidade Federal Do Espirito Santo, Hospital Universitário Cassiano Antônio de Moraes, Vitória (R.D.), Instituto de Medicina Tropical da Universidade Federal do Rio Grande do Norte, Natal (K.L.), and Universidade Federal de Mato Grosso do Sul, Campo Grande (R.V.C.) - all in Brazil; Takeda Pharmaceuticals International, Zurich, Switzerland (A.B., M.B., M.R., I.L., S. Bizjajeva); and Takeda Vaccines, Boston (D.W.)
| | - Chukiat Sirivichayakul
- From Takeda Vaccines, Singapore (S. Biswal); Centro de Atención e Investigación Médica, Bogota (H.R.), and Centro de Estudios en Infectología Pediatrica, Centro Médico Imbanaco and Department of Pediatrics, Universidad del Valle, Cali (P.L., E.L.-M.) - both in Colombia; the Department of Infectious Diseases at Hospital del Niño Dr. José Renán Esquivel, Sistema Nacional de Investigación at Secretaria Nacional de Ciencia y Tecnologia (SENACYT), Centro de Vacunación Internacional (Cevaxin), Panama City, Panama (X.S.-L., J.J.); the Research Institute for Tropical Medicine, Muntinlupa (C.B.-T.), and the University of the Philippines Manila, Ermita (L.B.) - both in the Philippines; Srinagarind Hospital, Khon Kaen University, Khon Kaen (P.K.), and the Department of Tropical Pediatrics, Faculty of Tropical Medicine, Mahidol University (C.S.), and Phramongkutklao Hospital (V.W.), Bangkok - all in Thailand; Hospital Maternidad Nuestra Senora de Altagracia, Santo Domingo, Dominican Republic (L.R.); National Autonomous University of Nicaragua, Leon (F.E.); Center for Clinical Management of Dengue and Dengue Haemorrhagic Fever, Negombo General Hospital, Negombo, Sri Lanka (L.K.F.); Universidade Federal Do Espirito Santo, Hospital Universitário Cassiano Antônio de Moraes, Vitória (R.D.), Instituto de Medicina Tropical da Universidade Federal do Rio Grande do Norte, Natal (K.L.), and Universidade Federal de Mato Grosso do Sul, Campo Grande (R.V.C.) - all in Brazil; Takeda Pharmaceuticals International, Zurich, Switzerland (A.B., M.B., M.R., I.L., S. Bizjajeva); and Takeda Vaccines, Boston (D.W.)
| | - Veerachai Watanaveeradej
- From Takeda Vaccines, Singapore (S. Biswal); Centro de Atención e Investigación Médica, Bogota (H.R.), and Centro de Estudios en Infectología Pediatrica, Centro Médico Imbanaco and Department of Pediatrics, Universidad del Valle, Cali (P.L., E.L.-M.) - both in Colombia; the Department of Infectious Diseases at Hospital del Niño Dr. José Renán Esquivel, Sistema Nacional de Investigación at Secretaria Nacional de Ciencia y Tecnologia (SENACYT), Centro de Vacunación Internacional (Cevaxin), Panama City, Panama (X.S.-L., J.J.); the Research Institute for Tropical Medicine, Muntinlupa (C.B.-T.), and the University of the Philippines Manila, Ermita (L.B.) - both in the Philippines; Srinagarind Hospital, Khon Kaen University, Khon Kaen (P.K.), and the Department of Tropical Pediatrics, Faculty of Tropical Medicine, Mahidol University (C.S.), and Phramongkutklao Hospital (V.W.), Bangkok - all in Thailand; Hospital Maternidad Nuestra Senora de Altagracia, Santo Domingo, Dominican Republic (L.R.); National Autonomous University of Nicaragua, Leon (F.E.); Center for Clinical Management of Dengue and Dengue Haemorrhagic Fever, Negombo General Hospital, Negombo, Sri Lanka (L.K.F.); Universidade Federal Do Espirito Santo, Hospital Universitário Cassiano Antônio de Moraes, Vitória (R.D.), Instituto de Medicina Tropical da Universidade Federal do Rio Grande do Norte, Natal (K.L.), and Universidade Federal de Mato Grosso do Sul, Campo Grande (R.V.C.) - all in Brazil; Takeda Pharmaceuticals International, Zurich, Switzerland (A.B., M.B., M.R., I.L., S. Bizjajeva); and Takeda Vaccines, Boston (D.W.)
| | - Luis Rivera
- From Takeda Vaccines, Singapore (S. Biswal); Centro de Atención e Investigación Médica, Bogota (H.R.), and Centro de Estudios en Infectología Pediatrica, Centro Médico Imbanaco and Department of Pediatrics, Universidad del Valle, Cali (P.L., E.L.-M.) - both in Colombia; the Department of Infectious Diseases at Hospital del Niño Dr. José Renán Esquivel, Sistema Nacional de Investigación at Secretaria Nacional de Ciencia y Tecnologia (SENACYT), Centro de Vacunación Internacional (Cevaxin), Panama City, Panama (X.S.-L., J.J.); the Research Institute for Tropical Medicine, Muntinlupa (C.B.-T.), and the University of the Philippines Manila, Ermita (L.B.) - both in the Philippines; Srinagarind Hospital, Khon Kaen University, Khon Kaen (P.K.), and the Department of Tropical Pediatrics, Faculty of Tropical Medicine, Mahidol University (C.S.), and Phramongkutklao Hospital (V.W.), Bangkok - all in Thailand; Hospital Maternidad Nuestra Senora de Altagracia, Santo Domingo, Dominican Republic (L.R.); National Autonomous University of Nicaragua, Leon (F.E.); Center for Clinical Management of Dengue and Dengue Haemorrhagic Fever, Negombo General Hospital, Negombo, Sri Lanka (L.K.F.); Universidade Federal Do Espirito Santo, Hospital Universitário Cassiano Antônio de Moraes, Vitória (R.D.), Instituto de Medicina Tropical da Universidade Federal do Rio Grande do Norte, Natal (K.L.), and Universidade Federal de Mato Grosso do Sul, Campo Grande (R.V.C.) - all in Brazil; Takeda Pharmaceuticals International, Zurich, Switzerland (A.B., M.B., M.R., I.L., S. Bizjajeva); and Takeda Vaccines, Boston (D.W.)
| | - Felix Espinoza
- From Takeda Vaccines, Singapore (S. Biswal); Centro de Atención e Investigación Médica, Bogota (H.R.), and Centro de Estudios en Infectología Pediatrica, Centro Médico Imbanaco and Department of Pediatrics, Universidad del Valle, Cali (P.L., E.L.-M.) - both in Colombia; the Department of Infectious Diseases at Hospital del Niño Dr. José Renán Esquivel, Sistema Nacional de Investigación at Secretaria Nacional de Ciencia y Tecnologia (SENACYT), Centro de Vacunación Internacional (Cevaxin), Panama City, Panama (X.S.-L., J.J.); the Research Institute for Tropical Medicine, Muntinlupa (C.B.-T.), and the University of the Philippines Manila, Ermita (L.B.) - both in the Philippines; Srinagarind Hospital, Khon Kaen University, Khon Kaen (P.K.), and the Department of Tropical Pediatrics, Faculty of Tropical Medicine, Mahidol University (C.S.), and Phramongkutklao Hospital (V.W.), Bangkok - all in Thailand; Hospital Maternidad Nuestra Senora de Altagracia, Santo Domingo, Dominican Republic (L.R.); National Autonomous University of Nicaragua, Leon (F.E.); Center for Clinical Management of Dengue and Dengue Haemorrhagic Fever, Negombo General Hospital, Negombo, Sri Lanka (L.K.F.); Universidade Federal Do Espirito Santo, Hospital Universitário Cassiano Antônio de Moraes, Vitória (R.D.), Instituto de Medicina Tropical da Universidade Federal do Rio Grande do Norte, Natal (K.L.), and Universidade Federal de Mato Grosso do Sul, Campo Grande (R.V.C.) - all in Brazil; Takeda Pharmaceuticals International, Zurich, Switzerland (A.B., M.B., M.R., I.L., S. Bizjajeva); and Takeda Vaccines, Boston (D.W.)
| | - LakKumar Fernando
- From Takeda Vaccines, Singapore (S. Biswal); Centro de Atención e Investigación Médica, Bogota (H.R.), and Centro de Estudios en Infectología Pediatrica, Centro Médico Imbanaco and Department of Pediatrics, Universidad del Valle, Cali (P.L., E.L.-M.) - both in Colombia; the Department of Infectious Diseases at Hospital del Niño Dr. José Renán Esquivel, Sistema Nacional de Investigación at Secretaria Nacional de Ciencia y Tecnologia (SENACYT), Centro de Vacunación Internacional (Cevaxin), Panama City, Panama (X.S.-L., J.J.); the Research Institute for Tropical Medicine, Muntinlupa (C.B.-T.), and the University of the Philippines Manila, Ermita (L.B.) - both in the Philippines; Srinagarind Hospital, Khon Kaen University, Khon Kaen (P.K.), and the Department of Tropical Pediatrics, Faculty of Tropical Medicine, Mahidol University (C.S.), and Phramongkutklao Hospital (V.W.), Bangkok - all in Thailand; Hospital Maternidad Nuestra Senora de Altagracia, Santo Domingo, Dominican Republic (L.R.); National Autonomous University of Nicaragua, Leon (F.E.); Center for Clinical Management of Dengue and Dengue Haemorrhagic Fever, Negombo General Hospital, Negombo, Sri Lanka (L.K.F.); Universidade Federal Do Espirito Santo, Hospital Universitário Cassiano Antônio de Moraes, Vitória (R.D.), Instituto de Medicina Tropical da Universidade Federal do Rio Grande do Norte, Natal (K.L.), and Universidade Federal de Mato Grosso do Sul, Campo Grande (R.V.C.) - all in Brazil; Takeda Pharmaceuticals International, Zurich, Switzerland (A.B., M.B., M.R., I.L., S. Bizjajeva); and Takeda Vaccines, Boston (D.W.)
| | - Reynaldo Dietze
- From Takeda Vaccines, Singapore (S. Biswal); Centro de Atención e Investigación Médica, Bogota (H.R.), and Centro de Estudios en Infectología Pediatrica, Centro Médico Imbanaco and Department of Pediatrics, Universidad del Valle, Cali (P.L., E.L.-M.) - both in Colombia; the Department of Infectious Diseases at Hospital del Niño Dr. José Renán Esquivel, Sistema Nacional de Investigación at Secretaria Nacional de Ciencia y Tecnologia (SENACYT), Centro de Vacunación Internacional (Cevaxin), Panama City, Panama (X.S.-L., J.J.); the Research Institute for Tropical Medicine, Muntinlupa (C.B.-T.), and the University of the Philippines Manila, Ermita (L.B.) - both in the Philippines; Srinagarind Hospital, Khon Kaen University, Khon Kaen (P.K.), and the Department of Tropical Pediatrics, Faculty of Tropical Medicine, Mahidol University (C.S.), and Phramongkutklao Hospital (V.W.), Bangkok - all in Thailand; Hospital Maternidad Nuestra Senora de Altagracia, Santo Domingo, Dominican Republic (L.R.); National Autonomous University of Nicaragua, Leon (F.E.); Center for Clinical Management of Dengue and Dengue Haemorrhagic Fever, Negombo General Hospital, Negombo, Sri Lanka (L.K.F.); Universidade Federal Do Espirito Santo, Hospital Universitário Cassiano Antônio de Moraes, Vitória (R.D.), Instituto de Medicina Tropical da Universidade Federal do Rio Grande do Norte, Natal (K.L.), and Universidade Federal de Mato Grosso do Sul, Campo Grande (R.V.C.) - all in Brazil; Takeda Pharmaceuticals International, Zurich, Switzerland (A.B., M.B., M.R., I.L., S. Bizjajeva); and Takeda Vaccines, Boston (D.W.)
| | - Kleber Luz
- From Takeda Vaccines, Singapore (S. Biswal); Centro de Atención e Investigación Médica, Bogota (H.R.), and Centro de Estudios en Infectología Pediatrica, Centro Médico Imbanaco and Department of Pediatrics, Universidad del Valle, Cali (P.L., E.L.-M.) - both in Colombia; the Department of Infectious Diseases at Hospital del Niño Dr. José Renán Esquivel, Sistema Nacional de Investigación at Secretaria Nacional de Ciencia y Tecnologia (SENACYT), Centro de Vacunación Internacional (Cevaxin), Panama City, Panama (X.S.-L., J.J.); the Research Institute for Tropical Medicine, Muntinlupa (C.B.-T.), and the University of the Philippines Manila, Ermita (L.B.) - both in the Philippines; Srinagarind Hospital, Khon Kaen University, Khon Kaen (P.K.), and the Department of Tropical Pediatrics, Faculty of Tropical Medicine, Mahidol University (C.S.), and Phramongkutklao Hospital (V.W.), Bangkok - all in Thailand; Hospital Maternidad Nuestra Senora de Altagracia, Santo Domingo, Dominican Republic (L.R.); National Autonomous University of Nicaragua, Leon (F.E.); Center for Clinical Management of Dengue and Dengue Haemorrhagic Fever, Negombo General Hospital, Negombo, Sri Lanka (L.K.F.); Universidade Federal Do Espirito Santo, Hospital Universitário Cassiano Antônio de Moraes, Vitória (R.D.), Instituto de Medicina Tropical da Universidade Federal do Rio Grande do Norte, Natal (K.L.), and Universidade Federal de Mato Grosso do Sul, Campo Grande (R.V.C.) - all in Brazil; Takeda Pharmaceuticals International, Zurich, Switzerland (A.B., M.B., M.R., I.L., S. Bizjajeva); and Takeda Vaccines, Boston (D.W.)
| | - Rivaldo Venâncio da Cunha
- From Takeda Vaccines, Singapore (S. Biswal); Centro de Atención e Investigación Médica, Bogota (H.R.), and Centro de Estudios en Infectología Pediatrica, Centro Médico Imbanaco and Department of Pediatrics, Universidad del Valle, Cali (P.L., E.L.-M.) - both in Colombia; the Department of Infectious Diseases at Hospital del Niño Dr. José Renán Esquivel, Sistema Nacional de Investigación at Secretaria Nacional de Ciencia y Tecnologia (SENACYT), Centro de Vacunación Internacional (Cevaxin), Panama City, Panama (X.S.-L., J.J.); the Research Institute for Tropical Medicine, Muntinlupa (C.B.-T.), and the University of the Philippines Manila, Ermita (L.B.) - both in the Philippines; Srinagarind Hospital, Khon Kaen University, Khon Kaen (P.K.), and the Department of Tropical Pediatrics, Faculty of Tropical Medicine, Mahidol University (C.S.), and Phramongkutklao Hospital (V.W.), Bangkok - all in Thailand; Hospital Maternidad Nuestra Senora de Altagracia, Santo Domingo, Dominican Republic (L.R.); National Autonomous University of Nicaragua, Leon (F.E.); Center for Clinical Management of Dengue and Dengue Haemorrhagic Fever, Negombo General Hospital, Negombo, Sri Lanka (L.K.F.); Universidade Federal Do Espirito Santo, Hospital Universitário Cassiano Antônio de Moraes, Vitória (R.D.), Instituto de Medicina Tropical da Universidade Federal do Rio Grande do Norte, Natal (K.L.), and Universidade Federal de Mato Grosso do Sul, Campo Grande (R.V.C.) - all in Brazil; Takeda Pharmaceuticals International, Zurich, Switzerland (A.B., M.B., M.R., I.L., S. Bizjajeva); and Takeda Vaccines, Boston (D.W.)
| | - José Jimeno
- From Takeda Vaccines, Singapore (S. Biswal); Centro de Atención e Investigación Médica, Bogota (H.R.), and Centro de Estudios en Infectología Pediatrica, Centro Médico Imbanaco and Department of Pediatrics, Universidad del Valle, Cali (P.L., E.L.-M.) - both in Colombia; the Department of Infectious Diseases at Hospital del Niño Dr. José Renán Esquivel, Sistema Nacional de Investigación at Secretaria Nacional de Ciencia y Tecnologia (SENACYT), Centro de Vacunación Internacional (Cevaxin), Panama City, Panama (X.S.-L., J.J.); the Research Institute for Tropical Medicine, Muntinlupa (C.B.-T.), and the University of the Philippines Manila, Ermita (L.B.) - both in the Philippines; Srinagarind Hospital, Khon Kaen University, Khon Kaen (P.K.), and the Department of Tropical Pediatrics, Faculty of Tropical Medicine, Mahidol University (C.S.), and Phramongkutklao Hospital (V.W.), Bangkok - all in Thailand; Hospital Maternidad Nuestra Senora de Altagracia, Santo Domingo, Dominican Republic (L.R.); National Autonomous University of Nicaragua, Leon (F.E.); Center for Clinical Management of Dengue and Dengue Haemorrhagic Fever, Negombo General Hospital, Negombo, Sri Lanka (L.K.F.); Universidade Federal Do Espirito Santo, Hospital Universitário Cassiano Antônio de Moraes, Vitória (R.D.), Instituto de Medicina Tropical da Universidade Federal do Rio Grande do Norte, Natal (K.L.), and Universidade Federal de Mato Grosso do Sul, Campo Grande (R.V.C.) - all in Brazil; Takeda Pharmaceuticals International, Zurich, Switzerland (A.B., M.B., M.R., I.L., S. Bizjajeva); and Takeda Vaccines, Boston (D.W.)
| | - Eduardo López-Medina
- From Takeda Vaccines, Singapore (S. Biswal); Centro de Atención e Investigación Médica, Bogota (H.R.), and Centro de Estudios en Infectología Pediatrica, Centro Médico Imbanaco and Department of Pediatrics, Universidad del Valle, Cali (P.L., E.L.-M.) - both in Colombia; the Department of Infectious Diseases at Hospital del Niño Dr. José Renán Esquivel, Sistema Nacional de Investigación at Secretaria Nacional de Ciencia y Tecnologia (SENACYT), Centro de Vacunación Internacional (Cevaxin), Panama City, Panama (X.S.-L., J.J.); the Research Institute for Tropical Medicine, Muntinlupa (C.B.-T.), and the University of the Philippines Manila, Ermita (L.B.) - both in the Philippines; Srinagarind Hospital, Khon Kaen University, Khon Kaen (P.K.), and the Department of Tropical Pediatrics, Faculty of Tropical Medicine, Mahidol University (C.S.), and Phramongkutklao Hospital (V.W.), Bangkok - all in Thailand; Hospital Maternidad Nuestra Senora de Altagracia, Santo Domingo, Dominican Republic (L.R.); National Autonomous University of Nicaragua, Leon (F.E.); Center for Clinical Management of Dengue and Dengue Haemorrhagic Fever, Negombo General Hospital, Negombo, Sri Lanka (L.K.F.); Universidade Federal Do Espirito Santo, Hospital Universitário Cassiano Antônio de Moraes, Vitória (R.D.), Instituto de Medicina Tropical da Universidade Federal do Rio Grande do Norte, Natal (K.L.), and Universidade Federal de Mato Grosso do Sul, Campo Grande (R.V.C.) - all in Brazil; Takeda Pharmaceuticals International, Zurich, Switzerland (A.B., M.B., M.R., I.L., S. Bizjajeva); and Takeda Vaccines, Boston (D.W.)
| | - Astrid Borkowski
- From Takeda Vaccines, Singapore (S. Biswal); Centro de Atención e Investigación Médica, Bogota (H.R.), and Centro de Estudios en Infectología Pediatrica, Centro Médico Imbanaco and Department of Pediatrics, Universidad del Valle, Cali (P.L., E.L.-M.) - both in Colombia; the Department of Infectious Diseases at Hospital del Niño Dr. José Renán Esquivel, Sistema Nacional de Investigación at Secretaria Nacional de Ciencia y Tecnologia (SENACYT), Centro de Vacunación Internacional (Cevaxin), Panama City, Panama (X.S.-L., J.J.); the Research Institute for Tropical Medicine, Muntinlupa (C.B.-T.), and the University of the Philippines Manila, Ermita (L.B.) - both in the Philippines; Srinagarind Hospital, Khon Kaen University, Khon Kaen (P.K.), and the Department of Tropical Pediatrics, Faculty of Tropical Medicine, Mahidol University (C.S.), and Phramongkutklao Hospital (V.W.), Bangkok - all in Thailand; Hospital Maternidad Nuestra Senora de Altagracia, Santo Domingo, Dominican Republic (L.R.); National Autonomous University of Nicaragua, Leon (F.E.); Center for Clinical Management of Dengue and Dengue Haemorrhagic Fever, Negombo General Hospital, Negombo, Sri Lanka (L.K.F.); Universidade Federal Do Espirito Santo, Hospital Universitário Cassiano Antônio de Moraes, Vitória (R.D.), Instituto de Medicina Tropical da Universidade Federal do Rio Grande do Norte, Natal (K.L.), and Universidade Federal de Mato Grosso do Sul, Campo Grande (R.V.C.) - all in Brazil; Takeda Pharmaceuticals International, Zurich, Switzerland (A.B., M.B., M.R., I.L., S. Bizjajeva); and Takeda Vaccines, Boston (D.W.)
| | - Manja Brose
- From Takeda Vaccines, Singapore (S. Biswal); Centro de Atención e Investigación Médica, Bogota (H.R.), and Centro de Estudios en Infectología Pediatrica, Centro Médico Imbanaco and Department of Pediatrics, Universidad del Valle, Cali (P.L., E.L.-M.) - both in Colombia; the Department of Infectious Diseases at Hospital del Niño Dr. José Renán Esquivel, Sistema Nacional de Investigación at Secretaria Nacional de Ciencia y Tecnologia (SENACYT), Centro de Vacunación Internacional (Cevaxin), Panama City, Panama (X.S.-L., J.J.); the Research Institute for Tropical Medicine, Muntinlupa (C.B.-T.), and the University of the Philippines Manila, Ermita (L.B.) - both in the Philippines; Srinagarind Hospital, Khon Kaen University, Khon Kaen (P.K.), and the Department of Tropical Pediatrics, Faculty of Tropical Medicine, Mahidol University (C.S.), and Phramongkutklao Hospital (V.W.), Bangkok - all in Thailand; Hospital Maternidad Nuestra Senora de Altagracia, Santo Domingo, Dominican Republic (L.R.); National Autonomous University of Nicaragua, Leon (F.E.); Center for Clinical Management of Dengue and Dengue Haemorrhagic Fever, Negombo General Hospital, Negombo, Sri Lanka (L.K.F.); Universidade Federal Do Espirito Santo, Hospital Universitário Cassiano Antônio de Moraes, Vitória (R.D.), Instituto de Medicina Tropical da Universidade Federal do Rio Grande do Norte, Natal (K.L.), and Universidade Federal de Mato Grosso do Sul, Campo Grande (R.V.C.) - all in Brazil; Takeda Pharmaceuticals International, Zurich, Switzerland (A.B., M.B., M.R., I.L., S. Bizjajeva); and Takeda Vaccines, Boston (D.W.)
| | - Martina Rauscher
- From Takeda Vaccines, Singapore (S. Biswal); Centro de Atención e Investigación Médica, Bogota (H.R.), and Centro de Estudios en Infectología Pediatrica, Centro Médico Imbanaco and Department of Pediatrics, Universidad del Valle, Cali (P.L., E.L.-M.) - both in Colombia; the Department of Infectious Diseases at Hospital del Niño Dr. José Renán Esquivel, Sistema Nacional de Investigación at Secretaria Nacional de Ciencia y Tecnologia (SENACYT), Centro de Vacunación Internacional (Cevaxin), Panama City, Panama (X.S.-L., J.J.); the Research Institute for Tropical Medicine, Muntinlupa (C.B.-T.), and the University of the Philippines Manila, Ermita (L.B.) - both in the Philippines; Srinagarind Hospital, Khon Kaen University, Khon Kaen (P.K.), and the Department of Tropical Pediatrics, Faculty of Tropical Medicine, Mahidol University (C.S.), and Phramongkutklao Hospital (V.W.), Bangkok - all in Thailand; Hospital Maternidad Nuestra Senora de Altagracia, Santo Domingo, Dominican Republic (L.R.); National Autonomous University of Nicaragua, Leon (F.E.); Center for Clinical Management of Dengue and Dengue Haemorrhagic Fever, Negombo General Hospital, Negombo, Sri Lanka (L.K.F.); Universidade Federal Do Espirito Santo, Hospital Universitário Cassiano Antônio de Moraes, Vitória (R.D.), Instituto de Medicina Tropical da Universidade Federal do Rio Grande do Norte, Natal (K.L.), and Universidade Federal de Mato Grosso do Sul, Campo Grande (R.V.C.) - all in Brazil; Takeda Pharmaceuticals International, Zurich, Switzerland (A.B., M.B., M.R., I.L., S. Bizjajeva); and Takeda Vaccines, Boston (D.W.)
| | - Inge LeFevre
- From Takeda Vaccines, Singapore (S. Biswal); Centro de Atención e Investigación Médica, Bogota (H.R.), and Centro de Estudios en Infectología Pediatrica, Centro Médico Imbanaco and Department of Pediatrics, Universidad del Valle, Cali (P.L., E.L.-M.) - both in Colombia; the Department of Infectious Diseases at Hospital del Niño Dr. José Renán Esquivel, Sistema Nacional de Investigación at Secretaria Nacional de Ciencia y Tecnologia (SENACYT), Centro de Vacunación Internacional (Cevaxin), Panama City, Panama (X.S.-L., J.J.); the Research Institute for Tropical Medicine, Muntinlupa (C.B.-T.), and the University of the Philippines Manila, Ermita (L.B.) - both in the Philippines; Srinagarind Hospital, Khon Kaen University, Khon Kaen (P.K.), and the Department of Tropical Pediatrics, Faculty of Tropical Medicine, Mahidol University (C.S.), and Phramongkutklao Hospital (V.W.), Bangkok - all in Thailand; Hospital Maternidad Nuestra Senora de Altagracia, Santo Domingo, Dominican Republic (L.R.); National Autonomous University of Nicaragua, Leon (F.E.); Center for Clinical Management of Dengue and Dengue Haemorrhagic Fever, Negombo General Hospital, Negombo, Sri Lanka (L.K.F.); Universidade Federal Do Espirito Santo, Hospital Universitário Cassiano Antônio de Moraes, Vitória (R.D.), Instituto de Medicina Tropical da Universidade Federal do Rio Grande do Norte, Natal (K.L.), and Universidade Federal de Mato Grosso do Sul, Campo Grande (R.V.C.) - all in Brazil; Takeda Pharmaceuticals International, Zurich, Switzerland (A.B., M.B., M.R., I.L., S. Bizjajeva); and Takeda Vaccines, Boston (D.W.)
| | - Svetlana Bizjajeva
- From Takeda Vaccines, Singapore (S. Biswal); Centro de Atención e Investigación Médica, Bogota (H.R.), and Centro de Estudios en Infectología Pediatrica, Centro Médico Imbanaco and Department of Pediatrics, Universidad del Valle, Cali (P.L., E.L.-M.) - both in Colombia; the Department of Infectious Diseases at Hospital del Niño Dr. José Renán Esquivel, Sistema Nacional de Investigación at Secretaria Nacional de Ciencia y Tecnologia (SENACYT), Centro de Vacunación Internacional (Cevaxin), Panama City, Panama (X.S.-L., J.J.); the Research Institute for Tropical Medicine, Muntinlupa (C.B.-T.), and the University of the Philippines Manila, Ermita (L.B.) - both in the Philippines; Srinagarind Hospital, Khon Kaen University, Khon Kaen (P.K.), and the Department of Tropical Pediatrics, Faculty of Tropical Medicine, Mahidol University (C.S.), and Phramongkutklao Hospital (V.W.), Bangkok - all in Thailand; Hospital Maternidad Nuestra Senora de Altagracia, Santo Domingo, Dominican Republic (L.R.); National Autonomous University of Nicaragua, Leon (F.E.); Center for Clinical Management of Dengue and Dengue Haemorrhagic Fever, Negombo General Hospital, Negombo, Sri Lanka (L.K.F.); Universidade Federal Do Espirito Santo, Hospital Universitário Cassiano Antônio de Moraes, Vitória (R.D.), Instituto de Medicina Tropical da Universidade Federal do Rio Grande do Norte, Natal (K.L.), and Universidade Federal de Mato Grosso do Sul, Campo Grande (R.V.C.) - all in Brazil; Takeda Pharmaceuticals International, Zurich, Switzerland (A.B., M.B., M.R., I.L., S. Bizjajeva); and Takeda Vaccines, Boston (D.W.)
| | - Lulu Bravo
- From Takeda Vaccines, Singapore (S. Biswal); Centro de Atención e Investigación Médica, Bogota (H.R.), and Centro de Estudios en Infectología Pediatrica, Centro Médico Imbanaco and Department of Pediatrics, Universidad del Valle, Cali (P.L., E.L.-M.) - both in Colombia; the Department of Infectious Diseases at Hospital del Niño Dr. José Renán Esquivel, Sistema Nacional de Investigación at Secretaria Nacional de Ciencia y Tecnologia (SENACYT), Centro de Vacunación Internacional (Cevaxin), Panama City, Panama (X.S.-L., J.J.); the Research Institute for Tropical Medicine, Muntinlupa (C.B.-T.), and the University of the Philippines Manila, Ermita (L.B.) - both in the Philippines; Srinagarind Hospital, Khon Kaen University, Khon Kaen (P.K.), and the Department of Tropical Pediatrics, Faculty of Tropical Medicine, Mahidol University (C.S.), and Phramongkutklao Hospital (V.W.), Bangkok - all in Thailand; Hospital Maternidad Nuestra Senora de Altagracia, Santo Domingo, Dominican Republic (L.R.); National Autonomous University of Nicaragua, Leon (F.E.); Center for Clinical Management of Dengue and Dengue Haemorrhagic Fever, Negombo General Hospital, Negombo, Sri Lanka (L.K.F.); Universidade Federal Do Espirito Santo, Hospital Universitário Cassiano Antônio de Moraes, Vitória (R.D.), Instituto de Medicina Tropical da Universidade Federal do Rio Grande do Norte, Natal (K.L.), and Universidade Federal de Mato Grosso do Sul, Campo Grande (R.V.C.) - all in Brazil; Takeda Pharmaceuticals International, Zurich, Switzerland (A.B., M.B., M.R., I.L., S. Bizjajeva); and Takeda Vaccines, Boston (D.W.)
| | - Derek Wallace
- From Takeda Vaccines, Singapore (S. Biswal); Centro de Atención e Investigación Médica, Bogota (H.R.), and Centro de Estudios en Infectología Pediatrica, Centro Médico Imbanaco and Department of Pediatrics, Universidad del Valle, Cali (P.L., E.L.-M.) - both in Colombia; the Department of Infectious Diseases at Hospital del Niño Dr. José Renán Esquivel, Sistema Nacional de Investigación at Secretaria Nacional de Ciencia y Tecnologia (SENACYT), Centro de Vacunación Internacional (Cevaxin), Panama City, Panama (X.S.-L., J.J.); the Research Institute for Tropical Medicine, Muntinlupa (C.B.-T.), and the University of the Philippines Manila, Ermita (L.B.) - both in the Philippines; Srinagarind Hospital, Khon Kaen University, Khon Kaen (P.K.), and the Department of Tropical Pediatrics, Faculty of Tropical Medicine, Mahidol University (C.S.), and Phramongkutklao Hospital (V.W.), Bangkok - all in Thailand; Hospital Maternidad Nuestra Senora de Altagracia, Santo Domingo, Dominican Republic (L.R.); National Autonomous University of Nicaragua, Leon (F.E.); Center for Clinical Management of Dengue and Dengue Haemorrhagic Fever, Negombo General Hospital, Negombo, Sri Lanka (L.K.F.); Universidade Federal Do Espirito Santo, Hospital Universitário Cassiano Antônio de Moraes, Vitória (R.D.), Instituto de Medicina Tropical da Universidade Federal do Rio Grande do Norte, Natal (K.L.), and Universidade Federal de Mato Grosso do Sul, Campo Grande (R.V.C.) - all in Brazil; Takeda Pharmaceuticals International, Zurich, Switzerland (A.B., M.B., M.R., I.L., S. Bizjajeva); and Takeda Vaccines, Boston (D.W.)
| |
Collapse
|
20
|
Graeff SVB, Pícolli RP, Arantes R, Castro VDOLD, Cunha RVD. Epidemiological aspects of HIV infection and AIDS among indigenous populations. Rev Saude Publica 2019; 53:71. [PMID: 31508778 PMCID: PMC6758848 DOI: 10.11606/s1518-8787.2019053000362] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2017] [Accepted: 10/06/2018] [Indexed: 11/20/2022] Open
Abstract
OBJECTIVE To describe the epidemiological aspects of HIV infection and AIDS among indigenous peoples of the state of Mato Grosso do Sul, Brazil. METHODS This is a descriptive epidemiological study on the occurrence and distribution of HIV infection and AIDS in the indigenous population assisted by the Distrito Sanitário Especial Indígena (Indigenous Special Health District) Mato Grosso do Sul between 2001 and 2014, based on three secondary databases. Annual rates of HIV and AIDS detection and prevalence were calculated, considering case distribution according to village, Health Base Pole and sociodemographic variables. Accumulated rates of detection, mortality and case fatality were calculated by ethnic group and for the Health Base Pole with the highest number of cases. RESULTS The HIV detection rate fluctuated between 0.0 and 18.0/100 thousand people in the study period. For AIDS, there was no notification before 2007, but in 2012 its rate reached 16.6/100 thousand. HIV prevalence grew between 2001 and 2011, and it continuously grew for AIDS starting from 2007. The highest HIV detection rates occurred among Guarani peoples (167.1/100 thousand) and for AIDS, among the Kaiowá peoples (79.3/100 thousand); mortality and fatality rates were higher among the Kaiowá. Regarding the Dourados Health Base Pole, the AIDS detection rate increased, and the mortality and fatality rates decreased. CONCLUSIONS HIV infection and AIDS have been increasing among indigenous peoples, with distribution of the disease mainly in the Health Base Poles of the southern region of the state, where greater economic and social vulnerability are also observed. The endemic character of HIV and AIDS can become epidemic in some years given the existence of cases in other villages in the state. Its occurrence among the Guarani and Kaiowá populations indicates the need for expanded diagnosis, access to treatment and prevention measures.
Collapse
Affiliation(s)
| | | | - Rui Arantes
- Fundação Oswaldo Cruz. Escola Nacional de Saúde Pública Sérgio Arouca. Departamento de Endemias. Rio de Janeiro, RJ, Brasil
| | - Vivianne de Oliveira Landgraf de Castro
- Universidade Federal de Mato Grosso do Sul. Laboratório de Imunologia Clínica. Faculdade de Ciências Farmacêuticas, Alimentos e Nutrição. Campo Grande, MS, Brasil
| | | |
Collapse
|
21
|
Tiago ZDS, Picoli RP, Graeff SVB, Cunha RVD, Arantes R. Underreporting of gestational, congenital and acquired syphilis among indigenous peoples in Mato Grosso do Sul State, Brazil, 2011-2014. Epidemiol Serv Saude 2018; 26:503-512. [PMID: 28977175 DOI: 10.5123/s1679-49742017000300008] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2016] [Accepted: 11/30/2016] [Indexed: 11/02/2022] Open
Abstract
OBJECTIVE to describe the distribution, incidence, and underreporting of syphilis among indigenous peoples from Mato Grosso do Sul, Brazil. METHODS descriptive study performed with secondary data of the Information System for Notifiable Diseases (Sinan) and of the Special Indigenous Sanitary District of Mato Grosso do Sul (DSEI-MS), from 2011 to 2014; the data from both sources were compared to identify underreporting. RESULTS the highest incidence rates of syphilis in pregnant women were observed in 2014 (41.1/1,000 live births) and of congenital syphilis, in 2013 (10.7/1,000 live births); the highest numbers of underreporting of cases were for syphilis in pregnant women on Sinan (45/79), of congenital syphilis at DSEI-MS (8/17) in 2014, and of acquired syphilis on Sinan in 2011 and 2013 (5/9 and 10/18, respectively). CONCLUSION syphilis has a high incidence; underreporting hides the extent of the disease in indigenous peoples from Mato Grosso do Sul.
Collapse
Affiliation(s)
- Zuleica da Silva Tiago
- Universidade Federal de Mato Grosso do Sul, Programa de Mestrado Profissional em Saúde da Família, Campo Grande-MS, Brasil
| | | | - Samara Vilas-Boas Graeff
- Secretaria Especial de Saúde Indígena, Distrito Sanitário Especial Indígena, Campo Grande-MS, Brasil
| | | | - Rui Arantes
- Fundação Oswaldo Cruz/Mato Grosso do Sul, Campo Grande-MS, Brasil
| |
Collapse
|
22
|
Costa EMDS, Cunha RVD, Costa EAD. National Dengue Control Program implementation evaluation in two border municipalities in Mato Grosso do Sul State, Brazil, 2016. Epidemiol Serv Saude 2018; 27:e2017478. [PMID: 30517349 DOI: 10.5123/s1679-49742018000400007] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2018] [Accepted: 08/14/2018] [Indexed: 11/02/2022] Open
Abstract
OBJECTIVE to evaluate the degree of implementation of the National Dengue Control Program (PNCD) in two border municipalities in Mato Grosso do Sul State (Corumbá and Ponta Porã), Brazil, 2016. METHODS This was a normative evaluation based on indicators of service structure and work process; questionnaires were answered by health professionals involved in dengue prevention and control; the cut-off points used to determine the degree of implementation were 'implemented' (>75% of the activities implemented), 'partially implemented' (50 to 75%), 'low level of implementation' (25 to 49%), and 'not implemented' (<25%). RESULTS 383 health professionals participated in this study, 227 of whom were from Corumbá and 156 from Ponta Porã; the degree of PNCD implementation was 63.1% and 66.4% for Corumbá and Ponta Porã, respectively, thus being classified as partially implemented in both municipalities. CONCLUSION PNCD implementation was partial in both municipalities; problems observed indicate the need for program enhancement.
Collapse
Affiliation(s)
- Elisângela Martins da Silva Costa
- Universidade Federal de Mato Grosso do Sul, Programa de Pós-Graduação em Saúde e Desenvolvimento na Região Centro-Oeste, Campo Grande, MS, Brasil
| | - Rivaldo Venâncio da Cunha
- Universidade Federal de Mato Grosso do Sul, Programa de Pós-Graduação em Saúde e Desenvolvimento na Região Centro-Oeste, Campo Grande, MS, Brasil
| | - Edgar Aparecido da Costa
- Universidade Federal de Mato Grosso do Sul, Programa de Pós-Graduação em Estudos Fronteiriços, Corumbá, MS, Brasil
| |
Collapse
|
23
|
Barros TADC, Batista DDO, Torrentes de Carvalho A, Costa Faria NRD, Barreto-Vieira DF, Jácome FC, Barth OM, Nogueira RMR, Neves PCDC, Matos DCDS, Leal de Azeredo E, Vieira Damasco P, Cunha RVD, de-Oliveira-Pinto LM. Different aspects of platelet evaluation in dengue: Measurement of circulating mediators, ability to interact with the virus, the degree of activation and quantification of intraplatelet protein content. Virus Res 2018; 260:163-172. [PMID: 30282001 DOI: 10.1016/j.virusres.2018.09.013] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2018] [Revised: 09/06/2018] [Accepted: 09/19/2018] [Indexed: 10/28/2022]
Abstract
Platelets play a role in hemostasis, coagulation, angiogenesis, inflammation and immune response is one of the most affected cells in dengue. Here we describe some aspects of platelets by observing their specific circulating mediators, the ability to interact with the virus and morphological consequences of this interaction, activation markers and intraplatelet protein contents in dengue. We conducted this study using dengue-patients as well as healthy donors. Immunoenzymatic assay, flow cytometry, transmission electron microscopy and intraplatelet proteins expression assays were carried out. Briefly, we found an increase in sCD62L, NO or TBX2 ratio in platelet count, mostly in patients with the worse clinical outcome. After in vitro DENV infection or during natural infection, platelets underwent morphological alteration with increased expression of platelet activation markers, particularly in natural infections. Analysis of intraplatelet protein contents revealed different angiogenic and inflammatory profiles, maintaining or not extracellular matrix integrity between DF and DFWS patients. Thus, platelets are frequently affected by dengue, either by altering their own functionality, as "carrier" of the virus, or as an antiviral and mediator-secreting effector cell. Thus, strategies aimed at recovering platelet amounts in dengue seem to be essential for a better clinical outcome of the patients.
Collapse
Affiliation(s)
- Tamiris Azamor da Costa Barros
- Laboratory of Viral Immunology, Instituto Oswaldo Cruz, Fiocruz, Rio de Janeiro, Brazil; Laboratory of Immunological Technology, Instituto de Tecnologia em Imunobiológicos Bio-Manguinhos, Fiocruz, Rio de Janeiro, Brazil
| | | | | | | | | | - Fernanda Cunha Jácome
- Laboratory of Viral Morphology and Morphogenesis, Instituto Oswaldo Cruz, Fiocruz, Rio de Janeiro, Brazil
| | - Ortrud Monika Barth
- Laboratory of Viral Morphology and Morphogenesis, Instituto Oswaldo Cruz, Fiocruz, Rio de Janeiro, Brazil
| | | | - Patrícia Cristina da Costa Neves
- Laboratory of Immunological Technology, Instituto de Tecnologia em Imunobiológicos Bio-Manguinhos, Fiocruz, Rio de Janeiro, Brazil
| | - Denise Cristina de Souza Matos
- Laboratory of Immunological Technology, Instituto de Tecnologia em Imunobiológicos Bio-Manguinhos, Fiocruz, Rio de Janeiro, Brazil
| | | | - Paulo Vieira Damasco
- Rio-Laranjeiras Hospital, Gaffrée Guinle University Hospital (Federal University of the State of Rio de Janeiro), Rio de Janeiro, Brazil Pedro Ernesto University Hospital (University of the State of Rio de Janeiro), Rio de Janeiro, Brazil
| | - Rivaldo Venâncio da Cunha
- Department of Clinical Medicine, Federal University of the Mato Grosso do Sul University Hospital (Universidade Federal de Mato Grosso do Sul), Campo Grande, Brazil
| | | |
Collapse
|
24
|
Possas C, Lourenço-de-Oliveira R, Tauil PL, Pinheiro FDP, Pissinatti A, da Cunha RV, Freire M, Martins RM, Homma A. Yellow fever outbreak in Brazil: the puzzle of rapid viral spread and challenges for immunisation. Mem Inst Oswaldo Cruz 2018; 113:e180278. [PMID: 30427974 PMCID: PMC6135548 DOI: 10.1590/0074-02760180278] [Citation(s) in RCA: 115] [Impact Index Per Article: 19.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2018] [Accepted: 08/16/2018] [Indexed: 01/31/2023] Open
Abstract
We discuss the complex eco-social factors involved in the puzzle of the unexpected rapid viral spread in the ongoing Brazilian yellow fever (YF) outbreak, which has increased the reurbanisation risk of a disease without urban cases in Brazil since 1942. Indeed, this rapid spatial viral dissemination to the Southeast and South regions, now circulating in the Atlantic Forest fragments close to peri-urban areas of the main Brazilian megalopolises (São Paulo and Rio de Janeiro) has led to an exponential increase in the number of yellow fever cases. In less than 18 months, 1,833 confirmed cases and 578 deaths were recorded most of them reported in the Southeast region (99,9%). Large epizooties in monkeys and other non-human primates (NHPs) were communicated in the country with 732 YF virus (YFV) laboratory confirmed events only in the 2017/2018 monitoring period. We also discuss the peculiarities and similarities of the current outbreak when compared with previous great epidemics, examining several hypotheses to explain the recent unexpected acceleration of epizootic waves in the sylvatic cycle of the YFV together with the role of human, NHPs and mosquito mobility with respect to viral spread. We conclude that the most feasible hypothesis to explain this rapidity would be related to human behavior combined with ecological changes that promoted a significant increase in mosquito and NHP densities and their contacts with humans. We emphasize the urgent need for an adequate response to this outbreak such as extending immunisation coverage to the whole Brazilian population and developing novel strategies for immunisation of NHPs confined in selected reserve areas and zoos. Finally, we stress the urgent need to improve the quality of response in order to prevent future outbreaks and a catastrophic reurbanisation of the disease in Brazil and other South American countries. Continuous monitoring of YFV receptivity and vulnerability conditions with effective control of the urban vector Aedes aegypti and significant investments in YF vaccine production capacity and research and development for reduction of adverse effects are of the highest priority.
Collapse
Affiliation(s)
- Cristina Possas
- Fundação Oswaldo Cruz-Fiocruz, Bio-Manguinhos, Rio de Janeiro, RJ, Brasil
| | | | - Pedro Luiz Tauil
- Universidade de Brasília, Faculdade de Medicina, Brasília, DF, Brasil
| | | | - Alcides Pissinatti
- Centro de Primatologia do Rio de Janeiro, Instituto Estadual do Ambiente, Guapimirim, RJ, Brasil
| | | | - Marcos Freire
- Fundação Oswaldo Cruz-Fiocruz, Bio-Manguinhos, Rio de Janeiro, RJ, Brasil
| | | | - Akira Homma
- Fundação Oswaldo Cruz-Fiocruz, Bio-Manguinhos, Rio de Janeiro, RJ, Brasil
| |
Collapse
|
25
|
Badolato‐Corrêa J, Sánchez‐Arcila JC, Alves de Souza TM, Santos Barbosa L, Conrado Guerra Nunes P, da Rocha Queiroz Lima M, Gandini M, Bispo de Filippis AM, Venâncio da Cunha R, Leal de Azeredo E, de‐Oliveira‐Pinto LM. Human T cell responses to Dengue and Zika virus infection compared to Dengue/Zika coinfection. Immun Inflamm Dis 2018; 6:194-206. [PMID: 29282904 PMCID: PMC5946158 DOI: 10.1002/iid3.203] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2017] [Revised: 09/13/2017] [Accepted: 10/04/2017] [Indexed: 12/22/2022] Open
Abstract
INTRODUCTION Zika virus (ZIKV) and dengue virus (DENV) co-circulated during latest outbreaks in Brazil, hence, it is important to evaluate the host cross-reactive immune responses to these viruses. So far, little is known about human T cell responses to ZIKV and no reports detail adaptive immune responses during DENV/ZIKV coinfection. METHODS Here, we studied T cells responses in well-characterized groups of DENV, ZIKV, or DENV/ZIKV infected patients and DENV-exposed healthy donors. We evaluated chemokine receptors expression and single/multifunctional frequencies of IFNγ, TNF, and IL2-producing T cells during these infections. Even without antigenic stimulation, it was possible to detect chemokine receptors and IFNγ, TNF, and IL2-producing T cells from all individuals by flow cytometry. Additionally, PBMCs' IFNγ response to DENV NS1 protein and to polyclonal stimuli was evaluated by ELISPOT. RESULTS DENV and ZIKV infections and DENV/ZIKV coinfections similarly induced expression of CCR5, CX3CR1, and CXCR3 on CD4 and CD8 T cells. DENV/ZIKV coinfection decreased the ability of CD4+ T cells to produce IFNγ+ , TNF+ , TNF + IFNγ+ , and TNF + IL2+ , compared to DENV and ZIKV infections. A higher magnitude of IFNγ response to DENV NS1 was found in donors with a history of dengue infection, however, a hyporesponsiveness was found in acute DENV, ZIKV, or DENV/ZIKV infected patients, even previously infected with DENV. CONCLUSION Therefore, we emphasize the potential impact of coinfection on the immune response from human hosts, mainly in areas where DENV and ZIKV cocirculate.
Collapse
Affiliation(s)
- Jessica Badolato‐Corrêa
- Laboratory of Viral ImmunologyFundação Oswaldo CruzInstituto Oswaldo CruzRio de JaneiroBrazil
| | | | | | - Luciana Santos Barbosa
- Laboratory of Viral ImmunologyFundação Oswaldo CruzInstituto Oswaldo CruzRio de JaneiroBrazil
- Laboratory of Genetics, Institute of Paediatrics and Puericulture Martagão Gesteira (IPPMG)Federal University of Rio de Janeiro, UFRJRio de JaneiroBrazil
| | | | | | - Mariana Gandini
- Laboratory of Cellular MicrobiologyFundação Oswaldo CruzInstituto Oswaldo CruzRio de JaneiroBrazil
| | | | - Rivaldo Venâncio da Cunha
- Department of Clinical MedicineUniversidade Federal do Mato Grosso do SulBrazil
- Fundação Oswaldo CruzCampo GrandeMato Grosso do SulBrazil
| | | | | |
Collapse
|
26
|
Costa EMDS, Costa EAD, Cunha RVD. Percepções sobre dengue dos moradores de um município brasileiro de fronteira. Rev Epidemiol Control Infect 2018. [DOI: 10.17058/reci.v8i2.11120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Justificativa e Objetivos: As abordagens baseadas no saber da população se constituem em uma importante ferramenta para orientar o
desenvolvimento de estratégias adequadas e efetivas para controlar e prevenir os surtos de dengue. O objetivo do estudo foi identificar as percepções sobre conhecimento, ocorrência e ações de controle da dengue dos moradores do município de Ponta Porã, no estado de Mato Grosso do Sul, fronteira Brasil/Paraguai. Métodos: Foi realizado um estudo quali-quantitativo no período de novembro a dezembro de 2016 em amostra populacional de residentes na área urbana do município. Para a coleta de dados foram entrevistados 383 moradores, cuja análise do conteúdo se fez pela técnica do Discurso do Sujeito Coletivo. Resultados: Os discursos revelam coerência entre as informações disseminadas pelas campanhas de controle da dengue e o conhecimento da população sobre a doença. Observou-se responsabilização da própria população pela ocorrência da dengue. Os entrevistados demonstraram insatisfação com as ações de controle da dengue desenvolvidas pelo poder público municipal, principalmente com a intensidade, regularidade e continuidade delas.
Conclusões: A maioria dos entrevistados sabem o que é dengue, conhece sua forma de transmissão e como se dá o seu controle.
Collapse
|
27
|
Cavalcanti LPDG, Freitas ARR, Brasil P, Cunha RVD. Surveillance of deaths caused by arboviruses in Brazil: from dengue to chikungunya. Mem Inst Oswaldo Cruz 2017; 112:583-585. [PMID: 28767985 PMCID: PMC5530552 DOI: 10.1590/0074-02760160537] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2016] [Accepted: 03/04/2017] [Indexed: 11/23/2022] Open
Abstract
Did death occur DUE TO dengue, or in a patient WITH dengue virus infection? It seems a matter of semantics, but in fact, it underscores how challenging it is to distinguish whether the disease contributed to death, or was itself the underlying cause of death. Can a death be attributed to chikungunya virus, when some deaths occur after the acute phase? Did the virus decompensate the underlying diseases, leading to death? Did prolonged hospitalisation lead to infection, resulting in the patient’s progression to death? Were there iatrogenic complications during patient care? The dengue question, for which there has not yet been a definitive response, resurfaces prominently under the chikungunya surveillance scenario. We are facing an epidemic of a disease that seems to be more lethal than previously thought. The major challenge ahead is to investigate deaths suspected of occurring due to arbovirus infections and to understand the role of each infection in the unfavourable outcome.
Collapse
Affiliation(s)
| | - André Ricardo Ribas Freitas
- Faculdade São Leopoldo Mandic, Campinas, SP, Brasil.,Secretaria Municipal de Saúde, Departamento de Vigilância em Saúde, Campinas, SP, Brasil
| | - Patrícia Brasil
- Fundação Oswaldo Cruz-Fiocruz, Instituto Nacional de Infectologia Evandro Chagas, Rio de Janeiro, RJ, Brasil
| | | |
Collapse
|
28
|
Xavier-Carvalho C, Cezar RDDS, Freire NM, Vasconcelos CMMD, Solorzano VEF, de Toledo-Pinto TG, Fialho LG, do Carmo RF, Vasconcelos LRS, Cordeiro MT, Baptista P, de Azeredo EL, da Cunha RV, de Souza LJ, Pacheco AG, Kubelka CF, Moura PMMFD, Moraes MO. Association of rs1285933 single nucleotide polymorphism in CLEC5A gene with dengue severity and its functional effects. Hum Immunol 2017; 78:649-656. [PMID: 28764923 DOI: 10.1016/j.humimm.2017.07.013] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2016] [Revised: 06/26/2017] [Accepted: 07/27/2017] [Indexed: 12/16/2022]
Abstract
Outbreaks of the Zika, dengue, and chikungunya viruses, especially in the Americas, pose a global threat due to their rapid spread and difficulty controlling the vector. Extreme phenotypes are often observed, from asymptomatic to severe clinical manifestations, which are well-studied in dengue. Host variations are also important contributors to disease outcomes, and many case-control studies have associated single nucleotide polymorphisms (SNPs) with severe dengue. Here, we found that the TC genotype and T-carriers for SNP rs1285933 in the C-type lectin superfamily member 5 (CLEC5A) gene was associated with severe dengue in a Northern Brazilian population (OR=2.75 and p-value=0.01, OR=2.11 and p-value=0.04, respectively). We also tested the functional effect of the CLEC5A protein and found that it is upregulated on the surface of human monocytes after in vitro dengue infection. CLEC5A was correlated with viral load inside the monocytes (Spearman r=0.55, p=0.008) and TNF production in culture supernatants (Spearman r=0.72, p=0.03). Analysis of mRNA in blood samples from DENV4-infected patients exhibiting mild symptoms showed that CLEC5A mRNA expression is correlated with TNF (r=0.67, p=0.0001) and other immune mediators. Monocytes from rs1285933 TT/TC individuals showed lower CLEC5A expression compared to CC genotypes. However, in these cells, CLEC5A was not correlated with TNF production. In summary, we confirmed that CLEC5A is genetically associated with dengue severity outcome, playing a central role during the immune response triggered by a dengue viral infection, and rs1285933 is a relevant SNP that is able to regulate signaling pathways after interactions between the dengue virus and CLEC5A receptors.
Collapse
Affiliation(s)
- Caroline Xavier-Carvalho
- Laboratório de Hanseníase, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, FIOCRUZ, Rio de Janeiro, RJ, Brazil; Laboratório de Imunologia Viral, Instituto Oswaldo Cruz - FIOCRUZ, Rio de Janeiro, RJ, Brazil
| | | | - Naishe Matos Freire
- Faculdade de Ciências Médicas, Universidade de Pernambuco, Recife, PE, Brazil
| | | | | | | | - Luciana Gomes Fialho
- Laboratório de Imunologia Viral, Instituto Oswaldo Cruz - FIOCRUZ, Rio de Janeiro, RJ, Brazil
| | - Rodrigo Feliciano do Carmo
- Colegiado de Ciências Farmacêuticas, Universidade Federal do Vale do São Francisco, Petrolina, PE, Brazil
| | - Luydson Richardson Silva Vasconcelos
- Faculdade de Ciências Médicas, Universidade de Pernambuco, Recife, PE, Brazil; Laboratório de Doenças Transmissíveis, Departamento de Parasitologia, FIOCRUZ, Recife, PE, Brazil
| | | | - Paulo Baptista
- Faculdade de Ciências Médicas, Universidade de Pernambuco, Recife, PE, Brazil
| | | | - Rivaldo Venâncio da Cunha
- Departamento de Clínica Médica, FM, Universidade Federal do Mato Grosso do Sul, Campo Grande, MS, Brazil
| | - Luiz José de Souza
- Centro de Referência em Dengue e Faculdade de Medicina, Campos de Goytacazes, RJ, Brazil
| | | | | | - Patrícia Muniz Mendes Freire de Moura
- Instituto de Ciências Biológicas, Universidade de Pernambuco, Recife, PE, Brazil; Laboratório de Doenças Transmissíveis, Departamento de Parasitologia, FIOCRUZ, Recife, PE, Brazil
| | - Milton Ozorio Moraes
- Laboratório de Hanseníase, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, FIOCRUZ, Rio de Janeiro, RJ, Brazil.
| |
Collapse
|
29
|
Domingos JA, Soares LS, Bandeira LM, Bonin CM, Vicente ACP, Zanella L, Puga MAM, Tozetti IA, Motta-Castro ARC, da Cunha RV. Cytokine profile and proviral load among Japanese immigrants and non-Japanese infected with HTLV-1 in a non-endemic area of Brazil. PLoS One 2017; 12:e0174869. [PMID: 28376092 PMCID: PMC5380323 DOI: 10.1371/journal.pone.0174869] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2016] [Accepted: 03/16/2017] [Indexed: 02/06/2023] Open
Abstract
The lifetime risk of HTLV-1-associated myelopathy/tropical spastic paraparesis (HAM/TSP) development differs among ethnic groups. To better understand these differences, this prospective cohort study was conducted to investigate the cytokine profile and the HTLV-1 proviral load (PVL) in Japanese and non-Japanese populations with HAM/TSP and asymptomatic carriers (ACs). The serum IL-2, IL-4, IL-6, IL-10, IL-17, TNF-α, and IFN-γ levels were quantified using the Cytometric Bead Array in 40 HTLV-1-infected patients (11 HAM/TSP and 29 ACs) and 18 healthy controls (HCs) in Brazil. Among ACs, 15 were Japanese descendants and 14 were non-Japanese. Of 11 patients with HAM/TSP, only one was a Japanese descendant. The HTLV-1 PVL was quantified by real-time PCR. The HTLV-1 PVL was 2.7-fold higher in HAM/TSP patients than ACs. Regardless of the clinical outcome, the PVL was significantly higher in patients younger than 60 years than older patients. The HAM/TSP and ACs had higher IL-10 serum concentrations than that of HCs. The ACs also showed higher IL-6 serum levels than those of HCs. According to age, the IL-10 and IL-6 levels were higher in ACs non-Japanese patients older than 60 years. HAM/TSP patients showed a positive correlation between IL-6 and IL-17 and a negative correlation between the PVL and IL-17 and IFN-γ. In the all ACs, a significant positive correlation was observed between IL-2 and IL-17 and a negative correlation was detected between IL-10 and TNF-α. Only 6.25% of the Japanese patients were symptomatic carriers, compared with 41.67% of the non-Japanese patients. In conclusion, this study showed that high levels of HTLV-1 PVL was intrinsicaly associated with the development of HAM/TSP. A higher HTLV-1 PVL and IL10 levels found in non-Japanese ACs over 60 years old, which compared with the Japanese group depicts that the ethnic background may interfere in the host immune status. More researches also need to be undertaken regarding the host genetic background to better understand the low frequency of HAM/TSP in Japanese HTLV-1-infected individuals.
Collapse
Affiliation(s)
| | - Luana Silva Soares
- Federal University of Mato Grosso do Sul, Campo Grande, Mato Grosso do Sul, Brazil
| | - Larissa M. Bandeira
- Federal University of Mato Grosso do Sul, Campo Grande, Mato Grosso do Sul, Brazil
| | - Camila Mareti Bonin
- Federal University of Mato Grosso do Sul, Campo Grande, Mato Grosso do Sul, Brazil
| | | | | | | | | | - Ana Rita Coimbra Motta-Castro
- Federal University of Mato Grosso do Sul, Campo Grande, Mato Grosso do Sul, Brazil
- Oswaldo Cruz Foundation, Campo Grande, Mato Grosso do Sul, Brazil
- * E-mail: ,
| | - Rivaldo Venâncio da Cunha
- Federal University of Mato Grosso do Sul, Campo Grande, Mato Grosso do Sul, Brazil
- Oswaldo Cruz Foundation, Campo Grande, Mato Grosso do Sul, Brazil
| |
Collapse
|
30
|
Faria NRDC, Solorzano VEF, Nogueira RMR, Chouin-Carneiro T, Nunes PCG, Simões JBS, de Bruycker Nogueira F, Lima MDRQ, de Oliveira Pinto LM, Kubelka CF, da Cunha RV, de Azeredo EL, dos Santos FB. Dengue epidemics in two distinct periods reveal distinct epidemiological, laboratorial and clinical aspects in a same scenario: analysis of the 2010 and 2013 epidemics in Mato Grosso do Sul, Brazil. Trans R Soc Trop Med Hyg 2016; 110:228-36. [PMID: 26956779 DOI: 10.1093/trstmh/trw013] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2015] [Accepted: 01/20/2016] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Dengue is a major problem in Brazil. Epidemiological and clinical aspects were characterized in patients from two epidemics which occurred in Mato Grosso do Sul, Brazil. METHODS Dengue cases were classified according to the 2009 WHO criteria, tested by serological and molecular biology tests and analysed for nonstructural protein 1 (NS1) antigenemia. RESULTS Dengue was confirmed in 78.7% (48/61) and 75.6% (118/156) of the cases studied in 2010 and 2013, respectively. DENV-1 and DENV-2 were the serotypes involved in the 2010 epidemic and DENV-4 in the 2013 one. Most of the cases were classified as dengue without warning; however, severe dengue was observed in 18.7% (9/48) of the cases in 2010 and less observed in DENV-4 cases. NS1 levels were higher in patients with dengue with warning signs and severe dengue in 2010. Circulating aspartate aminotransferase (AST) and alanine transferase (ALT) were altered in all groups, independently of the infecting serotype or epidemic. Patients with DENV-1 and DENV-2 presented significant lower monocyte counts when compared to patients with DENV-4. An inverse correlation was found between platelet count, leucocytes, monocytes and NS1 levels. CONCLUSIONS Epidemics caused by the prevalence of distinct DENV serotypes had different impacts and clinical characteristics in a same scenario and, despite the occurrence of secondary infections, the DENV-4 emergence was not associated with severe cases.
Collapse
Affiliation(s)
- Nieli Rodrigues da Costa Faria
- Flavivirus Laboratory, Oswaldo Cruz Institute/FIOCRUZ, Av Brasil 4365, Manguinhos, Rio de Janeiro, RJ, 21045-360, Brazil Imunnology Viral Laboratory Oswaldo Cruz Institute, Rio de Janeiro, Brazil
| | | | - Rita Maria Ribeiro Nogueira
- Flavivirus Laboratory, Oswaldo Cruz Institute/FIOCRUZ, Av Brasil 4365, Manguinhos, Rio de Janeiro, RJ, 21045-360, Brazil
| | - Thaís Chouin-Carneiro
- Flavivirus Laboratory, Oswaldo Cruz Institute/FIOCRUZ, Av Brasil 4365, Manguinhos, Rio de Janeiro, RJ, 21045-360, Brazil
| | - Priscila Conrado Guerra Nunes
- Flavivirus Laboratory, Oswaldo Cruz Institute/FIOCRUZ, Av Brasil 4365, Manguinhos, Rio de Janeiro, RJ, 21045-360, Brazil
| | - Jaqueline Bastos Santos Simões
- Flavivirus Laboratory, Oswaldo Cruz Institute/FIOCRUZ, Av Brasil 4365, Manguinhos, Rio de Janeiro, RJ, 21045-360, Brazil
| | - Fernanda de Bruycker Nogueira
- Flavivirus Laboratory, Oswaldo Cruz Institute/FIOCRUZ, Av Brasil 4365, Manguinhos, Rio de Janeiro, RJ, 21045-360, Brazil
| | - Monique da Rocha Queiroz Lima
- Flavivirus Laboratory, Oswaldo Cruz Institute/FIOCRUZ, Av Brasil 4365, Manguinhos, Rio de Janeiro, RJ, 21045-360, Brazil
| | | | | | | | | | - Flavia Barreto dos Santos
- Flavivirus Laboratory, Oswaldo Cruz Institute/FIOCRUZ, Av Brasil 4365, Manguinhos, Rio de Janeiro, RJ, 21045-360, Brazil
| |
Collapse
|
31
|
Correia de Lima A, Venâncio da Cunha R, Dias Rolan Loureiro M, Ivo ML, Schiaveto de Souza A, Jardim Cury Pontes ER, Marques da Silva Junior A, Campos de Azevedo I, Ferreira Júnior MA. Phlebitis predictors in cardiac patients undergoing peripheral intravenous therapy. Int Arch Med 2016. [DOI: 10.3823/2095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
|
32
|
Bertolacci-Rocha LG, Cunha RVD, Lichs GGDC, Dal Fabbro MMFJ, Motta-Castro ARC. Introduction of the dengue virus type 4 in the State of Mato Grosso do Sul, Brazil. CAD SAUDE PUBLICA 2015; 30:1789-92. [PMID: 25210917 DOI: 10.1590/0102-311x00003914] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2014] [Accepted: 05/19/2014] [Indexed: 11/21/2022] Open
Abstract
We report on the first isolation of dengue virus serotype 4 (DENV-4) in the State of Mato Grosso do Sul, Brazil, in February, 2012. The cases were isolated in the city of Campo Grande, the state capital, and presented the classic signs and symptoms of dengue fever. DENV-4 was primarily identified through viral isolation in C6/36 clone lineage of Aedes albopictus cells; followed by indirect immunofluorescence, using type-specific monoclonal antibodies. The results were subsequently confirmed by Nested RT-PCR tests. The first description of the introduction of DENV-4 in a state whose population is susceptible to this serotype and the circulation of three other serotypes in the area is cause for concern due to the increased possibility of severe and lethal cases of the disease, and of huge epidemics.
Collapse
|
33
|
Venâncio da Cunha R. DENGUE CURRENT STATUS AND PERSPECTIVES. VR&R 2014. [DOI: 10.17525/vrr.v19i1.109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
|
34
|
Limonta D, Torrentes-Carvalho A, Marinho CF, de Azeredo EL, de Souza LJ, Motta-Castro ARC, da Cunha RV, Kubelka CF, Nogueira RMR, de-Oliveira-Pinto LM. Apoptotic mediators in patients with severe and non-severe dengue from Brazil. J Med Virol 2013; 86:1437-47. [PMID: 24170344 PMCID: PMC7167172 DOI: 10.1002/jmv.23832] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/24/2013] [Indexed: 12/26/2022]
Abstract
Despite being the most significant arboviral disease worldwide, dengue has no antiviral treatment or reliable severity predictors. It has been shown that apoptotic cells from blood and tissues may be involved in the complex pathogenesis of dengue. However, very little is known about the interplay between proapoptotic and antiapoptotic mediators in this disease. Therefore, plasma levels of the three proapoptotic mediators Fas ligand (FasL), tumor necrosis factor‐α (TNF‐α), and TNF‐related apoptosis‐inducing ligand (TRAIL) were measured in dengue patients. Patients were classified according to the World Health Organization classification of dengue revised in 2009. Additionally, inhibitors of apoptosis protein (IAPs) were determined in plasma (Survivin) and peripheral blood mononuclear cells (PBMCs) lysates (cIAP‐1, cIAP‐2, XIAP). Levels of apoptotic proteins in plasma were correlated with counts of blood cells. FasL and TRAIL levels were elevated in dengue patients without warning signs when compared to patients with severe dengue and controls. Dengue patients with warning signs showed decreased levels of Survivin compared to patients with severe dengue and controls. TRAIL was inversely correlated with counts of lymphocyte subsets. In contrast, Survivin was positively correlated with leukocyte counts. There was a trend of elevated IAPs levels in PBMCs of patients with severe dengue. The results suggest a likely antiviral effect of TRAIL in dengue. It appears that TRAIL might be involved with apoptosis induction of lymphocytes, whereas IAPs might participate in protecting leukocytes from apoptosis. Further research is needed to explore the interactions between pro and antiapoptotic molecules and their implications in dengue pathogenesis. J. Med. Virol. 86:1437–1447, 2014. © 2013 Wiley Periodicals, Inc.
Collapse
Affiliation(s)
- Daniel Limonta
- Laboratório de Imunologia Viral, Instituto Oswaldo Cruz (IOC), FIOCRUZ, Rio de Janeiro, Brasil; Laboratório de Flavivírus, Instituto Oswaldo Cruz (IOC), FIOCRUZ, Rio de Janeiro, Brasil
| | | | | | | | | | | | | | | | | | | |
Collapse
|
35
|
Tristão-Sá R, Kubelka CF, Zandonade E, Zagne SMO, Rocha NDSM, Zagne LO, Araújo NF, Amin B, Fazoli F, Souza LJD, Cruz OG, Cunha RVD, Nascimento DD, Froes IB, Nogueira RMR. Clinical and hepatic evaluation in adult dengue patients: a prospective two-month cohort study. Rev Soc Bras Med Trop 2013; 45:675-81. [PMID: 23295867 DOI: 10.1590/s0037-86822012000600004] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2011] [Accepted: 07/04/2012] [Indexed: 11/22/2022] Open
Abstract
INTRODUCTION To analyze the liver dysfunction and evolution of signs and symptoms in adult dengue patients during a two-month follow-up period. METHODS A prospective cohort study was conducted in Campos dos Goytacazes, Rio de Janeiro, Brazil, from January to July, 2008. The evolution of laboratory and clinical manifestations of 90 adult dengue patients was evaluated in five scheduled visits within a two-month follow-up period. Twenty controls were enrolled for the analysis of liver function. Patients with hepatitis B, hepatitis C, those known to be human immunodeficiency virus (HIV) seropositive and pregnant women were excluded from the study. RESULTS At the end of the second month following diagnosis, we observed that symptoms persisted in 33.3% (30/90) of dengue patients. We also observed that, 57.7% (15/26) of the symptoms persisted at the end of the second month. The most persistent symptoms were arthralgia, fatigue, weakness, adynamia, anorexia, taste alteration, and hair loss. Prior dengue virus (DENV) infection did not predispose patients to a longer duration of symptoms. Among hepatic functions, transaminases had the most remarkable elevation and in some cases remained elevated up to the second month after the disease onset. Alanine aminotransferase (ALT) levels overcame aspartate aminotransferase (AST) during the convalescent period. Male patients were more severely affected than females. CONCLUSIONS Dengue fever may present a wide number of symptoms and elevated liver transaminases at the end of the second month.
Collapse
Affiliation(s)
- Ricardo Tristão-Sá
- Departamento de Clínica Médica, Escola Superior de Ciências, Vitória, ES.
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
36
|
Gandini M, Gras C, Azeredo EL, Pinto LMDO, Smith N, Despres P, da Cunha RV, de Souza LJ, Kubelka CF, Herbeuval JP. Dengue virus activates membrane TRAIL relocalization and IFN-α production by human plasmacytoid dendritic cells in vitro and in vivo. PLoS Negl Trop Dis 2013; 7:e2257. [PMID: 23755314 PMCID: PMC3675005 DOI: 10.1371/journal.pntd.0002257] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2012] [Accepted: 04/28/2013] [Indexed: 12/15/2022] Open
Abstract
Background Dengue displays a broad spectrum of clinical manifestations that may vary from asymptomatic to severe and even fatal features. Plasma leakage/hemorrhages can be caused by a cytokine storm induced by monocytes and dendritic cells during dengue virus (DENV) replication. Plasmacytoid dendritic cells (pDCs) are innate immune cells and in response to virus exposure secrete IFN-α and express membrane TRAIL (mTRAIL). We aimed to characterize pDC activation in dengue patients and their function under DENV-2 stimulation in vitro. Methods & Findings Flow cytometry analysis (FCA) revealed that pDCs of mild dengue patients exhibit significantly higher frequencies of mTRAIL compared to severe cases or healthy controls. Plasma levels of IFN-α and soluble TRAIL are increased in mild compared to severe dengue patients, positively correlating with pDC activation. FCA experiments showed that in vitro exposure to DENV-2 induced mTRAIL expression on pDC. Furthermore, three dimension microscopy highlighted that TRAIL was relocalized from intracellular compartment to plasma membrane. Chloroquine treatment inhibited DENV-2-induced mTRAIL relocalization and IFN-α production by pDC. Endosomal viral degradation blockade by chloroquine allowed viral antigens detection inside pDCs. All those data are in favor of endocytosis pathway activation by DENV-2 in pDC. Coculture of pDC/DENV-2-infected monocytes revealed a dramatic decrease of antigen detection by FCA. This viral antigens reduction in monocytes was also observed after exogenous IFN-α treatment. Thus, pDC effect on viral load reduction was mainly dependent on IFN-α production Conclusions This investigation characterizes, during DENV-2 infection, activation of pDCs in vivo and their antiviral role in vitro. Thus, we propose TRAIL-expressing pDCs may have an important role in the outcome of disease. Dengue is an important endemic tropical disease to which there are no specific therapeutics or approved vaccines. Currently several aspects of pathophysiology remain incompletely understood. A crucial cellular population for viral infections, the plasmacytoid dendritic cells (pDCs) was analyzed in this study. The authors found an in vivo association between the activation state of pDCs and the disease outcome. Membrane TNF-related apoptosis inducing ligand (TRAIL) expressing pDCs, representing activated pDCs, were found in higher frequency in milder cases of dengue than severe cases or healthy individuals. Detection of antiviral cytokine interferon-alpha (IFN-α) and soluble TRAIL positively correlated with pDC activation. Dengue virus (DENV) serotype-2 was able to directly activate pDCs in vitro. Under DENV stimulation TRAIL was relocalized from intracellular to pDC plasma membrane and IFN-α was highly produced. The authors suggest an endocytosis-dependent pathway for DENV-induced pDC activation. It is also highlighted here a role for exogenous IFN-α and pDCs in reducing viral replication in monocytes, one of DENV main target cells. These findings may contribute in the future to the establishment of good prognostic immune responses together with clinical manifestations/warning signs.
Collapse
Affiliation(s)
- Mariana Gandini
- Laboratório de Imunologia Viral, Instituto Oswaldo Cruz, FIOCRUZ, Rio de Janeiro, Brazil
| | | | | | | | - Nikaïa Smith
- Chimie et Biologie, Nucléo(s)tides et Immunologie Thérapeutique (CBNIT), CNRS UMR 8601 Université Paris Descartes, Paris, France
| | - Philippe Despres
- Unité des Interactions moléculaires Flavivirus-Hôtes, Institut Pasteur, Paris, France
| | - Rivaldo Venâncio da Cunha
- Departamento de Clínica Medica, FM, Universidade Federal do Mato Grosso do Sul, Campo Grande, Brazil
| | | | | | - Jean-Philippe Herbeuval
- Chimie et Biologie, Nucléo(s)tides et Immunologie Thérapeutique (CBNIT), CNRS UMR 8601 Université Paris Descartes, Paris, France
- * E-mail:
| |
Collapse
|
37
|
Reis CB, Andrade SMOD, Cunha RVD. Aliados do A. Aegypti: fatores contribuintes para a ocorrência do dengue segundo as representações sociais dos profissionais das equipes de saúde da família. Ciênc saúde coletiva 2013; 18:517-26. [DOI: 10.1590/s1413-81232013000200023] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2011] [Accepted: 08/25/2011] [Indexed: 11/22/2022] Open
Abstract
Historicamente as políticas de saúde e as ações de combate ao dengue são pautadas no controle vetorial, com atividades de campo, deixando em segundo plano as atividades de educação em saúde. Conhecer as representações sociais de profissionais de unidades de saúde da família, sobre os fatores que contribuem para a manutenção dos índices de ocorrência do dengue é o objetivo desta pesquisa de forma a contribuir para a melhoria da comunicação entre profissionais de saúde e população, visando o controle da doença. Foi realizado estudo qualitativo com profissionais da estratégia de saúde da família de seis municípios selecionados, sendo os dados tabulados pela técnica do Discurso do Sujeito Coletivo. Os resultados mostraram quatro discursos referentes a aspectos que foram levantados através da pergunta sobre qual a causa da ocorrência de dengue. Conclui-se que os profissionais atribuem à população parte importante da responsabilidade pela ocorrência do dengue, mas também observam a falta de estrutura e organização dos serviços, bem como percebem dificuldades para que ocorra a mudança dos comportamentos observados com os recursos disponíveis.
Collapse
|
38
|
Reis CB, Andrade SMO, Cunha RVD. Responsabilização do outro: discursos de enfermeiros da Estratégia Saúde da Família sobre ocorrência de dengue. Rev Bras Enferm 2013; 66:74-8. [DOI: 10.1590/s0034-71672013000100011] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2011] [Accepted: 02/06/2013] [Indexed: 11/22/2022] Open
Abstract
O objetivo desta pesquisa foi conhecer, a partir do discurso dos enfermeiros da Estratégia Saúde da Família, os comportamentos da população em relação ao dengue, com a finalidade de melhorar a comunicação entre profissionais e população. Foi realizado um estudo qualitativo com enfermeiros da Estratégia Saúde da Família de seis municípios selecionados, sendo os dados analisados pela técnica do Discurso do Sujeito Coletivo. Os resultados mostraram quatro ideias centrais sobre o comportamento da população, a quem os enfermeiros atribuem parte importante da responsabilidade pela ocorrência da dengue. Conclui-se que o discurso dos enfermeiros aponta para a responsabilização do outro, seja um ente público ou privado, individual ou coletivo. Generalizam os comportamentos, apontando para aqueles negativos, que contribuem para a ocorrência da doença. Entende-se ser necessário implementar ações especificas com o objetivo de mudar condutas e mantê-las a longo prazo.
Collapse
|
39
|
Santos SCD, Marques AMC, Oliveira RLD, Cunha RVD. Scoring system for the diagnosis of tuberculosis in indigenous children and adolescents under 15 years of age in the state of Mato Grosso do Sul, Brazil. J Bras Pneumol 2013; 39:84-91. [PMID: 23503490 PMCID: PMC4075805 DOI: 10.1590/s1806-37132013000100012] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2012] [Accepted: 10/11/2012] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVE To evaluate the process of diagnosing pulmonary tuberculosis in smear-negative indigenous children and adolescents under 15 years of age with the modified Brazilian National Ministry of Health Scoring System (mBNMH-SS). METHODS This was a retrospective descriptive study involving 49 indigenous patients under 15 years of age with tuberculosis, treated between 2007 and 2010 in the state of Mato Grosso do Sul, Brazil. RESULTS Of the 49 patients, 27 (56%) were under 5 years of age, 33 (67%) had symptoms suggestive of tuberculosis, 24 (49%) were underweight, and 36 (73.5%) had been BCG vaccinated. The tuberculin skin test was positive in 28 patients (57%), 18 (64%) of whom had an induration > 10 mm. Chest X-rays were performed in 37 (76%) of the patients, 31 (84%) of whom had only one chest X-ray taken. Among those 37 patients, the radiological findings were suggestive of tuberculosis in 16 (43%), infiltration/condensation in 10 (27%), and normal in 4 (11%). The Indigenous Health Care Teams made the diagnosis in 31 (63%) of the cases, using the original BNMH-SS in only 14 (45%). We calculated the mBNMH-SS scores for 30 (61%) of the 49 patients. Among the 30 cases scored, a diagnosis of tuberculosis was found to be highly likely, possible, and unlikely in 16 (53%), 11 (37%), and 3 (10%), respectively. CONCLUSIONS The proportion of highly likely and possible diagnoses was consistent with the standard proportion of cases diagnosed by the teams (90%), demonstrating the epidemiological applicability of the mBNMH-SS for the diagnosis of pulmonary tuberculosis in the indigenous population, within the scenario of the health care provided.
Collapse
|
40
|
Domingos H, Cunha RVD, Paniago AMM, Souza ASD, Rodrigues RL, Domingos JA. Rosuvastatin and ciprofibrate in the treatment of dyslipidemia in patients with HIV. Arq Bras Cardiol 2012; 99:997-1007. [PMID: 23108642 DOI: 10.1590/s0066-782x2012005000096] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2011] [Accepted: 06/01/2012] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND Dyslipidemia secondary to highly active antiretroviral therapy in patients with HIV is associated with a significant increase in cardiovascular morbidity and mortality due to atherosclerotic disease, requiring, thus, immediate and effective treatment. OBJECTIVE To demonstrate the effectiveness and safety of rosuvastatin and ciprofibrate in the treatment of dyslipidemia associated with highly active antiretroviral therapy in patients with HIV. METHODS Three hundred and forty-six patients with dyslipidemia underwent pharmacological treatment as follows: 200 patients with hypertriglyceridemia received ciprofibrate (Group I); 79 patients with hypercholesterolemia received rosuvastatin (Group II); and 67 patients with mixed dyslipidemia received ciprofibrate associated with rosuvastatin (Group III). The lipid profile was assessed before and after the lipid-lowering treatment, and the Wilcoxon test was used for statistical comparison. Liver transaminases and creatine phosphokinase were measured to assess liver and muscle toxicity. RESULTS The serum concentrations of triglycerides and total cholesterol were significantly lower than those obtained before the lipid-lowering treatment in the three experimental groups (p < 0.002). A significant increase in HDL-cholesterol was observed in Groups I and III (p < 0.002). In Groups I and II, LDL-cholesterol was significantly lower (p < 0.001). None of the patients experienced elevations in transaminases or creatine phosphokinase to significantly toxic levels. CONCLUSION The results of this study show that ciprofibrate and rosuvastatin or a combination of both can be considered an effective, safe and well-tolerated lipid-lowering treatment for patients with AIDS on highly active antiretroviral therapy.
Collapse
Affiliation(s)
- Hamilton Domingos
- Faculdade de Medicina, Universidade Federal de Mato Grosso do Sul, Campo Grande, MS, Brasil.
| | | | | | | | | | | |
Collapse
|
41
|
da Cunha RV, de Oliveira ECL. Hematological and biochemical findings in patients with dengue fever: a current issue. Rev Bras Hematol Hemoter 2012; 34:78-9. [PMID: 23049396 PMCID: PMC3459387 DOI: 10.5581/1516-8484.20120026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2012] [Accepted: 02/15/2012] [Indexed: 11/27/2022] Open
|
42
|
de-Oliveira-Pinto LM, Marinho CF, Povoa TF, de Azeredo EL, de Souza LA, Barbosa LDR, Motta-Castro ARC, Alves AMB, Ávila CAL, de Souza LJ, da Cunha RV, Damasco PV, Paes MV, Kubelka CF. Regulation of inflammatory chemokine receptors on blood T cells associated to the circulating versus liver chemokines in dengue fever. PLoS One 2012; 7:e38527. [PMID: 22815692 PMCID: PMC3398008 DOI: 10.1371/journal.pone.0038527] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2012] [Accepted: 05/07/2012] [Indexed: 11/18/2022] Open
Abstract
Little is known about the role of chemokines/chemokines receptors on T cells in natural DENV infection. Patients from DENV-2 and -3- outbreaks were studied prospectively during the acute or convalescent phases. Expression of chemokine receptor and activation markers on lymphocyte subpopulations were determined by flow cytometry analysis, plasma chemokine ligands concentrations were measured by ELISA and quantification of CCL5/RANTES+ cells in liver tissues from fatal dengue cases was performed by immunochemistry. In the acute DENV-infection, T-helper/T-cytotoxic type-1 cell (Th1/Tc1)-related CCR5 is significantly higher expressed on both CD4 and CD8 T cells. The Th1-related CXCR3 is up-regulated among CD4 T cells and Tc2-related CCR4 is up-regulated among CD8 T cells. In the convalescent phase, all chemokine receptor or chemokine ligand expression tends to reestablish control healthy levels. Increased CCL2/MCP-1 and CCL4/MIP-1β but decreased CCL5/RANTES levels were observed in DENV-patients during acute infection. Moreover, we showed an increased CD107a expression on CCR5 or CXCR3-expressing T cells and higher expression of CD29, CD44HIGH and CD127LOW markers on CCR4-expressing CD8 T cells in DENV-patients when compared to controls. Finally, liver from dengue fatal patients showed increased number of cells expressing CCL5/RANTES in three out of four cases compared to three death from a non-dengue patient. In conclusion, both Th1-related CCR5 and CXCR3 among CD4 T cells have a potential ability to exert cytotoxicity function. Moreover, Tc1-related CCR5 and Tc2-related CCR4 among CD8 T cells have a potential ability to exert effector function and migration based on cell markers evaluated. The CCR5 expression would be promoting an enhanced T cell recruitment into liver, a hypothesis that is corroborated by the CCL5/RANTES increase detected in hepatic tissue from dengue fatal cases. The balance between protective and pathogenic immune response mediated by chemokines during dengue fever will be discussed.
Collapse
|
43
|
Oliveira SMDVLD, Ruffino-Netto A, Paniago AMM, Oliveira OAD, Marques M, Cunha RVD, Andreotti R. Tuberculin skin test: operational research in the state of Mato Grosso do Sul, Brazil. J Bras Pneumol 2012; 37:646-54. [PMID: 22042397 DOI: 10.1590/s1806-37132011000500012] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2011] [Accepted: 06/20/2011] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE To investigate operational aspects of tuberculin skin test (TST) use in tuberculosis control programs and at specialized Brazilian National Sexually Transmitted Diseases/AIDS and Viral Hepatitis Program health care clinics in priority municipalities for tuberculosis control in the state of Mato Grosso do Sul, Brazil. METHODS This was a descriptive, cross-sectional, epidemiological survey. Data on qualifications/training of professionals administering TSTs, timing of the TST, procedures in cases of loss to follow-up (reading), material availability, and material storage were collected through interviews and technical visits. For the 2008-2009 period, we determined the numbers of screenings in vulnerable populations, of TSTs performed, and of patients treated for latent tuberculosis. RESULTS We interviewed 12 program managers in six municipalities. Some programs/clinics did not perform TSTs. Nursing teams administered the TSTs, results were read by non-specialists, and specialization/refresher courses were scarce. The PPD RT23 was stored in 5-mL flasks under appropriate conditions. Insulin syringes were commonly used. Testing was available during business hours, three times a week. In cases of loss to follow-up, telephone calls or home visits were made. Of the 2,305 TSTs evaluated, 1,053 (46%) were performed in indigenous populations; 831 (36%) were screenings in prisons, performed for training; and only 421 (18%) involved contacts of tuberculosis patients or vulnerable populations. Four vulnerable patients and 126 indigenous subjects were treated for latent tuberculosis. CONCLUSIONS These priority municipalities showed operational difficulties regarding human resources, materials, and data records.
Collapse
|
44
|
Driemeier M, Andrade SMOD, Pontes ERJC, Paniago AMM, Cunha RVD. Vulnerability to AIDS among the elderly in an urban center in central Brazil. Clinics (Sao Paulo) 2012; 67:19-25. [PMID: 22249476 PMCID: PMC3248596 DOI: 10.6061/clinics/2012(01)04] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2011] [Revised: 08/28/2011] [Accepted: 09/14/2011] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVE As the world population ages with an improved quality of life and sexual longevity, the prevalence of AIDS is rising among the elderly. The purpose of this study was to estimate the vulnerability to AIDS among individuals attending senior community centers in Campo Grande, Mato Grosso do Sul, Brazil. METHOD This descriptive, exploratory investigation included 329 subjects selected in a probabilistic manner. Individuals with scores on the Mini-Mental State Examination indicating cognitive impairment were excluded from the analyses. Barthel's and Lawton's functional assessment scales were applied. Interviews were conducted to evaluate the presence of cognitive and behavioral factors associated with HIV transmission. RESULTS Most subjects were non-dependent, fell within the 60- to 69-year age bracket and were female. A majority of individuals reported having knowledge about AIDS and were aware that the elderly are vulnerable to the disease. More than a quarter (26.9%) of the sample reported previous HIV testing. No participants reported drug use, homosexual orientation, or alcohol abuse. A minority of participants reported using medication for erectile dysfunction. Casual and multiple partners accounted for 12% and 34% of reported intercourse experiences, respectively. Condom use was reported by 14% of respondents. CONCLUSION Unprotected sex was the primary factor accounting for vulnerability to AIDS among the elderly.
Collapse
|
45
|
Nascimento DD, Castro ARCMD, Froes ÍB, Bigaton G, Oliveira ÉCLD, Dal Fabbro MFJ, Cunha RVD, Costa IPD. Clinical and laboratory findings in patients with dengue associated with hepatopathy. Rev Soc Bras Med Trop 2011; 44:674-7. [DOI: 10.1590/s0037-86822011005000061] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2010] [Accepted: 05/17/2011] [Indexed: 01/12/2023] Open
Abstract
INTRODUCTION: Hepatic disorders caused by dengue infection may progress to severe manifestations, including mortality and morbidity. Cytokines are involved in it, such as the migration inhibitory factor of macrophages (MIF), tumor necrosis factor (TNF), natural killer cells (NK), B lymphocytes, and macrophages. METHODS: This study was carried out from January to April 2007 at a public hospital from the Federal University of Mato Grosso do Sul, Campo Grande, Brazil. Sixty-eight patients were studied concerning hepatic alterations, with 56 reported having classic dengue, 6 with hemorrhagic dengue grade I, and 6 with hemorrhagic dengue grade II. RESULTS: Among the 56 with classic dengue, 83.3% had aspartate aminotransferase (AST) alterations, and 69.6% had altered alanine aminotransferase (ALT). For those with hemorrhagic dengue grade I, 100% had AST alterations, and 83.3% had altered ALT. All the patients with hemorrhagic dengue grade II had AST and ALT alterations. AST variations reached 22.0 and 907.0, with an average value of 164.6. For ALT, we found variations between 25.0 and 867.0, with an average value of 166.07. There had been statistical significance between dengue clinical shapes and hepatic function markers. CONCLUSIONS: We conclude that the infection was predominant in adults, females, and in those with low income and education. The liver enzymes were of larger amount in hemorrhagic dengue, but there was weak statistical evidence of the clinical manifestations and transaminases. Major signs and clinical symptoms were fever, headache, myalgia, arthralgia, weakness, severe pain behind the eyes, and rashes.
Collapse
|
46
|
|
47
|
Alexandrino-de-Oliveira P, Santos-Oliveira JR, Dorval MEC, Da-Costa FDCB, Pereira GROL, da Cunha RV, Paniago AMM, Da-Cruz AM. HIV/AIDS-associated visceral leishmaniasis in patients from an endemic area in Central-west Brazil. Mem Inst Oswaldo Cruz 2011; 105:692-7. [PMID: 20835619 DOI: 10.1590/s0074-02762010000500016] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2010] [Accepted: 05/13/2010] [Indexed: 12/27/2022] Open
Abstract
An increase in morbidity associated with visceral leishmaniasis (VL) in human immunodeficiency virus (HIV)/AIDS patients has been described in Africa and the Mediterranean. Despite the high endemicity of VL and HIV-1/AIDS in Brazil, this association has not been thoroughly investigated. Our aim was to evaluate the epidemiologic and clinical characteristics of VL-HIV-1/AIDS cases from Central-west [Mato Grosso do Sul (MS)] Brazil. Medical records of 23 VL-HIV-1/AIDS patients were reviewed. Patients were predominantly adult males (87%) and 34.8% of the patients were intravenous drug users (IVDU). Leishmaniasis was the first opportunistic infection in 60% of the HIV-1 patients. Fever occurred in all patients, although splenomegaly and hepatomegaly were absent in 21.7% of the cases. CD4+ T-cell counts were below 200 cells/mm(3) in 80% of the cases and the counts did not increase after clinical remission despite antiretroviral therapy. The first drug chosen to treat the cases was antimonial, but the therapeutic regimen was altered to amphotericin B in 12 of 17 cases due to side effects. Relapses were reported in 56.5% of the patients. IVDU may constitute an important risk factor for the transmission of both diseases in MS. VL-HIV-1/AIDS patients in MS share similar clinical characteristics as those from other endemic regions worldwide. Thus, these findings are critical for improving the surveillance of VL-HIV/AIDS patients.
Collapse
|
48
|
Marques AMC, Pompilio MA, Santos SCD, Garnês SJDA, Cunha RVD. Tuberculose em indígenas menores de 15 anos, no Estado de Mato Grosso do Sul. Rev Soc Bras Med Trop 2010; 43:700-4. [DOI: 10.1590/s0037-86822010000600020] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2010] [Accepted: 07/13/2010] [Indexed: 11/22/2022] Open
Abstract
INTRODUÇÃO O objetivo do estudo foi descrever os aspectos epidemiológicos da tuberculose na população indígena com idade inferior a quinze anos, de Mato Grosso do Sul, Brasil, no período de 2000 a 2006, após a implantação do Subsistema de Saúde Indígena. MÉTODOS: Estudo descritivo, retrospectivo, de base de dados secundários, utilizando-se o Banco de dados do Distrito Sanitário Especial Indígena de Mato Grosso do Sul e do Sistema de Informações de Agravos de Notificação. Variáveis analisadas: frequência por grupo etário, distribuição por sexo, forma clínica e desfecho dos casos. Teste de Fischer e curva de tendência para incidência, p < 0,01. RESULTADOS: A proporção de casos de tuberculose em indígenas com idade inferior a 15 anos foi de 20,4% (224/1.096). Verificou-se elevados coeficientes de incidência de tuberculose em indígenas com menos de 15 anos de idade, porém com curva descendente e uma queda anual em torno de 14%. Houve predomínio em indivíduos com idade inferior a 5 anos e elevado número de casos com idade inferior a 1 ano. Mais da metade dos casos era do sexo masculino e a forma clínica pulmonar ocorreu em 92,9%. A maioria (91,1%) dos casos evoluiu para cura, 3,6% abandonaram o tratamento e 2,2% evoluíram para óbito. CONCLUSÕES: A elevada taxa de cura, a reduzida mortalidade e a progressiva queda de incidência da doença no grupo etário inferior a 15 anos apontam para a efetividade da estratégia do tratamento supervisionado da tuberculose, no contexto do novo modelo de assistência à saúde indígena implantado no ano de 2000.
Collapse
|
49
|
Oliveira ECLD, Pontes ERJC, Cunha RVD, Fróes IB, Nascimento DD. [Hematological abnormalities in patients with dengue]. Rev Soc Bras Med Trop 2010; 42:682-5. [PMID: 20209355 DOI: 10.1590/s0037-86822009000600014] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2009] [Accepted: 11/09/2009] [Indexed: 11/22/2022] Open
Abstract
Dengue is a neglected disease with high morbidity and mortality among children and adults that occurs mainly in tropical and subtropical regions. The objective of this study was to evaluate hematological changes in patients with clinical manifestations of dengue. Medical records relating to 543 cases of dengue virus 3 that occurred during the 2007 epidemic in Campo Grande, Mato Grosso do Sul, were studied. Cases of classic dengue predominated (90.2%), with mild clinical manifestations lacking complications. The main hematological findings were leukopenia (68.3%), thrombocytopenia (66.5%), lymphocytopenia (67.2%) and atypical lymphocytes (67%). In dengue hemorrhagic fever, thrombocytopenia was more prolonged and the number of atypical lymphocytes was higher, while the other hematological abnormalities presented daily evolution similar to those in classic dengue. The hematological changes observed in dengue present according to the clinical course of the disease and its severity.
Collapse
|
50
|
Domingos H, Cunha RVD, Paniago AMM, Martins DM, Elkhoury EB, Souza ASD. Metabolic effects associated to the highly active antiretroviral therapy (HAART) in AIDS patients. Braz J Infect Dis 2010; 13:130-6. [PMID: 20140358 DOI: 10.1590/s1413-86702009000200012] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2008] [Indexed: 11/22/2022] Open
Abstract
The aim of this study was to evaluate the metabolic abnormalities (dyslipidaemia and insulin resistance) associated with highly active antiretroviral therapy (HAART) in AIDS patients, treated in Campo Grande, Mato Grosso do Sul, Brazil. The patients were distributed in five different groups: Group 1, HIV-infected without antiretroviral therapy; Group 2, with Zidovudine, Lamivudine and Efavirenz or Nevirapine; Group 3, with Zidovudine, Lamivudine and Protease Inhibitor; Group 4, with Stavudine, Lamivudine and Efavirenz or Nevirapine; and Group 5, with Stavudine, Lamivudine and Protease Inhibitor. The lipid and glucose profile were determined and statistics comparison was made. The findings of this study showed significant statistics elevations of total cholesterol and triglycerides levels in patients of Groups 3, 4 and 5, when comparing to patients of Groups 1 and 2. Significant differences were not observed between the groups in the others parameters evaluated: Glucose, HDL cholesterol and LDL cholesterol. Comparing two drugs of same class (NNRTI) through the subgroups II-efavirenz and II-nevirapine, significant differences in the serum levels of total cholesterol, triglycerides and glucose favorable to the subgroup II-NVP were observed. These findings suggest that combinations including Protease Inhibitors and/or Stavudine could cause more adverse metabolic effects, and if possible, should be avoided in patients with others cardiovascular risk factors to prevent the precocious atherosclerosis in AIDS patients receiving HAART.
Collapse
|