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Mesquita SG, Gadd G, Coelho FS, Cieplinski A, Emery A, Lugli EB, Simões TC, Fonseca CT, Caldeira RL, Webster B. Laboratory and field validation of the recombinase polymerase amplification assay targeting the Schistosoma mansoni mitochondrial minisatellite region (SmMIT-RPA) for snail xenomonitoring for schistosomiasis. Int J Parasitol 2024; 54:247-256. [PMID: 38311021 DOI: 10.1016/j.ijpara.2024.01.005] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Revised: 12/22/2023] [Accepted: 01/29/2024] [Indexed: 02/06/2024]
Abstract
Improvements in diagnostics for schistosomiasis in both humans and snail hosts are priorities to be able to reach the World Health Organization (WHO) goal of eliminating the disease as a public health problem by 2030. In this context, molecular isothermal amplification tests, such as Recombinase Polymerase Amplification (RPA), are promising for use in endemic areas at the point-of-need for their accuracy, robustness, simplicity, and time-effectiveness. The developed recombinase polymerase amplification assay targeting the Schistosoma mansoni mitochondrial minisatellite region (SmMIT-RPA) was used to detect S. mansoni DNA from both laboratory and field Biomphalaria snails. Laboratory snails were experimentally infected and used at one, seven, and 28 days post-exposure (dpe) to 10 S. mansoni miracidia to provide samples in the early pre-patent infection stage. Field samples of Biomphalaria spp. were collected from the Mucuri Valley and Jequitinhonha Valley regions in the state of Minas Gerais, Brazil, which are endemic for S. mansoni. The sensitivity and specificity of the SmMIT-RPA assay were analysed and compared with existing loop-mediated isothermal amplification (LAMP), PCR-based methods, parasitological examination of the snails, and nucleotide sequencing. The SmMIT-RPA assay was able to detect S. mansoni DNA in the experimentally infected Biomphalaria glabrata as early as one dpe to 10 miracidia. It also detected S. mansoni infections (55.5% prevalence) in the field samples with the highest accuracy (100% sensitivity and specificity) compared with the other molecular tests used as the reference. Results from this study indicate that the SmMIT-RPA assay is a good alternative test to be used for snail xenomonitoring of S. mansoni due to its high sensitivity, accuracy, and the possibility of detecting early pre-patent infection. Its simplicity and portability also make it a suitable methodology in low-resource settings.
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Affiliation(s)
- Silvia Gonçalves Mesquita
- Department of Science, Natural History Museum, London, United Kingdom; Grupo de Pesquisa em Helmintologia e Malacologia Médica, Instituto René Rachou, Fundação Oswaldo Cruz, Belo Horizonte, Minas Gerais, Brasil.
| | - Grace Gadd
- Department of Science, Natural History Museum, London, United Kingdom; Department of Clinical Research, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Fernanda Sales Coelho
- Department of Science, Natural History Museum, London, United Kingdom; Department of Clinical Research, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Adam Cieplinski
- Department of Science, Natural History Museum, London, United Kingdom
| | - Aidan Emery
- Department of Science, Natural History Museum, London, United Kingdom
| | | | - Taynãna César Simões
- Núcleo de Estudos em Saúde Pública e Envelhecimento, Instituto René Rachou, Fundação Oswaldo Cruz, Belo Horizonte, Minas Gerais, Brasil
| | - Cristina Toscano Fonseca
- Grupo de Pesquisa em Biologia e Imunologia Parasitária, Instituto René Rachou, Fundação Oswaldo Cruz, Belo Horizonte, Minas Gerais, Brasil
| | - Roberta Lima Caldeira
- Grupo de Pesquisa em Helmintologia e Malacologia Médica, Instituto René Rachou, Fundação Oswaldo Cruz, Belo Horizonte, Minas Gerais, Brasil
| | - Bonnie Webster
- Department of Science, Natural History Museum, London, United Kingdom.
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Bruhn FRP, Werneck GL, Barbosa DS, Câmara DCP, Simões TC, Buzanovsky LP, Duarte AGS, de Melo SN, Cardoso DT, Donato LE, Maia-Elkhoury ANS, Belo VS. Spatio-temporal dynamics of visceral leishmaniasis in Brazil: A nonlinear regression analysis. Zoonoses Public Health 2024; 71:144-156. [PMID: 37984837 DOI: 10.1111/zph.13092] [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: 05/22/2023] [Revised: 10/06/2023] [Accepted: 10/29/2023] [Indexed: 11/22/2023]
Abstract
AIMS This study describes the spatio-temporal dynamics of new visceral leishmaniasis (VL) cases notified in Brazil between 2001 and 2020. METHODS AND RESULTS Data on the occurrence of the disease were obtained by means of the Notifiable Diseases Information System of the Brazilian Ministry of Health. Joinpoint, temporal generalized additive models and conditional autoregressive (CAR) models were used to analyse the temporal evolution of the rates in Brazil, states and regions. Spatio-temporal generalized additive and CAR models were used to identify the distribution of annual risks of VL occurrence in the Brazilian territory in relation to variation in the spatial average. There were 63,966 VL cases in the target period (3.198 cases/year), corresponding to a mean incidence rate of 1.68 cases/100,000 inhabitants. Of these, 4451 resulted in deaths, which gives a mean mortality rate of 0.12 deaths/100,000 inhabitants and a case fatality of 6.96%. The highest incidence rate was found in the North region, followed closely by the Northeast region, which presented the second and first highest mortality rates, respectively. For all of Brazil, and in the Northeast region, there were stability in the incidence rates, while the other regions showed an increasing trend in different time segments in the period: Central-West up to 2011, North up to 2008, Southeast up to 2004, and South up to 2010. On the other hand, all regions experienced a reduction in incidence rate during the last years of the series. The Northeast region had the highest number of municipalities with statistically significant elevated relative risks. The spatio-temporal analysis showed the highest risk area predominantly in the Northeast region in the beginning of the time series. From 2002 to 2018, this area expanded to the interior of the country. CONCLUSIONS The present study has shown that VL has expanded in Brazil. However, the North and Northeast regions continue to have the highest incidence, and the risk of infection has decreased in recent years.
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Affiliation(s)
- Fábio Raphael Pascoti Bruhn
- Laboratório de Epidemiologia Veterinária, Departamento de Veterinária Preventiva, Universidade Federal de Pelotas, Capão do Leão, Rio Grande do Sul, Brazil
| | - Guilherme Loureiro Werneck
- Departamento de Epidemiologia, Instituto de Medicina Social, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | - David Soeiro Barbosa
- Departamento de Parasitologia, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | | | - Taynãna César Simões
- NESPE - Núcleo de Estudos em Saúde Pública e Envelhecimento, Instituto Rene Rachou (Fiocruz-Minas), Belo Horizonte, Minas Gerais, Brazil
| | | | | | - Saulo Nascimento de Melo
- Universidade Federal de São João del-Rei, Campus Centro-Oeste Dona Lindu, Divinópolis, MG, Brazil
| | - Diogo Tavares Cardoso
- Departamento de Parasitologia, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | | | | | - Vinícius Silva Belo
- Universidade Federal de São João del-Rei, Campus Centro-Oeste Dona Lindu, Divinópolis, MG, Brazil
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Mesquita SG, Caldeira RL, Favre TC, Massara CL, Beck LCNH, Simões TC, de Carvalho GBF, Neves FGDS, de Oliveira G, Lacerda LDSB, de Almeida MA, Carvalho ODS, Mourão MM, Oliveira E, Silva-Pereira RA, Fonseca CT. Corrigendum: Assessment of the accuracy of 11 different diagnostic tests for the detection of Schistosomiasis mansoni in individuals from a Brazilian area of low endemicity using latent class analysis. Front Microbiol 2023; 14:1331715. [PMID: 38033597 PMCID: PMC10686067 DOI: 10.3389/fmicb.2023.1331715] [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: 11/01/2023] [Accepted: 11/02/2023] [Indexed: 12/02/2023] Open
Abstract
[This corrects the article DOI: 10.3389/fmicb.2022.1048457.].
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Affiliation(s)
- Silvia Gonçalves Mesquita
- Grupo de Pesquisa em Helmintologia e Malacologia Médica, Instituto René Rachou, Fundação Oswaldo Cruz, Belo Horizonte, Minas Gerais, Brazil
| | - Roberta Lima Caldeira
- Grupo de Pesquisa em Helmintologia e Malacologia Médica, Instituto René Rachou, Fundação Oswaldo Cruz, Belo Horizonte, Minas Gerais, Brazil
| | - Tereza Cristina Favre
- Laboratório de Educação em Ambiente e Saúde, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
| | - Cristiano Lara Massara
- Grupo de Pesquisa em Helmintologia e Malacologia Médica, Instituto René Rachou, Fundação Oswaldo Cruz, Belo Horizonte, Minas Gerais, Brazil
| | | | - Taynãna César Simões
- Núcleo de Estudos em Saúde Pública e Envelhecimento, Instituto René Rachou, Fundação Oswaldo Cruz, Belo Horizonte, Minas Gerais, Brazil
| | - Gardênia Braz Figueiredo de Carvalho
- Grupo de Pesquisa em Biologia e Imunologia de Doenças Infecciosas e Parasitárias, Instituto René Rachou, Fundação Oswaldo Cruz, Belo Horizonte, Minas Gerais, Brazil
| | - Flória Gabriela dos Santos Neves
- Grupo de Pesquisa em Helmintologia e Malacologia Médica, Instituto René Rachou, Fundação Oswaldo Cruz, Belo Horizonte, Minas Gerais, Brazil
| | - Gabriela de Oliveira
- Grupo de Pesquisa em Biologia e Imunologia de Doenças Infecciosas e Parasitárias, Instituto René Rachou, Fundação Oswaldo Cruz, Belo Horizonte, Minas Gerais, Brazil
| | - Larisse de Souza Barbosa Lacerda
- Grupo de Pesquisa em Biologia e Imunologia de Doenças Infecciosas e Parasitárias, Instituto René Rachou, Fundação Oswaldo Cruz, Belo Horizonte, Minas Gerais, Brazil
| | - Matheus Alves de Almeida
- Grupo de Pesquisa em Genômica Funcional de Parasitos, Instituto René Rachou, Fundação Oswaldo Cruz, Belo Horizonte, Minas Gerais, Brazil
| | - Omar dos Santos Carvalho
- Grupo de Pesquisa em Helmintologia e Malacologia Médica, Instituto René Rachou, Fundação Oswaldo Cruz, Belo Horizonte, Minas Gerais, Brazil
| | - Marina Moraes Mourão
- Grupo de Pesquisa em Helmintologia e Malacologia Médica, Instituto René Rachou, Fundação Oswaldo Cruz, Belo Horizonte, Minas Gerais, Brazil
| | - Edward Oliveira
- Grupo de Pesquisa em Genômica Funcional de Parasitos, Instituto René Rachou, Fundação Oswaldo Cruz, Belo Horizonte, Minas Gerais, Brazil
| | - Rosiane A. Silva-Pereira
- Grupo de Pesquisa em Biologia e Imunologia de Doenças Infecciosas e Parasitárias, Instituto René Rachou, Fundação Oswaldo Cruz, Belo Horizonte, Minas Gerais, Brazil
| | - Cristina Toscano Fonseca
- Grupo de Pesquisa em Biologia e Imunologia de Doenças Infecciosas e Parasitárias, Instituto René Rachou, Fundação Oswaldo Cruz, Belo Horizonte, Minas Gerais, Brazil
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Franco-Luiz APM, Fernandes NMGS, Silva TBDS, Bernardes WPDOS, Westin MR, Santos TG, Fernandes GDR, Simões TC, Silva EFE, Gava SG, Alves BM, de Carvalho Melo M, da Silva-Pereira RA, Alves PA, Fonseca CT. Longitudinal study of humoral immunity against SARS-CoV-2 of health professionals in Brazil: the impact of booster dose and reinfection on antibody dynamics. Front Immunol 2023; 14:1220600. [PMID: 37520570 PMCID: PMC10376701 DOI: 10.3389/fimmu.2023.1220600] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Accepted: 06/26/2023] [Indexed: 08/01/2023] Open
Abstract
Introduction The pandemic caused by SARS-CoV-2 has had a major impact on health systems. Vaccines have been shown to be effective in improving the clinical outcome of COVID-19, but they are not able to fully prevent infection and reinfection, especially that caused by new variants. Methods Here, we tracked for 450 days the humoral immune response and reinfection in 52 healthcare workers from Brazil. Infection and reinfection were confirmed by RT-qPCR, while IgM and IgG antibody levels were monitored by rapid test. Results Of the 52 participants, 19 (36%) got reinfected during the follow-up period, all presenting mild symptoms. For all participants, IgM levels dropped sharply, with over 47% of them becoming seronegative by the 60th day. For IgG, 90% of the participants became seropositive within the first 30 days of follow-up. IgG antibodies also dropped after this period reaching the lowest level on day 270 (68.5 ± 72.3, p<0.0001). Booster dose and reinfection increased the levels of both antibodies, with the interaction between them resulting in an increase in IgG levels of 130.3 arbitrary units. Conclusions Overall, our data indicate that acquired humoral immunity declines over time and suggests that IgM and IgG antibody levels are not associated with the prevention of reinfection.
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Affiliation(s)
- Ana Paula Moreira Franco-Luiz
- Grupo de Pesquisa em Biologia e Imunologia de Doenças Infecciosas e Parasitárias, Instituto René Rachou, Fundação Oswaldo Cruz, Belo Horizonte, Minas Gerais, Brazil
| | - Nubia Monteiro Gonçalves Soares Fernandes
- Grupo de Pesquisa em Biologia e Imunologia de Doenças Infecciosas e Parasitárias, Instituto René Rachou, Fundação Oswaldo Cruz, Belo Horizonte, Minas Gerais, Brazil
| | - Thais Bárbara de Souza Silva
- Grupo de Imunologia de Doenças Virais, Instituto René Rachou, Fundação Oswaldo Cruz, Belo Horizonte, Minas Gerais, Brazil
| | | | - Mateus Rodrigues Westin
- Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Thais Garcia Santos
- Grupo de Pesquisa em Biologia e Imunologia de Doenças Infecciosas e Parasitárias, Instituto René Rachou, Fundação Oswaldo Cruz, Belo Horizonte, Minas Gerais, Brazil
| | - Gabriel da Rocha Fernandes
- Grupo de Pesquisa em Informática de Biossistemas, Instituto René Rachou, Fundação Oswaldo Cruz, Belo Horizonte, Minas Gerais, Brazil
| | - Taynãna César Simões
- Núcleo de Estudos em Saúde Pública e Envelhecimento, Instituto René Rachou, Fundação Oswaldo Cruz, Belo Horizonte, Minas Gerais, Brazil
| | - Eduardo Fernandes E. Silva
- Serviço de capacitação em métodos quantitativos -SAMeQ, Instituto René Rachou, Fundação Oswaldo Cruz, Belo Horizonte, Minas Gerais, Brazil
| | - Sandra Grossi Gava
- Grupo de Pesquisa em Helmintologia e Malacologia Médica, Instituto René Rachou, Fundação Oswaldo Cruz, Belo Horizonte, Minas Gerais, Brazil
| | - Breno Magalhães Alves
- Centro de Vigilância em Saúde e Segurança do Paciente, Hospital Metropolitano Doutor Célio de Castro, Belo Horizonte, Minas Gerais, Brazil
| | - Mariana de Carvalho Melo
- Serviço Especializado em Segurança e Medicina do Trabalho, Hospital Metropolitano Doutor Célio de Castro, Belo Horizonte, Minas Gerais, Brazil
| | - Rosiane A. da Silva-Pereira
- Grupo de Pesquisa em Biologia e Imunologia de Doenças Infecciosas e Parasitárias, Instituto René Rachou, Fundação Oswaldo Cruz, Belo Horizonte, Minas Gerais, Brazil
| | - Pedro Augusto Alves
- Grupo de Imunologia de Doenças Virais, Instituto René Rachou, Fundação Oswaldo Cruz, Belo Horizonte, Minas Gerais, Brazil
| | - Cristina Toscano Fonseca
- Grupo de Pesquisa em Biologia e Imunologia de Doenças Infecciosas e Parasitárias, Instituto René Rachou, Fundação Oswaldo Cruz, Belo Horizonte, Minas Gerais, Brazil
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Meira KC, Simões TC, Guimarães RM, Beserra da Silva PG, Mendonça AB, Cristina de Jesus J, Covre-Sussai M. Female Homicides in Brazil and Its Major Regions (1980-2019): An Analysis of Age, Period, and Cohort Effects. Violence Against Women 2023:10778012231183657. [PMID: 37415498 DOI: 10.1177/10778012231183657] [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] [Indexed: 07/08/2023]
Abstract
The objective was to analyze the temporal effects of age, period, and cohort on mortality from all female homicides, and from female homicides and by firearms, in Brazil from 1980 to 2019. Data were accessed from Brazilian health records. There was an increase in the risk of death in the 2000s in the North and Northeast regions and a decrease in the Southeast, South, and Midwest. Younger women had a higher risk of death than women born between 1950 and 1954. The findings may be correlated with the inefficiency of the Brazilian state in protecting female victims of violence.
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Affiliation(s)
- Karina Cardoso Meira
- Health School, Federal University of Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil
| | - Taynãna César Simões
- René Rachou Institute, Oswaldo Cruz Foundation, Belo Horizonte, Minas Gerais, Brazil
| | | | - Pedro Gilson Beserra da Silva
- Onofre Lopes University Hospital of the Federal University of Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil
| | | | - Jordana Cristina de Jesus
- Department of Demography and Actuarial Sciences of the Federal University of Rio Grande do Norte, Brazil
| | - Maira Covre-Sussai
- Institute of Social Sciences/Social Sciences Institute (ICS), Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Brazil
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Belo VS, Bruhn FRP, Barbosa DS, Câmara DCP, Simões TC, Buzanovsky LP, Duarte AGS, de Melo SN, Cardoso DT, Donato LE, Maia-Elkhoury ANS, Werneck GL. Temporal patterns, spatial risks, and characteristics of tegumentary leishmaniasis in Brazil in the first twenty years of the 21st Century. PLoS Negl Trop Dis 2023; 17:e0011405. [PMID: 37285388 DOI: 10.1371/journal.pntd.0011405] [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: 02/17/2023] [Accepted: 05/22/2023] [Indexed: 06/09/2023] Open
Abstract
BACKGROUND Tegumentary leishmaniasis (TL) is a significant public health issue in Brazil. The present ecological study describes the clinical and epidemiological characteristics of TL cases reported in the country, and analyzes the spatial and temporal patterns of the incidences and risks of occurrence across the five geopolitical regions and 27 federative units. METHODOLOGY/PRINCIPAL FINDINGS Data regarding new cases of TL notified between 2001 and 2020 were obtained from the Information System for Notifiable Diseases of the Brazilian Ministry of Health. Joinpoint and spatial and temporal generalized additive models were used to establish trends in the evolution of TL during the target period. The incidence rate for the entire period was 226.41 cases/100,000 inhabitants. All regions of Brazil showed trends of decreasing incidence rates, albeit with fluctuations at specific times, with the exception of the Southeast where rates have increased since 2014, most particularly in Minas Gerais state. The disease was concentrated predominantly in the North region, with Acre state leading the incidence rank in the whole country, followed by Mato Grosso (Midwest), Maranhão and Bahia (Northeast) states. The spatial distribution of the risk of TL occurrence in relation to the annual averages was relatively stable throughout the period. The cutaneous form of TL was predominant and cases most frequently occurred in rural areas and among men of working age. The ages of individuals contracting TL tended to increase during the time series. Finally, the proportion of confirmations by laboratory tests was lower in the Northeast. CONCLUSION/SIGNIFICANCE TL shows a declining trend in Brazil, but its widespread occurrence and the presence of areas with increasing incidence rates demonstrate the persistent relevance of this disease and the need for constant monitoring. Our findings reinforce the importance of temporal and spatial tools in epidemiologic surveillance routines and are valuable for targeting preventive and control actions.
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Affiliation(s)
- Vinícius Silva Belo
- Campus Centro-Oeste Dona Lindu, Universidade Federal de São João del-Rei, Divinópolis, Minas Gerais, Brazil
| | - Fábio Raphael Pascoti Bruhn
- Departamento de Veterinária Preventiva, Faculdade de Veterinária, Universidade Federal de Pelotas, Pelotas, Rio Grande do Sul, Brazil
| | - David Soeiro Barbosa
- Departamento de Parasitologia, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Daniel Cardoso Portela Câmara
- Laboratório de Imunologia Viral, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro, Rio de Janeiro, Rio de Janeiro, Brazil
| | - Taynãna César Simões
- Instituto René Rachou, Fundação Oswaldo Cruz, Belo Horizonte, Minas Gerais, Brazil
| | - Lia Puppim Buzanovsky
- Centro Pan-Americano de Febre Aftosa, Organização Pan-Americana da Saúde, Rio de Janeiro, Rio de Janeiro, Brazil
- Organização Pan-Americana da Saúde, Rio de Janeiro, Rio de Janeiro, Brazil
| | - Anna Gabryela Sousa Duarte
- Campus Centro-Oeste Dona Lindu, Universidade Federal de São João del-Rei, Divinópolis, Minas Gerais, Brazil
| | - Saulo Nascimento de Melo
- Campus Centro-Oeste Dona Lindu, Universidade Federal de São João del-Rei, Divinópolis, Minas Gerais, Brazil
| | - Diogo Tavares Cardoso
- Departamento de Parasitologia, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | | | | | - Guilherme Loureiro Werneck
- Departamento de Epidemiologia, Instituto de Medicina Social, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Rio de Janeiro, Brazil
- Instituto de Estudos em Saúde Coletiva, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Rio de Janeiro, Brazil
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Bernardes WPDOS, Santos TG, Fernandes NMGS, de Souza Silva TB, Westin M, Simões TC, Fernandes E Silva E, Alves BM, Molina I, de Carvalho Melo M, Monte-Neto RLD, da Silva-Pereira RA, Alves PA, Fonseca CT. Comparison of diagnostic performance of RT-qPCR, RT-LAMP and IgM/IgG rapid tests for detection of SARS-CoV-2 among healthcare workers in Brazil. J Infect Public Health 2023; 16:1081-1088. [PMID: 37210925 DOI: 10.1016/j.jiph.2023.05.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [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: 12/07/2022] [Revised: 05/03/2023] [Accepted: 05/08/2023] [Indexed: 05/23/2023] Open
Abstract
BACKGROUND COVID-19 has become a major public health problem after the outbreak caused by SARS-CoV-2 virus. Great efforts to contain COVID-19 transmission have been applied worldwide. In this context, accurate and fast diagnosis is essential. METHODS In this prospective study, we evaluated the clinical performance of three different RNA-based molecular tests - RT-qPCR (Charité protocol), RT-qPCR (CDC (USA) protocol) and RT-LAMP - and one rapid test for detecting anti-SARS-CoV-2 IgM and IgG antibodies. RESULTS Our results demonstrate that RT-qPCR using the CDC (USA) protocol is the most accurate diagnostic test among those evaluated, while oro-nasopharyngeal swabs are the most appropriate biological sample. RT-LAMP was the RNA-based molecular test with lowest sensitivity while the serological test presented the lowest sensitivity among all evaluated tests, indicating that the latter test is not a good predictor of disease in the first days after symptoms onset. Additionally, we observed higher viral load in individuals who reported more than 3 symptoms at the baseline. Nevertheless, viral load had not impacted the probability of testing positive for SARS-CoV-2. CONCLUSION Our data indicates that RT-qPCR using the CDC (USA) protocol in oro-nasopharyngeal swabs samples should be the method of choice to diagnosis COVID-19.
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Affiliation(s)
| | - Thais Garcia Santos
- Grupo de Pesquisa em Biologia e Imunologia de Doenças Infecciosas e Parasitárias, Instituto René Rachou, Fundação Oswaldo Cruz, Belo Horizonte, Minas Gerais, Brazil
| | - Nubia Monteiro Gonçalves Soares Fernandes
- Grupo de Pesquisa em Biologia e Imunologia de Doenças Infecciosas e Parasitárias, Instituto René Rachou, Fundação Oswaldo Cruz, Belo Horizonte, Minas Gerais, Brazil
| | - Thais Bárbara de Souza Silva
- Grupo de Imunologia de Doenças Virais, Instituto René Rachou, Fundação Oswaldo Cruz, Belo Horizonte, Minas Gerais, Brazil
| | - Mateus Westin
- Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Taynãna César Simões
- Núcleo de Estudos em Saúde Pública e Envelhecimento, Instituto René Rachou, Fundação Oswaldo Cruz, Belo Horizonte, Minas Gerais, Brazil
| | - Eduardo Fernandes E Silva
- Núcleo de Estudos em Saúde Pública e Envelhecimento, Instituto René Rachou, Fundação Oswaldo Cruz, Belo Horizonte, Minas Gerais, Brazil
| | | | - Israel Molina
- Grupo de Pesquisa em Triatomíneos e Epidemiologia da Doença de Chagas, Instituto René Rachou, Fundação Oswaldo Cruz, Belo Horizonte, Minas Gerais, Brazil
| | | | - Rubens Lima do Monte-Neto
- Grupo de Pesquisa em Biotecnologia Aplicada ao Estudo de Patógenos (BAP), Instituto René Rachou, Fundação Oswaldo Cruz, Belo Horizonte, Minas Gerais, Brazil
| | - Rosiane A da Silva-Pereira
- Grupo de Pesquisa em Biologia e Imunologia de Doenças Infecciosas e Parasitárias, Instituto René Rachou, Fundação Oswaldo Cruz, Belo Horizonte, Minas Gerais, Brazil
| | - Pedro Augusto Alves
- Grupo de Imunologia de Doenças Virais, Instituto René Rachou, Fundação Oswaldo Cruz, Belo Horizonte, Minas Gerais, Brazil
| | - Cristina Toscano Fonseca
- Grupo de Pesquisa em Biologia e Imunologia de Doenças Infecciosas e Parasitárias, Instituto René Rachou, Fundação Oswaldo Cruz, Belo Horizonte, Minas Gerais, Brazil.
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de Melo SN, Barbosa DS, Câmara DCP, Simões TC, Buzanovsky LP, Duarte AGS, Maia-Elkhoury ANS, Cardoso DT, Donato LE, Werneck GL, Belo VS. Spatio-temporal relative risks and priority areas for visceral leishmaniasis control in Brazil, between 2001 and 2020. Acta Trop 2023; 242:106912. [PMID: 36990374 DOI: 10.1016/j.actatropica.2023.106912] [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] [Received: 01/21/2023] [Revised: 03/23/2023] [Accepted: 03/26/2023] [Indexed: 03/30/2023]
Abstract
Visceral leishmaniasis (VL) is a pressing public health problem in Brazil. The proper implementation of disease control programs in priority areas is a challenge for healthcare managers. The present study aimed to analyze the spatio-temporal distribution and identify high risk areas of VL occurrence in the Brazilian territory. We analyzed data regarding new cases with confirmed diagnosis of VL in Brazilian municipalities, from 2001 to 2020, extracted from the Brazilian Information System for Notifiable Diseases. The Local Index of Spatial Autocorrelation (LISA) was used to identify contiguous areas with high incidence rates in different periods of the temporal series. Clusters of high spatio-temporal risk were identified using the scan statistics. The accumulated incidence rate in the analyzed period was 33.53 cases per 100,000 inhabitants. The number of municipalities that reported cases showed an upward trend from 2001 onward, although there was a decrease in 2019 and 2020. According to LISA, the number of municipalities considered a priority increased in Brazil and in most states. Priority municipalities were predominantly concentrated in the states of Tocantins, Maranhão, Piauí, and Mato Grosso do Sul, in addition to more specific areas of Pará, Ceará, Piauí, Alagoas, Pernambuco, Bahia, São Paulo, Minas Gerais, and Roraima. The spatio-temporal clusters of high-risk areas varied throughout the time series and were relatively higher in the North and Northeast regions. Recent high-risk areas were found in Roraima and municipalities in northeastern states. VL expanded territorially in Brazil in the 21st century. However, there is still a considerable spatial concentration of cases. The areas identified in the present study should be prioritized for disease control actions.
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Rodrigues WTDS, Simões TC, Magnago C, Dantas ESO, Guimarães RM, Jesus JCD, de Andrade Fernandes SMB, Meira KC. The influence of the age-period-cohort effects on male suicide in Brazil from 1980 to 2019. PLoS One 2023; 18:e0284224. [PMID: 37053241 PMCID: PMC10101429 DOI: 10.1371/journal.pone.0284224] [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: 09/26/2022] [Accepted: 03/27/2023] [Indexed: 04/14/2023] Open
Abstract
Suicide is a complex and multi-determined phenomenon. Higher rates are observed in men and are related to multiple risk factors, including mental disorders, financial crises, unemployment, and easy access to highly lethal means of perpetration, such as firearms. We studied the effects of age, period, and cohort (APC) on total and firearm-related suicides in men in Brazil and its major regions from 1980 to 2019. Death records were extracted from the Brazilian Ministry of Health's Mortality Information System. Estimable functions were used to estimate APC models, through the Epi library of the R statistical program, version 4.2.1. During the study period, Brazil had an average rate of 10.22 deaths per 100,000 men. Among regions, rates ranged from 8.62 (Northeast) to 16.93 (South). The same profile was observed in suicides by firearms. After estimating the APC models, we observed a temporal trend of increasing total suicides for Brazil and regions, except for the South region, where the trend was stationary. The trend was downward for firearm suicides for all locations. A positive gradient was observed in the mortality rate with advancing age for total suicides; and peak incidence between 20-29 years, with subsequent stabilization, for suicides perpetrated by firearms. There was a reduction in the risk of death for suicides perpetrated by firearms in relation to the reference period (1995-1999) for all locations, except in the North region, where the effect was not significant. The younger generations from the 1960s onwards had a higher risk of death from total suicide and a lower risk for those perpetrated by firearms in relation to the reference cohort (1950-1954). We observed a reduction in the mortality trend for suicides perpetrated by firearms, a reduction in the risk of death in the 2000s and for men born after 1960. Our results suggest reducing the risk of death from suicide by firearms in Brazil and regions. However, there is an upward trend in mortality from total suicides in the study period (1980-2019) and for younger cohorts.
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Affiliation(s)
| | - Taynãna César Simões
- René Rachou Research Institute, Oswaldo Cruz Foundation of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Carinne Magnago
- School of Public Health, University of São Paulo, São Paulo, Brazil
| | | | | | | | | | - Karina Cardoso Meira
- School of Health, Federal University of Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil
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Mesquita SG, Caldeira RL, Favre TC, Massara CL, Beck LCNH, Simões TC, de Carvalho GBF, dos Santos Neves FG, de Oliveira G, de Souza Barbosa Lacerda L, de Almeida MA, dos Santos Carvalho O, Moraes Mourão M, Oliveira E, Silva-Pereira RA, Fonseca CT. Assessment of the accuracy of 11 different diagnostic tests for the detection of Schistosomiasis mansoni in individuals from a Brazilian area of low endemicity using latent class analysis. Front Microbiol 2022; 13:1048457. [PMID: 36590409 PMCID: PMC9797737 DOI: 10.3389/fmicb.2022.1048457] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Accepted: 11/04/2022] [Indexed: 12/16/2022] Open
Abstract
Background Schistosomiasis is a parasitic disease associated with poverty. It is estimated that 7.1 million people are infected with Schistosoma mansoni in Latin America, with 95% of them living in Brazil. Accurate diagnosis and timely treatment are important measures to control and eliminate schistosomiasis, but diagnostic improvements are needed to detect infections, especially in areas of low endemicity. Methodology This research aimed to evaluate the performance of 11 diagnostic tests using latent class analysis (LCA). A cross-sectional survey was undertaken in a low endemicity area of the municipality of Malacacheta, Minas Gerais, Brazil. Feces, urine, and blood samples were collected from 400 residents older than 6 years of age, who had not been treated with praziquantel in the 12 months previous to the collection of their samples. The collected samples were examined using parasitological (Helm Test® kit Kato-Katz), nucleic acid amplification tests -NAATs (PCR, qPCR and LAMP on urine; PCR-ELISA, qPCR and LAMP on stool), and immunological (POC-CCA, the commercial anti-Schistosoma mansoni IgG ELISA kit from Euroimmun, and two in-house ELISA assays using either the recombinant antigen PPE or the synthetic peptide Smp150390.1) tests. Results The positivity rate of the 11 tests evaluated ranged from 5% (qPCR on urine) to 40.8% (commercial ELISA kit). The estimated prevalence of schistosomiasis was 12% (95% CI: 9-15%) according to the LCA. Among all tests assessed, the commercial ELISA kit had the highest estimated sensitivity (100%), while the Kato-Katz had the highest estimated specificity (99%). Based on the accuracy measures observed, we proposed three 2-step diagnostic approaches for the active search of infected people in endemic settings. The approaches proposed consist of combinations of commercial ELISA kit and NAATs tests performed on stool. All the approaches had higher sensitivity and specificity than the mean values observed for the 11 tests (70.4 and 89.5%, respectively). Conclusion We showed that it is possible to achieve high specificity and sensitivity rates with lower costs by combining serological and NAATs tests, which would assist in the decision-making process for appropriate allocation of public funding aiming to achieve the WHO target of eliminating schistosomiasis as a public health problem by 2030.
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Affiliation(s)
- Silvia Gonçalves Mesquita
- Grupo de Pesquisa em Helmintologia e Malacologia Médica, Instituto René Rachou, Fundação Oswaldo Cruz, Belo Horizonte, Minas Gerais, Brazil
| | - Roberta Lima Caldeira
- Grupo de Pesquisa em Helmintologia e Malacologia Médica, Instituto René Rachou, Fundação Oswaldo Cruz, Belo Horizonte, Minas Gerais, Brazil
| | - Tereza Cristina Favre
- Laboratório de Educação em Ambiente e Saúde, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
| | - Cristiano Lara Massara
- Grupo de Pesquisa em Helmintologia e Malacologia Médica, Instituto René Rachou, Fundação Oswaldo Cruz, Belo Horizonte, Minas Gerais, Brazil
| | | | - Taynãna César Simões
- Núcleo de Estudos em Saúde Pública e Envelhecimento, Instituto René Rachou, Fundação Oswaldo Cruz, Belo Horizonte, Minas Gerais, Brazil
| | - Gardênia Braz Figueiredo de Carvalho
- Grupo de Pesquisa em Biologia e Imunologia de Doenças Infecciosas e Parasitárias, Instituto René Rachou, Fundação Oswaldo Cruz, Belo Horizonte, Minas Gerais, Brazil
| | - Flória Gabriela dos Santos Neves
- Grupo de Pesquisa em Helmintologia e Malacologia Médica, Instituto René Rachou, Fundação Oswaldo Cruz, Belo Horizonte, Minas Gerais, Brazil
| | - Gabriela de Oliveira
- Grupo de Pesquisa em Biologia e Imunologia de Doenças Infecciosas e Parasitárias, Instituto René Rachou, Fundação Oswaldo Cruz, Belo Horizonte, Minas Gerais, Brazil
| | - Larisse de Souza Barbosa Lacerda
- Grupo de Pesquisa em Biologia e Imunologia de Doenças Infecciosas e Parasitárias, Instituto René Rachou, Fundação Oswaldo Cruz, Belo Horizonte, Minas Gerais, Brazil
| | - Matheus Alves de Almeida
- Grupo de Pesquisa em Genômica Funcional de Parasitos, Instituto René Rachou, Fundação Oswaldo Cruz, Belo Horizonte, Minas Gerais, Brazil
| | - Omar dos Santos Carvalho
- Grupo de Pesquisa em Helmintologia e Malacologia Médica, Instituto René Rachou, Fundação Oswaldo Cruz, Belo Horizonte, Minas Gerais, Brazil
| | - Marina Moraes Mourão
- Grupo de Pesquisa em Helmintologia e Malacologia Médica, Instituto René Rachou, Fundação Oswaldo Cruz, Belo Horizonte, Minas Gerais, Brazil
| | - Edward Oliveira
- Grupo de Pesquisa em Genômica Funcional de Parasitos, Instituto René Rachou, Fundação Oswaldo Cruz, Belo Horizonte, Minas Gerais, Brazil
| | - Rosiane A. Silva-Pereira
- Grupo de Pesquisa em Biologia e Imunologia de Doenças Infecciosas e Parasitárias, Instituto René Rachou, Fundação Oswaldo Cruz, Belo Horizonte, Minas Gerais, Brazil
| | - Cristina Toscano Fonseca
- Grupo de Pesquisa em Biologia e Imunologia de Doenças Infecciosas e Parasitárias, Instituto René Rachou, Fundação Oswaldo Cruz, Belo Horizonte, Minas Gerais, Brazil
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Meira KC, Magnago C, Mendonça AB, Duarte SFS, de Freitas PHO, dos Santos J, de Souza DLB, Simões TC. Inequalities in Temporal Effects on Cervical Cancer Mortality in States in Different Geographic Regions of Brazil: An Ecological Study. Int J Environ Res Public Health 2022; 19:5591. [PMID: 35564986 PMCID: PMC9105639 DOI: 10.3390/ijerph19095591] [Citation(s) in RCA: 2] [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] [Figures] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Revised: 04/06/2022] [Accepted: 04/13/2022] [Indexed: 02/01/2023]
Abstract
Cervical cancer is a public health issue with high disease burden and mortality in Brazil. The objectives of the present study were, firstly, to analyze age, period, and cohort effects on cervical cancer mortality in women 20 years old or older from 1980 to 2019 in the North, South, and Southeast Regions of Brazil; and secondly, to evaluate whether the implementation of a national screening program and the expansion of access to public health services impacted the examined period and reduced the risk of death compared with previous years and among younger cohorts. The effects were estimated by applying Poisson regression models with estimable functions. The highest mortality rate per 100,000 women was found in Amazonas (24.13), and the lowest in São Paulo (10.56). A positive gradient was obtained for death rates as women's age increased. The states in the most developed regions (South and Southeast) showed a reduction in the risk of death in the period that followed the implementation of the screening program and in the cohort from the 1960s onwards. The North Region showed a decreased risk of death only in Amapá (2000-2004) and Tocantins (1995-2004; 2010-2019). The findings indicate that health inequities remain in Brazil and suggest that the health system has limitations in terms of decreasing mortality associated with this type of cancer in regions of lower socioeconomic development.
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Affiliation(s)
- Karina Cardoso Meira
- Health School, Federal University of Rio Grande do Norte, Natal 59078-970, Brazil
| | - Carinne Magnago
- School of Public Health, University of São Paulo, São Paulo 01246-904, Brazil;
| | - Angelo Braga Mendonça
- Brazilian National Cancer Institute, Rio de Janeiro 20230-130, Brazil; (A.B.M.); (J.d.S.)
| | - Stephane Fernanda Soares Duarte
- Department of Demography and Actuarial Sciences, Federal University of Rio Grande Norte, Natal 59078-970, Brazil; (S.F.S.D.); (P.H.O.d.F.)
| | - Pedro Henrique Oliveira de Freitas
- Department of Demography and Actuarial Sciences, Federal University of Rio Grande Norte, Natal 59078-970, Brazil; (S.F.S.D.); (P.H.O.d.F.)
| | - Juliano dos Santos
- Brazilian National Cancer Institute, Rio de Janeiro 20230-130, Brazil; (A.B.M.); (J.d.S.)
| | | | - Taynãna César Simões
- René Rachou Institute, Oswaldo Cruz Foundation, Belo Horizonte 30190-002, Brazil;
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Bueno MAM, Simões TC, Luz TCB. Differences in prescribed medicine availability in Primary Health Care: evidence from the Prover Project. Cien Saude Colet 2022; 27:1191-1203. [PMID: 35293455 DOI: 10.1590/1413-81232022273.38782020] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2020] [Accepted: 03/05/2021] [Indexed: 01/02/2023] Open
Abstract
This is a cross-sectional study on the availability of prescribed medicines in Primary Health Care (PHC), with a probabilistic sample of 1,221 users of public pharmacies in a health pole municipality in Minas Gerais, in 2017. Medicine availability indicators were estimated, and a hierarchical logistic regression was performed, according to the behavioral model of health service use. Only 39.3% of patients received all medicines in the prescribed quantities. The most and the least available medicines were, respectively, those for the digestive system/metabolism, and for blood and hematopoietic organs. Full availability of the prescribed treatment was associated with higher schooling (≥ 8 years OR: 1.7; 95% CI: 1.3-2.4); proximity to the pharmacy (≤15 min OR: 1.7; 95% CI: 1.2-2.3); absence of out-of-pocket expenditure on medicines (OR: 2.2; 95% CI: 1.7-2.9), and a smaller number of prescription drugs (≤ 2 OR: 3.2; 95% CI: 2.3-4.4; 3/4 OR: 1.6; 95% CI: 1.2-2.1). These results showed differences in medicine availability within the Brazilian Unified Health System (SUS), and highlighted the need to reorganize the dispensing services network and pharmaceutical procurement planning, as well as to develop public policies to protect the vulnerable population.
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Affiliation(s)
- Maria Angélica Martins Bueno
- Grupo de Estudos Transdisciplinares em Tecnologias em Saúde e Ambiente, Instituto René Rachou, Fundação Oswaldo Cruz. Av. Augusto de Lima 1715 Anexo, Barro Preto. 30190-002 Belo Horizonte MG Brasil.
| | - Taynãna César Simões
- Núcleo de Estudos em Saúde Pública e Envelhecimento, Instituto René Rachou, Fundação Oswaldo Cruz. Belo Horizonte MG Brasil
| | - Tatiana Chama Borges Luz
- Grupo de Estudos Transdisciplinares em Tecnologias em Saúde e Ambiente, Instituto René Rachou, Fundação Oswaldo Cruz. Av. Augusto de Lima 1715 Anexo, Barro Preto. 30190-002 Belo Horizonte MG Brasil. .,Strathclyde Institute of Pharmacy and Biomedical Sciences (SIPBS), Scotland
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13
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Carvalho LS, das Graças Braga M, da Silva Costa DA, Simões TC, Lula MD, Silveira MR. Lethality among individuals infected with visceral leishmaniasis in Brazil: a retrospective study (2007-2018). Parasitol Res 2022; 121:725-736. [PMID: 35013872 DOI: 10.1007/s00436-022-07429-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Accepted: 01/05/2022] [Indexed: 10/19/2022]
Abstract
Visceral leishmaniasis (VL) is a public health problem with a high prevalence and lethality in Brazil. This study aims to estimate the lethality and associated factors in individuals with VL and assess survival time, emphasizing VL/HIV coinfection. This retrospective study has 37,583 individuals notified and confirmed with VL in the Sistema de Informação de Agravos de Notificação (SINAN) between 2007 and 2018 (Brazil). Lethality was evaluated considering VL deaths, deaths from other causes (OC), and non-deaths. We performed a multinomial logistic regression, with non-death as the benchmark category. We conducted a survival analysis (Kaplan-Meier method), emphasizing VL/HIV coinfection. Most individuals were young, male, mixed race, low schooling level, and urban dwellers. The lethality rate was 10.2% (VL and OC deaths) and 7.8% (VL deaths). The prevalence of HIV infection was 8.81%. A higher likelihood of VL and OC deaths was observed in older age groups, females, and with a higher number of symptoms. A higher likelihood of OC deaths was identified in individuals with HIV. A lower likelihood of VL and OC deaths was observed for individuals on VL therapy. The mean survival time was longer for VL/HIV individuals, who had a lower survival rate than those with VL. The data point to the need for attention to the timely diagnosis of VL and HIV and adequate pharmacological treatment in this population.
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Affiliation(s)
- Luciana Silami Carvalho
- Social Pharmacy Department, Faculty of Pharmacy, Federal University of Minas Gerais, Belo Horizonte, Brazil. .,René Rachou Institute, Fiocruz Minas Gerais, Belo Horizonte, Brazil.
| | - Maria das Graças Braga
- Social Pharmacy Department, Faculty of Pharmacy, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | | | | | - Mariana Dias Lula
- Social Pharmacy Department, Faculty of Pharmacy, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | - Micheline Rosa Silveira
- Social Pharmacy Department, Faculty of Pharmacy, Federal University of Minas Gerais, Belo Horizonte, Brazil
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Maluf CB, Brito FDA, Simões TC, Peixoto SV, Vidigal PG. Laboratory profile after mining dam breach: Brumadinho Health Project results. Rev bras epidemiol 2022; 25:e220013. [DOI: 10.1590/1980-549720220013.supl.2] [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: 07/18/2022] [Accepted: 09/05/2022] [Indexed: 12/23/2022] Open
Abstract
ABSTRACT Objective: To evaluate changes in selected laboratory tests in the population included in the Brumadinho Health Project, according to the exposure to the dam failure. Methods: Cross-sectional study carried out on representative sample of residents (≥12 years) in Brumadinho, Minas Gerais, including: 1) non-exposed; 2) directly affected by tailings sludge; 3) residents in mining area. The prevalence of abnormal results of blood count, total, HDL and LDL cholesterol, triglycerides, aspartate aminotransferase, alanine aminotransferase, creatinine, urea, estimate of glomerular filtration rate (eGFR) and high-sensitivity C-reactive protein (hs-CRP) were estimated. The Prevalence Ratios (PR) and 95% Confidence Intervals (95%CI) of having an abnormal laboratory finding were estimated using Generalized Linear Models with Poisson probability distribution. Crude and adjusted models were estimated for age range, gender, diabetes, body mass index, smoking, hypertension. Results: After adjusting, there was no difference in PR between the three populations for most tests, with the exception of the population residing in an area with mining activity and not directly affected by the mud, with a lower chance of having altered total cholesterol (PR: 0.84; 95%CI 0.74–0.95) and a higher chance of having altered HDL cholesterol (PR: 1.26; 95%CI 1.07–1.50), hs-CRP (PR: 1.19; 95%CI 1.04–1.37), and eGFR <60mL/min/1,73 m2 (PR: 1.51; 95%CI 1.05–2.19). Conclusion: No significant differences were found in the prevalence of biochemical and hematological alterations between the populations directly exposed and not exposed to tailings. Only the group residing in the mining area had a higher prevalence of alterations related dyslipidemia, renal disease, and inflammation.
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Maluf CB, Brito FDA, Simões TC, Peixoto SV, Vidigal PG. Perfil laboratorial após rompimento de barragem de mineração: resultados do Projeto Saúde Brumadinho. Rev bras epidemiol 2022. [DOI: 10.1590/1980-549720220013.supl.2.1] [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] [Indexed: 12/23/2022] Open
Abstract
RESUMO Objetivo: Avaliar alterações em parâmetros laboratoriais na população do Projeto Saúde Brumadinho, segundo exposição ao rompimento da barragem. Métodos: Estudo transversal realizado em amostra representativa de residentes (≥12 anos) em Brumadinho, Minas Gerais, incluindo: não expostos (grupo referência); diretamente atingidos pela lama de rejeitos; e residentes em área de mineração. Foram estimadas as prevalências de resultados alterados de hemograma, colesterol total, colesterol lipoproteína de alta densidade (HDL), colesterol lipoproteína de baixa densidade (LDL), triglicérides, aspartato aminotransferase, alanina aminotransferase, creatinina, ureia, estimativa da taxa de filtração glomerular (TFGe) e proteína C-reativa ultrassensível (PCRus). As razões de prevalência (RP) e os intervalos de confiança de 95% (IC95%) de ter o exame alterado foram estimados por meio de modelos lineares generalizados com distribuição de probabilidade Poisson. Estimaram-se modelos brutos e ajustados por faixa etária, sexo, diabetes, índice de massa corporal, tabagismo, hipertensão. Resultados: Após ajustes, não se observou diferença nas RP entre as populações estudadas para a maioria dos testes, com exceção da população residente em área com atividade de mineração e não diretamente atingida pela lama, com menor chance de ter colesterol total alterado (RP=0,84; IC95% 0,74–0,95) e maior chance de ter colesterol HDL (RP=1,26; IC95% 1,07–1,50) e PCRus (RP=1,19; IC95% 1,04–1,37) alterado e TFGe<60 mL/min/1,73 m2 (RP=1,51; IC95% 1,05–2,19). Conclusão: Não foram encontradas diferenças significativas na prevalência de alterações bioquímicas e hematológicas entre a população diretamente exposta aos rejeitos e a população não exposta. Apenas o grupo residente em área de mineração apresentou maior prevalência de alterações relacionadas com dislipidemia, disfunção renal e inflamação.
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Simões TC, Meira KC, Santos JD, Câmara DCP. Prevalence of chronic diseases and access to health services in Brazil: evidence of three household surveys. Cien Saude Colet 2021; 26:3991-4006. [PMID: 34586254 DOI: 10.1590/1413-81232021269.02982021] [Citation(s) in RCA: 2] [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: 02/02/2021] [Accepted: 03/22/2021] [Indexed: 12/18/2022] Open
Abstract
Chronic non-communicable diseases (NCDs) are the leading causes of death globally, impacting heavily on the most vulnerable populations. This study aimed to analyze changes in the prevalence of these diseases, health conditions, access, and health services in Brazil between 2008 and 2019. Tests of differences and generalized linear models were used as analytical tools, considering complex sampling from the PNAD 2008, PNS 2013, and PNS 2019 surveys, to test temporal changes in the prevalence and the prevalence ratio estimates, adjusted by sociodemographic variables. An increase in the prevalence of Depression, Diabetes, Cancers, Neuropsychiatric Disorders, Chronic Pulmonary problems, and Musculoskeletal problems was observed. A decline in rheumatoid arthritis, chronic renal failure, and diseases of the circulatory system was identified. Among Brazilians with at least one NCD, an increase in coverage by the family health strategy over time was observed. However, there was a reduction in timely medical care and obtaining of free prescription drugs.
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Affiliation(s)
- Taynãna César Simões
- Núcleo de Estudos em Saúde Pública e Envelhecimento (NESPE), Instituto René Rachou, Fundação Oswaldo Cruz. Av. Augusto de Lima 1.715, Barro Preto. 30190-002 Belo Horizonte MG Brasil.
| | | | - Juliano Dos Santos
- Instituto Nacional do Câncer, Hospital do Câncer III. Rio de Janeiro RJ Brasil
| | - Daniel Cardoso Portela Câmara
- Laboratório de Mosquitos Transmissores de Hematozoários, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz. Rio de Janeiro RJ Brasil.,Núcleo Operacional Sentinela de Mosquitos Vetores, Fundação Oswaldo Cruz. Rio de Janeiro RJ Brasil
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Meira KC, Jomar RT, Santos JD, Silva GWDS, Dantas ESO, Resende EB, Rodrigues WTDS, Silva CMFPD, Simões TC. [Temporal effects of corrected female homicide mortality estimates in Northeast Brazil]. CAD SAUDE PUBLICA 2021; 37:e00238319. [PMID: 33624695 DOI: 10.1590/0102-311x00238319] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2019] [Accepted: 06/29/2020] [Indexed: 11/21/2022] Open
Abstract
This study aimed to analyze the temporal effects (age, period, and cohort) on female homicide mortality in the states of Northeast Brazil from 1980 to 2017. This ecological time trend study used APC with a Bayesian approach and the deterministic method Integrated Nested Laplace Approximations (INLA) in the parameters' inference. The female homicide rates for each state of the Northeast were standardized by the direct method after correction of the death records for quality of information and underreporting. Data were also obtained on race/color, place of death, and means of perpetration. During the period analyzed, after correcting the death records, the Northeast region showed a mean rate of 5.40 female homicide deaths per 100,000 women, with a significant increase in all the states in the 2000s. In all the states, there was an increase in relative risk (RR) of homicide death in the second and third decades of life and a protective effect in older women. Except for the state of Sergipe, there was an increase in the risk of death in all five-year periods in the 2000s. The Northeast region as a whole and the states of Paraíba, Pernambuco, and Piauí showed a protective effect for women from older generations. There were also higher proportions of deaths in black women, homicides committed at home, and those perpetrated with firearms. The current study's findings may correlate with the spread of violence in Brazil in the 2000s and the Brazilian State's failure to protect women from violence.
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Affiliation(s)
| | - Rafael Tavares Jomar
- Instituto Nacional de Câncer José Alencar Gomes da Silva, Rio de Janeiro, Brasil
| | - Juliano Dos Santos
- Instituto Nacional de Câncer José Alencar Gomes da Silva, Rio de Janeiro, Brasil
| | | | | | | | | | | | - Taynãna César Simões
- Instituto de Pesquisa René Rachou, Fundação Oswaldo Cruz, Belo Horizonte, Brasil
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Carvalho JDP, de Assis TM, Simões TC, Cota G. Estimating direct costs of the treatment for mucosal leishmaniasis in Brazil. Rev Soc Bras Med Trop 2021; 54:e04542020. [PMID: 33533816 PMCID: PMC7849328 DOI: 10.1590/0037-8682-0454-2020] [Citation(s) in RCA: 3] [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] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Accepted: 12/15/2020] [Indexed: 04/01/2024] Open
Abstract
INTRODUCTION The objective of this study was to estimate the direct medical costs of the treatment for mucosal leishmaniasis (ML) using three therapeutic approaches in the Brazilian context. METHODS We performed this economic assessment from the perspective of the Brazilian public healthcare system. The following therapeutic approaches were evaluated: meglumine antimoniate, liposomal amphotericin B, and miltefosine. Direct medical costs were estimated considering four treatment components: a) drug, b) combined medical products, c) procedures, and d) complementary tests. RESULTS Treatment with meglumine antimoniate had the lowest average cost per patient (US$ 167.66), followed by miltefosine (US$ 259.92) in the outpatient treatment regimen. The average cost of treatment with liposomal amphotericin B was US$ 715.35 both in inpatient regimen. In all estimates, the drugs accounted for more than 60% of the total cost for each treatment approach. CONCLUSIONS These results demonstrate the marked differences in costs between the therapeutic alternatives for ML. In addition to efficacy rates and costs related to adverse events, our data have the potential to support a complete cost-effectiveness study in the future. Complete analyses comparing costs and benefits for interventions will assist health managers in choosing drugs for ML treatment in Brazil as well as in establishing effective public health policies.
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Affiliation(s)
- Janaína de Pina Carvalho
- Fundação Oswaldo Cruz, Instituto René Rachou, Grupo de Pesquisa Clínica e Políticas Públicas em Doenças Infecciosas e Parasitárias, Belo Horizonte, MG, Brasil
| | - Tália Machado de Assis
- Fundação Oswaldo Cruz, Instituto René Rachou, Grupo de Pesquisa Clínica e Políticas Públicas em Doenças Infecciosas e Parasitárias, Belo Horizonte, MG, Brasil
- Centro Federal de Educação Tecnológica de Minas Gerais, Campus Contagem, Contagem, MG, Brasil
| | - Taynãna César Simões
- Fundação Oswaldo Cruz, Instituto René Rachou, Grupo de Pesquisa Clínica e Políticas Públicas em Doenças Infecciosas e Parasitárias, Belo Horizonte, MG, Brasil
| | - Gláucia Cota
- Fundação Oswaldo Cruz, Instituto René Rachou, Grupo de Pesquisa Clínica e Políticas Públicas em Doenças Infecciosas e Parasitárias, Belo Horizonte, MG, Brasil
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Drummond ED, Simões TC, Andrade FBD. An evaluation of non-adherence to pharmacotherapy for chronic diseases and socioeconomic inequalities in Brazil. Rev Bras Epidemiol 2020; 23:e200080. [PMID: 32696928 DOI: 10.1590/1980-549720200080] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2019] [Accepted: 03/16/2020] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVE To evaluate non-adherence to pharmacotherapy for chronic diseases and to investigate the existence of socioeconomic inequalities related to this outcome in Brazil. METHODS This was a cross-sectional study based on data from the National Survey on Access, Use and Promotion of the Rational Use of Medicines (PNAUM). The study population corresponded to individuals aged 18 years or older with a medical diagnosis of at least one chronic disease and an indication for pharmacological treatment. The dependent variable was non-adherence to chronic disease pharmacotherapy measured by less than 80% adherence to drug therapy. Socioeconomic inequality related to non-adherence was assessed by absolute (SII) and relative (RII) inequality indices, calculated by logistic regression analyses. RESULTS The prevalence of non-adherence to pharmacotherapy in Brazil was 20.2%, ranging from 17.0 to 27.8% between regions. Furthermore, this study revealed absolute and relative socioeconomic inequalities in non-adherence to pharmacotherapy of chronic diseases in Brazil (SII = -7.4; RII = 0.69) and the Northeast (SII = -14.0; RII = 0.59) and Center West (SII = -20.8; RII = 0.38) regions. The probability of non-adherence to pharmacotherapy in Brazil was higher among individuals with worse socioeconomic status. CONCLUSION The findings of the present study indicate the need for the restructuring and strengthening of public policies aimed at reducing socioeconomic inequalities, in order to promote equity in adherence to the pharmacotherapy associated with chronic diseases.
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Galvão EL, Assis TSMD, Pedras MJ, Cota GF, Simões TC, Rabello A. Economic impact of localized cutaneous leishmaniasis on adult patients of a referral service in Belo Horizonte, Minas Gerais State, Brazil. CAD SAUDE PUBLICA 2020; 36:e00136419. [PMID: 32696829 DOI: 10.1590/0102-311x00136419] [Citation(s) in RCA: 2] [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: 07/19/2019] [Accepted: 12/06/2019] [Indexed: 11/22/2022] Open
Abstract
Cutaneous leishmaniasis (CL) is a disease associated with low-income populations. Thus, in assessing the burden of this disease, it is important to include its economic impact on individuals. We aimed to evaluate CL economic impact on patients treated at a referral service in the State of Minas Gerais, Brazil. This is a cross-sectional study based on the analysis of interviews and medical records from which we assembled direct medical and non-medical costs related to CL, from a societal perspective. One hundred patients were included; 50% had a monthly per capita income of up to USD 259.60 and spent on average USD 187.32 with the disease, representing an average monthly impact of 22.5% (USD 133.80). The disease imposed direct medical costs, such as: private medical appointments, medications, medical exams, dressing material, and co-participation in health insurances. Direct non-medical costs were mainly related to patients' transportation to health centers (USD 4,911.00), but also included medically-necessary care, food, and domestic and business outsourcing services. Although the Brazilian public health system guarantees access to health care, CL still represents a substantial economic impact for patients. The main action to reduce the expenses with this disease is decentralizing services for CL diagnosis and therapeutic approach, as well as increasing their efficiency.
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Affiliation(s)
- Endi Lanza Galvão
- Instituto René Rachou, Fundação Oswaldo Cruz, Belo Horizonte, Brazil
| | | | | | | | | | - Ana Rabello
- Instituto René Rachou, Fundação Oswaldo Cruz, Belo Horizonte, Brazil
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Meira KC, Silva GWDS, dos Santos J, Guimarães RM, de Souza DLB, Ribeiro GPC, Dantas ESO, de Carvalho JBL, Jomar RT, Simões TC. Analysis of the effects of the age-period-birth cohort on cervical cancer mortality in the Brazilian Northeast. PLoS One 2020; 15:e0226258. [PMID: 32074101 PMCID: PMC7029866 DOI: 10.1371/journal.pone.0226258] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [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: 04/17/2019] [Accepted: 11/23/2019] [Indexed: 12/11/2022] Open
Abstract
Cervical cancer (CC) is a public health problem with a high disease burden and mortality in developing countries. In Brazil, areas with low human development index have the highest incidence rates of Brazil and upward temporal trend for this disease. The Northeast region has the second highest incidence of cervical cancer (20.47 new cases / 100,000 women). In this region, the mortality rates are similar to rates in countries that do not have a health system with a universal access screening program, as in Brazil. Thus, this study aimed to analyze the effects of age, period and birth cohorts on mortality from cervical cancer in the Northeast region of Brazil. Estimable functions predicted the effects of age, period and birth cohort. The average mortality rate was 10.35 deaths per 100,000 women during the period analyzed (1980–2014). The highest mortality rate per 100,000 women was observed in Maranhão (24.39 deaths), and the lowest mortality rate was observed in Bahia (11.24 deaths). According to the period effects, only the state of Rio Grande do Norte showed a reduction in mortality risk in the five years of the 2000s. There was a reduction in mortality risk for birth cohorts of women after the 1950s, except in Maranhão State, which showed an increasing trend in mortality risk for younger generations. We found that the high rates of cervical cancer mortality in the states of northeastern Brazil remain constant over time. Even after an increase in access to health services in the 2000s, associated with increased access to the cancer care network, which includes early detection (Pap Test), cervical cancer treatment and palliative care. However, it is important to note that the decreased risk of death and the mortality rates from CC among women born after the 1960s may be correlated with increased screening coverage, as well as increased access to health services for cancer treatment observed in younger women.
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Affiliation(s)
- Karina Cardoso Meira
- Health School, Federal University of Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil
- * E-mail:
| | | | - Juliano dos Santos
- Cancer Hospital III, National Cancer Institute, Rio de Janeiro, Rio de Janeiro, Brazil
| | | | | | - Gilcilene Pretta Cani Ribeiro
- Biologist, specialist in management in Health Systems and Services, State Secretariat of Espírito Santo, Vitória, Espírito Santo, Brazil
| | | | | | - Rafael Tavares Jomar
- Assistance Coordination, National Cancer Institute, Rio de Janeiro, Rio de Janeiro, Brazil
| | - Taynãna César Simões
- René Rachou Institute, Oswaldo Cruz Foundation, Belo Horizonte, Minas Gerais, Brazil
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Silva SLAD, Peixoto SV, Lima-Costa MF, Simões TC. [Effect of age, period, and birth cohort on incapacity in community-dwelling elderly: the Bambuí Elderly Cohort (1997-2012)]. CAD SAUDE PUBLICA 2019; 35:e00156018. [PMID: 31508696 DOI: 10.1590/0102-311x00156018] [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: 08/10/2018] [Accepted: 03/14/2019] [Indexed: 11/22/2022] Open
Abstract
Time trends in the prevalence rates of incapacity in the elderly can occur due to the effects of age, period, or cohort. Age is related to biological factors, the period to the subject's environmental context, and the cohort to the subject's exposures from birth to the present. The study aimed to verify which time dimensions most influence the evolution in the prevalence of incapacity in the elderly over the course of 15 years. Data were used from the Bambuí Elderly Cohort, and incapacity was assessed by report of "great difficulty" or "inability" to perform at least one of the activities related to mobility and basic and instrumental activities of daily living. The analysis was done with the age-period-cohort model for aggregate data, with calculation of the effects of time dimensions by analysis of deviance. A Poisson regression model determined the associations between age, period, and cohort and prevalence of incapacity, considering the total population and stratification by sex and schooling. Period effect was the most important for the three dimensions of incapacity, with an increase in prevalence at the start of the period, followed by a reduction over time, with minor differences in relation to sex and schooling. Cohort effect was significant, although less important than period effect. The results highlight the importance of analyzing the elder's environment for reducing prevalence of incapacity, with an emphasis on policies and programs that can positively impact the time trend in this outcome, given the consistent effect of period observed in this study.
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Affiliation(s)
| | - Sérgio Viana Peixoto
- Instituto de Pesquisas René Rachou, Fundação Oswaldo Cruz, Belo Horizonte, Brasil.,Universidade Federal de Minas Gerais, Belo Horizonte, Brasil
| | | | - Taynãna César Simões
- Instituto de Pesquisas René Rachou, Fundação Oswaldo Cruz, Belo Horizonte, Brasil
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Meira KC, Santos JD, Silva CMFPD, Ferreira AA, Guimarães RM, Simões TC. [Effects of age-period and cohort on mortality due to ovarian cancer in Brazil and its regions]. CAD SAUDE PUBLICA 2019; 35:e00087018. [PMID: 30864613 DOI: 10.1590/0102-311x00087018] [Citation(s) in RCA: 1] [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: 05/02/2018] [Accepted: 11/29/2018] [Indexed: 12/29/2022] Open
Abstract
This article sought to evaluate the effects of age, period and birth cohort (APC) on the temporal evolution of mortality due to ovarian cancer in Brazil and its regions from 1980 to 2014. This is an ecological, time-trend study using APC models with a Baysean approach and INLA (Integrated Nested Laplace Approximations) deterministic method for parameter inference. Mortality data and population data were obtained from the Brazilian Health Informatics Department. Rates of mortality due to ovarian cancer, according to geographical region, were standardized using the direct method, after correcting deaths for undefined causes and incomplete cancer diagnosis. In the period we studied, Brazil had 4.91 deaths due to ovarian cancer per 100,000 women, the Southern (5.66) and Southeastern regions (5.70) had higher rates per 100,000 women and the Northern region had the lowest rate (3.13/100,000 women). In all regions, there was a progressive increase in mortality as ages advanced. The multivariate best fit APC model showed positive risk of death in the Central and Northeast between 2010-2014 and, beginning in 1995-1999, in the South. We also observed a positive and significant risk of death for older cohorts in the South and Southeast and a reduced risk for younger cohorts. The inverse was opposed in the Northern and Northeastern regions. The data shows a heterogeneous pattern in the temporal evolution of mortality due to ovarian cancer in the Brazilian geographical regions, which may be related to the distinct demographic and epidemiological transition processes experienced in these regions.
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Affiliation(s)
| | - Juliano Dos Santos
- Instituto Nacional de Câncer José Alencar Gomes da Silva, Rio de Janeiro, Brasil
| | | | - Aline Alves Ferreira
- Instituto de Nutrição Josué de Castro, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brasil
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Galvão EL, Pedras MJ, Cota GF, Rabello A, Simões TC. How cutaneous leishmaniasis and treatment impacts in the patients' lives: A cross-sectional study. PLoS One 2019; 14:e0211374. [PMID: 30682151 PMCID: PMC6347173 DOI: 10.1371/journal.pone.0211374] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [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: 09/12/2018] [Accepted: 01/13/2019] [Indexed: 12/18/2022] Open
Abstract
Background Until now, few studies have evaluated the effect of cutaneous leishmaniasis (CL) on patients' quality of life, and none have used a specific instrument to measure this effect. The objective of this study was to identify factors that may be associated with the high impact of CL and to assess patients’ satisfaction with treatment and health services by utilizing a disease-specific questionnaire. Methodology Between December 2015 and May 2017, 100 patients with localized cutaneous leishmaniasis were interviewed at a leishmaniasis referral center in Brazil. Data were collected by two questionnaires. One questionnaire compiled the sociodemographic, economic, and clinical information related to the disease. The second questionnaire was the Cutaneous Leishmaniasis Impact Questionnaire (CLIQ), which consisted of two subscales that measured 1) the general impact of CL and 2) patients’ perceptions of treatment and health services. The median scores from each of these two subscales were used to dichotomize the dependent variables. Risk factors for the high impact of CL and for low patient satisfaction with treatment and health services were analyzed with a logistic regression analysis. Results The chance of higher impact of CL was increased in patients with the presence of comorbidities (OR: 3.9; CI 1.25–12.36), in those with absences from work (OR: 12.0; CI 3.78–42.55), in those who relied on public transportation by a municipal bus (OR: 5.8; CI 1.27–26.77), and in those who had illness-related expenses greater than U$137 (OR: 3.5; CI 1.17–10.24). The chance of patient dissatisfaction with treatment and health services increased with higher education (OR: 5.0; CI 1.19–21.03) and with illness-related expenses exceeding U$137 (OR: 4.64; CI 1.49–14.48). Once the sample was non-probabilistic, findings are not representative of CL patients in general. Conclusions CL and its treatment have a negative impact on patients’ quality of life. Considering these effects during public health planning may help patients to confront the disease.
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Affiliation(s)
- Endi Lanza Galvão
- Pesquisa Clínica e Políticas Públicas em Doenças Infecto-Parasitárias–Instituto René Rachou—Fundação Oswaldo Cruz, Fiocruz, Belo Horizonte, Minas Gerais, Brazil
- * E-mail:
| | - Mariana Junqueira Pedras
- Pesquisa Clínica e Políticas Públicas em Doenças Infecto-Parasitárias–Instituto René Rachou—Fundação Oswaldo Cruz, Fiocruz, Belo Horizonte, Minas Gerais, Brazil
| | - Gláucia Fernandes Cota
- Pesquisa Clínica e Políticas Públicas em Doenças Infecto-Parasitárias–Instituto René Rachou—Fundação Oswaldo Cruz, Fiocruz, Belo Horizonte, Minas Gerais, Brazil
| | - Ana Rabello
- Pesquisa Clínica e Políticas Públicas em Doenças Infecto-Parasitárias–Instituto René Rachou—Fundação Oswaldo Cruz, Fiocruz, Belo Horizonte, Minas Gerais, Brazil
| | - Taynãna César Simões
- Pesquisa Clínica e Políticas Públicas em Doenças Infecto-Parasitárias–Instituto René Rachou—Fundação Oswaldo Cruz, Fiocruz, Belo Horizonte, Minas Gerais, Brazil
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Simões TC, Borges LF, Parreira de Assis AC, Silva MV, dos Santos J, Meira KC. Chagas disease mortality in Brazil: A Bayesian analysis of age-period-cohort effects and forecasts for two decades. PLoS Negl Trop Dis 2018; 12:e0006798. [PMID: 30265661 PMCID: PMC6179299 DOI: 10.1371/journal.pntd.0006798] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [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: 03/01/2018] [Revised: 10/10/2018] [Accepted: 08/29/2018] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Chagas disease (CD) is a neglected chronic parasitic infection and a public health problem that is preventable, and has serious complications. In this study, the effects of age, period and birth cohort (APC Effects) on the evolution of the mortality of that disease in Brazil, from 1980-2014, according to sex and geographic region of the country, were analyzed. Mortality forecasts from the years 2015 to 2034 were estimated. METHODS This is an ecological cross-sectional study in which death records and population data were extracted from the DATASUS (Department of Information Technology of the National Health System) website, in age groups from 20-24 years of age to 80 years and over, from 1980 to 2014. The rates were standardized according to age and sex distributions using the direct method. The APC models were estimated using the Bayesian approach, and the INLA (Integrated Nested Laplace Approximations) method was used for parameter inference. Super dispersion of the data was considered, and we included unstructured random terms in the models. RESULTS During the analyzed period, there were 178,823 deaths in Brazil (3.85 annual deaths per 100,000 inhabitants). It was found that temporal effects on CD mortality varied by sex and region. In general, there was an increase in mortality rates up to 30 years of age, and the mortality rates were higher between 50 and 64 years of age. On average, men died five years younger than women. Mortality rates were highest in the Central West and Southeast regions. The Central West, Southeast and Southern regions had a reduction over time in the rate of CD deaths between 2000 and 2014. The mortality rate in the Northeast was not statistically different in any period analyzed, while the North had tendency to increase; however, a significant risk increase was only observed between 1995 and 1999. The rate of mortality was high in older birth cohorts. The overall prediction for the next two decades showed a progressive decline in CD mortality, which will be highest among the young. The expected average reduction was 76.1% compared to the last observed period (2010-2014) and the last predicted (2030-2034) period. The average reduction ranged from 86% in the 20-24 age group to 50% in the 80 and over age group. CONCLUSIONS In the present study, a higher death rate was observed for ages above 30 years, especially 50 to 64 years, and in the older birth cohorts. We believe these results can be related to period effects of vector control actions and preventive and care measures by the health system of Brazil, in addition to demographic changes in the period. The differences among the regions reflect socioeconomic inequities and access to the healthcare systems in the Brazilian population.
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Affiliation(s)
- Taynãna César Simões
- Clinical Research and Public Policy in Infectious and Parasitic Diseases Group, René Rachou Institute, Oswaldo Cruz Foundation, Belo Horizonte, Minas Gerais, Brazil
| | - Laiane Félix Borges
- School of Health, Federal University of Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil
| | | | - Maria Vitórias Silva
- School of Health, Federal University of Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil
| | - Juliano dos Santos
- Ministry of Health of Brazil, São Paulo State Nucleus, São Paulo, São Paulo, Brazil
| | - Karina Cardoso Meira
- School of Health, Federal University of Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil
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Galvão EL, Pedras MJ, Cota GF, Simões TC, Rabello A. Development and initial validation of a cutaneous leishmaniasis impact questionnaire. PLoS One 2018; 13:e0203378. [PMID: 30161222 PMCID: PMC6117079 DOI: 10.1371/journal.pone.0203378] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [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: 12/04/2017] [Accepted: 08/20/2018] [Indexed: 12/26/2022] Open
Abstract
Background The impact of cutaneous leishmaniasis (CL) on the quality of life of patients has been neglected in research studies worldwide. The few reported studies have used non-specific questionnaires for the disease, which represents a limitation since generic instruments may not address specific aspects of the disease, compromising the evaluation of its real impact. The aim of this paper is to describe the development and the initial validation of an instrument for evaluating the impact of CL, named the Cutaneous Leishmaniasis Impact Questionnaire. Methodology The formulation and validation of the instrument consisted of the following steps: (1) literature review; (2) conceptual framework construction and initial item generation; (3) tool analysis by health professionals (experts); (4) tool evaluation performed by the patients; and (5) a pilot study with 100 patients with localized CL, evaluated at a reference ambulatory facility in Belo Horizonte, in the state of Minas Gerais, Brazil. The structure of the proposed instrument was analyzed using hierarchical cluster analysis (ICLUST). Results Twenty-seven items were initially proposed by the researchers to compose the questionnaire. Content validity (evaluates if the instrument fully assesses the construct of interest) was evaluated by the panel of experts, while face validity (evaluates how potential participants interpret the items) was evaluated by the target population. In this step, some items were excluded, reformulated and/or included. After evaluating a factorial structure of the items in accordance with the cluster analysis, we assembled a questionnaire with 25 items (alpha = 0.86), with high reliability and homogeneity, which address the following: 1) the general impact of the disease (alpha = 0.91, beta = 0.67) and 2) the evaluation of the perception about the treatment and health services (alpha = 0.72, beta = 0.51). Conclusions The Cutaneous Leishmaniasis Impact Questionnaire, developed with contributions from patients and experts, was confirmed, in this first validation, as a useful and reliable instrument.
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Affiliation(s)
- Endi Lanza Galvão
- Pesquisa Clínica e Políticas Públicas em Doenças Infecto-Parasitárias–Instituto René Rachou—Fundação Oswaldo Cruz, Fiocruz, Belo Horizonte, Minas Gerais, Brazil
- * E-mail:
| | - Mariana Junqueira Pedras
- Pesquisa Clínica e Políticas Públicas em Doenças Infecto-Parasitárias–Instituto René Rachou—Fundação Oswaldo Cruz, Fiocruz, Belo Horizonte, Minas Gerais, Brazil
| | - Gláucia Fernandes Cota
- Pesquisa Clínica e Políticas Públicas em Doenças Infecto-Parasitárias–Instituto René Rachou—Fundação Oswaldo Cruz, Fiocruz, Belo Horizonte, Minas Gerais, Brazil
| | - Taynãna César Simões
- Pesquisa Clínica e Políticas Públicas em Doenças Infecto-Parasitárias–Instituto René Rachou—Fundação Oswaldo Cruz, Fiocruz, Belo Horizonte, Minas Gerais, Brazil
| | - Ana Rabello
- Pesquisa Clínica e Políticas Públicas em Doenças Infecto-Parasitárias–Instituto René Rachou—Fundação Oswaldo Cruz, Fiocruz, Belo Horizonte, Minas Gerais, Brazil
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Drummond ED, Simões TC, Andrade FBD. Access to prescribed medicine in the Brazilian adult population. Rev Bras Epidemiol 2018; 21:e180007. [PMID: 30088587 DOI: 10.1590/1980-549720180007] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2017] [Accepted: 10/18/2017] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVE To estimate the prevalence and check the factors associated with access to prescribed medicine by the Brazilian adult population; and to describe the distribution of the presence of monetary expenditure for the purchase, source of medicines, and the reasons for non-access. METHODS Based on a cross-sectional design, from the 2013 National Health Research data, we analyzed a representative sample of the population that comprised adults with prescriptions written by a health professional, in the two weeks prior to the survey. The dependent variable was the access to prescribed medicines (full access, partial access, no access). Data were analyzed using the multinomial logistic regression considering total access as the reference category. RESULTS The results showed high prevalence of full access to prescribed medicine in Brazil (83.0%; 95%CI 81.3 - 84.6). Most of the individuals had monetary expenditure on the purchase of medicines (63.9%), and the main reasons for no access were the lack of medicine in the public health service (57.6%) and having no money (11.9%). We found higher chances of partial access among individuals attending the public service (OR = 2.5; 95%CI 1.58 - 3.97). Greater chance of no access was associated with non-white skin color (OR = 1.43; 95%CI 1.03 - 1.99). CONCLUSION The results revealed significant inequity in access to medicine, emphasizing the need to strengthen the Unified Health System for the free supply of medicines in order to reduce inequalities.
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Diogo Ferreira CC, Torres Rego Monteiro G, César Simões T. Estado nutricional e fatores associados em idosos: evidências com base em inquérito telefônico. RBPS 2018. [DOI: 10.5020/18061230.2018.6279] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
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Souza ERD, Meira KC, Ribeiro AP, Santos JD, Guimarães RM, Borges LF, Oliveira LVE, Simões TC. Homicides among women in the different Brazilian regions in the last 35 years: an analysis of age-period-birth cohort effects. Cien Saude Colet 2017; 22:2949-2962. [PMID: 28954146 DOI: 10.1590/1413-81232017229.12392017] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2017] [Accepted: 05/22/2017] [Indexed: 11/22/2022] Open
Abstract
The aim of this study is to estimate the effects of age-period-birth cohort (APC) on female homicides. This is an ecological study which analyzed the violence-related death records of women aged 10 years and older, in the Brazilian geographic regions, between 1980 and 2014. Data on mortality were extracted from the Mortality Information System. The trend analysis was conducted using negative binomial regression and APC effects were analyzed using estimable functions. The average mortality rate for the period was 5.13 deaths per 100,000 women, with the highest rates observed in the Central-West (7.98 deaths), followed by the Southeast (4.78 deaths), North (4.77 deaths), Northeast (4.05 deaths) and South (3.82 deaths) regions. All regions presented a decrease in the risk of death in the period from 2010 to 2014, except for the Northeast region (RR = 1.06, 95% CI 1.02 to 1.10). There was a progressive increase in the homicide risk for women born from 1955 to 1959 in all Brazilian regions. Younger women are at higher risk of dying from homicides in all Brazilian geographic regions. The upward trend of homicide mortality rates according to birth cohort was significant and the highest risk was observed in women born between 2000 and 2004.
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Affiliation(s)
- Edinilsa Ramos de Souza
- Departamento de Estudos sobre Violência e Saúde Jorge Careli/Claves, Escola Nacional de Saúde Pública, Fiocruz. Av. Brasil 4036/7º, Manguinhos. 21040-210 Rio de Janeiro RJ Brasil.
| | | | - Adalgisa Peixoto Ribeiro
- Departamento de Estudos sobre Violência e Saúde Jorge Careli/Claves, Escola Nacional de Saúde Pública, Fiocruz. Av. Brasil 4036/7º, Manguinhos. 21040-210 Rio de Janeiro RJ Brasil.
| | | | | | - Laiane Felix Borges
- Escola de Saúde, Universidade Federal do Rio Grande do Norte. Natal RN Brasil
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Tonelli GB, Tanure A, Rêgo FD, Carvalho GMDL, Simões TC, Andrade Filho JD. Aspects of the ecology of phlebotomine sand flies (Diptera: Psychodidae) in the Private Natural Heritage Reserve Sanctuary Caraça. PLoS One 2017; 12:e0178628. [PMID: 28570640 PMCID: PMC5453570 DOI: 10.1371/journal.pone.0178628] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [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: 10/31/2016] [Accepted: 05/16/2017] [Indexed: 02/06/2023] Open
Abstract
Leishmaniases are a set of parasitic diseases of zoonotic origin that are transmitted by sandfly vectors in wild, rural and urban environments. Their distribution is dependent not only the distribution of vectors, but also on the distribution of mammalian reservoirs. Only by understanding the transmission cycle of these diseases, such as knowing the participating vectors and reservoirs, can one can understand the epidemiology and ecological relationships of leishmaniases. Ecotourism has become an important area of economic growth in Brazil. One of the most visited tourist attractions in the state of Minas Gerais, the Reserva Particular do Patrimônio Natural Santuário do Caraça (RPPNSC) is located in the Quadrilátero Ferrífero. The aim of this study was to contribute to the control of leishmaniasis among tourists of the RPPNPC by surveying its sand fly fauna and testing for the presence of Leishmania DNA in females. Twenty-five CDC light traps were exposed on 7 trails of the RPPNPC where samples were collected bimonthly for a year, starting in June 2013. A total of 376 specimens of 18 species and 10 genera of sandflies were captured. The predominant species were Psychodopygus lloydi (72.34%) and Pintomyia monticola (5.59%). HaeIII restriction enzyme detected and characterized Leishmania braziliensis DNA in 2 of the samples for an infection rate of 0.7% (2/266). Recent studies found specimens of Ps. lloyd infected with Leishmania braziliensis elsewhere in Minas Gerais, which may be an indication that this species is involved in the transmission of Leishmania in this state.
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Affiliation(s)
- Gabriel Barbosa Tonelli
- Grupo de Estudos em Leishmanioses, Centro de Pesquisas René Rachou, Fiocruz, Minas Gerais, Brasil
| | - Aline Tanure
- Grupo de Estudos em Leishmanioses, Centro de Pesquisas René Rachou, Fiocruz, Minas Gerais, Brasil
| | - Felipe Dutra Rêgo
- Grupo de Estudos em Leishmanioses, Centro de Pesquisas René Rachou, Fiocruz, Minas Gerais, Brasil
| | | | - Taynãna César Simões
- Pesquisa Clínica e Políticas Públicas em Doenças Infecciosas e Parasitárias, René Rachou, Fiocruz, Minas Gerais, Brasil
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Caragata EP, Rezende FO, Simões TC, Moreira LA. Diet-Induced Nutritional Stress and Pathogen Interference in Wolbachia-Infected Aedes aegypti. PLoS Negl Trop Dis 2016; 10:e0005158. [PMID: 27893736 PMCID: PMC5125575 DOI: 10.1371/journal.pntd.0005158] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [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: 05/09/2016] [Accepted: 11/03/2016] [Indexed: 11/19/2022] Open
Abstract
The pathogen interference phenotype greatly restricts infection with dengue virus (DENV) and other pathogens in Wolbachia-infected Aedes aegypti, and is a vital component of Wolbachia-based mosquito control. Critically, the phenotype's causal mechanism is complex and poorly understood, with recent evidence suggesting that the cause may be species specific. To better understand this important phenotype, we investigated the role of diet-induced nutritional stress on interference against DENV and the avian malarial parasite Plasmodium gallinaceum in Wolbachia-infected Ae. aegypti, and on physiological processes linked to the phenotype. Wolbachia-infected mosquitoes were fed one of four different concentrations of sucrose, and then challenged with either P. gallinaceum or DENV. Interference against P. gallinaceum was significantly weakened by the change in diet however there was no effect on DENV interference. Immune gene expression and H2O2 levels have previously been linked to pathogen interference. These traits were assayed for mosquitoes on each diet using RT-qPCR and the Amplex Red Hydrogen Peroxide/Peroxidase Assay Kit, and it was observed that the change in diet did not significantly affect immune expression, but low carbohydrate levels led to a loss of ROS induction in Wolbachia-infected mosquitoes. Our data suggest that host nutrition may not influence DENV interference for Wolbachia-infected mosquitoes, but Plasmodium interference may be linked to both nutrition and oxidative stress. This pathogen-specific response to nutritional change highlights the complex nature of interactions between Wolbachia and pathogens in mosquitoes.
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Affiliation(s)
- Eric Pearce Caragata
- Grupo Mosquitos Vetores: Endossimbiontes e Interação Patógeno Vetor, Centro de Pesquisas René Rachou—Fiocruz, Belo Horizonte, Minas Gerais, Brazil
| | - Fernanda Oliveira Rezende
- Grupo Mosquitos Vetores: Endossimbiontes e Interação Patógeno Vetor, Centro de Pesquisas René Rachou—Fiocruz, Belo Horizonte, Minas Gerais, Brazil
| | - Taynãna César Simões
- Serviço de Apoio a Métodos Quantitativos, Centro de Pesquisas René Rachou—Fiocruz, Belo Horizonte, Minas Gerais, Brazil
| | - Luciano Andrade Moreira
- Grupo Mosquitos Vetores: Endossimbiontes e Interação Patógeno Vetor, Centro de Pesquisas René Rachou—Fiocruz, Belo Horizonte, Minas Gerais, Brazil
- * E-mail:
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de Castro TP, Waissmann W, Simões TC, de Mello RCR, Carvalho DP. Predictors for papillary thyroid cancer persistence and recurrence: a retrospective analysis with a 10-year follow-up cohort study. Clin Endocrinol (Oxf) 2016; 85:466-74. [PMID: 26834009 DOI: 10.1111/cen.13032] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [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] [Received: 10/01/2015] [Revised: 01/25/2016] [Accepted: 01/26/2016] [Indexed: 12/26/2022]
Abstract
OBJECTIVE We aimed to determine outcome predictors of papillary thyroid cancer (PTC) persistence and recurrence, separately. CONTEXT The factors contributing to either persistence or recurrence of PTC are poorly defined, as both outcomes are usually evaluated together. DESIGN AND PATIENTS In this 10-year follow-up cohort study, 190 PTC patients were evaluated (18-85 years old; registered from 1 January 1990 to31 December 1999 at a Brazilian Cancer Care referral Hospital). After initial surgery, we examined persistence (disease detected up to 1 year), recurrence (disease detected after 1 year) and PTC-free status (disease absence during follow-up). MEASUREMENTS Outcome predictors were modelled using multinomial logit regression analysis. RESULTS The univariate analysis showed that persistence and recurrence were significantly associated with lymph node metastasis (OR = 12·33; OR = 2·84, respectively), local aggressiveness (OR = 5·22; OR = 3·35) and extrathyroidal extension (OR = 5·07; OR = 7·11). Persistence was associated with male sex (OR = 3·49), age above 45 years old at diagnosis (OR = 1·03), macroscopic lymph node metastasis (OR = 5·85), local aggressiveness (OR = 5·22), each 1-cm tumour size increase (OR = 1·34), a cancer care referral hospital as the place of initial surgery (OR = 2·3), thyroidectomy or near total thyroidectomy(OR = 3·03) and neck dissection (OR = 3·19). Recurrence was associated with the time of radioactive iodine ((131) I) therapy (OR = 3·71). After data modelling, persistence was associated with macroscopic lymph node metastasis (OR = 6·17), 1-cm increases in tumour size (OR = 1·30) and thyroidectomy or near total thyroidectomy (OR = 3·82), while recurrence was associated with surgery at referral hospital (OR = 3·79). CONCLUSIONS The best predictors of persistence were tumour size and macroscopic lymph node metastasis; when the initial surgery is of quality, the recurrence depends more on tumour's biology aspects.
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Affiliation(s)
- Taciana Padilha de Castro
- Department of Endocrinology, Medical School, Federal University of Rio de Janeiro - UFRJ, Rio de Janeiro, RJ, Brazil
- Research Center for Health Work and Human Ecology - CESTEH-ENSP/FIOCRUZ, Rio de Janeiro, RJ, Brazil
| | - William Waissmann
- Research Center for Health Work and Human Ecology - CESTEH-ENSP/FIOCRUZ, Rio de Janeiro, RJ, Brazil
| | - Taynãna César Simões
- Department of Epidemiology and Quantitative Methods in Health - DEMQS-ENSP/FIOCRUZ, Rio de Janeiro, RJ, Brazil
| | - Rossana Corbo R de Mello
- Department of Endocrinology, Medical School, Federal University of Rio de Janeiro - UFRJ, Rio de Janeiro, RJ, Brazil
- Cancer Hospital 1, National Institute of Cancer INCA, Rio de Janeiro, RJ, Brazil
| | - Denise P Carvalho
- Department of Endocrinology, Medical School, Federal University of Rio de Janeiro - UFRJ, Rio de Janeiro, RJ, Brazil
- Carlos Chagas Filho Institute of Biophysics - IBCCF/UFRJ, Rio de Janeiro, RJ, Brazil
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Simões TC, Luque-Martinez ÍV, Moraes RR, Sá ATG, Loguercio AD, Moura SK. Longevity of Bonding of Self-adhesive Resin Cement to Dentin. Oper Dent 2016; 41:E64-72. [DOI: 10.2341/14-266-lr] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
SUMMARY
Objective: To evaluate the effect of root dentin treatment on the bonding of self-adhesive resin cement after 24 hours and after 6 months.
Methods: A total of 48 single-rooted premolars were endodontically treated and divided into four groups (n=12): Adper Scotchbond Multi-Purpose + RelyX ARC (ARC); RelyX U200 (U200); EDTA + RelyX U200 (EU200); and phosphoric acid (H3PO4) + RelyX U200 (HU200). After filling the roots, an Exacto No. 2 fiber post was cleaned, treated with silane (60 seconds), positioned, and light cured (LED; 60 seconds at 1200 mW/cm2). After storage (37°C/24 h), the roots were cut to obtain two discs (1 mm) of each third. They were stored in distilled water (24 hours at 37°C); one disc of each root-third was subjected to the push-out test (0.5 mm/min) at 24 hours and the other disc after six months of water storage (37°C). The data on the root-thirds were averaged for statistical purposes. The average values of bond strength (MPa) were analyzed by two-way analysis of variance and post hoc Student-Newman-Keuls (5%).
Results: There were statistical differences for the treatment of dentin (p<0.001), for time (p=0.003), and the interaction of treatment and time (p=0.017). After 24 hours, we observed lower bond strength in the HU200 group when compared with other groups (ARC, U200, and EU200). After six months, HU200 showed the lowest bond strength. Higher strengths were observed for EU200 and U200 similarly, which were higher than ARC.
Conclusion: The bonding of the self-adhesive resin cement varied over time in the tested groups.
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Affiliation(s)
- TC Simões
- Tânia Christina Simões, DDS, MS, PhD, Restorative Dentistry, University North of Paraná, Londrina, Brazil
| | - ÍV Luque-Martinez
- Issis Virgínia Luque-Martinez, Dentistry Academic Unit, Faculty of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - RR Moraes
- Rafael R de Moraes, DDS, MS, PhD, professor, Restorative Dentistry, School of Dentistry, Federal University of Pelotas, Pelotas, Brazil
| | - ATG Sá
- André Tomazini Gomes de Sá, PhD, professor, Prosthodontics, Federal Institute of Paraná, Londrina, Brazil
| | - AD Loguercio
- Alessandro D Loguercio, DDS, MS, PhD, professor, Restorative Dentistry, State University of Ponta Grossa, Ponta Grossa, Brazil
| | - SK Moura
- Sandra Kiss Moura, DDS, MDS, PhD, professor, Restorative Dentistry, University North of Paraná, Londrina, Brazil
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Muloliwa AM, Camacho LAB, Verani JFS, Simões TC, Dgedge MDC. Impact of vaccination on the incidence of measles in Mozambique in the period 2000 to 2011. CAD SAUDE PUBLICA 2013; 29:257-69. [PMID: 23459812 DOI: 10.1590/s0102-311x2013000200013] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2012] [Accepted: 10/01/2012] [Indexed: 11/22/2022] Open
Abstract
The aim of this study was to contribute to the better planning of measles elimination actions in Mozambique, by considering the impact of vaccination actions over the period 2000 to 2011. Descriptive and ecological studies and case records made available by the Ministry of Health were used to analyze measles vaccination coverage. Statistical analysis was performed using time series and spatial analysis. Vaccine coverage rates ranged from 82% to 99%. Coverage rates in Maputo city were under 70% and in Niassa province they were over 100%. Coverage showed a clustered pattern in the districts. The measles incidence rate was 1.58 per 100,000 inhabitants (0.00-40.08 per 100,000 inhabitants); districts bordering neighboring countries presented high incidence rates. Although measles morbidity and mortality has decreased in Mozambique, vaccine coverage has been insufficient to interrupt measles transmission. Enhanced surveillance, including investigation of cases and outbreaks, and improvements in measles vaccination are recommended in order to achieve a homogenous coverage rate of ≥ 95% for both routine and mass vaccination campaigns.
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Mocellin MG, Simões TC, Nascimento TFSD, Teixeira MLF, Lounibos LP, Oliveira RLD. Bromeliad-inhabiting mosquitoes in an urban botanical garden of dengue endemic Rio de Janeiro--are bromeliads productive habitats for the invasive vectors Aedes aegypti and Aedes albopictus? Mem Inst Oswaldo Cruz 2010; 104:1171-6. [PMID: 20140379 DOI: 10.1590/s0074-02762009000800015] [Citation(s) in RCA: 29] [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: 10/30/2009] [Accepted: 12/03/2009] [Indexed: 11/22/2022] Open
Abstract
Immatures of both Aedes aegypti and Aedes albopictus have been found in water-holding bromeliad axils in Brazil. Removal of these plants or their treatment with insecticides in public and private gardens have been undertaken during dengue outbreaks in Brazil despite uncertainty as to their importance as productive habitats for dengue vectors. From March 2005-February 2006, we sampled 120 randomly selected bromeliads belonging to 10 species in a public garden less than 200 m from houses in a dengue-endemic neighborhood in Rio de Janeiro. A total of 2,816 mosquito larvae and pupae was collected, with an average of 5.87 immatures per plant per collection. Culex (Microculex) pleuristriatus and Culex spp of the Ocellatus Group were the most abundant culicid species, found in all species of bromeliads; next in relative abundance were species of the genus Wyeomyia. Only two individuals of Ae. aegypti (0.07%) and five of Ae. albopictus(0.18%) were collected from bromeliads. By contrast, immatures of Ae. aegypti were found in manmade containers in nearly 5% of nearby houses. These results demonstrate that bromeliads are not important producers of Ae. aegypti and Ae. albopictus and, hence, should not be a focus for dengue control. However, the results of this study of only one year in a single area may not represent outcomes in other urban localities where bromeliads, Ae. aegypti and dengue coincide in more disturbed habitats.
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Affiliation(s)
- Márcio Goulart Mocellin
- Laboratório de Transmissores de Hematozoários, Instituto Oswaldo Cruz-Fiocruz, Rio de Janeiro, Brasil
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