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Fernandez Montoya L, Alafo C, Martí-Soler H, Máquina M, Comiche K, Cuamba I, Munguambe K, Cator L, Aide P, Galatas B, Cuamba N, Marrenjo D, Saúte F, Paaijmans KP. Overlaying human and mosquito behavioral data to estimate residual exposure to host-seeking mosquitoes and the protection of bednets in a malaria elimination setting where indoor residual spraying and nets were deployed together. PLoS One 2022; 17:e0270882. [PMID: 36107865 PMCID: PMC9477321 DOI: 10.1371/journal.pone.0270882] [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] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Accepted: 06/21/2022] [Indexed: 11/18/2022] Open
Abstract
Characterizing persistent malaria transmission that occurs after the combined deployment of indoor residual spraying (IRS) and long-lasting insecticidal nets (LLINs) is critical to guide malaria control and elimination efforts. This requires a detailed understanding of both human and vector behaviors at the same temporal and spatial scale. Cross-sectional human behavior evaluations and mosquito collections were performed in parallel in Magude district, Mozambique. Net use and the exact time when participant moved into each of five environments (outdoor, indoor before bed, indoor in bed, indoor after getting up, and outdoor after getting up) were recorded for individuals from three different age groups and both sexes during a dry and a rainy season. Malaria mosquitoes were collected with CDC light traps in combination with collection bottle rotators. The percentage of residual exposure to host-seeking vectors that occurred in each environment was calculated for five local malaria vectors with different biting behaviors, and the actual (at observed levels of LLIN use) and potential (i.e. if all residents had used an LLIN) personal protection conferred by LLINs was estimated. Anopheles arabiensis was responsible for more than 74% of residents' residual exposure to host-seeking vectors during the Magude project. The other four vector species (An. funestus s.s., An. parensis, An. squamosus and An. merus) were responsible for less than 10% each. The personal protection conferred by LLINs prevented only 39.2% of the exposure to host-seeking vectors that survived the implementation of both IRS and LLINs, and it differed significantly across seasons, vector species and age groups. At the observed levels of bednet use, 12.5% of all residual exposure to host-seeking vectors occurred outdoor during the evening, 21.9% indoor before going to bed, almost two thirds (64%) while people were in bed, 1.4% indoors after getting up and 0.2% outdoor after leaving the house. Almost a third of the residual exposure to host-seeking vectors (32.4%) occurred during the low transmission season. The residual bites of An. funestus s.s. and An. parensis outdoors and indoor before bedtime, of An. arabiensis indoors when people are in bed, and of An. squamosus both indoors and outdoors, are likely to have sustained malaria transmission throughout the Magude project. By increasing LLIN use, an additional 24.1% of exposure to the remaining hosts-seeking vectors could have been prevented. Since An. arabiensis, the most abundant vector, feeds primarily while people are in bed, increasing net use and net feeding inhibition (through e.g. community awareness activities and the selection of more effective LLINs) could significantly reduce the exposure to remaining host-seeking mosquitoes. Nonetheless, supplementary interventions aiming to reduce human-vector contact outdoors and/or indoors before people go to bed (e.g. through larval source management, window and eave screening, eave tubes, and spatial repellents) will be needed to reduce residual exposure to the outdoor and early biting An. funestus s.s. and An. parensis.
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Affiliation(s)
- Lucia Fernandez Montoya
- ISGlobal, Hospital Clínic—Universitat de Barcelona, Barcelona, Spain
- Centro de Investigação em Saúde de Manhiça (CISM), Fundação Manhiça, Mozambique
| | - Celso Alafo
- Centro de Investigação em Saúde de Manhiça (CISM), Fundação Manhiça, Mozambique
- Goodbye Malaria, Tchau Tchau Malaria Foundation, Chibungo, Mozambique
| | | | - Mara Máquina
- Centro de Investigação em Saúde de Manhiça (CISM), Fundação Manhiça, Mozambique
| | - Kiba Comiche
- Centro de Investigação em Saúde de Manhiça (CISM), Fundação Manhiça, Mozambique
| | - Inocencia Cuamba
- Centro de Investigação em Saúde de Manhiça (CISM), Fundação Manhiça, Mozambique
| | - Khatia Munguambe
- Centro de Investigação em Saúde de Manhiça (CISM), Fundação Manhiça, Mozambique
| | | | - Pedro Aide
- Centro de Investigação em Saúde de Manhiça (CISM), Fundação Manhiça, Mozambique
- Instituto Nacional da Saúde, Ministério da Saúde, Maputo, Mozambique
| | - Beatriz Galatas
- ISGlobal, Hospital Clínic—Universitat de Barcelona, Barcelona, Spain
- Centro de Investigação em Saúde de Manhiça (CISM), Fundação Manhiça, Mozambique
| | - Nelson Cuamba
- Programa Nacional de Controlo da Malária, Ministério da Saúde, Maputo, Mozambique
- PMI VectorLink Project, Abt Associates Inc., Maputo, Mozambique
| | - Dulcisaria Marrenjo
- Programa Nacional de Controlo da Malária, Ministério da Saúde, Maputo, Mozambique
| | - Francisco Saúte
- Centro de Investigação em Saúde de Manhiça (CISM), Fundação Manhiça, Mozambique
| | - Krijn P. Paaijmans
- ISGlobal, Hospital Clínic—Universitat de Barcelona, Barcelona, Spain
- Centro de Investigação em Saúde de Manhiça (CISM), Fundação Manhiça, Mozambique
- Center for Evolution and Medicine, School of Life Sciences, Arizona State University, Tempe, AZ, United States of America
- The Biodesign Center for Immunotherapy, Vaccines and Virotherapy, Arizona State University, Tempe, AZ, United States of America
- Simon A. Levin Mathematical, Computational and Modeling Sciences Center, Arizona State University, Tempe, AZ, United States of America
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Valle-Hita C, Díaz-López A, Becerra-Tomás N, Martínez-González MA, García VR, Corella D, Goday A, Martínez JA, Alonso-Gómez ÁM, Wärnberg J, Vioque J, Romaguera D, López-Miranda J, Estruch R, Tinahones FJ, Lapetra J, Serra-Majem L, Cano-Ibáñez N, Tur JA, Rubín-García M, Pintó X, Delgado-Rodríguez M, Matía-Martín P, Vidal J, Fontao SM, Daimiel L, Ros E, Toledo E, Sorlí JV, Roca C, Abete I, Moreno-Rodriguez A, Crespo-Oliva E, Candela-García I, Morey M, Garcia-Rios A, Casas R, Fernandez-Garcia JC, Santos-Lozano JM, Diez-Espino J, Ortega-Azorín C, Comas M, Zulet MA, Sorto-Sanchez C, Ruiz-Canela M, Fitó M, Salas-Salvadó J, Babio N. Prospective associations between a priori dietary patterns adherence and kidney function in an elderly Mediterranean population at high cardiovascular risk. Eur J Nutr 2022; 61:3095-3108. [PMID: 35366708 PMCID: PMC9363380 DOI: 10.1007/s00394-022-02838-7] [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] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Accepted: 02/11/2022] [Indexed: 02/07/2023]
Abstract
Purpose To assess the association between three different a priori dietary patterns adherence (17-item energy reduced-Mediterranean Diet (MedDiet), Trichopoulou-MedDiet and Dietary Approach to Stop Hypertension (DASH)), as well as the Protein Diet Score and kidney function decline after one year of follow-up in elderly individuals with overweight/obesity and metabolic syndrome (MetS). Methods We prospectively analyzed 5675 participants (55–75 years) from the PREDIMED-Plus study. At baseline and at one year, we evaluated the creatinine-based estimated glomerular filtration rate (eGFR) and food-frequency questionnaires-derived dietary scores. Associations between four categories (decrease/maintenance and tertiles of increase) of each dietary pattern and changes in eGFR (ml/min/1.73m2) or ≥ 10% eGFR decline were assessed by fitting multivariable linear or logistic regression models, as appropriate. Results Participants in the highest tertile of increase in 17-item erMedDiet Score showed higher upward changes in eGFR (β: 1.87 ml/min/1.73m2; 95% CI: 1.00–2.73) and had lower odds of ≥ 10% eGFR decline (OR: 0.62; 95% CI: 0.47–0.82) compared to individuals in the decrease/maintenance category, while Trichopoulou-MedDiet and DASH Scores were not associated with any renal outcomes. Those in the highest tertile of increase in Protein Diet Score had greater downward changes in eGFR (β: − 0.87 ml/min/1.73m2; 95% CI: − 1.73 to − 0.01) and 32% higher odds of eGFR decline (OR: 1.32; 95% CI: 1.00–1.75). Conclusions Among elderly individuals with overweight/obesity and MetS, only higher upward change in the 17-item erMedDiet score adherence was associated with better kidney function after one year. However, increasing Protein Diet Score appeared to have an adverse impact on kidney health. Trial Registration Number: ISRCTN89898870 (Data of registration: 2014). Supplementary Information The online version contains supplementary material available at 10.1007/s00394-022-02838-7.
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Affiliation(s)
- Cristina Valle-Hita
- Department of Biochemistry and Biotechonology, Universitat Rovira i Virgili, Human Nutrition Unit, Carrer Sant Llorenç, 21, 43201, Reus, Spain
- Institut ďInvestigació Sanitària Pere Virgili (IISPV), 43204, Reus, Spain
- University Hospital of Sant Joan de Reus, Nutrition Unit, 43201, Reus, Spain
| | - Andrés Díaz-López
- Department of Biochemistry and Biotechonology, Universitat Rovira i Virgili, Human Nutrition Unit, Carrer Sant Llorenç, 21, 43201, Reus, Spain
- Institut ďInvestigació Sanitària Pere Virgili (IISPV), 43204, Reus, Spain
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y la Nutrición (CIBERObn), Institute of Health Carlos III, 28029, Madrid, Spain
- Serra Hunter Fellow, Nutrition and Mental Health Research Group (NUTRISAM), Universitat Rovira i Virgili, 43201, Reus, Spain
| | - Nerea Becerra-Tomás
- Department of Biochemistry and Biotechonology, Universitat Rovira i Virgili, Human Nutrition Unit, Carrer Sant Llorenç, 21, 43201, Reus, Spain.
- Institut ďInvestigació Sanitària Pere Virgili (IISPV), 43204, Reus, Spain.
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y la Nutrición (CIBERObn), Institute of Health Carlos III, 28029, Madrid, Spain.
- Department of Epidemiology and Biostatistics, School of Public Health, Faculty of Medicine, Imperial College London, St Mary's Campus, Norfolk Place, London, W2 1PG, UK.
| | - Miguel A Martínez-González
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y la Nutrición (CIBERObn), Institute of Health Carlos III, 28029, Madrid, Spain
- Department of Preventive Medicine and Public Health, University of Navarra, IdiSNA, 31008, Pamplona, Spain
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, 02115, USA
| | - Verónica Ruiz García
- Department of Biochemistry and Biotechonology, Universitat Rovira i Virgili, Human Nutrition Unit, Carrer Sant Llorenç, 21, 43201, Reus, Spain
- University Hospital of Tarragona Joan XXIII, 43005, Tarragona, Spain
| | - Dolores Corella
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y la Nutrición (CIBERObn), Institute of Health Carlos III, 28029, Madrid, Spain
- Department of Preventive Medicine, University of Valencia, 46010, Valencia, Spain
| | - Albert Goday
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y la Nutrición (CIBERObn), Institute of Health Carlos III, 28029, Madrid, Spain
- Cardiovascular Risk and Nutrition Research Group (CARIN), Hospital del Mar Research Institute (IMIM), Departament de Medicina, Universitat Autònoma de Barcelona, 08003, Barcelona, Spain
| | - J Alfredo Martínez
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y la Nutrición (CIBERObn), Institute of Health Carlos III, 28029, Madrid, Spain
- Department of Nutrition, Food Science and Physiology, University of Navarra, IdiSNA, 31008, Pamplona, Spain
- Precision Nutrition Program, CEI UAM + CSIC, IMDEA Food and Health Sciences, 28049, Madrid, Spain
| | - Ángel M Alonso-Gómez
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y la Nutrición (CIBERObn), Institute of Health Carlos III, 28029, Madrid, Spain
- Bioaraba Health Research Institute, Osakidetza Basque Health Service, Araba University Hospital, University of the Basque Country UPV/EHU, 01009, Vitoria-Gasteiz, Spain
| | - Julia Wärnberg
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y la Nutrición (CIBERObn), Institute of Health Carlos III, 28029, Madrid, Spain
- Department of Nursing, University of Málaga, Institute of Biomedical Research in Malaga (IBIMA), 29071, Málaga, Spain
| | - Jesús Vioque
- Instituto de Investigación Sanitaria y Biomédica de Alicante, Miguel Hernandez University (ISABIAL-UMH), 46020, Alicante, Spain
- CIBER de Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, 28029, Madrid, Spain
| | - Dora Romaguera
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y la Nutrición (CIBERObn), Institute of Health Carlos III, 28029, Madrid, Spain
- Health Research Institute of the Balearic Islands (IdISBa), 07120, Palma de Mallorca, Spain
| | - José López-Miranda
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y la Nutrición (CIBERObn), Institute of Health Carlos III, 28029, Madrid, Spain
- Department of Internal Medicine, Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Reina Sofia University Hospital, University of Cordoba, 14004, Cordoba, Spain
| | - Ramon Estruch
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y la Nutrición (CIBERObn), Institute of Health Carlos III, 28029, Madrid, Spain
- Department of Internal Medicine, Institutd'Investigacions Biomèdiques August Pi Sunyer (IDIBAPS), Hospital Clinic, University of Barcelona, 08036, Barcelona, Spain
| | - Francisco J Tinahones
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y la Nutrición (CIBERObn), Institute of Health Carlos III, 28029, Madrid, Spain
- Department of Endocrinology, Virgen de la Victoria Hospital Instituto de Investigación Biomédica de Málaga (IBIMA), University of Málaga, 29010, Málaga, Spain
| | - José Lapetra
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y la Nutrición (CIBERObn), Institute of Health Carlos III, 28029, Madrid, Spain
- Department of Family Medicine, Research Unit, Distrito Sanitario Atención Primaria Sevilla, 41013, Sevilla, Spain
| | - Luís Serra-Majem
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y la Nutrición (CIBERObn), Institute of Health Carlos III, 28029, Madrid, Spain
- Preventive Medicine Service, University of Las Palmas de Gran Canaria, Research Institute of Biomedical and Health Sciences (IUIBS), Centro Hospitalario Universitario Insular Materno Infantil (CHUIMI), Canarian Health Service, 35016, Las Palmas, Spain
| | - Naomi Cano-Ibáñez
- CIBER de Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, 28029, Madrid, Spain
- Department of Preventive Medicine, University of Granada, 18071, Granada, Spain
| | - Josep A Tur
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y la Nutrición (CIBERObn), Institute of Health Carlos III, 28029, Madrid, Spain
- Health Research Institute of the Balearic Islands (IdISBa), 07120, Palma de Mallorca, Spain
- Research Group On Community Nutrition and Oxidative Stress, University of Balearic Islands, 07122, Palma de Mallorca, Spain
| | - María Rubín-García
- Institute of Biomedicine (IBIOMED), University of León, 24071, León, Spain
| | - Xavier Pintó
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y la Nutrición (CIBERObn), Institute of Health Carlos III, 28029, Madrid, Spain
- Lipids and Vascular Risk Unit, Internal Medicine, Hospital Universitario de Bellvitge-IDIBELL, Hospitalet de Llobregat, 08907, Barcelona, Spain
- University of Barcelona, 08007, Barcelona, Spain
| | - Miguel Delgado-Rodríguez
- CIBER de Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, 28029, Madrid, Spain
- Division of Preventive Medicine, Faculty of Medicine, University of Jaén, 23071, Jaén, Spain
| | - Pilar Matía-Martín
- Department of Endocrinology and Nutrition, Instituto de Investigación Sanitaria Hospital Clínico San Carlos (IdISSC), 28040, Madrid, Spain
| | - Josep Vidal
- Departament of Endocrinology, IDIBAPS, Hospital Clínic, University of Barcelona, 08036, Barcelona, Spain
- CIBER Diabetes y Enfermedades Metabólicas (CIBERDEM), Instituto de Salud Carlos III (ISCIII), 28029, Madrid, Spain
| | - Sebastian Mas Fontao
- Department of Endocrinology and Nutrition, University Hospital Fundación Jimenez Díaz, Instituto de Investigaciones Biomédicas IISFJD, 28040, Madrid, Spain
| | - Lidia Daimiel
- CEI UAM + CSIC, Nutritional Control of the Epigenome Group, IMDEA Food, 28049, Madrid, Spain
| | - Emilio Ros
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y la Nutrición (CIBERObn), Institute of Health Carlos III, 28029, Madrid, Spain
- Department of Endocrinology and Nutrition, Lipid Clinic, Hospital Clínic, Institut d'Investigacions Biomèdiques August Pi Sunyer (IDIBAPS), 08036, Barcelona, Spain
| | - Estefania Toledo
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y la Nutrición (CIBERObn), Institute of Health Carlos III, 28029, Madrid, Spain
- Department of Preventive Medicine and Public Health, University of Navarra, IdiSNA, 31008, Pamplona, Spain
| | - José V Sorlí
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y la Nutrición (CIBERObn), Institute of Health Carlos III, 28029, Madrid, Spain
- Department of Preventive Medicine, University of Valencia, 46010, Valencia, Spain
| | - C Roca
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y la Nutrición (CIBERObn), Institute of Health Carlos III, 28029, Madrid, Spain
- Cardiovascular Risk and Nutrition Research Group (CARIN), Hospital del Mar Research Institute (IMIM), Departament de Medicina, Universitat Autònoma de Barcelona, 08003, Barcelona, Spain
| | - Iztiar Abete
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y la Nutrición (CIBERObn), Institute of Health Carlos III, 28029, Madrid, Spain
- Department of Nutrition, Food Science and Physiology, University of Navarra, IdiSNA, 31008, Pamplona, Spain
| | - Anai Moreno-Rodriguez
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y la Nutrición (CIBERObn), Institute of Health Carlos III, 28029, Madrid, Spain
- Bioaraba Health Research Institute, Osakidetza Basque Health Service, Araba University Hospital, University of the Basque Country UPV/EHU, 01009, Vitoria-Gasteiz, Spain
| | - Edelys Crespo-Oliva
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y la Nutrición (CIBERObn), Institute of Health Carlos III, 28029, Madrid, Spain
- Department of Nursing, University of Málaga, Institute of Biomedical Research in Malaga (IBIMA), 29071, Málaga, Spain
| | | | - Marga Morey
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y la Nutrición (CIBERObn), Institute of Health Carlos III, 28029, Madrid, Spain
- Health Research Institute of the Balearic Islands (IdISBa), 07120, Palma de Mallorca, Spain
| | - Antonio Garcia-Rios
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y la Nutrición (CIBERObn), Institute of Health Carlos III, 28029, Madrid, Spain
- Department of Internal Medicine, Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Reina Sofia University Hospital, University of Cordoba, 14004, Cordoba, Spain
| | - Rosa Casas
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y la Nutrición (CIBERObn), Institute of Health Carlos III, 28029, Madrid, Spain
- Department of Internal Medicine, Institutd'Investigacions Biomèdiques August Pi Sunyer (IDIBAPS), Hospital Clinic, University of Barcelona, 08036, Barcelona, Spain
| | - Jose Carlos Fernandez-Garcia
- Department of Endocrinology, Virgen de la Victoria Hospital Instituto de Investigación Biomédica de Málaga (IBIMA), University of Málaga, 29010, Málaga, Spain
| | - José Manuel Santos-Lozano
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y la Nutrición (CIBERObn), Institute of Health Carlos III, 28029, Madrid, Spain
- Department of Family Medicine, Research Unit, Distrito Sanitario Atención Primaria Sevilla, 41013, Sevilla, Spain
| | - Javier Diez-Espino
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y la Nutrición (CIBERObn), Institute of Health Carlos III, 28029, Madrid, Spain
- Department of Preventive Medicine and Public Health, University of Navarra, IdiSNA, 31008, Pamplona, Spain
- Atención Primaria, Servicio Navarro de Salud, Osasunbidea, Pamplona, Spain
| | - Carolina Ortega-Azorín
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y la Nutrición (CIBERObn), Institute of Health Carlos III, 28029, Madrid, Spain
- Department of Preventive Medicine, University of Valencia, 46010, Valencia, Spain
| | - M Comas
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y la Nutrición (CIBERObn), Institute of Health Carlos III, 28029, Madrid, Spain
- Cardiovascular Risk and Nutrition Research Group (CARIN), Hospital del Mar Research Institute (IMIM), Departament de Medicina, Universitat Autònoma de Barcelona, 08003, Barcelona, Spain
| | - M Angeles Zulet
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y la Nutrición (CIBERObn), Institute of Health Carlos III, 28029, Madrid, Spain
- Department of Nutrition, Food Science and Physiology, University of Navarra, IdiSNA, 31008, Pamplona, Spain
| | - Carolina Sorto-Sanchez
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y la Nutrición (CIBERObn), Institute of Health Carlos III, 28029, Madrid, Spain
- Bioaraba Health Research Institute, Osakidetza Basque Health Service, Araba University Hospital, University of the Basque Country UPV/EHU, 01009, Vitoria-Gasteiz, Spain
| | - Miguel Ruiz-Canela
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y la Nutrición (CIBERObn), Institute of Health Carlos III, 28029, Madrid, Spain
- Department of Preventive Medicine and Public Health, University of Navarra, IdiSNA, 31008, Pamplona, Spain
| | - Montse Fitó
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y la Nutrición (CIBERObn), Institute of Health Carlos III, 28029, Madrid, Spain
- Cardiovascular Risk and Nutrition Research Group (CARIN), Hospital del Mar Research Institute (IMIM), Departament de Medicina, Universitat Autònoma de Barcelona, 08003, Barcelona, Spain
| | - Jordi Salas-Salvadó
- Department of Biochemistry and Biotechonology, Universitat Rovira i Virgili, Human Nutrition Unit, Carrer Sant Llorenç, 21, 43201, Reus, Spain
- Institut ďInvestigació Sanitària Pere Virgili (IISPV), 43204, Reus, Spain
- University Hospital of Sant Joan de Reus, Nutrition Unit, 43201, Reus, Spain
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y la Nutrición (CIBERObn), Institute of Health Carlos III, 28029, Madrid, Spain
| | - Nancy Babio
- Department of Biochemistry and Biotechonology, Universitat Rovira i Virgili, Human Nutrition Unit, Carrer Sant Llorenç, 21, 43201, Reus, Spain
- Institut ďInvestigació Sanitària Pere Virgili (IISPV), 43204, Reus, Spain
- University Hospital of Sant Joan de Reus, Nutrition Unit, 43201, Reus, Spain
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y la Nutrición (CIBERObn), Institute of Health Carlos III, 28029, Madrid, Spain
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Alonso S, Català M, López D, Álvarez-Lacalle E, Jordan I, García-García JJ, Fumadó V, Muñoz-Almagro C, Gratacós E, Balanza N, Varo R, Millat P, Baro B, Ajanovic S, Arias S, Claverol J, de Sevilla MF, Bonet-Carne E, Garcia-Miquel A, Coma E, Medina-Peralta M, Fina F, Prats C, Bassat Q. Individual prevention and containment measures in schools in Catalonia, Spain, and community transmission of SARS-CoV-2 after school re-opening. PLoS One 2022; 17:e0263741. [PMID: 35171936 PMCID: PMC8849486 DOI: 10.1371/journal.pone.0263741] [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] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2021] [Accepted: 01/25/2022] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Despite their clear lesser vulnerability to COVID-19, the extent by which children are susceptible to getting infected by SARS-CoV-2 and their capacity to transmit the infection to other people remains inadequately characterized. We aimed to evaluate the role of school reopening and the preventive strategies in place at schools in terms of overall risk for children and community transmission, by comparing transmission rates in children as detected by a COVID-19 surveillance platform in place in Catalonian Schools to the incidence at the community level. METHODS AND FINDINGS Infections detected in Catalan schools during the entire first trimester of classes (September-December 2020) were analysed and compared with the ongoing community transmission and with the modelled predicted number of infections. There were 30.486 infections (2.12%) documented among the circa 1.5M pupils, with cases detected in 54.0% and 97.5% of the primary and secondary centres, respectively. During the entire first term, the proportion of "bubble groups" (stable groups of children doing activities together) that were forced to undergo confinement ranged between 1 and 5%, with scarce evidence of substantial intraschool transmission in the form of chains of infections, and with ~75% of all detected infections not leading to secondary cases. Mathematical models were also used to evaluate the effect of different parameters related to the defined preventive strategies (size of the bubble group, number of days of confinement required by contacts of an index case). The effective reproduction number inside the bubble groups in schools (R*), defined as the average number of schoolmates infected by each primary case within the bubble, was calculated, yielding a value of 0.35 for primary schools and 0.55 for secondary schools, and compared with the outcomes of the mathematical model, implying decreased transmissibility for children in the context of the applied measures. Relative homogenized monthly cumulative incidence ([Formula: see text]) was assessed to compare the epidemiological dynamics among different age groups and this analysis suggested the limited impact of infections in school-aged children in the context of the overall community incidence. CONCLUSIONS During the fall of 2020, SARS-CoV-2 infections and COVID-19 cases detected in Catalan schools closely mirrored the underlying community transmission from the neighbourhoods where they were set and maintaining schools open appeared to be safe irrespective of underlying community transmission. Preventive measures in place in those schools appeared to be working for the early detection and rapid containment of transmission and should be maintained for the adequate and safe functioning of normal academic and face-to-face school activities.
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Affiliation(s)
- Sergio Alonso
- Department of Physics, Universitat Politècnica de Catalunya, Barcelona, Spain
| | - Martí Català
- Department of Physics, Universitat Politècnica de Catalunya, Barcelona, Spain
- Comparative Medicine and Bioimage Centre of Catalonia (CMCiB), Fundació Institut d’Investigació en Ciències de la Salut Germans Trias i Pujol, Badalona, Catalonia, Spain
| | - Daniel López
- Department of Physics, Universitat Politècnica de Catalunya, Barcelona, Spain
| | | | - Iolanda Jordan
- Paediatric Intensive Care Unit, Hospital Sant Joan de Déu, University of Barcelona, Barcelona, Spain
- Institut de Recerca Sant Joan de Déu, University of Barcelona, Barcelona, Spain
- Consorcio de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Juan José García-García
- Institut de Recerca Sant Joan de Déu, University of Barcelona, Barcelona, Spain
- Consorcio de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Pediatrics Department, Hospital Sant Joan de Déu, Universitat de Barcelona, Esplugues, Barcelona, Spain
| | - Victoria Fumadó
- Infectious Diseases Department, Hospital Sant Joan de Déu, Barcelona, Spain
| | - Carmen Muñoz-Almagro
- Institut de Recerca Sant Joan de Déu, University of Barcelona, Barcelona, Spain
- Consorcio de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Department of Medicine, Universitat Internacional de Catalunya, Barcelona, Spain
| | - Eduard Gratacós
- BCNatal | Fetal Medicine Research Center (Hospital Clínic and Hospital Sant Joan de Déu), University of Barcelona, Barcelona, Spain
- Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
- Center for Biomedical Research on Rare Diseases (CIBER-ER), Madrid, Spain
| | - Núria Balanza
- ISGlobal, Hospital Clínic—Universitat de Barcelona, Barcelona, Spain
| | - Rosauro Varo
- ISGlobal, Hospital Clínic—Universitat de Barcelona, Barcelona, Spain
- Centro de Investigação em Saúde de Manhiça, Maputo, Mozambique
| | - Pere Millat
- ISGlobal, Hospital Clínic—Universitat de Barcelona, Barcelona, Spain
| | - Bàrbara Baro
- ISGlobal, Hospital Clínic—Universitat de Barcelona, Barcelona, Spain
| | - Sara Ajanovic
- ISGlobal, Hospital Clínic—Universitat de Barcelona, Barcelona, Spain
- Centro de Investigação em Saúde de Manhiça, Maputo, Mozambique
| | - Sara Arias
- ISGlobal, Hospital Clínic—Universitat de Barcelona, Barcelona, Spain
| | - Joana Claverol
- Institut de Recerca Sant Joan de Déu, University of Barcelona, Barcelona, Spain
- Fundació Sant Joan de Déu, Barcelona, Spain
| | - Mariona Fernández de Sevilla
- Institut de Recerca Sant Joan de Déu, University of Barcelona, Barcelona, Spain
- Consorcio de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Pediatrics Department, Hospital Sant Joan de Déu, Universitat de Barcelona, Esplugues, Barcelona, Spain
| | - Elisenda Bonet-Carne
- BCNatal | Fetal Medicine Research Center (Hospital Clínic and Hospital Sant Joan de Déu), University of Barcelona, Barcelona, Spain
- Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
- Universitat Politècnica de Catalunya BarcelonaTech, Barcelona, Spain
| | - Aleix Garcia-Miquel
- BCNatal | Fetal Medicine Research Center (Hospital Clínic and Hospital Sant Joan de Déu), University of Barcelona, Barcelona, Spain
| | - Ermengol Coma
- Sistema d’Informació dels Serveis d’Atenció Primària (SISAP), Institut Català de la Salut, Barcelona, Spain
| | - Manuel Medina-Peralta
- Sistema d’Informació dels Serveis d’Atenció Primària (SISAP), Institut Català de la Salut, Barcelona, Spain
| | - Francesc Fina
- Sistema d’Informació dels Serveis d’Atenció Primària (SISAP), Institut Català de la Salut, Barcelona, Spain
| | - Clara Prats
- Department of Physics, Universitat Politècnica de Catalunya, Barcelona, Spain
| | - Quique Bassat
- Consorcio de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Pediatrics Department, Hospital Sant Joan de Déu, Universitat de Barcelona, Esplugues, Barcelona, Spain
- ISGlobal, Hospital Clínic—Universitat de Barcelona, Barcelona, Spain
- Centro de Investigação em Saúde de Manhiça, Maputo, Mozambique
- ICREA, Catalan Institution for Research and Advanced Studies, Barcelona, Spain
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6
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Laucyte-Cibulskiene A, Ward LJ, Ebert T, Tosti G, Tucci C, Hernandez L, Kautzky-Willer A, Herrero MT, Norris CM, Pilote L, Söderberg M, Brismar TB, Ripsweden J, Stenvinkel P, Raparelli V, Kublickiene K. Role of GDF-15, YKL-40 and MMP 9 in patients with end-stage kidney disease: focus on sex-specific associations with vascular outcomes and all-cause mortality. Biol Sex Differ 2021; 12:50. [PMID: 34526107 PMCID: PMC8444580 DOI: 10.1186/s13293-021-00393-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Accepted: 08/29/2021] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Sex differences are underappreciated in the current understanding of cardiovascular disease (CVD) in association with chronic kidney disease (CKD). A hallmark of CKD is vascular aging that is characterised, amongst others, by; systemic inflammation, microbiota disbalance, oxidative stress, and vascular calcification-features linked to atherosclerosis/arteriosclerosis development. Thus, it is the necessary to introduce novel biomarkers related to athero-/arteriosclerotic damage for better assessment of vascular ageing in patients CKD. However, little is known about the relationship between uraemia and novel CVD biomarkers, such as growth differentiation factor-15 (GDF-15), cartilage glycoprotein-39 (YKL-40) and matrix metalloproteinase-9 (MMP-9). Therefore, we hypothesise that there are sex-specific relationships between GDF-15, YKL-40, MMP-9 levels in end-stage kidney disease (ESKD) patients in relation to gut microbiota, vascular calcification, inflammation, comorbidities, and all-cause mortality. METHODS ESKD patients, males (n = 151) and females (n = 79), not receiving renal replacement therapy were selected from two ongoing prospective ESKD cohorts. GDF-15, YKL-40 and MMP9 were analysed using enzyme-linked immunosorbent assay kits. Biomarker levels were analysed in the context of gut microbiota-derived trimethylamine N-oxide (TMAO), vascular calcification, inflammatory response, oxidative stress, comorbidities, and all-cause mortality. RESULTS Increased GDF-15 correlated with higher TMAO in females only, and with higher coronary artery calcification and IL-6. In females, diabetes was associated with elevated GDF-15 and MMP-9, whilst males with diabetes only had elevated GDF-15. No associations were found between biomarkers and CVD comorbidity. Deceased males and females had higher GDF-15 concentrations (p = 0.01 and p < 0.001, respectively), meanwhile only YKL-40 was increased in deceased males (p = 0.02). CONCLUSIONS In conclusion, in males GDF-15 and YKL-40 were related to vascular calcification, inflammation, and oxidative stress, whilst in females GDF-15 was related to TMAO. Increased levels of YKL-40 and GDF-15 in males, and only GDF-15 in females, were associated with all-cause mortality. Our findings suggest that sex-specific associations of novel CVD biomarkers have a potential to affect development of cardiovascular complications in patients with ESKD.
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Affiliation(s)
- Agne Laucyte-Cibulskiene
- Division of Renal Medicine, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden
- Department of Nephrology, Lund University, Skåne University Hospital, Malmö, Sweden
| | - Liam J Ward
- Division of Renal Medicine, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden
| | - Thomas Ebert
- Division of Renal Medicine, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden
| | - Giulia Tosti
- Institute of Internal Medicine, Catholic University of Rome, Fondazione Policlinico Gemelli IRCCS, Rome, Italy
| | - Claudia Tucci
- Department of Biomedical, Experimental and Clinical Sciences, University of Florence, Florence, Italy
| | - Leah Hernandez
- Division of Renal Medicine, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden
| | - Alexandra Kautzky-Willer
- Division of Endocrinology and Metabolism, Department of Medicine III, Medical University of Vienna, Vienna, Austria
| | - Maria-Trinidad Herrero
- Clinical and Experimental Neuroscience, Institutes for Aging Research and Bio-Health Research of Murcia, School of Medicine, University of Murcia, Murcia, Spain
| | - Colleen M Norris
- University of Alberta, Faculty of Nursing, Edmonton, AB, Canada
- Cardiovascular and Stroke Strategic Clinical Network, Alberta Health Services, Edmonton, AB, Canada
| | - Louise Pilote
- Division of Clinical Epidemiology, Research Institute of McGill University Health Centre, McGill University, Montreal, QC, Canada
| | - Magnus Söderberg
- Clinical Pharmacology and Safety Sciences, R&D, AstraZeneca, Göteborg, Sweden
| | - Torkel B Brismar
- Division of Medical Imaging and Technology, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden
- Department of Radiology, Karolinska University Hospital in Huddinge, Stockholm, Sweden
| | - Jonaz Ripsweden
- Division of Medical Imaging and Technology, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden
- Department of Radiology, Karolinska University Hospital in Huddinge, Stockholm, Sweden
| | - Peter Stenvinkel
- Division of Renal Medicine, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden
| | - Valeria Raparelli
- University of Alberta, Faculty of Nursing, Edmonton, AB, Canada
- Department of Translational Medicine, University of Ferrara, Ferrara, Italy
| | - Karolina Kublickiene
- Division of Renal Medicine, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden.
- Division of Renal Medicine, Department for Clinical Science, Intervention & Technology, Karolinska University Hospital-Flemingsberg Campus, 14186, Stockholm, Sweden.
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