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1.
PLoS Biol ; 17(11): e3000526, 2019 11.
Artigo em Inglês | MEDLINE | ID: mdl-31730640

RESUMO

The Amazon is Brazil's greatest natural resource and invaluable to the rest of the world as a buffer against climate change. The recent election of Brazil's president brought disputes over development plans for the region back into the spotlight. Historically, the development model for the Amazon has focused on exploitation of natural resources, resulting in environmental degradation, particularly deforestation. Although considerable attention has focused on the long-term global cost of "losing the Amazon," too little attention has focused on the emergence and reemergence of vector-borne diseases that directly impact the local population, with spillover effects to other neighboring areas. We discuss the impact of Amazon development models on human health, with a focus on vector-borne disease risk. We outline policy actions that could mitigate these negative impacts while creating opportunities for environmentally sensitive economic activities.


Assuntos
Agricultura/métodos , Conservação dos Recursos Naturais/métodos , Doenças Transmitidas por Vetores/epidemiologia , Agricultura/legislação & jurisprudência , Brasil , Mudança Climática , Conservação dos Recursos Naturais/legislação & jurisprudência , Doença/etiologia , Ecossistema , Florestas , Humanos , Doenças Transmitidas por Vetores/transmissão
2.
Epidemiol Infect ; 149: e264, 2021 11 04.
Artigo em Inglês | MEDLINE | ID: mdl-34732273

RESUMO

As of 03 January 2021, the WHO African region is the least affected by the coronavirus disease-2019 (COVID-19) pandemic, accounting for only 2.4% of cases and deaths reported globally. However, concerns abound about whether the number of cases and deaths reported from the region reflect the true burden of the disease and how the monitoring of the pandemic trajectory can inform response measures.We retrospectively estimated four key epidemiological parameters (the total number of cases, the number of missed cases, the detection rate and the cumulative incidence) using the COVID-19 prevalence calculator tool developed by Resolve to Save Lives. We used cumulative cases and deaths reported during the period 25 February to 31 December 2020 for each WHO Member State in the region as well as population data to estimate the four parameters of interest. The estimated number of confirmed cases in 42 countries out of 47 of the WHO African region included in this study was 13 947 631 [95% confidence interval (CI): 13 334 620-14 635 502] against 1 889 512 cases reported, representing 13.5% of overall detection rate (range: 4.2% in Chad, 43.9% in Guinea). The cumulative incidence of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) was estimated at 1.38% (95% CI: 1.31%-1.44%), with South Africa the highest [14.5% (95% CI: 13.9%-15.2%)] and Mauritius [0.1% (95% CI: 0.099%-0.11%)] the lowest. The low detection rate found in most countries of the WHO African region suggests the need to strengthen SARS-CoV-2 testing capacities and adjusting testing strategies.


Assuntos
COVID-19/diagnóstico , COVID-19/epidemiologia , SARS-CoV-2 , Organização Mundial da Saúde/organização & administração , África/epidemiologia , Idoso , COVID-19/mortalidade , COVID-19/virologia , Humanos , Incidência , Pessoa de Meia-Idade , Estudos Retrospectivos , Fatores de Tempo
3.
Epidemiol Infect ; 149: e259, 2021 05 10.
Artigo em Inglês | MEDLINE | ID: mdl-33966683

RESUMO

Successive waves of COVID-19 transmission have led to exponential increases in new infections globally. In this study, we have applied a decision-making tool to assess the risk of continuing transmission to inform decisions on tailored public health and social measures (PHSM) using data on cases and deaths reported by Member States to the WHO Regional Office for Africa as of 31 December 2020. Transmission classification and health system capacity were used to assess the risk level of each country to guide implementation and adjustments to PHSM. Two countries out of 46 assessed met the criteria for sporadic transmission, one for clusters of cases, and 43 (93.5%) for community transmission (CT) including three with uncontrolled disease incidence (Eswatini, Namibia and South Africa). Health system response's capacities were assessed as adequate in two countries (4.3%), moderate in 13 countries (28.3%) and limited in 31 countries (64.4%). The risk level, calculated as a combination of transmission classification and health system response's capacities, was assessed at level 0 in one country (2.1%), level 1 in two countries (4.3%), level 2 in 11 countries (23.9%) and level 3 in 32 (69.6%) countries. The scale of severity ranged from 0 to 4, with 0 the lowest. CT coupled with limited response capacity resulted in a level 3 risk assessment in most countries. Countries at level 3 should be considered as priority focus for additional assistance, in order to prevent the risk rising to level 4, which may necessitate enforcing hard and costly lockdown measures. The large number of countries at level 3 indicates the need for an effective risk management system to be used as a basis for adjusting PHSM at national and sub-national levels.


Assuntos
COVID-19/epidemiologia , Tomada de Decisões , SARS-CoV-2 , Organização Mundial da Saúde , África/epidemiologia , Atenção à Saúde , Humanos , Administração em Saúde Pública , Medição de Risco
4.
Emerg Infect Dis ; 26(11): 2555-2564, 2020 11.
Artigo em Inglês | MEDLINE | ID: mdl-33079032

RESUMO

Large-scale protracted outbreaks can be prevented through early detection, notification, and rapid control. We assessed trends in timeliness of detecting and responding to outbreaks in the African Region reported to the World Health Organization during 2017-2019. We computed the median time to each outbreak milestone and assessed the rates of change over time using univariable and multivariable Cox proportional hazard regression analyses. We selected 296 outbreaks from 348 public reported health events and evaluated 184 for time to detection, 232 for time to notification, and 201 for time to end. Time to detection and end decreased over time, whereas time to notification increased. Multiple factors can account for these findings, including scaling up support to member states after the World Health Organization established its Health Emergencies Programme and support given to countries from donors and partners to strengthen their core capacities for meeting International Health Regulations.


Assuntos
Surtos de Doenças , Saúde Pública , África/epidemiologia , Saúde Global , Humanos , Vigilância da População , Fatores de Tempo , Organização Mundial da Saúde
5.
BMC Vet Res ; 14(1): 229, 2018 Jul 31.
Artigo em Inglês | MEDLINE | ID: mdl-30124171

RESUMO

BACKGROUND: The incidence of visceral leishmaniasis (VL), one of the most important neglected diseases worldwide, is increasing in Brazil. The objectives of this study were to determine the canine VL (CanL) seroprevalence in an urban area of Araçatuba municipality and to evaluate its relationship with the characteristics of dogs and their owners. RESULTS: The CanL seroprevalence in the study area was 0.081 (95% credible interval [CI]: 0.068-0.096). The following covariates/categories were positively associated with the occurrence of a seropositive dog: more than 10 dogs that had lived in the house (odds ratio [OR] = 2.36; 95% CI: 1.03-5.43) (baseline: 0-10 dogs); house with dogs that previously died of VL (OR = 4.85; 95% CI: 2.65-8.86) or died of causes other than old age (OR = 2.26; 95% CI: 1.12-4.46) (baseline: natural or no deaths); dogs that spent the day in a sheltered backyard (OR = 2.14; 95% CI: 1.05-4.40); dogs that spent the day in an unsheltered backyard or the street (OR = 2.67; 95% CI: 1.28-5.57) (baseline: inside home). Spatial dependence among observations occurred within about 45.7 m. CONCLUSIONS: The number of dogs that had lived in the house, previous deaths by VL or other cause, and the place the dog stayed during the day were associated with the occurrence of a VL seropositive dog. The short-distance spatial dependence could be related to the vector characteristics, producing a local neighbourhood VL transmission pattern. The geostatistical approach in a Bayesian context using integrated nested Laplace approximation (INLA) allowed to identify the covariates associated with VL, including its spatially dependent transmission pattern.


Assuntos
Doenças do Cão/epidemiologia , Doenças do Cão/parasitologia , Leishmaniose Visceral/veterinária , Análise Espacial , Animais , Teorema de Bayes , Brasil/epidemiologia , Estudos Transversais , Cães , Feminino , Incidência , Leishmaniose Visceral/epidemiologia , Leishmaniose Visceral/mortalidade , Masculino , Características de Residência , Estudos Soroepidemiológicos
6.
Malar J ; 14: 452, 2015 Nov 14.
Artigo em Inglês | MEDLINE | ID: mdl-26573145

RESUMO

BACKGROUND: In the past decade fish farming has become an important economic activity in the Occidental Brazilian Amazon, where the number of new fish farms is rapidly increasing. One of the primary concerns with this phenomenon is the contribution of fishponds to the maintenance and increase of the anopheline mosquito population, and the subsequent increase in human malaria burden. This study reports the results of a 2-year anopheline abundance survey in fishponds and natural water bodies in a malaria-endemic area in northwest Brazil. The objective of this study was to investigate the contribution of natural water bodies (rivers, streams, creeks, ponds, and puddles) and artificial fishponds as breeding sites for Anopheles spp. in Mâncio Lima, Acre and to investigate the effect of limnological and environmental variables on Anopheles spp. larval abundance. METHODS: Natural water bodies and fishponds were sampled at eight different times over 2 years (early, mid and late rainy season, dry season) in the Amazonian town of Mâncio Lima, Acre. Anopheline larvae were collected with an entomological dipper, and physical, chemical and ecological characteristics of each water body were measured. Management practices of fishpond owners were ascertained with a systematic questionnaire. RESULTS: Fishponds were four times more infested with anopheline larvae than natural water bodies. Electrical conductivity and the distance to the nearest house were both significant inverse predictors of larval abundance in natural water bodies. The density of larvae in fishponds raised with increasing border vegetation. Fishponds owned by different farmers varied in the extent of anopheline larval infestation but ponds owned by the same individual had similar infestation patterns over time. Commercial fishponds were 1.7-times more infested with anopheline larvae compared to fishponds for family use. CONCLUSIONS: These results suggest that fishponds are important breeding sites for anopheline larvae, and that adequate management activities, such as removal of border vegetation could reduce the abundance of mosquito larvae, most importantly Anopheles darlingi.


Assuntos
Anopheles/crescimento & desenvolvimento , Aquicultura , Doenças Endêmicas , Malária/epidemiologia , Lagoas , Animais , Brasil/epidemiologia , Humanos , Larva/crescimento & desenvolvimento
7.
Mem Inst Oswaldo Cruz ; 110(4): 517-27, 2015 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-25946154

RESUMO

The objective of this study was to evaluate the effectiveness of Aedes aegypti mass trapping using the sticky trap MosquiTRAP (MQT) by performing a cluster randomised controlled trial in Manaus, state of Amazonas, Brazil. After an initial questionnaire and baseline monitoring of adult Ae. aegypti abundance with BG-Sentinel (BGS) traps in six clusters, three clusters were randomly assigned to the intervention arm where each participating household received three MQTs for mass trapping during 17 months. The remaining three clusters (control arm) did not receive traps. The effect of mass trapping on adult Ae. aegypti abundance was monitored fortnightly with BGS traps. During the last two months of the study, a serological survey was conducted. After the study, a second questionnaire was applied in the intervention arm. Entomological monitoring indicated that MQT mass trapping did not reduce adult Ae. aegypti abundance. The serological survey indicated that recent dengue infections were equally frequent in the intervention and the control arm. Most participants responded positively to questions concerning user satisfaction. According to the results, there is no evidence that mass trapping with MQTs can be used as a part of dengue control programs. The use of this sticky trap is only recommendable for dengue vector monitoring.


Assuntos
Aedes , Dengue/prevenção & controle , Insetos Vetores , Controle de Mosquitos/instrumentação , Adulto , Animais , Brasil , Dengue/transmissão , Feminino , Humanos , Masculino , Densidade Demográfica , Inquéritos e Questionários
8.
Int J Equity Health ; 13: 118, 2014 Nov 27.
Artigo em Inglês | MEDLINE | ID: mdl-25428334

RESUMO

INTRODUCTION: Vaccines are very important to reduce morbidity and mortality by preventable infectious diseases, especially during childhood. Optimal coverage is not always achieved, for several reasons. Here we assessed vaccine coverage for the first 12 months of age in children between 12 and 59 months old, residing in the urban area of a small Amazonian city, and factors associated with incomplete vaccination. METHODS: A census was performed in the urban area of Assis Brasil, in the Brazilian Amazon, in January 2010, with mothers of 282 children aged 12 to 59 months old, using structured interviews and data from vaccination cards. Mixed logistic regression was used to determine factors associated with incomplete vaccination schemes. RESULTS: Only 82.6% of all children had a completed the basic vaccine scheme for the first year of life. Vaccine coverage ranged from 52.7% coverage (oral rotavirus vaccine) to 99.7% coverage (for Bacille Calmette-Guérin). The major deficiencies occurred in doses administered after the first six months of life. Incomplete vaccination was associated with not having enough income to buy a house (aOR = 2.12, 95% CI 1.06-4.21), low maternal schooling (aOR = 2.60, 95% CI 1.28 - 5.29) , and time of residence of the child in the urban area of the city (aOR = 0.73, 95% CI 0.55 - 0.95). CONCLUSIONS: This study showed that vaccine coverage in the first twelve months of life in Assis Brasil is similar to other areas in the Amazon and it is below the coverage postulated by the Brazilian Ministry of Health. Low vaccine coverage was associated with socioeconomic inequities that still prevail in the Brazilian Amazon. Short and long-term strategies must be taken to update child vaccines and increase vaccine coverage in the Amazon.


Assuntos
Disparidades em Assistência à Saúde/estatística & dados numéricos , Programas de Imunização/estatística & dados numéricos , Vacinação/normas , Brasil , Pré-Escolar , Controle de Doenças Transmissíveis/métodos , Estudos Transversais , Feminino , Humanos , Lactente , Modelos Logísticos , Masculino , Fatores de Risco , Fatores Socioeconômicos , Serviços Urbanos de Saúde/estatística & dados numéricos
9.
Mem Inst Oswaldo Cruz ; 109(8): 1030-40, 2014 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-25494470

RESUMO

A longitudinal study was conducted in Manaus, Brazil, to monitor changes of adult Aedes aegypti (L.) abundance. The objectives were to compare mosquito collections of two trap types, to characterise temporal changes of the mosquito population, to investigate the influence of meteorological variables on mosquito collections and to analyse the association between mosquito collections and dengue incidence. Mosquito monitoring was performed fortnightly using MosquiTRAPs (MQT) and BG-Sentinel (BGS) traps between December 2008-June 2010. The two traps revealed opposing temporal infestation patterns, with highest mosquito collections of MQTs during the dry season and highest collections of BGS during the rainy seasons. Several meteorological variables were significant predictors of mosquito collections in the BGS. The best predictor was the relative humidity, lagged two weeks (in a positive relationship). For MQT, only the number of rainy days in the previous week was significant (in a negative relationship). The correlation between monthly dengue incidence and mosquito abundance in BGS and MQT was moderately positive and negative, respectively. Catches of BGS traps reflected better the dynamic of dengue incidence. The findings help to understand the effects of meteorological variables on mosquito infestation indices of two different traps for adult dengue vectors in Manaus.


Assuntos
Aedes , Dengue/epidemiologia , Umidade , Insetos Vetores , Estações do Ano , Animais , Brasil/epidemiologia , Dengue/transmissão , Feminino , Incidência , Estudos Longitudinais , Conceitos Meteorológicos , Controle de Mosquitos , Fatores de Tempo
10.
Mem Inst Oswaldo Cruz ; 109(6): 824-7, 2014 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-25317711

RESUMO

Currently, sticky traps are regularly employed to assist in the surveillance of Aedes aegypti infestation. We tested two alternative procedures for specimen identification performed by local health agents: directly in the field, as recommended by certain manufacturers, or after transportation to the laboratory. A total of 384 sticky traps (MosquiTRAP) were monitored monthly during one year in four geographically representative Brazilian municipalities. When the same samples were inspected in the field and in the laboratory, large differences were noted in the total number of mosquitoes recorded and in the number of specimens identified as Ae. aegypti by both procedures. Although field identification has the potential to speed vector surveillance, these results point to uncertainties in the evaluated protocol.


Assuntos
Aedes/classificação , Insetos Vetores/classificação , Animais , Brasil , Cidades , Monitoramento Ambiental , Laboratórios , Controle de Mosquitos/métodos
11.
Artigo em Inglês | MEDLINE | ID: mdl-38813663

RESUMO

Background: Yellow fever (YF) is a zoonotic disease transmitted by mosquitoes among humans and nonhuman primates. Although urban YF is eradicated, the sylvatic YF has reemerged in some areas of Brazil in the twenty-first century. From 2016 to 2019, a sylvatic YF epidemic occurred in Southeast Brazil, where it had been eradicated in the 1940s. Methods: This study's objective was to describe the epidemic in the states of the Southeast region, based on descriptive, cluster, and mobility analyses. Results: Both the descriptive and cluster analyses showed that the YF cases spread from the state of Minas Gerais southward, causing peaks in cases during the summer months. None of the state capitals was included in the clusters, but the connectivity between the municipalities in Greater Metropolitan São Paulo highlighted potential paths of spread. Despite differences in sociodemographic profiles between the Southeast and North of Brazil (the latter region considered endemic), the epidemiological profile was similar, except for patients' occupation, which was not related to rural work in the Southeast. Conclusion: The results contributed to our understanding of the paths by which YF spread across Southeast Brazil and the epidemiological profile in an area that had gone decades without autochthonous cases.

12.
Mem Inst Oswaldo Cruz ; 108 Suppl 1: 18-25, 2013.
Artigo em Inglês | MEDLINE | ID: mdl-24473799

RESUMO

Dengue is one of the world's most important mosquito-borne diseases and is usually transmitted by one of two vector species: Aedes aegypti or Aedes albopictus . These two diurnal mosquitoes are frequently found coexisting in similar habitats, enabling interactions between adults, such as cross-mating. The objective of this study was to assess cross-mating between Ae. aegypti females and Ae. albopictus males under artificial conditions and evaluate the locomotor activity of Ae. aegypti virgin females injected with male accessory gland (MAG) homogenates to infer the physiological and behavioural responses to interspecific mating. After seven days of exposure, 3.3-16% of Ae. aegypti females mated with Ae. albopictus males. Virgin Ae. aegypti females injected with conspecific and heterospecific MAGs showed a general decrease in locomotor activity compared to controls and were refractory to mating with conspecific males. The reduction in diurnal locomotor activity induced by injections of conspecific or heterospecific MAGs is consistent with regulation of female reproductive activities by male substances, which are capable of sterilising female Ae. aegypti through satyrisation by Ae. albopictus.


Assuntos
Aedes/fisiologia , Insetos Vetores/fisiologia , Inseminação/fisiologia , Atividade Motora/fisiologia , Comportamento Sexual Animal/fisiologia , Animais , Comportamento Animal/fisiologia , Dengue/transmissão , Feminino , Masculino , Fatores Sexuais , Especificidade da Espécie
13.
Infect Dis Poverty ; 12(1): 32, 2023 Apr 10.
Artigo em Inglês | MEDLINE | ID: mdl-37038199

RESUMO

BACKGROUND: Neglected tropical diseases affect the most vulnerable populations and cause chronic and debilitating disorders. Socioeconomic vulnerability is a well-known and important determinant of neglected tropical diseases. For example, poverty and sanitation could influence parasite transmission. Nevertheless, the quantitative impact of socioeconomic conditions on disease transmission risk remains poorly explored. METHODS: This study investigated the role of socioeconomic variables in the predictive capacity of risk models of neglected tropical zoonoses using a decade of epidemiological data (2007-2018) from Brazil. Vector-borne diseases investigated in this study included dengue, malaria, Chagas disease, leishmaniasis, and Brazilian spotted fever, while directly-transmitted zoonotic diseases included schistosomiasis, leptospirosis, and hantaviruses. Environmental and socioeconomic predictors were combined with infectious disease data to build environmental and socioenvironmental sets of ecological niche models and their performances were compared. RESULTS: Socioeconomic variables were found to be as important as environmental variables in influencing the estimated likelihood of disease transmission across large spatial scales. The combination of socioeconomic and environmental variables improved overall model accuracy (or predictive power) by 10% on average (P < 0.01), reaching a maximum of 18% in the case of dengue fever. Gross domestic product was the most important socioeconomic variable (37% relative variable importance, all individual models exhibited P < 0.00), showing a decreasing relationship with disease indicating poverty as a major factor for disease transmission. Loss of natural vegetation cover between 2008 and 2018 was the most important environmental variable (42% relative variable importance, P < 0.05) among environmental models, exhibiting a decreasing relationship with disease probability, showing that these diseases are especially prevalent in areas where natural ecosystem destruction is on its initial stages and lower when ecosystem destruction is on more advanced stages. CONCLUSIONS: Destruction of natural ecosystems coupled with low income explain macro-scale neglected tropical and zoonotic disease probability in Brazil. Addition of socioeconomic variables improves transmission risk forecasts on tandem with environmental variables. Our results highlight that to efficiently address neglected tropical diseases, public health strategies must target both reduction of poverty and cessation of destruction of natural forests and savannas.


Assuntos
Doença de Chagas , Doenças Transmissíveis , Animais , Humanos , Ecossistema , Pobreza , Zoonoses/epidemiologia , Doenças Negligenciadas/epidemiologia , Doenças Negligenciadas/parasitologia
14.
PLoS Negl Trop Dis ; 16(9): e0010746, 2022 09.
Artigo em Inglês | MEDLINE | ID: mdl-36095004

RESUMO

Dengue is a vector-borne disease present in most tropical countries, infecting an average of 50 to 100 million people per year. Socioeconomic, demographic, and environmental factors directly influence the transmission cycle of the dengue virus (DENV). In Brazil, these factors vary between regions producing different profiles of dengue transmission and challenging the epidemiological surveillance of the disease. In this article, we aimed at classifying the profiles of dengue transmission in 1,823 Brazilian municipalities, covering different climates, from 2010 to 2019. Time series data of dengue cases were obtained from six states: Ceará and Maranhão in the semiarid Northeast, Minas Gerais in the countryside, Espírito Santo and Rio de Janeiro in the tropical Atlantic coast, and Paraná in the subtropical region. To describe the time series, we proposed a set of epi-features of the magnitude and duration of the dengue epidemic cycles, totaling 13 indicators. Using these epi-features as inputs, a multivariate cluster algorithm was employed to classify the municipalities according to their dengue transmission profile. Municipalities were classified into four distinct dengue transmission profiles: persistent transmission (7.8%), epidemic (21.3%), episodic/epidemic (43.2%), and episodic transmission (27.6%). Different profiles were associated with the municipality's population size and climate. Municipalities with higher incidence and larger populations tended to be classified as persistent transmission, suggesting the existence of critical community size. This association, however, varies depending on the state, indicating the importance of other factors. The proposed classification is useful for developing more specific and precise surveillance protocols for regions with different dengue transmission profiles, as well as more precise public policies for dengue prevention.


Assuntos
Vírus da Dengue , Dengue , Animais , Brasil/epidemiologia , Humanos , Insetos Vetores , Densidade Demográfica
15.
PLoS Negl Trop Dis ; 16(6): e0010441, 2022 06.
Artigo em Inglês | MEDLINE | ID: mdl-35679262

RESUMO

Chikungunya, a mosquito-borne disease, is a growing threat in Brazil, where over 640,000 cases have been reported since 2017. However, there are often long delays between diagnoses of chikungunya cases and their entry in the national monitoring system, leaving policymakers without the up-to-date case count statistics they need. In contrast, weekly data on Google searches for chikungunya is available with no delay. Here, we analyse whether Google search data can help improve rapid estimates of chikungunya case counts in Rio de Janeiro, Brazil. We build on a Bayesian approach suitable for data that is subject to long and varied delays, and find that including Google search data reduces both model error and uncertainty. These improvements are largest during epidemics, which are particularly important periods for policymakers. Including Google search data in chikungunya surveillance systems may therefore help policymakers respond to future epidemics more quickly.


Assuntos
Febre de Chikungunya , Vírus Chikungunya , Animais , Teorema de Bayes , Brasil/epidemiologia , Febre de Chikungunya/epidemiologia , Incidência , Ferramenta de Busca
16.
Trop Med Infect Dis ; 7(7)2022 Jun 22.
Artigo em Inglês | MEDLINE | ID: mdl-35878126

RESUMO

Using collection methods for Aedes adults as surveillance tools provides reliable indices and arbovirus detection possibilities. This study compared the effectiveness of different methods for collecting Ae. aegypti and Ae. albopictus and detecting arboviruses circulating in field-caught female specimens. Collection sites were defined in urban, peri-urban, and rural landscapes in two Brazilian cities. Collections were performed using Adultraps (ADT), BG-Sentinel (BGS), CDC-like traps (CDC), and indoor (ASP-I) and outdoor (ASP-O) aspiration during the rainy and dry seasons of 2015 and 2016. Generalized linear mixed models were used to model the effectiveness of each collection method. A total of 434 Ae. aegypti and 393 Ae. albopictus were collected. In total, 64 Ae. aegypti and sixteen Ae. albopictus female pools were tested for DENV, CHIKV, ZIKV, or YFV; none were positive. Positivity and density were linear at low densities (<1 specimen); thereafter, the relationship became non-linear. For Ae. aegypti, ADT and CDC were less effective, and ASP-I and ASP-O were as effective as BGS. For Ae. albopictus, all collection methods were less effective than BGS. This study highlights the need for an integrated surveillance method as an effective tool for monitoring Aedes vectors.

17.
Cad Saude Publica ; 37(10): e00049821, 2021.
Artigo em Inglês, Português | MEDLINE | ID: mdl-34644749

RESUMO

In a context of community transmission and shortage of vaccines, COVID-19 vaccination should focus on directly reducing the morbidity and mortality caused by the disease. It was thus essential to define priority groups for vaccination by the Brazilian National Immunization Program (PNI in Portuguese), based on the risk of hospitalization and death from the disease. We calculated overrisk according to sex, age group, and comorbidities using hospitalization and death records from severe acute respiratory illness with confirmation of COVID-19 (SARI-COVID) in all of Brazil in the first 6 months of the epidemic. Higher overrisk was associated with male sex (hospitalization = 1.1 and death = 1.2), age over 45 years for hospitalization (OvRag ranging from 1.1 to 8.5), and age over 55 year for death (OvRag ranging from 1.5 to 18.3). In the groups with comorbidities, chronic kidney disease, diabetes mellitus, cardiovascular disease, and chronic lung disease were associated with overrisk, while there was no such evidence for asthma. Chronic kidney disease or diabetes and age over 60 showed an even stronger association, reaching overrisk of death 14 and 10 times greater than in the general population, respectively. For all the comorbidities, there was higher overrisk at older ages, with a downward gradient in the oldest age groups. This pattern was reversed when examining overrisk in the general population, for both hospitalization and death. The current study provided evidence of overrisk of hospitalization and death from SARI-COVID, assisting the definition of priority groups for COVID-19 vaccination.


Em um contexto de transmissão comunitária e escassez de vacinas, a vacinação contra a COVID-19 deve focar na redução direta da morbidade e da mortalidade causadas pela doença. Portanto, é fundamental a definição de grupos prioritários para a vacinação pelo Programa Nacional de Imunizações (PNI), baseada no risco de hospitalização e óbito pela doença. Para tal, calculamos o sobrerrisco por sexo, faixa etária e comorbidades por meio dos registros de hospitalização e óbito por síndrome respiratória aguda grave com confirmação de COVID-19 (SRAG-COVID) em todo o Brasil nos primeiros seis meses de epidemia. Apresentaram maior sobrerrisco pessoas do sexo masculino (hospitalização = 1,1 e óbito = 1,2), pessoas acima de 45 anos para hospitalização (SRfe variando de 1,1 a 8,5) e pessoas acima de 55 anos para óbitos (SRfe variando de 1,5 a 18,3). Nos grupos de comorbidades, doença renal crônica, diabetes mellitus, doença cardiovascular e pneumopatia crônica conferiram sobrerrisco, enquanto para asma não houve evidência. Ter doença renal crônica ou diabetes mellitus e 60 anos ou mais mostrou-se um fator ainda mais forte, alcançando sobrerrisco de óbito 14 e 10 vezes maior do que na população geral, respectivamente. Para todas as comorbidades, houve um sobrerrisco mais alto em idades maiores, com um gradiente de diminuição em faixas mais altas. Esse padrão se inverteu quando consideramos o sobrerrisco em relação à população geral, tanto para hospitalização quanto para óbito. O presente estudo forneceu evidências a respeito do sobrerrisco de hospitalização e óbito por SRAG-COVID, auxiliando na definição de grupos prioritários para a vacinação contra a COVID-19.


En un contexto de transmisión comunitaria y escasez de vacunas, la vacunación contra la COVID-19 debe enfocarse en la reducción directa de la morbilidad y de la mortalidad causadas por la enfermedad. Por lo tanto, es fundamental la definición de grupos prioritarios para la vacunación por el Programa Nacional de Inmunizaciones (PNI), basada en el riesgo de hospitalización y óbito por la enfermedad. Para tal fin, calculamos el sobrerriesgo por sexo, franja de edad y comorbilidades mediante los registros de hospitalización y óbito por síndrome respiratorio agudo grave con confirmación de COVID-19 (SRAG-COVID) en todo Brasil, durante los primeros seis meses de epidemia. Presentaron mayor sobrerriesgo personas del sexo masculino (hospitalización = 1,1 y óbito = 1,2), personas por encima de 45 años para hospitalización (SRfe variando de 1,1 a 8,5) y personas por encima de 55 años para óbitos (SRfe variando de 1,5 a 18,3). En los grupos de comorbilidades, enfermedad renal crónica, diabetes mellitus, enfermedad cardiovascular y neumopatía crónica ofrecieron sobrerriesgo, mientras que para el asma no hubo evidencia. Sufrir una enfermedad renal crónica o diabetes mellitus y tener 60 años o más mostró un factor todavía más fuerte, alcanzando sobrerriesgo de enfermedad 14 y 10 veces mayor que en la población general, respectivamente. Para todas las comorbilidades, hubo un sobrerriesgo más alto en edades mayores, con un gradiente de disminución en franjas más altas. Este patrón se invirtió cuando consideramos el sobrerriesgo en relación con la población general, tanto para hospitalización como para óbito. El presente estudio proporcionó evidencias respecto al sobrerriesgo de hospitalización y óbito por SRAG-COVID, ayudando en la definición de grupos prioritarios para la vacunación contra la COVID-19.


Assuntos
Vacinas contra COVID-19 , COVID-19 , Idoso , Brasil/epidemiologia , Comorbidade , Hospitalização , Humanos , Lactente , Masculino , Pessoa de Meia-Idade , SARS-CoV-2 , Vacinação
18.
Rev Bras Epidemiol ; 24: e210001, 2020.
Artigo em Português, Inglês | MEDLINE | ID: mdl-33331411

RESUMO

OBJECTIVE: To estimate the coverage of the first and second dose of the human papillomavirus (HPV) vaccine in Brazil according to microregion, comparing cohorts of girls aged 14, 15, and 16 years in 2017, and investigate the association between spatial heterogeneity in vaccination coverage and sociodemographic variables. METHODS: Information about the doses administered from 2013 to 2017 by age was gathered from the National Immunization Program. The number of girls aged seven, eight, and nine years living in each microregion in 2010 was obtained from the 2010 Brazilian Census. For the analysis, the cumulated vaccination coverage per microregion (n = 558) was categorized as low (< 80%) and adequate (≥ 80%), and a random intercept logistic model was adjusted, with adequate vaccination coverage as the outcome. The random effect (federative unit) was included to identify the correlation between microregions that belong to the same state. RESULTS: The percentage of microregions with adequate vaccination coverage was significantly higher in the first dose (between 91.8 and 159.2%), regardless of the cohort. The coverage of the second dose was lower (between 7 and 79.9%), with heterogeneity associated with the degree of urbanization and households with private bathrooms in the municipality. The random effect showed a strong explanatory power, suggesting important differences among Brazilian states as to the outreach of vaccination coverage. CONCLUSION: Although the HPV vaccine is available through the Immunization Program, the findings of the present study point to a difficulty in achieving adequate vaccination coverage.


OBJETIVO: Estimar a cobertura da primeira e da segunda dose da vacina papilomavírus humano (HPV) no Brasil, conforme a microrregião, comparando-se as coortes de meninas com 14, 15 e 16 anos em 2017, e investigar a associação da heterogeneidade espacial na cobertura vacinal com variáveis sociodemográficas. MÉTODOS: A informação sobre doses aplicadas nos anos de 2013 a 2017 por idade foi obtida do Programa Nacional de Imunizações. O número de meninas residentes com sete, oito e nove anos em 2010, em cada microrregião, é oriundo do censo brasileiro de 2010. Para a análise, a cobertura vacinal acumulada por microrregião (n = 558) foi categorizada em baixa (< 80%) e adequada (≥ 80%), e um modelo logístico com intercepto aleatório foi ajustado, tendo cobertura vacinal adequada como desfecho. O efeito aleatório (unidade da federação) foi incluído para captar a correlação entre microrregiões que pertencem ao mesmo estado. RESULTADOS: O percentual de microrregiões que alcançou a cobertura vacinal adequada foi significativamente maior para a primeira dose (entre 91,8 e 159,2%), independentemente da coorte. Observou-se menor cobertura da segunda dose (entre 7 e 79,9%), com heterogeneidade associada ao grau de urbanização e à presença de domicílios com banheiro de uso próprio no município. O efeito aleatório mostrou forte poder explicativo, sugerindo importantes diferenças entre os estados brasileiros no alcance da cobertura vacinal. CONCLUSÃO: Apesar de a vacina HPV estar disponível no Programa de Imunização, os achados do presente estudo apontam para uma dificuldade do alcance da cobertura vacinal adequada.


Assuntos
Alphapapillomavirus , Infecções por Papillomavirus/prevenção & controle , Vacinas contra Papillomavirus/administração & dosagem , Cobertura Vacinal/estatística & dados numéricos , Vacinação/estatística & dados numéricos , Adolescente , Brasil , Criança , Feminino , Humanos , Imunização , Vacinas contra Papillomavirus/efeitos adversos
19.
Cad Saude Publica ; 36Suppl 2(Suppl 2): e00211518, 2020.
Artigo em Inglês, Português | MEDLINE | ID: mdl-33111748

RESUMO

The difficulty in achieving ideal coverage rates with the influenza vaccine in Brazil and the growing wave of antivaccine movements in the world point to the need for a more in-depth understanding of the individual determinants of to this vaccine uptake. The Health Belief Model, a theoretical model that aims to explain and predict health-related behaviors, suggests that individual beliefs influence the adoption of health-related behaviors. The objective of this study was a cross-cultural adaptation of an instrument to assess predictors of influenza vaccine uptake in Brazilian adults. The authors conducted translation, back-translation, face validity, and a survey for construct validity. They also analyzed the factors associated with influenza vaccine uptake in 2017. An instrument originally with seven domains was identified and selected. In the factor analysis, four of the model's seven constructs were validated: Susceptibility, Barriers, Cues to action, and Self-efficacy. In the survey with 396 persons, 59.3% reported having received the influenza vaccine in the last campaign in 2017. Female sex, age > 50 years, pregnancy, vaccination in private healthcare services, hepatitis B vaccination, and influenza vaccination prior to 2017 were associated with vaccination in 2017. In the final logistic regression model, perceived Barriers appeared as a strong factor for non-vaccination, while Cues to action increased the odds of vaccination.


A dificuldade de alcançar coberturas ideais para a vacina contra influenza no Brasil e a crescente onda do movimento antivacina no mundo apontam a necessidade de aprofundar a compreensão dos determinantes individuais de adesão a essa vacina. O Modelo de Crenças em Saúde, um modelo teórico que objetiva explicar e predizer o comportamento em relação à saúde, sugere que crenças individuais influenciam a adoção de comportamentos relacionados a essa área. Este trabalho teve como objetivo a adaptação transcultural de um instrumento para avaliar os preditores de aceitação da vacina da influenza em adultos no Brasil. Realizaram-se a tradução, a retrotradução, a validade de face e um inquérito para validade de construto. Também foram analisados os fatores associados à adesão à vacina da influenza em 2017. Um instrumento, originalmente com sete domínios, foi identificado e selecionado. Na análise fatorial, quatro dos sete construtos do modelo teórico foram validados: Suscetibilidade, Barreiras, Estímulos para a ação e Motivação para a saúde. No inquérito das 396 pessoas, 59,3% relataram vacinação contra influenza na última campanha de 2017. Sexo feminino, idade > 50 anos, gestante, vacina na rede privada, vacinação contra a hepatite B e influenza antes de 2017 mostraram-se como fatores associados à vacinação em 2017. No modelo logístico final, a percepção de Barreiras apresentou-se como um forte Estímulo para não vacinação, ao passo que Estímulos para a ação atuou aumentando a chance de vacinação.


La dificultad de alcanzar coberturas ideales para la vacuna contra la gripe en Brasil y la creciente ola del movimiento antivacunas en el mundo apunta la necesidad de profundizar la comprensión de los determinantes individuales de adhesión a esa vacuna. El Modelo de Creencias en Salud, un modelo teórico que tiene como objetivo explicar y predecir el comportamiento en relación con la salud, sugiere que las creencias individuales influencian la adopción de comportamientos relacionados con esa área. El objetivo de este trabajo es la adaptación transcultural de un instrumento para evaluar los predictores de aceptación de la vacuna de la gripe en adultos en Brasil. Se realizó la traducción, retrotraducción, validez de la presentación, así como una encuesta para la validez del constructo. También se analizaron los factores asociados con la adhesión a la vacuna de la gripe en 2017. Un instrumento, originalmente con siete dominios, fue identificado y seleccionado. En el análisis factorial, cuatro de los siete constructos del modelo teórico fueron evaluados: Susceptibilidad, Barreras, Estímulos para la acción y Motivación para la salud. En el cuestionario a las 396 personas, 59,3% informaron haber sido vacunadas contra la gripe en la última campaña de 2017. Sexo femenino, edad > 50 años, embarazada, vacunada en la red privada, vacunación contra la hepatitis B y gripe antes de 2017 se mostraron como factores asociados a la vacunación en 2017. En el modelo logístico final, la percepción de Barreras se presentó como un fuerte Estímulo para la no vacunación, al paso que Estímulos para la acción actuó aumentando la oportunidad de vacunación.


Assuntos
Vacinas contra Influenza , Influenza Humana , Adulto , Brasil , Estudos Transversais , Feminino , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Influenza Humana/prevenção & controle , Pessoa de Meia-Idade , Portugal , Gravidez , Inquéritos e Questionários , Vacinação
20.
Acta Trop ; 212: 105715, 2020 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-32971068

RESUMO

BACKGROUND: In Brazil and several countries in the Americas, where dengue, chikungunya and Zika are cocirculating, there is a need to understand how different mosquito species relate to landscape and humans. Mosquito ecology and distribution, especially at finer spatial scales, are key factors to study since the relationship of mosquito communities to their habitats might have important consequences in the risk of disease transmission to humans. The aim of this study was to evaluate the diversity of resident culicids along heterogeneous landscapes in different endemic cities for dengue, chikungunya and Zika. METHODS: Fourteen collection sites were randomly selected in six landscapes characterized as urban, periurban and rural along two endemic metropolitan cities in Rio de Janeiro, Brazil: Itaboraí and Cachoeiras de Macacu, Rio de Janeiro. In each site, adult mosquito collections were performed using different traps and backpack aspiration. Collections took place during the rainy and dry seasons of 2015 and 2016. To measure diversity in each landscape, we generated species accumulation curves and used different indexes: rarefied species richness, Chao1-bc and ACE-1. Mosquito habitat segregation along different land use types was measured with a partial canonical correspondence analysis (pCCA). Generalized linear mixed models (GLMM) were used to model the probability of occurrence of the most abundant species along an Urban-Forest gradient. RESULTS: A total of 13,462 adult mosquitoes from 10 genera and 41 species were collected. The most abundant species were Culex quinquefasciatus Say, 1823, Aedes aegypti (Linnaeus, 1762) and Aedes albopictus (Skuse, 1895). There was a significant association between rarefied species richness and landscape, with higher richness in the Rural landscape. The number of observed species was matched only in the Urban landscape. Most species showed segregation along an Urban-Forest gradient, and the great majority were associated with forested habitats. We were able to fit prediction models for six mosquito species. DISCUSSION: The paper discusses the impact of human activities on landscape and its effects on mosquito populations, focusing on the segregation of different known vector species and their proximity to human altered environments. Most of these species are known arbovirus vectors and knowledge of their distribution are key elements that health authorities should take into account when planning arbovirus surveillance and vector control activities.


Assuntos
Arbovírus/isolamento & purificação , Culicidae , Ecossistema , Mosquitos Vetores/virologia , Animais , Brasil , Cidades , Culicidae/classificação , Culicidae/virologia , Vírus da Dengue/isolamento & purificação , Ecologia , Doenças Endêmicas , Feminino , Florestas , Humanos , Distribuição Aleatória , Estações do Ano , Zika virus/isolamento & purificação
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