Zika virus-spread, epidemiology, genome, transmission cycle, clinical manifestation, associated challenges, vaccine and antiviral drug development.

Zika Virus (ZIKV) is a Flavivirus transmitted primarily via the bite of infected Aedes aegypti mosquitoes. Globally, 87 countries and territories have recorded autochthonous mosquito-borne transmission of ZIKV as at July 2019 and distributed across four of the six WHO Regions. Outbreaks of ZIKV infection peaked in 2016 and declined substantially throughout 2017 and 2018 in the Americas region. There is the likely risk for ZIKV to spread to more countries. There is also the potential for the re-emergence of ZIKV in all places with prior reports of the virus transmission. The current status of ZIKV transmission and spread is, however, a global health threat, and from the aforementioned, has the potential to re-emerge as an epidemic. This review summarizes the past and present spread of ZIKV outbreak-2007-2019, the genome, transmission cycle, clinical manifestations, vaccine and antiviral drug advancement.

Cardiovascular Disease Epidemiology in Portuguese-Speaking Countries: data from the Global Burden of Disease, 1990 to 2016.

BACKGROUND: Portuguese-speaking countries (PSC) share the influence of the Portuguese culture but have socioeconomic development patterns that differ from that of Portugal. OBJECTIVE: To describe trends in cardiovascular disease (CVD) morbidity and mortality in the PSC between 1990 and 2016, stratified by sex, and their association with the respective sociodemographic indexes (SDI). METHODS: This study used the Global Burden of Disease (GBD) 2016 data and methodology. Data collection followed international standards for death certification, through information systems on vital statistics and mortality surveillance, surveys, and hospital registries. Techniques were used to standardize causes of death by the direct method, as were corrections for underreporting of deaths and garbage codes. To determine the number of deaths due to each cause, the CODEm (Cause of Death Ensemble Model) algorithm was applied. Disability-adjusted life years (DALYs) and SDI (income per capita, educational attainment and total fertility rate) were estimated for each country. A p-value <0.05 was considered significant. RESULTS: There are large differences, mainly related to socioeconomic conditions, in the relative impact of CVD burden in PSC. Among CVD, ischemic heart disease was the leading cause of death in all PSC in 2016, except for Mozambique and Sao Tome and Principe, where cerebrovascular diseases have supplanted it. The most relevant attributable risk factors for CVD among all PSC are hypertension and dietary factors. CONCLUSION: Collaboration among PSC may allow successful experiences in combating CVD to be shared between those countries.

Cardiovascular Disease Epidemiology in Portuguese-Speaking Countries: data from the Global Burden of Disease, 1990 to 2016 / Epidemiologia das Doenças Cardiovasculares em Países de Língua Portuguesa: Dados do "Global Burden of Disease", 1990 a 2016

Abstract Background: Portuguese-speaking countries (PSC) share the influence of the Portuguese culture but have socioeconomic development patterns that differ from that of Portugal. Objective: To describe trends in cardiovascular disease (CVD) morbidity and mortality in the PSC between 1990 and 2016, stratified by sex, and their association with the respective sociodemographic indexes (SDI). Methods: This study used the Global Burden of Disease (GBD) 2016 data and methodology. Data collection followed international standards for death certification, through information systems on vital statistics and mortality surveillance, surveys, and hospital registries. Techniques were used to standardize causes of death by the direct method, as were corrections for underreporting of deaths and garbage codes. To determine the number of deaths due to each cause, the CODEm (Cause of Death Ensemble Model) algorithm was applied. Disability-adjusted life years (DALYs) and SDI (income per capita, educational attainment and total fertility rate) were estimated for each country. A p-value <0.05 was considered significant. Results: There are large differences, mainly related to socioeconomic conditions, in the relative impact of CVD burden in PSC. Among CVD, ischemic heart disease was the leading cause of death in all PSC in 2016, except for Mozambique and Sao Tome and Principe, where cerebrovascular diseases have supplanted it. The most relevant attributable risk factors for CVD among all PSC are hypertension and dietary factors. Conclusion: Collaboration among PSC may allow successful experiences in combating CVD to be shared between those countries.

Resumo Fundamento: Os países de língua portuguesa (PLP) partilham a influência da cultura portuguesa com desenvolvimento socioeconômico diverso de Portugal. Objetivo: Descrever as tendências de morbidade e mortalidade por doenças cardiovasculares (DCV) nos PLP, entre 1990 e 2016, estratificadas por sexo, e sua associação com os respectivos índices sociodemográficos (SDI). Métodos: O estudo utilizou dados e metodologia do Global Burden of Disease (GBD) 2016. As informações seguiram padrões internacionais de certificação de óbito, através de sistemas de informação sobre estatísticas vitais e vigilância da mortalidade, pesquisas e registros hospitalares. Empregaram-se técnicas para padronização das causas de morte pelo método direto, e correções para sub-registro dos óbitos e garbage codes. Para determinar o número de mortes por cada causa, aplicou-se o algoritmo CODEm (Modelagem Agrupada de Causas de Morte). Estimaram-se os anos saudáveis de vida perdidos (DALYs) e o SDI (renda per capita, nível de escolaridade e taxa de fertilidade total) para cada país. Resultados: Existem grandes diferenças na importância relativa da carga de DCV nos PLP relacionadas principalmente às condições socioeconômicas. Entre as DCV, a doença isquêmica do coração foi a principal causa de morte nos PLP em 2016, com exceção de Moçambique e São Tomé e Príncipe, onde as doenças cerebrovasculares a suplantaram. Os fatores de risco atribuíveis mais relevantes para as DCV entre os PLP foram a hipertensão arterial e os fatores dietéticos. Um valor de p < 0,05 foi considerado significativo. Conclusão: A colaboração entre os PLP poderá permitir que experiências exitosas no combate às DCV sejam compartilhadas entre esses países.

Desafios da tuberculose no concelho da Praia-Cabo Verde: determinantes da tuberculose no período de 2006 a 2012 / Tuberculosis Challenges in Praia' county - Cape Verde: TB determinants from 2006 to 2012

A presente tese objetiva mensurar a magnitude da subnotificação da tuberculose (TB) e identificar os determinantes sociais da incidência da doença em Praia, Cabo Verde, no período de 2006 a 2012. Foram considerados os casos suspeitos e casos diagnosticados validados de TB obtidos nos centros de saúde, no hospital central e nos laboratórios dos concelhos que deram origem a dois manuscritos. O primeiro manuscrito descreve um estudo seccional onde o número de casos de TB validados, identificados nas unidades de saúde, foi comparado com o número de casos registrados no Programa Nacional de Luta contra Tuberculose e Lepra (PNLTL). A subnotificação foi calculada combinando duas abordagens. Na primeira abordagem, o número de casos de TB validados dos centros de atenção primária e hospital central foi comparado com o número de casos do PNLTL. Na segunda abordagem todos os casos de TB validados de todas as fontes de TB foram comparados com casos de PNLTL. O resultado revelou uma importante subnotificação da TB e compatível com as estimativas de subnotificação da Organização Mundial da saúde (OMS) para o país. O segundo manuscrito teve o objetivo de identificar os determinantes sociais da TB. A análise exploratória e análise de regressão foram utilizadas para este fim.. Na análise exploratória foi feita a avaliação da normalidade e identificação de autocorrelação espacial. Na análise de regressão utilizou-se o modelo binomial negativa cujos dados indicam que existe associação entre determinante social e incidência da TB em Praia

Vector competence of the Aedes aegypti population from Santiago Island, Cape Verde, to different serotypes of dengue virus.

BACKGROUND: Dengue is an arboviral disease caused by dengue virus (DENV), whose main vectors are the mosquitoes Aedes aegypti and Aedes albopictus. A. aegypti is the only DENV vector in Cape Verde, an African country that suffered its first outbreak of dengue in 2009. However, little is known about the variation in the level of vector competence of this mosquito population to the different DENV serotypes. This study aimed to evaluate the vector competence of A. aegypti from the island of Santiago, Cape Verde, to four DENV serotypes and to detect DENV vertical transmission. METHODS: Mosquitoes were fed on blood containing DENV serotypes and were dissected at 7, 14 and 21 days post-infection (dpi) to detect the virus in the midgut, head and salivary glands (SG) using RT-PCR. Additionally, the number of copies of viral RNA present in the SG was determined by qRT-PCR. Furthermore, eggs were collected in the field and adult mosquitoes obtained were analyzed by RT-PCR and the platelia dengue NS1 antigen kit to detect transovarial transmission. RESULTS: High rates of SG infection were observed for DENV-2 and DENV-3 whereas for DENV-1, viral RNA was only detected in the midgut and head. DENV-4 did not spread to the head or SG, maintaining the infection only in the midgut. The number of viral RNA copies in the SG did not vary significantly between DENV-2 and DENV-3 or among the different periods of incubation and the various titers of DENV tested. With respect to DENV surveillance in mosquitoes obtained from the eggs collected in the field, no samples were positive. CONCLUSION: Although no DENV positive samples were collected from the field in 2014, it is important to highlight that the A. aegypti population from Santiago Islands exhibited different degrees of susceptibility to DENV serotypes. This population showed a high vector competence for DENV-2 and DENV-3 strains and a low susceptibility to DENV-1 and DENV-4. Viral RNA copies in the SG remained constant for at least 21 dpi, which may enhance the vector capacity of A. aegypti and suggests the presence of a mechanism modulating virus replication in the SG.

[Dengue fever in Portuguese speaking countries: which epidemiological links may we set?]. / Dengue nos países da lusofonia: que ligações epidemiológicas poderemos traçar?

INTRODUCTION: The recent occurrence of a number of outbreaks of dengue in Portuguese speaking countries with no previous disease, aroused curiosity about the competing factors for the phenomenon and a need for better knowledge of the pathology. We review the dengue-related situation in Portuguese speaking countries, linking the various outbreaks and trying to contribute to a better understanding of the phenomenon. MATERIAL AND METHODS: Review of the literature on the topic and relevant information obtained from oral communications were included. RESULTS: The outbreaks occurred between the years of 2009 and 2013 in Cabo Verde, Madeira and Angola (excluding the endemic phenomenon in Brazil), share the same vector Aedes aegypti, but are due to different viral serotypes, as shown by genotypic studies. The strong sub-notification of the disease in Africa and lack of diagnostic tools prevent a true characterization of the situation. DISCUSSION: The hypothesis of a link between some of the outbreaks is not completely rejected. The Portuguese territory could be exposed to an increasingly high risk of dengue introduction, not only because of the proximity with these territories, but also because of the current climate changes. The main fight is, in spite of the still elusive emergent tools, the vector control. CONCLUSION: A link between the outbreaks has not been proven but local preparation of healthcare professionals, creation of public health strategies and maintenance of surveillance systems are needed. More epidemiological and entomological studies are needed to characterize the real incidence of disease in Portuguese speaking countries.

Introdução: A ocorrência recente de um conjunto de surtos de dengue em países da lusofonia previamente livres de doença, despertou- nos curiosidade quanto aos fatores concorrentes para o fenómeno e a necessidade de aprofundar conhecimentos quanto à patologia. Revemos a situação relativa à dengue nos países da lusofonia, relacionando os diferentes surtos e procurando contribuir para um melhor conhecimento do fenómeno. Material e Métodos: Revisão da literatura relativa ao tema e informação relevante obtida de comunicações orais. Resultados: Os surtos ocorridos entre os anos de 2009 e 2013 em Cabo Verde, Madeira e Angola (para lá da doença endémica no Brasil) partilham o mesmo vetor Aedes aegypti, mas são devidos a serotipos víricos com diferentes proveniências, como constatado em estudos genotípicos. A forte sub-notificação da doença em África e as dificuldades no diagnóstico e terapêutica são obstáculos ao real conhecimento da situação. Discussão: A hipótese de ligação entre alguns dos surtos não está completamente afastada. Pela elevada mobilidade de pessoas entre estas zonas e pelas alterações climáticas em curso, o território de Portugal expõe-se ao risco de introdução de dengue. A luta principal, a despeito de ferramentas emergentes ainda utópicas, é sem dúvida o controlo vetorial. Conclusão: Não foi possível provar qualquer ligação entre os diferentes surtos, mas é necessária preparação local dos profissionais de saúde, bem como o estabelecimento de estratégias de saúde pública e manutenção de redes de vigilância. Mais estudos epidemiológicos e entomológicos são necessários para caracterizar a verdadeira incidência de doença nos países lusófonos.

Teníases em São Domingos, Santiago, Cabo verde / Teniasis in são Domingos, Santiago, Cape verde

Com a finalidade de determinar a taxa de infecção por Taenia spp, e verificar a influência dos fatores analisados, no concelho de São Domingos, Santiago, Cabo Verde, foi realizado, no mês de Junho/2005, um levantamento coprológico entre crianças matriculadas em escolas da região. Os resultados demonstraram taxas de ocorrência da infecção em 27,1% das crianças com 10,9+1,7anos de idade (87%), sendo o local de residência o fator de maior influência sobre a variação da taxa de infecção durante o estudo.

With the purpose of determining the infection rate for Taenia spp, and the influence of the analyzed factors, in São Domingos, Santiago, Cape Verde, a coprologic survey among children from rural schools was performed on June/2005. The analysis demonstrated an infection rate of 27.1%, among children with 10.9±1.7 years old (87%), and that the residence place is the factor with higher influence on the infection rate variation during the survey.