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1.
Rev Saude Publica ; 55: 15, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33909869

RESUMEN

We report cognitive, language and motor neurodevelopment, assessed by the Bayley-III test, in 31 non-microcephalic children at age 3 with PCR-confirmed maternal Zika virus exposure (Rio de Janeiro, 2015-2016). Most children had average neurodevelopmental scores, however, 8 children (26%) presented delay in some domain. Language was the most affected: 7 children (22.6%) had a delay in this domain (2 presenting severe delay). Moderate delay was detected in the cognitive (3.2%) and motor (10%) domains. Maternal illness in the third trimester of pregnancy and later gestational age at birth were associated with higher Bayley-III scores. Zika-exposed children require long-term follow-up until school age.


Asunto(s)
Trastornos del Neurodesarrollo , Complicaciones Infecciosas del Embarazo , Infección por el Virus Zika , Virus Zika , Brasil , Niño , Preescolar , Femenino , Humanos , Lactante , Trastornos del Neurodesarrollo/etiología , Embarazo , Infección por el Virus Zika/epidemiología
2.
Braz Oral Res ; 35: e043, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33909865

RESUMEN

Numerous studies have reported abnormalities in the development of oral structures in congenital infections that also involve microcephaly. In this context, it is necessary to identify possible dental anomalies of shape and/or number in patients with Zika virus syndrome using radiography. The study population consisted of 35 children born with congenital ZIKV who underwent intraoral radiographic examinations for 24 consecutive months. A modified periapical technique was performed in an occlusal position for the maxilla and mandible. Categorical data were expressed as absolute and percentage frequencies and compared using Pearson's Chi-square test, with a 95% confidence interval. Of the entire sample, eight children (22.8%) had dental anomalies of shape and/or number, and four children (11.4%) presented with both anomalies, with agenesis of the upper and lower deciduous/permanent incisors and dental form modifications, such as microdontia and anomalous cusps. When we considered age and sex, there was no statistically significant difference between patients who presented with agenesis and those who presented with modifications. Children with congenital Zika virus syndrome were more likely to have dental modifications in the number and shape of their teeth, and it is essential to implement medium- to long-term monitoring to diagnose other possible alterations throughout the development of the mixed and permanent dentition, favoring their treatment.


Asunto(s)
Microcefalia , Anomalías Dentarias , Infección por el Virus Zika , Virus Zika , Niño , Humanos , Mandíbula , Microcefalia/diagnóstico por imagen , Anomalías Dentarias/diagnóstico por imagen , Infección por el Virus Zika/complicaciones , Infección por el Virus Zika/diagnóstico por imagen , Infección por el Virus Zika/epidemiología
3.
BMJ Glob Health ; 6(4)2021 04.
Artículo en Inglés | MEDLINE | ID: mdl-33849897

RESUMEN

INTRODUCTION: There has been no systematic comparison of how the policy response to past infectious disease outbreaks and epidemics was funded. This study aims to collate and analyse funding for the Ebola epidemic and Zika outbreak between 2014 and 2019 in order to understand the shortcomings in funding reporting and suggest improvements. METHODS: Data were collected via a literature review and analysis of financial reporting databases, including both amounts donated and received. Funding information from three financial databases was analysed: Institute of Health Metrics and Evaluation's Development Assistance for Health database, the Georgetown Infectious Disease Atlas and the United Nations Financial Tracking Service. A systematic literature search strategy was devised and applied to seven databases: MEDLINE, EMBASE, HMIC, Global Health, Scopus, Web of Science and EconLit. Funding information was extracted from articles meeting the eligibility criteria and measures were taken to avoid double counting. Funding was collated, then amounts and purposes were compared within, and between, data sources. RESULTS: Large differences between funding reported by different data sources, and variations in format and methodology, made it difficult to arrive at precise estimates of funding amounts and purpose. Total disbursements reported by the databases ranged from $2.5 to $3.2 billion for Ebola and $150-$180 million for Zika. Total funding reported in the literature is greater than reported in databases, suggesting that databases may either miss funding, or that literature sources overreport. Databases and literature disagreed on the main purpose of funding for socioeconomic recovery versus outbreak response. One of the few consistent findings across data sources and diseases is that the USA was the largest donor. CONCLUSION: Implementation of several recommendations would enable more effective mapping and deployment of outbreak funding for response activities relating to COVID-19 and future epidemics.


Asunto(s)
Brotes de Enfermedades/economía , Fiebre Hemorrágica Ebola/economía , Infección por el Virus Zika/economía , Ebolavirus , Fiebre Hemorrágica Ebola/epidemiología , Humanos , Virus Zika , Infección por el Virus Zika/epidemiología
4.
Nat Commun ; 12(1): 1671, 2021 03 15.
Artículo en Inglés | MEDLINE | ID: mdl-33723237

RESUMEN

Zika virus (ZIKV) has caused large, brief outbreaks in isolated populations, however ZIKV can also persist at low levels over multiple years. The reasons for these diverse transmission dynamics remain poorly understood. In Fiji, which has experienced multiple large single-season dengue epidemics, there was evidence of multi-year transmission of ZIKV between 2013 and 2017. To identify factors that could explain these differences in dynamics between closely related mosquito-borne flaviviruses, we jointly fit a transmission dynamic model to surveillance, serological and molecular data. We estimate that the observed dynamics of ZIKV were the result of two key factors: strong seasonal effects, which created an ecologically optimal time of year for outbreaks; and introduction of ZIKV after this optimal time, which allowed ZIKV transmission to persist over multiple seasons. The ability to jointly fit to multiple data sources could help identify a similar range of possible outbreak dynamics in other settings.


Asunto(s)
Infecciones por Flavivirus/epidemiología , Infecciones por Flavivirus/transmisión , Animales , Culicidae , Dengue/transmisión , Virus del Dengue , Brotes de Enfermedades , Epidemias , Fiji/epidemiología , Flavivirus , Humanos , Mosquitos Vectores/virología , Estaciones del Año , Virus Zika , Infección por el Virus Zika/epidemiología , Infección por el Virus Zika/transmisión
5.
Artículo en Inglés | MEDLINE | ID: mdl-33668584

RESUMEN

Colombia experienced an outbreak of Zika virus infection during September 2015 until July 2016. This study aimed to identify the socioeconomic factors that at the municipality level correlate with this outbreak and therefore could have influenced its incidence. An analysis of publicly available, municipality-aggregated data related to eight potential explanatory socioeconomic variables was conducted. These variables are school dropout, low energy strata, social security system, savings capacity, tax, resources, investment, and debt. The response variable of interest in this study is the number of reported cases of Zika virus infection per people (projected) per square kilometer. Binomial regression models were performed. Results show that the best predictor variables of Zika virus occurrence, assuming an expected inverse relationship with socioeconomic status, are "school", "energy", and "savings". Contrary to expectations, proxies of socioeconomic status such as "investment", "tax", and "resources" were associated with an increase in the occurrence of Zika virus infection, while no association was detected for "social security" and "debt". Energy stratification, school dropout rate, and the percentage of the municipality's income that is saved conformed to the hypothesized inverse relationship between socioeconomic standing and Zika occurrence. As such, this study suggests these factors should be considered in Zika risk modeling.


Asunto(s)
Infección por el Virus Zika , Virus Zika , Colombia/epidemiología , Brotes de Enfermedades , Humanos , Incidencia , Factores Socioeconómicos , Infección por el Virus Zika/epidemiología
6.
BMC Infect Dis ; 21(1): 265, 2021 Mar 17.
Artículo en Inglés | MEDLINE | ID: mdl-33731022

RESUMEN

BACKGROUND: Increasing arbovirus infections have been a global burden in recent decades. Many countries have experienced the periodic emergence of arbovirus diseases. However, information on the prevalence of arboviruses is largely unknown or infrequently updated because of the lack of surveillance studies, especially in Africa. METHODS: A surveillance study was conducted in Gabon, Central Africa, on arboviruses, which are a major public health concern in Africa, including: West Nile virus (WNV), dengue virus (DENV), Zika virus (ZIKV), yellow fever virus (YFV), chikungunya virus (CHIKV), and Rift Valley fever virus (RVFV). Serological and molecular assays were performed to investigate past infection history and the current status of infection, using serum samples collected from healthy individuals and febrile patients, respectively. RESULTS: The overall seroprevalence during 2014-2017 was estimated to be 25.3% for WNV, 20.4% for DENV, 40.3% for ZIKV, 60.7% for YFV, 61.2% for CHIKV, and 14.3% for RVFV. No significant differences were found in the seroprevalence of any of the viruses between the male and female populations. However, a focus on the mean age in each arbovirus-seropositive individual showed a significantly younger age in WNV- and DENV-seropositive individuals than in CHIKV-seropositive individuals, indicating that WNV and DENV caused a relatively recent epidemic in the region, whereas CHIKV had actively circulated before. Of note, this indication was supported by the detection of both WNV and DENV genomes in serum samples collected from febrile patients after 2016. CONCLUSIONS: This study revealed the recent re-emergence of WNV and DENV in Gabon as well as the latest seroprevalence state of the major arboviruses, which indicated the different potential risks of virus infections and virus-specific circulation patterns. This information will be helpful for public health organizations and will enable a rapid response towards these arbovirus infections, thereby preventing future spread in the country.


Asunto(s)
Arbovirus/aislamiento & purificación , Dengue/epidemiología , Infección por el Virus Zika/epidemiología , Adolescente , Animales , Infecciones por Arbovirus/diagnóstico , Infecciones por Arbovirus/epidemiología , Arbovirus/clasificación , Niño , Preescolar , Enfermedades Transmisibles Emergentes , Dengue/diagnóstico , Femenino , Fiebre/epidemiología , Fiebre/virología , Gabón/epidemiología , Humanos , Lactante , Masculino , Salud Pública , Estudios Seroepidemiológicos , Infección por el Virus Zika/diagnóstico
7.
Vaccine ; 39(17): 2458-2466, 2021 04 22.
Artículo en Inglés | MEDLINE | ID: mdl-33781600

RESUMEN

Rapid development of vaccines for COVID-19 has relied on the application of existing vaccine technologies. This work examines the maturity of ten technologies employed in candidate vaccines (as of July 2020) and NIH funding for published research on these technologies from 2000-2019. These technologies vary from established platforms, which have been used successfully in approved products, to emerging technologies with no prior clinical validation. A robust body of published research on vaccine technologies was supported by 16,358 fiscal years of NIH funding totaling $17.2 billion from 2000-2019. During this period, NIH funding for published vaccine research against specific pandemic threats such as coronavirus, Zika, Ebola, and dengue was not sustained. NIH funding contributed substantially to the advance of technologies available for rapid development of COVID-19 vaccines, suggesting the importance of sustained public sector funding for foundational technologies in the rapid response to emerging public health threats.


Asunto(s)
Vacunas , Infección por el Virus Zika , Virus Zika , Humanos , Pandemias , Infección por el Virus Zika/epidemiología , Infección por el Virus Zika/prevención & control
8.
PLoS Negl Trop Dis ; 15(3): e0009259, 2021 03.
Artículo en Inglés | MEDLINE | ID: mdl-33705409

RESUMEN

Dengue, Zika and chikungunya are diseases of global health significance caused by arboviruses and transmitted by the mosquito Aedes aegypti, which is of worldwide circulation. The arrival of the Zika and chikungunya viruses to South America increased the complexity of transmission and morbidity caused by these viruses co-circulating in the same vector mosquito species. Here we present an integrated analysis of the reported arbovirus cases between 2007 and 2017 and local climate and socio-economic profiles of three distinct Colombian municipalities (Bello, Cúcuta and Moniquirá). These locations were confirmed as three different ecosystems given their contrasted geographic, climatic and socio-economic profiles. Correlational analyses were conducted with both generalised linear models and generalised additive models for the geographical data. Average temperature, minimum temperature and wind speed were strongly correlated with disease incidence. The transmission of Zika during the 2016 epidemic appeared to decrease circulation of dengue in Cúcuta, an area of sustained high incidence of dengue. Socio-economic factors such as barriers to health and childhood services, inadequate sanitation and poor water supply suggested an unfavourable impact on the transmission of dengue, Zika and chikungunya in all three ecosystems. Socio-demographic influencers were also discussed including the influx of people to Cúcuta, fleeing political and economic instability from neighbouring Venezuela. Aedes aegypti is expanding its range and increasing the global threat of these diseases. It is therefore vital that we learn from the epidemiology of these arboviruses and translate it into an actionable local knowledge base. This is even more acute given the recent historical high of dengue cases in the Americas in 2019, preceding the COVID-19 pandemic, which is itself hampering mosquito control efforts.


Asunto(s)
Fiebre Chikungunya/epidemiología , Dengue/epidemiología , Infección por el Virus Zika/epidemiología , Aedes/fisiología , Aedes/virología , Animales , Fiebre Chikungunya/economía , Fiebre Chikungunya/virología , Virus Chikungunya/fisiología , Clima , Colombia/epidemiología , Dengue/economía , Dengue/virología , Virus del Dengue/fisiología , Ecosistema , Humanos , Mosquitos Vectores/fisiología , Mosquitos Vectores/virología , América del Sur , Temperatura , Virus Zika/fisiología , Infección por el Virus Zika/economía , Infección por el Virus Zika/virología
9.
Rev Soc Bras Med Trop ; 54: e08372020, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33656154

RESUMEN

INTRODUCTION: This study evaluated the epidemiological implications of arbovirus infections and coronavirus disease (COVID-19) co-occurrences in Espírito Santo, Brazil. METHODS: This ecological study of dengue, chikungunya, zika, and COVID-19 was performed from January 1 to July 31, 2020. RESULTS: Espírito Santo registered 44,614, 8,092, 3,138, and 91,483 cases of dengue, chikungunya, zika, and COVID-19, respectively (January-July, 2020). In the 27 and four municipalities with a high incidence of dengue and chikungunya, respectively, the incidence of COVID-19 was 647.0-3,721.7 and 1,787.2-3,403.0 cases per 100,000 inhabitants, respectively. CONCLUSIONS: Espírito Santo experienced an overlap of epidemics, especially in urban areas.


Asunto(s)
Fiebre Chikungunya , Coronavirus , Dengue , Epidemias , Infección por el Virus Zika , Virus Zika , Brasil/epidemiología , Fiebre Chikungunya/epidemiología , Dengue/epidemiología , Humanos , Infección por el Virus Zika/complicaciones , Infección por el Virus Zika/epidemiología
10.
BMC Med Res Methodol ; 21(1): 50, 2021 03 11.
Artículo en Inglés | MEDLINE | ID: mdl-33706715

RESUMEN

BACKGROUND: Outbreaks of infectious diseases generate outbreaks of scientific evidence. In 2016 epidemics of Zika virus emerged, and in 2020, a novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) caused a pandemic of coronavirus disease 2019 (COVID-19). We compared patterns of scientific publications for the two infections to analyse the evolution of the evidence. METHODS: We annotated publications on Zika virus and SARS-CoV-2 that we collected using living evidence databases according to study design. We used descriptive statistics to categorise and compare study designs over time. RESULTS: We found 2286 publications about Zika virus in 2016 and 21,990 about SARS-CoV-2 up to 24 May 2020, of which we analysed a random sample of 5294 (24%). For both infections, there were more epidemiological than laboratory science studies. Amongst epidemiological studies for both infections, case reports, case series and cross-sectional studies emerged first, cohort and case-control studies were published later. Trials were the last to emerge. The number of preprints was much higher for SARS-CoV-2 than for Zika virus. CONCLUSIONS: Similarities in the overall pattern of publications might be generalizable, whereas differences are compatible with differences in the characteristics of a disease. Understanding how evidence accumulates during disease outbreaks helps us understand which types of public health questions we can answer and when.


Asunto(s)
/prevención & control , Publicaciones/estadística & datos numéricos , Publicaciones/tendencias , Infección por el Virus Zika/prevención & control , Virus Zika/aislamiento & purificación , /epidemiología , Estudios de Casos y Controles , Estudios Transversales , Brotes de Enfermedades , Humanos , Pandemias , Publicaciones Periódicas como Asunto/estadística & datos numéricos , Publicaciones Periódicas como Asunto/tendencias , Virus Zika/fisiología , Infección por el Virus Zika/epidemiología , Infección por el Virus Zika/virología
11.
BMC Infect Dis ; 21(1): 237, 2021 Mar 05.
Artículo en Inglés | MEDLINE | ID: mdl-33663410

RESUMEN

BACKGROUND: Healthcare workers are usually the first responders during outbreaks and are instrumental in educating the populace about the prevention of different diseases and illnesses. The aim of this study was to assess the association between healthcare workers' characteristics and knowledge, attitudes and practices toward Zika virus. METHODS: This was a cross-sectional study that collected data from healthcare workers at 3 medical facilities using a validated self-administered questionnaire between July 2017 - September 2017. Logistic regression models were used to examine the association between sociodemographic and knowledge, attitudes, and practices. RESULTS: A total of 190 healthcare workers were analyzed. Of these, 60, 72.6 and 64.7% had good knowledge, positive attitudes, and good practices toward Zika virus, respectively. Healthcare workers without a formal degree were less likely to have good knowledge of Zika virus (adjusted odds ratio (AOR) = 0:49; 95% confidence interval (CI) = 0.24-0.99) compared to those with a formal degree. Reduced odds for positive attitude towards Zika virus were observed in healthcare workers with low income as compared to those with high income (AOR = 0.31; 95% CI =0.13-0.75). Being younger than 40 years old was associated with poor Zika virus practices (AOR = 0:34; 95% CI = 0.15-0.79). CONCLUSIONS: Significant association between healthcare workers' sociodemographic characteristics and Zika virus knowledge, attitudes and practices were observed. Public health interventions that seek to increase Zika virus awareness should aim to train healthcare workers who are younger, without formal degree and those earning low income.


Asunto(s)
Conocimientos, Actitudes y Práctica en Salud , Personal de Salud/estadística & datos numéricos , Virus Zika , Adulto , Estudios Transversales , Femenino , Instituciones de Salud/estadística & datos numéricos , Humanos , Masculino , Persona de Mediana Edad , Oportunidad Relativa , San Kitts y Nevis/epidemiología , Factores Socioeconómicos , Encuestas y Cuestionarios , Infección por el Virus Zika/epidemiología
12.
An Acad Bras Cienc ; 93(3): e20200670, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33681889

RESUMEN

Arboviral diseases are disseminated all over the world. In Brazil, they remain neglected, alerting public authorities to possible outbreaks. Over here, we report the epidemiological indicators of Dengue from 2010 to 2015, Zika between 2015 and 2016, and Chikungunya from 2014 to 2016, within 19 municipalities of Southwestern Region of Bahia, Brazil. The data were collected from Brazilian national public information systems (SISFAD, SINAN, and IBGE) and by Endemic Control Agents. The analysis consisted of a description of vector characteristics, Home Infestation Index and characterization of human reported cases. The years 2011 and 2013 were recorded as having the highest frequencies of positive properties for the presence of the arboviruse vectors. Most municipalities presented high annual values of Home Infestation Index indicating an alert situation (62.28%). In the evaluated period, there were (i) 9,196 cases of Dengue, (ii) 636 cases of Zika and (iii) 224 cases of Chikungunya reported. This is the first report of the epidemiological characteristics of these arboviruses in the 19 municipalities of Bahia. It is believed that the data collected may contribute to public health policies aimed at controlling future epidemics of these arboviruses.


Asunto(s)
Arbovirus , Fiebre Chikungunya , Dengue , Infección por el Virus Zika , Virus Zika , Brasil/epidemiología , Fiebre Chikungunya/epidemiología , Dengue/epidemiología , Humanos , Infección por el Virus Zika/epidemiología
13.
Artículo en Inglés | MEDLINE | ID: mdl-33572650

RESUMEN

Aedes aegypti is a cosmopolitan vector for arboviruses dengue, Zika and chikungunya, disseminated in all Brazilian states. The Eco-Bio-Social (EBS) strategy is vital in Aedes aegypti control as it mobilizes stakeholders (government, professionals, society, and academics) to promote healthy environments. This paper describes the rationale and methods of expanding the EBS strategy for Aedes aegypti control in Fortaleza, Northeast Brazil. A cluster, non-randomized controlled clinical trial was developed to analyze the strategy's effectiveness in vulnerable territories (high incidence of dengue and violent deaths; low HDI; substandard urban infrastructure, high population density, and water scarcity). We selected two intervention and two control groups, resulting in a sample of approximately 16,000 properties. The intervention consisted of environmental management by sealing large elevated water tanks, introduction of beta fish in waterholes, elimination of potential breeding sites, and mobilization and training of schoolchildren, endemic disease workers, health workers, social mobilizers, and community leaders; community surveillance of arboviruses; construction and validation of a booklet for the prevention of arboviruses in pregnant women. We analyzed the costs of arboviruses to government and households, the intervention cost-effectiveness, chikungunya's chronicity, and acceptance, sustainability, and governance of vector control actions. The primary outcome (infestation) was analyzed using the house, container, and Breteau indices. We hope that this study will help us understand how to scale up strategies to fight Aedes aegypti in vulnerable areas.


Asunto(s)
Aedes , Dengue , Infección por el Virus Zika , Virus Zika , Animales , Brasil/epidemiología , Niño , Dengue/epidemiología , Dengue/prevención & control , Femenino , Humanos , Control de Mosquitos , Mosquitos Vectores , Embarazo , Infección por el Virus Zika/epidemiología , Infección por el Virus Zika/prevención & control
14.
Public Health ; 192: 21-29, 2021 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-33607517

RESUMEN

OBJECTIVES: The primary aim of this study was to evaluate the temporal correlation between Wikitrends and conventional surveillance data generated for Chikungunya, Dengue, Zika, and West Nile Virus infection reported by bulletin of Italian National Institute of Health (Istituto Superiore di Sanità in italian, ISS). STUDY DESIGN: A cross-sectional study design was used. METHODS: The reported cases of Dengue and Chikungunya were selected from July 2015 to December 2019. For West Nile Virus, the bulletins are issued in the period June-November (6 months) of the years 2015-2019, and for Zika virus, the data reported in the ISS bulletin start from January 2016. From Wikipedia Trends, we extracted the number of monthly views by users from the July 2015 to December 2019 of the pages Chikungunya, Dengue, Zika virus, and West Nile Virus. RESULTS: A correlation was observed between the bulletin of ISS and Wikipedia Wikitrends, the correlation was strong for Chikungunya and West Nile Virus (r = 0.9605; r = 0.9556, respectively), and highly statistically significant with P-values <0.001. The correlation was moderate for Dengue and Zika virus (r = 0.6053; r = 0.5888, respectively), but highly statistically significant with P-values <0.001. CONCLUSIONS: Classical surveillance system should be integrated with the tools of digital epidemiology that have potential role in public health for the dynamic information and provide near real-time indicators of the spread of infectious disease.


Asunto(s)
Arbovirus , Fiebre Chikungunya/epidemiología , Culicidae/virología , Dengue/epidemiología , Internet , Fiebre del Nilo Occidental/epidemiología , Infección por el Virus Zika/epidemiología , Animales , Arbovirus/clasificación , Arbovirus/aislamiento & purificación , Virus Chikungunya , Estudios Transversales , Dengue/virología , Virus del Dengue , Monitoreo Epidemiológico , Humanos , Italia/epidemiología , Masculino , Salud Pública , Virus del Nilo Occidental , Virus Zika
15.
Viruses ; 13(2)2021 02 04.
Artículo en Inglés | MEDLINE | ID: mdl-33557048

RESUMEN

Recent outbreaks of Zika virus (ZIKV) infection highlight the urgent need to evaluate the efficacy of current public health measures to educate susceptible groups about how to prevent infection, modes of viral transmission, and consequences of infection. We performed a cross-sectional study in the city of Jundiaí, São-Paulo, from March 2016 to August 2017. In 315 high-risk pregnant women we evaluated the rate of ZIKV infection, knowledge of pathways of ZIKV transmission, and the use of protective measures. Data were analyzed and correlated with sociodemographic variables. The rate of ZIKV infection was 10.8%. ZIKV transmission by mosquitoes was the best-known means of virus acquisition, while transmission of ZIKV by sexual intercourse as well as mother-fetus transmission was known by less than half of the women. The use of insect repellent, reported by 53% of participants, was correlated with higher education and personal directives from health professionals. Condom use was reported by 19.5% of subjects. Improved strategies to increase awareness of ZIKV infection and its consequences, designed to appeal to specific, targeted populations, are clearly necessary to more accurately prevent the spread of this infection and diminish adverse consequences in the pregnant population.


Asunto(s)
Conocimientos, Actitudes y Práctica en Salud , Complicaciones Infecciosas del Embarazo/prevención & control , Mujeres Embarazadas , Infección por el Virus Zika/prevención & control , Infección por el Virus Zika/transmisión , Adolescente , Adulto , Brasil/epidemiología , Estudios Transversales , Femenino , Humanos , Persona de Mediana Edad , Embarazo , Complicaciones Infecciosas del Embarazo/epidemiología , Riesgo , Adulto Joven , Virus Zika , Infección por el Virus Zika/epidemiología
16.
Cad Saude Publica ; 37(2): e00145819, 2021.
Artículo en Portugués | MEDLINE | ID: mdl-33624694

RESUMEN

This study aimed to understand the meanings, risk perceptions, and strategies to prevent infection with the Zika virus developed by pregnant women with different socioeconomic conditions seen at public and private health services in the city of Salvador, Bahia State, Brazil, as well the contribution by their male partners in dealing with the risk of infection since the emergence of this virus in Brazil. A qualitative study was performed with 18 semi-structured interviews, nine each with pregnant women seen in the public and private health systems, respectively. The resulting data revealed insufficient knowledge in pregnant women concerning important aspects of Zika virus infection. The pregnant women's socioenvironmental situation was an important factor for risk perception and preventive strategies. Women interviewed in the public health system felt more vulnerable to the risk of infection than women interviewed in the private health system, with a major impact on their psychosocial well-being. According to the women, their partners placed huge demands on them to adopt preventive measures, but the male partners themselves failed to take the same precautions, e.g., ignoring the risk of sexual transmission of the Zika virus. In conclusion, three years since the outbreak reached Brazil, the Zika virus still has a major impact on the lives of pregnant women. It is crucial to strengthen health communications activities to guarantee the availability of information on the disease that responds adequately to the population's needs.


Asunto(s)
Complicaciones Infecciosas del Embarazo , Infección por el Virus Zika , Virus Zika , Brasil/epidemiología , Femenino , Conocimientos, Actitudes y Práctica en Salud , Humanos , Masculino , Percepción , Embarazo , Complicaciones Infecciosas del Embarazo/prevención & control , Mujeres Embarazadas , Infección por el Virus Zika/epidemiología , Infección por el Virus Zika/prevención & control
17.
Mem Inst Oswaldo Cruz ; 115: e200278, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33566939

RESUMEN

BACKGROUND: The impact of arbovirus cocirculation in Brazil is unknown. Dengue virus (DENV) reinfection may result in more intense viraemia or immunopathology, leading to more severe disease. The Zika virus (ZIKV) epidemic in the Americas provided pathogenicity evidence that had not been previously observed in flavivirus infections. In contrast to other flaviviruses, electron microscopy studies have shown that ZIKV may replicate in viroplasm-like structures. Flaviviruses produce an ensemble of structurally different virions, collectively contributing to tissue tropism and virus dissemination. OBJECTIVES AND METHODS: In this work, the Aedes albopictus mosquito cell lineage (C6/36 cells) and kidney epithelial cells from African green monkeys (Vero cells) were infected with samples of the main circulating arboviruses in Brazil [DENV-1, DENV-2, DENV-3, DENV-4, ZIKV, Yellow Fever virus (YFV) and Chikungunya virus (CHIKV)], and ultrastructural studies by transmission electron microscopy were performed. FINDINGS: We observed that ZIKV, the DENV serotypes, YFV and CHIKV particles are spherical. ZIKV, DENV-1, -2, -3 and -4 presented diameters of 40-50 nm, and CHIKV presented approximate diameters of 50-60 nm. Viroplasm-like structures was observed in ZIKV replication cycle. MAIN CONCLUSIONS: The morphogenesis of these arboviruses is similar to what has been presented in previous studies. However, we understand that further studies are needed to investigate the relationship between viroplasm-like structures and ZIKV replication dynamics.


Asunto(s)
Arbovirus , Fiebre Chikungunya , Dengue , Epidemias , Fiebre Amarilla , Infección por el Virus Zika , Virus Zika , Animales , Brasil/epidemiología , Fiebre Chikungunya/epidemiología , Chlorocebus aethiops , Dengue/epidemiología , Células Vero , Infección por el Virus Zika/epidemiología
18.
BMC Med Res Methodol ; 21(1): 34, 2021 02 14.
Artículo en Inglés | MEDLINE | ID: mdl-33583405

RESUMEN

BACKGROUND: Ensemble modeling aims to boost the forecasting performance by systematically integrating the predictive accuracy across individual models. Here we introduce a simple-yet-powerful ensemble methodology for forecasting the trajectory of dynamic growth processes that are defined by a system of non-linear differential equations with applications to infectious disease spread. METHODS: We propose and assess the performance of two ensemble modeling schemes with different parametric bootstrapping procedures for trajectory forecasting and uncertainty quantification. Specifically, we conduct sequential probabilistic forecasts to evaluate their forecasting performance using simple dynamical growth models with good track records including the Richards model, the generalized-logistic growth model, and the Gompertz model. We first test and verify the functionality of the method using simulated data from phenomenological models and a mechanistic transmission model. Next, the performance of the method is demonstrated using a diversity of epidemic datasets including scenario outbreak data of the Ebola Forecasting Challenge and real-world epidemic data outbreaks of including influenza, plague, Zika, and COVID-19. RESULTS: We found that the ensemble method that randomly selects a model from the set of individual models for each time point of the trajectory of the epidemic frequently outcompeted the individual models as well as an alternative ensemble method based on the weighted combination of the individual models and yields broader and more realistic uncertainty bounds for the trajectory envelope, achieving not only better coverage rate of the 95% prediction interval but also improved mean interval scores across a diversity of epidemic datasets. CONCLUSION: Our new methodology for ensemble forecasting outcompete component models and an alternative ensemble model that differ in how the variance is evaluated for the generation of the prediction intervals of the forecasts.


Asunto(s)
Brotes de Enfermedades , Predicción/métodos , Modelos Estadísticos , /epidemiología , Fiebre Hemorrágica Ebola/epidemiología , Humanos , Gripe Humana/epidemiología , Infección por el Virus Zika/epidemiología
19.
Viruses ; 13(1)2021 Jan 05.
Artículo en Inglés | MEDLINE | ID: mdl-33466404

RESUMEN

Upper respiratory obstruction is a common sequela in children with Zika-related microcephaly (ZRM). As a cross-sectional analysis nested in a cohort study, this study aims to investigate the prevalence of adenoid hypertrophy (AH) in children with ZRM and symptoms of respiratory obstruction. The data were collected in the first three years of life from children with ZRM who were followed in two reference centers for otorhinolaryngological care of patients with congenital Zika syndrome. Out of 92 children with confirmed ZRM, 57 were evaluated by nasopharyngoscopy after presenting with upper respiratory obstruction symptoms. In this study, 31 of the 57 (54%) children with ZRM who were evaluated had obstructive AH. Thirteen children with obstructive AH were submitted to surgery, which resulted in the complete resolution of symptoms for 11, partial resolution in 1, and no improvement in 1. No evidence of direct involvement by Zika virus (ZIKV) infection in the adenoid tissues was demonstrated by histology or immunohistochemistry. Our results suggest that there is a high prevalence and early presentation of AH in children with ZRM, with consequent upper airway obstruction causing upper airway obstructive disorder, secretory otitis media, and dysphagia.


Asunto(s)
Tonsila Faríngea/patología , Microcefalia/epidemiología , Infección por el Virus Zika/epidemiología , Brasil , Preescolar , Estudios de Cohortes , Estudios Transversales , Femenino , Humanos , Hipertrofia/complicaciones , Hipertrofia/epidemiología , Lactante , Masculino , Microcefalia/patología , Microcefalia/virología , Prevalencia , Infección por el Virus Zika/patología
20.
Mil Med ; 186(Suppl 1): 82-90, 2021 01 25.
Artículo en Inglés | MEDLINE | ID: mdl-33499489

RESUMEN

INTRODUCTION: Zika virus (ZIKV) is a mild febrile illness generally transmitted via the bite of infected Aedes species mosquitoes, including Aedes aegypti, with the potential to cause neurological complications. Nearly 200 U.S. military installations are located within areas where Aedes mosquitos are found, putting thousands of personnel at risk for infection with ZIKV. This analysis aims to quantify the benefits of interventions, including vaccination, to decrease the risk of ZIKV on U.S. military installations. METHODS: The authors developed a dynamic transmission model to test the "effectiveness" of vaccination, personal protective measures (PPM), and mosquito control at reducing morbidity within U.S. military populations. ZIKV transmission was modeled as a compartmental susceptible-exposed-infected-recovered model tracking interactions between humans and mosquitos and incorporating seasonality of mosquito populations and the potential for herd immunity. The model included two-dose vaccination as well as symptomatic and asymptomatic infection. The model was calibrated against 2016 public health data in Puerto Rico; sensitivity analyses were performed on model parameters and interventions. RESULTS: The greatest reduction in total modeled ZIKV cases resulted from vaccination combined with mosquito control and PPM. All three interventions at their highest estimated level of efficiency reduced ZIKV cases by 99.9% over the baseline case of low-level adherence to PPM. The addition of vaccination had limited additional benefit over effective vector control and PPM since the significant lag to vaccine-induced protection limited effectiveness of vaccination. CONCLUSIONS: Given the current vaccine, the model predicted that up to 92.8% of Zika cases occurring in deployment settings over a 10-year period could be prevented by adding vaccination to current low-level PPM. Combining vaccination with other interventions can reduce cases further. A location-specific cost-benefit analysis would be a valuable contribution to outbreak control policy as it could evaluate the economic impact of the interventions versus the reduced level of illness and downtime in this setting.


Asunto(s)
Infección por el Virus Zika , Virus Zika , Aedes , Animales , Humanos , Mosquitos Vectores , Puerto Rico , Vacunación , Vacunas Virales , Infección por el Virus Zika/epidemiología , Infección por el Virus Zika/prevención & control
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