T Cell Response in Tuberculosis-Infected Patients Vaccinated against COVID-19.

Many studies have focused on SARS-CoV-2 and Mycobacterium tuberculosis (Mtb) co-infection consequences. However, after a vaccination plan against COVID-19, the cases of severe disease and death are consistently controlled, although cases of asymptomatic and mild COVID-19 still happen together with tuberculosis (TB) cases. Thus, in this context, we sought to compare the T cell response of COVID-19-non-vaccinated and -vaccinated patients with active tuberculosis exposed to SARS-CoV-2 antigens. Flow cytometry was used to analyze activation markers (i.e., CD69 and CD137) and cytokines (IFN-γ, TNFα, IL-17, and IL-10) levels in CD4+ and CD8+ T cells upon exposure to SARS-CoV-2 peptides. The data obtained showed that CD8+ T cells from non-vaccinated TB patients present a high frequency of CD69 and TNF-α after viral challenge compared to vaccinated TB donors. Conversely, CD4+ T cells from vaccinated TB patients show a high frequency of IL-10 after spike peptide stimulus compared to non-vaccinated patients. No differences were observed in the other parameters analyzed. The results suggest that this reduced immune balance in coinfected individuals may have consequences for pathogen control, necessitating further research to understand its impact on clinical outcomes after COVID-19 vaccination in those with concurrent SARS-CoV-2 and Mtb infections.

Análise espacial da tuberculose e sua relação com fatores socioeconômicos na Paraíba: um estudo ecológico / Spatial analysis of tuberculosis and its relationship with socioeconomic factors in Paraíba: an ecological study

OBJETIVO: Analisar a distribuição espacial da tuberculose e sua associação com fatores socioeconômicos. MÉTODO: Estudo ecológico, misto, com análise espacial dos casos de tuberculose no estado da Paraíba, notificados no período de 2015 a 2018. RESULTADOS: Foram notificados 6.082 casos, com incidência média de 37,4/100 mil habitantes. Nenhum município foi classificado com desenvolvimento "muito baixo", embora exista significância estatística entre as taxas de incidência e os fatores socioambientais. CONCLUSÃO: O índice de Moran apontou autocorrelação positiva entre as áreas com altas incidências. O Moran Map releva clusters que indicam concentração da infecção entre a Zona da Mata e o Agreste Paraibano, sendo o maior deles formado por 19 municípios.

OBJECTIVE: To analyze the spatial distribution of tuberculosis and its association with socioeconomic factors. METHOD: A mixed-methods ecological study with spatial analysis of tuberculosis cases in the state of Paraíba, reported from 2015 to 2018. RESULTS: A total of 6,082 cases were reported, with a mean incidence of 37.4/100,000 inhabitants. No municipality was classified as having "very low" development, although statistical significance exists between the incidence rates and the socioenvironmental factors. CONCLUSION: The Moran Index pointed out a positive autocorrelation between areas with high incidence values. The Moran Map reveals clusters that indicate a concentration of the infection between Zona da Mata and Agreste Paraibano, the largest of which comprises 19 municipalities.

Projeto de extensão universitária fortalecendo as ações de vigilância da saúde no Estado da Paraíba: relato de experiência / University extension project strengthening surveillance of health actions in the State of Paraíba: experience report

O presente artigo teve como objetivo relatar a experiência vivenciada no projeto de extensão "Educação Permanente em Saúde: fortalecendo ações da vigilância da saúde no Estado da Paraíba". Trata­ se de um documento descritivo, do tipo relato de experiência acerca de um projeto de extensão de caráter institucional e interdepartamental, desenvolvido pelo Núcleo de Estudos em Saúde Coletiva, da Universidade Federal da Paraíba, com o intuito de realizar ações de educação em saúde em face de endemias em diferentes cidades, por meio de oficinas e ações de informação, comunicação e educação popular como estratégia de vigilância da saúde. Durante as atividades, observou ­se a importância das práticas educavas que tinham em vista a conscientização, sensibilização e mobilização não só da população, mas, também, de órgãos governamentais, no que tange às estratégias da vigilância epidemiológica frente ao combate de doenças emergentes e reemergentes no Estado. Nesse sendo, o artigo reitera a credibilidade da extensão universitária ao oportunizar os compromissos ético­ científico e político ­social da universidade com a comunidade, atendendo demandas sociais mediante seu envolvimento com diferentes realidades e favorecendo uma postura crítica sobre as políticas de saúde do país. No âmbito locorregional, no que se refere aos princípios e diretrizes do Sistema Único de Saúde, verifica - se a priorização das doenças negligenciadas, bem como a ênfase no ensinar e aprender em vigilância da saúde.

The objective of this article was to report the experience lived in the extension project "Permanent Education in Health: strengthening actions of Health Surveillance in the State of Paraíba". It is a descriptive document, of the experience report type about an extension Project of institutional and interdepartmental character, developed by the Collective Health Study Nucleus of the Federal University of Paraíba (Núcleo de Estudos em Saúde Coletiva, da Universidade Federal da Paraíba), with the purpose of performing health education actions in face of endemics in different cities, through workshops and information, communication and popular education actions as a health surveillance strategy. During the activities, it was observed the importance of educational practices that had in view the awareness, sensitization and mobilization not only of the population, but also of governmental agencies, regarding epidemiological surveillance strategies in face of the combat of emerging and reemerging diseases in the State. In this sense, the article reiterates the credibility of the university extension by opportunizing ethical­ scientific and political­ social commitments of the university with the community, meeting social demands through its involvement with different realities and favoring a critical posture on health policies in the country. At the loco­regional level, regarding the principles and guidelines of the Brazilian Health System, there is a prioritization of neglected diseases, as well as an emphasis on teaching and learning in the surveillance of health.

Molecular and clinical epidemiological surveillance of dengue virus in Paraíba, Northeast Brazil.

INTRODUCTION:: Despite being the most prevalent arboviral disease worldwide, dengue has been neglected lately. However, recent epidemics of arboviruses such as Zika and chikungunya in locations throughout the world have alerted health authorities to these diseases. This study evaluated the incidence pattern of dengue, its clinical characteristics, and co-circulation of serotypes from 2007 to 2015 in Paraiba State, Northeast Brazil. METHODS:: Data on dengue cases from 2007 to 2015 were extracted from clinical reports of the National System for Notifiable Diseases [Sistema Nacional de Agravos de Notificação (SINAN)] of Brazil provided by the Paraiba Health Department. Reverse transcription polymerase chain reaction (RT-PCR) assays for dengue serotypes were carried out on plasma samples obtained from patients with suspected dengue. The data were analysed using descriptive statistics. RESULTS:: According to clinical features, dengue fever [n = 39,083 (70.2%)] and dengue without warning signs [n = 15,365 (27.7%)] were the most common classifications of dengue. On RT-PCR, DENV 1 was the most commonly identified serotype (80.5%) in all years studied. Co-circulation of all four DENV serotypes was observed in 2013 and 2014. Furthermore, we observed an increase in dengue notifications in 2015, possibly due to the rise of Zika and chikungunya. CONCLUSIONS:: Our findings support the hypothesis that co-circulation of the four DENV serotypes may be a reason for the increased prevalence of severe forms of dengue in the years studied. This study may contribute to directing research, health policy, and financial resources toward reducing poorly controlled epidemic diseases.

Molecular and clinical epidemiological surveillance of dengue virus in Paraíba, Northeast Brazil

ABSTRACT INTRODUCTION: Despite being the most prevalent arboviral disease worldwide, dengue has been neglected lately. However, recent epidemics of arboviruses such as Zika and chikungunya in locations throughout the world have alerted health authorities to these diseases. This study evaluated the incidence pattern of dengue, its clinical characteristics, and co-circulation of serotypes from 2007 to 2015 in Paraiba State, Northeast Brazil. METHODS: Data on dengue cases from 2007 to 2015 were extracted from clinical reports of the National System for Notifiable Diseases [Sistema Nacional de Agravos de Notificação (SINAN)] of Brazil provided by the Paraiba Health Department. Reverse transcription polymerase chain reaction (RT-PCR) assays for dengue serotypes were carried out on plasma samples obtained from patients with suspected dengue. The data were analysed using descriptive statistics. RESULTS: According to clinical features, dengue fever [n = 39,083 (70.2%)] and dengue without warning signs [n = 15,365 (27.7%)] were the most common classifications of dengue. On RT-PCR, DENV 1 was the most commonly identified serotype (80.5%) in all years studied. Co-circulation of all four DENV serotypes was observed in 2013 and 2014. Furthermore, we observed an increase in dengue notifications in 2015, possibly due to the rise of Zika and chikungunya. CONCLUSIONS: Our findings support the hypothesis that co-circulation of the four DENV serotypes may be a reason for the increased prevalence of severe forms of dengue in the years studied. This study may contribute to directing research, health policy, and financial resources toward reducing poorly controlled epidemic diseases.