Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 3.514
Filtrar
1.
Recurso na Internet em Português | LIS - Localizador de Informação em Saúde | ID: lis-48419

RESUMO

Um microorganismo implantado em mosquitos reduziu em 70% a ocorrência de casos de dengue, 66% de incidência de casos de chinkungunya e 40% de Zika em Niterói, no Rio de Janeiro.


Assuntos
Dengue/prevenção & controle , Zika virus , Planos e Programas de Pesquisa em Saúde , Aedes , Wolbachia
3.
Artigo em Inglês | MEDLINE | ID: mdl-34406289

RESUMO

Infections caused by arboviruses that have mostly impacted the Brazilian morbidity and mortality are caused by the same vector, Aedes aegypti. Preventive actions related to the vector are the most effective strategies in the prevention and control of these diseases. This study aimed to associate the knowledge on the vector that transmits dengue, Zika and chikungunya with the sociodemographic and behavioral preventive practices towards Aedes aegypti in the municipality of Tangara da Serra, Mato Grosso State, in the Brazilian Legal Amazon. A probabilistic urban population sampling was obtained by clusters: census sectors and households. The sample size calculation considered 10% of loss and a 1.5 design effect. This is a cross-sectional research carried out through a household survey in February and March 2018. There were 583 participants. The study variables were knowledge on the vector, sociodemographic characteristics and preventive practices related to the vector. The statistical analysis was based on a bivariate analysis and Poisson multiple regressions. Inadequate or insufficient knowledge on the vector Aedes aegypti remained associated with education in the categories illiterate (p<0.001) and 8 years of study or less (p<0.001), in addition to not adopting practices of capping and cleaning the water tank (p=0.002) and not using insecticides at home (p=0.007). It is concluded that there is a need for health communication actions that consider characteristics the population, especially the level of education and previous knowledge on the vector, allowing a dialogical approach and enabling the community participation in preventive practices and control of the vector Aedes aegypti .


Assuntos
Aedes , Dengue , Infecção por Zika virus , Zika virus , Animais , Estudos Transversais , Dengue/prevenção & controle , Humanos , Controle de Mosquitos , Mosquitos Vetores , Infecção por Zika virus/epidemiologia , Infecção por Zika virus/prevenção & controle
4.
PLoS Negl Trop Dis ; 15(8): e0009603, 2021 08.
Artigo em Inglês | MEDLINE | ID: mdl-34370734

RESUMO

BACKGROUND: The COVID-19 pandemic has induced unprecedented reductions in human mobility and social contacts throughout the world. Because dengue virus (DENV) transmission is strongly driven by human mobility, behavioral changes associated with the pandemic have been hypothesized to impact dengue incidence. By discouraging human contact, COVID-19 control measures have also disrupted dengue vector control interventions, the most effective of which require entry into homes. We sought to investigate how and why dengue incidence could differ under a lockdown scenario with a proportion of the population sheltered at home. METHODOLOGY & PRINCIPAL FINDINGS: We used an agent-based model with a realistic treatment of human mobility and vector control. We found that a lockdown in which 70% of the population sheltered at home and which occurred in a season when a new serotype invaded could lead to a small average increase in cumulative DENV infections of up to 10%, depending on the time of year lockdown occurred. Lockdown had a more pronounced effect on the spatial distribution of DENV infections, with higher incidence under lockdown in regions with higher mosquito abundance. Transmission was also more focused in homes following lockdown. The proportion of people infected in their own home rose from 54% under normal conditions to 66% under lockdown, and the household secondary attack rate rose from 0.109 to 0.128, a 17% increase. When we considered that lockdown measures could disrupt regular, city-wide vector control campaigns, the increase in incidence was more pronounced than with lockdown alone, especially if lockdown occurred at the optimal time for vector control. CONCLUSIONS & SIGNIFICANCE: Our results indicate that an unintended outcome of lockdown measures may be to adversely alter the epidemiology of dengue. This observation has important implications for an improved understanding of dengue epidemiology and effective application of dengue vector control. When coordinating public health responses during a syndemic, it is important to monitor multiple infections and understand that an intervention against one disease may exacerbate another.


Assuntos
COVID-19/prevenção & controle , Dengue/epidemiologia , SARS-CoV-2 , Animais , Dengue/prevenção & controle , Dengue/transmissão , Humanos , Incidência , Controle de Mosquitos , Saúde Pública
5.
Nat Immunol ; 22(8): 958-968, 2021 08.
Artigo em Inglês | MEDLINE | ID: mdl-34267374

RESUMO

Antibody-dependent enhancement (ADE) is an important safety concern for vaccine development against dengue virus (DENV) and its antigenically related Zika virus (ZIKV) because vaccine may prime deleterious antibodies to enhance natural infections. Cross-reactive antibodies targeting the conserved fusion loop epitope (FLE) are known as the main sources of ADE. We design ZIKV immunogens engineered to change the FLE conformation but preserve neutralizing epitopes. Single vaccination conferred sterilizing immunity against ZIKV without ADE of DENV-serotype 1-4 infections and abrogated maternal-neonatal transmission in mice. Unlike the wild-type-based vaccine inducing predominately cross-reactive ADE-prone antibodies, B cell profiling revealed that the engineered vaccines switched immunodominance to dispersed patterns without DENV enhancement. The crystal structure of the engineered immunogen showed the dimeric conformation of the envelope protein with FLE disruption. We provide vaccine candidates that will prevent both ZIKV infection and infection-/vaccination-induced DENV ADE.


Assuntos
Anticorpos Facilitadores/imunologia , Antígenos Virais/imunologia , Reações Cruzadas/imunologia , Vacinas contra Dengue/imunologia , Dengue/prevenção & controle , Zika virus/imunologia , Aedes , Animais , Anticorpos Neutralizantes/imunologia , Anticorpos Antivirais/imunologia , Linfócitos B/imunologia , Chlorocebus aethiops , Cricetinae , Vírus da Dengue/imunologia , Células HEK293 , Humanos , Camundongos , Camundongos Endogâmicos BALB C , Camundongos Knockout , Receptor de Interferon alfa e beta/genética , Vacinação , Células Vero , Infecção por Zika virus/imunologia , Infecção por Zika virus/prevenção & controle
6.
Vaccine ; 39(34): 4759-4765, 2021 08 09.
Artigo em Inglês | MEDLINE | ID: mdl-34253416

RESUMO

Dengue vaccination would enhance the control of dengue, one of the most frequent vector-borne viral diseases globally. CYD-TDV is the first dengue vaccine to be licensed, but global uptake has been hampered due to its use being limited to seropositive persons aged 9 years and above, and the need for a 3-dose schedule. The Partnership for Dengue Control (PDC) organized a meeting with key opinion leaders and stakeholders to deliberate on implementation strategies for the use of CYD-TDV. New data have emerged that support the shortening of the primary schedule from a 3 to 2 dose schedule, extending the age range below 9 to 6 years of age, and expanding the indication from endemic populations to also include travelers to endemic areas. Cost-effectiveness may improve with the modified 2-dose regimen and with multiple testing. Strategies to implement a dengue vaccination program have been developed, in particular school-based strategies. A range of delivery scenarios can then be considered, using various settings for each step of the intervention. However, several challenges remain, including communication about limiting the use of this vaccine to seropositive individuals only. Affordability will vary from country to country, as will government commitment and community acceptance. Well-tailored communication strategies that target key stakeholders are expected to make up a significant part of any future dengue vaccination program.


Assuntos
Vacinas contra Dengue , Vírus da Dengue , Dengue , Anticorpos Antivirais , Análise Custo-Benefício , Dengue/prevenção & controle , Humanos , Vacinas Atenuadas
7.
BMC Public Health ; 21(1): 1362, 2021 07 09.
Artigo em Inglês | MEDLINE | ID: mdl-34243740

RESUMO

BACKGROUND: The outbreak of Zika virus in Brazil in 2015 followed the arrival of chikungunya in 2014 and a long history of dengue circulation. Vital to the response to these outbreaks of mosquito-borne pathogens has been the dissemination of public health messages, including those promoted through risk communication posters. This study explores the content of a sample of posters circulated in Brazil towards the end of the Zika epidemic in 2017 and analyses their potential effectiveness in inducing behaviour change. METHODS: A content analysis was performed on 37 posters produced in Brazil to address outbreaks of mosquito-borne pathogens. The six variables of the Health Belief Model were used to assess the potential effectiveness of the posters to induce behaviour change. RESULTS: Three overarching key messages emerged from the posters. These included (i) the arboviruses and their outcomes, (ii) a battle against the mosquito, and (iii) a responsibility to protect and prevent. Among the six variables utilised through the Health Belief Model, cues to action were most commonly featured, whilst the perceived benefits of engaging in behaviours to prevent arbovirus transmission were the least commonly featured. CONCLUSIONS: The posters largely focused on mosquito-borne transmission and the need to eliminate breeding sites, and neglected the risk of the sexual and congenital transmission of Zika and the importance of alternative preventive actions. This, we argue, may have limited the potential effectiveness of these posters to induce behaviour change.


Assuntos
Aedes , Arbovírus , Vírus da Dengue , Dengue , Infecção por Zika virus , Zika virus , Animais , Brasil/epidemiologia , Dengue/epidemiologia , Dengue/prevenção & controle , Humanos , Mosquitos Vetores , Saúde Pública , Infecção por Zika virus/epidemiologia , Infecção por Zika virus/prevenção & controle
8.
Molecules ; 26(12)2021 Jun 17.
Artigo em Inglês | MEDLINE | ID: mdl-34204264

RESUMO

The present research investigated the chemical characterization and insecticidal activity of n-Hexane extracts of Epaltes divaricata (NH-EDx) along with their chief derivatives n-Hexadecanoic acid (n-HDa) and n-Octadecanoic acid (n-ODa) against the dengue vector Aedes aegypti and lepidopteran pest Spodoptera litura. Chemical screening of NH-EDx through GC-MS analysis delivered nine major derivatives, and the maximum peak area percentage was observed in n-Hexadecanoic acid (14.63%) followed by n-Octadecadienoic acid (6.73%). The larvicidal activity of NH-EDx (1000 ppm), n-HDa (5 ppm), and n-ODa (5 ppm) against the A. aegypti and S. litura larvae showed significant mortality rate in a dose-dependent way across all the instars. The larvicidal activity was profound in the A. aegypti as compared to the S. litura across all the larval instars. The sublethal dosages of NH-EDx (500 ppm), n-HDa (2.5 ppm), and n-ODa (2.5 ppm) also showed alterations in the larval/pupal durations and adult longevity in both the insect pests. The enzyme activity revealed that the α- and ß-carboxylesterase levels were decreased significantly in both the insect pests, whereas the levels of GST and CYP450 uplifted in a dose-dependent manner of NH-EDx, n-HDa, and n-ODa. Correspondingly, midgut tissues such as the epithelial layer (EL), gut lumen (GL), peritrophic matrix (Pm), and brush border membrane (BBM) were significantly altered in their morphology across both A. aegypti and S. litura against the NH-EDx and their bioactive metabolites. NH-EDx and their bioactive metabolites n-HDa and n-ODa showed significant larvicidal, growth retardant, enzyme inhibition, and midgut toxicity effects against two crucial agriculturally and medically challenging insect pest of ecological importance.


Assuntos
Aedes/efeitos dos fármacos , Asteraceae/metabolismo , Extratos Vegetais/farmacologia , Spodoptera/efeitos dos fármacos , Animais , Asteraceae/efeitos dos fármacos , Culex/efeitos dos fármacos , Dengue/prevenção & controle , Hexanos/química , Inseticidas/farmacologia , Larva/efeitos dos fármacos , Mosquitos Vetores/efeitos dos fármacos , Folhas de Planta/química , Solventes/química
9.
BMC Med ; 19(1): 160, 2021 07 09.
Artigo em Inglês | MEDLINE | ID: mdl-34238298

RESUMO

BACKGROUND: East Africa is home to 170 million people and prone to frequent outbreaks of viral haemorrhagic fevers and various bacterial diseases. A major challenge is that epidemics mostly happen in remote areas, where infrastructure for Biosecurity Level (BSL) 3/4 laboratory capacity is not available. As samples have to be transported from the outbreak area to the National Public Health Laboratories (NPHL) in the capitals or even flown to international reference centres, diagnosis is significantly delayed and epidemics emerge. MAIN TEXT: The East African Community (EAC), an intergovernmental body of Burundi, Rwanda, Tanzania, Kenya, Uganda, and South Sudan, received 10 million € funding from the German Development Bank (KfW) to establish BSL3/4 capacity in the region. Between 2017 and 2020, the EAC in collaboration with the Bernhard-Nocht-Institute for Tropical Medicine (Germany) and the Partner Countries' Ministries of Health and their respective NPHLs, established a regional network of nine mobile BSL3/4 laboratories. These rapidly deployable laboratories allowed the region to reduce sample turn-around-time (from days to an average of 8h) at the centre of the outbreak and rapidly respond to epidemics. In the present article, the approach for implementing such a regional project is outlined and five major aspects (including recommendations) are described: (i) the overall project coordination activities through the EAC Secretariat and the Partner States, (ii) procurement of equipment, (iii) the established laboratory setup and diagnostic panels, (iv) regional training activities and capacity building of various stakeholders and (v) completed and ongoing field missions. The latter includes an EAC/WHO field simulation exercise that was conducted on the border between Tanzania and Kenya in June 2019, the support in molecular diagnosis during the Tanzanian Dengue outbreak in 2019, the participation in the Ugandan National Ebola response activities in Kisoro district along the Uganda/DRC border in Oct/Nov 2019 and the deployments of the laboratories to assist in SARS-CoV-2 diagnostics throughout the region since early 2020. CONCLUSIONS: The established EAC mobile laboratory network allows accurate and timely diagnosis of BSL3/4 pathogens in all East African countries, important for individual patient management and to effectively contain the spread of epidemic-prone diseases.


Assuntos
COVID-19/prevenção & controle , Redes Comunitárias , Dengue/epidemiologia , Doença pelo Vírus Ebola/epidemiologia , Laboratórios , Unidades Móveis de Saúde , Burundi/epidemiologia , COVID-19/terapia , Dengue/prevenção & controle , Epidemias , Doença pelo Vírus Ebola/prevenção & controle , Doença pelo Vírus Ebola/terapia , Humanos , Quênia/epidemiologia , Unidades Móveis de Saúde/economia , Saúde Pública , Ruanda/epidemiologia , SARS-CoV-2 , Sudão do Sul/epidemiologia , Tanzânia/epidemiologia , Uganda/epidemiologia
10.
Gac Med Mex ; 157(2): 187-193, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34270541

RESUMO

In American countries, simultaneously with the coronavirus disease 2019 (COVID-19) pandemic, epidemics caused by different arboviruses (dengue, chikungunya and Zika viruses) are occurring. In Mexico, several of the strategies to control the Aedes aegypti mosquito, which transmits arboviruses, involve the interaction of health personnel with the community. Due to the COVID-19 pandemic, social distancing and home confinement measures have been implemented. To obey these measures and avoid the risk of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) transmission, the National Center for Preventive Programs and Disease Control (CENAPRECE) has presented the vector control strategy in the scenario of simultaneous dengue and COVID-19 transmission in Mexico. In this work, we mention the routine comprehensive mosquito control measures and describe the adaptations that have been made. Furthermore, we discuss the relevance of medical personnel training and supervision, especially focusing on the similarity of symptoms between both pathologies.


Assuntos
Aedes/virologia , Infecções por Arbovirus/epidemiologia , COVID-19/epidemiologia , Monitoramento Epidemiológico , Controle de Mosquitos/métodos , Pandemias , Animais , Infecções por Arbovirus/prevenção & controle , COVID-19/prevenção & controle , Febre de Chikungunya/epidemiologia , Febre de Chikungunya/prevenção & controle , Dengue/epidemiologia , Dengue/prevenção & controle , Promoção da Saúde , Humanos , Disseminação de Informação , Distanciamento Físico , Infecção por Zika virus/epidemiologia
11.
Recurso na Internet em Português | LIS - Localizador de Informação em Saúde | ID: lis-48251

RESUMO

Publicados na revista científica The New England Journal of Medicine, os resultados de um ensaio clínico randomizado (RCT, sigla em inglês) apontaram uma redução de 77% dos casos de dengue nas áreas que receberam o mosquito Aedes aegypti com Wolbachia, em Yogyakarta, na Indonésia.


Assuntos
Wolbachia/imunologia , Dengue/prevenção & controle , Aedes , Ensaio Clínico Controlado Aleatório
12.
N Engl J Med ; 384(23): 2177-2186, 2021 06 10.
Artigo em Inglês | MEDLINE | ID: mdl-34107180

RESUMO

BACKGROUND: Aedes aegypti mosquitoes infected with the wMel strain of Wolbachia pipientis are less susceptible than wild-type A. aegypti to dengue virus infection. METHODS: We conducted a cluster-randomized trial involving releases of wMel-infected A. aegypti mosquitoes for the control of dengue in Yogyakarta, Indonesia. We randomly assigned 12 geographic clusters to receive deployments of wMel-infected A. aegypti (intervention clusters) and 12 clusters to receive no deployments (control clusters). All clusters practiced local mosquito-control measures as usual. A test-negative design was used to assess the efficacy of the intervention. Patients with acute undifferentiated fever who presented to local primary care clinics and were 3 to 45 years of age were recruited. Laboratory testing was used to identify participants who had virologically confirmed dengue (VCD) and those who were test-negative controls. The primary end point was symptomatic VCD of any severity caused by any dengue virus serotype. RESULTS: After successful introgression of wMel into the intervention clusters, 8144 participants were enrolled; 3721 lived in intervention clusters, and 4423 lived in control clusters. In the intention-to-treat analysis, VCD occurred in 67 of 2905 participants (2.3%) in the intervention clusters and in 318 of 3401 (9.4%) in the control clusters (aggregate odds ratio for VCD, 0.23; 95% confidence interval [CI], 0.15 to 0.35; P = 0.004). The protective efficacy of the intervention was 77.1% (95% CI, 65.3 to 84.9) and was similar against the four dengue virus serotypes. The incidence of hospitalization for VCD was lower among participants who lived in intervention clusters (13 of 2905 participants [0.4%]) than among those who lived in control clusters (102 of 3401 [3.0%]) (protective efficacy, 86.2%; 95% CI, 66.2 to 94.3). CONCLUSIONS: Introgression of wMel into A. aegypti populations was effective in reducing the incidence of symptomatic dengue and resulted in fewer hospitalizations for dengue among the participants. (Funded by the Tahija Foundation and others; AWED ClinicalTrials.gov number, NCT03055585; Indonesia Registry number, INA-A7OB6TW.).


Assuntos
Aedes/microbiologia , Controle de Doenças Transmissíveis/métodos , Dengue/transmissão , Mosquitos Vetores , Wolbachia , Adolescente , Adulto , Aedes/virologia , Animais , Criança , Pré-Escolar , Dengue/diagnóstico , Dengue/epidemiologia , Dengue/prevenção & controle , Vírus da Dengue/isolamento & purificação , Feminino , Humanos , Incidência , Indonésia/epidemiologia , Masculino , Pessoa de Meia-Idade , Mosquitos Vetores/microbiologia , Mosquitos Vetores/virologia , Adulto Jovem
13.
Nat Med ; 27(8): 1395-1400, 2021 08.
Artigo em Inglês | MEDLINE | ID: mdl-34168334

RESUMO

More than half of the world's population lives in areas at risk for dengue virus infection. A vaccine will be pivotal to controlling spread, however, the only licensed vaccine, Dengvaxia, has been shown to increase the risk of severe disease in a subset of individuals. Vaccine efforts are hampered by a poor understanding of antibody responses, including those generated by vaccines, and whether antibody titers can be used as a marker of protection from infection or disease. Here we present the results of an ancillary study to a phase III vaccine study (n = 611). All participants received three doses of either Dengvaxia or placebo and were followed for 6 years. We performed neutralization tests on annual samples and during confirmed dengue episodes (n = 16,508 total measurements). We use mathematical models to reconstruct long-term antibody responses to vaccination and natural infection, and to identify subclinical infections. There were 87 symptomatic infections reported, and we estimated that there were a further 351 subclinical infections. Cumulative vaccine efficacy was positive for both subclinical and symptomatic infection, although the protective effect of the vaccine was concentrated in the first 3 years following vaccination. Among individuals with the same antibody titer, we found no difference between the risk of subsequent infection or disease between placebo and vaccine recipients, suggesting that antibody titers are a good predictor of both protection and disease risk.


Assuntos
Infecções Assintomáticas , Vacinas contra Dengue/imunologia , Dengue/imunologia , Adolescente , Anticorpos Antivirais/imunologia , Criança , Pré-Escolar , Dengue/prevenção & controle , Humanos , Fatores de Risco
14.
Salud Publica Mex ; 63(3 May-Jun): 452-458, 2021 May 03.
Artigo em Espanhol | MEDLINE | ID: mdl-34098620

RESUMO

Objetivo. Describir y analizar el gasto de la Secretaría de Salud asociado con iniciativas de comunicación social de las campañas de prevención de enfermedades transmitidas por vectores (Zika, chikunguña y dengue) y la evaluación de impacto o resultados. Material y métodos. La in-formación se obtuvo de 690 contratos de prestación de servicios de comunicación social (2015-2017), asociados con dos declaraciones de emergencia epidemiológica (EE- 2-2015 y EE-1-2016). Resultados. Se concluye una débil evaluación de impacto del gasto público. No existe evidencia suficiente que demuestre la correspondencia del gasto en comunicación social con la efectividad y cumplimiento de las campañas. Conclusiones. Los hallazgos permiten definir recomendaciones para vigilar, transparentar y hacer más eficiente el gasto público. Existe información pública sobre el gasto; sin embargo, es necesario garantizar mecanismos de transparencia, trazabilidad de contratos y evaluación de impacto de las campañas.


Assuntos
Comunicação em Saúde , Promoção da Saúde , Febre de Chikungunya/epidemiologia , Febre de Chikungunya/prevenção & controle , Dengue/epidemiologia , Dengue/prevenção & controle , Comunicação em Saúde/economia , Promoção da Saúde/economia , Humanos , México/epidemiologia , Avaliação de Programas e Projetos de Saúde , Infecção por Zika virus/epidemiologia , Infecção por Zika virus/prevenção & controle
17.
Recurso na Internet em Português | LIS - Localizador de Informação em Saúde | ID: lis-48207

RESUMO

Desde a chegada da pandemia de Covid-19, sintomas como: dor de cabeça, febre e diarreia têm causado mais preocupação às pessoas. Entretanto, quem apresenta esses sintomas pode não estar contaminado pelo novo coronavírus; o quadro é característico, também, em casos de dengue e influenza (gripe comum). Por isso, é importante conhecer os sintomas de cada doença, e intensificar ainda mais os hábitos de prevenção.


Assuntos
Infecções por Coronavirus/prevenção & controle , Pneumonia Viral/prevenção & controle , Dengue/prevenção & controle , Influenza Humana/prevenção & controle , Sinais e Sintomas ,
19.
Vaccine ; 39(25): 3388-3396, 2021 06 08.
Artigo em Inglês | MEDLINE | ID: mdl-33992441

RESUMO

Dengue is endemic in several regions, and the global incidence is increasing. The recombinant, live, attenuated, tetravalent dengue vaccine (CYD-TDV) is recommended for dengue seropositive individuals ≥ 9 years. Human papillomavirus (HPV) vaccination is recommended for girls aged 9-14 years to prevent HPV infection-related cancers. This study assessed the immunogenicity and safety of a bivalent HPV (types 16 and 18) vaccine and CYD-TDV when co-administered concomitantly or sequentially. This was a Phase IIIb, randomized, open-label, multicenter study in girls aged 9-14 years in Mexico (NCT02979535). Participants were randomized 1:1 to receive three doses of CYD-TDV 6 months apart and two doses of bivalent HPV vaccine either concomitantly with, or 1 month before (sequentially), the first 2 CYD-TDV doses. Antibody levels were measured at baseline and 28-days after each vaccine dose for all participants, using an enzyme-linked immunosorbent assay for HPV-16 and HPV-18 antibodies, and a plaque reduction neutralization test for the four dengue serotypes; results are reported only for participants who were seropositive at baseline. Safety was assessed for all randomized participants throughout the study. Of the randomized participants, 305/478 (63.8%) were seropositive for dengue at baseline: 154 in the concomitant group and 151 in the sequential group. After the last HPV vaccine dose, the antibody titers for HPV were comparable in seropositive participants between treatment groups, with between group titer ratios of 0.966 for HPV-16 and 0.999 for HPV-18. After dose 3 of CYD-TDV, antibody titers were comparable for the concomitant and sequential groups across all serotypes, with between-group ratios close to 1 (serotype 1: 0.977; serotype 2: 0.911; serotype 3: 0.921; serotype 4: 0.931). CYD-TDV and a bivalent HPV vaccine administered concomitantly or sequentially in dengue seropositive girls aged 9-14 years elicited comparable immune responses with similar safety profiles.


Assuntos
Vacinas contra Dengue , Dengue , Vacinas contra Papillomavirus , Anticorpos Antivirais , Dengue/prevenção & controle , Vacinas contra Dengue/efeitos adversos , Feminino , Humanos , Imunogenicidade da Vacina , México , Vacinas contra Papillomavirus/efeitos adversos , Vacinas Combinadas
20.
Trials ; 22(1): 374, 2021 May 30.
Artigo em Inglês | MEDLINE | ID: mdl-34053466

RESUMO

BACKGROUND: In common with many South East Asian countries, Malaysia is endemic for dengue. Dengue control in Malaysia is currently based on reactive vector management within 24 h of a dengue case being reported. Preventive rather than reactive vector control approaches, with combined interventions, are expected to improve the cost-effectiveness of dengue control programs. The principal objective of this cluster randomized controlled trial is to quantify the effectiveness of a preventive integrated vector management (IVM) strategy on the incidence of dengue as compared to routine vector control efforts. METHODS: The trial is conducted in randomly allocated clusters of low- and medium-cost housing located in the Federal Territory of Kuala Lumpur and Putrajaya. The IVM approach combines: targeted outdoor residual spraying with K-Othrine Polyzone, deployment of mosquito traps as auto-dissemination devices, and community engagement activities. The trial includes 300 clusters randomly allocated in a 1:1 ratio. The clusters receive either the preventive IVM in addition to the routine vector control activities or the routine vector control activities only. Epidemiological data from monthly confirmed dengue cases during the study period will be obtained from the Vector Borne Disease Sector, Malaysian Ministry of Health e-Dengue surveillance system. Entomological surveillance data will be collected in 12 clusters randomly selected from each arm. To measure the effectiveness of the IVM approach on dengue incidence, a negative binomial regression model will be used to compare the incidence between control and intervention clusters. To quantify the effect of the interventions on the main entomological outcome, ovitrap index, a modified ordinary least squares regression model using a robust standard error estimator will be used. DISCUSSION: Considering the ongoing expansion of dengue burden in Malaysia, setting up proactive control strategies is critical. Despite some limitations of the trial such as the use of passive surveillance to identify cases, the results will be informative for a better understanding of effectiveness of proactive IVM approach in the control of dengue. Evidence from this trial may help justify investment in preventive IVM approaches as preferred to reactive case management strategies. TRIAL REGISTRATION: ISRCTN ISRCTN81915073 . Retrospectively registered on 17 April 2020.


Assuntos
Aedes , Dengue , Animais , Dengue/diagnóstico , Dengue/epidemiologia , Dengue/prevenção & controle , Humanos , Incidência , Malásia/epidemiologia , Controle de Mosquitos , Mosquitos Vetores , Ensaios Clínicos Controlados Aleatórios como Assunto
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA
...