RESUMO
OBJECTIVES: This study aimed to synthesize and compare the prioritization strategies outlined in the national vaccination plans (NVPs) against Coronavirus Disease 2019 (COVID-19) developed by countries in the Latin America and Caribbean (LAC) region. STUDY DESIGN: We conducted a comparative policy analysis based on COVID-19 NVPs. METHODS: We conducted a search strategy in three stages to identify NVPs for COVID-19 across 41 countries/territories in the LAC region. Sources included official governmental repositories, complementary Google searches, and less formal documentation. We extracted key variables and conducted a comparative policy analysis based on the prioritization criteria and specific prioritization groups. RESULTS: The study identified 52 NVPs for COVID-19, corresponding to 27 (65.8 %) out of 41 countries/territories in the LAC region. Official national websites yielded documents for 12 countries. All NVPs included frontline healthcare personnel in the first prioritization phase/stage, whilst some included residents of long-term healthcare facilities, adults aged 60 years or more, and people with disabilities. The decision criteria for prioritization were declared in 14 countries/territories. Ethical considerations declared in five NVPs included human welfare, equality, solidarity, equity, and social justice as values. CONCLUSION: The early stages of vaccination rollout in LAC countries prioritized protection of the healthcare system and epidemiological risk for severe disease. Few countries included ethical considerations in their NVPs, and global inequities in vaccine access and distribution led to varied protections for vulnerable populations across LAC. This analysis highlights the need for improved emergency-response capacity, planning, and enhanced multilateral cooperation in the LAC region for future public health emergencies.
Assuntos
Vacinas contra COVID-19 , COVID-19 , Adulto , Humanos , América Latina/epidemiologia , Vacinas contra COVID-19/uso terapêutico , COVID-19/epidemiologia , COVID-19/prevenção & controle , Região do Caribe/epidemiologia , Saúde PúblicaRESUMO
OBJECTIVES: Conducting contact tracing (CT) programs in low- and middle-income countries is challenging, and there is no evidence of their effectiveness in Latin America. We evaluated the effectiveness of CT on reducing fatality from COVID-19 in Colombia. STUDY DESIGN: The study design is a retrospective cohort study with nation-wide data of suspected and confirmed cases of severe acute respiratory syndrome (SARS-CoV-2) infection and their registered contacts. METHODS: We analyzed confirmed and suspected COVID-19 cases and their chains of contact using a nation-wide registry from March 28, 2020 to January 13, 2021. To estimate the effect of CT on fatality, we adjusted a multilevel negative binomial model using the number of deaths and the number of people within a chain of contacts as the outcome variable and offset variable, respectively. Sensitivity analysis was conducted using different cutoff values of contacts traced and a logistic model for the effect of CT on death at an individual level. RESULTS: We analyzed 1.4 million cases, 542,936 chains of contact, and 46,087 deaths. Only, 5.8% of total cases and contacts were included in a chain of a case and five or more contacts. We found that tracing of at least five contacts per case reduces fatality by 48% (95% confidence interval: 45-51), and, at the current levels of tracing in Colombia, it prevents 1.8% of deaths. Results obtained from the sensitivity analysis were consistent with the reduction of fatality at an individual level and higher protective effect with the higher number of contacts traced. CONCLUSIONS: In Colombia, tracing of at least five contacts per case reduces fatality from COVID-19. The coverage and intensity of tracing needs to be increased as a strategy to mitigate fatality in Colombia.
Assuntos
COVID-19 , Busca de Comunicante , Colômbia/epidemiologia , Humanos , Estudos Retrospectivos , SARS-CoV-2RESUMO
Listeria monocytogenes can survive and grow in a variety of environments, including refrigeration, making it difficult to control and highlighting the importance of optimizing control strategies against this pathogen. Listeria phages are attractive biocontrol agents because phages bind to specific wall teichoic acids (WTA) on the bacterial cell wall, inhibiting pathogens without disrupting the normal microbiota or structure of the food. Common stresses found on dairy products can affect cell wall composition and structure and subsequently affect the efficiency of control strategies that target the cell wall. The goal of this study was to determine the effect of a range of pH and temperatures on the effectiveness of a commercial phage cocktail treatment against several strains of L. monocytogenes in a cheese matrix. We developed a laboratory-scale cheese model that was made at different pH, treated with phage, and then inoculated with L. monocytogenes. Cheeses were incubated at 6, 14, or 22°C for 14 d, and bacterial counts were determined on d 1, 7, and 14. Our data show that phage treatment has a limited ability to reduce L. monocytogenes counts at each temperature tested; however, it was more effective on specific strains of L. monocytogenes when cheese was stored at higher temperatures. More specifically, the average counts of L. monocytogenes on phage-treated cheese stored at 22°C were significantly lower than those on phage-treated cheese stored at 6 or 14°C. Similarly, phage treatment was significantly more effective at inhibiting L. monocytogenes on cheese made at higher pH (6 and 6.5) compared with counts on cheese made at pH 5.5, where L. monocytogenes did not grow. Furthermore, serotype was found to affect the susceptibility of L. monocytogenes to phage treatment; serotype 1/2 strains showed significantly higher susceptibility to phage treatment than serotype 4b strains. Overall, our results suggest the importance of considering the efficacy of phage under conditions (i.e., temperature and pH) specific to a given food matrix when applying interventions against this important foodborne pathogen.
Assuntos
Bacteriófagos , Queijo/microbiologia , Microbiologia de Alimentos , Listeria monocytogenes/virologia , Animais , Carga Bacteriana , Humanos , Concentração de Íons de Hidrogênio , Análise dos Mínimos Quadrados , Listeria monocytogenes/classificação , Listeria monocytogenes/efeitos dos fármacos , Listeria monocytogenes/crescimento & desenvolvimento , Sorogrupo , Temperatura , Fatores de TempoRESUMO
Among the tumors affecting the choroid plexus in dogs, the papilloma ranks second place in incidence after cell carcinoma tumors. Presumptive diagnosis can be made through imaging methods, such as computed tomography and magnetic resonance images. Definitive diagnosis of plexus choroid tumor is based on histopathological findings. This report presented the tomographic features of the brain in a 6-year-old intact female Rottweiler with choroid plexus papilloma. The computed tomography showed right lateral ventricle enlargement, midline deviation and an enhanced mass into the postcontrast phase. At necropsy, a mass on the floor of the right lateral ventricle was observed, associated with important ventricle dilatation. The histopathological analysis demonstrated the presence of neoplastic cell forms with papillary projections. The computed tomography proved to be an effective tool in the presumptive diagnosis of this kind of cerebral disorder.
Dentre os tumores que afetam o plexo coroide em cães, o papiloma figura como o segundo tipo de maior incidência, antecedido apenas pelo carcinoma. O diagnóstico presuntivo pode ser elaborado por meio de métodos de imagem, como a tomografia computadorizada e a ressonância magnética. O diagnóstico definitivo de tumor do plexo coroide é estabelecido com base nos achados histopatológicos. Relatamos os aspectos tomográficos do crânio em uma fêmea de 6 anos, inteira, da raça Rottweiler, com papiloma do plexo coroide. A tomografia computadorizada revelou dilatação do ventrículo lateral direito, desvio da linha média e a presença de uma massa, que sofreu realce na fase pós-contraste. À necropsia, foi observada uma massa sobre o assoalho do ventrículo lateral direito, associada à importante dilatação ventricular. A análise histopatológica demonstrou a presença de células poligonais neoplásicas, arranjadas em papilas longas. A tomografia computadorizada apresentou-se como uma ferramenta eficaz no diagnóstico presuntivo desse tipo de alteração cerebral.
Assuntos
Animais , Cães , Neoplasias/patologia , Papiloma/patologia , Plexo Corióideo/anatomia & histologia , Tomografia , Cães/classificaçãoRESUMO
Among the tumors affecting the choroid plexus in dogs, the papilloma ranks second place in incidence after cell carcinoma tumors. Presumptive diagnosis can be made through imaging methods, such as computed tomography and magnetic resonance images. Definitive diagnosis of plexus choroid tumor is based on histopathological findings. This report presented the tomographic features of the brain in a 6-year-old intact female Rottweiler with choroid plexus papilloma. The computed tomography showed right lateral ventricle enlargement, midline deviation and an enhanced mass into the postcontrast phase. At necropsy, a mass on the floor of the right lateral ventricle was observed, associated with important ventricle dilatation. The histopathological analysis demonstrated the presence of neoplastic cell forms with papillary projections. The computed tomography proved to be an effective tool in the presumptive diagnosis of this kind of cerebral disorder.(AU)
Dentre os tumores que afetam o plexo coroide em cães, o papiloma figura como o segundo tipo de maior incidência, antecedido apenas pelo carcinoma. O diagnóstico presuntivo pode ser elaborado por meio de métodos de imagem, como a tomografia computadorizada e a ressonância magnética. O diagnóstico definitivo de tumor do plexo coroide é estabelecido com base nos achados histopatológicos. Relatamos os aspectos tomográficos do crânio em uma fêmea de 6 anos, inteira, da raça Rottweiler, com papiloma do plexo coroide. A tomografia computadorizada revelou dilatação do ventrículo lateral direito, desvio da linha média e a presença de uma massa, que sofreu realce na fase pós-contraste. À necropsia, foi observada uma massa sobre o assoalho do ventrículo lateral direito, associada à importante dilatação ventricular. A análise histopatológica demonstrou a presença de células poligonais neoplásicas, arranjadas em papilas longas. A tomografia computadorizada apresentou-se como uma ferramenta eficaz no diagnóstico presuntivo desse tipo de alteração cerebral.(AU)