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Article ; Online: Correction: Lack of efficacy of standard doses of ivermectin in severe COVID-19 patients.

Camprubí, Daniel / Almuedo-Riera, Alex / Martí-Soler, Helena / Soriano, Alex / Hurtado, Juan Carlos / Subirà, Carme / Grau-Pujol, Berta / Krolewiecki, Alejandro / Muñoz, Jose

PloS one

2022 Volume 17, Issue 5, Page(s) e0268667

Abstract: This corrects the article DOI: 10.1371/journal.pone.0242184.]. ...

Abstract	[This corrects the article DOI: 10.1371/journal.pone.0242184.].
Language	English
Publishing date	2022-05-12
Publishing country	United States
Document type	Published Erratum
ZDB-ID	2267670-3
ISSN	1932-6203 ; 1932-6203
ISSN (online)	1932-6203
ISSN	1932-6203
DOI	10.1371/journal.pone.0268667
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Article: Molecular Detection of Soil-Transmitted Helminths and Enteric Protozoa Infection in Children and Its Association with Household Water and Sanitation in Manhiça District, Southern Mozambique

Grau-Pujol, Berta / Cuamba, Inocencia / Jairoce, Chenjerai / Cossa, Anelsio / Da Silva, Juliana / Sacoor, Charfudin / Dobaño, Carlota / Nhabomba, Augusto / Mejia, Rojelio / Muñoz, Jose

Pathogens. 2021 July 03, v. 10, no. 7

2021

Abstract: Intestinal parasite infections can have detrimental health consequences in children. In Mozambique, soil-transmitted helminth (STH) infections are controlled through mass drug administration since 2011, but no specific control program exists for enteric ... ...

Abstract	Intestinal parasite infections can have detrimental health consequences in children. In Mozambique, soil-transmitted helminth (STH) infections are controlled through mass drug administration since 2011, but no specific control program exists for enteric protozoa. This study evaluates STH and protozoan infections in children attending healthcare in Manhiça district, Southern Mozambique, and its association with water and sanitation conditions. We conducted a cross-sectional study in children between 2 and 10 years old in two health centers (n = 405). A stool sample and metadata were collected from each child. Samples were analyzed by multi-parallel real-time quantitative PCR (qPCR). We fitted logistic regression-adjusted models to assess the association between STH or protozoan infection with household water and sanitation use. Nineteen percent were infected with at least one STH and 77.5% with at least one enteric protozoon. qPCR detected 18.8% of participants with intestinal polyparasitism. Protected or unprotected water well use showed a higher risk for at least one protozoan infection in children (OR: 2.59, CI: 1.01–6.65, p-value = 0.010; OR: 5.21, CI: 1.56–17.46, p-value = 0.010, respectively) compared to household piped water. A high proportion of children had enteric protozoan infections. Well consumable water displayed high risk for that.
Keywords	Protozoa ; children ; cross-sectional studies ; drugs ; feces ; health services ; helminths ; intestines ; metadata ; protozoal infections ; quantitative polymerase chain reaction ; risk ; sanitation ; Mozambique
Language	English
Dates of publication	2021-0703
Publishing place	Multidisciplinary Digital Publishing Institute
Document type	Article
ZDB-ID	2695572-6
ISSN	2076-0817
ISSN	2076-0817
DOI	10.3390/pathogens10070838
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Article ; Online: Neighbors' use of water and sanitation facilities can affect children's health: a cohort study in Mozambique using a spatial approach.

Grau-Pujol, Berta / Cano, Jorge / Marti-Soler, Helena / Casellas, Aina / Giorgi, Emanuele / Nhacolo, Ariel / Saute, Francisco / Giné, Ricard / Quintó, Llorenç / Sacoor, Charfudin / Muñoz, Jose

BMC public health

2022 Volume 22, Issue 1, Page(s) 983

Abstract: Background: Impact evaluation of most water, sanitation and hygiene (WASH) interventions in health are user-centered. However, recent research discussed WASH herd protection - community WASH coverage could protect neighboring households. We evaluated ... ...

Abstract	Background: Impact evaluation of most water, sanitation and hygiene (WASH) interventions in health are user-centered. However, recent research discussed WASH herd protection - community WASH coverage could protect neighboring households. We evaluated the effect of water and sanitation used in the household and by household neighbors in children's morbidity and mortality using recorded health data. Methods: We conducted a retrospective cohort including 61,333 children from a district in Mozambique during 2012-2015. We obtained water and sanitation household data and morbidity data from Manhiça Health Research Centre surveillance system. To evaluate herd protection, we estimated the density of household neighbors with improved facilities using a Kernel Density Estimator. We fitted negative binomial adjusted regression models to assess the minimum children-based incidence rates for every morbidity indicator, and Cox regression models for mortality. Results: Household use of unimproved water and sanitation displayed a higher rate of outpatient visit, diarrhea, malaria, and anemia. Households with unimproved water and sanitation surrounded by neighbors with improved water and sanitation high coverage were associated with a lower rate of outpatient visit, malaria, anemia, and malnutrition. Conclusion: Household and neighbors' access to improve water and sanitation can affect children's health. Accounting for household WASH and herd protection in interventions' evaluation could foster stakeholders' investment and improve WASH related diseases control. Distribution of main water and sanitation facilities used during study period.
MeSH term(s)	Child ; Child Health ; Cohort Studies ; Humans ; Mozambique/epidemiology ; Retrospective Studies ; Sanitation ; Water ; Water Supply
Chemical Substances	Water (059QF0KO0R)
Language	English
Publishing date	2022-05-16
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2041338-5
ISSN	1471-2458 ; 1471-2458
ISSN (online)	1471-2458
ISSN	1471-2458
DOI	10.1186/s12889-022-13373-9
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Article ; Online: Pre-exposure prophylaxis with hydroxychloroquine for high-risk healthcare workers during the COVID-19 pandemic: A structured summary of a study protocol for a multicentre, double-blind randomized controlled trial.

Grau-Pujol, Berta / Camprubí, Daniel / Marti-Soler, Helena / Fernández-Pardos, Marc / Guinovart, Caterina / Muñoz, Jose

Trials

2020 Volume 21, Issue 1, Page(s) 688

Abstract: Objectives: The aim of this study is to assess the efficacy of the use of pre-exposure prophylaxis (PrEP) with hydroxychloroquine against placebo in healthcare workers with high risk of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) ... ...

Abstract	Objectives: The aim of this study is to assess the efficacy of the use of pre-exposure prophylaxis (PrEP) with hydroxychloroquine against placebo in healthcare workers with high risk of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in reducing their risk of coronavirus disease 2019 (COVID-19) disease during an epidemic period. As secondary objectives, we would like to: i) assess the efficacy of the use of PrEP with hydroxychloroquine against placebo in healthcare workers with high risk of SARS-CoV-2 infection in reducing their risk of exposure to SARS-CoV-2 (defined by seroconversion) during an epidemic period, ii) evaluate the safety of PrEP with hydroxychloroquine in adults, iii) describe the incidence of SARS-CoV-2 infection among healthcare workers at high risk of SARS-CoV-2 infection, iv) identify clinical, analytical and microbiological predictors of COVID-19 among healthcare workers at high risk of SARS-CoV-2 infection, v) set up a repository of serum samples obtained from healthcare workers at high risk of SARS-CoV-2 infection for future research on blood markers to predict SARS-CoV-2 infection. Trial design: Multicentre double-blind parallel design (ratio 1:1) randomized controlled clinical trial. Participants: Approximately 440 healthcare workers of four Spanish hospitals (Hospital Clínic of Barcelona, Hospital de la Santa Creu i Sant Pau of Barcelona, Hospital Plató of Barcelona, Hospital General de Granollers, Barcelona) will be recruited. Participants are considered to be at high-risk of SARS-CoV-2 infection due to their frequent contact with suspected and confirmed cases of COVID-19. For eligibility, healthcare workers with 18 years old or older working at least 3 days a week in a hospital with both negative SARS-CoV-2 polymerase chain reaction (PCR) assays and serological COVID-19 rapid diagnostic tests (RDT) are invited to participate. Participants with any of the following conditions are excluded: pregnancy, breastfeeding, ongoing antiviral, antiretroviral or corticosteroids treatment, chloroquine or hydroxychloroquine uptake the last month or any contraindication to hydroxychloroquine treatment. Intervention and comparator: Eligible participants will be allocated to one of the two study groups: Intervention group (PrEP): participants will receive the standard of care and will take 400mg of hydroxychloroquine (2 tablets of 200 mg per Dolquine® tablet) daily the first four consecutive days, followed by 400 mg weekly for a period of 6 months. Control group: participants will receive placebo tablets with identical physical appearance to hydroxychloroquine 200 mg (Dolquine®) tablets following the same treatment schedule of the intervention group. Both groups will be encouraged to use the personal protection equipment (PPE) for COVID-19 prevention according to current hospital guidelines. Main outcomes: The primary endpoint will be the number of confirmed cases of a COVID-19 (defined by a positive PCR for SARS-CoV-2 or symptoms compatible with COVID-19 with seroconversion) in the PrEP group compared to the placebo group at any time during the 6 months of the follow-up in healthcare workers with negative SARS-CoV-2 PCR and serology at day 0. As secondary endpoints, we will obtain: i) the SARS-CoV-2 seroconversion in the PrEP group compared to placebo during the 6 months of follow-up in healthcare workers with negative serology at day 0; ii) the occurrence of any adverse event related with hydroxychloroquine treatment; iii) the incidence of SARS-CoV-2 infection and COVID-19 among healthcare workers in the non-PrEP group, among the total of healthcare workers included in the non-PrEP group during the study period; iv) the risk ratio for the different clinical, analytical and microbiological conditions to develop COVID-19; v) a repository of serum samples obtained from healthcare workers confirmed COVID-19 cases for future research on blood markers to predict SARS-CoV-2 infection. Randomisation: Participants meeting all eligibility requirements will be allocated to one of the two study arms (PrEP with hydroxychloroquine or non-PrEP control group) in a 1:1 ratio using simple randomisation with computer generated random numbers. Blinding (masking): Participants, doctors and nurses caring for participants, and investigators assessing the outcomes will be blinded to group assignment. Numbers to be randomised (sample size): Each intervention group will have 220 participants, giving a total of 440 participants. Trial status: The current protocol version is 1.5, 2 Trial registration: This trial was registered on April 2 Full protocol: The full protocol is attached as an additional file, accessible from the Trials website (Additional file 1). In the interest in expediting dissemination of this material, the familiar formatting has been eliminated; this Letter serves as a summary of the key elements of the full protocol.
MeSH term(s)	Humans ; COVID-19/epidemiology ; COVID-19/prevention & control ; Double-Blind Method ; Health Personnel ; Hydroxychloroquine/adverse effects ; Hydroxychloroquine/therapeutic use ; Pandemics/prevention & control ; Pre-Exposure Prophylaxis ; Randomized Controlled Trials as Topic ; SARS-CoV-2 ; Occupational Exposure/adverse effects ; Infectious Disease Transmission, Patient-to-Professional/prevention & control ; Multicenter Studies as Topic
Chemical Substances	Hydroxychloroquine (4QWG6N8QKH)
Keywords	covid19
Language	English
Publishing date	2020-07-29
Publishing country	England
Document type	Clinical Trial Protocol ; Letter
ZDB-ID	2040523-6
ISSN	1745-6215 ; 1468-6694 ; 1745-6215
ISSN (online)	1745-6215
ISSN	1468-6694 ; 1745-6215
DOI	10.1186/s13063-020-04621-7
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Article ; Online: Correction

Daniel Camprubí / Alex Almuedo-Riera / Helena Martí-Soler / Alex Soriano / Juan Carlos Hurtado / Carme Subirà / Berta Grau-Pujol / Alejandro Krolewiecki / Jose Muñoz

PLoS ONE, Vol 17, Iss

Lack of efficacy of standard doses of ivermectin in severe COVID-19 patients

2022 Volume 5

Keywords	Medicine ; R ; Science ; Q
Language	English
Publishing date	2022-01-01T00:00:00Z
Publisher	Public Library of Science (PLoS)
Document type	Article ; Online
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Article ; Online: Task Force for a rapid response to an outbreak of severe acute hepatitis of unknown aetiology in children in Portugal in 2022.

Grau-Pujol, Berta / Vieira Martins, João / Goncalves, Isabel / Rodrigues, Fernanda / de Sousa, Rita / Oliveira, Dina / Bettencourt, Joana / Mendes, Diana / Mateus de Cunha, Inês / Pocinho, Sara / Firme, Ana / Dos Santos, Benvinda Estela / Peralta Santos, André / Albuquerque, Maria João / Pinto-Leite, Pedro / Tato Marinho, Rui / Vasconcelos, Paula

Euro surveillance : bulletin Europeen sur les maladies transmissibles = European communicable disease bulletin

2023 Volume 28, Issue 38

Abstract: On 5 April 2022, the United Kingdom reported an increase of cases of severe acute hepatitis of unknown aetiology in children, several needing hospitalisation and some required liver transplant or died. Thereafter, 35 countries reported probable cases, ... ...

Abstract	On 5 April 2022, the United Kingdom reported an increase of cases of severe acute hepatitis of unknown aetiology in children, several needing hospitalisation and some required liver transplant or died. Thereafter, 35 countries reported probable cases, almost half of them in Europe. Facing the alert, on 28 April, Portugal created a multidisciplinary Task Force (TF) for rapid detection of probable cases and response. The experts of the TF came from various disciplines: clinicians, laboratory experts, epidemiologists, public health experts and national and international communication. Moreover, Portugal adopted the European Centre for Disease Prevention and Control (ECDC) and the World Health Organization (WHO) case definition and recommendations. By 31 December 2022, 28 probable cases of severe acute hepatitis of unknown aetiology were reported: 16 male and 17 aged under 2 years. Of these cases, 23 were hospitalised but none required liver transplant or died. Adenovirus was detected from nine of 26 tested cases. No association was observed between adenovirus infection and hospital admission after adjusting for age, sex and region in a binomial regression model. The TF in Portugal may have contributed to increase awareness among clinicians, enabling early detection and prompt management of the outbreak.
MeSH term(s)	Child ; Humans ; Male ; Aged ; Portugal/epidemiology ; Disease Outbreaks ; Hepatitis ; Europe ; Liver Transplantation ; Acute Disease
Language	English
Publishing date	2023-09-21
Publishing country	Sweden
Document type	Journal Article
ZDB-ID	1338803-4
ISSN	1560-7917 ; 1025-496X
ISSN (online)	1560-7917
ISSN	1025-496X
DOI	10.2807/1560-7917.ES.2023.28.38.2300171
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Article: Molecular Detection of Soil-Transmitted Helminths and Enteric Protozoa Infection in Children and Its Association with Household Water and Sanitation in Manhiça District, Southern Mozambique.

Grau-Pujol, Berta / Cuamba, Inocencia / Jairoce, Chenjerai / Cossa, Anelsio / Da Silva, Juliana / Sacoor, Charfudin / Dobaño, Carlota / Nhabomba, Augusto / Mejia, Rojelio / Muñoz, Jose

Pathogens (Basel, Switzerland)

2021 Volume 10, Issue 7

Abstract	Intestinal parasite infections can have detrimental health consequences in children. In Mozambique, soil-transmitted helminth (STH) infections are controlled through mass drug administration since 2011, but no specific control program exists for enteric protozoa. This study evaluates STH and protozoan infections in children attending healthcare in Manhiça district, Southern Mozambique, and its association with water and sanitation conditions. We conducted a cross-sectional study in children between 2 and 10 years old in two health centers (n = 405). A stool sample and metadata were collected from each child. Samples were analyzed by multi-parallel real-time quantitative PCR (qPCR). We fitted logistic regression-adjusted models to assess the association between STH or protozoan infection with household water and sanitation use. Nineteen percent were infected with at least one STH and 77.5% with at least one enteric protozoon. qPCR detected 18.8% of participants with intestinal polyparasitism. Protected or unprotected water well use showed a higher risk for at least one protozoan infection in children (OR: 2.59, CI: 1.01-6.65,
Language	English
Publishing date	2021-07-03
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2695572-6
ISSN	2076-0817
ISSN	2076-0817
DOI	10.3390/pathogens10070838
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Article ; Online: Single-Nucleotide Polymorphisms in the Beta-Tubulin Gene and Its Relationship with Treatment Response to Albendazole in Human Soil-Transmitted Helminths in Southern Mozambique.

Grau-Pujol, Berta / Gandasegui, Javier / Escola, Valdemiro / Marti-Soler, Helena / Cambra-Pellejà, Maria / Demontis, Maria / Brienen, Eric A T / Jamine, Jose Carlos / Muchisse, Osvaldo / Cossa, Anelsio / Sacoor, Charfudin / Cano, Jorge / Van Lieshout, Lisette / Martinez-Valladares, Maria / Muñoz, Jose

The American journal of tropical medicine and hygiene

2022

Abstract: Soil-transmitted helminth (STH) cornerstone control strategy is mass drug administration (MDA) with benzimidazoles. However, MDA might contribute to selection pressure for anthelmintic resistance, as occurred in livestock. The aim of this study is to ... ...

Abstract	Soil-transmitted helminth (STH) cornerstone control strategy is mass drug administration (MDA) with benzimidazoles. However, MDA might contribute to selection pressure for anthelmintic resistance, as occurred in livestock. The aim of this study is to evaluate the treatment response to albendazole and the relationship with the presence of putative benzimidazole resistance single-nucleotide polymorphisms (SNPs) in the β-tubulin gene of STH in Southern Mozambique. After screening 819 participants, we conducted a cohort study with 184 participants infected with STH in Manhiça district, Southern Mozambique. A pretreatment and a posttreatment stool samples were collected and the STH infection was identified by duplicate Kato-Katz and quantitative polymerase chain reaction (qPCR). Cure rate and egg reduction rates were calculated. Putative benzimidazole resistance SNPs (F167Y, F200T, and E198A) in Trichuris trichiura and Necator americanus were assessed by pyrosequencing. Cure rates by duplicate Kato-Katz and by qPCR were 95.8% and 93.6% for Ascaris lumbricoides, 28% and 7.8% for T. trichiura, and 88.9% and 56.7% for N. americanus. Egg reduction rate by duplicate Kato-Katz was 85.4% for A. lumbricoides, 34.9% for T. trichiura, and 40.5% for N. americanus. Putative benzimidazole resistance SNPs in the β-tubulin gene were detected in T. trichiura (23%) and N. americanus (21%) infected participants at pretreatment. No statistical difference was observed between pretreatment and posttreatment frequencies for none of the SNPs. Although treatment response to albendazole was low, particularly in T. trichiura, the putative benzimidazole resistance SNPs were not higher after treatment in the population studied. New insights are needed for a better understanding and monitoring of human anthelmintic resistance.
Language	English
Publishing date	2022-07-18
Publishing country	United States
Document type	Journal Article
ZDB-ID	2942-7
ISSN	1476-1645 ; 0002-9637
ISSN (online)	1476-1645
ISSN	0002-9637
DOI	10.4269/ajtmh.21-0948
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Article ; Online: Chemical and in vitro bioanalytical assessment of drinking water quality in Manhiça, Mozambique.

Villanueva, Cristina M / Grau-Pujol, Berta / Evlampidou, Iro / Escola, Valdemiro / Goñi-Irigoyen, Fernando / Kuckelkorn, Jochen / Grummt, Tamara / Arjona, Lourdes / Lazaro, Beatriz / Etxeandia, Arsenio / Ulibarrena, Enrique / Nhacolo, Ariel / Muñoz, Jose

Journal of exposure science & environmental epidemiology

2021 Volume 31, Issue 2, Page(s) 276–288

Abstract: Background: The chemical quality of drinking water is widely unknown in low-income countries.: Objective: We conducted an exploratory study in Manhiça district (Mozambique) to evaluate drinking water quality using chemical analyses and cell-based ... ...

Abstract	Background: The chemical quality of drinking water is widely unknown in low-income countries. Objective: We conducted an exploratory study in Manhiça district (Mozambique) to evaluate drinking water quality using chemical analyses and cell-based assays. Methods: We measured nitrate, fluoride, metals, pesticides, disinfection by-products, and industrial organochlorinated chemicals, and conducted the bioassays Ames test for mutagenicity, micronuclei assay (MN-FACS), ER-CALUX, and antiAR-CALUX in 20 water samples from protected and unprotected sources. Results: Nitrate was present in all samples (median 7.5 mg/L). Manganese, cobalt, chromium, aluminium, and barium were present in 90-100% of the samples, with median values of 32, 0.6, 2.0, 61, 250 μg/l, respectively. Manganese was above 50 μg/l (EU guideline) in eight samples. Arsenic, lead, nickel, iron, and selenium median values were below the quantification limit. Antimony, cadmium, copper, mercury, zinc and silver were not present. Trihalomethanes, haloacetic acids, haloacetonitriles and haloketones were present in 5-28% samples at levels ≤4.6 μg/l. DDT, dieldrin, diuron, and pirimiphos-methyl were quantified in 2, 3, 3, and 1 sample, respectively (range 12-60 ng/L). Fluoride was present in one sample (0.11 mg/l). Trichloroethene and tetrachloroethene were not present. Samples were negative in the in vitro assays. Significance: Results suggest low exposure to chemicals, mutagenicity, genotoxicity and endocrine disruption through drinking water in Manhiça population. High concentration of manganese in some samples warrants confirmatory studies, given the potential link to impaired neurodevelopment.
MeSH term(s)	Arsenic/analysis ; Drinking Water ; Environmental Monitoring ; Mozambique ; Water Pollutants, Chemical/analysis ; Water Quality
Chemical Substances	Drinking Water ; Water Pollutants, Chemical ; Arsenic (N712M78A8G)
Language	English
Publishing date	2021-01-07
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2218551-3
ISSN	1559-064X ; 1559-0631
ISSN (online)	1559-064X
ISSN	1559-0631
DOI	10.1038/s41370-020-00282-5
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Article ; Online: Neighbors’ use of water and sanitation facilities can affect children’s health

Berta Grau-Pujol / Jorge Cano / Helena Marti-Soler / Aina Casellas / Emanuele Giorgi / Ariel Nhacolo / Francisco Saute / Ricard Giné / Llorenç Quintó / Charfudin Sacoor / Jose Muñoz

BMC Public Health, Vol 22, Iss 1, Pp 1-

a cohort study in Mozambique using a spatial approach

2022 Volume 11

Abstract: Abstract Background Impact evaluation of most water, sanitation and hygiene (WASH) interventions in health are user-centered. However, recent research discussed WASH herd protection – community WASH coverage could protect neighboring households. We ... ...

Abstract	Abstract Background Impact evaluation of most water, sanitation and hygiene (WASH) interventions in health are user-centered. However, recent research discussed WASH herd protection – community WASH coverage could protect neighboring households. We evaluated the effect of water and sanitation used in the household and by household neighbors in children’s morbidity and mortality using recorded health data. Methods We conducted a retrospective cohort including 61,333 children from a district in Mozambique during 2012–2015. We obtained water and sanitation household data and morbidity data from Manhiça Health Research Centre surveillance system. To evaluate herd protection, we estimated the density of household neighbors with improved facilities using a Kernel Density Estimator. We fitted negative binomial adjusted regression models to assess the minimum children-based incidence rates for every morbidity indicator, and Cox regression models for mortality. Results Household use of unimproved water and sanitation displayed a higher rate of outpatient visit, diarrhea, malaria, and anemia. Households with unimproved water and sanitation surrounded by neighbors with improved water and sanitation high coverage were associated with a lower rate of outpatient visit, malaria, anemia, and malnutrition. Conclusion Household and neighbors’ access to improve water and sanitation can affect children’s health. Accounting for household WASH and herd protection in interventions’ evaluation could foster stakeholders’ investment and improve WASH related diseases control. Graphical Abstract Distribution of main water and sanitation facilities used during study period.
Keywords	Water ; Sanitation ; Wash ; Herd protection ; Community coverage ; Morbidity ; Public aspects of medicine ; RA1-1270
Subject code	360
Language	English
Publishing date	2022-05-01T00:00:00Z
Publisher	BMC
Document type	Article ; Online
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