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Article ; Online: Combining Digital and Molecular Approaches Using Health and Alternate Data Sources in a Next-Generation Surveillance System for Anticipating Outbreaks of Pandemic Potential

Pablo Ivan P Ramos / Izabel Marcilio / Ana I Bento / Gerson O Penna / Juliane F de Oliveira / Ricardo Khouri / Roberto F S Andrade / Roberto P Carreiro / Vinicius de A Oliveira / Luiz Augusto C Galvão / Luiz Landau / Mauricio L Barreto / Kay van der Horst / Manoel Barral-Netto

JMIR Public Health and Surveillance, Vol 10, p e

2024 Volume 47673

Abstract: Globally, millions of lives are impacted every year by infectious diseases outbreaks. Comprehensive and innovative surveillance strategies aiming at early alert and timely containment of emerging and reemerging pathogens are a pressing priority. ... ...

Abstract	Globally, millions of lives are impacted every year by infectious diseases outbreaks. Comprehensive and innovative surveillance strategies aiming at early alert and timely containment of emerging and reemerging pathogens are a pressing priority. Shortcomings and delays in current pathogen surveillance practices further disturbed informing responses, interventions, and mitigation of recent pandemics, including H1N1 influenza and SARS-CoV-2. We present the design principles of the architecture for an early-alert surveillance system that leverages the vast available data landscape, including syndromic data from primary health care, drug sales, and rumors from the lay media and social media to identify areas with an increased number of cases of respiratory disease. In these potentially affected areas, an intensive and fast sample collection and advanced high-throughput genome sequencing analyses would inform on circulating known or novel pathogens by metagenomics-enabled pathogen characterization. Concurrently, the integration of bioclimatic and socioeconomic data, as well as transportation and mobility network data, into a data analytics platform, coupled with advanced mathematical modeling using artificial intelligence or machine learning, will enable more accurate estimation of outbreak spread risk. Such an approach aims to readily identify and characterize regions in the early stages of an outbreak development, as well as model risk and patterns of spread, informing targeted mitigation and control measures. A fully operational system must integrate diverse and robust data streams to translate data into actionable intelligence and actions, ultimately paving the way toward constructing next-generation surveillance systems.
Keywords	Public aspects of medicine ; RA1-1270
Language	English
Publishing date	2024-01-01T00:00:00Z
Publisher	JMIR Publications
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Urbanization and cardiovascular health among Indigenous groups in Brazil

Anderson da Costa Armstrong / Carlos Dornels Freire de Souza / Juracy Marques dos Santos / Rodrigo Feliciano do Carmo / Dinani Matoso Fialho de Oliveira Armstrong / Vanessa Cardoso Pereira / Ana Marice Ladeia / Luis Claudio Lemos Correia / Manoel Barral-Netto / Joao Augusto Costa Lima

Communications Medicine, Vol 3, Iss 1, Pp 1-

2023 Volume 7

Abstract: Armstrong et al. describe how rates of obesity and hypertension differ across three sub-populations of Brazil, including two under-studied Indigenous groups. The more urbanized cultures experience more obesity and hypertension, suggesting urbanization ... ...

Abstract	Armstrong et al. describe how rates of obesity and hypertension differ across three sub-populations of Brazil, including two under-studied Indigenous groups. The more urbanized cultures experience more obesity and hypertension, suggesting urbanization impacts cardiovascular health.
Keywords	Medicine ; R
Language	English
Publishing date	2023-02-01T00:00:00Z
Publisher	Nature Portfolio
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Vaccine coverage and effectiveness against laboratory-confirmed symptomatic and severe Covid-19 in indigenous people in Brazil

Julia M. Pescarini / Andrey M. Cardoso / Ricardo Ventura Santos / Priscila F. Scaff / Enny S. Paixao / Otavio T. Ranzani / Thiago Cerqueira-Silva / Viviane S. Boaventura / Juracy Bertoldo-Junior / Vinicius A. de Oliveira / Guilherme L. Werneck / Mauricio L. Barreto / Manoel Barral-Netto

BMC Public Health, Vol 23, Iss 1, Pp 1-

a cohort study

2023 Volume 11

Abstract: Abstract Background Indigenous people have historically suffered devastating impacts from epidemics and continue to have lower access to healthcare and be especially vulnerable to respiratory infections. We estimated the coverage and effectiveness of ... ...

Abstract	Abstract Background Indigenous people have historically suffered devastating impacts from epidemics and continue to have lower access to healthcare and be especially vulnerable to respiratory infections. We estimated the coverage and effectiveness of Covid-19 vaccines against laboratory-confirmed Covid-19 cases among indigenous people in Brazil. Methods We linked nationwide Covid-19 vaccination data with flu-like surveillance records and studied a cohort of vaccinated indigenous people aged ≥ 5 years between 18th January 2021 and 1st March 2022. We considered individuals unexposed from the date they received the first dose of vaccine until the 13th day of vaccination, partially vaccinated from the 14th day after the first dose until the 13th day after receiving the second dose, and fully vaccinated onwards. We estimated the Covid-19 vaccination coverage and used Poisson regression to calculate the relative risks (RR) and vaccine effectiveness (VE) of CoronaVac, ChAdOx1, and BNT162b2 against Covid-19 laboratory-confirmed cases incidence, mortality, hospitalisation, and hospital-progression to Intensive Care Unit (ICU) or death. VE was estimated as (1-RR)*100, comparing unexposed to partially or fully vaccinated. Results By 1st March 2022, 48.7% (35.0-62.3) of eligible indigenous people vs. 74.8% (57.9–91.8) overall Brazilians had been fully vaccinated for Covid-19. Among fully vaccinated indigenous people, we found a lower risk of symptomatic cases (RR: 0.47, 95%CI: 0.40–0.56) and mortality (RR: 0.47, 95%CI: 0.14–1.56) after the 14th day of the second dose. VE for the three Covid-19 vaccines combined was 53% (95%CI:44–60%) for symptomatic cases, 53% (95%CI:-56-86%) for mortality and 41% (95%CI:-35-75%) for hospitalisation. In our sample, we found that vaccination did not reduce Covid-19 related hospitalisation. However, among hospitalised patients, we found a lower risk of progression to ICU (RR: 0.14, 95%CI: 0.02–0.81; VE: 87%, 95%CI:27–98%) and Covid-19 death (RR: 0.04, 95%CI:0.01–0.10; VE: 96%, 95%CI: 90–99%) ...
Keywords	COVID-19 ; Vaccine effectiveness ; Vaccine coverage ; Cohort study ; Indigenous peoples ; Brazil ; Public aspects of medicine ; RA1-1270
Subject code	390
Language	English
Publishing date	2023-06-01T00:00:00Z
Publisher	BMC
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Metabolic disorders and post-acute hospitalization in black/mixed-race patients with long COVID in Brazil

Ana Paula Andrade Barreto / Marcio Andrade Barreto Filho / Lucimeire Cardoso Duarte / Thiago Cerqueira-Silva / Aquiles Camelier / Natalia Machado Tavares / Manoel Barral-Netto / Viviane Boaventura / Marcelo Chalhoub Coelho Lima

PLoS ONE, Vol 17, Iss

A cross-sectional analysis

2022 Volume 10

Abstract: Background Although low-middle income countries have been disproportionately affected by the COVID-19 pandemic, there is scarce information about the impact of long COVID on their population. This study aimed to evaluate long COVID symptomatology, ... ...

Abstract	Background Although low-middle income countries have been disproportionately affected by the COVID-19 pandemic, there is scarce information about the impact of long COVID on their population. This study aimed to evaluate long COVID symptomatology, complications (hospital readmission and metabolic disorders), and main clinical features that impact Quality of Life (QoL). Methods This cross-sectional study provides a detailed clinical and laboratory picture of individuals who presented residual symptoms after mild to severe acute COVID-19. Between Aug-2020 to Sep-2021, long COVID patients were evaluated in a reference center for long COVID in Bahia State, Brazil. The EQ-5D-5L questionnaire accessed QoL. Results A total of 1164 (52 ±13.4 years, 57% female, 88% black/mixed-race) were evaluated 2.3 [IQR = 1.6–3.7] months after mild (n = 351, 30.2%), moderate (338, 29.0%) or severe (475, 40.8%) acute illness. Dyspnea (790, 67.9%), fatigue (738, 63.5%), and chest pain (525, 42.9%) were the most frequent residual symptoms regardless of acute severity, affecting the QoL of 88.9% of patients (n/N—826/925), mainly the domains of anxiety/depression and pain/discomfort. High levels of HbA1c were detected for 175 out of 664 patients (26.6%), 40% of them without a previous diagnosis of diabetes mellitus. Of note, hospital admission one-to-three months after the acute phase of disease was required for 51 (4.4%) patients. Conclusion In this majority-black/mixed-race population, long COVID was associated with post-acute hospitalization, newly diagnosed diabetes mellitus, and decreased QoL, particularly in women and regardless of disease severity of acute infection, suggesting important implications for health care system.
Keywords	Medicine ; R ; Science ; Q
Subject code	360
Language	English
Publishing date	2022-01-01T00:00:00Z
Publisher	Public Library of Science (PLoS)
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Immunoregulation in human malaria

Vitor R de Mendonça / Manoel Barral-Netto

Memórias do Instituto Oswaldo Cruz., Vol 110, Iss 8, Pp 945-

the challenge of understanding asymptomatic infection

2015 Volume 955

Abstract: Asymptomatic Plasmodium infection carriers represent a major threat to malaria control worldwide as they are silent natural reservoirs and do not seek medical care. There are no standard criteria for asymptomaticPlasmodium infection; therefore, its ... ...

Abstract	Asymptomatic Plasmodium infection carriers represent a major threat to malaria control worldwide as they are silent natural reservoirs and do not seek medical care. There are no standard criteria for asymptomaticPlasmodium infection; therefore, its diagnosis relies on the presence of the parasite during a specific period of symptomless infection. The antiparasitic immune response can result in reducedPlasmodium sp. load with control of disease manifestations, which leads to asymptomatic infection. Both the innate and adaptive immune responses seem to play major roles in asymptomatic Plasmodiuminfection; T regulatory cell activity (through the production of interleukin-10 and transforming growth factor-β) and B-cells (with a broad antibody response) both play prominent roles. Furthermore, molecules involved in the haem detoxification pathway (such as haptoglobin and haeme oxygenase-1) and iron metabolism (ferritin and activated c-Jun N-terminal kinase) have emerged in recent years as potential biomarkers and thus are helping to unravel the immune response underlying asymptomatic Plasmodium infection. The acquisition of large data sets and the use of robust statistical tools, including network analysis, associated with well-designed malaria studies will likely help elucidate the immune mechanisms responsible for asymptomatic infection.
Keywords	asymptomatic infection ; immune response ; biomarkers ; networks ; Arctic medicine. Tropical medicine ; RC955-962 ; Microbiology ; QR1-502
Subject code	570
Language	English
Publishing date	2015-12-01T00:00:00Z
Publisher	Instituto Oswaldo Cruz, Ministério da Saúde
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Reorganização da atenção primária à saúde para vigilância universal e contenção da COVID-19

Maria Glória Teixeira / Maria Guadalupe Medina / Maria da Conceição N. Costa / Manoel Barral-Netto / Roberto Carreiro / Rosana Aquino

Epidemiologia e Serviços de Saúde, Vol 29, Iss

2020 Volume 4

Keywords	Medicine ; R ; Public aspects of medicine ; RA1-1270
Language	English
Publishing date	2020-08-01T00:00:00Z
Publisher	Ministério da Saúde do Brasil
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Influence of age on the effectiveness and duration of protection of Vaxzevria and CoronaVac vaccines

Thiago Cerqueira-Silva / Vinicius de Araújo Oliveira / Viviane S. Boaventura / Julia M. Pescarini / Juracy Bertoldo Júnior / Tales Mota Machado / Renzo Flores-Ortiz / Gerson O. Penna / Maria Yury Ichihara / Jacson Venâncio de Barros / Mauricio L. Barreto / Guilherme Loureiro Werneck / Manoel Barral-Netto

The Lancet Regional Health. Americas, Vol 6, Iss , Pp 100154- (2022)

A population-based study

2022

Abstract: Summary: Background: Aging influences COVID-19 severity and response to vaccination, but previous vaccine effectiveness (VE) analyzes lack the power to evaluate its role in subgroups within the elderly age group. Here we analyzed the impact of age on ... ...

Abstract	Summary: Background: Aging influences COVID-19 severity and response to vaccination, but previous vaccine effectiveness (VE) analyzes lack the power to evaluate its role in subgroups within the elderly age group. Here we analyzed the impact of age on viral vector and inactivated virus vaccines' effectiveness, the main platforms used in low- and middle-income countries. Methods: We report a retrospective longitudinal study of 75,919,840 Brazilian vaccinees from January 18 to July 24, 2021, evaluating documented infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), COVID-19-related hospitalisation, ICU admission, and death. Negative binomial regression models adjusted for sociodemographic characteristics were used for VE estimation. Findings: The overall analyzes of full vaccination showed VE against hospitalisation, ICU admission, and death of 91·4% (95%CI:90·1–92·5), 91·1% (95%CI:88·9–92·9) and 92·3% (95%CI:90·5–93·7) for Vaxzevria and 71·2% (95%CI:70·0–72·4), 72·2% (95%CI:70·2–74·0) and 73·7% (95%CI:72·1–75·2) for CoronaVac, respectively. VE for all outcomes is progressively lower with age. In fully-Vaxzevria-vaccinated individuals aged <60 years, VE against death was 96.5% (95%CI:82.1–99.3) versus 68·5% (95%CI:40·0–83·4) in those ≥90 years. Among fully-CoronaVac-vaccinated individuals, VE against death was 84.8% (95%CI:77.1–89.9) in those <60 years compared to 63.5 (95%CI 58.7–67.7) for vaccinees aged 80–89 years and 48·6%; (95%CI:35·0–59·3) for individuals aged ≥90 years. Post-vaccination daily cumulative incidence curves for all outcomes showed increased risk from younger to elder decades of life. There was no increase in the incidence of hospitalisation for individuals <60 years vaccinated during the same period as those aged ≥90 years. Interpretation: Although both vaccines have been effective in protecting against infection, hospitalization and death; Vaxzevria and CoronaVac demonstrated high effectiveness against severe outcomes for individuals up to 79 years of age. Our ...
Keywords	COVID-19 ; Vaccine ; Effectiveness ; CoronaVac ; Vaxzevria ; Public aspects of medicine ; RA1-1270
Language	English
Publishing date	2022-02-01T00:00:00Z
Publisher	Elsevier
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Effectiveness of mRNA boosters after homologous primary series with BNT162b2 or ChAdOx1 against symptomatic infection and severe COVID-19 in Brazil and Scotland

Thiago Cerqueira-Silva / Syed Ahmar Shah / Chris Robertson / Mauro Sanchez / Srinivasa Vittal Katikireddi / Vinicius de Araujo Oliveira / Enny S Paixão / Igor Rudan / Juracy Bertoldo Junior / Gerson O Penna / Neil Pearce / Guilherme Loureiro Werneck / Mauricio L Barreto / Viviane S Boaventura / Aziz Sheikh / Manoel Barral-Netto

PLoS Medicine, Vol 20, Iss 1, p e

A test-negative design case-control study.

2023 Volume 1004156

Abstract: Background Brazil and Scotland have used mRNA boosters in their respective populations since September 2021, with Omicron's emergence accelerating their booster program. Despite this, both countries have reported substantial recent increases in ... ...

Abstract	Background Brazil and Scotland have used mRNA boosters in their respective populations since September 2021, with Omicron's emergence accelerating their booster program. Despite this, both countries have reported substantial recent increases in Coronavirus Disease 2019 (COVID-19) cases. The duration of the protection conferred by the booster dose against symptomatic Omicron cases and severe outcomes is unclear. Methods and findings Using a test-negative design, we analyzed national databases to estimate the vaccine effectiveness (VE) of a primary series (with ChAdOx1 or BNT162b2) plus an mRNA vaccine booster (with BNT162b2 or mRNA-1273) against symptomatic Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) infection and severe COVID-19 outcomes (hospitalization or death) during the period of Omicron dominance in Brazil and Scotland compared to unvaccinated individuals. Additional analyses included stratification by age group (18 to 49, 50 to 64, ≥65). All individuals aged 18 years or older who reported acute respiratory illness symptoms and tested for SARS-CoV-2 infection between January 1, 2022, and April 23, 2022, in Brazil and Scotland were eligible for the study. At 14 to 29 days after the mRNA booster, the VE against symptomatic SARS-CoV-2 infection of ChAdOx1 plus BNT162b2 booster was 51.6%, (95% confidence interval (CI): [51.0, 52.2], p < 0.001) in Brazil and 67.1% (95% CI [65.5, 68.5], p < 0.001) in Scotland. At ≥4 months, protection against symptomatic infection waned to 4.2% (95% CI [0.7, 7.6], p = 0.02) in Brazil and 37.4% (95% CI [33.8, 40.9], p < 0.001) in Scotland. VE against severe outcomes in Brazil was 93.5% (95% CI [93.0, 94.0], p < 0.001) at 14 to 29 days post-booster, decreasing to 82.3% (95% CI [79.7, 84.7], p < 0.001) and 98.3% (95% CI [87.3, 99.8], p < 0.001) to 77.8% (95% CI [51.4, 89.9], p < 0.001) in Scotland for the same periods. Similar results were obtained with the primary series of BNT162b2 plus homologous booster. Potential limitations of this study ...
Keywords	Medicine ; R
Language	English
Publishing date	2023-01-01T00:00:00Z
Publisher	Public Library of Science (PLoS)
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Anti-chikungunya virus seroprevalence in Indigenous groups in the São Francisco Valley, Brazil.

Jandir Mendonça Nicacio / Ricardo Khouri / Antônio Marconi Leandro da Silva / Manoel Barral-Netto / João Augusto Costa Lima / Ana Marice Teixeira Ladeia / Rodrigo Feliciano do Carmo / Anderson da Costa Armstrong

PLoS Neglected Tropical Diseases, Vol 15, Iss 6, p e

2021 Volume 0009468

Abstract: Background Chikungunya fever (CHIKF) is a serious public health problem with a high rate of infection and chronic disabling manifestations that has affected more than 2 million people worldwide since 2005. In spite of this, epidemiological data on ... ...

Abstract	Background Chikungunya fever (CHIKF) is a serious public health problem with a high rate of infection and chronic disabling manifestations that has affected more than 2 million people worldwide since 2005. In spite of this, epidemiological data on vulnerable groups such as Indigenous people are scarce, making it difficult to implement public policies in order to prevent this disease and assist these populations. Objective To describe the serological and epidemiological profile of chikungunya virus (CHIKV) in two Indigenous populations in Northeast Brazil, as well as in an urbanized control community, and to explore associations between CHIKV and anthropometric variables in these populations. Methodology/principal findings This is a cross-sectional ancillary study of the Project of Atherosclerosis among Indigenous Populations (PAI) that included people 30 to 70 years old, recruited from two Indigenous tribes (the less urbanized Fulni-ô and the more urbanized Truká people) and an urbanized non-Indigenous control group from the same area. Subjects underwent clinical evaluation and were tested for anti-CHIKV IgG by enzyme-linked immunosorbent assay. Serological profile was described according to ethnicity, sex, and age. The study population included 433 individuals distributed as follows: 109 (25·2%) Truká, 272 (62·8%) Fulni-ô, and 52 (12%) from the non-Indigenous urbanized control group. Overall prevalence of CHIKV IgG in the study sample was 49.9% (216; 95% CI: 45·1-54·7). When the sample was stratified, positive CHIKV IgG was distributed as follows: no individuals in the Truká group, 78·3% (213/272; 95% CI: 72·9-83·1) in the Fulni-ô group, and 5.8% (3/52; 95% CI: 1.21-16) in the control group. Conclusions/significance Positive tests for CHIKV showed a very high prevalence in a traditional Indigenous population, in contrast to the absence of anti-CHIKV serology in the Truká people, who are more urbanized with respect to physical landscape, socio-cultural, and historical aspects, as well as a low prevalence in the ...
Keywords	Arctic medicine. Tropical medicine ; RC955-962 ; Public aspects of medicine ; RA1-1270
Subject code	390
Language	English
Publishing date	2021-06-01T00:00:00Z
Publisher	Public Library of Science (PLoS)
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Dissecting disease tolerance in Plasmodium vivax malaria using the systemic degree of inflammatory perturbation

Caian L. Vinhaes / Thomas A. Carmo / Artur T. L. Queiroz / Kiyoshi F. Fukutani / Mariana Araújo-Pereira / María B. Arriaga / Marcus V. G. Lacerda / Manoel Barral-Netto / Bruno B. Andrade

PLoS Neglected Tropical Diseases, Vol 15, Iss

2021 Volume 11

Abstract: Homeostatic perturbation caused by infection fosters two major defense strategies, resistance and tolerance, which promote the host’s survival. Resistance relates to the ability of the host to restrict the pathogen load. Tolerance minimizes collateral ... ...

Abstract	Homeostatic perturbation caused by infection fosters two major defense strategies, resistance and tolerance, which promote the host’s survival. Resistance relates to the ability of the host to restrict the pathogen load. Tolerance minimizes collateral tissue damage without directly affecting pathogen fitness. These concepts have been explored mechanistically in murine models of malaria but only superficially in human disease. Indeed, individuals infected with Plasmodium vivax may present with asymptomatic malaria, only mild symptoms, or be severely ill. We and others have reported a diverse repertoire of immunopathological events that potentially underly susceptibility to disease severity in vivax malaria. Nevertheless, the combined epidemiologic, clinical, parasitological, and immunologic features associated with defining the disease outcomes are still not fully understood. In the present study, we perform an extensive outlining of cytokines and inflammatory proteins in plasma samples from a cohort of individuals from the Brazilian Amazon infected with P. vivax and presenting with asymptomatic (n = 108) or symptomatic (n = 134) disease (106 with mild presentation and 28 with severe malaria), as well as from uninfected endemic controls (n = 128) to elucidate these gaps further. We employ highly multidimensional Systems Immunology analyses using the molecular degree of perturbation to reveal nuances of a unique profile of systemic inflammation and imbalanced immune activation directly linked to disease severity as well as with other clinical and epidemiologic characteristics. Additionally, our findings reveal that the main factor associated with severe cases of P. vivax infection was the number of symptoms, despite of a lower global inflammatory perturbation and parasitemia. In these participants, the number of symptoms directly correlated with perturbation of markers of inflammation and tissue damage. On the other hand, the main factor associated with non-severe infections was the parasitemia values, that ...
Keywords	Arctic medicine. Tropical medicine ; RC955-962 ; Public aspects of medicine ; RA1-1270
Subject code	610
Language	English
Publishing date	2021-11-01T00:00:00Z
Publisher	Public Library of Science (PLoS)
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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