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Article ; Online: Investigación científica prioritaria en Latinoamérica para orientar la prevención y el control de la COVID-19

Zulma M. Cucunubá

Biomédica: revista del Instituto Nacional de Salud, Vol 40, Iss Supl. 2, Pp 9-

2020 Volume 13

Keywords	infecciones por coronavirus ; epidemias ; colombia ; Medicine ; R ; Arctic medicine. Tropical medicine ; RC955-962
Language	English
Publishing date	2020-10-01T00:00:00Z
Publisher	Instituto Nacional de Salud
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: De la epidemia de Zika en Latinoamérica y la toma de decisiones bajo incertidumbre

Zulma M. Cucunubá

Revista de la Universidad Industrial de Santander. Salud, Vol 48, Iss 2, Pp 158-

2016 Volume 160

Keywords	Medicine ; R
Language	English
Publishing date	2016-06-01T00:00:00Z
Publisher	Publicaciones UIS
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Designing school reopening in the COVID-19 pre-vaccination period in Bogotá, Colombia

Guido España / Zulma M Cucunubá / Hernando Diaz / Sean Cavany / Nelson Castañeda / Laura Rodriguez

PLOS Global Public Health, Vol 2, Iss 6, p e

A modeling study.

2022 Volume 0000467

Abstract: The COVID-19 pandemic has affected millions of people around the world. In Colombia, 1.65 million cases and 43,495 deaths were reported in 2020. Schools were closed in many places around the world to slow down the spread of SARS-CoV-2. In Bogotá, ... ...

Abstract	The COVID-19 pandemic has affected millions of people around the world. In Colombia, 1.65 million cases and 43,495 deaths were reported in 2020. Schools were closed in many places around the world to slow down the spread of SARS-CoV-2. In Bogotá, Colombia, most of the public schools were closed from March 2020 until the end of the year. School closures can exacerbate poverty, particularly in low- and middle-income countries. To reconcile these two priorities in health and fighting poverty, we estimated the impact of school reopening for in-person instruction in 2021. We used an agent-based model of SARS-CoV-2 transmission calibrated to the daily number of deaths. The model includes schools that represent private and public schools in terms of age, enrollment, location, and size. We simulated school reopening at different capacities, assuming a high level of face-mask use, and evaluated the impact on the number of deaths in the city. We also evaluated the impact of reopening schools based on grade and multidimensional poverty index. We found that school at 35% capacity, assuming face-mask adherence at 75% in>8 years of age, had a small impact on the number of deaths reported in the city during a third wave. The increase in deaths was smallest when only pre-kinder was opened, and largest when secondary school was opened. At larger capacities, the impact on the number of deaths of opening pre-kinder was below 10%. In contrast, reopening other grades above 50% capacity substantially increased the number of deaths. Reopening schools based on their multidimensional poverty index resulted in a similar impact, irrespective of the level of poverty of the schools that were reopened. The impact of schools reopening was lower for pre-kinder grades and the magnitude of additional deaths associated with school reopening can be minimized by adjusting capacity in older grades.
Keywords	Public aspects of medicine ; RA1-1270
Subject code	370
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: Correction

Edgar-Yaset Caicedo / Kelly Charniga / Amanecer Rueda / Ilaria Dorigatti / Yardany Mendez / Arran Hamlet / Jean-Paul Carrera / Zulma M Cucunubá

PLoS Neglected Tropical Diseases, Vol 17, Iss 1, p e

The epidemiology of Mayaro virus in the Americas: A systematic review and key parameter estimates for outbreak modelling.

2023 Volume 0011034

Abstract: This corrects the article DOI:10.1371/journal.pntd.0009418.]. ...

Abstract	[This corrects the article DOI:10.1371/journal.pntd.0009418.].
Keywords	Arctic medicine. Tropical medicine ; RC955-962 ; Public aspects of medicine ; RA1-1270
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: Impact of contact tracing on COVID-19 mortality

Andres I Vecino-Ortiz / Juliana Villanueva Congote / Silvana Zapata Bedoya / Zulma M Cucunuba

PLoS ONE, Vol 16, Iss 3, p e

An impact evaluation using surveillance data from Colombia.

2021 Volume 0246987

Abstract: Background Contact tracing is a crucial part of the public health surveillance toolkit. However, it is labor-intensive and costly to carry it out. Some countries have faced challenges implementing contact tracing, and no impact evaluations using ... ...

Abstract	Background Contact tracing is a crucial part of the public health surveillance toolkit. However, it is labor-intensive and costly to carry it out. Some countries have faced challenges implementing contact tracing, and no impact evaluations using empirical data have assessed its impact on COVID-19 mortality. This study assesses the impact of contact tracing in a middle-income country, providing data to support the expansion and optimization of contact tracing strategies to improve infection control. Methods We obtained publicly available data on all confirmed COVID-19 cases in Colombia between March 2 and June 16, 2020. (N = 54,931 cases over 135 days of observation). As suggested by WHO guidelines, we proxied contact tracing performance as the proportion of cases identified through contact tracing out of all cases identified. We calculated the daily proportion of cases identified through contact tracing across 37 geographical units (32 departments and five districts). Further, we used a sequential log-log fixed-effects model to estimate the 21-days, 28-days, 42-days, and 56-days lagged impact of the proportion of cases identified through contact tracing on daily COVID-19 mortality. Both the proportion of cases identified through contact tracing and the daily number of COVID-19 deaths are smoothed using 7-day moving averages. Models control for the prevalence of active cases, second-degree polynomials, and mobility indices. Robustness checks to include supply-side variables were performed. Results We found that a 10 percent increase in the proportion of cases identified through contact tracing is related to COVID-19 mortality reductions between 0.8% and 3.4%. Our models explain between 47%-70% of the variance in mortality. Results are robust to changes of specification and inclusion of supply-side variables. Conclusion Contact tracing is instrumental in containing infectious diseases. Its prioritization as a surveillance strategy will substantially impact reducing deaths while minimizing the impact on the fragile ...
Keywords	Medicine ; R ; Science ; Q
Subject code	306
Language	English
Publishing date	2021-01-01T00:00:00Z
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: Estimating Zika virus attack rates and risk of Zika virus-associated neurological complications in Colombian capital cities with a Bayesian model

Kelly Charniga / Zulma M. Cucunubá / Diana M. Walteros / Marcela Mercado / Franklyn Prieto / Martha Ospina / Pierre Nouvellet / Christl A. Donnelly

Royal Society Open Science, Vol 9, Iss

2022 Volume 11

Abstract: Zika virus (ZIKV) is a mosquito-borne pathogen that caused a major epidemic in the Americas in 2015–2017. Although the majority of ZIKV infections are asymptomatic, the virus has been associated with congenital birth defects and neurological ... ...

Abstract	Zika virus (ZIKV) is a mosquito-borne pathogen that caused a major epidemic in the Americas in 2015–2017. Although the majority of ZIKV infections are asymptomatic, the virus has been associated with congenital birth defects and neurological complications (NC) in adults. We combined multiple data sources to improve estimates of ZIKV infection attack rates (IARs), reporting rates of Zika virus disease (ZVD) and the risk of ZIKV-associated NC for 28 capital cities in Colombia. ZVD surveillance data were combined with post-epidemic seroprevalence data and a dataset on ZIKV-associated NC in a Bayesian hierarchical model. We found substantial heterogeneity in ZIKV IARs across cities. The overall estimated ZIKV IAR across the 28 cities was 0.38 (95% CrI: 0.17–0.92). The estimated ZVD reporting rate was 0.013 (95% CrI: 0.004–0.024), and 0.51 (95% CrI: 0.17–0.92) cases of ZIKV-associated NC were estimated to be reported per 10 000 ZIKV infections. When we assumed the same ZIKV IAR across sex or age group, we found important spatial heterogeneities in ZVD reporting rates and the risk of being reported as a ZVD case with NC. Our results highlight how additional data sources can be used to overcome biases in surveillance data and estimate key epidemiological parameters.
Keywords	arboviruses ; emerging infectious diseases ; reporting rates ; outbreak analysis ; Guillain–Barré syndrome ; mathematical modelling ; Science ; Q
Subject code	333
Language	English
Publishing date	2022-11-01T00:00:00Z
Publisher	The Royal Society
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Spatiotemporal variations in exposure

Julia Ledien / Zulma M. Cucunubá / Gabriel Parra-Henao / Eliana Rodríguez-Monguí / Andrew P. Dobson / María-Gloria Basáñez / Pierre Nouvellet

BMC Medical Research Methodology, Vol 22, Iss 1, Pp 1-

Chagas disease in Colombia as a case study

2022 Volume 12

Abstract: Abstract Age-stratified serosurvey data are often used to understand spatiotemporal trends in disease incidence and exposure through estimating the Force-of-Infection (FoI). Typically, median or mean FoI estimates are used as the response variable in ... ...

Abstract	Abstract Age-stratified serosurvey data are often used to understand spatiotemporal trends in disease incidence and exposure through estimating the Force-of-Infection (FoI). Typically, median or mean FoI estimates are used as the response variable in predictive models, often overlooking the uncertainty in estimated FoI values when fitting models and evaluating their predictive ability. To assess how this uncertainty impact predictions, we compared three approaches with three levels of uncertainty integration. We propose a performance indicator to assess how predictions reflect initial uncertainty. In Colombia, 76 serosurveys (1980–2014) conducted at municipality level provided age-stratified Chagas disease prevalence data. The yearly FoI was estimated at the serosurvey level using a time-varying catalytic model. Environmental, demographic and entomological predictors were used to fit and predict the FoI at municipality level from 1980 to 2010 across Colombia. A stratified bootstrap method was used to fit the models without temporal autocorrelation at the serosurvey level. The predictive ability of each model was evaluated to select the best-fit models within urban, rural and (Amerindian) indigenous settings. Model averaging, with the 10 best-fit models identified, was used to generate predictions. Our analysis shows a risk of overconfidence in model predictions when median estimates of FoI alone are used to fit and evaluate models, failing to account for uncertainty in FoI estimates. Our proposed methodology fully propagates uncertainty in the estimated FoI onto the generated predictions, providing realistic assessments of both central tendency and current uncertainty surrounding exposure to Chagas disease.
Keywords	Force of infection ; Model averaging ; Chagas disease ; Infectious disease ; Modelling ; Medicine (General) ; R5-920
Subject code	310
Language	English
Publishing date	2022-01-01T00:00:00Z
Publisher	BMC
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Spatial and temporal invasion dynamics of the 2014-2017 Zika and chikungunya epidemics in Colombia.

Kelly Charniga / Zulma M Cucunubá / Marcela Mercado / Franklyn Prieto / Martha Ospina / Pierre Nouvellet / Christl A Donnelly

PLoS Computational Biology, Vol 17, Iss 7, p e

2021 Volume 1009174

Abstract: Zika virus (ZIKV) and chikungunya virus (CHIKV) were recently introduced into the Americas resulting in significant disease burdens. Understanding their spatial and temporal dynamics at the subnational level is key to informing surveillance and ... ...

Abstract	Zika virus (ZIKV) and chikungunya virus (CHIKV) were recently introduced into the Americas resulting in significant disease burdens. Understanding their spatial and temporal dynamics at the subnational level is key to informing surveillance and preparedness for future epidemics. We analyzed anonymized line list data on approximately 105,000 Zika virus disease and 412,000 chikungunya fever suspected and laboratory-confirmed cases during the 2014-2017 epidemics. We first determined the week of invasion in each city. Out of 1,122, 288 cities met criteria for epidemic invasion by ZIKV and 338 cities by CHIKV. We analyzed risk factors for invasion using linear and logistic regression models. We also estimated that the geographic origin of both epidemics was located in Barranquilla, north Colombia. We assessed the spatial and temporal invasion dynamics of both viruses to analyze transmission between cities using a suite of (i) gravity models, (ii) Stouffer's rank models, and (iii) radiation models with two types of distance metrics, geographic distance and travel time between cities. Invasion risk was best captured by a gravity model when accounting for geographic distance and intermediate levels of density dependence; Stouffer's rank model with geographic distance performed similarly well. Although a few long-distance invasion events occurred at the beginning of the epidemics, an estimated distance power of 1.7 (95% CrI: 1.5-2.0) from the gravity models suggests that spatial spread was primarily driven by short-distance transmission. Similarities between the epidemics were highlighted by jointly fitted models, which were preferred over individual models when the transmission intensity was allowed to vary across arboviruses. However, ZIKV spread considerably faster than CHIKV.
Keywords	Biology (General) ; QH301-705.5
Subject code	330
Language	English
Publishing date	2021-07-01T00:00:00Z
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: Descriptive analysis of surveillance data for Zika virus disease and Zika virus-associated neurological complications in Colombia, 2015-2017.

Kelly Charniga / Zulma M Cucunubá / Diana M Walteros / Marcela Mercado / Franklyn Prieto / Martha Ospina / Pierre Nouvellet / Christl A Donnelly

PLoS ONE, Vol 16, Iss 6, p e

2021 Volume 0252236

Abstract: Zika virus (ZIKV) is a mosquito-borne pathogen that recently caused a major epidemic in the Americas. Although the majority of ZIKV infections are asymptomatic, the virus has been associated with birth defects in fetuses and newborns of infected mothers ... ...

Abstract	Zika virus (ZIKV) is a mosquito-borne pathogen that recently caused a major epidemic in the Americas. Although the majority of ZIKV infections are asymptomatic, the virus has been associated with birth defects in fetuses and newborns of infected mothers as well as neurological complications in adults. We performed a descriptive analysis on approximately 106,000 suspected and laboratory-confirmed cases of Zika virus disease (ZVD) that were reported during the 2015-2017 epidemic in Colombia. We also analyzed a dataset containing patients with neurological complications and recent febrile illness compatible with ZVD. Females had higher cumulative incidence of ZVD than males. Compared to the general population, cases were more likely to be reported in young adults (20 to 39 years of age). We estimated the cumulative incidence of ZVD in pregnant females at 3,120 reported cases per 100,000 population (95% CI: 3,077-3,164), which was considerably higher than the incidence in both males and non-pregnant females. ZVD cases were reported in all 32 departments. Four-hundred and eighteen patients suffered from ZIKV-associated neurological complications, of which 85% were diagnosed with Guillain-Barré syndrome. The median age of ZIKV cases with neurological complications was 12 years older than that of ZVD cases. ZIKV-associated neurological complications increased with age, and the highest incidence was reported among individuals aged 75 and older. Even though neurological complications and deaths due to ZIKV were rare in this epidemic, better risk communication is needed for people living in or traveling to ZIKV-affected areas.
Keywords	Medicine ; R ; Science ; Q
Subject code	616
Language	English
Publishing date	2021-01-01T00:00:00Z
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: The epidemiology of Mayaro virus in the Americas

Edgar-Yaset Caicedo / Kelly Charniga / Amanecer Rueda / Ilaria Dorigatti / Yardany Mendez / Arran Hamlet / Jean-Paul Carrera / Zulma M Cucunubá

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

A systematic review and key parameter estimates for outbreak modelling.

2021 Volume 0009418

Abstract: Mayaro virus (MAYV) is an arbovirus that is endemic to tropical forests in Central and South America, particularly within the Amazon basin. In recent years, concern has increased regarding MAYV's ability to invade urban areas and cause epidemics across ... ...

Abstract	Mayaro virus (MAYV) is an arbovirus that is endemic to tropical forests in Central and South America, particularly within the Amazon basin. In recent years, concern has increased regarding MAYV's ability to invade urban areas and cause epidemics across the region. We conducted a systematic literature review to characterise the evolutionary history of MAYV, its transmission potential, and exposure patterns to the virus. We analysed data from the literature on MAYV infection to produce estimates of key epidemiological parameters, including the generation time and the basic reproduction number, R0. We also estimated the force-of-infection (FOI) in epidemic and endemic settings. Seventy-six publications met our inclusion criteria. Evidence of MAYV infection in humans, animals, or vectors was reported in 14 Latin American countries. Nine countries reported evidence of acute infection in humans confirmed by viral isolation or reverse transcription-PCR (RT-PCR). We identified at least five MAYV outbreaks. Seroprevalence from population based cross-sectional studies ranged from 21% to 72%. The estimated mean generation time of MAYV was 15.2 days (95% CrI: 11.7-19.8) with a standard deviation of 6.3 days (95% CrI: 4.2-9.5). The per-capita risk of MAYV infection (FOI) ranged between 0.01 and 0.05 per year. The mean R0 estimates ranged between 2.1 and 2.9 in the Amazon basin areas and between 1.1 and 1.3 in the regions outside of the Amazon basin. Although MAYV has been identified in urban vectors, there is not yet evidence of sustained urban transmission. MAYV's enzootic cycle could become established in forested areas within cities similar to yellow fever virus.
Keywords	Arctic medicine. Tropical medicine ; RC955-962 ; Public aspects of medicine ; RA1-1270
Subject code	333
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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