Last data update: Sep 16, 2024. (Total: 47680 publications since 2009)
Records 1-30 (of 39 Records) |
Query Trace: Martins T [original query] |
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Investigation of SARS-CoV-2 infection among companion animals in households with confirmed human COVID-19 Cases
Venkat H , Yaglom HD , Hecht G , Goedderz A , Ely JL , Sprenkle M , Martins T , Jasso-Selles D , Lemmer D , Gesimondo J , Ruberto I , Komatsu K , Engelthaler DM . Pathogens 2024 13 (6) We aimed to characterize SARS-CoV-2 infection in companion animals living in households with COVID-19-positive people and understand the dynamics surrounding how these animals become infected. Public health investigators contacted households with at least one confirmed, symptomatic person with COVID-19 for study recruitment. Blood, nasal, and rectal swab specimens were collected from pet dogs and cats and a questionnaire was completed. Specimens were tested for SARS-CoV-2 by RT-PCR, and for neutralizing antibodies; genomic sequencing was performed on viral-positive samples. A total of 36.4% of 110 pets enrolled had evidence of infection with SARS-CoV-2. Pets were more likely to test positive if the pet was immunocompromised, and if more than one person in the home was positive for COVID-19. Among 12 multi-pet households where at least one pet was positive, 10 had at least one other pet test positive. Whole-genome sequencing revealed the genomes of viral lineages circulating in the community during the time of sample collection. Our findings suggest a high likelihood of viral transmission in households with multiple pets and when pets had very close interactions with symptomatic humans. Further surveillance studies are needed to characterize how new variants impact animals and to understand opportunities for infection and spillover in susceptible species. |
Reply to Rasmussen and Ringwald, "Continued Low Efficacy of Artemether-Lumefantrine in Angola?"
Dimbu PR , Horth R , Cândido ALM , Ferreira CM , Caquece F , Garcia LEA , André K , Pembele G , Jandondo D , Bondo BJ , Nieto Andrade B , Labuda S , Ponce de León G , Kelley J , Patel D , Svigel SS , Talundzic E , Lucchi N , Morais JFM , Fortes F , Martins JF , Pluciński MM . Antimicrob Agents Chemother 12/28/2021 65 (6) We thank Rasmussen and Ringwald for further highlighting the importance of routine monitoring of antimalarial drug efficacy in sub-Saharan Africa, including Angola (1). Longitudinal monitoring is critical to identify potential new, persistent, and/or expanding foci of parasite resistance to available drugs. In 3 of the last 4 rounds, artemether-lumefantrine (AL) was estimated to have an efficacy of <90% at one of the three sentinel sites in Angola. To our knowledge, in sub-Saharan Africa, only Angola and Burkina Faso (2) have shown AL efficacy of <90% across multiple therapeutic efficacy study (TES) rounds. Thus, we chose a title to highlight this persistent concern. | | We concur that the significance of the high rates of day 2 slide positivity in Lunda Sul Province is not fully known, and as pointed out, there may be various explanations for this finding. Measuring drug levels is resource intensive and not feasible every year, but this could help rule out underdosing in future studies. However, we believe our study procedures, as described in this and previous studies, are robust and thus make systematic underdosing unlikely. We have always strictly adhered to WHO guidelines, including hemoglobin criteria and analysis of day 1 severe cases, to inform our classifications. |
Therapeutic response to four artemisinin-based combination therapies in Angola, 2021
Dimbu PR , Labuda S , Ferreira CM , Caquece F , André K , Pembele G , Pode D , João MF , Pelenda VM , Nieto Andrade B , Horton B , Kennedy C , Svigel SS , Zhou Z , Morais JFM , Rosário Jd , Fortes F , Martins JF , Plucinski MM . Antimicrob Agents Chemother 2024 e0152523 Monitoring antimalarial efficacy is important to detect the emergence of parasite drug resistance. Angola conducts in vivo therapeutic efficacy studies (TESs) every 2 years in its fixed sentinel sites in Benguela, Lunda Sul, and Zaire provinces. Children with uncomplicated Plasmodium falciparum malaria were treated with artemether-lumefantrine (AL), artesunate-amodiaquine (ASAQ), dihydroartemisinin-piperaquine (DP), or artesunate-pyronaridine (ASPY) and followed for 28 (AL and ASAQ) or 42 days (DP and ASPY) to assess clinical and parasitological response to treatment. Two drugs were sequentially assessed in each site in February-July 2021. The primary indicator was the Kaplan-Meier estimate of the PCR-corrected efficacy at the end of the follow-up period. A total of 622 patients were enrolled in the study and 590 (95%) participants reached a study endpoint. By day 3, ≥98% of participants were slide-negative in all study sites and arms. After PCR correction, day 28 AL efficacy was 88.0% (95% CI: 82%-95%) in Zaire and 94.7% (95% CI: 90%-99%) in Lunda Sul. For ASAQ, day 28 efficacy was 92.0% (95% CI: 87%-98%) in Zaire and 100% in Lunda Sul. Corrected day 42 efficacy was 99.6% (95% CI: 99%-100%) for ASPY and 98.3% (95% CI: 96%-100%) for DP in Benguela. High day 3 clearance rates suggest no clinical evidence of artemisinin resistance. This was the fourth of five rounds of TES in Angola showing a corrected AL efficacy <90% in a site. For Zaire, AL has had an efficacy <90% in 2013, 2015, and 2021. ASAQ, DP, and ASPY are appropriate choices as artemisinin-based combination therapies in Angola. |
Perspectives on advancing countermeasures for filovirus disease: Report from a multi-sector meeting
Sprecher A , Cross R , Marzi A , Martins KA , Wolfe D , Montgomery JM , Spiropoulou CF , Cihlar T , Ahuka-Mundeke S , Nyhuis T , Teicher C , Crozier I , Strong J , Kobinger G , Woolsey C , Geisbert TW , Feldmann H , Muyembe JJ . J Infect Dis 2023 228 S474-S478 Although there are now approved treatments and vaccines for Ebola virus disease (EVD), the case fatality of EVD remains unacceptably high even when treated with the newly approved therapeutics; furthermore, these countermeasures are not expected to be effective against disease caused by other filoviruses. A meeting of subject matter experts from public health, research, and countermeasure development agencies and manufacturers was held during the 10th International Filovirus Symposium to discuss strategies to address these gaps, including how newer countermeasures could be advanced for field readiness. Several investigational therapeutics, vaccine candidates, and combination strategies were presented. In all, a common theme emerged: the greatest challenge to completing development was the implementation of well-designed clinical trials of safety and efficacy during filovirus disease outbreaks. These outbreaks are usually of short duration, providing but a brief opportunity for trials to be launched, and have too few cases to allow for full enrollment during a single outbreak, so clinical trials will necessarily need to span multiple outbreaks which may occur in a number of at-risk countries. Preparing for this will require agreed-upon common protocols for trials intended to bridge multiple outbreaks across all at-risk countries. A multi-national research consortium including, and led by, at-risk countries would be an ideal mechanism to negotiate agreement on protocol design and coordinate preparation. Discussion participants recommended a follow-up meeting be held in Africa with national public health and research agencies from at-risk countries to establish such a consortium. |
The HEARTS partner forum-supporting implementation of HEARTS to treat and control hypertension
Khan T , Moran AE , Perel P , Whelton PK , Brainin M , Feigin V , Kostova D , Richter P , Ordunez P , Hennis A , Lackland DT , Slama S , Pineiro D , Martins S , Williams B , Hofstra L , Garg R , Mikkelsen B . Front Public Health 2023 11 1146441 Cardiovascular diseases (CVD), principally ischemic heart disease (IHD) and stroke, are the leading causes of death (18. 6 million deaths annually) and disability (393 million disability-adjusted life-years lost annually), worldwide. High blood pressure is the most important preventable risk factor for CVD and deaths, worldwide (10.8 million deaths annually). In 2016, the World Health Organization (WHO) and the United States Centers for Disease Control (CDC) launched the Global Hearts initiative to support governments in their quest to prevent and control CVD. HEARTS is the core technical package of the initiative and takes a public health approach to treating hypertension and other CVD risk factors at the primary health care level. The HEARTS Partner Forum, led by WHO, brings together the following 11 partner organizations: American Heart Association (AHA), Center for Chronic Disease Control (CCDC), International Society of Hypertension (ISH), International Society of Nephrology (ISN), Pan American Health Organization (PAHO), Resolve to Save Lives (RTSL), US CDC, World Hypertension League (WHL), World Heart Federation (WHF) and World Stroke Organization (WSO). The partners support countries in their implementation of the HEARTS technical package in various ways, including providing technical expertise, catalytic funding, capacity building and evidence generation and dissemination. HEARTS has demonstrated the feasibility and acceptability of a public health approach, with more than seven million people already on treatment for hypertension using a simple, algorithmic HEARTS approach. Additionally, HEARTS has demonstrated the feasibility of using hypertension as a pathfinder to universal health coverage and should be a key intervention of all basic benefit packages. The partner forum continues to find ways to expand support and reinvigorate enthusiasm and attention on preventing CVD. Proposed future HEARTS Partner Forum activities are related to more concrete information sharing between partners and among countries, expanded areas of partner synergy, support for implementation, capacity building, and advocacy with country ministries of health, professional societies, academy and civil societies organizations. Advancing toward the shared goals of the HEARTS partners will require a more formal, structured approach to the forum and include goals, targets and published reports. In this way, the HEARTS Partner Forum will mirror successful global partnerships on communicable diseases and assist countries in reducing CVD mortality and achieving global sustainable development goals (SDGs). |
Molecular Markers of Sulfadoxine-Pyrimethamine Resistance in Samples from Children with Uncomplicated Plasmodium falciparum at Three Sites in Angola in 2019.
Rosillo SR , Dimbu PR , Cândido ALM , Oh JM , Ferreira CM , Nieto Andrade B , Labuda S , Horth R , Kelley J , Morais JFM , Fortes F , Martins JF , Talundzic E , Pluciński MM . Antimicrob Agents Chemother 2023 67 (4) e0160122 Sulfadoxine-pyrimethamine (SP) is used for prevention of malaria in pregnant women in Angola. We sequenced the Plasmodium falciparum dihydrofolate reductase (pfdhfr) and dihydropteroate synthase (pfdhps) genes, implicated in SP resistance, in samples collected during a 2019 study of artemisinin-based combination therapy efficacy in Benguela, Lunda Sul, and Zaire provinces. A total of 90 day 0 and day of failure samples were individually sequenced, while 508 day 0 samples from participants without recurrent parasitemia were pooled after DNA extraction into 61 pools. The N51I, C59R, and S108N pfdhfr mutations and A437G pfdhps mutations were present at high proportions in all provinces (weighted allele frequencies, 62% to 100%). The K540E pfdhps mutation was present at lower proportions (10% to 14%). The A581G pfdhps mutation was only observed in Zaire, at a 4.6% estimated prevalence. The I431V and A613S mutations were also only observed in Zaire, at a prevalence of 2.8% to 2.9%. The most common (27% to 66%) reconstructed haplotype in all three provinces was the canonical quadruple pfdhfr pfdhps mutant. The canonical quintuple mutant was absent in Lunda Sul and Benguela and present in 7.9% of samples in Zaire. A single canonical sextuple (2.6%) mutant was observed in Zaire Province. Proportions of the pfdhps K540E and A581G mutations were well below the World Health Organization thresholds for meaningful SP resistance (prevalence of 95% for K540E and 10% for A581G). Samples from therapeutic efficacy studies represent a convenient source of samples for monitoring SP resistance markers. |
A new WHO bottle bioassay method to assess the susceptibility of mosquito vectors to public health insecticides: results from a WHO-coordinated multi-centre study
Corbel V , Kont MD , Ahumada ML , Andréo L , Bayili B , Bayili K , Brooke B , Pinto Caballero JA , Lambert B , Churcher TS , Duchon S , Etang J , Flores AE , Gunasekaran K , Juntarajumnong W , Kirby M , Davies R , Lees RS , Lenhart A , Lima JBP , Martins AJ , Müller P , N'Guessan R , Ngufor C , Praulins G , Quinones M , Raghavendra K , Verma V , Rus AC , Samuel M , Ying KS , Sungvornyothin S , Uragayala S , Velayudhan R , Yadav RS . Parasit Vectors 2023 16 (1) 21 BACKGROUND: The continued spread of insecticide resistance in mosquito vectors of malaria and arboviral diseases may lead to operational failure of insecticide-based interventions if resistance is not monitored and managed efficiently. This study aimed to develop and validate a new WHO glass bottle bioassay method as an alternative to the WHO standard insecticide tube test to monitor mosquito susceptibility to new public health insecticides with particular modes of action, physical properties or both. METHODS: A multi-centre study involving 21 laboratories worldwide generated data on the susceptibility of seven mosquito species (Aedes aegypti, Aedes albopictus, Anopheles gambiae sensu stricto [An. gambiae s.s.], Anopheles funestus, Anopheles stephensi, Anopheles minimus and Anopheles albimanus) to seven public health insecticides in five classes, including pyrethroids (metofluthrin, prallethrin and transfluthrin), neonicotinoids (clothianidin), pyrroles (chlorfenapyr), juvenile hormone mimics (pyriproxyfen) and butenolides (flupyradifurone), in glass bottle assays. The data were analysed using a Bayesian binomial model to determine the concentration-response curves for each insecticide-species combination and to assess the within-bioassay variability in the susceptibility endpoints, namely the concentration that kills 50% and 99% of the test population (LC(50) and LC(99), respectively) and the concentration that inhibits oviposition of the test population by 50% and 99% (OI(50) and OI(99)), to measure mortality and the sterilizing effect, respectively. RESULTS: Overall, about 200,000 mosquitoes were tested with the new bottle bioassay, and LC(50)/LC(99) or OI(50)/OI(99) values were determined for all insecticides. Variation was seen between laboratories in estimates for some mosquito species-insecticide combinations, while other test results were consistent. The variation was generally greater with transfluthrin and flupyradifurone than with the other compounds tested, especially against Anopheles species. Overall, the mean within-bioassay variability in mortality and oviposition inhibition were < 10% for most mosquito species-insecticide combinations. CONCLUSION: Our findings, based on the largest susceptibility dataset ever produced on mosquitoes, showed that the new WHO bottle bioassay is adequate for evaluating mosquito susceptibility to new and promising public health insecticides currently deployed for vector control. The datasets presented in this study have been used recently by the WHO to establish 17 new insecticide discriminating concentrations (DCs) for either Aedes spp. or Anopheles spp. The bottle bioassay and DCs can now be widely used to monitor baseline insecticide susceptibility of wild populations of vectors of malaria and Aedes-borne diseases worldwide. |
Retrospective molecular investigation of Mayaro and Oropouche viruses at the human-animal interface in West-central Brazil, 2016-2018.
Dias HG , de Lima RC , Barbosa LS , Souza TMA , Badolato-Correa J , Maia LMS , Ferreira RDS , Neves Nads , Costa MCS , Martins LR , Souza EM , Carvalho MDS , Araujo-Oliveira A , Marques WA , Sabino-Santos G , Marques MS , Macedo GC , Nantes WAG , Santos FM , Netto CC , Morgado TO , Bianchini MA , Correa SHR , Almeida JR , Campos LP , Souza IM , Barreto WTG , Porfírio G , Alencar JAF , Herrera HM , Shlessarenko RD , Cunha RVD , Azeredo EL , Salyer SJ , Komar N , Pauvolid-Corrêa A , Dos Santos FB . PLoS One 2022 17 (11) e0277612 Mayaro virus (MAYV, Togaviridae) and Oropouche orthobunyavirus (OROV, Peribunyaviridae) are emerging enzootic arboviruses in Latin America. Outbreaks of febrile illness associated with MAYV and OROV have been reported among humans mainly in the northern region of Brazil since the 1980s, and recent data suggest these viruses have circulated also in more populated areas of western Brazil. MAYV shares mosquito vectors with yellow fever virus and it has been historically detected during yellow fever epidemics. Aiming to investigate the transmission of OROV and MAYV at the human-animal interface during a yellow fever, chikungunya and Zika outbreaks in Brazil, we conducted a retrospective molecular investigation in 810 wild and domestic animals, 106 febrile patients, and 22.931 vectors collected from 2016 to 2018 in Cuiaba and Campo Grande metropolitan regions, western Brazil. All samples tested negative for OROV and MAYV RNA by RT-qPCR. Findings presented here suggest no active circulation of MAYV and OROV in the sampled hosts. Active surveillance and retrospective investigations are instrumental approaches for the detection of cryptic and subclinical activity of enzootic arboviruses and together serve as a warning system to implement appropriate actions to prevent outbreaks. |
The evolution of medical countermeasures for Ebola virus disease: Lessons learned and next steps
Crozier I , Britson KA , Wolfe DN , Klena JD , Hensley LE , Lee JS , Wolfraim LA , Taylor KL , Higgs ES , Montgomery JM , Martins KA . Vaccines (Basel) 2022 10 (8) The Ebola virus disease outbreak that occurred in Western Africa from 2013-2016, and subsequent smaller but increasingly frequent outbreaks of Ebola virus disease in recent years, spurred an unprecedented effort to develop and deploy effective vaccines, therapeutics, and diagnostics. This effort led to the U.S. regulatory approval of a diagnostic test, two vaccines, and two therapeutics for Ebola virus disease indications. Moreover, the establishment of fieldable diagnostic tests improved the speed with which patients can be diagnosed and public health resources mobilized. The United States government has played and continues to play a key role in funding and coordinating these medical countermeasure efforts. Here, we describe the coordinated U.S. government response to develop medical countermeasures for Ebola virus disease and we identify lessons learned that may improve future efforts to develop and deploy effective countermeasures against other filoviruses, such as Sudan virus and Marburg virus. |
First national-scale evaluation of temephos resistance in Aedes aegypti in Peru
Palomino M , Pinto J , Yañez P , Cornelio A , Dias L , Amorim Q , Martins AJ , Lenhart A , Lima JBP . Parasit Vectors 2022 15 (1) 254 BACKGROUND: The development of resistance against insecticides in Aedes aegypti can lead to operational failures in control programs. Knowledge of the spatial and temporal trends of this resistance is needed to drive effective monitoring campaigns, which in turn provide data on which vector control decision-making should be based. METHODS: Third-stage larvae (L3) from the F1 and F2 generations of 39 Peruvian field populations of Ae. aegypti mosquitoes from established laboratory colonies were evaluated for resistance against the organophosphate insecticide temephos. The 39 populations were originally established from eggs collected in the field with ovitraps in eight departments of Peru during 2018 and 2019. Dose-response bioassays, at 11 concentrations of the insecticide, were performed following WHO recommendations. RESULTS: Of the 39 field populations of Ae. aegypti tested for resistance to temephos , 11 showed high levels of resistance (resistance ratio [RR] > 10), 16 showed moderate levels of resistance (defined as RR values between 5 and 10) and only 12 were susceptible (RR < 5). The results segregated the study populations into two geographic groups. Most of the populations in the first geographic group, the coastal region, were resistant to temephos, with three populations (AG, CR and LO) showing RR values > 20 (AG 21.5, CR 23.1, LO 39.4). The populations in the second geographic group, the Amazon jungle and the high jungle, showed moderate levels of resistance, with values ranging between 5.1 (JN) and 7.1 (PU). The exception in this geographic group was the population from PM, which showed a RR value of 28.8 to this insecticide. CONCLUSIONS: The results of this study demonstrate that Ae. aegypti populations in Peru present different resistance intensities to temephos, 3 years after temephos use was discontinued. Resistance to this larvicide should continue to be monitored because it is possible that resistance to temephos could decrease in the absence of routine selection pressures. |
Determining the role of natural SARS-CoV-2 infection in the death of domestic pets: 10 cases (2020-2021).
Carpenter A , Ghai RR , Gary J , Ritter JM , Carvallo FR , Diel DG , Martins M , Murphy J , Schroeder B , Brightbill K , Tewari D , Boger L , Gabel J , Cobb R , Hennebelle J , Stanton JB , McCullough K , Mosley YC , Naikare HK , Radcliffe R , Parr B , Balsamo G , Robbins B , Smith D , Slavinski S , Williams C , Meckes D , Jones D , Frazier T , Steury K , Rooney J , Torchetti M , Wendling N , Currie D , Behravesh CB , Wallace RM . J Am Vet Med Assoc 2021 259 (9) 1032-1039 OBJECTIVE: To establish a pathoepidemiological model to evaluate the role of SARS-CoV-2 infection in the first 10 companion animals that died while infected with SARS-CoV-2 in the US. ANIMALS: 10 cats and dogs that tested positive for SARS-CoV-2 and died or were euthanized in the US between March 2020 and January 2021. PROCEDURES: A standardized algorithm was developed to direct case investigations, determine the necessity of certain diagnostic procedures, and evaluate the role, if any, that SARS-CoV-2 infection played in the animals' course of disease and death. Using clinical and diagnostic information collected by state animal health officials, state public health veterinarians, and other state and local partners, this algorithm was applied to each animal case. RESULTS: SARS-CoV-2 was an incidental finding in 8 animals, was suspected to have contributed to the severity of clinical signs leading to euthanasia in 1 dog, and was the primary reason for death for 1 cat. CONCLUSIONS AND CLINICAL RELEVANCE: This report provides the global community with a standardized process for directing case investigations, determining the necessity of certain diagnostic procedures, and determining the clinical significance of SARS-CoV-2 infections in animals with fatal outcomes and provides evidence that SARS-CoV-2 can, in rare circumstances, cause or contribute to death in pets. |
Prevalence and characterization of pertactin deficient Bordetella pertussis strains in Brazil, a whole-cell vaccine country
Leite D , Camargo CH , Kashino SS , Polatto R , Martins LM , Pereira JC , Pawloski L , Tondella ML , Oliveira RSD , Vaz de Lima LRDA . Vaccine: X 2021 8 100103 Many countries have reported antigenic divergence among circulating Bordetella pertussis strains, mainly in those countries which introduced the acellular pertussis (aP) vaccine. This phenomenon can be seen, for example, with the recent rise of pertactin (Prn)-deficient B. pertussis strains, one of the antigens included in aP vaccine formulas. The whole cell pertussis (wP) vaccine has been used in Brazil since 1977 for the primary pertussis, diphtheria and tetanus immunization series. In 2014, the aP vaccine was recommended for women during pregnancy to protect infants in the first months of life. Our objective was to determine the prevalence of Prn-deficiency in 511 isolates of B. pertussis collected in Brazil during 2010–2016. All isolates were characterized, through PFGE and serotyping, and screened for the loss of Prn by ELISA. Prn-deficiency was confirmed by immunoblotting, and identification of the possible genetic markers was performed with PCR and Sanger sequencing. Results indicate that 110 PFGE profiles are currently circulating, with five profiles representing the majority, and the predominant serotype 3, has been gradually replaced by serotype 2 and serotype 2,3. ELISA screening and immunoblotting identified three Prn-deficient isolates. Genotypic characterization by PCR and sequencing indicated that one isolate had a promoter mutation in prn, while the other two did not have an obvious genetic explanation for their deficiency. While the lack of Prn was identified in a few isolates, this study did not detect a relevant occurrence of Prn-deficiency, until 2016, confirming previous observations that Prn-deficiency is likely aP vaccine-driven. © 2021 |
Continued low efficacy of artemether-lumefantrine in Angola, 2019.
Dimbu PR , Horth R , Cândido ALM , Ferreira CM , Caquece F , Garcia LEA , André K , Pembele G , Jandondo D , Bondo BJ , Nieto Andrade B , Labuda S , Ponce de León G , Kelley J , Patel D , Svigel SS , Talundzic E , Lucchi N , Morais JFM , Fortes F , Martins JF , Pluciński MM . Antimicrob Agents Chemother 2020 65 (2) BACKGROUND: Biennial therapeutic efficacy monitoring is a crucial activity for ensuring efficacy of currently used artemisinin-based combination therapy in Angola. METHODS: Children with acute uncomplicated P. falciparum infection in sentinel sites in Benguela, Zaire, and Lunda Sul Provinces were treated with artemether-lumefantrine (AL) or artesunate amodiaquine (ASAQ) and followed for 28 days to assess clinical and parasitological response. Molecular correction was performed using seven microsatellite markers. Samples from treatment failures were genotyped for the pfk13, pfcrt, and pfmdr1 genes. RESULTS: Day 3 clearance rates were ≥95% in all arms. Uncorrected Day-28 Kaplan-Meier efficacy estimates ranged from 84.2 to 90.1% for the AL arms, and 84.7 to 100% for the ASAQ arms. Corrected Day-28 estimates were 87.6% (95% Confidence interval [CI]: 81-95%) for the AL arm in Lunda Sul, 92.2% (95%CI: 87-98%) for AL in Zaire, 95.6% (95%CI: 91-100%) for ASAQ in Zaire, 98.4% (95%CI: 96-100%) for AL in Benguela, and 100% for ASAQ in Benguela and Lunda Sul. All 103 analyzed samples had wildtype pfk13 sequences. The 76T pfcrt allele was found in most (92%, 11/12) ASAQ late failure samples but only 16% (4/25) of AL failure samples. The N86 pfmdr1 allele was found in 97% (34/35) of treatment failures. CONCLUSION: AL efficacy in Lunda Sul was below the 90% World Health Organization threshold, the third time in four rounds that this threshold was crossed for an AL arm in Angola. In contrast, observed ASAQ efficacy has not been below 95% to date in Angola, including this latest round. |
Malaria Risk and Prevention in Asian Migrants to Angola.
Martins JF , Marques C , Nieto-Andrade B , Kelley J , Patel D , Nace D , Herman C , Barratt J , Ponce de Leon G , Talundzic E , Rogier E , Halsey ES , Plucinski MM . Am J Trop Med Hyg 2020 103 (5) 1918-1926 The number of Asian migrants working in sub-Saharan developing countries like Angola has been increasing. Their malaria risk, prevention, and care-seeking practices have not been characterized. A cross-sectional survey was conducted in 733 Chinese and Southeast Asian migrants in Angola. Respondents were interviewed and provided blood samples. Samples were analyzed to detect Plasmodium antigen and characterize host anti-Plasmodium response. Positive samples were genotyped using the pfs47 marker. Most respondents (72%; 95% CI: 68-75) reported using bed nets, but less than 1% reported using chemoprophylaxis. Depending on the assay, 1-4% of respondents had evidence of active malaria infection. By contrast, 55% (95% CI: 52-59) were seropositive for Plasmodium antibodies. Most infections were Plasmodium falciparum, but infection and/or exposure to Plasmodium vivax and Plasmodium malariae was also detected. Seroprevalence by time in Angola showed most exposure occurred locally. One respondent had sufficiently high parasitemia for pfs47 genotyping, which showed that the infection was likely locally acquired despite recent travel to home country. Asian migrants to Angola are at substantial risk of malaria. Employers should consider enhanced malaria prevention programs, including chemoprophylaxis; embassies should encourage prevention practices. Angolan healthcare workers should be aware of high malaria exposure in Asian migrants. |
Applying an innovative model of disaster resilience at the neighborhood level: The COPEWELL New York City Experience
Slemp CC , Sisco S , Jean MC , Ahmed MS , Kanarek NF , Eros-Sarnyai M , Gonzalez IA , Igusa T , Lane K , Tirado FP , Tria M , Lin S , Martins VN , Ravi S , Kendra JM , Carbone EG , Links JM . Public Health Rep 2020 135 (5) 565-570 Community resilience is a community's ability to maintain functioning (ie, delivery of services) during and after a disaster event. The Composite of Post-Event Well-Being (COPEWELL) is a system dynamics model of community resilience that predicts a community's disaster-specific functioning over time. We explored COPEWELL's usefulness as a practice-based tool for understanding community resilience and to engage partners in identifying resilience-strengthening strategies. In 2014, along with academic partners, the New York City Department of Health and Mental Hygiene organized an interdisciplinary work group that used COPEWELL to advance cross-sector engagement, design approaches to understand and strengthen community resilience, and identify local data to explore COPEWELL implementation at neighborhood levels. The authors conducted participant interviews and collected shared experiences to capture information on lessons learned. The COPEWELL model led to an improved understanding of community resilience among agency members and community partners. Integration and enhanced alignment of efforts among preparedness, disaster resilience, and community development emerged. The work group identified strategies to strengthen resilience. Searches of neighborhood-level data sets and mapping helped prioritize communities that are vulnerable to disasters (eg, medically vulnerable, socially isolated, low income). These actions increased understanding of available data, identified data gaps, and generated ideas for future data collection. The COPEWELL model can be used to drive an understanding of resilience, identify key geographic areas at risk during and after a disaster, spur efforts to build on local metrics, and result in innovative interventions that integrate and align efforts among emergency preparedness, community development, and broader public health initiatives. |
Candida auris outbreak involving liver transplant recipients in a Surgical Intensive Care Unit.
Theodoropoulos NM , Bolstorff B , Bozorgzadeh A , Brandeburg C , Cumming M , Daly JS , Ellison RT3rd , Forsberg K , Gade L , Gibson L , Greenough T , Litvintseva AP , Mack DA , Madoff L , Martins PN , McHale E , Melvin Z , Movahedi B , Stiles T , Vallabhaneni S , Levitz SM . Am J Transplant 2020 20 (12) 3673-3679 Candida auris is a difficult to eradicate yeast that has caused outbreaks in healthcare facilities. We report a cluster of five patients in one intensive care unit who were colonized or infected in 2017. The initial two patients were recipients of liver transplants who had cultures that grew C. auris within three days of each other in June 2017 (days 43 and 30 post-transplant). Subsequent screening cultures identified two additional patients with C. auris colonization. Respiratory and urine cultures from a fifth patient yielded C. auris. All isolates were fluconazole-resistant but susceptible to echinocandins. Whole genome sequencing showed the strains were clonal, suggesting in-hospital transmission, and related but distinct from NY/NJ strains, consistent with a separate introduction. However, no source or contact was found. Two of the five patients died. C. auris infection likely contributed to one patient death by infecting a vascular aneurysm at the graft anastomosis. Strict infection control precautions were initiated to control the outbreak. Our experience reveals that while severe disease from C. auris can occur in transplant recipients, outbreaks can be controlled using recommended infection control practices. We have had no further patients infected with C. auris to date. |
Zika Virus Surveillance at the Human-Animal Interface in West-Central Brazil, 2017-2018.
Pauvolid-Correa A , Goncalves Dias H , Marina Siqueira Maia L , Porfirio G , Oliveira Morgado T , Sabino-Santos G , Helena Santa Rita P , Teixeira Gomes Barreto W , Carvalho de Macedo G , Marinho Torres J , Arruda Gimenes Nantes W , Martins Santos F , Oliveira de Assis W , Castro Rucco A , Mamoru Dos Santos Yui R , Bosco Vilela Campos J , Rodrigues Leandro ESilva R , da Silva Ferreira R , Aparecido da Silva Neves N , Charlles de Souza Costa M , Ramos Martins L , Marques de Souza E , Dos Santos Carvalho M , Goncalves Lima M , de Cassia Goncalves Alves F , Humberto Guimaraes Riquelme-Junior L , Luiz Batista Figueiro L , Fernandes Gomes de Santana M , Gustavo Rodrigues Oliveira Santos L , Serra Medeiros S , Lopes Seino L , Hime Miranda E , Henrique Rezende Linhares J , de Oliveira Santos V , Almeida da Silva S , Araujo Lucio K , Silva Gomes V , de Araujo Oliveira A , Dos Santos Silva J , de Almeida Marques W , Schafer Marques M , Junior Franca de Barros J , Campos L , Couto-Lima D , Coutinho Netto C , Strussmann C , Panella N , Hannon E , Cristina de Macedo B , Ramos de Almeida J , Ramos Ribeiro K , Carolina Barros de Castro M , Pratta Campos L , Paula Rosa Dos Santos A , Marino de Souza I , de Assis Bianchini M , Helena Ramiro Correa S , Ordones Baptista Luz R , Dos Santos Vieira A , Maria de Oliveira Pinto L , Azeredo E , Tadeu Moraes Figueiredo L , Augusto Fonseca Alencar J , Maria Barbosa de Lima S , Miraglia Herrera H , Dezengrini Shlessarenko R , Barreto Dos Santos F , Maria Bispo de Filippis A , Salyer S , Montgomery J , Komar N . Viruses 2019 11 (12) Zika virus (ZIKV) was first discovered in 1947 in Uganda but was not considered a public health threat until 2007 when it found to be the source of epidemic activity in Asia. Epidemic activity spread to Brazil in 2014 and continued to spread throughout the tropical and subtropical regions of the Americas. Despite ZIKV being zoonotic in origin, information about transmission, or even exposure of non-human vertebrates and mosquitoes to ZIKV in the Americas, is lacking. Accordingly, from February 2017 to March 2018, we sought evidence of sylvatic ZIKV transmission by sampling whole blood from approximately 2000 domestic and wild vertebrates of over 100 species in West-Central Brazil within the active human ZIKV transmission area. In addition, we collected over 24,300 mosquitoes of at least 17 genera and 62 species. We screened whole blood samples and mosquito pools for ZIKV RNA using pan-flavivirus primers in a real-time reverse-transcription polymerase chain reaction (RT-PCR) in a SYBR Green platform. Positives were confirmed using ZIKV-specific envelope gene real-time RT-PCR and nucleotide sequencing. Of the 2068 vertebrates tested, none were ZIKV positive. Of the 23,315 non-engorged mosquitoes consolidated into 1503 pools tested, 22 (1.5%) with full data available showed some degree of homology to insect-specific flaviviruses. To identify previous exposure to ZIKV, 1498 plasma samples representing 62 species of domestic and sylvatic vertebrates were tested for ZIKV-neutralizing antibodies by plaque reduction neutralization test (PRNT90). From these, 23 (1.5%) of seven species were seropositive for ZIKV and negative for dengue virus serotype 2, yellow fever virus, and West Nile virus, suggesting potential monotypic reaction for ZIKV. Results presented here suggest no active transmission of ZIKV in non-human vertebrate populations or in alternative vector candidates, but suggest that vertebrates around human populations have indeed been exposed to ZIKV in West-Central Brazil. |
Second WIN International Conference on "Integrated approaches and innovative tools for combating insecticide resistance in vectors of arboviruses", October 2018, Singapore
Corbel V , Durot C , Achee NL , Chandre F , Coulibaly MB , David JP , Devine GJ , Dusfour I , Fonseca DM , Griego J , Juntarajumnong W , Lenhart A , Kasai S , Martins AJ , Moyes C , Ng LC , Pinto J , Pompon JF , Muller P , Raghavendra K , Roiz D , Vatandoost H , Vontas J , Weetman D . Parasit Vectors 2019 12 (1) 331 The past 40 years have seen a dramatic emergence of epidemic arboviral diseases transmitted primarily by mosquitoes. The frequency and magnitude of the epidemics, especially those transmitted by urban Aedes species, have progressively increased over time, accelerating in the past 10 years. To reduce the burden and threat of vector-borne diseases, the World Health Organization (WHO) has recently adopted the Global Vector Control Response (GVCR) in order to support countries in implementing effective sustainable vector control. The evidence-base to support vector control is however limited for arboviral diseases which make prioritization difficult. Knowledge gaps in the distribution, mechanisms and impact of insecticide resistance on vector control impedes the implementation of locally tailored Aedes control measures. This report summarizes the main outputs of the second international conference of the Worldwide Insecticide resistance Network (WIN) on "Integrated approaches and innovative tools for combating insecticide resistance in arbovirus vectors" held in Singapore, 1-3 October 2018. The aims of the conference were to review progress and achievements made in insecticide resistance surveillance worldwide, and to discuss the potential of integrated vector management and innovative technologies for efficiently controlling arboviral diseases. The conference brought together 150 participants from 26 countries. |
One hypervirulent clone, sequence type 283, accounts for a large proportion of invasive Streptococcus agalactiae isolated from humans and diseased tilapia in Southeast Asia.
Barkham T , Zadoks RN , Azmai MNA , Baker S , Bich VTN , Chalker V , Chau ML , Dance D , Deepak RN , van Doorn HR , Gutierrez RA , Holmes MA , Huong LNP , Koh TH , Martins E , Mehershahi K , Newton P , Ng LC , Phuoc NN , Sangwichian O , Sawatwong P , Surin U , Tan TY , Tang WY , Thuy NV , Turner P , Vongsouvath M , Zhang D , Whistler T , Chen SL . PLoS Negl Trop Dis 2019 13 (6) e0007421 BACKGROUND: In 2015, Singapore had the first and only reported foodborne outbreak of invasive disease caused by the group B Streptococcus (GBS; Streptococcus agalactiae). Disease, predominantly septic arthritis and meningitis, was associated with sequence type (ST)283, acquired from eating raw farmed freshwater fish. Although GBS sepsis is well-described in neonates and older adults with co-morbidities, this outbreak affected non-pregnant and younger adults with fewer co-morbidities, suggesting greater virulence. Before 2015 ST283 had only been reported from twenty humans in Hong Kong and two in France, and from one fish in Thailand. We hypothesised that ST283 was causing region-wide infection in Southeast Asia. METHODOLOGY/PRINCIPAL FINDINGS: We performed a literature review, whole genome sequencing on 145 GBS isolates collected from six Southeast Asian countries, and phylogenetic analysis on 7,468 GBS sequences including 227 variants of ST283 from humans and animals. Although almost absent outside Asia, ST283 was found in all invasive Asian collections analysed, from 1995 to 2017. It accounted for 29/38 (76%) human isolates in Lao PDR, 102/139 (73%) in Thailand, 4/13 (31%) in Vietnam, and 167/739 (23%) in Singapore. ST283 and its variants were found in 62/62 (100%) tilapia from 14 outbreak sites in Malaysia and Vietnam, in seven fish species in Singapore markets, and a diseased frog in China. CONCLUSIONS: GBS ST283 is widespread in Southeast Asia, where it accounts for a large proportion of bacteraemic GBS, and causes disease and economic loss in aquaculture. If human ST283 is fishborne, as in the Singapore outbreak, then GBS sepsis in Thailand and Lao PDR is predominantly a foodborne disease. However, whether transmission is from aquaculture to humans, or vice versa, or involves an unidentified reservoir remains unknown. Creation of cross-border collaborations in human and animal health are needed to complete the epidemiological picture. |
Trends in human immunodeficiency virus diagnoses among men who have sex with men in North America, Western Europe, and Australia, 2000-2014
Chapin-Bardales J , Schmidt AJ , Guy RJ , Kaldor JM , McGregor S , Sasse A , Archibald C , Rank C , Casabona Barbara J , Folch C , Vives N , Cowan SA , Cazein F , Velter A , An der Heiden M , Gunsenheimer-Bartmeyer B , Marcus U , Op de Coul ELM , van Sighem A , Aldir I , Cortes Martins H , Berglund T , Velicko I , Gebhardt M , Delpech V , Hughes G , Nardone A , Hall HI , Johnson AS , Sullivan PS . Ann Epidemiol 2018 28 (12) 874-880 PURPOSE: The aim of the article was to investigate recent trends in human immunodeficiency virus (HIV) diagnosis rates among men who have sex with men (MSM) in high-income countries in North America, Western Europe, and Australia. METHODS: Data on annual rates of HIV diagnoses among MSM aged 15 to 65 years from 2000 to 2014 were collected from 13 high-income countries. Joinpoint regression software was used to empirically determine country-specific trend periods. Trends in HIV diagnosis rates and in the proportion of diagnoses occurring in young MSM aged 15 to 24 years were analyzed using Poisson regression and log-binomial regression, respectively. RESULTS: Six countries experienced an increasing trend from 2000 to 2007-08 followed by either a stable or declining trend through 2014. Five countries had recently increasing trends, and two countries had one stable trend from 2000 to 2014. All 13 countries experienced increases in the proportion of diagnoses occurring in young MSM. CONCLUSIONS: Since 2008, half of the 13 high-income countries examined experienced stable or decreasing trends. Still, some countries continue to experience increasing HIV trends, and young MSM are increasingly represented among new diagnoses. Efforts to support early sexual health promotion, reduce barriers to pre-exposure prophylaxis, and improve care engagement for young MSM are critical to addressing current HIV trends. |
Efficacy and safety of artemether-lumefantrine, artesunate-amodiaquine, and dihydroartemisinin-piperaquine for the treatment of uncomplicated Plasmodium falciparum malaria in three provinces in Angola, 2017.
Davlantes E , Dimbu PR , Ferreira CM , Florinda Joao M , Pode D , Felix J , Sanhangala E , Andrade BN , Dos Santos Souza S , Talundzic E , Udhayakumar V , Owens C , Mbounga E , Wiesner L , Halsey ES , Martins JF , Fortes F , Plucinski MM . Malar J 2018 17 (1) 144 BACKGROUND: The Angolan government recommends three artemisinin-based combinations for the treatment of uncomplicated Plasmodium falciparum malaria: artemether-lumefantrine (AL), artesunate-amodiaquine (ASAQ), and dihydroartemisinin-piperaquine (DP). Due to the threat of emerging anti-malarial drug resistance, it is important to periodically monitor the efficacy of artemisinin-based combination therapy (ACT). This study evaluated these medications' therapeutic efficacy in Benguela, Lunda Sul, and Zaire Provinces. METHODS: Enrollment occurred between March and July 2017. Study participants were children with P. falciparum monoinfection from each provincial capital. Participants received a 3-day course of a quality-assured artemisinin-based combination and were monitored for 28 (AL and ASAQ arms) or 42 days (DP arm). Each ACT was assessed in two provinces. The primary study endpoints were: (1) follow-up without complications and (2) failure to respond to treatment or development of recurrent P. falciparum infection. Parasites from each patient experiencing recurrent infection were genotyped to differentiate new infection from recrudescence of persistent parasitaemia. These parasites were also analysed for molecular markers associated with ACT resistance. RESULTS: Of 608 children enrolled in the study, 540 (89%) reached a primary study endpoint. Parasitaemia was cleared within 3 days of medication administration in all participants, and no early treatment failures were observed. After exclusion of reinfections, the corrected efficacy of AL was 96% (91-100%, 95% confidence interval) in Zaire and 97% (93-100%) in Lunda Sul. The corrected efficacy of ASAQ was 100% (97-100%) in Benguela and 93% (88-99%) in Zaire. The corrected efficacy of DP was 100% (96-100%) in Benguela and 100% in Lunda Sul. No mutations associated with artemisinin resistance were identified in the pfk13 gene in the 38 cases of recurrent P. falciparum infection. All 33 treatment failures in the AL and ASAQ arms carried pfmdr1 or pfcrt mutations associated with lumefantrine and amodiaquine resistance, respectively, on day of failure. CONCLUSIONS: AL, ASAQ, and DP continue to be efficacious against P. falciparum malaria in these provinces of Angola. Rapid parasite clearance and the absence of genetic evidence of artemisinin resistance are consistent with full susceptibility to artemisinin derivatives. Periodic monitoring of in vivo drug efficacy remains a priority routine activity for Angola. |
International workshop on insecticide resistance in vectors of arboviruses, December 2016, Rio de Janeiro, Brazil
Corbel V , Fonseca DM , Weetman D , Pinto J , Achee NL , Chandre F , Coulibaly MB , Dusfour I , Grieco J , Juntarajumnong W , Lenhart A , Martins AJ , Moyes C , Ng LC , Raghavendra K , Vatandoost H , Vontas J , Muller P , Kasai S , Fouque F , Velayudhan R , Durot C , David JP . Parasit Vectors 2017 10 (1) 278 Vector-borne diseases transmitted by insect vectors such as mosquitoes occur in over 100 countries and affect almost half of the world's population. Dengue is currently the most prevalent arboviral disease but chikungunya, Zika and yellow fever show increasing prevalence and severity. Vector control, mainly by the use of insecticides, play a key role in disease prevention but the use of the same chemicals for more than 40 years, together with the dissemination of mosquitoes by trade and environmental changes, resulted in the global spread of insecticide resistance. In this context, innovative tools and strategies for vector control, including the management of resistance, are urgently needed. This report summarizes the main outputs of the first international workshop on Insecticide resistance in vectors of arboviruses held in Rio de Janeiro, Brazil, 5-8 December 2016. The primary aims of this workshop were to identify strategies for the development and implementation of standardized insecticide resistance management, also to allow comparisons across nations and across time, and to define research priorities for control of vectors of arboviruses. The workshop brought together 163 participants from 28 nationalities and was accessible, live, through the web (> 70,000 web-accesses over 3 days). |
Association of neighbourhood food availability with the consumption of processed and ultra-processed food products by children in a city of Brazil: a multilevel analysis
Leite FH , de Carvalho Cremm E , de Abreu DS , Oliveira MA , Budd N , Martins PA . Public Health Nutr 2017 21 (1) 1-12 OBJECTIVE: To investigate the association between neighbourhood food availability and the consumption of ready-to-consume products (RCP), either processed or ultra-processed, and unprocessed/minimally processed foods (UF-MPF) by children. DESIGN: Cross-sectional. 24 h Dietary recalls were collected from children from January 2010 to June 2011. Neighbourhood food availability data were collected from 672 food stores located within 500 m of participants' homes, using an adapted and validated instrument. Neighbourhood-level socio-economic status (SES) was obtained by calculating the mean years of household head's education level in each census tract covered by 500 m buffers. Foods that were consumed by children and/or available in the food stores were classified based on their degree of industrial processing. Multilevel random-effect models examined the association between neighbourhood food availability and children's diets. SETTING: Santos, Brazil. SUBJECTS: Children (n 513) under 10 years old (292 aged <6 years, 221 aged ≥6 years). RESULTS: The availability of RCP in food stores was associated with increased RCP consumption (P<0.001) and decreased UF-MPF consumption (P<0.001). The consumption of UF-MPF was positively associated with neighbourhood-level SES (P<0.01), but not with the availability of UF-MPF in the neighbourhood. CONCLUSIONS: Results suggest that food policies and interventions that aim to reduce RCP consumption in Santos and similar settings should focus on reducing the availability in food stores. The results also suggest that interventions should not only increase the availability of UF-MPF in lower-SES neighbourhoods, but should strive to make UF-MPF accessible within these environments. |
Tracking insecticide resistance in mosquito vectors of arboviruses: the Worldwide Insecticide resistance Network (WIN)
Corbel V , Achee NL , Chandre F , Coulibaly MB , Dusfour I , Fonseca DM , Grieco J , Juntarajumnong W , Lenhart A , Martins AJ , Moyes C , Ng LC , Pinto J , Raghavendra K , Vatandoost H , Vontas J , Weetman D , Fouque F , Velayudhan R , David JP . PLoS Negl Trop Dis 2016 10 (12) e0005054 The transmission of the arboviral agents of dengue, yellow fever, Chikungunya, and Zika by Aedes mosquitoes represents expanding threats to global health. At the 69th World Health Assembly [1], the WHO Director-General Margaret Chan declared that the spread of the Zika virus was "the result of the abandon of mosquito control" by governments since the 1970s and urged Member States to mobilize more efforts and resources to prevent further spread of the diseases. The recent rise of microcephaly cases and other neurological disorders reported in Brazil prompted WHO to declare Zika as a Public Health Emergency of International Concern [2]. After limited early outbreaks in the Pacific in 2007 and 2013, the Zika virus has spread to more than 30 countries in the Americas and the Caribbean, affecting over 1.5 million people [3]. With growing evidence supporting the link between microcephaly and Zika [4, 5] and preliminary evidence confirming Aedes aegypti as the primary vector in the Brazilian outbreak [6], the mandate for control is clear and urgent. | Although progress is being made on vaccine development (for example, Sanofi Pasteur’s recently licensed dengue vaccine Dengvaxia [7]), vector control by removing larval habitats and using biological and chemical insecticides still remain the first line of defence against arboviruses [8]. Unfortunately, decades of efforts failed to consistently control Aedes mosquito populations and/or to curtail the cycle of epidemics. Control of adult mosquitoes using space spray applications of pyrethroids and organophospates in plural is fraught with complications, including high cost, slow operational response, low community buy-in, ineffective timing of application, and rather low efficacy and/or residual effect [9–11]. Furthermore, some countries have a lack of capacity in monitoring the use of public health insecticides for the control of arbovirus vectors [12] that is essential for guiding pesticide management systems on appropriate use and reduction of risks to human health and environment. |
Erratum: Environmental distribution of Cryptococcus neoformans and C. gattii around the Mediterranean basin
Cogliati M , D'Amicis R , Zani A , Montagna MT , Caggiano G , De Giglio O , Balbino S , De Donno A , Serio F , Susever S , Ergin C , Velegraki A , Ellabib MS , Nardoni S , Macci C , Oliveri S , Trovato L , Dipineto L , Rickerts V , McCormick-Smith I , Akcaglar S , Tore O , Mlinaric-Missoni E , Bertout S , Mallié M , Martins MD , Vencà AC , Vieira ML , Sampaio AC , Pereira C , Criseo G , Romeo O , Ranque S , Al-Yasiri MH , Kaya M , Cerikcioglu N , Marchese A , Vezzulli L , Ilkit M , Desnos-Ollivier M , Pasquale V , Korem M , Polacheck I , Scopa A , Meyer W , Ferreira-Paim K , Hagen F , Theelen B , Boekhout T , Lockhart SR , Tintelnot K , Tortorano AM , Dromer F , Varma A , Kwon-Chung KJ , Inácio J , Alonso B , Colom MF . FEMS Yeast Res 2016 16 (7) This paper has been updated to correct a spelling error concerning an author name. It previously showed as Giuseppe Griseo, however the correct spelling is Giuseppe Criseo. |
Mortality Information System in Portugal: transition to e-death certification
Pinto CS , Anderson RN , Martins H , Marques C , Maia C , do Carmo Borralho M . Eurohealth (Lond) 2016 22 (2) 1-53 Inability to invest in and develop mortality information systems has been considered the single most critical failure in health information systems and there is a recognized urgent need to improve mortality statistics and cause of death information. Although there have been major developments in information technology with the potential to improve public health information systems, mortality data collection has largely remained unchanged in most countries, mainly due to legal and operational barriers. Electronic registration and certification of death certificates has the potential to improve the quality and timeliness of mortality statistics. The Mortality Information System in Portugal has, since 1950, been a paper-form death certification model. The Portuguese Directorate-General of Health recently implemented electronic death certification as the basis of a new mortality information system. A strategic multistep approach, defined by geographic areas of the country, was planned for implementation of the system. National implementation was completed in December of 2013 and 100% e-death certification was achieved beginning January 2014. This article reports the implementation process and describes the newly established mortality information system. |
Population Genetic Analysis Reveals a High Genetic Diversity in the Brazilian Cryptococcus gattii VGII Population and Shifts the Global Origin from the Amazon Rainforest to the Semi-arid Desert in the Northeast of Brazil.
Souto AC , Bonfietti LX , Ferreira-Paim K , Trilles L , Martins M , Ribeiro-Alves M , Pham CD , Martins L , Dos Santos W , Chang M , Brito-Santos F , Santos DC , Fortes S , Lockhart SR , Wanke B , Melhem MS , Lazera MS , Meyer W . PLoS Negl Trop Dis 2016 10 (8) e0004885 Cryptococcus neoformans and Cryptococcus gattii are responsible globally for almost one million cryptococcosis cases yearly, mostly in immunocompromised patients, such as those living with HIV. Infections due to C. gattii have mainly been described in tropical and subtropical regions, but its adaptation to temperate regions was crucial in the species evolution and highlighted the importance of this pathogenic yeast in the context of disease. Cryptococcus gattii molecular type VGII has come to the forefront in connection with an on-going emergence in the Pacific North West of North America. Taking into account that previous work pointed towards South America as an origin of this species, the present work aimed to assess the genetic diversity within the Brazilian C. gattii VGII population in order to gain new insights into its origin and global dispersal from the South American continent using the ISHAM consensus MLST typing scheme. Our results corroborate the finding that the Brazilian C. gattii VGII population is highly diverse. The diversity is likely due to recombination generated from sexual reproduction, as evidenced by the presence of both mating types in clinical and environmental samples. The data presented herein strongly supports the emergence of highly virulent strains from ancestors in the Northern regions of Brazil, Amazonia and the Northeast. Numerous genotypes represent a link between Brazil and other parts of the world reinforcing South America as the most likely origin of the C. gattii VGII subtypes and their subsequent global spread, including their dispersal into North America, where they caused a major emergence. |
Neonatal infections: Case definition and guidelines for data collection, analysis, and presentation of immunisation safety data
Vergnano S , Buttery J , Cailes B , Chandrasekaran R , Chiappini E , Clark E , Cutland C , de Andrade SD , Esteves-Jaramillo A , Guinazu JR , Jones C , Kampmann B , King J , Kochhar S , Macdonald N , Mangili A , de Menezes Martins R , Munoz CV , Padula M , Munoz FM , Oleske J , Sanicas M , Schlaudecker E , Spiegel H , Subelj M , Sukumaran L , Tagbo BN , Top KA , Tran D , Heath PT . Vaccine 2016 34 (49) 6038-6046 Maternal vaccination is an important area of research and requires appropriate and internationally comparable definitions and safety standards. The GAIA group, part of the Brighton Collaboration was created with the mandate of proposing standardised definitions applicable to maternal vaccine research. This study proposes international definitions for neonatal infections. The neonatal infections GAIA working group performed a literature review using Medline, EMBASE and the Cochrane collaboration and collected definitions in use in neonatal and public health networks. The common criteria derived from the extensive search formed the basis for a consensus process that resulted in three separate definitions for neonatal blood stream infections (BSI), meningitis and lower respiratory tract infections (LRTI). For each definition three levels of evidence are proposed to ensure the applicability of the definitions to different settings. Recommendations about data collection, analysis and presentation are presented and harmonized with the Brighton Collaboration and GAIA format and other existing international standards for study reporting. |
Meta-analysis of the performance of a combined treponemal and non-treponemal rapid diagnostic test for syphilis and yaws
Marks M , Yin YP , Chen XS , Castro A , Causer L , Guy R , Wangnapi R , Mitja O , Aziz A , Castro R , da Luz Martins Pereira F , Taleo F , Guinard J , Belec L , Tun Y , Bottomley C , Ballard RC , Mabey DC . Clin Infect Dis 2016 63 (5) 627-633 BACKGROUND: The human treponematoses are important causes of disease. Mother-to-child transmission of syphilis remains a major cause of stillbirth and neonatal death. There are also almost 100,000 cases of endemic treponemal disease reported annually, predominantly yaws. Rapid diagnostic tests would improve access to screening for these diseases. Most RDTs cannot distinguish current and previous infection. The Dual Path Platform Syphilis Screen and Confirm test includes both a treponemal (T1) and non-treponemal (T2) component and may improve the accuracy of diagnosis. METHODS: We conducted a meta-analysis of published and unpublished evaluations of the DPP Rapid Diagnostic Test (RDT) for the diagnosis of syphilis and yaws. We calculated the sensitivity, specificity and overall agreement of the test compared to reference laboratory tests. RESULTS: Nine evaluations including a total of 7,267 tests were included. Sensitivity was higher in patients with higher titre RPR (≥1:16) for both the T1 (98.2% vs 90.1%, p<0.0001) and the T2 component (98.2% vs 80.6%, p<0.0001). Overall agreement between the DPP test and reference serology was 85.2% (84.4-86.1%). Agreement was highest for high titre active infection and lowest for past infection CONCLUSIONS: The RDT has good sensitivity and specificity of the treponemal and non-treponemal components both in cases of suspected syphilis and yaws, although the sensitivity is decreased at lower antibody titres. |
Environmental distribution of Cryptococcus neoformans and Cryptococcus gattii around the Mediterranean basin
Cogliati M , D'Amicis R , Zani A , Montagna MT , Caggiano G , De Giglio O , Balbino S , De Donno A , Serio F , Susever S , Ergin C , Velegraki A , Ellabib MS , Nardoni S , Macci C , Oliveri S , Trovato L , Dipineto L , Rickerts V , McCormick-Smith I , Akcaglar S , Tore O , Mlinaric-Missoni E , Bertout S , Mallie M , Martins MD , Venca AC , Vieira ML , Sampaio AC , Pereira C , Griseo G , Romeo O , Ranque S , Al-Yasiri MH , Kaya M , Cerikcioglu N , Marchese A , Vezzulli L , Ilkit M , Desnos-Ollivier M , Pasquale V , Korem M , Polacheck I , Scopa A , Meyer W , Ferreira-Paim K , Hagen F , Theelen B , Boekhout T , Lockhart SR , Tintelnot K , Tortorano AM , Dromer F , Varma A , Kwon-Chung KJ , Inacio J , Alonso B , Colom MF . FEMS Yeast Res 2016 16 (4) In order to elucidate the distribution of Cryptococcus neoformans and C. gattii in the Mediterranean basin, an extensive environmental survey was carried out during 2012-15. A total of 302 sites located in 12 countries were sampled, 6436 samples from 3765 trees were collected, and 5% of trees were found to be colonized by cryptococcal yeasts. Cryptococcus neoformans was isolated from 177 trees and C. gattii from 13. Cryptococcus neoformans colonized 27% of Ceratonia, 10% of Olea, Platanus and Prunus trees and a lower percentage of other tree genera. The 13 C. gattii isolates were collected from five Eucalyptus, four Ceratonia, two Pinus, and two Olea trees. C. neoformans was distributed all around the Mediterranean basin, whereas C. gattii was isolated in Greece, Southern Italy, and Spain, in agreement with previous findings from both clinical and environmental sources. Among C. neoformans isolates VNI was the prevalent molecular type but VNII, VNIV and VNIII hybrid strains were also isolated. With the exception of a single VGIV isolate, all C. gattii isolates were VGI. The results confirmed the presence of both Cryptococcus species in the Mediterranean environment, and showed that both carob and olive trees represent an important niche for these yeasts. |
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