Last data update: Sep 16, 2024. (Total: 47680 publications since 2009)
Records 1-21 (of 21 Records) |
Query Trace: de Castro R [original query] |
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North-south pathways, emerging variants, and high climate suitability characterize the recent spread of dengue virus serotypes 2 and 3 in the Dominican Republic
Miguel I , Feliz EP , Agramonte R , Martinez PV , Vergara C , Imbert Y , De la Cruz L , de Castro N , Cedano O , De la Paz Y , Fonseca V , Santiago GA , Muñoz-Jordán JL , Peguero A , Paulino-Ramírez R , Grubaugh ND , de Filippis AMB , Alcantara LCJ , Rico JM , Lourenço J , Franco L , Giovanetti M . BMC Infect Dis 2024 24 (1) 751 BACKGROUND: Dengue fever remains a significant public health challenge in tropical and subtropical regions, with its transmission dynamics being influenced by both environmental factors and human mobility. The Dominican Republic, a biodiversity hotspot in the Caribbean, has experienced recurrent dengue outbreaks, yet detailed understanding of the virus's transmission pathways and the impact of climatic factors remains limited. This study aims to elucidate the recent transmission dynamics of the dengue virus (DENV) in the Dominican Republic, utilizing a combination of genomic sequencing and epidemiological data analysis, alongside an examination of historical climate patterns. METHODS: We conducted a comprehensive study involving the genomic sequencing of DENV samples collected from patients across different regions of the Dominican Republic over a two-year period. Phylogenetic analyses were performed to identify the circulation of DENV lineages and to trace transmission pathways. Epidemiological data were integrated to analyze trends in dengue incidence and distribution. Additionally, we integrated historical climate data spanning several decades to assess trends in temperature and their potential impact on DENV transmission potential. RESULTS: Our results highlight a previously unknown north-south transmission pathway within the country, with the co-circulation of multiple virus lineages. Additionally, we examine the historical climate data, revealing long-term trends towards higher theoretical potential for dengue transmission due to rising temperatures. CONCLUSION: This multidisciplinary study reveals intricate patterns of dengue virus transmission in the Dominican Republic, characterized by the co-circulation of multiple DENV lineages and a novel transmission pathway. The observed correlation between rising temperatures and increased dengue transmission potential emphasizes the need for integrated climate-informed strategies in dengue control efforts. Our findings offer critical insights for public health authorities in the Dominican Republic and similar settings, guiding resource allocation and the development of preparedness strategies to mitigate the impacts of climate change on dengue transmission. |
Emergence of dengue virus serotype 2 cosmopolitan genotype, Brazil
Giovanetti M , Pereira LA , Santiago GA , Fonseca V , Mendoza MPG , de Oliveira C , de Moraes L , Xavier J , Tosta S , Fristch H , de Castro Barbosa E , Rodrigues ES , Figueroa-Romero D , Padilla-Rojas C , Cáceres-Rey O , Mendonça AF , de Bruycker Nogueira F , Venancio da Cunha R , de Filippis AMB , Freitas C , Peterka CRL , de Albuquerque CFC , Franco L , Méndez Rico JA , Muñoz-Jordán JL , Lemes da Silva V , Alcantara LCJ . Emerg Infect Dis 2022 28 (8) 1725-1727 We used nanopore sequencing and phylogenetic analyses to identify a cosmopolitan genotype of dengue virus serotype 2 that was isolated from a 56-year-old male patient from the state of Goiás in Brazil. The emergence of a cosmopolitan genotype in Brazil will require risk assessment and surveillance to reduce epidemic potential. |
Serum Concentrations of Cotinine and Trans-3'-Hydroxycotinine in US Adults: Results From Wave 1 (2013-2014) of the Population Assessment of Tobacco and Health Study
Sosnoff CS , Caron K , Akins JR , Dortch K , Hunter RE , Pine BN , Feng J , Blount BC , Li Y , van Bemmel DM , Kimmel HL , Edwards KC , Goniewicz ML , Hatsukami DK , de Castro BR , Bernert JT , Arnstein S , Borek N , Deng-Bryant Y , Mishina E , Lawrence C , Hyland A , Hecht SS , Conway KP , Pirkle JL , Wang L . Nicotine Tob Res 2021 24 (5) 736-744 INTRODUCTION: The Population Assessment of Tobacco and Health (PATH) Study is a nationally representative cohort of tobacco product users and nonusers. The study's main purpose is to obtain longitudinal epidemiologic data on tobacco use and exposure among the US population. AIMS AND METHODS: Nicotine biomarkers-cotinine (COT) and trans-3'-hydroxycotinine (HCT)-were measured in blood samples collected from adult daily tobacco users and nonusers during Wave 1 of the PATH Study (2013-2014; n = 5012; one sample per participant). Participants' tobacco product use and exposure to secondhand smoke were categorized based on questionnaire responses. Nonusers were subdivided into never users and recent former users. Daily tobacco users were classified into seven tobacco product use categories: exclusive users of cigarette, smokeless tobacco, electronic cigarette, cigar, pipe, and hookah, as well as polyusers. We calculated sample-weighted geometric mean (GM) concentrations of cotinine, HCT, and the nicotine metabolite ratio (NMR) and evaluated their associations with tobacco use with adjustment for potential confounders. RESULTS: The GMs (95% confidence intervals) of COT and HCT concentrations for daily tobacco users were 196 (184 to 208) and 72.5 (67.8 to 77.4) ng/mL, and for nonusers they were 0.033 (0.028 to 0.037) and 0.021 (0.018 to 0.023) ng/mL. Exclusive smokeless tobacco users had the highest COT concentrations of all user groups examined. The GM NMR in daily users was 0.339 (95% confidence interval: 0.330 to 0.350). CONCLUSIONS: These nationally representative estimates of serum nicotine biomarkers could be the basis for reference ranges characterizing nicotine exposure for daily tobacco users and nonusers in the US adult population. IMPLICATIONS: This report summarizes the serum nicotine biomarker measurements in Wave 1 of the PATH Study. We are reporting the first estimates of HCT in serum for daily tobacco users and nonusers in the noninstitutionalized, civilian US adult population; the first nationally representative serum COT estimates for daily exclusive users of different tobacco products and daily polyusers; and the first nationally representative estimate of the serum NMR in daily tobacco users by age, race/ethnicity, and sex. |
Identifying and minimizing errors in the measurement of early childhood development: Lessons learned from the cognitive testing of the ECDI2030
Cappa C , Petrowski N , De Castro EF , Geisen E , Lebaron P , Allen-Leigh B , Place JM , Scanlon PJ . Int J Environ Res Public Health 2021 18 (22) Challenges in measuring early childhood development (ECD) at scale have been docu-mented, yet little is known about the specific difficulties related to questionnaire design and question interpretation. The purpose of this paper is to discuss the challenges of measuring ECD at scale in the context of household surveys and to show how to overcome them. The paper uses examples from the cognitive interviewing exercises that were conducted as part of the methodological work to develop a measure of ECD outcomes, the ECDI2030. It describes the methodological work carried out to inform the selection and improvement of question items and survey implementation tools as a fun-damental step to reduce and mitigate systematic measurement error and improve data quality. The project consisted of a total of five rounds of testing, comprising 191 one-on-one, in-depth cognitive interviews across six countries (Bulgaria, India, Jamaica, Mexico, Uganda, and the USA). Qualitative data analysis methods were used to determine matches and mismatches between intention of items and false positives or false negative answers among subgroups of respondents. Key themes emerged that could potentially lead to systematic measurement error in population-based surveys on ECD: (1) willingness of child to perform task versus ability of child to perform task; (2) performing task versus performing task correctly; (3) identifying letters or numbers versus recognizing letters or numbers; (4) consistently performing task versus correctly performing task; (5) applicability of skills being asked versus observability of skills being asked; and (6) language production versus language comprehension. Through an iterative process of testing and subsequent revision, improvements were made to item wording, response options, and interviewer training instructions. Given the difficulties inherent in population-level data collection in the context of global monitoring, this study’s findings confirm the importance of cognitive testing as a crucial step in careful, culturally relevant, and sensitive questionnaire design and as a means to reduce response bias in cross-cultural contexts. © 2021 by the authors. Licensee MDPI, Basel, Switzerland. |
Exoproteomic analysis of two MLST clade 2 strains of Clostridioides difficile from Latin America reveal close similarities.
de Melo Pacífico D , Costa CL , Moura H , Barr JR , Maia GA , Filho VB , Moreira RS , Wagner G , Domingues Rmcp , Quesada-Gómez C , de Oliveira Ferreira E , de Castro Brito GA . Sci Rep 2021 11 (1) 13273 Clostridioides difficile BI/NAP1/ribotype 027 is an epidemic hypervirulent strain found worldwide, including in Latin America. We examined the genomes and exoproteomes of two multilocus sequence type (MLST) clade 2 C. difficile strains considered hypervirulent: ICC-45 (ribotype SLO231/UK[CE]821), isolated in Brazil, and NAP1/027/ST01 (LIBA5756), isolated during a 2010 outbreak in Costa Rica. C. difficile isolates were cultured and extracellular proteins were analyzed using high-performance liquid chromatography-tandem mass spectrometry. Genomic analysis revealed that these isolates shared most of the gene composition. Only 83 and 290 NAP1/027 genes were considered singletons in ICC-45 and NAP1/027, respectively. Exoproteome analysis revealed 197 proteins, of which 192 were similar in both strains. Only five proteins were exclusive to the ICC-45 strain. These proteins were involved with catalytic and binding functions and indirectly interacted with proteins related to pathogenicity. Most proteins, including TcdA, TcdB, flagellin subunit, and cell surface protein, were overrepresented in the ICC-45 strain; 14 proteins, including mature S-layer protein, were present in higher proportions in LIBA5756. Data are available via ProteomeXchange with identifier PXD026218. These data show close similarity between the genome and proteins in the supernatant of two strains with hypervirulent features isolated in Latin America and underscore the importance of epidemiological surveillance of the transmission and emergence of new strains. |
Tobacco-specific nitrosamines (NNAL, NNN, NAT, and NAB) exposures in the US Population Assessment of Tobacco and Health (PATH) Study Wave 1 (2013-2014)
Xia B , Blount BC , Guillot T , Brosius C , Li Y , Van Bemmel DM , Kimmel HL , Chang CM , Borek N , Edwards KC , Lawrence C , Hyland A , Goniewicz ML , Pine BN , Xia Y , Bernert JT , De Castro BR , Lee J , Brown JL , Arnstein S , Choi D , Wade EL , Hatsukami D , Ervies G , Cobos A , Nicodemus K , Freeman D , Hecht SS , Conway K , Wang L . Nicotine Tob Res 2020 23 (3) 573-583 INTRODUCTION: The tobacco-specific nitrosamines (TSNAs) are an important group of carcinogens found in tobacco and tobacco smoke. To describe and characterize the levels of TSNAs in the Population Assessment of Tobacco and Health (PATH) Study Wave 1 (2013-2014), we present four biomarkers of TSNA exposure: N'-nitrosonornicotine, N'-nitrosoanabasine, N'-nitrosoanatabine, and 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanol (NNAL) which is the primary urinary metabolite of 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanone. METHODS: We measured total TSNAs in 11 522 adults who provided urine using automated solid-phase extraction coupled to isotope dilution liquid chromatography-tandem mass spectrometry. After exclusions in this current analysis, we selected 11 004 NNAL results, 10 753 N'-nitrosonornicotine results, 10 919 N'-nitrosoanatabine results, and 10 996 N'-nitrosoanabasine results for data analysis. Geometric means and correlations were calculated using SAS and SUDAAN. RESULTS: TSNA concentrations were associated with choice of tobacco product and frequency of use. Among established, every day, exclusive tobacco product users, the geometric mean urinary NNAL concentration was highest for smokeless tobacco users (993.3; 95% confidence interval [CI: 839.2, 1147.3] ng/g creatinine), followed by all types of combustible tobacco product users (285.4; 95% CI: [267.9, 303.0] ng/g creatinine), poly tobacco users (278.6; 95% CI: [254.9, 302.2] ng/g creatinine), and e-cigarette product users (6.3; 95% CI: [4.7, 7.9] ng/g creatinine). TSNA concentrations were higher in every day users than in intermittent users for all the tobacco product groups. Among single product users, exposure to TSNAs differed by sex, age, race/ethnicity, and education. Urinary TSNAs and nicotine metabolite biomarkers were also highly correlated. CONCLUSIONS: We have provided PATH Study estimates of TSNA exposure among US adult users of a variety of tobacco products. These data can inform future tobacco product and human exposure evaluations and related regulatory activities. |
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. |
Seroprevalence of hepatitis A and hepatitis E viruses among pregnant women in Haiti
Tejada-Strop A , Tohme RA , Andre-Alboth J , Childs L , Ji X , de Oliveira Landgraf de Castro V , Boncy J , Kamili S . Am J Trop Med Hyg 2019 101 (1) 230-232 Hepatitis E virus (HEV) infection is associated with a high fatality rate among pregnant women, and gestational complications have been reported among pregnant women infected with hepatitis A virus (HAV). The aim of this study was to determine the seroprevalence of HAV and HEV infections among pregnant women in Haiti. We stratified the population (n = 1,307) between West and non-West regions. Specimens were tested for total HAV antibody (anti-HAV), and IgM and IgG HEV antibody (anti-HEV). Overall, 96.8% pregnant women were positive for total anti-HAV, 10.3% for IgG anti-HEV, and 0.3% for IgM anti-HEV. The prevalence of IgG anti-HEV in the non-West region (12.3%) was significantly greater than that in the West region (5.3%) (P < 0.0001). Most pregnant women in Haiti had evidence of past exposure and immunity to HAV. The non-West region had a higher prevalence of HEV. Improvement in water and sanitation will help in the prevention and control of these infections in Haiti. |
An automated immunoblot method for detection of IgG antibodies to hepatitis C virus: A potential supplemental antibody confirmatory assay
Kodani M , Martin M , de Castro VL , Drobeniuc J , Kamili S . J Clin Microbiol 2019 57 (3) An estimated 41,200 people were newly infected with hepatitis C virus (HCV) in 2016 in the United States. Screening tests for antibodies to HCV may generate up to 32% false positivity in low-risk populations. Current Centers for Disease Control and Prevention (CDC) screening recommendations do not require confirmatory testing of a screening anti-HCV positive test, however confirmation is valuable for surveillance in the absence of HCV RNA testing. Recombinant Immunoblot Assay (RIBA) was used as a confirmatory assay for anti-HCV reactive samples but was discontinued in 2013. Another anti-HCV confirmatory assay, INNO-LIA, is commercially available in Europe but not approved by the Food and Drug Administration (FDA) in the United States. We report the development of an anti-HCV assay performed on an automated immunoblot platform using a fourth generation HCV recombinant fusion protein. Based on testing of 70 well characterized samples of which 40 were HCV RNA and anti-HCV positive, 15 HCV RNA positive/anti-HCV negative and 15 HCV RNA and anti-HCV negative, the specificity and sensitivity of the HCV-WES assay was 100% and 95%, respectively. Concordance between INNO-LIA and HCV WES, was determined by testing 205 HCV RNA negative/anti-HCV positive samples, of which 149 (72.7%) were positive by HCV-WES, while 146 (71.2%) were positive by INNO-LIA. We have shown proof of concept for the use of this test for confirmation of screening anti-HCV results. The HCV-WES assay is advantageous over manual western blot assays and INNO-LIA including ease of use, low cost and reduced hands-on time. |
From the small screen to breast cancer screening: examining the effects of a television storyline on awareness of genetic risk factors
Rosenthal EL , de Castro Buffington S , Cole G . J Commun Healthc 2018 11 (2) 140-150 Background: The topic of breast cancer genetics entered the public discourse following Angelina Jolie's 2013 announcement that she carries the BRCA1 mutation and underwent a prophylactic double mastectomy to reduce her breast cancer risk. A year prior to Jolie's announcement, the teen drama 90210 ran an eight-episode story arc on the BRCA gene mutations. This study focuses on an evaluation of the impact of this particular media text within the broader context of research on the persuasive effects of entertainment narratives (i.e. entertainment education). Method: The evaluation consisted of two complementary studies of adult women: a pre-test/post-test study using a panel sample of regular television viewers who were directed to watch a particular episode (Study 1), and a cross-sectional study using a convenience sample of frequent 90210 viewers (Study 2). Results: In both studies, storyline exposure was associated with increased knowledge (familiarity with the BRCA gene, knowledge about mastectomy). Study 1 additionally saw evidence of increased fears regarding the consequences of the BRCA gene and intentions to talk to a doctor. In Study 2, the number of episodes viewed was positively related to both knowledge and behavior (finding out about one's family history of breast cancer). Conclusions: These findings suggest that despite unprecedented changes in the ways audiences engage with and consume entertainment media, television narratives remain a powerful method of educating viewers about health risks and inspiring them to take action. |
The development and testing of a module on child functioning for identifying children with disabilities on surveys. III: Field testing
Cappa C , Mont D , Loeb M , Misunas C , Madans J , Comic T , de Castro F . Disabil Health J 2018 11 (4) 510-518 BACKGROUND: A module on child functioning developed by UNICEF and the Washington Group on Disability Statistics (WG) for use in censuses and surveys reflects current thinking around disability measurement and is intended to produce internationally comparable data. The Child Functioning Module (CFM) was developed in response to limitations of the Ten Question Screening Instrument (TQSI) for use in surveys and builds on the WG Short Set (WG-SS) of questions that was designed to capture disability in censuses, particularly among the adult population. OBJECTIVE: This paper documents the testing of the module and summarizes its results, including a description of prevalence levels across countries using different cut-offs, and comparisons with prevalence levels obtained using the TQSI and the WG-SS. METHODS: Field tests were conducted in Samoa as part of the 2014 Demographic and Health Survey and in Mexico as part of the 2015 National Survey of Boys, Girls and Women. The module was also implemented in Serbia as part of a dedicated survey conducted in the province of Vojvodina, in February 2016. RESULTS: Using the recommended cut-offcut-off, the percentage of children reported as having functional difficulty ranges from 1.1% in Serbia to 2% in Mexico among children aged 2-4 years, and from 3.2% in Samoa to 11.2% in Mexico among children aged 5-17 years. Across all three countries, the prevalence of functional difficulty was highest in the socio-emotional domains. A comparison of the prevalence levels obtained using the WG-SS and the CFM shows that, except for the question on cognition/learning, the WG-SS and the CFM are relatively close for children aged 5-17 years for the domains that are included in both question sets, but the WG-SS excludes many children identified by the CFM in other domains. The comparison between the TQSI and the CFM shows that, while the prevalence estimates are similar for seeing and hearing, significant differences affect other domains, particularly cognition/learning and communication. CONCLUSIONS: The CFM addresses a full range of functional domains that are important for child development. The module represents an improvement on the TQSI in that it allows for scaled responses to determine the degree of difficulty, and so can separate out many potential false positives. The module is also preferred over the WG-SS for collecting data on children, first, because most of the questions in the WG-SS are not suitable for children under the age of 5 years, and second, because the WG-SS leaves out important functional domains for children aged 5-17 years, namely those related to developmental disabilities and behavioural issues. |
Smoking behavior and exposure: Results of a menthol cigarette cross-over study
Watson CV , Richter P , de Castro BR , Sosnoff C , Potts J , Clark P , McCraw J , Yan X , Chambers D , Watson C . Am J Health Behav 2017 41 (3) 309-319 OBJECTIVE: Our objective was to improve understanding of the differences in use behavior and exposure when smoking menthol and non-menthol cigarettes using a 2-part cross-over design. METHODS: Adult daily smokers were assigned randomly to alternate between 2 weeks of exclusively smoking a menthol test cigarette or a non-menthol test cigarette. Urine and saliva were collected for biomarker measurements; carbon monoxide (CO) was measured, and participants smoked test cigarettes through a CreSS(R) smoking topography device during 3 clinic visits. Participants turned in their cigarette butts from the test periods for determination of mouth level nicotine and completed subjective questionnaires related to the test cigarettes. RESULTS: Regardless of cigarette preference, participants had higher salivary cotinine when smoking the non-menthol test cigarette, but there were no significant differences detected in urine 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanol between the 2 test cigarettes. Mouth level nicotine, puff volume, and puff duration were significantly higher when smoking the menthol brand. Both menthol and non-menthol smokers reported significantly lower enjoyment and satisfaction scores for test cigarettes compared with their brand of choice. CONCLUSIONS: Our results suggest that mentholation has an effect on measures of smoking behavior and that mouth level nicotine is a useful indicator of between-brand smoke exposure. |
Blood lead levels among children aged <6 years - Flint, Michigan, 2013-2016
Kennedy C , Yard E , Dignam T , Buchanan S , Condon S , Brown MJ , Raymond J , Rogers HS , Sarisky J , de Castro R , Arias I , Breysse P . MMWR Morb Mortal Wkly Rep 2016 65 (25) 650-4 During April 25, 2014-October 15, 2015, approximately 99,000 residents of Flint, Michigan, were affected by changes in drinking water quality after their water source was switched from the Detroit Water Authority (DWA), sourced from Lake Huron, to the Flint Water System (FWS), sourced from the Flint River.* Because corrosion control was not used at the FWS water treatment plant, the levels of lead in Flint tap water increased over time. Adverse health effects are associated with lead exposure (1). On January 2, 2015, a water advisory was issued because of detection of high levels of trihalomethanes, byproducts of disinfectants.(dagger)(,)( section sign) Studies conducted by local and national investigators detected an increase in the prevalence of blood lead levels (BLLs) ≥5 microg/dL (the CDC reference level) among children aged <5 years living in Flint (2) and an increase in water lead levels after the water source switch (3). On October 16, 2015, the Flint water source was switched back to DWA, and residents were instructed to use filtered tap water for cooking and drinking. During that time, pregnant and breastfeeding women and children aged <6 years were advised to consume bottled water.( paragraph sign) To assess the impact on BLLs of consuming contaminated drinking water, CDC examined the distribution of BLLs ≥5 microg/dL among children aged <6 years before, during, and after the switch in water source. This analysis enabled determination of whether the odds of having BLLs ≥5 microg/dL before the switch differed from the odds during the switch to FWS (before and after the January 2, 2015, water advisory was issued), and after the switch back to DWA. Overall, among 9,422 blood lead tests in children aged <6 years, 284 (3.0%) BLLs were ≥5 microg/dL during April 25, 2013-March 16, 2016. The adjusted probability of having BLLs ≥5 microg/dL was 46% higher during the period after the switch from DWA to FWS (and before the January 2, 2015, water advisory) than during the period before the water switch to FWS. Although unrelated to lead in the water, the water advisory likely reduced tap water consumption and increased consumption of bottled water. Characterizing exposure to lead contaminated drinking water among children aged <6 years living in Flint can help guide appropriate interventions. |
Still Searching for a Suitable Molecular Test to Detect Hidden Plasmodium Infection: A Proposal for Blood Donor Screening in Brazil.
Lima GF , Lucchi NW , Silva-Flannery L , Macedo-de-Oliveira A , Hristov AD , Inoue J , Costa-Nascimento Mde J , Udhayakumar V , Di Santi SM . PLoS One 2016 11 (3) e0150391 BACKGROUND: Efforts have been made to establish sensitive diagnostic tools for malaria screening in blood banks in order to detect malaria asymptomatic carriers. Microscopy, the malaria reference test in Brazil, is time consuming and its sensitivity depends on microscopist experience. Although molecular tools are available, some aspects need to be considered for large-scale screening: accuracy and robustness for detecting low parasitemia, affordability for application to large number of samples and flexibility to perform on individual or pooled samples. METHODOLOGY: In this retrospective study, we evaluated four molecular assays for detection of malaria parasites in a set of 56 samples previously evaluated by expert microscopy. In addition, we evaluated the effect of pooling samples on the sensitivity and specificity of the molecular assays. A well-characterized cultured sample with 1 parasite/muL was included in all the tests evaluated. DNA was extracted with QIAamp DNA Blood Mini Kit and eluted in 50 muL to concentrate the DNA. Pools were assembled with 10 samples each. Molecular protocols targeting 18S rRNA, included one qPCR genus specific (Lima-genus), one duplex qPCR genus/Pf (PET-genus, PET-Pf) and one duplex qPCR specie-specific (Rougemont: Roug-Pf/Pv and Roug-Pm/Po). Additionally a nested PCR protocol specie-specific was used (Snou-Pf, Snou-Pv, Snou-Pm and Snou-Po). RESULTS: The limit of detection was 3.5 p/muL and 0.35p/mul for the PET-genus and Lima-genus assays, respectively. Considering the positive (n = 13) and negative (n = 39) unpooled individual samples according to microscopy, the sensitivity of the two genus qPCR assays was 76.9% (Lima-genus) and 72.7% (PET-genus). The Lima-genus and PET-genus showed both sensitivity of 86.7% in the pooled samples. The genus protocols yielded similar results (Kappa value of 1.000) in both individual and pooled samples. CONCLUSIONS: Efforts should be made to improve performance of molecular tests to enable the detection of low-density parasitemia if these tests are to be utilized for blood transfusion screening. |
Feasibility of conducting a longitudinal, transnational study of Filipino migrants to the United States: a dual-cohort design
Gee GC , de Castro AB , Wang MC , Crespi CM , Morey BN , Fujishiro K . J Health Care Poor Underserved 2015 26 (2) 488-504 Most studies of immigrant health are cross-sectional and fail to collect information prior to migration, leading to potential bias and confounding. The present pilot study examines the feasibility of studying migrants prospectively, with baseline data collected before migration. The study followed two cohorts of Filipinos for one year, a migrant cohort (n=27) that emigrated to the U.S. and a second non-migrant cohort (n=26) that remained in the Philippines. The one-year retention rate was 96%. The migrant cohort arrived in the U.S. within two months of their baseline assessment. Migrants and non-migrants did not differ with regard to body mass index, waist circumference, or waist to hip ratio at baseline or at follow-up. It is feasible to conduct a transnational, longitudinal study of two cohorts of Filipinos. This design provides important pre-migration information, is analogous to a natural experiment, can be upscaled, and allows for a rigorous examination of immigrant health. |
Examining pre-migration health among Filipino nurses
de Castro AB , Gee G , Fujishiro K , Rue T . J Immigr Minor Health 2014 17 (6) 1670-8 The healthy immigrant hypothesis asserts that immigrants arrive in the receiving country healthier than same race/ethnic counterparts born there. Contemporary research, however, has not evaluated pre-migration health among migrants, nor has explicitly considered comparisons with non-migrants in the country of origin. Pre-migration health was examined among 621 Filipino nurses, including self-reported physical health, mental health, health behaviors, and social stress. Measures were compared by intention to migrate and also tested as predictors of actual migration using time-to-event analysis. Nurses intending to migrate had higher proportion of depression and reported higher general perceived stress compared to those not. Predictors of actual migration included age, mentally unhealthy days, social strain, and social support. Physical health and health behavior measures had no association with migration intention or actual migration. Findings suggest that, relative to those not intending to migrate, nurses intending to migrate have worse mental health status and social stress; and, do not have a physical health advantage. Future research must span the pre- to post-migration continuum to better understand the impact of moving from one country to another on health and well-being. |
Discrimination, harassment, abuse, and bullying in the workplace: contribution of workplace injustice to occupational health disparities
Okechukwu CA , Souza K , Davis KD , de Castro AB . Am J Ind Med 2014 57 (5) 573-86 BACKGROUND: This paper synthesizes research on the contribution of workplace injustices to occupational health disparities. METHODS: We conducted a broad review of research and other reports on the impact of workplace discrimination, harassment, and bullying on workers' health and on family and job outcomes. RESULTS: Members of demographic minority groups are more likely to be victims of workplace injustice and suffer more adverse outcomes when exposed to workplace injustice compared to demographic majority groups. A growing body of research links workplace injustice to poor psychological and physical health, and a smaller body of evidence links workplace injustice to unhealthy behaviors. Although not as well studied, studies show that workplace injustice can influence workers' health through effects on workers' family life and job-related outcomes. CONCLUSION: Injustice is a key contributor to occupational health injustice and prospective studies with oversample of disadvantaged workers and refinement of methods for characterizing workplace injustices are needed. |
International study to evaluate PCR methods for detection of Trypanosoma cruzi DNA in blood samples from Chagas disease patients
Schijman AG , Bisio M , Orellana L , Sued M , Duffy T , Mejia Jaramillo AM , Cura C , Auter F , Veron V , Qvarnstrom Y , Deborggraeve S , Hijar G , Zulantay I , Lucero RH , Velazquez E , Tellez T , Sanchez Leon Z , Galvao L , Nolder D , Monje Rumi M , Levi JE , Ramirez JD , Zorrilla P , Flores M , Jercic MI , Crisante G , Anez N , De Castro AM , Gonzalez CI , Acosta Viana K , Yachelini P , Torrico F , Robello C , Diosque P , Triana Chavez O , Aznar C , Russomando G , Buscher P , Assal A , Guhl F , Sosa Estani S , DaSilva A , Britto C , Luquetti A , Ladzins J . PLoS Negl Trop Dis 2011 5 (1) e931 BACKGROUND: A century after its discovery, Chagas disease still represents a major neglected tropical threat. Accurate diagnostics tools as well as surrogate markers of parasitological response to treatment are research priorities in the field. The purpose of this study was to evaluate the performance of PCR methods in detection of Trypanosoma cruzi DNA by an external quality evaluation. METHODOLOGY/FINDINGS: An international collaborative study was launched by expert PCR laboratories from 16 countries. Currently used strategies were challenged against serial dilutions of purified DNA from stocks representing T. cruzi discrete typing units (DTU) I, IV and VI (set A), human blood spiked with parasite cells (set B) and Guanidine Hidrochloride-EDTA blood samples from 32 seropositive and 10 seronegative patients from Southern Cone countries (set C). Forty eight PCR tests were reported for set A and 44 for sets B and C; 28 targeted minicircle DNA (kDNA), 13 satellite DNA (Sat-DNA) and the remainder low copy number sequences. In set A, commercial master mixes and Sat-DNA Real Time PCR showed better specificity, but kDNA-PCR was more sensitive to detect DTU I DNA. In set B, commercial DNA extraction kits presented better specificity than solvent extraction protocols. Sat-DNA PCR tests had higher specificity, with sensitivities of 0.05-0.5 parasites/mL whereas specific kDNA tests detected 5.10(-3) par/mL. Sixteen specific and coherent methods had a Good Performance in both sets A and B (10 fg/microl of DNA from all stocks, 5 par/mL spiked blood). The median values of sensitivities, specificities and accuracies obtained in testing the Set C samples with the 16 tests determined to be good performing by analyzing Sets A and B samples varied considerably. Out of them, four methods depicted the best performing parameters in all three sets of samples, detecting at least 10 fg/microl for each DNA stock, 0.5 par/mL and a sensitivity between 83.3-94.4%, specificity of 85-95%, accuracy of 86.8-89.5% and kappa index of 0.7-0.8 compared to consensus PCR reports of the 16 good performing tests and 63-69%, 100%, 71.4-76.2% and 0.4-0.5, respectively compared to serodiagnosis. Method LbD2 used solvent extraction followed by Sybr-Green based Real time PCR targeted to Sat-DNA; method LbD3 used solvent DNA extraction followed by conventional PCR targeted to Sat-DNA. The third method (LbF1) used glass fiber column based DNA extraction followed by TaqMan Real Time PCR targeted to Sat-DNA (cruzi 1/cruzi 2 and cruzi 3 TaqMan probe) and the fourth method (LbQ) used solvent DNA extraction followed by conventional hot-start PCR targeted to kDNA (primer pairs 121/122). These four methods were further evaluated at the coordinating laboratory in a subset of human blood samples, confirming the performance obtained by the participating laboratories. CONCLUSION/SIGNIFICANCE: This study represents a first crucial step towards international validation of PCR procedures for detection of T. cruzi in human blood samples. |
Associations of workplace aggression with work-related well-being among nurses in the Philippines
Fujishiro K , Gee GC , de Castro AB . Am J Public Health 2010 101 (5) 861-7 OBJECTIVES: We examined whether workplace aggression was associated with self-rated health and work-related injury and illness among nurses in the Philippines. METHODS: Our data came from a cross-sectional survey of nurses (n=687) in the Philippines. We assessed the associations of self-reported physical assault and verbal abuse with self-rated health, work-related injury and illness, and missed workdays with Poisson regression. Control variables included demographic and work characteristics (e.g., hours worked, work setting, shift). RESULTS: Verbal abuse was associated with poor general health (prevalence ratio [PR]=1.94; 95% confidence interval [CI]=1.09, 3.45). Both physical assault and verbal abuse were associated with work-related injury (PR=1.48; 95% CI=1.00, 2.20; PR=1.72; 95% CI=1.34, 2.23, respectively) and work-related illness (PR=1.46; 95% CI=0.99, 2.15; PR=1.68; 95% CI=1.32, 2.14, respectively) after demographic and work characteristics were accounted for in the model. In addition, physical assault was associated with missed workdays (PR=1.56; 95% CI=1.02, 2.33). CONCLUSIONS: Workplace aggression was associated with increased risks of poor general health and adverse work-related health outcomes among nurses in the Philippines. (Am J Public Health. Published online ahead of print November 18, 2010: e1-e7. doi:10.2105/AJPH.2009.188144). |
Associations between work schedule characteristics and occupational injury and illness
de Castro A , Fujishiro K , Rue T , Tagalog E , Samaco-Paquiz L , Gee G . Int Nurs Rev 2010 57 (2) 188-194 BACKGROUND: Nurses often endure working irregular day, night and evening shifts as well as mandatory overtime (i.e. employer-imposed work time in excess of one's assigned schedule). While these work characteristics are examined as potential risks for nurses' safety and health, it is not clear whether negative health impacts occur simply because of working long hours or in combination with other mechanisms. AIM: This study investigates how these work characteristics are associated with nurses' work-related injury and illness over and above long work hours. METHODS: In this cross-sectional study, questionnaire data were collected from a sample of 655 registered nurses in the Philippines. Multiple logistic regression was used to assess associations of shift work and mandatory overtime with four work-related health outcomes. RESULTS: After weekly work hours, shift length and demographic variables were accounted for, non-day shifts were associated with work-related injury [odds ratio (OR) = 1.54; 95% confidence interval (CI): 1.07, 2.24] and work-related illness (OR = 1.48; 95% CI: 1.02, 2.16). Also, frequency of working mandatory overtime was associated with work-related injury (OR = 1.22; 95% CI: 1.06, 1.41), work-related illness (OR = 1.19; 95% CI: 1.04, 1.37) and missing more than 2 days of work because of a work-related injury or illness (OR = 1.25; 95% CI: 1.08, 1.44). CONCLUSIONS: These findings suggest that non-day shifts and mandatory overtime may negatively impact nurses' health independent of working long hours. Mechanisms through which these work characteristics affect health, such as circadian rhythm disturbance, nurse-to-patient ratios and work-family conflict, should be examined in future studies. |
Successful seroresponses to measles and rubella following aerosolized Triviraten vaccine, but poor response to aerosolized mumps (Rubini) component: comparisons with injected MMR
Diaz-Ortega JL , Bennett JV , Castaneda D , Vieyra JR , Valdespino-Gomez JL , de Castro JF . Vaccine 2010 28 (3) 692-8 Seroresponses to measles, rubella and mumps were evaluated following the injection of MMR II and injection or aerosol administration of Triviraten in young adults. Response to aerosolized Rubini mumps strain was a focus of interest, given robust responses to aerosolized mumps vaccine (Leningrad-Zagreb strain) in a prior study using aerosolized MMR vaccine. The aerosolized Edmonston-Zagreb (EZ) measles vaccine was significantly more immunogenic than injected EZ vaccine, and comparable to results following injected Moraten measles vaccine having twice the dosage. Responses to rubella were comparable in the three MMR study groups. Aerosolized Rubini vaccine was very highly and unexpectedly less immunogenic than either injected Rubini or Jeryl-Lyn strains. The high attenuation of Rubini vaccine appears to have limited its affinity for respiratory tract receptors, which may underlie its lack of clinical effectiveness. |
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