31 results on '"Werneck, Guilherme Loureiro"'
Search Results
2. The interfaces between One Health and Global Health: A scoping review
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Pungartnik, Paula Cristina, Abreu, Ariane, dos Santos, Cleber Vinicius Brito, Cavalcante, João Roberto, Faerstein, Eduardo, and Werneck, Guilherme Loureiro
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- 2023
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3. The effect of BCG vaccination on infection and antibody levels against SARS-CoV-2—The results of ProBCG: a multicenter randomized clinical trial in Brazil
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Santos, Ana Paula, Werneck, Guilherme Loureiro, Dalvi, Ana Paula Razal, dos Santos, Carla Conceição, Tierno, Paulo Fernando Guimarães Morando Marzocchi, Condelo, Hanna Silva, Macedo, Bruna, de Medeiros Leung, Janaina Aparecida, de Souza Nogueira, Jeane, Malvão, Ludmila, Galliez, Rafael, Aguiar, Roberta, Stefan, Roberto, Knackfuss, Sabrina Modena, da Silva, Elisangela Costa, Castineiras, Terezinha Marta Pereira Pinto, de Andrade Medronho, Roberto, e Silva, José Roberto Lapa, Alves, Rogério Lopes Rufino, de Moraes Sobrino Porto, Luís Cristóvão, Rodrigues, Luciana Silva, Kritski, Afrânio Lineu, and de Queiroz Mello, Fernanda Carvalho
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- 2023
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4. The impact of the COVID-19 pandemic in tuberculosis preventive treatment in Brazil: a retrospective cohort study using secondary data
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Coutinho, Iane, Alves, Layana Costa, Werneck, Guilherme Loureiro, and Trajman, Anete
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- 2023
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5. CoronaVac vaccine is effective in preventing symptomatic and severe COVID-19 in pregnant women in Brazil: a test-negative case-control study
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Paixao, Enny S., Wong, Kerry L. M., Alves, Flavia Jôse Oliveira, de Araújo Oliveira, Vinicius, Cerqueira-Silva, Thiago, Júnior, Juracy Bertoldo, Machado, Tales Mota, Junior, Elzo Pereira Pinto, Boaventura, Viviane S., Penna, Gerson O., Werneck, Guilherme Loureiro, Rodrigues, Laura C., Pearce, Neil, Barreto, Mauricio L., and Barral-Netto, Manoel
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- 2022
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6. Congenital Zika syndrome and living conditions in the largest city of northeastern Brazil
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Souza, Marcos Paulo Almeida, da Natividade, Márcio Santos, Werneck, Guilherme Loureiro, and dos Santos, Darci Neves
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- 2022
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7. Influence of age on the effectiveness and duration of protection of Vaxzevria and CoronaVac vaccines: A population-based study
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Cerqueira-Silva, Thiago, Oliveira, Vinicius de Araújo, Boaventura, Viviane S., Pescarini, Julia M., Júnior, Juracy Bertoldo, Machado, Tales Mota, Flores-Ortiz, Renzo, Penna, Gerson O., Ichihara, Maria Yury, de Barros, Jacson Venâncio, Barreto, Mauricio L., Werneck, Guilherme Loureiro, and Barral-Netto, Manoel
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- 2022
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8. Effectiveness of mRNA boosters after homologous primary series with BNT162b2 or ChAdOx1 against symptomatic infection and severe COVID-19 in Brazil and Scotland: A test-negative design case-control study
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Cerqueira-Silva, Thiago, Shah, Syed Ahmar, Robertson, Chris, Sanchez, Mauro, Katikireddi, Srinivasa Vittal, de Araujo Oliveira, Vinicius, Paixão, Enny S., Rudan, Igor, Junior, Juracy Bertoldo, Penna, Gerson O., Pearce, Neil, Werneck, Guilherme Loureiro, Barreto, Mauricio L., Boaventura, Viviane S., Sheikh, Aziz, and Barral-Netto, Manoel
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Biological sciences ,Comirnaty (Vaccine) -- Testing ,AZD1222 (Vaccine) -- Testing -- Dosage and administration - Abstract
Background Brazil and Scotland have used mRNA boosters in their respective populations since September 2021, with Omicron's emergence accelerating their booster program. Despite this, both countries have reported substantial recent increases in Coronavirus Disease 2019 (COVID-19) cases. The duration of the protection conferred by the booster dose against symptomatic Omicron cases and severe outcomes is unclear. Methods and findings Using a test-negative design, we analyzed national databases to estimate the vaccine effectiveness (VE) of a primary series (with ChAdOx1 or BNT162b2) plus an mRNA vaccine booster (with BNT162b2 or mRNA-1273) against symptomatic Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) infection and severe COVID-19 outcomes (hospitalization or death) during the period of Omicron dominance in Brazil and Scotland compared to unvaccinated individuals. Additional analyses included stratification by age group (18 to 49, 50 to 64, [greater than or equal to]65). All individuals aged 18 years or older who reported acute respiratory illness symptoms and tested for SARS-CoV-2 infection between January 1, 2022, and April 23, 2022, in Brazil and Scotland were eligible for the study. At 14 to 29 days after the mRNA booster, the VE against symptomatic SARS-CoV-2 infection of ChAdOx1 plus BNT162b2 booster was 51.6%, (95% confidence interval (CI): [51.0, 52.2], p < 0.001) in Brazil and 67.1% (95% CI [65.5, 68.5], p < 0.001) in Scotland. At [greater than or equal to]4 months, protection against symptomatic infection waned to 4.2% (95% CI [0.7, 7.6], p = 0.02) in Brazil and 37.4% (95% CI [33.8, 40.9], p < 0.001) in Scotland. VE against severe outcomes in Brazil was 93.5% (95% CI [93.0, 94.0], p < 0.001) at 14 to 29 days post-booster, decreasing to 82.3% (95% CI [79.7, 84.7], p < 0.001) and 98.3% (95% CI [87.3, 99.8], p < 0.001) to 77.8% (95% CI [51.4, 89.9], p < 0.001) in Scotland for the same periods. Similar results were obtained with the primary series of BNT162b2 plus homologous booster. Potential limitations of this study were that we assumed that all cases included in the analysis were due to the Omicron variant based on the period of dominance and the limited follow-up time since the booster dose. Conclusions We observed that mRNA boosters after a primary vaccination course with either mRNA or viral-vector vaccines provided modest, short-lived protection against symptomatic infection with Omicron but substantial and more sustained protection against severe COVID-19 outcomes for at least 3 months., Author(s): Thiago Cerqueira-Silva 1,2, Syed Ahmar Shah 3, Chris Robertson 4,5, Mauro Sanchez 6, Srinivasa Vittal Katikireddi 4,7, Vinicius de Araujo Oliveira 2,8, Enny S. Paixão 9, Igor Rudan 3, [...]
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- 2023
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9. Epidemiology and the Covid-19 pandemic: opportunities to review trajectories and plan for the future/Epidemiologia e pandemia de Covid-19: oportunidades para rever trajetórias e planejar o futuro/Epidemiología y pandemia de Covid-19: oportunidades para revisar trayectorias y planear el futuro
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Werneck, Guilherme Loureiro
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- 2023
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10. Immune system challenge improves recognition memory and reverses malaria-induced cognitive impairment in mice
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de Sousa, Luciana Pereira, Ribeiro-Gomes, Flávia Lima, de Almeida, Roberto Farina, Souza, Tadeu Mello e, Werneck, Guilherme Loureiro, Souza, Diogo Onofre, and Daniel-Ribeiro, Cláudio Tadeu
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- 2021
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11. Impact of 4% Deltamethrin-Impregnated Dog Collars on the Incidence of Human Visceral Leishmaniasis: A Community Intervention Trial in Brazil.
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Werneck, Guilherme Loureiro, Figueiredo, Fabiano Borges, and Cruz, Maria do Socorro Pires e
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VISCERAL leishmaniasis ,DOG collars ,POISSON regression ,SAND flies ,LEISHMANIA infantum ,FENITROTHION - Abstract
Background: In Brazil, human visceral leishmaniasis (HVL) is caused by the protozoan parasite Leishmania infantum, primarily transmitted by the sand fly Lutzomyia longipalpis, with dogs acting as the main urban reservoir. This study aims to evaluate the effectiveness of 4% deltamethrin-impregnated dog collars (DMC) on HVL incidence. Methods: This is a community intervention study carried out from 2012 to 2015 in the municipalities of Araguaína, State of Tocantins, and Montes Claros, State of Minas Gerais, Brazil. Two areas in each were randomly allocated to either (1) culling seropositive dogs + residual insecticide spraying (control area—CA) or (2) culling seropositive dogs + residual insecticide spraying + DMC fitted to dogs every six months for two years (intervention area—IA). Cases of HVL (n = 1202) occurring from 2008 to 2020 were identified from the Brazilian Reportable Diseases Information System and georeferenced to the control and intervention areas. The HVL cases from 2008 to 2012 were considered as occurring in the "pre-intervention" period. Those cases from 2013 to 2016 and from 2017 to 2020 were regarded as occurring in the "intervention" and "post-intervention" periods, respectively. We used a mixed-effects Poisson regression model to estimate the effectiveness of the intervention, comparing the changes from the pre-intervention period to the intervention and post-intervention periods in the control and intervention areas. Results: In Araguaína, there was a statistically significant reduction in the incidence of HVL in both the control and intervention areas, comparing both the intervention and post-intervention periods with the pre-intervention period. The intervention with DMC was significantly associated with a reduction in HVL when comparing the intervention and pre-intervention periods, yielding an effectiveness estimate of the DMC of 27% (IC95% 1–46%, p = 0.045). No differences were observed when comparing the pre- and post-intervention periods (p = 0.827). In Montes Claros, cases reduced in both the control and intervention areas from the pre-intervention period to the intervention period (p = 0.913). In the post-intervention period, the incidence increased in the control area, while cases continued to decrease in the DMC area (p = 0.188). Conclusions: The use of DMC was associated with a reduction of 27% in the incidence of HVL during the period of DMC delivery, indicating that DMC is effective as an additional strategy for controlling visceral leishmaniasis in Brazil. However, no significant reduction associated with DMC was detected after the intervention period, suggesting that a control program based on the large-scale deployment of DMC might have to be maintained for more extended periods without interruption. [ABSTRACT FROM AUTHOR]
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- 2024
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12. Temporal patterns, spatial risks, and characteristics of tegumentary leishmaniasis in Brazil in the first twenty years of the 21st Century.
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Belo, Vinícius Silva, Bruhn, Fábio Raphael Pascoti, Barbosa, David Soeiro, Câmara, Daniel Cardoso Portela, Simões, Taynãna César, Buzanovsky, Lia Puppim, Duarte, Anna Gabryela Sousa, de Melo, Saulo Nascimento, Cardoso, Diogo Tavares, Donato, Lucas Edel, Maia-Elkhoury, Ana Nilce Silveira, and Werneck, Guilherme Loureiro
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LEISHMANIASIS ,NEGLECTED diseases ,PARASITIC diseases ,NEUROCYSTICERCOSIS ,TWENTY-first century ,PUBLIC health ,BURULI ulcer - Abstract
Background: Tegumentary leishmaniasis (TL) is a significant public health issue in Brazil. The present ecological study describes the clinical and epidemiological characteristics of TL cases reported in the country, and analyzes the spatial and temporal patterns of the incidences and risks of occurrence across the five geopolitical regions and 27 federative units. Methodology/Principal findings: Data regarding new cases of TL notified between 2001 and 2020 were obtained from the Information System for Notifiable Diseases of the Brazilian Ministry of Health. Joinpoint and spatial and temporal generalized additive models were used to establish trends in the evolution of TL during the target period. The incidence rate for the entire period was 226.41 cases/100,000 inhabitants. All regions of Brazil showed trends of decreasing incidence rates, albeit with fluctuations at specific times, with the exception of the Southeast where rates have increased since 2014, most particularly in Minas Gerais state. The disease was concentrated predominantly in the North region, with Acre state leading the incidence rank in the whole country, followed by Mato Grosso (Midwest), Maranhão and Bahia (Northeast) states. The spatial distribution of the risk of TL occurrence in relation to the annual averages was relatively stable throughout the period. The cutaneous form of TL was predominant and cases most frequently occurred in rural areas and among men of working age. The ages of individuals contracting TL tended to increase during the time series. Finally, the proportion of confirmations by laboratory tests was lower in the Northeast. Conclusion/Significance: TL shows a declining trend in Brazil, but its widespread occurrence and the presence of areas with increasing incidence rates demonstrate the persistent relevance of this disease and the need for constant monitoring. Our findings reinforce the importance of temporal and spatial tools in epidemiologic surveillance routines and are valuable for targeting preventive and control actions. Author summary: Leishmaniasis, a neglected tropical disease caused by parasitic protozoa, exists in various clinical forms, the most common of which is tegumentary leishmaniasis (TL). The lethality of TL is low, but the skin lesions may produce physical deformities and stigma. Brazil has the highest number of TL cases in the American continent and the disease is present in all federative units. However, studies performed so far have been restricted to localized areas of Brazil and do not provide a broad view of the situation in the country. Therefore, we described the clinical and epidemiological characteristics of TL cases in Brazil and evaluated the spatial and temporal patterns from 2001 to 2020. Our findings show that the occurrence of TL declined between 2001 and 2020 in all regions of the country except for the Southeast where incidence rates have recently increased. We have identified those areas of the country where the population remains at greater risk of contracting the disease and have found that the situation has changed little over the years. The knowledge gained about the spatial and temporal variations of the incidence of TL, the profiles of those affected by the disease, and the diagnostics and treatment employed might be valuable to improve the policies and actions against the disease. [ABSTRACT FROM AUTHOR]
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- 2023
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13. Efectos masivos a largo plazo de la pandemia de COVID-19 en la población: un largo camino por recorre
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Werneck, Guilherme Loureiro
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- 2022
14. Sociodemographic and environmental factors associated with dengue, Zika, and chikungunya among adolescents from two Brazilian capitals.
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Dalvi, Ana Paula Razal, Gibson, Gerusa, Ramos Jr., Alberto Novaes, Bloch, Katia V., Sousa, Geziel dos Santos de, Silva, Thiago Luiz Nogueira da, Braga, José Ueleres, Castro, Marcia C., and Werneck, Guilherme Loureiro
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CHIKUNGUNYA ,ARBOVIRUS diseases ,SOCIODEMOGRAPHIC factors ,DENGUE hemorrhagic fever ,DENGUE ,TEENAGERS - Abstract
Among the emerging and reemerging arboviral diseases, Zika, dengue and chikungunya deserve special attention due to their wide geographical distribution and clinical severity. The three arboviruses are transmitted by the same vector and can present similar clinical syndromes, bringing challenges to their identification and register. Demographic characteristics and individual and contextual social factors have been associated with the three arboviral diseases. However, little is known about such associations among adolescents, whose relationships with the social environment are different from those of adult populations, implying potentially different places, types, and degrees of exposure to the vector, particularly in the school context. This study aims to identify sociodemographic and environmental risk factors for the occurrence of Zika, dengue, and chikungunya in a cohort of adolescents from the Study of Cardiovascular Risks in Adolescents—ERICA—in the cities of Rio de Janeiro/RJ and Fortaleza/CE, from January 2015 to March 2019. Cases were defined as adolescents with laboratory or clinical-epidemiological diagnosis of Zika, dengue, or chikungunya, notified and registered in the Information System for Notifiable Diseases (SINAN). The cases were identified by linkage between the databases of the ERICA cohort and of SINAN. Multilevel Cox regression was employed to estimate hazard ratios (HR) as measures of association and respective 95% confidence intervals (95%CI). In comparison with adolescents living in lower socioeconomic conditions, the risk of becoming ill due to any of the three studied arboviral diseases was lower among those living in better socioeconomic conditions (HR = 0.43; 95%CI: 0.19–0.99; p = 0.047) and in the adolescents who attended school in the afternoon period (HR = 0.17; 95%CI: 0.06–0.47; p<0.001). When compared to areas whose Building Infestation Index (BII) for Aedes aegypti was considered satisfactory, a BII in the school region classified as "alert" and "risk" was associated with a higher risk of arboviral diseases (HR = 1.62, 95%CI: 0.98–2.70; p = 0.062; HR = 3.72, 95%CI: 1.27–10.9; p = 0.017, respectively). These findings indicate that living in less favored socioeconomic conditions, attending school in the morning, and having a high BII for Ae. aegypti in school's region can contribute to an increased risk of infection by Zika, dengue, or chikungunya in adolescents. The identification of residential or school areas based on those variables can contribute to the implementation of control measures in population groups and priority locations. Author summary: Zika, dengue, and chikungunya are arbovirus with a wide geographic distribution that can cause serious diseases. The three pathogens are transmitted by the same vector and can present similar symptoms, hindering their identification and register. Despite the great efforts to control arboviruses diseases, Brazil still registers frequently epidemics. Scientific evidence of the association of the environment, vectors, humans, and their behaviors in the arbovirus transmission is vast, but little in know about those association in adolescents. This study focused on adolescents, a part of the population whose relationships with the social environment are different from those of adult and child populations, implying different types, and degrees of exposure to the vector, particularly in the school context. For this reason, this study aims to identify sociodemographic and environmental factors associated with Zika, dengue, and chikungunya disease in adolescents in Rio de Janeiro and Fortaleza municipalities in Brazil from 2015 to 2019. The results obtained in this study highlight factors that may be influencing the transmission of Zika, dengue and Chikungunya, enabling effective measures to be implemented in the school context to control these arboviruses. [ABSTRACT FROM AUTHOR]
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- 2023
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15. Beliefs and Sociodemographic and Occupational Factors Associated with Vaccine Hesitancy among Health Workers.
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de Araújo, Tânia Maria, Souza, Fernanda de Oliveira, Pinho, Paloma de Sousa, and Werneck, Guilherme Loureiro
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VACCINE hesitancy ,COMMUNITY health workers ,MEDICAL care ,SOCIODEMOGRAPHIC factors ,VACCINE safety - Abstract
Introduction: Vaccine hesitancy has been implicated in the low-vaccination coverage in several countries. Knowledge about vaccine hesitancy predictors in health workers is essential because they play a central role in communication about the importance and safety of vaccines. This study aimed to assess beliefs and sociodemographic and occupational factors associated with vaccine hesitancy in health workers. Methods: This was a cross-sectional study among 453 health workers in primary and medium complexity services in a municipality in the state of Bahia, Brazil. The variable vaccine hesitancy was operationalized based on the answers related to incomplete vaccination against hepatitis B, measles, mumps and rubella, and diphtheria and tetanus. Associations between variables were expressed as prevalence ratios (PR) and their respective 95% confidence intervals (CI). Results: Endemic disease combat agents, administrative service workers, and support staff had the highest levels of vaccine hesitancy. Among the analyzed variables, the following were associated with vaccine hesitancy: working in secondary health care services (PR: 1.21; CI: 1.07–1.36), working as an endemic disease combat agent (PR = 1.42; 95% CI: 1.165–1.75), not sharing information about vaccines on social media (PR = 1.16; 95% CI: 1.05–1.28), distrusting information about vaccinations (PR: 0.86; CI: 0.75–0.99), and not feeling safe receiving new vaccines (PR = 1.16; 95% CI: 1.06–1.28). Conclusions: Strategies to enhance confidence in vaccination among health workers should consider differences in occupations and their working settings. Improving vaccination-related content in training and continuing education activities and facilitating access to onsite vaccinations at the workplace are crucial elements to reduce vaccine hesitancy among health workers. [ABSTRACT FROM AUTHOR]
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- 2022
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16. Efficacy and effectiveness of SARS-CoV-2 vaccines for death prevention: A protocol for a systematic review and meta-analysis.
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Trajman, Anete, Lachapelle-Chisholm, Sophie, Zikos, Théodora, Werneck, Guilherme Loureiro, and Benedetti, Andrea
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COVID-19 vaccines ,RESEARCH protocols ,VACCINATION status ,RANDOMIZED controlled trials ,MORTALITY - Abstract
Background: There is consistent evidence that SARS-CoV-2 vaccines have statistical and clinical significant efficacy to prevent incident and severe cases of COVID-19, although different outcomes were analyzed and different risk reductions were observed. However, randomized control trials (RCT) were not designed or powered to assess whether the vaccines prevent deaths, even though this was a secondary or exploratory outcome across many studies. Early real-world observational data suggest that these vaccines are highly effective in reducing hospitalization and all-cause mortality. Our objective is to summarize and appraise—the existing evidence on the efficacy and real-world effectiveness of all SARS-CoV-2 vaccines currently approved for full or limited use to prevent all-cause and COVID-19-attributed mortality. Methods: The population consists of persons with a record of vaccination status and the outcome of interest. Randomized controlled trials, comparative cohort and case-control studies reporting vaccination with any of the vaccines approved (intervention) will be eligible. The primary outcome will be all cause deaths. COVID-19-attributed deaths and deaths attributable to the vaccination (adverse event deaths) will be secondary outcomes. We will compare deaths occurring in vaccinated persons versus those non-vaccinated or having received placebo. Studies in any language will be eligible. Two independent reviewers will screen for inclusion and assess quality of studies using the Cochrane Risk of Bias 2 and the ROBINS-1 tool, as appropriate. Hazard ratios will be calculated. Assessment of statistical heterogeneity amongst the studies will be done using I
2 and prediction intervals, as well as visual inspection of the forest plots. Publication bias will be assessed using a funnel plot and Egger statistical test if we have more than 10 studies in a forest plot. We have followed the PRISMA-Protocol checklist for the current protocol, which is registered at Prospero (York University, CRD42021262211). [ABSTRACT FROM AUTHOR]- Published
- 2022
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17. Spatial distribution of Leishmania seropositive dogs in the Angelim neighborhood, Teresina, Piauí, Brazil: appraisal of three spatial clustering methods.
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da Silva, Lília Aparecida Marques, Braga, José Ueleres, da Silva, João Pereira, e Cruz, Maria do Socorro Pires, de Oliveira, André Luiz Sá, and Werneck, Guilherme Loureiro
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VISCERAL leishmaniasis ,SCAN statistic ,LEISHMANIA ,LEISHMANIASIS ,DOGS ,CROSS-sectional method - Abstract
The detection of spatial clusters has been suggested as a potential tool for guiding the delivery of interventions against visceral leishmaniasis; however, little attention has been given to the consistency of results by using different spatial clustering methods. The present study aimed to assess the performance of three different techniques for identifying patterns in the spatial distribution of canine leishmaniasis in the city of Teresina, Brazil. This cross-sectional study was based on a serological survey for canine leishmaniasis in which each dog domicile was georeferenced to the exact location of each animal in space. The spatial analysis was performed using three methods: the Cuzick-Edwards statistic, the Hierarchical Nearest Neighbour analysis, and the Kulldorff Scan statistic. All techniques were able to identify clusters of high prevalences of canine leishmaniasis, but results were not consistent among techniques. The feasibility of the identification and location of clusters of cases in a restricted number of villages in neighborhoods might contribute to the optimization of control measures against visceral leishmaniasis. However, given the relative inconsistency of the results provided by the different methods, protocols for assessing clusters of diseases should always include more than one method of evaluation. [ABSTRACT FROM AUTHOR]
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- 2021
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18. Long-term mass population effects of the COVID-19 pandemic: a long way to go.
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Werneck, Guilherme Loureiro
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- 2022
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19. The Salvador Primary Care Longitudinal Study of Child Development (CohortDICa) Following the Zika Epidemic: Study Protocol.
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Santos, Darci Neves, de Araújo, Tânia Maria, dos Santos, Leticia Marques, Kuper, Hannah, Aquino, Rosana, Da Silveira, Ismael Henrique, Miranda, Samilly Silva, Pereira, Marcos, and Werneck, Guilherme Loureiro
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- 2022
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20. CSP and Epidemiology: a history of synergies and a future of challenges.
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Werneck GL
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- Humans, Brazil epidemiology, Periodicals as Topic trends, History, 20th Century, Epidemiology trends
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- 2024
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21. Partial recovery of tuberculosis preventive treatment in Brazil after pandemic drawback.
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Coutinho I, Alves LC, Werneck GL, and Trajman A
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- Humans, Brazil epidemiology, Disease Notification, Tuberculosis prevention & control, Tuberculosis epidemiology, Pandemics prevention & control, SARS-CoV-2, Latent Tuberculosis prevention & control, Latent Tuberculosis epidemiology, COVID-19 prevention & control, COVID-19 epidemiology
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Brazil was heavily affected by COVID-19 both with death toll and economically, with absence of a centralized Federal Government response. Tuberculosis (TB) notifications decreased in 2020 but partial recovery was observed in 2021. We have previously shown a sharp (93%) reduction in TB preventive treatment notifications among five Brazilian cities with more than 1,000 notifications in 2021. We hypothesized TB preventive treatment would also recover. We updated the previous analysis by adding other cities that hold more than a 1,000 notifications until 2022. Data aggregated by 2-week periods were extracted from the Information System for Notifying People Undergoing Treatment for LTBI (IL-TB). Biweekly percentage change (BPC) of notifications until October 2022 and outcomes until July 2022 (in the two weeks of TB preventive treatment initiation) were analyzed using Joinpoint software. A total of 39,701 notifications in 11 cities were included, 66% from São Paulo and Rio de Janeiro, Brazil. We found a significant increase of TB preventive treatment notifications in the beginning of 2021 (BPC range 1.4-49.6), with sustained progression in seven out of the 11 cities. Overall, median completion rates were 65%. In most cities, a gradual and steady decrease of treatment completion rates was found, except for Rio de Janeiro and Manaus (Amazonas State, Brazil), where a BPC of 1.5 and 1.2, respectively, was followed by a sustained increase. Notifications and completion proportions of TB preventive treatment were heterogeneous, which partly reflects the heterogeneity in local response to the pandemic. We found that notifications were recovered, and that the sharp 2021 decrease was no longer observed, which suggests delays in notification. In conclusion, the sharp reductions in TB preventive treatment completion rates in most cities might have been caused by delays in reporting; however, the sustained and progressive decrease are a concern.
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- 2024
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22. Restoring High Vaccine Coverage in Brazil: Successes and Challenges.
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Fernandes EG, Werneck GL, Haddad AE, Maciel ELN, and Lima NVT
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- Brazil, Vaccination, Immunization Programs, Vaccines
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- 2024
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23. Characterisation of an area of coexistent visceral and cutaneous leishmaniasis transmission in the State of Piauí, Brazil.
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Vasconcelos SA, de Sousa RLT, Costa Junior E, Diniz E Souza JP, Cavalcante D, da Silva ACL, de Mendonça IL, Mallet J, Teixeira CR, Werneck GL, Araújo-Pereira T, Pita-Pereira D, Britto C, Vilela ML, and Gomes R
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- Animals, Female, Brazil epidemiology, Insect Vectors genetics, DNA, Leishmaniasis, Cutaneous epidemiology, Leishmaniasis, Visceral epidemiology, Leishmania infantum genetics
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Background: In Brazil, transmission of visceral and cutaneous leishmaniasis has expanded geographically over the last decades, with both clinical forms occurring simultaneously in the same area., Objectives: This study characterised the clinical, spatial, and temporal distribution, and performed entomological surveillance and natural infection analysis of a leishmaniasis-endemic area., Methods: In order to characterise the risk of leishmaniasis transmission in Altos, Piauí, we described the clinical and socio-demographic variables and the spatial and temporal distribution of cases of American visceral leishmaniasis (AVL) and American cutaneous leishmaniasis (ACL) cases and identified potential phlebotomine vectors., Findings: The urban area concentrated almost 54% of ACL and 86.8% of AVL cases. The temporal and spatial distribution of AVL and ACL cases in Altos show a reduction in the number of risk areas, but the presence of permanent disease transmission foci is observed especially in the urban area. 3,808 phlebotomine specimens were captured, with Lutzomyia longipalpis as the most frequent species (98.45%). Of the 35 females assessed for natural infection, one specimen of Lu. longipalpis tested positive for the presence of Leishmania infantum and Leishmania braziliensis DNA., Main Conclusion: Our results indicate the presence of risk areas for ACL and AVL in the municipality of Altos and highlight the importance of entomological surveillance to further understand a possible role of Lu. longipalpis in ACL transmission.
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- 2024
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24. Corrigendum to "How, what, and why: housing, water & sanitation and wealth patterns in a cross-sectional study of the Guarani Birth Cohort, the first indigenous birth cohort in Brazil" [The Lancet Regional Health - Americas 2023;21: 100496].
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Diniz Rodrigues Caldas A, Nobre AA, Brickley E, Alexander N, Werneck GL, Farias YN, Garcia Barreto Ferrão CT, Tavares FG, de Nazaré Pantoja L, Cristina da Luz Duarte M, and Cardoso AM
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[This corrects the article DOI: 10.1016/j.lana.2023.100496.]., (© 2023 The Author(s).)
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- 2023
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25. How, what, and why: housing, water & sanitation and wealth patterns in a cross-sectional study of the Guarani Birth Cohort, the first Indigenous birth cohort in Brazil.
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Caldas ADR, Nobre AA, Brickley E, Alexander N, Werneck GL, Farias YN, Garcia Barreto Ferrão CT, Tavares FG, Pantoja LN, Duarte MCDL, and Cardoso AM
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Background: Despite the importance of social determinants of health, studies on the effects of socioeconomic, sanitary, and housing conditions on Indigenous child health are scarce worldwide. This study aims to identify patterns in housing, water & sanitation, and wealth (HSW) in the first Indigenous birth cohort in Brazil-The Guarani Birth Cohort., Methods: Cross-sectional study using baseline data from The Guarani Birth Cohort. We used Multiple Correspondence Analysis and Cluster Analysis. The clusters identified were ordered in increasing degrees of access to public policies and wealth, defining the patterns of HSW. Finally, we explored the association between the patterns and one of the health outcomes, hospitalization, in the birth cohort., Findings: Three patterns were identified for housing and water & sanitation, and four for wealth status, resulting in 36 combinations of patterns (3 × 3 × 4). More than 62% of children in the cohort were found with the lowest wealth patterns. The distribution of children across patterns in one dimension was not fully determined by the other two dimensions. Statistically significant associations were found between precarious households and extreme poverty, and hospitalization., Interpretation: We observed substantial heterogeneity in the distribution of children across the 36 combinations. These findings highlight that, should the dimensions of HSW be associated with health outcomes, as seen for hospitalization, they should be considered separately in multivariable models, in order to improve the estimation of their independent effects., Funding: National Council for Scientific and Technological Development, Brazil (CNPq); Oswaldo Cruz Foundation, Brazil (Fiocruz); Research Foundation of the State of Rio de Janeiro, Brazil (FAPERJ)., Competing Interests: All authors declare that they have no competing interests., (© 2023 The Author(s).)
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- 2023
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26. The effectiveness of COVID-19 vaccines against severe cases and deaths in Brazil from 2021 to 2022: a registry-based study.
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Santos CVBD, Valiati NCM, Noronha TG, Porto VBG, Pacheco AG, Freitas LP, Coelho FC, Gomes MFDC, Bastos LS, Cruz OG, Lana RM, Luz PM, Carvalho LMF, Werneck GL, Struchiner CJ, and Villela DAM
- Abstract
Background: Brazil started the COVID-19 mass vaccination in January 2021 with CoronaVac and ChAdOx1, followed by BNT162b2 and Ad26.COV2.S vaccines. By the end of 2021, more than 317 million vaccine doses were administered in the adult population. This study aimed at estimating the effectiveness of the primary series of COVID-19 vaccination and booster shots in protecting against severe cases and deaths in Brazil during the first year of vaccination., Methods: A cohort dataset of over 158 million vaccination and severe cases records linked from official national registries was analyzed via a mixed-effects Poisson model, adjusted for age, state of residence, time after immunization, and calendar time to estimate the absolute vaccine effectiveness of the primary series of vaccination and the relative effectiveness of the booster. The method permitted analysis of effectiveness against hospitalizations and deaths, including in the periods of variant dominance., Findings: Vaccine effectiveness against severe cases and deaths remained over 25% and 50%, respectively, after 19 weeks from primary vaccination of BNT162b2, ChAdOx1, or CoronaVac vaccines. The boosters conferred greater protection than the primary series of vaccination, with heterologous boosters providing marginally greater protection than homologous. The effectiveness against hospitalization during the Omicron dominance in the 60+ years old population started at 61.7% (95% CI, 26.1-86.2) for ChAdOx1, 95.6% (95% CI, 82.4-99.9) for CoronaVac, and 72.3% (95% CI, 51.4-87.4) for the BNT162b2 vaccine., Interpretation: This study provides real-world evidence of the effectiveness of COVID-19 vaccination in Brazil, including during the Omicron wave, demonstrating protection even after waning effectiveness. Comparisons of the effectiveness among different vaccines require caution due to potential bias effects related to age groups, periods in the pandemic, and eventual behavioural changes., Funding: Fundação Oswaldo Cruz (FIOCRUZ), Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq), Fundação de Amparo a Pesquisa do Estado do Rio de Janeiro (FAPERJ), Pan American Health Organization (PAHO), Departamento de Ciência e Tecnologia da Secretaria de Ciência, Tecnologia, Inovação e Insumos Estratégicos em Saúde do Ministério da Saúde do Brasil (DECIT/SCTIE/MS)., Competing Interests: DAMV, PML, MFCG, LSB, OGC, AGP, NCMV, LPF and TGN are affiliated with Fundação Oswaldo Cruz, which manufactures the ChAdOx nCoV-19 vaccine in Brazil through a full technology transfer agreement with AstraZeneca. VBGP is a Brazilian Ministry of Health employee at the National Immunization Program (NIP), being responsible for the pharmacovigilance of the vaccines used by the NIP. DAMV, TGN and MFCG are invited, unpaid members of the Technical Advisory Board for COVID-19 immunization in the Brazilian Ministry of Health. MFCG received travel and lunch expenses for a meeting promoted by the Butantan Institute, the manufacturer of CoronaVac in Brazil. All other authors declare no competing interests., (© 2023 The Authors.)
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- 2023
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27. Estimated COVID-19 severe cases and deaths averted in the first year of the vaccination campaign in Brazil: A retrospective observational study.
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Santos CVBD, Noronha TG, Werneck GL, Struchiner CJ, and Villela DAM
- Abstract
Background: A nationwide Severe Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) vaccination campaign was initiated in Brazil in January 2021 with CoronaVac (Sinovac Biotech) and ChAdOx1 nCoV-19 (AstraZeneca) followed by BNT162b2 mRNA (Pfizer-BioNTech) and Ad26.COV2.S (Johnson & Johnson-Janssen) vaccines. Here we provide estimates of the number of severe cases and deaths due to coronavirus disease (COVID-19) averted during the first year of the mass vaccination campaign in Brazil., Methods: Data on COVID-19 vaccination and COVID-19-related illness and death were obtained from the Brazilian Ministry of Health and used to estimate the direct effects of the vaccination campaign on the number of severe cases and deaths due to COVID-19 occurring between January 17, 2021 and January 31, 2022. To this end, we compared the daily age-specific rates between the unvaccinated population and the "at least partly vaccinated" population (received at least one dose of a two-dose vaccine), as well as other two vaccination subgroups, "fully vaccinated" (completed the one- or two-dose vaccine schedule), and "boosted-vaccinated" (fully vaccinated and recipients of booster dose) populations., Findings: We estimated that 74% (n = 875,846; 95% confidence interval, CI 843,383-915,709) of total expected cases of severe COVID-19 and 82% (n = 303,129; 95% CI 284,019-321,681) of total expected deaths due to COVID-19 were averted in the first year of the national vaccination campaign. The averted burden was heterogeneous between age groups and higher in the more populous states. However, outcome rate differences between vaccinated and unvaccinated groups were higher in the less populated states., Interpretation: The first year of the COVID-19 vaccination program in Brazil saved the lives of at least 303,129 adults. The results highlight the need for future vaccination campaigns, including those required in the current pandemic, to rapidly achieve high uptake, particularly among the elderly and residents of the least populous regions., Funding: Ministry of Health (Brazil)., Competing Interests: D.A.M.V. and T.G.d.N. are affiliated with Fundação Oswaldo Cruz, which manufactures the ChAdOx nCoV-19 vaccine in Brazil through a full technology transfer agreement with AstraZeneca. T.G.d.N. received payment from the Ministry of Health to coordinate a national network to monitor the safety and effectiveness of the Covid-19 vaccination campaign in Brazil. All other authors declare no competing interests., (© 2022 The Author(s).)
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- 2023
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28. Dynamics and immunomodulation of cognitive deficits and behavioral changes in non-severe experimental malaria.
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Rosa-Gonçalves P, de Sousa LP, Maia AB, Ribeiro-Gomes FL, Gress CCTL, Werneck GL, Souza DO, Almeida RF, and Daniel-Ribeiro CT
- Subjects
- Humans, Immunomodulation, Diphtheria-Tetanus Vaccine, Immunity, Cognition, Cognition Disorders, Cognitive Dysfunction
- Abstract
Data recently reported by our group indicate that stimulation with a pool of immunogens capable of eliciting type 2 immune responses can restore the cognitive and behavioral dysfunctions recorded after a single episode of non-severe rodent malaria caused by Plasmodium berghei ANKA. Here we explored the hypothesis that isolated immunization with one of the type 2 immune response-inducing immunogens, the human diphtheria-tetanus (dT) vaccine, may revert damages associated with malaria. To investigate this possibility, we studied the dynamics of cognitive deficits and anxiety-like phenotype following non-severe experimental malaria and evaluated the effects of immunization with both dT and of a pool of type 2 immune stimuli in reversing these impairments. Locomotor activity and long-term memory deficits were assessed through the open field test (OFT) and novel object recognition task (NORT), while the anxiety-like phenotype was assessed by OFT and light/dark task (LDT). Our results indicate that poor performance in cognitive-behavioral tests can be detected as early as the 12
th day after the end of antimalarial treatment with chloroquine and may persist for up to 155 days post infection. The single immunization strategy with the human dT vaccine showed promise in reversal of long-term memory deficits in NORT, and anxiety-like behavior in OFT and LDT., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Rosa-Gonçalves, de Sousa, Maia, Ribeiro-Gomes, Gress, Werneck, Souza, Almeida and Daniel-Ribeiro.)- Published
- 2022
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29. What do we need to know about the monkeypox virus infection in humans?
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Brasil P, Martins EB, Calvet GA, and Werneck GL
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- Brazil, Humans, Mpox (monkeypox) epidemiology, Monkeypox virus
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- 2022
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30. The challenges for targeting Chagas disease for elimination as a public health problem.
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Werneck GL
- Subjects
- Humans, Public Health, Chagas Disease prevention & control, Trypanosoma cruzi
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- 2022
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31. The COVID-19 pandemic: challenges in assessing the impact of complex and multidimensional problems on the health of populations.
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Werneck GL
- Subjects
- Brazil epidemiology, Humans, Pandemics, SARS-CoV-2, COVID-19 epidemiology
- Published
- 2022
- Full Text
- View/download PDF
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