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188. Global Communications Newsletter.

Author

Sattar B. Sadkhan, Dinko Begusic, Nikola Rozic, Josko Radic, Matko Saric, Katarina Rados, Sinisa Krajnovic, Pascal Lorenz, Joel J. P. C. Rodrigues, Tao Huang, Mohan Jacob, and Chia-Han Lee

Published
2022
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195. Population-based surveillance for congenital zika virus syndrome: a latent class analysis of recorded cases from 2015–2018

Author

Enny S. Paixao, Laura C. Rodrigues, Maria da Conceição N. Costa, Rita de Cassia Oliveira de Carvalho-Sauer, Wanderson K. Oliveira, Luciana L. Cardim, Lavinia Schuler-Faccini, Roberto F. S. Andrade, Moreno S. Rodrigues, Elizabeth B. Brickley, Rafael V. Veiga, Larissa C. Costa, Eduardo H. Carmo, Liam Smeeth, Mauricio L. Barreto, and Maria Gloria Teixeira

Subjects
Congenital zika syndrome, Mortality, Microcephaly, Imaging findings, Gynecology and obstetrics, RG1-991
Abstract

Abstract Objective This study aims to describe clinical findings and determine the medium-term survival of congenital zika syndrome (CZS) suspected cases. Methods A retrospective cohort study using routine register-based linked data. It included all suspected cases of CZS born in Brazil from January 1, 2015, to December 31, 2018, and followed up from birth until death, 36 months, or December 31, 2018, whichever came first. Latent class analysis was used to cluster unconfirmed cases into classes with similar combinations of anthropometry at birth, imaging findings, maternally reported rash, region, and year of birth. Kaplan–Meier curves were plotted, and Cox proportional hazards models were fitted to determine mortality up to 36 months. Results We followed 11,850 suspected cases of CZS, of which 28.3% were confirmed, 9.3% inconclusive and 62.4% unconfirmed. Confirmed cases had almost two times higher mortality when compared with unconfirmed cases. Among unconfirmed cases, we identified three distinct clusters with different mortality trajectories. The highest mortality risk was observed in those with abnormal imaging findings compatible with congenital infections (HR = 12.6; IC95%8.8–18.0) and other abnormalities (HR = 11.6; IC95%8.6–15.6) compared with those with normal imaging findings. The risk was high in those with severe microcephaly (HR = 8.2; IC95%6.4–10.6) and macrocephaly (HR = 6.6; IC95%4.5–9.7) compared with normal head size. Conclusion Abnormal imaging and head circumference appear to be the main drivers of the increased mortality among suspected cases of CZS. We suggest identifying children who are more likely to die and have a greater need to optimise interventions and resource allocation regardless of the final diagnoses.

Published
2022
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196. CoronaVac vaccine is effective in preventing symptomatic and severe COVID-19 in pregnant women in Brazil: a test-negative case-control study

Author

Enny S. Paixao, Kerry L. M. Wong, Flavia Jôse Oliveira Alves, Vinicius de Araújo Oliveira, Thiago Cerqueira-Silva, Juracy Bertoldo Júnior, Tales Mota Machado, Elzo Pereira Pinto Junior, Viviane S. Boaventura, Gerson O. Penna, Guilherme Loureiro Werneck, Laura C. Rodrigues, Neil Pearce, Mauricio L. Barreto, and Manoel Barral-Netto

Subjects
Vaccine effectiveness, Inactivated vaccine, Pregnant women, COVID-19, SARS-CoV-2, Medicine
Abstract

Abstract Background More doses of CoronaVac have been administered worldwide than any other COVID-19 vaccine. However, the effectiveness of COVID-19 inactivated vaccines in pregnant women is still unknown. We estimated the vaccine effectiveness (VE) of CoronaVac against symptomatic and severe COVID-19 in pregnant women in Brazil. Methods We conducted a test-negative design study in all pregnant women aged 18–49 years with COVID-19-related symptoms in Brazil from March 15, 2021, to October 03, 2021, linking records of negative and positive SARS-CoV-2 reverse transcription polymerase chain reaction (RT-PCR) tests to national vaccination records. We also linked records of test-positive cases with notifications of severe, hospitalised or fatal COVID-19. Using logistic regression, we estimated the adjusted odds ratio and VE against symptomatic COVID-19 and against severe COVID-19 by comparing vaccine status in test-negative subjects to test-positive symptomatic cases and severe cases. Results Of the 19,838 tested pregnant women, 7424 (37.4%) tested positive for COVID-19 and 588 (7.9%) had severe disease. Only 83% of pregnant women who received the first dose of CoronaVac completed the vaccination scheme. A single dose of the CoronaVac vaccine was not effective at preventing symptomatic COVID-19. The effectiveness of two doses of CoronaVac was 41% (95% CI 27.1–52.2) against symptomatic COVID-19 and 85% (95% CI 59.5–94.8) against severe COVID-19. Conclusions A complete regimen of CoronaVac in pregnant women was effective in preventing symptomatic COVID-19 and highly effective against severe illness in a setting that combined high disease burden and marked COVID-19-related maternal deaths.

Published
2022
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197. Differences in risk factors for incident and recurrent preterm birth: a population-based linkage of 3.5 million births from the CIDACS birth cohort

Author

Aline S. Rocha, Rita de Cássia Ribeiro-Silva, Rosemeire L. Fiaccone, Enny S. Paixao, Ila R. Falcão, Flavia Jôse O. Alves, Natanael J. Silva, Naiá Ortelan, Laura C. Rodrigues, Maria Yury Ichihara, Marcia F. de Almeida, and Mauricio L. Barreto

Subjects
Preterm birth, Incident preterm birth, Recurrent preterm birth, Risk factor, Poor populations, Medicine
Abstract

Abstract Background Preterm birth (PTB) is a syndrome resulting from a complex list of underlying causes and factors, and whether these risk factors differ in the context of prior PTB history is less understood. The aim of this study was to explore whether PTB risk factors in a second pregnancy were different in women with versus without previous PTB. Methods We conducted a population-based cohort study using data from the birth cohort of the Center for Data and Knowledge Integration for Health (CIDACS) for the period 2001 to 2015. We used longitudinal transition models with multivariate logistic regression to investigate whether risk factors varied between incident and recurrent PTB. Results A total of 3,528,050 live births from 1,764,025 multiparous women were analyzed. We identified different risk factors (P difference

Published
2022
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198. Constraints on kinematic parameters at $z\ne0$

Author

Filho, C. Rodrigues and Barboza Jr, Edésio M.

Subjects
Astrophysics - Cosmology and Nongalactic Astrophysics, General Relativity and Quantum Cosmology
Abstract

The standard cosmographic approach consists in performing a series expansion of a cosmological observable around $z=0$ and then using the data to constrain the cosmographic (or kinematic) parameters at present time. Such a procedure works well if applied to redshift ranges inside the $z$-series convergence radius ($z<1$), but can be problematic if we want to cover redshift intervals that fall outside the $z-$series convergence radius. This problem can be circumvented if we work with the $y-$redshift, $y=z/(1+z)$, or the scale factor, $a=1/(1+z)=1-y$, for example. In this paper, we use the scale factor $a$ as the variable of expansion. We expand the luminosity distance and the Hubble parameter around an arbitrary $\tilde{a}$ and use the Supernovae Ia (SNe Ia) and the Hubble parameter data to estimate $H$, $q$, $j$ and $s$ at $z\ne0$ ($\tilde{a}\neq1$). We show that the last relevant term for both expansions is the third. Since the third order expansion of $d_L(z)$ has one parameter less than the third order expansion of $H(z)$, we also consider, for completeness, a fourth order expansion of $d_L(z)$. For the third order expansions, the results obtained from both SNe Ia and $H(z)$ data are incompatible with the $\Lambda$CDM model at $2\sigma$ confidence level, but also incompatible with each other. When the fourth order expansion of $d_L(z)$ is taken into account, the results obtained from SNe Ia data are compatible with the $\Lambda$CDM model at $2\sigma$ confidence level, but still remains incompatible with results obtained from $H(z)$ data. These conflicting results may indicate a tension between the current SNe Ia and $H(z)$ data sets., Comment: 16 pages, 6 tables, 5 figures, accepted for publication in JCAP

Published
2017
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