181 results on '"Denise Alves Ferreira"'
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2. Evaluation of chimeric recombinant antigens for the serodiagnosis of Trypanosoma cruzi in dogs: a promising tool for Chagas disease surveillance
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Natália Dantas Fontes, Fernanda Lopes Habib, Leonardo Maia Leony, Natália Erdens Maron Freitas, Ângelo Antônio Oliveira Silva, Filipe Dantas-Torres, Kamila Gaudêncio da Silva Sales, Antônia Cláudia Jácome da Câmara, Vicente Toscano de Araújo-Neto, Leila Denise Alves Ferreira Amorim, Paola Alejandra Fiorani Celedon, Nilson Ivo Tonin Zanchin, and Fred Luciano Neves Santos
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Chagas disease ,Trypanosoma cruzi ,Canine serodiagnosis ,Recombinant chimeric antigens ,Latent class analysis ,Diagnostic performance ,Infectious and parasitic diseases ,RC109-216 - Abstract
Abstract Background Chagas disease (CD), a neglected parasitic disease caused by Trypanosoma cruzi, poses a significant health threat in Latin America and has emerged globally because of human migration. Trypanosoma cruzi infects humans and over 100 other mammalian species, including dogs, which are important sentinels for assessing the risk of human infection. Nonetheless, the serodiagnosis of T. cruzi in dogs is still impaired by the absence of commercial tests. In this study, we investigated the diagnostic accuracy of four chimeric recombinant T. cruzi IBMP antigens (IBMP-8.1, IBMP-8.2, IBMP-8.3, and IBMP-8.4) for detecting anti-T. cruzi antibodies in dogs, using latent class analysis (LCA). Methods We examined 663 canine serum samples, employing indirect ELISA with the chimeric antigens. LCA was utilized to establish a latent variable as a gold standard for T. cruzi infection, revealing distinct response patterns for each antigen. Results The IBMP (Portuguese acronym for the Molecular Biology Institute of Paraná) antigens achieved area under the ROC curve (AUC) values ranging from 90.9% to 97.3%. The highest sensitivity was attributed to IBMP-8.2 (89.8%), while IBMP-8.1, IBMP-8.3, and IBMP-8.4 achieved 73.5%, 79.6%, and 85.7%, respectively. The highest specificity was observed for IBMP-8.4 (98.6%), followed by IBMP-8.2, IBMP-8.3, and IBMP-8.1 with specificities of 98.3%, 94.4%, and 92.7%, respectively. Predictive values varied according to prevalence, indicating higher effectiveness in endemic settings. Conclusions Our findings underscore the remarkable diagnostic performance of IBMP-8.2 and IBMP-8.4 for the serodiagnosis of Trypanosoma cruzi in dogs, representing a promising tool for the diagnosis of CD in dogs. These chimeric recombinant antigens may not only enhance CD surveillance strategies but also hold broader implications for public health, contributing to the global fight against this neglected tropical disease. Graphical Abstract
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- 2024
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3. Patterns of metabolic syndrome and associated factors in women from the ELSA-Brasil: a latent class analysis approach
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Nila Mara Smith Galvão, Sheila Maria Alvim de Matos, Maria da Conceição Chagas de Almeida, Ligia Gabrielli, Sandhi Maria Barreto, Estela M. L. Aquino, Maria Inês Schmidt, and Leila Denise Alves Ferreira Amorim
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Metabolic Syndrome ,Women ,Latent Class Analysis ,Social Determinants of Health ,Medicine ,Public aspects of medicine ,RA1-1270 - Abstract
Abstract: This study aimed to identify patterns of metabolic syndrome among women and estimate their prevalence and relationship with sociodemographic and biological characteristics. In total, 5,836 women were evaluated using baseline data from the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil). Patterns of metabolic syndrome were defined via latent class analysis, using the following metabolic abnormalities as indicators: abdominal obesity, hyperglycemia, hypertension, hypertriglyceridemia, and reduced HDL cholesterol. The relationship between these patterns and individual characteristics was assessed using latent class analysis with covariates. Three patterns of metabolic syndrome were identified: high metabolic expression, moderate metabolic expression, and low metabolic expression. The first two patterns represented most women (53.8%) in the study. Women with complete primary or secondary education and belonging to lower social classes were more likely to have higher metabolic expression. Black and mixed-race women were more likely to have moderate metabolic expression. Menopausal women aged 50 years and older were more often classified into patterns of greater health risk. This study addressed the heterogeneous nature of metabolic syndrome, identifying three distinct profiles for the syndrome among women. The combination of abdominal obesity, hyperglycemia, and hypertension represents the main metabolic profile found among ELSA-Brasil participants. Sociodemographic and biological factors were important predictors of patterns of metabolic syndrome.
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- 2023
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4. Características percebidas da vizinhança e a prática de atividade física entre adolescentes e adultos jovens: um modelo com respostas distais
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Daiane Nascimento de Castro, Rosana Aquino, and Leila Denise Alves Ferreira Amorim
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Vizinhança ,Análise de Classes Latentes ,Atividade Motora ,Adolescente ,Medicine ,Public aspects of medicine ,RA1-1270 - Abstract
Os objetivos do estudo foram identificar perfis de vizinhança percebidos por adolescentes e adultos jovens, e estimar sua associação com a realização de atividade física global e de lazer. Utilizaram-se dados de 1.637 indivíduos entre 15 e 24 anos, de um estudo transversal, com amostragem por conglomerados, de uma cidade do Estado da Bahia, Brasil, em 2011. A atividade física foi mensurada pelo International Physical Activity Questionnaire (IPAQ), versão curta, além de questão sobre atividade no lazer. A percepção de características do ambiente físico e social da vizinhança se baseou em escala com 14 questões. Perfis de vizinhança foram definidos por meio de análise de classes latentes (LCA), e a estimação dos seus efeitos na atividade física usou o modelo com respostas distais. A análise de perfil latente resultou em três padrões de vizinhança, descritos como “urbana, sociável e favorável à atividade física - classe 1” (39,6%); “sociável e segura - classe 2” (24,4%); e “insegura, de baixa sociabilidade - classe 3” (36%). Os indivíduos pertencentes à “classe 1” apresentaram maior probabilidade de se exercitar (56,4%), enquanto, para as classes 2 e 3, estes percentuais corresponderam a 46,3% e 42,8%, respectivamente. Associação estatisticamente significante foi identificada apenas na classe “urbana, sociável e favorável à atividade física”, cuja chance de realizar atividade de lazer foi de 72% (OR = 1,72; IC95%: 1,29-2,29). Bairros com atributos favoráveis à prática de atividade física e a existência de elementos de urbanização aumentam a chance do comportamento ativo no lazer entre os adolescentes e adultos jovens. O uso de LCA e do modelo com repostas distais é promissor e inovador na abordagem sobre vizinhança.
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- 2022
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5. Ideal cardiovascular health at ELSA-Brasil: non-additivity effects of gender, race, and schooling by using additive and multiplicative interactions
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Roberta Souza Freitas, Itamar de Souza Santos, Sheila Maria Alvim de Matos, Estela Maria Leão de Aquino, and Leila Denise Alves Ferreira Amorim
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Intersectionality ,Heart Diseases ,Cardiovascular Diseases ,Risk Factors ,Cross-sectional Studies ,Medicine ,Public aspects of medicine ,RA1-1270 - Abstract
This study aims to assess the non-additivity effects of gender, race, and schooling on ideal cardiovascular health among participants of the Brazilian Longitudinal Study of Adult Health - ELSA-Brasil. This is a cross-sectional study using data from the baseline of ELSA-Brasil, conducted from 2008 to 2010. The American Heart Association defined a score of ideal cardiovascular health (ICH) as the sum of indicators for the presence of seven favorable health factors and behaviors: non-smoking, ideal body mass index, physical activity and healthy diet, adequate levels of total cholesterol, normal blood pressure, and absence of diabetes mellitus. Multiplicative and additive interactions between gender, race, and schooling were assessed using the Poisson regression model to discuss intersectionality. The mean cardiovascular health score was 2.49 (SD = 1.31). This study showed a positive interaction between gender and schooling (women with high school and higher education) in both additive and multiplicative scales for the score of ideal cardiovascular health. We observed a trend towards higher mean values of cardiovascular health for increased schooling, with a marked difference among women. The lowest cardiovascular health scores observed reinforce the importance of understanding the psychosocial experiences that influence health attitudes, access to health care, and healthy lifestyle choices, which affect ICH, to reduce inequities in health and propose more adequate public policies that assist and prevent cardiovascular diseases.
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- 2022
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6. Performance evaluation of tuberculosis control in Brazilian municipalities
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Priscila Fernanda Porto Scaff Pinto, Beatriz Pinheiro Schindler dos Santos, Camila Silveira Silva Teixeira, Joilda Silva Nery, Leila Denise Alves Ferreira Amorim, Mauro Niskier Sanchez, Mauricio Lima Barreto, and Julia Moreira Pescarini
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Tuberculosis, prevention & control ,Outcome and Process Assessment, Health Care ,Program Evaluation ,Ecological Studies ,Public aspects of medicine ,RA1-1270 - Abstract
ABSTRACT OBJECTIVE To evaluate the performance of tuberculosis control in Brazilian municipalities. METHODS This is an ecological study on Brazilian municipalities that notified at least four new cases of tuberculosis, with a minimum of one new case of pulmonary tuberculosis between 2015 and 2018. The municipalities were stratified according to the population in < 50 thousand, 50–100 thousand, 100–300 thousand, and > 300 thousand inhabitants, and the k-means method was used to group them within each population range according to the performance of six indicators of the disease. RESULTS A total of 2,845 Brazilian municipalities were included, comprising 98.5% (208,007/211,174) of new tuberculosis cases in the period. For each population range, three groups (A, B, and C) of municipalities were identified according to the performance of the indicators: A, the most satisfactory; B, the intermediates; and C, the least satisfactory. Municipalities in group A with < 100 thousand inhabitants presented results above the targets for laboratory confirmation (≥ 72%), abandonment (≤ 5%), and cure (≥ 90%), and comprised 2% of new cases of the disease. Conversely, municipalities of groups B and C presented at least five indicators with results below the targets – HIV testing (< 100%), contact investigation (< 90%), directly observed therapy (< 90%), abandonment (> 5%), and cure (< 90%) –, and corresponded to 66.7% of new cases of tuberculosis. In group C of municipalities with > 300 thousand inhabitants, which included 19 of the 27 capitals and 43.1% of new cases of tuberculosis, the lowest percentages of contact investigation (mean = 56.4%) and directly observed therapy (mean = 15.4%) were verified, in addition to high abandonment (mean = 13.9%) and low coverage of primary health care (mean = 66.0%). CONCLUSIONS Most new cases of tuberculosis occurred in municipalities with unsatisfactory performance for disease control. Expanding the coverage of primary health care in these places can reduce abandonment and increase the contact investigation and directly observed therapy.
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- 2022
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7. Obesidade abdominal no ELSA-Brasil: construcao de padraoouro latente e avaliacao da acuracia de indicadores diagnosticos/Abdominal obesity in ELSA-Brasil (Brazil's Longitudinal Study of Adult Health): construction of a latent gold standard and evaluation of the accuracy of diagnostic indicators
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Eickemberg, Michaela, Amorim, Leila Denise Alves Ferreira, da Conceição Chagas de Almeida, Maria, Pitanga, Francisco José Gondim, de Aquino, Estela Maria Leão, de Jesus Mendes da Fonseca, Maria, and Matos, Sheila Maria Alvim
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- 2020
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8. Social position and anthropometric status among adults in the ELSA-Brasil study: a latent class analysis
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Sheila Maria Alvim Matos, Leila Denise Alves Ferreira Amorim, Francisco José Gondim Pitanga, Ana Luísa Patrão, Sandhi M. Barreto, Dora Chor, Letícia de Oliveira Cardoso, Maria del Carmen Bisi Molina, Mauricio Lima Barreto, and Estela M. L. Aquino
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Overweight ,Latent Class Analysis ,Developing Countries ,Medicine ,Public aspects of medicine ,RA1-1270 - Abstract
Abstract: The objective of the present study was to evaluate the association between social position and anthropometric status in women and men Brazilian adult. This was a cross-sectional study that used baseline data collected from 2008 to 2010 for the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil, in Portuguese), in the six major Brazilian state capital cities. A total of 15,105 active and retired civil servants aged from 35 to 74 years. Two latent variables were defined by latent class analysis, social position and anthropometric status. Both constructs and the analyses were separately evaluated by sex. Associations were assessed using multivariate logistic regression analysis with adjustment for age, self-reported skin color/race, and marital status. Around 44% of the women and 26% of the men were classified as overweight or obese. Social position tended to be lower in women (43.2%) and higher among men (40.4%). Heavier women were more likely to be black and brown-skinned, whereas slimmer women were more likely to be white. After adjustment, women’s weight increased as social position decreased (OR = 1.52; 95%CI: 1.36-1.70), whereas in men weight decreased as social position decreased (OR = 0.87; 95%CI: 0.76-0.99). Social position affected the anthropometric status of women and men differently, with body patterns also being affected by ethnicity/skin color, showing the potentiality of taking the intersectional perspective when investigating the possible social determinants of the phenomenon.
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- 2021
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9. Immune response dynamics and Lutzomyia longipalpis exposure characterize a biosignature of visceral leishmaniasis susceptibility in a canine cohort.
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Manuela da Silva Solcà, Maiara Reis Arruda, Bruna Martins Macedo Leite, Tiago Feitosa Mota, Miriam Flores Rebouças, Matheus Silva de Jesus, Leila Denise Alves Ferreira Amorim, Valéria Matos Borges, Jesus Valenzuela, Shaden Kamhawi, Patrícia Sampaio Tavares Veras, Deborah Bittencourt Mothé Fraga, and Claudia Ida Brodskyn
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Arctic medicine. Tropical medicine ,RC955-962 ,Public aspects of medicine ,RA1-1270 - Abstract
BackgroundReports have shown correlations between the immune response to vector saliva and Leishmaniasis outcome. We followed dogs in an endemic area for two years characterizing resistance or susceptibility to canine visceral leishmaniasis (CVL) according to Leishmania infantum diagnosis and clinical development criteria. Then, we aimed to identify a biosignature based on parasite load, serum biological mediators' interactions, and vector exposure intensity associated with CVL resistance and susceptibility.Methodology/principal findingsA prospective two-year study was conducted in an area endemic for CVL. Dogs were evaluated at 6-month intervals to determine infection, clinical manifestations, immune profile, and sandfly exposure. CVL resistance or susceptibility was determined upon the conclusion of the study. After two years, 78% of the dogs were infected with L. infantum (53% susceptible and 47% resistant to CVL). Susceptible dogs presented higher splenic parasite load as well as persistence of the parasite during the follow-up, compared to resistant ones. Susceptible dogs also displayed a higher number of correlations among the investigated biological mediators, before and after infection diagnosis. At baseline, anti-saliva antibodies, indicative of exposure to the vector, were detected in 62% of the dogs, reaching 100% in one year. Higher sandfly exposure increased the risk of susceptibility to CVL by 1.6 times (CI: 1.11-2.41). We identified a discriminatory biosignature between the resistant and susceptible dogs assessing splenic parasite load, interaction of biological mediators, PGE2 serum levels and intensity of exposure to sandfly. All these parameters were elevated in susceptible dogs compared to resistant animals.Conclusions/significanceThe biosignature identified in our study reinforces the idea that CVL is a complex multifactorial disease that is affected by a set of factors which are correlated and, for a better understanding of CVL, should not be evaluated in an isolated way.
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- 2021
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10. Quality of antenatal care in Primary Health Care in Brazil: A Latent Class Analysis
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Ortelan, Naiá, primary, Flores-Quispe, Maria del Pilar, additional, Luz, Leandro Alves da, additional, Martufi, Valentina, additional, Anjos, Eduarda Ferreira dos, additional, de Lima, Acácia Mayra Pereira, additional, de Almeida, Josemir Ramos, additional, Passos, Michelle Pereira Vale dos, additional, Santos, Ythalo Hugo da Silva, additional, Amorim, Leila Denise Alves Ferreira, additional, Vieira-Meyer, Anya Pimentel Gomes Fernandes, additional, Ichihara, Maria Yury Travassos, additional, Aquino, Rosana, additional, Barreto, Mauricio Lima, additional, and Junior, Elzo Pereira Pinto, additional
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- 2023
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11. Acesso aos serviços de atenção primária à saúde por adolescentes e jovens em um município do Estado da Bahia, Brasil
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Maísa Mônica Flores Martins, Rosana Aquino, Marina Luna Pamponet, Elzo Pereira Pinto Junior, and Leila Denise Alves Ferreira Amorim
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Health Services Accessibity ,Primary Health Care ,Family Health Strategy ,Adolescent ,Medicine ,Public aspects of medicine ,RA1-1270 - Abstract
Resumo: O estudo teve como objetivo analisar a associação entre o acesso aos serviços de atenção primária à saúde dos adolescentes e adultos jovens e a cobertura da Estratégia Saúde da Família (ESF). Trata-se de estudo transversal, a partir de um inquérito domiciliar realizado com 812 indivíduos de 15 a 24 anos de idade, em Camaçari, Bahia, Brasil, por meio de uma amostragem por conglomerados. Variáveis demográficas, socioeconômicas, de saúde e dos serviços de saúde foram utilizadas para descrição da população, segundo a área de cobertura de atenção primária à saúde. A associação entre área de cobertura da atenção primária à saúde e acesso aos serviços desta, as barreiras de acesso e a participação em atividades educativas foram estimadas por meio da razão de prevalência (RP), com uso do modelo de regressão logística multinível no software R. O acesso aos serviços de atenção primária à saúde foi referido por 89,5% dos indivíduos, não havendo diferenças estatisticamente significantes entre esse tipo de acesso e a área de cobertura da ESF. Entretanto, entre indivíduos residentes em áreas cobertas pela ESF, verificou-se maior acesso às ações de prevenção de agravos e promoção da saúde (RP = 3,0; IC95%: 1,68-5,34), mas também menor probabilidade de o atendimento ocorrer no mesmo dia de marcação da consulta (RP = 0,60; IC95%: 0,48-0,74) e menor disponibilidade de transporte coletivo (RP = 0,59; IC95%: 0,39-0,90). Os dados deste estudo apontaram elevada prevalência de acesso aos serviços de atenção primátria à saúde entre os adolescentes e adultos jovens. Ainda que não se tenham observado diferenças do acesso entre as áreas com cobertura da ESF, a maior participação desses indivíduos em atividades de prevenção e promoção da saúde reforçam a importância dessa estratégia no âmbito do Sistema Único de Saúde (SUS).
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- 2019
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12. Indicators of Abdominal Adiposity and Carotid Intima-Media Thickness: Results from the Longitudinal Study of Adult Health (ELSA-Brazil)
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Michaela Eickemberg, Leila Denise Alves Ferreira Amorim, Maria da Conceição Chagas de Almeida, Estela Maria Leão de Aquino, Maria de Jesus Mendes da Fonseca, Itamar de Souza Santos, Dora Chor, Maria de Fátima Sander Diniz, Sandhi Maria Barreto, and Sheila Maria Alvim de Matos
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Doenças Cardiovasculares ,Fatores de Risco ,Metabolismo ,Síndrome Metabólica ,Obesidade abdominal ,Aterosclerose ,Espessura Íntima-Média Carotídea ,Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Abstract
Abstract Background: Abdominal adiposity is a risk factor for cardiovascular disease. Objective: To determine the magnitude of the association between abdominal adiposity, according to five different indicators, and the carotid intima-media thickness (CIMT). Methods: Data from 8,449 participants aged 35 to 74 years from the ELSA-Brazil study were used. The effect of waist circumference (WC), waist-to-hip ratio (WHR), conicity index (C index), lipid accumulation product (LAP) and visceral adiposity index (VAI) on CIMT were evaluated. Data were stratified by gender and analyzed using multivariate linear and logistic regressions. A significance level of 5% was considered. Results: Participants with CIMT > P75 showed a higher frequency of abdominal adiposity (men >72% and women >66%) compared to those with CIMT < P75. Abdominal adiposity was associated with the mean CIMT, mainly through WC in men (0.04; 95%CI: 0.033; 0.058). The abdominal adiposity identified by the WC, WHR, LAP, and VAI indicators in women showed an effect of 0.02 mm on the CIMT (WC: 0.025, 95%CI: 0.016, 0.035; WHR: 0.026, 95%CI: 0.016, 0.035; LAP: 0.024, 95%CI: 0.014; 0.034; VAI: 0.020, 95%CI: 0.010, 0.031). In the multiple logistic regression, the abdominal adiposity diagnosed by WC showed an important effect on the CIMT in both genders (men: OR = 1.47, 95%CI: 1.22-1.77, women: OR = 1.38; 95%CI: 1.17-1.64). Conclusion: Abdominal adiposity, identified through WC, WHR, LAP, and VAI, was associated with CIMT in both genders, mainly for the traditional anthropometric indicator, WC.
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- 2019
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13. Patterns of metabolic syndrome and associated factors in women from the ELSA-Brasil: a latent class analysis approach
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Galvão, Nila Mara Smith, primary, Matos, Sheila Maria Alvim de, additional, Almeida, Maria da Conceição Chagas de, additional, Gabrielli, Ligia, additional, Barreto, Sandhi Maria, additional, Aquino, Estela M. L., additional, Schmidt, Maria Inês, additional, and Amorim, Leila Denise Alves Ferreira, additional
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- 2023
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14. The mass use of deltamethrin collars to control and prevent canine visceral leishmaniasis: A field effectiveness study in a highly endemic area.
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Bruna Martins Macedo Leite, Manuela da Silva Solcà, Liliane Celestino Sales Santos, Lívia Brito Coelho, Leila Denise Alves Ferreira Amorim, Lucas Edel Donato, Sandra Maria de Souza Passos, Adriana Oliveira de Almeida, Patrícia Sampaio Tavares Veras, and Deborah Bittencourt Mothé Fraga
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Arctic medicine. Tropical medicine ,RC955-962 ,Public aspects of medicine ,RA1-1270 - Abstract
Visceral leishmaniasis (VL) is a zoonosis of great importance. Limitations in current VL control measures compromise efficacy, indicating the need to implement new strategies. The aim of this study was to evaluate the effectiveness of the mass use of deltamethrin-impregnated collars in dogs as a public health measure to control and prevent canine visceral leishmaniasis (CVL).An interventional study was implemented in two endemic areas in the district of Monte Gordo (Bahia-Brazil): an intervention area, in which VL seronegative dogs were collared, and a control area in which only conventional CVL control measures were applied. At baseline, seropositive dogs were removed and seronegative dogs were included. Dogs were then reevaluated every 7-8 months for almost two years. At each time point, dogs in the intervention area that remained seronegative received new collars and newly identified seronegative dogs were included and collared. The local zoonosis control authorities were notified of any dogs that tested seropositive in both areas, which were subsequently marked for euthanasia as mandated by the Brazilian Ministry of Health.In the first serological survey, seroprevalence was similar in both areas. At the second evaluation, significant reductions in seroprevalence were seen in both areas, while seroprevalence in the intervention area reduced to 6.0% during the final evaluation versus an increase of 11.0% in the control area. This significant increase and the estimated relative risk (RR = 0.55) indicated protection against CVL in the intervention area. Although CVL incidence did not differ significantly between the areas, an increased tendency was observed in the control area, which could be due to low seroconversion rates throughout the study or a high loss to follow-up.Although our evaluation of the effectiveness of deltamethrin-impregnated collars as a community-wide public health control measure was inconclusive, this measure likely provides protection over time. In endemic areas of Brazil, this strategy represents an operational challenge for local zoonosis control authorities, indicating the need for adjustments, including improved collar design.
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- 2018
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15. Bayesian Computation via the Gibbs Sampler for Mixture Models with Gaussian Distal Outcomes
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Gilmara S. Bispo, Leila Denise Alves Ferreira Amorim, and Lilia Costa
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Sociology and Political Science ,fungi ,Bayesian probability ,food and beverages ,General Decision Sciences ,macromolecular substances ,Latent variable ,Bayesian inference ,Mixture model ,Latent class model ,symbols.namesake ,Modeling and Simulation ,symbols ,Applied mathematics ,Latent variable model ,General Economics, Econometrics and Finance ,Categorical variable ,Mathematics ,Gibbs sampling - Abstract
Models with distal outcomes have been commonly used to evaluate the effect of categorical latent variables on an observed dependent variable, which can be binary, counting, or continuous. Several a...
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- 2021
16. Avaliação de desempenho do controle da tuberculose em municípios brasileiros
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Pinto, Priscila Fernanda Porto Scaff, Santos, Beatriz Pinheiro Schindler Dos, Teixeira, Camila Silveira Silva, Nery, Joilda Silva, Amorim, Leila Denise Alves Ferreira, Sanchez, Mauro Niskier, Barreto, Mauricio Lima, and Pescarini, Julia Moreira
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Tuberculosis, prevention & control ,Outcome and Process Assessment, Health Care ,Tuberculose, prevenção & controle ,Estudos Ecológicos ,Avaliação de Programas e Projetos de Saúde ,Ecological Studies ,Avaliação de Processos e Resultados em Cuidados de Saúde ,Program Evaluation - Abstract
OBJECTIVE To evaluate the performance of tuberculosis control in Brazilian municipalities. METHODS This is an ecological study on Brazilian municipalities that notified at least four new cases of tuberculosis, with a minimum of one new case of pulmonary tuberculosis between 2015 and 2018. The municipalities were stratified according to the population in < 50 thousand, 50–100 thousand, 100–300 thousand, and > 300 thousand inhabitants, and the k-means method was used to group them within each population range according to the performance of six indicators of the disease. RESULTS A total of 2,845 Brazilian municipalities were included, comprising 98.5% (208,007/211,174) of new tuberculosis cases in the period. For each population range, three groups (A, B, and C) of municipalities were identified according to the performance of the indicators: A, the most satisfactory; B, the intermediates; and C, the least satisfactory. Municipalities in group A with < 100 thousand inhabitants presented results above the targets for laboratory confirmation (≥ 72%), abandonment (≤ 5%), and cure (≥ 90%), and comprised 2% of new cases of the disease. Conversely, municipalities of groups B and C presented at least five indicators with results below the targets – HIV testing (< 100%), contact investigation (< 90%), directly observed therapy (< 90%), abandonment (> 5%), and cure (< 90%) –, and corresponded to 66.7% of new cases of tuberculosis. In group C of municipalities with > 300 thousand inhabitants, which included 19 of the 27 capitals and 43.1% of new cases of tuberculosis, the lowest percentages of contact investigation (mean = 56.4%) and directly observed therapy (mean = 15.4%) were verified, in addition to high abandonment (mean = 13.9%) and low coverage of primary health care (mean = 66.0%). CONCLUSIONS Most new cases of tuberculosis occurred in municipalities with unsatisfactory performance for disease control. Expanding the coverage of primary health care in these places can reduce abandonment and increase the contact investigation and directly observed therapy. RESUMO OBJETIVO Avaliar o desempenho no controle da tuberculose dos municípios brasileiros. MÉTODOS Estudo ecológico com municípios brasileiros que notificaram pelo menos quatro casos novos de tuberculose, com no mínimo um caso novo de tuberculose pulmonar entre 2015 e 2018. Os municípios foram estratificados de acordo com a população em < 50 mil, 50–100 mil, 100–300 mil e > 300 mil habitantes e foi utilizado o método k-médias para agrupá-los dentro de cada faixa populacional segundo desempenho de seis indicadores da doença. RESULTADOS Foram incluídos 2.845 municípios brasileiros abrangendo 98,5% (208.007/211.174) dos casos novos de tuberculose do período. Para cada faixa populacional identificou-se três grupos (A, B e C) de municípios segundo desempenho dos indicadores: A os mais satisfatórios, B os intermediários e C os menos satisfatórios. Municípios do grupo A com < 100 mil habitantes apresentaram resultados acima das metas para confirmação laboratorial (≥ 72%), abandono (≤ 5%) e cura (≥ 90%), e abrangeram 2% dos casos novos da doença. Por outro lado, os municípios dos grupos B e C apresentaram pelo menos cinco indicadores com resultados abaixo das metas – testagem HIV (< 100%), exame de contatos (< 90%), tratamento diretamente observado (< 90%), abandono (> 5%) e cura (< 90%) –, e corresponderam a 66,7% dos casos novos de tuberculose. Já no grupo C dos municípios com > 300 mil habitantes, que incluiu 19 das 27 capitais e 43,1% dos casos novos de tuberculose, encontrou-se os menores percentuais de exames de contatos (média = 56,4%) e tratamento diretamente observado (média = 15,4%), elevado abandono (média = 13,9%) e baixa cobertura da atenção básica (média = 66,0%). CONCLUSÕES Grande parte dos casos novos de tuberculose ocorreu em municípios com desempenho insatisfatório para o controle da doença, onde expandir a cobertura da atenção básica pode reduzir o abandono e elevar o exame de contatos e tratamento diretamente observado.
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- 2022
17. HIV/AIDS coinfection with the hepatitis B and C viruses in Brazil
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Silvano Barbosa de Oliveira, Edgar Merchan-Hamann, and Leila Denise Alves Ferreira Amorim
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Virus de la Hepatitis ,VIH ,Sindrome de Inmunodeficiencia Adquirida ,Coinfeccion ,Medicine ,Public aspects of medicine ,RA1-1270 - Abstract
The aim of this study is to estimate the prevalence of HIV/HBV and HIV/HCV coinfections among AIDS cases reported in Brazil, and to describe the epidemiological profile of these cases. Coinfection was identified through probabilistic record linkage of the data of all patients carrying the HIV virus recorded as AIDS patients and of those patients reported as carriers of hepatitis B or C virus in various databases from the Brazilian Ministry of Health from 1999 to 2010. In this period 370,672 AIDS cases were reported, of which 3,724 were HIV/HBV coinfections. Women are less likely to become coinfected than men and the chance of coinfection increases with age. This study allowed an important evaluation of HBV/HIV and HCV/HIV coinfections in Brazil using information obtained via merging secondary databases from the Ministry of Health, without conducting seroprevalence research. The findings of this study might be important for planning activities of the Brazilian epidemiologic surveillance agencies.
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- 2014
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18. Asthmatic Symptoms in Children and Adolescents: the Role of Maternal Experiences of Racial Discrimination
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Mauricio Lima Barreto, Darci Neves dos Santos, Leila Denise Alves Ferreira Amorim, Letícia Marques dos Santos, and Gisel Lorena Fattore
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medicine.medical_specialty ,Health (social science) ,Sociology and Political Science ,Population ,Atopy ,03 medical and health sciences ,Social support ,0302 clinical medicine ,Wheeze ,Epidemiology ,medicine ,030212 general & internal medicine ,education ,Asthma ,education.field_of_study ,030505 public health ,business.industry ,Health Policy ,Social change ,Public Health, Environmental and Occupational Health ,medicine.disease ,Mental health ,Anthropology ,medicine.symptom ,0305 other medical science ,business ,Clinical psychology - Abstract
Emerging evidence suggests that vicarious racial experiences of discrimination may negatively influence child health. Few studies have focus on childhood asthma symptoms and potential moderators of such relationship. We used two population-based cross-sectional studies from the Social Change Allergy and Asthma in Latin America project in Salvador, Brazil. A total of 1003 children and mothers interviewed in 2006 were included, of whom 873 were reached again in 2013. Vicarious racial discrimination was assessed in mothers by applying the Experiences of Discrimination scale. Data on wheeze and environmental exposures were collected with standardized questionnaires. Levels of allergen-specific IgE were measured to identify atopy. Generalized estimating equations were used to estimate the association between maternal discrimination and wheezing and asthma phenotypes. Interaction terms were evaluated to identify whether mothers’ mental health and family social support modified such associations. Children whose mothers reported racial discrimination had greater odds of have asthma symptoms (OR 1.75; 95% CI 1.15–2.67) and non-atopic asthma (OR 1.92; 95% CI 1.09–3.40). When we considered effect modification by social support, we found a higher ORs when the level of social support was lower (OR 2.43; 95% IC 1.19–4.97) than when the level of social support was higher (OR 1.12; CI 0.64–1.96). Maternal discrimination was associated with asthma symptoms and with non-atopic phenotype among their children. Enjoying wider social support network appears to buffer the effect on asthmatic symptoms. Intervention on childhood asthma needs to incorporate strategies that target the family.
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- 2021
19. Choosing the right strategy to model longitudinal count data in Epidemiology: An application with CD4 cell counts
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Raydonal Ospina, Daniele de Brito Trindade, Leila Denise Alves Ferreira Amorim, CNPq, and FAPESB
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medicine.medical_specialty ,lcsh:R5-920 ,business.industry ,Public health ,lcsh:Public aspects of medicine ,Negative binomial distribution ,Inference ,Statistical model ,Regression analysis ,lcsh:RA1-1270 ,Biostatistics ,Epidemiology ,Public Health ,Gee ,Statistics ,medicine ,business ,lcsh:Medicine (General) ,Count data - Abstract
Background: Statistical models for analysis of correlated count data are important for answering epidemiological questions that involve taking individual count measurements repeatedly over time through the use of longitudinal studies. Conventional regression models for this type of data are inadequate, leading to improper conclusions and inference. An important application of longitudinal studies in Public Health is the evaluation and monitoring of patients with infectious diseases, such as HIV/AIDS, to determine their health status, to verify the treatment effects, and to make prognosis concerning the evolution of the disease, including interdependencies of clinical manifestations. The purpose of this article is to characterize different statistical strategies for analysis of longitudinal count data, emphasizing how to choose the most suitable model for the data and how to interpret the results.Methods:We illustrate their applicability by evaluating the effect of associated factors on lymphocyte CD4+T cell count in HIV seropositive patients in Salvador/Bahia - Brazil. We describe Poisson and Negative Binomial models using multilevel (ML) approach and generalized estimations equations (GEE) for analysis of longitudinal count data.Results: It is worth noting that the interpretation of the results from ML and GEE differs and they should not be compared directly.Conclusion: We believe that the statistical methodology for analysis of longitudinal studies with correlated count data can be useful to address several important questions in public health, particularly by helping to monitor patients and checking the effectiveness of treatments.
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- 2022
20. [Perceived neighborhood characteristics and practice of physical activity among adolescents and young adults: a model with distal outcomes]
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Daiane Nascimento de, Castro, Rosana, Aquino, and Leila Denise Alves Ferreira, Amorim
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Young Adult ,Cross-Sectional Studies ,Leisure Activities ,Adolescent ,Residence Characteristics ,Surveys and Questionnaires ,Neighborhood Characteristics ,Humans ,Environment Design ,Walking ,Exercise ,Brazil - Abstract
This study aimed to identify neighborhood profiles perceived by adolescents and young adults and estimate their association with global and leisure-time physical activity. Data from 1,637 individuals aged 15 to 24 years were taken from a cross-sectional study with cluster sampling, conducted in a city in the State of Bahia, Brazil, in 2011. Physical activity was measured using the International Physical Activity Questionnaire (IPAQ), short version, in addition to a question about leisure activities. The perception of characteristics of the physical and social environment of the neighborhood was based on a scale with 14 questions. Neighborhood profiles were defined through latent class analysis (LCA), and the estimation of their effects on physical activity used a model with distal outcomes. The latent profile analysis resulted in three neighborhood patterns, described as "urban, sociable, and favorable to physical activity - class 1" (39.6%); "sociable and safe - class 2" (24.4%), "insecure, low sociability - class 3" (36%). Individuals belonging to "class 1" showed the highest probability to exercise (56.4%), while for classes 2 and 3 these percentages corresponded to 46.3% and 42.8%, respectively. A statistically significant association was identified only in the "urban, sociable and favorable to physical activity" class, whose chance of performing leisure activities was 72% (OR = 1.72; 95%CI: 1.29-2.29). Neighborhoods with attributes that favor the practice of physical activity and the existence of urbanization elements increase the chance of active leisure behavior among adolescents and young adults. The use of LCA and the model with distal outcomes are promising and innovative in neighborhood approaches.Os objetivos do estudo foram identificar perfis de vizinhança percebidos por adolescentes e adultos jovens, e estimar sua associação com a realização de atividade física global e de lazer. Utilizaram-se dados de 1.637 indivíduos entre 15 e 24 anos, de um estudo transversal, com amostragem por conglomerados, de uma cidade do Estado da Bahia, Brasil, em 2011. A atividade física foi mensurada pelo International Physical Activity Questionnaire (IPAQ), versão curta, além de questão sobre atividade no lazer. A percepção de características do ambiente físico e social da vizinhança se baseou em escala com 14 questões. Perfis de vizinhança foram definidos por meio de análise de classes latentes (LCA), e a estimação dos seus efeitos na atividade física usou o modelo com respostas distais. A análise de perfil latente resultou em três padrões de vizinhança, descritos como “urbana, sociável e favorável à atividade física - classe 1” (39,6%); “sociável e segura - classe 2” (24,4%); e “insegura, de baixa sociabilidade - classe 3” (36%). Os indivíduos pertencentes à “classe 1” apresentaram maior probabilidade de se exercitar (56,4%), enquanto, para as classes 2 e 3, estes percentuais corresponderam a 46,3% e 42,8%, respectivamente. Associação estatisticamente significante foi identificada apenas na classe “urbana, sociável e favorável à atividade física”, cuja chance de realizar atividade de lazer foi de 72% (OR = 1,72; IC95%: 1,29-2,29). Bairros com atributos favoráveis à prática de atividade física e a existência de elementos de urbanização aumentam a chance do comportamento ativo no lazer entre os adolescentes e adultos jovens. O uso de LCA e do modelo com repostas distais é promissor e inovador na abordagem sobre vizinhança.Los objetivos del estudio fueron identificar los perfiles de vecindario percibidos por los adolescentes y los adultos jóvenes y estimar su asociación con la realización de actividad física global y de ocio. Se utilizaron datos de 1.637 individuos entre 15 y 24 años, procedentes de un estudio transversal, con muestreo por conglomerados, de una ciudad del estado de Bahia, Brasil, en 2011. La actividad física se midió mediante el International Physical Activity Questionnaire (IPAQ), versión corta, además de una pregunta sobre actividad en el ocio. La percepción de las características del entorno físico y social del vecindario se basó en una escala con 14 preguntas. Los perfiles de la vecindad se definieron a través del análisis de clase latente (ACL), y la estimación de sus efectos sobre la actividad física utilizó el modelo con respuestas distales. El análisis de perfil latente dio como resultado tres patrones de vecindario, descritos como “urbano, sociable y favorable a la actividad física - clase 1” (39,6 %); “sociable y seguro - clase 2” (24,4 %), “inseguro, de baja sociabilidad - clase 3” (36%). Los individuos pertenecientes a la “clase 1” presentaron la mayor probabilidad de hacer ejercicio (56,4 %), mientras que para las clases 2 y 3 estos porcentajes correspondieron a 46,3 % y 42,8 %, respectivamente. Solamente se identificó una asociación estadísticamente significativa en la clase “urbana, sociable y favorable a la actividad física”, cuya probabilidad de realizar actividad de ocio fue de 72 % (OR = 1,72; IC95%: 1,29-2,29). Los barrios con atributos favorables para la actividad física y la existencia de elementos de urbanización aumentan la posibilidad de un comportamiento activo en el ocio entre los adolescentes y los adultos jóvenes. El uso de ACL y el modelo con respuestas distales son enfoques prometedores e innovadores para la vecindad.
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- 2022
21. The Rapid Test Based on Leishmania infantum Chimeric rK28 Protein Improves the Diagnosis of Canine Visceral Leishmaniasis by Reducing the Detection of False-Positive Dogs.
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Deborah Bittencourt Mothé Fraga, Luciano Vasconcellos Pacheco, Lairton Souza Borja, Pétala Gardênia da Silva Estrela Tuy, Leila Andrade Bastos, Manuela da Silva Solcà, Leila Denise Alves Ferreira Amorim, and Patrícia Sampaio Tavares Veras
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Arctic medicine. Tropical medicine ,RC955-962 ,Public aspects of medicine ,RA1-1270 - Abstract
Visceral Leishmaniasis (VL) has spread to many urban centers worldwide. Dogs are considered the main reservoir of VL, because canine cases often precede the occurrence of human cases. Detection and euthanasia of serologically positive dogs is one of the primary VL control measures utilized in some countries, including Brazil. Using accurate diagnostic tests can minimize one undesirable consequence of this measure, culling false-positive dogs, and reduce the maintenance of false-negative dogs in endemic areas. In December 2011, the Brazilian Ministry of Health replaced the ELISA (EIE CVL) screening method and Indirect Immunofluorescence Test (IFI CVL) confirmatory method with a new protocol using the rapid DPP CVL screening test and EIE CVL confirmatory test. A study of diagnostic accuracy of these two protocols was done by comparing their performance using serum samples collected from a random sample of 780 dogs in an endemic area of VL. All samples were evaluated by culture and real time PCR; 766 out of the 780 dogs were tested using the previous protocol (IFI CVL + EIE CVL) and all 780 were tested using the current protocol (DPP CVL + EIE CVL). Performances of both diagnostic protocols were evaluated using a latent class variable as the gold standard. The current protocol had a higher specificity (0.98 vs. 0.95) and PPV (0.83 vs. 0.70) than the previous protocol, although sensitivity of these two protocols was similar (0.73). When tested using sera from asymptomatic animals, the current protocol had a much higher PPV (0.63 vs. 0.40) than the previous protocol (although the sensitivity of either protocol was the same, 0.71). Considering a range of theoretical CVL prevalences, the projected PPVs were higher for the current protocol than for the previous protocol for each theoretical prevalence value. The findings presented herein show that the current protocol performed better than previous protocol primarily by reducing false-positive results.
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- 2016
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22. Abdominal obesity in ELSA-Brasil (Brazil’s Longitudinal Study of Adult Health): construction of a latent gold standard and evaluation of the accuracy of diagnostic indicators
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Michaela Eickemberg, Leila Denise Alves Ferreira Amorim, Maria da Conceição Chagas de Almeida, Francisco José Gondim Pitanga, Estela Maria Leão de Aquino, Maria de Jesus Mendes da Fonseca, and Sheila Maria Alvim Matos
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Longitudinal study ,Waist ,03 medical and health sciences ,0302 clinical medicine ,Waist–hip ratio ,Prevalence ,medicine ,Prevalência ,030212 general & internal medicine ,Abdominal obesity ,Adult health ,Black women ,030505 public health ,business.industry ,Avaliação nutricional ,Health Policy ,Incidence (epidemiology) ,Public Health, Environmental and Occupational Health ,Nutritional assessment ,Skin color ,Reference standards ,Obesidade abdominal ,Padrões de referência ,Public aspects of medicine ,RA1-1270 ,medicine.symptom ,0305 other medical science ,business ,Demography - Abstract
Resumo Este estudo avaliou a acurácia de indicadores de obesidade abdominal (OA), definindo uma variável latente como padrão-ouro. Foram estudados 12.232 participantes do ELSA-Brasil de 35 a 74 anos. Avaliou-se três indicadores de OA, estratificados por sexo e raça/cor: circunferência da cintura (CC), razão cintura quadril (RCQ) e índice de conicidade (Índice C). Todos os grupos mostraram elevadas prevalências de OA, maiores entre os homens brancos (~70%) e mulheres pretas (~60%). Observou-se alta acurácia da CC para homens, RCQ e índice C entre homens e mulheres para discriminar OA latente. Identificou-se os seguintes pontos de corte para os indicadores de OA entre os homens brancos, pardos e pretos, respectivamente: CC: 89,9; 90,2 e 91,7cm; RCQ: 0,92; 0,92 e 0,90; índice C: 1,24; 1,24 e 1,24. Para as mulheres brancas, pardas e pretas, respectivamente, os pontos de corte identificados foram: CC: 80,4; 82,7 e 85,4cm; RCQ: 0,82; 0,83 e 0,84; índice C: 1,20; 1,22 e 1,19. A CC entre os homens e a RCQ e índice C entre homens e mulheres apresentaram alto poder para discriminar OA latente, sendo o índice C o melhor indicador. Abstract This study evaluated the accuracy of abdominal obesity (AO) indicators, defining a latent variable as the gold standard. The study included 12,232 participants of the ELSA-Brasil (Brazil’s Longitudinal Study of Adult Health), between 35 and 74 years of age. Three AO indicators were evaluated: waist circumference (WC), waist hip ratio (WHR) and conicity index (C index). Analyses were stratified by sex and race/skin color. All groups had a high prevalence of AO, being greater among white men (~70%) and black women (~60%). A high incidence of WC was observed for men, WHR and C index between men and women for discriminating latent AO. The following cutoff points for AO indicators were identified among white, brown and black men, respectively: WC: 89.9cm; 90.2cm and 91.7cm; WHR: 0.92; 0.92 and 0.90; C index: 1.24; 1.24 and 1.24. The cutoff points identified among white, brown and black women were, respectively: WC: 80.4cm, 82.7cm and 85.4cm; WHR: 0.82; 0.83 and 0.84; C index: 1.20; 1.22 and 1.19 The WC among men and the WHR and C index among men and women presented high power to discriminate latent AO, the C index being the best indicator.
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- 2020
23. Experiences of Discrimination and Skin Color Among Women in Urban Brazil: A Latent Class Analysis
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Gisel Lorena Fattore, Leila Denise Alves Ferreira Amorim, Letícia Marques dos Santos, Darci Neves dos Santos, and Mauricio Lima Barreto
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Black women ,Scale (ratio) ,Anthropology ,media_common.quotation_subject ,Skin color ,Psychology ,Racism ,Applied Psychology ,Latent class model ,media_common ,Developmental psychology - Abstract
Experiences of discrimination are an important aspect of women’s life in Brazil, especially Black women. The Experiences of Discrimination scale (EOD) is often used for assessing discrimination in epidemiological studies, although divergent cutoff points have been used to characterize the exposure. We used latent class analysis (LCA) and logistic regression to identify and characterize subgroups of women exposed to discrimination and compared with a cutoff-based assignment of subgroups. One thousand two-hundred and four women living in Salvador, Brazil, responded to the EOD. We selected models with two latent classes, highly and lowly exposed. The classes differed in self-reported skin color and education level, revealing that darker skinned (odds ratio [ OR] = 11.3, 95% confidence interval [CI: 1.54, 82.7]) and more educated ( OR = 2.09, 95% CI [1.17, 3.72]) women were more likely to be classified into the highly exposed class. Comparing with LCA, the use of cutoff points overestimated the reporting of discrimination. Researchers should consider the use of more accurate measures of discrimination in order to identify the most vulnerable individuals so that prevention efforts could be better targeted.
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- 2020
24. Programa Mais Médicos: contexto de implantação e efeito no provimento de médicos na atenção primária à saúde no Brasil, 2008 a 2016
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Elzo Pereira Pinto Junior, Rosana Aquino, and Leila Denise Alves Ferreira Amorim
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Public Health, Environmental and Occupational Health - Published
- 2020
25. Ideal cardiovascular health at ELSA-Brasil: non-additivity effects of gender, race, and schooling by using additive and multiplicative interactions
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Freitas,Roberta Souza, Santos,Itamar de Souza, Matos,Sheila Maria Alvim de, Aquino,Estela Maria Leão de, and Amorim,Leila Denise Alves Ferreira
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Intersectionality ,Heart Diseases ,Cardiovascular Diseases ,Risk Factors ,Cross-sectional Studies - Abstract
This study aims to assess the non-additivity effects of gender, race, and schooling on ideal cardiovascular health among participants of the Brazilian Longitudinal Study of Adult Health - ELSA-Brasil. This is a cross-sectional study using data from the baseline of ELSA-Brasil, conducted from 2008 to 2010. The American Heart Association defined a score of ideal cardiovascular health (ICH) as the sum of indicators for the presence of seven favorable health factors and behaviors: non-smoking, ideal body mass index, physical activity and healthy diet, adequate levels of total cholesterol, normal blood pressure, and absence of diabetes mellitus. Multiplicative and additive interactions between gender, race, and schooling were assessed using the Poisson regression model to discuss intersectionality. The mean cardiovascular health score was 2.49 (SD = 1.31). This study showed a positive interaction between gender and schooling (women with high school and higher education) in both additive and multiplicative scales for the score of ideal cardiovascular health. We observed a trend towards higher mean values of cardiovascular health for increased schooling, with a marked difference among women. The lowest cardiovascular health scores observed reinforce the importance of understanding the psychosocial experiences that influence health attitudes, access to health care, and healthy lifestyle choices, which affect ICH, to reduce inequities in health and propose more adequate public policies that assist and prevent cardiovascular diseases.
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- 2022
26. Modelagem com variáveis latentes contínuas e categóricas: um tutorial usando software R
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Eustorgio Filho, Marcos Aurélio and Amorim, Leila Denise Alves Ferreira
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Análise de classes latentes ,R (Software Estatístico) ,Modelos com equações estruturais ,Análise de perfis latentes ,Variáveis latentes - Abstract
Marcos A. Eustorgio Filho teve bolsa de iniciação científica do CNPq, vinculada ao PIBIC-UFBA 2018-2019. O projeto de pesquisa ao qual se vinculou este trabalho teve financiamento da FAPESB (Termo de Outorga no.RED0005/2014). Submitted by Leila Amorim (leiladen@ufba.br) on 2021-11-26T20:06:17Z No. of bitstreams: 1 RelatorioTecnico_Marcos_Modelagem Variaveis Latentes no R.pdf: 885234 bytes, checksum: 44518c8544d0c90e707efd74f0e86ac3 (MD5) Approved for entry into archive by Solange Rocha (soluny@gmail.com) on 2021-11-29T18:40:08Z (GMT) No. of bitstreams: 1 RelatorioTecnico_Marcos_Modelagem Variaveis Latentes no R.pdf: 885234 bytes, checksum: 44518c8544d0c90e707efd74f0e86ac3 (MD5) Made available in DSpace on 2021-11-29T18:40:08Z (GMT). No. of bitstreams: 1 RelatorioTecnico_Marcos_Modelagem Variaveis Latentes no R.pdf: 885234 bytes, checksum: 44518c8544d0c90e707efd74f0e86ac3 (MD5) Previous issue date: 2021-11 Fundação de Amparo à Pesquisa do Estado da Bahia - FAPESB A modelagem com variáveis latentes é uma metodologia cujo uso vem crescendo ao longo do tempo, sobretudo devido à sua capacidade de aplicação no estudo de diversas questões científicas importantes para as quais os métodos estatísticos mais tradicionais podem não ser adequados. Alguns exemplos da aplicabilidade dessa metodologia envolvem estudos acerca de temas como inteligência, padrões comportamentais de indivíduos e ainda qualidade de vida, que apesar de não serem diretamente observáveis, podem se manifestar através de outras variáveis, tornando possível a definição de construtos e o estudo da sua relação com as variáveis observadas que os mensuram. Dentre os casos particulares de modelagem com variáveis latentes incluem-se os modelos de equações estruturais (SEM, Structural Equation Modeling, em inglês), a análise de classes latentes (LCA, Latent Class Analysis, em inglês), e a análise de perfis latentes (LPA, Latent Profile Analysis, em inglês). Essas metodologias têm uma grande vantagem se comparadas com as técnicas tradicionais por permitirem múltiplas relações entre as variáveis que compõe o modelo. A aplicação de métodos para modelar variáveis latentes necessita do uso de algum software estatístico, mas a grande maioria dos softwares que implementam esses métodos requerem o pagamento de licenças anuais ou semestrais. Contudo uma vasta quantidade de métodos para modelagem de variáveis latentes tem sido incorporada no software estatístico R, gratuito e de código livre, possibilitando a implementação de técnicas para estudar os casos particulares de modelagem com variáveis latentes definidos nesse trabalho. Neste trabalho, um dos objetivos centrais é entender quais metodologias são mais adequadas a cada tipo de problema, analisar a importância da verificação dos pressupostos dos métodos nas conclusões obtidas a partir do ajuste dos modelos, e fornecer um breve tutorial de aplicação dessas metodologias. Deste modo, espera-se contribuir para maior divulgação e utilização correta de metodologias envolvendo variáveis latentes, de forma gratuita, por pesquisadores de diversas áreas do conhecimento. Salvador, Bahia
- Published
- 2021
27. Structural equation modeling in epidemiology Modelagem de equações estruturais em epidemiologia
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Leila Denise Alves Ferreira Amorim, Rosemeire L. Fiaccone, Carlos Antônio S. T. Santos, Tereza Nadya dos Santos, Lia Terezinha L. P. de Moraes, Nelson F. Oliveira, Silvano O. Barbosa, Darci Neves dos Santos, Letícia Marques dos Santos, Sheila M. A. Matos, and Maurício L. Barreto
- Subjects
Modelos Matemáticos ,Análise Fatorial ,Causalidade ,Mathematical Models ,Statistical Factor Analysis ,Causality ,Medicine ,Public aspects of medicine ,RA1-1270 - Abstract
Structural equation modeling (SEM) is an important statistical tool for evaluating complex relations in several research areas. In epidemiology, the use and discussion of SEM have been limited thus far. This article presents basic principles and concepts in SEM, including an application using epidemiological data analysis from a study on the determinants of cognitive development in young children, considering constructs related to organization of the child's home environment, parenting style, and the child's health status. The relations between the constructs and cognitive development were measured. The results showed a positive association between psychosocial stimulus at home and cognitive development in young children. The article presents the contributions by SEM to epidemiology, highlighting the need for an a priori theoretical model for improving the study of epidemiological questions from a new perspective.A modelagem de equações estruturais (MEE) é uma ferramenta estatística importante para avaliar relações complexas em várias áreas do conhecimento. Em Epidemiologia sua divulgação e uso são limitados. Este artigo apresenta princípios e conceitos básicos da MEE, com exemplo de aplicação na análise de dados epidemiológicos. A análise de dados é realizada em estudo que investiga determinantes do desenvolvimento cognitivo infantil, sendo definidos construtos relacionados à organização do ambiente da criança, ao seu status de saúde, e às práticas e estilo de vida dos pais. O impacto positivo da qualidade de estimulação psicossocial do ambiente doméstico sobre o índice de desempenho cognitivo (IDC) esclarece que parte do efeito da estimulação sobre o IDC deve-se ao estilo parental de interação com a criança e às características físico-ambientais do contexto familiar. As potencialidades do uso da MEE em Epidemiologia são apresentadas, enfatizando-se a definição do modelo teórico e seu uso para aprofundamento de questões epidemiológicas sob nova perspectiva.
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- 2010
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28. Características percebidas da vizinhança e a prática de atividade física entre adolescentes e adultos jovens: um modelo com respostas distais
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Castro, Daiane Nascimento de, primary, Aquino, Rosana, additional, and Amorim, Leila Denise Alves Ferreira, additional
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- 2022
- Full Text
- View/download PDF
29. Ideal cardiovascular health at ELSA-Brasil: non-additivity effects of gender, race, and schooling by using additive and multiplicative interactions
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Freitas, Roberta Souza, primary, Santos, Itamar de Souza, additional, Matos, Sheila Maria Alvim de, additional, Aquino, Estela Maria Leão de, additional, and Amorim, Leila Denise Alves Ferreira, additional
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- 2022
- Full Text
- View/download PDF
30. Performance evaluation of tuberculosis control in Brazilian municipalities
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Priscila Fernanda Porto Scaff, Pinto, Beatriz Pinheiro Schindler Dos, Santos, Camila Silveira Silva, Teixeira, Joilda Silva, Nery, Leila Denise Alves Ferreira, Amorim, Mauro Niskier, Sanchez, Mauricio Lima, Barreto, and Julia Moreira, Pescarini
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Humans ,Tuberculosis ,Cities ,Contact Tracing ,Tuberculosis, Pulmonary ,Brazil - Abstract
To evaluate the performance of tuberculosis control in Brazilian municipalities.This is an ecological study on Brazilian municipalities that notified at least four new cases of tuberculosis, with a minimum of one new case of pulmonary tuberculosis between 2015 and 2018. The municipalities were stratified according to the population in50 thousand, 50-100 thousand, 100-300 thousand, and300 thousand inhabitants, and the k-means method was used to group them within each population range according to the performance of six indicators of the disease.A total of 2,845 Brazilian municipalities were included, comprising 98.5% (208,007/211,174) of new tuberculosis cases in the period. For each population range, three groups (A, B, and C) of municipalities were identified according to the performance of the indicators: A, the most satisfactory; B, the intermediates; and C, the least satisfactory. Municipalities in group A with100 thousand inhabitants presented results above the targets for laboratory confirmation (≥ 72%), abandonment (≤ 5%), and cure (≥ 90%), and comprised 2% of new cases of the disease. Conversely, municipalities of groups B and C presented at least five indicators with results below the targets - HIV testing (100%), contact investigation (90%), directly observed therapy (90%), abandonment (5%), and cure (90%) -, and corresponded to 66.7% of new cases of tuberculosis. In group C of municipalities with300 thousand inhabitants, which included 19 of the 27 capitals and 43.1% of new cases of tuberculosis, the lowest percentages of contact investigation (mean = 56.4%) and directly observed therapy (mean = 15.4%) were verified, in addition to high abandonment (mean = 13.9%) and low coverage of primary health care (mean = 66.0%).Most new cases of tuberculosis occurred in municipalities with unsatisfactory performance for disease control. Expanding the coverage of primary health care in these places can reduce abandonment and increase the contact investigation and directly observed therapy.
- Published
- 2021
31. Consumo de alimentos en adolescentes: Validación y calibración de un cuestionario de frecuencia alimentaria en un estudio con muestreo complejo
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Barroso, Rosemary da Rocha Fonseca, Aquino, Rosana, and Amorim, Leila Denise Alves Ferreira
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Calibración ,Amostragem complexa ,Validación ,Validação ,Calibração ,Muestreo complejo ,Adolescents ,Questionário de frequência alimentar (QFA) ,Validation ,Calibration ,Cuestionario de frecuencia alimentaria (CFA) ,Food frequency questionnaire (FFQ) ,Adolescentes ,Complex sampling - Abstract
Studies on dietary patterns depend on the validity of methods, such as the food frequency questionnaire (FFQ), to estimate long-term food intake, which can be overestimated, and the method needs to be validated. It is questioned whether validation studies nested in studies with complex sample design (CSD) should ignore data dependence. This study aims to validate the FFQ applied to school adolescents and estimate the calibration factors in a study with complex sampling. The validity of the FFQ is tested against dietary records (DR) applied to 85 adolescents in a study with CSD, with estimation of calibration factors (λ) for energy, nutrients, and dietary groups (DG). Intraclass correlation coefficient was calculated; mean differences were compared by modeling, and agreement analyzes were performed. The means between the methods differed for energy and nutrients (p
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- 2021
32. Mediação em análise de sobrevivência
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Passos, Michelle Pereira Vale dos and Amorim, Leila Denise Alves Ferreira
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Análise de sobrevida ,Mediação ,Análise de sobrevivência ,Análise de mediação ,Relatório técnico ,Modelo de Cox ,Tempo de vida acelerado ,Estatística - Abstract
Michelle Pereira Valle dos Passos teve bolsa de iniciação científica do CNPq, vinculada ao PIBIC-UFBA 2019-2020. O projeto ao qual se vinculou o projeto de iniciação científica foi aprovado e desenvolvido no Departamento de Estatística, sem financiamento, em parceria com Prof. Marcelo Magalhães Taddeo. Submitted by Leila Amorim (leiladen@ufba.br) on 2021-05-28T17:59:31Z No. of bitstreams: 1 RelatorioTecnico_Michelle_Mediacao Analise Sobrevivencia_maio2021.pdf: 1145661 bytes, checksum: c364842c174a7f48f19c787bab114e2e (MD5) Approved for entry into archive by Solange Rocha (soluny@gmail.com) on 2021-06-29T20:33:48Z (GMT) No. of bitstreams: 1 RelatorioTecnico_Michelle_Mediacao Analise Sobrevivencia_maio2021.pdf: 1145661 bytes, checksum: c364842c174a7f48f19c787bab114e2e (MD5) Made available in DSpace on 2021-06-29T20:33:48Z (GMT). No. of bitstreams: 1 RelatorioTecnico_Michelle_Mediacao Analise Sobrevivencia_maio2021.pdf: 1145661 bytes, checksum: c364842c174a7f48f19c787bab114e2e (MD5) Previous issue date: 2021-05 Este relatório técnico está vinculado ao Plano de Trabalho Mediação em Análise de Sobrevivência do PIBIC/UFBA 2019-2020 e inclui o estudo e sumarização de tópicos relacionados à análise de sobrevivência, mediação clássica e mediação em análise de sobrevivência, incluindo a implementação desses métodos em softwares estatísticos, especificamente o software R versão 3.6.0. No presente relatório estão sumarizados os conceitos e metodologias fundamentais para entendimento de mediação em análise de sobrevivência. Foram implementados dois estudos de simulação, apresentados nas secções 1 e 3. O primeiro estudo de simulação objetivou verificar a relação entre o modelo de tempo de vida acelerado e o modelo de Cox, na ausência e presença de censuras, para diferentes tamanhos amostrais. Assim, verifica-se que as estimativas se afastam da relação preconizada entre os parâmetros dos dois modelos à medida que aumentam o tamanho amostral e o percentual de censura. O segundo estudo de simulação, por sua vez, comparou as estimativas de efeito indireto em dois modelos de mediação em análise de sobrevivência, variando percentual de censura, tamanho amostral e magnitude do efeito. A estimação dos efeitos indiretos foi feita pelos métodos do produto e da diferença utilizando os modelos de tempo de vida acelerado e o de Cox, na presença e ausência de censuras. As estimativas são similares utilizando os métodos do produto e da diferença dos coeficientes no modelo de tempo de vida acelerado, o que não é observado no modelo de Cox, sobretudo à medida que o tamanho amostral decresce. Neste relatório apresentamos também nas secções 1, 2 e 3 análises de dados conduzidas para examinar, respectivamente: o tempo máximo de duração do aleitamento materno desde o nascimento da criança até o desmame; como a importância do tema causa uma determinada reação mediada pela influência presumida da mídia; e como o conhecimento da importância e função do sono afeta sua duração, que é mediada pela influência da higiene do sono. Salvador, Bahia
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- 2021
33. Avaliação de impacto de ações de combate ao Aedes aegypti na cidade de Salvador, Bahia Impact of action against Aedes aegypti in the city of Salvador, Bahia
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Maria da Glória Teixeira, Maurício Lima Barreto, Maria da Conceição N. Costa, Leila Denise Alves Ferreira, and Pedro Fernando da Costa Vasconcelos
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Dengue ,Epidemiologia ,Aedes aegypti ,Efetividade do controle ,Epidemiology ,Control effectiveness ,Public aspects of medicine ,RA1-1270 - Abstract
No atual estágio do conhecimento científico, a única medida de controle disponível para as infecções causadas pelo vírus da dengue é a eliminação do seu principal vetor urbano, o Aedes aegypti. O Brasil há muitas décadas desenvolve programas de combate a este mosquito; entretanto, observa-se desde o início dos anos oitenta uma expansão geográfica da infestação do seu território e circulação progressiva e intensa deste vírus, com registro de grandes epidemias e de transmissão endêmica em diferentes centros urbanos. Esta situação epidemiológica evidencia a existência de dificuldades para o controle destas infecções, razão pela qual o Ministério da Saúde solicitou uma avaliação da efetividade das ações que vinham sendo implementadas na cidade de Salvador pelo atual programa de combate vetorial, sendo o objetivo deste artigo apresentar os resultados deste estudo. Foi utilizado um desenho prospectivo, procedendo-se a inquéritos sorológicos de uma população amostral de indivíduos residentes em 30 distintos espaços da cidade - "áreas sentinelas". Os resultados revelaram elevadas soroprevalência (67,7%) e soroincidência (70,6%) para os sorotipos circulantes (DEN-1 e DEN-2), com grande variabilidade nos valores entre as 30 áreas estudadas. Verificou-se que a efetividade das medidas de combate vetorial é muito reduzida e, embora tenha sido encontrada uma Fração Prevenível de 29,7 %, mesmo em áreas sentinelas com Índices de Infestação Predial According to the current scientific knowledge, the only available means of controlling infections caused by the dengue virus is the elimination of its principal urban vector, the Aedes aegypti mosquito. Brazil has been implementing programs to fight the mosquito for decades; however, since the beginning of the 1980's the geographic range of infestation has been expanding steadily, resulting in increased circulation of the virus, large epidemics, and increased endemic transmission in different urban areas. The current epidemiological situation confirms the difficulties of preventing infection, and has led the Ministry of Health to request an evaluation of the effectiveness of the dengue control actions that have been implemented in the city of Salvador. In this article, we present the results of this evaluation. Using a prospective design, serologic inquiries were made in a sample population of residents of 30 urban "sentinel areas." The results revealed high overall seroprevalence (67.7%) and sero-incidence (70.6%) for the circulating serotypes (DEN-1 and DEN-2), with large variations among the 30 areas studied. The effectiveness of control measures appears to be low, and although a preventable fraction of 29.7% was found (even in sentinel areas with Infestation Rates < 3%), [Indices existe, mas rates é mais usado] the incidence of infections in these areas was still very high (55.4%). We believe it is necessary to revise the technical and operational strategies of the infection control program in order to attain infestation levels that are low enough to interrupt the circulation of the dengue virus.
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- 2002
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34. Avaliação de desempenho do controle da tuberculose em municípios brasileiros
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Priscila Fernanda Porto Scaff Pinto, Beatriz Pinheiro Schindler dos Santos, Camila Silveira Silva Teixeira, Joilda Silva Nery, Leila Denise Alves Ferreira Amorim, Mauro Niskier Sanchez, Mauricio Lima Barreto, and Julia Moreira Pescarini
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Public Health, Environmental and Occupational Health - Abstract
OBJETIVO Avaliar o desempenho no controle da tuberculose dos municípios brasileiros. MÉTODOS Estudo ecológico com municípios brasileiros que notificaram pelo menos quatro casos novos de tuberculose, com no mínimo um caso novo de tuberculose pulmonar entre 2015 e 2018. Os municípios foram estratificados de acordo com a população em < 50 mil, 50–100 mil, 100–300 mil e > 300 mil habitantes e foi utilizado o método k-médias para agrupá-los dentro de cada faixa populacional segundo desempenho de seis indicadores da doença. RESULTADOS Foram incluídos 2.845 municípios brasileiros abrangendo 98,5% (208.007/211.174) dos casos novos de tuberculose do período. Para cada faixa populacional identificou-se três grupos (A, B e C) de municípios segundo desempenho dos indicadores: A os mais satisfatórios, B os intermediários e C os menos satisfatórios. Municípios do grupo A com < 100 mil habitantes apresentaram resultados acima das metas para confirmação laboratorial (≥ 72%), abandono (≤ 5%) e cura (≥ 90%), e abrangeram 2% dos casos novos da doença. Por outro lado, os municípios dos grupos B e C apresentaram pelo menos cinco indicadores com resultados abaixo das metas – testagem HIV (< 100%), exame de contatos (< 90%), tratamento diretamente observado (< 90%), abandono (> 5%) e cura (< 90%) –, e corresponderam a 66,7% dos casos novos de tuberculose. Já no grupo C dos municípios com > 300 mil habitantes, que incluiu 19 das 27 capitais e 43,1% dos casos novos de tuberculose, encontrou-se os menores percentuais de exames de contatos (média = 56,4%) e tratamento diretamente observado (média = 15,4%), elevado abandono (média = 13,9%) e baixa cobertura da atenção básica (média = 66,0%). CONCLUSÕES Grande parte dos casos novos de tuberculose ocorreu em municípios com desempenho insatisfatório para o controle da doença, onde expandir a cobertura da atenção básica pode reduzir o abandono e elevar o exame de contatos e tratamento diretamente observado.
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- 2022
35. Evaluating the accuracy of molecular diagnostic testing for canine visceral leishmaniasis using latent class analysis.
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Manuela da Silva Solcà, Leila Andrade Bastos, Carlos Eduardo Sampaio Guedes, Marcelo Bordoni, Lairton Souza Borja, Daniela Farias Larangeira, Pétala Gardênia da Silva Estrela Tuy, Leila Denise Alves Ferreira Amorim, Eliane Gomes Nascimento, Geraldo Gileno de Sá Oliveira, Washington Luis Conrado dos-Santos, Deborah Bittencourt Mothé Fraga, and Patrícia Sampaio Tavares Veras
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Medicine ,Science - Abstract
Host tissues affected by Leishmania infantum have differing degrees of parasitism. Previously, the use of different biological tissues to detect L. infantum DNA in dogs has provided variable results. The present study was conducted to evaluate the accuracy of molecular diagnostic testing (qPCR) in dogs from an endemic area for canine visceral leishmaniasis (CVL) by determining which tissue type provided the highest rate of parasite DNA detection. Fifty-one symptomatic dogs were tested for CVL using serological, parasitological and molecular methods. Latent class analysis (LCA) was performed for accuracy evaluation of these methods. qPCR detected parasite DNA in 100% of these animals from at least one of the following tissues: splenic and bone marrow aspirates, lymph node and skin fragments, blood and conjunctival swabs. Using latent variable as gold standard, the qPCR achieved a sensitivity of 95.8% (CI 90.4-100) in splenic aspirate; 79.2% (CI 68-90.3) in lymph nodes; 77.3% (CI 64.5-90.1) in skin; 75% (CI 63.1-86.9) in blood; 50% (CI 30-70) in bone marrow; 37.5% (CI 24.2-50.8) in left-eye; and 29.2% (CI 16.7-41.6) in right-eye conjunctival swabs. The accuracy of qPCR using splenic aspirates was further evaluated in a random larger sample (n = 800), collected from dogs during a prevalence study. The specificity achieved by qPCR was 76.7% (CI 73.7-79.6) for splenic aspirates obtained from the greater sample. The sensitivity accomplished by this technique was 95% (CI 93.5-96.5) that was higher than those obtained for the other diagnostic tests and was similar to that observed in the smaller sampling study. This confirms that the splenic aspirate is the most effective type of tissue for detecting L. infantum infection. Additionally, we demonstrated that LCA could be used to generate a suitable gold standard for comparative CVL testing.
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- 2014
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36. Highly Accurate Chimeric Proteins for the Serological Diagnosis of Chronic Chagas Disease: A Latent Class Analysis
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Ana Clara P Campos, Marco Aurélio Krieger, Leila Denise Alves Ferreira Amorim, Yara M. Gomes, Paola Alejandra Fiorani Celedon, Rodrigo Pimenta Del-Rei, Nilson Ivo Tonin Zanchin, Fred Luciano Neves Santos, and Edimilson Domingos da Silva
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Trypanosoma cruzi ,030231 tropical medicine ,Protozoan Proteins ,Chronic Chagas' disease ,Antigens, Protozoan ,Sensitivity and Specificity ,Serology ,03 medical and health sciences ,0302 clinical medicine ,Antigen ,Virology ,Humans ,Medicine ,Chagas Disease ,Serologic Tests ,030212 general & internal medicine ,Reference standards ,Immunoassay ,business.industry ,Reproducibility of Results ,Articles ,Gold standard (test) ,Fusion protein ,Predictive value ,Latent class model ,Infectious Diseases ,Latent Class Analysis ,Immunology ,Parasitology ,business - Abstract
The existence of an imperfect reference standard presents complications when evaluating the unbiased performance of novel diagnostic techniques. This is especially true in the absence of a gold standard, as is the case in chronic Chagas disease (CD) diagnosis. To circumvent this constraint, we elected to use latent class analysis (LCA). Previously, our group demonstrated the high performance of four Trypanosoma cruzi–chimeric proteins (Molecular Biology Institute of Paraná [IBMP]-8.1, -8.2, -8.3, and -8.4) for CD diagnosis using several distinct immunoassays. Although commercial tests had previously been established as a reference standard, the diagnostic performance of these chimeric antigens could present bias because these tests fail to produce 100% accurate results. Thus, we used LCA to assess the performance of these IBMP chimeric antigens in chronic CD diagnosis. Using the LCA model as a gold standard, sensitivity and specificity values ranged from 93.5% to 99.4% and 99.6% to 100%, respectively. The accuracy values were 96.2% for IBMP-8.2, approximately 98% for IBMP-8.1 and IBMP-8.3, and nearly 100% for IBMP-8.4. For IBMP-8.1 and IBMP-8.2, higher positive predictive values were associated with increases in hypothetical prevalence. Similarly, higher hypothetical prevalence resulted in lower negative predictive values for IBMP-8.1, IBMP-8.2, and IBMP-8.3. In addition, samples with serodiscordant results from commercial serological tests were analyzed using LCA. Molecular Biology Institute of Paraná -8.1 demonstrated potential for use in confirmatory testing with regard to samples with inconsistent results. Moreover, our findings further confirmed the remarkable performance of the IBMP-8.4 antigen to diagnose chronic CD in both endemic and non-endemic areas.
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- 2018
37. Immune response dynamics and Lutzomyia longipalpis exposure characterize a biosignature of visceral leishmaniasis susceptibility in a canine cohort
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Matheus Silva de Jesus, Miriam Flores Rebouças, Tiago Feitosa Mota, Valéria M. Borges, Jesus G. Valenzuela, Leila Denise Alves Ferreira Amorim, Deborah Bittencourt Mothé Fraga, Maiara Reis Arruda, Cláudia Brodskyn, Shaden Kamhawi, Patrícia Sampaio Tavares Veras, Manuela da Silva Solcà, and Bruna Martins Macedo Leite
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Male ,Physiology ,RC955-962 ,Disease Vectors ,Parasite load ,Biochemistry ,Parasite Load ,Medical Conditions ,Arctic medicine. Tropical medicine ,Zoonoses ,Immune Physiology ,Medicine and Health Sciences ,Parasite hosting ,Bites and Stings ,Dog Diseases ,Prospective Studies ,Enzyme-Linked Immunoassays ,Leishmania infantum ,Leishmaniasis ,Mammals ,Protozoans ,Leishmania ,Immune System Proteins ,biology ,Eukaryota ,Veterinary Diagnostics ,Infectious Diseases ,Vertebrates ,Leishmaniasis, Visceral ,Female ,Disease Susceptibility ,Antibody ,Public aspects of medicine ,RA1-1270 ,Brazil ,Research Article ,Neglected Tropical Diseases ,Veterinary Medicine ,Immunology ,Research and Analysis Methods ,Antibodies ,Dinoprostone ,Immune system ,Dogs ,medicine ,Parasitic Diseases ,Animals ,Immunoassays ,Saliva ,Protozoan Infections ,business.industry ,Public Health, Environmental and Occupational Health ,Organisms ,Biology and Life Sciences ,Proteins ,biology.organism_classification ,medicine.disease ,Tropical Diseases ,Parasitic Protozoans ,Sandfly ,Insect Vectors ,Sand Flies ,Species Interactions ,Visceral leishmaniasis ,Amniotes ,biology.protein ,Immunologic Techniques ,Veterinary Science ,Psychodidae ,business ,Zoology ,Spleen - Abstract
Background Reports have shown correlations between the immune response to vector saliva and Leishmaniasis outcome. We followed dogs in an endemic area for two years characterizing resistance or susceptibility to canine visceral leishmaniasis (CVL) according to Leishmania infantum diagnosis and clinical development criteria. Then, we aimed to identify a biosignature based on parasite load, serum biological mediators’ interactions, and vector exposure intensity associated with CVL resistance and susceptibility. Methodology/Principal findings A prospective two-year study was conducted in an area endemic for CVL. Dogs were evaluated at 6-month intervals to determine infection, clinical manifestations, immune profile, and sandfly exposure. CVL resistance or susceptibility was determined upon the conclusion of the study. After two years, 78% of the dogs were infected with L. infantum (53% susceptible and 47% resistant to CVL). Susceptible dogs presented higher splenic parasite load as well as persistence of the parasite during the follow-up, compared to resistant ones. Susceptible dogs also displayed a higher number of correlations among the investigated biological mediators, before and after infection diagnosis. At baseline, anti-saliva antibodies, indicative of exposure to the vector, were detected in 62% of the dogs, reaching 100% in one year. Higher sandfly exposure increased the risk of susceptibility to CVL by 1.6 times (CI: 1.11–2.41). We identified a discriminatory biosignature between the resistant and susceptible dogs assessing splenic parasite load, interaction of biological mediators, PGE2 serum levels and intensity of exposure to sandfly. All these parameters were elevated in susceptible dogs compared to resistant animals. Conclusions/Significance The biosignature identified in our study reinforces the idea that CVL is a complex multifactorial disease that is affected by a set of factors which are correlated and, for a better understanding of CVL, should not be evaluated in an isolated way., Author summary Visceral Leishmaniasis (VL) is a disease that can affect humans and dogs, caused by a parasite called Leishmania transmitted through the bite of sandfly insects. During the bite, together with the parasite, the insects also inoculate their saliva into the host. The host immune response produces molecules to the sandfly saliva, such as antibodies and cytokines that can impact VL resistance or susceptibility. The presence of these molecules also indicates if the insects bit the hosts. We followed dogs of a VL endemic area for two years to study Canine Visceral Leishmaniasis (CVL) and immune response to sandfly saliva. Dogs were evaluated at 6-month intervals to determine Leishmania infection, clinical manifestations, parasite load, immune response, and sandfly exposure. CVL resistance or susceptibility was determined upon the conclusion of the study. Dogs living in the endemic area were intensely bitten, as at the beginning of the study, 62% of the dogs present anti-saliva antibodies, reaching 100% after one year. Our findings revealed a biosignature of CVL susceptibility characterized by elevated parasite load, interaction of cytokines, and higher exposure to the sandfly. This data reinforced that CVL is a complex disease affected by several factors related to each other.
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- 2021
38. Consumo alimentar de adolescentes: Validação e calibração de um questionário de frequência alimentar em estudo com amostragem complexa
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Barroso, Rosemary da Rocha Fonseca, primary, Aquino, Rosana, additional, and Amorim, Leila Denise Alves Ferreira, additional
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- 2021
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39. Posição social e estado antropométrico entre adultos no estudo ELSA-Brasil: uma análise de classes latentes
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Sheila Maria Alvim Matos, Leila Denise Alves Ferreira Amorim, Francisco José Gondim Pitanga, Ana Luísa Patrão, Sandhi M. Barreto, Dora Chor, Letícia de Oliveira Cardoso, Maria del Carmen Bisi Molina, Mauricio Lima Barreto, and Estela M. L. Aquino
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Adult ,Male ,Longitudinal study ,Países en Desarollo ,Países em Desenvolvimento ,Análisis de Clases Latentes ,Análise de Classes Latentes ,Overweight ,Logistic regression ,medicine ,Humans ,Social position ,Longitudinal Studies ,Social determinants of health ,Developing Countries ,business.industry ,Public Health, Environmental and Occupational Health ,Anthropometry ,Latent class model ,Cross-Sectional Studies ,Social Class ,Socioeconomic Factors ,Latent Class Analysis ,Sobrepeso ,Medicine ,Marital status ,Female ,Public aspects of medicine ,RA1-1270 ,medicine.symptom ,business ,Brazil ,Demography - Abstract
The objective of the present study was to evaluate the association between social position and anthropometric status in women and men Brazilian adult. This was a cross-sectional study that used baseline data collected from 2008 to 2010 for the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil, in Portuguese), in the six major Brazilian state capital cities. A total of 15,105 active and retired civil servants aged from 35 to 74 years. Two latent variables were defined by latent class analysis, social position and anthropometric status. Both constructs and the analyses were separately evaluated by sex. Associations were assessed using multivariate logistic regression analysis with adjustment for age, self-reported skin color/race, and marital status. Around 44% of the women and 26% of the men were classified as overweight or obese. Social position tended to be lower in women (43.2%) and higher among men (40.4%). Heavier women were more likely to be black and brown-skinned, whereas slimmer women were more likely to be white. After adjustment, women’s weight increased as social position decreased (OR = 1.52; 95%CI: 1.36-1.70), whereas in men weight decreased as social position decreased (OR = 0.87; 95%CI: 0.76-0.99). Social position affected the anthropometric status of women and men differently, with body patterns also being affected by ethnicity/skin color, showing the potentiality of taking the intersectional perspective when investigating the possible social determinants of the phenomenon. Resumo: O objetivo do estudo foi avaliar a associação entre posição social e o estado antropométrico em brasileiros adultos de ambos os sexos. O estudo transversal usou dados coletados entre 2008 e 2010 pelo Estudo Longitudinal de Saúde do Adulto (ELSA-Brasil), nas seis maiores capitais brasileiras. Um total de 15.105 funcionários públicos, ativos e aposentados, de ambos os sexos, entre 35 e 74 anos de idade. Duas variáveis latentes foram definidas pela análise de classes latentes: posição social e estado antropométrico. Os construtos e análises foram avaliados separadamente por sexo. As associações foram avaliadas com o uso de análise de regressão logística multivariada, ajustada para idade, cor/raça e estado civil. Em torno de 44% das mulheres e 26% dos homens foram classificados com sobrepeso ou obesidade. A posição social tendia a ser mais baixa nas mulheres (43,2%) e mais alta nos homens (40,4%). Houve uma proporção maior de mulheres com sobrepeso ou obesidade entre as pretas e pardas, e proporção maior de mulheres magras entre as brancas. Nas mulheres, após ajustes, o peso aumentava na medida em que a posição social diminuía (OR = 1,52; IC95%: 1,36-1,70), enquanto nos homens o peso diminuía junto com a diminuição da posição social (OR = 0,87; IC95%: 0,76-0,99). A posição social afetou de maneira diferente o estado antropométrico de mulheres e homens, com perfis corporais afetados também pela raça/cor da pele, indicando o potencial de levar em conta a perspectiva interseccional ao investigar os possíveis determinantes sociais do fenômeno. Resumen: El objetivo de este estudio fue evaluar la asociación entre posición social y estatus antropométrico de adultos brasileños de ambos sexos. Fue un estudio transversal, realizado usando datos de referencia recogidos entre 2008 y 2010, del Estudio Longitudinal Brasileño de Salud en Adultos (ELSA-Brasil), llevado a cabo en seis de las mayores capitales de estado brasileñas. Un total de 15.105 activos y jubilados, mujeres y hombres funcionarios públicos de 35 a 74 años de edad. Se definieron dos variables latentes mediante análisis de clases latentes: posición social y estatus antropométrico. Ambos constructos y análisis fueron evaluados separadamente por sexo. Las asociaciones fueron evaluadas usando una regresión logística multivariada con ajuste por edad, color de piel/raza autoinformado y estatus marital. Alrededor de un 44% de las mujeres y un 26% de los hombres fueron clasificados como con sobrepeso u obesos. La posición social tendió a ser más baja en mujeres (43,2%) y más alta entre hombres (40,4%). Las mujeres con más peso tenían más probabilidad de ser negras y mulatas/mestizas y las mujeres más delgadas tenían más probabilidad de ser blancas. En mujeres, tras el ajuste, se incrementó más el peso cuanto mayor decrecía la posición social (OR = 1,52; IC95%: 1,36-1,70), mientras en hombres el peso decrecía al igual que la posición social (OR = 0,87; IC95%: 0,76-0,99). La posición social afectó diferentemente al estatus antropométrico de mujeres y hombres, con los patrones corporales también estando afectados por etnicidad/color de piel, mostrando su potencialidad tomando en consideración la perspectiva transversal, cuando se está investigando los posibles determinantes sociales del fenómeno.
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- 2021
40. CIDACS-RL: a novel indexing search and scoring-based record linkage system for huge datasets with high accuracy and scalability
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Mauricio Lima Barreto, M Sanni Ali, Sandra Reis, Bruno Araujo, Liam Smeeth, Robespierre Pita, Marcos Barreto, Rosemeire L. Fiaccone, Leila Denise Alves Ferreira Amorim, Julia Moreira Pescarini, Samila Sena, Maria Yury Ichihara, and George Caique Gouveia Barbosa
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Information retrieval techniques ,Medical Records Systems, Computerized ,Computer science ,Datasets as Topic ,Information Storage and Retrieval ,Health Informatics ,02 engineering and technology ,lcsh:Computer applications to medicine. Medical informatics ,computer.software_genre ,Cohort Studies ,03 medical and health sciences ,0302 clinical medicine ,020204 information systems ,Entity resolution ,0202 electrical engineering, electronic engineering, information engineering ,Humans ,030212 general & internal medicine ,Sensitivity (control systems) ,Accuracy ,Linkage (software) ,Health Policy ,Search engine indexing ,Scalability ,Volume (computing) ,Scoring Search ,Gold standard (test) ,Data linkage ,Computer Science Applications ,RA Public aspects of medicine ,lcsh:R858-859.7 ,Indexing ,Single-core ,Medical Record Linkage ,Data mining ,computer ,Algorithms ,Record linkage ,Research Article - Abstract
Background Record linkage is the process of identifying and combining records about the same individual from two or more different datasets. While there are many open source and commercial data linkage tools, the volume and complexity of currently available datasets for linkage pose a huge challenge; hence, designing an efficient linkage tool with reasonable accuracy and scalability is required. Methods We developed CIDACS-RL (Centre for Data and Knowledge Integration for Health – Record Linkage), a novel iterative deterministic record linkage algorithm based on a combination of indexing search and scoring algorithms (provided by Apache Lucene). We described how the algorithm works and compared its performance with four open source linkage tools (AtyImo, Febrl, FRIL and RecLink) in terms of sensitivity and positive predictive value using gold standard dataset. We also evaluated its accuracy and scalability using a case-study and its scalability and execution time using a simulated cohort in serial (single core) and multi-core (eight core) computation settings. Results Overall, CIDACS-RL algorithm had a superior performance: positive predictive value (99.93% versus AtyImo 99.30%, RecLink 99.5%, Febrl 98.86%, and FRIL 96.17%) and sensitivity (99.87% versus AtyImo 98.91%, RecLink 73.75%, Febrl 90.58%, and FRIL 74.66%). In the case study, using a ROC curve to choose the most appropriate cut-off value (0.896), the obtained metrics were: sensitivity = 92.5% (95% CI 92.07–92.99), specificity = 93.5% (95% CI 93.08–93.8) and area under the curve (AUC) = 97% (95% CI 96.97–97.35). The multi-core computation was about four times faster (150 seconds) than the serial setting (550 seconds) when using a dataset of 20 million records. Conclusion CIDACS-RL algorithm is an innovative linkage tool for huge datasets, with higher accuracy, improved scalability, and substantially shorter execution time compared to other existing linkage tools. In addition, CIDACS-RL can be deployed on standard computers without the need for high-speed processors and distributed infrastructures.
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- 2020
41. Evaluating the impact of the Bolsa Familia conditional cash transfer program on premature cardiovascular and all-cause mortality using the 100 million Brazilian cohort: a natural experiment study protocol
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Mauricio Lima Barreto, Mirjam Allik, Alastair H Leyland, Sanni Ali, Liam Smeeth, Estela M. L. Aquino, Peter Craig, Srinivasa Vittal Katikireddi, Julia Moreira Pescarini, and Leila Denise Alves Ferreira Amorim
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Adult ,Male ,Matching (statistics) ,medicine.medical_specialty ,Natural experiment ,Cohort Studies ,medicine ,Humans ,Propensity Score ,Aged ,cardiac epidemiology ,business.industry ,Public health ,Conditional cash transfer ,public health ,General Medicine ,Per capita income ,Middle Aged ,Health policy ,Cardiovascular Diseases ,Cohort ,Propensity score matching ,Regression discontinuity design ,Income ,Premature Birth ,Medicine ,Female ,epidemiology ,business ,Brazil ,Demography - Abstract
IntroductionBrazil’s Bolsa Familia Program (BFP) is the world’s largest conditional cash transfer scheme. We shall use a large cohort of applicants for different social programmes to evaluate the effect of BFP receipt on premature all-cause and cardiovascular mortality.Methods and analysisWe will identify BFP recipients and non-recipients among new applicants from 2004 to 2015 in the 100 Million Brazilian Cohort, a database of 114 million individuals containing sociodemographic and mortality information of applicants to any Brazilian social programme. For individuals applying from 2011, when we have better recorded income data, we shall compare premature (age 30–69) cardiovascular and all-cause mortality among BFP recipients and non-recipients using regression discontinuity design (RDD) with household monthly per capita income as the forcing variable. Effects will be estimated using survival models accounting for individuals follow-up. To test the sensitivity of our findings, we will estimate models with different bandwidths, include potential confounders as covariates in the survival models, and restrict our data to locations with the most reliable data. In addition, we will estimate the effect of BFP on studied outcomes using propensity score risk-set matching, separately for individuals that applied ≤2010 and >2011, allowing comparability with RDD. Analyses will be stratified by geographical region, gender, race/ethnicity and socioeconomic position. We will investigate differential impacts of BFP and the presence of effect modification for a combination of characteristics, including gender and race/ethnicity.Ethics and disseminationThe study was approved by the ethics committees of Oswaldo Cruz Foundation and the University of Glasgow College of Medicine and Veterinary Life Sciences. The deidentified dataset will be provided to researchers, and data analysis will be performed in a safe computational environment without internet access. Study findings will be published in high quality peer-reviewed research articles. The published results will be disseminated in the social media and to policy-makers.
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- 2020
42. Immune response dynamics and Lutzomyia longipalpis exposure characterize a biosignature of visceral leishmaniasis susceptibility in a canine cohort
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Solcà, Manuela da Silva, primary, Arruda, Maiara Reis, additional, Leite, Bruna Martins Macedo, additional, Mota, Tiago Feitosa, additional, Rebouças, Miriam Flores, additional, de Jesus, Matheus Silva, additional, Amorim, Leila Denise Alves Ferreira, additional, Borges, Valéria Matos, additional, Valenzuela, Jesus, additional, Kamhawi, Shaden, additional, Veras, Patrícia Sampaio Tavares, additional, Fraga, Deborah Bittencourt Mothé, additional, and Brodskyn, Claudia Ida, additional
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- 2021
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43. The Brazilian conditional cash transfer program and cardiovascular mortality: a data linkage study
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Julia Moreira Pescarini, Leila Denise Alves Ferreira Amorim, E M L Aquino, Srinivasa Vittal Katikireddi, M S Ali, Alastair H Leyland, Liam Smeeth, Peter Craig, Mirjam Allik, and Mauricio Lima Barreto
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Actuarial science ,Conditional cash transfer ,Public Health, Environmental and Occupational Health ,Business ,Data Linkage ,Cardiovascular mortality - Abstract
Background Conditional cash transfer programmes (CCTs) make monetary transfers to poor families conditional on health check-ups and/or education attendance. CCTs have been key in reducing poverty and improving child and maternal health in low- and middle-income countries (LMICs) but their impact on cardiovascular mortality have not been studied. We aimed to evaluate the effect of the CCT Bolsa Familia Program (BFP) on premature all-cause and cardiovascular mortality in Brazil. Methods The 100 Million Brazilian Cohort combined information about individuals applying for social programmes, the BFP and mortality data. We analysed ∼8 million individuals aged 30-69 who applied from 2011 to 2015. We calculated inverse probability weights (IPW) for the probability to receive BFP based on baseline observed characteristics (age, education, race, geographical location, household characteristics and year of application). Individuals were followed until they reached 70 years of age, died by any cause, or until 31st Dec 2015. We used Poisson regression (with person-years as the offset) and IPWs to compare BFP recipients to a comparable control population. Females and males were analysed separately. Results By following individuals for up to 4 years, 43,562 deaths by all-causes occurred among 4,197,658 females and 69,209 deaths among 3,672,393 males. Female BFP beneficiaries had approximately 60% lower all-cause mortality (IRR=0.40;95%CI=0.37-0.42) and CVD mortality (IRR=0.42;95%CI=0.37-0.47) than non-beneficiaries. Males who are BFP beneficiaries had ∼50% lower all-cause (IRR=0.53;95%CI=0.52-0.55) and 60% lower cardiovascular mortality (IRR=0.40;95%CI=0.38-0.42) than non-beneficiaries. Conclusions BFP, the world's largest CCT, may substantially decrease premature mortality. CCTs might have important implications for the growing burden of non-communicable diseases, with impacts potentially due to improved nutrition, socioeconomic conditions and improved primary care access. Key messages The Brazilian CCT, a widely recognized programme for poverty alleviation, have showed to be associated with lower overall and cardiovascular premature mortality in both women and men. Other countries, particularly LMICs, may learn from the health benefits of CCTs and should consider its potential large effect on mortality when planning austerity policies.
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- 2020
44. O ALUNO NA ERA VIRTUAL: ESTRATÉGIAS DE APRENDIZAGEM
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Deusirene Magalhães de Araújo, Ana Cecília Ferreira Reis, Wesliane Gonçalves de Souza, Denise Alves Ferreira, and Meyrivane Teixeira Santos Arraes
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- 2020
45. Understanding the dynamics of asthma symptoms between childhood and adolescence using latent transition analysis
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Ana Clara P Campos, Leila Denise Alves Ferreira Amorim, Mauricio Lima Barreto, and Agostino Strina
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Male ,medicine.medical_specialty ,Health (social science) ,Adolescent ,Disease ,Asymptomatic ,03 medical and health sciences ,0302 clinical medicine ,Risk Factors ,medicine ,Humans ,030212 general & internal medicine ,Longitudinal Studies ,Risk factor ,Child ,Asthma ,Respiratory Sounds ,030505 public health ,business.industry ,Public health ,Public Health, Environmental and Occupational Health ,Age Factors ,Genetic Variation ,Asthma symptoms ,medicine.disease ,Latent class model ,Phenotype ,Child, Preschool ,Latent transition analysis ,Female ,medicine.symptom ,0305 other medical science ,business ,Brazil ,Clinical psychology - Abstract
Asthma patterns in childhood are important predictors of unwanted outcomes in adolescence. We aimed to define asthma phenotypes in childhood and adolescence and evaluate the transitions between these phenotypes and factors potentially associated with the transitions. Baseline (1445 children), first round (1363 children/early adolescents) and second round (1206 adolescents) data from the SCAALA Project in Salvador, Brazil, were used. Phenotypes were defined by latent class analysis at three time points. Transitions between phenotypes were described and the effects of factors associated with transition probabilities estimated using latent transition analysis. The “asymptomatic” and “symptomatic” phenotypes were identified. Approximately 5–6% of asymptomatic children in childhood/later childhood and early adolescence became symptomatic later in time. Maternal common mental disorders were identified as important risk factor for unhealthy states. Asthma manifestations are characterized by frequent movements, especially between childhood and adolescence. Our study, by simultaneously defining disease subtypes, and examining the transitions and their potential predictors, highlights the importance of longitudinal studies to advance the understanding of the effects of social, environmental and biological mechanisms underlying asthma trajectories over time.
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- 2020
46. Asthma similarities across ProAR (Brazil) and U-BIOPRED (Europe) adult cohorts of contrasting locations, ethnicity and socioeconomic status
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Ana R. Sousa, Anna Selby, Jeanette Bigler, Hans Bisgaard, J. Cunha, I.M. Adcock, A.C.C. Coelho, Ryan Santos Costa, Pieter-Paul Hekking, Louise Fleming, Kai Sun, Amphun Chaiboonchoe, C.V.N. Santana, P. Moura-Santos, Scott Wagers, Ratko Djukanovic, G.P. Pinheiro, G. Hedlin, J.V. de Jesus, Kian Fan Chung, Jacek Musiał, Thomas Geiser, F. Baribaud, Emília Maria Medeiros de Andrade Belitardo, L. Cardoso, Klaus Bønnelykke, Anthony D. Postle, P H Howarth, Adelmir Souza-Machado, Valmar Biao-Lima, Stephen J. Fowler, Craig E. Wheelock, Alvaro A. Cruz, Mauricio Lima Barreto, Maria Ilma Araujo, Massimo Caruso, Laurie Pahus, P. J. Cooper, Florian Singer, W.M.C. van Aalderen, Paulo Augusto Moreira Camargos, Wolfgang Seibold, Ildiko Horvath, René Lutter, P.C.A. Almeida, I. Pandis, Victoria M. Goss, Aruna T. Bansal, John H. Riley, M. Puig Valls, P. Powel, Amanda Roberts, Alexander Mazein, M. Miralpeix, I. Paixao-Araujo, B. De Meulder, Michael Boedigheimer, Isaac Suzart Gomes-Filho, Chris Compton, C. Auffray, Jamie Matthews, Diane Lefaudeux, Elena Formaggio, A.A. Cruz, L.M. Mello, Anthony V. D'Amico, A. Lima-Matos, J. Fernandes, P. J. Sterk, Clare S. Murray, Enrica Bucchioni, Andrea Meiser, D. Erzen, Roelinde Middelveld, M. van Geest, Jørgen Vestbo, Alan J. Knox, Graham Roberts, Norbert Krug, Stewart Bates, G. Santos-Lima, Maggie Davis, Stelios Pavlidis, Paul Skipp, Yike Guo, Ariane H. Wagener, E.V. Ponte, Jens M. Hohlfeld, A. Souza-Machado, M.A. Lessa, I.S. Muniz, C.S. Cruz, Nadja Hawwa Vissing, Neuza Maria Alcantara-Neves, Tim Higenbottam, Navin Rao, Dominic Burg, Sarah Masefield, Z. Weiszhart, Matthew J. Loza, J. Haughney, Simone Hashimoto, Per Bakke, B. Thornton, José Miguel Chatkin, Andrew Bush, SE Dahlen, Joost Brandsma, N. Mores, G. Praticò, Kathleen C. Barnes, Carolina Souza-Machado, Rafael Stelmach, V. Bião-Lima, Martina Gahlemann, Paolo Montuschi, T.M.O. Souza, V.S. Vasquez, Camila Alexandrina Figueiredo, P. Chanez, Eduardo Vieira Ponte, Neil Fitch, Anthony Rowe, Cecile T.J. Holweg, S.J. Wilson, K. Fichtner, Alexander Manta, Lidia Lins, Dominic E. Shaw, David Myles, Julie Corfield, B. Dahlén, Thomas Sandström, Peter J. Sterk, Ian M. Adcock, Ralf Sigmund, James P.R. Schofield, Urs Frey, Laura C. Rodrigues, Leila Denise Alves Ferreira Amorim, E.H.D. Bel, Anna James, R.A. Franco, Paula Cristina Andrade Almeida, Paul Brinkman, H. Ahmed, Veit J. Erpenbeck, Richard G. Knowles, National Institute for Health Research, Pulmonology, and AII - Inflammatory diseases
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Male ,Cardiac & Cardiovascular Systems ,BLOOD ,Cross-sectional study ,COUNT ,Respiratory System ,Ethnic group ,Disease ,Severity of Illness Index ,Cohort Studies ,0302 clinical medicine ,Quality of life ,Forced Expiratory Volume ,Disease management ,Medicine ,030212 general & internal medicine ,610 Medicine & health ,1102 Cardiorespiratory Medicine and Haematology ,Middle Aged ,PREVALENCE ,Europe ,Phenotypes ,Phenotype ,INFECTIONS ,Female ,Life Sciences & Biomedicine ,Brazil ,Cohort study ,Pulmonary and Respiratory Medicine ,Adult ,Cross sectional study ,U-BIOPRED Study Groups ,03 medical and health sciences ,FEV1/FVC ratio ,ProAR Study Group ,Humans ,Socioeconomic status ,Asthma ,Science & Technology ,business.industry ,1103 Clinical Sciences ,medicine.disease ,SPIROMETRY ,REFERENCE VALUES ,respiratory tract diseases ,SEVERITY ,Cross-Sectional Studies ,030228 respiratory system ,Social Class ,Cardiovascular System & Cardiology ,Quality of Life ,business ,Biomarkers ,Demography - Abstract
Background Asthma prevalence is 339 million globally. ‘Severe asthma’ (SA) comprises subjects with uncontrolled asthma despite proper management. Objectives To compare asthma from diverse ethnicities and environments. Methods A cross-sectional analysis of two adult cohorts, a Brazilian (ProAR) and a European (U-BIOPRED). U-BIOPRED comprised of 311 non-smoking with Severe Asthma (SAn), 110 smokers or ex-smokers with SA (SAs) and 88 mild to moderate asthmatics (MMA) while ProAR included 544 SA and 452 MMA. Although these projects were independent, there were similarities in objectives and methodology, with ProAR adopting operating procedures of U-BIOPRED. Results Among SA subjects, age, weight, proportion of former smokers and FEV1 pre-bronchodilator were similar. The proportion of SA with a positive skin prick tests (SPT) to aeroallergens, the scores of sino-nasal symptoms and quality of life were comparable. In addition, blood eosinophil counts (EOS) and the % of subjects with EOS > 300 cells/μl were not different. The Europeans with SA however, were more severe with a greater proportion of continuous oral corticosteroids (OCS), worse symptoms and more frequent exacerbations. FEV1/FVC pre- and post-bronchodilator were lower among the Europeans. The MMA cohorts were less comparable in control and treatment, but similar in the proportion of allergic rhinitis, gastroesophageal reflux disease and EOS >3%. Conclusions ProAR and U-BIOPRED cohorts, with varying severity, ethnicity and environment have similarities, which provide the basis for global external validation of asthma phenotypes. This should stimulate collaboration between asthma consortia with the aim of understanding SA, which will lead to better management.
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- 2019
47. Effect of Early-Life Geohelminth Infections on the Development of Wheezing at 5 Years of Age
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Sofia Loor, Martha E. Chico, Laura C. Rodrigues, Philip J. Cooper, Carlos Sandoval, Leila Denise Alves Ferreira Amorim, Maritza Vaca, Mauricio Lima Barreto, and David P. Strachan
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Adult ,Male ,0301 basic medicine ,Pulmonary and Respiratory Medicine ,Pediatrics ,medicine.medical_specialty ,Time Factors ,Eczema ,Helminthiasis ,Critical Care and Intensive Care Medicine ,medicine.disease_cause ,Risk Assessment ,Cohort Studies ,Atopy ,03 medical and health sciences ,0302 clinical medicine ,Allergen ,Helminths ,Wheeze ,parasitic diseases ,medicine ,Animals ,Humans ,Early childhood ,Developing Countries ,Respiratory Sounds ,Asthma ,business.industry ,Age Factors ,Infant, Newborn ,Infant ,Original Articles ,Allergens ,medicine.disease ,Early life ,030104 developmental biology ,030228 respiratory system ,Maternal Exposure ,Child, Preschool ,Cohort ,Gestation ,Female ,Ecuador ,medicine.symptom ,business ,Follow-Up Studies - Abstract
Exposures to geohelminths during gestation or early childhood may reduce risk of wheezing illness/asthma and atopy during childhood in tropical regions.To investigate the effect of maternal and early childhood geohelminths on development of wheeze/asthma and atopy during the first 5 years of life.A cohort of 2,404 neonates was followed to 5 years of age in a rural district in coastal Ecuador. Data on wheeze were collected by questionnaire and atopy was measured by allergen skin prick test reactivity to 10 allergens at 5 years. Stool samples from mothers and children were examined for geohelminths by microscopy.A total of 2,090 (86.9%) children were evaluated at 5 years. Geohelminths were observed in 45.5% of mothers and in 34.1% of children by 3 years. Wheeze and asthma were reported for 12.6% and 5.7% of children, respectively, whereas 14.0% had skin test reactivity at 5 years. Maternal geohelminths were associated with an increased risk of wheeze (adjusted odds ratio, 1.41; 95% confidence interval, 1.06-1.88), whereas childhood geohelminths over the first 3 years of life were associated with reduced risk of wheeze (adjusted odds ratio, 0.70; 95% confidence interval, 0.52-0.96) and asthma (adjusted odds ratio, 0.60; 95% confidence interval, 0.38-0.94) but not skin prick test reactivity. The effects on wheeze/asthma were greatest with later age of first infection, were observed only in skin test-negative children, but were not associated with parasite burden or specific geohelminths.Although maternal exposures to geohelminths may increase childhood wheeze, childhood geohelminths during the first 3 years may provide protection through a nonallergic mechanism. Registered as an observational study (ISRCTN41239086).
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- 2018
48. Defining Behavior Patterns Towards Exclusive Breastfeeding Using Latent Class Analysis
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Janaina S Dias, Leila Denise Alves Ferreira Amorim, Heli Vieira Brandão, Graciete Oliveira Vieira, Pryscila de Argolo Cerqueira, and Tatiana de Oliveira Vieira
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Behavior ,030219 obstetrics & reproductive medicine ,Breastfeeding ,lcsh:RJ1-570 ,lcsh:Pediatrics ,Child Nutrition ,Latent class model ,Developmental psychology ,03 medical and health sciences ,0302 clinical medicine ,Latent Class Analysis ,030212 general & internal medicine ,Quantitative Methods ,Psychology - Abstract
Background: The interruption of exclusive breastfeeding (EBF) is worrying. This study aimed to identify behavior patterns towards EBF among mothers and health professionals. Methods: This is a cross-sectional analysis of a cohort consisting of 1309 women. We used latent class analysis (LCA), considering 15 indicators for defining 4 constructs: maternal emotional state, availability to breastfeed, maternal attitude, and health professional’s attitude towards breastfeeding. Results: Among mothers, 36.5% were classified as being in an unfavorable emotional state; they presented a higher probability of feeling tired, nervous, and sad; 14.7% had less availability to breastfeed and a higher probability of including primiparous and partners not helping to care for the child; 41.5% had negative attitude towards breastfeeding, including mothers more likely to give a pacifier and bottle. Among health professionals, 62.0% were categorized with unfavorable attitude towards breastfeeding, not providing guidance on breastfeeding in the hospital.
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- 2018
49. Social position and anthropometric status among adults in the ELSA-Brasil study: a latent class analysis
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Matos, Sheila Maria Alvim, primary, Amorim, Leila Denise Alves Ferreira, additional, Pitanga, Francisco José Gondim, additional, Patrão, Ana Luísa, additional, Barreto, Sandhi M., additional, Chor, Dora, additional, Cardoso, Letícia de Oliveira, additional, Molina, Maria del Carmen Bisi, additional, Barreto, Mauricio Lima, additional, and Aquino, Estela M. L., additional
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- 2021
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50. Obesidade abdominal no ELSA-Brasil: construção de padrão-ouro latente e avaliação da acurácia de indicadores diagnósticos
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Eickemberg, Michaela, primary, Amorim, Leila Denise Alves Ferreira, additional, Almeida, Maria da Conceição Chagas de, additional, Pitanga, Francisco José Gondim, additional, Aquino, Estela Maria Leão de, additional, Fonseca, Maria de Jesus Mendes da, additional, and Matos, Sheila Maria Alvim, additional
- Published
- 2020
- Full Text
- View/download PDF
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