5 results on '"López-Varela, Elisa"'
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2. Epidemiología de la tuberculosis en la población infantil de Manhiça, Mozambique = Paediatric TB epidemiology in Manhiça, southern Mozambique
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López Varela, Elisa, Alonso, Pedro, Naniche, Denise, and Universitat de Barcelona. Facultat de Medicina
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Pediatria ,616.9 ,Tuberculosi ,Epidemiology ,Pediatría ,Enfermedades infecciosas ,Malalties infeccioses ,Communicable diseases ,Pediatrics ,Ciències de la Salut ,Malalties dels pulmons ,Pulmonary diseases ,Tuberculosis ,Epidemiología ,Enfermedades pulmonares ,Epidemiologia - Abstract
[spa] El objetivo general de este proyecto de investigación es aumentar la base de conocimiento sobre la TB pediátrica con el fin de contribuir al fin de la epidemia de TB. Esta tesis tiene por objeto mejorar las estimativas epidemiológicas de TB infantil, así como caracterizar a la enfermedad desde diferentes perspectivas con el fin de vencer barreras críticas para la detección de casos. El primer artículo de esta tesis proporciona nuevos datos de incidencia poblacional de TB infantil que no están disponibles actualmente en la mayoría de los países del África subsahariana. La tasa de incidencia mínima comunitaria (TIMC) de TB en niños menores de tres años en el distrito de Manhiça fue de 470 por cada 100.000 persona-año, consistentemente alta para todos los grupos de edad. Estos datos confirman la magnitud de la epidemia en esta región y ponen de manifiesto el alto nivel de transmisión comunitaria.El VIH está íntimamente ligado a la tuberculosis. Casi la mitad de los niños menores de 3 años con TB estaban coinfectados de VIH. Los niños con sospecha de TB e infectados por el VIH presentaron una probabilidad de tener tuberculosis seis veces mayor que los no infectados, aunque la probabilidad de obtener confirmación bacteriológica fue más baja en este grupo. La mortalidad en los niños VIH positivos fue significativamente mayor que en los no infectados, (el 14,4% frente al 3,8%, p
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- 2017
3. Community-based progress indicators for prevention of mother-to-child transmission and mortality rates in HIV-exposed children in rural Mozambique.
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Fuente-Soro, Laura, Fernández-Luis, Sheila, López-Varela, Elisa, Augusto, Orvalho, Nhampossa, Tacilta, Nhacolo, Ariel, Bernardo, Edson, Burgueño, Blanca, Ngeno, Bernadette, Couto, Aleny, Guambe, Helga, Tibana, Kwalila, Urso, Marilena, and Naniche, Denise
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VERTICAL transmission (Communicable diseases) ,HIV infection transmission ,HIV infections ,PEDIATRICS - Abstract
Background: Eliminating mother-to-child HIV-transmission (EMTCT) implies a case rate target of new pediatric HIV-infections< 50/100,000 live-births and a transmission rate < 5%. We assessed these indicators at community-level in Mozambique, where MTCT is the second highest globally..Methods: A cross-sectional household survey was conducted within the Manhiça Health Demographic Surveillance System in Mozambique (October 2017-April 2018). Live births in the previous 4 years were randomly selected, and mother/child HIV-status was ascertained through documentation or age-appropriate testing. Estimates on prevalence and transmission were adjusted by multiple imputation chained equation (MICE) for participants with missing HIV-status. Retrospective cumulative mortality rate and risk factors were estimate by Fine-Gray model.Results: Among 5000 selected mother-child pairs, 3486 consented participate. Community HIV-prevalence estimate in mothers after MICE adjustment was 37.6% (95%CI:35.8-39.4%). Estimates doubled in adolescents aged < 19 years (from 8.0 to 19.1%) and increased 1.5-times in mothers aged < 25 years. Overall adjusted vertical HIV-transmission at the time of the study were 4.4% (95% CI:3.1-5.7%) in HIV-exposed children (HEC). Pediatric case rate-infection was estimated at 1654/100,000 live-births. Testing coverage in HEC was close to 96.0%; however, only 69.1% of them were tested early(< 2 months of age). Cumulative child mortality rate was 41.6/1000 live-births. HIV-positive status and later birth order were significantly associated with death. Neonatal complications, HIV and pneumonia were main pediatric causes of death.Conclusions: In Mozambique, SPECTRUM modeling estimated 15% MTCT, higher than our district-level community-based estimates of MTCT among HIV-exposed children. Community-based subnational assessments of progress towards EMTCT are needed to complement clinic-based and modeling estimates. [ABSTRACT FROM AUTHOR]- Published
- 2021
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4. Caretakers' perspectives of paediatric TB and implications for care-seeking behaviours in Southern Mozambique.
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Mindu, Carolina, López-Varela, Elisa, Alonso-Menendez, Yara, Mausse, Yolanda, Augusto, Orvalho Joaquim, Gondo, Kizito, Múñoz, Jose, Sacarlal, Jahit, García-Basteiro, Alberto L., Alonso, Pedro L., and Munguambe, Khátia
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TUBERCULOSIS prevention , *PEDIATRICS , *BACTERIAL disease prevention , *TROPICAL medicine , *RNA viruses - Abstract
Background: Tuberculosis (TB) remains an important public health concern, especially in poorly resourced settings. TB diagnosis is challenging, particularly for children, who are the most vulnerable to its′ impacts. Lack of knowledge and awareness of the disease compromises prompt diagnosis and treatment compliance. Objective: To gain insights regarding caretakers′ knowledge of the aetiology and prevention of paediatric TB in southern Mozambique, to describe their care-seeking behaviours and to assess the acceptability of diagnostic procedures. Methods: A total of 35 caretakers were interviewed, all of which had children with TB compatible symptoms. Eleven were caretakers of children diagnosed with TB at the health facility, 11 of children for whom TB was excluded as a diagnosis at the health facility and 13 of children with TB compatible symptoms identified in the community. The first two groups took part in a TB incidence study, while the third group did not. All underwent the same semi-structured interviews, the results of which were analysed and compared using content analysis. Results: Even when confronted with signs suggestive of TB, most caretakers never suspected it or misinterpreted the signs, even among caretakers with TB and TB contacts. There was limited knowledge of TB, except among those undergoing treatment. The transgression of social norms was often presented as an explanation for TB in parallel to medically sound causes. The use of traditional care for prevention is widespread, but it varied for treatment purposes. TB diagnostic procedures were considered painful but were unanimously tolerated. Conclusions and significance: Misconceptions of paediatric TB, associated complex care-seeking itineraries and negative feelings of the diagnostic procedures may result in delays, low adherence and lost to follow-up, which needs to be addressed by adequately framed health promotion approaches. [ABSTRACT FROM AUTHOR]
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- 2017
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5. High Rates of Non-Tuberculous Mycobacteria Isolation in Mozambican Children with Presumptive Tuberculosis.
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López-Varela, Elisa, L. García-Basteiro, Alberto, Augusto, Orvalho J., Fraile, Oscar, Bulo, Helder, Ira, Tasmiya, Gondo, Kizito, van Ingen, Jakko, Naniche, Denise, Sacarlal, Jahit, and Alonso, Pedro L.
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TUBERCULOSIS in children , *MOZAMBICANS , *SPUTUM microbiology , *FLUOROPHORES , *HEALTH , *THERAPEUTICS ,DIAGNOSIS of tuberculosis in children - Abstract
Introduction: Non-tuberculous mycobacteria (NTM) can cause disease which can be clinically and radiologically undistinguishable from tuberculosis (TB), posing a diagnostic and therapeutic challenge in high TB settings. We aim to describe the prevalence of NTM isolation and its clinical characteristics in children from rural Mozambique. Methods: This study was part of a community TB incidence study in children <3 years of age. Gastric aspirate and induced sputum sampling were performed in all presumptive TB cases and processed for smear testing using fluorochrome staining and LED Microscopy, liquid and solid culture, and molecular identification by GenoType® Mycobacterium CM/AS assays. Results: NTM were isolated in 26.3% (204/775) of children. The most prevalent NTM species was M. intracellulare (N = 128), followed by M. scrofulaceum (N = 35) and M. fortuitum (N = 9). Children with NTM were significantly less symptomatic and less likely to present with an abnormal chest radiograph than those with M. tuberculosis. NTM were present in 21.6% of follow-up samples and 25 children had the same species isolated from ≥2 separate samples. All were considered clinically insignificant and none received specific treatment. Children with NTM isolates had equal all cause mortality and likelihood of TB treatment as those with negative culture although they were less likely to have TB ruled out. Conclusions: NTM isolation is frequent in presumptive TB cases but was not clinically significant in this patient cohort. However, it can contribute to TB misdiagnosis. Further studies are needed to understand the epidemiology and the clinical significance of NTM in children. [ABSTRACT FROM AUTHOR]
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- 2017
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