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2. Mental health of community health workers in the COVID-19 context

Author

Pimentel Gomes Fernandes Vieira-Meyer, Anya, Feitoza Farias, Sidney, Delano Soares Forte, Franklin, Silva Costa, Milena, Ximenes Guimaraes, Jose Maria, Pereira Morais, Ana Patricia, Sa de Oliveira, Andre Luiz, Guedes da Silva, Fernando Jose Jr., Ferreira do Nascimento, Elaine, Osawa Vasconcelos, Maristela Ines, Araujo Dias, Maria Socorro de, Proenco de Oliveira, Felipe, Antero Sousa Machado, Maria de Fatima, Castro, Marcia C., and Khizar Yousafzai, Aisha

Published
2023
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8. Quantifying gaps in the tuberculosis care cascade in Brazil: A mathematical model study using national program data

Author

Emani, Sivaram, Alves, Kleydson, Alves, Layana Costa, da Silva, Daiane Alves, Oliveira, Patricia Bartholomay, Castro, Marcia C., Cohen, Ted, Couto, Rodrigo de Macedo, Sanchez, Mauro, and Menzies, Nicolas A.

Subjects
EPUB (Standard), HIV (Viruses) -- Health aspects -- Social aspects, Health care reform -- Health aspects -- Social aspects, Medical research -- Health aspects -- Social aspects, Medicine, Experimental -- Health aspects -- Social aspects, Medical care, Cost of -- Health aspects -- Social aspects, Communicable diseases -- Health aspects -- Social aspects, Mortality -- Brazil, Tuberculosis -- Social aspects -- Health aspects, Markov processes -- Health aspects -- Social aspects, Biological sciences
Abstract

Background In Brazil, many individuals with tuberculosis (TB) do not receive appropriate care due to delayed or missed diagnosis, ineffective treatment regimens, or loss-to-follow-up. This study aimed to estimate the health losses and TB program costs attributable to each gap in the care cascade for TB disease in Brazil. Methods and findings We constructed a Markov model simulating the TB care cascade and lifetime health outcomes (e.g., death, cure, postinfectious sequelae) for individuals developing TB disease in Brazil. We stratified the model by age, human immunodeficiency virus (HIV) status, drug resistance, state of residence, and disease severity, and developed a parallel model for individuals without TB that receive a false-positive TB diagnosis. Models were fit to data (adult and pediatric) from Brazil's Notifiable Diseases Information System (SINAN) and Mortality Information System (SIM) for 2018. Using these models, we assessed current program performance and simulated hypothetical scenarios that eliminated specific gaps in the care cascade, in order to quantify incremental health losses and TB diagnosis and treatment costs along the care cascade. TB-attributable disability-adjusted life years (DALYs) were calculated by comparing changes in survival and nonfatal disability to a no-TB counterfactual scenario. We estimated that 90.0% (95% uncertainty interval [UI]: 85.2 to 93.4) of individuals with TB disease initiated treatment and 10.0% (95% UI: 7.6 to 12.5) died with TB. The average number of TB-attributable DALYs per incident TB case varied across Brazil, ranging from 2.9 (95% UI: 2.3 to 3.6) DALYs in Acre to 4.0 (95% UI: 3.3 to 4.7) DALYs in Rio Grande do Sul (national average 3.5 [95% UI: 2.8 to 4.1]). Delayed diagnosis contributed the largest health losses along the care cascade, followed by post-TB sequelae and loss to follow up from TB treatment, with TB DALYs reduced by 71% (95% UI: 65 to 76), 41% (95% UI: 36 to 49), and 10% (95% UI: 7 to 16), respectively, when these factors were eliminated. Total health system costs were largely unaffected by improvements in the care cascade, with elimination of treatment failure reducing attributable costs by 3.1% (95% UI: 1.5 to 5.4). TB diagnosis and treatment of false-positive individuals accounted for 10.2% (95% UI: 3.9 to 21.7) of total programmatic costs but contributed minimally to health losses. Several assumptions were required to interpret programmatic data for the analysis, and we were unable to estimate the contribution of social factors to care cascade outcomes. Conclusions In this study, we observed that delays to diagnosis, post-disease sequelae and treatment loss to follow-up were primary contributors to the TB burden of disease in Brazil. Reducing delays to diagnosis, improving healthcare after TB cure, and reducing treatment loss to follow-up should be prioritized to improve the burden of TB disease in Brazil., Author(s): Sivaram Emani 1,*, Kleydson Alves 2, Layana Costa Alves 2, Daiane Alves da Silva 2, Patricia Bartholomay Oliveira 3, Marcia C. Castro 4, Ted Cohen 5, Rodrigo de Macedo [...]

Published
2024
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10. Deaths Related to Chagas Disease and COVID-19 Co-Infection, Brazil, March-December 2020

Author

Martins-Melo, Francisco R., Castro, Marcia C., Ribeiro, Antonio Luiz P., Heukelbach, Jorg, and Werneck, Guilherme L.

Subjects
Comorbidity -- Care and treatment -- Patient outcomes, Chagas' disease -- Diagnosis -- Care and treatment, Health
Abstract

Chagas disease, caused by the protozoan Trypanosoma cruzi, is a neglected public health problem in Latin America (1). It is the most common infectious cause of cardiomyopathy worldwide and for [...]

Published
2022
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13. Exposure to Pesticides and Breast Cancer in an Agricultural Region in Brazil

Author

Panis, Carolina, primary, Candiotto, Luciano Zanetti Pessoa, additional, Gaboardi, Shaiane Carla, additional, Teixeira, Géssica Tuani, additional, Alves, Fernanda Mara, additional, da Silva, Janaína Carla, additional, Scandolara, Thalita Basso, additional, Rech, Daniel, additional, Gurzenda, Susie, additional, Ponmattam, Jamie, additional, Ohm, Joyce, additional, Castro, Marcia C., additional, and Lemos, Bernardo, additional

Published
2024
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17. Spatial and temporal fluctuations in COVID-19 fatality rates in Brazilian hospitals

Author

Brizzi, Andrea, Whittaker, Charles, Servo, Luciana M. S., Hawryluk, Iwona, Prete, Jr, Carlos A., de Souza, William M., Aguiar, Renato S., Araujo, Leonardo J. T., Bastos, Leonardo S., Blenkinsop, Alexandra, Buss, Lewis F., Candido, Darlan, Castro, Marcia C., Costa, Silvia F., Croda, Julio, de Souza Santos, Andreza Aruska, Dye, Christopher, Flaxman, Seth, Fonseca, Paula L. C., Geddes, Victor E. V., Gutierrez, Bernardo, Lemey, Philippe, Levin, Anna S., Mellan, Thomas, Bonfim, Diego M., Miscouridou, Xenia, Mishra, Swapnil, Monod, Mélodie, Moreira, Filipe R. R., Nelson, Bruce, Pereira, Rafael H. M., Ranzani, Otavio, Schnekenberg, Ricardo P., Semenova, Elizaveta, Sonabend, Raphael, Souza, Renan P., Xi, Xiaoyue, Sabino, Ester C., Faria, Nuno R., Bhatt, Samir, and Ratmann, Oliver

Published
2022
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20. Epidemiology of COVID-19 after Emergence of SARS-CoV-2 Gamma Variant, Brazilian Amazon, 2020-2021

Author

Nicolete, Vanessa C., Rodrigues, Priscila T., Fernandes, Anderson R.J., Corder, Rodrigo M., Tonini, Juliana, Buss, Lewis F., Sales, Flavia C., Faria, Nuno R., Sabino, Ester C., Castro, Marcia C., and Ferreira, Marcelo U.

Subjects
Amazonas, Brazil -- Health aspects, Company distribution practices, Health
Abstract

The novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) Gamma (P.1) variant emerged in November 2020 and drove the second wave of coronavirus disease (COVID-19) in Brazil. Emergence of this [...]

Published
2022
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27. Reduction in life expectancy in Brazil after COVID-19

Author

Castro, Marcia C., Gurzenda, Susie, Turra, Cassio M., Kim, Sun, Andrasfay, Theresa, and Goldman, Noreen

Subjects
Life expectancy -- Forecasts and trends -- Demographic aspects, Market trend/market analysis, Biological sciences, Health
Abstract

Brazil has been heavily affected by coronavirus disease 2019 (COVID-19). In this study, we used data on reported total deaths in 2020 and in January-April 2021 to measure and compare the death toll across states. We estimate a decline in 2020 life expectancy at birth (e.sub.0) of 1.3 years, a mortality level not seen since 2014. The reduction in life expectancy at age 65 (e.sub.65) in 2020 was 0.9 years, setting Brazil back to 2012 levels. The decline was larger for males, widening by 9.1% the female-male gap in e.sub.0. Among states, Amazonas lost 60.4% of the improvements in e.sub.0 since 2000. In the first 4 months of 2021, COVID-19 deaths represented 107% of the total 2020 figures. Assuming that death rates would have been equal to 2019 all-cause rates in the absence of COVID-19, COVID-19 deaths in 2021 have already reduced e.sub.0 in 2021 by 1.8 years, which is slightly larger than the reduction estimated for 2020 under similar assumptions. New estimates of life expectancy at birth and at age 65 years in Brazil reveal substantial declines as a result of COVID-19, bringing mortality back to levels observed 20 or more years ago., Author(s): Marcia C. Castro [sup.1] , Susie Gurzenda [sup.1] , Cassio M. Turra [sup.2] , Sun Kim [sup.1] , Theresa Andrasfay [sup.3] , Noreen Goldman [sup.4] Author Affiliations: (1) Department [...]

Published
2021
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31. Cost-effectiveness and health impact of screening and treatment ofMycobacterium tuberculosisinfection among formerly incarcerated individuals in Brazil

Author

van Lieshout Titan, Ana, primary, Klaassen, Fayette, additional, Pelissari, Daniele Maria, additional, Nildo de Barros Silva, José, additional, Alves, Kleydson, additional, Costa Alves, Layana, additional, Sanchez, Mauro, additional, Bartholomay, Patricia, additional, Dockhorn Costa Johansen, Fernanda, additional, Croda, Julio, additional, Andrews, Jason R., additional, Castro, Marcia C., additional, Cohen, Ted, additional, Vuik, Cornelis, additional, and Menzies, Nicolas A., additional

Published
2024
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39. Trends in Untreated Tuberculosis in Large Municipalities, Brazil, 2008-2017

Author

Chitwood, Melanie H., Pelissari, Daniele M., Silva, Gabriela Drummond Marques da, Bartholomay, Patricia, Rocha, Marli Souza, Arakaki-Sanchez, Denise, Sanchez, Mauro, Cohen, Ted, Castro, Marcia C., and Menzies, Nicolas A.

Subjects
Tuberculosis -- Forecasts and trends -- Statistics, Market trend/market analysis, Health
Abstract

Many countries that have considerable subnational variation in tuberculosis (TB) burden also have decentralized the management and implementation of control policies. In this context, local estimates of TB burden can [...]

Published
2021
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44. Changing Clinical Epidemiology of Plasmodium vivax Malaria as Transmission Decreases: Population-Based Prospective Panel Survey in the Brazilian Amazon.

Author

Fontoura, Pablo S, Macedo, Evelyn G, Calil, Priscila R, Corder, Rodrigo M, Rodrigues, Priscila T, Tonini, Juliana, Esquivel, Fabiana D, Ladeia, Winni A, Fernandes, Anderson R J, Johansen, Igor C, Silva, Marcos F, Fernandes, Amanda O S, Ladeia-Andrade, Simone, Castro, Marcia C, and Ferreira, Marcelo U

Subjects
PLASMODIUM vivax, CLINICAL epidemiology, MALARIA, STEREOLOGY, BONE marrow
Abstract

Background Malarial infections are often missed by microscopy, and most parasite carriers are asymptomatic in low-endemicity settings. Whether parasite detectability and its ability to elicit symptoms change as transmission declines remains unclear. Methods We performed a prospective panel survey with repeated measurements on the same participants over 12 months to investigate whether Plasmodium vivax detectability by microscopy and risk of symptoms upon infection varied during a community-wide larviciding intervention in the Amazon basin of Brazil that markedly reduced vector density. We screened 1096 to 1400 residents in the intervention site for malaria by microscopy and quantitative TaqMan assays at baseline and twice during intervention. Results We found that more P vivax infections than expected from their parasite densities measured by TaqMan assays were missed by microscopy as transmission decreased. At lower transmission, study participants appeared to tolerate higher P vivax loads without developing symptoms. We hypothesize that changes in the ratio between circulating parasites and those that accumulate in the bone marrow and spleen, by avoiding peripheral blood microscopy detection, account for decreased parasite detectability and lower risk of symptoms under low transmission. Conclusions P vivax infections are more likely to be subpatent and remain asymptomatic as malaria transmission decreases. [ABSTRACT FROM AUTHOR]

Published
2024
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45. Crowding and the shape of COVID-19 epidemics

Author

Rader, Benjamin, Scarpino, Samuel V., Nande, Anjalika, Hill, Alison L., Adlam, Ben, Reiner, Robert C., Pigott, David M., Gutierrez, Bernardo, Zarebski, Alexander E., Shrestha, Munik, Brownstein, John S., Castro, Marcia C., Dye, Christopher, Tian, Huaiyu, Pybus, Oliver G., and Kraemer, Moritz U. G.

Published
2020
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50. Author Correction: Spatial and temporal fluctuations in COVID-19 fatality rates in Brazilian hospitals

Author

Brizzi, Andrea, Whittaker, Charles, Servo, Luciana M. S., Hawryluk, Iwona, Prete, Jr, Carlos A., de Souza, William M., Aguiar, Renato S., Araujo, Leonardo J. T., Bastos, Leonardo S., Blenkinsop, Alexandra, Buss, Lewis F., Candido, Darlan, Castro, Marcia C., Costa, Silvia F., Croda, Julio, de Souza Santos, Andreza Aruska, Dye, Christopher, Flaxman, Seth, Fonseca, Paula L. C., Geddes, Victor E. V., Gutierrez, Bernardo, Lemey, Philippe, Levin, Anna S., Mellan, Thomas, Bonfim, Diego M., Miscouridou, Xenia, Mishra, Swapnil, Monod, Mélodie, Moreira, Filipe R. R., Nelson, Bruce, Pereira, Rafael H. M., Ranzani, Otavio, Schnekenberg, Ricardo P., Semenova, Elizaveta, Sonabend, Raphael, Souza, Renan P., Xi, Xiaoyue, Sabino, Ester C., Faria, Nuno R., Bhatt, Samir, and Ratmann, Oliver

Published
2022
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