Evaluation of emerging infectious disease and the importance of SINAN for epidemiological surveillance of Venezuelans immigrants in Brazil

Lima, Mario; Rodrigues, Gabbrielle Almeida; Lima, Maysa Ruiz de

doi:10.1016/j.bjid.2019.07.006

Cited by 17 publications

(15 citation statements)

References 18 publications

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“…Homeless overlapping risk groups have also shown high HIV prevalence rates, such as 3.4% in persons deprived of liberty and 19.1% in trans women in a worldwide metanalysis study, 460/1,637 (28.1%) in sex workers of sub-Saharan Africa, and 17-fold higher chance to have HIV in refugee mothers of Canada when compared to Canadian-born mothers [29][30][31]. In Brazil, 15/2,237 (0.7%) people with mental disorders, and 25/333 (7.5%) migrants from Venezuela were positive for HIV [32,33]. In addition, immunological impairment caused by HIV may aggravate co-infections, with a tendency of severe clinical manifestations in HIV-toxoplasmosis combination [14,34].…”

Section: Introductionmentioning

confidence: 99%

Serosurvey of anti-Toxoplasma gondii and anti-HIV antibodies in homeless persons of southeastern Brazil

Lg¹,

Pi²,

FFVd³

et al. 2020

Preprint

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Background: Homeless persons have been described as one of the most vulnerable populations worldwide, with higher morbidity and mortality of diseases associated with HIV occurrence. Seroprevalence of Toxoplasma gondii and HIV has been extensively studied in other vulnerable populations, however, no study to date have focused on their concomitant seroprevalence in homeless persons. Accordingly, the present study aimed to assess the concomitant seroprevalence of anti-T. gondii and anti-HIV antibodies and associated risk factors in homeless persons in a daytime homeless shelter of São Paulo, southeastern Brazil. Methods: Anti-T. gondii antibodies were detected by indirect fluorescent antibody test and anti-HIV levels by chemiluminescence enzyme immunoassay, with positive samples confirmed by rapid immunoblot assay. Results: Overall, IgG anti-T. gondii seropositivity was found in 43/120 (35.8%) homeless persons, with endpoint titers varying from 16 to 1,024. The only two pregnant women tested were negative for IgM by chemiluminescence enzyme immunoassay, with normal parturition and clinically healthy newborns in both cases. There were no statistical differences in the risk factors for anti-T. gondii serology (p>0.05). Anti- HIV seropositivity was found in 2/120 (1.7%) homeless persons, confirmed as HIV-1. One HIV seropositive individual was also sero-reactive to IgG anti-T. gondii, and both were negative to IgM anti-T. gondii. One HIV positive person was also diagnosed with syphilis, tuberculosis and body lice presence, while the other never returned for assistance. No evaluation of anti- HIV risk factors has been made due to the low seropositive rate. Conclusions: The anti-T. gondii prevalence herein was lower than other Brazilian populations, likely related to predominant intake of processed food such as ready-to-eat and fast-food meals, and thus, low ingestion of fresh salad and raw meat. On the other hand, the anti- HIV seropositivity was higher than the average of the general Brazilian population, with 0.4%. Despite the low prevalence of anti-T. gondii in homeless persons, clinical manifestations may be aggravated in HIV positive individuals. To the author's knowledge, this is the first study of anti-T. gondii serosurvey in homeless persons concomitantly assessed with anti-HIV seropositivity.

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Section: Introductionmentioning

confidence: 99%

Serosurvey of anti-Toxoplasma gondii and anti-HIV antibodies in homeless persons of southeastern Brazil

Lg¹,

Pi²,

FFVd³

et al. 2020

Preprint

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“…Another group at high risk of malaria is indigenous people, especially children, and some occupational groups, including miners, whom are particularly vulnerable to increased malaria transmission [ 13 ]. In Amazonas state of Brazil, P. falciparum malaria has been associated with indigenous populations [ 14 ], and in neighbouring Bolivar state in Venezuela, indigenous people have higher Annual Parasite Prevalence (API) than non-indigenous groups [ 15 ].…”

Section: Introductionmentioning

confidence: 99%

“…Previous studies of trends in malaria cases from Roraima state have analysed routine reporting of notifiable diseases through 2018 [ 9 , 13 , 20 ]. However, little is known about how the epidemiology of malaria in Brazil’s northernmost state has changed since 2018.…”

Section: Introductionmentioning

confidence: 99%

Changing transmission dynamics among migrant, indigenous and mining populations in a malaria hotspot in Northern Brazil: 2016 to 2020

Wetzler

Marchesini

Villegas

et al. 2022

Malar J

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Background Roraima state is the northernmost state in Brazil and the primary border-crossing point between Brazil and Venezuela. The uncontrolled surge of malaria in Venezuela, coupled with mass migration of Venezuelans to neighbouring countries and the upward trend in informal mining in the state, pose a serious threat to the broader region, especially to migrant, indigenous and mining populations, jeopardizing malaria elimination efforts. This study describes changes in the epidemiological profile of malaria in Roraima state related to time, place and populations at risk from 2016 to 2020. Methods De-identified malaria surveillance data were obtained from the Malaria Epidemiological Surveillance System from 2016 to 2020. Pearson’s chi-square tested differences between imported and autochthonous cases. Multivariable logistic regression was used to identify risk factors for imported versus autochthonous cases by demographic characteristics. Results Odds of being an imported case were higher for Plasmodium falciparum cases (AOR = 2.08). However, as the number of cases from Venezuela decreased in 2020 following closure of the border, the proportion of P. falciparum cases increased markedly, from 6.24% in 2019 to 18.50% in 2020. Over the 5-year period, the odds of being an imported case among miners were about nine times higher than the general population (AOR = 8.99). The proportion of total malaria cases that were among indigenous people increased from 33.09% in 2016 to 54.83% in 2020. Indigenous children had a higher burden of malaria with over 40% of cases in children 0 to 9 years old, compared to 8% in non-indigenous children 0 to 9 years old. In some municipalities, place of infection differed from place of notification, with a large proportion of cases in these municipalities reporting in Boa Vista. Conclusions Malaria remains a serious threat in Roraima state, especially among high-risk populations, such as miners, migrants, and indigenous people. As malaria cases have increased among indigenous people and miners, and the proportion of P. falciparum cases has increased, elimination efforts require understanding of these risk factors to tailor interventions appropriately. Furthermore, cross-border surveillance systems need to be urgently strengthened at formal and unofficial border points, especially since the border with Venezuela reopened in July 2021.

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“…Between March and September, more than 8,000 Venezuelans returned home when they lost their livelihoods in Brazil and wanted to be close to their families due to the pandemic (13). Indigenous people, especially children and some occupational groups, including miners are particularly vulnerable to increased malaria transmission brought about by changes in population structures brought about by internal and external factors (14). Though the in ux of migrants dropped when the border between the two countries closed when the COVID-19 pandemic began in 2020, population movements shifted within Roraima state as more people from Brazil sought work in the informal mining sector in speci c municipalities in riverine forested areas located near indigenous populations.…”

Section: Introductionmentioning

confidence: 99%

“…Previous studies of trends in malaria cases from Roraima state have analysed routine reporting of noti able diseases through 2018 (7,14,24). However, little is known about how the epidemiology of malaria in Brazil's northernmost state has changed since 2018.…”

Section: Introductionmentioning

confidence: 99%

Changing Transmission Dynamics Among Migrant, Indigenous and Mining Populations in a Malaria Hotspot in Northern Brazil: 2016 to 2020

Wetzler¹,

Marchesini²,

Villegas³

et al. 2021

Preprint

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Background Roraima state is the northernmost state in Brazil and the primary border-crossing point between Brazil and Venezuela. The uncontrolled surge of malaria in Venezuela, coupled with mass migration of Venezuelans to and from neighbouring countries and the uptick in informal mining in Roraima state, pose a serious threat to the broader region, especially to migrant, indigenous and mining populations, jeopardizing malaria elimination efforts. This study describes changes in the epidemiological profile of malaria in Roraima State related to time, place and populations at risk from 2016 to 2020. Methods De-identified malaria surveillance data were obtained from the Malaria Epidemiological Surveillance System from 2016 to 2020. Pearson’s chi-square tested different between imported and autochthonous cases. Multivariable logistic regression was used to identify risk factors for imported versus autochthonous cases by demographic characteristics. Results Odds of being an imported case were higher Plasmodium falciparum cases (AOR = 2.08). However, as the number of cases from Venezuela decreased in 2020 following closure of the border, the proportion of Plasmodium falciparum cases increased markedly, from 6.24% in 2019 to 18.50% in 2020. Over the 5-year period, the odds of being an imported case among miners were about nine times higher than the general population (AOR = 8.99). The proportion of total malaria cases that were among indigenous people increased from 33.09% in 2016 to 54.83% in 2020. Indigenous children had a higher burden of malaria with over 40% of cases in children 0 to 9 years old, compared to 8% in non-indigenous children 0 to 9 years old. In some municipalities, place of infection differed from place of notification, with a large proportion of cases in these municipalities reporting in Boa Vista. Conclusions Malaria remains a serious threat in Roraima state, especially among high-risk populations, such as miners, migrants, and indigenous people. As malaria cases have increased among indigenous people, miners, and the proportion of Plasmodium falciparum cases has increased, elimination efforts require understanding of these risk factors to tailor interventions appropriately. Furthermore, cross-border surveillance systems need to be urgently strengthened at formal and unofficial border points, especially since the border with Venezuela reopened in July 2021.

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Evaluation of emerging infectious disease and the importance of SINAN for epidemiological surveillance of Venezuelans immigrants in Brazil

Cited by 17 publications

References 18 publications

Serosurvey of anti-Toxoplasma gondii and anti-HIV antibodies in homeless persons of southeastern Brazil

Serosurvey of anti-Toxoplasma gondii and anti-HIV antibodies in homeless persons of southeastern Brazil

Changing transmission dynamics among migrant, indigenous and mining populations in a malaria hotspot in Northern Brazil: 2016 to 2020

Changing Transmission Dynamics Among Migrant, Indigenous and Mining Populations in a Malaria Hotspot in Northern Brazil: 2016 to 2020

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