Oswaldo Gonçalves Cruz

Office of Advanced Scientific Computing Research

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Leonardo Soares Bastos

Fundação Oswaldo Cruz

Cláudia Torres Codeço

Fundação Oswaldo Cruz

Flávio Codeço Coelho

Fundação Getulio Vargas

Raquel Martins Lana

Barcelona Supercomputing Center

Marília Sá Carvalho

Fundação Oswaldo Cruz

Marcelo Ferreira da Costa Gomes

Fundação Oswaldo Cruz

Laís Picinini Freitas

Fundação Oswaldo Cruz

Daniel Antunes Maciel Villela

Fundação Oswaldo Cruz

Marcelo Eduardo Borges

Universidade Federal de Goiás

Denis de Oliveira Rodrigues

Escola Nacional de Saúde Pública

Cooperative Institutions

Fundação Oswaldo Cruz

204

Academia Nacional de Medicina

140

Instituto de Historia

139

Public Health Agency

123

National Cancer Institute

120

Council of State

119

Public Risk Management Association

114

Universidade Federal do Rio de Janeiro

Universidade Federal Fluminense

Universidade de São Paulo

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Assessing the spread of COVID-19 in Brazil: Mobility, morbidity and social vulnerability

PLoS ONE (2020)

Flávio Codeço Coelho Raquel Martins Lana Oswaldo Gonçalves Cruz Daniel Antunes Maciel Villela Leonardo Soares Bastos

Brazil detected community transmission of COVID-19 on March 13, 2020. In this study we identified which areas in the country were the most vulnerable for COVID-19, both in terms of the risk of arrival of cases, the risk of sustained transmission and their social vulnerability. Probabilistic models were used to calculate the probability of COVID-19 spread from São Paulo and Rio de Janeiro, the initial hotspots, using mobility data from the pre-epidemic period, while multivariate cluster analysis of socio-economic indices was done to identify areas with similar social vulnerability. The results consist of a series of maps of effective distance, outbreak probability, hospital capacity and social vulnerability. They show areas in the North and Northeast with high risk of COVID-19 outbreak that are also highly socially vulnerable. Later, these areas would be found the most severely affected. The maps produced were sent to health authorities to aid in their efforts to prioritize actions such as resource allocation to mitigate the effects of the pandemic. In the discussion, we address how predictions compared to the observed dynamics of the disease.

Vulnerability

Pandemic

Social vulnerability

10.1371/journal.pone.0238214

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Citations (108)

Perfil de risco: método multivariado de classificação sócio-econômica de microáreas urbanas - os setores censitários da região metropolitana do Rio de Janeiro

Cadernos de Saúde Pública (1997)

Marília Sá Carvalho Oswaldo Gonçalves Cruz Flávio Fonseca Nobre

A method based on small area data analysis was developed to build a health risk classification for the Greater Rio de Janeiro Metropolitan Area. The approach uses 1991 census data and studies data pertaining to sanitation, ownership and type of housing, size and occupancy of the household, demography, schooling, and income. Principal component analysis applied over each dimension allowed for the choice of 15 variables, which summarized most of the observed variances. Additional analysis with these variables suggested that just six variables are sufficient for the construction of a classification using k-means method of multivariate cluster analysis. Five classes were obtained: (A) high income; (B) lower income; (C) poor; (D) low schooling and income; (E) low-level access to sanitation. The existing inequality in each of the geopolitical established areas was clearly identified. The proposed method allowed for the construction of compound indices to evaluate quality of life, based on widespread and easily obtained data (the census). Moreover, the method contributed to the detection of socioeconomic inequality, identifying, not only the larger poor regions but also the small excluded areas.

10.1590/s0102-311x1997000400007

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Citations (31)

Supplementary material from "Space–time dynamics of a triple epidemic: dengue, chikungunya and Zika clusters in the city of Rio de Janeiro"

Laís Picinini Freitas Oswaldo Gonçalves Cruz Rachel Lowe Marília Sá Carvalho

Zika Virus

10.6084/m9.figshare.c.4673105.v1

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Citations (0)

Author Correction: Fine-scale heterogeneity in population density predicts wave dynamics in dengue epidemics

Nature Communications (2022)

Victoria Romeo-Aznar Laís Picinini Freitas Oswaldo Gonçalves Cruz Aaron A. King Mercedes Pascual

Dynamics

10.1038/s41467-022-29163-1

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Citations (1)

Relação (incompleta) dos correspondentes de Adolpho Lutz

História Ciências Saúde-Manguinhos (2003)

Jaime Larry Benchimol Magali Sá Johann Becker Emil Absolon J Acott

10.1590/s0104-59702003000100013

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Perfil dos pacientes com câncer de pulmão atendidos no Instituto Nacional de Câncer, segundo condição tabagística, 2000 a 2007 Profile of patients with lung cancer assisted at the National Cancer Institute, according to their smoking status, from 2000 to 2007

Mírian Carvalho de Souza Paulo Antonio de Paiva Rebelo Oswaldo Gonçalves Cruz Escola Nacional de Saúde

AbstRAct: Introduction: Tobacco use is directly related to the future incidence of lung cancer. In Brazil, a growing tendency in age-adjusted lung cancer mortality rates was observed in recent years. Objective: To describe the profile of patients with lung cancer diagnosed and treated at the National Cancer Institute (INCA) in Rio de Janeiro, Brazil, between 2000 and 2007 according to their smoking status. Methods: An observational study was conducted using INCA’s database of cancer cases. To assess whether the observed differences among the categories of sociodemographic variables, characterization of the tumor, and assistance — pertaining to smokers and non-smokers — were statistically significant, a chi-square test was applied. A multiple correspondence analysis was carried out to identify the main characteristics of smokers and non-smokers. Results: There was a prevalence of smokers (90.5% of 1131 patients included in the study). The first two dimensions of the multivariate analysis explained 72.8% of data variability. Four groups of patients were identified, namely smokers, non-smokers, small-cell tumors, and tumors in early stages.

Chi-square test

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Eating patterns in the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil): an exploratory analysis

Cadernos de Saúde Pública (2016)

Letícia de Oliveira Cardoso Marília Sá Carvalho Oswaldo Gonçalves Cruz Cristiane Melere Vivian Cristine Luft

The food consumption of 15,071 public employees was analyzed in six Brazilian cities participating in the baseline for Brazilian Longitudinal Study of Adult Health (ELSA-Brasil, 2008-2010) with the aim of identifying eating patterns and their relationship to socio-demographic variables. Multiple correspondence and cluster analysis were applied. Four patterns were identified, with their respective frequencies: "traditional" (48%); "fruits and vegetables" (25%); "pastry shop" (24%); and "diet/light" (5%) The "traditional" and "pastry shop" patterns were more frequent among men, younger individuals, and those with less schooling. "Fruits and vegetables" and "diet/light" were more frequent in women, older individuals, and those with more schooling. Our findings show the inclusion of new items in the "traditional" pattern and the appearance of the "low sugar/low fat" pattern among the eating habits of Brazilian workers, and signal socio-demographic and regional differences.

Longitudinal Study

Healthy eating

Pastry

Food habits

10.1590/0102-311x00066215

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Citations (57)

Quantitative real-time PCR for differential diagnostics of parvovirus B19 infection in acute liver failure patients

Expert Review of Molecular Diagnostics (2019)

Arthur Daniel Rocha Alves Rita de Cássia Nasser Cubel Garcia Oswaldo Gonçalves Cruz Marcelo Alves Pinto Luciane Almeida Amado Leon

Human Parvovirus B19 (B19V) is a common pathogen worldwide. After primary infection, B19V-DNA may permanently persist in non-erythroid tissues, including the liver of patients with acute liver failure (ALF).To validate a real-time PCR (qPCR) for the quantification of B19V-DNA, in order to establish a differential diagnosis for B19V infection in ALF patients.The qPCR techniques were based on Sybr Green® and TaqMan® methodologies. To evaluate the quality parameters of both methods, samples from patients with or without B19V infection were tested. The diagnostic utility of qPCR in the detection B19V-DNA in patients with ALF was evaluated by testing archived serum and hepatic tissue explants from 10 patients.The Sybr Green® methodology showed 97% efficiency, the limits of detection and quantification were 62.6 and 53,200 copies/mL, respectively. The TaqMan® methodology showed 95% efficiency, the limits of detection and quantification were 4.48 and 310 copies/mL, respectively. A false positive result was found only with the Sybr Green® methodology. Among ALF patients without defined etiology, three (30%) were positive for B19V DNA in serum and liver.The qPCR methods validated here were effective in clarifying uncommon cases of B19V-related ALF and are fit for differential diagnosis of ALF causes.

TaqMan

SYBR Green I

10.1080/14737159.2019.1582333

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Citations (12)

“Evolución de la brecha entre el número de casos esperados y el notificado de Chagas congénito para la Argentina, en el período 2002 - 2008” por

Cynthia Spillmann título de Mestre Cláudia Torres Codeço Sérgio Sosa Estani Ricardo E. Gürtler

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Epidemiological data accessibility in Brazil

The Lancet Infectious Diseases (2016)

Flávio Codeço Coelho Cláudia Torres Codeço Oswaldo Gonçalves Cruz Sabrina Camargo Pierre‐Alexandre Bliman

Concerns about data sharing and transparency during epidemiological emergencies are not new.1Modjarrad K Moorthy VS Millett P Gsell PS Roth C Kieny MP Developing global norms for sharing data and results during public health emergencies.PLoS Med. 2016; 13: e1001935Crossref PubMed Scopus (91) Google Scholar, 2Whitty CJ Mundel T Farrar J Heymann DL Davies SC Walport MJ Providing incentives to share data early in health emergencies: the role of journal editors.Lancet. 2015; 386: 1797-1798Summary Full Text Full Text PDF PubMed Scopus (26) Google Scholar, 3NatureBenefits of sharing.Nature. 2016; 530: 129Crossref Scopus (8) Google Scholar, 4Callaway E Zika-microcephaly paper sparks data-sharing confusion.Nature. 2016; (published online Feb 12.)https://doi.org/10.1038/nature.2016.19367Crossref Google Scholar Dye and colleagues5Dye C Bartolomeos K Moorthy V Kieny MP Data sharing in public health emergencies: a call to researchers.Bull World Health Organ. 2016; 94: 158Crossref PubMed Scopus (49) Google Scholar have announced an initiative called Zika Open through which the manuscripts and respective data submitted to Bulletin of the World Health Organization would be publlished as open access from the date of submission onwards, under a Creative Commons License (CC BY IGO 3.0). This is an important initiative. Here we report challenges faced, particularly in Brazil, for timely, lawful access to governmental collected disease-notification data that are essential to understand the current Zika virus epidemic, and any future public health emergency. Brazil has a country-wide disease notification system, SINAN, that allows for continuous assessment of epidemiological dynamics throughout the country. Created in the 1990s, it continually records cases of many diseases via compulsory notification by health-care facilities all over the country. Case reports come mostly from public health-care facilities, because the private health-care sector does not seem to comply with the required notifications. SINAN is centrally managed and releases annual reports with aggregated data. It also has a web interface where one can tabulate notified cases of diseases per municipality, month, and covariates. This open notification system has fed many hundreds of epidemiological studies and has contributed to the development of a strong Brazilian epidemiological research. However, there are major drawbacks in SINAN,6Galvao PRS Ferreira AT Maciel M et al.An evaluation of the Sinan health information system as used by the Hansen's disease control programme, Pernambuco State, Brazil.Lepr Rev. 2008; 79: 171-182PubMed Google Scholar mainly its slow update cycle and restrictive data-access policies and tools. In the advent of public health emergencies, such as the current Zika virus epidemic, this is not satisfactory. First, there is a delay of months to years for data to be available to researchers. This is due to the logistics, but also the policy of cleaning the data before publishing. However, to be used for real-time epidemiological analysis, data are needed as they appear, even if they are to be corrected and updated later. Secondly, SINAN only provides access to monthly data, which is too coarse a time-scale for disease modelling. In general, many of the challenges regarding the usability of SINAN are related to the use of legacy database management systems and of data entry systems, which provide insufficient tools to prevent data entry errors. SINAN and other public health information systems also suffer from accessibility issues. They were designed for manual query by a human being. Modern mathematical and statistical epidemiology methods can consume large volumes of data and provide unique insight into the early dynamics of transmission,7Coelho FC de Carvalho LM Estimating the attack ratio of dengue epidemics under time-varying force of infection using aggregated notification data.Sci Rep. 2015; 5: 18455Crossref PubMed Scopus (12) Google Scholar, 8Gomes MF Piontti AP Rossi L et al.Assessing the international spreading risk associated with the 2014 west African Ebola outbreak.PloS Curr. 2014; (published online Sept 2.)https://doi.org/10.1371/currents.outbreaks.cd818f63d40e24aef769dda7df9e0da5Crossref PubMed Google Scholar but demand machine readable data (ie, data endpoints that can be automatically queried by analytical software). There is an opportunity for SINAN and other national notification systems to rethink their structure and data access policies. If this is not done, SINAN is risking complete obsolescence. A good example of an application that benefits from better access to readily accessible data are early warning and nowcasting systems for transmissible diseases, such as the InfoDengue, which is now running in Rio de Janeiro. By properly integrating data from different sources, such as climate, social media activity, and disease notification, each with its own level of sensitivity and specificity, InfoDengue acknowledges uncertainties in each of the individual sources and provide alerts and warnings to guide public health action. However, restrictive access policies make it very difficult to run nowcasting systems. The need for specific permissions and human interference to access data imposes limitations to such initiatives. Unfounded concerns about confidentiality and potential ill-effects of data transparency are among the main barriers to data-sharing, but these could be properly managed by well established techniques, such as some level of aggregation. Both the Brazilian and the international academic communities would greatly benefit from a clear stance on the part of the government, favouring open data access, along with the necessary investments required to make it a reality. On our part, InfoDengue is prepared to make our enriched dataset available to all interested under a Creative Commons License, as suggested by Dye and colleagues.5Dye C Bartolomeos K Moorthy V Kieny MP Data sharing in public health emergencies: a call to researchers.Bull World Health Organ. 2016; 94: 158Crossref PubMed Scopus (49) Google Scholar However, the regulatory foundations for such a service are still not clear. We hope that the current Zika virus epidemic can serve as wake-up call to change these outdated policies. Once we start to see the positive effect of better data accessibility on the response to epidemiological emergencies, perhaps the private health sector will begin to see the importance of better compliance with notification requirements. We declare no competing interests.

Data Sharing

Zika Virus

10.1016/s1473-3099(16)30007-x

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Citations (8)