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ABSTRACT: The main objective of this study was to measure the quality of life (QoL) during a dengue episode. We conducted a facility-based survey in central Brazil in 2005 and recruited 372 laboratory-confirmed dengue patients greater than 12 years of age in hospital and ambulatory settings. We administered the World Health Organization QoL instrument approximately 15 days after the onset of symptoms. We used principal component analysis with varimax rotation to identify domains related to QoL. The median age of interviewees was 36 years. Most (85%) reported their general health status as very good or good before the dengue episode. Although ambulatory patients were mainly classified as having dengue fever, 44.8% of hospitalized patients had dengue hemorrhagic fever or intermediate dengue. Principal component analysis identified five principal components related to cognition, sleep and energy, mobility, self-care, pain, and discomfort, which explained 73% of the variability of the data matrix. Hospitalized patients had significantly lower mean scores for dimensions cognition, self-care, and pain than ambulatory patients. This investigation documented the generally poor QoL during a dengue episode caused by the large number of domains affected and significant differences between health care settings.
The American journal of tropical medicine and hygiene 10/2011; 85(4):732-8. · 2.59 Impact Factor
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ABSTRACT: In Brazil, dengue endemic and epidemic patterns indicate an upward trend in incidence and hospitalization in the past decade.
To report dengue circulating serotypes from 1994 to 2003 and the role of distinct serotypes on dengue clinical outcomes in Central Brazil.
Virological surveillance for dengue cases was conducted in the city of Goiania ( approximately 1,200,000 population) from 1994 to 2003. Samples were tested using dengue IgM antibody (MAC-ELISA) and/or virus isolation. Circulating subtypes and genotypes were identified by reverse transcriptase PCR (RT-PCR) and by restricted site-specific PCR (RSS-PCR) patterns in selected samples.
Adults (87.4%) were the most affected group and dengue fever accounted for the majority of the cases. Laboratory surveillance identified mainly DEN 1 serotype from 1994 to 2002 shifting to a high circulation of DEN 3 in 2003. The ratio of dengue fever to dengue with complications/DHF remained constant following the introduction of DEN 3. Diagnosis of dengue was confirmed in approximately 50% of the suspected cases enhanced by RT-PCR. RSS-PCR patterns for DEN 1 and DEN 3 corresponded to the circulating subtypes in the country.
The result of virological surveillance did not suggest a major role of infecting DEN 3 serotype in increasing disease severity during its first-year spread in Central Brazil.
Journal of Clinical Virology 12/2006; 37(3):179-83. · 3.97 Impact Factor
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ABSTRACT: To identify potential prognostic factors for neonatal mortality among newborns referred to intensive care units.
A live-birth cohort study was carried out in Goiânia, Central Brazil, from November 1999 to October 2000. Linked birth and infant death certificates were used to ascertain the cohort of live born infants. An additional active surveillance system of neonatal-based mortality was implemented. Exposure variables were collected from birth and death certificates. The outcome was survivors (n=713) and deaths (n=162) in all intensive care units in the study period. Cox's proportional hazards model was applied and a Receiver Operating Characteristic curve was used to compare the performance of statistically significant variables in the multivariable model. Adjusted mortality rates by birth weight and 5-min Apgar score were calculated for each intensive care unit.
Low birth weight and 5-min Apgar score remained independently associated to death. Birth weight equal to 2,500 g had 0.71 accuracy (95% CI: 0.65-0.77) for predicting neonatal death (sensitivity =72.2%). A wide variation in the mortality rates was found among intensive care units (9.5-48.1%) and two of them remained with significant high mortality rates even after adjusting for birth weight and 5-min Apgar score.
This study corroborates birth weight as a sensitive screening variable in surveillance programs for neonatal death and also to target intensive care units with high mortality rates for implementing preventive actions and interventions during the delivery period.
Revista de Saúde Pública 11/2005; 39(5):775-81. · 1.33 Impact Factor
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ABSTRACT: To describe the epidemiological profile and patterns of cocaine use among hospitalized drug users.
A cross-sectional study was carried out among drug users, aged 18 years or more, hospitalized in one out six selected psychiatric hospitals in the metropolitan area of Greater S o Paulo, whose clinical conditions allowed them to reliably answer to a standardized questionnaire and who agreed to participate. Six psychiatric hospitals who attended spontaneously referred public and private patients from all Greater S o Paulo were selected. Data collection was conducted using structured interviews, individually applied by a trained psychologist. Statistical analysis was performed using Student t-test and Chi-square test at p<0.05.
There was a predominance of crack use (38.4%) over intravenous drug use (1.6%). Addicts who smoked cocaine had lower education, most were unemployed and had previously lived on the streets, and used higher amounts of drugs. These addicts also had been previously incarcerated more often than addicts who used other routes for drug administration.
Drug use is a serious public health problem in Greater S o Paulo, and this is shown by the great amount of hospital admissions due to drug addiction. Crack users have lower socioeconomic status and more often engage in violence and crimes.
Revista de Saúde Pública 01/2004; 37(6):751-9. · 1.33 Impact Factor
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ABSTRACT: BackgroundIn Brazil, dengue endemic and epidemic patterns indicate an upward trend in incidence and hospitalization in the past decade.ObjectiveTo report dengue circulating serotypes from 1994 to 2003 and the role of distinct serotypes on dengue clinical outcomes in Central Brazil.MethodsVirological surveillance for dengue cases was conducted in the city of Goiania (∼1,200,000 population) from 1994 to 2003. Samples were tested using dengue IgM antibody (MAC–ELISA) and/or virus isolation. Circulating subtypes and genotypes were identified by reverse transcriptase PCR (RT-PCR) and by restricted site-specific PCR (RSS-PCR) patterns in selected samples.ResultsAdults (87.4%) were the most affected group and dengue fever accounted for the majority of the cases. Laboratory surveillance identified mainly DEN 1 serotype from 1994 to 2002 shifting to a high circulation of DEN 3 in 2003. The ratio of dengue fever to dengue with complications/DHF remained constant following the introduction of DEN 3. Diagnosis of dengue was confirmed in ∼50% of the suspected cases enhanced by RT-PCR. RSS-PCR patterns for DEN 1 and DEN 3 corresponded to the circulating subtypes in the country.ConclusionsThe result of virological surveillance did not suggest a major role of infecting DEN 3 serotype in increasing disease severity during its first-year spread in Central Brazil.
Journal of Clinical Virology.
