Guilherme L Werneck

Rio de Janeiro State University | UERJ · Departamento de Epidemiologia

We analyzed epidemiologic characteristics and distribution of 492 deaths related to Chagas disease and coronavirus disease (COVID-19) co-infection in Brazil during March‒December 2020. Cumulative co-infected death rates were highest among advanced age groups, persons of Afro-Brazilian ethnicity and with low education levels, and geographically dist...

Background Trypanosoma cruzi/HIV coinfection has been described as a relevant clinical event and an emerging public health problem. Here, we describe the epidemiological patterns of deaths related to Chagas disease and HIV/AIDS coinfection in Brazil from 2000 to 2019. Methods We performed a nationwide population-based study using mortality data ob...

Dengue patients with comorbidities may be at higher risk of death. In this cross-sectional study, healthcare databases from Mexico (2008–2014), Brazil (2008–2015), and Colombia (2009–2017) were used to identify hospitalized dengue cases and their comorbidities. Case fatality rates (CFRs), relative risk, and odds ratios (OR) for in-hospital mortalit...

Visceral leishmaniasis is a neglected tropical disease widely distributed worldwide. In Brazil, the control measures adopted in the last decades have not been able to prevent the spread of the disease. This study aimed to evaluate the effectiveness of a population-based intervention using 4% deltamethrin-impregnated dog collars on the incidence of...

Assim como muitos outros membros da comunidade de epidemiologistas e da saúde coletiva, e de diversas outras comunidades científicas, temos atuado diuturnamente no esforço de gerar informações em tempo real sobre o curso e os efeitos da epidemia do novo coronavírus (Covid 19 no país, com o objetivo de subsidiar a tomada de decisão de agentes públic...

Like many other members of the community of epidemiologists and public health, and several other scientific communities, we have been working day in day out in the effort to generate real-time information about the course and effects of the new coronavirus epidemic (Covid 19 in the country, with the objective of subsidizing the decision making of p...

Background: In Brazil, mathematical models for deriving estimates and projections of COVID-19 cases have been developed without data on asymptomatic SARS-CoV-2 infection. We estimated the seroprevalence of antibodies to SARS-CoV-2 among blood donors in the State of Rio de Janeiro. Methods: Data were collected on 2,857 blood donors from April 14 to...

Background This study presents the malaria burden in Brazil from 1990 to 2017 using data from the Global Burden of Diseases, Injuries, and Risk Factors Study 2017 (GBD 2017), by analyzing disease burden indicators in federated units of the Legal Amazon and Extra Amazon regions, as well as describing malaria cases according to Plasmodium species occ...

The detection of spatial clusters has been suggested as a potential tool for guiding the delivery of interventions against visceral leishmaniasis; however, little attention has been given to the consistency of results by using different spatial clustering methods. The present study aimed to assess the performance of three different techniques for i...

Information concerning the factors affecting the circulation and distribution of free-roaming dogs is crucial in developing control actions and limiting the spread of zoonoses. The present study analyzes the influence of gender, sterilization, and environment on the spatial distribution of free-roaming dogs in urban settings. Animals were captured/...

Cutaneous leishmaniasis (CL) is a zoonotic disease with complex transmission cycle. Some environmental and socioeconomic factors are known to be the major determinants of the transmission process, which are involved in configuring the spatiotemporal patterns and thus can be delimiting. However, the relevance of these socioeconomic and environmental...

Background: The timely identification of visceral leishmaniasis (VL) patients with a higher risk of death is essential for meeting the target of reducing case-fatality rates in the Americas. This study aimed to identify factors associated with death from VL in the State of Piaui, Brazil. Methods: Case-control study evaluating the following putat...

There is little evidence that current control strategies for canine leishmaniosis (CanL), the veterinary disease caused by L. infantum infection, are having a positive impact. This is of critical importance because dogs are a primary reservoir for L. infantum and a significant source of parasite transmission to humans. Drugs intended primarily for...

Background Social determinants may influence the incidence and control of tuberculosis (TB). The aim of this study was to evaluate the correlation between social determinants and pulmonary TB (PTB) incidence and treatment outcomes in different regions in Brazil. Methods In this ecological study, PTB incidence and treatment outcome rates as well as...

INTRODUCTION: Visceral leishmaniasis (VL) is fatal if not diagnosed and treated. This study aimed to estimate the cost-effectiveness of diagnostic-therapeutic alternatives for VL in Brazil. METHODS: A decision model estimated the life expectancy and costs of six diagnostic-therapeutic strategies. RESULTS: IT LEISH + liposomal amphotericin B emerg...

Chagas disease continues to be an important cause of morbidity, mortality and disability in several Latin American countries including Brazil. Using findings from the Global Burden of Disease Study 2016 (GBD 2016), we present years of life lost (YLLs), years lived with disability (YLDs), and disability-adjusted life years (DALYs) due to Chagas dise...

BACKGROUND The prompt diagnosis of plasmodial species for effective treatment prevents worsening of individual health and avoids transmission maintenance or even malaria reintroduction in areas where Plasmodium does not exist. Polymerase chain reaction (PCR) allows for the detection of parasites below the threshold of microscopic examination. OBJE...

Resumo: O objetivo do estudo foi avaliar o uso de serviços de saúde e sua associação com diferentes medidas de multimorbidade. Trata-se de um estudo transversal aninhado a uma investigação longitudinal de funcionários técnico-administrativos no Município do Rio de Janeiro, Brasil: Estudo Pró-Saúde. Foram analisados dados coletados na fase 2 (2001-2...

Objective: to describe operational difficulties in the implementation of deltamethrin-impregnated dog collars for the control of visceral leishmaniasis. Methods: this was a community intervention trial in the municipality of Montes Claros, MG, Brazil, comparing (i) control area - dogs without dog collars - and (ii) intervention area - use of 4%...

BACKGROUND Visceral leishmaniasis is a major public health challenge in South America, and dogs are its main urban reservoir. OBJECTIVE Validation of the canine Dual-path Platform immunoassay for canine visceral leishmaniasis (DPP® CVL) for a sample set composed of 1446 dogs from different Brazilian endemic areas. METHODS A well-defined reference s...

Free-roaming dogs affected by visceral leishmaniasis (VL) contribute to the geographical expansion of the disease and require special attention from health authorities. The objectives of the present study were to determine the prevalences of VL in a population of free-roaming dogs in an endemic region of Brazil, to establish the spatial distributio...

Background The study presents estimates for the burden of visceral leishmaniasis (VL) and cutaneous and mucocutaneous leishmaniasis (CML) in Brazil and its 27 federated units using data from the Global Burden of Disease Study (GBD) 2016. Methodology We report the incidence, years of life lost (YLL), years lived with disability (YLD), and disability...

The study presents estimates for the burden of visceral leishmaniasis (VL) and cutaneous and mucocutaneous leishmaniasis (CML) in Brazil and its 27 federated units using data from the Global Burden of Disease Study (GBD) 2016.We report the incidence, years of life lost (YLL), years lived with disability (YLD), and disability-adjusted life years (DA...

Canine visceral leishmaniosis (CVL), a parasitic disease caused by Leishmania infantum, may evolve to a chronic condition and lead to death. Evaluation of infected dogs is important to establish the clinical and laboratory parameters involved in the evolution of the disease. The objectives of the present study were to discriminate a canine populati...

Background: Neglected Tropical Diseases (NTDs) are important causes of morbidity, disability, and mortality among poor and vulnerable populations in several countries worldwide, including Brazil. We present the burden of NTDs in Brazil from 1990 to 2016 based on findings from the Global Burden of Diseases, Injuries, and Risk Factors Study 2016 (GB...

DALY rates (per 100,000 population) from NTDs by age group in Brazil, 2016. DALYs = disability-adjusted life-year; NTDs = neglected tropical diseases. (TIF)

Distribution of absolute number of DALYs due to NTDs by sex, age group, and cause in Brazil, 2016. DALYs = disability-adjusted life-years; NTDs = neglected tropical diseases. (TIF)

This article deals with a public policy in education, Post Graduation in Collective Health, to identify forms of dialogue of this policy, with the public health policy, the SUS, starting in 1990. The main product of PGSC policy is the training of masters and doctors, essential for teaching and research in the field. Bibliographic review and analysi...

The influence of neighborhood characteristics on self-rated health has been little studied. A multilevel approach using hierarchical models was applied to analyze the relationship between the socioeconomic characteristics in 621 neighborhoods (level 2) in the city of Rio de Janeiro, Brazil, and the self-rated health of 3,054 university employees (l...

In Brazil, visceral leishmaniasis is caused by the protozoan Leishmania infantum, primarily transmitted by Lutzomyia longipalpis and with the dog as its main urban reservoir. This study aims to evaluate the effectiveness of 4% deltamethrin-impregnated dog collars (DMC) DIC, Scalibor® 65 cm model and MSD manufacturer, on the prevalence and incidence...

The domestic dog is considered the main reservoir of visceral leishmaniasis (VL) in urban areas, but the identification of cats infected by Leishmania suggests the possibility of these animals also acting as reservoirs. The incrimination of a species as reservoir requires the accumulation of epidemiological evidence on the co-occurrence between suc...

OBJECTIVE To estimate the cost of diagnosis and treatment of asthma. METHODS We used the perspective of society. We sequentially included for 12 months, in 2011-2012, 117 individuals over five years of age who were treated for asthma in the Pneumology and Allergy-Immunology Services of the Piquet Carneiro Polyclinic, Universidade do Estado do Rio...

Background: There is little information on the effect of using deltamethrin-impregnated dog collars for the control of canine visceral leishmaniasis. Objectives: The objective of this study was to evaluate the effectiveness of the use of 4% deltamethrin-impregnated collars (Scalibor®) in controlling visceral leishmaniasis in Lutzomyia longipalpi...

Dengue remains an unmet public health burden. We determined risk factors for dengue in-hospital mortality in Brazil. Of 326,380 hospitalized dengue cases in 9–45 years old individuals, there were 971 deaths. Risk of dying was 11 times higher in the presence of underlying common comorbidities (renal, infectious, pulmonary disease and diabetes), simi...

Background Inequalities in the utilisation of dental services in Brazil are remarkable. The aim of this study was to evaluate the association of contextual and individual factors with the utilisation of dental services by Brazilian adults using the Andersen’s behavioural model. Methods Individual-level data from 27,017 adults residents in the Stat...

Resumo: Foi avaliada a associação entre características ambientais obtidas por sensoriamento remoto e a prevalência da leishmaniose visceral canina (LVC) no bairro do Jacaré, área de recente introdução da doença, no Município de Niterói, Estado do Rio de Janeiro, Brasil. Trata-se de um estudo seccional para avaliação da prevalência de LVC, definida...

The aim of the present study was to estimate the financial costs of the incorporation and/or replacement of diagnostic tests for human visceral leishmaniasis (VL) in Brazil. The analysis was conducted from the perspective of the Brazilian Unified National Health System (SUS) over a period of three years. Six diagnostic tests were evaluated: the ind...

Resumo: Este estudo examina a associação entre uso e cobertura do solo e a ocorrência de leishmaniose visceral (LV) canina. Estudo caso-controle em que casos foram residências com cães soropositivos para LV canina e controles, as residências com cães soronegativos. Utilizaram-se imagens de sensoriamento remoto (CBERS: 2/CCD e 2B/HRC) para descrever...

The existence of free-roaming dogs raises important issues in animal welfare and in public health. A proper understanding of these animals’ ecology is useful as a necessary input to plan strategies to control these populations. The present study addresses the population dynamics and the effectiveness of the sterilization of unrestricted dogs using...

Weights of variables. (PDF)

Individual histories of captures. (PDF)

Protocol for sterilization and animal recovering procedures. (PDF)

Informative materials. (PDF)

Background The urbanization of visceral leishmaniasis (VL) and the concurrent movement of the HIV infection to rural areas in Brazil are possible mechanisms associated with an increased number of Leishmania/HIV coinfected people. This study aimed to describe the clinical and epidemiological profile of VL/HIV coinfected patients and compare this pro...

Demographic, clinical and epidemiological characteristics of patients aged 13 years or over, according to the analyzed group. Brazil. 2001–2010. (DOCX)

Demographic, clinical and epidemiological characteristics of children under 13 years of age according to the analyzed group. Brazil. 2001–2010. (DOCX)

INTRODUCTION The control of reservoirs for Leishmania infantum -induced zoonotic visceral leishmaniasis requires the identification of dogs posing a population risk. Here, we assessed the performance of several assays to identify Lutzomyia longipalpis infectious dogs. METHODS We evaluated 99 dogs that were positive for visceral leishmaniasis based...

INTRODUCTION: The drugs available for visceral leishmaniasis (VL) treatment in Brazil have specific characteristics in terms of operability, effectiveness, toxicity, and cost. The aim of this study was to estimate the direct costs of therapies recommended by the Ministry of Health (MH) for VL treatment in Brazil. METHODS: The analytical perspectiv...

The aim of this study was to investigate the role of intimate partner violence in the early interruption of exclusive breastfeeding in the first three months of life. We used data from a prospective cohort of 564 children attending four primary health clinics in Rio de Janeiro, Brazil. Interruption of exclusive breastfeeding was defined as a child...

Background The objective of study was to estimate the incremental cost-effectiveness ratio (ICER) of diagnostic options for visceral leishmaniasis (VL) in Brazil. Methods Six diagnostic tests were considered: IT LEISH, Kalazar Detect, DAT-LPC (DAT made in the Laboratório de Pesquisas Clínicas), IFAT, PCR and direct examination of bone marrow aspir...

The aim of this study was to characterize risk profiles for Leishmania infantum infection in a population living in an area endemic for visceral leishmaniasis. A cohort study was conducted between January 2004 and December 2006 with the participation of 430 individuals living in the city of Teresina, northeast Brazil, who were initially negative fo...

OBJECTIVE To analyze if maternal mental health is associated with infant nutritional status at six month of age. METHODS A cross-sectional study with 228 six-month-old infants who used primary health care units of the city of Rio de Janeiro, Southeastern Brazil. Mean weight-for-length and mean weight-for-age were expressed in z-scores considering...

A population survey was conducted to explore the prevalence and factors associated with Leishmania infection in the Fercal region of the Federal District. The Fercal region is a group of neighborhoods in Brasília in which the first cases of visceral leishmaniasis were described. Leishmania infection was established by a positive leishmanin test. Al...

Introduction: In Brazil, culling of seropositive dogs is one of the recommended strategies to control visceral leishmaniasis. Since infectiousness is correlated with clinical signs, control measures targeting symptomatic dogs could be more effective. Methods: A cross-sectional study was carried out among 1,410 dogs, predictive models were develo...

In Brazil, human and canine visceral leishmaniasis (CVL) caused by Leishmania infantum has undergone urbanisation since 1980, constituting a public health problem, and serological tests are tools of choice for identifying infected dogs. Until recently, the Brazilian zoonoses control program recommended enzyme-linked immunosorbent assays (ELISA) and...

The understanding of the structure of free-roaming dog populations is of extreme importance for the planning and monitoring of populational control strategies and animal welfare. The methods used to estimate the abundance of this group of dogs are more complex than the ones used with domiciled owned dogs. In this systematic review, we analyze the t...

Methods, results and limitations of the studies included in the systematic review. (DOCX)

PRISMA Checklist. From: Liberati A, Altman DG, Tetzlaff J, Mulrow C, Gotzsche PC, et al. (2009) The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate health care interventions: explanation and elaboration. PLoS Med 6: e1000100. doi:10.1371/journal.pmed1000097. (DOC)

Geospatial analysis was used to study the epidemiology of Schistosoma mansoni, intestinal parasites and co-infections in an area (Ilha das Flores) in Sergipe, Brazil. We collected individually georeferenced sociodemographic, behavioral and parasitological data from 500 subjects, analyzed them by conventional statistics, and produced risk maps by Ke...