Susana Pereira Silva

Susana Pereira Silva
National Institute of Health Dr. Ricardo Jorge | INSA · Department of Epidemiology

Masters in Biostatistics

About

85
Publications
25,385
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4,100
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Introduction
Susana Pereira Silva currently works at the Department of Epidemiology, National Institute of Health Dr. Ricardo Jorge. Susana does research in Analysis and Statistics. Their most relevant publication is 'Estimates of global seasonal influenza-associated respiratory mortality: A modelling study.'

Publications

Publications (85)
Article
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Background Fine particulate matter (PM 2.5 ) occurs within a mixture of other pollutant gases that interact and impact its composition and toxicity. To characterize the local toxicity of PM 2.5 , it is useful to have an index that accounts for the whole pollutant mix, including gaseous pollutants. We consider a recently proposed pollutant mixture c...
Article
Paediatric injuries are widely acknowledged as a major public health issue among different medical disciplines. In the context of injuries and accidents, the surrounding environment of children and young people remains a major health concern. The present study was developed to extend current knowledge on the characteristics and magnitude of home an...
Article
Home and Leisure Accidents (HLA) have been identified as a relevant public health issue with individual, societal and economic consequences. So, common cause of injury-related morbidity and mortality, especially among older people. Evidence shows that most of HLA among the older ones are associated with identifiable and modifiable risk factors. How...
Article
The CHILD Vigilance project is a European study supported by the Injury Prevention & Safety Promotion Section of the European Public Health Association (EUPHA INJ) and aims at assessing parenting knowledge and attitudes that are relevant to supervision and risk taking in children. For children the majority of these injuries occur in or around the h...
Article
Background The CHILD Vigilance project is a European study supported by the Injury Prevention section of the European Public Health Association and aims at contributing to the epidemiological knowledge of injuries and accidents in Greece, Portugal and Lithuania, through increasing knowledge on parents’ and caregivers’ safety perceptions. Methods A...
Article
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Objective To examine the associations between characteristics of daily rainfall (intensity, duration, and frequency) and all cause, cardiovascular, and respiratory mortality. Design Two stage time series analysis. Setting 645 locations across 34 countries or regions. Population Daily mortality data, comprising a total of 109 954 744 all cause, 3...
Article
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Portugal is the country in Europe where the death rate in winter and summer has the highest correlation with outdoor temperatures. The Portuguese National Institute of Public Health Ricardo Jorge has developed a national warning system for heat waves called ICARO, which has been in place since 1999 (and is the oldest in Europe). However, it present...
Article
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Background The association between nonoptimal temperatures and cardiovascular mortality risk is recognized. However, a comprehensive global assessment of this burden is lacking. Objectives The goal of this study was to assess global cardiovascular mortality burden attributable to nonoptimal temperatures and investigate spatiotemporal trends. Meth...
Article
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Background Seroepidemiological studies provide estimates of population‐level immunity, prevalence/incidence of infections, and evaluation of vaccination programs. We assessed the seroprevalence of protective antibodies against influenza and evaluated the correlation of seroprevalence with the cumulative annual influenza incidence rate. Methods We...
Technical Report
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In 2021, in Por tugal, a sentinel sur veillance system for severe acute respi- rator y infections (SARI) was implemented based on hospital electronic health records. This ar ticle aims to present this sur veillance system as well as the data collected, in the t wo hospital units involved, from October 2023. Hospitalized individuals (≥24 hours) who...
Article
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Since the end of November 2023, the European Mortality Monitoring Network (EuroMOMO) has observed excess mortality in Europe. During weeks 48 2023–6 2024, preliminary results show a substantially increased rate of 95.3 (95% CI: 91.7–98.9) excess all-cause deaths per 100,000 person-years for all ages. This excess mortality is seen in adults aged 45...
Article
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Background. Climate change can directly impact temperature-related excess deaths and might subsequently change the seasonal variation in mortality. In this study, we aimed to provide a systematic and comprehensive assessment of potential future changes in the seasonal variation, or seasonality, of mortality across different climate zones. Methods....
Article
Short-term exposure to ground-level ozone in cities is associated with increased mortality and is expected to worsen with climate and emission changes. However, no study has yet comprehensively assessed future ozone-related acute mortality across diverse geographic areas, various climate scenarios, and using CMIP6 multi-model ensembles, limiting ou...
Article
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Fungal flora in coastal/inland beach sand and recreational water is a neglected field of study, despite its potential impact on human health. A joint International Society for Human and Animal Mycology/European Confederation for Medical My cology (ISHAM/ECMM) w orking group w as formed in 2019 with the task to set up a vast international initiative...
Article
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Injuries are among the top ten conditions affecting children according to WHO's latest evidence on years lived with disability. Despite this fact, EU countries are still missing strong information systems for enabling efficient response to the problem. Data on child unintentional injuries are still inconsistently collected in Europe due to substant...
Article
Full-text available
The CHILD Vigilance project is a European study supported by the Injury Prevention & Safety Promotion Section of the European Public Health Association (EUPHA INJ) and aims at assessing parenting knowledge and attitudes that are relevant to supervision and risk taking in children. The study aims contribute to the epidemiological knowledge of injuri...
Article
Full-text available
Heat-related mortality has been identified as one of the key climate extremes posing a risk to human health. Current research focuses largely on how heat mortality increases with mean global temperature rise, but it is unclear how much climate change will increase the frequency and severity of extreme summer seasons with high impact on human health...
Article
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Combined heat and humidity is frequently described as the main driver of human heat‐related mortality, more so than dry‐bulb temperature alone. While based on physiological thinking, this assumption has not been robustly supported by epidemiological evidence. By performing the first systematic comparison of eight heat stress metrics (i.e., temperat...
Article
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Introduction: The use of face masks in public was one of several COVID-19 non-pharmaceutical interventions adopted to mitigate the pandemic in Portugal. The aim of this study was to evaluate the impact of lifting the mask mandate on the April 22, 2022 on COVID-19 incidence and mortality in mainland Portugal and in the Azores. As a secondary objecti...
Article
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Background: Heat and cold are established environmental risk factors for human health. However, mapping the related health burden is a difficult task due to the complexity of the associations and the differences in vulnerability and demographic distributions. In this study, we did a comprehensive mortality impact assessment due to heat and cold in...
Article
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Background: Cardiovascular disease is the leading cause of death worldwide. Existing studies on the association between temperatures and cardiovascular deaths have been limited in geographic zones and have generally considered associations with total cardiovascular deaths rather than cause-specific cardiovascular deaths. Methods: We used unified data...
Article
The present study employed data collected during the Mycosands survey to investigate the environmental factors influencing yeasts and molds distribution along European shores applying a species distribution modelling approach. Occurrence data were compared to climatic datasets (temperature, precipitation, and solar radiation), soil datasets (chemic...
Article
Fungal diseases correlated to beach sand or water have not yet been demonstrated due to the lack of epidemiological studies. This study aims to illustrate the fungal population in beach sands of the two largest Italian lakes and in sands and waters of Mediterranean coasts of Southern Italy to contribute to the identification and assessment of cause...
Article
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Introduction Population health, including mental health, is influenced by its socioeconomic context. After the 2008 global economic crisis, studies found contradicting results: some showed an increased risk for self-harm and suicidal behavior, while others found the opposite association. To the best of our knowledge, there is no research in Portuga...
Article
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Background Vaccination is essential to control SARS-CoV-2 transmission and complications. The study aimed to estimate the number of SARS-CoV-2 infections, COVID-19 hospitalizations and deaths averted by booster vaccination in Portuguese population aged 80 or more years old. Methods We developed an ecological study for the period of the Omicron var...
Preprint
Full-text available
Heat-related mortality has been identified as one of the key climate extremes posing a risk to human health. Current research focuses largely on how heat mortality increases with mean global temperature rise, but it is unclear how much climate change will increase the frequency and severity of extreme summer seasons with high impact on human health...
Article
Full-text available
Background Non-pharmaceutical interventions (NPIs) were implemented worldwide to control the spread of SARS-CoV-2. Aim To evaluate the impact of tiered NPIs and a nationwide lockdown on reduction of COVID-19 incidence during the second and third epidemic waves in Portugal. Methods Surveillance data on laboratory-confirmed COVID-19 cases were used...
Article
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Rationale: The associations between ambient coarse particulate matter (PM2.5-10) and daily mortality is not fully understood at a global scale. Objectives: To evaluate the short-term associations between PM2.5-10 and total, cardiovascular, and respiratory mortality across multiple countries/regions worldwide. Methods: We collected daily mortal...
Article
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Background Genomic surveillance of SARS-CoV-2 in Portugal was rapidly implemented by the National Institute of Health in the early stages of the COVID-19 epidemic, in collaboration with more than 50 laboratories distributed nationwide. Methods By applying recent phylodynamic models that allow integration of individual-based travel history, we reco...
Article
Excess mortality not directly related to the virus has been shown to have increased during the COVID-19 pandemic. However, changes in heat-related mortality during the pandemic have not been addressed in detail. Here, we performed an observational study crossing daily mortality data collected in Portugal (SICO/DGS) with high-resolution temperature...
Article
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An uneven case fatality rate of COVID-19 is obser ved among European countries. In order to understand these dif ferences, this study aims to test the association bet ween COVID-19 case fatality rate and health determinants. As a secondar y objective, typologies of European countries were analysed according to their level of lethality by COVID-19....
Article
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Em 2021, a 'Bandeira Azul' introduziu a qualidade das areias das praias como critério-guia para atribuição do galardão. Seguindo a recomen-dação das novas guidelines da Organização Mundial de Saúde para as águas balneares, o novo critério para areias baseia-se na quantificação do número de unidades formadoras de colónias (UFC), por grama de areia,...
Article
The goal of most studies published on sand contaminants is to gather and discuss knowledge to avoid faecal contamination of water by run-offs and tide-retractions. Other life forms in the sand, however, are seldom studied but always pointed out as relevant. The Mycosands initiative was created to generate data on fungi in beach sands and waters, of...
Article
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We show that the SARS-CoV-2 B.1.1.7 lineage is highly disseminated in Portugal, with the odds of B.1.1.7 proportion increasing at an estimated 89% (95% confidence interval: 83–95%) per week until week 3 2021. RT-PCR spike gene target late detection (SGTL) can constitute a useful surrogate to track B.1.1.7 spread, besides the spike gene target failu...
Article
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Introduction: Syndromic surveillance allows early detection of changes in the population's morbidity pattern. The aim of this study is to evaluate the usefulness of indicators related to access to healthcare services, in COVID-19 surveillance. Material and methods: A time series analysis was performed using the weekly incidence rate of COVID-19...
Article
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The European monitoring of excess mortality for public health action (EuroMOMO) network monitors weekly excess all-cause mortality in 27 European countries or subnational areas. During the first wave of the coronavirus disease (COVID-19) pandemic in Europe in spring 2020, several countries experienced extraordinarily high levels of excess mortality...
Article
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Since the beginning of the current COVID-19 pandemic, laboratory diagnosis has been and continues to be an essential tool in the identification of new cases of infection by the SARS-CoV-2 coronavirus. Laboratory diagnosis has been essential to identify symptomatic and in particular asymptomatic cases and is crucial in the implementation of strategi...
Article
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As part of a sustainable water resources management, the Lisbon municipality identified groundwater and treated wastewater use increase as two opportunities for better and sustainable water use, with natural safeguard for public health as a priority. In this context, the aim of our research was to assess the suitability of the human-associated mark...
Article
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Background Reliable influenza burden estimates are essential for a true understanding of the influenza epidemics' impact; informed decision-making and effective risk communication. This study aimed to estimate the influenza burden in Portugal in 2013/14 - 2018/19 seasons. Methods We estimated seasonal influenza burden, ranging from medically atten...
Article
Background Following the worldwide economic crisis of 2008, studies have found an increased risk for self-harm and suicide attempts, many of which need hospital care. There is no research in Portugal on the matter. Therefore, our goal was to estimate the impact of the Portuguese economic crisis of 2009-2014 on the hospital admission rates by attemp...
Article
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A remarkable excess mortality has coincided with the COVID-19 pandemic in Europe. We present preliminary pooled estimates of all-cause mortality for 24 European countries/federal states participating in the European monitoring of excess mortality for public health action (EuroMOMO) network, for the period March-April 2020. Excess mortality particul...
Article
Background: Heatwaves can lead to increased mortality. In the Portuguese heat-health warning system (HHWS), ÍCARO, a daily report with heat-related mortality prediction is sent to heat-health action plan (HHAP) practitioners. HHAP practitioners assess risk and implement measures to prevent heatwave-related impact, but ÍCARO's use and understanding...
Article
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Current regulations and legislation require critical revision to determine safety for alternative water sources and water reuse as part of the solution to global water crisis. In order to fulfill those demands, Lisbon municipality decided to start water reuse as part of a sustainable hydric resources management, and there was a need to confirm safe...
Article
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Objective To assess short term mortality risks and excess mortality associated with exposure to ozone in several cities worldwide. Design Two stage time series analysis. Setting 406 cities in 20 countries, with overlapping periods between 1985 and 2015, collected from the database of Multi-City Multi-Country Collaborative Research Network. Popul...
Article
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Filamentous fungi and yeast are ubiquitous in nature, including bathing areas and therefore, sand. However, certain fungal species can cause infections or allergies in humans. Previous studies have shown that there are opportunistic or pathogenic microorganisms that can survive and grow in sand. Since bathing areas are used by a large numbers of pe...
Article
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Between the 1s t and 6t h of August 2018, Portugal was under a period of extreme heat, and the ICARO surveillance system anticipated serious consequences in terms of mortality. An estimated excess of 6.9 deaths per 100,000 inhabitants was attributed to the period of extreme heat, in Portugal. Lisbon and Tagus Valley (LVT) region, individuals with m...
Article
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Background Heatwaves can lead to increased mortality. Portugal has a Heat-Health Warning System (HHWS) in place (ÍCARO system). Researchers at the Instituto Ricardo Jorge send a daily report with heat-related mortality forecasts to key stakeholders (e.g. Heat-Health Action Plans (HHAP) staff). HHAP practitioners issue warnings and implement measure...
Poster
The objective of this work was to study the geographical distribution of the risk of death in mainland Portugal districts to extreme temperatures using summer data (from june 1st to September 30th) between 2008 and 2018.
Article
Ice is widely used to preserve fish on markets, playing a major role in the food industry. If manufactured, stored or distributed in inadequate sanitary conditions, it can represent a considerable health risk for both consumers and professionals. The present study characterizes ice used in marketplaces, on microbiological and chemical parameters. T...
Article
Full-text available
Objectives: The weekly monitoring of European all-cause excess mortality, the EuroMOMO network, observed a high excess mortality in participating countries during the 2017/18 winter season, especially among elderly; elevated levels of hospitalisations were also observed. This was unexpected as the dominating influenza virus was type B, commonly con...
Article
Full-text available
Respiratory syncytial virus (RSV) has been recognized as a major respiratory pathogen, especially in infants and older adults. In adults, RSV infection is usually mild and self-limited, but its impact on the population morbidit y and mor talit y has long been recognized. With this work we intend to estimate the all-cause mor talit y at tributable t...
Article
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Although many archeo-epidemiological studies have assessed the mortality impact of the 1918-19 influenza pandemic, detailed estimates are not available for Portugal. We applied negative binomial models to monthly mortality data from respiratory and all-causes at the national and district-level from Portugal, 1916-1922. Influenza-related excess mort...
Article
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Mitigation of global warming scenarios by the United Nations Economic Commission for Europe (UNECE) water convention requires better water use policies by all management parties. One of Lisbon’s municipal contributions to target a sustainable urban water cycle has been to assess the microbial and hydrochemical quality of groundwater. The aim is to...
Article
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Background: The aim of this study was to estimate excess pneumonia and influenza (P&I) hospitalizations during influenza epidemics and measure their correlation with influenza vaccine coverage in the 65 and more years old, according to the type/subtype of influenza virus. Methods: The study period comprised week 40/1998-40/2015. Age-specific wee...
Article
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Influenza is associated with severe illness, death, and economic burden. Sentinel surveillance systems have a central role in the community since they support public health interventions. This study aimed to describe and compare the influenza-coded primary care consultations with the reference index of influenza activity used in Portugal, General P...
Data
Cross correlation coefficients between weekly ILI incidence rate and weekly R80 consultations number. (DOCX)
Data
Cross correlation coefficients between weekly Goldstein Index and weekly R80 consultations number. (DOCX)
Article
Background: Estimates of influenza-associated mortality are important for national and international decision making on public health priorities. Previous estimates of 250 000-500 000 annual influenza deaths are outdated. We updated the estimated number of global annual influenza-associated respiratory deaths using country-specific influenza-assoc...
Article
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Since December 2016, excess all-cause mortality was observed in many European countries, especially among people aged ≥ 65 years. We estimated all-cause and influenza-attributable mortality in 19 European countries/regions. Excess mortality was primarily explained by circulation of influenza virus A(H3N2). Cold weather snaps contributed in some cou...
Article
Introduction: Immune profile for influenza viruses is highly changeable over time. Serological studies can assess the prevalence of influenza, estimate the risk of infection, highlight asymptomatic infection rate and can also provide data on vaccine coverage. The aims of the study were to evaluate pre-existing cross-protection against influenza A(...
Technical Report
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A Rede Médicos Sentinela é um instrumento de observação em saúde, constituída por médicos de família distribuídos por todo o país. No ano de 2015 estiveram em notificação os seguintes problemas de saúde: síndrome gripal, hipertensão arterial, diabetes mellitus, enfarte agudo do miocárdio, acidente vascular cerebral e prescrição de anticoagulantes....
Article
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Background Toxoplasma gondii is an obligate intracellular protozoan infecting up to one-third of the world's population, constituting a life threat if transmitted from mother to child during pregnancy. In Portugal, there is a lack of knowledge of the current epidemiological situation, as the unique toxoplasmosis National Serological Survey was perf...
Poster
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Background: Population immune profile for influenza is highly affected by circulating influenza viruses, thus changing the risk of infection for influenza. This study aims to assess influenza immunity in the Portuguese population by age groups, during 2014 and 2015 and establish a relationship between seroprotection and circulating influenza viruse...
Poster
Full-text available
As areias das praias contêm por vezes microrganismos nocivos para a saúde humana, frequentemente em superiores às que existem na água. Atualmente (Brandão et al. 2002; Sabino et al. 2012; Solo-Gabriele et al. 2015) não existe regulamentação para a amostragem, análise e apreciação da qualidade microbiológica de areias. O Programa Nacional de Avaliaç...
Article
It is well known that meteorological conditions influence the comfort and human health. Southern European countries, including Portugal, show the highest mortality rates during winter, but the effects of extreme cold temperatures in Portugal have never been estimated. The objective of this study was the estimation of the effect of extreme cold temp...
Poster
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Em Portugal, assim como noutros países do hemisfério norte, os efeitos das temperaturas extremas na saúde, especificamente do calor extremo na mortalidade, já se encontram descritos [1-6]. Em Portugal Continental existe um sistema de vigilância e alerta para períodos de calor extremo - sistema de vigilância ÍCARO (“Importância do Calor: Repercussã...
Conference Paper
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Objetivo: - Estimar o excesso de mortalidade “por todas as causas”, observado durante o período de inverno 2014/15 em Portugal Continental, por sexo, grupo etário e região de saúde Conclusões: - Excesso de óbitos significativo (S50/2014; S01/2015 - S10/2015); - Máximo observado na S03/2015 (36 % acima do esperado); - Excesso global de 17% (IC95...
Article
Full-text available
Since December 2014 and up to February 2015, the weekly number of excess deaths from all-causes among individuals ≥ 65 years of age in 14 European countries have been significantly higher than in the four previous winter seasons. The rise in unspecified excess mortality coincides with increased proportion of influenza detection in the European infl...
Conference Paper
The aim of this study was to estimate the excess mortality associated with the heat wave identified by the Portuguese national heat/health warning system (ICARO) in June and July 2013 and by the Portuguese Institute of Ocean and Atmosphere (IPMA). Available mortality data from the Portuguese Daily Mortality Monitoring (VDM) System was used. The imp...
Article
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O Estuário do Sado é um ecossistema com elevada sensibilidade e valor ecológico, e, simultaneamente, com importante valor económico, nomeadamente para as atividades piscatórias, turísticas e industriais. Embora tenham já sido realizados estudos ambientais sobre a contaminação desde estuário por metais pesados e os seus efeitos nos sistemas ecológic...