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Biomedical subjects

E Massad

Publications and source records attributed to E Massad.

At least 37 records · Page 2Linked to original sources
PubMed2001

Neutralizing antirabies antibodies in urban terrestrial wildlife in Brazil.

The prevalence of rabies neutralizing antibodies (NA) in sera of wild animals from São Paulo City (Brazil) was investigated using the Rapid Fluorescent Focus Inhibition Test between 1994 and 1997. Sera from 547 specimens were examined. Marsupials represented 45% of the sample and primates 37%; carnivores, rodents, deer and edentates represented 6, 6, 3 and 2%, respectively. The overall prevalence of NA was 14%. The prevalence of NA was 18% in primates; whereas in marsupials, carnivores, edentates and rodents it was 13, 9, 8 and 6%, respectively. The stratification according to sex, age, and site of capture of the marsupials and primates showed a small predominance in males versus females and a large predominance of adults versus juveniles. The same relationship was seen in specimens captured near human habitations versus specimens captured in their own habitat. It is evident that there is circulation of rabies virus in wild animals, which are not recommended as pets since they represent a potential risk of exposure to rabies virus for both humans and domestic animals.

Animals↗
PubMed2000

Rabies seroprevalence of street dogs from São Paulo City, Brazil.

A sample of 602 street dogs captured by the São Paulo zoonosis-control municipal service was analyzed for the presence of serum antibodies against the rabies virus and compared to a control sample of 37 dogs from the kennel of the police of São Paulo. Data were stratified into 4 age intervals and the age from the street-dog sample was estimated by general aspects and dental observation according to standard techniques. We assumed that seropositivity was due to previous vaccination (no sub-clinical infection). From the prevalence data, we estimated the age-dependent incidence-density rate of vaccination by a simple mathematical model, which also allowed the estimation of the period of antibody protection given by the supposed vaccination. Crude seroprevalence in the street-dog sample was 16.5% and in the sample from the police-kennel dogs was 80%. The average age of first vaccination calculated for the street-dog sample was 5 years of age (if we assumed an average period of vaccine protection of 3 years) - but 5 months of age for the police-kennel sample.

Age Factors↗
PubMed2000

Correlation between HIV and HCV in Brazilian prisoners: evidence for parenteral transmission inside prison.

OBJECTIVE: It is an accepted fact that confinement conditions increase the risk of some infections related to sexual and/or injecting drugs practices. Mathematical techniques were applied to estimate time-dependent incidence densities of HIV infection among inmates. METHODS: A total of 631 prisoners from a Brazilian prison with 4,900 inmates at that time were interviewed and their blood drawn. Risky behavior for HIV infection was analyzed, and serological tests for HIV, hepatitis C and syphilis were performed, intended as surrogates for parenteral and sexual HIV transmission, respectively. Mathematical techniques were used to estimate the incidence density ratio, as related to the time of imprisonment. RESULTS: Prevalence were: HIV - 16%; HCV - 34%; and syphilis - 18%. The main risk behaviors related to HIV infection were HCV prevalence (OR=10.49) and the acknowledged use of injecting drugs (OR=3.36). Incidence density ratio derivation showed that the risk of acquiring HIV infection increases with the time of imprisonment, peaking around three years after incarceration. CONCLUSIONS: The correlation between HIV and HCV seroprevalence and the results of the mathematical analysis suggest that HIV transmission in this population is predominantly due to parenteral exposure by injecting drug, and that it increases with time of imprisonment.

Adult↗
PubMed2000

Decision trees and fuzzy logic: a comparison of models for the selection of measles vaccination strategies in Brazil.

In 1997, health authorities of the state of São Paulo, Brazil designed a vaccination campaign against measles based on a decision model that utilized fuzzy logic. The chosen mass vaccination strategy was implemented and changed the natural course of the epidemic in that state. We have built a model using a decision tree and compare it to the fuzzy logic model. Using essentially the same set of assumptions about this problem, we contrast the two approaches. The models identify the same strategy as being the best one, but exhibit differences in the ranking of the remaining strategies.

Brazil↗
PubMed1999

Seroprevalence of HIV, HCV and syphilis in Brazilian prisoners: preponderance of parenteral transmission.

Between November 1993 and April 1994, our physicians' team interviewed and took blood samples of 631 prisoners randomly drawn from the largest prison of South America, which counted about 4700 inmates at that time. The interview consisted of questions related to risk behaviour for HIV infection, and the subjects were asked to provide blood for serological tests for HIV, hepatitis C and syphilis. Our main purpose was to investigate the relationship between HCV and injecting drug use as related to HIV seropositivity. Participation in the study was voluntary and confidentiality was guaranteed. Overall prevalences found were as follows: HIV: 16% (95% confidence interval (CI): 13-19%); HCV: 34% (95% CI: 30-38%), and syphilis: 18% (95% CI: 15-21%). Acknowledged use of ever injecting drug was 22% and no other parenteral risk was reported. Our results, as compared with other studies in the same prison, suggest that HIV prevalence has been stable in recent years, and that the major risk factor for HIV infection in this population is parenteral exposure by injecting drug use.

Adolescent↗
PubMed1999

Ascaris-Trichuris association and malnutrition in Brazilian children.

This work was designed to evaluate the role of intestinal parasites on nutritional status in three rural areas of Brazil. A total of 520 children aged 1-12 years were studied through a questionnaire concerning housing, socio-economic conditions and a 24-h food intake recall. Measurements of weight and height were also performed, and three stool samples were collected on consecutive days for parasitological analysis. Scores of the standard deviation (z-scores) for the weight-for-height and height-for-age were used to characterise the growth profile. A high prevalence of intestinal parasites was detected, with Giardia lamblia (44%), Endolimax nana (43%), Ascaris lumbricoides (41%) and Trichuris trichiura (40%) being the most prevalent. Eleven per cent of the children were classified as showing stunting. Inadequate daily caloric intake was observed in 78% of the population and the proportion of those with inadequate protein intake was 34%. Logistic regression analysis was employed for the multivariate study. Stunting was significantly associated with estimators of low economic income, inadequate protein intake and polyparasitism, especially the association between Ascaris lumbricoides and Trichuris trichiura.

Analysis of Variance↗
PubMed1999

Fuzzy logic and measles vaccination: designing a control strategy.

BACKGROUND: The State of São Paulo, the most populous in Brazil, was virtually free of measles from 1987 until the end of 1996 when the number of cases started to rise. It reached alarming numbers in the middle of 1997 and local health authorities decided to implement a mass vaccination campaign. METHODS: Fuzzy Decision Making techniques are applied to the design of the vaccination campaign. RESULTS: The mass vaccination strategy chosen changed the natural course of the epidemic. It had a significant impact on the epidemic in the metropolitan area of São Paulo city, but a second epidemic in the State's interior forced the public health authorities to implement a second mass vaccination campaign 2 months after the first. CONCLUSIONS: Fuzzy Logic techniques are a powerful tool for the design of control strategies against epidemics of infectious diseases.

Brazil↗
PubMed1999

Hepatitis A incidence rate estimates from a pilot seroprevalence survey in Rio de Janeiro, Brazil.

BACKGROUND: To assess the impact of water sanitation and sewage disposal, part of a major environmental control programme in Rio de Janeiro, we carried out sero-prevalence studies for Hepatitis A virus (HAV) in three micro-regions in Rio de Janeiro. Each region varied with regard to level of sanitation. We are interested in assessing the discriminating power of age-specific prevalence curves for HAV as a proxy for improvement in sanitation. These curves will serve as baseline information to future planned surveys as the sanitation programme progresses. METHODS: Incidence rate curves from prevalence data are estimated parametrically via a Weibull-like survival function, and non-parametrically via maximum likelihood and monotonic splines. Sera collected from children and adults in the three areas are used to detect antibodies against HAV through ELISA. RESULTS: We compare baseline incidence curves at the three sites estimated by the three methods. We observe a strong negative correlation between level of sanitation and incidence rates for HAV infection. Incidence estimates yielded by the parametric and non-parametric approaches tend to agree at early ages in the microregion showing the best level of sanitation and to increasingly disagree in the other two. CONCLUSION: Our results support the choice of HAV as a sentinel disease that is associated with level of sanitation. We also introduce monotonic splines as a novel non-parametric approach to estimate incidence from prevalence data. This approach outperforms current estimating procedures.

Adolescent↗
PubMed1999

Relationship between human papillomavirus (HPV) genotyping and genital neoplasia in HIV-positive patients of Santos City, São Paulo, Brazil.

Among HIV-positive women, infection with multiple human papillomavirus (HPV) types is known to be more frequent and persistent, as well as a greater prevalence of high-grade genital lesions. This study aims to characterize, for the first time in Brazil, HPV presence and types among HIV-positive women of a high-risk population for genital intraepithelial neoplasia (GIN) development. A non-anonymous, voluntary, cross-sectional epidemiological survey was conducted, from June 1996 to April 1997, among 141 HIV-positive women followed at the Center of Reference in AIDS (CRAIDS). They were submitted to gynaecological examination, cytological screening and biopsies whenever necessary, for GIN and HPV DNA detection through polymerase chain reaction (PCR) technique. Positive HPV DNA were found in 80.8% patients. Two or more HPV types were detected in 45% of the samples. The most frequent HPV types detected were 16, 18 (30.5%); 61, 53 (24.4%), and non-identified types (18.7%). According to the oncogenic potential, 34.8% were considered of high-risk types. Among these HIV-positive patients, a great variety of HPV types, including high-risk types, was found in anogenital environment, as well as among young women, a great prevalence of high-grade genital lesions. Thus, it should strengthen the need for a periodical careful gynaecological examination among those women.

Acquired Immunodeficiency Syndrome↗
PubMed1999

HIV infection and related risk behaviours in a disadvantaged youth institution of São Paulo, Brazil.

In order to study the prevalence of HIV and related risky behaviours among disadvantaged youth, we interviewed and bled, between December 1994 and April 1995, 1122 young males and 93 young females who were serving time in FEBEM, a state institution that cares for homeless and offender youth of São Paulo, Brazil. Our questionnaire covered the following areas: sexual practices and use of illicit drugs; knowledge of HIV and STDs and their prevention; and myths and beliefs about AIDS. Seroprevalence of HIV was assessed and related with risk-taking behaviours by means of uni-, bi- and multivariate analysis. We found 2.6% of the males and 10.3% of the females to be positive to HIV. The prevalence of hepatitis C virus (HCV) antibodies resulted in 5.9% for males and 4.6% for females, respectively. The risk for parenterally transmitted HIV among the males was higher than that for sexually related transmission. The inverse relationship was found among the females.

Acquired Immunodeficiency Syndrome↗
PubMed1999

A theoretical model of the evolution of virulence in sexually transmitted HIV/AIDS.

INTRODUCTION: The evolution of virulence in host-parasite relationships has been the subject of several publications. In the case of HIV virulence, some authors suggest that the evolution of HIV virulence correlates with the rate of acquisition of new sexual partners. In contrast some other authors argue that the level of HIV virulence is independent of the sexual activity of the host population. METHODS: Provide a mathematical model for the study of the potential influence of human sexual behaviour on the evolution of virulence of HIV is provided. RESULTS: The results indicated that, when the probability of acquisition of infection is a function both of the sexual activity and of the virulence level of HIV strains, the evolution of HIV virulence correlates positively with the rate of acquisition of new sexual partners. CONCLUSION: It is concluded that in the case of a host population with a low (high) rate of exchange of sexual partners the evolution of HIV virulence is such that the less (more) virulent strain prevails.

Acquired Immunodeficiency Syndrome↗
PubMed1998

Seroepidemiological study of respiratory syncytial virus in São Paulo state, Brazil.

Transmission of respiratory syncytial virus is thought to be highly seasonal based on reported clinical cases, although transmission resulting in mild disease in all age groups has been little studied. This has been investigated in a seroepidemiological survey using sera from São Paulo, Brazil. Seroprevalence was found to increase rapidly with age, reaching over 90% by three years of age. This is typical of viral infections, which produce life-long immunity following primary infection. One-hundred percent seropositivity was attained by five years of age and maintained throughout adulthood, whereas mean antibody titers continued to increase with age. The mean duration of maternal antibodies was estimated to be 3.3 months with antibody decay demonstrated in paired samples from infants. The results are discussed in relation to possible mechanisms generating such a profile.

Adolescent↗
PubMed1998

Modeling and simulating morphological evolution in an artificial life environment.

This paper presents a computer-based environment designed to study biological evolution considering morphological aspects. It was inspired on cellular automata and evolutionary algorithm principles. Simple rules are used to determine the genotype and phenotype of individuals and their relationships with behavioral aspects in a square matrix environment, where individuals can evolve. Two methods to simulate mutational errors and to introduce variability of mutations are discussed. A series of four simulations show that the model promotes phenotype evolution depending on the distribution of food over the environment; morphology evolved as to favor movement of the individuals towards the portion of the environment in which the food has been distributed or to capture falling food.

Algorithms↗
PubMed1998

Seroepidemiology of group A rotavirus in suburban São Paulo, Brazil.

Age-specific patterns of rotavirus infection were investigated using a randomly selected and representative sample of sera from a suburban community of São Paulo, Brazil screened for class-specific antibodies to group A rotavirus. Age-serology of anti-rotavirus IgG showed primary infection predominant in young infants with a median age of around 18 months consistent with IgM serology suggesting highest rates of recent infection between ages 4 and 48 months. Anti-rotavirus serum IgA prevalence increased gradually with age. Paired samples from infants, collected 1 month apart, indicated high exposure rates with seroconversion occurring in several infants during the reported low transmission season. Between 5 and 10% of adults had elevated IgM levels indicative of recent infection and, potentially, of an important contribution adults may play to rotavirus transmission. Further understanding of the dynamics of rotavirus transmission within populations, at group and serotype level, would benefit the design and monitoring of future immunization programmes.

Adolescent↗
PubMed1998

Infection with group C rotavirus in a suburban community in Brazil.

Group C rotaviruses are associated with sporadic outbreaks of gastroenteritis worldwide. Age-specific seroprevalence of group C rotavirus antibodies was investigated in sera, randomly collected and representative of a suburban community in Brazil which had previously been screened for group A rotavirus antibodies. Antibody prevalence to group C rotavirus was low in children under 5 years and increased slowly with age to 36% seropositivity in adults, reflecting continuous exposure to primary infection in all age groups. This suggests a higher incidence of infection than disease might predict. Adult antibody prevalence was similar to that in other geographical settings. No obvious patterns of infection with group A and group C rotavirus were found within individuals, which suggests independent transmission. However, further epidemiological studies are required to understand group C rotavirus dynamics and possible interactions with group A rotavirus transmission and immunity.

Adolescent↗
PubMed1998

Population biology, evolution, and immunology of vaccination and vaccination programs.

The purpose of prophylactic vaccination is to reduce morbidity and mortality in a population. Many questions related to the design of vaccines and vaccination programs require a population standpoint for their sharp formulation and laboratory and field studies to understand their immunologic background. Practical suggestions of the workshop included increased studies of age-specific immunity, better immunoepidemiologic surveillance, better design of efficacy studies, and more systematic sampling of parasite strains to study the evolutionary pressure exerted by vaccines. Theoretical immunology has much to contribute. One of the realizations of the workshop was the value of a strong interdisciplinary approach in vaccine development, utilizing relevant contributions from immunology, population biology, mathematical modeling, epidemiology, molecular biology, and virology.

Animals↗
PubMed1997

Acquired immunity on a schistosomiasis transmission model - fitting the data.

A semi-stochastic model is proposed to analyse the effects of acquired immunity on the transmission of schistosomiasis in the human host. The basic model's assumptions are as follows. The human host is assumed to build up an immune response after elapsing a fixed period of time L from the first infection. This acquired immunity is assumed to be partially effective and it is never lost. The parasite infection event is a Poisson process with multiple occurrences, i.e., in each event one or more cercaria are assumed to invade the host. The model treats deterministically the age distribution of human host. The model shows a good retrieving capacity of real data from two endemic areas of schistosomiasis: Touros, Brazil (Schistosoma mansoni) and Misungwi, Tanzania (Schistosoma haematobium).

Animals↗