Influence of socio-economic indicators and territorial networks at the spatiotemporal spread dynamics of Covid-19 in Brazil

This work aims to provide an overview of the territorial evolution of COVID-19 (SARS-CoV-2) in Brazil using socio-demographic variables, for the time span between February 26, 2020 until January 24, 2021. Socio-demographic indicators, basic sanitation infrastructure data, and epidemiological bulletins were integrated using Principal Components Analysis (PCA) to develop a social vulnerability index (SVI), to estimate the degree of exposure risk of the Brazilian population to COVID-19. The results indicate that the majority of confirmed cases were reported from the main Brazilian capitals, linked to well-developed port and airport modes. In terms of deaths, the states of São Paulo, Rio de Janeiro, Ceará and Pernambuco were at the top of the ranking. On the contrary, there were some states of the mid-west (Mato Grosso do Sul) and the north (Acre, Amapá, Roraima, Rondônia and Tocantins), that recorded low mortality indexes. The SVI reveals that the states of the north and north-east are the most vulnerable. Regarding the metropolitan areas, it was observed that the main capitals of the north and north-east, with the exception of Salvador, present significantly more critical numbers in terms of dissemination and deaths by COVID-19 than the capitals of the south-southeast, where the SVI is lower. The comparative exception was Santa Catarina state metropolitan areas. Finally, as the virus does not strike everyone in the same way, one of the great challenges is to search for solutions to cope with COVID-19 in the face of very unequal realities. Thus, a reflection on the strategies adopted by the Brazilian government is relevant, while considering the continental dimensions and the diversity of the Brazilian regions, to obtain a better analysis of the more vulnerable populations and social groups

O impacto da implantação do teste NAT-HBV na Fundação Centro de Hemoterapia e Hematologia do Estado do Pará (HEMOPA), Região Norte do Brasil

Nucleic acid testing (NAT) for virus detection during blood screening has helped to prevent transfusion-transmitted infections worldwide. In northern Brazil, NAT was implemented in 2012 for HIV and HCV and more recently, in January 2015, the screening for HBV was included and currently used concomitant with serological tests (HBsAg and anti-HBc). This study aims to evaluate the prevalence and the incidence of HBV infection among voluntary blood donors at ten regional blood centers of HEMOPA Foundation in Pará state and to compare the residual risk of transfusion-transmitted HBV infection before and after the Brazilian HBV-NAT implementation. The prevalence (restricted to FT donors) and incidence (restricted to RP donors) of HBV were calculated based on rates of confirmed positive samples. Residual risk was based on the incidence and WP model described by Schreiber and coauthors. Logistic and Poisson regression were used in the statistical analysis by SPSS v20.0. A p value <0.05 was considered statistically significant. HBV prevalence in the periods before and after the implementation of HBV-NAT were 247 and 251 per 100,000 donations, respectively. Seroconversion rates were 114 and 122 per 100,000 donations in the two periods, respectively. The residual risk (RR) for HBV decreased significantly in the period after the implementation of HBV-NAT, with a reduction of 1: 144.92 to 1: 294.11 donations (p <0.001), significantly increasing transfusion safety at HEMOP Foundation, in the Northern Region of Brazil.CAPES - Coordenação de Aperfeiçoamento de Pessoal de Nível SuperiorO teste de ácidos nucléicos (NAT) para detecção de vírus durante a triagem de sangue ajudou a prevenir infecções transmitidas por transfusão em todo o mundo. No norte do Brasil, o NAT foi implementado em 2012 para os vírus HIV e HCV e, em janeiro de 2015, a triagem para HBV foi incluída e atualmente usada concomitantemente com testes sorológicos (HBsAg e anti-HBc). Este estudo teve como objetivo avaliar a prevalência e a incidência de infecção pelo HBV entre doadores voluntários de sangue em dez hemocentros regionais da Fundação HEMOPA no estado do Pará e comparar o risco residual da infecção pelo HBV transmitida por transfusão antes e após a implementação do HBV-NAT no Brasil. A prevalência restrita a doadores de primeira vez (FT) e a incidência restrita a doadores de repetição (RP) do HBV foram calculadas com base nas taxas de amostras positivas confirmadas. O risco residual foi baseado na incidência e no modelo WP descritos por Schreiber e coautores. A regressão logística e de Poisson foram utilizadas na análise estatística pelo SPSS v20.0. Um valor de p <0,05 foi considerado estatisticamente significativo. A prevalência do HBV nos períodos antes e após a implantação do HBV-NAT foi de 247 e 251 por 100.000 doações, respectivamente. As taxas de soroconversão foram 114 e 122 por 100.000 doações nos dois períodos, respectivamente. O risco residual (RR) para HBV diminuiu significativamente no período posterior à implementação do HBV-NAT, com redução de 1: 144,92 para 1: 294,11 doações (p <0,001), aumentando significativamente a segurança transfusional na Fundação HEMOPA, na região Norte do Brasil

Prevalence, incidence and residual risk of transfusion-transmitted HBV infection before and after the implementation of HBV-NAT in northern Brazil.

BACKGROUND:Nucleic acid testing (NAT) for virus detection during blood screening has helped to prevent transfusion-transmitted infections worldwide. In northern Brazil, NAT was implemented in 2012 for HIV and HCV and more recently, in January 2015, the screening for HBV was included and currently used concomitant with serological tests (HBsAg and anti-HBc). This study aims to evaluate the prevalence and the incidence of HBV infection among voluntary blood donors at ten regional blood centers of HEMOPA Foundation in Pará state and to compare the residual risk of transfusion-transmitted HBV infection before and after the Brazilian HBV-NAT implementation. METHODS:The prevalence (restricted to first time donors- FT) and seroconversion rate (restricted to repeat donors- RP) of HBV were calculated based on rates of confirmed positive samples. Residual risk was based on the incidence and window period (WP) model described by Schreiber and coauthors. Logistic and Poisson regression were used in the statistical analysis by SPSS v20.0. A p value <0.05 was considered statistically significant. RESULTS:HBV prevalence in the periods before and after the implementation of HBV-NAT were 247 and 251 per 100,000 donations, respectively. Seroconversion rates were 114 and 122 per 100,000 donations in the two periods, respectively. The residual risk (RR) for HBV decreased significantly in the posterior period to the HBV-NAT implementation, when compared to RR before implementation, with a reduction of 1:144,92 to 1:294,11 donations (p <0,001). CONCLUSIONS:The RR to HBV decreased after the implementation of HBV-NAT, increasing significantly the transfusional security in the North region of Brazil at HEMOPA Foundation

Prevalence of Dengue, Chikungunya and Zika Viruses in Blood Donors in the State of Pará, Northern Brazil: 2018–2020

Arboviruses have been reported over the years as constant threats to blood transfusion recipients, given the high occurrence of asymptomatic cases and the fact that the presence of viremia precedes the onset of symptoms, making it possible that infected blood from donors act as a source of dissemination. This work aims to identify the prevalence of dengue virus (DENV), Zika virus (ZIKV) and Chikungunya virus (CHIKV) infection in blood donors during epidemic and non-epidemic periods; classify the donor as symptomatic or asymptomatic; and verify the need to include DENV, CHIKV and ZIKV in the nucleic acid test (NAT) platform in northern Brazil. We investigated 36,133 thousand donations in two years of collection in Northern Brazil. One donor was positive for DENV and one for CHIKV (0.002% prevalence). As the prevalence for arboviruses was low in this study, it would not justify the individual screening of samples from donors in a blood bank. Thus, DENV- and CHIKV-positive samples were simulated in different amounts of sample pools, and both were safely detected by molecular biology even in a pool of 14 samples, which would meet the need to include these three viruses in the routine of blood centers in endemic countries such as Brazil