Analysis of the Spatial Distribution of New Cases of Leprosy in the State of Pernambuco, Northeast Brazil Celivane Cavalcanti Barbosa, Gilberto Silva Nunes Bezerra, Amanda Tavares Xavier, André Luiz Sá de Oliveira, Marcílio Sandro de Medeiros, et al. Tropical Medicine and Infectious Disease, 2025 Spatial analysis of leprosy case distribution serves as a critical tool for identifying priority areas for intervention, particularly in settings with marked epidemiological heterogeneity. This study aimed to analyze the spatial distribution of new leprosy cases in Pernambuco, Brazil, 2000–2024. This is an ecological study with the municipalities of residence as the units of analysis. The data was extracted from the Notifiable Diseases Information System. The average incidence rates were calculated: general, in children under 15 years of age and with grade 2 physical disability at diagnosis, for four five-year periods. Bayesian smoothing and Moran’s global and local autocorrelation statistics were applied. The average rates of overall detection were 29.0/100,000 inhabitants per year (very high); in children under 15 years of age, 10.7/100,000 inhabitants per year (hyperendemic); and grade 2 physical disability, 1.6/100,000 inhabitants per year (low). Spatial analysis showed significant spatial heterogeneity, with clusters of high overall detection rates of leprosy cases, high detection rates among children under 15, and high rates of grade 2 physical disability at diagnosis, mainly in macro-regions I and IV. There is circulation of Mycobacterium leprae across all macro-regions of the state, with evidence of active transmission foci in macro-region III. Therefore, municipalities with a priority for intervention are concentrated in macro-regions I and IV, highlighting the need to strengthen leprosy surveillance and control actions in the state.
Sepsis Prediction: Biomarkers Combined in a Bayesian Approach João V. B. Cabral, Maria M. B. M. da Silveira, Wilma T. F. Vasconcelos, Amanda T. Xavier, Fábio H. P. C. de Oliveira, et al. International Journal of Molecular Sciences, 2025 Sepsis is a serious public health problem. sTREM-1 is a marker of inflammatory and infectious processes that has the potential to become a useful tool for predicting the evolution of sepsis. A prediction model for sepsis was constructed by combining sTREM-1, CRP, and a leukogram via a Bayesian network. A translational study carried out with 32 children with congenital heart disease who had undergone surgical correction at a public referral hospital in Northeast Brazil. In the postoperative period, the mean value of sTREM-1 was greater among patients diagnosed with sepsis than among those not diagnosed with sepsis (394.58 pg/mL versus 239.93 pg/mL, p < 0.001). Analysis of the ROC curve for sTREM-1 and sepsis revealed that the area under the curve was 0.761, with a 95% CI (0.587–0.935) and p = 0.013. With the Bayesian model, we found that a 100% probability of sepsis was related to postoperative blood concentrations of CRP above 71 mg/dL, a leukogram above 14,000 cells/μL, and sTREM-1 concentrations above the cutoff point (283.53 pg/mL). The proposed model using the Bayesian network approach with the combination of CRP, leukocyte count, and postoperative sTREM-1 showed promise for the diagnosis of sepsis.
Culex quinquefasciatus Density Associated with Socioenvironmental Conditions in a Municipality with Indeterminate Transmission of Lymphatic Filariasis in Northeastern Brazil Amanda Xavier, Cristine Bonfim, Pablo Cantalice, Walter Barbosa Júnior, Filipe Santana da Silva, et al. Pathogens, 2024 Lymphatic filariasis (LF) is a neglected tropical disease associated with poverty and poor environmental conditions. With the inclusion of vector control activities in LF surveillance actions, there is a need to develop simple methods to identify areas with higher mosquito density and thus a higher consequent risk of W. bancrofti transmission. An ecological study was conducted in Igarassu, which is in the metropolitan region of Recife, Pernambuco, Brazil. The mosquitoes were captured in 2060 houses distributed across 117 census tracts. The vector density index (VDI), which measures the average number of lymphatic-filariasis-transmitting mosquitoes per number of houses collected in the risk stratum, was constructed. Moreover, the social deprivation indicator (SDI) was constructed and calculated through principal component factor analysis. An average of 242 female C. quinquefasciatus were found in the high-risk stratum, while the average in the low-risk stratum was 108. The overall VDI was 6.8 mosquitoes per household. The VDI for the high-risk stratum was 13.2 mosquitoes per household, while for the low/medium-risk stratum, it was 5.2. This study offers an SDI for the density of C. quinquefasciatus mosquitoes, which can help reduce the costs associated with data collection and allows for identifying priority areas for vector control actions.
Trigger receptor expressed in myeloid cell type-1 (TREM-1) as a biomarker of systemic inflammatory response syndrome (SIRS) in pediatrics João Victor Batista Cabral, Thaysa Maria Gama Albuquerque Leão de Menezes, Maria Mariana Barros Melo da Silveira, Amanda Tavares Xavier, Leuridan Cavalcante Torres, et al. Medicina Brazil, 2024 Objective: to determine the validity of TREM-1 as a SIRS biomarker in pediatric patients. Method:systematic review, according to PRISMA, of studies published until October 2022 indexed in the VHL, Cochrane Library, PubMed/MEDLINE and Science Direct databases. The search strategy included the descriptors: TREM-1; SIRS; Child; Biomarker. Registration number PROSPERO CRD: 42022381838. Results: four studies comprising 2.353 patients aged 11 months to 18 years were included, with SIRS being present in 75% of these. Cutoff values ranged from 18.7 pg/mL to > 629 pg/mL. The results support a role for TREM-1 as a diagnostic tool for pediatric SIRS, but cannot be considered conclusive as a quantitative synthesis was not possible due to heterogeneity in study design. Conclusion: we conclude a potential use of TREM-1 in the pediatric population, specifically for the diagnosis of SIRS, with a good perspective in cardiac surgerythrough its elevation after surgery. However, it was not possible to establish a cut-off point, but rather to determine the possibility of its use for stratifying mortality risk, compared to baseline values, when the patient has SIRS.
Socio-Environmental Risk Indicator: A Possible Tool for Surveillance of Lymphatic Filariasis Iranian Journal of Parasitology, 2023
Systematic Review of Survival Analysis in Leprosy Studies—Including the Following Outcomes: Relapse, Impairment of Nerve Function, Reactions and Physical Disability Celivane Cavalcanti Barbosa, Gilberto Silva Nunes Bezerra, Amanda Tavares Xavier, Maria de Fátima Pessoa Militão de Albuquerque, Cristine Vieira do Bonfim, et al. International Journal of Environmental Research and Public Health, 2022 Leprosy is a public health problem in South American, African and Oceanian countries. National programs need to be evaluated, and the survival analysis model can aid in the construction of new indicators. The aim of this study was to assess the period of time until the outcomes of interest for patients with or exposed to leprosy by means of survival analysis surveys. This review researched articles using the databases of PubMed, Science Direct, Scopus, Scielo and BVS published in English and Portuguese. Twenty-eight articles from Brazil, India, Bangladesh, the Philippines and Indonesia were included. The Kaplan–Meier method, which derives the log-rank test, and Cox’s proportional hazards regression, which obtains the hazard ratio, were applied. The mean follow-up until the following outcomes were: (I) leprosy (2.3 years) in the population who were exposed to it, (II) relapse (5.9 years), (III) clinical manifestations before, during and after treatment—nerve function impairment (5.2 years), leprosy reactions (4.9 years) and physical disability (8.3 years) in the population of patients with leprosy. Therefore, the use of survival analysis will enable the evaluation of national leprosy programs and assist in the decision-making process to face public health problems.
Lymphatic filariasis: A systematic review on morbidity and its repercussions in countries in the americas Zulma M. Medeiros, Amanda V. B. Vieira, Amanda T. Xavier, Gilberto S. N. Bezerra, Maria de Fátima C. Lopes, et al. International Journal of Environmental Research and Public Health, 2022 The Global Program to Eliminate Lymphatic Filariasis (GPELF) is a program that aims to eliminate lymphatic filariasis by 2030. The GPELF strategy is based on interrupting transmission using mass drug administration (MDA) and, in parallel, managing morbidity cases. However, it has been seen that there is a shortage of research in the literature and public policies regarding this last pillar. In this study, we reviewed the literature and available information regarding the burden of filarial morbidity. In addition, we identified that in the Americas, the implementation of structured services with regard to morbidity assistance in the Americas was scarce. We formed a review that aimed to assess the pathogenesis, epidemiology, repercussions, and treatment of filarial morbidity in countries in the Americas where lymphatic filariasis is endemic. Structured searches were carried out on PubMed, LILACS, Scopus, and Web of Science databases without time and language restrictions. Three reviewers evaluated the 2150 studies and performed data extraction, and quality assessment by assigning scores to the studies found. The current literature and available information on the burden of filarial morbidity, as well as the implementation of structured services with regard to morbidity assistance in the Americas, were all found to be scarce. Now that this knowledge gap has been identified, both health services and researchers need to seek the implementation and enhancement of the maintenance of GPELF strategies that relate to the morbidity pillar.
Influence of social and environmental factors for Culex quinquefasciatus distribution in Northeastern Brazil: a risk index Amanda Xavier, Cristine Bonfim, Walter Barbosa Júnior, Gilberto Bezerra, Claudia Oliveira, et al. International Journal of Environmental Health Research, 2022 Culex quinquefasciatus is a vector of lymphatic filariasis. One important component in planning filariasis control activities is the mapping of vector distribution. A tool that involves socio-environmental factors and Cx. quinquefasciatus density can contribute to the identification of areas that should be prioritized in surveillance actions. This is an ecological study based on the construction and validation of a risk score of urban areas according to social and environmental variables extracted from a national database. Based on this stratification, female Cx. quinquefasciatus were captured. In total, 30,635 Cx. quinquefasciatus were captured, of which 17,161 (56%) were females. The highest vector density index of mosquitoes were captured in households located in the high-risk stratum and the indicator proved to be a tool that identified an association between social and environmental conditions and areas with the highest vector density index of females Cx. quinquefasciatus.
