Publications by authors named "Francisco Hideo Aoki"

10 Publications

  • Page 1 of 1

A prospective, multicentre, cohort study to assess the incidence of dengue illness in households from selected communities in Brazil (2014-2018).

Int J Infect Dis 2021 Apr 21;108:443-453. Epub 2021 Apr 21.

Instituto de Tecnologia em Imunobiológicos Bio-Manguinhos/Fiocruz, Avenida Brasil 4.365, Manguinhos, Rio de Janeiro - RJ, 21.040-900, Brazil.

Objectives: To estimate the incidence of dengue infection across geographically distinct areas of Brazil.

Methods: This prospective, household-based, cohort study enrolled participants in five areas and followed them up for up to 4 years (2014-2018). Dengue seroprevalence was assessed at each scheduled visit. Suspected dengue cases were identified through enhanced passive and active surveillance. Acute symptomatic dengue infection was confirmed through reverse-transcriptase quantitative polymerase chain reaction in combination with an antigenic assay (non-structural protein 1) and serology.

Results: Among 3300 participants enrolled, baseline seroprevalence was 76.2%, although only 23.3% of participants reported a history of dengue. Of 1284 suspected symptomatic dengue cases detected, 50 (3.9%) were laboratory-confirmed. Based on 8166.5 person-years (PY) of follow-up, the incidence of laboratory-confirmed symptomatic infection (primary endpoint) was 6.1 per 1000 PY (95% confidence interval [CI]: 4.5, 8.1). Incidence varied substantially in different years (1.8-7.4 per 1000 PY). The incidence of inapparent primary dengue infection was substantially higher: 41.7 per 1000 PY (95% CI: 31.1, 54.6).

Conclusions: Our findings, highlighting that the incidence of dengue infection is underestimated in Brazil, will inform the design and implementation of future dengue vaccine trials.

Clinical Trial Registration: NCT01751139.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.ijid.2021.04.062DOI Listing
April 2021

Bartonella henselae endocarditis in an elderly patient.

PLoS Negl Trop Dis 2020 07 30;14(7):e0008376. Epub 2020 Jul 30.

Applied Research in Dermatology and Bartonella Infection Laboratory, University of Campinas (UNICAMP) Medical School, Campinas, Sao Paulo, Brazil.

View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1371/journal.pntd.0008376DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7392202PMC
July 2020

Knowledge and compliance as factors associated with needlestick injuries contaminated with biological material: Brazil and Colombia.

Cien Saude Colet 2020 Feb 5;25(2):715-727. Epub 2018 Jul 5.

Departamento de Saúde Coletiva, Universidade de Brasília. Brasília, DF, Brasil.

This was a cross-sectional study to start a cohort in two University Hospitals of two countries - Brazil and Colombia - for assessing the prevalence of needlestick and sharps injuries (NSI), the level of compliance with standard precautions (SPs), and knowledge on blood borne pathogens and associated factors among health students and professionals, within the framework of the implementation of the NR-32 standard. We created compliance scales based on 12 and 10 questions, for assessing knowledge. We used the Multinomial Poisson-Tweedie Regression to evaluate the relationship between knowledge and compliance with SPs within NSI. We evaluated 965 individuals (348 students and 614 professionals). The mean score points for level of knowledge was 10.98, with a median of 11 (10; 12) and α-Cr of 0,625. Compliance with SP had a mean of 30.74 and median of 31 (28; 34), with a α-Cr coefficient of 0.745, associated with country, group (student) and risk perception. Among the factors associated with the report of NSI, we singled out knowledge and compliance, country of origin, and full vaccination scheme against the Hepatitis B virus. We concluded that the level of knowledge and compliance were adequate among participants, but better among Brazilian participants, and it was associated with NSI reporting.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1590/1413-81232020252.04812018DOI Listing
February 2020

Occupational Exposure to Potentially Infectious Biological Material Among Physicians, Dentists, and Nurses at a University.

Saf Health Work 2019 Dec 2;10(4):445-451. Epub 2019 Aug 2.

Faculty of Dentistry of Piracicaba, State University of Campinas, Campinas, Brazil.

Objective: The objective of this study was to evaluate the prevalence and incidence of accidents with biological material, the level of knowledge, and compliance to standard precautions (SPs) among dentists, physicians, nurses, and dental and medical students.

Methods: A closed cohort study with a prospective and retrospective component was conducted between August 2014 and September 2015. The participants were contacted in two moments during the follow-up period, during which a structured questionnaire divided into six sections was used; the interviews were conducted during the follow-up period (Month 6) and at the end of the observation period (Month 12).

Results: The global prevalence of accidents in the previous 12 months was 10.2%, with a difference between professionals and students (13.0% vs. 5.1%, respectively;  0.003). The incidence rate was 6.49 per 100 person/year, with difference between the groups (6.09 per 100 person/year in professionals and 7.26 per 100 person/year in students), type of specialization (hazard ratio, 3.27), and hours worked per week (hazard ratio, 2.27). The mean of compliance to SP was 31.99 (±3.85) points, with a median of 33 (30, 35) points against the expected 27.75 points. Adherence to SP was associated with the accident report ( < 0.020).

Conclusion: We conclude that the proportion/incidence rate of accidents with biological material was high in relation to that in the literature, being higher in professionals and especially among physicians. The levels of knowledge and adherence to SP were good, with the best found in dentists and dental students.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.shaw.2019.07.005DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6933159PMC
December 2019

Bartonella henselae bacteremia diagnosed post-mortem in a myelodysplastic syndrome patient.

Rev Inst Med Trop Sao Paulo 2019 Sep 12;61:e50. Epub 2019 Sep 12.

Universidade Estadual de Campinas, Faculdade de Ciências Médicas, Campinas, São Paulo, Brazil.

This study involves a 49-year-old male, who for three years suffered with a myelodysplastic syndrome and who needed frequent blood transfusions. One day following a transfusion, he presented fever and abdominal pain. The fever became persistent and only improved temporarily with two cycles of intravenous ciprofloxacin. Nearly 120 days after beginning the second cycle of treatment, he had experienced a weight loss of 16 kg and recurring fever. Screening for fever of unknown origin was conducted, including Bartonella infection. No etiology could be found. The patient improved with an antimicrobial regimen composed of oral doxycycline and intravenous ciprofloxacin. After 15 days afebrile, the patient was discharged with a four-month oral prescription of doxycycline and ciprofloxacin. Eight months following the antibiotic treatment, the patient received an allogeneic bone marrow transplant. Five days following the transplant, the patient initiated a febrile neutropenia and died. From a blood sample collected and stored at the time of hospitalization, a microbiological and molecular study was performed again. Blood- and liquid culture-PCRs from the same blood sample were all negative, but an isolate from solid subculture was found. The molecular reactions from this isolate were all positive and the sequence was 100% homologous to Bartonella henselae . The present report points to the limitations of laboratory techniques currently available for investigation of possible cases of bartonellosis in clinical practice, and the potential risk of Bartonella spp. transmission through blood transfusions.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1590/S1678-9946201961050DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6746197PMC
September 2019

Cost-utility analysis of outpatient parenteral antimicrobial therapy (OPAT) in the Brazilian national health system.

Expert Rev Pharmacoecon Outcomes Res 2019 Jun 5;19(3):341-352. Epub 2018 Nov 5.

a Hospital Epidemiology Department and Health Technology Assessment Department , Clinical Hospital of State University of Campinas , Campinas , Brazil.

Background: Outpatient parenteral antimicrobial therapy (OPAT) has been used for decades in different countries to reduce hospitalization rates, with favorable clinical and economic outcomes. This study assesses the cost-utility of OPAT compared to inpatient parenteral antimicrobial therapy (IPAT) from the perspective of a public university hospital and the Brazilian National Health System (Unified Health System -SUS).

Methods: Prospective study with adult patients undergoing OPAT at an infusion center, compared to IPAT. Clinical outcomes and quality-adjusted life year (QALY) were assessed, as well as a micro-costing. Cost-utility analysis from the hospital and SUS perspectives were conducted by means of a decision tree, within a 30-day horizon time.

Results: Forty cases of OPAT (1112 days) were included and monitored, with a favorable outcome in 97.50%. OPAT compared to IPAT generated overall savings of 31.86% from the hospital perspective and 26.53% from the SUS perspective. The intervention reduced costs, with an incremental cost-utility ratio of -44,395.68/QALY for the hospital and -48,466.70/QALY for the SUS, with better cost-utility for treatment times greater than 14 days. Sensitivity analysis confirmed the stability of the model.

Conclusion: Our economic assessment demonstrated that, in the Brazilian context, OPAT is a cost-saving strategy both for hospitals and for the SUS.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1080/14737167.2019.1541404DOI Listing
June 2019

Development of a Multiplex PCR Test with Automated Genotyping Targeting E7 for Detection of Six High-Risk Human Papillomaviruses.

PLoS One 2015 18;10(6):e0130226. Epub 2015 Jun 18.

Department of Obstetrics and Gynecology, Faculty of Medical Sciences, University of Campinas (UNICAMP), Campinas, Sao Paulo, Brazil.

Cervical cancer is caused by high-risk human papillomaviruses (HPV) and viral detection tests aid in the diagnosis of precursor lesions. In the present study, a molecular test for detection of high-risk HPV DNA, called E7-HPV, was standardized and assessed in samples from women with pre-cancerous lesions. The development of the E7-HPV test for detection and genotyping of six high-risk HPV (types 16, 18, 31, 33, 45 and 52), consisted of evaluating primer quality and adjusting the multiplex PCR conditions. Primer design was based on the E7 region of each HPV, and the fluorochrome 6-FAM was added to PCR primers. Viral detection was performed by capillary electrophoresis in automated sequencer in samples obtained from 60 women (55 with ASC-H/HSIL cytology) from August to September 2013. A non-inferiority analysis was conducted with the cobas HPV test as a reference and following international guidelines for the development of new tests. The two tests had a high concordance rate in HPV16 detection (kappa=0.972), with only one discordant case (cervical intraepithelial neoplasia grade 3, negative with cobas and positive for HPV16 by E7-HPV) and complete agreement in HPV18 detection. When comparing detection of all high-risk HPV, three cases were positive with cobas but negative with E7-HPV, and another three cases were negative with cobas but positive with E7-HPV (HPV16, 31 and 52). When we evaluate the cases initially suspected by cytology, the two tests had the same sensitivity in detection CIN2 or worse. In conclusion, the E7-HPV test has satisfactory initial results, and its development can be continued.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0130226PLOS
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4472756PMC
April 2016

[Knowledge of and compliance with universal precautions: students dealing with biohazards in Brazil and Colombia].

Rev Salud Publica (Bogota) 2015 May;17(3):429-442

Universidade Estadual de Campinas, Brasil.

Objective To assess scales of adherence to universal precautions and means of knowledge transmission among healthcare students in Brazil and Colombia. Methods We conducted a pilot study to validate the questionnaire that started a cohort study. Twenty-six students in Colombia and 25 in Brazil were intentionally selected. The participants were comparable in number and sociodemographic characteristics in both countries and studied the health professions (medicine, nursing and dentistry). The program SPSS version 18.0 was used to create the database and to carry out statistical analysis. Results We evaluated a total of 51 students. They had a a mean (SD) age of 21.78 (2.33), 84.3 % were women, 66.7 % had white skin, 47.1 % were medical students, and 70,6 % were in their 4th year. They answered about sexual habits reporting that 45.1 had only one partner% in the last year, 23.5 % did not use protection, and, of those who were protected, 45.1 % used a condom. The mean knowledge was 10.88 (±0.952) points to an expected 9 points; Cronbach's Alpha (α) was 0.823. The mean adherence to universal precautions (UPs) was 33.69 (±3.36) points to an expected 30.75; α was 0.741. We found a significant difference in knowledge levels (p<0.007) between the two countries and in the adherence to PUs by year of study (p<0.001). Conclusions Knowledge about means of transmission was good. Adherence to universal precautions was acceptable, but low in terms of the use of glasses, face masks, and discarding sharp objects. Dentistry students showed the best adherence.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.15446/rsap.v17n3.44907DOI Listing
May 2015

[Fatal evolution of Chagas'disease/Aids co-infection: diagnostic difficulties between myocarditis reactivation and chronic chagasic myocardiopathy].

Rev Soc Bras Med Trop 2009 Mar-Apr;42(2):199-202

Departamento de Clínica Médica, Faculdade de Ciências Médicas, Universidade Estadual de Campinas, Campinas, SP.

Chagas disease is a type of parasitosis caused by the protozoan Trypanosoma cruzi, and it is transmitted by triatomine insects. This disease is found between the southern United States to Argentina and approximately 14 million people in Latin America are believed to be infected, predominantly with the chronic form of the disease. Reactivation of Chagas disease can occur among immunosuppressed patients, as has been observed among AIDS patients. In one such case, we observed cardiac decompensation with severe ventricular dysfunction and arrhythmias. This case was thought to be reactivation of Chagas disease in the myocardium, since the xenodiagnosis was positive. Specific treatment for Trypanosoma cruzi was administered, consisting of benznidazole, but the course of treatment was not completed because the patient died due to cardiopathic complications. The necropsy showed the usual stigmas of chronic Chagas cardiopathy, such as fibrosing myocarditis and a decreased number of neurons in the digestive system. There were no amastigote forms of Trypanosoma cruzi in any of the tissue samples studied. Therefore, reactivation of Chagas disease was not demonstrated but, rather, the natural evolution of chronic Chagas cardiopathy was demonstrated.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1590/s0037-86822009000200021DOI Listing
July 2009

Viral hepatitis in patients infected with human immunodeficiency virus.

Braz J Infect Dis 2003 Aug;7(4):253-61

Faculty of Medecine, UNICAMP, São Paulo, Campinas, Brazil.

From 1992 to 1995 we studied 232 (69% male, 87% Caucasian) anti-human immunodeficiency virus (anti-HIV) positive Brazilian patients, through a questionnaire; HIV had been acquired sexually by 50%, from blood by 32%, sexually and/or from blood by 16.4% and by an unknown route by 1.7%. Intravenous drug use was reported by 29%; it was the most important risk factor for HIV transmission. The alanine aminotransferase quotient (qALT) was >1 for 40% of the patients, 93.6% had anti-hepatitis A virus antibody, 5.3% presented hepatitis B surface antigen, 44% were anti-hepatitis B core antigen positive and 53.8% were anti-hepatitis C virus (anti-HCV) positive. The anti-HCV test showed a significant association with qALT>1. Patients for whom the probable HIV transmission route was blood had a 10.8 times greater risk of being anti-HCV positive than patients infected by other routes. Among 30 patients submitted to liver biopsy, 18 presented chronic hepatitis.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1590/s1413-86702003000400005DOI Listing
August 2003