Browsing by Author "Brum, Laura"
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- Environment and Health in Children Day Care CentresPublication . Neuparth, Nuno; Papoila, Ana Luísa; Aelenei, Daniel; Cano, Manuela; Paixão, Paulo; Viegas, João; Martins, Pedro; Araújo Martins, José; Leiria Pinto, Paula; Caires, Iolanda; Pedro, Catarina; Nogueira, Susana; Mendes, Ana; Aguiar, Fátima; Teixeira, João Paulo; Proença, Carmo; Piedade, Cátia; Santos, Madalena; Silvestre, Maria José; Brum, Laura; Nunes, Baltazar; Guiomar, Raquel; Curran, Martin D.; Carvalho, Ana; Marques, Teresa; Virella, Daniel; Alves, Marta; Marques, João; Rosado-Pinto, José; Neuparth, Nuno; Aelenei,Daniel; Caires, Iolanda; Teixeira, João Paulo; Viegas, João; Cano, Manuela; Pinto, Paula LeiriaThis project addresses a set of common clinical problems in the context of children attending day care centres. It is common sense that children get sick more often as soon as they start attending a day care centre on a daily basis and this is particularly true for some groups at risk, as wheezing infants and wheezing pre-school children. Concerning this, some questions remain unclear: 1. The role of indoor air quality - what is the health impact of indoor air environment (including indoor pollutants, house dust mite, temperature and humidity) in wheezing children? 2. The role of virus infections - We don’t know the real role of virus infections in respiratory conditions at day care centre level. There is a lack of information concerning how indoor air environment influence virus infections. 3. The role of building ventilation - what is the impact of building ventilation in the health of wheezing and non-wheezing children? How is ventilation affecting indoor air quality? How is ventilation of day care centres affected by the structure of the buildings? 4. Social impact of this study - what should be the recommendations to improve IAQ? What is new in this project is the collaboration of a health team (medical doctors and other health professionals) with environment specialists, mechanical, civil engineers, epidemiologists and statisticians.
- Using genomics to understand the origin and dispersion of multidrug and extensively drug resistant tuberculosis in PortugalPublication . Perdigão, João; Gomes, Pedro; Miranda, Anabela; Maltez, Fernando; Machado, Diana; Silva, Carla; Phelan, Jody E.; Brum, Laura; Campino, Susana; Couto, Isabel; Viveiros, Miguel; Clark, Taane G.; Portugal, IsabelPortugal is a low incidence country for tuberculosis (TB) disease. Now figuring among TB low incidence countries, it has since the 1990s reported multidrug resistant and extensively drug resistant (XDR) TB cases, driven predominantly by two strain-types: Lisboa3 and Q1. This study describes the largest characterization of the evolutionary trajectory of M/XDR-TB strains in Portugal, spanning a time-period of two decades. By combining whole-genome sequencing and phenotypic susceptibility data for 207 isolates, we report the geospatial patterns of drug resistant TB, particularly the dispersion of Lisboa3 and Q1 clades, which underly 64.2% and 94.0% of all MDR-TB and XDR-TB isolates, respectively. Genomic-based similarity and a phylogenetic analysis revealed multiple clusters (n = 16) reflecting ongoing and uncontrolled recent transmission of M/XDR-TB, predominantly associated with the Lisboa3 and Q1 clades. These clades are now thought to be evolving in a polycentric mode across multiple geographical districts. The inferred evolutionary history is compatible with MDR- and XDR-TB originating in Portugal in the 70's and 80's, respectively, but with subsequent multiple emergence events of MDR and XDR-TB particularly involving the Lisboa3 clade. A SNP barcode was defined for Lisboa3 and Q1 and comparison with a phylogeny of global strain-types (n = 28 385) revealed the presence of Lisboa3 and Q1 strains in Europe, South America and Africa. In summary, Portugal displays an unusual and unique epidemiological setting shaped by >40 years of uncontrolled circulation of two main phylogenetic clades, leading to a sympatric evolutionary trajectory towards XDR-TB with the potential for global reach.