Browsing by Author "Miranda, A."
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- Efeito da congelação e armazenamento de amostras de plasma na estabilidade de ensaios de coagulação - Tempo de Protrombina (PT) e Tempo de Tromboplastina Parcial Ativado (APTT)Publication . Botelho, M.C.; Magalhães, M.C.; Miranda, A.; Bourbon, M.; Vicente, A.M.
- Tuberculosis in a child - search for the infected adult nearby; case report, Portugal, 2007Publication . Duarte, R.; Tavares, E.; Miranda, A.; Carvalho, A.Tuberculosis (TB) transmission in a non-household setting is difficult to detect, because contact with the source case is often not obvious. Here, we report on a case of a four-year-old child who got infected through sporadic non-household exposure at a coffee shop. The source case was a woman who had suffered from weight loss, productive cough and fatigue for two months before being diagnosed with TB. Screening the child s contacts revealed two active TB cases within its family. Overall 148 contacts were screened for both cases and 18 cases of latent TB infection detected. The connection between the child and the source case, who were not aware of their contact, was confirmed by molecular fingerprinting. Our case report illustrates the difficulty in detecting non-household transmission between individuals that do not have significant contact, and draws attention to the need to look for the infected adult whenever a child falls ill with TB. This report is a reminder of the importance to consider possibly neglected ways of TB transmission and highlights once again the need of early diagnosis of TB.
- Tuberculosis in a shopping centre, Portugal, 2004-5Publication . Duarte, R.; Miranda, A.; Braga, R.; Carvalho, A.; Rola, J.; Marques, A.; Barros, H.Genotyping enables to confirm or exclude a tuberculosis (TB) cluster. Excluding the link between cases is particularly important in countries with intermediate/high incidence of TB where the emergence of several TB cases in a particular location in space or time (higher than the expected) could be explained by chance alone. During 2004 and 2005, five TB cases occurred in five shops of a Portuguese shopping centre which employed a total of about 1000 workers. After an epidemiological survey, 52 close contacts were identified and screened. Latent tuberculosis infection was diagnosed in 10 contacts (eight family members and two work colleagues of cases). Genotyping of the Mycobacterium tuberculosis isolates revealed no link between the cases. For this reason no screening of all staff of the shopping centre was carried out. However, close contacts (52) and all fellow workers (1000) were kept under surveillance for two years, and no additional cases were diagnosed. The present analysis demonstrates that the exclusion of a chain of ongoing transmission by genotyping for the investigation of a cluster is cost-effective from the perspective of the public health service, because it allows to avoid unnecessary large scale screening operation and instead to direct resources to more effective measures of TB control.