Browsing by Author "Soares, Patricia"
Now showing 1 - 10 of 19
Results Per Page
Sort Options
- Adapting to COVID-19: Insights from Portuguese residents' home-based lifePublication . Aguiar, Ana; Soares, Patricia; Barbosa, Pedro; Duarte, Raquel; Pinto, MartaBackground: The COVID-19 pandemic led to widespread lockdowns and remote work and educational practices that have impacted the lives of many families. Objective: We aimed to investigate how parents and caregivers altered their routines due to online schooling and teleworking, exploring their association with increased anxiety and depression symptoms. Methods: We conducted an online cross-sectional study and collected data through snowball sampling. We asked questions about age, gender, dwelling area, educational level, and marital status, as well as an open-ended question about teleworking and homeschooling - "Did your routine change due to your children being forced to stay home and take online classes? If so, please explain how it has influenced your personal and professional life, both positively and negatively". Thematic analysis was used to analyse the responses. Results: A total of 181 respondents, primarily women (72.4%), averaging 36.6 years old, holding bachelor's degrees (44.2%), were included. About 78.5% reported routine adjustments. Four salient themes emerged: 1) Perceived changes in professional and personal life, 2) Perceived changes in learning methods, 3) Mental health issues and 4) Perceived advantages of working from home with children at online school. Regarding mental health, 25.4% exhibited symptoms of anxiety, and 7.7% displayed depression symptoms, predominantly linked (80%) to the pandemic's impact. Conclusion: Family routines were disrupted, causing stress. In future crises, policymakers, public health experts, and researchers must acknowledge these challenges to mitigate negative consequences. Simultaneously, they should focus on strategies that enhance the positive aspects of restrictive measures and related policies.
- Association between the adrenoreceptor β2 gene and pediatric asthma severity – a study of the PACMAN cohortPublication . Caleiro, Maria Leonor; Soares, Patricia; Antunes, Marilia"Pharmacogenetics of Asthma medication in Children: Medication with Anti-Inflammatory effects" (PACMAN) is an observational retrospective pharmacy-based study carried out in 2009, in the Netherlands, aiming to investigate the effects of genetic variation on treatment response to asthma medication in children and to identify (profiles of) SNPs that characterize response phenotypes. Data on respiratory symptoms and medication use, including medication type and amount, was collected from pharmaceutical records of asthmatic children and data on the children’s sex, age, genetic traits, and ethnicity. We aimed to assess the association between asthma severity and the Arg16Glu polymorphism of the β2 adrenoreceptor gene (ADRB2). This gene is expressed in bronchial muscle cells, which is involved in the physiological response of the airway response and has been associated with clinical drug response and asthma exacerbations. We used the PACMAN data and considered the dispensing of oral corticosteroid prescriptions as a proxy of the disease severity since corticoids are commonly used in uncontrolled asthmatic states (exacerbations). We considered two different genetic models – additive and genotypic, which can be translated for analysis purposes into a numeric format, corresponding to the number of copies of the minor allele, and categorical (each genotype representing a category), respectively. We used models of the class of the Generalized Linear Mixed Models for count data with excess of zeros, namely zero-inflated and hurdle models, considering a Negative Binomial distribution to account for overdispersion. Both models included the polymorphism in the zero and count components and were adjusted for children’s baseline characteristics. In both approaches to deal with the excess of zeros, a significant effect of the polymorphism was found only in the binary component of the models. In the count component, only sex and age showed a significant effect. This points towards the existence of an effect of the polymorphism in the presence of asthma exacerbations, with not shown effect in the frequency of OCS prescription.
- Avaliação de conhecimentos, atitudes e práticas em relação a mosquitos enquanto vetores de doença numa comunidade estudantil em LisboaPublication . Simplício, Leonor; Soares, Patricia; Anjos, João; Almeida-Silva, Marina; Osório, HugoIntrodução: Os agentes infeciosos transmitidos por mosquitos vetores que provocam doenças como o dengue, Zika ou chikungunya são uma ameaça à saúde pública. Os mosquitos das espécies Aedes aegypti e Ae. albopictus são atualmente os principais vetores e responsáveis por surtos na região europeia (WHO, 2020). Torna-se crucial avaliar o conhecimento, atitudes e práticas em relação aos mosquitos e às doenças associadas, de modo a aumentar a adesão da população às medidas de controlo. Alguns exemplos destas medidas são a eliminação de criadouros domésticos, o uso de inseticidas e a aplicação da Técnica do Inseto Estéril (SIT), que consiste num método de controlo biológico com a aplicação de insetos machos estéreis em áreas alvo de intervenção, com o objetivo de suprimir a população (IAEA, 2023). Objetivos: Avaliar os conhecimentos, atitudes e práticas em relação aos mosquitos vetores, doenças associadas e medidas de controlo numa comunidade estudantil em Lisboa. Metodologia: Foi desenvolvido um questionário com recurso à ferramenta Google Forms e dividido em quatro secções: 1. Perceção sobre mosquitos na zona de residência, 2. Avaliação do conhecimento sobre mosquitos, 3. Prevenção individual e controlo vetorial e 4. Dados do participante. Este questionário foi aplicado à população alvo de uma escola de ensino superior localizada em Lisboa e divulgado em 2021 internamente via email, tendo ficado disponível à participação durante todo o mês de março. Posteriormente, foi feita uma análise descritiva dos resultados através da determinação da frequência absoluta e relativa. Resultados: Obteve-se um total de 140 questionários completos, dos quais 81% dos participantes correspondiam ao género feminino e 73% tinha uma idade inferior a 25 anos. Verificou-se que apenas duas pessoas acertaram todas as questões de conhecimento. Em relação à questão da técnica SIT, 86% dos participantes desconheciam esta técnica, contudo, 73% concorda totalmente com a sua aplicação. Apenas 13 participantes identificam que são os mosquitos do género feminino que picam e conhecem a técnica SIT e apenas um destes 13 participantes não concorda com a aplicação desta técnica. Em relação às práticas verificou-se que 16% dos participantes adotam medidas de proteção individual contra mosquitos e medidas de controlo nas suas residências e que cinco destes não considera estas medidas suficientes e eficazes. Outro resultado foi o facto de 7,1% dos participantes afirmarem extrema preocupação pelos mosquitos transmitirem doenças, contudo apenas cinco adotam medidas de proteção tanto individual como de controlo. Em relação ao nível de incomodidade, 89% dos participantes não sente qualquer incómodo em relação aos mosquitos e 25% dos participantes que sentem desconforto alteram as suas atividades ao ar livre. Conclusão: Os resultados evidenciam a importância de manter a população informada e de a integrar em atividades que visem o aumento do conhecimento em relação aos vetores e às doenças associadas, uma vez que um elevado número das doenças transmitidas por vetores pode ser evitável através de medidas de proteção e mobilização da comunidade (WHO, 2020).
- COVID-19 vaccine effectiveness in the paediatric population aged 5-17 years: a multicentre cohort study using electronic health registries in six European countries, 2021 to 2022Publication . Soares, Patricia; Machado, Ausenda; Nicolay, Nathalie; Monge, Susana; Sacco, Chiara; Hansen, Christian Holm; Meijerink, Hinta; Martínez-Baz, Iván; Schmitz, Susanne; Humphreys, James; Fabiani, Massimo; Echeverria, Aitziber; AlKerwi, Ala'a; Nardone, Anthony; Mateo-Urdiales, Alberto; Castilla, Jesús; Kissling, Esther; Nunes, Baltazar; VEBIS-Lot 4 working groupBackground: During the first year of the COVID-19 pandemic, vaccination programmes targeted children and adolescents to prevent severe outcomes of SARS-CoV-2 infection. Aim: To estimate COVID-19 vaccine effectiveness (VE) against hospitalisation due to COVID-19 in the paediatric population, among those with and without previously documented SARS-CoV-2 infection. Methods: We established a fixed cohort followed for 12 months in Denmark, Norway, Italy, Luxembourg, Navarre (Spain) and Portugal using routine electronic health registries. The study commenced with paediatric COVID-19 vaccination campaign at each site between June 2021 and January 2022. The outcome was hospitalisation with a laboratory-confirmed SARS-CoV-2 infection or COVID-19 as the main diagnosis. Using Cox proportional hazard models, VE was estimated as 1 minus the confounder-adjusted hazard ratio of COVID-19 hospitalisation between vaccinated and unvaccinated. A random-effects meta-analysis was used to pool VE estimates. Results: We included 4,144,667 5-11-year-olds and 3,861,841 12-17-year-olds. In 12-17-year-olds without previous infection, overall VE was 69% (95% CI: 40 to 84). VE declined with time since vaccination from 77% ≤ 3 months to 48% 180-365 days after immunisation. VE was 94% (95% CI: 90 to 96), 56% (95% CI: 3 to 80) and 41% (95% CI: -14 to 69) in the Delta, Omicron BA.1/BA.2 and BA.4/BA.5 periods, respectively. In 12-17-year-olds with previous infection, one dose VE was 80% (95% CI: 18 to 95). VE estimates were similar for 5-11-year-olds but with lower precision. Conclusion: Vaccines recommended for 5-17-year-olds provided protection against COVID-19 hospitalisation, regardless of a previously documented infection of SARS-CoV-2, with high levels of protection in the first 3 months of the vaccination.
- Distribution of the West Nile Virus vector, Culex pipiens, in mainland Portugal: A geospatial modelling studyPublication . Martinho, Júlia; Costa Osório, Hugo; Amaro, Fátima; Silva, Manuel; Marques Zé-Zé, Líbia Maria; Pereira Figueira Alves, Maria João; Nunes, Baltazar; Soares, PatriciaBackground: Culex pipiens, Portugal’s most abundant mosquito, is a vector for several pathogens including the West Nile virus. Understanding its spatial distribution can contribute to vector-borne diseases control and public health planning, given Portugal’s favourable climate. National-level data on its spatial distribution, especially in relation to climatic variables is limited. We aimed to predict the suitability of Culex pipiens distribution in mainland Portugal, considering climatic factors. Methods: A maximum entropy (Maxent) model was applied, using presence records for adult and larvae of Culex pipiens mosquitoes sampled across mainland Portugal between January 2017 and October 2023, as part of the REVIVE – Vector Surveillance Network program. Adults were sampled using CDC light traps and BG-Sentinel traps between May and October at random sites and year-round at point-of-entry sites. Larvae were sampled using dippers at breeding sites. Sampling bias was corrected by filtering presence records to one per 1 km2 cell grid. Climatic data, including temperature, precipitation and elevation, were used as predictors. Results: Out of 6,859 records, 354 unique sites were obtained after filtering and cell-duplicate removal. Suitable habitats seem to be primarily in the northern and central coastal regions. Temperature was the most important predictor. Convenience sampling bias may be present. Conclusions: Most West Nile virus case reports have come from southern Portugal, but Culex pipiens’s potential distribution covers the entire mainland territory, with seemingly higher distribution in the north. West Nile vector surveillance should be a priority in all regions to accurately assess transmission risk and implement effective control measures.
- Effectiveness of XBB.1.5 Monovalent COVID‐19 Vaccines During a Period of XBB.1.5 Dominance in EU/EEA Countries, October to November 2023: A VEBIS‐EHR Network StudyPublication . Monge, Susana; Humphreys, James; Nicolay, Nathalie; Braeye, Toon; Van Evercooren, Izaak; Holm Hansen, Christian; Emborg, Hanne‐Dorthe; Sacco, Chiara; Mateo‐Urdiales, Alberto; Castilla, Jesús; Martínez‐Baz, Iván; de Gier, Brechje; Hahné, Susan; Meijerink, Hinta; Kristoffersen, Anja Bråthen; Machado, Ausenda; Soares, Patricia; Nardone, Anthony; Bacci, Sabrina; Kissling, Esther; Nunes, BaltazarUsing a common protocol across seven countries in the European Union/European Economic Area, we estimated XBB.1.5 monovalent vaccine effectiveness (VE) against COVID-19 hospitalisation and death in booster-eligible ≥ 65-year-olds, during October–November 2023. We linked electronic records to construct retrospective cohorts and used Cox models to estimate adjusted hazard ratios and derive VE. VE for COVID-19 hospitalisation and death was, respectively, 67% (95%CI: 58–74) and 67% (95%CI: 42–81) in 65- to 79-year-olds and 66% (95%CI: 57–73) and 72% (95%CI: 51–85) in ≥ 80-year-olds. Results indicate that periodic vaccination of individuals ≥ 65 years has an ongoing benefit and support current vaccination strategies in the EU/EEA.
- Evolution of the risk perception of infection by COVID-19 – Evidence from the COVID-19 Barometer: Social OpinionPublication . Paixão, Inês; Antunes, Marília; Soares, PatriciaSince the beginning of the COVID-19 pandemic, several non-phar-maceutical interventions (NPI) have been adopted worldwide in an attempt to keep the growing transmission of the virus under control. Several factors might influence the effectiveness of NPI. This study aimed to evaluate the evolution of the perception of the risk of infection by COVID-19 in Portugal between March 2020 and March 2022, and to identify associated factors. We used the "Covid-19 Barometer: Social Opinion" barometer, which was launched at the beginning of the pan-demic in Portugal to identify and monitor the evolution of the Portuguese population's perception of the pandemic and its impact on daily life and was online during two years. We also considered COVID-19 incidence, stringency data, COVID-19 variants’ prevalence and Google searches on COVID-19.The outcome considered was the per-ceived risk of infection by COVID-19, which was classified into low versus high/moderate. The explanatory variables from the Barometer were grouped into dimensions: general factors (socio-demographic and health-related variables), adherence to protection measures, vaccine hesitancy and coping mechanisms.Considering the nature of this study and the outcome variable, generalized linear models were used to study the temporal evolution of the considered variables – in particular, mixed effects logistic regressions. One model was fit per group of vari-ables/dimension. Preliminary results show that, linked to a higher risk perception are lower levels of education, poor health status and working full-time at the workplace (as opposed to remote working) – the last two with a growing tendency over time. On the other hand, individuals with a previous COVID-19 diagnosis and a better mental health status are more likely to perceive lower risks, a propensity that diminishes over time.Students and unemployed individuals are also more likely to have a lower perception of risk, when compared to employed individuals of the same age and sex. Additionally, there is in general a higher probabil-ity of perceiving a lower risk of infection as time progresses.
- Impacte direto e indireto da Pandemia COVID-19 na mortalidade por todas as causas e por causas específicas em Portugal entre março de 2020 e dezembro de 2021Publication . Rodrigues, Ana Paula; Leite, Andreia; Machado, Ausenda; Nunes, Baltazar; Matias Dias, Carlos; Barreto, Marta; Soares, Patricia; Sá, Regina; Silva, SusanaIntrodução: Durante a pandemia de COVID-19 foram observados excessos de mortalidade muito elevados e muito superiores aos observados no período pré-pandemia. No entanto, é menor a evidência sobre o impacte direto (devido à infeção e suas complicações) e indireto (em consequência das medidas não farmacológicas e das alterações no acesso e procura de cuidados de saúde). Este trabalho teve como objetivo colmatar essa lacuna do conhecimento, e pretendeu: i) estimar o excesso de mortalidade por todas as causas e por causas específicas; ii) estimar o impacte direto e indireto da COVID-19. Material e Métodos: Foi realizado um estudo quasi-experimental de séries temporais no qual se estimou o excesso de mortalidade por todas as causas e por causas específicas, como a diferença entre a mortalidade observada e esperada tendo em conta condições atmosféricas (temperaturas, poluição atmosférica) e epidemiológicas (incidência de gripe). Numa segunda fase foram considerados os efeitos diretos da COVID-19 (mortalidade por COVID-19) e efeitos indiretos da COVID-19 (Índice de Contingência; ocupação hospitalar por COVID-19) para estimar a fração do excesso de mortalidade diretamente atribuível à COVID-19. Resultados: Foram estimados 21 243 (204 por 100 000) óbitos em excesso por todas as causas, 90 % dos quais foram diretamente atribuíveis à COVID-19. Ainda na mortalidade por todas as causas, estimaram-se excessos significativos nos grupos etários acima dos 65 anos de idade e nas regiões do Norte até ao Alentejo. Observou-se um aumento do excesso de mortalidade com a idade (2 924 óbitos em excesso por 100 000 no grupo etário ≥ 85 anos) e um aumento crescente de norte para sul (174 por 100 000 no Norte a 413 por 100 000 no Alentejo). Quanto ao impacto direto da COVID-19, este variou inversamente com a idade (95 % entre os 65-74 anos até 85 % ≥ 85 anos) e entre regiões (63 % no Alentejo a 83 % no Centro). Foram estimados 187 óbitos em excesso por 100 000 nas causas respiratórias, 98 % dos quais diretamente atribuíveis à COVID-19 e 18 óbitos em excesso por 100 000 nas causas acidentais. O aumento das mortes por causas acidentais ocorreu em períodos de menor intensidade das medidas restritivas. Foi ainda observado um aumento nas causas de mortes mal-definidas ou desconhecidas, que parece maioritariamente associado ao efeito direto da COVID-19 (69 %). Nas restantes causas de morte estudadas não foram identificados excessos de mortalidade para todo o período. Contudo, no primeiro ano da pandemia observou-se um aumento da mortalidade, em períodos específicos, de várias causas de morte, seguido de uma diminuição da mortalidade abaixo da linha de base após fevereiro de 2021. Esta evolução temporal não é habitual e deverá ser analisada em estudos específicos para identificação dos mecanismos subjacentes. Conclusão: A pandemia de COVID-19 teve um impacte de muito elevada intensidade na mortalidade, principalmente devido às mortes por COVID-19. Estes impactes não foram iguais para toda a população, tendo sido mais intensos nos grupos etários mais idosos e nos indivíduos com doenças crónicas. Tal reforça a necessidade de dar prioridade a estes grupos populacionais na preparação e resposta a futuras pandemias, quer na proteção em relação à infeção e suas complicações, quer na prevenção e mitigação dos efeitos secundários das medidas não farmacológicas.
- Individual risk factors associated with SARS-CoV-2 infection during Alpha variant in high-income countries: a systematic review and meta-analysisPublication . Moniz, Marta; Pereira, Sofia; Soares, Patricia; Aguiar, Pedro; Donato, Helena; Leite, AndreiaObjectives: This study aimed to systematically appraise risk factors associated with SARS-CoV-2 infection in high-income countries during the period of predominance of the Alpha variant (January 2020 to April 2021). Methods: Four electronic databases were used to search observational studies. Literature search, study screening, data extraction and quality assessment were conducted by two authors independently. Meta-analyses were conducted for each risk factor, when appropriate. Results: From 12,094 studies, 27 were included. The larger sample size was 17,288,532 participants, more women were included, and the age range was 18-117 years old. Meta-analyses identified men [Odds Ratio (OR): 1.23, 95% Confidence Interval (CI): 1.97-1.42], non-white ethnicity (OR: 1.63, 95% CI: 1.39-1.91), household number (OR: 1.08, 95% CI: 1.06-1.10), diabetes (OR: 1.22, 95% CI: 1.08-1.37), cancer (OR: 0.82, 95% CI: 0.68-0.98), cardiovascular diseases (OR: 0.92, 95% CI: 0.84-1.00), asthma (OR: 0.83, 95% CI: 0.75-0.92) and ischemic heart disease (OR: 0.82, 95% CI: 0.74-0.91) as associated with SARS-CoV-2 infection. Conclusion: This study indicated several risk factors for SARS-CoV-2 infection. Due to the heterogeneity of the studies included, more studies are needed to understand the factors that increase the risk for SARS-CoV-2 infection.
- Investigating the role of symptom valorisation in tuberculosis patient delay in urban areas in PortugalPublication . de Morais, Margarida; Sousa, Sofia; Marques, Jéssica; Moniz, Marta; Duarte, Raquel; Leite, Andreia; Soares, Patricia; Carreira, Mário; Pereira, Sofia; Alves, Catarina; Alves, Filipe; Rodrigues, Ana; Moreira, Ana; Cardoso, Márcia; Mota, Sandra; Gomes, Ana; Ferreira, Liliana; Lopes, Marta; Correia, Isabel; Rachadell, Juan; Gameiro, Maria; Dias, Ângela; Pereira, Manuel; Gonçalves, Jorge; Gonçalves, Maria; Taveira, Adriana; Neves, Celene; Silva, Lucinda; Mendes, Maria; Teixeira, Maria; Pereira, Maria; Piedade, Milena; Teixeira, Antónia; Carvalho, CarlosBackground: Diagnosis delay contributes to increased tuberculosis (TB) transmission and morbimortality. TB incidence has been decreasing in Portugal, but median patient delay (PD) has risen. Symptom valorisation may determine PD by influencing help-seeking behaviour. We aimed to analyse the association between symptom valorisation and PD, while characterising individuals who disregarded their symptoms. Methods: A cross-sectional study was conducted among TB patients in Lisbon and Oporto in 2019 - 2021. Subjects who delayed seeking care because they did not value their symptoms or thought these would go away on their own were considered to have disregarded their symptoms. PD was categorised using a 21-day cut-off, and a 30-day cut-off for sensitivity analysis. We estimated the effect of symptom valorisation on PD through a directed acyclic graph. Then, a multivariable regression analysis characterised patients that disregarded their symptoms, adjusting for relevant variables. We fitted Poisson regression models to estimate crude and adjusted prevalence ratios (PR). Results: The study included 75 patients. Median PD was 25 days (IQR 11.5-63.5), and 56.0% of participants had PD exceeding 21 days. Symptom disregard was reported by 38.7% of patients. Patients who did not value their symptoms had higher prevalence of PD exceeding 21 days compared to those who valued their symptoms [PR 1.59 (95% CI 1.05-2.42)]. The sensitivity analysis showed consistent point estimates but wider confidence intervals [PR 1.39 (95% CI 0.77-2.55)]. Being a smoker was a risk factor for symptom disregard [PR 2.35 (95% CI 1.14-4.82)], while living in Oporto [PR 0.35 (95% CI 0.16-0.75)] and having higher household incomes [PR 0.39 (95% CI 0.17-0.94)] were protective factors. Conclusions: These findings emphasise the importance of symptom valorisation in timely TB diagnosis. Patients who did not value their symptoms had longer PD, indicating a need for interventions to improve symptom recognition. Our findings also corroborate the importance of the socioeconomic determinants of health, highlighting tobacco as a risk factor both for TB and for PD.