Browsing by Author "Vasconcelos, Paula"
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- Ongoing outbreak of hepatitis A associated with sexual transmission among men who have sex with men, Portugal, October 2023 to April 2024Publication . Rosendal, Ebba; von Schreeb, Sebastian; Gomes, Alexandre; Lino, Sara; Grau-Pujol, Berta; Magalhães, Sara; Ricoca Peixoto, Vasco; Roque, Carla; Moreno, Joana; Maltez, Fernando; Almeida, Fernando; Sá Machado, Rita; Marinho, Rui Tato; Vasconcelos, Paula; de Sousa, Rita; Vieira Martins, JoãoAn outbreak of hepatitis A is ongoing in Portugal, with 71 confirmed cases from 7 October 2023 to 24 April 2024. Most cases are male, aged 18-44 years, with many identifying as men who have sex with men (MSM) and reported as suspected sexual transmission. Phylogenetic analysis identified the subgenotype IA, VRD 521-2016 strain, last observed in an MSM-associated multi-country outbreak in 2016 to 2018. We wish to alert colleagues in other countries to investigate potential similar spread.
- Surveillance in the time of austerity; Portuguese HIV/AIDS Surveillance achieves a 30% improvement in efficiency after LEAN inspired changes to processingPublication . Shivaji, Tara; Cortes Martins, Helena; Diniz, Antonio; Nogueira, Paulo J; Vasconcelos, Paula; Silva, AndreiaBackground In 2013, following reminders about statutory notification of HIV/AIDS, Portuguese clinicians notified all cases, irrespective of previous notification. At the same time, hospitals introduced electronic records that automatically generated additional paper notification reports. No supplemental resources were available to process the 10-fold increase in notifications. The ensuing backlog caused delays in providing timely information for HIV program planning and evaluation. We investigated whether management principles from the automobile industry (LEAN) could improve data management efficiency. Methods Efficiency was defined as the time spent processing the paper report into electronic surveillance information. We used value stream mapping to understand the process and employed focus groups to identify areas for improvement (LEAN methodology). We recorded the time taken to complete this process for randomly selected batches of reports and calculated the average time per report. Results When consulted, stakeholders expressed the need for information about recent HIV/AIDS diagnoses. We prioritized processing cases diagnosed between 2011-2013. We reduced data-entry errors and transcribing time by inserting drop-down menus and automatic variable calculators. We implemented auto-search during data entry to prevent duplication. We redesigned the data entry mask to match the paper report. Before intervention, processing time was 9 minutes and 28 seconds (95%CI 8:53-10:58) per report. Two months post-intervention, this was 6 minutes and 34 seconds (95% CI 6:25-6:43), reducing the time to process the remaining backlog (10,000 reports) by 54 days. Conclusion Applying LEAN techniques to HIV/AIDS surveillance in Portugal enabled delivery of crucial information to national and international HIV stakeholders through a 30% reduction in data processing time and optimization of data quality. Public health practitioners should consider LEAN techniques to improve data quality and efficiency of surveillance systems.
- Viral genetic clustering and transmission dynamics of the 2022 mpox outbreak in PortugalPublication . Borges, Vítor; Duque, Mariana Perez; Martins, João Vieira; Vasconcelos, Paula; Ferreira, Rita; Sobral, Daniel; Pelerito, Ana; de Carvalho, Isabel Lopes; Núncio, Maria Sofia; Borrego, Maria José; Roemer, Cornelius; Neher, Richard A.; O’Driscoll, Megan; Rocha, Raquel; Lopo, Sílvia; Neves, Raquel; Palminha, Paula; Coelho, Luís; Nunes, Alexandra; Isidro, Joana; Pinto, Miguel; Santos, João Dourado; Mixão, Verónica; Santos, Daniela; Duarte, Silvia; Vieira, Luís; Martins, Fátima; Machado, Jorge; Veríssimo, Vítor Cabral; Grau, Berta; Peralta-Santos, André; Neves, José; Caldeira, Margarida; Pestana, Mafalda; Fernandes, Cândida; Caria, João; Pinto, Raquel; Póvoas, Diana; Maltez, Fernando; Sá, Ana Isabel; Salvador, Mafalda Brito; Teófilo, Eugénio; Rocha, Miguel; Moneti, Virginia; Duque, Luis Miguel; e Silva, Francisco Ferreira; Baptista, Teresa; Vasconcelos, Joana; Casanova, Sara; Mansinho, Kamal; Alves, João Vaz; Alves, João; Silva, António; Alpalhão, Miguel; Brazão, Cláudia; Sousa, Diogo; Filipe, Paulo; Pacheco, Patrícia; Peruzzu, Francesca; de Jesus, Rita Patrocínio; Ferreira, Luís; Mendez, Josefina; Jordão, Sofia; Duarte, Frederico; Gonçalves, Maria João; Pena, Eduarda; Silva, Claúdio Nunes; Guimarães, André Rodrigues; Tavares, Margarida; Freitas, Graça; Cordeiro, Rita; Gomes, João PauloPathogen genome sequencing during epidemics enhances our ability to identify and understand suspected clusters and investigate their relationships. Here, we combine genomic and epidemiological data of the 2022 mpox outbreak to better understand early viral spread, diversification and transmission dynamics. By sequencing 52% of the confirmed cases in Portugal, we identified the mpox virus sublineages with the highest impact on case numbers and fitted them into a global context, finding evidence that several international sublineages probably emerged or spread early in Portugal. We estimated a 62% infection reporting rate and that 1.3% of the population of men who have sex with men in Portugal were infected. We infer the critical role played by sexual networks and superspreader gatherings, such as sauna attendance, in the dissemination of mpox virus. Overall, our findings highlight genomic epidemiology as a tool for the real-time monitoring and control of mpox epidemics, and can guide future vaccine policy in a highly susceptible population.