Departamento de Epidemiologia
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Percorrer Departamento de Epidemiologia por Domínios Científicos e Tecnológicos (FOS) "Ciências Naturais"
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- Congenital Anomalies and Cerebral Palsy: Data from the Portuguese Cerebral Palsy Surveillance ProgramPublication . Cadete, Ana; Folha, Teresa; Braz, Paula; Calado, Eulália; Alvarelhão, Joaquim; Virella, DanielBackground and Objectives: Attention was recently drawn to the association of congenital anomalies (CA) with severity and complexity of cerebral palsy (CP). Evidence of this association is presented. Participants-Methods: The Portuguese National Surveillance of Cerebral Palsy (PNSCP) registers data of 5-to-8-year-old children with CP, born since 2001. The PNSCP follows the Surveillance of Cerebral Palsy in Europe (SCPE) common database protocol. Data were cross-referenced with the Portuguese National Registry of Congenital Anomalies. Children born between 2001-2015, notified until September 2024, were analyzed. CA were characterized according to ICD-10, following the EUROCAT criteria. Associations between the clinical forms of CP, complexity indicators and the presence of CA were explored. Results: Of 2251 registered children, 603 (27%; 95%CI 24.9-28.6) had at least one CA recorded; 228 children had multiple CA (10%; 95%CI 8.9-11.4). CA of the nervous system Q00-Q07 (CANS) are the most frequent (16%; 95%CI 14.9-18.0), followed by CA of the circulatory system Q20-Q28 (CACS) (4.9%; 95%CI 4.1-59). The odds of having at least one indicator of CP complexity increases by 2.6 times when having a CA (OR 2.6; 95%CI 2.01-3.48); slightly higher if a CANS exists (2.9; 95%CI 2.06-4,21), and slightly lower if a CACS exists (1.6; 95%CI 0.98-2.83). Conclusion: The prevalence of CA in children with CP is much higher than in the general population and increases the odds for greater severity and/or complexity of CP. The odds seems to be higher in the presence of CANS. This should be considered when assessing the prognosis and planning intervention.
- Exposure to mycotoxins in the Portuguese adult populationPublication . Maris, Elias; Namorado, Sónia; Chen, A.; Pero-Gason, Roger; De Boevre, Marthe; De Saeger, Sarah; Silva, Maria João; Alvito, PaulaMycotoxins are toxic fungal metabolites commonly found in food, posing health risks such as immunosuppression, carcinogenicity, and endocrine disruption. Despite regulatory limits, chronic low-level exposure remains a concern. Understanding real-life exposure in populations is essential for effective risk assessment. This study aims to investigate mycotoxin exposure among young adults in Portugal, contributing to evidence-based public health interventions. This study leveraged data and biospecimens from the INSEF-ExpoQuim survey, a cross-sectional study nested within thPortuguese National Health Examination Survey (INSEF). Data was collected via REDCap-assisted telephone interviews, covering sociodemographic and exposure-relevant variables. A subset of 295 first morning urine samples was collected from adults aged 28–39 years between May 2019 and March 2020. Urine samples were analyzed by a newly optimized and validated LC-MS/MS method targeting 40 mycotoxins and/or their corresponding metabolites in urine. Urinary creatinine was measured using a validated colorimetric method to allow adjustment and standardization of mycotoxin concentrations, ensuring accurate exposure assessment and comparability. This methodological approach enabled a robust characterization of mycotoxin exposure in a representative Portuguese population cohort.The study included 58% females and 42% males. Most participants had medium to high education, and urbanization was nearly evenly split between towns/suburbs (36.9%) and rural areas (35.9%), with fewer living in cities (27.1%). The majority were employed, and sampling was primarily conducted in summer and autumn. The number of mycotoxin co-exposures in the Portuguese population ranged from 0 to 5, with two simultaneous exposures being most common (n = 160). Among the 40 mycotoxins analysed, deoxynivalenol and tenuazonic acid were most frequently detected, with frequency of detection of 85% and 96%, respectively. This study offers robust biomonitoring data on mycotoxin exposure in Portuguese young adults using a validated LC-MS/MS method. The high prevalence of deoxynivalenol and tenuazonic acid suggests low level dietary contamination. These findings support the need for continued monitoring and the integration ofhuman biomonitoring into national food safety strategies. Detailed sociodemographic analyses are planned to further clarify exposure patterns and enable targeted public health interventions.
- Impact of non-pharmacological interventions on the first wave of COVID-19 in Portugal 2020Publication . Loyens, Dinis B.; Caetano, Constantino; Matias-Dias, CarlosIntroduction: The COVID-19 pandemic caused over 7 million global deaths. Without vaccines during the first wave, governments implemented nonpharmacological interventions (NPIs) such as lockdowns, school closures, and travel restrictions. This study quantifies the impact of NPIs on COVID-19 transmission in Portugal between 24th February and 1st May. Methods: A compartmental SEIR (Susceptible, Exposed, Infectious, Removed) model was employed to simulate the first COVID-19 wave in Portugal, using a Bayesian approach and symptom-onset incidence data. The effect of the lockdown, which began on March 22, 2020, on the effective reproductive number, R t was measured. A counterfactual scenario was created to ascertain the number of cases prevented by the NPIs during the first 15 days after the implementation of NPI. Results: The lockdown reduced overall transmission by 68·6 % (95%Credible Interval (95%CrI): 59·2 %; 77·5 %), almost immediately. This corresponds to a reduction in the effective reproductive number from 2·56 (95%CrI: 2·08; 3·40) to 0·80 (95%CrI: 0·76; 0·84). The counterfactual scenario estimated that the lockdown prevented 118052 (95%CrI: 99464; 145605) cases between 24th February and 6th April. Discussion: The lockdown significantly reduced COVID-19 transmission in Portugal, bringing Rt below 1, meaning each person infected fewer than one individual. While costly, lockdowns effectively control disease spread in the absence of vaccines. Conclusion: Our findings suggest NPIs curbed epidemic transmission, reducing Rt below 1 and easing hospital loads and deaths. This research will help inform future pandemic decision-making and infectious disease modeling worldwide.
- Tracking Mycotoxin Exposure in Portugal: New Insights and Key DeterminantsPublication . Namorado, Sónia; Maris, Elias; Chen, A.; Pero-Gascon, Roger; de Boevre, Marthe; De Saeger, Sarah; Silva, Maria João; Alvito, Paula; .Human biomonitoring (HBM) is a vital tool for assessing exposure to environmental chemicals. Mycotoxins have been associated with various adverse health effects, including estrogenic, immunotoxic, nephrotoxic, and teratogenic outcomes. In this presentation an overview of two recent HBM studies on multiple mycotoxins exposure biomarkers conducted in Portugal will be given. The first study analyzed 37 mycotoxin biomarkers in urine samples from 94 adult participants (48.4 ± 15.2 years), as part of the National Food, Nutrition, and Physical Activity Survey (2015–2016). Six different mycotoxins -DON, ZEN, AOH, OTA, FB1, and CIT- was confirmed through the quantification of 12 urinary biomarkers in paired 24 h and first-morning urine samples. DON and its metabolites were among the most frequently detected biomarkers and AOH was identified for the first time in urine samples from a European population. Associations between urinary mycotoxin biomarkers and consumption of specific food items were also observed. More recently, a subset of 295 first-morning urine samples from adults (28–39 years) was collected between 2019-2020, as part of a cross-sectional study embedded within the Portuguese National Health Examination Survey (INSEF). These samples were analyzed using a newly optimized and validated LC-MS/MS method capable of detecting 40 mycotoxins and/or their metabolites in urine. DON and tenuazonic acid were the most frequently detected, with detection rates of 85% and 96%, respectively. Further investigations into key exposure determinants—including dietary habits, demographic factors, and geographical variations—are ongoing and will be presented. Altogether, these findings highlight the importance of continued surveillance and the integration of HBM into national food safety and public health strategies.