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- COVID-19 Vaccine Effectiveness among older adultsPublication . Laniece Delaunay, Charlotte; Mateo-Urdiales, Alberto; Pérez-Gimeno, Gloria; O'Reilly, Karen; Uras, Marina; Erdwiens, Annika; Mlinaric, Ivan; Túri, Gergo; Martínez-Baz, Iván; Meijer, Adam; Rodrigues, Ana Paula; Lazar, Mihaela; Latorre-Margalef, Neus; Lucaccioni, Héloïse; Verdasca, Nuno; Bella, Antonino; Rafael de la Cruz Lopez, Maria Angeles; Kelly, Eva; Enouf, Vincent; Tolksdorf, Kristin; Puzelli, Simona; Ibáñez Pérez, Ana Carmen; Fitzgerald, Margaret; Masse, Shirley; Oh, Djin-Ye; Kaczmarek, Marlena; Bacci, Sabrina; Kissling, Esther; VEBIS Primary Care Vaccine Effectiveness GroupIntroduction: From September to November 2025, many European countries launched COVID-19 vaccination campaigns, when SARS-CoV-2 incidence was decreasing after a period of high circulation.1 These campaigns targeted specific groups, including older adults (ie, individuals aged at or above a minimum threshold that varied from age 60 to 70 years across countries). We estimated the effectiveness of COVID-19 vaccines administered during these seasonal vaccination campaigns in Europe against medically attended, symptomatic SARS-CoV-2 infection among older adults, from September 29, 2025, to January 10, 2026.
- 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.
- Effectiveness of the XBB.1.5 COVID-19 Vaccines Against SARS-CoV-2 Hospitalisation Among Adults Aged ≥ 65 Years During the BA.2.86/JN.1 Predominant Period, VEBIS Hospital Study, Europe, November 2023 to May 2024Publication . Antunes, Liliana; Rojas-Castro, Madelyn; Lozano, Marcos; Martínez-Baz, Iván; Leroux-Roels, Isabel; Borg, Maria-Louise; Oroszi, Beatrix; Fitzgerald, Margaret; Dürrwald, Ralf; Jancoriene, Ligita; Machado, Ausenda; Petrović, Goranka; Lazar, Mihaela; Součková, Lenka; Bacci, Sabrina; Howard, Jennifer; Verdasca, Nuno; Basile, Luca; Castilla, Jesús; Ternest, Silke; Džiugytė, Aušra; Túri, Gergő; Duffy, Roisin; Hackmann, Carolin; Kuliese, Monika; Gomez, Verónica; Makarić, Zvjezdana Lovrić; Marin, Alexandru; Husa, Petr; Nicolay, Nathalie; Rose, Angela M.C.; VEBIS SARI VE network teamWe estimated the effectiveness of the adapted monovalent XBB.1.5 COVID-19 vaccines against PCR-confirmed SARS-CoV-2 hospitalisation during the BA.2.86/JN.1 lineage-predominant period using a multicentre test-negative case-control study in Europe. We included older adults (≥ 65 years) hospitalised with severe acute respiratory infection from November 2023 to May 2024. Vaccine effectiveness was 46% at 14-59 days and 34% at 60-119 days, with no effect thereafter. The XBB.1.5 COVID-19 vaccines conferred protection against BA.2.86 lineage hospitalisation in the first 4 months post-vaccination.
- First identification and molecular characterization of CTX-M-15 extended-spectrum β-lactamase and OXA-9 β-lactamase in Haemophilus influenzae in the Iberian PeninsulaPublication . González-Díaz, A.; Pinto, M.; Cadenas-Jiménez, I.; Duarte, S.; Ardanuy, C.; Ribeiro, M.M.; Martí, S.; Bajanca-Lavado, P.We describe, for the first time, the presence and characterization of CTX-M-15 and OXA-9 in two Haemophilus influenzae strains: PTHi-14525 (CTX-M-15) from Portugal and HUB-HI042681 (OXA-9) from Spain. Multidrug-resistant PTHi-14525 carried blaCTX-M-15 (two copies) and blaTEM-1 in an ICEHpaHUB5-like element. HUB-HI042681, resistant to β-lactams and aminoglycosides, carried a novel ICEHinHUB1. These findings highlight the genomic plasticity and expanded resistome of H. influenzae, raising concerns about treatment and emphasizing the need for continuous genomic surveillance.
- Late HIV diagnosis: trends, risk factors, and progress toward the 2025 target of <20% late diagnosis in 23 EU/EEA countries, 2022 to 2024Publication . Reyes-Urueña, Juliana; Stoppa, Giorgia; Pizzolato, Federica; Marrone, Gaetano; Hansson, Disa; EU/EEA HIV networkIn 2022-2024, 14,153 of 28,521 (49.6%) new HIV diagnoses in 23 European Union and Economic Area (EU/EEA) countries were late. In adjusted analyses, older age and migrant status increased late diagnosis risk. The proportion of late diagnoses was 2.6-fold higher among migrants with pre-migration HIV acquisition than post-migration. Late-diagnosed migrants with likely post-migration HIV acquisition were often women, ≥ 50-year-olds, heterosexuals, people who inject drugs, or from South and South-East Asia. The 2025 target of < 20% late diagnosis was unachieved.
- A multinational genomic framework for predicting β-lactam resistance in Haemophilus influenzaePublication . Deghmane, A.E.; Asmi, M.; Abel, S.; Bajanca-Lavado, P.; Claus, H.; D'Aeth, J.; Garcia, I.; Kiedrowska, M.; Lam, T.T.; Litt, D.; Martiny, D.; Meilleur, C.; Skoczyńska, A; Tzanakaki, G.; Xirogianni, A.; Taha, M. K.Background: Haemophilus influenzae resistance to β-lactams is mediated by β-lactamase and amino acid alterations in penicillin-binding protein 3 encoded by ftsI gene, which shows incomplete phenotype-genotype concordance. Objectives: To develop and evaluate a genomic classification framework to predict clinically relevant β-lactam resistance categories. Methods: We analysed 5288 H. influenzae isolates collected in eight European countries and Canada. Among these, 4833 isolates had phenotypic β-lactam susceptibility that were classified into three categories: susceptible to amoxicillin (AMX), resistant to AMX but susceptible to cefotaxime and resistant to both. A 621 bp DNA fragments of the whole ftsI gene (between codons 326 and 532) were analysed to construct category-specific k-mer vocabulary and an allele classifier using Python scripts. Performance was assessed using independent allele validation and agreement with phenotypic classification was evaluated using Cohen's κ coefficient. An additional 455 isolates lacked phenotypic data and were used for external genomic application. Results: Forty-seven frequent ftsI alleles and 34 additional alleles were used for the implementation and the refinement of the vocabulary. Subsequently, 23 other alleles were used for independent allele validation and resulted in correctly predicted resistance categories for 21 alleles (accuracy 91.3%). Agreement with phenotypic classification was high (Cohen's κ 0.853; weighted κ 0.880). Application of the classifier to 455 UK isolates predicted resistance distributions consistent with those observed in phenotypically characterized datasets. Conclusions: A recurrence-filtered k-mer-based vocabulary provides a promising standardized genomic framework that complements phenotypic AST, particularly when phenotypic testing is unavailable, incomplete or heterogeneous.
- A New World disease: Dual diagnostic challenges in travelers returning from Costa RicaPublication . Brazão, Cláudia; Borges-Costa, João; Antunes-Duarte, Sofia; Mancha, Dora; Sun, Lanyu; Marques, Tiago; Gargaté, Maria João; Vilares, Anabela; Reis, Tânia; de Vasconcelos, Pedro; Soares-de-Almeida, Luís; Filipe, PauloCutaneous diseases in returning travelers encompass a wide spectrum of etiologies and often pose diagnostic challenges. We present the cases of a 50-year-old man and a 57-year-old woman who presented with a 3-month history of erythematous, ulcerated plaques with well-defined elevated borders and a necrotic center on the lower limbs that began 3 weeks after returning from vacation in Costa Rica. Cutaneous biopsy revealed epidermal ulceration and extensive caseating granulomas throughout the full thickness of the dermis. Giemsa staining revealed no amastigotes. Microbiological examinations identified Leishmania braziliensis and excluded mycobacteria and fungi. The diagnosis of cutaneous Leishmaniasis was established. Owing to clinical severity and antimonial unavailability, the man was treated with liposomal amphotericin B. The woman underwent surgical excision of the single lesion, along with oral fluconazole. Complete resolution was documented in both patients. These cases, which posed diagnostic and therapeutic challenges, highlight that cutaneous leishmaniasis, in all its versatile and often perplexing presentations, is a parasitic infection that should always be considered in dermatologic patients returning from vacation in endemic countries.
- Systematic review and modelling of seroprevalence in humans, Europe, 2000 to 2021Publication . Friesema, Ingrid Hm; Waap, Helga; Swart, Arno; Györke, Adriana; Le Roux, Delphine; Evangelista, Francisco Md; Spano, Furio; Schares, Gereon; Deksne, Gunita; Gargaté, Maria João; Calero-Bernal, Rafael; Jokelainen, Pikka; Seeber, Frank; Sroka, Jacek; Lundén, Anna; van den Berg, Oda; Jore, Solveig; Wisselink, Henk J.; Dámek, Filip; Vestergaard, Lasse S.; Opsteegh, Marieke; APAGARBackground: Toxoplasma gondii is a zoonotic protozoan capable of infecting warm-blooded animal species and humans. Although toxoplasmosis presents mostly as mild or asymptomatic infection in immunocompetent individuals, in unborn children and people with weakened immune systems, the disease can be severe with ocular, neurological or multi-systemic manifestations and even death. Aim: We aimed to collate and analyse data on T. gondii seroprevalence in humans to model and compare age-dependent prevalence in geographic regions in Europe. Methods: A systematic review identified 1,822 scientific publications, from which seroprevalence data were extracted from 69 studies. Data were analysed using a Bayesian hierarchical model. Results: The modelling of the seroprevalence indicated the highest incidence rates in eastern (50%) and western (48%) Europe, with the lowest estimates in northern Europe (18%) and the United Kingdom (UK) (18%). Eastern and western Europe were regions where T. gondii infections occurred earliest in life, with half of the population expected to be seropositive by the age of 44 and 47 years, respectively. In contrast, in northern Europe and the UK the modelled median time to infection exceeded 170 years. Conclusions: Results of the study provide a robust baseline for future epidemiological research on human T. gondii infections in Europe and may be useful to validate subsequent research, such as risk assessment studies.
- Umrah- and travel-associated meningococcal disease due to multiple serogroup W ST-11 sub-strains pre-Hajj 2024Publication . Lucidarme, Jay; Deghmane, Ala-Eddine; Sharma, Shalabh; Meilleur, Courtney; Eriksson, Lorraine; Mölling, Paula; Claus, Heike; van Sorge, Nina; Bettencourt, Célia; Bajanca-Lavado, Paula; Tsang, Raymond S.W.; Caugant, Dominique A.; Stefanelli, Paola; Neri, Arianna; Tzanakaki, Georgina; Lekshmi, Aiswarya; Campbell, Helen; Clark, Stephen A.; Heymer, Emma J.; Ribeiro, Sonia; Willerton, Laura; Walsh, Lloyd; Bai, Xilian; Lâm, Thiên-Trí; Wagle, Basanta R.; Walia, Vishakh; Howie, Rebecca L.; Neatherlin, John; Rubis, Amy; Vachon, Madhura; McNamara, Lucy A.; Ladhani, Shamez N.; Taha, Muhamed-Kheir; Borrow, RayObjectives: Collectively, the Hajj and Umrah pilgrimages draw > 30 million pilgrims to the Kingdom of Saudi Arabia (KSA) each year. Before Hajj 2024 (14 to 19 June), the meningococcal serogroup W ST-11 complex (W:cc11) Hajj-strain sublineage caused multiple international cases of invasive meningococcal disease (IMD) associated with travel to the Middle East and Asia. Here we identify and characterise the strains responsible. Methods: All Hajj strain sublineage genomes on PubMLST.org underwent core genome MLST comparisons (PubMLST.org). Results: Isolates from 30 cases, across seven countries, formed five phylogenetic clusters within two distinct strains. Travel histories included KSA, other Middle Eastern countries, India, Mauritius, Kenya via Turkey, and no known associated travel. The prevalent strain, representing four clusters, had no African, and limited Middle Eastern, representation. The geo-temporal distribution of available genomes indicated Eastern Europe as a possible source. Conclusions: The rapid expansion of Umrah/travel-related W:cc11 IMD cases in early 2024 was due to multiple strains/sublineages. Despite the involvement of non-KSA travel-destinations, the coincidence of cases with the busy month of Ramadan, and the abrupt cessation during Hajj (when vaccine compliance is maximal), suggest that Umrah was a key driver and highlight the need to reinforce mandatory vaccination whilst maintaining global vigilance.
- Vaccine effectiveness against medically attended, laboratory-confirmed influenza in the I-MOVE primary care network in Europe, VEBIS project, 2024/25Publication . Lucaccioni, Héloïse; Pozo, Francisco; Pérez-Gimeno, Gloria; Dürrwald, Ralf; Uras, Marina; Domegan, Lisa; Oroszi, Beatrix; Meijer, Adam; Trobajo-Sanmartín, Camino; Ujvari, Dorina; Rodrigues, Ana Paula; Mlinarić, Ivan; Lazar, Mihaela; Rivas Wagner, Eva; Erdwiens, Annika; Enouf, Vincent; McKenna, Adele; Túri, Gergő; de Lange, Marit; Martínez-Baz, Iván; Latorre-Margalef, Neus; Guiomar, Raquel; Kurečić Filipovic, Sanja; Dinu, Sorin; Mokoroa, Olatz; Tolksdorf, Kristin; Masse, Shirley; Bennett, Charlene; Kristóf, Katalin; Hooiveld, Mariette; Castilla, Jesús; Santos Almeida, João; Višekruna Vučina, Vesna; Popescu, Rodica; Bacci, Sabrina; Kaczmarek, Marlena; Kissling, EstherBackground: We conducted a multicenter test-negative study to estimate vaccine effectiveness (VE) against medically attended, laboratory-confirmed influenza in primary care, Europe, 2024/25. Research design and methods: Specimens were collected from patients with acute respiratory infection. All or a random sample of viruses were sequenced. VE was (1-odds ratio) × 100, adjusted for confounders. Results: We included 7275 cases and 17,516 controls (weeks 40-2024-18-2025). The overall VE was 46% (95% CI: 40-52), lowest in adults ≥65 years at 28% (95% CI: 12-42). VE against influenza A(H1N1)pdm09 was 30% (95% CI: 19-40); ranging 16-34% by age and vaccination target group. Most (88%) circulating clades were 5a.2a, distinct from the vaccine clade. VE was 28% (95% CI: 7-45) against 5a.2a (C.1.9), and 6% (95% CI: -62-45) against the vaccine-matched clade 5a.2a.1 (D). VE against influenza A(H3N2) was 38% (95% CI: 26-49); ranging 20-66% by age and target group. Circulating viruses belonged to the vaccine clade 2a.3a.1, with 88% subclade (J.2). VE against influenza B was 76% (95% CI: 69-81); ranging 70-80% by age and target group; all viruses belonged to the vaccine clade V1A.3a.2, with diverse subclades. Conclusions: Influenza vaccination protected approximately one in two vaccinated individuals against medically attended infection in primary care in Europe, 2024/25, varying by (sub)type and age.
