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Epidemiology and Clinical Features of Mycobacterium avium Complex Pulmonary Disease in a Brazilian Amazon Cohort

Advances in Microbiology 2024年第6期14卷 287-302页

作者： j.se tadeu colares monteiro Adriana Rodrigues Barretto Ruan seguin Azevedo Quaresma Bianca Miranda Gouveia Ismari Perini Furlaneto Victória Menezes da Costa Yan Corrêa Rodrigues Layana Rufino Ribeiro Ricardo j. de Paula Souza e Guimarães Alex Brito Souza Ana Roberta Fusco da Costa Karla Valéria Batista Lima joao de Barros Barreto University Hospital Federal University of Par Belm Brazil Center for Biological and Health Sciences Ph.D. Program in Parasitic Biology in the Amazon Region (PPGBPA) State University of Par (UEPA) Belm Brazil Department of Medicine Centro Universitrio do Par CESUPA Belm Brazil Bacteriology and Mycology section Evandro Chagas Institute (SABMI/IEC) Ministry of Health Ananindeua Brazil Geoprocessing Laboratory Evandro Chagas Institute/SVSA/MS Ananineua Brazil

The incidence of Mycobacterium avium complex pulmonary disease (MACPD) has been globally increasing. The present study aims to provide a comprehensive analysis of clinical characteristics and treatment response among patients in the Amazon region of Brazil and conduct a retrospective cohort study at a prominent referral hospital in the State of Par, Brazil, from 2012 to 2020. The M. avium group represented 58.9% of cases, followed by M. intracellulare (35.7%), M. colombiense (3.6%), and M. chimaera (1.8%). The majority of patients (73.2%) were female and with an average age of 63 years. Primary clinical manifestations included persistent cough and sputum production. The Charlson comorbidity index (CCI) averaged 2.47, with 36.3% of patients having a CCI score equal to higher than 3. Notably, over 70% of patients had received treatment for pulmonary tuberculosis before initiating treatment for MAC infection. The fibrocavitary radiologic form was the most prevalent (55.4%), frequently exhibiting a bilateral distribution (53.6%). Antimicrobial susceptibility revealed a significant prevalence of MAC resistance to drugs in the therapeutic regimen. Despite this, most of the patients experienced clinical improvement (50%). In conclusion, this study highlights a higher prevalence of MAC infections among middle-aged women, with a history of pulmonary tuberculosis treatment and presenting the fibrocavitary radiological form was predominant.

关键词： MACDP Nontuberculous Mycobacteria Mycobacterium avium Lung Disease

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Modelling the test, trace and quarantine strategy to control the COVID-19 epidemic in the state of São Paulo, Brazil

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Infectious Disease Modelling 2021年第1期6卷 46-55页

作者： Marcos Amaku Dimas tadeu Covas Francisco Antonio Bezerra Coutinho Raymundo Soares Azevedo Neto Claudio Struchiner Annelies Wilder-Smith Eduardo Massad School of Medicine University of Sao Paulo and LIM01-HCFMUSPSao PauloBrazil Instituto Butantan Sao PauloBrazil School of Applied Mathematics Fundacao Getulio VargasRio de JaneiroBrazil School of Veterinary Medicine University of Sao PauloSao PauloBrazil Department Public Health and Clinical Heidelberg Institute of Global HealthUniversity of HeidelbergGermany Medicine Epidemiology and Global HealthUmeåUniversitySE-90185UmeåSweden Department of Disease Control London School of Hygiene and TropicalMedicineUK

Testing for detecting the infection by SARS-CoV-2 is the bridge between the lockdown and the opening of *** this paper we modelled and simulated a test-trace-andquarantine strategy to control the COVID-19 outbreak in the State of São Paulo,*** State of São Paulo failed to adopt an effective social distancing strategy,reaching at most 59%in late March and started to relax the measures in late june,dropping to 41%in 08 ***,São Paulo relies heavily on a massive testing strategy in the attempt to control the *** alternative strategies combined with economic evaluations were *** strategy included indiscriminately testing the entire population of the State,reaching more than 40 million people at a maximum cost of 2.25 billion USD,that would reduce the total number of cases by the end of 2020 by 90%.The second strategy investigated testing only symptomatic cases and their immediate contacts e this strategy reached a maximum cost of 150 million USD but also reduced the number of cases by 90%.The conclusion is that if the State of São Paulo had decided to adopt the simulated strategy on April the 1st,it would have been possible to reduce the total number of cases by 90%at a cost of 2.25 billion US dollars for the indiscriminate strategy but at a much smaller cost of 125 million US dollars for the selective testing of symptomatic cases and their contacts.

关键词： COVID-19 SARS-CoV-2 Testing Cost-analysis Modelling

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