Publications by authors named "Gustavo Amorim"

Observational databases provide unprecedented opportunities for secondary use in biomedical research. However, these data can be error-prone and must be validated before use. It is usually unrealistic to validate the whole database because of resource constraints.

View Article and Find Full Text PDF
Article Synopsis
  • Gut dysbiosis is thought to be connected to immune-mediated diseases like psoriasis, with this study focusing on the gut microbiome in patients with severe psoriatic disease and those with psoriatic arthritis.
  • The research utilized 16S rRNA gene sequencing to analyze stool samples from 30 patients, revealing significant differences in the gut microbiome composition, particularly an increase in the Bacteroides genus in those with psoriatic arthritis.
  • Although the study highlights these microbiome differences, it notes limitations like the small patient group and ongoing questions about whether gut dysbiosis is a cause or effect of the disease, emphasizing the potential for future interventions.
View Article and Find Full Text PDF

Background: Despite receiving adequate treatment, many tuberculosis (TB) survivors are left with post-tuberculosis complications, possibly due to lung tissue damage incurred during the active period of the disease. Current TB programs worldwide deliver quality care throughout the course of active TB treatment, yet often fail to provide organized follow-up once treatment ends. Post-tuberculosis lung disease (PTLD) is a prominent, yet underrecognized cause of chronic lung disease, managed similarly to chronic respiratory diseases with pharmacotherapy and/or personalized pulmonary rehabilitation interventions.

View Article and Find Full Text PDF
Article Synopsis
  • TB treatment response varies based on genetic ancestry, with a study in Brazil showing differing risks for adverse drug reactions (ADRs) linked to African and European ancestry.
  • Patients with a higher proportion of African ancestry had a lower risk of Grade 2+ ADRs, while those with higher European ancestry faced an increased risk; however, this trend changed for patients living with HIV.
  • The research involved 941 pulmonary TB patients, and no significant associations were found for Amerindian ancestry or other treatment outcomes in the cohort.
View Article and Find Full Text PDF
Article Synopsis
  • The study established new therapeutic drug ranges (TDR) for standard anti-tuberculosis (TB) drugs aimed at minimizing toxicity while maximizing effectiveness in treating TB.
  • It analyzed data from 448 patients with drug-susceptible pulmonary TB, identifying drug concentrations that maintained a low probability of adverse drug reactions (ADR) and a high probability of treatment success.
  • Findings revealed that the TDR for isoniazid (INH) and rifampin (RIF) were different from current recommendations, suggesting higher upper limits for INH and lower for RIF, while the ranges for ethambutol (EMB) and pyrazinamide (PZA) were consistent with existing guidelines.
View Article and Find Full Text PDF

Antimicrobials are the most frequently prescribed drug in pediatrics, with an estimated 37% of infants and 61% of hospitalized children having received them. Approximately 20-50% of prescriptions have been shown to be potentially unnecessary or inappropriate. The World Health Organization (WHO) estimates that the continued increase in antimicrobial resistance by the year 2050 will lead to the death of 10 million people per year.

View Article and Find Full Text PDF

Background: Since 2014, Brazil has gradually implemented the Xpert MTB/RIF (Xpert) test to enhance early tuberculosis (TB) and drug-resistant (DR-TB) detection and control, yet its nationwide impact remains underexplored. Our study conducts an intervention time-series analysis (ITSA) to evaluate how the Xpert's implementation has improved TB and DR-TB detection nationwide.

Methods: 1,061,776 cases from Brazil's National TB Registry (2011-2022) were reviewed and ITSA (2011-2019) was used to gauge the impact of the Xpert's adoption on TB and DR-TB notification.

View Article and Find Full Text PDF

Diagnosis of M. tuberculosis (Mtb) infection in close contacts is critical for TB control. Smoking is a risk factor for Mtb infection and TB disease but its effect on longitudinal interferon-gamma release assay (IGRA) results remains unknown.

View Article and Find Full Text PDF

The study evoluated an in-house Spike Receptor Binding Domain Enzyme-Linked Immunosorbent Assay (RBD-IgG-ELISA) for detecting SARS-CoV-2 IgG antibodies in infected and vaccinated individuals. The assay demonstrated a sensitivity of 91%, specificity of 99.25%, and accuracy of 95.

View Article and Find Full Text PDF

Introduction: Patient satisfaction with clinical services can have an effect on retention in HIV care and adherence to antiretroviral therapy. This study assessed patient satisfaction and its association with retention and viral suppression in Zambézia Province, Mozambique.

Methods: Monthly exit interviews with persons living with HIV were completed from August 2017-January 2019 in 20 health facilities; clinical data were extracted from medical records.

View Article and Find Full Text PDF

Validation studies are often used to obtain more reliable information in settings with error-prone data. Validated data on a subsample of subjects can be used together with error-prone data on all subjects to improve estimation. In practice, more than one round of data validation may be required, and direct application of standard approaches for combining validation data into analyses may lead to inefficient estimators since the information available from intermediate validation steps is only partially considered or even completely ignored.

View Article and Find Full Text PDF

Globally, viral pathogens are the leading cause of acute respiratory infection in children under-five years. We aim to describe the epidemiology of viral respiratory pathogens in hospitalized children under-two years of age in Eastern Province of Sierra Leone, during the second year of the SARS-CoV-2 pandemic. We conducted a prospective study of children hospitalized with respiratory symptoms between October 2020 and October 2021.

View Article and Find Full Text PDF

Background: Lower respiratory tract infections are the leading cause of mortality in young children globally. In many resource-limited settings clinicians rely on guidelines such as IMCI or ETAT + that promote empiric antibiotic utilization for management of acute respiratory illness (ARI). Numerous evaluations of both guidelines have shown an overall positive response however, several challenges have also been reported, including the potential for over-prescribing of unnecessary antibiotics.

View Article and Find Full Text PDF

Background: Genetic polymorphisms have been associated with risk of anti-tuberculosis treatment toxicity. We characterized associations with adverse events and treatment failure/recurrence among adults treated for tuberculosis in Brazil.

Methods: Participants were followed in Regional Prospective Observational Research in Tuberculosis (RePORT)-Brazil.

View Article and Find Full Text PDF

Background: An estimated 2.4 million babies died within the first 28 days of life in 2020. The third leading cause of neonatal death continues to be neonatal sepsis.

View Article and Find Full Text PDF

Introduction: As COVID-19 continues to spread globally and within Mozambique, its impact among immunosuppressed persons, specifically persons living with HIV (PLHIV), and on the health system is unknown in the country. The 'id and h' (COVIV) study aims to investigate: (1) the seroprevalence and seroincidence of SARS-CoV-2 among PLHIV and healthcare workers providing HIV services; (2) knowledge, attitudes, practices and perceptions regarding SARS-CoV-2 infection; (3) the pandemic's impact on HIV care continuum outcomes and (4) facility level compliance with national COVID-19 guidelines.

Methods And Analysis: A multimethod study will be conducted in a maximum of 11 health facilities across Mozambique, comprising four components: (1) a cohort study among PLHIV and healthcare workers providing HIV services to determine the seroprevalence and seroincidence of SARS-CoV-2, (2) a structured survey to assess knowledge, attitudes, perceptions and practices regarding COVID-19 disease, (3) analysis of aggregated patient data to evaluate retention in HIV services among PLHIV, (4) an assessment of facility implementation of infection prevention and control measures.

View Article and Find Full Text PDF

The community adherence support group (CASG) was one of the first differentiated service delivery (DSD) models introduced in Mozambique. This study assessed the impact of this model on retention in care, loss to follow-up (LTFU), and viral suppression among antiretroviral therapy (ART)-treated adults in Mozambique. A retrospective cohort study included CASG-eligible adults enrolled between April 2012 and October 2017 at 123 health facilities in Zambézia Province.

View Article and Find Full Text PDF

Objectives: to identify in scientific literature which simulated clinical scenarios were developed and validated for teaching and learning in nursing.

Methods: integrative review, carried out in seven sources of information. The Rayyan program was used for selection, content analysis to explore the findings and the methodological assessment tool of the validity process, entitled Quality Appraisal tool for Validity Studies.

View Article and Find Full Text PDF

Objective: To analyze the association of dysglycemia with clinical, laboratory, and radiographic characteristics of patients with pulmonary tuberculosis (PTB), as well as with their tuberculosis treatment outcomes.

Methods: This was a longitudinal study involving 140 patients diagnosed with PTB (positive cultures for Mycobacterium tuberculosis or positive Xpert MTB/RIF results from sputum samples). Patients were evaluated at diagnosis (M0), after completing the second month of treatment (M2), and at the end of treatment (MEND).

View Article and Find Full Text PDF

Introduction: Contraceptive implants containing etonogestrel and levonorgestrel have emerged as popular contraceptive options among women in areas of high HIV burden in sub-Saharan Africa. However, recent pharmacokinetic data have shown drug-drug interactions between implants and efavirenz-containing antiretroviral therapy (ART), reducing the effectiveness of the implants. Here, we evaluated pregnancy incidence in 6-month intervals following implant initiation among women using efavirenz and contraceptive implants to assess whether the risk of breakthrough pregnancy is higher after specific periods of implant use.

View Article and Find Full Text PDF

Background: Successful tuberculosis (TB) treatment is necessary for disease control. The World Health Organization (WHO) has a target TB treatment success rate of ≥90%. We assessed whether the different types of unfavorable TB treatment outcome had different predictors.

View Article and Find Full Text PDF

Introduction: Mentor Mothers (MM) provide peer support to pregnant and postpartum women living with HIV (PPWH) and their infants with perinatal HIV exposure (IPE) throughout the cascade of prevention of vertical transmission (PVT) services. MM were implemented in Zambézia Province, Mozambique starting in August 2017. This evaluation aimed to determine the effect of MM on PVT outcomes.

View Article and Find Full Text PDF