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巴西里约热内卢一个低收入城区的基于人群的出生队列研究:研究的实施和特征描述。

A populational-based birth cohort study in a low-income urban area in Rio de Janeiro, Brazil: implementation and description of the characteristics of the study.

机构信息

Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz, Rio de Janeiro, Brasil.

Programa de Computação Científica, Fundação Oswaldo Cruz, Rio de Janeiro, Brasil.

出版信息

Cad Saude Publica. 2019 May 23;35(5):e00023918. doi: 10.1590/0102-311X00023918.

Abstract

A comprehensive cohort study including an entomological surveillance component can contribute to our knowledge of clinical aspects and transmission patterns of arbovirosis. This article describes the implementation of a populational-based birth cohort study that included an entomological surveillance component, and its associated challenges in a low-income community of Rio de Janeiro, Brazil. The participants were recruited in two periods: from 2012 to 2014, and from 2015 to 2017. The children had scheduled pediatric consultations and in case of fever. Epidemiological, clinical data and biological samples were collected at pediatric visits. Active febrile surveillance was performed by telephone calls, social networking, message apps, and household visits. A total of 387 newborns and 332 new children were included during the first and second recruitment periods, respectively. By July 2017, there were 451 children on follow-up. During the study, 2,759 pediatric visits were performed: 1,783 asymptomatic and 976 febrile/rash consultations. The number of febrile or rash consultations increased 3.5-fold after the use of media tools for surveillance. No temporal pattern, seasonality or peak of febrile cases was observed during the study period. A total of 10,105 adult mosquitoes (including 3,523 Aedes spp. and 6,582 Culex quinquefasciatus) and 46,047 Aedes eggs were collected from households, schools, and key sites. Although challenging, this structured sentinel populational-based birth cohort is relevant to the knowledge of risks and awareness of emerging pathogens.

摘要

一项包含昆虫学监测部分的全面队列研究可以帮助我们了解虫媒病毒病的临床方面和传播模式。本文描述了在巴西里约热内卢一个低收入社区实施的一项基于人群的出生队列研究,该研究包括昆虫学监测部分,以及在实施过程中遇到的挑战。参与者分两个阶段招募:2012 年至 2014 年和 2015 年至 2017 年。儿童定期接受儿科就诊,如果发烧则进行就诊。在儿科就诊时收集流行病学、临床数据和生物样本。通过电话、社交网络、消息应用程序和家访进行主动发热监测。在第一个和第二个招募期分别有 387 名新生儿和 332 名新儿童入组。截至 2017 年 7 月,共有 451 名儿童接受随访。在研究期间,共进行了 2759 次儿科就诊:1783 次无症状就诊和 976 次发热/出疹就诊。使用监测媒体工具后,发热或出疹就诊的次数增加了 3.5 倍。在研究期间未观察到发热病例的时间模式、季节性或高峰期。共从家庭、学校和重点场所采集到 10105 只成年蚊子(包括 3523 只埃及伊蚊和 6582 只致倦库蚊)和 46047 只埃及伊蚊卵。尽管具有挑战性,但这种结构化的哨点人群出生队列研究对于了解风险和新兴病原体的认识具有重要意义。

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