Pritesh Lalwani1, Bárbara Batista Salgado2, Ivanildo Vieira Pereira Filho3, Danielle Severino Sena da Silva2, Thiago Barros do Nascimento de Morais2, Maele Ferreira Jordão2, Aguyda Rayany Cavalcante Barbosa4, Isabelle Bezerra Cordeiro5, Júlio Nino de Souza Neto6, Enedina Nogueira de Assunção6, Rafaella Oliveira Dos Santos2, Nani Oliveira Carvalho2, Wlademir Braga Salgado Sobrinho2, Cristiano Fernandes da Costa7, Pedro Elias de Souza8, Bernardino Claudio de Albuquerque9, Christian A Ganoza10, Roger V Araujo-Castillo11, Spartaco Astofi Filho12, Jaila Dias Borges Lalwani13. 1. Instituto Leônidas e Maria Deane (ILMD), Fiocruz Amazônia, Manaus, Amazonas, Brazil. Electronic address: pritesh.lalwani@fiocruz.br. 2. Instituto Leônidas e Maria Deane (ILMD), Fiocruz Amazônia, Manaus, Amazonas, Brazil. 3. Instituto Leônidas e Maria Deane (ILMD), Fiocruz Amazônia, Manaus, Amazonas, Brazil; Faculdade de Ciências Farmacêuticas (FCF), Universidade Federal do Amazonas (UFAM), Manaus, Amazonas, Brazil. 4. Instituto Leônidas e Maria Deane (ILMD), Fiocruz Amazônia, Manaus, Amazonas, Brazil; Instituto de Ciências Biológicas (ICB), Universidade Federal do Amazonas (UFAM), Manaus, Amazonas, Brazil. 5. Instituto de Ciências Biológicas (ICB), Universidade Federal do Amazonas (UFAM), Manaus, Amazonas, Brazil. 6. Centro de Apoio Multidisciplinar (CAM), Universidade Federal do Amazonas (UFAM), Manaus, Amazonas, Brazil. 7. Fundação de Vigilância em Saúde do Amazonas (FVS/AM), Manaus, Amazonas, Brazil. 8. Programa de Pós - Graduação em Cirurgia, Faculdade de Medicina, Universidade Federal do Amazona (UFAM), Manaus, Amazonas, Brazil. 9. Faculdade de Medicina (FM), Universidade Federal do Amazonas (UFAM), Manaus, Amazonas, Brazil. 10. Instituto de Medicina Tropical Alexander von Humboldt, Universidad Peruana Cayetano Heredia, Lima, Peru. 11. Facultad de Ciencias de la Salud, Universidad Peruana de Ciencias Aplicadas, Lima, Peru. 12. Instituto de Ciências Biológicas (ICB), Universidade Federal do Amazonas (UFAM), Manaus, Amazonas, Brazil; Centro de Apoio Multidisciplinar (CAM), Universidade Federal do Amazonas (UFAM), Manaus, Amazonas, Brazil. 13. Faculdade de Ciências Farmacêuticas (FCF), Universidade Federal do Amazonas (UFAM), Manaus, Amazonas, Brazil. Electronic address: jaila@ufam.edu.br.
Abstract
BACKGROUND: Manaus located in the Brazilian rainforest has twice experienced a health system collapse due to the SARS-CoV-2 pandemic. However, little is known about which groups among the general population have been more affected. METHODS: A convenience sampling strategy via online advertising recruited 3046 adults between 19/08/2020 and 02/10/2020. Sociodemographic characteristics, COVID-19-related symptoms, COVID-19 testing, self-medication and prescribed medications were recorded. Serum anti-SARS-CoV-2 nucleocapsid IgG antibodies were measured with an ELISA. Prevalence ratios (PR) were obtained using cluster-corrected and adjusted Poisson's regression models. RESULTS: A crude positivity rate among asymptomatic and symptomatic individuals, was estimated at 29.10%, with a maximum possible seroprevalence of 44.82% corrected by test characteristics and an antibody decay rate of 32.31%. Regression models demonstrated a strong association towards marginalized low-income and vulnerable residents with limited health access. Presence of a COVID-19 case (PR 1.39, 1.24-1.57) or death (PR 2.14, 1.74-2.62) in a household increased greatly the risk of other household members acquiring infection. SARS-CoV-2 seroprevalence was higher among those who self-medicated to prevent infection (PR 1.36, 1.27-1.46). CONCLUSIONS: A disproportionate social and economic disparity was observed among the study participants. The syndemic nature of COVID-19 in the Amazon region needs differential policies and urgent solutions to control the ongoing pandemic.
BACKGROUND: Manaus located in the Brazilian rainforest has twice experienced a health system collapse due to the SARS-CoV-2 pandemic. However, little is known about which groups among the general population have been more affected. METHODS: A convenience sampling strategy via online advertising recruited 3046 adults between 19/08/2020 and 02/10/2020. Sociodemographic characteristics, COVID-19-related symptoms, COVID-19 testing, self-medication and prescribed medications were recorded. Serum anti-SARS-CoV-2 nucleocapsid IgG antibodies were measured with an ELISA. Prevalence ratios (PR) were obtained using cluster-corrected and adjusted Poisson's regression models. RESULTS: A crude positivity rate among asymptomatic and symptomatic individuals, was estimated at 29.10%, with a maximum possible seroprevalence of 44.82% corrected by test characteristics and an antibody decay rate of 32.31%. Regression models demonstrated a strong association towards marginalized low-income and vulnerable residents with limited health access. Presence of a COVID-19 case (PR 1.39, 1.24-1.57) or death (PR 2.14, 1.74-2.62) in a household increased greatly the risk of other household members acquiring infection. SARS-CoV-2 seroprevalence was higher among those who self-medicated to prevent infection (PR 1.36, 1.27-1.46). CONCLUSIONS: A disproportionate social and economic disparity was observed among the study participants. The syndemic nature of COVID-19 in the Amazon region needs differential policies and urgent solutions to control the ongoing pandemic.
Authors: Swapnil Mishra; Sören Mindermann; Mrinank Sharma; Charles Whittaker; Thomas A Mellan; Thomas Wilton; Dimitra Klapsa; Ryan Mate; Martin Fritzsche; Maria Zambon; Janvi Ahuja; Adam Howes; Xenia Miscouridou; Guy P Nason; Oliver Ratmann; Elizaveta Semenova; Gavin Leech; Julia Fabienne Sandkühler; Charlie Rogers-Smith; Michaela Vollmer; H Juliette T Unwin; Yarin Gal; Meera Chand; Axel Gandy; Javier Martin; Erik Volz; Neil M Ferguson; Samir Bhatt; Jan M Brauner; Seth Flaxman Journal: EClinicalMedicine Date: 2021-07-31
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Authors: Maria Karoliny da Silva Torres; Felipe Teixeira Lopes; Aline Cecy Rocha de Lima; Carlos Neandro Cordeiro Lima; Wandrey Roberto Dos Santos Brito; Bernardo Cintra Dos Santos; Renata Santos de Sousa; Jayanne Lilian Carvalho Gomes; Bruno José Sarmento Botelho; Ana Carolina Alves Correa; Luiz Fernando A Machado; Rosimar Neris Martins Feitosa; Sandra Souza Lima; Izaura Maria Vieira Cayres Vallinoto; Antonio Carlos R Vallinoto Journal: Sci Rep Date: 2022-05-20 Impact factor: 4.996
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