EDUARDO MASSAD
Projetos de Pesquisa
Unidades Organizacionais
Departamento de MedicinaLegal, Ética Médica e Medicina Social e do Trabalho, Faculdade de Medicina - Docente
LIM/01 - Laboratório de Informática Médica, Hospital das Clínicas, Faculdade de Medicina - Líder
LIM/01 - Laboratório de Informática Médica, Hospital das Clínicas, Faculdade de Medicina - Líder
46 resultados
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- Potential exposure to Zika virus for foreign tourists during the 2016 Carnival and Olympic Games in Rio de Janeiro, Brazil(2016) BURATTINI, M. N.; COUTINHO, F. A. B.; LOPEZ, L. F.; XIMENES, R.; QUAM, M.; WILDER-SMITH, A.; MASSAD, E.
- The risk of dengue for non-immune foreign visitors to the 2016 summer olympic games in Rio de Janeiro, Brazil(2016) XIMENES, Raphael; AMAKU, Marcos; LOPEZ, Luis Fernandez; COUTINHO, Francisco Antonio Bezerra; BURATTINI, Marcelo Nascimento; GREENHALGH, David; WILDER-SMITH, Annelies; STRUCHINER, Claudio Jose; MASSAD, EduardoBackground: Rio de Janeiro in Brazil will host the Summer Olympic Games in 2016. About 400,000 non-immune foreign tourists are expected to attend the games. As Brazil is the country with the highest number of dengue cases worldwide, concern about the risk of dengue for travelers is justified. Methods: A mathematical model to calculate the risk of developing dengue for foreign tourists attending the Olympic Games in Rio de Janeiro in 2016 is proposed. A system of differential equation models the spread of dengue amongst the resident population and a stochastic approximation is used to assess the risk to tourists. Historical reported dengue time series in Rio de Janeiro for the years 2000-2015 is used to find out the time dependent force of infection, which is then used to estimate the potential risks to a large tourist cohort. The worst outbreak of dengue occurred in 2012 and this and the other years in the history of Dengue in Rio are used to discuss potential risks to tourists amongst visitors to the forthcoming Rio Olympics. Results: The individual risk to be infected by dengue is very much dependent on the ratio asymptomatic/symptomatic considered but independently of this the worst month of August in the period studied in terms of dengue transmission, occurred in 2007. Conclusions: If dengue returns in 2016 with the pattern observed in the worst month of August in history (2007), the expected number of symptomatic and asymptomatic dengue cases among tourists will be 23 and 206 cases, respectively. This worst case scenario would have an incidence of 5.75 (symptomatic) and 51.5 (asymptomatic) per 100,000 individuals.
- The cost of dengue control(2011) MASSAD, Eduardo; COUTINHO, Francisco Antonio Bezerra
conferenceObject The risk of infectious diseases introduction into non-infected countries by travelers visiting endemic countries(2015) MASSAD, E.; LOPEZ, L. F.; AMAKU, M.; COUTINHO, F. A. B.; QUAM, M.; BURATTINI, M. N.; STRUCHINER, C. J.; WILDER-SMITH, A.- A Note on the Risk of Infections Invading Unaffected Regions(2018) AMAKU, Marcos; COUTINHO, Francisco Antonio Bezerra; ARMSTRONG, Margaret; MASSAD, EduardoWe present two probabilistic models to estimate the risk of introducing infectious diseases into previously unaffected countries/regions by infective travellers. We analyse two distinct situations, one dealing with a directly transmitted infection (measles in Italy in 2017) and one dealing with a vector-borne infection (Zika virus in Rio de Janeiro, which may happen in the future). To calculate the risk in the first scenario, we used a simple, nonhomogeneous birth process. The second model proposed in this paper provides a way to calculate the probability that local mosquitoes become infected by the arrival of a single infective traveller during his/her infectiousness period. The result of the risk ofmeasles invasion of Italy was of 93% and the result of the risk of Zika virus invasion of Rio de Janeiro was of 22%.
- The risk of urban yellow fever resurgence in Aedes-infested American cities(2018) MASSAD, Eduardo; AMAKU, Marcos; COUTINHO, Francisco Antonio Bezerra; STRUCHINER, Claudio Jose; LOPEZ, Luis Fernandez; COELHO, Giovanini; WILDER-SMITH, Annelies; BURATTINI, Marcelo NascimentoAedes aegypti, historically known as yellow fever (YF) mosquito, transmits a great number of other viruses such as Dengue, West Nile, Chikungunya, Zika, Mayaro and perhaps Oropouche, among others. Well established in Africa and Asia, Aedes mosquitoes are now increasingly invading large parts of the American continent, and hence the risk of urban YF resurgence in the American cities should because of great concern to public health authorities. Although no new urban cycle of YF was reported in the Americas since the end of an Aedes eradication programme in the late 1950s, the high number of non-vaccinated individuals that visit endemic areas, that is, South American jungles where the sylvatic cycle of YF is transmitted by canopy mosquitoes, and return to Aedes-infested urban areas, increases the risk of resurgence of the urban cycle of YF. We present a method to estimate the risk of urban YF resurgence in dengue-endemic cities. This method consists in (1) to estimate the number of Aedes mosquitoes that explains a given dengue outbreak in a given region; (2) calculate the force of infection caused by the introduction of one infective individual per unit area in the endemic area under study; (3) using the above estimates, calculate the probability of at least one autochthonous YF case per unit area produced by one single viraemic traveller per unit area arriving from a YF endemic or epidemic sylvatic region at the city studied. We demonstrate that, provided the relative vector competence, here defined as the capacity to being infected and disseminate the virus, of Ae. aegypti is greater than 0.7 (with respect to dengue), one infected traveller can introduce urban YF in a dengue endemic area.
- Interpretations and pitfalls in modelling vector-transmitted infections(2015) AMAKU, M.; AZEVEDO, F.; BURATTINI, M. N.; COUTINHO, F. A. B.; LOPEZ, L. F.; MASSAD, E.In this paper we propose a debate on the role of mathematical models in evaluating control strategies for vector-borne infections. Mathematical models must have their complexity adjusted to their goals, and we have basically two classes of models. At one extreme we have models that are intended to check if our intuition about why a certain phenomenon occurs is correct. At the other extreme, we have models whose goals are to predict future outcomes. These models are necessarily very complex. There are models in between these classes. Here we examine two models, one of each class and study the possible pitfalls that may be incurred. We begin by showing how to simplify the description of a complicated model for a vector-borne infection. Next, we examine one example found in a recent paper that illustrates the dangers of basing control strategies on models without considering their limitations. The model in this paper is of the second class. Following this, we review an interesting paper (a model of the first class) that contains some biological assumptions that are inappropriate for dengue but may apply to other vector-borne infections. In conclusion, we list some misgivings about modelling presented in this paper for debate.
- A public health risk assessment for yellow fever vaccination: a model exemplified by an outbreak in the state of Sao Paulo, Brazil(2015) RIBEIRO, Ana Freitas; TENGAN, Cilea; SATO, Helena Keico; SPINOLA, Roberta; MASCHERETTI, Melissa; FRANCA, Ana Cecilia Costa; PORT-CARVALHO, Marcio; PEREIRA, Mariza; SOUZA, Renato Pereira de; AMAKU, Marcos; BURATTINI, Marcelo Nascimento; COUTINHO, Francisco Antonio Bezerra; LOPEZ, Luis Fernandez; MASSAD, EduardoWe propose a method to analyse the 2009 outbreak in the region of Botucatu in the state of Sao Paulo (SP), Brazil, when 28 yellow fever (YF) cases were confirmed, including 11 deaths. At the time of the outbreak, the Secretary of Health of the State of Sao Paulo vaccinated one million people, causing the death of five individuals, an unprecedented number of YF vaccine-induced fatalities. We apply a mathematical model described previously to optimise the proportion of people who should be vaccinated to minimise the total number of deaths. The model was used to calculate the optimum proportion that should be vaccinated in the remaining, vaccine-free regions of SP, considering the risk of vaccine-induced fatalities and the risk of YF outbreaks in these regions.
- A Comparative Analysis of the Relative Efficacy of Vector-Control Strategies Against Dengue Fever(2014) AMAKU, Marcos; COUTINHO, Francisco Antonio Bezerra; RAIMUNDO, Silvia Martorano; LOPEZ, Luis Fernandez; BURATTINI, Marcelo Nascimento; MASSAD, EduardoDengue is considered one of the most important vector-borne infection, affecting almost half of the world population with 50 to 100 million cases every year. In this paper, we present one of the simplest models that can encapsulate all the important variables related to vector control of dengue fever. The model considers the human population, the adult mosquito population and the population of immature stages, which includes eggs, larvae and pupae. The model also considers the vertical transmission of dengue in the mosquitoes and the seasonal variation in the mosquito population. From this basic model describing the dynamics of dengue infection, we deduce thresholds for avoiding the introduction of the disease and for the elimination of the disease. In particular, we deduce a Basic Reproduction Number for dengue that includes parameters related to the immature stages of the mosquito. By neglecting seasonal variation, we calculate the equilibrium values of the model's variables. We also present a sensitivity analysis of the impact of four vector-control strategies on the Basic Reproduction Number, on the Force of Infection and on the human prevalence of dengue. Each of the strategies was studied separately from the others. The analysis presented allows us to conclude that of the available vector control strategies, adulticide application is the most effective, followed by the reduction of the exposure to mosquito bites, locating and destroying breeding places and, finally, larvicides. Current vector-control methods are concentrated on mechanical destruction of mosquitoes' breeding places. Our results suggest that reducing the contact between vector and hosts (biting rates) is as efficient as the logistically difficult but very efficient adult mosquito's control.
- Maximum Equilibrium Prevalence of Mosquito-Borne Microparasite Infections in Humans(2013) AMAKU, Marcos; BURATTINI, Marcelo Nascimento; COUTINHO, Francisco Antonio Bezerra; LOPEZ, Luis Fernandez; MASSAD, EduardoTo determine the maximum equilibrium prevalence of mosquito-borne microparasitic infections, this paper proposes a general model for vector-borne infections which is flexible enough to comprise the dynamics of a great number of the known diseases transmitted by arthropods. From equilibrium analysis, we determined the number of infected vectors as an explicit function of the model's parameters and the prevalence of infection in the hosts. From the analysis, it is also possible to derive the basic reproduction number and the equilibrium force of infection as a function of those parameters and variables. From the force of infection, we were able to conclude that, depending on the disease's structure and the model's parameters, there is a maximum value of equilibrium prevalence for each of the mosquito-borne microparasitic infections. The analysis is exemplified by the cases of malaria and dengue fever. With the values of the parameters chosen to illustrate those calculations, the maximum equilibrium prevalence found was 31% and 0.02% for malaria and dengue, respectively. The equilibrium analysis demonstrated that there is a maximum prevalence for the mosquito-borne microparasitic infections.