ERIKA REGINA MANULI
Projetos de Pesquisa
Unidades Organizacionais
LIM/46 - Laboratório de Parasitologia Médica, Hospital das Clínicas, Faculdade de Medicina
3 resultados
Resultados de Busca
Agora exibindo 1 - 3 de 3
- Performance Evaluation of VIDAS(& REG;) Diagnostic Assays Detecting Anti-Chikungunya Virus IgM and IgG Antibodies: An International Study(2023) PEREIRA, Geovana M.; MANULI, Erika R.; COULON, Laurie; CORTES, Marina F.; RAMUNDO, Mariana S.; DROMENQ, Loic; LARUE-TRIOLET, Audrey; RAYMOND, Frederique; TOURNEUR, Carole; LAZARI, Carolina dos Santos; BRASIL, Patricia; FILIPPIS, Ana Maria Bispo de; PARANHOS-BACCALA, Glaucia; BANZ, Alice; SABINO, Ester C.Chikungunya (CHIK) is a debilitating mosquito-borne disease with an epidemiology and early clinical symptoms similar to those of other arboviruses-triggered diseases such as dengue or Zika. Accurate and rapid diagnosis of CHIK virus (CHIKV) infection is therefore challenging. This international study evaluated the performance of the automated VIDAS(& REG;) anti-CHIKV IgM and IgG assays compared to that of manual competitor IgM and IgG ELISA for the detection of anti-CHIKV IgM and IgG antibodies in 660 patients with suspected CHIKV infection. Positive and negative agreements of the VIDAS(& REG;) CHIKV assays with ELISA ranged from 97.5% to 100.0%. The sensitivity of the VIDAS(& REG;) CHIKV assays evaluated in patients with a proven CHIKV infection confirmed reported kinetics of anti-CHIKV IgM and IgG response, with a positive detection of 88.2-100.0% for IgM & GE; 5 days post symptom onset and of 100.0% for IgG & GE; 11 days post symptom onset. Our study also demonstrated the superiority of ELISA and VIDAS(& REG;) assays over rapid diagnostic IgM/IgG tests. The analytical performance of VIDAS(& REG;) anti-CHIKV IgM and IgG assays was excellent, with a high precision (coefficients of variation & LE; 7.4%) and high specificity (cross-reactivity rate & LE; 2.9%). This study demonstrates the suitability of the automated VIDAS(& REG;) anti-CHIKV IgM and IgG assays to diagnose CHIKV infections and supports its applicability for epidemiological surveillance and differential diagnosis in regions endemic for CHIKV.
- Clinical markers of post-Chikungunya chronic inflammatory joint disease: A Brazilian cohort(2023) LAZARI, Carolina dos Santos; RAMUNDO, Mariana Severo; TEN-CATEN, Felipe; BRESSAN, Clarisse S.; FILIPPIS, Ana Maria Bispo de; MANULI, Erika Regina; MORAES, Isabella de; PEREIRA, Geovana Maria; CORTES, Marina Farrel; CANDIDO, Darlan da Silva; GERBER, Alexandra L.; GUIMARAES, Ana Paula; FARIA, Nuno Rodrigues; NAKAYA, Helder I.; VASCONCELOS, Ana Tereza R.; BRASIL, Patricia; PARANHOS-BACCALA, Glaucia; SABINO, Ester CerdeiraBackgroundChikungunya-fever (CHIKF) remains a public health major issue. It is clinically divided into three phases: acute, post-acute and chronic. Chronic cases correspond to 25-40% individuals and, though most of them are characterized by long-lasting arthralgia alone, many of them exhibit persistent or recurrent inflammatory signs that define post-Chikungunya chronic inflammatory joint disease (pCHIKV-CIJD). We aimed to identify early clinical markers of evolution to pCHIKV-CIJD during acute and post-acute phases. Methodology/Principal findingsWe studied a prospective cohort of CHIKF-confirmed volunteers with longitudinal clinical data collection from symptoms onset up to 90 days, including a 21-day visit (D21). Of 169 patients with CHIKF, 86 (50.9%) completed the follow-up, from whom 39 met clinical criteria for pCHIKV-CIJD (45.3%). The relative risk of chronification was higher in women compared to men (RR = 1.52; 95% CI = 1.15-1.99; FDR = 0.03). None of the symptoms or signs presented at D0 behaved as an early predictor of pCHIKV-CIJD, while being symptomatic at D21 was a risk factor for chronification (RR = 1.31; 95% CI = 1.09-1.55; FDR = 0.03). Significance was also observed for joint pain (RR = 1.35; 95% CI = 1.12-1.61; FDR = 0.02), reported edema (RR = 3.61; 95% CI = 1.44-9.06; FDR = 0.03), reported hand and/or feet small joints edema (RR = 4.22; 95% CI = 1.51-11.78; FDR = 0.02), and peri-articular edema observed during physical examination (RR = 2.89; 95% CI = 1.58-5.28; FDR = 0.002). Furthermore, patients with no findings in physical examination at D21 were at lower risk of chronic evolution (RR = 0.41, 95% CI = 0.24-0.70, FDR = 0.01). Twenty-nine pCHIKV-CIJD patients had abnormal articular ultrasonography (90.6% of the examined). The most common indings were synovitis (65.5%) and joint effusion (58.6%). ConclusionThis cohort has provided important insights into the prognostic evaluation of CHIKF. Symptomatic sub-acute disease is a relevant predictor of evolution to chronic arthritis with synovitis, drawing attention to joint pain, edema, multiple articular involvement including small hand and feet joints as risk factors for chronification beyond three months, especially in women. Future studies are needed to accomplish the identification of accurate and early biomarkers of poor clinical prognosis, which would allow better understanding of the disease's evolution and improve patients' management, modifying CHIKF burden on global public health. Author summaryChikungunya fever (CHIKF) is a vector-borne viral disease first described in 1952 in Africa, which recently reached the Americas, where it then originated epidemics of unprecedented magnitude. Its acute phase is characterized by fever associated with joint pain and edema, which resolve in about seven days for most patients. However, 25-40% of these patients develop chronic musculoskeletal and arthritic symptoms, which may be incapacitating and lead to permanent joint damage. We have conducted a prospective longintudinal cohort of CHIKF confirmed individuals, in Brazil, which aimed to identify clinical early markers of evolution to post-Chikungunya chronic inflammatory joint disease (pCHIKV-CIJD) after 90 days, using objective physical examination to define pCHIKV-CIJD. We have also performed joint ultrasonography to improve evaluation of chronic arthritis. We found that 45.3% of patients who completed the follow-up met criteria for pCHIKV-CIJD. Women were at higher risk of chronification, as well as individuals who remain symptomatic 21 days after the onset of symptoms. Abnormal ultrasonography results were seen in 90.6% of examined pCHIKV-CIJD patients, in whom synovitis and joint effusion were the most commom songraphic signs, affecting mostly ankles and knees. The adoption of objective criteria to define pCHIKV-CIJD is crucial to estimate accurately the proportion of patients who evolve to chronic rheumatism, and to indentify early risk factors to this outcome, which may add important information to tailor therapeutic strategies for this particular population. It may also help to understand the burden of CHIKF in developing countries, measuring either its impact in individual's quality of life, or its communitary repercussion after widespread outbreaks.
- Evolution and epidemic spread of SARS-CoV-2 in Brazil(2020) CANDIDO, Darlan S.; CLARO, Ingra M.; JESUS, Jaqueline G. de; SOUZA, William M.; MOREIRA, Filipe R. R.; DELLICOUR, Simon; MELLAN, Thomas A.; PLESSIS, Louis du; PEREIRA, Rafael H. M.; SALES, Flavia C. S.; MANULI, Erika R.; THEZE, Julien; ALMEIDA, Luiz; MENEZES, Mariane T.; VOLOCH, Carolina M.; FUMAGALLI, Marcilio J.; COLETTI, Thais M.; SILVA, Camila A. M.; RAMUNDO, Mariana S.; AMORIM, Mariene R.; HOELTGEBAUM, Henrique H.; MISHRA, Swapnil; GILL, Mandev S.; CARVALHO, Luiz M.; BUSS, Lewis F.; JR, Carlos A. Prete; ASHWORTH, Jordan; I, Helder Nakaya; PEIXOTO, Pedro S.; BRADY, Oliver J.; NICHOLLS, Samuel M.; TANURI, Amilcar; ROSSI, Atila D.; V, Carlos K. Braga; GERBER, Alexandra L.; GUIMARAES, Ana Paula de C.; JR, Nelson Gaburo; ALENCAR, Cecila Salete; FERREIRA, Alessandro C. S.; LIMA, Cristiano X.; LEVI, Jose Eduardo; GRANATO, Celso; FERREIRA, Giulia M.; JR, Ronaldo S. Francisco; GRANJA, Fabiana; GARCIA, Marcia T.; MORETTI, Maria Luiza; JR, Mauricio W. Perroud; CASTINEIRAS, Terezinha M. P. P.; LAZARI, Carolina S.; HILL, Sarah C.; SANTOS, Andreza Aruska de Souza; SIMEONI, Camila L.; FORATO, Julia; SPOSITO, Andrei C.; SCHREIBER, Angelica Z.; SANTOS, Magnun N. N.; SA, Camila Zolini de; SOUZA, Renan P.; RESENDE-MOREIRA, Luciana C.; TEIXEIRA, Mauro M.; HUBNER, Josy; LEME, Patricia A. F.; MOREIRA, Rennan G.; NOGUEIRA, Mauricio L.; FERGUSON, Neil M.; COSTA, Silvia F.; PROENCA-MODENA, Jose Luiz; VASCONCELOS, Ana Tereza R.; BHATT, Samir; LEMEY, Philippe; WU, Chieh-Hsi; RAMBAUT, Andrew; LOMAN, Nick J.; AGUIAR, Renato S.; PYBUS, Oliver G.; SABINO, Ester C.; FARIA, Nuno RodriguesBrazil currently has one of the fastest-growing severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) epidemics in the world. Because of limited available data, assessments of the impact of nonpharmaceutical interventions (NPIs) on this virus spread remain challenging. Using a mobility-driven transmission model, we show that NPIs reduced the reproduction number from >3 to 1 to 1.6 in Sao Paulo and Rio de Janeiro. Sequencing of 427 new genomes and analysis of a geographically representative genomic dataset identified >100 international virus introductions in Brazil. We estimate that most (76%) of the Brazilian strains fell in three clades that were introduced from Europe between 22 February and 11 March 2020. During the early epidemic phase, we found that SARS-CoV-2 spread mostly locally and within state borders. After this period, despite sharp decreases in air travel, we estimated multiple exportations from large urban centers that coincided with a 25% increase in average traveled distances in national flights. This study sheds new light on the epidemic transmission and evolutionary trajectories of SARS-CoV-2 lineages in Brazil and provides evidence that current interventions remain insufficient to keep virus transmission under control in this country.