Browsing by Author "Arrais, Margarete"
Now showing 1 - 10 of 10
Results Per Page
Sort Options
- Allergic sensitisation and relationship with asthma and other allergic diseases in children in the province of Bengo, AngolaPublication . Arrais, Margarete; Lulua, Ofélia; Quifica, Francisca; Gama, Jorge; Taborda-Barata, Luis; Brito, MiguelBackground: In recent decades, the prevalence of allergies has increased, especially in children. In Africa, few studies have evaluated allergic sensitization and in Angola, none. The aim of this study was to evaluate the profile of allergic sensitization in children with asthma and other allergic diseases. Method: This was a cross-sectional study, using the methodology of the International Study of Asthma and Allergic Diseases in Children (ISAAC), conducted from September to November 2017 in 5 to 14-year-old children in the Bengo Province, Angola. Out of a total of 33 public schools, 5 (15%) were randomly selected, 3 in urban and 2 in rural areas. Allergic sensitization was defined by positive skin prick tests (SPT) and/or positive inhalant Phadiatop. Data were analyzed with SPSS Statistics v25.0. Results: The sample consisted of 1023 children, 48% girls, 58% 10-14-year-old, 61% living in urban areas. Of these children, 8% had positive SPT with the most frequent sensitization being to mites (B.tropicalis, D.farinae, D.pteronyssinus) and cockroach mix, without statistically significant differences between sexes, age, and urban or rural area residents. About 56% of children were monosensitized, 44% were polysensitized, and most sensitized children (55%) were asymptomatic. No significant differences in allergen sensitization patterns were observed among atopic children who were asymptomatic, had asthma, rhinitis, or eczema. Conclusion: Allergic sensitization to dust mites, cockroach mix, and fungi is the most frequent pattern observed in 5-14-year-old Angolan children in Bengo but this was not different between sensitized children with and without allergic diseases.
- Clinical characteristics and variables associated with COVID-19 morbidity and mortality in Luanda, Angola, in the first year of the pandemicPublication . Arrais, Margarete; Dias, Welwitschia; Silva, Maura; Neto, Luquenia; Pedro, Naiol; Jungo, Sónia; Miguel, Avelina; Fortes-Gabriel, Elsa; Sebastião, Cruz; Gama, Jorge; Brito, MiguelBackground: The impact of SARS-CoV-2 infection in Africa is still unclear. In comparison to Europe and North America, morbidity and death rates are lower. Several factors have been proposed, including geographical variation in virus impact, environmental factors, differences in age distribution, and the impact of infectious diseases such as malaria, HIV infection, and tuberculosis. Objectives: We investigated the clinical characteristics and putative determinants linked with COVID-19 in Angolan patients. Methods: Cross-sectional study undertaken at Military Hospital, Luanda, from March 2020 to March 2021. The survey collected sociodemographic and clinical information. Results: The sample included 1,683 patients aged ≥18 years, 64% men, with a mean age of 46.3 years. SARS-CoV-2 was positive in 39% of the cases with RT-PCR. Patients ≥46 years with a level of education of ≥12 years had a considerably higher likelihood of testing positive. About 58% of positive patients had at least one comorbidity, of which hypertension and Diabetes were associated with SARS-CoV-2 infection. HIV and pulmonary TB were putative protective factors. About 14% of positive patients died. Most deaths occurred in patients ≥46 years old, with less education and unemployment. Working as a healthcare practitioner was linked to a protective effect. Malignant diseases were the most common comorbidities associated with death. Conclusions: We identified putative factors related to SARS-CoV-2 infection and mortality. HIV and TB were protective and not associated with mortality. Further study with a broader scope should be conducted to explain the main features related to COVID-19 mortality in Angola.
- Clinical features related to severity and mortality among COVID-19 patients in a pre-vaccine period in Luanda, AngolaPublication . Sebastião, Cruz S.; Cogle, Adis; Teixeira, Alice D’Alva; Cândido, Ana Micolo; Tchoni, Chissengo; Amorim, Maria João; Loureiro, N’gueza; Parimbelli, Paolo; Penha-Gonçalves, Carlos; Demengeot, Jocelyne; Sacomboio, Euclides; Mendes, Manuela; Arrais, Margarete; Morais, Joana; Vasconcelos, Jocelyne Neto de; Brito, MiguelBackground: Infection due to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is associated with clinical features of diverse severity. Few studies investigated the severity and mortality predictors of coronavirus disease 2019 (COVID-19) in Africa. Herein, we investigated the clinical features of severity and mortality among COVID-19 patients in Luanda, Angola. Methods: This multicenter cohort study involved 101 COVID-19 patients, between December 2020 and April 2021, with clinical and laboratory data collected. Analysis was done using independent-sample t-tests and Chi-square tests. The results were deemed significant when p < 0.05. Results: The mean age of patients was 51 years (ranging from 18 to 80 years) and 60.4% were male. Fever (46%), cough (47%), gastrointestinal symptoms (26.7%), and asthenia (26.7%), were the most common symptoms. About 64.4% of the patients presented coexistent disorders, including hypertension (42%), diabetes (17%), and chronic renal diseases (6%). About 23% were non-severe, 77% were severe, and 10% died during hospitalization. Variations in the concentration of neutrophil, urea, creatinine, c-reactive protein, sodium, creatine kinase, and chloride were independently associated with severity and/or mortality (p < 0.05). Conclusion: Several factors contributed to the severity and mortality among COVID-19 patients in Angola. Further studies related to clinical features should be carried out to help clinical decision-making and follow-up of COVID-19 patients in Angola.
- Helminth infections and allergic diseases: systematic review and meta-analysis of the global literaturePublication . Arrais, Margarete; Maricoto, Tiago; Nwaru, Bright I.; Cooper, Philip J.; Gama, Jorge M.R.; Brito, Miguel; Taborda-Barata, LuisBackground: There is considerable research interest in the role of helminth infections in the development of allergic diseases. However, findings from previous studies are mixed. Existing systematic reviews of these studies are outdated. We performed a systematic review of the global literature on the association between helminth infections and development and clinical outcomes of allergic diseases. Methods: We searched Cochrane Library, MEDLINE, EMBASE, ISI Web of Science, PubMed, Global Index Medicus, Scielo, KoreaMed, Google Scholar, and Lilacs for studies published up to January 2020. We included observational epidemiological studies (cohort, case-control, and cross-sectional studies) of children and adults reporting associations between helminth infections and asthma, allergic rhinitis, eczema, and atopy. We performed a random-effects meta-analysis to summarize the effect estimates. Results: We included 80 studies with 99,967 participants. In the meta-analyses, we did not observe an overall association between helminth infections and allergic diseases. There was, however, evidence that Ascaris lumbricoides infections were associated with an increased risk of bronchial hyperreactivity in children (risk ratio, 1.41; 95% CI, 1.17-1.70; I2 = 50; P for I2 = .09), and were associated with an increased risk of atopy among helminth-infected adults (risk ratio, 1.37; 95% CI, 1.18-1.61; I2 = 52; P for I2 = .02). We found no study that addressed the association between helminth infection and clinical outcomes of allergic diseases. The overall strength of the underlying evidence was low to moderate. Conclusions: Helminth infections may increase the risk of bronchial hyperreactivity in children and atopy in adults. Well-designed longitudinal cohorts may help clarify potential causal associations between chronic helminth infections and allergic diseases.
- Helminth infections, atopy, asthma and allergic diseases: protocol for a systematic review of observational studies worldwidePublication . Arrais, Margarete; Maricoto, Tiago; Cooper, Philip; Gama, Jorge M. R.; Nwaru, Bright I; Brito, Miguel; Taborda Barata, LuisIntroduction: Childhood infections, particularly those caused by helminths are considered to be important environmental exposures influencing the development of allergic diseases. However, epidemiological studies focusing on the relationship between helminth infections and the risk of allergic diseases, performed worldwide, show inconsistent findings. Previous systematic reviews of observational studies published 10 or more years ago showed conflicting findings regarding the effects of helminths on allergic diseases. Over the past 10 years, there has been growing literature addressing this research area, and these need to be considered in order to appreciate the most contemporary evidence. The objective of the current systematic review will be to provide an up-to-date synthesis of findings of observational studies investigating the influence of helminth infections on atopy, and allergic diseases. Methods and analysis: This systematic review protocol was registered at PROSPERO. We will search Cochrane Library, MEDLINE, EMBASE, CINAHL, AMED, ISI Web of Science, WHO Global Health Library, Scielo, IndMed, PakMediNet, KoreaMed, Ichushi for published studies from 1970 to January 2020. Bibliographies of all eligible studies will be reviewed to identify additional studies. Unpublished and ongoing research will also be searched in key databases. There will be no language or geographical restrictions regarding publications. Critical Appraisal Skills Programme quality assessment tool will be used to appraise the methodological quality of the included studies. A descriptive summary with data tables will be constructed, and if adequate, meta-analysis using random-effects will be performed. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses checklist will be followed for reporting of the systematic review. Ethics and dissemination: Since this systematic review will be only based on published and retrievable literature, no ethics approval will be sought. The multidisciplinary team performing this systematic review will participate in relevant dissemination activities. Findings will be presented at scientific meetings and publish the systematic review in international, peer-reviewed, open-access journals.
- Lack of association between asthma, atopy and helminthic infection in school-age children in the province of Bengo, AngolaPublication . Arrais, Margarete; Sachicola, Ofélia; Quifica, Francisca; Gama, Jorge; Taborda-Barata, Luis; Brito, MiguelBackground: Epidemiological studies conducted in several countries worldwide and in some African countries have shown that there is controversy in the relationship between asthma, atopy, and helminthic infection. The aim of this study was to fully evaluate such a relationship in children living in areas of high and moderate helminthic prevalence. Method: Cross-sectional study using the methodology of the International Study of Asthma and Allergies in Childhood (ISAAC), conducted from September to November 2017, in the Province of Bengo, Angola. From a total of 33 schools, five (15%), three in urban and two in rural areas were randomly selected. Atopy was defined by positive skin prick tests and/or specific IgE to aeroallergens (Phadiatop), and helminthic infection was defined by the presence of helminths in feces. Data were obtained regarding the helminthic load, types of helminths, previous infections, and anti-helminthic treatments, and were analyzed with SPSS Statistics v25.0. Results: The sample consisted of 1023 children, 48% female, 58% 10 to 14 years old, and 61% living in urban areas. About 9% had asthma, 22% had rhinitis, 16% had eczema, 8% were atopic and 36% were infected by helminths. The most frequently detected helminths were Ascaris lumbricoides (23% of children), Hymenolepsis nana (6%), and Trichuris trichiuria (4%). No relationship was detected between the prevalence of asthma, rhinitis, or atopy and parameters of helminthic infection. Conclusion: No relationship was apparent between the prevalence of asthma, atopy, and helminth infection. Further studies are warranted, namely, cohort studies with long follow-up monitoring since birth.
- Lack of consistent association between asthma, allergic diseases, and intestinal helminth infection in school-aged children in the Province of Bengo, AngolaPublication . Arrais, Margarete; Lulua, Ofélia; Quifica, Francisca; Rosado-Pinto, José; Gama, Jorge M.; Cooper, Philip J.; Taborda-Barata, Luis; Brito, MiguelEpidemiological studies have shown conflicting findings on the relationship between asthma, atopy, and intestinal helminth infections. There are no such studies from Angola; therefore, we aimed to evaluate the relationship between asthma, allergic diseases, atopy, and intestinal helminth infection in Angolan schoolchildren. We performed a cross-sectional study of schoolchildren between September and November 2017. Five schools (three urban, two rural) were randomly selected. Asthma, rhinoconjunctivitis, and eczema were defined by appropriate symptoms in the previous 12 months: atopy was defined by positive skin prick tests (SPT) or aeroallergen-specific IgE; intestinal helminths were detected by fecal sample microscopy. In total, 1023 children were evaluated (48.4% female; 57.6% aged 10–14 years; 60.5% urban). Asthma, rhinoconjunctivitis, or eczema were present in 9%, 6%, and 16% of the studied children, respectively. Only 8% of children had positive SPT, but 64% had positive sIgE. Additionally, 40% were infected with any intestinal helminth (A. lumbricoides 25.9%, T. trichiura 7.6%, and H. nana 6.3%). There were no consistent associations between intestinal helminth infections and asthma, allergic diseases, or atopy, except for A. lumbricoides, which was inversely associated with rhinoconjunctivitis and directly associated with aeroallergen-specific IgE. We concluded that, overall, intestinal helminth infections were not consistently associated with allergic symptoms or atopy. Future, preferably longitudinal, studies should collect more detailed information on helminth infections as part of clusters of environmental determinants of allergies.
- Physicians’ perceptions of their knowledge and the preparedness of health facilities in Angola to diagnose and manage COVID-19Publication . Arrais, Margarete; Dias, Welwitschia; Gama, Jorge M. R.; Brito, MiguelBackground: Healthcare professionals represent a vulnerable group in terms of responding to COVID-19. Knowledge can influence healthcare professionals through the adoption of the correct attitudes and practices. The aim of this study was to evaluate, by a questionnaire, the perceptions of physicians about their level of knowledge as well as conditions in their workplaces for dealing with COVID-19. Methods: A cross-sectional study of Angolan physicians took place from 11 May to 23 June 2020. A questionnaire was electronically shared across social media and via email. Results: The sample consisted of 637 valid questionnaires; 53% of respondents were female, 41% were aged 31-40 y and 79% were from Luanda province. About 51% of physicians perceived that they had adequate knowledge about COVID-19 and 64% used personal protective equipment. These figures were higher among specialists from the province of Luanda. About 81% stated that their health units lacked the technical capacity to diagnose COVID-19. Only 35% of health units have chest tomography equipment; 44% are prepared for the care and/or isolation of patients. Only 33% of units are running intensive care units. The main concerns of physicians were training opportunities and limited access to personal protective equipment. Conclusion: The results show that it is necessary to strengthen physicians' knowledge about COVID-19, as well as to improve the conditions of the health units, so as to promote safe practices.
- Sensitisation to aeroallergens in relation to asthma and other allergic diseases in Angolan children: a cross-sectional studyPublication . Arrais, Margarete; Lulua, Ofélia; Quifica, Francisca; Rosado-Pinto, José; Gama, Jorge; Brito, Miguel; Taborda-Barata, LuisIntroduction and Objectives: In Africa, few studies of sensitization profiles have been performed in children or adolescents and, in Angola, there are none. The objectives of the present study were to assess the sensitization profile of Angolan schoolchildren and to determine the relationship between that pattern, sociodemographic factors, asthma, and other allergic diseases. Materials and Methods: Cross-sectional, observational study in 5-14-year-old children, performed between September and November 2017, in the Province of Bengo, Angola. Five schools (15%) were randomly selected in the geographical area of the study: three from an urban area, and two from a rural area. Data were collected using the Portuguese versions of the ISAAC questionnaires for children and adolescents, regarding asthma, rhinitis, and eczema. Skin prick tests (SPT) were performed with a battery of 12 aeroallergens. Stools were assessed for the presence of helminths. Descriptive statistics were used, as well as a univariate calculation of odds ratios. Results: Sensitisation to aeroallergens was low (8%) and most sensitized children were asymptomatic. Most frequent sensitizations involved house dust mites, cockroaches, or fungi, and a high proportion of children (78.1%) were monosensitized. No relationship was detected between sensitizations and asthma, rhinitis or eczema. Place of residence, gender, age or helminthic infection did not affect the probability of having positive SPTs. Conclusions: The most frequent sensitizations in children from Bengo Province in Angola involve house dust mites, followed by cockroaches and fungi. No relationship was found between atopic sensitization and asthma or other allergic diseases.
- The impact of the ABO/Rh blood group on susceptibility and severity among COVID-19 patients in Luanda, AngolaPublication . Sebastião, Cruz S.; Teixeira, Alice; Luísa, Ana; Arrais, Margarete; Tchonhi, Chissengo; Cogle, Adis; Sacomboio, Euclides; Cardoso, Bruno; Morais, Joana; Vasconcelos, Jocelyne Neto de; Brito, MiguelSARS-CoV-2 is a public health concern worldwide. Identification of biological factors that could influence transmission and worsen the disease has been the subject of extensive investigation. Herein, we investigate the impact of the ABO/Rh blood group on susceptibility and severity among COVID-19 patients in Luanda, Angola. This was a multicentric cohort study conducted with 101 COVID-19 patients. Chi-square and logistic regression were calculated to check factors related to the worsening of the disease and deemed significant when p<0.05. Blood type O (51.5%) and Rh-positive (93.1%) were the most frequent. Patients from blood type O had a high risk to severe disease [OR: 1.33 (95% CI: 0.42 - 4.18), p=0.630] and hospitalization [OR: 2.59 (95% CI: 0.84 - 8.00), p=0.099]. Also, Rh-positive blood type presented a high risk for severe disease (OR: 10.6, p=0.007) and hospitalization (OR: 6.04, p=0.026). We find a high susceptibility, severity, hospitalization, and mortality, respectively, among blood group O and Rh-positive patients, while blood group AB presented a low susceptibility, severity, hospitalization, and mortality, respectively. Our findings add to the body of evidence suggesting that ABO/Rh blood groups play an important role in the course of SARS-CoV-2 infection.