ABSTRACT
This study aims to report analyses regarding the global distribution of institutions involved in clinical trials of COVID-19 vaccines throughout February 2022. We retrieved global data from the World Health Organization report on vaccine development. These data allowed us to identify project institutions and plot their geographic coordinates. We produced a georeferenced map using an R programming environment and, based on the geographical location of vaccine developers, we analyzed the subcontinental distribution of clinical trials and the nature of the vaccines. Regionally, South-Southeast Asian countries carried out more clinical trials than any other region, proportionally, although this happened solely for mature technologies. Few trials were under implementation in Latin America and Africa. Our findings confirm previous studies on the regional concentration in the development of technology. However, our contribution lies in showing these phenomena for COVID-19 vaccines in specific subcontinents and technologies, at a country level. Our data underscores which subcontinents perform very few clinical trials for COVID-19 and seem to be ill-prepared for future disease outbreaks, and if these become epidemics or even pandemics and require domestic vaccine development or production. We also consider the case of Brazil, which did not finish the complete cycle of COVID-19 vaccine development in the indicated period; but, with favorable policies, it has potential to engage further in COVID-19 vaccine technology.
Subject(s)
COVID-19 Vaccines , COVID-19 , Humans , Brazil , Disease Outbreaks , PandemicsABSTRACT
Abstract: This study aims to report analyses regarding the global distribution of institutions involved in clinical trials of COVID-19 vaccines throughout February 2022. We retrieved global data from the World Health Organization report on vaccine development. These data allowed us to identify project institutions and plot their geographic coordinates. We produced a georeferenced map using an R programming environment and, based on the geographical location of vaccine developers, we analyzed the subcontinental distribution of clinical trials and the nature of the vaccines. Regionally, South-Southeast Asian countries carried out more clinical trials than any other region, proportionally, although this happened solely for mature technologies. Few trials were under implementation in Latin America and Africa. Our findings confirm previous studies on the regional concentration in the development of technology. However, our contribution lies in showing these phenomena for COVID-19 vaccines in specific subcontinents and technologies, at a country level. Our data underscores which subcontinents perform very few clinical trials for COVID-19 and seem to be ill-prepared for future disease outbreaks, and if these become epidemics or even pandemics and require domestic vaccine development or production. We also consider the case of Brazil, which did not finish the complete cycle of COVID-19 vaccine development in the indicated period; but, with favorable policies, it has potential to engage further in COVID-19 vaccine technology.
Resumo: O objetivo desta comunicação é relatar análises sobre a distribuição global das instituições envolvidas em ensaios clínicos relacionados às vacinas de COVID-19 até fevereiro de 2022. Obtivemos dados globais da Organização Mundial da Saúde sobre o desenvolvimento de vacinas. Isso nos permitiu identificar as instituições de projetos e traçar as suas coordenadas geográficas. Produzimos um mapa georreferenciado usando a linguagem de programação R e, a partir da localização geográfica dos desenvolvedores de vacinas, analisamos a distribuição subcontinental dos ensaios clínicos e a natureza das vacinas testadas. Regionalmente, os países do Sul-Sudeste Asiático realizaram proporcionalmente mais ensaios clínicos do que qualquer outra região, embora isso tenha acontecido para tecnologias maduras. Poucos ensaios estavam em fase de implementação na América Latina e na África. Nossos achados confirmam estudos anteriores sobre a concentração regional no desenvolvimento de tecnologia. No entanto, a nossa contribuição está em demonstrar esses fenômenos para vacinas contra a COVID-19 em subcontinentes e tecnologias específicas em nível nacional. Os nossos dados ressaltam quais subcontinentes realizam muito poucos ensaios clínicos para COVID-19 e parecem estar mal preparados para futuros surtos de doenças e no caso de esses se tornarem epidemias ou mesmo pandemias e exigirem desenvolvimento ou produção de vacinas domésticas. Consideramos também o caso do Brasil, que não encerrou o ciclo completo de desenvolvimento da vacina contra a COVID-19 no período indicado; mas, com políticas favoráveis, tem potencial para se envolver ainda mais na tecnologia de vacinas contra a COVID-19.
Resumen: El propósito de este texto es reportar un análisis sobre la distribución global de instituciones involucradas en ensayos clínicos relacionados con vacunas del COVID-19 hasta febrero de 2022. Se recogieron datos globales de la Organización Mundial de la Salud sobre el desarrollo de vacunas; lo que se pudo identificar las instituciones del proyecto y rastrear sus coordenadas geográficas. Se elaboró un mapa georreferenciado utilizando el lenguaje de programación R y, a partir de la ubicación geográfica de los desarrolladores de vacunas, se analizó la distribución subcontinental de los ensayos clínicos y la naturaleza de las vacunas probadas. A nivel regional, los países del Sur Sureste Asiático llevaron a cabo proporcionalmente más ensayos clínicos que cualquier otra región, aunque esto se realizó con tecnologías consolidadas. Se registraron pocos ensayos en la etapa de implementación en América Latina y África. Los hallazgos confirman los estudios previos sobre la concentración regional en el desarrollo tecnológico. Sin embargo, permiten un aporte al demostrar estos fenómenos para vacunas contra el COVID-19 en subcontinentes y tecnologías específicas a nivel nacional. Los datos revelan los subcontinentes que realizan pocos ensayos clínicos para el COVID-19 y que no parecen estar bien preparados para futuros brotes de enfermedades, en caso de que se conviertan en epidemias o incluso pandemias, requiriendo el desarrollo o la producción de vacunas nacionales. Se considera también el caso de Brasil, que no completó el ciclo completo de desarrollo de la vacuna contra el COVID-19 en el periodo señalado; pero, con políticas favorables, tiene el potencial de involucrarse aún más en la tecnología de la vacuna del COVID-19.
ABSTRACT
Around 14% of world dengue virus (DENV) cases occur in the Americas, most of them in Brazil. While socioeconomic, environmental, and behavioral correlates have been analyzed thoroughly, the role played by population mobility on DENV epidemics, especially at the local level, remains scarce. This study assesses whether the daily pattern of population mobility is associated with DENV incidence in Campinas, a Brazilian major city with over 1.2 million inhabitants in São Paulo State. DENV notifications from 2007 to 2015 were geocoded at street level (n = 114,884) and combined with sociodemographic and environmental data from the 2010 population census. Population mobility was extracted from the Origin-Destination Survey (ODS), carried out in 2011, and daily precipitation was obtained from satellite imagery. Multivariate zero-inflated negative binomial regression models were applied. High population mobility presented a relevant positive effect on higher risk for DENV incidence. High income and residence in apartments were found to be protective characteristics against the disease, while unpaved streets, number of strategic points (such as scrapyards and tire repair shops), and precipitation were consistently risk factors.
Subject(s)
Dengue Virus , Dengue , Epidemics , Brazil/epidemiology , Cities/epidemiology , Dengue/epidemiology , HumansABSTRACT
AIM: To assess edentulism-free life expectancy (EFLE) and the related inequalities by sex and schooling among older Brazilian adults from 2006 to 2016. BACKGROUND: Tooth loss is related to shortened longevity and unhealthy life expectancy in old age. MATERIALS AND METHODS: The outcome of the study was EFLE, assessed by age, sex and schooling. EFLE was estimated using the Sullivan method, considering the years and proportion of remaining life and the prevalence of edentulism-assessed in the Health, Well-being, and Aging cohort study, as well as the official mortality data for adults aged 60 years or older living in São Paulo, Brazil. RESULTS: EFLE increased from 10.9 (95% CI: 10.4-11.5) to 13.8 (95% CI: 13.2-14.5) years, considering data from 2006 to 2016, among 60-year-old individuals. In relative terms, these individuals expected to live 50.7% (95% CI: 48.1-53.2) of their remaining life free of edentulism in 2006, while this expectation was 62.8% (95% CI: 60.0-65.6) in 2016. Within both years, women and the less educated had lower EFLE than men and the higher educated. CONCLUSION: EFLE increased from 2006 to 2016. However, inequalities concerning sex and education remained significant, thereby highlighting the need to continuously address inequalities in tooth loss throughout life to contribute to a healthy ageing.
Subject(s)
Aging , Life Expectancy , Brazil/epidemiology , Cohort Studies , Educational Status , Female , Humans , MaleABSTRACT
Abstract Background Frailty is considered one of the major conditions faced by ageing societies. Little has been reported about the transitions between the different frailty states in developing countries. Objective This study aimed to identify the factors associated with transitions between frailty states between 2006 and 2010 among older adults in Brazil. Method The present investigation is part of the SABE study (Health, Well-being and Ageing). Frailty state was classified according to the Fried's criteria (nonfrail, prefrail, and frail). The final study sample was composed of 1,399 individuals representing 1,019,243 older adults in the city of Sao Paulo, Brazil. Multiple logistic regression was used to identify factors associated with changes in frailty states. Results Women were more likely to present a decline in frailty states. In the prefrail-to-nonfrail model, level of education was the most strongly associated factor. Advanced age and difficulty in performing at least one basic activity of daily living reduced in 9 and 64% the risk of becoming nonfrail, respectively. Conclusion Addressing the factors associated with transition between frailty states among older adults is essential. Adequate interventions are important to reduce vulnerability and improve the health and well-being of older persons.
Resumo Introdução A fragilidade é considerada uma das principais condições enfrentadas pelas sociedades que envelhecem. Poucos estudos têm explorado as transições entre os diferentes estados de fragilidade nos países em desenvolvimento. Objetivo Identificar os fatores associados às transições de estado de fragilidade dos idosos no Brasil no período entre 2006 e 2010. Método A presente investigação é parte do estudo SABE (Saúde, Bem-Estar e Envelhecimento). O estado de fragilidade foi classificado de acordo com os critérios da Fried (não frágil, pré-frágil e frágil). A amostra final era composta por 1.399 indivíduos que representam 1.019.243 idosos na cidade de São Paulo. Modelos de regressão logística binária múltiplo foram estimados para identificar os fatores associados às mudanças no estado de fragilidade. Resultados As mulheres eram mais propensas a declinar para o estado de fragilidade. No modelo de pré-frágil para não frágil, o nível de escolaridade foi o fator mais fortemente relacionado. Aumento na idade e dificuldade em pelo menos uma atividade básica de vida diária reduziram em 9% e 64% o risco de se tornar não frágil, respectivamente. Conclusão Abordar os fatores associados com as transições de estados de fragilidade entre idosos é essencial. Adequadas intervenções são importantes para reduzir vulnerabilidade e melhorar a saúde e bem-estar dos idosos.
ABSTRACT
Around 14% of world dengue virus (DENV) cases occur in the Americas, most of them in Brazil. While socioeconomic, environmental, and behavioral correlates have been analyzed thoroughly, the role played by population mobility on DENV epidemics, especially at the local level, remains scarce. This study assesses whether the daily pattern of population mobility is associated with DENV incidence in Campinas, a Brazilian major city with over 1.2 million inhabitants in São Paulo State. DENV notifications from 2007 to 2015 were geocoded at street level (n = 114,884) and combined with sociodemographic and environmental data from the 2010 population census. Population mobility was extracted from the Origin-Destination Survey (ODS), carried out in 2011, and daily precipitation was obtained from satellite imagery. Multivariate zero-inflated negative binomial regression models were applied. High population mobility presented a relevant positive effect on higher risk for DENV incidence. High income and residence in apartments were found to be protective characteristics against the disease, while unpaved streets, number of strategic points (such as scrapyards and tire repair shops), and precipitation were consistently risk factors.
Cerca de 14% de todos os casos de dengue (DENV) ocorrem nas Américas, a maioria dos quais no Brasil. Os correlatos socioeconômicos, ambientais e comportamentais já foram analisados em profundidade, mas há pouco conhecimento, principalmente em nível local, sobre o papel da mobilidade populacional nas epidemias de DENV. O estudo pretende verificar se o padrão diário de mobilidade populacional está associado à incidência do DENV em Campinas, cidade brasileira com mais de 1,2 milhão de habitantes no Estado de São Paulo. As notificações de DENV entre 2007 e 2015 foram georreferenciadas em nível de logradouro (n = 114.884) e combinadas com dados sociodemográficos e ambientais do censo populacional de 2010. A mobilidade populacional foi extraída da Pesquisa de Origem/Destino (POD) realizada em 2011, e a pluviometria diária foi obtida através de imagens de satélite. Foram aplicados modelos de regressão multivariada com resposta binomial negativa inflacionados de zeros. A mobilidade populacional alta apresentou efeito positivo relevante sobre a incidência mais elevada de DENV. Renda alta e residência em apartamento mostrou efeito protetor contra a doença, enquanto ruas não pavimentadas, número de pontos críticos (p.ex.: ferros-velhos e borracharias) e pluviosidade alta apareceram enquanto fatores de risco.
Alrededor del 14% de los casos mundiales de virus dengue (DENV por sus siglas en inglés) se produce en las Américas, la mayoría de ellos en Brasil. Mientras que las correlaciones socioeconómicas, ambientales y de comportamiento se han analizado a fondo, el papel jugado por la movilidad de la población con epidemia de DENV, especialmente en un nivel local, continúa siendo escasa. Este estudio evalúa si el patrón diario de movilidad de población está asociado con la incidencia de DENV en Campinas, una gran ciudad brasileña con más de 1,2 millones de habitantes en el estado de São Paulo. Las notificaciones de DENV desde 2007 a 2015 fueron geocodificadas en un nivel de calle (n = 114,884), y combinadas con datos sociodemográficos, además de ambientales mediante el censo de población de 2010. La movilidad de la población se extrajo de la Encuesta Origen-Destino (ODS por sus siglas en inglés), llevada a cabo en 2011, la precipitación diaria se obtuvo mediante imágenes por satélite. Se aplicaron modelos de regresión binomial negativa multivariados con ceros inflados. La alta movilidad de la población presentó un efecto positivo relevante, respecto a un mayor riesgo en la incidencia por DENV. Contar con ingresos altos y residir en apartamentos resultaron ser factores protectores contra la enfermedad, mientras que las calles sin pavimentar, así como algunos puntos estratégicos como los desguaces y tiendas de reparación de ruedas, al igual que las precipitaciones fueron consistentemente factores de riesgo.
