Browsing by Author "Dias, Carlos Matias"
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- Monitoring influenza vaccine effectiveness using the national influenza surveillance systemPublication . Machado, Ausenda; Freitas, Graça; Guiomar, Raquel; Dias, Carlos Matias; Nunes, BaltazarBackground: Flu vaccine composition is reformulated on a yearly basis. As such, the vaccine effectiveness (VE) from previous seasons cannot be considered for subsequent years, and it is necessary to monitor the VE for each season. This study (MonitorEVA- monitoring vaccine effectiveness) intends to evaluate the feasibility of using the national influenza surveillance system (NISS) for monitoring the influenza VE. Material and methods: Data was collected within NISS during 2004 to 2014 seasons. We used a case-control design where laboratory confirmed incident influenza like illness (ILI) patients (cases) were compared to controls (ILI influenza negative). Eligible individuals consisted on all aged individuals that consult a general practitioner or emergency room with ILI symptoms with a swab collected within seven days of symptoms onset. VE was estimated as 1- odds ratio of being vaccinated in cases versus controls adjusted for age and month of onset by logistic regression. Sensitivity analyses were conducted to test possible effect of assumptions on vaccination status, ILI definition and timing of swabs (<3 days after onset). Results: During the 2004-2014 period, a total of 5302 ILI patients were collected but 798 ILI were excluded for not complying with inclusion criteria. After data restriction the sample size in both groups was higher than 148 individuals/ season; minimum sample size needed to detect a VE of at least 50% considering a level of significance of 5% and 80% power. Crude VE point estimates were under 45% in 2004/05, 2005/06, 2011/12 and 2013/14 season; between 50%-70% in 2006/07, 2008/09 and 2010/11 seasons, and above 70% in 2007/08 and 2012/13 season. From season 2006/07 to 2013/14, all crude VE estimates were statistically significant. After adjustment for age group and month of onset, the VE point estimates decreased and only 2008/09, 2012/13 and 2013/14 seasons were significant. Discussion and Conclusions: MonitorEVA was able to provide VE estimates for all seasons, including the pandemic, indicating if the VE was higher than 70% and less than 50%. When comparing with other observational studies, MonitorEVA estimates were comparable but less precise and VE estimates were in accordance with the antigenic match of the circulating virus/ vaccine strains. Given the sensitivity results, we propose a MonitorEVA based on: a) Vaccination status defined independently of number of days between vaccination and symptoms onset; b) use of all ILI data independent of the definition; c) stratification of VE according to time between onset and swab (< 3 and ≥3 days).
- Perfil Terapêutico da Hipertensão na rede Médicos Sentinela : 12 Anos DepoisPublication . Souto, Diana; Simões, José Augusto; Torre, Carla; Mendes, Zilda; Falcão, Isabel Marinho; Ferreira, Fernando; Miranda, Ana da Costa; Dias, Carlos MatiasObjectives: To determine the treatment profile of hypertension in theQPortuguese sentinel practice network and compare the results 12 years after an initial study. Study design: Cross-sectional study Setting: Portuguese sentinel practice network Participants: Hypertensive patients over 18 years of age on the lists of general practitioners in the sentinel practice network who attended a consultation with their physician between June 7, 2010 and December 31, 2010. Results: In 2010, 616 hypertensive patients were included in the study. Between the two periods (1998 and 2010) there was a slight increase in the average age of the participants (62.0 years in 1998 and 64.3 years in 2010), with a higher proportion of female patients in both periods. The meanQaverage duration of hypertension since the time of diagnosis increased significantly (<0.0001). Approximately half of the hypertensive patients presented target organ damage, in both periods with heart disease as the most common lesion. Dyslipidemia, hyperuricemia and diabetes were the most common co-morbid conditions. From 1998 to 2010, the proportion of patients on monotherapy decreased from 47.6% to 30.3%. Angiotensin-converting enzyme inhibitors were the most frequently prescribed drugs for monotherapy in both periods. In 1998, the antihypertensive treatment most frequently prescribed was angiotensin-converting enzyme inhibitors as monotherapy (24.3%). In 2010 the combination of angiotensin receptor blockers with thiazide diuretics was the most common treatment (15.4%). Conclusions: Drugs acting on the renin-angiotensin system were the antihypertensive drugs most frequently prescribed in both periods as monotherapy and in combination with other drugs. The number of antihypertensive drugs prescribed differed between the two periods in relation to the existence and type of co-morbidities.
- Trends in diabetes incidence from 1992 to 2015 and projections for 2024: A Portuguese General Practitioner’s Network studyPublication . Uva, Mafalda Sousa; Antunes, L; Nunes, Baltazar; Rodrigues, AP; Simões, JA; Ribeiro, RT; Boavida, José Manuel; Dias, Carlos MatiasBackground: Diabetes is known as a major cause of morbidity and mortality worldwide. Portugal is known as the European country with the highest prevalence of this disease. While diabetes prevalence data is updated annually in Portugal, the General Practitioner’s (GP) Sentinel Network represents the only data source on diabetes incidence. This study describes the trends in Diabetes incidence, between 1992 and 2015, and estimate projections for the future incidence rates in Portugal until 2024. Methods: An ecological time-series study was conducted using data from GP Sentinel Network between 1992 and 2015. Family doctors reported all new cases of Diabetes in their patients’ lists. Annual trends were estimated through Poisson regression models as well as the future incidence rates (until 2024), sex and age group stratified. Incidence rate projections were adjusted to the distribution of the resident Portuguese population given Statistics Portugal projections. Results: The average increase in Diabetes incidence rate was in total 4.29% (CI95% 3.80–4.80) per year under study. Until 1998–2000, the annual incidence rate was higher in women, and from 1998–2000 to 2013–2015 turn out to be higher in men. The incidence rate projected for 2022–2024 was 972.77/105 inhabitants in total, and 846.74/105 and 1114.42/105, respectively, in women and men. Conclusions: This is the first study in Portugal to estimate diabetes incidence rate projections. The disturbing reported projections seem realistic if things continue as in the past. Actually, effective public health policies will need to be undertaken to minimize this alarming future scenario.