Percorrer por autor "Shivaji, Tara"
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- Characteristics of late presentation of HIV infection in MSM and heterosexual adults in Portugal 2011 -2013Publication . Shivaji, Tara; Diniz, Antonio; Cortes-Martins, HelenaIt is estimated that over half of newly diagnosed HIV infections in Europe present late. An HIV positive individual presenting late to care represents a missed opportunity to benefit from treatment, increasing the risk of morbidity and mortality at an individual level, and onward disease transmission at population level. Reducing late presentation is a strategic priority of the Portuguese HIV/AIDS program.We set out to describe the characteristics of late presentation in the two largest transmission risk groups currently in Portugal to inform HIV prevention and treatment.
- Equity-focused health impact assessment of Portuguese tobacco control legislationPublication . Costa, Andreia; Cortes, Maria; Sena, Catarina; Nunes, Emília; Nogueira, Paulo; Shivaji, TaraThe World Health Organization recommend the Equity-Focused Health Impact Assessment (HIA) as a means to assess the impact of social and economic policies on the health of populations, and acknowledges their contribution to health inequality. We describe the application of the Equity-focusedImpact Assessment methodology on the Portuguese law on Smoking Prevention and Tobacco Control (Law No. 37/2007). A rapid assessment was carried out to issue recommendations which could be incorporated into the law during a revision in 2014. Quantitative (consumption and health status indicators; equity analysis) and qualitative (Focus Group) approaches were taken to evaluate the impact of the law and formulate recommendations. Young people, men and women of low socioeconomic status, and pregnant women were identified as requiring specific and appropriate interventions to prevent smoking and support smoking cessation.
- Improving data management practices in the Portuguese HIV/AIDS surveillance system during a time of public sector austerityPublication . Shivaji, Tara; Martins, Helena CortesIn a climate of public sector austerity, the demand for accurate information about disease epidemiology rises as health program managers try to align spending to health needs. A policy of case re-notification to improve HIV information quality resulted in a nine-fold increase in the number of case reports received in 2013 by the Portuguese HIV surveillance office. We used value stream mapping to introduce improvements to data processing practices, identify and reduce waste. Two cycles of improvement were trialled. Before intervention, processing time was nine minutes and 28 seconds (95%CI 8:53-10:58) per report. Two months post intervention, it was six minutes and 34 seconds (95% CI 6:25-6:43). One year after the start of the project, processing time was five minutes and 20 seconds (95% CI 1:46-8:52).
- A large community outbreak of Legionnaires’ disease in Vila Franca de Xira, Portugal, October to November 2014Publication . Shivaji, Tara; Pinto, Cátia Sousa; San-Bento, Ana; Serra, Luis A Oliveira; Valente, João; Machado, J; Marques, Teresa; Carvalho, L; Nogueira, Paulo; Nunes, Baltazar; Vasconcelos, PaulaAn outbreak of Legionnaires’ disease with 334 confirmed cases was identified on 7 November 2014 in Vila Franca de Xira, Portugal and declared controlled by 21 November. Epidemiological, environmental and microbiological analysis identified industrial wet cooling systems to be the probable source of infection. Preliminary results from sequence-based typing of clinical specimens and environmental isolates confirmed this link. A series of meteorological phenomena are likely to have contributed to the scale of this outbreak.
- A large outbreak of Legionnaires’ Disease in an industrial town in PortugalPublication . George, Francisco; Shivaji, Tara; Pinto, Cátia Sousa; Serra, Luis; Valente, João; Albuquerque, Maria João; Vicêncio, Paula; San-Bento, Ana; Diegues, Paulo; Nogueira, Paulo; Marques, Teresa; et alBackground: We describe the investigation and control of an outbreak of Legionnaires’ disease in Portugal in October, November and December 2014. Methods: Confirmed cases were individuals with pneumonia, laboratory evidence of Legionella pneumophila serogroup 1 and exposure, by residence, occupational or leisure tothe affected municipalities. 49 possible sources were reduced to four potential sources, all industries with wet cooling system, following risk assessment. We geo-referenced cases’ residences and the location of cooling towers defining four study areas 10 km buffer centeredon each cooling tower system. We compared the number of cases with expected numbers,calculated from the outbreak’s attack rates applied to 2011 census population. Using Stones’Test, we tested observed to expected ratios for decline in risk, with distance up to 10 km fourdirections. Isolates of Legionella pneumophila were compared using molecular methods.