Effectiveness of the TAK-003 dengue vaccine in adolescents during the 2024 outbreak in São Paulo, Brazil: a test-negative, case-control study.

Background: Dengue is a substantial public health challenge in tropical regions, and is considered a global health threat owing to its expanding geographical range and increasing incidence as a result of climate change. Despite the availability of tetravalent dengue vaccines, real-world evidence on their effectiveness is scarce. We aimed to evaluate the vaccine effectiveness of the dengue vaccine TAK-003 in adolescents during the 2024 dengue outbreak in the state of São Paulo, Brazil.

Antispike IgG antibody decay after immunisation with fractional versus full booster doses of COVID-19 vaccines: a 6-month longitudinal analysis of the FRACT-COV trial in Brazil.

Objectives: To compare antispike IgG levels over a period of 182 days of follow-up in healthy adults who received full or fractional booster doses of BNT162b2 or AZD1222 after completing a primary series of Sinovac, BNT162b2 or AZD1222.

Design: Double-blind, parallel-arm, phase IV randomised trial.

Setting: The study was conducted in Campo Grande, Brazil, and participants were recruited in neighbourhoods with the lowest booster vaccine coverage.

The participation of people deprived of liberty in tuberculosis vaccine trials: should they be protected from research, or through research?

People deprived of liberty are among the populations experiencing the highest rates of tuberculosis. Prisons typically create ideal conditions for Mycobacterium tuberculosis transmission, including overcrowding and prolonged exposure in poorly ventilated environments, and often have populations at high risk of developing disease. The development of a novel, effective tuberculosis vaccine to prevent adult pulmonary tuberculosis is considered a crucial objective for improving tuberculosis control and, ultimately, elimination.

The concentration of tuberculosis within Paraguay's Indigenous population, 2018-2022: a retrospective population-based study.

Background: While over the past decade global incidence rates of tuberculosis (TB) have decreased, in Paraguay incidence has risen. A new reporting system implemented in 2018 has not previously been used to characterise trends in TB and identify areas to prioritise for the expansion of access to TB diagnostics and treatment programmes.

Methods: We conducted a retrospective study of all TB cases notified to the Paraguay National Program for Tuberculosis Control (NPTC) from 2018 to 2022.

The role of tuberculosis symptoms in transmission risk to cell contacts in prisons.

Background: Understanding determinants of transmission is critical to devising effective strategies to reduce its burden. Whether and to what extent symptoms influence transmission remains poorly understood.

Methods: Between 2020 and 2022, we systematically screened PDL from three prisons in Brazil for TB by symptom assessment and sputum testing with Xpert MTB/RIF Ultra.

Tuberculosis treatment outcomes after transfer or release from incarceration: A retrospective cohort study from Brazil.

Background: Tuberculosis (TB) disproportionately affects people deprived of liberty. Prior studies have shown higher TB treatment completion rates among incarcerated individuals compared to the general population. However, little is known about how incarceration-related movements such as transfers between facilities or releases to the community affect TB treatment outcomes.

Evaluation of an ultra-portable X-ray system with automated interpretation for tuberculosis active case finding in carceral settings: a diagnostic test accuracy study.

Background: The World Health Organization recommends systematic active case finding for tuberculosis (TB) among high-risk population including incarcerated individuals; however, many prisons lack screening capacity. In this study, we aimed to evaluate the diagnostic performance of an ultra-portable digital chest radiography system paired with LunitTB, an automated interpretation algorithm, to detect TB disease.

Methods: We performed a diagnostic test accuracy study using data collected for a prospective active case finding study for TB in a Brazilian prison from February 2023 through May 2024.

Immunogenicity and reactogenicity of fractional vs. full booster doses of COVID-19 vaccines: a non-inferiority, randomised, double-blind, phase IV clinical trial in Brazil.

Background: Fractional doses of vaccine to protect against COVID-19 offer the potential to expand vaccine availability, reduce side effects, and enhance vaccination campaign efficiency. This study aimed to assess the immune response and safety of fractional doses of SARS-CoV-2 booster vaccines compared to full doses in immunocompetent adults aged 18-60 who had previously received a full series of Sinovac, AZD1222 (AstraZeneca), or BNT162b2 (Pfizer/BioNTech).

Methods: This trial was structured as a parallel-group, double-blind, randomised Phase IV non-inferiority study, carried out in Campo Grande, Midwest, Brazil.

Travel-associated international spread of Oropouche virus beyond the Amazon.

Oropouche virus (OROV), first detected in Trinidad and Tobago in 1955, was historically confined to the Brazilian Amazon Basin. However, since late 2022, an increasing number of OROV cases have been reported across various regions of Brazil as well as in urban centers in Bolivia, Ecuador, Guyana, Colombia, Cuba, Panama, and Peru. In collaboration with Central Public Health Laboratories across Brazil, we integrated epidemiological metadata with genomic analyses from recent cases, generating 133 whole-genome sequences covering the virus's three genomic segments (L, M, and S).

A Methodological Approach to Measuring the Impact of TAK-003 for the Prevention of Dengue in Dourados, Brazil: Optimizing Strategies for Public Health.

: Takeda's tetravalent dengue vaccine TAK-003 has been approved by the Brazilian regulatory agency ANVISA for dengue disease prevention in individuals aged 4 to 60 years. Dourados, in the state of Mato Grosso do Sul, became the world's first city to implement a mass vaccination campaign targeting approximately 120,000 individuals. An ongoing collaborative, observational, population-based study using national surveillance and vaccination data was planned to measure the impact of the vaccine on the reduction in dengue incidence.

Mapping the viral battlefield: SARS-CoV-2 infection dynamics among healthcare workers in Brazil.

Background: Understanding the dynamics of SARS-CoV-2 viral infection and factors associated with in-hospital transmission rates among healthcare workers (HCW) is crucial for their protection. Brazil experienced high mortality rates due to COVID-19, and limited data are available on transmission of SARS-CoV-2 infection among HCW. This cohort study aimed to assess the dynamic of SARS-CoV-2 infections in HCW from two tertiary hospitals in central Brazil, one of them a Reference Hospital for COVID-19.

Effect of Bacille Calmette-Guérin vaccination on immune responses to SARS-CoV-2 and COVID-19 vaccination.

Objectives: Bacille Calmette-Guérin (BCG) vaccination has off-target effects on disease risk for unrelated infections and immune responses to vaccines. This study aimed to determine the immunomodulatory effects of BCG vaccination on immune responses to vaccines against SARS-CoV-2.

Methods: Blood samples, from a subset of 275 SARS-CoV-2-naïve healthcare workers randomised to BCG vaccination (BCG group) or no BCG vaccination (Control group) in the BRACE trial, were collected before and 28 days after the primary course (two doses) of ChAdOx1-S (Oxford-AstraZeneca) or BNT162b2 (Pfizer-BioNTech) vaccination.

Impact of strategic public health interventions to reduce tuberculosis incidence in Brazil: a Bayesian structural time-series scenario analysis.

Background: Despite government efforts, tuberculosis (TB) remains a major public health threat in Brazil. In 2023, TB incidence was 39.8 cases per 100,000 population, far above the WHO's target of 6.

The burden, clinical features and outcomes of SARS-CoV-2, Influenza and co-infections during concurrently out-of-season outbreaks in Brazil.

Objectives: Little is known about the burden and the clinical presentation and prognosis of individuals with Influenza and SARS-CoV-2 during concurrent outbreaks. We aimed to describe the burden, clinical characteristics and outcomes of hospitalized adults during the Influenza A/H3N2 and Omicron outbreaks in Brazil.

Study Design: Cross-sectional analysis of national surveillance data.

Signatures of transmission in within-host Mycobacterium tuberculosis complex variation: a retrospective genomic epidemiology study.

Background: Mycobacterium tuberculosis complex (MTBC) species evolve slowly, so isolates from individuals linked in transmission often have identical or nearly identical genomes, making it difficult to reconstruct transmission chains. Finding additional sources of shared MTBC variation could help overcome this problem. Previous studies have reported MTBC diversity within infected individuals; however, whether within-host variation improves transmission inferences remains unclear.

Mass incarceration as a driver of the tuberculosis epidemic in Latin America and projected effects of policy alternatives: a mathematical modelling study.

Background: Tuberculosis incidence is increasing in Latin America, where the incarcerated population has nearly quadrupled since 1990. We aimed to quantify the impact of historical and future incarceration policies on the tuberculosis epidemic, accounting for effects in and beyond prisons.

Methods: In this modelling study, we calibrated dynamic compartmental transmission models to historical and contemporary data from Argentina, Brazil, Colombia, El Salvador, Mexico, and Peru, which comprise approximately 80% of the region's incarcerated population and tuberculosis burden.

The greatest Dengue epidemic in Brazil: Surveillance, Prevention, and Control.

In this review, we discuss dengue surveillance, prevention, and control measures in Brazil. Data on dengue epidemics between 2000 and 2024 indicates an increase in the number of dengue cases and deaths. Global climate change is a key driver of this growth.