Author
Pascoal Torres Muniz
Bio: Pascoal Torres Muniz is an academic researcher from Universidade Federal do Acre. The author has contributed to research in topics: Population & Anemia. The author has an hindex of 22, co-authored 66 publications receiving 1432 citations.
Papers published on a yearly basis
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Federal University of Rio de Janeiro1, Rio de Janeiro State University2, Oswaldo Cruz Foundation3, Brazilian Institute of Geography and Statistics4, Sao Paulo State University5, Federal University of Pará6, Universidade Federal de Goiás7, State University of Feira de Santana8, Universidade Federal do Rio Grande do Sul9, Federal University of Amazonas10, Universidade Federal de Minas Gerais11, Universidade Federal do Amapá12, Universidade Federal do Espírito Santo13, University of São Paulo14, Universidade Federal de Santa Catarina15, Federal University of Rio Grande do Norte16, Universidade Federal de Mato Grosso17, State University of Campinas18, Federal University of Bahia19, Pontifícia Universidade Católica do Paraná20, Federal University of Pernambuco21, University of Brasília22, Universidade Federal de Rondônia23, Federal University of Piauí24, Universidade Federal do Acre25, Federal University of Maranhão26, Federal University of Ceará27, Universidade Federal de Sergipe28, Federal University of Paraíba29, Federal University of Alagoas30, Federal University of Roraima31
TL;DR: The study findings will be instrumental to the development of public policies aiming at the prevention of obesity, atherosclerotic diseases and diabetes in an adolescent population.
Abstract: The Study of Cardiovascular Risk in Adolescents (Portuguese acronym, “ERICA”) is a multicenter, school-based country-wide cross-sectional study funded by the Brazilian Ministry of Health, which aims at estimating the prevalence of cardiovascular risk factors, including those included in the definition of the metabolic syndrome, in a random sample of adolescents aged 12 to 17 years in Brazilian cities with more than 100,000 inhabitants. Approximately 85,000 students were assessed in public and private schools. Brazil is a continental country with a heterogeneous population of 190 million living in its five main geographic regions (North, Northeast, Midwest, South and Southeast). ERICA is a pioneering study that will assess the prevalence rates of cardiovascular risk factors in Brazilian adolescents using a sample with national and regional representativeness. This paper describes the rationale, design and procedures of ERICA.
143 citations
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TL;DR: Significant spatial clustering of malaria was observed in the areas of most recent occupation, indicating that the continuous influx of nonimmune settlers to forest-fringe areas perpetuates the cycle of environmental change and colonization that favors malaria transmission in rural Amazonia.
Abstract: Little follow-up data on malaria transmission in communities originating from frontier settlements in Amazonia are available. Here we describe a cohort study in a frontier settlement in Acre, Brazil, where 509 subjects contributed 489.7 person-years of follow-up. The association between malaria morbidity during the follow-up and individual, household, and spatial covariates was explored with mixed-effects logistic regression models and spatial analysis. Incidence rates for Plasmodium vivax and Plasmodium falciparum malaria were 30.0/100 and 16.3/100 person-years at risk, respectively. Malaria morbidity was strongly associated with land clearing and farming, and decreased after five years of residence in the area, suggesting that clinical immunity develops among subjects exposed to low malaria endemicity. Significant spatial clustering of malaria was observed in the areas of most recent occupation, indicating that the continuous influx of nonimmune settlers to forest-fringe areas perpetuates the cycle of environmental change and colonization that favors malaria transmission in rural Amazonia.
103 citations
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TL;DR: Addressing morbidities and multiple nutritional deficiencies in children and mothers and improving the purchasing power of poorer families are potentially important interventions to reduce the burden of anemia.
Abstract: Background
Although iron deficiency is considered to be the main cause of anemia in children worldwide, other contributors to childhood anemia remain little studied in developing countries. We estimated the relative contributions of different factors to anemia in a population-based, cross-sectional survey.
101 citations
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Rio de Janeiro State University1, Federal University of Rio de Janeiro2, Oswaldo Cruz Foundation3, Universidade Federal do Rio Grande do Sul4, Brazilian Institute of Geography and Statistics5, Federal University of Pará6, University of São Paulo7, State University of Feira de Santana8, Federal University of Amazonas9, Universidade Federal de Minas Gerais10, Universidade Federal do Amapá11, Universidade Federal do Espírito Santo12, Universidade Federal de Santa Catarina13, Federal University of Rio Grande do Norte14, Universidade Federal de Mato Grosso15, Federal University of Bahia16, Pontifícia Universidade Católica do Paraná17, Federal University of Pernambuco18, University of Brasília19, Universidade Federal de Rondônia20, State University of Campinas21, Federal University of Piauí22, Universidade Federal do Acre23, Universidade Federal de Goiás24, Federal University of Maranhão25, Federal University of Ceará26, Universidade Federal de Sergipe27, Federal University of Paraíba28, Federal University of Alagoas29, Federal University of Roraima30, Sao Paulo State University31
TL;DR: Despite the prevalence of Metabolic Syndrome being low, the high prevalences of some components and participation of others in the syndrome composition shows the importance of early diagnosis of this changes, even if not grouped within the metabolic syndrome.
Abstract: OBJECTIVE To determine the prevalence of metabolic syndrome and its components in Brazilian adolescents. METHODS We evaluated 37,504 adolescents who were participants in the Study of Cardiovascular Risks in Adolescents (ERICA), a cross-sectional, school-based, national study. The adolescents, aged from 12 to 17 years, lived in cities with populations greater than 100,000 inhabitants. The sample was stratified and clustered into schools and classes. The criteria set out by the International Diabetes Federation were used to define metabolic syndrome. Prevalences of metabolic syndrome were estimated according to sex, age group, school type and nutritional status. RESULTS Of the 37,504 adolescents who were evaluated: 50.2% were female; 54.3% were aged from 15 to 17 years, and 73.3% were from public schools. The prevalence of metabolic syndrome was 2.6% (95%CI 2.3-2.9), slightly higher in males and in those aged from 15 to 17 years in most macro-regions. The prevalence was the highest in residents from the South macro-region, in the younger female adolescents and in the older male adolescents. The prevalence was higher in public schools (2.8% [95%CI 2.4-3.2]), when compared with private schools (1.9% [95%CI 1.4-2.4]) and higher in obese adolescents when compared with nonobese ones. The most common combinations of components, referring to 3/4 of combinations, were: enlarged waist circumference (WC), low HDL-cholesterol (HDL-c) and high blood pressure; followed by enlarged WC, low HDL-c and high triglycerides; and enlarged WC, low HDL-c, high triglycerides and blood pressure. Low HDL was the second most frequent component, but the highest prevalence of metabolic syndrome (26.8%) was observed in the presence of high triglycerides. CONCLUSIONS ERICA is the first Brazilian nation-wide study to present the prevalence of metabolic syndrome and describe the role of its components. Despite the prevalence of Metabolic Syndrome being low, the high prevalences of some components and participation of others in the syndrome composition shows the importance of early diagnosis of this changes, even if not grouped within the metabolic syndrome.
76 citations
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TL;DR: Prevalence rates for malnutrition, intestinal parasitic infections, anemia, and iron deficiency in under-five children in the urban area of two counties in the Western Brazilian Amazon, Assis Brasil and Acrelandia are presented.
Abstract: The article presents prevalence rates for malnutrition, intestinal parasitic infections, anemia, and iron deficiency in under-five children in a population-based cross-sectional survey performed in the urban area of two counties in the Western Brazilian Amazon, Assis Brasil (n = 200) and Acrelandia (n = 477). Available data included: (a) weight and height measurements, standardized as z-scores using the 1977 NCHS reference population, (b) diagnosis of current intestinal parasitic infection, (c) blood hemoglobin levels, and (d) plasma ferritin and soluble transferrin receptor levels. Overall prevalence rates of low weight-for-height, low weight-for-age, and low height-for-age were 3.7%, 8.7%, and 7.5%, respectively, with similar figures in the two towns. Intestinal parasites were detected in 32.5% children; helminths were uncommon. Anemia and iron deficiency were diagnosed in 30.6% and 43.5% of the children, respectively. Evidence of anemia was found in only 47.6% of the children with depleted iron reserves, indicating that hemoglobin measurement alone would severely underestimate the magnitude of iron deficiency in this population. In both towns, anemia and malnutrition were significantly more prevalent among children in the lowest socioeconomic stratum.
73 citations
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TL;DR: Iron-deficiency anemia was the top cause globally, although 10 different conditions were among the top 3 in regional rankings, and Malaria, schistosomiasis, and chronic kidney disease-related anemia were the only conditions to increase in prevalence.
1,427 citations
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TL;DR: A systematic review and meta-analysis finds that sanitation is associated with a reduced risk of transmission of helminthiases to humans.
Abstract: Background
In countries of high endemicity of the soil-transmitted helminth parasites Ascaris lumbricoides, Trichuris trichiura, and hookworm, preventive chemotherapy (i.e., repeated administration of anthelmintic drugs to at-risk populations) is the main strategy to control morbidity. However, rapid reinfection of humans occurs after successful deworming, and therefore effective preventive measures are required to achieve public health goals with optimal efficiency and sustainability.
504 citations
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TL;DR: A systematic review of endemic population surveys in which P. falciparum prevalence had been measured by both microscopy and a more-sensitive polymerase chain reaction (PCR)-based technique found that microscopy can miss a substantial proportion of P. Falconerum infections in surveys of endemic populations, especially in areas with low transmission of infection.
Abstract: Introduction. Light microscopy examination of blood slides is the main method of detecting malaria infection; however, it has limited sensitivity. Low-density infections are most likely to be missed, but they contribute to the infectious reservoir. Quantifying these submicroscopic infections is therefore key to understanding transmission dynamics and successfully reducing parasite transmission. Methods. We conducted a systematic review of endemic population surveys in which P. falciparum prevalence had been measured by both microscopy and a more-sensitive polymerase chain reaction (PCR)-based technique. The combined microscopy: PCR prevalence ratio was estimated by random-effects meta-analysis, and the effect of covariates was determined by meta-regression. Results. Seventy-two pairs of prevalence measurements were included in the study. The prevalence of infection measured by microscopy was, on average, 50.8% (95% confidence interval [CI], 45.2%-57.1%) of that measured by PCR. For gametocyte-specific detection, the microscopy prevalence was, on average, 8.7% (95% CI, 2.8%-26.6%) of the prevalence measured by PCR. A significantly higher percentage of total infections was detected by microscopy in areas of high, compared with low, transmission (74.5% when the prevalence determined by PCR was >75% versus 12.0% when the prevalence determined by PCR was <10%). Discussion. Microscopy can miss a substantial proportion of P. falciparum infections in surveys of endemic populations, especially in areas with low transmission of infection. The extent of the submicroscopic reservoir needs to be taken into account for effective surveillance and control.
487 citations
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TL;DR: The clinical data presented here derive largely from long-term cohort studies that are supported by controlled animal studies, and the mechanisms by which enteric infections lead to undernutrition and by which malnutrition worsens intestinal infections are reviewed.
Abstract: Malnutrition is a major contributor to mortality and is increasingly recognized as a cause of potentially lifelong functional disability. Yet, a rate-limiting step in achieving normal nutrition may be impaired absorptive function due to multiple repeated enteric infections. This is especially problematic in children whose diets are marginal. In malnourished individuals, the infections are even more devastating. This review documents the evidence that intestinal infections lead to malnutrition and that malnutrition worsens intestinal infections. The clinical data presented here derive largely from long-term cohort studies that are supported by controlled animal studies. Also reviewed are the mechanisms by which enteric infections lead to undernutrition and by which malnutrition worsens enteric infections, with implications for potential novel interventions. Further intervention studies are needed to document the relevance of these mechanisms and, most importantly, to interrupt the vicious diarrhea-malnutrition cycle so children may develop their full potential.
467 citations