Título: | PREPAREDNESS FOR PUBLIC HEALTH EMERGENCIES: THE COVID-19 RESPONSE FROM A VULNERABILISED COMMUNITY IN BRAZIL | ||||||||||||
Autor: |
AMANDA DE ARAUJO BATISTA DA SILVA |
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Colaborador(es): |
SILVIO HAMACHER - Orientador FERNANDO AUGUSTO BOZZA - Coorientador OTAVIO TAVARES RANZANI - Coorientador |
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Catalogação: | 12/JUN/2025 | Língua(s): | ENGLISH - UNITED STATES |
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Tipo: | TEXT | Subtipo: | THESIS | ||||||||||
Notas: |
[pt] Todos os dados constantes dos documentos são de inteira responsabilidade de seus autores. Os dados utilizados nas descrições dos documentos estão em conformidade com os sistemas da administração da PUC-Rio. [en] All data contained in the documents are the sole responsibility of the authors. The data used in the descriptions of the documents are in conformity with the systems of the administration of PUC-Rio. |
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Referência(s): |
[pt] https://www.maxwell.vrac.puc-rio.br/projetosEspeciais/ETDs/consultas/conteudo.php?strSecao=resultado&nrSeq=70989&idi=1 [en] https://www.maxwell.vrac.puc-rio.br/projetosEspeciais/ETDs/consultas/conteudo.php?strSecao=resultado&nrSeq=70989&idi=2 |
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DOI: | https://doi.org/10.17771/PUCRio.acad.70989 | ||||||||||||
Resumo: | |||||||||||||
The COVID-19 pandemic, which caused over 6.9 million deaths worldwide,
exposed critical weaknesses in healthcare systems and deepened structural inequalities,
particularly in low- and middle-income countries (LMICs). In Brazil, some favela
communities effectively led their responses to the crisis, creating successful initiatives
based on solidarity and leveraging existing social structures, often surpassing
government-led efforts and highlighting the vital role of community engagement and
empowerment in public health responses. This thesis explores strategies for addressing
public health emergencies in vulnerable populations, aiming to establish a
comprehensive, all-hazards preparedness system for future crises. The study focuses on
community-based interventions, including public health and social measures, vaccination
campaigns, risk communication, infodemic management, community engagement, and
cohort studies, integrating epidemiological surveillance data to mitigate COVID-19 s
impact. These interventions were implemented in Complexo da Maré, one of Rio de
Janeiro s largest favela complexes with over 140,000 inhabitants. The research employs
advanced data analysis techniques, such as descriptive and inferential statistics,
deterministic and probabilistic linkage, Inverse Probability Weighting (IPW), survival
analysis, and Difference-in-Differences (DiD) analysis. The dataset includes serosurvey
results, COVID-19 testing data, case and death notifications, vaccination records, and
national census data. The thesis, structured as a compilation of four articles, demonstrated
the effectiveness of a proposed multicomponent intervention in improving case detection,
reducing mortality, and mitigating healthcare inequities in favelas. Results highlighted
the impact of locally adapted strategies, such as widely distributed vaccination sites in
accessible community locations with flexible hours, significantly enhancing vaccination
coverage. The study also established a community-based prospective cohort study to
describe COVID-19 seroprevalence, sociodemographic characteristics, and the burden of
COVID-19, followed by an estimate of the association of socioeconomic factors and
disease burden with seroprevalence. Our results identified critical sociodemographic,
geographic, and behavioural factors influencing booster vaccine adherence, reinforcing
the importance of healthcare access and socioeconomic conditions in shaping public
health outcomes. These findings provided valuable insights for global health strategies
and policies, particularly in guiding resource allocation and designing targeted actions to
address community-specific needs. Besides, they support the establishment of a public
health data repository and strengthen communication and mobilisation efforts, fostering
data-driven decision-making and public health responses, especially in LMICs. By
emphasising the role of community-based interventions and evidence-based
policymaking, this research contributes to building more resilient and equitable
healthcare systems, enhancing preparedness and response capabilities for future
infectious disease outbreaks.
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