Population Health Assessment

The mission of the Population Health Assessment team is to evaluate the health status and health determinants of various population groups and to measure the impact of health care interventions. These will generate data for healthcare professionals and health authorities to design new strategies or ameliorate current policies to improve Population Health.
Presently, the Population Health Assessment team is organized in 4 main topics with the following main aims:

MICROELEMENTS IN HEALTH AND DISEASE: Evaluate how the new policy of recommending iodine supplementation in preconception, pregnancy and lactation impact on the prevalence of iodine deficiency in pregnant women from the Minho region of Portugal, and whether timing of iodine supplementation initiation influences maternal thyroid function and psychomotor development of children.

INFECTIOUS DISEASES: i) Identify individuals with latent tuberculosis, through an unprecedented, detailed characterization of the immune response of blood leukocytes to two Mtb glycolipids, using mass-cytometry and secretome analysis. ii) Identify and understand risk behaviours for human immunodeficiency virus (HIV) transmission/infection and identify awareness, motivation and willingness to use PrEP or antiretroviral therapy. iii) Develop new diagnostic and prognostic tools of SARSCOV2 infection, by uncovering new prognostic biomarkers, prediction models and treatment strategies

NON-INFECTIONS RESPIRATORY CHRONIC DISEASES: i) Epi-Asthma: population-based nationwide cross-sectional study to determine the prevalence of asthma in Portugal, characterize patients with asthma underdiagnosis and misdiagnosis and to develop and validate a clinical prediction model to support asthma diagnosis. ii) Studies on chronic obstructive pulmonary disease (COPD) intend to estimate the prevalence of COPD in Portugal and to characterize COPD patients and to assess the feasibility and value of an interactive telemonitoring system for earlier detection and supported management of COPD exacerbations.

CARDIOMETABOLIC DISEASES: Ongoing studies on vascular and brain aging, using chronobiologic asynchrony intend to i) phenotype representative samples of the Iberian population. ii) Search for new circulating, imaging and functional biomarkers for early detection of subjects at risk of cardiovascular and cognitive diseases. iii) Establish new cost-effective interventions to reduce the expression of risk phenotypes. iv) Establish longitudinal population-based studies to evaluate the prevalence of risk phenotypes and measure the impact of planned interventions.

Team Members

Team Members

Joana Almeida Palha

Senior Researcher
Team Coordinator

Margarida Correia-Neves

Principal Investigator

Cláudia Bulhões

Clinician-Researcher

Jaime Correia de Sousa

Clinician-Researcher

John Yaphe

Clinician-Researcher

Pedro Alves-Peixoto

Clinician-Researcher

Pedro Guimarães Cunha

Clinician-Researcher

Susana Roque

Postdoctoral Researcher

Maria José Costeira

Affiliated Researcher

Joana Ferreira

PhD Student

Pedro Fonte

PhD Student

Sarai Machado

PhD Student

Projects

Success Story

Iodine is necessary for the proper development of the central nervous system. Our findings in 2009 contributed to the Portuguese National Health Authorities to recommend, in 2013, iodine supplementation to women during preconception, pregnancy and lactation. We now showed that Portuguese pregnant women remain iodine deficient, likely due to incomplete compliance on the duration of iodine supplementation, as observed from supplement sales. Worldwide strategies, such as the use of iodized salt, could contribute to solve the deficiency but are still poorly followed in Portugal, as we identified through analysis of food retailer iodized salt sales and literacy surveys. Our studies provide the evidence for additional urgent informed action by the health authorities, as already recognized by the National Plan for Healthy Eating.

There is good evidence that effective treatment of asthma can reduce suffering and improve quality of life for patients. There is also evidence that there are barriers to the proper delivery of proven treatments. The research published on Inhalers in Asthma and COPD looked at the ways that asthma and COPD treatment are used in the real world. Its significance lies in understanding the factors whose correction can be translated into improved care for patients, focused on non-adherence to inhaled medication, prescribers’ disagreement to therapeutic standards, inhalers mishandling, the relationship between non-adherence, inhalers mishandling or treatment deviations from guidelines and common clinical outcomes.

Selected Research Outputs

Alvarez-Bueno C, Cunha PG, Martinez-Vizcaino V, Pozuelo-Carrascosa DP, Visier-Alfonso ME, Jimenez-Lopez E, Cavero-Redondo I. Arterial Stiffness and Cognition Among Adults: A Systematic Review and Meta-Analysis of Observational and Longitudinal Studies. J Am Heart Assoc. 2020 Mar 3;9(5):e014621. doi: 10.1161/JAHA.119.014621.

Kocks J, Bosnic-Anticevich S, van Cooten J, Correia de Sousa J, Cvetkovski B, Dekhuijzen R, Dijk L, Garcia Pardo M, Gardev A, Gawlik R, van der Ham I, Janse Y, Lavorini F, Maricoto T, Meijer J, Metz B, Price D, Roman Rodriguez M, Schuttel K, Stoker N, Tsiligianni I, Usmani O, Voorham J, Leving MT. Identifying critical inhalation technique errors in Dry Powder Inhaler use in patients with COPD based on the association with health status and exacerbations: findings from the multi-country cross-sectional observational PIFotal study. BMC Pulm Med. 2023 Aug 17;23(1):302.

Lopes-Pereira M, Quialheiro A, Costa P, Roque S, Correia Santos N, Correia-Neves M, Goios A, Carvalho I, Korevaar TIM, Vilarinho L, Palha JA. Iodine supplementation: compliance and association with adverse obstetric and neonatal outcomes. Eur Thyroid J. 2022 Jan 1;11(1):e210035. doi: 10.1530/ETJ-21-0035.

Lopes-Pereira M, Roque S, Machado SI, Korevaar TIM, Quialheiro A, Machado A, Vilarinho L, Correia-Neves M, Galanti MR, Bordalo AA, Costa P, Palha JA. Iodineminho Study: Iodine Supplementation and Prevalence of Iodine Deficiency in Pregnant Women. J Clin Endocrinol Metab (in press) 2024 doi: 10.1210/clinem/dgae041.

Oliveira O, Ribeiro AI, Krainski ET, Rito T, Duarte R, Correia-Neves M. Using Bayesian spatial models to map and to identify geographical hotspots of multidrug-resistant tuberculosis in Portugal between 2000 and 2016. Sci Rep. 2020 Oct 6;10(1):16646. doi: 10.1038/s41598-020-73759-w.

Samuel TM, Binia A, de Castro CA, Thakkar SK, Billeaud C, Agosti M, Al-Jashi I, Costeira MJ, Marchini G, Martínez-Costa C, Picaud JC, Stiris T, Stoicescu SM, Vanpeé M, Domellöf M, Austin S, Sprenger N. Impact of maternal characteristics on human milk oligosaccharide composition over the first 4 months of lactation in a cohort of healthy European mothers. Sci Rep. 2019 Aug 13;9(1):11767. doi: 10.1038/s41598-019-48337-4.

Guimarães Cunha P, Stolarz-Skrzypek K, Persu A. Increased Blood Pressure Variability May Herald Cognitive Decline and Dementia. Hypertension. 2020 Oct;76(4):1076-1078. doi: 10.1161/HYPERTENSIONAHA.120.14785.

Serre-Miranda C, Nobrega C, Roque S, Canto-Gomes J, Silva CS, Vieira N, Barreira-Silva P, Alves-Peixoto P, Cotter J, Reis A, Formigo M, Sarmento H, Pires O, Carvalho A, Petrovykh DY, Diéguez L, Sousa JC, Sousa N, Capela C, Palha JA, Cunha PG, Correia-Neves M. Performance assessment of 11 commercial serological tests for SARS-CoV-2 on hospitalised COVID-19 patients. Int J Infect Dis. 2021 Mar;104:661-669. doi: 10.1016/j.ijid.2021.01.038

Silva CS, Sundling C, Folkesson E, Fröberg G, Nobrega C, Canto-Gomes J, Chambers BJ, Lakshmikanth T, Brodin P, Bruchfeld J, Nigou J, Correia-Neves M, Källenius G. High Dimensional Immune Profiling Reveals Different Response Patterns in Active and Latent Tuberculosis Following Stimulation With Mycobacterial Glycolipids. Front Immunol. 2021 Nov 23;12:727300. doi: 10.3389/fimmu.2021.727300.

Dijk L, Kerkhof M, Driessen M, Gerritsma YH, Bosnic-Anticevich S, Correia-de-Sousa J, Dekhuijzen PNR, Leving M, Price DB, Tsiligianni I, Usmani O, Kerstjens HAM, Kocks JWH. Does mixing inhaler devices lead to unchecked inhaler technique errors in patients with COPD? Findings from the cross-sectional observational MISMATCH study. BMJ Open Respir Res. 2023 Dec 22;10(1):e001821.