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Papers by Cintia Muñoz Quiles
Journal of infection and public health, Jul 1, 2024
The journal of infectious diseases (Online. University of Chicago Press)/The Journal of infectious diseases, Feb 8, 2024
International journal of infectious diseases, Jun 1, 2024
WOS, 2021
DRIVE (Development of Robust and Innovative Vaccine Effectiveness) is an IMI funded public-privat... more DRIVE (Development of Robust and Innovative Vaccine Effectiveness) is an IMI funded public-private platform that aims to annually estimate brand-specific influenza vaccine effectiveness (IVE), for public health and regulatory purposes. IVE analyses and reporting are conducted by public partners in the consortium. In 2019/20, four primary care-based test-negative design (TND) studies (Austria, England, Italy (n = 2)), eight hospital-based TND studies (Finland, France, Italy, Romania, Spain (n = 4)), and one population-based cohort study (Finland) were conducted. The COVID-19 pandemic affected influenza surveillance in all participating study sites, therefore the study period was truncated on February 29, 2020. Age-stratified (6 m-17y, 18-64y, ≥65y), confounder-adjusted, site-specific adjusted IVE estimates were calculated and pooled through meta-analysis. Parsimonious confounder-adjustment was performed, adjusting the estimates for age, sex and calendar time. TND studies included 3531 cases (351 vaccinated) and 5546 controls (1415 vaccinated) of all ages. IVE estimates were available for 8/11 brands marketed in Europe in 2019. Most children and adults < 64y were captured in primary care setting and the most frequently observed vaccine brand was Vaxigrip Tetra. The estimate against any influenza for Vaxigrip Tetra in primary care setting was 61% (95%CI 38-77) in children and 32% (95%CI -13-59) in adults up to 64y. Most adults ≥ 65y were captured in hospital setting and the most frequently observed brand was Fluad, with an estimate of 52% (95%CI 27-68). The population-based cohort covered 511,854 person-years and two vaccine brands. In children aged 2-6y, the IVE against any influenza was 68% (95%CI 58-75) for Fluenz Tetra and 71% (56-80) for Vaxigrip Tetra. In adults ≥ 65y, IVE against any influenza was 29% (20-36) for Vaxigrip Tetra. DRIVE is a growing platform. Public health institutes with surveillance data and hospitals in countries with high influenza vaccine coverage are encouraged to join DRIVE.
The Journal of Infectious Diseases
Currently several immunisation products are being developed against respiratory syncytial virus (... more Currently several immunisation products are being developed against respiratory syncytial virus (RSV) for children, pregnant females and older adults, and some products have already received authorisation. Therefore, studies to monitor the effectiveness of these products are needed in the following years. To assist researchers to conduct post-marketing studies, we developed a generic protocol for register-based cohort studies to evaluate immunisation product effectiveness against RSV-specific and non-specific outcomes. To conduct a study on the basis of this generic protocol the researchers can use any relevant databases or healthcare registers that are available at the study site.
The Journal of Infectious Diseases
An association exists between severe respiratory syncytial virus (RSV)–bronchiolitis and a subseq... more An association exists between severe respiratory syncytial virus (RSV)–bronchiolitis and a subsequent increased risk of recurrent wheezing (RW) and asthma. However, a causal relationship remains unproven. Using a retrospective population-based cohort study (339 814 children), bronchiolitis during the first 2 years of life (regardless of etiology and severity) was associated with at least a 3-fold increased risk of RW/asthma at 2–4 years and an increased prevalence of asthma at ≥5 years of age. The risk was similar in children with mild bronchiolitis as in those with hospitalized RSV-bronchiolitis and was higher in children with hospitalized non-RSV-bronchiolitis. The rate of RW/asthma was higher when bronchiolitis occurred after the first 6 months of life. Our results seem to support the hypothesis of a shared predisposition to bronchiolitis (irrespective of etiology) and RW/asthma. However, 60% of hospitalized bronchiolitis cases in our setting are due to RSV, which should be param...
Additional file 1: Annex S1. Electronic case report form (eCRF). Annex S2. Questionnaire used for... more Additional file 1: Annex S1. Electronic case report form (eCRF). Annex S2. Questionnaire used for the study (english version). Annex S3. Resource consumption—related questions. Annex S4. Questionnaire ratings by dimension. Annex S5. HRQoL scores by age group and dimension. Annex S6. Prices used in the healthcare resource consumption estimations.
Additional file 1: Supplementary Table 1. CIE-9-MC codes for immunocompromised.
Additional file 2: Supplementary Table 2. Generalized lineal models.
Generalized linear models. Table including the different statistical GLM utilized to compare the ... more Generalized linear models. Table including the different statistical GLM utilized to compare the COPD and the non-COPD populations depending on the outcome variable. (DOCX 15 kb)
Figure S1: Markers of apoptosis. A. Cytosolic Caspase-3. Postcond-CsA and IPC decrease capscase 3... more Figure S1: Markers of apoptosis. A. Cytosolic Caspase-3. Postcond-CsA and IPC decrease capscase 3 activity. B. Mitochondrial Bax. Postcond-CsA and IPC decrease Bax activity. Bars represent mean values avec SD. n=6 for IR, 6 for postcond-CsA and 5 for IPC. Figure S2: Different technical procedures of surgery. There is no reproducibility for each time of ischemia in bilateral clamping group. There is no correlation between the time of ischemia and renal function in unilateral nephrectomy and contralateral clamping group. Figure S3: Linear correlation between calcium retention capacity (CRC) and renal function. CRC (nmolCa 2+/ mg of protein) correlates with creatinine (µmol/L), R² = 0.99. Results are mean ± SD.
Vaccine, 2021
To assess the effectiveness of the HPV vaccines in preventing genital warts (GW) in women aged 14... more To assess the effectiveness of the HPV vaccines in preventing genital warts (GW) in women aged 14-23 years and to estimate the incidence of GW in the whole population aged from 14 to 65. Population-based retrospective cohort study using real-world data from the Valencia health system Integrated Databases (VID). All subjects aged 14-65 years residing in the Valencia Region during 2009-2017 (n = 4,492,724), including a cohort of 563,240 females aged 14-23 years followed-up for the vaccine effectiveness (VE) estimations. Incident cases of GW defined as the first activation of GW-related codes (ICD-9-CM 078.11 or ICD-10-CM A63.0) in hospital, primary and specialized care during the study period. Adjusted VE was estimated as (1-Relative Risk (RR)) × 100 by a negative binomial Bayesian model. There were 23,049 cases of GW in the overall population and 2,565 in the females' cohort 14-23 years old. The incidence rate (IR) (in 100,000 persons-year) was 69.1 (95% CI 68.21-69.99) in the population overall, being higher in men (72.73; 95% CI 71.45-74.04). The IR of GW was 104.08 (95% CI 100.79-108.94) in the cohort of young women. The RR of GW increased with age from 14 to 21 years, reaching a plateau from 21 to 23. The VE of a complete schedule was 74% (95% CrI 68-79) for quadrivalent HPV vaccine (HPV4v). No effectiveness was seen with a full vaccination course with the bivalent HPV vaccine (HPV2v) in girls up to 21 years old. GW IR tends to be higher in unvaccinated cohorts covered by HPV4v vaccine than in unvaccinated cohorts not covered by HPV4v vaccine. A complete HPV4v vaccination schedule was 74% effective in reducing GW in our population. Our results also suggest an indirect protection to unvaccinated and HPV2v vaccinated girls.
Cervical cancer is the fourth most common malignancy in women worldwide, although it is preventab... more Cervical cancer is the fourth most common malignancy in women worldwide, although it is preventable with prophylactic HPV vaccination. HPV transmission-dynamic models can predict the potential for global elimination of cervical cancer. The random network model is a new approach that allows individuals to be followed, and to implement a given vaccination policy according to their clinical records. We developed an HPV transmission dynamics model on a lifetime sexual partners network based on individual contacts, also accounting for the sexual behavior of men who have sex with men (MSM). We analyzed the decline in the prevalence of HPV infection in a scenario of 75% and 90% coverage for both sexes. An important herd immunity effect for men and women was observed in the heterosexual network, even with 75% coverage. However, HPV in-fections are persistent in the MSM population, with sustained circulation of the virus among un-vaccinated individuals. Coverage around 75% of both sexes woul...
BMC Infectious Diseases, 2020
Background Estimate the incidence of herpes zoster (HZ), its complications and healthcare utiliza... more Background Estimate the incidence of herpes zoster (HZ), its complications and healthcare utilization rates in adults (≥ 18-years-old) with a wide range of immunocompromised (IC) conditions compared to IC-free cohort. Method A population-based retrospective study using the Valencia healthcare Integrated Databases (VID) (2009–2014). HZ and IC were defined using ICD-9 codes in primary care (PC) and hospitalization registers. Incidence rates (IR), risk of HZ, HZ-recurrence, HZ-complications and healthcare utilization rates were estimated in the IC-cohort compared to IC-free. Results The study population consisted of 4,382,590 subjects, of which 578,873 were IC (13%). IR (in 1000 persons-year) of HZ overall, in IC and in IC-free cohort was 5.02, 9.15 and 4.65, respectively. IR of HZ increased with age in both cohorts and it was higher for all IC conditions studied, reaching up to twelvefold in subjects with stem cell transplantation. IC subjects had 51% higher risk of developing HZ, 25%...
BMC Psychiatry, 2020
Background Real-World Data (RWD) studies provide important insights in disease epidemiology, in r... more Background Real-World Data (RWD) studies provide important insights in disease epidemiology, in real clinical populations, with long follow-up periods. The aim of the present study was to describe the epidemiology of schizophrenia spectrum disorders (SD) during an 8-year period in Spain. Methods A retrospective cohort of subjects aged 15 to 64 years was followed-up using electronic healthcare databases of the Valencia region (2008–2015). SD cases included outpatient and inpatient settings (ICD 9 codes 295.XX). Prevalence of SD was assessed. Incidence rate (IR) in the subpopulation aged between 15 and 34 years was also provided. Healthcare utilization (HCU) rates, including outpatient, specialists, hospitalizations and antipsychotic dispensations were estimated. Results The cohort included 3,976,071 subjects; 24,749 of them had a prevalent diagnosis of SD. The overall prevalence for SD was 6.2 per 1000 persons. SD were 76% more prevalent in men than women. IR in the subpopulation age...
International Journal of Epidemiology, 2019
Journal of infection and public health, Jul 1, 2024
The journal of infectious diseases (Online. University of Chicago Press)/The Journal of infectious diseases, Feb 8, 2024
International journal of infectious diseases, Jun 1, 2024
WOS, 2021
DRIVE (Development of Robust and Innovative Vaccine Effectiveness) is an IMI funded public-privat... more DRIVE (Development of Robust and Innovative Vaccine Effectiveness) is an IMI funded public-private platform that aims to annually estimate brand-specific influenza vaccine effectiveness (IVE), for public health and regulatory purposes. IVE analyses and reporting are conducted by public partners in the consortium. In 2019/20, four primary care-based test-negative design (TND) studies (Austria, England, Italy (n = 2)), eight hospital-based TND studies (Finland, France, Italy, Romania, Spain (n = 4)), and one population-based cohort study (Finland) were conducted. The COVID-19 pandemic affected influenza surveillance in all participating study sites, therefore the study period was truncated on February 29, 2020. Age-stratified (6 m-17y, 18-64y, ≥65y), confounder-adjusted, site-specific adjusted IVE estimates were calculated and pooled through meta-analysis. Parsimonious confounder-adjustment was performed, adjusting the estimates for age, sex and calendar time. TND studies included 3531 cases (351 vaccinated) and 5546 controls (1415 vaccinated) of all ages. IVE estimates were available for 8/11 brands marketed in Europe in 2019. Most children and adults < 64y were captured in primary care setting and the most frequently observed vaccine brand was Vaxigrip Tetra. The estimate against any influenza for Vaxigrip Tetra in primary care setting was 61% (95%CI 38-77) in children and 32% (95%CI -13-59) in adults up to 64y. Most adults ≥ 65y were captured in hospital setting and the most frequently observed brand was Fluad, with an estimate of 52% (95%CI 27-68). The population-based cohort covered 511,854 person-years and two vaccine brands. In children aged 2-6y, the IVE against any influenza was 68% (95%CI 58-75) for Fluenz Tetra and 71% (56-80) for Vaxigrip Tetra. In adults ≥ 65y, IVE against any influenza was 29% (20-36) for Vaxigrip Tetra. DRIVE is a growing platform. Public health institutes with surveillance data and hospitals in countries with high influenza vaccine coverage are encouraged to join DRIVE.
The Journal of Infectious Diseases
Currently several immunisation products are being developed against respiratory syncytial virus (... more Currently several immunisation products are being developed against respiratory syncytial virus (RSV) for children, pregnant females and older adults, and some products have already received authorisation. Therefore, studies to monitor the effectiveness of these products are needed in the following years. To assist researchers to conduct post-marketing studies, we developed a generic protocol for register-based cohort studies to evaluate immunisation product effectiveness against RSV-specific and non-specific outcomes. To conduct a study on the basis of this generic protocol the researchers can use any relevant databases or healthcare registers that are available at the study site.
The Journal of Infectious Diseases
An association exists between severe respiratory syncytial virus (RSV)–bronchiolitis and a subseq... more An association exists between severe respiratory syncytial virus (RSV)–bronchiolitis and a subsequent increased risk of recurrent wheezing (RW) and asthma. However, a causal relationship remains unproven. Using a retrospective population-based cohort study (339 814 children), bronchiolitis during the first 2 years of life (regardless of etiology and severity) was associated with at least a 3-fold increased risk of RW/asthma at 2–4 years and an increased prevalence of asthma at ≥5 years of age. The risk was similar in children with mild bronchiolitis as in those with hospitalized RSV-bronchiolitis and was higher in children with hospitalized non-RSV-bronchiolitis. The rate of RW/asthma was higher when bronchiolitis occurred after the first 6 months of life. Our results seem to support the hypothesis of a shared predisposition to bronchiolitis (irrespective of etiology) and RW/asthma. However, 60% of hospitalized bronchiolitis cases in our setting are due to RSV, which should be param...
Additional file 1: Annex S1. Electronic case report form (eCRF). Annex S2. Questionnaire used for... more Additional file 1: Annex S1. Electronic case report form (eCRF). Annex S2. Questionnaire used for the study (english version). Annex S3. Resource consumption—related questions. Annex S4. Questionnaire ratings by dimension. Annex S5. HRQoL scores by age group and dimension. Annex S6. Prices used in the healthcare resource consumption estimations.
Additional file 1: Supplementary Table 1. CIE-9-MC codes for immunocompromised.
Additional file 2: Supplementary Table 2. Generalized lineal models.
Generalized linear models. Table including the different statistical GLM utilized to compare the ... more Generalized linear models. Table including the different statistical GLM utilized to compare the COPD and the non-COPD populations depending on the outcome variable. (DOCX 15 kb)
Figure S1: Markers of apoptosis. A. Cytosolic Caspase-3. Postcond-CsA and IPC decrease capscase 3... more Figure S1: Markers of apoptosis. A. Cytosolic Caspase-3. Postcond-CsA and IPC decrease capscase 3 activity. B. Mitochondrial Bax. Postcond-CsA and IPC decrease Bax activity. Bars represent mean values avec SD. n=6 for IR, 6 for postcond-CsA and 5 for IPC. Figure S2: Different technical procedures of surgery. There is no reproducibility for each time of ischemia in bilateral clamping group. There is no correlation between the time of ischemia and renal function in unilateral nephrectomy and contralateral clamping group. Figure S3: Linear correlation between calcium retention capacity (CRC) and renal function. CRC (nmolCa 2+/ mg of protein) correlates with creatinine (µmol/L), R² = 0.99. Results are mean ± SD.
Vaccine, 2021
To assess the effectiveness of the HPV vaccines in preventing genital warts (GW) in women aged 14... more To assess the effectiveness of the HPV vaccines in preventing genital warts (GW) in women aged 14-23 years and to estimate the incidence of GW in the whole population aged from 14 to 65. Population-based retrospective cohort study using real-world data from the Valencia health system Integrated Databases (VID). All subjects aged 14-65 years residing in the Valencia Region during 2009-2017 (n = 4,492,724), including a cohort of 563,240 females aged 14-23 years followed-up for the vaccine effectiveness (VE) estimations. Incident cases of GW defined as the first activation of GW-related codes (ICD-9-CM 078.11 or ICD-10-CM A63.0) in hospital, primary and specialized care during the study period. Adjusted VE was estimated as (1-Relative Risk (RR)) × 100 by a negative binomial Bayesian model. There were 23,049 cases of GW in the overall population and 2,565 in the females' cohort 14-23 years old. The incidence rate (IR) (in 100,000 persons-year) was 69.1 (95% CI 68.21-69.99) in the population overall, being higher in men (72.73; 95% CI 71.45-74.04). The IR of GW was 104.08 (95% CI 100.79-108.94) in the cohort of young women. The RR of GW increased with age from 14 to 21 years, reaching a plateau from 21 to 23. The VE of a complete schedule was 74% (95% CrI 68-79) for quadrivalent HPV vaccine (HPV4v). No effectiveness was seen with a full vaccination course with the bivalent HPV vaccine (HPV2v) in girls up to 21 years old. GW IR tends to be higher in unvaccinated cohorts covered by HPV4v vaccine than in unvaccinated cohorts not covered by HPV4v vaccine. A complete HPV4v vaccination schedule was 74% effective in reducing GW in our population. Our results also suggest an indirect protection to unvaccinated and HPV2v vaccinated girls.
Cervical cancer is the fourth most common malignancy in women worldwide, although it is preventab... more Cervical cancer is the fourth most common malignancy in women worldwide, although it is preventable with prophylactic HPV vaccination. HPV transmission-dynamic models can predict the potential for global elimination of cervical cancer. The random network model is a new approach that allows individuals to be followed, and to implement a given vaccination policy according to their clinical records. We developed an HPV transmission dynamics model on a lifetime sexual partners network based on individual contacts, also accounting for the sexual behavior of men who have sex with men (MSM). We analyzed the decline in the prevalence of HPV infection in a scenario of 75% and 90% coverage for both sexes. An important herd immunity effect for men and women was observed in the heterosexual network, even with 75% coverage. However, HPV in-fections are persistent in the MSM population, with sustained circulation of the virus among un-vaccinated individuals. Coverage around 75% of both sexes woul...
BMC Infectious Diseases, 2020
Background Estimate the incidence of herpes zoster (HZ), its complications and healthcare utiliza... more Background Estimate the incidence of herpes zoster (HZ), its complications and healthcare utilization rates in adults (≥ 18-years-old) with a wide range of immunocompromised (IC) conditions compared to IC-free cohort. Method A population-based retrospective study using the Valencia healthcare Integrated Databases (VID) (2009–2014). HZ and IC were defined using ICD-9 codes in primary care (PC) and hospitalization registers. Incidence rates (IR), risk of HZ, HZ-recurrence, HZ-complications and healthcare utilization rates were estimated in the IC-cohort compared to IC-free. Results The study population consisted of 4,382,590 subjects, of which 578,873 were IC (13%). IR (in 1000 persons-year) of HZ overall, in IC and in IC-free cohort was 5.02, 9.15 and 4.65, respectively. IR of HZ increased with age in both cohorts and it was higher for all IC conditions studied, reaching up to twelvefold in subjects with stem cell transplantation. IC subjects had 51% higher risk of developing HZ, 25%...
BMC Psychiatry, 2020
Background Real-World Data (RWD) studies provide important insights in disease epidemiology, in r... more Background Real-World Data (RWD) studies provide important insights in disease epidemiology, in real clinical populations, with long follow-up periods. The aim of the present study was to describe the epidemiology of schizophrenia spectrum disorders (SD) during an 8-year period in Spain. Methods A retrospective cohort of subjects aged 15 to 64 years was followed-up using electronic healthcare databases of the Valencia region (2008–2015). SD cases included outpatient and inpatient settings (ICD 9 codes 295.XX). Prevalence of SD was assessed. Incidence rate (IR) in the subpopulation aged between 15 and 34 years was also provided. Healthcare utilization (HCU) rates, including outpatient, specialists, hospitalizations and antipsychotic dispensations were estimated. Results The cohort included 3,976,071 subjects; 24,749 of them had a prevalent diagnosis of SD. The overall prevalence for SD was 6.2 per 1000 persons. SD were 76% more prevalent in men than women. IR in the subpopulation age...
International Journal of Epidemiology, 2019