Seroprevalence of Toxoplasma gondii infection among indian people living in Iauareté, São Gabriel da Cachoeira, Amazonas, Brazil

The goal of this survey was to estimate the seroprevalence of Toxoplasma gondii infection in Iauareté, a multiethnic Indian community in the upper Rio Negro basin. We carried out a cross-sectional survey (n = 260), in order to obtain serum samples and demographic data. The sample was randomly selected, by family conglomerate analysis. Serodiagnosis was performed by an enzyme-linked immunosorbent assay and indirect immunofluorescence. Prevalence of reactivity was 73.5% (191/260), being higher in the older-age groups, reaching 95.7% (44/46) in the group aged 50 years or more. The majority of seropositive subjects had titers equal to or less than 1:64. Seroprevalence was greater in Indians belonging to the Hupda ethnic group (p = 0.03). According to the present survey, Indian people living in Iauareté have a high prevalence of antibodies to T. gondii. Demographic concentration and urbanization within low sanitation and poor hygiene backgrounds, as well as unfiltered water consumption, may be related to the high frequency of T. gondii seroprevalence observed in the studied area.

Co-infection of Dengue virus by serotypes 3 and 4 in patients from Amazonas, Brazil

The natural co-infection with dengue virus can occur in highly endemic areas where different serotypes have been observed for many years. We report here four cases of DENV-3/DENV-4 co-infection detected by serological and molecular tests among 674 patients with acute undifferentiated fever from the tropical medicine reference center of Manaus City, Brazil, between 2005 and 2010. Analysis of the sequences obtained indicated the presence of genotype 3 and 1 for DENV-3 and DENV-4 respectively.

HEAD LICE IN HAIR SAMPLES FROM YOUTHS, ADULTS AND THE ELDERLY IN MANAUS, AMAZONAS STATE, BRAZIL

A study of head lice infestations among young people, adults and elderly individuals was conducted from August 2010 to July 2013 in Manaus, AM, Northern Brazil. Hair samples collected from 1,860 individuals in 18 barber shops and beauty parlors were examined for the ectoparasite. The occurrence of pediculosis and its association with factors, such as sex, age, ethnicity, hair characteristics and the socioeconomic profile of salon customers, salon location and seasonal variation were determined. The overall occurrence rate was 2.84%. Occurrence was higher in hair samples from non-blacks and the elderly. Higher occurrence was also observed during kindergarten, elementary and junior education school holidays. The results indicate that the occurrence of head lice among young people, adults and the elderly in Manaus is relatively low compared to that determined in children and in other regions of the country. After children, the elderly were the most affected. The study also indicated the need to adopt additional procedures to improve surveys among the population with low or no purchasing power, which is usually the most affected by this ectoparasitic disease.

Doença diarreica aguda (DDA) em crianças de um mês a um ano de idade residentes em Parintins, Amazonas

Um grupo de 199 crianças de 1 mês a 1 ano de idade, residentes em Parintins, AM, divididas em casos e controles de DDA, foram comparadas segundo: idade; ocupação do chefe da família; condições de moradia; condições demográficas; participação social da família; nutrição; percepção de suscetibilidade e gravidade da DDA; crenças sobre a causalidade da DDA. Foram aceitas as hipóteses nulas de não-associação entre as variáveis independentes e a presença de DDA, exceto idade. Questiona-se a representatividade da amostra tomada. Propõe-se o prosseguimento dos estudos relativos aos fatores que condicionam a manutenção da DDA como principal causa da mortalidade em nosso meio.

A parasitological and serological malária survey in Amazonas, 1971

Thick blood films and malaria indirect fluorescent antibody test (P. falciparum and P. vivax) were done in four different regions in Amazonas. There was a very low prevalence of parasites anã the antibody rates suggest a small amount of transmission and that P. vivax was the predominant parasite. The calculation of probability of being infected per year was about 8% in Tefé. Coari, Colonia Fernanão Costa and Labrea and 0.8% in Anori.

Hepatite fulminante e febre negra de Lábrea: estudo de 5 casos procedentes de Codajás, Amazonas, Brasil

São descritas as manifestações clinicas, laboratoriais e aspectos evolutivos de cinco pacientes procedentes de Codajás-Amazonas, atendidos no Instituto de Medicina Tropical de Manaus devido ao quadro de hepatopatia grave, com período médio de doença de quatro dias. Quatro destes pacientes evoluiram para óbito, com uma média de cinco dias desde o inicio dos pródromos. A sorologia para hepatite B mostrou que o Ag HBs estava presente em quatro e o Anti - HBc em todos. Dos pacientes que foram ao óbito, através da necropsia a histopatologia do fígado revelou quadro de hepatite fulminante em dois e de febre de Lábrea nos outros dois.

Frequency of human leukocyte antigen (hla) in patients with malaria and in the general population of Humaitá county, Amazonas state, Brazil

In August 1983,85 inhabitants of the municipality of Humaitá, Amazonas State, Brazil were studied to determine the prevalence of antigens to HLA-A, -B, -C and DR. Thirty-eight were sick with malaria due to Plasmodium falciparum. All subjects were examined for splenomegaly, blood parasitaemia and antibodies to malaria. They constituted three groups: 1) 25 subjects native to the Amazon region who had never had malaria; 2) 38 Amazonian subjects who had malaria in the past or currently had an infection; 3) 22 patients with malaria who had acquired the infection in the Amazon Region but came from other regions of Brazil. Blood was taken from each person, the lymphocytes were separated and typed by the test of microlymphocytotoxicity. There was a high frequency of antigens that could not be identified in the groups studied which suggests the existence of a homozygote or phenotype not identified in the population. There was a high frequency of the phenotype Ag(W24) (44.7%) in group 2 when compared with group 1 (32%) or group 3 (9%). Also the individuals in group 2 showed an elevated frequency of antigen DR(4)80%) when compared with group 1 (36.6%) or group 3 (16.6%). These observations suggest the possibility of a genetic susceptibility to malaria among Amazonian residents and indicate a necessity for more extensive studies of the frequency of HLA antigens among inhabitants of this endemic malarial zone.

Infrequency of asymptomatic malaria in an endemic area in Amazonas, Brazil

A malaria survey was conducted in an area of high transmission (Costa Marques, Rondonia, Brazil) to determine the prevalence of asymptomatic parasitemia and its clinical significance. Most of the people surveyed were immigrants who had lived in the endemic area < 5 years. The people had easy access to free diagnostic and treatment services at the Malaria Clinic in the town of Costa Marques. The prevalence of plasmodial parasitemia in 344 people was 22%. There were 36 individuals with asymptomatic infections among the 77 parasitemic patients. During the two days following the initial examination, 19 ofthe 36 individuals: with asymptomatic infections developed malaria. Among the 17 patients who remained asymptomatic for > 2 days, 4 had only gametocytes, 1 had taken inadequate anti-malarial treatment, 3 were under treatment and 2 moved. Six asymptomatic patients denied the use of anti-malarial drugs and they developed malaria 3-6 days after the initial parasitological diagnosis. The final patient remained asymptomatic during the 7 day observation period. He had a history of > 40 malaria attacks and denied the use of antimalarial treatment. With the exception of the latter all of the other asymptomatic patients, were either in the incubation period or had been treated It is concluded that asymptomatic malaria is rare in the Costa Marques area and that it is necessary to treat all individuals with plasmodial parasitemia.

Malaria in humait a county, state of Amazonas, Brazil. XIX - evaluation of clindamycin for the treatment of patients with Plasmodium falciparum infection

A total of 207 patients with malaria caused by Plasmodium falciparum were submitted to 5 different treatment schedules with clindamycin from 1981 to 1984: A - 89 patients were treated intravenously and orally, or intramuscularly and orally with 20 mg/kg/day divided into two daily applications for 5 to 7 days; B-40 patients were treated orally with 20 mg/kg/day divided into two daily doses for 5 to 7 days; C-27 patients were treated with 20 mg/kg/day intravenously or orally divided into two daily applications for 3 days; D-16 patients were treated orally and/or intravenously with a single daily dose of 20 to 40 mg/kg/day for 5 to 7 days; E-35 patients were treated orally with 5 mg/kg/day divided into two doses for 5 days. Patients were examined daily during treatment and reexamined on the 7th, 24th, 21st, 28th and 35th day both clinically and parasitologically (blood test). Eighty three (40.1%) had moderate or severe malaria, and 97 (46.8%) had shown resistance to chloroquine or to the combination ofsulfadoxin and pyrimethamine. The proportion of cured patients was higher than 95% among patients submitted to schedules A and B. Side effects were only occasional and of low intensity. Three deaths occurred (1.4%), two of them involving patients whose signs and symptoms were already very severe when treatment was started. Thus, clindamycin proved to be very useful in the treatment of patients with malaria caused by Plasmodium falciparum and we recommend schedule A for moderate and severe cases and Bfor initial cases.

Ataque de populações humanas por triatomíneos silvestres no Amazonas: uma nova forma de transmissão da infecção chagásica?

Comprovou-se o "ataque" de triatomineos silvestres (Rhodnius brethesi) a colhedores de piaçava (Leopoldinia piaçaba), em piaçabal na localidade de Acuquaia, no Rio Padauari, afluente do Rio Negro, no Município de Barcelos, Estado do Amazonas, onde em trabalho anterior verificamos uma prevalência sorológica para anticorpos anti-T. cruzi em 12,5% da população na sede do município, com uma forte associação do contato dessa população com triatomineos silvestres, conhecidos na área como "piolho da piaçava", os quais vivem predominantemente nas piaçabeiras. O "ataque " de triatomineos a populações humanas foi possivelmente o mecanismo inicial de abordagem dos triatomineos ao homem, adaptando-se posteriormente ao seu peridomicílio e domicílio, principalmente em áreas desmaiadas ou de cerrado com poucos reservatórios silvestres. No caso do Amazonas, relatado neste trabalho, os triatomineos estavam provavelmente famintos por escassez de outros animais de sangue quente para sua alimentação.

Relato de um caso de latrodectismo ocorrido em Manaus, Amazonas, Brasil

Em 02/07/1995, foi atendido no Instituto de Medicina Tropical do Amazonas, paciente masculino, 11 anos, acidentado em Manaus, por picada na região retroauricular direita, clínicamente compatível com aquele causado por Latrodectus. Observavam-se abalos musculares, febre, calafrios e sudorese intensa. Instituída terapêutica com neostigmine precedido de atropina, gluconato de cálcio, cimetidina, diazepam e hidrocortisona. No terceiro dia apresentava-se melhorado, consciente, orientado e com diminuição importante do edema palpebral. A despeito de uma melhora progressiva diária, no quinto dia surgiu eritema máculo-pápulo-vesiculoso. Em 14/07/1995 teve alta, assintomático. O caso relatado é o primeiro descrito na região Amazônica, ocorrido na periferia de Manaus e pode ter sido uma consequência da expansão urbana das duas últimas décadas.

Description of a possible clonal expansion of Plasmodium vivax in Manaus - Amazonas - Brazil

Atypical P. vivax cases reported in Manaus municipality led us to detect a genetic isolate of P. vivax. Variable regions of SSUrRNA were examined from the initial time of infection and in the two recrudescences/relapses from a patient exhibiting chloroquine and primaquine resistance. A unique isolate, found at all stages of infection, suggests the presence of a clonal expansion.