Health survey on the Ilha da Conceição, state of Rio de Janeiro, II: selected health characteristics in children

As part of the health survey on the Ilha da Conceição, a 25 percent random sample of households was identified and a health guestionnaire completed at 236 households. These households contained 536 children, of whom 239 were under age six. Prenatal care had been obtained by 70 percent of the mothers during the pregnancies of the youngest children and 83 percent of these children had been born in hospital. The use of available health facilities was reported more frequently for the younger children in comparison to the older children. Over 90 percent of the children had been vaccinated against one or more diseases but only 50 to 60 percent of the children had complete vaccination against pertussis, diphtheria and tetanus. Almost two-thirds of the stool specimens from the children revealed evidence of parasites and were most commonly found in children two to three years of age. Low hemoglobin values were found commonly under age three and hemoglobin leveis ábove 12 grams were not commonly found until age six. Compared with a North American standard for height and weight, proportionately more children on the Ilha da Conceição were found below the 25th and 3rd percentiles. These findings suggest that an improved health status for the children on the Ilha da Conceição would result from a household health record maintained at the island clinic including current information on vaccination status of all children, and a health education program focused on expectant mothers and the well baby clinic program.

Re-evaluation of the basic procedures involved in the storage of measles vaccine in public health units of the municipality of Niterói, state of Rio de Janeiro, Brazil

Four years after the first visit seventeen public health units were visited again and evaluated as to standards of storage recommended by the Brazilian Immunization Programme. In 100% of the units, refrigerators and proper inside location of vaccines in the refrigerator were adequatety or regularfy maintained and checked, respectively. However, when control of temperature was checked, onfy 64.7% presented adequate storage conditions. In 94.1 % of the units, health workers complained of lack of immediate technical support in emergency situations. In 55.2 % the titers vaccine samples of were under the minimal recommended potency. It is necessary that the factors concerning the cold chain be continualfy evaluated so that the quality of the vaccines that will be used is not affected.

Dengue infection in Paracambi, State of Rio de Janeiro, 1990-1995

A seroepidemiological survey was carried out during 1994 in the municipality of Paracambi, state of Rio de Janeiro. Haemagglutination inhibition test positivity was detected in 145 out of 370 (39.2%) schoolchildren. The frequency of positive test by sex was 53.8% (78/145) female and 46.2% (67/145) male. Distribution by age showed the increasing of antibody posivity in older children. Strains of dengue virus type 1 and dengue virus type 2 were isolated before (1990) showing the co-circulation of both serotypes in that area. The house index infestation of Aedes albopictus and Aedes aegypti has been determined.

An intermittent schedule is better than continuous regimen of antimonial therapy for cutaneous leishmaniasis in the municipality of Rio de Janeiro, Brazil

This study reviews a series of cutaneous leishmaniasis cases diagnosed and treated in outpatient units in the municipality of Rio de Janeiro, where the intermittent schedule of antimonial therapy was replaced by the continuous regimen. Both schedules were based on daily intramuscular injections of pentavalent antimonial. Forty-nine subjects received the intermittent regimen, consisting of three ten-day series alternated with ten-day rest intervals whereas seventy-one patients received the continuous regimen during 20 consecutive days. The study groups had similar composition regarding age, sex and clinical condition. The cure rate was significantly higher in the group receiving the intermittent schedule than in the group receiving continuous therapy (89.8% vs 63.3%). Moreover, loss to follow-up was significantly more frequent in the group receiving continuous therapy (19.7% vs 4.1% in the intermittent therapy). Under field conditions, the intermittent regimen provided higher effectiveness and adherence than the continuous schedule.

Atypical lymphocytosis in leptospirosis: a cohort of hospitalized cases between 1996 and 2009 in State of Rio de Janeiro, Brazil

INTRODUCTION: Leptospirosis is a zoonotic disease found in tropical and temperate countries, and its clinical diagnostic confusion with arboviruses (dengue fever, oropouche fever and yellow fever), Brazilian spotted fever, viral hepatitis and hantaviruses has been an ongoing public health concern. The aim of this observational study was to demonstrate an association between findings of atypical lymphocytosis and the progression of endemic leptospirosis. METHODS: A retrospective analysis was performed on the demographic, epidemiological, clinical and laboratory aspects of 27 human leptospirosis cases that occurred over a period of 13 years (1996-2009) with no reported epidemic outbreaks in Rio de Janeiro, Brazil. RESULTS: The overall mortality rate was 11.1% in our cohort of hospitalized cases. However, there was no mortality among patients with atypical lymphocytosis (OR = 11.1; 95% CI = 1.12-110.9; p = 0.04). Two patients who were in the septicemic phase showed signs of expansion of γδ T cell responses in peripheral blood. CONCLUSIONS: Atypical lymphocytosis may be observed in patients with leptospirosis. Our observations suggest that these atypical leukocyte subsets are associated with partial protection during the disease course of leptospirosis.

Lutzomyia longipalpis (Diptera: Psychodidae: Phlebotominae) in the region of Saquarema: potential area of visceral leishmaniasis transmission in the state of Rio de Janeiro, Brazil

INTRODUCTION: Lutzomyia longipalpis is the main vector of Leishmania infantum chagasi in the Americas. METHODS: Phlebotomine captures were conducted during 2008 and 2009 in a rural area endemic for cutaneous leishmaniasis located in the municipality of Saquarema, Rio de Janeiro. RESULTS: Among other species captured, we observed the presence of Lutzomyia longipalpis. CONCLUSIONS: This is the first report of the occurrence of Lutzomyia longipalpis in this region, demonstrating the potential risk of visceral leishmaniasis transmission in the coastal area of the State of Rio de Janeiro. Therefore, active vigilance by all municipalities in the area is necessary.

Circulation of the rabies virus in non-hematophagous bats in the city of Rio de Janeiro, Brazil, during 2001-2010

INTRODUCTION: Rabies is one of the most known lethal zoonosis, responsible for 55,000 human deaths per year. It is transmitted to humans mainly by the bite of domestic or wild animals infected with the virus. This paper shows the circulation of this virus in non-hematophagous bats in the City of Rio de Janeiro, Brazil. METHODS: A survey was performed on the number of bats that had been sent for diagnosis by the Seção de Virologia of the Instituto Municipal de Medicina Veterinária Jorge Vaitsman and were positive for rabies. The positive animals were identified, and the isolated viruses were sent for antigenic typification with indirect immunofluorescence. The results were compared with the antigenic panel of the Centers for Disease Control and Prevention. RESULTS: During 2001-2010, the laboratory received 555 non-hematophagous bats for rabies diagnosis, with 198 (35.7%) from Rio de Janeiro City. A total of 11 (5.5%) animals were positive for this disease. Antigenic typification revealed the predominance of variant 3 in 9 (81.8%) of the isolated viruses; 1 virus was classified as variant 4 and 1 variant was identified that segregated with the viruses in insectivorous bats. CONCLUSIONS: The data obtained in this study showed the presence of the rabies virus in synanthropic populations of non-hematophagous bats in the City of Rio de Janeiro. The circulation of this agent in these animals represents a serious risk to human and animal health and requires attention and control measures by the authorities.

Prevalence and risk factors for Toxoplasma gondii infection among pregnant and postpartum women attended at public healthcare facilities in the City of Niterói, State of Rio de Janeiro, Brazil

IntroductionTo determine the prevalence of immunoglobulin G (IgG) and immunoglobulin M (IgM) anti-Toxoplasma gondii antibodies among pregnant and postpartum women attended within the public healthcare system in Niterói, State of Rio de Janeiro, and to detect possible exposure factors associated with T. gondii infection in this population.MethodsIgM and IgG anti-T. gondii antibodies were investigated in 276 pregnant and 124 postpartum women by using the indirect immunofluorescence (IFAT) and immunoenzymatic assay (ELISA) techniques. The participants were selected by convenience sampling. All these 400 patients filled out a free and informed consent statement, answered an epidemiological questionnaire and were informed about the disease.ResultsAmong the 400 samples analyzed, 234 (58.5%) were reactive to IgG anti-T. gondii antibodies, according to the IFAT and/or ELISA assay. One pregnant woman was found to be reactive to IgM anti-T. gondii antibodies, with an intermediate IgG avidity test. Risk factor analysis showed that seropositivity was significantly associated (p<0.05) with age, contact with cats and presence of rodents at home. Through a logistic regression model, these associations were confirmed for age and contact with cats, while education at least of the high school level was found to be a protective factor.ConclusionsThe prevalence rate of IgG anti-T. gondii antibodies in the City of Niterói was high and the risk factors for infection detected after multivariate analysis were: age over 30 years, contact with cats and education levels lower than university graduate level.

Survey of sandfly vectors of leishmaniasis in Marambaia Island, municipality of Mangaratiba, State of Rio de Janeiro, Brazil

IntroductionThe influx and efflux of military personnel in the possible endemic areas of leishmaniasis provided the impetus for research on the sandflies on Marambaia Island.MethodsSandflies were collected with light traps installed in the 3 ecotypes of 3 areas chosen for their particular landscape aspects.ResultsIn 2009, were collected 32,006 specimens of sandflies belonging to 13 species. The species that showed highest density were Nyssomyia intermedia and Migoneimyia migonei.ConclusionsN. intermedia and M. migonei are the principal vectors of American tegumentary leishmaniasis (ATL) in Brazil; thus, extension studies related to the eco-epidemiology of these species of Marambaia Island are essential.

Immature mosquitoes (Diptera: Culicidae) in a eutrophic landfill tank from State of Rio de Janeiro, Brazil

Introduction To determine the faunal composition of immature culicids inhabiting a percolation tank in the landfill of Sapucaia, State of Rio de Janeiro, Brazil, immature mosquitoes were collected over a two-day period during the third weeks of April, August and October 2011. Results The species found were Culex usquatus, Lutzia bigoti, Anopheles argyritarsis and Limatus durhamii. This study is the first to report the colonization of eutrophic breeding sites by these species. Conclusions The oviposition behavior observed in this study suggests a secondary adaptation or change in habit to select eutrophic environments during the developmental stages of the observed species.

Molecular identification of the agent of Q fever – Coxiella burnetii – in domestic animals in State of Rio de Janeiro, Brazil

Introduction Over the last recent years, the number of Q fever cases have has increased throughout the world. An epidemiological investigation was performed in the area in which the first molecular documentation of Q fever in Brazil was previously reported. Methods Indirect immunofluorescence assay (IFA) and PCR of Coxiella burnetii targeting the htpAB gene were performed in samples from 14 dogs (blood); 1 cat (blood); 10 goats (blood, milk, vaginal swab and anal swab); 3 sheep (blood); and 2 horses (blood). Results Two dogs, two sheep and five goats were seroreactive. DNA was amplified from 6 milk and 2 blood samples from goats and from dogs, respectively. The sequence of the amplicons exhibited 99% sequence similarity with the homologous sequence of the htpAB gene of C. burnetii RSA 331 (GenBank - CP000890). Conclusions The results confirm C. burnetii infection in animals in Rio de Janeiro and reinforce the need for the surveillance of Q fever in Brazil.

The epidemiological scenario of feline sporotrichosis in Rio de Janeiro, State of Rio de Janeiro, Brazil

Introduction Sporotrichosis is a mycosis affecting both humans and animals. Within the context of the ongoing sporotrichosis epidemic in the State of Rio de Janeiro, Brazil, sick cats plays an important role in the zoonotic transmission. The aim of this study was to update the number of feline cases diagnosed at the Fundação Oswaldo Cruz (2005-2011). Methods The medical records of the cats followed were reviewed; the inclusion criterion was the isolation of Sporothrix spp. in culture. Results In total, 2,301 feline cases were identified. Conclusions These results should alert sanitary authorities to the difficulties associated with sporotrichosis control.

High visceral leishmaniasis mortality rate in Barra Mansa, a new area of visceral leishmaniasis transmission in the State of Rio de Janeiro, Brazil

Introduction Nine cases of visceral leishmaniasis occurred recently in Barra Mansa, State of Rio de Janeiro, with a high mortality rate. Methods We reviewed the medical records of the patients. Results Eight were male; 7 were adults. Patients who died progressed to death quickly and presented with aggravating factors: systemic steroid therapy before diagnosis, bleeding, severe liver involvement, infection, and/or refusal to receive transfusion. Conclusions We warn clinicians to be aware of the emergence of visceral leishmaniasis in new areas and to keep in mind the possibility of atypical clinical pictures and aggravating factors, so timely diagnosis can be made and prompt and adequate treatment can be initiated.

Studies on Phlebotominae (Diptera: Psychodidae) in the Campus FIOCRUZ Mata Atlântica, Jacarepaguá, in the City of Rio de Janeiro, Brazil

INTRODUCTION: The presence of American cutaneous leishmaniasis (ACL) in the communities of the Campus FIOCRUZ Mata Atlântica (CFMA) in the City of Rio de Janeiro initiated the investigation of the Phlebotominae fauna in the Atlantic Forest to determine the occurrence of putative ACL vectors associated with the enzootic cycle. METHODS: For 24 consecutive months, sand flies were captured inside the forest and in the border area near the communities. RESULTS: The following sand fly species were identified: Brumptomyia brumpti, Brumptomyia cunhai, Brumptomyia nitzulescui, Lutzomyia edwardsi, Lutzomyia pelloni, and Lutzomyia quinquefer. Other identified sand fly vectors, such as Lutzomyia intermedia (the predominant species), Lutzomyia migonei, Lutzomyia whitmani, Lutzomyia fischeri, and Lutzomyia hirsuta hirsuta, are associated with ACL transmission, and the vector for American visceral leishmaniases (AVL), Lutzomyia longipalpis, was also found. CONCLUSIONS: All sand fly vectors were found in both studied environments except for Lutzomyia whitmani, which was only identified in the forest. This study represents the first identification of Lutzomyia longipalpis in the CFMA, and the epidemiological implications are discussed.