Neglected tropical diseases in Brazil

Poverty is intrinsically related to the incidence of Neglected Tropical Diseases (NTDs). The main countries that have the lowest human development indices (HDI) and the highest burdens of NTDs are located in tropical and subtropical regions of the world. Among these countries is Brazil, which is ranked 70th in HDI. Nine out of the ten NTDs established by the World Health Organization (WHO) are present in Brazil. Leishmaniasis, tuberculosis, dengue fever and leprosy are present over almost the entire Brazilian territory. More than 90% of malaria cases occur in the Northern region of the country, and lymphatic filariasis and onchocerciasis occur in outbreaks in a particular region. The North and Northeast regions of Brazil have the lowest HDIs and the highest rates of NTDs. These diseases are considered neglected because there is not important investment in projects for the development of new drugs and vaccines and existing programs to control these diseases are not sufficient. Another problem related to NTDs is co-infection with HIV, which favors the occurrence of severe clinical manifestations and therapeutic failure. In this article, we describe the status of the main NTDs currently occurring in Brazil and relate them to the HDI and poverty.

Epidemiology of neglected tropical diseases in transplant recipients: review of the literature and experience of a Brazilian HSCT center

The rising success rate of solid organ (SOT) and haematopoietic stem cell transplantation (HSCT) and modern immunosuppression make transplants the first therapeutic option for many diseases affecting a considerable number of people worldwide. Consequently, developing countries have also grown their transplant programs and have started to face the impact of neglected tropical diseases (NTDs) in transplant recipients. We reviewed the literature data on the epidemiology of NTDs with greatest disease burden, which have affected transplant recipients in developing countries or may represent a threat to transplant recipients living in other regions. Tuberculosis, Leprosy, Chagas disease, Malaria, Leishmaniasis, Dengue, Yellow fever and Measles are the topics included in this review. In addition, we retrospectively revised the experience concerning the management of NTDs at the HSCT program of Amaral Carvalho Foundation, a public transplant program of the state of São Paulo, Brazil.

INVENTORY OF MOSQUITOES (DIPTERA: CULICIDAE) IN CONSERVATION UNITS IN BRAZILIAN TROPICAL DRY FORESTS

In Brazil, most studies of the Culicidae family are concentrated in rainforest regions. As such, there is a lack of knowledge regarding the diversity of Culicidae in regions with different climatic and vegetational characteristics. The aim of this study was to compile an inventory of Culicidae in protected areas of the semi-arid region of the state of Minas Gerais, Brazil, in order to better understand the diversity of the family within this region. The study was conducted across four protected areas in the northern region of the state, in tropical dry forest (TDF) fragments. Sampling methods included Shannon trap and CDC light trap, as well as active collection. A total of 11,219 mosquito specimens were collected between August 2008 and July 2012, belonging to 11 genera and 45 species; 15 new records for the state of Minas Gerais were registered, as well as 26 new records for semi-arid regions within the state. The high number of new Culicidae records in this region demonstrates the importance of inventory studies for increasing the knowledge of culicid biodiversity in Minas Gerais, and in particular within semi-arid regions of the state.

Report on ticks collected in the Southeast and Mid-West regions of Brazil: analyzing the potential transmission of tick-borne pathogens to man

Specimens of ticks were collected in 1993, 1996, 1997, and 1998, mostly from wild and domestic animals in the Southeast and Mid-West regions of Brazil. Nine species of Amblyommidae were identified: Anocentor nitens, Amblyomma cajennense, Amblyomma ovale, Amblyomma fulvum, Amblyomma striatum, Amblyomma rotundatum, Boophilus microplus, Boophilus annulatus, and Rhipicephalus sanguineus. The potential of these tick species as transmitters of pathogens to man was analyzed. A Flaviviridade Flavivirus was isolated from Amblyomma cajennense specimens collected from a sick capybara (Hydrochaeris hydrochaeris). Amblyomma cajennense is the main transmitter of Rickettsia rickettsii (=R. rickettsi), the causative agent of spotted fever in Brazil. Wild mammals, mainly capybaras and deer, infested by ticks and living in close contact with cattle, horses and dogs, offer the risk of transmission of wild zoonosis to these domestic animals and to man.

Quality of essential drugs in tropical countries: evaluation of antimalarial drugs in the Brazilian Health System

INTRODUCTION: The emergence of drug resistance is one of the main problems concerning malaria treatment. The use of counterfeit and/or substandard antimalarial drugs can contribute to the development of parasite resistance. Thus, the aim of this study was to evaluate the quality of antimalarial drugs distributed in Brazil. METHODS: Samples containing chloroquine phosphate, mefloquine hydrochloride, primaquine phosphate, and quinine sulfate tablets were delivered to the Rio de Janeiro central storeroom (CENADI), state storerooms (SS), and Basic Health Units (BHUs) in the north region of Brazil - a total of 10 sample sets. After 5 months of storage, the samples were collected, and in vitro quality control analyses according to official and published methods were performed. RESULTS: Inadequate drug storage conditions were found in two SS and in all BHUs evaluated. There were no quality deviations found in the chloroquine samples. The quinine samples exhibited weight variation above the allowed limits. The primaquine samples were found to have packaging deficiency. The release of mefloquine in samples from some regions showed a statistically significant difference when compared with the CENADI samples. CONCLUSIONS: It is important to periodically evaluate the quality and storage conditions of essential drugs. The quality deviations found with the primaquine and quinine samples are not related to storage conditions and must be addressed urgently. The decreased mefloquine release from tablets is related to formulation problems or influenced by inadequate storage conditions, prompting further investigation. Even with the mentioned problems, the samples would probably not contribute to resistant parasite selection.

Epidemiological profile of meningococcal disease in the State of Minas Gerais and in the Central, North, and Triângulo Mineiro regions, Brazil, during 2000-2009

INTRODUCTION: Infection by Neisseria meningitidis, termed as meningococcal disease, can cause meningococcal meningitis and septicemia with or without meningitis. Meningococcal disease is endemic in Brazil and has a high potential to cause large-scale epidemics; therefore, it requires the immediate notification of cases to the Information System for Notifiable Diseases (SINAN) in Brazil. The aim of this study was to describe an epidemiological profile using data from notified and confirmed cases in the State of Minas Gerais, Brazil, from January 2000 to December 2009, obtained from the investigation records of individuals with meningitis registered with SINAN. METHODS: This was a retrospective, population-based study. Descriptive analysis of the data was made using the simple and relative frequencies of the categorical variables in the investigation records. RESULTS: There were 1,688 confirmed patients in Minas Gerais of which 45.5% lived in the Central, North, and Triângulo Mineiro regions. The highest frequencies of cases were in the 1-4-years age group (26.3%), males (54.7%), caucasian (36.4%), and lived in an urban area (80%). In the patients with specified education, 650 (60.9%) patients had secondary education. Serogrouping of meningococci had been performed in 500 (29.6%) patients by age and gender; 285 (57%) belonged to serogroup C, 67 (13.4%) were in the 1-to 4-years age group, and 168 (33.6%) were male. CONCLUSIONS: The epidemiological profiles of patients in the Central, North, and Triângulo Mineiro regions were not significantly different from the profile of patients in Minas Gerais.

Pandemic influenza A (H1N1) 2009: epidemiological analysis of cases in a tropical/semi-arid region of Brazil

IntroductionThe year 2009 marked the beginning of a pandemic caused by a new variant of influenza A (H1N1). After spreading through North America, the pandemic influenza virus (H1N1) 2009 spread rapidly throughout the world. The aim of this study was to describe the clinical and epidemiological characteristics of cases of pandemic influenza in a tropical/semi-arid region of Brazil.MethodsA retrospective study analyzed all suspected cases of pandemic influenza (H1N1) 2009 reported in the Ceará State through the National Information System for Notifiable Diseases during the pandemic period between 28 April, 2009 and November 25, 2010.ResultsA total of 616 suspected cases were notified, 58 (9.4%) in the containment phase and 558 (90.6%) in the mitigation phase. Most cases were of affected young people resident in the City of Fortaleza, the largest urban center in the State of Ceará. The most frequent symptoms presented by the cases with confirmed infection were fever, cough, myalgia, arthralgia, and nasal congestion. Mortality rate was 0.0009/1,000 inhabitants and lethality was 5.6%. Deaths were observed only in the mitigation phase. Mortality rates were similar for both sexes but were higher in the age group under 5 years.ConclusionsThe study suggests that the influenza A (H1N1) pandemic in this tropical/semi-arid region had a lower magnitude when compared to states in the Southern and Southeastern regions of Brazil.

Population biology of the crab Armases angustipes (Crustacea, Decapoda, Sesarmidae) at Brazilian tropical coast

The semi terrestrial crabs are important elements of the fauna of coastal regions. The aim of this study was to analyze the population structure of Armases angustipes (Dana, 1852) at estuaries of the Ariquindá River, considered a non impacted area, and Mamucabas River, considered a few impacted area, on the south coast of state of Pernambuco, Brazil. The species occurred in all months of the year. The number of individuals per month varied, being higher in the months of transition between the seasons. This is probably due to significant seasonal variations of air and burrow temperature and burrow salinity. There was no sexual dimorphism in size of A. angustipes in the mangrove of Ariquindá River, but males were larger than females in the mangrove of Mamucabas River. In both estuaries, the sex ratio did not differ from Mendelian proportion, but showed a deviation for females. The analysis of temporal variation in sex ratio showed significant differences in some months of the year. These variations are due to cyclical events that act distinctly on each sex. In both estuaries, size classes of carapace width were equally represented by both sexes. The ovigerous females of A. angustipes occurred only in some months of the year, especially in summer, in both estuaries. Probably the high phytoplankton productivity observed in summer favors the reproductive activity, since these algae serve as food for the larvae. Specimens of the population of Rio Ariquindá are largest and wider than those of Mamucabas River. This fact, associated with the low abundance of crabs and the lower frequency of ovigerous females observed in Mamucabas River, is an indication that this population may be influenced by the environmental impacts that this estuary has received.

The feature of papers and citation analysis of eleven journals in tropical medicine indexed by Science Citation Index Expanded

To determine the features of papers, authors, and citation of eleven journals in tropical medicine indexed by Science Citation Index Expanded, the database of the Institute for Scientific Information, we analyzed original articles, editorials, reviews, corrections, letters, biographies, and news published in these journals. The results show that these journals covered 107 countries or regions on six continents. The average number of reference was 23.05, with 87.89% of the references from periodicals. The Price Index was 31.43% and the self-citing rate was 7.02%. The references in the first 20 journals ranked by the amount of citation accounted for 36.71% of the total citations. Brazil, United States, India, and England are more advanced in tropical medicine research. The conclusion is that these journals covered most research done in these countries or regions. Most researches were done by cooperation of the researchers, but many of the publications used outdated articles and should include newer information.

Effects of soil water depletion on the water relations in tropical kudzu

Tropical kudzu (Pueraria phaseoloides (Roxb.) Benth., Leguminosae: Faboideae) is native to the humid Southeastern Asia. Tropical kudzu has potential as a cover crop in regions subjected to dryness. The objective of this paper was to evaluate the effect of soil water depletion on leaflet relative water content (RWC), stomatal conductance (g) and temperature (T L) in tropical kudzu. RWC of waterstressed plants dropped from 96 to 78%, following a reduction in SWC from 0.25 to 0.17 g (H2O).g (dry soil)-1.Stomatal conductance of stressed plants decreased from 221 to 98 mmol.m-2.s-1, following the reduction in soil water content (SWC). The day after re-irrigation, g of water stressed plants was 15% lower than g of unstressed plants. Differences in T L between waterstressed and unstressed plants (deltaT L) rose linearly from 0.1 to 2.2ºC following progressive water deficit. RWC and T L of waterstressed plants paralled RWC and T L of unstressed plants the day after reirrigation. The strong decrease in SWC found in this study only induced moderate water stress in tropical kudzu. In addition, tropical kudzu recover rapidly from the induced water stress after the re-irrigation.

Distribution and agroclimatic characterization of potential cultivation regions of physic nut in Mexico

The purposes of this study were to determine the distribution and climatic patterns of current and future physic nut (Jatropha curcas) cultivation regions in Mexico, and to identify possible locations for in vivo germplasm banks establishment, using geographic information systems. Current climatic data were processed by Floramap software to obtain distribution maps and climatic patterns of regions where wild physic nuts could be found. DIVA-GIS software analyzed current climatic data (Worldclim model) and climatic data generated by CCM3 model to identify current and future physic nut cultivation regions, respectively. The distribution map showed that physic nut was present in most of the tropical and subtropical areas of Mexico, which corresponded to three agroclimatic regions. Climate types were Aw2, Aw1, and Bs1, for regions 1, 2 and 3, respectively. Nontoxic genotypes were associated with region 2, and toxic genotypes were associated with regions 1 and 3. According to the current and future cultivation regions identified, the best suitable ones to establish in vivo germplasm collections were the coast of Michoacán and the Isthmus of Tehuantepec, located among the states of Veracruz, Oaxaca and Chiapas.

Climatic potential for wine grape production in the tropical north region of Minas Gerais State, Brazil

The tropical north region of Minas Gerais State is one of the least developed of Brazil and viticulture could be an alternative to develop its agriculture zone. The objective of this work was to evaluate the climatic potential of that region for wine grape production. The evaluations were carried out applying the Multicriteria Climatic Classification System (Geoviticulture MCC System), that utilizes three reference climatic indexes (Dryness Index - DI, Heliothermal Index - HI and Cool Night Index - CI). Three locations - Pirapora (17º 21'S, 44º56'W, 489m), Montes Claros (16º43'S, 43º52'W, 647m) and Diamantina (18º15'S, 43º36'W, 1297m) - and two potential production cycles along the year - October to March (spring-summer period) and April to September (autumn-winter period) - were evaluated. The results showed that in the spring-summer period (SS period) Pirapora and Montes Claros presented a 'humid, very warm and with warm nights' of viticultural climate, according to MCC System. For the autumn-winter period (AW period), those two regions presented a 'moderately dry, warm and with temperate nights' according to MCC System. Otherwise, the Diamantina SS period presented a 'humid, temperate warm and with temperate nights' viticultural climate. In the AW period, the Diamantina climatic condition values represent a 'subhumid, temperate and with cool nights' viticultural climate. Based on those results it can be concluded that the North Region of Minas Gerais State has a great climatic potential to became a grape-growing region for wine-making, specially in the autumn-winter period.

Does the edge effect influence plant community structure in a tropical dry forest?

Edge effects are considered a key factor in regulating the structure of plant communities in different ecosystems. However, regardless to few studies, edge influence does not seem to be decisive in semiarid regions such as the Brazilian tropical dry forest known as Caatinga but this issue remains inconclusive. The present study tests the null hypothesis that the plant community of shrubs and trees does not change in its structure due to edge effects. Twenty-four plots (20 x 20 m) were set up in a fragment of Caatinga, in which 12 plots were in the forest edges and 12 plots were inside the fragment. Tree richness, abundance and species composition did not differ between edge and interior plots. The results of this study are in agreement with the pattern previously found for semiarid environments and contrasts with previous results obtained in different environments such as Rainforests, Savanna and Forest of Araucaria, which indicate abrupt differences between the border and interior of the plant communities in these ecosystems, and suggest that the community of woody plants of the Caatinga is not ecologically affected by the presence of edges.

Corticolous cyanobacteria from tropical forest remnants in northwestern São Paulo State, Brazil

Cyanobacteria are common in aquatic environments but are also well-adapted to terrestrial habitats where they are represented by a diversified flora. The present study aimed to contribute to our taxonomic knowledge of terrestrial cyanobacteria by way of a floristic survey of the main components of corticolous communities found in seasonal semideciduous forest fragments. Samples of visible growths of Cyanobacteria, algae, and bryophytes found on tree bark were randomly collected and their taxonomies examined. Eighteen species of Cyanobacteria were found belonging to the genera Aphanothece, Chroococcus, Lyngbya, Phormidium, Porphyrosiphon, Hapalosiphon, Hassalia, Nostoc, Scytonema, and Stigonema. Many genera and species observed in the present work have been reported in previous surveys of the aerophytic flora in several regions of the world, although six species were described only on the basis of populations found in the forest fragments studied, which highlights the importance of taxonomic studies of cyanobacteria in these habitats.