Identificação do sangue ingerido por Lutzomyia (Lutzomyia) longipalpis (Lutz & Neiva, 1912) e Lutzomyia (Lutzomyia) almerioi (Galati & Nunes, 1999) pela técnica imunoenzimática do ELISA de captura, no sistema avidina-biotina

Lutzomyia longipalpis e Lutzomyia almerioi, espécies integrantes da fauna flebotomínea da Serra da Bodoquena, no Estado de Mato Grosso do Sul, têm sido objeto de estudo devido às suas elevadas abundâncias no Assentamento Guaicurus, foco de leishmaniose tegumentar humana e visceral canina. Em pesquisas que vem sendo realizadas neste acampamento para a identificação de vetores destas parasitoses, foram capturados no período de 2002 a 2004, com armadilhas automáticas luminosas, instaladas em ambiente peridoméstico (galinheiro), 83 exemplares ingurgitados de Lutzomyia longipalpis e Lutzomyia almerioi. O presente estudo teve como objetivo a investigação do hábito alimentar para ave das fêmeas de ambas as espécies de flebotomíneos, mediante o emprego da técnica imunoenzimática de captura,comparando-se a reatividade durante os anos de 2002 a 2004. Dentre 57 amostras de Lutzomyia longipalpis e 26 de Lutzomyia almerioi, foram encontradas 72% reagentes para ave em Lutzomyia longipalpis e 96% em Lutzomyia almerioi, o que justifica o estudo do hábito alimentar na região, como medida de prevenção e instituição de vigilância epidemiológica.

Modificações na prevalência das lesões intra-epiteliais escamosas cervicais e dos fatores de risco em pacientes HIV/AIDS atendidas em serviço especializado no sul do Brasil nos períodos 1995-1999 e 2006-2007

O objetivo deste trabalho foi estudar mudanças na prevalência de lesões intra-epiteliais escamosas cervicais entre mulheres HIV-1 positivas após a introdução da terapia antiretroviral altamente eficaz e avaliar modificações na prevalência de fatores de risco para lesões intra-epiteliais escamosas cervicais. Foram estudadas 50 pacientes em 1995-1999 e 120 pacientes em 2006-2007. Coletaram-se dados demográficos, comportamentais, laboratoriais. Calculou-se a prevalência de lesões intra-epiteliais escamosas cervicais entre os dois períodos, assim como as prevalências dos outros fatores de risco. No primeiro período, encontrou-se uma prevalência de lesões intra-epiteliais escamosas cervicais de 66% e no segundo de 43% (p=0,007). A média do CD4 em 1995-1999 foi de 275,71 (DP 283,23); a média do CD4 em 2006-2007 foi de 463,32 (DP 231.90), (p=0,001). Houve mudanças significativas nos fatores idade, cor, estado conjugal e fumo entre os dois períodos. A diminuição da prevalência de lesões intra-epiteliais escamosas cervicais pode estar relacionada ao uso da estratégia de terapia antiretroviral altamente eficaz assim como à mudança de fatores de risco para lesões intra-epiteliais escamosas cervicais ao longo do tempo.

Controle da leishmaniose visceral no município de Porteirinha, estado de Minas Gerais, no período de 1998 a 2003

INTRODUÇÃO: No município de Porteirinha, Estado de Minas Gerais, foram registrados 23 casos humanos de leishmaniose visceral (LV) nos anos de 1998 e 1999. MÉTODOS: Foi realizado um estudo envolvendo a tríade de ações preconizadas no controle da LV. Pacientes com leishmaniose humana foram tratados e cães sorologicamente positivos foram eutanasiados, trimestralmente. O inseticida piretróide α-cipermetrina foi aplicado nos bairros onde casos humanos foram registrados. RESULTADOS: Houve uma redução da soroprevalência canina e de flebotomíneos capturados, após a implementação das medidas de controle, refletindo na diminuição de casos humanos de leishmaniose visceral. CONCLUSÕES: Os resultados mostraram a eficiência destas medidas quando empregadas em conjunto.

Infecção pelo HIV-1 após acidente ocupacional, no Estado do Amazonas: primeiro caso documentado

O atendimento de acidentes ocupacionais na Fundação de Medicina Tropical Dr. Heitor Dourado (FMT- HVD), envolvendo sangue e fluídos corpóreos, iniciou-se de forma rotineira em 1999. O objetivo deste relato é enfatizar a importância da utilização de medidas para o controle dos acidentes com material biológico. Após investigação epidemiológica detalhada, confirmamos um caso de soroconversão ao vírus da imunodeficiência humana (HIV) após acidente ocupacional, envolvendo fluído corpóreo e perfurocortante.

Use of Poisson spatiotemporal regression models for the Brazilian Amazon Forest: malaria count data

INTRODUCTION: Malaria is a serious problem in the Brazilian Amazon region, and the detection of possible risk factors could be of great interest for public health authorities. The objective of this article was to investigate the association between environmental variables and the yearly registers of malaria in the Amazon region using Bayesian spatiotemporal methods. METHODS: We used Poisson spatiotemporal regression models to analyze the Brazilian Amazon forest malaria count for the period from 1999 to 2008. In this study, we included some covariates that could be important in the yearly prediction of malaria, such as deforestation rate. We obtained the inferences using a Bayesian approach and Markov Chain Monte Carlo (MCMC) methods to simulate samples for the joint posterior distribution of interest. The discrimination of different models was also discussed. RESULTS: The model proposed here suggests that deforestation rate, the number of inhabitants per km², and the human development index (HDI) are important in the prediction of malaria cases. CONCLUSIONS: It is possible to conclude that human development, population growth, deforestation, and their associated ecological alterations are conducive to increasing malaria risk. We conclude that the use of Poisson regression models that capture the spatial and temporal effects under the Bayesian paradigm is a good strategy for modeling malaria counts.

Simultaneous circulation of all four dengue serotypes in Manaus, State of Amazonas, Brazil in 2011

INTRODUCTION: Manaus, the capital city of the state of Amazon with nearly 2 million inhabitants, is located in the middle of the Amazon rain forest and has suffered dengue outbreaks since 1998. METHODS: In this study, blood samples were investigated using reverse transcriptase-polymerase chain reaction (RT-PCR), aimed at identifying dengue virus serotypes. RESULTS: Acute phase sera from 432 patients were tested for the presence of dengue virus. Out of the 432 patients, 137 (31.3%) were found to be positive. All the four dengue virus serotypes were observed. CONCLUSIONS: The simultaneous circulation of the four dengue serotypes is described for the first time in Manaus and in Brazil.

Multiple causes of death related to Chagas' disease in Brazil, 1999 to 2007

INTRODUCTION: Chagas' disease is a major public health problem in Brazil and needs extensive and reliable information to support consistent prevention and control actions. This study describes the most common causes of death associated with deaths related to Chagas' disease (underlying or associated cause of death). METHODS: Mortality data were obtained from the Mortality Information System of the Ministry of Health (approximately 9 million deaths). We analyzed all deaths that occurred in Brazil between 1999 and 2007, where Chagas' disease was mentioned on the death certificate as underlying or associated cause (multiple causes of death). RESULTS: There was a total of 53,930 deaths related to Chagas' disease, 44,543 (82.6%) as underlying cause and 9,387 (17.4%) as associated cause. The main diseases and conditions associated with death by Chagas' disease as underlying cause included direct complications of cardiac involvement, such as conduction disorders/arrhythmias (41.4%) and heart failure (37.7%). Cerebrovascular disease (13.2%), ischemic heart disease (13.2%) and hypertensive diseases (9.3%) were the main underlying causes of deaths in which Chagas' disease was identified as an associated cause. CONCLUSIONS: Cardiovascular diseases were often associated with deaths related to Chagas' disease. Information from multiple causes of death recorded on death certificates allows reconstruction of the natural history of Chagas' disease and suggests preventive and therapeutic potential measures more adequate and specifics.

AIDS tendencies in São Mateus microregion, state of Espírito Santo, and Brazil from 1999 to 2008

INTRODUCTION: In Brazil, AIDS has been described as a multi-faceted pandemic. This study aimed to describe the trends of AIDS in São Mateus microregion, in Espírito Santo, and in Brazil, from 1999 to 2008. METHODS: Data were collected from the Notification Offences System, and a trend analysis was made. RESULTS: Microregion-based results are close to the state and national levels but with particular features that indicate the presence of regional sub-epidemics. CONCLUSIONS: Despite progress in nearly thirty years of the epidemic, AIDS remains an incurable disease, and prevention is still the best defense against it together with the implementation of specific public policies.

Factors related to severe dengue during an epidemic in Vitoria, State of Espirito Santo, Brazil, 2011

Introduction The prognosis of dengue depends on early diagnosis and treatment, which can help prevent severe forms whose characteristics were evaluated here. Methods A cross-sectional study was conducted involving dengue cases in Vitória, State of Espírito Santo, Brazil, in 2011. Results Two health regions registered 56.3% of 371 cases of severe dengue. Of these cases, 21.3% presented with dengue hemorrhagic fever. There were associations between dengue hemorrhagic fever with younger ages and a longer time before receiving care. Conclusions There was a greater involvement of dengue hemorrhagic fever in young people. Delay in care, poor urban quality and high endemicity were identified as possible risk factors for dengue severity.

Comparative study of lymphocytes from individuals that were vaccinated and unvaccinated against the pandemic 2009-2011 H1N1 influenza virus in Southern Brazil

ABSTRACTINTRODUCTION:While no single factor is sufficient to guarantee the success of influenza vaccine programs, knowledge of the levels of immunity in local populations is critical. Here, we analyzed influenza immunity in a population from Southern Brazil, a region with weather conditions that are distinct from those in the rest of country, where influenza infections are endemic, and where greater than 50% of the population is vaccinated annually.METHODS:Peripheral blood mononuclear cells were isolated from 40 individuals. Of these, 20 had received the H1N1 vaccine, while the remaining 20 were unvaccinated against the disease. Cells were stimulated in vitro with the trivalent post-pandemic influenza vaccine or with conserved major histocompatibility complex I (MHC I) peptides derived from hemagglutinin and neuraminidase. Cell viability was then analyzed by [3-(4,5-dimethylthiazol-2-yl)-2,5- diphenyltetrazolium bromide)]-based colorimetric assay (MTT), and culture supernatants were assayed for helper T type 1 (Th1) and Th2-specific cytokine levels.RESULTS:Peripheral blood lymphocytes from vaccinated, but not unvaccinated, individuals exhibited significant proliferation in vitro in the presence of a cognate influenza antigen. After culturing with vaccine antigens, cells from vaccinated individuals produced similar levels of interleukin (IL)-10 and interferon (IFN)-γ, while those from unvaccinated individuals produced higher levels of IFN-γ than of IL-10.CONCLUSIONS:Our data indicate that peripheral blood lymphocytes from vaccinated individuals are stimulated upon encountering a cognate antigen, but did not support the hypothesis that cross-reactive responses related to previous infections can ameliorate the immune response. Moreover, monitoring IL-10 production in vaccinated individuals could comprise a valuable tool for predicting disease evolution.

Evaluation of the World Health Organization 2009 classification of dengue severity in autopsied individuals, during the epidemics of 2011 and 2012 in Brazil

Abstract: INTRODUCTION: The dengue classification proposed by the World Health Organization (WHO) in 2009 is considered more sensitive than the classification proposed by the WHO in 1997. However, no study has assessed the ability of the WHO 2009 classification to identify dengue deaths among autopsied individuals suspected of having dengue. In the present study, we evaluated the ability of the WHO 2009 classification to identify dengue deaths among autopsied individuals suspected of having dengue in Northeast Brazil, where the disease is endemic. METHODS: This retrospective study included 121 autopsied individuals suspected of having dengue in Northeast Brazil during the epidemics of 2011 and 2012. All the autopsied individuals included in this study were confirmed to have dengue based on the findings of laboratory examinations. RESULTS: The median age of the autopsied individuals was 34 years (range, 1 month to 93 years), and 54.5% of the individuals were males. According to the WHO 1997 classification, 9.1% (11/121) of the cases were classified as dengue hemorrhagic fever (DHF) and 3.3% (4/121) as dengue shock syndrome. The remaining 87.6% (106/121) of the cases were classified as dengue with complications. According to the 2009 classification, 100% (121/121) of the cases were classified as severe dengue. The absence of plasma leakage (58.5%) and platelet counts <100,000/mm3 (47.2%) were the most frequent reasons for the inability to classify cases as DHF. CONCLUSIONS: The WHO 2009 classification is more sensitive than the WHO 1997 classification for identifying dengue deaths among autopsied individuals suspected of having dengue.

Análise da variabilidade diária da precipitação em área de pastagem para a época chuvosa de 1999 - projeto TRMM/LBA

Como parte das investigações do experimento TRMM/LBA na Amazônia, medidas de chuva foram obtidas continuamente sobre uma área de pastagem. Neste trabalho foram analisados dados de precipitação durante o período compreendido entre 10 de janeiro a 28 de fevereiro de 1999 (período chuvoso). Os totais mensais de precipitação para o período estudado foram de 322,3 e 468,6 mm para janeiro e fevereiro, respectivamente. As análises da distribuição de frequência para os eventos inferiores a 1 mm/h e superiores a 1, 3 , 5, 10, 15 e 20 mm.h-1, mostraram diferentes distribuição temporal. Os eventos inferiores a 1 mm.h-1 apresentaram uma distribuição temporal mais regular, porém representando apenas cerca de 3% do volume total de precipitação (27 mm). Os eventos com precipitação superiores a 1, 3, 5 mm.h-1 apresentaram um padrão similar entre si, sendo que os casos mais frequentes ocorreram durante a madrugada e final da tarde. Esses eventos representaram cerca de 97, 91 e 86% do total da precipitação, respectivamente. Finalmente, os eventos acima de 10, 15 e 20 mm.h-1 totalizaram, respectivamente, 73, 68 e 62% do total da precipitação, e as maiores frequências relativas concentraram-se entre 2 às 4 HL e 15 às 17 HL. A precipitação observada pode ser classificada em 2 sistemas distintos de produção de chuva: convecção isolada local e sistemas convectivos de mesoescala, os quais provocaram máximos de precipitação às 16 e 4 HL, respectivamente.