Chagas disease: from bush to huts and houses. Is it the case of the Brazilian amazon?

Two of the major problems facing the Amazon - human migration from the other areas and uncontrolled deforestation - constitute the greatest risk for the establishment of endemic Chagas disease in this part of Brazil. At least 18 species of triatomines had been found in the Brazilian Amazon, 10 of them infected with Trypanosoma cruzi, associated with numerous wild reservoirs. With wide-range deforestation, wild animals will perforce be driven into other areas, with tendency for triatomines to become adapted to alternative food sources in peri and intradomicilies. Serological surveys and cross-sectional studies for Chagas disease, carried out in rural areas of the Rio Negro, in the Brazilian Amazon, showed a high level of seropositivity for T. cruzi antibodies. A strong correlation of seroreactivity with the contact of gatherers of piaçava fibers with wild triatomines could be evidenced.

Making it Better Through Pharmacy in the Community (PDF 345KB)

A new strategy to facilitate the fuller integration of pharmacy services across the HSC

Making It Happen (PDF 748 KB)

Guide for Risk Managers on How to Populate a Risk Register

Skin reactions to thimerosal and Leishmania in dogs from a leishmaniasis endemic area: it is better to keep them apart

Positive Montenegro's skin test is a delayed type hypersensitivity reaction widely used as indicative of previous infection with Leishmania in both humans and dogs. Montenegro's antigen consists of a crude Leishmania antigen solution, usually containing thimerosal as preserving agent. In this work it is shown that a large proportion of dogs (11 out of 56) examined in an endemic area of leishmaniasis presented induration at the site of injection of a diluent containing thimerosal alone. This clearly demonstrates that thimerosal leads to a high number of false positive skin reactions in dogs and that its use in Montenegro's skin test antigenic preparations should be avoided.

Agenda for Change: What Will It Mean For You? (PDF 53 KB)

A Guide for Staff

GP Contract - The New GP Contract - What It Means To You

GP Contract - The New GP Contract - What It Means To You

Making It Better - A Strategy for Pharmacy in the Community 2004

Making It Better - A Strategy for Pharmacy in the Community 2004

Making it Better - A Strategy for Pharmacy in the Community

Strategy for Pharmacy in the community

Making It Better - A Strategy for Pharmacy in the Community (PDF 233 KB)

A Strategy for Community Pharmacy (Consultation Paper)

Consent - Patient Information Leaflet- Consent - it's up to you (PDF 15 KB)

Consent - Patient Information Leaflet- Consent - it's up to you