Comparative study of human exposure to mercury in riverside communities in the Amazon region

Four populations in the Amazon area were selected for a comparative study of mercury-exposed and non-exposed populations: São Luiz do Tapajós, Barreiras, Panacauera, and Pindobal Grande. The highest mercury levels in human hair samples were found in São Luiz do Tapajós and Barreiras, greatly exceeding the limits established by the World Health Organization. Panacauera showed an intermediate level below 9 µg/g. This was the first comparative and simultaneous evaluation of mercury exposure in the Amazon area. Also, thanks to this type of monitoring, we were able to eliminate the uncertainties about the reference dose. On the basis of these data, we can conclude that the mercury levels detected in exposed populations of the Tapajós River basin may be dangerous not only because they are above the World Health Organization limits, but also because the simultaneous mercury detection in non-exposed populations with similar characteristics provided a valid control and revealed lower mercury levels. Our results support the importance of continuous monitoring in both exposed and non-exposed populations.

The AIDS epidemic in the Amazon region: a spatial case-control study in Rondonia, Brazil

OBJETIVO Analisar mudanças espaciais no risco de Aids e a relação entre incidência da doença e variáveis socioeconômicas. MÉTODOS Estudo caso-controle espacial, de base populacional, realizado em Rondônia, Brasil, com 1.780 casos notificados pelo Sistema de Vigilância Epidemiológica e os controles a partir de dados demográficos de 1987 a 2006. Os casos foram agrupados em cinco períodos de cinco anos consecutivos. Um modelo aditivo generalizado foi ajustado aos dados. O status dos indivíduos (caso ou controle) foi considerado como a variável dependente e independente: um alisamento ( spline ) bidimensional das coordenadas geográficas e variáveis socioeconômicas municipais. Os valores observados para o teste Moran I foram comparados com a distribuição de referência dos valores obtidos em condições de aleatoriedade espacial. RESULTADOS O risco de Aids apresentou padrão espacial e temporal marcado. A incidência associou-se a indicadores socioeconômicos municipais, como urbanização e capital humano. As maiores taxas de incidência de Aids ocorreram em municípios ao longo da rodovia BR-364; os resultados do teste Moran I mostram correlação espacial positiva associada à contiguidade dos municípios com a rodovia, no terceiro e quarto períodos (p = 0,05). CONCLUSÕES A incidência da doença foi maior em municípios de maior riqueza econômica e urbanização e naqueles cortados pelas estradas principais de Rondônia. O rápido desenvolvimento associado à ocupação de regiões remotas pode ser acompanhado por aumento de riscos à saúde.

Prevalence of health promotion programs in primary health care units in Brazil

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Characteristics of physical activity programs in the Brazilian primary health care system

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Implementation of physiotherapeutic shares in the prevention of diabetes complications in a Family Health Strategy

Introduction In the Family Health Strategy (FHS), the treatment of Diabetes Mellitus (DM) includes education and lifestyle change strategies. Physiotherapists have a key role in this health setting. Objectives To implement actions of evaluation and guidelines for patients with type 2 DM who attend a Family Health Strategy (FHS), regarding diabetic foot and the practice of regular physical exercise in the control and prevention of the complications of Diabetes Mellitus. Methods 17 individuals from an FHS were evaluated, with the following procedures: clinical and anthropometric parameters, inspection, a questionnaire on diabetic neuropathy, tests of vibratory and tactile sensitivity, muscle function, range of motion, functional analysis, questions about exercise practice and guidance regarding controlling blood glucose and foot care. Results Deformities, dry skin, calluses, dehydration, ulceration, cracking and brittle nails were found. Peripheral neuropathy was not observed; tactile sensitivity was altered in the heel region and the vibratory sense was absent in 5% of individuals. A decrease in functionality of ankle movements was verified. Of the participants, 76% were sedentary, 24% knew about the benefits of practicing regular exercise, 25% had undergone a medical evaluation prior to performing physical exercise and, of these, 25% were supervised by a qualified professional. Discussion The implementation of physiotherapy actions in diabetics from an FHS was important for highlighting the presence of risk factors for diabetic complications. Conclusions Individuals attending the FHS need more information and programs for the prevention of diabetic complications.

Epidemiological profile of hepatitis C virus infection in patients from west region of Minas Gerais State, Brazil

Hepatitis C virus (HCV) is a serious public health problem and is the leading cause of liver transplantation due to cirrhosis and hepatocellular carcinoma. In Brazil, it is estimated that there are approximately 2 to 3 million HCV chronic carriers. Few data regarding HCV infection are available in West region of Minas Gerais State. Due to the absence of an effective vaccine against this important human pathogen and the high costs of antiviral treatment, it is important to conduct epidemiological studies with the purpose of carry out the planning and implementation of measures to prevent hepatitis C in different populations. Therefore, the aim of this study is to describe the epidemiological aspects of HCV patients from West region of Minas Gerais State, Brazil. Sociodemographic data and risk factors for HCV infection were determined from 74 HCV patients from Uberlandia city (Minas Gerais State). Reactive anti-HCV sera samples were submitted to HCV RNA and genotype detection. Most of individuals were male (63.5%) with mean age of 51 years and presenting low socioeconomic status. HCV genotype was determined among 40 samples and the frequencies were: genotype 2 (45%), 1 (37.5%) and 3 (17.5%). Hepatitis C virus (HCV) infection was common among male and low socioeconomic status individuals.

Seroprevalence of salmonella and mycoplasma in commercial broilers, backyard chickens, and spent hens in the region of Triangulo Mineiro, state of Minas Gerais, Brazil

Avian salmonellosis and mycoplasmosis are infectious diseases that, in addition of causing lack of flock uniformity, represent a hazard to human health. The objective of the present study was to evaluate the seroprevalence of mycoplasmosis and salmonellosis in commercial broilers, backyard chickens, and spent hens slaughtered at a processing plant with local health inspection in Uberlandia, MG, Brazil. A total of 210 samples were randomly collected at the time of bleeding. Samples were submitted to rapid plate serum agglutination test (RSA) for the classification of Salmonella pullorum, Salmonella gallinarum, Mycoplasma gallisepticum and Mycoplasma synoviae. In order to increase result specificity, mycoplasmosis-positive samples were submitted to hemagglutination inhibition test (HI). No samples presented detectable antibodies against Salmonella pullorum or Salmonella gallinarum in the RSA test. Only Mycoplasma synoviae was detected in 14% of the backyard chickens and 0.74% in commercial broilers, whereas no antibodies were detected in spent hens. The seroprevalence rates found in the present study emphasize the need of keeping chicken flocks free from disease using effective biosafety systems.

The shadows of a ghost: a survey of canine leishmaniasis in Presidente Prudente and its spatial dispersion in the western region of São Paulo state, an emerging focus of visceral leishmaniasis in Brazil

Visceral leishmaniasis is an emerging zoonosis and its geographic distribution is restricted to tropical and temperate regions. Most of the individuals infected in Latin America are in Brazil. Despite the control measures that have been adopted, the disease is spreading throughout new regions of the country. Domestic dogs are involved in the transmission cycle and are considered to be the main epidemiologic reservoir of Leishmania infantum (syn. L. chagasi). Our aim was to determine the prevalence of canine leishmaniasis (CL) and Ehrlichiosis infection in Presidente Prudente as well as the spatial dispersion of the disease in the western region of São Paulo state. Dogs underwent clinical examination and symptoms related to CL were recorded. Anti- Leishmania antibodies were detected using ELISA, rK39-immunocromatographic tests (DPP), and an indirect fluorescent antibody test (IFAT). Anti-E. canis antibodies were detected by IFAT. A follow-up was conducted in dogs that were positive in the ELISA at the baseline study. Data on the spatial distribution of L. longipalpis and CL in São Paulo state were obtained from Brazilian public health agencies. Serum samples from 4547 dogs were analyzed. The seroprevalence of CL was 11.2 % by ELISA and 4.5 % by IFAT. In the follow-up, seroprevalence was 32.9 % by ELISA, 15.3 % by IFAT, 11.8 % by DPP test, and 66.5 % for E. canis. There was a significant positive association between Leishmania and E. canis infection (P < 0.0001). In the follow-up, clinical examinations revealed symptoms compatible with CL in 33.5 % of the dogs. L. longipalpis was found in 24 and CL in 15 counties of the Presidente Prudente mesoregion. The dispersion route followed the west frontier of São Paulo state toward Paraná state. Low CL and high ehrlichiosis prevalence rates were found in Presidente Prudente city. This emerging focus of CL is moving through the western region of São Paulo state toward the border of Paraná state. Integrated actions to fight the vector, parasites, infected dogs, and humans are needed to monitor the disease and implement strategies for epidemiologic control.

Epidemiological profile of hepatitis C virus infection in patients from west region of Minas Gerais State, Brazill

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Assessment of the quality evaluation of compounded fluconazole capsules marketed in the region of Araraquara (SP, Brazil)

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Detection of serum antibodies to parainfluenza type 3 virus, respiratory syncytial virus, bovine viral diarrhea virus, and herpes virus type 1 in sheep in the region of Botucatu, São Paulo - Brazil

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Reducing the Public Health Impact of Bovine Tuberculosis by Controlling Disease Transmission Between Cattle and White-Tailed Deer in Northwestern Minnesota

Bovine tuberculosis, caused by infection with Mycobacterium bovis, is a re-emerging zoonotic disease. It has staged a comeback by establishing infections in wildlife and cattle, creating the potential for human disease in locations where it was thought to be under control. In northwestern Minnesota, infected cattle and white-tailed deer were first discovered in 2005. A major bovine tuberculosis eradication campaign is underway in the state, with multiple efforts employed to control M. bovis infection in both cattle and deer populations. In order to effectively eradicate bovine tuberculosis in Minnesota, there is a need for better understanding of the factors that increase the risk of deer and cattle interacting in a way that facilitates tuberculosis transmission. By reducing the risk of disease transmission within the animal populations, we will also reduce the risk that bovine tuberculosis will again become a common disease in human populations. The purpose of this study is to characterize the risk of interactions between cattle and white-tailed deer in northern Minnesota in order to prevent M. bovis transmission. A survey originally developed to assess deer-cattle interactions in Michigan was modified for use in Minnesota, introducing a scoring method to evaluate the areas of highest priority at risk of potential deer-cattle interaction. The resulting semi-quantitative deer-cattle interaction risk assessment was used at 53 cattle herds located in the region adjacent to the bovine tuberculosis “Core Area”. Two evaluators each scored the farm separately, and then created a management plan for the farm that prioritized the areas of greatest risk for deer-cattle interactions. Herds located within the “Management Zone” were evaluated by Minnesota Board of Animal Health staff, and results from these surveys were used as a point of comparison.

Yellowstone Super-Volcano: Evalutaion, Potential Threats, and Possible effects on Nebraska Citizens Health and Prosperity

Abstract Yellowstone National Park is located over a hot spot under the North American tectonic plate and holds a potentially explosive super-volcano that has the ability to cause deadly consequences on the North American continent. After an eruption the surrounding region would see the greatest devastation, covered by pyroclastic deposits and thick ash fall exterminating most all life and destroying all structures in its path. In landscapes of greater distance from the event the consequences will be less dramatic yet still substantial. Records of previous eruption data from the Yellowstone super-volcano show that the ash fall out from the eruption can cover areas as large as one million square kilometers and could leave Nebraska covered in ash up to 10 centimeters thick. This would cause destruction of agriculture, extensive damage to structures, decreased temperatures, and potential respiratory hazards. The effects of volcanic ash on the human respiratory system have been shown to cause acute symptoms from heavy exposure. Symptoms include nasal irritation, throat irritation, coughing, and if preexisting conditions are present some can develop bronchial symptoms, which can last for a few days. People with bronchitis and asthma are shown to experience airway irritation and uncomfortable breathing. In most occurrences, exposure of volcanic ash is too short to cause long-term health hazards. Wearing facial protection can alleviate much of the symptoms. Most of the long-term ramifications of the eruption will be from the atmospheric changes caused from disruption of solar radiation, which will affect much of the global population. The most pertinent concerns for Nebraska citizens are from the accumulation of ash deposits over the landscape and the climatic perturbations. Potential mitigation procedures are essential to prepare our essentially unaware population of the threat that they may soon face if the volcano continues on its eruption cycle.

Plasmodium vivax Duffy binding protein: baseline antibody responses and parasite polymorphisms in a well-consolidated settlement of the Amazon Region

Objective To investigate risk factors associated with the acquisition of antibodies against Plasmodium vivax Duffy binding protein (PvDBP) a leading malaria vaccine candidate in a well-consolidated agricultural settlement of the Brazilian Amazon Region and to determine the sequence diversity of the PvDBP ligand domain (DBPII) within the local malaria parasite population. Methods Demographic, epidemiological and clinical data were collected from 541 volunteers using a structured questionnaire. Malaria parasites were detected by conventional microscopy and PCR, and blood collection was used for antibody assays and molecular characterisation of DBPII. Results The frequency of malaria infection was 7% (6% for P. vivax and 1% for P. falciparum), with malaria cases clustered near mosquito breeding sites. Nearly 50% of settlers had anti-PvDBP IgG antibodies, as detected by enzyme-linked immunosorbent assay (ELISA) with subjects age being the only strong predictor of seropositivity to PvDBP. Unexpectedly, low levels of DBPII diversity were found within the local malaria parasites, suggesting the existence of low gene flow between P. vivax populations, probably due to the relative isolation of the studied settlement. Conclusion The recognition of PvDBP by a significant proportion of the community, associated with low levels of DBPII diversity among local P. vivax, reinforces the variety of malaria transmission patterns in communities from frontier settlements. Such studies should provide baseline information for antimalarial vaccines now in development.