Epidemiology of infectious meningitis in the State of Amazonas, Brazil

INTRODUCTION: In the State of Amazonas, particularly in the capital Manaus, meningitis has affected populations of different cultures and social strata over the years. Bacterial meningitis is caused by several different species and represents a major issue of public health importance. The present study reports the meningitis case numbers with different etiologies in Amazonas from January 1976 to December 2012. METHODS: Since the 1970s, the (currently named) Tropical Medicine Foundation of Doutor Heitor Vieira Dourado [Fundação de Medicina Tropical Doutor Heitor Vieira Dourado (FMT-HVD)] has remained a reference center in Amazonas for the treatment of meningitis through the diagnosis and notification of cases and the confirmation of such cases using specific laboratory tests. RESULTS: The foundation has achieved coverage of over 90% of the state medical records for many years. Between 1990 and 2012, meningitis cases caused by Haemophilus influenzae decreased with the introduction of the H. influenzae vaccine. Meningococcal disease previously had a higher frequency of serogroup B disease, but starting in 2008, the detection of serogroup C increased gradually and has outpaced the detection of serogroup B. Recently, surveillance has improved the etiological definition of viral meningitis at FMT-HVD, with enteroviruses, Epstein-Barr virus (EBV) and varicella zoster virus (VZV) prevailing in this group of pathogens. With the advent of acquired immunodeficiency syndrome (AIDS), cryptococcal meningitis has become an important disease in Amazonas. Additionally, infectious meningitis is an important burden in the State of Amazonas. CONCLUSIONS: Changes in the epidemiological profile for the different etiology-defined cases are the result of continuous epidemiological surveillance and laboratory capacity improvements and control measures, such as Haemophilus influenzae vaccination.

Clinical, demographic, and epidemiologic characteristics of hepatitis B virus-infected patients at a tertiary public hospital in Presidente Prudente, State of São Paulo, Brazil

Abstract: INTRODUCTION: Few studies have addressed the primary characteristics of patients infected with hepatitis B virus (HBV) in the general population, especially those living in small- and medium-sized cities in Brazil. We aimed to determine the clinical, demographic, and epidemiologic characteristics of patients diagnosed with HBV who were followed up at an infectious diseases clinic of a public hospital in State of São Paulo, Brazil. METHODS: Medical records of patients aged >18 years and diagnosed with HBV infection between January 2000 and December 2013 were reviewed. RESULTS: Seventy-five patients were enrolled with male-female main infection-associated risk factors; 9 (12%) were co-infected with human immunodeficiency virus (HIV), 5 (6.7%) with hepatitis C virus (HCV), and 3 (4%) were co-infected with both HIV and HCV. Antiviral HBV therapy was applied in 21 (28%) patients and tenofovir monotherapy was the most prescribed medication. After approximately 2 years of antiviral treatment, the HBV-DNA viral load was undetectable in 12 (92.3%) patients and lower levels of alanine aminotransferase were found in these patients. CONCLUSIONS: Over a 13-year interval, very few individuals infected with HBV were identified, highlighting the barriers for caring for patients with HBV in developing countries. New measures need to be implemented to complement curative practices.

Occurrence of Lutzomyia longipalpis andhuman and canine cases of visceral leishmaniasis and evaluation of their expansion in the Northwest region of the State of São Paulo, Brazil

Abstract: INTRODUCTION This paper aims to describe the dispersion of Lutzomyia longipalpis and the autochthonous occurrence of visceral leishmaniasis (VL) in the Northwest region of the State of São Paulo between 2007 and 2013 and to analyze their expansion. METHODS Information about the vector and associated cases was described using maps. The incidence, mortality, and lethality of human visceral leishmaniasis (HVL) were calculated. In municipalities in which more than one HVL case occurred, incidences were calculated according to census sector, and spatial and spatiotemporal clusters were identified. RESULTS The first case of HVL was reported in the municipality of Jales in 2007. By 2013, the vector and the disease had expanded from west to east, with the vector being detected in 29 municipalities. A total of 11 municipalities had cases of canine visceral leishmaniasis (CVL), and six had cases of HVL. Vector expansion occurred by vicinity with previously infested municipalities, and the expansion of VL was related to the major highways and the capital municipalities of the micro-regions in the study area. The highest incidence of HVL occurred in children between 0-4 years old, and the highest mortality and lethality occurred among persons aged 60 and older. The occurrence of HLV was more intense in the peripheral areas of municipalities with the disease. CONCLUSIONS The findings of this study may be useful for improving VL surveillance and control activities by slowing VL expansion and/or mitigating VL effects when they occur.

Characteristics of Triatomine infestation and natural Trypanosoma cruzi infection in the State of Rio Grande do Norte, Brazil

Abstract: INTRODUCTION Natural and artificial ecotope infestation by the kissing bug triatomines and their colonization and infection by Trypanosoma cruzi , the Chagas disease agent, were evaluated in nine municipalities of the State of Rio Grande do Norte, Brazil. METHODS Following identification, triatomine intestinal contents were analyzed by direct microscopic examination, xenoculture, and polymerase chain reaction (PCR) for parasite detection. Trypanosoma cruzi isolates were genotyped using three different markers. RESULTS Of 842 triatomines captured, 65% were Triatoma brasiliensis , 17.8% Triatoma pseudomaculata , 12.5% Panstrongylus lutzi , and 4.7% Rhodnius nasutus . Triatoma brasiliensis and P. lutzi adults were found in the intradomicile. T. brasiliensis, T. pseudomaculata , and R. nasutus nymphs and adults were found in the peridomicile and wild environment. Intradomiciliary and peridomiciliary infestation indexes were 5.6% and 33.7%, respectively. In the peridomicile, chicken coops were the most infested ecotope. The T. cruzi triatomine infection rate was 30.2%, of which PCR detected 29%. P . lutzi (78.1%), T . brasiliensis (24.5%), and T . pseudomaculata (22.7%) were the most infected species. TcII and III genotypes were detected in T. brasiliensis and TcIII in P. lutzi . CONCLUSIONS T. brasiliensis was found in all environments and most ecotopes with high T. cruzi infection rates. High infection rates were also detected in T . pseudomaculata and P. lutzi , suggesting their role in the interchange between the wild and peridomestic transmission cycles. The combination of PCR, microscopic examination, and xenoculture contributed to improving T. cruzi infection evaluation in triatomine bugs. The TcII and TcIII genotypes were predominant in the study area.

Malaria epidemiology in the State of Piauí, Northeastern Brazil: a retrospective study with secondary data

Abstract: INTRODUCTION Malaria is not considered endemic in State of Piauí. METHODS Malaria epidemiology was examined using surveillance data. RESULTS: During 2002-2013, of the 484 cases of malaria, 217 were classified as probably acquired in Piauí, most frequently in the Campo Largo, Buriti dos Lopes, and Luzilândia municipalities, and 267 were considered probably imported, from the States of Pará, Maranhão, Amazonas, Roraima, and Rondônia. Probably-imported cases occurred throughout the year, while 80.2% of the probably-acquired cases occurred in April-August, peaking at the end of the rainy season. CONCLUSIONS Malaria surveillance should be intensified. Further ecoepidemiological and entomological studies are needed.

Predictive factors for Leishmania infantum infection in dogs examined at a veterinary teaching hospital in Teresina, State of Piauí, Brazil

Abstract: INTRODUCTION: In Brazil, culling of seropositive dogs is one of the recommended strategies to control visceral leishmaniasis. Since infectiousness is correlated with clinical signs, control measures targeting symptomatic dogs could be more effective. METHODS: A cross-sectional study was carried out among 1,410 dogs, predictive models were developed based on clinical signs and an indirect immunofluorescence antibody test. RESULTS: The validated predictive model showed sensitivity and specificity of 86.5% and 70.0%, respectively. CONCLUSIONS: Predictive models could be used as tools to aid control programs in focusing on a smaller fraction of dogs contributing more to infection dissemination.

Rheumatic fever: a multicenter study in the State of São Paulo

Rheumatic fever is still the most commonly seen rheumatic disease in Brazilian pediatric rheumatology clinics. It remains a significant health problem since subsequent cardiac sequelae represent one of the most important causes of chronic heart disease in children. We reviewed the clinical manifestations of rheumatic fever in 786 patients, followed at seven pediatric rheumatology clinics in the state of São Paulo, Brazil. All patients were diagnosed according to revised Jones' criteria. Regarding major criteria, 396 (50.4%) children exhibited carditis, 453 (57.6%) polyarthritis, 274 (34.8%) chorea, 13 (1.6%) erythema marginatum, and 12 (1.5%) subcutaneous nodules. Valvular lesions documented by echocardiography in the absence of accompanying auscultatory findings were found in 144 (18.3%) patients. Migratory polyarthritis was observed in 290 (64.0%) patients with articular involvement. Documented previous streptococcal infection assessed by serum antistreptolysin (ASO) titers occurred in 531 (67.5%) patients. Even though prophylaxis with benzathine penicillin was recommended to all patients, recurrent attacks were observed in 147 (18.7%). We emphasize the high frequency of chorea, silent carditis and recurrences in our series as well as the variable clinical presentation of arthritis in rheumatic fever. Multicenter studies should be encouraged to improve our understanding of the clinical features of rheumatic diseases in children and adolescents.

Cataract surgery: expectations of patients assisted during a community project in São Paulo, state of São Paulo, Brazil

OBJECTIVE: To identify social characteristics and expectations of individuals seen during a community project for the treatment of senile cataracts. Expected results from their eye surgery and its consequences to their quality of life were studied as well. METHODOLOGY: Cataract patients (visual acuity equal to or lower than 0.2 in the more superior eye) aged 50 years or over, were surveyed by means of interviews held during their visit at the Cataract Project in São Paulo city, State of São Paulo, Brazil, in 1999. RESULTS: The sample was composed of 331 subjects of low socioeconomic level ranging in age from 50 to 97 years (average = 71.8 years). Expectation of total recovery from the cataract condition by means of surgery was declared by 80.0% of the respondents, with no significant differences between male and female subjects (P < 0.1723). Hope to resume manual activities was expressed by 59.8%. CONCLUSION: A predominance of expectations of resuming normal activity and achieving a better quality of life after cataract surgery were identified.

The algal flora of two distinct habitats along the Moa River in the state of Acre, Brazil

Twenty-eoght algal samples were collected in September-October, 1984, from two distinct habitats in the state of Acre, Brazil. Eleven were from the Moa River, and 17 were from a sulfur water spring which flows into the Moa River. A total of 74 species, representing 48 genera of algae, were identified from these samples. Forty-nine species were found in the Moa River and 67 in the sulfur water spring. Both coolection site had rich assemblages of cyanophycean algae, chlorophycean algae, and diatoms. Chlorophycean species dominated the algae flora at both sites, cut were more numerous at the sulfur water spring. There was also a definite difference in the relatives proportions of desmids to filamentous chlorophycean algae at the two sites.

Two new Haploporidae (Trematoda) of Fishes from the Brazilian state of Rondônia

Two new Haploporidae (Trematoda) are described from fishes of the State of Rondônia, Brazil. Rondotrema microvitellarum gen. et sp. n., an intestinal parasite of Hemiodus microlepis, is characterized as having intercecal vitellaria limited to one small cluster on either side postero-lateral to the ovary. Lecithobotrioides elongatus sp. n., from Prochilodus nigricans, has an elongate, cylindrical body, short thick ceca, a small hemaphroditic sac and extensive vitellaria.

Tube-jack and sonic testing for the evaluation of the state of stress in historical masonry

In the investigation and diagnosis of damages to historical masonry structures, the state of stress of the masonry is an important characteristic that must be determined with as much accuracy as possible. Flat-jack testing is a traditional method used to determine the state of stress in historical masonry structures. However, when irregular masonry is tested the method can cause damage to the masonry units and the accuracy of the method is reduced. An enhanced technique, called tube-jack testing, is being developed at the University of Minho to reduce the damage caused during testing and improve the accuracy when used on irregular masonry. This method uses multiple cylindrical jacks inserted in a line of holes drilled in the mortar joints of the masonry, avoiding damage to the masonry units. Concurrently with the development of tube-jack testing, the effect of stress state on sonic testing is being studied. Sonic testing is often used to determine locations of voids and damage in masonry. The focus of these studies was to determine if the state of stress is influencing the sonic test results. In this paper the results of tube-jack testing and sonic testing on masonry walls, built for the purpose of this study in the laboratory, loaded in compression is presented. The tube-jack testing is used to estimate the state of stress in the masonry and the sonic test results are evaluated based on the effect of the applied load on the wall. Future testing and study are suggested for continued development of these test methods.

Floristic composition and diversity of Amazonian rainforest bryophytes in the state of Acre, Brazil

Bryophyte diversity in Amazonian Brazil is high, presently recorded at 514 species distributed among 36 families and 89 genera. Comparisions of species richness among the Amazonian states of Brazil suggests that the bryoflora of Acre is still underestimated, presently recorded at 106 species distributed among 33 families and 63 genera. After two field trips, the diversity increased 50% showing that the bryoflora is still poorly known. Collection data and comments on morphology, ecology and distribution are given for sixty-two species of bryophytes collected in the state of Acre, Brazil, which are new (fifty-two species) or interesting floristic records (ten species). Microlejeunea crenulifolia (Gottsche) Steph. and Stictolejeunea balfourdii Mitt. are new records for Brazil and fifty species are new records for Acre.

Screening of plants found in the State of Amazonas, Brazil for activity against Aedes aegypti larvae

Ethanol, methanol and water extracts representing mostly native plant species found in the Amazon region were prepared, respectively, by maceration, continuous liquid-solid extraction and infusion, followed by evaporation and freeze-drying. The freeze-dried extracts were tested for lethality toward Aedes aegypti larvae at test concentrations of 500 mg / mL. In general, methanol extracts exhibited the greatest larvicidal activity. The following 7 methanol extracts of (the parts of) the indicated plant species were the most active, resulting in 100% mortality in A. aegypti larvae: Tapura amazonica Poepp. (root), Piper aduncum L. (leaf and root), P. tuberculatum Jacq. (leaf, fruit and branch). and Simaba polyphylla (Cavalcante) W.W. Thomas (branch).

Diversity of the land resources in the Amazonian State of Rondônia, Brazil

Conflicting opinions are recorded in the literature concerning the suitability of Amazon lands for sustainable agriculture following deforestation. This article has been written to shed light on this question by summarizing climate, landform, soil and vegetation features from the findings of a land resource study of the Brazilian state of Rondônia in south-west Amazonia. The work, which followed the World Soils and Terrain Digital Database (SOTER) methodology, was financed by the World Bank. During the course of the survey special emphasis was given to studying soils; 2914 profiles were analyzed and recorded. The study identified a complex pattern of land units with clear differences in climate, landform, soils and native vegetation. Forested areas mosaic with lesser areas of natural savannas. The latter occur on both poorly-drained and well-drained, albeit nutrient deficient sandy soils. The tallest and most vigorous forests or their remnants were seen growing on well-drained soils formed from nutrient-rich parent materials. Many of these soils could, or are being used for productive agriculture. Soils developed on nutrient-poor parent materials support forests that are significantly lower in height, and would require large lime and fertilizer inputs for agriculture. Low forests with high palm populations and minor areas of wet land savannas cover the poorly drained soils. It is evident that forest clearing in the past was indiscriminant; this cannot be condoned. The diversity of land conditions found throughout Rondônia would suggest that many past studies in the Amazon have simply been too broad to identify significant soil differences.

Decapod crustaceans used as food by the Yanomami Indians of the Balawa-ú village, State of Amazonas, Brazil

The Yanomami are a group of South American Indians that live in the rainforest along the borderlands of Brazil and Venezuela. They depend on hunting, gardening and wild food for survival; crustaceans are a highly prized food item in their diet. Taxonomical and ethnozoological aspects of the Yanomami Indians of the Balawa-ú village, state of Amazonas, Brazil, related to the crustaceans are described. Information and specimens were obtained from August to December, 2003. Interviews were conducted with residents of the village and focused on questions about species exploited, indigenous names, modes of capture and use of the species. One shrimp species of the family Palaemonidae (Macrobrachium brasiliense) and two crab species of Trichodactylidae (Sylviocarcinus pictus, Valdivia serrata) as well as two of Pseudothelphusidae (Fredius fittkaui, F. platyacanthus) were recorded. The indigenous names applied to these species are: shuhu, for shrimp, oko and peimatherimi for each of the two pseudothelphusid crabs, and hesiki tôtôrema for both trichodactylid crabs.