Study of infection by Rickettsiae of the spotted fever group in humans and ticks in an urban park located in the City of Londrina, State of Paraná, Brazil

INTRODUCTION: Spotted fevers are emerging zoonoses caused by Rickettsia species in the spotted fever group (SFG). Rickettsia rickettsii is the main etiologic agent of Brazilian spotted fever (BSF) and it is transmitted by Amblyomma spp. ticks. METHODS: The study aimed to investigate SFG rickettsiae in the Arthur Thomas Municipal Park in Londrina, PR, by collecting free-living ticks and ticks from capybaras and blood samples from personnel working in these areas. Samples from A. dubitatum and A. cajennense were submitted for PCR in pools to analyze the Rickettsia spp. gltA (citrate synthase gene). RESULTS: All the pools analyzed were negative. Human sera were tested by indirect immunofluorescence assay with R. rickettsii and R. parkeri as antigens. Among the 34 sera analyzed, seven (20.6%) were reactive for R. rickettsii: four of these had endpoint titers equal to 64, 2 titers were 128 and 1 titer was 256. None of the samples were reactive for R. parkeri. An epidemiological questionnaire was applied to the park staff, but no statistically significant associations were identified. CONCLUSIONS: The serological studies suggest the presence of Rickettsiae related to SFG that could be infecting the human population studied; however, analysis of the ticks collected was unable to determine which species may be involved in transmission to humans.

Hepatitis B marker seroprevalence and vaccination coverage in adolescents in the City of Itajaí, State of Santa Catarina, Southern Brazil, in 2008

INTRODUCTION: Hepatitis B infection constitutes an important cause of morbidity and mortality worldwide. In Brazil, however, the current epidemiological situation is not clear. Considering the importance of establishing this prevalence, the aim of this study was to determine the prevalence of HBV markers in voluntary adolescents, junior high (secondary school) students, in the City of Itajaí, State of Santa Catarina, Brazil. METHODS: A seroepidemiological, transverse study was conducted with 353 randomly chosen adolescents from elementary school in 2008. Blood samples were analyzed for HBsAg, anti-HBc and anti-HBs. All analyses were conducted by automated microparticle enzyme immunosorbent assay (Abbott®, AxSYM system, Deerfield, IL, USA), according to the manufacturer's instructions. RESULTS: The prevalence of HBsAg was 0.6% (CI 95% 0.1 - 2.0), that of anti-HBc was 1.1% (CI 95% 0.3 - 2.9) and that of detectable anti-HBs was 83.6% (CI 95% 79.3 - 87.3). Hepatitis B vaccination coverage was 97.5% (CI 95% 95.2 - 98.8). CONCLUSIONS: These results demonstrate the success of the vaccination program against hepatitis B in the region studied and indicate that prevention strategies must be maintained and, if possible, expanded to contribute to the establishment of positive prevalence rates in all age groups.

Geographic analysis on the occurrence of human and canine leptospirosis in the city of Maringá, state of Paraná, Brazil

INTRODUCTION: Leptospirosis is a zoonotic disease, the primary hosts of which are wild, synanthropic, and household animals. Humans behave as terminal and accidental hosts. The prevalence of leptospirosis depends on carrier animals that disseminate the agent, on the environmental survival of this agent, and on the contact of susceptible individuals. Each serovar has one or more hosts with different adaptation levels. The focuses of leptospirosis are infected, sick, and asymptomatic animals, which are considered to be sources of environmental infection. This study aimed to determine the risk areas for leptospiral infection in stray dogs and patients diagnosed with leptospirosis from 2006 to 2008 in Maringá, State of Paraná, Brazil. METHODS: Three hundred and thirty-five stray dogs and 25 patients were studied. Serum from both animals and patients was examined by the microscopic serum agglutination test to study anti-leptospiral antibodies. To determine the risk areas and the spatial distribution of the disease, thematic maps were designed. RESULTS: Forty-one (12.2%) dogs positive for one or more leptospire serovars were observed, the most frequent serovars being Pyrogenes (43.9%), Canícola (21.9%), and Copennhageni (19.5%). Among the humans, 2 (8%) were positive for serovars Pyrogenes and Hardjo Prajitno and for Pyrogenes and Cynopteri. CONCLUSIONS: Spatial analysis showed that the risk for dogs and humans in the City of Maringá to become infected with leptospires exists in both the central and the peripheral areas, a fact that reinforces the relevance of this study and of continuous epidemiological and environmental surveillance actions to control the disease in animals and in humans.

Incidence of congenital toxoplasmosis in the city of Belém, state of Pará, northern Brazil, determined by a neonatal screening program: preliminary results

INTRODUCTION: The aim of this study was to determinate the incidence of congenital toxoplasmosis among a group of newborns (NBs) from Belém using neonatal screening. METHODS: Among the 6,000 newborns referred for investigation of genetic and metabolic diseases, 1,000 were selected for screening for congenital toxoplasmosis by determining the amount of IgM in the eluates of blood collected on filter paper. Positive tests were confirmed using paired serology of the NB and his mother. RESULTS: Out of the 1,000 NBs assessed, one had a positive screening result that was confirmed by paired serology. CONCLUSIONS: The incidence of congenital toxoplasmosis in Belém was 10/10,000 live NBs.

Circulation of the rabies virus in non-hematophagous bats in the city of Rio de Janeiro, Brazil, during 2001-2010

INTRODUCTION: Rabies is one of the most known lethal zoonosis, responsible for 55,000 human deaths per year. It is transmitted to humans mainly by the bite of domestic or wild animals infected with the virus. This paper shows the circulation of this virus in non-hematophagous bats in the City of Rio de Janeiro, Brazil. METHODS: A survey was performed on the number of bats that had been sent for diagnosis by the Seção de Virologia of the Instituto Municipal de Medicina Veterinária Jorge Vaitsman and were positive for rabies. The positive animals were identified, and the isolated viruses were sent for antigenic typification with indirect immunofluorescence. The results were compared with the antigenic panel of the Centers for Disease Control and Prevention. RESULTS: During 2001-2010, the laboratory received 555 non-hematophagous bats for rabies diagnosis, with 198 (35.7%) from Rio de Janeiro City. A total of 11 (5.5%) animals were positive for this disease. Antigenic typification revealed the predominance of variant 3 in 9 (81.8%) of the isolated viruses; 1 virus was classified as variant 4 and 1 variant was identified that segregated with the viruses in insectivorous bats. CONCLUSIONS: The data obtained in this study showed the presence of the rabies virus in synanthropic populations of non-hematophagous bats in the City of Rio de Janeiro. The circulation of this agent in these animals represents a serious risk to human and animal health and requires attention and control measures by the authorities.

Cases distribution of leptospirosis in City of Manaus, State of Amazonas, Brazil, 2000-2010

INTRODUCTION: Leptospirosis is an infectious disease caused by microorganisms of the genus Leptospira that affects several species of animals, including the human beings. The study described the confirmed cases of leptospirosis in Manaus, from 2000 to 2010. METHODS: A descriptive study based on secondary data analysis of Secretaria Municipal de Saúde (SEMSA), Sistema de Informação de Agravos de Notificação SINAN and Sistema de Informação sobre Mortalidade (SIM) analyzing the variables: age group, gender, clinical aspects and geographic area and lethality. RESULTS: Were reported 665 cases of leptospirosis, 339 were confirmed and 35 (10.3%) died. The largest number of cases occurred in May (16.8%), March (13.3%) and April (11.4%), a period of intense rainfall. The city areas with the greatest occurrence of the disease were South (26.6%), West (23.5%) and East (19.7%), areas of the greatest precariousness socio-environment. The largest number of cases, including deaths, occurred in the age group from 14 to 44.9 years (74%), being that 291 (85.8%) were male and 48 (14.1%) females. The most frequent symptoms were fever, myalgia, headache and jaundice. In relation to the social conditions were identified low education, poor housing, absence of sanitation and low income. CONCLUSIONS: In Manaus, despite the implementation of the Social and Environmental Program of Igarapés of Manaus (PROSAMIM), there are still areas that need a proper urbanization and improvements in socio-environmental conditions, reducing the level of exposure of the human beings that living in these locations.

Demographic determinants of survival of people living with HIV attending an outpatient reference unit in the city of Três Lagoas, state of Mato Grosso do Sul, Brazil, in the period 1984-2009

INTRODUCTION: While the incidence of HIV infection and AIDS is increasing in small Brazilian cities, epidemiological studies are often conducted in large urban centers. METHODS: Our group conducted a retrospective analysis of survival determinants among 358 patients who attended a reference unit in a small city. RESULTS: Death risk was lower among men that had sex with men, patients with an HIV-seropositive partner, and those admitted after highly active antiretroviral therapy (HAART) was available. CONCLUSIONS: The study documents the striking beneficial effect of HAART. The finding of other groups with improved survival may aid in the development of programmatic strategies.

Spatial distribution of trachoma cases in the City of Bauru, State of São Paulo, Brazil, detected in 2006: defining key areas for improvement of health resources

IntroductionThe objective of this study was to analyze the spatial behavior of the occurrence of trachoma cases detected in the City of Bauru, State of São Paulo, Brazil, in 2006 in order to use the information collected to set priority areas for optimization of health resources.Methodsthe trachoma cases identified in 2006 were georeferenced. The data evaluated were: schools where the trachoma cases studied, data from the 2000 Census, census tract, type of housing, water supply conditions, distribution of income and levels of education of household heads. In the Google Earth® software and TerraView® were made descriptive spatial analysis and estimates of the Kernel. Each area was studied by interpolation of the density surfaces exposing events to facilitate to recognize the clusters.ResultsOf the 66 cases detected, only one (1.5%) was not a resident of the city's outskirts. A positive association was detected of trachoma cases and the percentage of heads of household with income below three minimum wages and schooling under eight years of education.ConclusionsThe recognition of the spatial distribution of trachoma cases coincided with the areas of greatest social inequality in Bauru City. The micro-areas identified are those that should be prioritized in the rationalization of health resources. There is the possibility of using the trachoma cases detected as an indicator of performance of micro priority health programs.

Prevalence and risk factors for Toxoplasma gondii infection among pregnant and postpartum women attended at public healthcare facilities in the City of Niterói, State of Rio de Janeiro, Brazil

IntroductionTo determine the prevalence of immunoglobulin G (IgG) and immunoglobulin M (IgM) anti-Toxoplasma gondii antibodies among pregnant and postpartum women attended within the public healthcare system in Niterói, State of Rio de Janeiro, and to detect possible exposure factors associated with T. gondii infection in this population.MethodsIgM and IgG anti-T. gondii antibodies were investigated in 276 pregnant and 124 postpartum women by using the indirect immunofluorescence (IFAT) and immunoenzymatic assay (ELISA) techniques. The participants were selected by convenience sampling. All these 400 patients filled out a free and informed consent statement, answered an epidemiological questionnaire and were informed about the disease.ResultsAmong the 400 samples analyzed, 234 (58.5%) were reactive to IgG anti-T. gondii antibodies, according to the IFAT and/or ELISA assay. One pregnant woman was found to be reactive to IgM anti-T. gondii antibodies, with an intermediate IgG avidity test. Risk factor analysis showed that seropositivity was significantly associated (p<0.05) with age, contact with cats and presence of rodents at home. Through a logistic regression model, these associations were confirmed for age and contact with cats, while education at least of the high school level was found to be a protective factor.ConclusionsThe prevalence rate of IgG anti-T. gondii antibodies in the City of Niterói was high and the risk factors for infection detected after multivariate analysis were: age over 30 years, contact with cats and education levels lower than university graduate level.

Temporal, spatial and spatiotemporal analysis of the occurrence of visceral leishmaniasis in humans in the City of Birigui, State of São Paulo, from 1999 to 2012

Introduction In 1999, Birigui and Araçatuba were the first municipalities in the State of São Paulo to present autochthonous cases of visceral leishmaniasis in humans (VLH). The aim of this study was to describe the temporal, spatial and spatiotemporal behaviors of VLH in Birigui. Methods Secondary data were obtained from the Notifiable Diseases Information System from 1999 to 2012. The incidence, mortality and case fatality rates by sex and age were calculated. The cases of VLH were geocoded and grouped according to census tracts. Local empirical Bayesian incidence rates were calculated. The existence of spatial and spatiotemporal clusters was investigated using SaTScan software. Results There were 156 confirmed cases of autochthonous VLH. The incidence rate was higher in the 0-4-year-old children, and the mortality and case fatality rates were higher in people aged 60 years and older. The peaks of incidence occurred in 2006 and 2011. The Bayesian rates identified the presence of VLH in all of the census tracts in the municipality; however, spatial and spatiotemporal clusters were found in the central area of the municipality. Conclusions Birigui, located in the Araçatuba region, has recently experienced increasing numbers of VLH cases; this increase is contrary to the behavior observed over the entire region, which has shown a decreasing trend in the number of VLH cases. The observations that the highest incidence is in children 0-4 years old and the highest mortality is in people 60 years and older are in agreement with the expected patterns of VLH.

Epidemiological and environmental aspects of visceral leishmaniasis in children under 15 years of age between 2007 and 2012 in the City of Araguaína, State of Tocantins, Brazil

Introduction Visceral leishmaniasis (VL) stands out as a zoonosis observed on four continents and also in urban expansion zones in several regions of Brazil. Methods A cross-sectional epidemiological study of VL cases in children under 15 years of age in the period from 2007 to 2012. Clinical data were gathered from medical reports; meteorological data were obtained at the Meteorological Measurement Department of UFT. Environmental variables were divided into two periods, rainy and dry. Results The study revealed no difference by gender (p=0.67) among the 821 patients. However, the most affected age group was between one and five years of age (58.6%; p<0.01); the highest prevalence of the disease (99.03%; p<0.01) occurred in urban zones; and the most affected ethnic group (85.5%; p<0.01) was mixed race. The highest incidence coefficients in this population occurred in 2007 and 2008 (578.39/100,000 inhabitants; 18.5/100,000 inhabitants, respectively), whereas the highest lethality coefficients occurred in 2008 and 2011 (0.85/100 deaths). There was no significant correlation between average rainfall and the number of VL cases. The correlation between temperature and number of VL cases was negative (r = -0.4039; p<0.01). Conclusions In Araguaína, visceral leishmaniasis in children under 15 years is an urban-based endemic disease distributed across all districts of the city wherein temperature as an environmental factor, a higher prevalence in mixed race children between one and five years of age, and a high incidence coefficient all strongly contribute to child mortality.

Studies on Phlebotominae (Diptera: Psychodidae) in the Campus FIOCRUZ Mata Atlântica, Jacarepaguá, in the City of Rio de Janeiro, Brazil

INTRODUCTION: The presence of American cutaneous leishmaniasis (ACL) in the communities of the Campus FIOCRUZ Mata Atlântica (CFMA) in the City of Rio de Janeiro initiated the investigation of the Phlebotominae fauna in the Atlantic Forest to determine the occurrence of putative ACL vectors associated with the enzootic cycle. METHODS: For 24 consecutive months, sand flies were captured inside the forest and in the border area near the communities. RESULTS: The following sand fly species were identified: Brumptomyia brumpti, Brumptomyia cunhai, Brumptomyia nitzulescui, Lutzomyia edwardsi, Lutzomyia pelloni, and Lutzomyia quinquefer. Other identified sand fly vectors, such as Lutzomyia intermedia (the predominant species), Lutzomyia migonei, Lutzomyia whitmani, Lutzomyia fischeri, and Lutzomyia hirsuta hirsuta, are associated with ACL transmission, and the vector for American visceral leishmaniases (AVL), Lutzomyia longipalpis, was also found. CONCLUSIONS: All sand fly vectors were found in both studied environments except for Lutzomyia whitmani, which was only identified in the forest. This study represents the first identification of Lutzomyia longipalpis in the CFMA, and the epidemiological implications are discussed.

Prevalence of intestinal parasites and risk factors forspecific and multiple helminth infections in a remote city of the Brazilian Amazon

Abstract: INTRODUCTION: Few studies have described the risk factors of intestinal parasitic infections in the Amazon. METHODS: A cross-sectional survey was performed in a City of the State of Amazonas (Brazil) to estimate the prevalence of intestinal parasites and determine the risk factors for helminth infections. RESULTS: Ascaris lumbricoides was the most prevalent parasite. The main risk factors determined were: not having a latrine for A. lumbricoides infection; being male and having earth or wood floors for hookworm infection; and being male for multiple helminth infections. CONCLUSIONS: We reported a high prevalence of intestinal parasites and determined some poverty-related risk factors.

Parasite-host relationship between the tambaqui (Colossoma macropomum Cuvier 1818) and ectoparasites, collected from fish farms in the city of Rolim de Moura, State of Rondônia, Western Amazon, Brazil

In this study we investigated the relationship between tambaqui fish (Colossoma macropomumi Cuvier 1818) and parasites in two fish farms (L204S and L180N) in the state of Rondônia, Brazil, during a 1-year period. The objective of the study was to describe the relationships between parasites, hosts and the environment. From the 80 fish specimens collected, 100% were parasitized by at least one parasite species. Seven ectoparasites species were recorded, six of the class Monogenea: Anacanthorus spathulatusi, Mymarothecium spp. (Mymarothecium sp. 1, Mymarothecium sp. 2 and M. viatorum), Notozothecium sp. and Linguadactyloides brinkimanni, classified as dominants, and the copepod Perulernaea gamitanae, classified as subordinate. Despite their high prevalence, the parasites were not abundant. A. spathulatus presented positive and significant correlations between the abundance of parasitism and the standard length of the hosts in the two fish farms; Mymarothecium spp. showed significant correlations, negative in L180N, and positive in L204S; significant positive correlations were observed for Notozothecium sp. in L204S, and for L.brinkimanni in L180N. Young monogeneans were found; these parasites presented a negative correlation in L180N and a significant negative correlation in L204S. The results of the correlation between the relative condition factor (Kn) and the abundance of parasites were not significant for the recorded parasite species. Regarding the hepatosomatic relation (HSR) of fish and the abundance of parasites, Anacanthorus spathulatusi showed a significant negative correlation with the HSR in L180N, and a positive correlation in L204S. Mymarothecium spp. and Notozothecium sp. presented significant positive correlations in L204S. Considering the correlation of the fish splenosomatic relation (SSR) and the abundance of parasites, L. brinkimanni presented significant correlations, positive in L180N and negative in L204S. Despite 100% prevalence, the high water quality contributes to infracommunities with low parasite abundance and good levels of Kn, HSR and SSR, allowing good tambaqui development.

Relation between oral health and socioeconomic variables among schoolchildren aged 12 in the City of Manaus - AM

Studies have shown that the age of 12 was determined as the age of global monitoring of caries for international comparisons and monitoring of disease trends. The aimed was to evaluate the prevalence of dental caries, fluorosis and periodontal condition and their relation with socioeconomic factors among schoolchildren aged twelve in the city of Manaus, AM. This study with a probabilistic sample of 661 children was conducted, 609 from public and 52 from private schools, in 2008. Dental caries, periodontal condition and dental fluorosis were evaluated. In order to obtain the socioeconomic classification of each child (high, upper middle, middle, lower middle, low and lower low socioeconomic classes), the guardians were given a questionnaire. The mean decayed teeth, missing teeth, and filled teeth (DMFT) found at age twelve was 1.89. It was observed that the presence of dental calculus was the most severe periodontal condition detected in 39.48%. In relation to dental fluorosis, there was a low prevalence in the children examined, i.e., the more pronounced lines of opacity only occasionally merge, forming small white areas. The study showed a significant association of 5% among social class with dental caries and periodontal condition. In schoolchildren of Manaus there are low mean of DMFT and fluorosis, but a high occurrence of gingival bleeding.