João Paulo Amaral Haddad

Avaliação do nível de conhecimento e de atitudes preventivas da população sobre a leishmaniose visceral em Belo Horizonte, Minas Gerais, Brasil

Objetivou-se avaliar o nivel de conhecimento e algumas atitudes preventivas em relacao a leishmaniose visceral em Belo Horizonte, Minas Gerais, Brasil, em 2006. Foi feito um estudo de caso-controle, com visitas domiciliares e questionario semi-estrurado. Comparou-se dois grupos: (1) 82 casos humanos de leishmaniose visceral ocorridos em 2004 e (2) 164 controles, constituidos por vizinhos dos casos. A leishmaniose visceral acometeu mais em criancas, com aumento do risco de contrair leishmaniose visceral de 109,77 vezes para menores de dez anos. O homem demonstrou ter 2,57 vezes mais chances de adoecer que a mulher. A escolaridade da populacao mostrou-se baixa (68,3% nao completaram o ensino medio). Cinquenta por cento dos casos desconheciam-na quando foram infectados e apenas 1,2% conhecia o vetor. Conhecer algo sobre a leishmaniose visceral minimizou o risco de adoecer em 2,24 vezes. Quanto as atitudes de protecao, o risco de se contrair leishmaniose visceral diminui em 1,94 vez para pessoas que mantem limpos os domicilios ou que levam o cao ao veterinario. Em Belo Horizonte, o conhecimento da populacao perante a leishmaniose visceral e superficial e as atitudes preventivas inespecificas.

Soroprevalência de aglutininas anti-Leptospira spp. em ovinos nas Mesorregiões Sudeste e Sudoeste do Estado Rio Grande do Sul, Brasil

The presence of anti-Leptospira agglutinins in 1.360 samples of ovine sera was determined. Clinically healthy sheep with more than one year of age, raised in pasture in 136 farms of 18 counties, 10 located in the southeast Mesorregions and 8 in the southwest Mesorregions of the state of Rio Grande do Sul, Brazil, between the months of January and March of 1999. Were used sera tested by the Microscopic Agglutination Technique (MAT), from the 1.360 samples of serum tested, 466 (34.26%) were positive and the titers of anti-Leptospira spp. agglutinins varied from 100 to 3.200. The serovars founded were: hardjo (Norma), 210 (28.4%), sentot, 152 (16.8%); hardjoprajitno, 133 (14.5%); fortbragg, 73 (6.3%); wolffi, 39 (4.7%); pyrogenes, 25 (1.8%); australis, 21 (1.6%); pomona, 20 (1.6%); sejroe, 19 (2.2%); castellonis, 18 (1.8%); hebdomadis, 17 (1.3%); icterohaemorrhagiae, 16 (0.5%); grippotyphosa, 9 (0.7%); canicola , 8 (0.6%); tarassovi, 7 (0.6%), bratislava, 4 (0.29%), autumnalis, 3 (0.2%). The results demonstrate that Leptospira spp are disseminated in the majority of the farms that raise sheep in the southeast and southwest Mesorregions of the State of Rio Grande do Sul, Brazil.

Prevalência de aglutininas anti-Leptospira interrogans em cães de Belo Horizonte, Minas Gerais, 2001 a 2002

Prevalence of anti-Leptospira interrogans agglutinins in dogs captured by the Zoonosis Control Center, in nine administrative districts of Belo Horizonte city, throughout the year, was evaluated. The areas with positive prevalence were correlated to the areas of environmental sanitation, using sources of georeference. Blood samples from 3,417 dogs captured, were submitted to microscopic agglutination test from September 2001 to September 2002, showed 13.1% of seropositivity. The most reactive serovars were Canicola, Ballum, Pyrogenes and Icterohaemorrhagiae. High prevalences were observed at Center-Southern - 22.5%, Eastern - 19.1% and Northeastern - 13.2% districts. Pampulha district got 8.2% of prevalence, the lowest percentage of positive reactions. High number of dog infection was observed during December, 2001 and January, 2002, characterized as rainy period and high environmental temperature. Villages, slums and suburbs with environmental sanitation deficiency are areas of high risk.

The spatial distribution of Schistosoma mansoni infection before and after chemotherapy in the Jequitinhonha Valley in Brazil

Schistosomiasis prevalence and egg counts remained low one year after chemotherapy in most households in a hyperendemic rural area in northern Minas Gerais but several distinct spatial patterns could be observed in relation to IgE levels and to a lesser extent to exposure risk (TBM) and type of water supply. An inverse relationship between pre-treatment household prevalence and egg counts on the one hand and post-treatment IgE levels on the other were noted in two of the five communities. Low exposure risk was associated with the low pre-treatment infection rates in the central village but did not contribute to the decline of infection rates after chemotherapy in the study area, as indicated by the significant increase in water contact during the posttreatment period (p < 0.0001). Distance between households and the streams and socioeconomic factors were also unimportant in predicting the spatial distribution of infection. These results are consistent with the production and antiparasitic effect of high levels of IgE in Schistosoma mansoni infection.

Distribuição temporal e espacial da raiva bovina em Minas Gerais, 1976 a 1997

A retrospective observational study was performed for evaluating space and time distribution of bovine rabies in Minas Gerais State, Brazil, from 1976 to 1997. A total of 7,526 records of bovine rabies diagnoses using direct immunofluorescence was analysed. The MAP-INFO professional 4.5 was used for examining space distribution of bovine rabies. An annual growth tendency of positive diagnoses of rabies (Y=23,586X) mainly from April to August and in the number of positive counties (Y=0,0461X) was observed, characterizing an intense expansion of bovine rabies in Minas Gerais.

Edentulism and shortened dental arch in Brazilian elderly from the National Survey of Oral Health 2003

OBJECTIVE To describe the distribution of edentulism and estimate the prevalence of functional dentition and shortened dental arch among elderly population. METHODS A population-based epidemiological study was carried out with a sample of 5,349 respondents aged 65 to 74 years obtained from the 2002 and 2003 Brazilian Ministry of Health/Division of Oral Health survey database. The following variables were studied: gender; macroregion of residence; missing teeth; percentage that met the World Health Organization goal for oral health in the age group 65 to 74 years (50% having at least 20 natural teeth); presence of shortened dental arch; number of posterior occluding pairs of teeth. The Chi-square test assessed the association between categorical variables. The Kruskal-Wallis and Mann-Whitney tests were used to assess differences of mean between number of posterior occluding pairs teeth, macro-region and gender. RESULTS The elderly population had an average of 5.49 teeth (SD: 7.93) with a median of 0. The proportion of completely edentulous respondents was 54.7%. Complete edentulism was 18.2% in the upper arch and 1.9% in the lower arch. The World Health Organization goal was achieved in 10% of all respondents studied. However, only 2.7% had acceptable masticatory function and aesthetics (having at least shortened dental arch) and a mean number of posterior occluding pairs of 6.94 (SD=2.97). There were significant differences of the percentage of respondents that met the World Health Organization goal and presence of shortened dental arch between men and women. There were differences in shortened dental arch between macroregions. CONCLUSIONS The Brazilian epidemiological oral health survey showed high rate of edentulism and low rate of shortened dental arch in the elderly population studied, thus suggesting significant functional and aesthetic impairment in all Brazilian macroregions especially among women.OBJETIVO: Descrever a distribuicao de edentulismo e estimar a prevalencia de denticao funcional e arco dentario reduzido entre idosos. METODOS: Estudo epidemiologico populacional com 5.349 individuos de 65 a 74 anos do banco de dados do inquerito nacional de saude bucal do Ministerio da Saude/Coordenacao Nacional de Saude Bucal em 2002 e 2003. Foram avaliados perda dentaria; cumprimento a meta da Organizacao Mundial da Saude para a faixa etaria (50% com pelo menos 20 dentes); presenca de arco dental reduzido, numero de pares em oclusao posterior; sexo e macro-regiao da residencia. O teste qui-quadrado avaliou a associacao entre variaveis categoricas. Os testes Kruskal-Wallis e Mann-Whitney foram usados para determinar diferencas do numero medio de pares de dentes posteriores em oclusao, macro-regiao e sexo. RESULTADOS: Os idosos tinham, em media, 5,49 dentes (DP = 7,93) (mediana = 0). A porcentagem de individuos totalmente edentulos foi de 54,7%. O edentulismo foi de 18,2% no arco superior e 1,9% no inferior. A meta da Organizacao Mundial da Saude foi alcancada por 10% dos individuos; no entanto, 2,7% tinham a funcao mastigatoria e estetica aceitaveis (com pelo menos o arco dental reduzido). Entre esses, o numero medio de pares de oclusao posterior foi 6,94 (DP = 2,97). A presenca de arco dental reduzido foi mais frequente entre homens, assim como o alcance da meta da Organizacao Mundial da Saude. Tambem se observaram diferencas quanto ao arco dental reduzido entre as macro-regioes. CONCLUSOES: O levantamento epidemiologico de saude bucal brasileira apresentou alto percentual de edentulismo e baixo de arco dental reduzido, sugerindo o comprometimento funcional e estetico consideravel em todas as regioes do Pais, especialmente entre mulheres.

Distribuição temporal e espacial da leishmaniose visceral em humanos e cães em Belo Horizonte-MG, 1993 a 2007

O objetivo desta pesquisa foi descrever as analises da serie cronologica e determinar a tendencia da leishmaniose visceral em humanos e caes para o municipio de Belo Horizonte, de 1993 a 2007. De 1994, quando surgiram os primeiros casos da doenca, ate 2007, foram registrados 994 casos humanos autoctones com 116 obitos. De 1993 a 2007, foram analisadas 1.492.401 amostras de sangue canino com percentual de positividade de 5,9%, utilizando-se os testes de enzyme-linked immunosorbent assay (ELISA) como triagem e de imunofluorescencia indireta (IFI) como confirmatorio. As analises indicaram que a leishmaniose visceral apresentou tendencia crescente dos coeficientes de incidencia em humanos e de prevalencia em caes, e observaram-se arquetipos distintos dessa tendencia, retratando o momento historico de transicao endemica. A leishmaniose visceral em caes nao apresentou caracteristicas de distribuicao sazonal, e nao foi possivel concluir a existencia ou nao de ciclicidade do fenomeno. A leishmaniose visceral em humanos e caes tem ampla distribuicao espacial nas nove regionais administrativas com risco diferenciado de acometimento da doenca, apesar da presenca das fontes de infeccao e dos susceptiveis em todo o municipio.

Presença de animais associada ao risco de transmissão da leishmaniose visceral em humanos em Belo Horizonte, Minas Gerais

This study evaluated the animal presence in dwellings and the risk for transmission of visceral leishmaniasis (VL) in Belo Horizonte, Brazil, 2006. A case-control study was conducted by means of dwelling visits, direct interviews, and image register in the houses. The risk estimates were produced comparing the dwelling condition between two groups: 1) 82 human cases of VL recorded in 2004; and 2) 164 controls (neighbors of the first). The cases presented a higher proportion in the animal presence compared to controls. Using an unconditional logistic regression, it was selected the presence of ducks with an OR of 4.18 (CI 95% - 0.74 to 23.32); rodents with an OR of 1.81 (CI 95% - 0.96 to 3.39); birds with an OR of 1.56 (CI 95% - 0.90 to 2.69), and chicken with an OR of 1.47 (CI 95% - 0.74 to 2.90). The owners of dogs were 2.17 more likely to have VL than those who did not have dogs, and this estimate increased with the number of dogs in the house. For those who had only one dog, the OR was 1.87, while for those who owned two dogs at home, the OR increased to 3.36; when compared to people who did not own those animals.

Prevalência de anticorpos contra o vírus da língua azul em bovinos e ovinos do sudoeste e sudeste do Rio Grande do Sul

It was studied bluetongue virus antibodies prevalence for sheep and cattle in Southwest and Southeast regions of Rio Grande do Sul State. A total of 2613 serum samples (1272 bovine and 1341 ovine) were tested by agar gel immunodiffusion. Eight bovine and two ovine samples were positive meaning a prevalence of 0.63% and 0.15%, respectively. These results show that most of animals in these regions are negative to bluetongue.

The severity of dental caries in adults aged 35 to 44 years residing in the metropolitan area of a large city in Brazil: a cross-sectional study.

BackgroundIn recent decades, studies in the field of public health have increasingly focused on social determinants that affect the health-illness process. The epidemiological perspective considers oral health to be a reflection of socioeconomic and environmental aspects, and it is particularly influenced by the social context. The aim of the present study was to assess the association between the severity of dental caries among adults aged 35 to 44 years and characteristics on the different levels at which the determinants of caries operate (individual, social structure and social context).MethodsA home-based, cross-sectional field study was carried out involving a sample of 1,150 adults (35 to 44 years of age) residing in metropolitan Belo Horizonte, Brazil. The DMFT (decayed, missing, filled tooth) index (≥14) was used to determine the severity of dental caries. Bivariate and multivariate analyses were carried out using the Poisson regression model with the level of significance set at 5% (p < 0.05) and 95% confidence intervals.ResultsThe majority of the participants (68.5%) had high caries severity. The rate of high-severity caries in the group between 40 and 44 years of age was 1.15-fold (CI: 1.04-1.26) greater than that among those aged 35 to 39 years. A greater prevalence of high caries severity was found among those who frequently visited the dentist (PR = 1.18; CI: 1.07-1.30), those with a lower income (PR = 1.11; CI: 1.01-1.23), those who reported that their neighborhood did not come together in the previous year to petition political leaders for benefits (PR = 1.16; CI: 1.05-1.28) and those who are unable to make decisions (without empowerment) (PR = 1.12; CI: 1.01-1.24).ConclusionsThe present study revealed high dental caries severity in adults, which was associated with individual characteristics, health-related behavior and social structure and contextual variables. These findings underscore the importance of considering social determinants involved in the health-illness process when carrying out epidemiological studies on dental caries.