Maria Inês Costa Dourado

Epidemiologia da leishmaniose tegumentar americana e suas relações com a lavoura e o garimpo, em localidade do Estado da Bahia (Brasil)

Realizou-se um estudo sobre a associacao entre infeccao leishmaniotica e a ocupacao dos individuos em Lencois-Bahia (Brasil). Foram utilizados um questionario com variaveis biologicas, sociais e economicas e o teste de Montenegro. Houve captura de flebotomineos em locais peri e intra-domiciliares. Encontrou-se maior prevalencia da infeccao no grupo ocupacional de lavradores/garimpeiros em comparacao as demais ocupacoes. Explica-se esse resultado em razao da dupla exposicao dos lavradores/garimpeiros a leishmaniose tegumentar americana, em sua area de moradia e local de trabalho.This study was carried out in the city of Lencois, State of Bahia, with the objective of verifying the association between leishmaniasis infection and occupation. A Montenegro test and a questionnaire including biological and socio-economic variables were applied to the study group. Sandflies were captured in and around dwellings. The higher-than-average prevalence of leishmaniasis observed among agricultural workers and prospectors is explained by the double exposure to the infection-both at home and at work.

Field evaluation of the whole blood immunochromatographic test for rapid bancroftian filariasis diagnosis in the northeast of Brazil.

This study evaluated the whole blood immunochromatographic card test (ICT card test) in a survey performed in Northeastern Brazil. 625 people were examined by the thick blood film (TBF) and ICT card test. Residents of a non-endemic area were also tested by the whole blood card test and Og4C3. The sensitivity of the ICT card test was 94.7% overall, but lower in females than males, based on the reasonable assumption that TBF is 100% specific. However, since TBF and other methods have unknown sensitivity, the true specificity of the card test is unknown. Nevertheless, it is possible to estimate upper and lower limits for the specificity, and relate it to the prevalence of the disease. In the endemic area, the possible range of the specificity was from 72.4% to 100%. 29.6% of the card tests performed in the non-endemic area exhibited faint lines that were interpreted as positives. Characteristics of the method including high sensitivity, promptness and simplicity justify its use for screening of filariasis. However, detailed information about the correct interpretation in case of extremely faint lines is essential. Further studies designed to consider problems arising from imperfect standards are necessary, as is a sounder diagnostic definition for the card test.

Disparities in mother-to-child transmission in Northeast Brazil: regional failures within successful country programs

Abstract Perinatal HIV prevention has been successful in developing countries but disparities in success between rich countries and poor countries have also been observed. Access to prevention of mother-to-child transmission (PMTCT) remains a challenge in many developing countries. In 2007, the Ministry of Health launched the Plan to Reduce the Vertical Transmission of HIV and Syphilis in Brazil to address this need. A cross-sectional study of children living in families affected by HIV was conducted in Ceará State, Northeast Brazil between June 2008 and January 2009 to explore socioeconomic effects of HIV status. Proportion of children with an HIV-positive test was calculated and stratified by age to estimate the impact of PMTCT programs. Chi-square test was employed to compare those proportions. Stata™10.0 software was used for the calculation. We interviewed 437 adults who were visiting the hospital for a consultation or to pickup medication who also had a child less than 13 years of age living with them. They also provided information about other household members (n=1789). Our study showed that children infected with HIV or who live in a household with one or both parents infected with HIV or dead from AIDS live in families of low social class and educational achievement. Seroprevalence is not lower in the cohort of those children 0–2 as compared to 3–4 and 5–12 years of age. Even in Brazil, with its successful PMTCT program overall, there are great disparities among sites. Data from the sites reported here are equivalent to many poor areas in sub-Saharan Africa. This argues that global concern for targeting areas most affected by the epidemic must consider areas within some of the most prosperous countries in the world.

Migrações internas e malária urbana - Bahia, Brasil

Estuda-se as caracteristicas socio-economicas dos individuos acometidos pela malaria, em 1983, na area urbana de Camacari - Bahia, Brasil, com destaque para os subgrupos migrantes e nao migrantes. As condicoes de vida precarias de ambos os subgrupos sao apontadas como os determinantes do surto de malaria desencadeado no local.

Underreporting of Congenital Syphilis as a Cause of Fetal and Infant Deaths in Northeastern Brazil.

Introduction Of all syphilis-related pregnancy outcomes, fetal death is certainly the most common one, being directly related to the availability, accessibility and quality of prenatal care. The present study aimed to analyze the underreporting of fetal and infant deaths and other maternal factors associated with congenital syphilis (CS) death. Methods This cross-sectional study integrated data of infants that were diagnosed and/or died of CS from the Sistema de Informação de Agravos de Notificação–Sinan (Notifiable Diseases Information System) and the Sistema de Informação de Mortalidade–SIM (Mortality Information System) in Fortaleza, Northeastern Brasil to identify unreported cases of congenital syphilis. We assessed data during the period from 2007 to 2013. Results The underreporting of CS as a cause of fetal or infant death increased from 41 to 415 cases (90.1%) during 2007–2013. Exactly 3,209 cases of CS were identified in Sinan and 6,578 deaths in SIM. After database linkage, we identified 382 cases that were reported in the SIM and SINAN databases consisting of 309 fetal deaths and 73 infant deaths related to CS. From the children notified at Sinan that born alive, 3.0% (78/2,542) died; Out of these, 39 (50.0%) were early and 25 (32.1%) were late neonatal deaths. The proportion of death by CS increased from 0.62 to 5.8 from 2007 to 2013. At logistic regression, the variable that maintained statistical significance with fetal and infant death outcomes was the presence of CS signs and/or symptoms at birth (OR = 3.20; IC 95% 1.54–6.62; p = 0.002). Conclusions Neonatal and Infant deaths following CS-associated live births are underreported in Northeastern Brazil. Data base linkage identified unreported fetal and neonatal deaths due to CS leading to an increased awareness of fetal/infant mortality due to this infection.

Leishmaniose tegumentar e trabalho agrícola na região cacaueira da Bahia

Estuda a relacao entre a infeccao leishmaniotica e ocupacao produtiva. Em um inquerito epdemiologico realizado com a populacao de 5 localidades da Regiao Cacaueira, utilizou, para identificacao dos infectados o teste alergico de Montenegro e um questionario para as variaveis biologicas e socio-economicas. Apresenta uma prevalencia de 11% de infeccao por Leishmania s.p. entre os 987 individuos estudados, com idade igual ou superior a 15 anos. Os resultados nao foram conclusivos para a associacao entre ocupacao e infeccao leishmaniotica, conquanto os dois subgrupos ocupacionais, lavradores e nao lavradores, nao apresentaram taxas diferenciadas de infeccao por Leishmania