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PubMed2001

Impact of canine control on the epidemiology of canine and human visceral leishmaniasis in Brazil.

Brazil is the only country endemic for zoonotic visceral leishmaniasis (ZVL) that regularly conducts epidemiologic and prophylactic control programs that involve the treatment of human cases, insect vector control, and the removal of seropositive infected dogs. This report reviews 60 studies reporting data on the efficacy of these recommended control tools and concludes that in Brazil 1) eradication of the disease in Minas Gerais was achieved by the concomitant use of the three control methods, 2) although seropositivity by an immunofluorescent assay is not completely related to infectiousness, the removal of seropositive dogs leads to a significant reduction of canine and human incidence, 3) improvement of the sensitivity of the diagnostic tool used for canine control should optimize the efficacy of control, and 4) although difficult and expensive, the public health dog control campaigns performed in Brazil reduced the incidence of ZVL and should be maintained since treatment of dogs is an unrealistic intervention, both because of its prohibitive cost and relatively poor effectiveness.

Animals↗
PubMedDate not supplied

[Acquired immunodeficiency syndrome in Brazil and the State of Ceará].

Since February 1998, a total of 129,000 cases of acquired immune deficiency syndrome have been reported in Brazil. The cumulative frequency of the disease is 82 per 100,000 which makes Brazil one of the countries moderately affected. There are considerable differences between regions in the frequency of cases, from 25 per 100,000 in the north and north east to 152 per 100,000 in the south east. Sexual intercourse is still the predominant means of transmission. Transmission in the early years of the epidemic was mostly between homosexuals and bisexuals, but transmission via heterosexual intercourse is increasing. The contribution made by intravenous drug use differs between the regions, and is particularly large in the mid-south region. A pilot project in the city of Fortaleza has shown that it is possible to successfully integrate the diagnosis of STD and AIDS in health care units at an intermediate level. This appears to be an appropriate strategy for the integration of STD treatment into primary health care in Ceará State. The non-uniform pattern of development of this epidemic must be taken into account in epidemiological analyses of AIDS in Brazil.

Acquired Immunodeficiency Syndrome↗
PubMed2000

Antimicrobial resistance in Brazil: comparison of results from two multicenter studies.

To evaluate whether our previous study of the antimicrobial resistance patterns in three centers in Brazil represented the pattern in the country as a whole, the results were compared to new data on 855 isolates from 20 clinical laboratories and 36 hospitals located in different regions of Brazil. Both multicenter studies showed high rates of antimicrobial resistance among Gram-negative bacilli isolated in Brazilian hospitals with the most important problems being: 1) E.coli and K.pneumoniae that produce ESBL; 2) Enterobacter spp. which likely express chromosomally mediated (AmpC) stably derepressed cephalosporinases producing resistance to third-generation cephalosporins and broad spectrum penicillins; 3) carbapenem resistance among Acinetobacter spp. and P.aeruginosa; and 4) fluoroquinolone and aminoglycoside resistance among many Gram-negative species. Our results emphasize the importance of regional antimicrobial resistance surveillance programs in guiding empirical therapy and for focusing intervention controls of antimicrobial resistance. Although the SENTRY Program has only three participating centers in Brazil, its results were validated by a larger Brazilian multicenter study.

Brazil↗
PubMedDate not supplied

Cholera in north Brazil: on the occurrence of strains of Vibrio cholerae O1 which fail to ferment sucrose during routine plating on thiosulphate-citrate-bile salt-sucrose agar (TCBS). A new problem in diagnosis and control?

The occurrence is recorded from a biochemical strain variant of Vibrio cholerae O1 originating from the municipality of Oiapoque, Amapá State, north Brazil and responsible for an epidemic outbreak of cholera in that region in August, 1994. The principal characteristic of the strain is its incapacity of break down sucrose on T.C.B.S. agar plates, and its delayed utilization of that sugar only after 48 hs. when cultivated in liquid medium. The strain spread rapidly in north Brazil, becoming responsible for most of the cases of cholera reported in Amazonian Brazil. The importance of this observation in laboratory diagnosis and the control of cholera is discussed.

Agar↗
PubMed2000

HIV seroprevalence among blood donors in southern Brazil in the decade of 1990.

The objective of this study was to establish the time trend in HIV seroprevalence among blood donors to a large blood bank in southern Brazil during the decade of 1990, and compare it to other data sources from the same region. To this end, a retrospective study of blood donor records in HEMOSC (Center of Hematology and Hemotherapy of Santa Catarina), federal state of Santa Catarina, Brazil, was conducted for the period 1991 through 1999. Annual seroprevalence of HIV among blood donors and its time trend for the entire period were calculated. The HIV seropositive fraction doubled every 3 years, reaching 4 new cases per 1,000 donors per year by the end of the decade, or roughly twice the national average. The increase occurred particularly among female blood donors, those over 46 years of age, and those residing in the Florianópolis metropolitan area. We conclude that, in the decade of 1990, the frequency of HIV in southern Brazil increased in the population seeking to donate blood. Possible reasons for this increase include an increased use of blood donation as a means to obtain HIV testing or increased transmission among low risk populations. The effect of increased transfusion risk of HIV transmission requires urgent attention.

Adolescent↗
PubMed2001

From 'culture of dehumanization of childbirth' to 'childbirth as a transformative experience': changes in five municipalities in north-east Brazil.

Brazil has become a country known as having one of the most extreme examples of the consequences of the hospital-based medicalization of delivery care, while a model of humanization of birth was developed in the State of Ceará in the 1970s. The Government of Japan, through the Japanese International Cooperation Agency (JICA), collaborated with the Federal Ministry of Health of Brazil and the Government of the State of Ceará, in implementing the Maternal and Child Health Improvement Project in north-east Brazil (1996-2001). This project focused on 'humanization of childbirth', with training based intervention activities. Behavioral changes among health professionals who received the project's participatory type of training were described using rapid anthropological assessment procedure (RAP) survey results. Changes from 'a culture of dehumanization of childbirth' to 'childbirth as a transformative experience' were observed.

Brazil↗
PubMed2002

The early history of neurosurgery in Brazil.

This article describes the professional lives of the founders of neurological surgery in Brazil as well as the Brazilian Society of Neurosurgery. The pioneers were Augusto Brandão Filho, the first general surgeon to perform brain surgery in Brazil, and José Ribe Portugal and Elyseu Paglioli, the founders of the first two neurosurgery schools in Brazil. The Brazilian Society of Neurosurgery was founded in Brussels, Belgium, on July 26, 1957, during the First International Congress of Neurological Surgery, at the initiative of José Ribe Portugal and José Geraldo Albernaz.

Brazil↗
PubMed2002

Aphids (Hemiptera: Aphidoidea) of ornamental plants from São Carlos, São Paulo state, Brazil.

A total of 25 aphid species were collected from 49 ornamental plant species in São Carlos-São Paulo, Brazil; 12 aphids were monophagous, four oligophagous and nine polyphagous. A total of 58 aphid-plant associations are recorded, 43 unknown from Brazil. Eucarazzia elegans (Ferrari, 1872) (Aphididae: Aphidinae: Macrosiphini) is recorded for the first time from Brazil, and Nectandra megapotamica Spreng. (Lauraceae) is recorded for the first time as host plant for Lizerius tuberculatus (E.E. Blanchard, 1939) (Drepanosiphidae: Drepanosiphinae: Lizeriini). We also describe the injuries caused by aphids to the ornamental plants.

Animals↗
PubMedDate not supplied

[The social and economic integration of Portuguese immigrants in Brazil at the end of the nineteenth century and in the twentieth century].

"This survey of Portuguese migration to Brazil analyses the Portuguese and Brazilian statistics to determine the volume, timing and quality of Portuguese immigrants to Brazil as well as the importance of Brazil in the overall Portuguese emigration. The patterns of geographic and economic mobility for the Brazilian resident Portuguese is examined, especially for the period since 1900." The analysis suggests that "though their rapid integration into the Brazilian economy may explain their very low rates of return migration--the lowest of the major European immigrants--they were also the most endogamous of the European migrants, having relatively low rates of intermarriage with native Brazilians and other immigrants." (SUMMARY IN ENG)

Acculturation↗
PubMed2002

The incidence of venous disease in Brazil based on the CEAP classification.

BACKGROUND: Venous disease presents an extremely complex problem with various clinical manifestations. This is an epidemiological study of venous disease as it occurs in an area of Brazil. For the first time in Brazil the CEAP classification is used. METHODS: A total of 2104 people, were randomly recruited at the registration desks of the General Policlinic Department of the University Hospital and public health centers. The "C" of the CEAP classification was used to classify the clinical features of the venous diseases. The subjects were categorized according to sex and age. In addition, women were also subdivided according to number of their pregnancies. RESULTS: In the age group of females aged 14 to 22, we found 46.42% without symptoms and obvious veins (CEAP 0A/0A). Only 12.29% were symptomatic, and 41.25% of all patients in this group presented with visible veins or telangiectasias, though without symptoms. In the age group of women ranging from 23 to 48, 66.47% had had up to 3 pregnancies. In this group 10.43% were (CEAP 0A/0A). Those who had symptoms with prominent veins totaled 37.53% and those who presented with prominent veins without symptoms, 51.83%. In the female group over 48 years of age, only 4.67% were (CEAP 0A/0A). The majority (62.79%) had symptoms and prominent veins. In the male group, the greater part (65.54%) was (CEAP 0A/0A). Only 13.97% were considered symptomatic with some kind of prominent veins. CONCLUSIONS: This large epidemiological study is the first in Brazil to validate the CEAP classification as an important tool in the epidemiology of venous pathology: a method allowing an objective approach to venous disease. The data in this study were similar to those of western countries. Venous disease was found to be much more frequent in females than males. Age and number of pregnancies are important factors in the development of the disease. Over 50% of young women presented with visible veins in their legs but were without symptoms and this was considered a purely esthetic problem.

Adolescent↗
PubMed2003

[Leprosy in Brazil].

Leprosy or Hansen's disease is a chronic infectious disease caused by the Mycobacterium leprae. The skin and nervous manifestations of the disease present a singular clinical picture that is easily recognized. After India, Brazil still is the second country with the greatest number of cases in the world. Around 94% of the known cases and 94% of the new cases reported in America, come from Brazil. The disease presents itself in two well-defined stable and opposite poles (lepromatous and tuberculoid) and two unstable groups (indeterminate and dimorphic). The spectrum of presentation of the disease may also be classified as: tuberculoid tuberculoid (TT), borderline tuberculoid (BT), borderline borderline (BB), borderline lepromatous (BL) and lepromatous lepromatous (LL). The finding of acid fast bacillus in tissue is the most useful method of diagnosis. The effective treatment of leprosy includes the use of specific therapy, suppression of lepra reactions, prevention of physical incapacity, and physical and psychosocial rehabilitation. Chemotherapy with rifampin, dapsone and clofazimine have produced very good results and the control of the disease in Brazil in the foreseeable future is likely.

Brazil↗
PubMed2002

Rural workers' health and productivity: an economic assessment of pesticide use in Minas Gerais, Brazil.

This paper evaluates the economic impact of pesticide intoxication on the health of rural workers in the State of Minas Gerais, Brazil. To estimate the economic impact we considered the purchase cost of pesticides and the treatment costs of rural workers' affected by intoxication. These impacts were compared to the benefits of pesticide use, as estimated by the crop losses avoided through pesticide application. Data were obtained from the Fundacentro/Ministry of Work agency for the years 1991-2000, in nine municipalities of Minas Gerais, Brazil; and included epidemiological surveillance records and blood screening results. Rural workers' probabilities of intoxication were estimated as a function of their expositure characteristics by means of a logistic regression model. The changes in marginal probabilities associated with changes in expositure characteristics were also estimated. When health intoxication costs are included in the farmer's decision process, the financial benefit of pesticide use with certain crops is reduced. For zucchini, beans and corn, respectively, treatment costs represent about 42%, 25% and 25% of the pesticide use benefit. This study points to the need for an extensive investigation into the real benefits of pesticide use and its consequences for the environment and health in Brazil.

Adolescent↗
PubMed2002

Varroa-tolerant Italian honey bees introduced from Brazil were not more efficient in defending themselves against the mite Varroa destructor than Carniolan bees in Germany.

In Europe and North America honey bees cannot be kept without chemical treatments against Varroa destructor. Nevertheless, in Brazil an isolated population of Italian honey bees has been kept on an island since 1984 without treatment against this mite. The infestation rates in these colonies have decreased over the years. We looked for possible varroa-tolerance factors in six Italian honey bee colonies prepared with queens from this Brazilian island population, compared to six Carniolan colonies, both tested at the same site in Germany. One such factor was the percentage of damaged mites in the colony debris, which has been reported as an indicator of colony tolerance to varroa. A mean of 35.8% of the varroa mites collected from the bottoms of the Italian bee colonies were found damaged, among which 19.1% were still alive. A significantly greater proportion of damaged mites were found in the Carniolan bees (42.3%) and 22.5% were collected alive. The most frequent kind of damage found was damaged legs alone, affecting 47.4% of the mites collected from debris in Italian bees, which was similar to the amount found in Carniolan colonies (46%). The mean infestation rate by the varroa mite in the worker brood cells in the Italian bee colonies was 3.9% in June and 3.5% in July, and in drone brood cells it was 19.3% in June. In the Carniolan honey bee colonies the mean infestation rates in worker brood cells were 3.0 and 6.7%, respectively in the months of June and July and 19.7% in drone brood cells in June. In conclusion, the 'Varroa-tolerant' Italian honey bees introduced from Brazil produced lower percentages of damaged mites (Varroa destructor) in hive debris and had similar brood infestation rates when compared to 'susceptible' Carniolan bees in Germany. In spite of the apparent adaptation of this population of Italian bees in Brazil, we found no indication of superiority of these bees when we examined the proportions of damaged mites and the varroa-infestation rates, compared to Carniloan bees kept in the same apiary in Germany.

Animals↗
PubMed2004

Water environments: anthropogenic pressures and ecosystem changes in the Atlantic drainage basins of Brazil.

Densely occupied drainage basins and coastal zones in developing countries that are facing economic growth are likely to suffer from moderate to severe environmental impacts regarding different issues. The catchment basins draining towards the Atlantic coast from northeastern to southern Brazil include a wide range of climatic zones and diverse ecosystems. Within its borders lies the Atlantic rain forest, significant extensions of semiarid thorn forests (caatinga), vast tree and scrub woodlands (cerrado) and most of the 6670 km of the Brazilian coast and its marine ecosystems. In recent decades, human activities have increasingly advanced over these natural resources. Littoralization has imposed a burden on coastal habitats and communities. Most of the native vegetation of the cerrado and caatinga was removed and only 7% of the original Atlantic rainforest still exists. Estuaries, bays and coastal lagoons have been irreversibly damaged. Land uses, damming and water diversion have become the major driving forces for habitat loss and aquatic ecosystem modification. Regardless of the contrast between the drought-affected northeastern Brazil and the much more prosperous and industrialized southeastern/southern Brazil, the impacts on habitat and communities were found equally severe in both cases. Attempts to halt environmental degradation have not been effective. Instead of focusing on natural resources separately, it is suggested that more integrated environmental policies that focus on aquatic ecosystems integrity are introduced.

Brazil↗
PubMed2004

Incidence of proximal femur fractures in Marilia, Brazil.

BACKGROUND SETTING: Three general hospitals in the town of Marília that have an orthopaedic and traumatologic unit. Marília is a Municipality with 161.000 inhabitants in the middle-east of São Paulo State, Brazil. PATIENTS/PARTICIPANTS: All inpatients, living in Marília-SP, aged 20 years or more, with a diagnosis of proximal femur fracture (WHO, International Classification of Diseases, 9th.ed., code 820), in the period of January 01, 1994 and December 31, 1995. MAIN OUTCOME MEASURES: The incidence rates of the proximal femur fractures in Marília-SP. Secondary Measurements: mean-age of the occurrence (male and female), in-hospital mortality, hospitalar costs to S.U.S. (Government Health System), the average length of hospital stay, seasonality, mean-interval between admission and surgical procedure, type of fracture: transcervical and pertrochanteric, content validity of S.I.H.-S.U.S data base report on proximal femur fractures, when compared with hospital registrations. OBJECTIVE: To determine the incidence (crude, age-specific and age-adjusted) of fractures of the proximal femur in Marília-SP, Brazil, in 1994 and 1995. DESIGN: Retrospective cohort study. RESULTS: The crude incidence rate was 4.96/10,000 inhabitants/year in 1994 and 5.51/10,000 inhabitants/year in 1995; the age-specific incidence rate increased from 0.25/10,000 inhabitants 20-49 years/year to 100.27/10,000 inhabitants 70 years or more/year in 1995 among women; the age-adjusted incidence rate was 29.48/10,000 inhabitants 60 years or more/year in 1994, and 35.83/10,000 inhabitants 60 years or more/year in 1995. CONCLUSION: The crude incidence rate of the proximal femur fractures in Marília-SP, Brazil was 4.96 / 10,000 inhabitants in 1994 and 5.51/10,000 inhabitants in 1995. It was significantly greater among women (7.2/10,000 inhabitants in 1994 and 8.6/10,000 inhabitants in 1995) and among the elderly, 70 year-old or more (female: 90.21/10,000 inhabitants in 1994 and 100.27/10,000 inhabitants in 1995; male: 25.46/10,000 inhabitants in 1994 and 45.66/10,000 inhabitants in 1995).

Adult↗
PubMed2004

Cost-effective solutions for sewage treatment in developing countries--the case of Brazil.

Cost-effective solutions are a must in developing countries, not only regarding investment costs, but also in respect to technology and operating practices. With these two goals in mind, in Brazil a particular effort has been directed for the development and application of the Chemical Enhanced Primary Treatment (CEPT) process and of the Upflow Anaerobic Sludge Blanket (UASB) process, both followed by complementary secondary treatment. Both technologies are under current expansion in Brazil. Large CEPT plants have been designed and built, up to 3.7 m3/s average design flow, as well as large UASB reactors, up to 3.0 m3/s average design flow. The applied technologies are cost-effective: they present low investment and efficiencies of BOD removal of up to 50% to 70%. They allow the plant construction in steps, an initial phase with efficiency over the usual primary treatment, and in order to achieve best effluent quality and meet legal water quality standards, a logic upgrade post-treatment can later on be implemented. The higher initial reduction of BOD and TSS also permits savings in construction and operational costs of secondary treatment, due to lower organic load and lower energy consumption. Sludge represents a particular point of attention: in the cases when the CEPT was used, Chemical Stabilisation of the Sludge (CSS) has also been practiced, eliminating the high construction costs of the digesters, all the plant staying chemically operated. In the cases when the UASB is used preceding secondary treatment, sludge can easily return to the anaerobic vessel, the costly sludge digestion unit being avoided. UASB reactors have practically no equipment in the anaerobic vessel, no energy consumption, low sludge production, and when applied in hot climates as in Brazil, heating devices are not required. The Brazilian experience, some particular cases, special comments on design and different secondary treatment processes are presented in this paper, as a contribution to the discussion of cost and benefits, a prime point to be considered.

Bacteria, Anaerobic↗
PubMed2004

Genetic structure of natural populations of Aedes aegypti at the micro- and macrogeographic levels in Brazil.

Genetic variation in 13 populations of Aedes aegypti from 3 regions of Brazil was compared using variation at 10 isozyme loci. Heterozygosities varied from 0.050 +/- 0.027 to 0.280 +/- 0.120, and a large genetic differentiation (F(ST) = 0.144) was observed among all populations. The largest within-regions differences were found between populations from the urban areas of northeast Brazil (F(ST) = 0.152). Ecological conditions are likely having an impact on the population structure of Ae. aegypti in the different regions of Brazil.

Aedes↗
PubMed2005

Breastfeeding and pacifier use in Brazil.

OBJECTIVE: To determine the relationship between pacifier use and the duration of exclusive breast-feeding in the first six months of age, among poor children with unfavourable birth weight, from an underdeveloped region in Brazil. METHOD: Prospective cohort study with infants followed from birth to 6 months of age. Healthy children born with unfavourable birth weight (< 3,000), being exclusively breastfed, were selected from 8 maternity hospitals in the city of Fortaleza (Brazil) between November 1996 and April 1997. Two main outcome measures were used: (i) time to stop exclusive breast-feeding at the 1st and (ii) at the 6th month of life. Main exposures were pacifier use at 1st and 6th month of age. Data were collected at maternity hospitals and during home interviews, using structured questionnaires, by trained data collectors unaware of the study aims, and analyzed using survival analysis and the Cox Proportional Hazard Model. RESULTS: 500 children were enrolled and 13% were lost to follow up at the 1st month. Most of the families had a monthly income less than five times the minimum wage. One third of the mothers were adolescents, one fifth were working outside the home by the 6th month and most attended prenatal care visits. Approximately 60% of the children were using pacifiers by the 1st month. The average number of days for exclusive breast-feeding for pacifier use by the 6th month was 125.3 compared to 87.0 among non-users (p=0.0001). Children using pacifiers were 1,9 more likely to have stopped exclusive breastfeeding by the 6th month compared to non-users, even after controlling potential confounders. CONCLUSION: Pacifier use was associated with the early termination of breast-feeding in Brazil, among poor children with unfavourable birth weight, living in an underdeveloped area. As a possible marker of early weaning, pacifier use can help health workers identify those mothers in need of extended counselling to reinforce breast-feeding practices.

Birth Weight↗