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PubMed2005

[Congenital transmission of Trypanosoma cruzi in Brazil: estimation of prevalence based on preliminary data of national serological surveys in children under 5 years old and other sources].

A prevalence estimation of congenital transmission in Brazil is performed, based on several sources of recent data. From a serological survey conducted now in Brazil, with children below 5 years old, preliminary data from the state of Minas Gerais only 19/9,556 children did have antibodies against Trypanosoma cruzi. All 19 mothers were infected, but only one child persisted with antibodies on a second blood collection, hence diagnosed as congenital. The other were just passive transference of maternal antibodies. From a recent publication, 278 children born from 145 infected mothers were studied. Two cases (0.7%) were congenital. In other source, from 1,348 blood donors, 35 were born in non endemic areas. When 10 of them were called, 8 were born from infected mothers and five may be congenital. Finally, no infection was detected in 93 children born from 78 infected mothers. The reasons for this low prevalence are discussed, are lower than in other countries of the South Cone, that harbor also T. cruzi 2, but are unrecognized up to now.

Animals↗
PubMed2006

Brazil's fight against AIDS and its implications for global health governance.

The paper traces Brazil's efforts to fight AIDS in the last 20 years. The analysis concentrates on the efforts to combat and prevent the deadly infectious disease through ingenious efforts of private citizens, government agencies, national and international NGOs, which challenged multinational companies, international organizations and foreign governments. While the investigation led to a positive evaluation of the joint efforts in managing the threat, it is made clear that the fight against the HIV/AIDS virus is far from over in Brazil and will have to be strengthened on the local, national and international level.

Acquired Immunodeficiency Syndrome↗
PubMedDate not supplied

[Legal protection of the genetic heritage in Brazil (comments on the new "Biosafety Law" of March 24, 2005)].

The purpose of the current article is to outline and comment the most important aspects of the regulation of Brazil's criminal legislation about the protection of the human genome, which establishes crimes related to genetic manipulation and to the dissemination of transgenics in the environment. It also refers to the problems related to the application of the old legal text (Law 8.974/1995), which punished conducts that stayed without the enough development. These gaps complicated so much the application of those rules that the Brazilian Parliament has recently proposed the complete modification of the present legislation by a new Biosecurity Law (Law 11.105/2005). This law for the first time authorizes research with human embrionyc stem cells in Brazil, trying thus to solve in this way the problem of cryoconserved human embryos produced by in vitro fertilization programmes. The new law is analyzed here from a legal and ethical view point.

Brazil↗
PubMed2006

Population structure of the malaria vector Anopheles darlingi in a malaria-endemic region of eastern Amazonian Brazil.

Anopheles darlingi is the primary malaria vector in Latin America, and is especially important in Amazonian Brazil. Historically, control efforts have been focused on indoor house spraying using a variety of insecticides, but since the mid-1990s there has been a shift to patient treatment and focal insecticide fogging. Anopheles darlingi was believed to have been significantly reduced in a gold-mining community, Peixoto de Azevedo (in Mato Grosso State), in the early 1990s by insecticide use during a severe malaria epidemic. In contrast, although An. darlingi was eradicated from some districts of the city of Belem (the capital of Para State) in 1968 to reduce malaria, populations around the water protection area in the eastern district were treated only briefly. To investigate the population structure of An. darlingi including evidence for a population bottleneck in Peixoto, we analyzed eight microsatellite loci of 256 individuals from seven locations in Brazil: three in Amapa State, three in Para State, and one in Mato Grosso State. Allelic diversity and mean expected heterozygosity were high for all populations (mean number alleles/locus and H(E) were 13.5 and 0.834, respectively) and did not differ significantly between locations. Significant heterozygote deficits were associated with linkage disequilibrium, most likely due to either the Wahlund effect or selection. We found no evidence for a population bottleneck in Peixoto, possibly because the reduction was not extreme enough to be detected. Overall estimates of long-term N(e) varied from 92.4 individuals under the linkage disequilibrium model to infinity under the heterozygote excess model. Fixation indices and analysis of molecular variance demonstrated significant differentiation between locations north and south of the Amazon River, suggesting a degree of genetic isolation between them, attributed to isolation by distance.

Animals↗
PubMed2006

Delay in the diagnosis of leprosy in the Metropolitan Region of Vitória, Brazil.

This paper reports on the time between the onset of the first lesion and diagnosis, defined as delay, and is based on results obtained by interviewers from a survey carried out amongst 450 leprosy patients in a leprosy endemic area in the Metropolitan Region of Vitória (MRV), state of Espirito Santo, Brazil. The mean age at diagnosis in all cases was 41.47 years and the median was 42.5 years. The mean age at diagnosis in MB (42.9 years) was greater than in PB (38.5 years). The mean of the delay in all cases was 25.25 months, median 12 months and range 0-360 months. The mean of the delay in MB (27.2 months) was greater than in PB (21.3 months). The results of this study suggest that although the delay in leprosy diagnosis in this region of Brazil was not too long when it was compared with other studies in endemic countries, it is still a problem: 65.4% of patients were diagnosed after a delay of 6 months. The Leprosy Control Programme in this state needs more effective health education in order to reduce the current period of delay before diagnosis.

Adolescent↗
PubMed2006

[First autochthonous cases, caused by the Dengue-3 serotype in Federal District, Brazil].

During the first four months of 2003, the survey laboratory of the Federal District (LACEN Laboratory of Virology), Brasília, Brazil, isolated ten strains of dengue virus serotype 3, five of them autochthonous, and the remaining ones from cases imported from Tocantins, Goias and Bahia States. The virus isolations were performed in C6/36 cell culture inoculated with total blood collected between the 1st and the 5th days after the onset of the symptoms. The age of the patients varied from 26 to 59 years old. The strains were typed as DEN-3 by indirect immunofluorescence assay using serotype-specific monoclonal antibodies. Viral RNAs were extracted from total blood using the trizol method. The nested RT-PCR method detected DNA products of 290 bp, confirming the serotype identifications. The introduction of DEN-3 in Brazil and especially in the Federal District represents a serious threat, since most people are susceptible to this serotype and many have already been infected by serotypes DEN-1 or DEN-2, thus increasing the risk of epidemic of more severe forms of the disease. The use of a fast and reliable method for continuous monitoring of the circulation of this serotype is of primary importance for the prevention and control of future epidemics.

Adult↗
PubMed2006

Short report: Isolation of two vaccinia virus strains from a single bovine vaccinia outbreak in rural area from Brazil: Implications on the emergence of zoonotic orthopoxviruses.

Outbreaks of bovine vaccinia disease caused by circulation of Vaccinia virus (VACV) strains have been a common occurrence in Brazil in the recent years, being an important emergent zoonosis. During a single outbreak that took place in 2001, two genetically different VACV strains were isolated and named Guarani P1 virus (GP1V) and Guarani P2 virus (GP2V). Molecular diagnosis was done through restriction fragment length polymorphism (RFLP) of ati gene (A26L) and by sequence analysis of a group of five VACV genes including the C11R, J2R, A56R, B18R, and E3L genes. These findings confirmed the co-circulation of two different Vaccinia virus strains during the same outbreak, raising important questions about the origin, emergence, and circulation of VACV strains in Brazil.

Animals↗
PubMed2006

Helicobacter pylori infection in children of low and high socioeconomic status in northeastern Brazil.

This survey was designed to evaluate the prevalence of Helicobacter pylori infection in asymptomatic children from families of low and high socioeconomic status living in two neighboring communities in Teresina in northeastern Brazil. The study included 303 children, 163 (53.8%) males and 140 (46.2%) females, ranging in age from 6 months to 12 years. Helicobacter pylori status was determined by the H. pylori stool antigens test, in which sensitivity and specificity values for Brazilian children were 96.9% and 100%, respectively. The prevalence rates were 55.0% (93 of 169) and 16.4% (22 of 134) for children of low and high socioeconomic status, respectively (P < 0.001). Infection with H. pylori occurred early in life (before 2 years of age) in both groups (22.9% versus 14.3%; P = 0.061) and increased as the children became older. The rate of infection in children 11-12 years of age living in the poor area was as high as the levels found in Brazilian adults. An improved standard of living is followed by a sharp decrease in the prevalence rates in children, even in a developing country such as Brazil.

Brazil↗
PubMed2006

Effect of abiotic factors on seasonal population dynamics of Lutzomyia longipalpis (Diptera: Psychodidae) in northeastern Brazil.

The resurgence of visceral leishmaniasis in Brazil increases the need for studies to elucidate the spatial and temporal dynamics of Lutzomyia longipalpis (Lutz and Neiva) (Diptera: Psychodidae), the vector of Leishmania infantum, the causative agent of visceral leishmaniasis in Brazil. Sand flies were captured in peridomestic habitats biweekly for 3 yr. Cross-correlation tests and spectral analysis were used to analyze the simultaneous and lag-time correlations between Lu. longipalpis population densities and abiotic factors of temperature, relative humidity, wind velocity, and rainfall. Distinct seasonal patterns were observed for males and females, with intervals of 6 mo between population peaks for males and 12 mo for females. Peak female population densities lagged 3 mo behind the maximum annual temperature. Female population density was negatively correlated with relative humidity. An increase in average wind velocity was followed by a decrease in the number of females for 2 wk. Understanding the relationship between the seasonal population dynamics of Lu. longipalpis and abiotic factors will contribute to the design of better control measures to decrease transmission of L. infantum and consequently the incidence of leishmaniasis.

Animals↗
PubMedDate not supplied

Comparison between a commercial and an in-house ELISA or anti-M. avium paratuberculosis antibodies detection in dairy herds in Rio de Janeiro, Brazil.

Paratuberculosis (Johne's disease) is a chronic enteritis that affects ruminants and is caused by Mycobacterium avium subsp. paratuberculosis (Map). The disease is worldwide spread and causes important economic losses. In Brazil, Map has already been isolated, but there are no enough epidemiological studies about its prevalence. In this study, 179 sera of dairy cows originated from Rio de Janeiro State, Brazil, were tested for the presence of anti-Map antibodies using two ELISAs. First one was an "in house" ELISA using a protoplasmic paratuberculosis antigen (PPA - Allied Monitor) as capture antigen and a monoclonal anti-bovine IgG conjugated to alkaline phosphatase (Sigma) and the other was "HerdChek Mpt" (IDEXX), used as standard method in this study. Fifty-nine (32.9%) samples were reactive in the PPA-ELISA. Sensitivity of ELISA-PPA in relation to HerdCheck was 47.5% and specificity was 86.8%, with 54/103 of false negatives and 10/76 of false positives. Positive predictive value of PPA-ELISA was calculated as 86% and efficiency as 64.2%. PPA-ELISA and HerdChek results were also compared by kappa test (k) and concordance index was 0.320. PPA-ELISA can be useful as a collective herd test and can be recommended as a screening test for identification of infected herds and foci of Johne's disease.

Animals↗
PubMed2006

Short report: Evidence and potential for transmission of human and swine Taenia solium cysticercosis in the Piracuruca region, Piauí, Brazil.

The study conducted in the Cocal dos Alves municipality, located in the Piracuruca region of Piauí State, Brazil in November of 2003 was based on both a socio-behavioral survey and analysis of serum antibodies and parasitic materials. Pig raising is the main economic activity with 91.4% using extensive farming. On the studied population, 54.3% of people did not apply any sanitary measures to wastewater, 45.7% used septic tanks, and 69.1% consumed water without treatment. The data collected indicated the occurrence and active transmission of the taeniasis-cysticercosis complex in the region. One of seven voluntary persons was positive in antibody-ELISA tests using both native and recombinant antigens. Multiplex PCR and DNA sequencing of cyst samples obtained from a pig revealed the presence of the Afro-American genotype of Taenia solium. This study revealed the occurrence of human and porcine cysticercosis in the Piracuruca region of Piauí State, middle-north of Brazil.

Animals↗
PubMed2006

Health systems research training as a tool for more effective Hansen's disease control programmes in Brazil.

In Brazil, Hansen's disease (HD) is still a public health problem. Although much progress has been made in Hansen's disease control (HDC) at all levels of government over the past 20 years, efforts have been hampered by information gaps related to specific areas of the disease, exacerbated by an absence of appropriate evaluation instruments and routine systematic analysis. Health Systems Research (HSR) aims to collect the necessary data to provide the most relevant information to policy makers and health managers to take more informed decisions. In Brazil, four HSR courses on HDC were organized by two non-governmental organizations (NGOs), Netherlands Leprosy Relief (NLR) and the British Leprosy Relief Association (LEPRA) between 2001 and 2005. Key personnel working in HDC from various states were invited to participate in the courses. The research proposals were developed during an HSR workshop and carried out in the field. The research topics of the projects included the following: the integration of HDC programmes into the primary health care system; the high percentage of the new patients diagnosed and treated at state referral centres; the psychological and social impact of surgical rehabilitation; the efficacy of neurolysis; the quality of the national health information system and the effectiveness of new case detection and health education campaigns. Following the completion of the field work, the data were analysed and a research report written. The results and recommendations were later presented to key stakeholders and policy makers in the states. Practical outcomes of the HSR courses include the drafting of new HDC guidelines; improvement of health information system databases and the revision of epidemiological data. These results have been presented at national and international congresses and published in peer-reviewed jornals. HSR has had a positive impact on the working routines of trainees through the process of learning the research methodology, collecting relevant data and implementing the recommendatons that originate from the findings. We conclude that HSR is an important vehicle for human resource development and a practical tool to improve the effectiveness of HDC programmes, primarily at the state and municipal levels. HSR also is an example of a successful cooperation between NGOs and governmental organizations working in HDC.

Brazil↗
PubMed2007

The cost-effectiveness of DOTS in urban Brazil.

SETTING: Rio de Janeiro, Brazil, is a middle-income setting with an estimated 1% adult human immunodeficiency virus (HIV) seroprevalence. OBJECTIVE: To examine the cost-effectiveness of DOTS in Rio de Janeiro. DESIGN: Cost-effectiveness analysis based on cost data and an epidemiological model based on programmatic outcomes from the Health Department in Rio de Janeiro, cost data from the retail market sector and epidemiological data from published studies. RESULTS: The 10-year cost of a tuberculosis program treating a population of 262 000 based on self-administered therapy (SAT) was estimated to be $580 271 compared to $1047 886 for DOTS. The largest portion of the DOTS budget was for staff costs and costs incurred by patients, both at 28%. For SAT, the largest percentage of the budget was allocated to medication costs, at 34%. Upgrading from SAT to DOTS averted 1558 cases of tuberculosis (TB, uncertainty range [UR] 1418-1704) and 143 TB deaths (UR 131-155). The incremental cost effectiveness ratio (ICER) for DOTS was $300 per case averted (UR $289-$312) and $3270 per death averted (UR $3123-$3435). In terms of disability adjusted life years (DALYs), DOTS saved 5426 DALYs (UR 4908-5961). The ICER for DOTS was $86 per DALY saved (UR $74-$100). CONCLUSIONS: DOTS is a highly cost-effective intervention in Brazil.

Antitubercular Agents↗
PubMed2007

Suicide trends and characteristics among persons in the Guaraní Kaiowá and Nandeva communities--Mato Grosso do Sul, Brazil, 2000-2005.

Suicide rates among indigenous communities around the world vary substantially; in many nations these groups have the highest suicide risk of any identifiable cultural or ethnic group. Mato Grosso do Sul is a state in the southwest corner of Brazil that borders Bolivia and Paraguay. In 2004, the Guaraní, an indigenous ethnic group in the region, accounted for 2.6% of Mato Grosso do Sul's population (approximately 2,230,702). During 1975-2000, the infant mortality rate decreased, and overall life expectancy increased in Mato Grosso do Sul; however, suicide increased as a proportion of overall mortality among the Kaiowá and Nandeva communities of the Guaraní population. In 2000, the National Health Foundation (FUNASA) of the Brazilian Ministry of Health (BMH) initiated a study of suicide trends and characteristics in these two Guaraní communities; data were collected during 2000-2005, and epidemiologic assistance was provided by CDC. This report summarizes the results of that study, which suggested that the suicide rate among Guaraní was 19 times higher than the national rate in Brazil and 10 times higher than the rate in Mato Grosso do Sul and that suicides disproportionately affected Guaraní adolescents and young adults. To decrease suicide rates, BMH initiated research and prevention programs among the Guaraní, and the Guaraní initiated measures to increase their economic self-sufficiency.

Adult↗
PubMed1991

Comparative epidemiology of oral cancer in Brazil and India.

A comparison of the risk factors and occurrence of oral cancer in Brazil and India is presented. These two countries have among the highest incidence rates for such cancer in the world. A distinct pattern of risk factors was observed for each country: in India, tobacco chewing was the predominant risk factor: in Brazil, the major risk factor was the combination of tobacco smoking and alcohol consumption. Observations by descriptive epidemiology reveal high age-standardized incidence rates of oral cancer along with some distinctive differences associated with age distribution, sex ratios, and trends in each country. The desirability of additional oral cancer prevention research is also emphasized.

Adult↗
PubMedDate not supplied

Isolation and identification of chicken infectious anemia virus in Brazil.

Seven chicken infectious anemia virus (CIAV) isolates were obtained from seven broiler flocks with poor performance in two states of Brazil. All isolates induced thymus atrophy, bone-marrow aplasia, and low hematocrit values when inoculated into 1-day-old susceptible chicks. The CIAV isolates were resistant to treatment with chloroform and were able to pass through 50-nm-pore-size filters. CIAV-specific antigens could be demonstrated in tissues of experimentally infected chicks using a monoclonal antibody specific for CIAV. These characteristics of the virus and the virus-induced lesions demonstrate that CIAV is present in Brazil and that the virus is associated with production problems.

Anemia↗
PubMed1991

Hypertension in Brazil: a review of the epidemiological evidence.

Population-based studies of hypertension in Brazil were reviewed. Nineteen studies were identified, all employing cross-sectional study designs. The majority of these studies were conducted in the south and southeast regions of the country, although increasing mortality from cardiovascular diseases is now a nationwide problem in Brazil. Except for Amazonian Indians, age and blood pressure were positively correlated in the studies reviewed. Men generally had higher blood pressures than women up to age 50; studies consistently reported that blacks, or groups combining blacks and mulattoes, had higher blood pressures than whites. Methodological problems that characterize many of these studies were noted, and some suggestions for future research were offered.

Adolescent↗