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HIV infection is presented in the chapters of the Clinical Protocol and Therapeutic Guidelines for Comprehensive Care for People with Sexually Transmitted Infections, published by the Brazilian Ministry of Health in 2020. Health professionals and managers must learn the signs and symptoms of HIV infection and know how to diagnose it to provide appropriate treatment and reduce complications. HIV infection has become a chronic disease. Its treatment includes addressing common comorbidities such as arterial hypertension, diabetes, and dyslipidemia, in addition to cardiac risk assessment, cancer prevention, and guidance on immunization. Initiation of treatment for HIV patients is recommended regardless of clinical or immunological criteria as adopted by the Ministry of Health since 2013. Lately, it has been simplified with more tolerable first-line medications and fewer drug interactions, making its management easy to implement, including by primary health care. HIV cases are concentrated in specific population groups, such as sex workers, men who have sex with men, transexuals, people who use alcohol or other drugs, and vulnerable people, such as black, incarcerated, or people living on the streets.

Introduction: Chagas disease is a major public health problem that is endemic in Brazil and Latin America. This study aimed to determine the socioeconomic, demographic, and clinical characteristics of 171 patients (mean age, 45 years; female, 65%) with Chagas disease at Hospital Universitário de Brasília, Federal District, Brazil., Methods: We implemented this cross-sectional study using a clinical epidemiological questionnaire, electrocardiography, echocardiography, and quantitative detection of Trypanosoma cruzi DNA in blood using qRT-PCR., Results: Among the patients, 26.3% had a full elementary education, and 13.2% were illiterate. Most (63.6%) were economically classified as class C, and 51.5% were born in Bahia state. A total of 62.0% participants reported previous contact with the triatomine bug. The clinical forms of the disease were indeterminate (69.51%), cardiac (15.24%), digestive (10.37%), and mixed (4.88%). The most common electrocardiographic abnormality was complete right bundle branch block in association with a divisional anterosuperior block. Only 14.6% of the patients complied with benznidazole medication for at least 60 days, and 164 of them were assessed by echocardiography. The parasite load was positive in 56% of the patients., Conclusions: Chagas disease affected mostly women, with the indeterminate chronic form of the disease.

The benign characteristics formerly attributed to Plasmodium vivax infections have recently changed owing to the increasing number of reports of severe vivax malaria resulting in a broad spectrum of clinical complications, probably including undernutrition. Causal inference is a complex process, and arriving at a tentative inference of the causal or non-causal nature of an association is a subjective process limited by the existing evidence. Applying classical epidemiology principles, such as the Bradford Hill criteria, may help foster an understanding of causality and lead to appropriate interventions being proposed that may improve quality of life and decrease morbidity in neglected populations. Here, we examined these criteria in the context of the available data suggesting that vivax malaria may substantially contribute to childhood malnutrition. We found the data supported a role for P. vivax in the etiology of undernutrition in endemic areas. Thus, the application of modern causal inference tools, in future studies, may be useful in determining causation.

The medical care of occupational accidents in Tropical Medicine Foundation Dr. Heitor Dourado (FMT-HVD), involving blood and body fluids, started routinely in 1999. The objective of this report is to emphasize the importance of the measures used for the control of accidents with biological material. This study is carried out after a detailed epidemiological investigation confirmed one case of human immunodeficiency virus (HIV) seroconversion after an occupational accident involving bodily fluids and sharp instruments.

The presence of Cryptococcus gattii was investigated in different regions of the State of Espírito Santo. The largest number (73) of samples was collected from trees located in public places in Vitória; 47 came from preserved areas or areas with only minor human impact, surrounding this city, at altitudes from 0 to 900m above sea level; 48 came from trees native of the northern and southern regions of the state. The samples were collected from tree hollows and trunks by of swabs and yielded two isolates (1.2%) of Cryptococcus neoformans, two (1.2%) of Cryptococcus gattii and one (0.6%) of Cryptococcus laurentii. The species Cryptococcus gattii was found only in native trees from the northern region, in areas that still have remains of the Atlantic Forest, while none of the samples from any of the 22 tree species located in urban areas was able to show the presence of Cryptococcus gattii. These results show a possible relationship between the presence of Atlantic Forest and occurrences of Cryptococcus gattii. They confirm that the environment is a source of infection with this fungus.

The early diagnosis of leprosy, its correct classification and the risk factors related to seropositivity have become important for patient treatment and disease control, especially where the responsibility for treatment has been transferred to basic health care centers. This descriptive, exploratory study using logistic regression was undertaken to evaluate the association between the variables of sex, age, mode of detection, number of skin lesions and affected nerves, disability grade and bacilloscopy with the results of the ML Flow serological test in 1,072 new leprosy cases in 13 municipalities in Minas Gerais State. Seropositivity (50.7%) was statistically associated with patients 15 years-old or over (OR:2.6) and those with more than five skin lesions (OR:7.5), more than one affected nerve (OR:2.4) and a positive bacilloscopic index (OR:5.5 for 0or=2), thus contributing to the appropriate classification and treatment of patients.

This is a descriptive, exploratory study correlating ML Flow, bacilloscopy and classification of paucibacillary (PB) and multibacillary (MB), involving 1,041 new leprosy cases in 13 municipalities of Minas Gerais State, from October 2002 to March 2004. Agreement between ML Flow and the classification of the number of skin lesions and bacilloscopy was moderate (K:0.51 and K:0.48, respectively); and substantial for final classification (K:0.77). From January 2000 to March 2004, the proportion of new MB cases in Minas Gerais decreased from 78.1 to 65.8%. The reduction in the percentage of MB cases was higher in health centers that participated in the ML Flow study (73.1% to 53.3%). The difference between PB and MB in the participating and non-participating health centers from January to March 2004 was statistically significant. Implementation of the ML Flow test influenced the classification of patients, suggesting a direct and beneficial impact on patient treatment and the control of the leprosy endemic in Minas Gerais, Brazil.

A report on two cases of botulism, one fatal, in which disease diagnosis was difficult and collaboration between public health and epidemiological surveillance services was poor. The objective of this report is to warn professionals of the seriousness of this disease and to reflect on existing public health surveillance practices.

From January 1996 to December 1998, artemisinin derivatives were prescribed to 108 children infected with Plasmodium falciparum. The therapeutic effect was evaluated. Only children with moderate or severe malaria were included. Group I (intravenous artesunate; n = 62): 50.8% with moderate malaria and 49.2% with severe malaria; 53.2% with mild parasitemia, 22.6% with moderate parasitemia and 24.2% with high parasitemia; Group II (intramuscular artemether [Paluter ]; n = 46): 67.4% with moderate malaria and 32.6% with severe malaria; 52.2% with mild parasitemia, 36.2% with moderate parasitemia and 15.2% with high parasitemia; clinical amelioration and clearance of parasitemia showed no statistical difference between the groups. All patients cleared the parasitemia at the seventh day of follow-up (D7). In order to avoid recrudescence, mefloquine or clindamycin was used.