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Objetivo: Avaliar características da versão brasileira do Older Americans Resources and Services Multidimensional Functional Assessment Questionnaire (BOMFAQ) e da versão em português do Health Assessment Questionnaire (HAQ) para identificar dependência funcional. Métodos: Estudo transversal de amostra aleatória dos idosos (60+ anos) do município de Ouro Preto em 2002. Foram considerados dependentes os idosos com muita dificuldade ou incapacidade para realizar adaptapelo menos uma atividade de vida diária. As causas de dependência foram agrupadas nos domínios mobilidade, saúde mental, órgãos dos sentidos segundo exame médico e ganho de peso. Análise estatística foi realizada por meio do teste do Qui-quadrado. Resultados: Foram avaliados 102 idosos pelo exame médico, sendo 89 idosos classificados como dependentes e 13 como controles. O HAQ e BOMFAQ apresentaram sensibilidade de 58% e 83%, especificidade de 85% e 69%, valores de predição positiva de 79% e 73% e negativa de 67% e 81%, respectivamente. O HAQ apresentou boa sensibilidade, especificidade e valores de predição para identificar dependência no domínio mobilidade. O BOMFAQ demonstrou sensibilidade boa ou excelente, mas especificidade e valores de predição positivo baixos em todos os domínios. Os testes apresentaram boa acurácia intraobservador, mas baixa acurácia interobservador. Conclusões: O HAQ é adequado para o rastreamento de dependência funcional no domínio mobilidade numa população geral de idosos. Por sua baixa especificidade, o BOMFAQ pode superestimar a prevalência de dependência. A baixa acurácia interobservador deverá ser considerada no planejamento dos estudos que utilizem esses instrumentos.

Introdução e objetivo: Este estudo avalia problemas de saúde em idosos, aplica um índice de envelhecimento bem-sucedido e analisa sua relação com fatores sociodemográficos e capacidade funcional em amostra aleatória representativa de Ouro Preto. Métodos: Associação entre capacidade funcional e variáveis sociodemográficas e clínicas foi avaliada usando regressão logística múltipla. Resultados: A mediana de idade foi 67; 59% eram de classe econômica baixa e 50% de baixa escolaridade. Foi elevada a prevalência de incontinência urinária, quedas, depressão, dependência, problemas de visão, audição, imunização e rastreamento de neoplasias. Houve associação entre dependência funcional e sexo feminino, idade, déficit cognitivo e problemas de visão. A chance de apresentar envelhecimento bem-sucedido foi menor entre mulheres, idosos de 75-79 anos e escolaridade baixa. Conclusão: Os idosos apresentam elevada prevalência de problemas de saúde. Maior expectativa de vida em mulheres não se associou a ganho de expectativa de vida livre de incapacidade. O envelhecimento bem-sucedido pode ser privilégio de classes mais favorecidas.

Background: Accurate and rapid testing for COVID-19 is critical for effective disease management and control. The One-Step-COVID-2019-Test was developed as a rapid serological test to detect antibodies against SARS-CoV-2. Objective: To estimate the accuracy of the rapid serological test for COVID-19 using One-Step-COVID-2019. Methods: We conducted a population-based serological survey with a stratified sampling of 593 adults between October and December 2020, prior to mass vaccination and during a period of limited availability of rapid tests. Participants provided 7.5 mL of serum, which was tested using the One-Step-COVID-2019-Test for IgM-IgG antibodies without distinction, as well as an in-house ELISA for IgG against the spike protein. Statistical analysis accounted for sampling weights, with accuracy assessed through sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), Youden index, and kappa coefficient, using ELISA as the reference standard. McNemar’s test identified significant differences between the test results. Results: The ELISA-based prevalence of infection was 11.1%. The One-Step-COVID-2019-Test showed low sensitivity (27.0–30.8%) but high specificity (89.9–96.6%), with poor agreement (kappa: 0.290–0.337), particularly among asymptomatic individuals. Conclusions: The One-Step-COVID-2019 rapid test for COVID-19 demonstrated inadequate performance, characterized by low sensitivity and poor reliability, making it unsuitable for effective serological surveillance.

Highlights The prevalence of vitamin D deficiency was higher in patients with diabetes mellitus; The FokI polymorphism was associated with DM and, in synergism with vitamin D deficiency, increased the likelihood of DM in adults. The FokI polymorphism was the most frequent in individuals with diabetes; Individuals with VDD were more predisposed to have DM regardless of phenotype, meaning that vitamin D deficiency is a relevant predictor for developing DM, regardless of whether or not there is an alteration in the VDR receptor.

Abstract To evaluate association of vitamin D with sleep quality in adults and the influence of VDR-gene polymorphism FokI (rs2228570;A > G). Cross-sectional population-based study in adults, conducted in Brazil. The outcome was sleep-quality, evaluated by the Pittsburgh Sleep Quality Index. Vitamin D was determined by indirect electrochemiluminescence and classified as deficiency (VDD), 25(OH)D

Abstract Mental disorders are intricate and multifaceted and encompass social, economic, environmental, and biological factors. This study aimed to explore the potential association between vitamin D deficiency and anxiety and depression symptoms in adults, considering the role of the vitamin D receptor gene polymorphism FokI (rs2228570). This was a population-based cross-sectional study with stratified and cluster sampling, evaluating anxiety symptoms (AS) and depression symptoms (DS) in 1637 adults. Vitamin D levels were measured using electrochemiluminescence and were considered deficient when

Abstract Background The prevalence of intestinal parasites is known to be high among Amerindian populations; further, there are serious problems in the healthcare of these populations in Brazil. The Maxakali, located in the northeastern region of Minas Gerais, Brazil, is an indigenous group that still preserves many of its cultural aspects. This study aimed to compare the positivity rate of schistosomiasis and soil-transmitted helminths in this ethnic group in epidemiological surveys conducted in 1972 and 2014. Methods Stool parasitological examinations were performed by the Kato-Katz technique during both periods in this population. In 2014, the parasitological diagnosis was also realized with the TF-Test® technique. Results In 1972, 270 inhabitants were examined. The positivity rates were 67.4% for Schistosoma mansoni, 72.9% for hookworms, 43.7% for Ascaris lumbricoides, and 23.7% for Trichuris trichiura. In 2014, 545 individuals were examined, and the positivity rates obtained were 45.7% for S. mansoni, 22.8% for hookworms, 0.6% for A. lumbricoides, and 2.8% for T. trichiura. Conclusions The comparison of the parasitological surveys conducted in 1972 and 2014, indicates that the indigenous Maxakali remained neglected by the health and indigenous protection authorities during these four decades. The infection rate observed in 2014 for schistosomiasis and hookworm remains high, considering the current epidemiological view of these diseases in the Brazilian population.

ABSTRACT Objective: To evaluate symptoms, lung function, and quality of life of a cohort of patients hospitalized for severe COVID-19 12 months after hospital admission. Methods: This was a cross-sectional study. We included severe COVID-19 survivors hospitalized in one of three tertiary referral hospitals for COVID-19 in the city of Belo Horizonte, Brazil. Participants were submitted to lung function and six-minute walk tests and completed the EQ-5D-3L questionnaire. Results: The whole sample comprised 189 COVID-19 survivors (mean age = 59.6 ± 13.4 years) who had been admitted to a ward only (n = 96; 50.8%) or to an ICU (n = 93; 49.2%). At 12 months of follow-up, 43% of patients presented with dyspnea, 27% of whom had a restrictive ventilatory disorder and 18% of whom presented with impaired DLCO. There were no significant differences in FVC, FEV1, and TLC between the survivors with or without dyspnea. However, those who still had dyspnea had significantly more impaired DLCO (14.9% vs. 22.4%; p < 0.020) and poorer quality of life. Conclusions: After one year, survivors of severe COVID-19 in a middle-income country still present with high symptom burden, restrictive ventilatory changes, and loss of quality of life. Ongoing follow-up is needed to characterize long COVID-19 and identify strategies to mitigate its consequences.

Abstract Objective: To investigate whether the combined consumption of fresh/minimally processed and ultra-processed food is associated with food insecurity (FI) during the COVID-19 pandemic. Design: Cross-sectional observational study was derived from a survey using a population-based search of a complex sample. FI was assessed using the validated Brazilian Food Insecurity Scale. Food consumption was assessed using a qualitative FFQ and the NOVA classification for fresh/minimally processed food and ultra-processed food. A scoring system was used to evaluate combined food consumption according to the extent and purpose of processing, considering the weekly consumption of the two groups (according to the NOVA classification). Higher punctuation reflects worse diet quality (higher consumption of ultra-processed foods and lower consumption of fresh/minimally processed foods). A theoretical causality model was constructed using a directed acyclic graph, and multivariate analysis was performed using Poisson regression to test the association between FI and food consumption. Setting: Ouro Preto and Mariana, Brazil, between October and December 2020. Participants: An epidemiological household survey was conducted with 1753 individuals selected through a stratified and clustered sampling design in three stages. Results: Those with food consumption scores in the fourth quartile had a 60 % higher prevalence ratio (PR) for FI (PR: 1·60 and 95 % CI: 1·06 - 2·40). Also, the increased consumption of fresh/minimally processed foods and low consumption of ultra-processed foods presented a 45 % lower prevalence ratio of FI (PR: 0·55 and 95 % CI: 0·40 – 0·80). Conclusion: These results indicate an inverse association between FI and diet quality.

Abstract Background We aimed to evaluate the association of sedentary behavior (SB) and moderate to vigorous leisure-time physical activity (MVPA) with sleep quality during the COVID-19 pandemic. Methods Cross-sectional, population-based study in adults, conducted from October to December 2020 in the Iron Quadrangle region, Brazil. The outcome was sleep quality, evaluated with the Pittsburgh Sleep Quality Index. SB was assessed by self-report of total sitting time, before and during the pandemic. Individuals with ≥ 9 h of total sitting time were classified as SB. In addition, the ratio of time spent in MVPA to time in SB was analyzed. A contrasted directed acyclic graph (DAG) model was constructed to adjust logistic regression models. Results A total of 1629 individuals were evaluated, the prevalence of SB before the pandemic was 11.3% (95%CI: 8.6–14.8), and during the pandemic 15.2% (95%CI: 12.1–18.9). In multivariate analysis, the chance of poor sleep quality was 77% higher in subjects with SB ≥ 9 h per day (OR: 1.77; 95% CI: 1.02–2.97). Furthermore, a one-hour increase in SB during the pandemic, increased the chance of poor sleep quality by 8% (OR: 1.08; 95%CI 1.01–1.15). In the analysis of the ratio of MVPA per SB in individuals with SB ≥ 9 h, practicing 1 min of MVPA per hour of SB reduces the chance of poor sleep quality by 19% (OR: 0.84; 95%CI: 0.73–0.98). Conclusion SB during the pandemic was a factor associated with poor sleep quality, and the practice of MVPA can reduce the effects of SB. Graphical Abstract

Objective: To evaluate the BOAH (Body mass index, Observed apnea, Age, and Hypertension) and No-apnea score's diagnostic values for detecting obstructive sleep apnea (OSA) risk in shift workers. Methods: Cross-sectional study with male rotating shift workers and drivers of heavy off-road machinery. The BOAH score is based on body mass index, witnessed apneas during sleep, age, and hypertension. The No-apnea score is based on neck circumference and age. Based on the apnea-hypopnea index (AHI), the severity of OSA was categorized as least mild OSA (AHI ≥5/h), moderate to severe OSA (AHI ≥15/h), and severe OSA (AHI ≥30/h). Sensitivity, specificity, positive predictive value, negative predictive value, and areas under the curve (AUC) were calculated. Results: Among 119 workers evaluated, 84.0% had AHI ≥5, 46.2% had AHI ≥15, and 14.3% had AHI ≥30. BOAH score with 2 points for AHI ≥5, the AUC was 0.679, and sensitivity and specificity were 41.0% and 94.7%, respectively. No-apnea score with 3 points AHI ≥5, the AUC was 0.692, and sensitivity and specificity were 70.0% and 68.4%, respectively. Furthermore, using at least one of the positive scores, the AUC was higher when compared to the single tests for AHI ≥5 (AUC = 0.727). And when both scores were positive, the AUC was higher for AHI ≥30 (AUC = 0.706). Conclusion: In rotating shift workers and drivers of heavy off-road machinery, BOAH, and No-apnea scores can be helpful tools in identifying individuals at risk for sleep apnea. In addition, matching the scores may increase the prediction of OSA.

Objective To evaluate the association between sleep parameters and hypovitaminosis D in rotating shift drivers.

Abstract Background The COVID-19 pandemic has brought drastic changes to the lives of the global population. The restrictions imposed by government agencies impacted the daily lives of citizens, influencing several health behaviors, such as physical activity (PA). Thus, the present study aimed to assess the prevalence of physical inactivity (PI) and its associated factors before and during the COVID-19 pandemic. Methods A population-based household seroepidemiological survey was conducted in two Brazilian municipalities located in the state of Minas Gerais, in which 1750 volunteers were interviewed between October and December 2020. Face-to-face interviews were conducted using a structured questionnaire in an electronic format. The moments considered for the PI analysis were M0 (before the pandemic), M1 (from March to July 2020), and M2 (from October to December 2020). Descriptive statistics and univariate and multivariate logistic regression were used to examine the factors associated with PI before (M0) and during the pandemic (M1 and M2). Results The prevalence of PI was higher in the first months of the pandemic (M1) (67.3%; 95% confidence interval (CI): 62.4–71.9) than in the months from October to December 2020 (M2) (58.7%; 95% CI: 52.8–64.3); however, at both times (M1 and M2), PI was more prevalent than in the period before the pandemic started (M0) (39.7%; 95% CI: 35.6–43.8). Individuals who were overweight, obese, and had low educational levels were more likely to be physically inactive. At both M1 and M2, individuals who worked at a work from home were less likely to have PI. Conclusions The results suggest that the COVID-19 pandemic negatively influenced PA, substantially increasing the prevalence of PI. The determinants associated with PI were education, body mass index, and work from home.

ABSTRACT Background: The emergence of Trypanosoma cruzi infection via oral transmission has a habitual character in its primitive endemic cycle. Recent findings revealed the first death by oral transmission of T. cruzi in the state of Espírito Santo, Brazil, in 2012, which was recorded in the rural area of Guarapari. This study evaluated the characteristics related to the occurrence of natural T. cruzi infection among dogs from the rural areas of Alegre and Iconha, municipalities of Espírito Santo. Methods: Logistic regression analysis of factors contributing to serological detection of T. cruzi in dogs was performed in environments where Espírito Santo’s Department of Health Surveillance had previously notified triatomines positive for Trypanosoma spp. from 2014 to 2017. Results: A total of 36 dogs were analyzed, of which 10 (27.77%) tested positive, one was borderline (2.79%), and 25 tested negative (69.44%) for T. cruzi infection. São Caetano, a district from the Iconha municipality, presented a 25 times greater chance for the detection of positive tests (OR:25; 95% CI; 2.37->100). Dogs with updated mandatory vaccination presented with a lower risk of positive serodiagnosis (OR:0.12; 95% CI: 0.02-0.63). Conclusions: Our results highlight for the first time the occurrence of natural T. cruzi canine infection, detected in the municipality of Iconha, mainly among dogs with un-updated mandatory vaccines in the district of São Caetano.

Background and aimThe growing increase in diet- and behavior-related illnesses has drawn the attention of many epidemiologists who attribute such changes to the epidemiological and nutritional transition. Thus, this study aims to evaluate the association between the combined occurrence of health risk behaviors, such as sedentary lifestyles, high weekly consumption of ultra-processed foods (UPFs), and non-daily consumption of fruits and vegetables, and symptoms of anxiety or depression in adults.MethodsThis is a cross-sectional study based on an epidemiological survey in two Brazilian cities. The outcome, anxiety, and depression symptoms were assessed using the Generalized Anxiety Disorder 7-item (GAD-7) and the Patient Health Questionnaire-9 (PHQ-9). Food consumption was assessed using a qualitative food frequency questionnaire (FFQ) with reference to consumption in the last 3 months and categorized into the consumption of fruits and vegetables and the consumption of UPFs according to the NOVA classification. Sedentary behavior was assessed by considering the amount of sitting or reclining time per day reported by participants and categorized as less than 9 h of sitting or reclining and 9 h or more. For the analysis, adjusted Poisson regression (PR) was used to estimate the prevalence ratio and the 95% confidence interval (CI).ResultsThose with the health risk behaviors, non-daily consumption of fruits and vegetables, and high consumption of UPFs had a 2.6 higher prevalence ratio for symptoms of mental disorder (PR: 2.6 and 95%CI: 1.1–6.5), as well as those with all three health risk behaviors, had a 2.8 higher prevalence ratio for symptoms of mental disorder (PR: 2.8 and 95%CI: 1.3–6.1).ConclusionThis study revealed that the existence of a combination of two and three health risk behaviors led to a higher prevalence of symptoms of anxiety or depression.

ABSTRACT BACKGROUND: The coronavirus disease (COVID-19) pandemic has adversely affected the health of the global population, with sleep quality being one of the affected parameters. OBJECTIVES: To evaluate sleep quality and its associated factors in adults during the COVID-19 pandemic in Brazil. DESIGN AND SETTING: A population-based cross-sectional serological survey of 1,762 adults in the Iron Quadrangle region of Brazil. METHODS: The Pittsburgh Sleep Quality Index was used to assess sleep quality. Sociodemographic variables, health conditions, health-related behaviors, anxiety, vitamin D levels, weight gain/loss, and pandemic characteristics were assessed using a structured questionnaire. Univariate and multivariate analyses using Poisson regression with robust variance were performed to identify factors associated with sleep quality. RESULTS: More than half of the participants reported poor sleep quality (52.5%). Multivariate analysis revealed that the factors associated with poor sleep quality included living alone (prevalence ratio [PR] = 1.34; 95% confidence interval [CI]: 1.04–1.73), anxiety disorder (PR = 1.32; 95% CI: 1.08–1.62), 5.0% weight loss (PR = 1.21; 95% CI: 1.02–1.44), 5.0% weight gain (PR = 1.27; 95% CI: 1.03–1.55), vitamin D deficiency (PR = 1.16; 95% CI: 1.01–1.35), and COVID-19 symptoms (PR = 1.29; 95% CI: 1.10–1.52). CONCLUSIONS: Our study revealed that more than half of the participants experienced poor sleep quality during the COVID-19 pandemic. Factors associated with poor sleep quality included vitamin D deficiency and weight changes related to the pandemic.

Background: Porteirinha is endemic for visceral leishmaniasis (VL), with intense disease transmission of the disease. We evaluated the impact of canine euthanasia as a single control measure on the incidence of VL in humans and canines. Methods: A prospective observational cohort study was carried out over four years (1998–2002) in 8 of the 12 neighborhoods of the city. The dynamics of canine visceral leishmaniasis (CVL) transmission were evaluated for 2 years, before beginning the screening–culling intervention. The comparative morbidity index (CMI) was used to stratify areas with the greatest risk of CVL, and the spatial distribution of human and canine VL cases was compared using univariate and bivariate K-functions. Results: Human cases conglomerated in three neighborhoods. Spatial clusters were detected for CVL in 1998, 2000, and 2001, but not in 1999, when greater spatial dispersion occurred. The screening and culling intervention reduced the number of human VL cases and decreased the incidence of CVL, mainly in neighborhoods with a high CMI. Conclusions: The systematic euthanasia of seropositive dogs was shown to be an effective control action of the Program for Control of Visceral Leishmaniasis (PCLV) in Brazil. The fundamental role of domestic dogs in the epidemiological chain of VL was reaffirmed.

Background: COVID-19 has been associated with persistent symptoms and functional changes, especially in those surviving severe disease. Methods: We conducted a prospective multicenter study in patients with severe COVID-19 to determine respiratory sequelae. Patients were stratified into two groups: ward admission (WA) and intensive care unit (ICU) admission. In each follow-up visit, the patients where inquired about cough and dyspnea, and performed spirometry, lung volumes, carbon monoxide diffusion capacity (DLCO), 6-minute walk test (6MWT), and respiratory muscle strength (MIP and MEP). Results of pulmonary function tests at 45 days and 6 months after hospital admission were compared using paired analysis. Results: 211 patients were included, 112 in WA and 99 in ICU. Dyspnea persisted in 64.7% in the WA and 66.7% in the ICU group after 6 months. Lung function measures showed significant improvement between 45 days and 6 months, both in WA and ICU groups in VC, FVC, FEV1, total lung capacity, and 6MW distance measures. The improvement in the proportions of the altered functional parameters was significant in the ICU group for VC (44.2% 45 d; 20.8% 6 m; p = 0,014), FVC (47.6% 45 d; 28% 6 m; p = 0,003), FEV1 (45.1% 45 d; 28% 6 m; p = 0,044), DLCO (33.8% 45 d; 7.7% 6 m; p < 0,0001). Conclusion: Six months follow-up of patients with the severe forms of COVID-19 showed significant improvement in the lung function measures compared to 45 days post hospital discharge. The difference was more evident in those requiring ICU admission.

Objective: The present study aims to assess the associations of adductor pollicis muscle thickness (APMT) with age, skin color, sexual maturation, anthropometric indicators and physical activity in Brazilian adolescents. Materials and methods: Cross-sectional study of adolescents aged 14-19 years. Weight, height, body mass index (BMI), arm circumference (AC), APMT, body fat, fat-free mass (FFM), fat-free mass index (FFMI), sexual maturation, time of physical activity and skin color were evaluated. APMT was associated with categorical variables using Mann-Whitney or Kruskal-Wallis tests and correlated with anthropometric variables using Spearman’s correlation. Linear regression was used with APMT as a dependent and the other variables as predictors. Data analysis was carried out in SPSS® software (version 17.0) with a 5% significance level. Results: 828 adolescents were evaluated, 57.6% female, with a mean age of 16.13 ± 1.20 years. APMT had an average value of 18.0 mm in females and 21.0 mm in males. The measure was greater in males, in more advanced stages of sexual maturation, overweight and physical activity. It presented a moderate correlation with FFM, FFMI, body fat and AC. In the final model of multiple linear regression for females, the variables AC and body fat explain 20.1% of the APMT variability. For men, the variables AC and FFMI explain 30.5% of the APMT variability. Conclusion: It is recommended that APMT be used in a complementary manner in the nutritional assessment of adolescents.

ABSTRACT Objective: Because SARS-CoV-2 infection can severely affect the lungs and persistent functional changes can occur after severe disease, we aimed to determine lung function parameters of COVID-19 patients at 45 days after hospital discharge and compare changes according to the severity of the disease. Methods: This was a prospective descriptive analytical multicenter study. The participants were allocated into three groups: ward admission (WA) group; ICU admission not on mechanical ventilation (ICU/MV−) group; and ICU admission on MV (ICU/MV+) group. Lung volumes, DLco, MIP, MEP, and six-minute walk distance (6MWD) were measured 45 days after discharge. Results: The sample comprised 242 patients (mean age = 59.4 ± 14.8 years; 52.1% of males), and 232 (96%) had altered lung function. In the total cohort, restrictive disorder was observed in 96%, as well as reductions in DLco (in 21.2% of the patients), FEV1/FVC (in 39.7%), and PEmax (in 95.8%), with no differences between the groups. Comparing the groups, the ICU/MV+ group had reduced DLco in 50% of the patients (p < 0.001) and a lower mean 6MWD % of the predicted value (p = 0.013). Oxygen desaturation in the six-minute walk test was observed in 32.3% of the cohort and was less frequent in the IE group. Conclusions: This is the first South American study involving severe COVID-19 survivors whose lung function was assessed 45 days after hospital discharge. Changes were frequent, especially in those on MV, which highlights the importance of lung function evaluation after severe COVID-19.

Abstract INTRODUCTION: Leishmaniasis is a complex vector-borne infectious diseases caused by protozoan parasites in the genus Leishmania and spread by hematophagous phlebotomine sand flies (Diptera: Psychodidae, Phlebotominae). The aim of this study was to investigate the phlebotomine fauna, endophily and exophily of the species found, and possible influence of climatic factors on their populations. METHODS: The study was conducted in the Xakriabá Indigenous Reserve (XIR) in the municipality of São João das Missões in northern Minas Gerais state, Brazil. Insects were collected over three consecutive nights in the last week of each month for 12 months from July 2015 to May 2016 from four houses in four different villages. Two traps were set up in each house: one in the intra-domicile and another in the peri-domicile. RESULTS: A total of 2,012 phlebotomine sand fly specimens representing 23 species and belonging to 10 different genera were captured and identified. Among the studied villages, Riacho do Brejo showed the highest density and diversity of phlebotomine sand flies. The species Lutzomyia longipalpis (80.3%) and Nyssomyia intermedia (7.3%), which are major vectors of visceral and cutaneous leishmaniasis, respectively, had the highest population densities, both in the intra- and peri-domicile. No correlation was observed between climatic factors and the density of phlebotomine sand flies. CONCLUSIONS: The results of the present study may contribute to a better understanding and targeting of the measures for preventing and controlling leishmaniasis by the authorities responsible for indigenous health.

BACKGROUND Visceral Leishmaniasis (VL) is an infectious disease that is a significant cause of death among infants aged under 1 year and the elderly in Brazil. Serodiagnosis is a mainstay of VL elimination programs; however, it has significant limitations due to low accuracy. OBJECTIVE This study aimed to evaluate three recombinant Leishmania infantum proteins (rFc, rC9, and rA2) selected from previous proteomics and genomics analyses to develop enzyme-linked immunosorbent assay (ELISA) and immunochromatographic tests (ICT) for the serodiagnosis of human VL (HVL) and canine VL (CVL). METHODS A total of 186 human (70 L. infantum-infected symptomatic, 20 other disease-infected, and 96 healthy) and 185 canine (82 L. infantum-infected symptomatic, 27 L. infantum-infected asymptomatic, and 76 healthy) sera samples were used for antibody detection. FINDINGS Of the three proteins, rA2 (91.5% sensitivity and 87% specificity) and rC9 (95.7% sensitivity and 87.5% specificity) displayed the best performance in ELISA-HVL and ELISA-CVL, respectively. ICT-rA2 also displayed the best performance for HVL diagnosis (92.3% sensitivity and 88.0% specificity) and had high concordance with immunofluorescence antibody tests (IFAT), ELISA-rK39, IT-LEISH®, and ELISAEXT. ICT-rFc, ICT-rC9, and ICT-rA2 had sensitivities of 88.6%, 86.5%, and 87.0%, respectively, with specificity values of 84.0%, 92.0%, and 100%, respectively for CVL diagnosis. MAIN CONCLUSIONS The three antigens selected by us are promising candidates for VL diagnosis regardless of the test format, although the antigen combinations and test parameters may warrant further optimisation.

ABSTRACT Intestinal parasitic infections are a common health problem among Amerindian populations and schistosomiasis represents one of the most prevalent diseases in Maxakali people. The Kato-Katz is the diagnostic method recommended by WHO for epidemiological studies; however, one of the technique’s limitations is the failure to detect parasites in individuals with low parasite load. The aim of this study was to establish the prevalence of Schistosoma mansoni in indigenous Maxakali villages, evaluating the TF-Test® performance for diagnosis compared to the Kato-Katz technique. Stool samples from 545 individuals were processed by the TF-Test® (1 sample) and Kato-Katz (1 slide). The positivity rate for S. mansoni by Kato-Katz was 45.7%. The rate by the TF-Test® was 33.2%, and 51.9% by the combined parasitological techniques. The amplitude of parasite load was 24 to 4,056 eggs per gram of feces (epg), with a geometric mean of 139 epg. The co-positivity, co-negativity, and accuracy values by TF-Test® in relation to Kato-Katz were 59.0%, 88.5%, and 75.0%, respectively. The agreement between these techniques was moderate (k=0.486) as determined by the kappa index. Thus, the results of this study demonstrated that the performance of Kato-Katz was superior (p

Introduction: In children, the presence of obesity is a major risk factor for the occurrence of cardiovascular diseases on the adulthood. Objective: To evaluate the association of anthropometry, body composition, clinical variables and biochemical profile with C-reactive protein and adiponectin levels, and insulin resistance in children in the municipality of Nova Era, Brazil. Methods: Nested case-control study following a crosssectional study. We evaluated 178 children, 57 of them classified as obese and 121 as normal-weight from a population of 1024 schoolchildren 6 to 10 years old: Blood samples were collected after 12-hour fast to obtain serum and plasma. We collected anthropometric and body composition measures, systolic and diastolic blood pressure data. Sexual maturation was assessed according to the stage of sexual development. We performed Student's t-test, Mann-Whitney U test, Pearson's correlation, Spearman's test and multiple linear regression analysis. Independent variables with p < 0.05 were included in the multiple regression model. Residual analysis was performed to assess model validity. Results: Among obese children, C-reactive protein levels were associated with triacylglycerol levels and body fat percentage estimated by skinfold thickness (R²adjusted = 27.6%, p < 0.001). Adiponectin was associated with HOMA-IR, HOMA-AD and body fat percentage estimated by skinfold thickness (R²adjusted = 75.5%, p < 0.001). HOMA-AD index was associated with HOMA-IR, adiponectin, systolic blood pressure and weight (R²adjusted = 90.7%, p < 0.001). Conclusion: Significant associations were found between body composition, anthropometry, clinical variables, biochemical profile and adiponectin and C-reactive protein levels and insulin resistance in obese and normal-weight children.

The etiological treatment of Chagas disease is recommended for all patients with acute or recent chronic infection, but controversies remain regarding the benefit of chemotherapy and interpretations of the parasitological cure after etiological treatment. This study compares the laboratory and clinical evaluations of Chagas disease patients who were diagnosed 13 years earlier. Fifty-eight Chagas disease patients (29 treated with benznidazole and 29 untreated) were matched at the time of treatment based on several variables. Conventional serology revealed the absence of seroconversion in all patients. However, lower serological titres were verified in the treated group, primarily among patients who had the indeterminate form of the disease. Haemoculture performed 13 years after the intervention was positive for 6.9% and 27.6% of the treated and untreated patients, respectively. Polymerase chain reaction tests were positive for 44.8% and 13.8% of the treated and untreated patients, respectively. Patients who presented with the indeterminate form of the disease at the beginning of the study exhibited less clinical progression (17.4%) compared with the untreated group (56.5%). Therefore, this global analysis revealed that etiological treatment with benznidazole may benefit patients with respect to the clinical progression of Chagas disease and the prognosis, particularly when administered to patients with the indeterminate form of the disease.

O objetivo deste estudo foi determinar a prevalência de parasitos intestinais na etnia Maxakali em Minas Gerais, Brasil. Os exames parasitológico das fezes foram realizados através da técnica TF-Test, sendo as amostras fecais coletadas em três dias alternados, em tubos independentes, contendo formol a 10%, unificados para dupla filtragem por centrifugação. Triplicatas de uma alíquota do sedimento foram examinadas em microscópio (10x e 40x) para identificação de ovos, cistos e larvas. A prevalência de parasitos (89,5%) e do poliparasitismo (46%) foi semelhante quanto ao sexo e idade, e variou entre as aldeias. As espécies prevalentes foram: Entamoeba histolytica/Entamoeba dispar (48,9%), Giardia duodenalis (32%), Entamoeba coli (40,8%), Endolimax nana (10,3%), ancilostomídeos (37,9%), Schistosoma mansoni (23,7%), Hymenolepis nana (18,6%), Strongyloides stercoralis (5,4%), Ascaris lumbricoides (4,9%) e Trichuris trichiura (0,5%). Os Maxakali vivem em condições de vulnerabilidade social, e medidas de infraestrutura e de educação em saúde necessitam ser implementadas pelas instituições governamentais.

O objetivo deste estudo foi determinar a prevalência de parasitos intestinais na etnia Maxakali em Minas Gerais, Brasil. Os exames parasitológico das fezes foram realizados através da técnica TF-Test, sendo as amostras fecais coletadas em três dias alternados, em tubos independentes, contendo formol a 10%, unificados para dupla filtragem por centrifugação. Triplicatas de uma alíquota do sedimento foram examinadas em microscópio (10x e 40x) para identificação de ovos, cistos e larvas. A prevalência de parasitos (89,5%) e do poliparasitismo (46%) foi semelhante quanto ao sexo e idade, e variou entre as aldeias. As espécies prevalentes foram: Entamoeba histolytica/Entamoeba dispar (48,9%), Giardia duodenalis (32%), Entamoeba coli (40,8%), Endolimax nana (10,3%), ancilostomídeos (37,9%), Schistosoma mansoni (23,7%), Hymenolepis nana (18,6%), Strongyloides stercoralis (5,4%), Ascaris lumbricoides (4,9%) e Trichuris trichiura (0,5%). Os Maxakali vivem em condições de vulnerabilidade social, e medidas de infraestrutura e de educação em saúde necessitam ser implementadas pelas instituições governamentais.El objetivo de este estudio fue determinar la prevalencia de parásitos intestinales en la etnia Maxakali. Los exámenes parasitológicos de las heces se realizaron a través de la técnica TF-Test, las muestras fecales se recogieron en tres días alternados, en tubos independientes, conteniendo formol a un 10%, unificados para un doble filtrado por centrifugación. Triplicados de una alícuota del sedimento se examinaron en microscopio (10x y 40x) para la identificación de huevos, quistes y larvas. La prevalencia de parásitos (89,5%) y del poliparasitismo (46%) fue semejante en cuanto al sexo y edad, y varió entre las aldeas. Las especies prevalentes fueron: Entamoeba histolytica/Entamoeba dispar (48,9%), Giardia duodenalis (32%), Entamoeba coli (40,8%), Endolimax nana (10,3%), ancilostomídeos (37,9%), Schistosoma mansoni (23,7%), Hymenolepis nana (18,6%), Strongyloides stercoralis (5,4%), Ascaris lumbricoides (4,9%) y Trichuris trichiura (0,5%). Los Maxakali viven en condiciones de vulnerabilidad social, y medidas de infraestructura y de educación en salud necesitan ser implementadas por instituciones gubernamentales.A prevalence survey using the TF-Test technique to identify intestinal parasites was conducted in the Maxakali indigenous villages in Minas Gerais State, Brazil. Stool samples were collected on three alternating days, in separate tubes, containing 10% formalin, and unified in a laboratory by double filtering centrifugation. Samples of sediment aliquot were prepared in triplicate and examined by microscope (10x and 40x) for eggs, cysts, and larvae. Prevalence of parasites (89.5%) and polyparasitism (46%) were similar by sex and age, but varied by village. Prevalent species were: Entamoeba histolytica/Entamoeba dispar (48.9%), Giardia duodenalis (32%), Entamoeba coli (40.8%), Endolimax nana (10.3%), hookworms (37.9%), Schistosoma mansoni (23.7%), Hymenolepis nana (18.6%), Strongyloides stercoralis (5.4%), Ascaris lumbricoides (4.9%), and Trichuris trichiura (0.5%). The Maxakali population lives in socially vulnerable conditions, and government agencies need to introduce measures to improve sanitation infrastructure and health education.

Ischemic strokes have been implicated as a cause of death in Chagas disease patients. Inflammation has been recognized as a key component in all ischemic processes, including the intravascular events triggered by vessel interruption, brain damage and repair. In this study, we evaluated the association between inflammatory markers and the death risk (DR) and stroke risk (SR) of patients with different clinical forms of chronic Chagas disease. The mRNA expression levels of cytokines, transcription factors expressed in the adaptive immune response (Th1, Th2, Th9, Th17, Th22 and regulatory T cell), and iNOS were analyzed by real-time PCR in peripheral blood mononuclear cells of chagasic patients who exhibited the indeterminate, cardiac, digestive and cardiodigestive clinical forms of the disease, and the levels of these transcripts were correlated with the DR and SR. Cardiac patients exhibited lower mRNA expression levels of GATA-3, FoxP3, AHR, IL-4, IL-9, IL-10 and IL-22 but exhibited higher expression of IFN-γ and TNF-α compared with indeterminate patients. Digestive patients showed similar levels of GATA-3, IL-4 and IL-10 than indeterminate patients. Cardiodigestive patients exhibited higher levels of TNF-α compared with indeterminate and digestive patients. Furthermore, we demonstrated that patients with high DR and SR exhibited lower GATA-3, FoxP3, and IL-10 expression and higher IFN-γ, TNF-α and iNOS mRNA expression than patients with low DR and SR. A negative correlation was observed between Foxp3 and IL-10 mRNA expression and the DR and SR. Moreover, TNF-α and iNOS expression was positively correlated with DR and SR. Our data suggest that an inflammatory imbalance in chronic Chagas disease patients is associated with a high DR and SR. This study provides a better understanding of the stroke pathobiology in the general population and might aid the development of therapeutic strategies for controlling the morbidity and mortality of Chagas disease.

This study compares the diagnostic accuracy of the TF-Test® (TFT) for human parasitosis with results obtained using the traditional Kato-Katz (KK), Hoffman-Pons-Janer (HPJ), Willis and Baermann-Moraes (BM) techniques. Overall, four stool samples were taken from each individual; three alternate-day TFT stool samples and another sample that was collected in a universal container. Stool samples were taken from 331 inhabitants of the community of Quilombola Santa Cruz. The gold standard (GS) for protozoa detection was defined as the combined results for TFT, HPJ and Willis coproscopic techniques; for helminth detection, GS was defined as the combined results for all five coproscopic techniques (TFT, KK, HPJ, Willis and BM). The positivity rate of each method was compared using the McNemar test. While the TFT exhibited similar positivity rates to the GS for Entamoeba histolytica/dispar (82.4%) and Giardia duodenalis (90%), HPJ and Willis techniques exhibited significantly lower positivity rates for these protozoa. All tests exhibited significantly lower positivity rates compared with GS for the diagnosis of helminths. The KK technique had the highest positivity rate for diagnosing Schistosoma mansoni (74.6%), while the TFT had the highest positivity rates for Ascaris lumbricoides (58.1%) and hookworm (75%); HPJ technique had the highest positivity rate for Strongyloides stercoralis (50%). Although a combination of tests is the most accurate method for the diagnosis of enteral parasites, the TFT reliably estimates the prevalence of protozoa and selected helminths, such as A. lumbricoides and hookworm. Further studies are needed to evaluate the detection accuracy of the TFT in samples with varying numbers of parasites.

The authors conducted a cross-sectional study of the local canine population in the Krenak indigenous community to detect parasites of the genus Leishmania and identify the circulating species and the proportion of asymptomatic dogs, while investigating associations between canine infection and the dogs' sex, age, and hair length. A seroepidemiological survey was performed, including 63 dogs. All the animals underwent clinical examination to verify the presence of characteristic signs, and serum samples were taken for serological tests (ELISA, IIF). Infected dogs culled by the health service were necropsied and the material was analyzed using molecular diagnostic techniques. The cross-sectional study detected a 46% prevalence rate, and the circulating species was Leishmania (L.) chagasi. The statistical analysis showed no association between infection and the independent variables. The study generated data on the epidemiological situation with canine infection in the area, which was previously unknown.Foi realizado um estudo seccional para detectar, na população canina, a presença de parasitos do gênero Leishmania e a espécie circulante, a proporção de cães assintomáticos, investigando concomitantemente a existência de associações entre a infecção canina e as variáveis: sexo, idade e tipo de pelo dos cães. Para o estudo seccional, foi realizado um inquérito censitário, que avaliou 63 cães. Todos passaram por uma avaliação clínica para verificar a presença de sintomas característicos da infecção; amostras de soro foram coletadas para os testes sorológicos (ELISA, RIFI). Os cães positivos retirados pelo serviço de saúde foram necropsiados, e o material, analisado pelas técnicas de diagnóstico molecular. O estudo seccional realizado detectou uma prevalência de 46%, sendo a espécie circulante a Leishmania (L.) chagasi. A análise estatística não detectou nenhuma associação entre infecção e as variáveis investigadas. Este estudo possibilitou a geração de dados sobre a situação epidemiológica da infecção canina na área, o que antes era desconhecido.

Using data from the 2000 Brazilian Demographic Census of Brazilian Institute of Geography and Statistics (IBGE), the fifteen municipalities with the highest percentage of indigenous people were analyzed. The fact of indigenous people represents a significant portion of total population in these fifteen municipalities does not mean they have demographic and socioeconomic conditions similar to those of white population.

Objective: To analyze how demographic dynamics and racial-ethnic reclassification may have contributed to the growth of indigenous population residing in Minas Gerais in the period between 1991 and 2000. Methods: An epidemiological study using secondary data from Demographic Censuses from the period of 1991 to 2000. The impact of the increase was determined by the calculation of vegetative growth, migration and racial-ethnic reclassification within this increment. Results: There was a growth rate of the self-declared indigenous population of 26% per year, with an increase of 800% in the number of indigenous people. This was evidenced from the migration of mulatto population to indigenous. The migratory process to the state increased in 2.7% the studied population and there was an increment in the urbanization process from 66% to 78%. Conclusion: The results show that in Minas Gerais population dynamics has little influence in indigenous population growth and racial-ethnic reclassification is the main reason for explaining this phenomenon.

FUNDAMENTO: A doença arterial obstrutiva periférica (DAOP) está associada ao maior índice de risco cardiovascular. No Brasil, faltam dados sobre sua prevalência e fatores de risco. OBJETIVO: Avaliar prevalência e fatores de risco associados à DAOP nas cidades brasileiras com > cem mil habitantes. MÉTODOS: Estudo transversal, multicêntrico, que avaliou 1.170 indivíduos (>18 anos), em 72 centros urbanos, participantes do Projeto Corações do Brasil. O diagnóstico de DAOP baseou-se na medida do índice tornozelo-braquial (ITB) < 0,90. A análise estatística utilizou teste Qui-quadrado (Pearson) corrigido para amostras complexas e intervalos de confiança. P < 0,05 foi considerado significativo. RESULTADOS: A prevalência de DAOP foi de 10,5% e apenas 9% dos portadores da doença apresentaram claudicação. A DAOP esteve associada à presença de diabetes, obesidade total e abdominal, acidente vascular cerebral (AVC) e doença isquêmica do coração (DIC). Houve tendência a maior prevalência de DAOP na presença de hipertensão, insuficiência cardíaca, insuficiência renal dialítica e tabagismo >20 anos/maço. Mulheres coronariopatas apresentaram risco 4,9 vezes maior de ter DAOP, do que aquelas sem coronariopatia e, entre homens diabéticos, o risco de DAOP foi 6,6 maior em comparação aos não diabéticos. CONCLUSÃO: A prevalência de DAOP foi elevada, considerando-se a baixa média de idade da população avaliada (44±14,7 anos). A minoria dos portadores apresentava claudicação, o que denota o grande contingente de indivíduos assintomáticos. Os fatores mais fortemente associados à doença foram diabetes, obesidade, AVC e DIC. Os autores concluíram que a medida do ITB deve ser considerada na avaliação de pacientes de moderado e alto risco cardiovascular.BACKGROUND: Peripheral arterial disease (PAD) is associated with increased cardiovascular risk. In Brazil, data on PAD prevalence and risk factors are scarce. OBJECTIVE: To assess prevalence and risk factors related to PAD in Brazilian urban centers with more than 100,000 inhabitants. METHODS: National, multicenter, cross-sectional study of 1,170 individuals (>18 years), from 72 major Brazilian urban centers participating in the "Hearts of Brazil Project". PAD diagnosis was based on ankle-brachial index (ABI) < 0.90. The statistical analysis used the corrected Chi-square (Pearson) test for complex samples and confidence intervals. P< 0.05 was considered statitically significant. RESULTS: PAD prevalence was 10.5%. Intermittent claudication (IC) was present in only 9% of PAD patients. A significant association was found between PAD and the following factors: diabetes, total and abdominal obesity, stroke and ischemic heart disease (IHD). There was a trend of higher PAD prevalence among individuals with hypertension, heart failure, chronic renal failure on dialysis, as well as those who had smoked over 20 pack-years. For females, presence of IHD was associated with a 4.9-fold greater risk of PAD. Among males, a 6.6-fold increased risk of PAD was found for diabetic in comparison to non-diabetic individuals. CONCLUSION: PAD prevalence was markedly high, considering the low mean age of the studied population (44±14.7 yrs). IC was detected in a minority of PAD subjects, indicating a considerable number of asymptomatic individuals. Diabetes, obesity, stroke and IHD were the stronger predictors of PAD. The authors concluded that ABI measurement should be considered in the evaluation of moderate to high cardiovascular risk patients.

The objectives of this article were to discuss the rapid spread of visceral leishmaniasis in urban areas of Brazil and to raise practical questions and perspectives related to control of the disease. Among the proposed methods, the elimination of seropositive dogs is the most controversial and least accepted by society. Its impact on incidence rates varies among studies (positive in some and relatively unimportant in others). Treatment of infected dogs, although widespread in veterinary practice, is based on studies with weak scientific evidence. Insecticide spraying of areas is more acceptable to the population, but is costly and operationally difficult. Intra and inter-urban factors have scarcely been studied and may affect control of the disease. Finally, the article discusses the use of deltamethrin-impregnated dog collars and vaccines, with high expectations for impact on disease transmission, although no product currently available on the market has been fully evaluated, so that further studies are required.

As populações indígenas aldeadas no Brasil apresentam alta taxa de fecundidade total (TFT), sendo que em alguns casos é observado o crescimento destas taxas ao longo do tempo. Já os dados do Instituto Brasileiro de Geografia e Estatística (IBGE) revelam um declínio da TFT da população autodeclarada indígena, independente da situação de domicílio (urbano, rural e rural específico). Este trabalho utiliza dados do Censo Demográfico 2000 para descrever e comparar a estrutura e o nível da fecundidade de período e coorte das mulheres autodeclaradas indígenas residentes em Minas Gerais, Brasil. Foram calculadas as taxas específicas de fecundidade (TEF), a TFT de período para o ano 2000 e a TFT de coorte para mulheres com cinqüenta anos e mais de idade. Os resultados mostram que as mulheres autodeclaradas indígenas residentes em Minas Gerais experimentaram um passado de alta fecundidade, independente da situação de domicílio. Concluiu-se que o uso do Censo Demográfico 2000 é uma importante fonte de dados para os estudos sobre populações indígenas no Brasil, tanto pelo seu alto grau de cobertura quanto pela riqueza das informações coletadas.Indigenous populations living in villages in Brazil have presented high total fertility rates (TFR) that have increased over time in some cases. Meanwhile, data from the Brazilian Institute of Geography and Statistics (IBGE) or National Census Bureau show a decline in the TFR for the total self-declared indigenous population (combining urban, rural, and specific rural residence). The current study uses data from the 2000 Population Census to describe and compare the structure and level of period fertility for the cohort of self-declared indigenous women living in the State of Minas Gerais. We calculated age-specific fertility rates (ASFR), the period TFR for 2000, and the cohort TFR for women 50 years and older. According to the findings, self-declared indigenous women living in Minas Gerais experienced high fertility in the past, regardless of their place of residence. In conclusion, the 2000 Population Census is an important data source for studies on indigenous populations in Brazil, based on the high coverage and wealth of information.

Six years after the beginning of the epidemiological surveillance of Chagas disease in Berilo and José Gonçalves de Minas, Jequitinhonha Valley, MG, Brazil, a serological inquiry was performed to observe whether the transmission of this endemy was occurring in this area. A randomized sample of 1,412 children seven to 14 years old, was screened. Six asymptomatic children were found to be positive, leading to 0.4% of prevalence. Hemoculture confirmed infection in five out of the six positive cases. Additional epidemiological investigation revealed important antecedents, such as disease reports in relatives and predisposing ecological and housing conditions. Our results demonstrated similar seroprevalence (0.4%) in schoolchildren, ranging from seven to 14 years old, and that were observed six years ago (0.2%) for children 0-9 year-old. Thus, considering the constant presence of Panstrogylus megistus in the peridomicile these findings emphasize the need of continuous improved epidemiological surveillance of Chagas disease in this region.Seis anos após o início da vigilância epidemiológica para doença de Chagas em Berilo e José Gonçalves de Minas, Vale do Jequitinhonha, MG, Brasil, foi realizado um inquérito sorológico para verificar se a transmissão desta endemia estava ocorrendo naquela área. Uma amostra aleatória de 1.412 crianças, de 7 a 14 anos, foi avaliada. Foram encontradas seis crianças positivas assintomáticas, totalizando uma prevalência de 0,4%. Hemocultura confirmou a infecção em cinco dos seis casos positivos. Uma investigação epidemiológica adicional, revelou importantes antecedentes, tais como: casos da doença em parentes e condições de moradia e ecológicas predisponentes. Nossos resultados demonstram uma soroprevalência similar (0,4%) em escolares de 7 a 14 anos àquela observada há seis anos (0,2%) em crianças de 0-9 anos. Dessa forma, considerando a presença constante de Panstrogylus megistus estes achados reforçam a necessidade de uma vigilância epidemiológica contínua e aperfeiçoada para Doença de Chagas naquela região.

The first choice of treatment for American cutaneous leishmaniasis is the pentavalent antimonial drug. Although it has been shown that this treatment is mostly effective and indicated, some disadvantages should be taken into account such as side effects, long term treatment inconveniences and counter-indication for patients suffering from cardiopathy, nephropathy; yet, aging, pregnancy and other conditions. With the advent of the vaccine anti-American cutaneous leishmaniasis as a prophylactic measure, studies on therapy using the vaccine associated or not with other drugs have been performed by many investigators and it is currently among the alternative treatments and prevention measures for American cutaneous leishmaniasis. In conclusion, the association between antimony and vaccine (immunochemotherapy) showed the same cure rate when compared with the standard treatment (100%) and it was also able to reduce the salt volume in 17.9% and treatment length from 87 to 62 days, decreasing side effects.O tratamento de primeira escolha para leishmaniose tegumentar americana é o antimonial pentavalente. Embora este tratamento seja na maioria das vezes efetivo e indicado, devem ser consideradas as desvantagens tais como efeitos colaterais, longa duração do tratamento e contra-indicação para cardiopatas, nefropatas, idosos, grávidas e outras condições. Com o advento da vacina antileishmaniose tegumentar americana para fins profiláticos e terapêuticos, associando-a ou não a outros fármacos, muitas pesquisas têm sido desenvolvidas, sendo a vacina a principal entre os atuais recursos no tratamento e prevenção da leishmaniose tegumentar americana. Em conclusão, a associação do antimônio com a vacina (imunoquimioterapia) apresentou o mesmo índice de cura em relação ao tratamento padrão (100%), e ainda reduziu o volume do sal em 17,9% e o tempo de cura significativamente, de 87 para 62 dias; conseqüentemente, reduzindo os efeitos colaterais.

INTRODUCTION: The study analyzed positivity of polymerase chain reaction (PCR) on detection of DNA from Leishmania in patients' samples. METHODS: Extracted DNA was submitted to L150/L152, 13Y/13Z, and seminested PCR (snPCR). RESULTS: Results were evidenced by bands of approximately 120, 720, and 670 bp for L150/L152, 13Y/13Z, and snPCR, respectively. L150/L152, 13Y/13Z, and snPCR positivity indexes were 76.9, 56.4, and 9.2 (p>0.05), respectively, for suspected and 93.7, 68.7, and 84.4 (p

BACKGROUND: American tegumentary leishmaniasis (ATL) is endemic in Latin America, where Brazil has over 27 thousand cases per year. The aim of the present study was to develop an immunohistochemical method (IHC) for ATL diagnosis. For this purpose, we used serum from a dog naturally infected with Leishmania (L) infantum (canine hyperimmune serum) as the primary antibody, followed by a detection system with a secondary biotinylated antibody. METHODOLOGY: Skin samples were obtained from 73 patients in an endemic area of Caratinga, Minas Gerais (MG) State, Brazil all testing positive for ATL with the Montenegro skin test, microscopy, and PCR. Canine hyperimmune serum of a dog naturally infected with Leishmania (L.) infantum was employed as a primary antibody in an immunohistochemical diagnostic method using streptavidin-biotin peroxidase. To assess the specificity of this reaction, IHC assays employing two monoclonal antibodies were carried out. As the polymer-based technology is less time-consuming and labor intensive than the IHC labeled streptavidin-biotin peroxidase method, we compared the two methods for all samples. RESULTS: The IHC method detected ATL in 67 of the 73 cases (91.8%). Immunolabeled parasites were primarily detected inside macrophages either in the superficial or the deep dermis. Detection was facilitated by the high contrast staining of amastigotes (dark brown) against the light blue background. A lower detection rate (71.2%) was observed with the both of the monoclonal Leishmania antibodies compared to the canine hyperimmune serum. This may have been due to a non-specific background staining observed in all histological samples rendering positive detection more difficult. The higher efficacy of the canine hyperimmune serum in the IHC method was confirmed by the method using streptavidin-biotin peroxidase as well as that with the polymer-based technology (biotin-avidin-free system). CONCLUSIONS: The data are encouraging with regard to validating IHC as a standard alternative method for ATL diagnosis.

This study evaluates whether blood collected on filter paper kept at 4 degrees C and tested at different intervals of time (1, 7, 15, 30 and 60 days after collection) would present similar results when compared to the serum samples and whether the type of filter paper influences the results. Eluates from filter paper samples were tested for Trypanosoma cruzi antibodies using indirect immunofluorescence antibody test (IFAT), indirect haemagglutination (IHA) and enzyme-linked immunosorbent assay (ELISA) as reference, the antibody titer in sera. Analysis of data showed that results obtained with IFAT, IHA (cut off point = 1:40) and ELISA in sera had similar sensitivity and good concordance among reactions. The use of a multiple linear regression model indicated that titer fall in eluates occurs up to the 7th day after the collection, and it is more marked for samples with lower antibodies titers. However, no significant differences were observed by IFAT, IHA (cut off point = 1:20) and ELISA in the proportion of positive reactions between sera and eluates. The results also showed that Melitta, Klabin or Whatman (reference) filter papers could be indicated for surveys, since they have shown similar capacity of maintenance of anti-T. cruzi immunoglobulins.

Abstract INTRODUCTION: Despite the advances of disease control programs, severe forms of schistosomiasis are prevalent. The prevalence of the disease in areas frequented by tourists urges for permanent prevention and control. The aim of this study was to describe the morbidity of schistosomiasis in the district of Antônio Pereira, Ouro Preto, Minas Gerais, Brazil. METHODS: The proportion of positives was defined by Kato-Katz coproscopy and urinary POC-CCA rapid test. Hepatosplenic form was diagnosed using abdominal ultrasound. RESULTS: Out of 180 participants,97 were examined by Kato-Katz, with 4 (4.1%) being positive. Thirty-four (22.1%) out of 154 were positive by POC-CCA. Five (2.8%) of 177 examined by ultrasound had hepatosplenic form. One of them had undergone splenectomy. One (0.6%)participant had myeloradiculopathy. CONCLUSIONS: Severe forms of schistosomiasis are still prevalent in low endemic areas and should be thoroughly investigated.

Resumo Objetivo: analisar os fatores sociodemográficos relacionados ao não uso do preservativo nas relações sexuais e a prevalência de infecções sexualmente transmissíveis (IST) em comunidades rurais de Ouro Preto, Minas Gerais, Brasil, entre 2014 e 2016. Métodos: foram coletados dados de entrevista individual e realizados testes rápidos; as associações foram testadas pelo modelo de regressão de Poisson, com intervalo de confiança de 95% (IC95%). Resultados: foram detectados 3,8 casos/10 mil habitantes de hepatite B e sífilis, e 1,3/10 mil hab. de hepatite C; não foram detectados casos de HIV; na análise multivariada, foram encontradas maiores prevalências de não uso de preservativos entre indivíduos casados/em união estável/viúvos (RP=1,20 - IC95% 1,06;1,36). Conclusão: o grupo com maior prevalência de não uso de preservativo é o de pessoas com relacionamento fixo; novos casos de sífilis e de hepatites virais foram detectados pelo teste rápido, aplicado no inquérito.

Resumo Objetivo: verificar o potencial discriminatório dos indicadores de adiposidade na predição da apneia obstrutiva do sono (AOS) em trabalhadores de turnos. Métodos: estudo transversal realizado em uma empresa de extração de minério de ferro, em Minas Gerais, Brasil. Dados antropométricos foram coletados e polissonografia (PSG) foi realizada em 118 trabalhadores de turno do sexo masculino que possuíam ao menos um fator de risco global para doença cardiovascular. Resultados: a prevalência de AOS na amostra foi de 84,7%. Entre os indicadores de adiposidade usados para predizerem a AOS (≥ 5 eventos/hora), o índice de massa corporal (IMC), a circunferência da cintura (CC), a relação cintura/estatura (RCE) e a gordura corporal total (GCT), revelaram valores de sensibilidade acima de 70%. Gordura visceral (GV), circunferência do pescoço (CP) e relação pescoço-estatura (RPE) foram as mais efetivas em identificar corretamente trabalhadores sem AOS (valores de especificidade acima de 70%). As áreas sob a curva de Característica de Operação do Receptor (COR) para CC e RPE foram maiores que 0,7, o que indicou que o teste foi eficaz na discriminação de indivíduos com AOS. Conclusões: alterações nos indicadores de adiposidade abdominal e cervical têm relação significativa com a presença de AOS e demostraram eficácia como método de rastreamento para PSG. CC e RPE são considerados bons indicadores para predizerem a AOS.