Norovirus genogroups I and II in environmental water samples from Belém city, Northern Brazil.

This study investigated the presence of norovirus (NoV) GI and GII in environmental samples from the northern region of Brazil. Water samples were collected monthly (November 2008/October 2010) from different sources and sewage and concentrated by the adsorption-elution method. The NoV investigation used molecular methods followed by sequencing reactions. The general positivity for NoV was 33.9% (57/168). Considering the results obtained only in the semi-nested RT-PCR (reverse transcription polymerase chain reaction) and only in the TaqMan® real-time PCR, the rates were 26.8% (45/168) and 27.4% (46/168), respectively, being for NoV GI 22.2% (10/45) and 19.6% (9/46); for GII 17.8% (8/45) and 15.2% (7/46); and for GI + GII 60% (27/45) and 65.2% (30/46), respectively. Different GI (GI.1, GI.4, GI.7 and GI.8) and GII (GII.4, GII.6, GII.9, GII.12 and GII.14) genotypes were detected. These results demonstrated the NoV was disseminated in the waters of Belém city due to a lack of sanitation that allowed the discharge of contaminated effluents into these aquatic ecosystems.

Physiotherapy Methods Applied in the Prevention of Functional Loss Associated with Human T-Lymphotropic Virus 1 Infection: An Overview.

To achieve the objective of this study, we conducted a narrative review on physical therapeutic modalities applied to prevent functional losses associated with human T-lymphotropic virus 1 (HTLV-1) infections to promote health education and viable and accessible alternatives in the development of health education technology adapted to the home environment. This study comprised a qualitative stage of theoretical development to construct a digital booklet with an observational basis based on studies that reiterate themes about educational technologies as tools to conduct a home protocol of guided exercises without the direct supervision of professional physical therapists. Results indicate a lack of research on the development of health education technologies to assist patients with HTLV-1 without tropical spastic paraparesis or HTLV-1-associated myelopathy/tropical spastic paraparesis (HAM/TSP). We believe that this narrative review can initiate a theoretical framework to conduct a home exercise program aimed at people with HTLV-1 who have subtle symptoms, and also at people without the clinical definition of HAM/TSP, helping to train human resources for care and research on the subject and increase scientific production in physical therapy.

New Perspectives about Drug Candidates Targeting HTLV-1 and Related Diseases.

Among the human T-lymphotropic virus (HTLV) types, HTLV-1 is the most prevalent, and it has been linked to a spectrum of diseases, including HAM/TSP, ATLL, and hyperinfection syndrome or disseminated strongyloidiasis. There is currently no globally standard first-line treatment for HTLV-1 infection and its related diseases. To address this, a comprehensive review was conducted, analyzing 30 recent papers from databases PubMed, CAPES journals, and the Virtual Health Library (VHL). The studies encompassed a wide range of therapeutic approaches, including antiretrovirals, immunomodulators, antineoplastics, amino acids, antiparasitics, and even natural products and plant extracts. Notably, the category with the highest number of articles was related to drugs for the treatment of ATLL. Studies employing mogamulizumab as a new perspective for ATLL received greater attention in the last 5 years, demonstrating efficacy, safe use in the elderly, significant antitumor activity, and increased survival time for refractory patients. Concerning HAM/TSP, despite corticosteroid being recommended, a more randomized clinical trial is needed to support treatment other than corticoids. The study also included a comprehensive review of the drugs used to treat disseminated strongyloidiasis in co-infection with HTLV-1, including their administration form, in order to emphasize gaps and facilitate the development of other studies aiming at better-directed methodologies. Additionally, docking molecules and computer simulations show promise in identifying novel therapeutic targets and repurposing existing drugs. These advances are crucial in developing more effective and targeted treatments against HTLV-1 and its related diseases.

Moderate endemicity of the human T-lymphotropic virus infection in the metropolitan region of Belém, Pará, Brazil. / Moderada endemicidade da infecção pelo vírus linfotrópico-T humano na região metropolitana de Belém, Pará, Brasil.

INTRODUCTION: The spread of the HTLV infection in families living in the metropolitan area of Belém, Pará, Brazil, and the lack of studies in the general population requires studies to better understand its prevalence in the region. METHODS: An anti-HTLV-1/HTLV-2 antibodies test was carried out on random adults in public places in Belém between November 2014 and November 2015. A proviral DNA test detected if the person was infected, and then a clinical evaluation and an intrafamilial investigation were carried out. RESULTS: Of the 1059 individuals being investigated, 21 (2.0%) had seroreagent samples, 15 (1.4%) had HTLV-1, 5 (0.5%) had HTLV-2, and proviral DNA was undetectable in one case. The mean age of the infected people (57.2) was higher than that of those that were uninfected (46.2) (p = 0.0010). The prevalence of infection increased with age, especially in individuals with a family income equal to or less than a minimum wage. Intrafamilial transmission seems to have occurred in all of the families being studied. Among the patients with HTLV-1, 30% (3/10) already had some symptom related to the infection. DISCUSSION: The increase in prevalence rates according to age may be due to late seroconversion of a previously acquired infection, or the cumulative risk of new infections, especially in women. CONCLUSION: There was a moderate prevalence of the HTLV infection among adult individuals from the metropolitan area of Belém, with a predominance of HTLV-1. This infection was associated with low income and increasingly older women. It also presented intrafamily spread and negligence in the diagnosis of associated diseases.

INTRODUÇÃO: A disseminação da infecção pelo vírus linfotrópico-T humano (HTLV) em famílias da área metropolitana de Belém, Pará, Brasil, e a ausência de estudos na população em geral requisitam investigações que esclareçam melhor a sua prevalência na região. METODOLOGIA: Foi realizada pesquisa de anticorpos anti-HTLV-1/HTLV-2 em indivíduos adultos transeuntes de logradouros públicos de Belém, entre novembro de 2014 e novembro de 2015. A infecção foi confirmada por pesquisa de DNA proviral e foi realizada avaliação clínica e investigação intrafamiliar dos infectados. RESULTADOS: Dos 1.059 indivíduos investigados, 21 (2,0%) apresentaram amostras sororeagentes, 15 (1,4%) confirmados para HTLV-1, 5 (0,5%) para HTLV-2 e o DNA proviral foi indetectável em 1 caso. A média de idade dos infectados (57,2) foi maior que a dos não infectados (46,2) (p = 0,0010). A infecção aumentou com a idade e se destacou nos indivíduos com renda familiar menor ou igual a um salário mínimo. A transmissão intrafamiliar parece ter ocorrido em todas as famílias investigadas. Dentre os portadores de HTLV-1, 30% (3/10) já apresentavam algum sintoma relacionado à infecção. DISCUSSÃO: O aumento da infecção de acordo com a idade pode ocorrer por soroconversão tardia de infecção pré-adquirida ou pelo risco cumulativo de novas infecções, sobretudo em mulheres. CONCLUSÃO: A infecção por HTLV demonstrou moderada prevalência na população estudada, com predomínio do HTLV-1. Essa mostrou-se associada à baixa renda e ao aumento da idade das mulheres. Também apresentou disseminação intrafamiliar e negligência no diagnóstico das doenças associadas.

Prevalence of Human Papillomavirus Infection and Cervical Cancer Screening among Riverside Women of the Brazilian Amazon.

Purpose The aim of this study was to evaluate the overall and type-specific prevalence of human papillomavirus (HPV) infection among females living in riverside communities in the state of Pará, in the Eastern Brazilian Amazon. These communities are inhabited by low-income people, and are accessible only by small boats. Cervical cytology and risk factors for HPV infection were also assessed. Methods Cervical samples from 353 women of selected communities were collected both for Papanicolau (Pap) test and HPV detection. Conventional polymerase chain reaction (PCR) and real-time PCR were used to assess the overall and type-specific prevalence of HPV-16 and HPV-18, the main oncogenic types worldwide. Epidemiological questionnaires were used for the assessment of the risk factors for HPV infection. Results The mean age of the participants was 37 years (standard deviation [SD] ± 13.7). Most were married or with a fixed sexual partner (79%), and had a low educational level (80%) and family monthly income (< U$ 250; 53%). Overall, HPV prevalence was 16.4% (n = 58), with 8 cases of HPV-16 (2.3%) and 5 of HPV-18 (1.4%). Almost 70% of the women surveyed had never undergone the Pap test. Abnormal cytology results were found in 27.5% (n = 97) of the samples, with higher rates of HPV infection according to the severity of the lesions (p = 0.026). Conclusions The infections by HPV-16 and HPV-18 were not predominant in our study, despite the high prevalence of overall HPV infection. Nevertheless, the oncogenic potential of these types and the low coverage of the Pap test among women from riverside communities demonstrate a potential risk for the development of cervical lesions and their progression to cervical cancer, since the access to these communities is difficult and, in most cases, these women do not have access to primary care and public health services.

Objetivo O objetivo deste estudo foi avaliar a prevalência global e tipo-específica da infecção pelo papilomavírus humano (HPV) entre mulheres que vivem em comunidades ribeirinhas do estado do Pará, Amazônia oriental, Brasil. Estas comunidades são habitadas por pessoas de baixa renda, e são acessíveis somente por meio de pequenos barcos. A citologia cervical e os fatores de risco para a infecção por HPV também foram avaliados. Métodos Amostras cervicais de 353 mulheres de comunidades selecionadas foram coletadas para a análise citológica e para a detecção do HPV. A prevalência global e tipo-específica dos HPV-16 e HPV-18, principais tipos oncogênicos no mundo, foram avaliadas por meio de reação em cadeia de polimerase (PCR) convencional e PCR em tempo real. Os fatores de risco para a infecção por HPV foram avaliados a partir de questionários epidemiológicos. Resultados A idade média das participantes foi de 37 anos (desvio padrão [DP] ± 13,7). A maioria era casada ou tinha um parceiro sexual fixo (79%) e baixo nível de escolaridade (80%) e de renda familiar mensal (< U$ 250; 53%). A prevalência global do HPV foi de 16,4% (n = 58), com 8 casos de HPV-16 (2,3%) e 5 casos de HPV-18 (1,4%). Aproximadamente 70% das mulheres entrevistadas nunca tinha realizado o exame preventivo de Papanicolau. Os resultados citológicos anormais foram encontrados em 27,5% (n = 97) das amostras, com taxas mais altas da infecção por HPV de acordo com a severidade das lesões (p = 0,026). Conclusões As infecções por HPV-16 e HPV-18 não foram predominantes em nosso estudo, apesar da alta prevalência global da infecção por HPV. No entanto, o potencial oncogênico desses tipos e a baixa cobertura do exame de Papanicolau entre mulheres de comunidades ribeirinhas demonstram um risco potencial para o desenvolvimento de lesões cervicais e sua progressão para o câncer de colo do útero, uma vez que o acesso a essas comunidades é difícil e, na maioria dos casos, estas mulheres não têm acesso aos serviços de atenção primária e de saúde pública.

Desenvolvimento de webtecnologia educacional sobre citologia clínica para estudantes e profissionais da área da saúde / Desarrollo de tecnología web educativa. sobre citología clínica para estudiantes y profesionales de la salud / Development of educational webtechnology on clinical cytology for students and healthcare professionals

Objetivo: Descrever o processo de desenvolvimento de uma webtecnologia educacional, do tipo blog, sobre citologia clínica, para estudantes e profissionais da área da saúde. Métodos: Pesquisa metodológica para construção de tecnologia educacional em saúde, desenvolvida em três etapas: Revisão da literatura (2019), a partir da qual se deu o delineamento teórico; Fotodocumentação (2020), que foi a fase responsável pela obtenção do conteúdo imagético; Construção (2020-2021), a partir da qual se deu a criação do blog. Resultados: Na primeira fase, obteve-se a fundamentação teórica. Na segunda fase, realizou-se a obtenção das imagens e na terceira fase, o desenvolvimento do produto técnico-tecnológico. Conclusão: O blog, emerge como modelo de suporte para proporcionar um caráter de ubiquidade à informação e como consequência disso, ampliar o potencial gerador de conhecimento sobre citologia clínica entre estudantes e profissionais de diversos campos da área da saúde, com enfoque à Biomedicina e Enfermagem(AU)

Objective: To describe the development process of an educational webtechnology, like a blog, about clinical cytology, for students and health professionals. Methods: Methodological research for the construction of educational technology in health, developed in three stages: Literature review (2019), from which the theoretical outline was given; Photodocumentation (2020), which was the phase responsible for obtaining the image content; Construction (2020-2021), from which the creation of the blog took place. Results: In the first phase, the theoretical foundation was obtained. In the second phase, the images were obtained and in the third phase, the development of the technical-technological product. Conclusion: The blog emerges as a support model to provide a ubiquitous character to information and, as a consequence, expand the potential generator of knowledge about clinical cytology among students and professionals from different fields of health, with a focus on Biomedicine and Nursing(AU)

Objetivo: Describir el proceso de desarrollo de una tecnología web educativa, como un blog, sobre citología clínica, para estudiantes y profesionales de la salud. Métodos: Investigación metodológica para la construcción de tecnología educativa en salud, desarrollada en tres etapas: Revisión de la literatura (2019), a partir de la cual se dio el esquema teórico; Fotodocumentación (2020), que fue la fase encargada de obtener el contenido de la imagen; Construcción (2020-2021), a partir de la cual tuvo lugar la creación del blog. Resultados: En la primera fase se obtuvo el fundamento teórico. En la segunda fase se obtuvieron las imágenes y en la tercera fase, el desarrollo del producto técnico-tecnológico. Conclusión: El blog surge como un modelo de apoyo para dotar de un carácter ubicuo a la información y, como consecuencia, ampliar el potencial generador de conocimiento sobre citología clínica entre estudiantes y profesionales de diferentes campos de la salud, con enfoque en Biomedicina y Enfermería(AU)

SAPOVIRUSES IN CHILDREN WITH ACUTE GASTROENTERITIS FROM MANAUS , AMAZON REGION, BRAZIL, 2010-2011.

Sapoviruses (SaVs) are responsible for acute gastroenteritis in humans, especially children and the elderly. In Brazil, data on SaVs infections are very limited, especially in Northern Brazil. Here, we investigated the occurrence of SaVs in samples from hospitalized children under ten years old that presented acute gastroenteritis. Positive samples were genotyped and phylogenetic analysis was performed using prototype strains sequences obtained from GenBank database. In total, 156 fecal samples were screened by RT-PCR for SaVs. A positivity rate of 3.8% (6/156) was found in children under three years of age. Four genotypes were detected: GI.I, GI.2 and GII.2?-GII.4?/GII.4, suggesting a possible inter-genotypes recombination. Most infections (83.3%) occurred between August and September. The positivity was similar to that found in other countries and genotyping demonstrated the presence of distinct genotypes. To our knowledge, this is the first study reporting the circulation of SaVs in Manaus, state of Amazonas, Amazon region, Brazil.

As descobertas genômicas do SARS-CoV-2 e suas implicações na pandemia de COVID-19 / The genomic discoveries of SARS-CoV-2 and their implications for the COVID-19 pandemic

Objetivo: Auxiliar no entendimento da COVID-19 em relação à origem do SARS-CoV-2, suas descobertas genômicas, patogenia, possíveis hospedeiros primários e intermediários, além da comparação com outros coronavírus. Metodos: foram utilizadas as bases de dados Scientific Eletronic Library Online e PubMed, com artigos de revisão e originais, em língua portuguesa e inglesa, pesquisados no período de 05 de março a 10 de abril de 2020, adotando os seguintes descritores: SARS-CoV, COVID-19, coronavirus, Wuhan, genome, structure, origin, transmission, evolution, zoonotic. Os artigos originais identificados foram incluídos nesta revisão, juntamente com artigos de suporte referenciados por estes. Resultados: As características genômicas descritas até o momento podem explicar, em parte, a infectividade e a transmissibilidade do SARS-CoV-2 em humanos. Devido aos notáveis recursos de SARS-CoV-2, incluindo o local otimizado do domínio de ligação ao receptor (RBD) e de clivagem polibásica, é pouco provável um cenário laboratorial para a origem do SARS-CoV-2. Conclusão: Para o presente, é de extrema importância obter mais dados genéticos e funcionais sobre o SARS-CoV-2, incluindo estudos em animais, sequenciamento do vírus em casos muito precoces e identificação dos parentes virais mais próximos do SARS-CoV-2 que circulam em animais.(AU)

Objective: To assist in the understanding of COVID-19 in relation to the origin of SARS-CoV-2, its genomic discoveries, pathogenesis, possible primary and intermediate hosts, in addition to comparison with other coronaviruses. Methods: the Scientific Electronic Library Online and PubMed databases were used, with review articles and originals, in Portuguese and English, researched from March 5 to April 10, 2020, adopting the following descriptors: SARS-CoV , COVID-19, coronavirus, Wuhan, genome, structure, origin, transmission, evolution, zoonotic. The original articles identified were included in this review, along with supporting articles referenced by them. Results: The genomic characteristics described so far may partly explain the infectivity and transmissibility of SARS-CoV-2 in humans. Due to the remarkable resources of SARS-CoV-2, including the optimized site of the receptor binding domain (RBD) and polybasic cleavage, a laboratory scenario for the origin of SARS-CoV-2 is unlikely. Conclusion: For the present, it is extremely important to obtain more genetic and functional data on SARS-CoV-2, including studies on animals, sequencing of the virus in very early cases and identification of the closest viral relatives of SARS-CoV-2 that circulate in animals.(AU)

Occurrence of strongyloidiasis among patients with HTLV-1/2 seen at the outpatient clinic of the Núcleo de Medicina Tropical, Belém, State of Pará, Brazil.

INTRODUCTION: This study investigated the occurrence of Strongyloides stercoralis infestation and coinfection with HTLV-1/2 in Belém, Brazil. METHODS: S. stercoralis was investigated in stool samples obtained from individuals infected with HTLV-1/2 and their uninfected relatives. RESULTS: The frequency of S. stercoralis was 9% (9/100), including six patients infected with HTLV-1 (14.3%), two patients infected with HTLV-2 (11.1%), and one uninfected relative. Two cases of hyperinfestation by S. stercoralis were characterized as HTLV-1. CONCLUSIONS: These results support the need for the routine investigation of S. stercoralis in patients with HTLV-1, in an attempt to prevent the development of severe forms of strongyloidiasis.

Moderada endemicidade da infecção pelo vírus linfotrópico-T humano na região metropolitana de Belém, Pará, Brasil / Moderate endemicity of the human T-lymphotropic virus infection in the metropolitan region of Belém, Pará, Brazil

RESUMO: Introdução: A disseminação da infecção pelo vírus linfotrópico-T humano (HTLV) em famílias da área metropolitana de Belém, Pará, Brasil, e a ausência de estudos na população em geral requisitam investigações que esclareçam melhor a sua prevalência na região. Metodologia: Foi realizada pesquisa de anticorpos anti-HTLV-1/HTLV-2 em indivíduos adultos transeuntes de logradouros públicos de Belém, entre novembro de 2014 e novembro de 2015. A infecção foi confirmada por pesquisa de DNA proviral e foi realizada avaliação clínica e investigação intrafamiliar dos infectados. Resultados: Dos 1.059 indivíduos investigados, 21 (2,0%) apresentaram amostras sororeagentes, 15 (1,4%) confirmados para HTLV-1, 5 (0,5%) para HTLV-2 e o DNA proviral foi indetectável em 1 caso. A média de idade dos infectados (57,2) foi maior que a dos não infectados (46,2) (p = 0,0010). A infecção aumentou com a idade e se destacou nos indivíduos com renda familiar menor ou igual a um salário mínimo. A transmissão intrafamiliar parece ter ocorrido em todas as famílias investigadas. Dentre os portadores de HTLV-1, 30% (3/10) já apresentavam algum sintoma relacionado à infecção. Discussão: O aumento da infecção de acordo com a idade pode ocorrer por soroconversão tardia de infecção pré-adquirida ou pelo risco cumulativo de novas infecções, sobretudo em mulheres. Conclusão: A infecção por HTLV demonstrou moderada prevalência na população estudada, com predomínio do HTLV-1. Essa mostrou-se associada à baixa renda e ao aumento da idade das mulheres. Também apresentou disseminação intrafamiliar e negligência no diagnóstico das doenças associadas.

ABSTRACT: Introduction: The spread of the HTLV infection in families living in the metropolitan area of Belém, Pará, Brazil, and the lack of studies in the general population requires studies to better understand its prevalence in the region. Methods: An anti-HTLV-1/HTLV-2 antibodies test was carried out on random adults in public places in Belém between November 2014 and November 2015. A proviral DNA test detected if the person was infected, and then a clinical evaluation and an intrafamilial investigation were carried out. Results: Of the 1059 individuals being investigated, 21 (2.0%) had seroreagent samples, 15 (1.4%) had HTLV-1, 5 (0.5%) had HTLV-2, and proviral DNA was undetectable in one case. The mean age of the infected people (57.2) was higher than that of those that were uninfected (46.2) (p = 0.0010). The prevalence of infection increased with age, especially in individuals with a family income equal to or less than a minimum wage. Intrafamilial transmission seems to have occurred in all of the families being studied. Among the patients with HTLV-1, 30% (3/10) already had some symptom related to the infection. Discussion: The increase in prevalence rates according to age may be due to late seroconversion of a previously acquired infection, or the cumulative risk of new infections, especially in women. Conclusion: There was a moderate prevalence of the HTLV infection among adult individuals from the metropolitan area of Belém, with a predominance of HTLV-1. This infection was associated with low income and increasingly older women. It also presented intrafamily spread and negligence in the diagnosis of associated diseases.

Prevalence of Human Papillomavirus Infection and Cervical Cancer Screening among Riverside Women of the Brazilian Amazon / Prevalência da infecção pelo papilomavírus humano e rastreamento do câncer em mulheres ribeirinhas da Amazônia brasileira

Abstract Purpose The aim of this study was to evaluate the overall and type-specific prevalence of human papillomavirus (HPV) infection among females living in riverside communities in the state of Pará, in the Eastern Brazilian Amazon. These communities are inhabited by low-income people, and are accessible only by small boats. Cervical cytology and risk factors for HPV infection were also assessed. Methods Cervical samples from 353 women of selected communities were collected both for Papanicolau (Pap) test and HPV detection. Conventional polymerase chain reaction (PCR) and real-time PCR were used to assess the overall and type-specific prevalence of HPV-16 and HPV-18, the main oncogenic types worldwide. Epidemiological questionnaires were used for the assessment of the risk factors for HPV infection. Results The mean age of the participants was 37 years (standard deviation [SD] ± 13.7). Most were married or with a fixed sexual partner (79%), and had a low educational level (80%) and family monthly income (< U$ 250; 53%). Overall, HPV prevalence was 16.4% (n = 58), with 8 cases of HPV-16 (2.3%) and 5 of HPV-18 (1.4%). Almost 70% of the women surveyed had never undergone the Pap test. Abnormal cytology results were found in 27.5% (n = 97) of the samples, with higher rates of HPV infection according to the severity of the lesions (p = 0.026). Conclusions The infections by HPV-16 and HPV-18 were not predominant in our study, despite the high prevalence of overall HPV infection. Nevertheless, the oncogenic potential of these types and the low coverage of the Pap test among women from riverside communities demonstrate a potential risk for the development of cervical lesions and their progression to cervical cancer, since the access to these communities is difficult and, in most cases, these women do not have access to primary care and public health services.

Resumo Objetivo O objetivo deste estudo foi avaliar a prevalência global e tipo-específica da infecção pelo papilomavírus humano (HPV) entre mulheres que vivem em comunidades ribeirinhas do estado do Pará, Amazônia oriental, Brasil. Estas comunidades são habitadas por pessoas de baixa renda, e são acessíveis somente por meio de pequenos barcos. A citologia cervical e os fatores de risco para a infecção por HPV também foram avaliados. Métodos Amostras cervicais de 353 mulheres de comunidades selecionadas foram coletadas para a análise citológica e para a detecção do HPV. A prevalência global e tipoespecífica dos HPV-16 e HPV-18, principais tipos oncogênicos no mundo, foram avaliadas por meio de reação em cadeia de polimerase (PCR) convencional e PCR em tempo real. Os fatores de risco para a infecção por HPV foram avaliados a partir de questionários epidemiológicos. Resultados A idade média das participantes foi de 37 anos (desvio padrão [DP] ± 13,7). A maioria era casada ou tinha um parceiro sexual fixo (79%) e baixo nível de escolaridade (80%) e de renda familiar mensal (< U$ 250; 53%). A prevalência global do HPV foi de 16,4% (n = 58), com 8 casos de HPV-16 (2,3%) e 5 casos de HPV-18 (1,4%). Aproximadamente 70% das mulheres entrevistadas nunca tinha realizado o exame preventivo de Papanicolau. Os resultados citológicos anormais foram encontrados em 27,5% (n = 97) das amostras, com taxas mais altas da infecção por HPV de acordo com a severidade das lesões (p = 0,026). Conclusões As infecções por HPV-16 e HPV-18 não foram predominantes em nosso estudo, apesar da alta prevalência global da infecção por HPV. No entanto, o potencial oncogênico desses tipos e a baixa cobertura do exame de Papanicolau entre mulheres de comunidades ribeirinhas demonstram um risco potencial para o desenvolvimento de lesões cervicais e sua progressão para o câncer de colo do útero, uma vez que o acesso a essas comunidades é difícil e, na maioria dos casos, estas mulheres não têm acesso aos serviços de atenção primária e de saúde pública.

Occurrence of strongyloidiasis among patients with HTLV-1/2 seen at the outpatient clinic of the Núcleo de Medicina Tropical, Belém, State of Pará, Brazil

Introduction This study investigated the occurrence of Strongyloides stercoralis infestation and coinfection with HTLV-1/2 in Belém, Brazil. Methods S. stercoralis was investigated in stool samples obtained from individuals infected with HTLV-1/2 and their uninfected relatives. Results The frequency of S. stercoralis was 9% (9/100), including six patients infected with HTLV-1 (14.3%), two patients infected with HTLV-2 (11.1%), and one uninfected relative. Two cases of hyperinfestation by S. stercoralis were characterized as HTLV-1. Conclusions These results support the need for the routine investigation of S. stercoralis in patients with HTLV-1, in an attempt to prevent the development of severe forms of strongyloidiasis. .

Perfil dos exames citológicos do colo do útero realizados no Laboratório Central do Estado do Pará, Brasil / Profile of cervical cytological examinations performed at the Pará State Central Laboratory, Brazil

Com o objetivo de identificar o perfil dos exames citológicos do colo do útero realizados no Estado do Pará, este estudo analisou todos os resultados de exames cujas lâminas foram encaminhadas ao Laboratório Central do Estado do Pará (Lacen-PA), originados de 16 municípios paraenses, no ano 2008. Foram utilizados os testes Binomial e Exato de Fisher para verificar a significância estatística das diferenças de proporções encontradas, ao nível de confiança de 95 por cento. Dos 26.203 exames realizados, aproximadamente 3,7 por cento (n = 970) foram considerados insatisfatórios e 4,05 por cento (n = 1060) apresentaram algum tipo de alteração citológica, sendo de 0,9 por cento (n = 236) e 0,1 por cento (n = 25) as frequências de células atípicas sugestivas de lesões potencialmente malignas (lesões intraepiteliais de alto grau e microinvasivas) e de câncer invasor, respectivamente. Os resultados sugestivos de câncer invasor foram encontrados em 0,17 por cento (10/5.995) das mulheres que nunca haviam realizado o exame preventivo do colo do útero (PCCU) e em 0,08 por cento (14/17.932) das que já haviam realizado o exame anteriormente (p = 0,0301). A frequência de alterações citológicas sugestivas de câncer invasor está entre as maiores relatadas pela literatura brasileira em demanda proveniente dos serviços de atenção primária à saúde, além de apresentar-se mais elevada nas mulheres que nunca haviam realizado o PCCU. Este indicador pode estar evidenciando uma falha de cobertura na prevenção do câncer de colo do útero no Estado do Pará.

This study aimed to identify the profile of cervical cytological exams by analyzing all slides collected in 16 cities in Pará State and sent to the Pará State Central Laboratory (Lacen-PA) during 2008. Data were analyzed using the binomial and Fisher's exact tests to identify the statistical significance of the proportional differences based on a 95 per cent confidence level. Of the 26,203 exams, approximately 3.7 per cent (n=970) were considered unsatisfactory, and 4.05 per cent (n=1060) showed some type of cytological change. The incidence of atypical cells suggestive of potentially malignant lesions (high-grade and microinvasive intraepithelial lesions) and of invasive cancer were 0.9 per cent (n=236) and 0.1 per cent (n=25), respectively. Exam results suggestive of invasive cancer were found in 0.17 per cent (10/5,995) of women who had never had cervical cancer preventive examinations (Pap smears) and in 0.08 per cent (14/17,932) of women who had already undergone the exam (p=0.0301). In the Brazilian literature, the incidence of cytological changes suggestive of invasive cancer was highest among women diagnosed via primary care services. That incidence was higher for women who had never had the exam. This finding may indicate a gap in cervical cancer prevention coverage in Pará State.

Soroprevalência do vírus linfotrópico de células T humanas em comunidades ribeirinhas da região nordeste do Estado do Pará, Brasil / Human T-lymphotropic virus seroprevalence in riparian communities in the northeastern region of Pará State, Brazil

O vírus-T linfotrópico humano do tipo 1 (HTLV-1) foi o primeiro retrovírus humano a ser identificado e está associado a várias doenças de bilitantes. O Estado do Pará é o terceiro do Brasil com maior frequência de infecção por HTLV entre doadores de sangue. As comunidades ribeirinhas são carentes de ações de educação e assistência à saúde, pela característica de terem moradias espalhadas ao longo de furos e pela dificuldade de acesso aos centros urbanos. Este estudo objetivou investigar a infecção causada pelo HTLV em comunidades ribeirinhas do nordeste paraense, atendidas pelo Programa Luz na Amazônia, entre fevereiro de 2009 e junho de 2010. Pesquisa de anticorpos anti-HTLV-1/2 foi realizada em 175 ribeirinhos, sendo 30 (17,14 por cento) da comunidade de São Pedro (Acará); 62 (35,43 por cento) da comunidade do Furo do Aurá (Belém) e 83 (47,43 por cento) de Santa Maria (Acará). Nos casos reagentes, métodos de biologia molecular foram utilizados para confirmação da infecção e identificação do tipo viral. A prevalência total do HTLV-1 foi de 1,14 por cento (2/175), variando entre zero (0/34) em São Pedro, 1,20 por cento (1/83) em Santa Maria e 1,61 por cento (1/62) no Furo do Aurá. O HTLV-1 foi identificado em duas das 117 (1,71 por cento) famílias analisadas das três comunidades. Não foi observado nenhum caso de transmissão familiar na amostra. O HTLV-2 não foi encontrado na amostra estudada. Este estudo demonstrou a ocorrência de HTLV-1 nas comunidades ribeirinhas estudadas, com frequências semelhantes às de populações urbanas, indicando a necessidade de maior investigação e ações de prevenção das doenças associadas ao vírus nessas comunidades.

The human T-lymphotropic virus 1 (HTLV-1) was the first human retrovirus identified, and it is associated with several debilitating diseases. Pará State has the third highest frequency rate of HTLC infections among blood donors in Brazil. Its riparian communities lack educational policies and health care assistance mainly because they inhabit "furos" (Amazonian river channels) and do not have easy access to urban centers. This study aimed to investigate the infection by HTLV in riparian communities of northeastern Pará included in the Luz na Amazônia Program between February 2009 and June 2010. A total of 175 riparian individuals were selected for detection of anti-HTLV-1/2 antibodies: 30 from the São Pedro community (Municipality of Acará), 62 from the Furo do Aurá Community (Municipality of Belém), and 83 from Santa Maria (Municipality of Acará). In the HTLV-reactive individuals we used molecular methods to confirm infection and identify the viral type. HTLV-2 was not found in the study samples. The overall prevalence of HTLV-1 was 1.14 per cent (2/1 75), ranging from zero (0/34) in São Pedro to 1.20 per cent (1/83) in Santa Maria and 1.61 per cent (1/62) in Furo do Aurá. HTLV-1 was identified in two of 117 (1.35 per cent) families from all three communities. We reported no evidence of familial transmission through testing of samples. HTLV-2 was not found in the samples tested. This study demonstrates the occurrence of HTLV-1 in the riparian communities studied, with frequency rates similar to those of urban populations, which warrants further research and actions to prevent diseases associated with HTLV in these communities.