RESUMO
Leptospirosis is a zoonosis of great importance for One Health. In this context, the Amazonian biome may harbor numerous hosts for Leptospira spp. that contribute to the maintenance of the pathogen in the environment. Some reptiles, such as chelonians, have been little studied in terms of their involvement with leptospires. The objective of this study was to detect Leptospira spp. DNA in Kinosternon scorpioides turtles kept in captivity in a region of the Brazilian Amazon. A total of 147 samples of blood (n = 40), cloacal fluid (n = 27), cloacal lavage (n = 40), and stomach (n = 40) were collected from 40 chelonians. After DNA extraction, the samples were subjected to amplification of a 331 base pair product of the 16S rRNA gene using the Lep1 and Lep2 primers. PCR products were Sanger sequenced, assembled, and subjected to online blast search and phylogenetic analysis. Of the animals tested, 40% (16/40, 95% confidence interval [CI]: 25-55) had at least one or two samples positive for Leptospira spp. Considering the total number of samples collected, 12.93% (19/147) were positive, being blood clots (27.5%; 11/40), followed by cloacal washings (10%; 4/40), cloacal fluid (11.11%; 3/27) and gastric washings (2.5%; 1/40). Of these, 11 samples were sequenced and showed 99% to 100% identity with Leptospira interrogans sequences, which was confirmed by phylogenetic analysis. This is the first study to detect pathogenic Leptospira DNA in chelonians in a region of the Brazilian Amazon. It has been concluded that K. scorpioides turtles in captivity have been exposed to pathogenic Leptospira.
RESUMO
Descrever o perfil clínico-epidemiológico dos acidentes ofídicos ocorridos na ilha de Colares, Pará,Brasil. O estudo consistiu em uma investigação epidemiológica transversal a partir da análise de todos os casos de envenenamento por serpentes peçonhentas atendidos no Hospital Municipal e notificados ao Sistema Nacional de Notificações e Agravos (SINAN) do Ministério da Saúde, entre janeiro de 2007 e dezembro de 2011. Os dados obtidos a partir das fichas de notificação foram analisados utilizando-se estatística descritiva simples no Microsoft Excel (versão 2007). Foram notificados ao SINAN 94 casos de acidentes ofídicos, sendo observada maior concentração dos envenenamentos no primeiro semestre de cada ano, período em que ocorrem os maiores índices pluviométricos para a região. A maioria dos acidentes aconteceu na zona rural (85,11%), durante a realização dos trabalhos braçais (55,32%), com maior incidência em homens (73,40%), predominantemente provocados por serpentes do gênero Bothrops(69,62%). Foram identificadas falhas no protocolo de soroterapia, sendo verificada sua utilização em dois casos cujas serpentes não eram peçonhentas e não administrado em dois casos confirmados de acidentes ofídicos envolvendo serpentes peçonhentas. O pé foi a região mais acometida (51,06%) e a dor, edema e manifestações vagais foram os sinais mais frequentes. Estes resultados demonstram que o município de Colares segue o perfil dos acidentes ofídicos de outras localidades rurais amazônicas, sendo necessária maior atenção dos profissionais de saúde quanto ao preenchimento das fichas de notificação e aos protocolos terapêuticos dispensados às vítimas.
To describe the clinical and epidemiological profile of snakebites occurred on the island of Colares,Pará, Brazil. The study consisted of a cross-epidemiological research based on the analysis of allcases of poisoning by venomous snakes treated at City Hospital and served on the National System Notifications and Disability (SINAN) and conducted to the Ministry of Health between January 2007 and December 2011. Data obtained from the notification records were analyzed using simple descriptive statistics in Microsoft Excel (2007 version). Ninety-four cases of snakebites were reported to SINAN and the highest frequency occurred in the first half of each year, a period in which most precipitation occurs in the region. Most accidents occurred in rural areas (85.11%), while performing manual labor (55.32%), with higher incidence in men (73.40%), with predominance of accidents caused by snakes of the genus (Bothrops) (69.62%). Failures were identified in the protocol of serum therapy, as it was used in two cases in which the snakes were not venomous and not used in two other cases involving poisono us snakes. Regarding clinical aspects, the foot was the most affected region (51.06%) while pain, edema and vagal manifestations were the most frequent signs. These results demonstrate that the municipality of necklaces follows the profile of snakebites other Amazonian rural areas. Greater attention is needed from health professionals when filling in the notification forms and when following therapeutic protocols of snakebite victims.