Body Condition Scores in Cats and Associations with Systolic Blood Pressure, Glucose Homeostasis, and Systemic Inflammation.

BACKGROUND: Feline obesity is the most common nutritional disease in cats. This study aimed to investigate the differences between systolic blood pressure (SBP) and circulating concentrations of glucose, fructosamine, and serum amyloid-A (SAA) in ideal-weight, overweight, and obese cats. METHODS: The animals were divided into three groups: ideal-weight (BCS 5, N = 20), overweight (BCS 6, N = 20), and obese cats (BCS ≥ 7, N = 20). SBP, circulating concentrations of glucose, fructosamine, and SAA were evaluated. RESULTS: The SBP values of the ideal-weight, overweight, and obese cats were 140.0 mmHg, 160.0 mmHg, and 160.0 mmHg, respectively. The blood glucose and fructosamine levels for the ideal, overweight, and obese cats were 104.0 mg/dL and 245.0 µmol/L, 123.0 mg/dL and 289.0 µmol/L, and 133.0 mg/dL and 275.0 µmol/L, respectively, for each group. The SAA values were <5 ug/mL in all the groups. The SBP values of the cats with ideal BCS were significantly lower compared to overweight (p = 0.019) and obese (p = 0.001) cats. The blood glucose values of obese cats were higher than those of ideal-weight cats (p = 0.029). There was no statistical difference between the groups for fructosamine and SAA. CONCLUSIONS: Obese cats had significantly higher SBP and blood glucose concentrations than ideal-weight cats, showing the effect of BSC on these parameters.

Spatio-temporal distribution and contributing factors of tegumentary and visceral leishmaniasis: A comparative study in Bahia, Brazil.

Tegumentary (TL) and visceral (VL) leishmaniasis are neglected zoonotic diseases in Brazil, caused by different parasites and transmitted by various vector species. This study investigated and compared spatio-temporal patterns of TL and VL from 2007 to 2020 in the state of Bahia, Brazil, and their correlations with extrinsic factors. The results showed that the total number of cases of both TL and VL were decreasing. The number of municipalities with reported cases reduced for TL over time but remained almost unchanged for VL. There were few municipalities with reported both diseases. Statistical analysis showed that local TL incidence was associated positively with natural forest. Local VL incidence was associated positively with Cerrado (Brazilian savannah) vegetation. This study identified different patterns of occurrence of VL and TL and the risk areas that could be prioritized for epidemiological surveillance.

Tungiasis: Participation of Cats and Chickens in the Dispersion and Maintenance of the Disease in an Endemic Tourist Area in Brazil.

Tunga spp. are fleas commonly found in impoverished tropical regions. In Vila Juerana, a tourist community in Ilheus, Bahia, Brazil, where tungiasis is endemic, dogs are the main host of fleas during their life cycle. However, there is no information about the role of cats and chickens in tungiasis in the village. Of the 272 households investigated, 112 had domestic animals, 48 had only dogs, 28 had only cats, and nine had only chickens. Of the 27 households with cohabitation among species, 16 had cats and dogs, eight had chickens and dogs, and three had dogs, cats, and chickens. The injuries due to tungiasis were ranked according to the Fortaleza classification, considering stages I, II, and III as viable lesions. The paws/feet of 71/111 (63.9%) cats and 173/439 (39.4%) chickens were inspected. Dogs that lived with positive cats and chickens also were inspected. Among the 38% (27/7; 95% IC 26.74-49.32) positive cats, 16 cohabited houses with infected dogs but none lived with positive chickens. Of the chickens, 2.3% (4/173; 95% IC 0.07-4.5) had lesions caused by tungiasis. In each household where a cat was infected, the dog was also positive. Two chickens cohabited with an infected dog and the other two did not coexist with other species. Cohabitation with infected dogs and the absence of house confinement restrictions in Vila Juerana make cats important carriers that spread tungiasis in this community. Chickens had a low frequency of tungiasis lesions despite living in proximity to infected dogs and cats.

Detection of Rickettsia spp. in Animals and Ticks in Midwestern Brazil, Where Human Cases of Rickettsiosis Were Reported.

Brazilian spotted fever (BSF) is the most important tick-borne diseases affecting humans in Brazil. Cases of BSF have recently been reported in the Goiás state, midwestern Brazil. All cases have been confirmed by reference laboratories by seroconversion to Rickettsia rickettsii antigens. Because serological cross-reactions among different rickettsial species that belong to the spotted fever group (SFG) are common, the agent responsible for BSF cases in Goiás remains unknown. From March 2020 to April 2022, ticks and plasma were collected from dogs, horses and capybaras (Hydrochoerus hydrochaeris), and from the vegetation in an area where BSF cases have been reported and two areas under epidemiological surveillance in Goiás. Horses were infested by Amblyomma sculptum, Dermacentor nitens and Rhipicephalus microplus; dogs by Rhipicephalus sanguineus sensu lato (s.l.), Amblyomma ovale and A. sculptum, and capybaras by A. sculptum and Amblyomma dubitatum. Adults of A. sculptum, A. dubitatum, Amblyomma rotundatum and immature stages of A. sculptum and A. dubitatum, and Amblyomma spp. were collected from the vegetation. DNA of Rickettsia that did not belong to the SFG was detected in A. dubitatum, which was identified by DNA sequencing as Rickettsia bellii. Seroreactivity to SFG and Rickettsia bellii antigens was detected in 25.4% (42/165) of dogs, 22.7% (10/44) of horses and 41.2% (7/17) of capybaras, with higher titers for R. bellii in dogs and capybaras. The seropositivity of animals to SFG Rickettsia spp. antigens demonstrates the circulation of SFG rickettsiae in the region. Further research is needed to fully determine the agent responsible for rickettsiosis cases in this area.

Patterns and drivers of Human Visceral Leishmaniasis in Pernambuco (Brazil) from 2007 to 2018.

Visceral leishmaniasis (VL) is the second most common protozoosis that affects people around the world. The aim of this study is to understand how environmental and socioeconomic factors, as well as VL control and surveillance interventions, influence the spread and detection of VL cases in Pernambuco state (Brazil). A novel model was developed to analyze cases of VL between 2007 and 2018, enabling the quantification of the association of these variables with two processes: the probability of "invasion" (emergence of new cases) at municipalities by VL, and the probability of detecting cases not reported in municipalities that have already been invaded. Pernambuco state identified 1,410 cases of VL between 2007 and 2018, with an average of 128 cases per year and average incidence of 1.28/100 thousand people. These cases were distributed in 77.1% (142/184) of the municipalities, and 54.8% (773/1,410) of them were autochthonous. Our model reveals that the proportion of agriculture was positively associated with VL invasion probability. We also find that municipalities that are closer to notification centers and/or that have received technical training and support tend to have higher detection rates of VL cases. Taken together, these results suggest that a municipality with almost no agriculture and that received technical training, located close to a notification center, is unlikely to be invaded if no cases have ever been detected. On the other hand, a municipality that is far from the notification center, with no technical training, with a large agricultural area might have already been invaded but the surveillance system might have routinely failed to detect VL cases due to low detection probability. By disentangling the processes of invasion and detection, we were able to generate insights that are likely to be useful for the strategic allocation of VL prevention and control interventions.

Spatial Distribution of Off-Host Stages of Tunga penetrans in the Soil within the Home Range of Nine Infected Dogs in An Endemic Tourist Area in Brazil.

Tungiasis is a neglected disease caused by the sand flea Tunga penetrans, and dogs are considered the main reservoirs in Brazil. This study aimed to identify the role of dogs as tungiasis dispersers and to investigate the presence of T. penetrans in the soil of an endemic tourist area. Nine dogs infected by T. penetrans were included in this study and received GPS collars to analyze their movement through the village. Duplicate sand samples were collected in different areas of the community. Those areas were classified as peridomicile (n = 110), open area (n = 110), beach (n = 50), and river (n = 58). The analysis of the points recorded by the collars showed that the dogs roamed throughout the community, potentially facilitating the spread of the disease. Samples contaminated with developmental forms of the parasite were found in the circulation area of three dogs. Adult fleas were found in 3/328 samples. These data emphasize that infected dogs' roaming can influence the fleas' dispersion in the soil. Statistically, none of the study variables had a significant correlation (p > 0.5) with the presence of T. penetrans in the area analyzed. This study was the first to assess infected dogs' role as tungiasis propagators.

Cross-sectional spatial and epidemiological analysis of canine visceral leishmaniasis cases in the triple border region, Brazil, Argentina and Paraguay, between 2015 and 2020.

Visceral Leishmaniasis is one of the most important vector-borne zoonoses in the world. In 2013, the first autochthonous canine case of the disease in the state of Paraná, southern region of Brazil, was reported in Foz do Iguaçu, on the triple border between Brazil, Argentina and Paraguay. In 2015, the first human case was related. Once the endemic was confirmed, the Zoonoses Control Center (ZCC), an agency of the Municipal Health Department, started actions to implement the Human Visceral Leishmaniasis (HVL) Surveillance and Control Program (VLSCP), of the Ministry of Health. Between 2015 and 2020, 12,205 dog samples were analyzed for the diagnosis of the disease. A prevalence of 37.94% (4,630 samples) was found: 2016 had the highest prevalence, with 46.25%, and the year with the lowest prevalence was 2020, with 25.98%. Possible risk factors for dogs were analyzed, and the results obtained were: whether the request for the exam was performed by the ZCC was a significant protective factor, with a lower prevalence (37.5%) than dogs coming from private clinics (OR = 0.89, p-value = 0.016). Males were significantly more infected than females, with 41.1% and 35.7% positivity, respectively (OR = 1.24, p < 0.0001). Companion dogs and mixed breed dogs were significantly less affected than the other groups tested (OR = 0.44, p < 0.001; OR = 0.79, p = 0.012, respectively). The dogs' dark coat color was a significant risk factor with respect to the other color categories. Short and medium coat sizes were significantly considered risk factors, with 41.3% and 31.3% positivity. Long-haired dogs had only 22.7% positivity. In univariate analyses, giant, large and medium dogs were significantly more affected than small dogs. Dogs up to four years of age were significantly less affected than those in other age groups. There was a coincidence of human and canine cases in the spatial distribution. However, according to the literature, a higher incidence would be expected in humans, due to the high prevalence found in dogs. Therefore, further studies should be carried out to understand the dynamics of the disease in this region.

Fast surveillance response reveals the introduction of a new yellow fever virus sub-lineage in 2021, in Minas Gerais, Brazil.

BACKGROUND: In Brazil, the yellow fever virus (YFV) is maintained in a sylvatic cycle involving wild mosquitoes and non-human primates (NHPs). The virus is endemic to the Amazon region; however, waves of epidemic expansion reaching other Brazilian states sporadically occur, eventually causing spillovers to humans. OBJECTIVES: To report a surveillance effort that led to the first confirmation of YFV in NHPs in the state of Minas Gerais (MG), Southeast region, in 2021. METHODS: A surveillance network was created, encompassing the technology of smartphone applications and coordinated actions of several research institutions and health services to monitor and investigate NHP epizootics. FINDINGS: When alerts were spread through the network, samples from NHPs were collected and YFV infection confirmed by reverse transcription-quantitative polymerase chain reaction (RT-qPCR) and genome sequencing at an interval of only 10 days. Near-complete genomes were generated using the Nanopore MinION sequencer. Phylogenetic analysis indicated that viral genomes were related to the South American genotype I, clustering with a genome detected in the Amazon region (state of Pará) in 2017, named YFVPA/MG sub-lineage. Fast YFV confirmation potentialised vaccination campaigns. MAIN CONCLUSIONS: A new YFV introduction was detected in MG 6 years after the beginning of the major outbreak reported in the state (2015-2018). The YFV strain was not related to the sub-lineages previously reported in MG. No human cases have been reported, suggesting the importance of coordinated surveillance of NHPs using available technologies and supporting laboratories to ensure a quick response and implementation of contingency measures to avoid YFV spillover to humans.

Seroprevalence and hematological abnormalities associated with Ehrlichia canis in dogs referred to a veterinary teaching hospital in central-western Brazil / Soroprevalência e alterações hematológicas associadas com Ehrlichia canis em cães encaminhados a um hospital veterinário-escola no centro-oeste do Brasil

Ticks are significant parasites of dogs in the tropics, where tick-borne pathogens are highly prevalent, especially in areas where tick control measures are frequently neglected. This study investigated the seroprevalence and hematological abnormalities associated with Ehrlichia canis in dogs referred to a veterinary teaching hospital in Central-western Brazil. Out of 264 dogs tested for anti-Ehrlichia canis antibodies by an indirect immunofluorescence assay (IFA), 59.1% (156/264) were positive. Seropositivity was significantly associated to anemia and thrombocytopenia, alone or in combination, and to leukopenia. Conversely, there were no differences in terms of seroprevalence according to sex, breed and age. This study demonstrated that dogs referred to a veterinary teaching hospital in Central-western Brazil are highly exposed to E. canis and that seropositive dogs are more likely to present hematological abnormalities, particularly anemia, thrombocytopenia and leukopenia. To our knowledge, this is the first study on detection of anti-E. canis antibodies by means of IFA among dogs in the state of Goiás. These findings highlighted the need for increasing awareness among dog owners regarding tick control measures in Central-western Brazil, ultimately to reduce the risk of exposure to E. canis and other tick-borne pathogens.

Carrapatos são importantes parasitos de cães nos trópicos, onde patógenos transmitidos por carrapatos são altamente prevalentes, especialmente em áreas onde as medidas de controle de carrapatos são frequentemente negligenciadas. O estudo investigou a soroprevalência e as anormalidades hematológicas associadas à Ehrlichia canis em cães encaminhados para um hospital veterinário-escola no Centro-oeste do Brasil. Dos 264 cães testados para anticorpos anti-Ehrlichia canis por meio da reação de imunofluorescência indireta (RIFI), 59.1% (156/264) foram positivos. A soropositividade foi associada significativamente à anemia e trombocitopenia, isoladamente ou em combinação, e à leucopenia. Por outro lado, não houve diferenças quanto à soroprevalência segundo sexo, raça e idade. Este estudo demonstrou que cães encaminhados a um hospital veterinário-escola na região Centro-oeste do Brasil são altamente expostos à E. canis, e que cães soropositivos têm maior probabilidade de apresentar alterações hematológicas, principalmente anemia, trombocitopenia e leucopenia. Para o nosso conhecimento, este é o primeiro estudo sobre a detecção de anticorpos anti-E. canis por meio da RIFI em cães do estado de Goiás. Essas descobertas destacam a necessidade de aumentar a conscientização entre os proprietários de cães em relação às medidas de controle do carrapato no Centro-oeste do Brasil, em última análise, para reduzir o risco de exposição ao E. canis e outros patógenos transmitidos por carrapatos.

Fast surveillance response reveals the introduction of a new yellow fever virus sub-lineage in 2021, in Minas Gerais, Brazil

BACKGROUND In Brazil, the yellow fever virus (YFV) is maintained in a sylvatic cycle involving wild mosquitoes and non-human primates (NHPs). The virus is endemic to the Amazon region; however, waves of epidemic expansion reaching other Brazilian states sporadically occur, eventually causing spillovers to humans. OBJECTIVES To report a surveillance effort that led to the first confirmation of YFV in NHPs in the state of Minas Gerais (MG), Southeast region, in 2021. METHODS A surveillance network was created, encompassing the technology of smartphone applications and coordinated actions of several research institutions and health services to monitor and investigate NHP epizootics. FINDINGS When alerts were spread through the network, samples from NHPs were collected and YFV infection confirmed by reverse transcription-quantitative polymerase chain reaction (RT-qPCR) and genome sequencing at an interval of only 10 days. Near-complete genomes were generated using the Nanopore MinION sequencer. Phylogenetic analysis indicated that viral genomes were related to the South American genotype I, clustering with a genome detected in the Amazon region (state of Pará) in 2017, named YFVPA/MG sub-lineage. Fast YFV confirmation potentialised vaccination campaigns. MAIN CONCLUSIONS A new YFV introduction was detected in MG 6 years after the beginning of the major outbreak reported in the state (2015-2018). The YFV strain was not related to the sub-lineages previously reported in MG. No human cases have been reported, suggesting the importance of coordinated surveillance of NHPs using available technologies and supporting laboratories to ensure a quick response and implementation of contingency measures to avoid YFV spillover to humans.

Characteristics and Factors Associated with SARS-CoV-2 Infections in Individuals That Attended Referral Hospitals from Southern Region of Bahia State, Brazil: A Surveillance Network Retrospective Study.

In December 2019, a novel coronavirus was detected in Wuhan, China, and rapidly spread worldwide. In Brazil, to date, there have been more than 20,000,000 confirmed cases of COVID-19 and more than 550,000 deaths. The purpose of the current study was to determine the clinical and epidemiological profile of the population affected by COVID-19 that have attended referral hospitals in Southern region of Bahia State, to better understand the disease and its risk factors in order to enable more appropriate conduct for patients. An observational, descriptive, cross-sectional, exploratory study was conducted using secondary data collected from the Laboratório de Farmacogenômica e Epidemiologia Molecular, Universidade Estadual de Santa Cruz (LAFEM/UESC). Chi-squared and Fisher's exact tests were applied to determine the association between clinical symptoms and laboratory results, and to identify risk factors associated with SARS-CoV-2 infection. A total of 3135 individuals with suspected severe respiratory illness were analyzed and 41.4% of them tested positive for SARS-CoV-2 infection. Male individuals and having comorbidities were risk factors significantly associated with SARS-CoV-2 infection (OR = 1.17 and OR = 1.37, respectively). Interestingly, being a healthcare professional was a significantly protective factor (OR = 0.81, p < 0.001). Our findings highlight the importance of routinely testing the population for early identification of infected individuals, and also provide important information to health authorities and police makers to improve control measures, management, and screening protocols.

Investigation of canine visceral leishmaniasis in a non-endemic area in Brazil and the comparison of serological and molecular diagnostic tests.

INTRODUCTION: Visceral leishmaniasis (VL) is an important zoonosis in Brazil. Previous identification of parasitized dogs can also help prevent the disease in humans, even in non-endemic areas of the country. The Brazilian Ministry of Health recommends diagnosis in dogs using a DPP® (rapid test) as a screening test and an immunoenzymatic assay (ELISA) as a confirmatory test (DPP®+ELISA), and culling infected dogs as a legal control measure. However, the accuracy of these serological tests has been questioned. METHODS: VL in dogs was investigated in a non-endemic area of the São Paulo state for three consecutive years, and the performances of different diagnostic tests were compared. RESULTS: A total of 331 dog samples were collected in 2015, 373 in 2016, and 347 in 2017. The seroprevalence by DPP®+ELISA was 3.3, 3.2, and 0.3%, respectively, and by indirect immunofluorescence assay (IFA), it was 3.0, 5.6, and 5.5%, respectively. ELISA confirmed 18.4% of DPP® positive samples. The concordance between the IFA and DPP® was 83.9%. The concordance between IFA and DPP®+ELISA was 92.9%. A molecular diagnostic test (PCR) was performed in 63.2% of the seropositive samples, all of which were negative. CONCLUSIONS: In non-endemic areas, diagnostic tests in dogs should be carefully evaluated to avoid false results.

Does deforestation drive visceral leishmaniasis transmission? A causal analysis.

Vector-borne diseases (VBDs) are important contributors to the global disease burden and are a key factor in perpetuating economic inequality. Although environmental changes are often cited as drivers of VBDs, the link between deforestation and VBD occurrence remains unclear. Here, we examined this relationship in detail using the spread of visceral leishmaniasis (VL) in São Paulo state (Brazil) as the case study. We used a two-step approach to estimate the causal effects (overall, direct, and indirect) of deforestation on the occurrence of the VL vector, canine visceral leishmaniasis (CVL), and human visceral leishmaniasis (HVL). We first estimated the parameters via a double Metropolis-Hastings algorithm and then estimated the causal effects through a Gibbs sampler. We observed that the odds of vector, CVL, and HVL occurrence were 2.63-, 2.07-, and 3.18-fold higher, respectively, in deforested compared with forested municipalities. We also identified a significant influence of the presence of vector, CVL, and HVL in one municipality on disease occurrence in previously naive neighbouring municipalities. Lastly, we found that a hypothetical reduction in deforestation prevalence from 50 to 0% across the state would reduce vector, CVL, and HVL occurrence by 11%, 6.67%, and 29.87%, respectively. Our results suggest that implementing an eco-friendly development strategy that considers trade-offs between agriculture, urbanization, and conservation could be an effective mechanism of controlling VL.

Sarcocystis neurona, seroprevalence of antibodies in equines and research of oocystis in opossum in Ilhéus - Itabuna microregion, Bahia, Brazil.

The aims of this study were to determine the seroprevalence of Sarcocystis neurona antibodies in equines in the Ilhéus-Itabuna microregion (BA), and identify possible factors associated with infection. The presence of sporocysts/oocysts of Sarcocystis spp. was also verified in Didelphis spp. A total of 669 serum samples were collected from equines in 56 properties located in 12 municipalities in the region. Indirect fluorescent antibody test was performed with slides containing merozoites of the S. neurona, using a cut-off titer of 1:80. Occurrence of 7.92% of anti-S. neurona antibodies was observed in the sampled equines. The purposes trade and work were significantly associated with the presence of antibodies (p<0.05), and being used for the purpose of work (21.6%) was considered a risk factor, while being used for the purpose of trade (3.6%) was a protective factor. A total of 25 Didelphis spp. was captured for research on sporocysts/oocysts in stool samples and intestinal scrapings, being all negative. Didelphis spp. were all negative for the presence of Sarcocystis spp. and this circumstance does not change the fact that seroprevalence of S. neurona has been observed in horses raised in the southern Bahia.

Seasonal dynamics of Amblyomma sculptum in two areas of the Cerrado biome midwestern Brazil, where human cases of rickettsiosis have been reported.

Amblyomma sculptum is a common human-biting tick in Brazil, where it plays an important role as a vector of Rickettsia rickettsii, the agent of the Brazilian spotted fever. Herein, we studied the seasonal dynamics of A. sculptum in an urban area of the Cerrado biome in midwestern Brazil, where human rickettsiosis is endemic. Ticks were collected in two sites located within the campus of Federal University of Goiás. The collections were done by dragging, flagging and visual search. In total, 117,685 ticks were collected, including 100,627 Amblyomma spp. larvae, 10,055 nymphs and 6977 adults of A. sculptum, and one nymph and 25 adults of Amblyomma dubitatum. The highest peak of larvae occurred in June 2018 and in July 2019, whereas nymphs peaked in July 2018 and September 2019. Adults reached their highest numbers in March 2018 and November 2019. These data suggest that A. sculptum develops one generation per year in this urban area of the Cerrado biome in midwestern Brazil. Interestingly, the peak of nymphs occurred during the same period of all confirmed cases of rickettsiosis in Goiás, suggesting a possible relationship between the seasonal dynamics of this tick stage and rickettsiosis transmission in this state.

Epidemiological profile and lethality of visceral leishmaniasis/human immunodeficiency virus co-infection in an endemic area in Northeast Brazil.

INTRODUCTION: The association of visceral leishmaniasis (VL) and human immunodeficiency virus (HIV) infection is a concern worldwide, and this co-infection is linked to increased lethality. The Northeast is the region that mostly reports cases of VL in Brazil. The knowledge of risk factors associated with VL/HIV co-infection and its impact on lethality is extremely important. METHODS: The present study analyzed the epidemiologic features of cases with VL/HIV co-infection in the state of Pernambuco, Northeast of Brazil, from 2014 to 2018. RESULTS: There were 858 and 11,514 reported cases of VL and HIV infection, respectively. The average incidences of VL and HIV infection were 1.82 and 24.4/100,000 inhabitants, respectively. Of all reported cases of VL, 4.9% (42/858) also had HIV infection. There was an inverse spatial association between VL and HIV infection incidences. The lethality rates of VL, HIV infection, and co-infection were 9.9%, 26.1%, and 16.6%, respectively. Most of the patients were males and lived in urban areas. The cases of VL mostly occurred in children aged below 10 years, whereas the cases of HIV infection and VL/HIV co-infection were primarily observed in adults between 20 years and 39 years old. CONCLUSIONS: We defined the profile and areas with most cases of co-infection and found that the lethality of VL with co-infection increased in the current period. These findings contribute to applying efforts with a greater focus in these identified populations to prevent future deaths.

American cutaneous leishmaniasis associated with degradation of native forest, regardless of economic, social and infrastructure vulnerability.

American cutaneous leishmaniasis (ACL) is a notifiable dermatozoonosis with relevant morbidity. The present study aimed to evaluate the epidemiological aspects of cases of ACL reported in Northern Paraná (2007-2016), as well as to georeference and analyse the influence of economic, social and environmental variables. Data from ACL notification forms were obtained and the patients' houses were georeferenced. Descriptive statistics, calculations of disease incidence and proportion of vegetation cover by municipality, spatial analysis, multiple linear regression and vulnerability analysis by census sector (CS) were performed. One thousand four hundred fifty-one cases of ACL were reported in the 89 municipalities of four regional health (RH). The average incidence of cases per 10,000 inhabitants was as follows: 11.58, 8.79, 4.92 and 4.03 in 18thRH, 15thRH, 16thRH and 17thRH. Peaks of incident cases were observed in 2008, 2012 and 2015. There was a statistically significant difference between the HR when comparing the proportions of the variables gender, age, education level, area of residence, clinical form, diagnostic criteria, response to treatment and drug used in case of failure. It was observed that the lower the proportion of remaining Atlantic Forest, the greater the incidence of ACL in the municipality. With regard to clusters analysis, treatment abandonment clusters were observed in the 15thRH and mucous form clusters were observed in the 15thRH, 16thRH and 17thRH. The vulnerability analysis by CS allowed us to observe a statistically significant difference in all vulnerability indicators: economic and social in 15thRH and 17thRH; home infrastructure in 15thRH and 18thRH, urban infrastructure in 15thRH and 18thRH and compound vulnerability index in 15thRH and 18thRH. However, the most vulnerable areas did not always have the highest number of cases. The data presented demonstrate that preventive and health education measures must be mainly directed to areas of greater degradation of native forest; regardless of the vulnerability situation.

Sarcocystis neurona, seroprevalence of antibodies in equines and research of oocystis in opossum in Ilhéus - Itabuna microregion, Bahia, Brazil / Sarcocystis neurona, seroprevalência de anticorpos em equinos e pesquisa de oocistos em gambás na microrregião de Ilhéus - Itabuna, Bahia, Brasil

Abstract The aims of this study were to determine the seroprevalence of Sarcocystis neurona antibodies in equines in the Ilhéus-Itabuna microregion (BA), and identify possible factors associated with infection. The presence of sporocysts/oocysts of Sarcocystis spp. was also verified in Didelphis spp. A total of 669 serum samples were collected from equines in 56 properties located in 12 municipalities in the region. Indirect fluorescent antibody test was performed with slides containing merozoites of the S. neurona, using a cut-off titer of 1:80. Occurrence of 7.92% of anti-S. neurona antibodies was observed in the sampled equines. The purposes trade and work were significantly associated with the presence of antibodies (p<0.05), and being used for the purpose of work (21.6%) was considered a risk factor, while being used for the purpose of trade (3.6%) was a protective factor. A total of 25 Didelphis spp. was captured for research on sporocysts/oocysts in stool samples and intestinal scrapings, being all negative. Didelphis spp. were all negative for the presence of Sarcocystis spp. and this circumstance does not change the fact that seroprevalence of S. neurona has been observed in horses raised in the southern Bahia.

Resumo O presente estudo foi realizado na microrregião de Ilhéus-Itabuna, Bahia. Os objetivos deste estudo foram determinar a soroprevalência de anticorpos contra Sarcocystis neurona em equinos da microrregião Ilhéus-Itabuna (BA) e identificar possíveis fatores associados à infecção. A presença de esporocistos/oocistos de Sarcocystis spp. também foi pesquisada em Didelphis spp. Foram coletadas 669 amostras de soro de equinos em 56 propriedades localizadas em 12 municípios da região. Foi utilizada a reação de imunofluorescência indireta (RIFI), utilizando-se lâminas confeccionadas com merozoítos de Sarcocystis neurona (cepa SN138) e ponto de corte na diluição de 1:80. A ocorrência de anticorpos anti- S. neurona, nos equinos amostrados, foi de 7,92%. As finalidades dos animais - comércio e trabalho - apresentaram-se significativas (p<0.05), sendo que a finalidade trabalho (21,6%) foi considerada fator de risco, enquanto a finalidade comércio (3,6%) foi considerada fator de proteção. Foram capturados 25 Didelphis spp., para pesquisa de esporocistos/oocistos em amostras de fezes e raspado de mucosa intestinal. Todos os Didelphis spp. foram negativos para a presença de Sarcocystis spp., mesmo assim essa circunstância não alterou o fato da ocorrência de S. neurona ter sido observada em cavalos criados na mesorregião do sul da Bahia.

Epidemiological profile and lethality of visceral leishmaniasis/human immunodeficiency virus co-infection in an endemic area in Northeast Brazil

Abstract INTRODUCTION: The association of visceral leishmaniasis (VL) and human immunodeficiency virus (HIV) infection is a concern worldwide, and this co-infection is linked to increased lethality. The Northeast is the region that mostly reports cases of VL in Brazil. The knowledge of risk factors associated with VL/HIV co-infection and its impact on lethality is extremely important. METHODS: The present study analyzed the epidemiologic features of cases with VL/HIV co-infection in the state of Pernambuco, Northeast of Brazil, from 2014 to 2018. RESULTS: There were 858 and 11,514 reported cases of VL and HIV infection, respectively. The average incidences of VL and HIV infection were 1.82 and 24.4/100,000 inhabitants, respectively. Of all reported cases of VL, 4.9% (42/858) also had HIV infection. There was an inverse spatial association between VL and HIV infection incidences. The lethality rates of VL, HIV infection, and co-infection were 9.9%, 26.1%, and 16.6%, respectively. Most of the patients were males and lived in urban areas. The cases of VL mostly occurred in children aged below 10 years, whereas the cases of HIV infection and VL/HIV co-infection were primarily observed in adults between 20 years and 39 years old. CONCLUSIONS: We defined the profile and areas with most cases of co-infection and found that the lethality of VL with co-infection increased in the current period. These findings contribute to applying efforts with a greater focus in these identified populations to prevent future deaths.

Investigation of canine visceral leishmaniasis in a non-endemic area in Brazil and the comparison of serological and molecular diagnostic tests

Abstract INTRODUCTION: Visceral leishmaniasis (VL) is an important zoonosis in Brazil. Previous identification of parasitized dogs can also help prevent the disease in humans, even in non-endemic areas of the country. The Brazilian Ministry of Health recommends diagnosis in dogs using a DPP® (rapid test) as a screening test and an immunoenzymatic assay (ELISA) as a confirmatory test (DPP®+ELISA), and culling infected dogs as a legal control measure. However, the accuracy of these serological tests has been questioned. METHODS: VL in dogs was investigated in a non-endemic area of the São Paulo state for three consecutive years, and the performances of different diagnostic tests were compared. RESULTS: A total of 331 dog samples were collected in 2015, 373 in 2016, and 347 in 2017. The seroprevalence by DPP®+ELISA was 3.3, 3.2, and 0.3%, respectively, and by indirect immunofluorescence assay (IFA), it was 3.0, 5.6, and 5.5%, respectively. ELISA confirmed 18.4% of DPP® positive samples. The concordance between the IFA and DPP® was 83.9%. The concordance between IFA and DPP®+ELISA was 92.9%. A molecular diagnostic test (PCR) was performed in 63.2% of the seropositive samples, all of which were negative. CONCLUSIONS: In non-endemic areas, diagnostic tests in dogs should be carefully evaluated to avoid false results.