Avaliação da acurácia do teste rápido para diagnóstico de Helicobacter pylori em pacientes não submetidos à terapia de erradicação prévia sujeitados á endoscopia digestiva alta / Assessment of the accuracy of the rapid test for the diagnosis of helicobacter pylori in patients that didn't undergo previous eradication therapy and who went through endoscopy

ABSTRACT Background: Helicobacter pylori infection is widely spread globally and is known to cause potentially serious diseases. Several diagnostic methods exist to identify and treat carriers of this bacterium. Serological tests for the diagnosis of infection are based on the detection of antibodies immunoglobulin G against H. pylori, a non-invasive, inexpensive, and easy-to-perform option. Objective: This research aims to ascertain the accuracy of an immunochromatographic serological test to verify the feasibility of using this method in patients who have not undergone previous eradication therapy. Methods: Rapid tests and questionnaires were applied to 53 patients that underwent upper digestive endoscopy with research for H. pylori between the period of September and October 2021. The results were compared with histopathology. Results: In the rapid tests, seven positive and 46 negative results were obtained. When compared with the gold stan­dard, the following values were described: sensitivity 54.5%, specificity 97.6%, positive predictive value 85.7%, and negative predictive value 89.1%. Conclusion: In the present study, the immunochromatographic serological tests had an accuracy close to the values found in other similar studies. Therefore, it may be concluded that the rapid serological test remains a reasonable choice for screening large populations due to its low cost and ease of application, especially in those individuals who have not undergone previous treatment.

RESUMO Contexto: A infecção pelo Helicobacter pylori apresenta-se amplamente difundida globalmente e é comprovadamente causadora de patologias potencialmente graves. Diversos métodos diagnósticos existem com o propósito de identificar e tratar os portadores dessa bactéria. Testes sorológicos para diagnóstico da infecção se baseiam na detecção de anticorpos imunoglobulina G anti-H.pylori, sendo uma opção não-invasiva, barata e de fácil realização. Objetivo: O objetivo dessa pesquisa é determinar a acurácia de um teste sorológico imunocromatográfico para verificar a viabilidade do uso desse método em pacientes que não realizaram terapia de erradicação prévia. Métodos: Foram aplicados testes rápidos e questionários em 53 participantes que realizaram endoscopia digestiva alta com pesquisa de H. pylori entre o período de setembro e outubro de 2021. Os resultados foram comparados com a histopatologia. Resultados: Foram obtidos nos testes rápidos 7 resultados positivos e 46 negativos. Ao comparar com o padrão-ouro, os seguintes valores foram descritos: Sensibilidade 54,5%, especificidade 97,6%, valor preditivo positivo 85,7% e valor preditivo negativo 89,1%. No presente estudo, os testes sorológicos imunocromatográficos tiveram acurácia próxima aos valores encontrados em outros trabalhos semelhantes. Conclusão: Sendo assim, conclui-se que o teste rápido sorológico permanece como escolha razoável para screening de grandes populações devido ao seu baixo custo e facilidade de aplicação, especialmente naqueles indivíduos que não realizaram tratamento prévio.

Efficacy of some avian influenza H5 vaccines against local highly pathogenic avian influenza viruses subtype H5N8 isolated in 2018 and 2020 in Egypt

Commercial inactivated avian influenza H5 vaccine is used as an essential control strategy for avian influenza disease in Egypt. Since the initial outbreaks of highly pathogenic avian influenza H5N8, the virus has diverged with new genotypes and variant viruses continuing to emerge which mainly stand behind vaccination failure. In the present work, four different commercial avian influenza vaccines were inoculated in specific pathogenic free chickens for assessing its efficacy against local highly pathogenic avian influenza H5N8 virus isolated in 2018 and 2020. Two hundred and forty specific pathogenic free chickens were clustered into four groups; each group was inoculated with the corresponding vaccine (60 specific pathogenic free chickens/vaccine). Sixty specific pathogenic free chicks were kept as control unvaccinated group. Sera collected from vaccinated chicken groups at 3rd and 4th week post vaccination were examined for calculating neutralizing antibodies using heterologous highly pathogenic avian influenza H5N8 2018 and 2020. At 4th week post vaccination, vaccinated chickens were challenged; moreover, oropharyngeal swabs were collected from challenged vaccinated chickens to calculate the viral shedding. Our findings revealed the groups vaccinated with vaccine code no 1 and 2 that contains two vaccine strains (H5N1 and H5N8) of local origin exhibited the highest hemagglutination inhibition titer, protection (percent) and reduction in viral shedding titer when examined by highly pathogenic avian influenza H5N8 2018 while, vaccine code no 3 induced lower antibody response, protection (percent) and reduction in viral shedding, but still within satisfactory level when compared to previous groups. When highly pathogenic avian influenza H5N8 2020 was used, it was found the seroconversion rate, protection (percent) and mean titer of reduction of viral shedding decreased in comparison to those recorded for highly pathogenic avian influenza H5N8 2018. Vaccine code no 4 was impotent to either highly pathogenic avian influenza 2018 or 2020. Accordingly, it was recommended to update vaccine strain according to epidemiological condition and used the predominant circulating strain isolate in challenge test(AU)

La vacuna comercial inactivada H5 se utiliza como estrategia esencial de control de la enfermedad de la gripe aviar en Egipto. Desde los brotes iniciales de la gripe aviar altamente patógena H5N8, el virus ha variado al aparecer continuamente nuevos genotipos y variantes virales, que son los principales responsables del fracaso de la vacunación. En el presente trabajo, cuatro vacunas comerciales diferentes contra la gripe aviar se inocularon en pollos libres de patógenos específicos para evaluar su eficacia contra cepas del virus local de la gripe aviar altamente patógeno H5N8 aisladas en 2018 y 2020. Se agruparon 240 pollos pollos libres de patógenos específicos en cuatro grupos, cada uno fue inoculado con la vacuna correspondiente (60 pollos pollos libres de patógenos específicos/vacuna). Sesenta pollos SPF se mantuvieron como grupo control sin vacunar. Los sueros de los pollos vacunados recogidos en la 3ª y 4ª semana después de la vacunación se examinaron para calcular los anticuerpos neutralizantes contra la gripe aviar heteróloga H5N8 2018 y 2020. En la cuarta semana después de la vacunación, los pollos vacunados fueron retados; además, se recogieron hisopados orofaríngeos de los pollos vacunados retados para calcular la diseminación viral. Nuestros resultados revelaron que los grupos vacunados con las vacunas con códigos nº 1 y 2, que contienen dos cepas vacunales (H5N1 y H5N8) de origen local, mostraron el mayor título de inhibición de la hemaglutinación, protección (por ciento) y reducción del título de excreción viral cuando se evaluaron contra la gripe aviar altamente patógena H5N8 2018, mientras que la vacuna con código nº 3 indujo menor respuesta de anticuerpos, protección (por ciento) y reducción de la excreción viral, pero todavía dentro de un nivel satisfactorio en comparación con los grupos anteriores. Al utilizar la vacuna contra la gripe aviar altamente patógena H5N8 2020, se observó que la tasa de seronconversión, la protección (por ciento) y el título medio de reducción de la excreción viral disminuyeron en comparación con los registrados para la gripe aviar altamente patógena H5N8 2018. La vacuna con código nº 4 no fue potente para la gripe aviar altamente patógena de 2018 o de 2020. Por consiguiente, se recomendó actualizar la cepa de la vacuna de acuerdo con las condiciones epidemiológicas y utilizar el aislamiento de la cepa circulante predominante en la prueba de reto(AU)

Perfil epidemiológico e prevalência de inaptidão clínica e sorológica entre candidatos à doação de sangue / Epidemiological profile and prevalence of clinical and serological disability among candidates for blood donation / Perfil epidemiológico y prevalencia de discapacidad clínica y serológica en candidatos a donación de sangre

Objetivo: descrever o perfil epidemiológico e identificar as causas prevalentes de inaptidão clínica e sorológica entre os candidatos à doação nos últimos cinco anos. Método: trata-se de um estudo seccional, exploratório e analítico. Os dados foram obtidos por meio do Sistema Hemote Plus®. Resultados: a maioria dos candidatos eram homens (50,9%), de 20 a 29 anos (34,0%), brancos (66,7%), solteiros (59,9%) com ensino médio completo (33,3%) e motivação espontânea (65,5%). Dentre eles,25,9% foram considerados inaptos. As causas mais prevalentes de inaptidão foram: anemia (27,7%) e infecções sexualmente transmissíveis (12,4%). Tenderam mais à inaptidão as mulheres (57,9%), indivíduos menor nível de escolaridade (53,9%), e com menos de 39 anos (65,5%). Conclusão: evidencia-se a necessidade de práticas educativas e orientação sobre comportamentos de risco na captação de doadores e triagem clínica, ressaltando a importância do profissional de enfermagem neste contexto

Objetivo: to describe the epidemiological profile and identify the prevalent causes of clinical and serological unfitness among donation candidates in the last five years. Methods: this is a cross-sectional, exploratory and analytical study. Data were obtained using the Hemote Plus® System. Results: most candidates were men (50.9%), aged 20 to 29 years (34.0%), white (66.7%), single (59.9%) with high school education (33.3 %) and spontaneous motivation (65.5%). Among them, 25.9% were considered unfit. The most prevalent causes of disability were: anemia (27.7%) and sexually transmitted infections (12.4%). Women (57.9%), individuals with a lower level of education (53.9%), and those with less than 39 years of age (65.5%) tended more toward disability. Conclusion: it is evident the need for educational practices and guidance on risk behaviors in the recruitment of donors and clinical screening, emphasizing the importance of the nursing professional in this context

Objetivos: describir el perfil epidemiológico e identificar las causas prevalentes de ineptitud clínica y serológica entre los candidatos a donación en los últimos cinco años. Metodo: se trata de um estudio transversal, exploratorio y analítico. Los datos se obtuvieron utilizando el sistema Hemote Plus®. Resultados: la mayoría de los candidatos eran hombres (50,9 %), de 20 a 29 años (34,0 %), blancos (66,7 %), solteros (59,9 %), com educación secundaria (33,3 %) y motivación espontánea (65,5 %). Entre ellos, el 25,9% fueron considerados no aptos. Las causas de discapacidad más prevalentes fueron: anemia (27,7%) e infecciones de transmisión sexual (12,4%). Las mujeres (57,9%), los indivíduos con menor nivel educativo (53,9%) y los menores de 39 años (65,5%) tendían más a la discapacidad. Conclusión: se evidencia la necesidad de prácticas educativas y orientaciones sobre comportamientos de riesgo em la captación de donantes y tamizaje clínico, destacando la importância del profesional de enfermeira en este contexto

A evolução da pandemia por Covid-19 em estados do Sul e Nordeste do Brasil: um estudo descritivo da resposta dos sistemas de saúde a partir da divulgação de dados epidemiológicos e das medidas de enfrentamento decretadas / The Covid-19 pandemic in the South and Northeast regions of Brazil: a descriptive study of the health system's response regarding the pandemic data dissemination and countermeasures decreed

Após a pandemia provocada pelo SARS COV-2 atingir a Europa, o Brasil tornou-se um dos epicentros. Considerando diferenças históricas nos indicadores de saúde entre as regiões Sul e Nordeste do país, regidas pelo mesmo sistema de saúde, este estudo tem como objetivo descrever a evolução inicial da pandemia nestas regiões a partir de informações das plataformas digitais das secretarias estaduais de saúde. Foram analisados número de casos, óbitos e testes realizados, de fevereiro de 2020 a maio de 2021. Os dados foram relacionados com as medidas de enfrentamento à pandemia tomadas pelos estados, coletadas a partir dos decretos de restrições e flexibilizações dos serviços e comércio. No Sul, o estado com mais casos foi Santa Catarina (13350/100.000hab), o Rio Grande do Sul teve maior taxa de mortalidade (246,8/100.000hab) e mais testagens (32378/100.000hab). No Nordeste, Sergipe teve mais casos (10216/100.000hab), Piauí mais testagens (23.917/100.000hab) e Ceará teve maior taxa de mortalidade (222,8/100.000hab). As medidas de enfrentamento ao coronavírus no Brasil não foram uniformes entre os estados, nem a aplicação das testagens, evidenciando a falta de coordenação nacional nas ações. [au]

After the pandemic caused by SARS COV2 reached Europe, Brazil became one of the epicenters. Considering historical differences in health indicators between the South and Northeast regions of the country, coordinated by the same health care system, this study aims to describe the early evolution of the pandemic in these regions based on information collected from state health secretariats online platforms. Data of numbers of cases, deaths and tests carried out, from 2020 to May 2021 were analyzed and related to measures to combat the pandemic by the states, based on decrees. In the South, the state with the most cases was Santa Catarina (13350/100,000 inhab), Rio Grande do Sul had the highest mortality rate (246.8/100,000 inhab) and more testing (32378/100,000 inhab). In the Northeast, Sergipe had more cases (10216/100,000 inhab) and Piau testing (23295/100,000 inhab), Ceará had higher mortality rates (222.8/100,000 inhab). The measures to combat the coronavirus in Brazil were not uniform between the states, nor testing, evidencing the lack of national coordination. [au]

Prevalence and factors associated with late diagnosis of the HIV infection in a municipality of São Paulo / Prevalencia y factores asociados al diagnóstico tardío de la infección ocasionada por el VIH en un municipio de São Pauloo / Prevalência e fatores associados ao diagnóstico tardio da infecção pelo hiv em um município paulista

ABSTRACT Objective: to identify the prevalence and factors associated with late diagnosis of the infection by the Human Immunodeficiency Virus (HIV), in a municipality of São Paulo. Method: an epidemiological, analytical and retrospective study that analyzed the HIV and AIDS cases notified by the health services in the period from 2015 to 2017 using data from the notifications of the Information System for Notifiable Diseases (SINAN Net) corresponding to the users recently diagnosed with HIV/AIDS infection in the municipality of Ribeirão Preto/SP, Brazil. Data collection was in May 2018. The chi-square test was performed, as well as binary logistic regression, where the dependent variable was the AIDS criterion at the moment of notifying infection by HIV. A p-value<0.05 was considered for the association between the variables studied in relation to late diagnosis. Results: of the 829 (100%) new HIV cases, 290 (35.0%) were diagnosed in the condition of AIDS. Most of the population was male and aged between 15 and 34 years old. Oral candidiasis and weight loss greater than 10% were the main symptoms associated with AIDS. It was observed that people with lower schooling levels and older were more prone to late diagnoses. Conclusion: it is necessary to devise strategies that favor timely diagnosis in the municipality under study, particularly among the individuals aged over 45 years old and with lower schooling levels.

RESUMEN Objetivo: identificar la prevalencia y los factores asociados al diagnóstico tardío de la infección ocasionada por el Virus de Inmunodeficiencia Humana (HIV) en un municipio del interior de Brasil. Método: estudio epidemiológico, analítico y retrospectivo que analizó los casos de VIH y SIDA notificados por los servicios de salud entre 2015 y 2017 por medio de los datos de las notificaciones del Sistema de Información de Problemas de Salud pasibles de Notificación (SINAN Net) referentes a los usuarios recién diagnosticados con la infección ocasionada por el VIH/SIDA en el municipio de Ribeirão Preto/SP, Brasil. La recolección de datos fue en mayo de 2018. Se realizaron tanto una prueba de chi-cuadrado como un análisis de regresión logística binaria, en la cual la variable dependiente fue el criterio de SIDA al momento de notificar la infección ocasionada por el HIV. Se consideró un valor de p<0,05 para la asociación entre las variables estudiadas en relación con el diagnóstico tardío. Resultados: entre los 829 (100%) casos nuevos de HIV, 290 (35,0%) fueron diagnosticados en la condición de SIDA. La mayoría de la población era del sexo masculino y pertenecía al grupo etario de 15 a 34 años. Candidiasis oral y pérdida de peso superior al 10% fueron los principales síntomas asociados al SIDA. Se observó que las personas con niveles de educación más bajos y de mayor edad fueron más propensas a ser diagnosticadas tardíamente. Conclusión: es necesario elaborar estrategias que favorezcan el diagnóstico oportuno en el municipio estudiado, particularmente entre las personas de más de 45 años de edad y con niveles de educación más bajos.

RESUMO Objetivo: identificar a prevalência e os fatores associados ao diagnóstico tardio da infecção pelo vírus da imunodeficiência humana (HIV), em um município do interior paulista. Método: estudo epidemiológico, analítico e retrospectivo que analisou os casos de HIV e AIDS notificados pelos serviços de saúde no período de 2015 a 2017 por meio dos dados das notificações do Sistema de Informação de Agravos de Notificação (Sinan Net) dos usuários recém-diagnosticados para a infecção pelo HIV/AIDS no município de Ribeirão Preto/SP, Brasil. A coleta de dados ocorreu em maio de 2018. Foi realizado o teste qui-quadrado e regressão logística binária, no qual a variável dependente foi o critério de AIDS no momento da notificação da infecção pelo HIV. Foi considerado o valor de p<0,05 para a associação entre as variáveis estudadas com relação ao diagnóstico tardio. Resultados: dentre os 829 (100%) casos novos de HIV, 290 (35,0%) foram diagnosticados na condição de AIDS. A maioria da população pertencia ao sexo masculino e na faixa etária dos 15 aos 34 anos. A candidose oral e a perda de peso acima de 10% foram os principais sintomas associados à AIDS. Observou-se que pessoas com menor escolaridade e com o aumento da idade eram mais propensas a serem diagnosticadas tardiamente. Conclusão: estratégias que favoreçam o diagnóstico oportuno no município estudado são necessárias, particularmente entre os indivíduos com idade acima de 45 anos e com menor escolaridade.

O uso do teste Ml flow entre casos de hanseníase recém-diagnosticados e contatos intradomiciliares / The use of the Ml flow test between newly diagnostic leprosy cases and in-home contacts / El uso de la prueba de flujo Ml entre casos de lepra recientemente diagnósticos y contactos en el hogar

Objetivo: identificar o resultado de teste Ml Flow entre casos de hanseníase recém-diagnosticados e contatos intradomiciliares.Métodos: estudo transversal, descritivo, com abordagem quantitativa realizado no município de Caxias, Maranhão, Brasil, onde recrutou-se casos recém-diagnosticados, virgens de tratamento e contatos intradomiciliares. Resultados: recrutou-se 324 contatos de casos de hanseníase, no período de 2015 a 2018. Nos casos recém-diagnosticados o teste Ml Flow foi negativo em 87,5% (7/8) dos paucibacilares e positivo em 70% (21/30) dos multibacilares, ambos concordantes com a baciloscopia do raspado intradérmico. Identificou-se 30 (9%) contatos intradomiciliares com alto risco de adoecer. Conclusão: o teste Ml Flow constitui-se uma ferramenta útil para correta detecção de contatos com alta chance de adoecer da hanseníase, bem como para classificar corretamente os casos novos

Objective: to identify the Ml Flow test result between newly diagnosed leprosy cases and household contacts. Methods: cross-sectional, descriptive study with a quantitative approach carried out in the city of Caxias, Maranhão, Brazil, where newly diagnosed cases, treatment virgins and intra-household contacts were recruited. Results: 324 contacts of leprosy cases were recruited from 2015 to 2018. In newly diagnosed cases, the Ml Flow test was negative in 87.5% (7/8) of paucibacillary patients and positive in 70% (21/ 30) of the multibacillary, both in agreement with the bacilloscopy of the intradermal smear. Thirty (9%) household contacts with high risk of illness were identified. Conclusion: the Ml Flow test is a useful tool for the correct detection of contacts with a high chance of getting sick from leprosy, as well as for correctly classifying new cases

Objetivo: identificar el resultado de la prueba Ml Flow entre casos de lepra recién diagnosticados y contactos domésticos. Métodos: estudio descriptivo transversal con abordaje cuantitativo realizado en la ciudad de Caxias, Maranhão, Brasil, donde se reclutaron casos recién diagnosticados, vírgenes en tratamiento y contactos intrafamiliares. Resultados: se reclutaron 324 contactos de casos de lepra entre 2015 y 2018. En los casos recién diagnosticados, la prueba Ml Flow fue negativa en el 87,5% (7/8) de los pacientes paucibacilares y positiva en el 70% (21/30) de los multibacilares, ambos de acuerdo con la baciloscopia del frotis intradérmico. Identificamos 30 (9%) contactos dentro del hogar con alto riesgo de enfermarse. Conclusión: la prueba Ml Flow es una herramienta útil para la correcta detección de contactos con alta probabilidad de enfermarse de lepra, así como para clasificar correctamente nuevos casos

An outlook on coronavirus disease 2019 detection methods / 药物分析学报

Diagnostic testing plays a fundamental role in the mitigation and containment of coronavirus disease 2019(COVID-19),as it enables immediate quarantine of those who are infected and contagious and is essential for the epidemiological characterization of the virus and estimating the number of infected cases worldwide.Confirmation of viral infections,such as COVID-19,can be achieved through two general approaches:nucleic acid amplification tests(NAATs)or molecular tests,and serological or antibody-based tests.The genetic material of the pathogen is detected in NAAT,and in serological tests,host antibodies produced in response to the pathogen are identified.Other methods of diagnosing COVID-19 include radiological imaging of the lungs and in vitro detection of viral antigens.This review covers different approaches available to diagnosing COVID-19 by outlining their advantages and short-comings,as well as appropriate indications for more accurate testing.

Análise da implementação das estratégias de comunicação para as ações de testagem e sua vinculação ao tratamento de HIV/aids em homens que fazem sexo com homens em Curitiba / Analysis of the implementation of the communication strategies for men who have sex with men to be tested for HIV and aids and test connection with their treatment in Curitiba, Brazil / Análisis de la implementación de las estrategias de comunicación para las acciones de prueba y su vinculación al tratamiento del VIH/Sida en hombres que tienen sexo con otros hombres en Curitiba, Brasil

Há barreiras de acesso enfrentadas por homens gays e homens que fazem sexo com outros homens (HSH) à testagem e ao tratamento de HIV/aids devido a fatores estruturais e simbólicos. Daí, o objetivo do estudo que fundamenta este artigo é analisar a implementação das estratégias de comunicação para ampliar a testagem e vincular seu resultado ao tratamento de HIV/aids, em Curitiba (PR), pelo projeto A Hora é Agora (AHA), realizado de dezembro de 2014 a setembro de 2017, visando à maior aproximação dos que o executam com homens gays e HSH e ao desenvolvimento de meios mais efetivos de comunicação, identificando facilidades e dificuldades. Utilizou-se abordagem qualitativa por meio da análise documental do plano de comunicação e dos relatórios de atividades. As lições aprendidas foram a boa aceitação das campanhas 'corpo a corpo' feitas por educadores de pares nos espaços públicos, sobretudo em festas gays, e a necessidade de desenvolver estratégias específicas para HSH que não se identificam como gay.

There are access barriers faced by gay men and men who have sex with men (MSM) to be tested for HIV/ Aids and their treatment due to structural and symbolic factors. Hence, the objective of the study that underlies this article is to analyze the implementation of the communication strategies for expanding the testing and to link its result to treatment for HIV/Aids in Curitiba, Paraná, Brazil, by the project A Hora é Agora (AHA), implemented from December 2014 to September 2017, with the aim of coming closer to gay men and MSM and developing more effective means of communication, identifying facilities and difficulties. A qualitative approach by means of the documental analysis of the communication plan and activity reports was developed. The lessons learned were the good acceptance of the 'face to face' campaigns made by peer educators in public spaces, especially at gay parties, and the need to develop specific strategies for MSM who do not identify themselves as being gay.

Los hombres homosexuales y los hombres que tienen sexo con hombres (HSH) enfrentan barreras de acceso a las pruebas y al tratamiento del VIH/Sida provocadas por factores estructurales y simbólicos. De ahí que el objetivo del estudio presentado en este artículo sea analizar la implementación de estrategias de comunicación para ampliar las pruebas y las vincular al tratamiento del VIH/Sida en Curitiba, Paraná, Brasil, practicada por el proyecto A Hora é Agora (AHA), realizado desde diciembre de 2014 hasta septiembre de 2017, con el objetivo de acercarse más a los hombres homosexuales y HSH y desarrollar medios de comunicación más efectivos, identificando facilidades y dificultades. Se utilizó un enfoque cualitativo por medio del análisis documental del plan de comunicación e informes de actividad. Las lecciones aprendidas fueron la buena aceptación de las campañas "mano a mano" realizadas por los educadores de pares en los espacios públicos, especialmente en las fiestas gay, y la necesidad de desarrollar estrategias específicas para los HSH que no se identifican como gay.

Identification of a small-scale pig farm infected with Brucella suis linked to a clinical case of human brucellosis in Buenos Aires province, Argentina / Identificación de un establecimiento de producción porcina infectado con Brucella suis a partir de un caso clínico de brucelosis humana en la provincia de Buenos Aires, Argentina

Resumen En este trabajo reportamos un caso de brucelosis humana ocasionada por Brucella suis en una persona que trabajaba en un establecimiento de producción porcina en pequeña escala. La granja no tenía antecedentes de la enfermedad y los animales no registraban signos clínicos al ser examinados. Se obtuvieron muestras de suero de todos los padrillos (n=3), de 16/22 chanchas y 9/25 cachorras y se analizaron mediante las técnicas de aglutinación rápida en placa con antígeno tamponado (BPA) y Rosa de Bengala (RB) y Polarización de la Fluorescencia (FPA). Muestras de tejido de un padrillo y de una hembra serológicamente positivos fueron analizadas por cultivo bacteriológico y por la técnica de Inmunofluorescencia Directa (IFD). Se detectaron anticuerpos específicos en el 53% de los cerdos adultos (10/19), mientras que todas las cachorras fueron seronegativas. Se aisló B. suis biovar 1 de un padrillo. En contraste, la bacteria no fue aislada en ninguno de los tejidos de la cerda seropositiva aunque sí se detectó la bacteria mediante IFD. A partir de los datos bacteriológicos y serológicos se evidencia la presencia de una infección endémica por B. suis. Asimismo, teniendo en cuenta la falta de medidas de prevención y de bioseguridad se concluye que la persona probablemente adquirió la enfermedad por contacto directo con los animales infectados o con el ambiente contaminado con la bacteria.

Abstract Here we report a case of human brucellosis due to Brucella suis in a person who worked in a small-scale pig farm. The farm had no history of clinical brucellosis, and signs of the disease were not observed upon clinical examination of the animals. Serum from all the 3 boars, 16/22 sows and 9/25 gilts was obtained for serological examination by Buffered Plate Agglutination Test (BPAT), Rose Bengal Test (RBT) and Fluorescent Polarization Assay (FPA). Bacteriological culture and Direct Fluorescence Antibody Test (DFAT) were performed in tissue samples from a seropositive boar and a sow. Specific antibodies were detected in 53 % (10/19) adult pigs, while all sampled gilts were seronegative. B. suis biovar 1 was isolated from one boar. In contrast, while the bacterium was not isolated from any tissue from a seropositive sow, it was detected by DFAT. From the bacteriological and serological evidence of B. suis endemic infection in the pig farm and the lack of preventive measures and biosecurity practices, it is concluded that the person most likely acquired the disease from the infected animals or by contact with contaminated environment in the farm.

Situação clínico-epidemiológica da sífilis gestacional em anápolis-go: uma análise retrospectiva / Situación clínica y epidemiológica de la sífilis gestacional en anápolis-go: un análisis retrospectivo / Clinical-epidemiological situation of gestational syphilis in anápolis-go: a retrospective analysis

RESUMO Objetivo: descrever a situação clínica e epidemiológica da sífilis gestacional em Anápolis, Goiás, Brasil, entre os anos de 2012 e 2018. Método: estudo epidemiológico, descritivo e transversal de natureza quantitativa. Como instrumento de coleta, foram utilizados dados da ficha de notificação da sífilis gestacional cadastradas no Departamento de Vigilância Epidemiológica. Para análise estatística, foi utilizado o teste qui-quadrado com nível de significância 5% (p<0,05). Resultados: evidenciou-se aumento dos casos de sífilis gestacional. A assistência foi oferecida a 522 pacientes, entre 19 e 29 anos (58,1%), com etnia parda (69,1%) e com ensino médio incompleto (24,5%); predominou a sífilis primária (30,8%) e alto índice de não tratamento do parceiro (57,1%). Conclusão: dentro do período estudado, houve aumento dos casos de sífilis gestacional e não tratamento do parceiro. Este estudo poderá contribuir para o planejamento de ações de prevenção primária e secundária, visando diminuir a incidência da doença e suas consequências.

RESUMEN Objetivo: describir la situación clínica y epidemiológica de la sífilis gestacional en Anápolis, Goiás, Brasil, entre los años 2012 y 2018. Método: estudio descriptivo y transversal de carácter cuantitativo. Se utilizaron como instrumento de recogida los datos de la ficha de notificación de sífilis gestacional registrada en el Departamento de Vigilancia Epidemiológica. Para el análisis estadístico se utilizó la prueba de chi-cuadrado con un nivel de significación del 5% (p<0,05). Resultados: se evidenció un aumento de los casos de sífilis gestacional. La asistencia se ofreció a 522 mujeres, con edades comprendidas entre los 19 y los 29 años (58,1%), de etnia parda (69,1%) y con estudios secundarios incompletos (24,5%); predominó la sífilis latente (58,1%), seguida de la sífilis primaria (30,8%) y un alto índice de no tratamiento de la pareja (57,1%). Conclusión: dentro del período estudiado, hubo un aumento de los casos de sífilis gestacional y no tratamiento de la pareja. Este estudio puede contribuir a la planificación de acciones de prevención primaria y secundaria, con el objetivo de disminuir la incidencia de la enfermedad y sus consecuencias.

ABSTRACT Objective: to describe the clinical and epidemiological situation of gestational syphilis in Anápolis, Goiás, Brazil, between the years 2012 to 2018. Method: descriptive, cross-sectional study of a quantitative nature. As a collection instrument, data from the gestational syphilis notification form registered in the Epidemiological Surveillance Department were used. For statistical analysis, the chi-square test was used, with a 5% significance level (p<0.05). Results: an increase in gestational syphilis cases was evidenced. Care was offered to 522 women, aged between 19 and 29 years (58.1%), with brown ethnicity (69.1%) and incomplete high school education (24.5%); latent syphilis predominated (58.1%), followed by primary syphilis (30.8%) and a high rate of non-treatment of the partner (57.1%). Conclusion: within the period studied, there was an increase in cases of gestational syphilis and non-treatment of the partner. This study may contribute to the planning of primary and secondary prevention actions, aiming to decrease the incidence of the disease and its consequences.

Positividade ao hiv e fatores associados em um centro de testagem e aconselhamento / Positividad al vih y factores asociados en un centro de consejería y pruebas / Hiv positivity and associated factors in a counseling and testing center

RESUMO Objetivo: Analisar os fatores sociodemográficos e comportamentais associados à positividade ao Vírus da Imunodeficiência Humana (HIV) em usuários de um Centro de Testagem e Aconselhamento (CTA). Método: Estudo transversal com 5.229 usuários que realizaram o teste rápido para HIV, registrados no Sistema de Informação do CTA. As análises bivariadas e multivariadas foram realizadas utilizando-se a regressão logística binária, com apresentação do OddsRatio, intervalo de confiança de 95% e p-valor <0,05. Resultados: A prevalência de infecção pelo HIV foi de 5,0% (259), com maior acometimento da população mais jovem (p=0,010). Observou-se maior positividade entre as pessoas vivendo com HIV/Aids (91,3%; p<0,001) e homens que fazem sexo com homens (HSH) (20%; p<0,001). Nas análises multivariadas verificou-se maior associação à infecção pelo HIV no modelo 2 que inclui, as variáveis sociodemográficas e comportamentais, como: o recorte populacional de HSH, o compartilhamento de seringas, a orientação sexual HSH, ter infecções sexualmente transmissíveis (IST) nos últimos 12 meses, parceiro soropositivo para HIV e uso irregular ou não uso do preservativo nos últimos 12 meses com parceiro fixo. Conclusão: A vulnerabilidade ao HIV foi mais associada aos fatores relacionados ao compartilhamento de seringas e ao comportamento sexual, especialmente os HSH e as parcerias fixas.

resumen Objetivo: analizar los factores sociodemográficos y comportamentales asociados a la positividad al Virus de la Inmunodeficiencia Humana (VIH) en usuarios de un Centro de Consejería y Pruebas. Método: estudio transversal con 5.229 usuarios que realizaron la prueba rápida para VIH, registrados en el Sistema de Información del Centro. Los análisis bivariados y multivariados fueron realizados utilizando la regresión logística binaria, con presentación del OddsRatio, intervalo de confianza de 95% y p-valor <0,05. Resultados: la prevalencia de infección por el VIH fue de 5,0% (259), con mayor acometimiento de la población más joven (p=0,010). Se observó mayor positividad entre las personas viviendo con VIH/sida (91,3%; p<0,001) y hombres que hacen sexo con hombres (HSH) (20%; p<0,001). En los análisis multivariados se verificó mayor asociacióna la infección por el VIH en el modelo 2 que incluye las variables sociodemográficas y comportamentales como: el recorte poblacional de HSH, el compartir jeringas, la orientación sexual HSH, tener enfermedades de transmisión sexual (ETS) en los últimos 12 meses, compañero seropositivo para VIHy uso irregular o la falta del uso de preservativo en los últimos 12 meses con compañero fijo. Conclusión: la vulnerabilidad al VIH fue más asociada a los factores relacionados al compartir jeringas y al comportamiento sexual, especialmente los HSH y los compañeros fijos.

ABSTRACT Objective: To analyze the sociodemographic and behavioral factors associated with Human Immunodeficiency Virus (HIV) positivity in users of a Counseling and Testing Center (CTC). Method: Across-sectional study with 5,229 users who performed the rapid HIV test, registered in the CTC's Information System. Bivariate and multivariate analyzes were performed using binary logistic regression, presenting OddsRatio, 95% confidence interval and p-value <0.05. Results: The prevalence of HIV infection was 5.0% (259), with greater involvement of the younger population (p=0.010). Greater positivity was observed among people living with HIV/AIDS(91.3%; p <0.001) and men who have sex with men (MSM) (20%; p<0.001). In multivariate analyzes, there was a greater association with HIV infection in model 2, which includes sociodemographic and behavioral variables, such as: the populational cut of MSM, needle sharing, MSM sexual orientation, having sexually transmitted infections (STIs) in the last 12 months, HIV-positive partner and irregular or no condom use in the last 12 months with a steady partner. Results: Conclusion: Vulnerability to HIV was more associated with factors related to needle sharing and sexual behavior, especially MSM and steady partnerships.

Serological detection and clinical manifestations of brucellosis in the key occupational population in Baotou City / 中国职业医学

OBJECTIVE: To analyze the serological positive results of brucellosis and its clinical manifestations in the key occupational population in Baotou City. METHODS: A total of 9 937 individuals from eight districts who were engaged in livestock breeding, grazing, slaughtering, processing, and selling from 2018 to 2019 in Baotou City were selected as the study subjects by a cluster sampling method. Blood samples were collected and serological tests of brucellosis were performed. The demographic characteristics and clinical manifestations of these subjects were investigated by a questionnaire. RESULTS: The seropositive rate of brucellosis in the study subjects was 2.7%(273/9 937). The average age of the individuals with serological positive reaction of brucellosis was(44±13) years. The seropositive rate of brucellosis was higher in males than females(4.8% vs 1.2%, P<0.05). In the brucellosis seropositive population, the regional distribution was the highest in Damao Qi district and the lowest in Qingshan district; the mainly occupation distribution was farmers, herdsmen and workers in beef and mutton processing plants. The exposure ways were mainly slaughtering animals and delivering lambs. The main clinical manifestations were fatigue(54.2%), followed by fever(48.7%). CONCLUSION: The characteristics of brucellosis serological positive reaction are young age, males, and farmers and herdsmen in key occupational group in Baotou City. The prevention and control of brucellosis should be focused on young male farmers and herdsmen engaged in slaughtering animals and delivering lambs.

Factors associated with leprosy in children contacts of notified adults in an endemic region of Midwest Brazil / Fatores associados à hanseníase em crianças contatos de adultos notificados em umaregião endêmica do Centro-Oeste do Brasil

Abstract Objectives: To analyze the factors associated with leprosy in children who were intradomiciliary contacts of notified adults with the disease in an endemic municipality in Mato Grosso, Brazil. Method: Case-control study with 204 children under 15 years of age, living in an endemic municipality. Cases (n = 40) were considered as the children with leprosy registered at the National Information System of Notifiable Diseases in 2014 and 2015, who were intradomiciliary contacts of at least one adult diagnosed with the disease in the family, and as a control group (n = 164) of children living within a radius of up to 100 m of the notified cases. Data were obtained through medical file analysis, interviews, and blood samples for anti-PGL-I serological test by the ELISA method. The binary logistic regression technique was used, with p ≤ 0.05. Results: After adjustments, the following were associated with leprosy: age (95% CI: 1.24-9.39, p = 0.018), area of residence (95% CI: 1.11-6.09, p = 0.027), waste disposal (95% CI: 1.91-27.98, p = 0.004), family history of the disease (95% CI: 3.41-22.50, p = 0.000), and time of residence (95% CI: 1.45-7.78, p = 0.005). Conclusion: Factors associated with the disease indicate greater vulnerability of children aged 8-14 years, associated with living conditions and time of residence, as well as the family history of the disease.

Resumo Objetivos: Analisar os fatores associados à hanseníase em crianças contatos intradomiciliares de adultos notificados com a doença em município endêmico, Mato Grosso, Brasil. Método: Estudo caso-controle com 204 menores de 15 anos residentes em um município endêmico. Consideraram-se casos (n = 40) crianças registradas com hanseníase no Sistema Nacional de Agravos de Notificação em 2014 e 2015 e que eram contatos intradomiciliares de pelo menos um adulto diagnosticado com a doença na família e como grupo controle (n = 164) crianças residentes a um raio de 100 metros dos casos notificados. Os dados foram obtidos por meio de análise de prontuários, entrevistas e coleta de amostras de sangue para investigação sorológica do anti-PGL-I pelo método Elisa. Usou-se a técnica de regressão logística binária e p ≤ 0,05. Resultados: Mostraram-se associados à hanseníase após ajustes: idade (IC 95%: 1,24-9,39; p = 0,018), zona de residência (IC 95%: 1,11-6,09; p = 0,027), destino de lixo (IC 95%: 1,91-27,98; p = 0,004), história da doença na família (IC 95%: 3,41-22,50; p = 0,000) e tempo de moradia (IC 95%: 1,45-7,78; p = 0,005). Conclusão: Os fatores associados à doença indicam maior vulnerabilidade em menores de 8 a 14 anos, ligadas as condições e ao tempo de moradia, bem como a história da doença na família.

The effect of Spirulina algae on the immune response of SPF chickens to commercial inactivated Newcastle vaccine in poultry / El efecto del alga Spirulina sobre la respuesta inmune de pollos SPF inducida por la vacuna inactivada comercial contra la enfermedad de Newcastle

The objective of this study was to investigate the effects of Spirulina platensis (SP) powder supplementation on immune response in SPF chickens. For this purpose, 120 SPF chicks were randomly clustered into six groups consisting of 20 birds each which assigned to five groups vaccinated by commercial inactivated Newcastle disease (ND) vaccine at 21 days of age. The four groups were supplemented with 0.5, 1, 1.5 and 2 g of SP per kg of ration at 7 day of age and other group as control treatment group. Control unvaccinated group still without any treatment. Individual blood samples were collected weekly from all groups, and NDV-HI antibodies were measured using Hemagglutination inhibition (HI) test. After 28 days post-vaccination, ten birds from all groups were challenged intramuscularly at a dose 0.5 mL/bird containing 106 EID50 of local NDV genotype VII. Challenge virus shedding was detected using real time qrt-PCR of oropharyngeal swabs that were collected from all challenged chicken groups of at 3, 5, 7 and 10 days post challenge. Obtained results showed that vaccinated groups of SPF-chickens either supplied with Spirulina or control treatment group induced positive serological response as NDV-HI antibody were measured in sera of immunized chicks (7.6, 8, 8.3, 8.9 and 7.4 log2, respectively) at 4 weeks post vaccination (WPV). Significant differences were observed at 2 WPV in the vaccinated SPF chickens consumed 1, 1.5 and 2 g of SP/kg of ration, compared to untreated vaccinated group (p<0.05). Immunized SPF chickens supplied with different SP concentration confer satisfactory protection against heterologous challenge virus (90 percent, 100 percent, 100 percent and 100 percent respectively), in contrast to untreated vaccinated chickens. Different percentages of reduction of viral shedding (55 percent, 65 percent, 76 percent and 87 percent) of treated vaccinated chickens with different concentration of SP were detected, despite untreated group were reduced 46 percent from total viral shedding. These findings suggest that dietary Spirulina has immune-stimulatory effects on the immune system of SPF chickens. One gram from SP per kg of ration was minimum recommended concentration that able to exhibit optimum immune response, increase protection against heterologous strains and able to reduce viral shedding(AU)

El objetivo de este estudio fue investigar los efectos de la suplementación con polvo de Spirulina platensis (SP) sobre la respuesta inmune en pollos SPF. Para este propósito se agruparon al azar 120 polluelos SPF en seis grupos de 20 aves cada uno, que se asignaron a cinco grupos vacunados con la vacuna comercial inactivada contra la enfermedad de Newcastle (ND) a los 21 días de edad. Cuatro grupos se suplementaron con 0,5; 1; 1,5 y 2 g de SP por kg de ración a los 7 días de edad, un grupo vacunado sin suplemento y un grupo sin ningún tratamiento. Semanalmente, se recogieron muestras de sangre individuales de todos los grupos y se midieron los anticuerpos hemaglutinantes contra el virus Newcastle (NDV-HI) mediante la prueba de inhibición de la hemaglutinación (HI). 28 días después de la vacunación, fueron retadas diez aves de cada grupo por vía intramuscular a una dosis 106 EID50 del genotipo VII del NDV local en un volumen de 0,5 mL/ave. Se detectó la eliminación del virus mediante qrt-PCR en hisopos orofaríngeos que se recolectaron en todos los grupos a los 3, 5, 7 y 10 días después del reto. Los resultados obtenidos mostraron que los grupos vacunados de pollos y suplementados con Espirulina y el grupo de control vacunado, indujeron una respuesta serológica positiva cuando se determinaron los anticuerpos NDV-HI en los pollitos inmunizados (7,6; 8; 8,3; 8,9 y 7,4 log2 respectivamente) a las 4 semanas después de la vacunación (SPV). Se observaron diferencias significativas a las 2 SPV en los pollos vacunados que consumieron 1, 1,5 y 2 g de SP/kg de ración, en comparación con el grupo vacunado no tratado (p<0,05). Los pollos inmunizados que recibieron diferentes concentraciones de SP mostraron una protección satisfactoria contra el desafío heterólogo viral (90 por ciento, 100 por ciento y 100 por ciento respectivamente), en contraste con los pollos vacunados no tratados. Se observaron diferentes porcentajes de reducción de la diseminación viral (55 por ciento, 76 por ciento y 87 por ciento) entre los pollos vacunados tratados con diferente concentración de SP. En el grupo no tratado se redujo al 46 por ciento. Estos hallazgos sugieren que la Espirulina en la dieta tiene efectos inmunoestimuladores sobre el sistema inmunitario de los pollos. Un gramo de SP por kg de ración fue la concentración mínima recomendada para una respuesta inmune óptima, y de esta forma aumentar la protección contra las cepas heterólogas y disminuir la diseminación viral(AU)

Detección molecular de sífilis gestacional y congénita / Molecular detection of gestational and congenital syphilis

Objetivo: estandarizar una qPCR para la determinación de T. pallidum en muestras de suero de pacientes con sífilis gestacional y congénita. Materiales y métodos: se optimizó una qPCR con sonda para la amplificación del gen TpN47 en muestras de suero, se evaluó la sensibilidad, especificidad y eficiencia analítica de la técnica. Se comparó con pruebas serológicas (VDRL y TPPA) y se calculó índice de concordancia Kappa. Resultados: la qPCR mostró un límite de detección de 0.113 femtogramos, especificidad analítica del 100% y fidelidad de 104%. Se evidenció correlación optima en la prueba, sugerida por un r2 de 0.99 y un valor p <0,0001 de la qPCR. Se observó acuerdo entre las pruebas serológicas y moleculares. Conclusiones: se desarrolló una herramienta molecular prometedora con buena sensibilidad, óptima especificidad analítica y gran potencial diagnóstico para la detección y hallazgo de T. pallidum subsp. pallidum, a través de la amplificación del gen TpN47 en muestras clínicas de pacientes con diagnóstico presuntivo de sífilis gestacional y congénita.

Objective: to evaluate a qPCR to detect T.pallidum in serum samples from patients with gestational and congenital syphilis. Methodology: qPCR with probe was optimized for the amplification of the TpN47 gene in serum samples, the sensitivity, specificity and analytical efficiency of the technique were evaluated. It was compared with the serological tests (VDRL and TPPA) and the Kappa concordance index was calculated. Results: the qPCR showed a detection limit of 0.113 femtograms, an analytical specificity of 100% and an accuracy of 104%. Optimal correlation was evidenced in the test, suggested by an r2 of 0.99 and a p value <0.0001 of the qPCR. An agreement was observed between serological and molecular tests. Conclusion: a promising molecular tool was developed with good sensitivity, excellent analytical specificity and great diagnostic potential for the detection and finding of T. pallidum subsp. pallidum, through the amplification of the TpN47 gene in serum from patients with gestational and congenital syphilis.

Serological Evaluation of Clinically Suspected Leptospirosis Cases in a Tertiary Care Hospital

Leptospirosis is a zoonotic infection caused by the spirochaete Leptospira, which has worldwide distribution. Laboratory diagnosis is routinely performed by serological tests like dipstick assay, lateral flow assay and latex agglutination which are rapid tests recommended for screening the disease. Microscopic Agglutination Test (MAT) is the standard test for serological diagnosis of leptospiral infection which is not included in the test panel in most of the peripheral laboratories as the procedure is laborious and it requires to maintain live leptospira. Therefore, one of the rapid tests is routinely employed for demonstration of leptospiral antibodies. Our objective was to screen the acute cases of leptospirosis by Leptochek WB IgM and PanBio IgM Elisa and compare the findings with the MAT and correlate the clinical findings with the serological tests.METHODSThis study was conducted in a tertiary care hospital in Mangalore from August 2010 to September 2013. A total of 314 cases of clinically suspected leptospirosis were included based on the Faine’s criteria. Patients’ serum was screened for leptospiral antibodies by Leptochek WB IgM, PanBio IgM ELISA and Microscopic Agglutination Test (MAT).RESULTSOut of 314 clinically suspected cases screened, seropositivity for leptospirosis by Leptochek WB-IgM, PanBio IgM ELISA and MAT was found to be 49 (15.6%), 65 (20.7%) and 78 (24.8%) respectively. Thus, an overall prevalence rate of leptospirosis was 24.8% (78/314) based on the MAT test. Sensitivity, specificity, positive predictive value and negative predictive value of Leptocheck WB IgM was 53.8%, 97%, 85.7 and 86.4% with MAT while the comparative values of PanBio-ELISA IgM with respect to MAT test was 74.5%, 97 %, 89.2% and 92% respectively. Common clinical features among MAT positive cases were fever, chills and rigors, oliguria, vomiting, jaundice and headache.CONCLUSIONSMAT is a standard serological test for Leptospirosis. This test is not always available for peripheral health centres, as the test is time consuming and cumbersome. Thus, screening tests are now being employed for screening the patients. Rapid tests like Leptocheck -WB can be supplemented with an ELISA test for screening of clinically suspected cases of Leptospirosis and later confirmed with the MAT at reference centres.

Percepção dos profissionais de saúde e dos usuários sobre o aconselhamento no teste rápido para HIV / Percepción de los profesionales de salud y usuarios acerca del conseñado en el contexto de la prueba rápida para VIH / Perception of health professionals and users about counseling in the context of rapid HIV testing

RESUMO Objetivo Analisar a percepção acerca do aconselhamento no contexto do teste rápido para o HIV. Método Pesquisa com abordagem qualitativa realizada no Centro de Testagem e Aconselhamento com profissionais de saúde e com usuários do Centro de Testagem e Aconselhamento. A análise seguiu os passos propostos na fenomenologia empírica de Giorgi articulando-a com a literatura. Resultados Identificaram-se cinco categorias: a experiência anterior à realização do Teste Rápido; Intencionalidade de sentimentos; Percepção do aconselhamento pelo usuário; Percepção do aconselhamento individual no pós-teste e; Percepção de profissionais sobre o aconselhamento. O aconselhamento coletivo é percebido pelos usuários como palestra sobre HIV/Aids com ênfase em consequências negativas; e o aconselhamento individual, como mais confortável e como possibilidade para exposição de dúvidas. Discussão Considera-se que, mesmo sabendo da importância do aconselhamento, este é realizado de forma empírica, reduzindo o ato ao repasse de informações com teor educativo, visando apenas à aprendizagem cognitiva como meio de disseminar o conhecimento, tentando, assim, reduzir a cadeia de transmissão da HIV/Aids.

RESUMEN Objetivo Analizar la percepción acerca del asesoramiento en el contexto de la prueba rápida para el VIH. Método Investigación con enfoque cualitativo realizada en el Centro de Pruebas y Asesoramiento con profesionales de salud y de los usuarios del Centro de Pruebas y Asesoramiento. El análisis siguió los pasos propuestos en la fenomenología empírica de Giorgi, articulando con la literatura. Resultados Se identificaron cinco categorías: la experiencia anterior a la realización de la prueba rápida; Intencionalidad de sentimientos; Percepción del asesoramiento por el usuario; Percepción del asesoramiento individual en el post-test y; Percepción de profesionales sobre el asesoramiento. El asesoramiento colectivo es percibido por los usuarios como conferencia sobre HIV / SIDA con énfasis en consecuencias negativas y el asesoramiento individual como más cómodo y posibilidad para la exposición de dudas. Discusión: Se considera que, aunque se sabe de la importancia del asesoramiento, éste se realiza de forma empírica, reduciendo el acto al traspaso de informaciones con contenido educativo, visando que el sólo el aprendizaje cognoscitivo y como medio de diseminar el conocimiento, intentando así reducir la cadena de transmisión de la HIV / SIDA.

ABSTRACT Objective To recognize the perception of counseling by professionals and users of the Testing and Counseling Center to perform the Rapid Test for the diagnosis of HIV. Method Qualitative research conducted at the Testing and Counseling Center. We interviewed users and professionals who performed the rapid test. The analysis followed the steps proposed in the empirical phenomenology of Giorgi, articulating with the literature. Results Five categories were identified: Prepredicative experience when performing The rapid test; Intent of feelings; Perception of user advice; Perception of individual counseling in the post-test and; Perception of professionals about counseling. Collective counseling is perceived by the users as a talk about STI / Aids with an emphasis on negative consequences and individual counseling as more comfortable and possibility for exposing doubts. Discussion It is considered that even knowing the importance of counseling, this is done in an empirical way, reducing the act to the transfer of information with educational content, aiming at only cognitive learning and as a means of disseminating knowledge, thus trying to reduce the HIV/ Aids transmission chain.

Evaluation of Rapid Immunochromatographic Tests in Comparison to ELISA for Detection of NS1, IgM and IgG Antibodies for Early Detection of Dengue Infection in Pediatric Patients

Dengue fever is one of the most common arthropod-borne viral disease seen in humans. It is one of the major public health problems in developing countries including India. The signs and symptoms of dengue fever may range from moderate fever to thrombocytopenia, hemorrhagic manifestation and shock. Severe untreated cases may even prove to be fatal. The diagnosis of dengue fever may be made on the basis of detection NS1 antigen or IgM and IgG antibodies. This study was aimed at analyzing the sensitivity and specificity of RICT kit with ELISA for NS1 antigen and IgM, IgG detection so as to explore its suitability for regular use in any modest resource constrain laboratory or primary health center as a bedside test. Methods: This was a prospective cohort study conducted from August 2018 to Jan 2019 in a tertiary care private and teaching hospital. Informed written consent was taken from parents or caretakers of patients. The institutional ethical committee approved the study. Samples were collected during the acute phase of illness i.e. 1-5 days of fever. The samples were grouped into 2 categories according to the days of fever - 1-5days and 5-15 days. The NS1 Antigen, IgG and IgM antibodies tests were done by ELISA and ICT in all the cases. EDTA blood samples were collected & the platelet count was done. SSPE 21.0 software was used for statistical purpose. Results: A total of 200 blood samples were studied. Out of the 200 studied sample 132 (66%) belonged to male patients and remaining 68 (34%) belonged to female patients. The M: F ratio was found to be 1:0.51. Most common age group of the patients was between 4-10 years (66%) followed by 15-18 (14.5%) and 11-15 years (10.5%). The least common age group was found to be less than 4 years of age (9%). 102 (51%) patients were having platelet count of less than 1 lac/mm3. The analysis of blood samples for NS1 antigen positivity showed that out of 200 sample NS1 was positive in 51 (25.5%) patients by ELISA and 49 (24.5%) patients by ICT. IgG/IgM ELISA was positive in 81 (40.5%) samples whereas IgG/IgM ICT was positive in 79 (39.50%) samples. Presence of either NS1 antigen or IgG/IgM antibodies was positive in 122 (61%) by ELISA and 119 (59.50%) by ICT. The comparison of NS1 ELISA and NS1 ICT showed that the results were comparable for both the tests with no statistically significant difference (P>0.05). Similarly, there was no statistically significant difference in IgG/IgM ELISA and IgG/IgM ICT and a combination of NS1 and IgG/IgM by ELISA and ICT (P>0.05). Conclusion: Performance of rapid diagnostic tests to detect the presence of Dengue NS1 antigen & IgM & IgG antibodies to dengue virus in comparison to ELISA in present specimen was found to be satisfactory. Even though RDT is treated as screening test places where other advanced diagnostics are not available RDT can be used for the diagnosis of Dengue virus infection.

Utility of rapid diagnostic kit tests for diagnosis of suspected dengue fever

Background: Dengue fever often presents as an undifferentiated febrile illness requiring a laboratory test for identification. Serological tests particularly on rapid kits for the detection of NS1Antigen, IgG and IgM antibodies are the most commonly performed test across the country.Methods: The serum samples of suspected dengue cases were tested by Rapid test kits for assessing all the three parameters as well as by ELISA for NS1 antigen test. The platelet count of the patients was obtained from automated coulter counter. The results thus obtained were analyzed in Excel format.Results: The serum samples from 304 suspected Dengue fever cases were received in the lab, of which 190 samples were positive either by rapid or ELISA and 176 when rapid card test was considered alone Highest seropositivity of dengue cases were observed in the age group of ≥60 years (79.2%) followed by 45-59 years (70.7%). On rapid test, 78 cases were NS1 antigen positive of which 60 cases were positive only for NS1 antigen. When NS1 rapid and ELISA tests when compared, 16 kit negative tests were positive on ELISA while 34 kit positive tests were ELISA negative.  Sensitivity, specificity, PPV and NPV when only NS1 was considered on rapid test kits when compared with ELISA were 78.9%, 87.8%, 63.8% and 93.8%. 33.5% of serologically positive cases of Dengue had low platelet count on admission while only among negative cases 17.2% had a low platelet.Conclusions: Rapid kits often show variable results thus needing a validation of them from end user. As a positive dengue test result is an essential prerequisite for diagnosis thus it is essential that for serological tests ELISA technique should be used for reporting. Thus, it also mandates more efforts at decentralization of NVBDCP to include both government and non government institutions.

Análise do tratamento dos pacientes com Hepatite B Crônica no município de Chapecó - SC / Analysis of the treatment of patients with Chronic Hepatitis B in the city of Chapecó - SC

A hepatite B crônica é uma doença causada pelo vírus da hepatite B (VHB), sendo seu diagnóstico confirmado pela persistência por mais de seis meses do antígeno de superfície HBsAg no plasma. Visto que é uma doença sem cura e que pode dar origem a uma série de complicações, o tratamento deve ser instituído de forma precoce e sempre acompanhado. O presente estudo fez uma análise do tratamento de pacientes com hepatite B crônica no município de Chapecó ­ SC. Participaram do estudo 65 pacientes com hepatite B crônica que iniciaram o tratamento entre os anos de 2010 a 2012 no Setor de Hepatites da Secretaria Municipal de Saúde de Chapecó ­ SC. Em relação ao tratamento, logo antes de iniciá-lo, 50,8% dos pacientes apresentavam VHB-DNA entre 2.000 e 100.000 UI/ml. Com a introdução da medicação, após um ano, 76,9% passaram a apresentar índices indetectáveis de VHB-DNA e após dois, esse índice elevou-se para 90,8%. O marcador sorológico HBsAg apresentou soroconversão em 3,1% da amostra após dois anos de tratamento; por outro lado, houve soroconversão do HBeAg em 95,4% dos pacientes após um ano, sendo que essa condição se manteve no ano seguinte. O tratamento para hepatite B crônica se mostrou efetivo em diminuir os níveis virais, o que é um fator imprescindível para um melhor prognóstico na evolução da doença e na qualidade de vida do paciente.

Chronic hepatitis B is a disease caused by the hepatitis B virus (HBV), and its diagnosis is confirmed by persisting for more than six months of the HBsAg surface antigen in plasma. Since this is an incurable disease and may give rise to a number of complications, the treatment should be set early and always accompanied. The present study made an analysis of the clinical profile and treatment of patients with chronic hepatitis B in Chapecó ­ SC. Participated in the study sixty-five patients with chronic hepatitis B who started treatment between the years 2010 to 2012 at the Setor de Hepatites da Secretaria Municipal de Saúde de Chapecó ­ SC. In relation to treatment, just before starting it, 50.8% of patients had HBV-DNA from 2,000 to 100,000 UI / ml. With the introduction of medication after one year, 76.9% showed undetectable levels of HBV-DNA and after two this index increased to 90.8%. The serologic marker HBsAg presented seroconversion in 3.1% of the sample after two years of treatment; on the other hand, there was HBeAg seroconversion in 95.4% of patients after a year, and this condition was maintained in one year later. The treatment for chronic hepatitis B was effective in reducing viral levels, which is an essential factor for a better prognosis in the evolution of the disease and the quality of life of patients.