Jovens cientistas: enfrentamento às arboviroses e participação juvenil no território / Young scientists: facing arboviruses and youth participation in the territory / Jóvenes investigadores: enfrentamiento a las arbovirosis y participación juvenil en el território

O estudo analisa uma formação em Iniciação Científica sobre arboviroses, a partir da percepção de jovens estudantes, em Ceilândia ­ Distrito Federal. Objetivo: compreender em que medida a Iniciação Científica mobiliza esses jovens a participarem de ações de vigilância e promoção da saúde no território, e entender sua motivação para participar do projeto. Metodologia: abrangeu-se a análise das redações escritas para a seleção ao Curso de Formação para Iniciação Científica na Educação Básica e as Arboviroses; a administração desse curso e; posteriormente, um grupo focal com estudantes para análise do processo educativo da Iniciação Científica que vivenciaram. Resultados: a análise de conteúdo evidenciou a percepção dos alunos sobre a Iniciação Científica, centrada em seis categorias analíticas: motivação dos alunos para Iniciação Científica; processo de formação do saber; formação de jovens cientistas; saúde e meio ambiente; participação e empoderamento juvenil e percepções acerca do Sistema Público de Saúde. Conclusão: o enfrentamento às arboviroses exige políticas e intervenções de amplo espectro, e a Iniciação Científica fortaleceu esses jovens estudantes enquanto sujeitos de direitos, ampliou sua percepção sobre ciência, saúde, relação com o ambiente, com o Sistema Único de Saúde e estimulou o interesse em ações preventivas no combate às arboviroses nesses territórios.

This study analyzes a Scientific Initiation (SI) program on arboviroses, from the perception of young high school students in Ceilândia ­ Distrito Federal. Objective: It aims to understand to what extent the SI mobilizes these young people to participate in surveillance and health promotion actions in the territory and understand their motivation to participate in this project. Methodology: The methodology included the analysis of the essays written for the selection to the Training Course for Scientific Initiation in Basic Education and the Arboviroses, the administration of this course, and later a focus group with students to analyze the SI educational process they experienced. Results: The result of the Content Analysis showed that the students' perception about the SI could be grouped into six categories: students' motivation for the scientific initiation; the learning process; the training of young scientists; health and environment; youth participation and empowerment, and perceptions of the Public health system in Brazil (SUS). Conclusion: Confronting arboviroses requires broad-spectrum policies and interventions, and the SI strengthened these young students as subjects of rights, broadened their perception of science, health, relationship with the environment, with the Sistema Único de Saúde and stimulated interest in preventive actions to combat arboviroses in these territories. Keywords: Health education; Arbovirus infections; Adolescents; Public health.

Analiza una formación en Iniciación Científica (IC) sobre arbovirus, desde la percepción de jóvenes estudiantes de secundaria en Ceilândia, Distrito Federal. Objetivo: el objetivo es comprender en qué medida la IC moviliza a estos jóvenes a participar en acciones de vigilancia y promoción de la salud en el territorio, así como entender su motivación para participar en proyectos de IC. Metodología: la metodología incluyó el análisis de las redacciones escritas para la selección al Curso de Formación para Iniciación Científica en Educación Básica y Arbovirus, la administración de este curso y, posteriormente, un grupo focal con los estudiantes para analizar el proceso educativo de IC que vivieron. Resultados: los resultados del Análisis de Contenido mostraron la percepción de los estudiantes sobre la IC enfocada en seis categorías analíticas: motivación de los estudiantes por la iniciación científica; proceso de formación de conocimientos; formación de jóvenes científicos; salud y medio ambiente; participación y empoderamiento de los jóvenes y percepciones sobre el Sistema Público de Salud (SUS). Conclusiones: Enfrentar los arbovirus requiere políticas e intervenciones de amplio espectro, y la IC fortaleció a estos jóvenes estudiantes como sujetos de derechos, ampliando su percepción sobre ciencia, salud, relación con el entorno, con el Sistema Único de Salud y estimuló el interés en acciones preventivas en la lucha contra los arbovirus en estos territorios.

Análise bibliométrica da produção científica global em chikungunya: perspectiva da Vigilância em Saúde / Bibliometric analysis of global scientific production on chikungunya: Health Surveillance perspective / Análisis bibliométrico de la producción científica mundial sobre chikungunya: una perspectiva de Vigilancia Sanitária

Chikungunya, arbovirose que provoca febre e artralgia debilitante, demonstra potencial crônico e incapacitante por longos períodos, não havendo vacinas ou terapias específicas. Recentemente, a doença evoluiu da condição negligenciada para uma ameaça à saúde pública, impactando milhões de pessoas em regiões tropicais e subtropicais. Este estudo analisa a produção do conhecimento sobre a Chikungunya, na perspectiva da Vigilância em Saúde. Trata-se de metodologia exploratória-descritiva, com análise bibliométrica. Realizou-se a coleta nas bases Scopus e Web of Science para artigos de 2008 a 2022. A análise revelou uma série temporal de produção destacando a contribuição de Estados Unidos, Brasil e França. Identificaram-se como áreas mais produtivas: doenças transmissíveis, medicina tropical e parasitologia, fundamentais à Vigilância em Saúde e ao planejamento de políticas públicas. Quanto aos pesquisadores, Weaver, Scott C., Failloux, Anna-Bella e De Lamballerie, Xavier foram relevantes no cenário global, indicando a importância da colaboração e da abordagem interdisciplinar.

Chikungunya, an arbovirus that causes fever and debilitating arthralgia, has potential to be chronic and incapacitating for long periods, and there are no vaccines or therapies available for it. Recently, the disease has evolved from a neglected condition to public health threat, impacting millions in tropical and subtropical regions. This study analyzed the knowledge production about chikungunya, from the perspective of Health Surveillance, using an exploratory-descriptive methodology and bibliometric analysis. Articles from 2008 to 2022 were collected from Scopus and Web of Science databases. The analysis showed a production time series, highlighting the contribution of United States, Brazil, and France. The most productive areas were identified as: communicable diseases, tropical medicine and parasitology, which are fundamental to Health Surveillance and public policy planning. Regarding researchers, Weaver, Scott C., Failloux, Anna-Bella, and De Lamballerie, Xavier were relevant in the global scenario, indicating the importance of collaboration and of the interdisciplinary approach.

El chikungunya, arbovirus que causa fiebre y artralgia debilitante, tiene potencial de ser crónico e incapacitante por largos periodos, todavía no hay vacunas ni terapias. Recientemente, la enfermedad ha pasado de afección desatendida a amenaza para la salud pública, afectando a millones en regiones tropicales y subtropicales. Este estudio analiza la producción de conocimientos sobre chikungunya, desde la perspectiva de la Vigilancia Sanitaria. Se utilizó una metodología exploratoria-descriptiva con análisis bibliométrico. Se recompilaron artículos de Scopus y Web of Science, 2008-2022. El análisis reveló una serie temporal de producción, destacando la contribución de EEUU, Brasil y Francia. Se identificaron como áreas más productivas: enfermedades transmisibles, medicina tropical y parasitología, fundamentales para la Vigilancia Sanitaria y la planificación de políticas públicas. En cuanto a los investigadores, Weaver, Scott C., Failloux, Anna-Bella y De Lamballeire, Xavier fueron relevantes en el escenario global, indicando la importancia de la colaboración y del enfoque interdisciplinario.

Guías Latinoamericanas de Infecciones Congénitas y Perinatales de la Sociedad Latinoamericana de Infectología Pediátrica (SLIPE). Parte II / Latin American Guidelines on Congenital and Perinatal Infections from the Latin-American Society of Pediatric Infectious Diseases (SLIPE). Part II

Las infecciones perinatales son una causa de morbilidad, tanto fetal como neonatal, y que compromete la salud de la mujer embarazada, por lo que su diagnóstico, tratamiento, e intento de eliminación son una prioridad en América Latina y el Caribe. Este documento representa la segunda entrega realizada por expertos en la región dentro de la Sociedad Latinoamericana de Infectología Pediátrica (SLIPE), brindando una mirada actualizada en el manejo de las infecciones congénitas y entrega herramientas para detectar posibles momentos estratégicos de intervención y cambio en el manejo de las infecciones congénitas.

Perinatal infections are a major cause of morbidity and mortality in the fetus, neonate, and the health of the pregnant woman. Diagnosis, treatment, and the search for elimination of these diseases are a priority in Latin America and the Caribbean. This document represents the second delivery by a group of experts in the region inside the Latin-American Society of Pediatric Infectious Diseases (SLIPE), presenting a up-to-date look into the management of congenital infectious diseases and give a tool to detect possible strategic sceneries and a change in the management of congenital infections in our region.

Plan técnico para la ejecución de la "Jornada a nivel nacional de acciones integrales e intersectoriales para lucha contra las Arbovirosis en Centros Escolares y Centros de Votación 2024" / Technical plan for the implementation of the "National day of comprehensive and intersectoral actions to combat Arbovirosis in Schools and Voting Centers 2024

En la situación del dengue en El Salvador, inciden determinantes (ambientales, económicos, políticos y sociales), la constante migración del campo a la ciudad, una creciente urbanización sin planificación ni regulación alguna, pobreza, inequidad en el ingreso y condiciones de exclusión que relegan a la población en esta situación a exponerse permanentemente a condiciones de alto riesgo y vulnerabilidad que favorecen la persistencia de la transmisión de arbovirosis, entre ellos se pueden señalar crecimiento poblacional, construcción de viviendas inadecuadas que generan condiciones críticas de hacinamiento, deficiente abastecimiento de agua que obliga a las personas a almacenarla inadecuadamente, una deficiente recolección de desechos sólidos, todo lo cual genera condiciones adecuadas para la multiplicación del Aedes aegypti y la transmisión de la enfermedad. El Ministerio de Salud, anticipándose al retorno de alumnos a un aproximado de 5,000 centros escolares públicos y privados, además de la prevención en 1,600 centros de votación, se ha programado la ejecución de una jornada a nivel nacional de acciones, la cual tiene por objetivo el control del vector en su fase larvaria y adulta; así como, la realización de acciones gubernamentales de carácter preventivas, en el que se realizarán actividades de promoción de la salud encaminadas a la eliminación de criaderos y otras actividades que sean factibles de desarrollar por la comunidad.

In the situation of dengue in El Salvador, determinants (environmental, economic, political and social), the constant migration from the countryside to the city, a growing urbanization without any planning or regulation, affect poverty, inequity in income and conditions of exclusion that relegate the population in this situation to be permanently exposed to conditions of high risk and vulnerability that favor the persistence of transmission of arbovirosis, These include population growth, construction of inadequate housing that generates critical conditions of overcrowding, poor water supply that forces people to store it improperly, poor solid waste collection, all of which generates adequate conditions for the multiplication of Aedes aegypti and the transmission of the disease. The Ministry of Health, anticipating the return of students to approximately 5,000 public and private schools, in addition to prevention in 1,600 voting centers, has scheduled the execution of a day at the national level of actions, which has as its objective the control of the vector in its larval and adult phase; as well as the carrying out of preventive governmental actions, which will include health promotion activities aimed at the elimination of hatcheries and other activities that are feasible to develop by the community

Usefulness of minimally invasive autopsy in the diagnosis of arboviruses to increase the sensitivity of the Epidemiological Surveillance System in Ceará, Brazil / Utilidad de la autopsia mínimamente invasiva en el diagnóstico de arbovirus para aumentar la sensibilidad del Sistema de Vigilancia Epidemiológica en Brasil: experiencia de Ceará, Brasil / Utilidade da autópsia minimamente invasiva no diagnóstico das arboviroses para ampliação da sensibilidade do Sistema de Vigilância Epidemiológica no Brasil: experiência do Ceará

Abstract Objective: To create a protocol for performing minimally invasive autopsies (MIA) in detecting deaths from arboviruses and report preliminary data from its application in Ceará state, Brazil. Methods: Training was provided to medical pathologists on MIA. Results: A protocol was established for performing MIA, defining criteria for sample collection, storage methods, and diagnoses to be carried out according to the type of biological sample; 43 MIAs were performed in three months. Of these, 21 (48.8%) arrived at the Death Verification Service (SVO) with arboviruses as a diagnostic hypothesis, and seven (16.3%) were confirmed (six chikungunya cases and one dengue case); cases of COVID-19 (n = 9), tuberculosis (n = 5), meningitis (n = 4), cryptococcosis (n = 1), Creutzfeldt-Jakob disease (n = 1), breast cancer (n = 1), and human rabies (n = 1) were also confirmed. Conclusion: The protocol implemented enabled identification of a larger number of suspected arbovirus-related deaths, as well as confirmation of other diseases of interest for surveillance.

Resumen Objetivo: Estabelecer un protocolo utilizado para la realización de autopsias mínimamente invasivas (AMI) para la detección de muertes por arbovirus y presentar datos preliminares de este protocolo en Ceará, Brasil. Métodos: Se llevó a cabo la capacitación de médicos patólogos en AMI. Resultados: Se estableció un protocolo para la realización de AMI, que define los criterios para la toma de muestras, métodos de almacenamiento y diagnóstico; en tres meses se realizaron 43 AMI; de estas, 21 (48,8%) llegaron al Servicio de Verificación de Óbito (SVO) con una hipótesis diagnóstica de alguna arbovirosis y siete (16,3%) fueron confirmadas (seis casos de chikungunya y uno de dengue); también se confirmaron casos de Covid-19 (n = 9), tuberculosis (n = 5), meningitis (n = 4), criptococosis (n = 1), enfermedad de Creutzfeldt-Jakob (n = 1), neoplasia de mama (n = 1) y rabia humana (n = 1). Conclusión: El protocolo implementado permitió la identificación de un mayor número de muertes sospechosas de arbovirus, además de la confirmación de otras patologías de interés.

Resumo Objetivo: Estabelecer protocolo para realização de autópsias minimamente invasivas (AMIs) na detecção de óbitos por arboviroses e relatar dados preliminares desse protocolo no Ceará, Brasil. Métodos: Médicos patologistas foram treinados em AMI. Resultados: Estabeleceu-se protocolo para AMI, definindo-se critérios para amostras a serem coletadas, suas formas de armazenamento e diagnóstico, segundo o tipo de amostra biológica; em três meses, foram realizadas 43 AMIs, das quais 21 (48,8%) chegaram ao Serviço de Verificação de Óbito (SVO) com hipótese diagnóstica de alguma arbovirose e sete (16,3%) foram confirmados (seis de chikungunya; uma de dengue); também foram confirmados casos de covid-19 (n = 9), tuberculose (n = 5), meningite (n = 4), criptococose (n = 1), doença de Creutzfeldt-Jakob (n = 1), neoplasia de mama (n = 1) e raiva humana (n = 1). Conclusão: O protocolo implantado permitiu a captação de um maior número de óbitos suspeitos de arboviroses, além da confirmação de outras patologias de interesse da vigilância.

Evaluation of the maturational auditory process in children with the infection by Zika congenital syndrome / Avaliação do processo maturacional auditivo em crianças portadoras da síndrome da infecção congênita pelo Zika vírus

ABSTRACT Purpose: to analyze the absolute latencies of waves I. III and V and the interpeak intervals I-III. III-V and I-V of the ABR recorded from different age groups of children with congenital zika virus infection and their peers without risk indicators for hearing impairment. Methods: 84 newborns and infants (N=51 study group and N=33 control group) divided into groups with different post-conceptual ages. with the results of their hearing exams analyzed by age group and compared with their peers without other risk indicators for hearing impairment. The assessment of the auditory pathway was conducted through tympanometry. otoacoustic emissions and auditory brain stem responses. Results: only the latency of wave I and the interpeak III-V showed no significant difference between the study and control groups. The absolute latency and interpeak values found in the study group were significantly lower than those found in the control group. Conclusion: the maturation of the brain stem in children with ZIKV infection occurred within normal limits. with no retrocochlear disorders until the age of 5 years.

RESUMO Objetivo: analisar as latências absolutas das ondas I. III e V e os intervalos interpicos I-III. III-V e I-V do Potencial Evocado Auditivo de Tronco Encefálico obtidos em diversos grupos etários de crianças portadoras de infecção congênita por zika vírus e nos seus pares sem indicadores de risco para deficiência auditiva. Métodos: foram recrutados 84 recém-nascidos e lactentes (N=51 grupo de estudo e N=33 grupo controle) separados por grupos com diferentes idades pós-conceptuais. sendo os resultados dos seus exames auditivos analisados por faixa etária e comparados com seus pares sem outros indicadores de risco para deficiência auditiva. A avaliação da via auditiva foi realizada por meio da timpanometria. emissões otoacústicas transientes e potencial evocado de tronco encefálico. Resultados: somente a latência da onda I e o intervalo interpico III-V não apresentaram diferença significante entre grupo de estudo e controle. Os valores de latências absolutas e interpicos encontrados no grupo de estudo foram menores do que os obtidos no grupo controle de forma significativa. Conclusão: a maturação do tronco encefálico nas crianças portadoras de infecção por Zika Vírus ocorreu dentro da normalidade. não apresentando alterações retrococleares até a idade de 5 anos.

Dengue Burden and Factors Influencing Severity in Honduras: A Descriptive and Analytical Study

ABSTRACT Background: Dengue is a disease that accounts for a major morbidity and mortality in Honduras. Methods: This descriptive study used an analytical component based on the data from the National Virology Laboratory between 2016-2022. Ordinal logistic regression was used to identify the factors associated with the classification of dengue without warning signs (DWOS), dengue with warning signs (DWS), and severe dengue (SD). Results: Overall, 14,687 dengue cases were included; 50.1% had DWOS, 36.5% had DWS, and 13.4% had SD. Patients that were more associated with a higher probability of DWS and SD were patients in the age groups 1-4 years (DWS OR 1.61; 95%CI:1.33-1.94), (SD OR 1.52; 95% CI:1.26-1.84), 5-9 years (DWS OR 2.01; 95% CI:1.68-2.40), (SD OR 2.00; 95% CI:1.67-2.40), and 10-19 years (DWS OR 1.55; 95% CI:1.30-1.85) (SD OR 1.57; 95% CI:1.31-1.88). The departments that were associated with a higher probability of DWS and SD were La Paz (OR 6.35; 95% CI:3.53-11.42), (OR 10.94; 95% CI:5.96-20.08), Copán (OR 6.94; 95% CI:5.05-9.53) (OR 7.33; 95% CI: 5.35-10.03), Valle (OR 5.22; 95% CI:1.25-21.82) (OR 10.71; 95% CI:2.21-51.88). Conclusions: During the study period, dengue presented endemic behavior, with peaks consistent with the last two epidemics in Honduras in 2015 and 2019. The main factors associated with dengue severity were age< 19 years, male sex, and being from La Paz, Copán, or Valle.

Use of insect repellent as personal protection among women of childbearing age in an arbovirus endemic area in Northeastern Brazil / Uso de repelente como medida de proteção pessoal por mulheres em idade fértil residentes em áreas endêmicas para arboviroses no Nordeste do Brasil

ABSTRACT Objective: To analyze the factors associated with the individual use of insect repellent by women of childbearing age living in area endemic for arboviruses in Fortaleza, Brazil. Methods: This is a cohort study carried out between 2018 and 2019 with women aged between 15 and 39 years in Fortaleza, state of Ceará, Brazil. A total of 1,173 women users of one of the four selected primary health care units participated in the study. The outcome was divided into: continued use, discontinued use, and nonuse of insect repellent. Crude and adjusted multinominal logistic regression analysis was carried out guided by a hierarchical model, with presentation of the respective odds ratio (OR) and 95% confidence intervals (95%CI). The independent variables include: socioeconomic and demographic data, environmental and sanitary characteristics, knowledge of the insect repellent, and behavioral and pregnancy-related aspects. Results: Only 28% of the participants reported using insect repellent during the two waves of the cohort. Women with higher education (OR=2.55; 95%CI 1.44-4.51); who are employed (OR=1.51; 95%CI 1.12-2.03); who received guidance from healthcare professionals (OR=1.74; 95%CI 1.28-2.36) and the media (OR=1.43; 95%CI 1.01-2.02); who intensified precautions against mosquitoes during the epidemic (OR=3.64; 95%CI 2.29-5.78); and who were pregnant between 2016 and 2019 (OR=2.80; 95%CI 1.83-4.30) had increased odds for continued use of insect repellent. Conclusion: The use of insect repellent among women of childbearing age was associated with a higher level of education, employment, guidance on insect repellent provided by healthcare professionals and the media, behavioral changes to protect against mosquitoes during the Zika virus epidemic, and pregnancy when occurring as of the beginning of the epidemic period.

RESUMO Objetivo: Analisar os fatores associados ao uso de repelente individual por mulheres em idade fértil residentes em área endêmicas para arboviroses em Fortaleza, Brasil. Métodos: Coorte realizada entre 2018 e 2019, com mulheres entre 15 e 39 anos, moradoras em Fortaleza, Ceará, Brasil. Participaram 1.173 mulheres, usuárias de quatro unidades primárias de saúde do município. O desfecho foi categorizado em: uso continuado, uso descontinuado e não uso de repelente. Realizada análise de regressão logística multinominal norteada por modelo hierárquico, com apresentação dos respectivos odds ratio (OR) e intervalos de confiança de 95% (IC95%). As variáveis independentes incluem: dados socioeconômicos e demográficos, características ambientais e sanitárias, conhecimento sobre o repelente e aspectos comportamentais e relacionados à gravidez. Resultados: Somente 28% das participantes referiram o uso de repelente durante as duas ondas da coorte. Mulheres com escolaridade superior (OR=2,55; IC95% 1,44-4,51); com emprego (OR=1,51; IC95% 1,12-2,03); que receberam orientações por profissionais da saúde (OR=1,74; IC95% 1,28-2,36) e pela mídia (OR=1,43; IC95% 1,01-2,02); que intensificaram os cuidados contra o mosquito na epidemia (OR=3,64; IC95% 2,29-5,78); estavam grávidas entre 2016 e 2019 (OR=2,80; IC95% 1,83-4,30) tiveram as chances aumentadas para uso continuado de repelente. Conclusões: O uso de repelente entre mulheres em idade fértil mostrou-se associado a um maior nível de escolaridade, ao emprego, às orientações sobre repelente fornecidas por profissionais de saúde e pela mídia, às mudanças comportamentais de cuidado contra o mosquito durante a epidemia da Zika e à gravidez quando ocorrida a partir do início do período epidêmico.

"Clock dial pattern", a radiologic clue to neuro-chikungunya diagnosis: a case series / "Padrão em ponteiro de relógio", uma dica radiológica para o diagnóstico de neurochikungunya: série de casos

Abstract Background Chikungunya is a mosquito-borne disease caused by the chikungunya virus (CHIKV) and can lead to neurological complications in severe cases. Objective This study examined neuroimaging patterns in chikungunya cases during two outbreaks in Brazil to identify specific patterns for diagnosis and treatment of neuro-chikungunya. Methods Eight patients with confirmed chikungunya and neurological involvement were included. Clinical examinations and MRI scans were performed, and findings were analyzed by neuroradiologists. Data on age, sex, neurological symptoms, diagnostic tests, MRI findings, and clinical outcomes were recorded. Results Patients showed different neuroimaging patterns. Six patients exhibited a "clock dial pattern" with hyperintense dotted lesions in the spinal cord periphery. One patient had thickening and enhancement of anterior nerve roots. Brain MRI revealed multiple hyperintense lesions in the white matter, particularly in the medulla oblongata, in six patients. One patient had a normal brain MRI. Conclusion The "clock dial pattern" observed in spinal cord MRI may be indicative of chikungunya-related nervous system lesions. Isolated involvement of spinal cord white matter in chikungunya can help differentiate it from other viral infections. Additionally, distinct brainstem involvement in chikungunya-associated encephalitis, particularly in the rostral region, sets it apart from other arboviral infections. Recognizing these neuroimaging patterns can contribute to early diagnosis and appropriate management of neuro-chikungunya.

Resumo Antecedentes A chikungunya é uma doença transmitida por mosquitos causada pelo vírus chikungunya (CHIKV) e pode levar a complicações neurológicas em casos graves. Objetivo Este estudo examinou padrões de neuroimagem em casos de chikungunya durante dois surtos no Brasil para identificar padrões específicos para o diagnóstico e tratamento de neurochikungunya. Métodos Oito pacientes com chikungunya confirmada e envolvimento neurológico foram incluídos. Exames clínicos e ressonâncias magnéticas (RM) foram realizados, e os achados foram analisados por neurorradiologistas. Dados sobre idade, sexo, sintomas neurológicos, testes diagnósticos, achados de RM e desfechos clínicos foram registrados. Resultados Os pacientes apresentaram diferentes padrões de neuroimagem. Seis pacientes apresentaram um "padrão de mostrador de relógio" com lesões pontilhadas hiperintensas na periferia da medula espinhal. Um paciente apresentou espessamento e realce das raízes nervosas anteriores. A RM do cérebro revelou múltiplas lesões hiperintensas na substância branca, especialmente no bulbo em seis pacientes. Um paciente apresentou uma RM cerebral normal. Conclusão O "padrão de mostrador de relógio" observado na RM da medula espinhal pode ser indicativo de lesões do sistema nervoso relacionadas à chikungunya. O envolvimento isolado da substância branca da medula espinhal na chikungunya pode ajudar a diferenciá-la de outras infecções virais. Além disso, o envolvimento distinto do tronco cerebral na encefalite associada à chikungunya, especialmente na região rostral, a distingue de outras infecções por arbovírus. O reconhecimento desses padrões de neuroimagem pode contribuir para o diagnóstico precoce e manejo adequado da neurochikungunya.

Prevalence of arboviruses in sickle cell disease patients from two different regions of Brazil, the North and Northeast

ABSTRACT Sickle Cell Disease (SCD) is a hereditary disease characterized by extravascular and intravascular hemolysis and clinical variability, from mild pain to potentially life-threatening. Arboviruses include mainly Zika (ZIKV), Chikungunya (CHKV), and Dengue (DENV) virus, and are considered a public and social health problem. The present cross-sectional observational study aimed to investigate the prevalence of arbovirus infection in SCD patients from two Brazilian cities, Salvador and Manaus located in Bahia and Amazonas states respectively. A total of409 individuals with SCD were included in the study, and 307 (75.06 %) patients tested positive for DENV-IgG, 161 (39.36 %) for ZIKV-IgG, and 60 (14.67 %) for CHIKV-IgG. Only one individual was positive for DENV-NS1 and another for DENV-IgM, both from Salvador. No individuals had positive serology for ZIKV-IgM or CHIKV-IgM. Arbovirus positivity by IgG testing revealed that the SCD group presented high frequencies in both cities. Interestingly, these differences were only statistically significant for ZIKV-IgG (p = 0.023) and CHIKV-IgG (p = 0.005) among SCD patients from Manaus. The reshaping of arbovirus from its natural habitat by humans due to disorderly urban expansion and the ease of international Mobility has been responsible for facilitating the spread of vector-borne infectious diseases in humans. We found the need for further studies on arboviruses in this population to elucidate the real association and impact, especially in acute infection. We hope that this study will contribute to improvements in the personalized clinical follow-up of SCD patients, identifying the influence of arbovirus infection in severe disease manifestations.

Vertical transmission of chikungunya virus: a worldwide concern

Abstract The Chikungunya Virus (CHIKV) already has endemic circulation in about 100 countries and the number of infected patients increases every year, due to the effectiveness of the vector and human universal susceptibility to infection. The virus can also be transmitted from mother to child, more frequently intrapartum. About 50 % of neonates with CHIKV symptoms will have neurodevelopmental delay. It is therefore an infection of worldwide concern with a great impact on people's quality of life. The objective of this work is to describe two cases of confirmed vertical transmission by chikungunya virus, one of them with intrauterine infection and death of the neonate. Neonates with vertical chikungunya infection may present with clinical sepsis in the first few days of life, which is why this is a very important diagnosis, especially during outbreaks of the infection.

Worldwide distribution, symptoms and diagnosis of the coinfections between malaria and arboviral diseases: a systematic review

The coinfection between malaria (ML) and arboviral diseases represents a major global public health problem, particularly in tropical and subtropical countries. Despite its relevance, this topic is still insufficiently discussed in the current literature. Here, we aimed to investigate the worldwide distribution, symptoms, and diagnosis during coinfection between ML and arboviral diseases. We conducted a systematic review following the Preferred reporting items for systematic reviews and meta-analyses (PRISMA) statement and assessed the selection and eligibility criteria, created and diagrammed maps, and analysed major symptoms with 95% confidence intervals (CI) using prevalence ratio and effect size, also performing latent class analysis. A total of 85,485 studies were retrieved, of which 56 were included: 57.14% in Asia, 25% in Africa, 14.30% in South America, and 3.56% in Europe. A total of 746 individuals were reported to be coinfected with Plasmodium and arbovirus. Concurrent ML, Dengue (DEN), Chikungunya (CHIK), and Zika (ZIK) patients are more likely to present headache and skin rash. Regarding diagnosis, 58,253 were made, of which 38,176 were positive (ML and at least one arboviral disease). The magnitude of these pathogens' coexistence points out the pressing need for improvements in public health policies towards diagnosis and prevention of both diseases, especially in endemic areas.

Occurrence of arbovirus infections in two riverine populations in the municipality of Humaitá, Amazonas, Brazil

ABSTRACT Background: The riverine communities of the Amazon comprise different social groups that inhabit the rural areas on the banks of rivers and lakes. Residents usually travel by river to rural and urban areas and are then exposed to urbanized diseases such as those caused by arbovirus infection. In Brazil, emerging diseases such as dengue, Zika, chikungunya, and those caused by infection with Oropouche and Mayaro viruses necessitate epidemiological surveillance. This study was aimed at determining the frequency of positivity for immunoglobulin (Ig)G and IgM antibodies against Zika, chikungunya, and dengue viruses and performing molecular analyses to detect viral RNA for the Zika, chikungunya, dengue virus, Oropouche, and Mayaro viruses, in the same serum samples obtained from riverside populations. Methods: This cross-sectional study was conducted in a riverside population in the Humaitá municipality of the Brazilian Amazon. More than 80% of the local population participated in this study. Entomological samples were collected to identify local mosquito vectors. Results: Analysis of 205 human serological samples revealed IgG antibodies against the dengue virus in 85 individuals. No molecular positivity was observed in human samples. Entomological analyses revealed 3,187 Diptera species, with Mansonia being the most frequent genus. Aedes aegypti and Aedes albopictus were not detected in the two collections. Conclusions: IgG antibodies against the dengue virus were highly prevalent, suggesting previous exposure. The absence of the arbovirus vectors Aedes aegypti and Aedes albopictus in the samples supports the hypothesis that the infections recorded likely occurred outside the riverside communities investigated.

Métodos de aprendizaje automático para predecir el comportamiento epidemiológico de enfermedades arbovirales: revisión estructurada de literatura / Machine learning methods to predict epidemiological behavior of arbovirals diseases: structured literature review

Introducción: Los métodos de aprendizaje automático permiten manejar datos estructurados y no estructurados para construir modelos predictivos y apoyar la toma de decisiones. Objetivo: Identificar los métodos de aprendizaje automático aplicados para predecir el comportamiento epidemiológico de enfermedades arbovirales utilizando datos de vigilancia epidemiológica. Metodología: Se realizó búsqueda en EMBASE y PubMed, análisis bibliométrico y síntesis de la información. Resultados: Se seleccionaron 41 documentos, todos publicados en la última década. La palabra clave más frecuente fue dengue. La mayoría de los autores (88,3 %) participó en un artículo de investigación. Se encontraron 16 métodos de aprendizaje automático, el más frecuente fue Red Neuronal Artificial, seguido de Máquinas de Vectores de Soporte. Conclusiones: En la última década se incrementó la publicación de trabajos que pretenden predecir el comportamiento epidemiológico de arbovirosis por medio de diversos métodos de aprendizaje automático que incorporan series de tiempo de los casos, variables climatológicas, y otras fuentes de información de datos abiertos.

Introduction: Machine learning methods allow to manipulate structured and unstructured data to build predictive models and support decision-making. Objective: To identify machine learning methods applied to predict the epidemiological behavior of vector-borne diseases using epidemiological surveillance data. Methodology: A literature search in EMBASE and PubMed, bibliometric analysis, and information synthesis were performed. Results: A total of 41 papers were selected, all of them were published in the last decade. The most frequent keyword was dengue. Most authors (88.3 %) participated in a research article. Sixteen machine learning methods were found, the most frequent being Artificial Neural Network, followed by Support Vector Machines. Conclusions: In the last decade there has been an increase in the number of articles that aim to predict the epidemiological behavior of vector-borne diseases using by means of various machine learning methods that incorporate time series of cases, climatological variables, and other sources of open data information.

Review of dengue, zika and chikungunya infections in nervous system in endemic areas / Revisão da infecção por dengue, zika e chikungunya no sistema nervoso em áreas endêmicas

Abstract Dengue, zika, and chikungunya are arboviruses of great epidemiological relevance worldwide. The emergence and re-emergence of viral infections transmitted by mosquitoes constitute a serious human public health problem. The neurological manifestations caused by these viruses have a high potential for death or sequelae. The complications that occur in the nervous system associated with arboviruses can be a challenge for diagnosis and treatment. In endemic areas, suspected cases should include acute encephalitis, myelitis, encephalomyelitis, polyradiculoneuritis, and/or other syndromes of the central or peripheral nervous system, in the absence of a known explanation. The confirmation diagnosis is based on viral (isolation or RT-PCR) or antigens detection in tissues, blood, cerebrospinal fluid, or other body fluids, increase in IgG antibody titers between paired serum samples, specific IgM antibody in cerebrospinal fluid and serological conversion to IgM between paired serum samples (non-reactive in the acute phase and reactive in the convalescent). The cerebrospinal fluid examination can demonstrate: 1. etiological agent; 2. inflammatory reaction or protein-cytological dissociation depending on the neurological condition; 3. specific IgM, 4. intrathecal synthesis of specific IgG (dengue and chikungunya); 5. exclusion of other infectious agents. The treatment of neurological complications aims to improve the symptoms, while the vaccine represents the great hope for the control and prevention of neuroinvasive arboviruses. This narrative review summarizes the updated epidemiology, general features, neuropathogenesis, and neurological manifestations associated with dengue, zika, and chikungunya infection.

Resumo Dengue, zika e chikungunya são arboviroses de grande relevância epidemiológica em todo o mundo. A emergência e reemergência dessas infecções virais transmitidas por mosquitos constituem um grave problema de saúde pública humana. As manifestações neurológicas causadas por esses vírus têm alto potencial de morte ou sequelas. As complicações que ocorrem no sistema nervoso associadas às arboviroses podem representar um desafio diagnóstico e de tratamento. Em áreas endêmicas, casos suspeitos devem incluir encefalite, mielite, encefalomielite, polirradiculoneurite e/ou outras síndromes do sistema nervoso central ou periférico, na ausência de explicação conhecida. Caso confirmado de arbovirose neuroinvasivo é baseado na detecção viral (isolamento ou RT-PCR) ou de antígenos em tecidos, sangue, líquido cefalorraquidiano ou outros fluidos corporais, aumento dos títulos de anticorpos IgG entre amostras de soro pareadas, anticorpo IgM específico no líquido cefalorraquidiano e conversão sorológica para IgM entre amostras de soro pareadas. O exame do líquido cefalorraquidiano pode demonstrar: 1. agente etiológico; 2. reação inflamatória ou dissociação proteico-citológica, dependendo do quadro neurológico; 3. valor absoluto de IgM específica; 4. síntese intratecal de anticorpos IgG específicos (dengue e chikungunya); 5. exclusão de outros agentes infecciosos. O tratamento das complicações neurológicas visa melhorar os sintomas, enquanto a vacina representa a grande esperança para o controle e a prevenção das arboviroses neuroinvasivas. Esta revisão narrativa resume a atualização da epidemiologia, características gerais, neuropatogênese e manifestações neurológicas associadas à infecção pelos vírus da dengue, zika e chikungunya.

Características clínicas y laboratoriales de pacientes adultos ambulatorios con Chikungunya del Hospital Nacional de Itauguá de Paraguay durante la epidemia 2022-2023

Introducción: La infección aguda por chikungunya produce una infección auto-limitada caracterizada principalmente por fiebre alta, artralgias, artritis, cefalea, mialgias y exantema pruriginoso; una minoría presenta síntomas persistentes que puede evolucionar a la cronicidad. Objetivo: describir las características clínicas y laboratoriales de pacientes adultos ambulatorios con chikungunya en un hospital de referencia durante la epidemia del 2022-2023 en Paraguay. Metodología: estudio descriptivo de corte trasversal de pacientes adultos con chikungunya que consultaron en el Hospital Nacional de Itauguá entre enero-marzo de 2023. Resultados: Se incluyeron 140 pacientes entre 19 y 79 años (edad media: 46,6±13,6), 77,9 % del sexo femenino y 89,3 % del departamento Central. El 72,9 % de los pacientes fueron confirmados por RT-PCR y el resto por la serología o nexo epidemiológico. El 48,6 % tenía alguna comorbilidad, el 65% se encontraba en la fase aguda, y el resto en la fase subaguda (35 %). Los síntomas más frecuentes fueron la poliartralgia (96,4 %); artritis (98,6 %), fiebre (95,7 %), astenia (100 %), mialgias (96,4 %), cefalea (82,9 %), exantema (95 %). Los síntomas gastrointestinales fueron menos frecuentes; náuseas (37 %), vómitos (15,7 %) y diarrea (20 %). Entre los principales hallazgos laboratoriales se encontraron la proteína C reactiva aumentada (45,7 %), leucopenia (23,6 %), eritrosedimentación aumentada (27,9 %), citólisis hepática leve (13,6 %). Todos fueron tratados con paracetamol; el 60,4 % y el 87,8 % de los pacientes en fase aguda y subaguda recibieron AINES, respectivamente. Discusión: La combinación de fiebre alta y artralgia severa fue el rasgo característico de la infección por el virus chikungunya en la epidemia en Paraguay.

Introduction: Acute infection by chikungunya produces a self-limited infection characterized mainly by high fever, arthralgia, arthritis, headache, myalgia and pruritic rash; a minority presents persistent symptoms that can evolve to chronicity. Objective: to describe the clinical and laboratory characteristics of adult ambulatory patients with chikungunya at a referral hospital during the 2022-2023 epidemic in Paraguay. Method: descriptive cross-sectional study of adult patients with chikungunya infection who consulted at the Hospital National de Itauguá between January-March 2023. Results: 140 patients between 19 and 79 years old (mean age: 46.6 ± 13.6), 77.9% female and 89.3% from the Central department, were included. 72.9% of the patients were confirmed by RT-PCR and the rest by serology or epidemiological nexus. 48.6% had some comorbidity, 65% were in the acute phase, and the rest in the subacute phase (35%). The most frequent symptoms were polyarthralgia (96.4%); arthritis (98.6%), fever (95.7%), fatigue (100%), myalgia (96.4%), headache (82.9%), rash (95%). Gastrointestinal symptoms were less frequent such as; nausea (37%), vomiting (15.7%) and diarrhea (20%). Increased C-reactive protein (45.7%), leukopenia (23.6%), increased erythrocyte sedimentation rate (27.9%), and mild hepatic cytolysis (13.6%) were among the main laboratory findings. All patients were treated with paracetamol; 60.4% and 87.8% of the patients in the acute and subacute phase, respectively, received NSAIDs. Discussion: The combination of high fever and severe arthralgia can be considered the characteristic feature of chikungunya virus infection in this epidemic.

Distribución de Aedes albopictus en Ibagué: potencial riesgo de brotes de arbovirosis

Introducción. Aedes albopictus es un vector de arbovirus como dengue, Zika, chikungunya y fiebre amarilla. Los primeros reportes en el continente americano datan de 1985 y dada su capacidad de adaptación ecológica y fisiológica, se ha distribuido rápidamente en el territorio colombiano desde su primer reporte en 1998. Objetivo. Determinar la distribución de A. albopictus en las comunas de Ibagué, Colombia. Materiales y métodos. Los muestreos se realizaron entre mayo y noviembre de 2022 en zonas con abundante vegetación de las 13 comunas de Ibagué. Se emplearon aspiradores y redes entomológicas. Los mosquitos fueron transportados al Laboratorio de Investigaciones en Parasitología Tropical de la Universidad del Tolima para su determinación taxonómica. Resultados. Se identificaron 708 ejemplares de A. albopictus, distribuidos en las comunas de Ibagué. La mayor abundancia del vector se presentó en las comunas 10, 11, 7, 8, 2 y 9. Las comunas 3, 4, 5, 6, 12 y 13 presentaron abundancias relativas cercanas al 3 %, y la comuna 1 tuvo una abundancia del 2 %. Conclusiones. Aedes albopictus está distribuido en todas las comunas de Ibagué, probablemente su dispersión se ha visto favorecida por las condiciones ambientales y sociales de esta región. Se recomienda hacer seguimiento anual a las poblaciones de este vector y realizar una caracterización molecular de los arbovirus encontrados. Además, el conocer la distribución de este mosquito en la ciudad permitirá focalizar las estrategias de control entomológico y prevenir futuros brotes de arbovirosis.

Introduction. Aedes albopictus is a vector for arboviruses, such as dengue, Zika, chikungunya, and yellow fever. The first A. albopictus reports on the American continent date back to 1985. It has spread rapidly throughout Colombia since its first report in 1998 due to its ecological and physiological adaptation capability. Objective. To determine A. albopictus distribution in the 13 communes of Ibagué, Colombia. Materials and methods. Samples were collected between May and November 2022 in the 13 communes of Ibagué. Vacuum sampling and sweep-netting entomological nets were used in areas with abundant vegetation. The mosquitoes were transported to the Laboratorio de Investigaciones en Parasitología Tropical at the Universidad del Tolima for taxonomic determination. Results. We identified 708 A. albopictus specimens distributed throughout Ibague's 13 communes. The highest vector abundance occurred in communes 10, 11, 7, 8, 2, and 9; communes 3, 4, 5, 6, 12, and 13 had a relative abundance of around 3%, while commune 1 had 2% of relative abundance. Conclusions. Aedes albopictus is distributed throughout all the communes of Ibague. Its dispersion has probably been favored by this region's environmental and social conditions. We recommend annual monitoring of these vectors populations and molecular characterization of the found arboviruses. Ascertaining this mosquito's distribution throughout the city will enable focusing entomological control strategies and preventing future arbovirus outbreaks.

Brote de Zika en Panamá. Caracterización del primer brote epidémico del virus Zika registrado en Panamá

Introducción: La caracterización de los brotes de Zika es de gran importancia para lograr determinar los factores de riesgos individuales y colectivos que participan en su ocurrencia y es la base para el desarrollo de estrategias efectivas para la vigilancia, prevención y control de la transmisión de esta enfermedad. Objetivo: Describir epidemiológicamente las principales características del primer brote epidémico de Zika registrado en Panamá, en la Comarca de Guna Yala. Materiales y métodos: Se diseño y realizó un estudio descriptivo y retrospectivo del primer brote de Zika ocurrido entre el 27 de noviembre de 2015 y el 22 de enero de 2016 en Guna Yala, Panamá. Resultados: Se colectaron un total de 68 muestras de suero de pacientes sospechosos, 38 muestras fueron positivas por PCR para Zika en la Comarca de Guna Yala, Ustupo registró la mayor cantidad de casos (n = 29, 76,3%), el (n = 43; 86%) de los casos fueron menores de 59 años, el (n = 37; 74%) de los casos eran población económicamente activa (14 a 65 años de edad) y el (n = 30; 60%) de los casos fueron de sexo femenino. Conclusión: Este estudio ha permitido mostrar la facilidad con que las enfermedades arbovirales como el Zika puede introducirse, propagarse y llegar a producir un impacto en la salud pública de la población, el sistema de salud y establecerse en las regiones donde ocurren estos eventos sanitarios. Es necesario realizar más estudios, el fortalecimiento de la vigilancia epidemiológica y la consideración de los factores de riesgo para garantizar la sostenibilidad de las intervenciones sanitarias y lograr reducir el impacto social y económico de este arbovirosis. (provisto por Infomedic International)

Introduction: The characterization of Zika outbreaks is of great importance to determine the individual and collective risk factors involved in their occurrence and is the basis for the development of effective strategies for surveillance, prevention and control of Zika transmission. Objective: To describe epidemiologically the main characteristics of the first epidemic outbreak of Zika recorded in Panama, in the Guna Yala region.  Materials and methods: A descriptive and retrospective study of the first Zika outbreak that occurred between 27 November 2015 and 22 January 2016 in Guna Yala, Panama, was designed and conducted.  Results: A total of 68 serum samples were collected from suspected patients, 38 samples were positive by PCR for Zika in the Guna Yala Comarca, Ustupo registered the highest number of cases (n = 29, 76.3%), (n = 43; 86%) of the cases were younger than 59 years, (n = 37; 74%) of the cases were economically active population (14 to 65 years of age) and (n = 30; 60%) of the cases were female. Conclusion: This study has shown the ease with which arboviral diseases such as Zika can be introduced, spread and have an impact on the public health of the population, the health system and become established in the regions where these health events occur. Further studies strengthened epidemiological surveillance and consideration of risk factors are needed to ensure the sustainability of health interventions and to reduce the social and economic impact of this arbovirosis. (provided by Infomedic International)

Caracterización clínica y epidemiológica de la epidemia de Chikungunya en el Paraguay / Clinical and epidemiological characterization of the Chikungunya epidemic in Paraguay

Durante el verano del 2022 y 2023 ocurrió la mayor epidemia de Chikungunya en Paraguay, y una de las más grandes reportadas en la región. Estuvo centralizada en el área metropolitana de Asunción en una primera etapa, pero se expandió al resto del país durante los primeros meses del 2023. Este trabajo tiene el objetivo de describir epidemiológica y clínicamente la epidemia desde su inicio en la semana epidemiológica 40 del 2022 hasta la semana 20 del 2023. Metodología: es un estudio descriptivo que utiliza los datos públicos disponibles en la página de la Dirección General de Vigilancia de la Salud. Fueron confirmados 86.761 casos, 58% femenino, 8227 ingresos hospitalarios y 248 fallecidos. La letalidad global es de 2.8 por mil casos confirmados. Los grupos etarios más afectados corresponden a la franja de 0 a 4 años (9%), sin embargo, la mayor incidencia de casos se da en mayores de 80 años. Los principales desafíos de esta enfermedad son el abordaje multidisciplinario en la gestión del manejo del vector, la evaluación de las causas de esta alta letalidad y la necesidad de una vacuna de uso poblacional.

During the summer of 2022 and 2023, the largest Chikungunya epidemic occurred in Paraguay, and one of the largest reported in the region. It was centralized in the metropolitan area of Asunción in a first stage, but it expanded to the rest of the country during the first months of 2023. This work has the objective of describing the epidemic epidemiologically and clinically from its beginning in epidemiological week 40 of 2022 to week 20 of 2023. Methodology: it is a descriptive study that uses the public data available on the page of the General Directorate of Health Surveillance. 86,761 cases were confirmed, 58% female, 8,227 hospital admissions, and 248 deaths. The global lethality is 2.8 per thousand confirmed cases. The most affected age groups correspond to the 0 to 4-year-old group (9%), however, the highest incidence of cases occurs in people over 80 years of age. The main challenges of this disease are the multidisciplinary approach in the management of the vector, the evaluation of the causes of this high lethality and the need for a vaccine for population use.

Caracterización clínica y epidemiológica de la epidemia de Chikungunya en el Paraguay

Durante el verano del 2022 y 2023 ocurrió la mayor epidemia de Chikungunya en Paraguay, y una de las más grandes reportadas en la región. Estuvo centralizada en el área metropolitana de Asunción en una primera etapa, pero se expandió al resto del país durante los primeros meses del 2023. Este trabajo tiene el objetivo de describir epidemiológica y clínicamente la epidemia desde su inicio en la semana epidemiológica 40 del 2022 hasta la semana 20 del 2023. Metodología: es un estudio descriptivo que utiliza los datos públicos disponibles en la página de la Dirección General de Vigilancia de la Salud. Fueron confirmados 86.761 casos, 58% femenino, 8227 ingresos hospitalarios y 248 fallecidos. La letalidad global es de 2.8 por mil casos confirmados. Los grupos etarios más afectados corresponden a la franja de 0 a 4 años (9%), sin embargo, la mayor incidencia de casos se da en mayores de 80 años. Los principales desafíos de esta enfermedad son el abordaje multidisciplinario en la gestión del manejo del vector, la evaluación de las causas de esta alta letalidad y la necesidad de una vacuna de uso poblacional.

During the summer of 2022 and 2023, the largest Chikungunya epidemic occurred in Paraguay, and one of the largest reported in the region. It was centralized in the metropolitan area of Asunción in a first stage, but it expanded to the rest of the country during the first months of 2023. This work has the objective of describing the epidemic epidemiologically and clinically from its beginning in epidemiological week 40 of 2022 to week 20 of 2023. Methodology: it is a descriptive study that uses the public data available on the page of the General Directorate of Health Surveillance. 86,761 cases were confirmed, 58% female, 8,227 hospital admissions, and 248 deaths. The global lethality is 2.8 per thousand confirmed cases. The most affected age groups correspond to the 0 to 4-year-old group (9%), however, the highest incidence of cases occurs in people over 80 years of age. The main challenges of this disease are the multidisciplinary approach in the management of the vector, the evaluation of the causes of this high lethality and the need for a vaccine for population use.