Utilization of machine learning for dengue case screening.

Dengue causes approximately 10.000 deaths and 100 million symptomatic infections annually worldwide, making it a significant public health concern. To address this, artificial intelligence tools like machine learning can play a crucial role in developing more effective strategies for control, diagnosis, and treatment. This study identifies relevant variables for the screening of dengue cases through machine learning models and evaluates the accuracy of the models. Data from reported dengue cases in the states of Rio de Janeiro and Minas Gerais for the years 2016 and 2019 were obtained through the National Notifiable Diseases Surveillance System (SINAN). The mutual information technique was used to assess which variables were most related to laboratory-confirmed dengue cases. Next, a random selection of 10,000 confirmed cases and 10,000 discarded cases was performed, and the dataset was divided into training (70%) and testing (30%). Machine learning models were then tested to classify the cases. It was found that the logistic regression model with 10 variables (gender, age, fever, myalgia, headache, vomiting, nausea, back pain, rash, retro-orbital pain) and the Decision Tree and Multilayer Perceptron (MLP) models achieved the best results in decision metrics, with an accuracy of 98%. Therefore, a tree-based model would be suitable for building an application and implementing it on smartphones. This resource would be available to healthcare professionals such as doctors and nurses.

Anti-Pythium insidiosum activity of bioactive compounds from medicinal plants.

Pythiosis is a serious disease caused by the aquatic oomycete Pythium insidiosum that mainly affects mammals. Unlike fungal and bacterial resistance induced by the indiscriminate use of drugs, P. insidiosum has low susceptibility to antifungal drugs. In this sense, essential oils and their major components emerge as a promising treatment line for this disease. Given the above, this study sought to verify P. insidiosum (n = 34) susceptibility to the bioactive compounds eugenol, α-terpineol, menthol, and carvacrol and correlate them with the respective essential oils of Eugenia caryophyllata, Melaleuca alternifolia, Mentha piperita, and Origanum vulgare. The essential oils and bioactive compounds were purchased commercially and tested according to the Clinical and Laboratory Standards Institute protocol M38-A2. Our findings showed that eugenol, α-terpineol, and carvacrol had superior anti-P. insidiosum action than their respective essential oils, suggesting that they may be responsible for inhibitory activity against P. insidiosum. Notably, the major compound with the best anti-P. insidiosum activity was α-terpineol; nonetheless, menthol showed less activity than its essential oil. The results imply that essential oils and their major compounds may be important allies in treating pythiosis, expanding the perspectives of developing new drugs with anti-P. insidiosum activity.

Disentangling associations between vegetation greenness and dengue in a Latin American city: Findings and challenges.

Being a Re-Emerging Infectious Disease, dengue causes 390 million cases globally and is prevalent in many urban areas in South America. Understanding the fine-scale relationships between dengue incidence and environmental and socioeconomic factors can guide improved disease prevention strategies. This ecological study examines the association between dengue incidence and satellite-based vegetation greenness in 3826 census tracts nested in 474 neighborhoods in Belo Horizonte, Brazil, during the 2010 dengue epidemic. To reduce potential bias in the estimated dengue-greenness association, we adjusted for socioeconomic vulnerability, population density, building height and density, land cover composition, elevation, weather patterns, and neighborhood random effects. We found that vegetation greenness was negatively associated with dengue incidence in a univariate model, and this association attenuated after controlling for additional covariates. The dengue-greenness association was modified by socioeconomic vulnerability: while a positive association was observed in the least vulnerable census tracts, the association was negative in the most vulnerable areas. Using greenness as a proxy for vegetation quality, our results show the potential of vegetation management in reducing dengue incidence, particularly in socioeconomically vulnerable areas. We also discuss the role of water infrastructure, sanitation services, and tree cover in lowering dengue risk.

Spatiotemporal relationship between agriculture, livestock, deforestation, and visceral leishmaniasis in Brazilian legal Amazon.

Visceral leishmaniasis (VL) is an urgent public health concern in Brazil. We evaluated the spatiotemporal distribution of VL to better understand the effects of economic activities related to agriculture, livestock, and deforestation on its incidence in the Brazilian Legal Amazon (BLA). The data on newly confirmed cases of VL in Brazilian municipalities from 2007 to 2020 were extracted from the Brazilian Notifiable Diseases Information System (SINAN) and analyzed. The data on agricultural production (planted area in hectares) and livestock (total number of cattle) were obtained from the Brazilian Institute of Geography and Statistics (IBGE), whereas deforestation data (in hectares) were obtained from the Amazon Deforestation Estimation Project (PRODES). SatScan and the local indicators of spatial association (LISA) were used to identify the spatial and temporal patterns of VL and its relationships with economic and environmental variables. The cumulative incidence rate was found to be 4.5 cases per 100,000 inhabitants. Based on the LISA results, areas with a high incidence of VL and deforestation were identified in the states of Roraima, Pará, and Maranhão. Strengthening deforestation monitoring programs and environmental enforcement actions can help implement public policies to control illegal deforestation and mitigate the socio-environmental vulnerability in the BLA. Therefore, areas identified in this study should be prioritized for controlling VL.

Profile and temporal dynamics of the feline sporotrichosis epidemic in southern Brazil: A forecasting analysis.

A detailed clinical-epidemiological analysis of feline sporotrichosis was conducted, and 288 cases reported between the years 2007 and 2018 were analyzed. The studied cases primarily involved mongrel cats (240/260), males (212/282), and adults (121/200). The main objectives were to identify the risk factors, calculate the monthly incidence rates, and establish a predictive model using the seasonal autoregressive integrated moving average (SARIMA) approach. The statistical analysis revealed significant associations (p < 0.05) between prolonged lesion evolution times and factors such as respiratory signs, prior treatments, and lesion contact. Empirical treatment was identified as a significant risk factor for disease progression. Moreover, the number of cases demonstrated an increasing trend over the study period, with annual peaks noted in disease incidence. The SARIMA model proved to be an effective tool for forecasting the incidence of sporotrichosis, offering robust support for epidemiological surveillance and facilitating targeted public health interventions in endemic regions. The predictive accuracy of the developed model underscored its utility in enhancing disease monitoring and supporting proactive health measures for the effective management of sporotrichosis.

Equidae pythiosis in Brazil and the world: a systematic review of the last 63 years (1960-2023).

This systematic review compiles reports of clinical pythiosis in horses, mules and donkeys from 1960 to 2023 worldwide, focusing on Brazil. We searched databases and included 71 articles detailing clinical characteristics, geographic distribution, epidemiology, diagnostic methods, therapies, and outcomes. The results showed that publications on equine pythiosis have significantly increased since 2010. Brazil reported the highest incidence, comprising 55% of cases, predominantly in the southern, northeastern, and central-western regions during summer and autumn. Cutaneous pythiosis was the most prevalent form, generally presenting as single lesions in the appendicular region, and affected females more than males. Diagnosis typically involved histopathology, used alone or with other methods. Various treatments have been employed, with surgery, often combined with chemotherapy and immunotherapy, being the most common. Notably, 80.84% of treated animals recovered, highlighting the effectiveness of these therapies in enhancing survival rates. The limitations of the study included the lack of data in published case reports, which made it difficult to collect and calculate epidemiological data. Additionally, we recognize that pythiosis in Brazil is underreported, since this disease does not have mandatory notification and several cases are not registered and/or reported in the literature. Lastly, it is hypothesized that equid pythiosis may be more widespread than currently known, and its real occurrence in Brazil remains uncertain.

Absence of Leishmania spp. DNA in road-killed wild mammals in Southern Brazil.

Leishmaniasis are neglected diseases transmitted by vectors that affect domestic and wild animals, including humans. Due to its incidence and lethality, this zoonosis is a worrying public health problem, making it essential to identify all links in the transmission chain. Infection of wild mammals by Leishmania spp. remains poorly understood, especially in southern Brazil. Therefore, the objective was to research, using the PCR technique, the presence of Leishmania spp. DNA in road-killed wild mammals in Southern Brazil. Carcasses of 96 animals were collected from highways in the Pelotas microregion, Rio Grande do Sul, southern Brazil and subjected to necropsies. Tissue fragments (spleen, skin, liver, kidney, heart, lung, lymph nodes, bone marrow and blood) were collected and genomic DNA was extracted. PCR protocols targeting the ITS1, kDNA and 18S genes were tested. We found no evidence of Leishmania spp. circulation in the studied population. However, epidemiological studies like this one are of great relevance, as they allow monitoring of the occurrence of pathogens and help identify possible risk areas. As these animals act as epidemiological markers for the presence of the microorganism, studies must be carried out continuously to understand whether there are sources of infection in the region.

Description of the parasitic fauna of a specimen of Didelphis albiventris at Rio Grande do Sul.

Didelphis albiventris is considered the most common marsupial in Rio Grande do Sul. With omnivorous and synanthropic habits, it can serve as a host to various parasites, playing an important role in maintaining their biological cycle. Despite being a widespread and abundant species, it has a relatively little-known parasitic fauna. Therefore, the aim of this study was to report the diversity of parasites in a fecal sample from D. albiventris in Rio Grande do Sul, Southern Brazil. Modified Centrifugal-flotation and Spontaneous sedimentation techniques were used, revealing a high taxonomic diversity of parasites. Eggs of Ancylostoma spp., Toxocara spp., and Anoplocephalidae were reported for the first time in the host in the southern region of the country, along with the first report of pseudoparasitism by Syphacia spp. and Monocystis spp. in this animal species. The presence of different parasites in the feces of D. albiventris is of utmost importance, primarily for public health, but also for understanding the biodiversity of parasites present in wildlife, which has been poorly studied until now. This allows the implementation of effective strategies for controlling, preventing and treating these diseases.

Didelphis albiventris é considerado o marsupial mais comum no Rio Grande do Sul. Com hábitos onívoros e sinantrópicos, pode servir de hospedeiro para diversos parasitas, desempenhando importante papel na manutenção do seu ciclo biológico. Apesar de ser uma espécie difundida e abundante, possui uma fauna parasitária relativamente pouco conhecida. Portanto, o objetivo deste estudo foi relatar a diversidade de parasitas em uma amostra fecal de D. albiventris no Rio Grande do Sul, Sul do Brasil. Foram utilizadas técnicas modificadas de flutuação centrífuga e sedimentação espontânea, revelando uma alta diversidade taxonômica de parasitas. Ovos de Ancylostoma spp., Toxocara spp. e Anoplocephalidae foram relatados pela primeira vez no hospedeiro na região sul do país, juntamente com o primeiro relato de pseudoparasitismo por Syphacia spp. e Monocystis spp. nesta espécie animal. A presença de diferentes parasitas nas fezes de D. albiventris é de extrema importância, principalmente para a saúde pública, mas também para a compreensão da biodiversidade de parasitas presentes na vida selvagem, que tem sido pouco estudada até agora. Isto permite a implementação de estratégias eficazes para controlar, prevenir e tratar estas doenças.

Spatio-temporal dynamics of visceral leishmaniasis in Brazil: A nonlinear regression analysis.

AIMS: This study describes the spatio-temporal dynamics of new visceral leishmaniasis (VL) cases notified in Brazil between 2001 and 2020. METHODS AND RESULTS: Data on the occurrence of the disease were obtained by means of the Notifiable Diseases Information System of the Brazilian Ministry of Health. Joinpoint, temporal generalized additive models and conditional autoregressive (CAR) models were used to analyse the temporal evolution of the rates in Brazil, states and regions. Spatio-temporal generalized additive and CAR models were used to identify the distribution of annual risks of VL occurrence in the Brazilian territory in relation to variation in the spatial average. There were 63,966 VL cases in the target period (3.198 cases/year), corresponding to a mean incidence rate of 1.68 cases/100,000 inhabitants. Of these, 4451 resulted in deaths, which gives a mean mortality rate of 0.12 deaths/100,000 inhabitants and a case fatality of 6.96%. The highest incidence rate was found in the North region, followed closely by the Northeast region, which presented the second and first highest mortality rates, respectively. For all of Brazil, and in the Northeast region, there were stability in the incidence rates, while the other regions showed an increasing trend in different time segments in the period: Central-West up to 2011, North up to 2008, Southeast up to 2004, and South up to 2010. On the other hand, all regions experienced a reduction in incidence rate during the last years of the series. The Northeast region had the highest number of municipalities with statistically significant elevated relative risks. The spatio-temporal analysis showed the highest risk area predominantly in the Northeast region in the beginning of the time series. From 2002 to 2018, this area expanded to the interior of the country. CONCLUSIONS: The present study has shown that VL has expanded in Brazil. However, the North and Northeast regions continue to have the highest incidence, and the risk of infection has decreased in recent years.

First record of Contracaecum australe (Nematoda: Anisakidae) infecting Neotropic cormorant (Phalacrocorax brasilianus) (Aves: Phalacrocoracidae) in southern Brazil with a phylogenetic analysis.

Phalacrocorax brasilianus (Gmelin, 1789) (Aves: Phalacrocoracidae) is one of the few piscivorous birds inhabiting freshwater and saline environments, being considered one of the most abundant aquatic species in Rio Grande do Sul, Brazil, especially along the state's coastline. It is known that birds are hosts to a wide variety of disease-causing agents, among them, nematodes of the Contracaecum (Anisakidae) have a large number of recognized species. However, little is still known about the occurrence of these parasites in the Southern region of Brazil. Herein we identified for the first time Contracaecum australe Garbin, Mattiucci, Paoletti, González-Acuña, and Nascetti, 2011 (Nematoda: Anisakidae) parasitizing P. brasilianus in Southern Brazil. Nematodes found in the bird's proventriculus were subjected to morphometric analyses, by optical microscopy and scanning electron microscopy, and molecular analyses. Molecular phylogeny based on the analysis of the 18S, ITS-1, 5.8S and ITS-2 genes showed our sequences identical to those of C. australe. Therefore, this is the first record of C. australe in southern Brazil, expanding the geographical distribution of the parasite species in the country. Additionally, new molecular sequences are being provided, contributing to the knowledge of Contracaecum species parasitizing cormorants.

First record of Hydatigera taeniaeformis in Geoffroy's cat (Leopardus geoffroyi) in Brazil.

Leopardus geoffroyi (Geoffroy's cat) is a neotropical feline considered globally threatened. In Brazil, it occurs exclusively in the Pampa biome. Its predatory habits contribute to the infection, dispersion, and continuation of the life cycle of various pathogens, including helminths, within ecosystems. However, few studies involving cestodes in wild felines are found in the literature, especially in Brazil. Therefore, we aimed to report the first case of parasitism by Hydatigera taeniaeformis in L. geoffroyi. The helminths were found in the small intestine of the necropsied feline. Specimens were analyzed morphometrically and subjected to molecular analyses for taxonomic identification. The molecular phylogeny based on the analysis of the mitochondrial gene (COX1) allowed the identification of these parasites. Thus, this is the first description of H. taeniaeformis parasitizing L. geoffroyi in Brazil. Consequently, the number of known host species parasitized by this helminth in the country and the world is increased. Additionally, a new molecular sequence is being provided, contributing to the knowledge of Hydatigera in South America.

Tegumentary leishmaniasis in Brazil: priority municipalities and spatiotemporal relative risks from 2001 to 2020.

Understanding the distribution of tegumentary leishmaniasis (TL) in different periods enables the adequate conduction of actions at the public health level. The present study analyzes the spatiotemporal evolution of TL incidence rates in the municipalities of Brazil and identifies priority areas from 2001 to 2020. Notifications of new cases were analyzed employing space-time scan statistics and Local Indicators of Spatial Association. As TL incidence rates presented a downward trend in most Brazilian municipalities, spatiotemporal clusters of high relative risks (RR) were more frequent in the first decade of the series. There was a concentration of those clusters in the North and Northeast regions, mainly in the Legal Amazon area. More recent high-RR areas were identified in municipalities of different regions. The number of priority municipalities showed a stable trend in Brazil. There was a great concentration of such municipalities in the states of Acre, Mato Grosso, Rondônia, Pará, and Amapá, as well as large areas in Roraima, Amazonas, Maranhão, and Tocantins, and smaller areas in the states of Goiás, Ceará, Bahia, Minas Gerais, São Paulo, and Paraná. The present study contributes to the understanding of the historical evolution of TL in Brazil and subsidizes actions to combat the disease.

Factors associated with seroprevalence of Neospora caninum in dairy cattle in southeastern Brazil.

Neosporosis is an infectious disease caused by Neospora caninum, an obligate intracellular cyst-forming protozoan considered a major cause of miscarriage in dairy cattle in many parts of the world. This cross-sectional study evaluated the relationship between reproductive abnormalities and seropositivity to N. caninum in 1,204 dairy cows from 40 farms located in the state of Minas Gerais, southeastern Brazil. Producers were interviewed, and blood samples were collected to perform indirect immunofluorescence tests (IFAT 1:200). Association between reproductive abnormalities and seropositivity in cattle was evaluated with generalized estimating equations. The true herd-level seroprevalence of N. caninum was 95 % (83.3-99.1), while the individual-level true seroprevalence was 21.6 % (19.2-24.2). Several reproductive abnormalities were significantly associated with seropositivity to N. caninum: occurrence of repeated estrus (p=0.02; OR=3.84; 95 % CI=1.239-11.893), repeated miscarriages (p=0.001; OR=2.54; 95 % CI=1.423-5.402), and temporary anestrus (p=0.001; OR=3.44; 95 % CI=1.976-5.994). Furthermore, loose dogs (p=0.041; OR=2.20; 95 % CI=1.033-4.672) when fed raw meat (p=0.001; OR=1.91; 95 % CI=1.443-2.519) are risk factors for N. caninum infection. We observed that seropositivity to N. caninum in cattle increases risk of miscarriage by almost twice throughout the reproductive life of cows (p=0.004; OR=1.978; 95 % CI=1.249-3.131). Serologic evidence in this study indicates that N. caninum infection is widely distributed among dairy herds and significantly associated with reproductive disorders, especially miscarriage, repeated estrus, and temporary anestrus.

Spatial and temporal dynamics of leptospirosis in South Brazil: A forecasting and nonlinear regression analysis.

Although leptospirosis is endemic in most Brazilian regions, South Brazil shows the highest morbidity and mortality rates in the country. The present study aimed to analyze the spatial and temporal dynamics of leptospirosis cases in South Brazil to identify the temporal trends and high-risk areas for transmission and to propose a model to predict the disease incidence. An ecological study of leptospirosis cases in the 497 municipalities of the state of Rio Grande do Sul, Brazil, was conducted from 2007 to 2019. The spatial distribution of disease incidence in southern Rio Grande do Sul municipalities was evaluated, and a high incidence of the disease was identified using the hotspot density technique. The trend of leptospirosis over the study period was evaluated by time series analyses using a generalized additive model and a seasonal autoregressive integrated moving average model to predict its future incidence. The highest incidence was recorded in the Centro Oriental Rio Grandense and metropolitan of Porto Alegre mesoregions, which were also identified as clusters with a high incidence and high risk of contagion. The analysis of the incidence temporal series identified peaks in the years 2011, 2014, and 2019. The SARIMA model predicted a decline in incidence in the first half of 2020, followed by an increase in the second half. Thus, the developed model proved to be adequate for predicting leptospirosis incidence and can be used as a tool for epidemiological analyses and healthcare services.Temporal and spatial clustering of leptospirosis cases highlights the demand for intersectorial surveillance and community control policies, with a focus on reducing the disparity among municipalities in Brazil.

Determining the relationship between dengue and vulnerability in a Brazilian city: a spatial modeling analysis.

Dengue is a viral infection transmitted by the Aedes aegypti mosquito. This study aimed to assess the distribution of cases and deaths from dengue and severe dengue, and its relationship with social vulnerability in Belo Horizonte, State of Minas Gerais, Brazil, from 2010 to 2018. The incidence and lethality rates of dengue and their relationship with sex, age, education, skin color, and social vulnerability were studied using chi-square tests, Ordinary Least Squares (OLS), and Geographically Weighted Regression (GWR) analyses. The number of cases of dengue in Belo Horizonte during the study period was 324,044 dengue cases, with 1,334 cases of severe dengue and 88 deaths. During the past few decades, the incidence rate of both dengue and severe cases varied, with an average incidence rate of respectively 1515.5 and 6.2/100,000 inhabitants. The increase in dengue cases was directly related to areas with higher social vulnerability areas and more working-age people. Also, the disease is more severe in people self-declared as black, elderly, and male. The findings of this study might provide relevant information for health services in the organization of control and prevention policies for this problem, emphasizing the most vulnerable urban areas and categories.

Ctenocephalides felis (Siphonaptera, Pulicidae) parasitizing White-eared opossum (Didelphis albiventris) at Southern Brazil - Case report.

Didelphis albiventris is a marsupial with synanthropic habits, whose contact with domestic animals and humans is increasing. They are considered potential disseminators of diseases, present as definitive hosts or reservoirs of various pathogenic agents. The present study aim to report, for the first time, the parasitism by Ctenocephalides felis in D. albiventris in Rio Grande, Southern Rio Grande do Sul state, Brazil. An adult female White-eared Opossum (D. albiventris), killed by being run over, was collected on the roads of the city of Rio Grande, Rio Grande do Sul, Brazil and sent to the laboratory for necropsy. During external inspection, a flea was found, which was stored in 70o alcohol until taxonomic identification, being classified as C. felis. This study reports the occurrence of parasitism by C. felis in D. albiventris for the first time in the location studied, demonstrating that these arthropods circulate between the wild and urban environments, and play an important role in the cycle of zoonotic pathogens among wild fauna, companion animals and humans.

Didelphis albiventris é um marsupial de hábitos sinantrópicos, cujo contato com animais domésticos e humanos está aumentando. São considerados potenciais disseminadores de doenças, apresentando-se como hospedeiros definitivos ou reservatórios de vários agentes patogênicos. O presente estudo tem como objetivo relatar, pela primeira vez, o parasitismo por Ctenocephalides felis em D. albiventris em Rio Grande, Sul do Rio Grande do Sul, Brasil. Uma fêmea adulta de gambá-de-orelha-branca (D. albiventris), morta por atropelamento, foi recolhida nas estradas da cidade de Rio Grande, Rio Grande do Sul, Brasil e encaminhado ao laboratório para necropsia. Durante inspeção externa foi encontrada uma pulga que foi armazenada em álcool 70º até a identificação taxonômica sendo classificado como C. felis. Este estudo relata a ocorrência de parasitismo por C. felis em D. albiventris para o primeira vez no local estudado, demonstrando que esses artrópodes circulam entre a natureza e ambientes urbanos e desempenham um papel importante no ciclo de patógenos zoonóticos entre a fauna selvagem, animais de companhia e humanos.

Spatio-temporal relative risks and priority areas for visceral leishmaniasis control in Brazil, between 2001 and 2020.

Visceral leishmaniasis (VL) is a pressing public health problem in Brazil. The proper implementation of disease control programs in priority areas is a challenge for healthcare managers. The present study aimed to analyze the spatio-temporal distribution and identify high risk areas of VL occurrence in the Brazilian territory. We analyzed data regarding new cases with confirmed diagnosis of VL in Brazilian municipalities, from 2001 to 2020, extracted from the Brazilian Information System for Notifiable Diseases. The Local Index of Spatial Autocorrelation (LISA) was used to identify contiguous areas with high incidence rates in different periods of the temporal series. Clusters of high spatio-temporal relative risks were identified using the scan statistics. The accumulated incidence rate in the analyzed period was 33.53 cases per 100,000 inhabitants. The number of municipalities that reported cases showed an upward trend from 2001 onward, although there was a decrease in 2019 and 2020. According to LISA, the number of municipalities considered a priority increased in Brazil and in most states. Priority municipalities were predominantly concentrated in the states of Tocantins, Maranhão, Piauí, and Mato Grosso do Sul, in addition to more specific areas of Pará, Ceará, Piauí, Alagoas, Pernambuco, Bahia, São Paulo, Minas Gerais, and Roraima. The spatio-temporal clusters of high-risk areas varied throughout the time series and were relatively higher in the North and Northeast regions. Recent high-risk areas were found in Roraima and municipalities in northeastern states. VL expanded territorially in Brazil in the 21st century. However, there is still a considerable spatial concentration of cases. The areas identified in the present study should be prioritized for disease control actions.

Temporal patterns, spatial risks, and characteristics of tegumentary leishmaniasis in Brazil in the first twenty years of the 21st Century.

BACKGROUND: Tegumentary leishmaniasis (TL) is a significant public health issue in Brazil. The present ecological study describes the clinical and epidemiological characteristics of TL cases reported in the country, and analyzes the spatial and temporal patterns of the incidences and risks of occurrence across the five geopolitical regions and 27 federative units. METHODOLOGY/PRINCIPAL FINDINGS: Data regarding new cases of TL notified between 2001 and 2020 were obtained from the Information System for Notifiable Diseases of the Brazilian Ministry of Health. Joinpoint and spatial and temporal generalized additive models were used to establish trends in the evolution of TL during the target period. The incidence rate for the entire period was 226.41 cases/100,000 inhabitants. All regions of Brazil showed trends of decreasing incidence rates, albeit with fluctuations at specific times, with the exception of the Southeast where rates have increased since 2014, most particularly in Minas Gerais state. The disease was concentrated predominantly in the North region, with Acre state leading the incidence rank in the whole country, followed by Mato Grosso (Midwest), Maranhão and Bahia (Northeast) states. The spatial distribution of the risk of TL occurrence in relation to the annual averages was relatively stable throughout the period. The cutaneous form of TL was predominant and cases most frequently occurred in rural areas and among men of working age. The ages of individuals contracting TL tended to increase during the time series. Finally, the proportion of confirmations by laboratory tests was lower in the Northeast. CONCLUSION/SIGNIFICANCE: TL shows a declining trend in Brazil, but its widespread occurrence and the presence of areas with increasing incidence rates demonstrate the persistent relevance of this disease and the need for constant monitoring. Our findings reinforce the importance of temporal and spatial tools in epidemiologic surveillance routines and are valuable for targeting preventive and control actions.

Multidrug-Resistant Hospital Bacteria: Epidemiological Factors and Susceptibility Profile.

Increase in antimicrobial resistance to antibiotics is the product of the evolution and natural adaptation of microorganisms through mutations and genetic recombination caused by the indiscriminate use of antibiotics and the ineffective control and prevention of infection. The current study analyzes the profile of multiresistant hospital bacteria in two hospitals in Pelotas, state of Rio Grande do Sul, Brazil. Over the course of 4 months, patient's gender and age, hospital accommodation type, and sample site were evaluated. Two hundred and eighty-six microbiological culture antibiogram reports of hospitalized patients and outpatients of both sexes, between zero and 96 years of age, were analyzed. Bacterium Klebsiella pneumoniae was the most prevalent. The most resistant Gram-negative bacilli (GNB) were K. pneumoniae (27.5%); Acinetobacter baumannii (24.1%); Escherichia coli (14.7%); and Pseudomonas aeruginosa (14.5%). The most resistant Gram-positive cocci (GPC) were Enterococcus faecium (27.5%) and Staphylococcus aureus (25.5%). The classes of antibiotics with the greatest number of resistant GNB included penicillins (84.8%), quinolones (77.5%), and cephalosporins (75.7%). In the case of GPC, the most resistant were macrolides (95.4%); lincosamides (90.3%), and penicillins (77%). Among GNBs, polypeptides had the highest sensitivity rate (81.3%), whereas, among GPC, fusidanes, glycylcyclines, and lipopeptides had 100% sensitivity.

Seroepidemiology of Toxoplasma gondii in Dairy Cows in Southeastern Brazil: Seropositive Cows on All Farms Investigated.

PURPOSE: This study aimed to estimate the prevalence and identify the risk factors associated with the higher in-herd T. gondii seroprevalence in dairy cows in 37 farms in southern Minas Gerais, Southeastern Brazil. METHODS: Serum samples from 1,105 dairy cows were subjected to an indirect fluorescence antibody test (IFAT 1:64) for anti-T. gondii IgG. The association existing between possible risk factors at the herd level and the seroprevalence were verified through Generalized Estimating Equation (GEE) multiple logistic regression models. RESULTS: Anti-T. gondii antibodies were observed in 31.4% of the cows (347; 95% CI= 28.7-34.2) and on 100% of the farms (37; 95% CI= 90.6-100.0%), indicating that all properties possessed at least one seropositive animal. For univariate analysis, herds with seroprevalence were categorized as greater and less than 30% as the outcome. The "breeding of Holstein Friesian cows" (p= 0.016, OR= 6.667, 95% CI= 1.500-29.628) and in an "intensive system" (p= 0.013, OR= 6.120, 95% CI= 1.394-26.876) increased the chance of the herd seroprevalence being greater than 30% by approximately six-fold. However, these variables did not exhibit a significant association (p >0.05) in the Generalized Estimating Equations (GEE) logistic regression model. CONCLUSIONS: The results demonstrate that T. gondii infection is widespread among dairy cows in the south of Minas Gerais, with a wide environmental dispersion of the parasite on farms in this region.