Leishmania infantum (syn. Leishmania chagasi) detection in blood donors living in an endemic area.

Human visceral leishmaniasis (HVL) is a neglected disease that occurs in 98 countries on five continents, and it is endemic in tropical and subtropical regions. In South America, the etiological agent of HVL is Leishmania infantum (syn. Leishmania chagasi), mainly transmitted through the bite of an infected sandfly female from the genus Lutzomyia. In American HVL endemic areas, the occurrence of asymptomatic infection is common, which contributes to the possibility of L. infantum transmission during a blood transfusion. To know the prevalence of L. infantum asymptomatic infection in blood donors from the microregion of Adamantina, we investigated 324 peripheral blood samples from donors through immunofluorescence (IFAT) and PCR-RFLP techniques. Seven blood samples (2.16%) tested positive for Leishmania by IFAT, and from those, six presented positive results by PCR (85.71%), which were later identified as L. infantum by RFLP. The presence of L. infantum in the peripheral blood of blood donors supported the hypothesis of transmission by blood transfusion and points to the need to include tests for visceral leishmaniasis in blood bank screening tests and pre-storage measures, especially in endemic areas to prevent the exponential increase of HVL by blood transfusion.

The enigmatic role of cholinergic reflex in the pathogenesis of Chagas disease.

This study evaluated the inflammatory process in the colons of mice infected with Trypanosoma cruzi QM2 strain, through the analysis of muscle reactivity and the measurement of butyrylcholinesterase (BuChE) in plasma. "Swiss" mice were infected with T. cruzi QM2 strain and after 15 (G15), 30 (G30), 60 (G60), 90 (G90), and 210 (G210) days, each group had blood collected for the measurement of butyrylcholinesterase plasma concentrations ([BuChE]), a measure which functioned as an indicator of plasmatic Ach levels. All groups, except G15, had a segment of proximal colon removed to assess muscle reactivity to acetylcholine (Ach) and noradrenaline (NA) stimulation. After reactivity tests, the tissues were then fixed and stained with hematoxylin and eosin (HE) for histological evaluation of inflammatory response. The QM2 strain did induce inflammatory process in mice colon, and demonstrated differences in muscular contraction between the G60 and G210 groups, with p < 0.05. Plasma [BuChE] increased during the acute phase of infection (p < 0.05) with subsequent heterogeneous decline in the late chronic phase. These results show that the QM2 strain has tropism to the colon of mice and causes damage characteristic of megacolon; also, Ach has an enigmatic importance in the anti-inflammatory reflex over the course of T. cruzi infection.

Oral Infection and Survival of Trypanosoma cruzi in Sugarcane Juice Conditioned at Different Temperatures.

PURPOSE: The current most important form of transmission for Trypanosoma cruzi is the oral route, being responsible for high mortality during the acute phase in infected individuals. Thus, this study aimed to investigate the possibility of infection for this parasite using sugarcane juice in different temperatures employing metacyclic trypomastigotes obtained from xenodiagnosis performed in Swiss mice previously infected with T.cruzi Y strain, and then diluted in sugarcane juice. METHODS: For stomach histopathological analysis, 20 mice were infected with metacyclic trypomastigotes diluted in sugarcane juice and euthanized after the 2nd, 4th, 10th, and 15th days after infection. Concurrently, six batches of ten mice were fed using 1.5 mL of the mixture and kept for 12 h at the temperatures of - 80 ºC, - 20 ºC, + 2 ºC, + 28 ºC, + 60 ºC, and + 80 ºC, for later infection verification. RESULTS: Inflammatory infiltrate was found after the 2nd day of infection, and amastigotes nests were present after the 4th, 10th, and 15th day in the margo plicatus stomach region. Viable trypomastigotes were observed in the microtubes kept at - 80 ºC, - 20 ºC, and + 2 ºC, but the animal's infection was observed in the - 80 ºC and + 2 ºC groups. In vitro tests demonstrated the decrease of T. cruzi trypomastigote viability, which was negative after 120 h at -20 ºC and 144 h at + 2 ºC, in contrast to the maintenance of survival after 168 h at - 80 ºC. CONCLUSION: We observed the ability of survival and infection of T. cruzi packaged at - 80 ºC without the use of preservatives and, therefore, less suitable for storing food.

Severe visceral leishmaniasis and COVID-19 coinfection in an immunosuppressed patient.

Visceral leishmaniasis (VL) is an opportunistic disease in immunosuppressed individuals, who may present severe clinical conditions, such as the ones described in this patient. She lived in an endemic region for VL, and was possibly infected with L. (L.) infantum chagasi through the bite of a contaminated sand fly. This initial infection has triggered a pemphigus vulgaris condition by immunogenic proteins present in the mosquito's saliva. The immunosuppression caused by the use of high doses of corticosteroids to control the disease promoted a severe VL condition, with hepatosplenomegaly, thrombocytopenia and hemorrhages, requiring hospitalization and the onset of a subsequent SARS-CoV-2 infection. Due to the intensity of clinical manifestations related to VL, aggravated by COVID-19, she died two days after admission to the Clinical Hospital of Marilia Medical School (HC-Famema).

Influence of galantamine in the inflammatory process and tissular lesions caused by Trypanosoma cruzi QM2 strain.

INTRODUCTION: Trypanosoma cruzi infection triggers an inflammatory process with exacerbated production of cytokines that stimulate inflammatory and anti-inflammatory signals, including the efferent anti-inflammatory signal known as the anti-inflammatory cholinergic pathway. Thus, the use of anticholinesterase drugs, such as galantamine, could minimize the inflammatory process caused by this disease. METHODS: For the study at 30, 60, and 90 days, 120 Swiss mice were divided into three groups. Each group was subdivided into four subgroups: uninfected/untreated (CTRL), uninfected/treated (GAL), infected/untreated (INF), and infected/treated (GAL/INF). The infected groups were inoculated intraperitoneally with 0.1 ml of mouse blood containing 5 × 104 trypomastigote forms of the T. cruzi QM2 strain. The galantamine-treated groups received 5 mg/kg of galantamine orally, through pipetting. From each subgroup, the parameters of parasitemia, histopathological analysis, butyrylcholinesterase activity (BuChE), and functional study of the colon were evaluated. RESULTS: BuChE performance was observed when AChE was suppressed, with increased activity in the GAL/INF group similar to the INF group on the 30th day post infection, thus corroborating the absence of a significant difference in parasitic curves and histopathological analysis. CONCLUSIONS: The presence of an inflammatory process and nests of amastigotes, as well as evidence of reactivity to ACh and NOR, suggest that galantamine did not interfere with the colonic inflammatory response or even in colonic tissue parasitism at this stage of Chagas disease.

Epidemiological and genetic aspects of the largest dengue outbreak recorded in 2015 in Southeastern Brazil.

Dengue virus, the etiological agent of dengue fever (DF) occurs in four genetically distinct serotypes (DENV1-4), being transmitted by female Aedes mosquitoes. DF incidence is increasing in Brazil, following vector dispersal, proliferation and DENV serotypes introduction, co-circulation and substitution. Medium- and small-sized cities in Sao Paulo State, such as Marilia (Midwest region), have been affected by huge epidemics. To understand the evolution of DENV epidemics in medium-sized cities, in this study a historical data on DENV incidence (2000-2015) in Marilia, was evaluated. Previous studies disclosed regional and specific DF outcomes associated with 2007 outbreak in that city, when co-circulating DENV1 and DENV3 presented different hematological profiles. In this study, characteristics of 2007 DENV epidemics were compared to the epidemiological, hematological and demographic outlines of the major outbreak of DENV1 in Marilia in 2015. DENV1 genetic diversity was assessed through capsid and pre-membrane junction encoding gene (CprM) sequencing. The results revealed circulation of DENV1 serotype from 2007 to 2015, with epidemics occurring every three-years until 2013 and then, increasing yearly. There were significant differences in hematological profiles of DENV1 patients between 2015 and 2007. CprM showed DENV1 genetic variability in 2015, contrasting with the unique sequence pattern in 2007. These results reinforce the regional and temporal characteristics of DENV epidemics that need local public health research to improve care for people and to limit the spread of new serotypes/genotypes to uninfected areas.

Spatio-temporal distribution of human American visceral leishmaniasis in the Western region of Sao Paulo State, from 2004 to 2018.

Leishmaniasis comprises a group of zoonotic diseases caused by protozoa belonging to the Leishmania genus, noting that the visceral form is the most severe and lethal, if untreated. Nowadays visceral leishmaniasis is widespread in Brazil and the Adamantina microregion, located in the west of Sao Paulo State, has been affected by Human American Visceral Leishmaniasis (HAVL) since 2004. We evaluated the epidemiological profile of HAVL in the Adamantina microregion through a Geographic Information Systems (GIS) and established its incidence rate by location and time. Notified cases were provided by the Sao Paulo State Epidemiological Surveillance Center. Home addresses of patients who tested positive to HAVL were converted into geographic coordinates through the Google Geocoding Application Programming Interface submitted to ArcMap 10.5 System for georeferencing. Kernel spatial analyses were performed to obtain the incidence distribution and the total area involvement rate. From 2004 to 2018, 325 cases of HAVL were diagnosed in 11 of the 12 municipalities belonging to the of Adamantina microregion. The disease has disseminated to the Northwest and East-Southeast directions, taking place along the Comandante Joao Ribeiro de Barros highway, with higher incidences rates in the municipalities where the highway passes. HAVL incidence was higher in children aged between 0 to 9 years and in the elderly; there was no difference in relation to sex and the majority of cases were located in urban areas. The determination of the epidemiological profile and the the spread of disease patterns can indicate possible areas of vulnerability, in order to contribute to the management and prevention of the disease through a strategic resources optimization.

Biological and Molecular Characterization of Trypanosoma cruzi Strains from Four States of Brazil.

Chagas disease affects between six and seven million people. Its etiological agent, Trypanosoma cruzi, is classified into six discrete typing units (DTUs). The biological study of 11 T. cruzi strains presented here included four parameters: growth kinetics, parasitemia curves, rate of macrophage infection, and serology to evaluate IgM, total IgG, IgG1, IgG2a, and IgG3. Sequencing of small subunit of ribosomal RNA (SSU rRNA)was performed and the T. cruzi strains were classified into three DTUs. When their growth in liver infusion tryptose medium was represented in curves, differences among the strains could be noted. The parasitemia profile varied among the strains from the TcI, TcII, and TcIII groups, and the 11 T. cruzi strains produced distinct parasitemia levels in infected BALB/c. The TcI group presented the highest rate of macrophage infection by amastigotes, followed by TcII and TcIII. Reactivity to immunoglobulins was observed in the TcI, TcII, and TcIII; all the animals infected with the different strains of T. cruzi showed anti-T. cruzi antibodies. The molecular study presented here resulted in the classification of the T. cruzi strains into the TcI (Bolivia, T lenti, Tm, SC90); TcII (Famema, SC96, SI8, Y); and TcIII (QMM3, QMM5, SI5) groups. These biological and molecular results from 11 T. cruzi strains clarified the factors involved in the biology of the parasite and its hosts. The collection of triatomine (vector) species, and the study of geographic distribution, as well as biological and molecular characterization of the parasite, will contribute to the reporting and surveillance measures in Brazilian states.

Antioxidant effect of Morus nigra on Chagas disease progression.

Considering the widespread popular use of Morus nigra and the amount of scientific information on its antioxidant and anti-inflammatory activity, the effectiveness of this phytotherapeutic compound in the parasitemia progression during the acute phase of Chagas disease and its role in the development of the inflammatory process as well as its effects on the oxidative damage in the chronic phase of infection were evaluated. Thus, 96 male Swiss mice were randomly divided into eight groups, four groups were uninfected controls, and four groups were intraperitoneally infected with 5.0 x 104 blood trypomastigotes forms of T. cruzi QM2 strain. Four batches composed of one uninfected and one infected group were respectively treated with 70% alcohol solution and 25 µL, 50 µL and 75 µL of the phytotherapeutic compound. Levels of antioxidant elements (TBARS, FRAP, GSH and Sulfhydryl groups) were measured in plasma samples. The phytotherapeutic compound's antioxidant activity was measured by polyphenol and total flavonoid quantification, DPPH, NO, and FRAP method. Our results showed that the vehicle influenced some of the results that may have physiological relevance in Chagas disease. However, an important action of M. nigra tincture was observed in the progression of Chagas disease, since our results demonstrated a reduction in parasitemia of treated groups when compared to controls, especially in the group receiving 25 µL. However, in the chronic phase, the 50-µL dosage presented a better activity on some antioxidant defenses and minimized the tissue inflammatory process. Results indicated an important action of M. nigra tincture on the Chagas disease progression.

Severe visceral leishmaniasis and COVID-19 coinfection in an immunosuppressed patient

ABSTRACT Visceral leishmaniasis (VL) is an opportunistic disease in immunosuppressed individuals, who may present severe clinical conditions, such as the ones described in this patient. She lived in an endemic region for VL, and was possibly infected with L. (L.) infantum chagasi through the bite of a contaminated sand fly. This initial infection has triggered a pemphigus vulgaris condition by immunogenic proteins present in the mosquito's saliva. The immunosuppression caused by the use of high doses of corticosteroids to control the disease promoted a severe VL condition, with hepatosplenomegaly, thrombocytopenia and hemorrhages, requiring hospitalization and the onset of a subsequent SARS-CoV-2 infection. Due to the intensity of clinical manifestations related to VL, aggravated by COVID-19, she died two days after admission to the Clinical Hospital of Marilia Medical School (HC-Famema).

Evaluation of antioxidant therapy in experimental Chagas disease.

INTRODUCTION:: Stimulation of inflammatory mediators such as cytokines and chemokines may cause oxidative stress in Chagas disease. In this study, we evaluated the merit of vitamins C and E as antioxidant therapy to minimize the oxidative stress-induced damage in an experimental model of Chagas disease. METHODS:: Ninety-six Swiss mice were infected with Trypanosoma cruzi QM2 and treated with vitamins C, E, or both (C/E) for 60 and 120 days, and their effects compared to placebo administration were evaluated in the acute and chronic disease phases. RESULTS:: There was no difference in parasitemia among treatment groups. However, histological analysis showed more severe inflammation in the skeletal muscle in the vitamin supplementation groups at both the acute and chronic phases. Biochemical analyses during the acute phase showed increased ferric-reducing ability of plasma (FRAP) and glutathione (GSH) levels in the vitamin C and C/E groups. In the chronic phase, a decrease in GSH levels was observed in the vitamin E group and a decrease in thiobarbituric acid reactive substances (TBARS) was observed in the vitamin C/E group. Moreover, there was a decrease in TBARS in the cardiac tissues of the vitamin C and C/E groups compared to that of the placebo group, although this level was greater in the vitamin E group than in the vitamin C group. CONCLUSIONS:: The antioxidant action of vitamins C and E reduced oxidative stress in both the acute and chronic phases of Chagas disease, with a marked effect from joint administration, indicating their inherent synergism.

[Rupestrian triatomines infected by Trypanosomatidae, collected in Quaraí, Rio Grande do Sul, 2003]. / Triatomíneos rupestres infectados por Trypanosomatidae, coletados em Quaraí, Rio Grande do Sul, 2003.

Rupestrian triatomines were captured in six Quaraí city localities, RS, to verify the level of Trypanosomatidae infection, as well as the animal reservoir. The capture occurred in a wild environment and 453 samples were collected, which were identified and separated by nymphal instar. 421 (92.9%) samples of Triatoma rubrovaria, 26 (5.7%) of Triatoma circummaculata and 6 (1.3%) of Panstrongylus tupynambai were collected. Only 13 samples (4.2%) of Triatoma rubrovaria presented Trypanosomatidae infection. After mice and LIT culture inoculation, five strains of Trypanosoma cruzi were isolated. Of these triatomines, 4 (30.8%) displayed no reagent precipitin for the antiserum tested, 4 (30.8%) were positive for rodent antiserum, 4 (30.8%) were positive for goat antiserum and 1 (7.7%) were positive for human and pig antiserum.

INTESTINAL AND PULMONARY INFECTION BY Cryptosporidium parvum IN TWO PATIENTS WITH HIV/AIDS.

We describe two patients with HIV/AIDS who presented pulmonary and intestinal infection caused by Cryptosporidium parvum, with a fatal outcome. The lack of available description of changes in clinical signs and radiographic characteristics of this disease when it is located in the extra-intestinal region causes low prevalence of early diagnosis and a subsequent lack of treatment.

Influence of galantamine in the inflammatory process and tissular lesions caused by Trypanosoma cruzi QM2 strain

Abstract INTRODUCTION: Trypanosoma cruzi infection triggers an inflammatory process with exacerbated production of cytokines that stimulate inflammatory and anti-inflammatory signals, including the efferent anti-inflammatory signal known as the anti-inflammatory cholinergic pathway. Thus, the use of anticholinesterase drugs, such as galantamine, could minimize the inflammatory process caused by this disease. METHODS For the study at 30, 60, and 90 days, 120 Swiss mice were divided into three groups. Each group was subdivided into four subgroups: uninfected/untreated (CTRL), uninfected/treated (GAL), infected/untreated (INF), and infected/treated (GAL/INF). The infected groups were inoculated intraperitoneally with 0.1 ml of mouse blood containing 5 × 104 trypomastigote forms of the T. cruzi QM2 strain. The galantamine-treated groups received 5 mg/kg of galantamine orally, through pipetting. From each subgroup, the parameters of parasitemia, histopathological analysis, butyrylcholinesterase activity (BuChE), and functional study of the colon were evaluated. RESULTS: BuChE performance was observed when AChE was suppressed, with increased activity in the GAL/INF group similar to the INF group on the 30th day post infection, thus corroborating the absence of a significant difference in parasitic curves and histopathological analysis. CONCLUSIONS: The presence of an inflammatory process and nests of amastigotes, as well as evidence of reactivity to ACh and NOR, suggest that galantamine did not interfere with the colonic inflammatory response or even in colonic tissue parasitism at this stage of Chagas disease.

EFFECTS OF VITAMIN C SUPPLEMENTATION ON THE CHRONIC PHASE OF CHAGAS DISEASE.

INTRODUCTION: In order to examine the effectiveness of vitamin C (ascorbic acid) in combating the oxidative insult caused by Trypanosoma cruzi during the development of the chronic phase of Chagas disease, Swiss mice were infected intraperitoneally with 5.0 × 104 trypomastigotes of T. cruzi QM1strain. METHODS: Mice were given supplements of two different doses of vitamin C for 180 days. Levels of lipid oxidation (as indicated by thiobarbituric acid reactive substances-TBARS), total peroxide, vitamin C, and reduced glutathione were measured in the plasma, TBARS, total peroxide and vitamin C were measured in the myocardium and histopathologic analysis was undertaken in heart, colon and skeletal muscle. RESULTS: Animals that received a dose equivalent to 500 mg of vitamin C daily showed increased production of ROS in plasma and myocardium and a greater degree of inflammation and necrosis in skeletal muscles than those that received a lower dose or no vitamin C whatsoever. CONCLUSION: Although some research has shown the antioxidant effect of vitamin C, the results showed that animals subject to a 500 mg dose of vitamin C showed greater tissue damage in the chronic phase of Chagas disease, probably due to the paradoxical actions of the substance, which in this pathology, will have acted as a pro-oxidant or pro-inflammatory.

Clinical and epidemiological profile of patients in the chronic phase of Chagas disease treated at a reference center in Southeastern Brazil / Perfil clínico y epidemiológico de pacientes chagásicos en fase crónica atendidos en un centro de referencia dei sudeste de Brasil

Abstract Introduction: After implementing measures to control vector transmission by Triatoma infestans in Brazil, the number of new cases of Chagas disease (CD) decreased. Currently, the American continent has an annual incidence of 28 000 cases, but a large number of older adults are still affected by the chronic phase of this disease. Objective: To characterize the clinical and epidemiological profile of patients in the chronic phase of CD treated at a reference center located in the state of São Paulo, Brazil. Materials and methods: A cross-sectional, descriptive study was conducted based on the analysis of the medical records of 62 patients in the chronic phase of CD and treated at the Hospital das Clínicas de Marília. Results: No significant differences were found regarding sex, age and time of diagnosis. Cardiac problems were the most reported clinical sign. A significant difference was observed in the case of the indeterminate form of the disease, which was more predominant in males. In addition, functional classification B1 of CD was more common in women, while B2 predominated in men. Conclusion: A late diagnosis of CD may increase the chances of presenting digestive complications. However, the classic manifestations of the disease and its comorbidities can be successfully managed as long as comprehensive (multidisciplinary) medical care is provided, since this would help delay the course of the disease and, consequently, improve the patients' quality of life.

Resumen Introducción. Luego de la implementación de medidas de control de la transmisión vectorial por Triatoma infestans en Brasil, hubo una reducción en el número de nuevos casos de la enfermedad de Chagas (EC). Actualmente, en el continente americano la incidencia anual de EC es de 28 000 casos, pero cabe señalar que aún existe una gran cantidad de adultos mayores que padecen los síntomas y signos de la fase crónica de esta enfermedad. Objetivo. Caracterizar el perfil clínico y epidemiológico de pacientes chagásicos en fase crónica atendidos en un centro de referencia ubicado en el estado de São Paulo, Brasil. Materiales y métodos. Estudio transversal y descriptivo. Se analizaron las historias clínicas de 62 pacientes chagásicos crónicos atendidos en el Hospital das Clínicas de Marília. Resultados. No hubo diferencias significativas con respecto a sexo, edad y tiempo de diagnóstico. Los problemas cardiacos fueron el signo clínico más reportado. Se observó una diferencia significativa en el caso de la forma indeterminada de la enfermedad, siendo más predominante en los hombres. Por otra parte, el estadio B1 fue más frecuente en las mujeres, mientras que el estadio B2 fue predominante en los hombres. Conclusión. El diagnóstico tardío de la EC puede aumentar la probabilidad de presentar complicaciones digestivas. Sin embargo, las manifestaciones clásicas de esta enfermedad y sus comorbilidades pueden ser controladas siempre que se cuente con atención médica integral (multidisciplinar), ya que de esta forma se retrasa su evolución y, en consecuencia, se mejora la calidad de vida de estos pacientes.

[Biological and histopathological characterization together with nucleic acids analysis of a Trypanosoma cruzi strain from Marília, São Paulo State]. / Caracterização biológica, histopatológica e análise de ácido nucléico de uma cepa Trypanosoma cruzi da região de Marília, SP, Brasil.

The aim of this report was to study the biological and histopathological behavior of a Trypanosoma cruzi strain, which is found in the region of Marília. The strain was isolated in 1997, by artificial xenodiagnosis. Twenty-five swiss mice were intraperitoneally inoculated. Eleven were used for observation of parasitemia and trypomastigotes morphology and 14 were sacrificed after 17, 23, 30, 60 and 180 days post-infection. Heart, esophagus, liver, colon, and skeletal muscle (fragment of the right thigh) were collected for histopathological study. LIT culture medium was accomplished for DNA analysis. The results showed predominance of broad forms, low parasitemia with mean peaks of 860 trypomastigotes/5mul of blood of the 20th day of infection. No animal died in the acute phase of infection. Histopathological analysis showed several pseudocysts of amastigotes in heart, rare in skeletal muscle and colon with discreet inflammatory process. When Famema strain was compared with Y strain, which was isolated from a patient who lived in the same area, a distinct behaviour and biological characteristics were observed. However, DNA analysis placed them in same group, hence displaying the proximity of these strains.

Parasitoses intestinais em pacientes atendidos no Hospital das Clínicas da Faculdade de Medicina de Marília-SP / Intestine parasitosis in patients at the Hospital of the School of Medicine in Marília, Brazil

O objetivo desta pesquisa foi verificar a prevalência de enteroparasitoses em pacientes atendidos no Hospital das Clínicas da Faculdade de Medicina de Marília-SP. Desta forma foi realizado um estudo descritivo e analítico, do tipo transversal retrospectivo, com coleta dos dados no Sistema Hospitalar Informatizado do Laboratório de Parasitologia da Faculdade de Medicina de Marília. Entre janeiro de 2012 a dezembro de 2017 foram analisadas 14.343 amostras. Os dados de prevalência foram representados por razão de prevalência e seus respectivos Intervalos de Confiança de 95%. Diferenças significativas entre anos ou faixa etárias foram determinadas pela não intersecção dos limites inferiores e superiores de seus IC95%. Observaram-se 2.149 amostras positivas para parasitas, predominando Blastocystis hominis (10,13%), Giardia lamblia (3,35%) e Strongyloides stercoralis (1,16%). Pode-se inferir que a redução da prevalência das parasitoses é o resultado de políticas públicas pelo uso de medicamentos profiláticos no intuito de interromper a transmissão fecal-oral e não somente pela melhora da infraestrutura sanitária.

The prevalence of enteroparasitosis in patients at the hospital of the School of Medicine in Marília SP Brazil, is analyzed through a descriptive, analytic, retrospective and transversal study. Data were retrieved from the Digitalized Information System of the Laboratory of Parasitology of the School of Medicine in Marília where 14,343 patients were investigated between January 2012 and December 2017. Prevalence data were given in ranking and their respective confidence intervals at 95%. Significant differences between years or age groups were determined by non-intersection of lower and higher limits of IC95%. There were 2,149 positive samples for parasites, with a predominance of Blastocystis hominis (10.13%), Giardia lamblia (3.35%) and Strongyloides stercoralis (1.16%). Results show that the decrease of parasite prevalence is due to public policies through prophylactic medicine to interrupt the fecal-oral transmission rather than by improvement of the sanitary infrastructure.

Vitamin C effects in mice experimentally infected with Trypanosoma cruzi QM2 strain.

INTRODUCTION: To evaluate the efficacy of vitamin C in reducing the consequences generated by the production of free radicals in the acute and chronic phases of Chagas disease, two different doses of ascorbic acid were administered orally to 60 mice infected by Trypanosoma cruzi QM2 strain. METHODS: The animals were divided into six groups: G1, G2, and G3 for the acute phase study, and G'1, G'2, and G'3 for the chronic stage. The groups G1 and G'1 received 8.6 x 10⁻4 mg/g of vitamin C daily, whereas G2 and G'2 received 7.14 x 10⁻³ mg/g daily. The other groups, G3 and G'3, were considered placebos and received 10 µL of mineral water. RESULTS: The study of the acute phase showed statistically significant differences between G1 and the other groups at various count days of the parasitemia evolution. The multiplying parasite was slower in G1 until the 11th day, but on the 22nd day it had greater parasitemia than in G2 and G3, and from the 36th day on, parasitemia stabilized at higher levels. However, when the histopathology of acute and chronic phases is considered, one does not note significant differences. CONCLUSIONS: The administration of two different doses of vitamin C was not able to protect mice and to contain the oxidative stress caused by free radicals formed by the metabolism of oxygen (reactive oxygen species) and nitrogen (reactive nitrogen species).

Effects of vitamin C supplementation on acute phase Chagas disease in experimentally infected mice with Trypanosoma cruzi QM1 strain.

The tissue changes that occur in Chagas disease are related to the degree of oxidative stress and antioxidant capacity of affected tissue. Studies with vitamin C supplementation did not develop oxidative damage caused by Chagas disease in the host, but other studies cite the use of peroxiredoxins ascorbate - dependent on T. cruzi to offer protection against immune reaction. Based on these propositions, thirty "Swiss" mice were infected with T. cruzi QM1 strain and treated with two different vitamin C doses in order to study the parasitemia evolution, histopathological changes and lipid peroxidation biomarkers during the acute phase of Chagas disease. The results showed that the parasite clearance was greater in animals fed with vitamin C overdose. There were no significant differences regarding the biomarkers of lipid peroxidation and inflammatory process or the increase of myocardium in animals treated with the recommended dosage. The largest amount of parasite growth towards the end of the acute phase suggests the benefit of high doses of vitamin C for trypomastigotes. The supplementation doesn't influence the production of free radicals or the number of amastigote nests in the acute phase of Chagas disease.