Epidemiological, clinical, and geographical characterization of Leprosy in the County of Santarém-Pará: Insights for effective control and targeted intervention.

Leprosy is an infectious disease characterized by slow and chronic evolution, caused by Mycobacterium leprae and or Mycobacterium lepromatosis, an intracellular alcohol-acid-resistant (BAAR) bacillus. The objective of this study was to provide an epidemiological, clinical, and geographic characterization of leprosy in the city of Santarém-Pará during the period 2011-2020. A cross-sectional, descriptive, and quantitative approach was used, employing maps and tables to illustrate clinical and epidemiological variables, including: sex, age, race, area of residence, operational classification, clinical form, number of skin lesions, number of affected nerves, and health units. During the analyzed period, 581 cases of leprosy were diagnosed, resulting in the following cumulative incidence rates: male (60%); age over 15 years (94%); urban area (73%); multibacillary (74%); borderline form (46%); skin lesions greater than 5 (34%); and no nerves affected (68%). In the urban perimeter, a higher cumulative incidence of cases was observed in the central area with 133 cases. However, the health unit reporting the largest number of cases belonged to the southern area, specifically the Basic Health Unit of Nova República, with 48 cases. This study highlights the need to characterize the nuances of leprosy and its variability within the urban environment, according to different areas. Further research is essential to inform the implementation of public policies aimed at addressing the population with the highest vulnerability index, thereby reducing leprosy rates in Santarém.

Epidemiological Evaluation of Events Allegedly Attributable to COVID-19 Vaccination: A Cross-Sectional Study in the Brazilian Amazon.

The emergence of SARS-CoV-2, leading to the widespread outbreak of COVID-19, has unveiled a spectrum of symptoms and severe health complications, challenging healthcare systems and impacting millions of lives worldwide. To analyze events allegedly attributable to vaccination or immunization (ESAVI) against SARS-CoV-2 (COVID-19) in the municipality of Santarém, in the interior of the state of Pará, an epidemiological, descriptive study was conducted using data from e-SUS Notifica in Santarém/PA from January 2021 to January 2022. The analyzed data for ESAVI cases included the administered immunobiologicals (Coronavac, Covishield, and Comirnaty), the type of event, case progression, time in days between immunobiological administration, and symptom onset, causality, and classification of ESAVI according to the vaccine package inserts. The incidence rate of ESAVI due to the COVID-19 vaccine was 17 per 100,000 doses administered in the municipality. According to the ESAVI classification, 14.0% were classified as Serious ESAVI (ESAVIG) (IR: 8.12 per 100,000 doses administered), with 100% of these events resulting in full recovery without sequelae, and 82.4% of reported cases were classified as Non-Serious ESAVI (ESAVING) (IR: 47.78), of which 3.60% were immunization errors (IR: 2.08 IE per 100,000 doses). This study fosters discussion on the importance of accurate recording of ESAVI related to COVID-19 vaccines, demonstrating their safety for the population.

Antimicrobial Activity on Streptococcus mutans and Enterococcus faecalis of Cyperus articulatus Ethanolic Extracts.

Oral diseases are one of the biggest public health problems worldwide, caused by opportunistic pathogens such as Streptococcus mutans and Enterococcus faecalis. Cyperus articulatus (priprioca) is a plant conventionally used in traditional medicine in the Amazon region. However, little is known about the possible dentistry-related uses of extracts from the rhizomes and solid waste generated by the extraction of essential oils from this vegetable. This study aimed to investigate the chemical composition of volatile compounds and antimicrobial activity through the Minimum Inhibitory Concentration test (MIC and assessment of the toxicity by Hens Egg Test-Chorion Allantoic Membrane (HET-CAM) of the ethanolic extracts from Cyperus articulatus intact rhizomes and solid waste. We identified sesquiterpenes as the main constituents, strong antimicrobial activity of the ethanolic extract of intact rhizomes against S. mutans (MIC = 0.29 mg/mL), moderate antimicrobial activity against E. faecalis of the extract obtained from the solid waste (MIC = 1.17 mg/mL), and absence of toxicity for both tested extracts. The absence of irritation and the antibacterial activity of the ethanolic extract from C. articulatus rhizomes and solid waste reveal its potential for use in the alternative control of bacteria that cause oral infections and may present economic viability as a raw material for dental products.

Empowering Riverine Communities in the Amazon: Strategies for Preventing Rabies.

Rabies, caused by the Lyssavirus genus, is a highly lethal zoonotic disease transmitted by animals such as bats and domestic and wild carnivores to humans, claiming nearly 100% of lives. In Brazil, recent evidence suggests an increasing role of bats in human deaths from rabies, particularly in the Amazon region. This neglected tropical disease disproportionately affects impoverished and vulnerable populations in rural areas, where approximately 80% of human cases are concentrated. This article presents research conducted in riverine communities of the Tapajós/Arapiuns Extractive Reserve in Brazil to combat rabies in September 2022. The study adopted a participatory and collaborative approach, involving community members, healthcare professionals, and educators. Prioritizing proactive interventions, the health team administered prophylactic vaccinations to 30 individuals residing in communities exposed to the Lyssavirus. Educational activities focused on dispelling myths and raising awareness about preventive measures, with 100% of individuals reporting prior doubts about the disease, emphasizing the essential nature of the clarification, especially regarding preventive aspects. This study underscores the importance of community involvement, personalized interventions, and ongoing education to effectively combat rabies. By reinforcing public health policies and promoting health education, we can empower communities to take proactive measures in rabies prevention, leading to a reduction in incidence and an improvement in quality of life.

Antiplasmodial Activity of Hydroalcoholic Extract from Jucá (Libidibia ferrea) Pods.

Malaria is an infectious and parasitic disease caused by protozoa of the genus Plasmodium, which affects millions of people in tropical and subtropical areas. Recently, there have been multiple reports of drug resistance in Plasmodium populations, leading to the search for potential new active compounds against the parasite. Thus, we aimed to evaluate the in vitro antiplasmodial activity and cytotoxicity of the hydroalcoholic extract of Jucá (Libidibia ferrea) in serial concentrations. Jucá was used in the form of a freeze-dried hydroalcoholic extract. For the cytotoxicity assay, the(3-[4,5-dimethylthiazol-2-yl]-2,5 diphenyl tetrazolium bromide (MTT) method with the WI-26VA4 human cell line was used. For the antiplasmodial activity, Plasmodium falciparum synchronized cultures were treated with serial concentrations (0.2 to 50 µg/mL) of the Jucá extract. In terms of the chemical composition of the Jucá extract, gas chromatography coupled to mass spectrometry measurements revealed the main compounds as ellagic acid, valoneic acid dilactone, gallotannin, and gallic acid. The Jucá hydroalcoholic extract did not show cytotoxic activity per MTT, with an IC50 value greater than 100 µg/mL. Regarding the antiplasmodial activity, the Jucá extract presented an IC50 of 11.10 µg/mL with a selective index of nine. Because of its antiplasmodial activity at the tested concentrations and low toxicity, the Jucá extract is presented as a candidate for herbal medicine in the treatment of malaria. To the best of our knowledge, this is the first report of antiplasmodial activity in Jucá.

Anti-Inflammatory Potential of the Oleoresin from the Amazonian Tree Copaifera reticulata with an Unusual Chemical Composition in Rats.

Copaifera reticulata Ducke is a popularly known species known as copaíba that is widely spread throughout the Amazon region. The tree yields an oleoresin which is extensively used in local traditional medicine mainly as an anti-inflammatory and antinociceptive agent. The aim of the present study was to assess the anti-inflammatory potential of this oleoresin obtained from a national forest in the central Amazon which presented an unusual chemical composition. The chemical composition of volatile compounds of oleoresin was analyzed by gas chromatography-mass spectrometry. The acute toxicity assay was performed with a single dose of 2000 mg/kg. The anti-inflammatory potential was evaluated by carrageenan-induced paw edema and air pouch assays using four different C. reticulata oleoresin concentrations (10, 100, and 400 mg/kg). The exudate was evaluated for nitrite concentration through the colorimetric method and for TNF-α, IL-1ß, and PGE2 by ELISA. C. reticulata oleoresin collected in the Amazonian summer contained six major sesquiterpene compounds (ß-bisabolene, cis-eudesma-6,11-diene, trans-α-bergamotene, ß-selinene, α-selinene, and ß-elemene) and was nontoxic at a dose of 2000 mg/kg, showing low acute toxicity. Different from oleoresin obtained from other sites of the Brazilian Amazon, the major volatile compound found was ß-Bisabolene with 25.15%. This ß-Bisabolene-rich oleoresin reduced the formation of paw edema induced by carrageenan and reduced the global number of cells in the air pouch assay, as well as exudate volume and nitrite, TNF-α, IL-1ß, and prostaglandin E2 levels (p < 0.05). C. reticulata oleoresin with a high ß-Bisabolene concentration showed anti-inflammatory activity, reducing vascular permeability and consequently edema formation, and thus reducing cell migration and the production of inflammatory cytokine, confirming its traditional use by local Amazonian communities.

Chemical Composition and Antiproliferative Activity of the Ethanolic Extract of Cyperus articulatus L. (Cyperaceae).

Cyperus articulatus L. (Priprioca) is a plant of the Cyperaceae family traditionally used in traditional medicine in the Amazon region. Studies of the essential oil of this species have identified many terpene compounds. However, little is known about the possible uses of solid waste generated by the extraction of essential oils. This study aimed to investigate the chemical composition of volatile compounds and to evaluate the antiproliferative activity of the ethanolic extract of solid residues generated by the extraction of the essential oil of C. articulatus L. rizhomes in experimental models in vitro using peritoneal macrophages of mice and human tumor cell lines. The analysis of the chemical composition of volatile compounds indicated the presence of sesquiterpenes and particularly sequiterpenic ketones as main constituents. The results showed that the treatment with ethanolic extract of C. articulatus L. reduced the activity of the enzyme arginase and proliferation of cancer cells (p < 0.0001). The extract also showed no cytotoxicity in macrophages in concentrations between 12.5; 25 and 50 mg/mL (p < 0.0001). The results indicated that the extract of C. articulatus L. exerts antiproliferative activity (p < 0.0001) with low toxicity on healthy cells in experimental models in vitro.

Chemical Composition and In Vitro Antiplasmodial Activity of the Ethanolic Extract of Cyperus articulatus var. nodosus Residue.

Cyperus articulatus L. is popularly known as priprioca. Its rhizomes are used as a medicine in the treatment of malaria in traditional medicine. Since priprioca oil is extracted for commercial purpose, we evaluated if the components from the priprioca residue can be a source of antiplasmodial active molecules. This study aimed to determine the in vitro antiplasmodial and cytotoxicity activities of the ethanolic extract of C. articulatus as an in vitro antiplasmodial agent. From the solid residue of the plant rhizomes, 40 g samples were removed and subjected to hot extraction using a Soxhlet extractor. The in vitro antiplasmodial activity was determined using the W2 and 3D7 strains of P. falciparum. The phytochemical study identified the following main compounds: corymbolone (14.25%), cyclocolorenone (9.75%), and cadalene (8.36%). The extract exhibited moderate IC50 (inhibitory concentration) against the two strains of P. falciparum: 1.21 ± 0.01 against the W2 strain and 1.10 ± 0.06 µg/mL against the 3D7 strain. Our results show the therapeutic potential of priprioca residue as a low-cost antiplasmodial agent.

In vitro and in vivo antimalarial activity of the volatile oil of Cyperus articulatus (Cyperaceae) / Atividade antimalárica in vitro e in vivo do óleo essencial de Cyperus articulatus (Cyperaceae)

Malaria is a disease of global tropical distribution, being endemic in more than 90 countries and responsible for about 212 million cases worldwide in 2016. To date, the strategies used to eradicate this disease have been ineffective, without specific preventive measures such as vaccines. Currently, the existing therapeutic arsenal is limited and has become ineffective against the expansion of artemisinin-resistant Plasmodium, demonstrating the need for studies that would allow the development of new compounds against this disease. In this context, we studied the volatile oil obtained from rhizomes of Cyperus articulatus (VOCA), a plant species commonly found in the Amazon region and popularly used as a therapeutic alternative for the treatment of malaria, in order to confirm its potential as an antimalarial agent by in vitro and in vivo assays. We cultured Plasmodium falciparum W2 (chloroquine-resistant) and 3D7 (chloroquine-sensitive) strains in erythrocytes and exposed them to VOCA at different concentrations in 96-well microplates. In vivo antimalarial activity was tested in BALB/c mice inoculated with approximately 106 erythrocytes infected with Plasmodium berghei. VOCA showed a high antimalarial potential against the two P. falciparum strains, with IC50 = 1.21 μg mL-1 for W2 and 2.30 μg mL-1 for 3D7. VOCA also significantly reduced the parasitemia and anemia induced by P. berghei in mice. Our results confirmed the antimalarial potential of the volatile oil of Cyperus articulatus.(AU)

A malária é uma doença de distribuição tropical, sendo endêmica em mais de 90 países, responsável por cerca de 212 milhões de casos reportados ao redor do mundo em 2016. As estratégias de erradicação dessa doença são ineficazes até o presente, sem medidas de prevenção específica, como vacinas. Atualmente, o arsenal terapêutico existente é limitado e vem se tornando ineficaz frente à expansão de plasmódios resistentes a artemisinina, evidenciando a necessidade de estudos que viabilizem o desenvolvimento de novos compostos contra a doença. Nesse contexto, estudamos o óleo essencial obtido de rizomas de Cyperus articulatus (VOCA), uma espécie vegetal comumente encontrada na região amazônica, utilizada popularmente como alternativa terapêutica para o tratamento de malária. Visamos confirmar o potencial antimalárico da planta através de testes in vitro e in vivo. Utilizamos cepas de Plasmodium falciparum W2 (cloroquina-resistente) e 3D7 (cloroquina-sensível) cultivadas em hemácias e expostas ao VOCA em microplacas de 96 poços. A atividade antimalárica in vivo foi testada em camundongos da linhagem BALB/c infectados com aproximadamente 106 eritrócitos parasitados por Plasmodium berghei. O VOCA apresentou alto potencial antimalárico (IC50 < 10 µg ml-1) frente às duas cepas de P. falciparum testadas (IC50=1,21 µg ml-1 para W2 e 2,3 µg ml-1 para 3D7). Além disso, houve redução significativa da parasitemia induzida por P. Berghei em camundongos tratados com EOAC, e também observamos diminuição da anemia, uma sintomatologia provocada pela infecção. Nossos resultados confirmam o potencial antimalárico do óleo essencial de Cyperus articulatus.(AU)

In vitro and in vivo antimalarial activity of the volatile oil of Cyperus articulatus (Cyperaceae)

Malaria is a disease of global tropical distribution, being endemic in more than 90 countries and responsible for about 212 million cases worldwide in 2016. To date, the strategies used to eradicate this disease have been ineffective, without specific preventive measures such as vaccines. Currently, the existing therapeutic arsenal is limited and has become ineffective against the expansion of artemisinin-resistant Plasmodium, demonstrating the need for studies that would allow the development of new compounds against this disease. In this context, we studied the volatile oil obtained from rhizomes of Cyperus articulatus (VOCA), a plant species commonly found in the Amazon region and popularly used as a therapeutic alternative for the treatment of malaria, in order to confirm its potential as an antimalarial agent by in vitro and in vivo assays. We cultured Plasmodium falciparum W2 (chloroquine-resistant) and 3D7 (chloroquine-sensitive) strains in erythrocytes and exposed them to VOCA at different concentrations in 96-well microplates. In vivo antimalarial activity was tested in BALB/c mice inoculated with approximately 106 erythrocytes infected with Plasmodium berghei. VOCA showed a high antimalarial potential against the two P. falciparum strains, with IC50 = 1.21 µg mL-1 for W2 and 2.30 µg mL-1 for 3D7. VOCA also significantly reduced the parasitemia and anemia induced by P. berghei in mice. Our results confirmed the antimalarial potential of the volatile oil of Cyperus articulatus. (AU)

Avaliação da transmissibilidade ultrassônica do gel fitoterápico de Copaifera duckei Dwyer / Evaluation of ultrasonic transmission of Copaifera duckei Dwyer herbal gel

Esse estudo teve por objetivo avaliar o potencial de transmissibilidade ultrassônica de um gel fitoterápico de copaíba da espécie Copaifera duckei Dwyer na concentração de 10%. A pesquisa foi registrada junto ao Sistema Brasileiro de Biodiversidade. O gel fitoterápico de Copaifera duckei 10% foi manipulado de acordo diretrizes da Farmacopéia Brasileira e testado em um aparelho de Ultrassom (US) operado na faixa de 1 MHz. Como grupos controle foram selecionados a água destilada e o gel hidroalcoólico. A análise ocorreu de forma qualitativa e quantitativa através do modelo proposto na literatura. O US foi programado para modos de corrente pulsado/contínuo e testados nas intensidades (0,2/0,4/0,6/0,8/1,0W/cm2), em 1mim/cm2. Os dados receberam tratamento estatístico pelo software BioEstat 5.3 e foi admitido um nível de significância de ≥0,05. No modo contínuo e na intensidade de 0.2W/cm2 o gel foi considerado "Bom transmissor", na intensidade de 0.4 W/cm2 e 0.6W/cm2 um "Transmissor moderado" e nas intensidades de 0.8W/cm2 e 1.0W/cm2 um "Transmissor pobre". Concluiu-se que o gel de C. duckei 10% não atenuou as ondas de US em nenhum modo ou intensidade testado. E pode assim ser adicionado a esse para tratamentos sendo considerado transmissor bom ou moderado de acordo com a intensidade do US.(AU)

This study aimed to evaluate the potential of transmissibility of an herbal gel of Copaifera duckei Dwyer at a concentration of 10%. The research was registered with the Brazilian Biodiversity System. The gel of Copaifera duckei 10% was guidelined by the Brazilian Pharmacopoeia and tested on an Ultrasound device (US) operated in the range of 1 MHz. The control groups were selected distilled water and hydro alcoholic gel. The analysis was qualitatively and quantitatively using the model proposed in the literature. The US was scheduled to current modes pulsed/continuous and tested in the intensities (0.2/0.4/0.6/0.8/1.0W/cm2) in 1mim/cm2. The data received statistical treatment by BioEstat software 5.3 and was admitted to a significance level of ≥0.05. In continuous mode and intensity of 0.2W/cm2 gel was considered "good transmitter" at the intensity of 0.4W/cm2 and 0.6W/cm2 a "moderate Transmitter" and the intensity of 0.8W/cm2 and 1.0W/cm2 a "poor transmitter". It was concluded that the 10% gel C. duckei US did not attenuate US waves in any form or intensity tested; it can thus be used for this treatment being considered a good or moderate transmitter according to the intensity of US.(AU)

Avaliação da transmissibilidade ultrassônica do gel fitoterápico de Copaifera duckei Dwyer / Evaluation of ultrasonic transmission of Copaifera duckei Dwyer herbal gel

Esse estudo teve por objetivo avaliar o potencial de transmissibilidade ultrassônica de um gel fitoterápico de copaíba da espécie Copaifera duckei Dwyer na concentração de 10%. A pesquisa foi registrada junto ao Sistema Brasileiro de Biodiversidade. O gel fitoterápico de Copaifera duckei 10% foi manipulado de acordo diretrizes da Farmacopéia Brasileira e testado em um aparelho de Ultrassom (US) operado na faixa de 1 MHz. Como grupos controle foram selecionados a água destilada e o gel hidroalcoólico. A análise ocorreu de forma qualitativa e quantitativa através do modelo proposto na literatura. O US foi programado para modos de corrente pulsado/contínuo e testados nas intensidades (0,2/0,4/0,6/0,8/1,0W/cm2), em 1mim/cm2. Os dados receberam tratamento estatístico pelo software BioEstat 5.3 e foi admitido um nível de significância de ≥0,05. No modo contínuo e na intensidade de 0.2W/cm2 o gel foi considerado “Bom transmissor”, na intensidade de 0.4 W/cm2 e 0.6W/cm2 um “Transmissor moderado” e nas intensidades de 0.8W/cm2 e 1.0W/cm2 um “Transmissor pobre”. Concluiu-se que o gel de C. duckei 10% não atenuou as ondas de US em nenhum modo ou intensidade testado. E pode assim ser adicionado a esse para tratamentos sendo considerado transmissor bom ou moderado de acordo com a intensidade do US.(AU)

This study aimed to evaluate the potential of transmissibility of an herbal gel of Copaifera duckei Dwyer at a concentration of 10%. The research was registered with the Brazilian Biodiversity System. The gel of Copaifera duckei 10% was guidelined by the Brazilian Pharmacopoeia and tested on an Ultrasound device (US) operated in the range of 1 MHz. The control groups were selected distilled water and hydro alcoholic gel. The analysis was qualitatively and quantitatively using the model proposed in the literature. The US was scheduled to current modes pulsed/continuous and tested in the intensities (0.2/0.4/0.6/0.8/1.0W/cm2) in 1mim/cm2. The data received statistical treatment by BioEstat software 5.3 and was admitted to a significance level of ≥0.05. In continuous mode and intensity of 0.2W/cm2 gel was considered “good transmitter” at the intensity of 0.4W/cm2 and 0.6W/cm2 a “moderate Transmitter” and the intensity of 0.8W/cm2 and 1.0W/cm2 a “poor transmitter”. It was concluded that the 10% gel C. duckei US did not attenuate US waves in any form or intensity tested; it can thus be used for this treatment being considered a good or moderate transmitter according to the intensity of US.(AU)