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1.
Braz. j. biol ; 82: e238665, 2022. tab
Artículo en Inglés | LILACS-Express | LILACS | ID: biblio-1153463

RESUMEN

Abstract Malakand region is an endemic area for cutaneous leishmaniasis (CL). However, there are limited number of studies of this disease in Pakistan. Therefore, a study was conducted to understand the level of awareness attitude and practice among the residents of Makaland towards CL and the disease vectors. This study adopted a cross-sectional approach with a total of 400 respondents (n=93 rural and n= 307 urban). Overall, the population in Malakand region (61.2%) were well-informed in the role of sand fly in transmitting diseases, but most lack knowledge on the vector's behavior and almost a quarter (24.5%) were unable to provide knowledge on proper control measures. Alarmingly, the practice and attitudes of the general population was not satisfactory as close to half (49.8%) of the population did adopt any control method. This study calls for increase in awareness through health education campaign to reduce the risk of cutaneous leishmaniasis outbreaks in the future.


Resumo A região de Malakand é uma área endêmica para leishmaniose cutânea (CL). No entanto, há um número limitado de estudos sobre esta doença no Paquistão. Portanto, foi realizado um estudo para entender o nível de atitude e prática de conscientização entre os residentes de Makaland em relação aos CL e os vetores da doença. Este estudo adotou uma abordagem transversal com um total de 400 entrevistados (n = 93 rural e n = 307 urbano). No geral, a população da região de Malakand (61,2%) estava bem informada sobre o papel da mosca na transmissão de doenças, mas a maioria não possui conhecimento sobre o comportamento do vetor e quase um quarto (24,5%) foi incapaz de fornecer conhecimento sobre medidas de controle adequadas . De maneira alarmante, a prática e as atitudes da população em geral não foram satisfatórias, pois cerca da metade (49,8%) da população adotou algum método de controle. Este estudo apela ao aumento da conscientização por meio de campanhas de educação em saúde para reduzir o risco de surtos de leishmaniose cutânea no futuro.

2.
Braz. j. biol ; 81(3): 557-565, July-Sept. 2021. tab, graf
Artículo en Inglés | LILACS-Express | LILACS | ID: biblio-1153389

RESUMEN

Abstract Cutaneous leishmaniasis (CL) is a neglected tropical disease with a wide distribution in the Americas. Brazil is an endemic country and present cases in all states. This study aimed to describe the occurrence, the underlying clinical and epidemiological factors, and the correlation of climatic variables with the frequency of reported CL cases in the municipality of Caxias, state of Maranhão, Brazil. This is a retrospective and descriptive epidemiological study based on data extracted from the Brazilian Information System of Diseases Notification, from 2007 to 2017. Maximum and minimum temperature, precipitation, and relative air humidity data were provided by the Brazilian National Institute of Meteorology. A total of 201 reported autochthonous CL cases were analyzed. The predominance of cases was observed in males (70.1%). The age range between 31 and 60 years old was the most affected, with 96 cases (47.9%). Of the total number of registered cases, 38.8% of the affected individuals were engaged in agriculture-related activities. The georeferenced distribution revealed the heterogeneity of disease occurrence, with cases concentrated in the Western and Southern regions of the municipality. An association was detected between relative air humidity (monthly mean) and the number of CL cases per month (p = 0.04). CL continues to be a concerning public health issue in Caxias. In this context, there is a pressing need to strengthen measures of prevention and control of the disease through the network of health services of the municipality, considering local and regional particularities.


Resumo A leishmaniose cutânea (CL) é uma doença tropical negligenciada, com ampla distribuição nas Américas. O Brasil é um país endêmico e apresenta casos em todos os estados. Este estudo teve como objetivo descrever a ocorrência, os fatores clínicos e epidemiológicos subjacentes e a correlação de variáveis climáticas com a frequência de casos de CL notificados no município de Caxias, estado do Maranhão, Brasil. Este é um estudo epidemiológico retrospectivo e descritivo, com base em dados extraídos da Notificação do Sistema Brasileiro de Informação de Doenças, de 2007 a 2017. Dados máximos e mínimos de temperatura, precipitação e umidade relativa do ar foram fornecidos pelo Instituto Nacional de Meteorologia. Foram analisados 201 casos de CL autóctones relatados. A predominância de casos foi observada no sexo masculino (70,1%). A faixa etária entre 31 e 60 anos foi a mais afetada, com 96 casos (47,9%). Do número total de casos registrados, 38,8% dos indivíduos afetados estavam envolvidos em atividades relacionadas à agricultura. A distribuição georreferenciada revelou a heterogeneidade da ocorrência da doença, com casos concentrados nas regiões oeste e sul do município. Foi detectada associação entre a umidade relativa do ar (média mensal) e o número de casos de CL por mês (p = 0,04). O CL continua sendo uma questão preocupante de saúde pública em Caxias. Nesse contexto, há uma necessidade premente de fortalecer medidas de prevenção e controle da doença por meio da rede de serviços de saúde do município, considerando as particularidades locais e regionais.

3.
Braz. j. biol ; 81(3): 665-673, July-Sept. 2021. tab, graf
Artículo en Inglés | LILACS-Express | LILACS | ID: biblio-1153396

RESUMEN

Abstract Educational interventions may trigger actions that contribute to prevent parasitic diseases, such as Chagas disease (CD). This study aimed at investigating the impact of an instructional video named "Documentary on Chagas Disease" on knowledge about CD and its vectors displayed by a population that lives in an endemic area in Brazil, so as to validate it as an educational tool. The video was shown to 226 subjects, divided into two groups. Group 1 was composed of users of Basic Health Units (BHU) in Pelotas and Pinheiro Machado, cities located in Rio Grande do Sul (RS) state, Brazil, where CD is endemic. Group 2 consisted of students who attend three public schools located in the rural area in Pinheiro Machado, RS. Two questionnaires with questions about their knowledge about triatomines and CD were applied, before and after the documentary was shown. After the video was shown, there was significant increase in individuals' knowledge (in both groups) about "kissing bugs", their notification, the disease and its prevention. Besides, watchers considered that the quality of the material was satisfactory. Since the "Documentary on CD" can be easily accessed on the internet and was effective in teaching the population that lives in endemic areas, its use should be encouraged in places and meetings connected to health that aim at fighting against triatominae and at exposing an updated view of CD.


Resumo Intervenções educacionais podem desencadear ações que contribuam para a prevenção de doenças parasitárias, como a doença de Chagas (DC). Este estudo teve como objetivo investigar o impacto de um vídeo instrucional denominado "Documentário Doença de Chagas" no conhecimento sobre DC e seus vetores exibidos a uma população que vive em área endêmica no Brasil, para validá-lo como uma ferramenta educacional. O vídeo foi exibido para 226 indivíduos, divididos em dois grupos. O grupo 1 foi composto por usuários das Unidades Básicas de Saúde (UBS) de Pelotas e Pinheiro Machado, cidades do estado do Rio Grande do Sul (RS), Brasil, onde a DC é endêmica. O grupo 2 foi formado por estudantes que frequentam três escolas públicas localizadas na zona rural de Pinheiro Machado, RS. Dois questionários com perguntas sobre conhecimentos sobre triatomíneos e DC foram aplicados, antes e depois da exibição do documentário. Após a exibição do vídeo, houve um aumento significativo no conhecimento dos indivíduos (em ambos os grupos) sobre "triatomíneos", sua notificação, a doença e sua prevenção. Além disso, os observadores consideraram que a qualidade do material era satisfatória. Como o "Documentário DC" pode ser facilmente acessado na Internet e ser eficaz no ensino à população que vive em áreas endêmicas, seu uso deve ser incentivado em locais e reuniões relacionadas à saúde, que visam combater os triatomíneos e exibir uma informação atualizada sobre a DC.

4.
Rev Bras Epidemiol ; 24: e210009, 2021.
Artículo en Portugués, Inglés | MEDLINE | ID: mdl-33950138

RESUMEN

OBJECTIVE: To compare lifestyle changes during the COVID-19 pandemic according to the presence or absence of noncommunicable diseases (NCDs) in Brazilian adults. METHODS: Cross-sectional study, using data from the ConVid survey, between April and May 2020. The following variables were evaluated: lifestyle and presence of one or more NCDs (diabetes, hypertension, respiratory disease, heart disease, and cancer). Sociodemographic characteristics were used as adjustment. Relative frequencies and confidence intervals (CI) of 95% of the explanatory variables were calculated before and during the pandemic. For the comparison of groups, with or without NCDs, crude and adjusted (PRadj) prevalence ratios were estimated by Poisson regression. RESULTS: There was a reduction in physical activity (60% in those without NCDs and 58% in those with NCDs) and in vegetable consumption (10.8% in those without NCDs and 12.7% in those with NCDs). On the other hand, there was an increase in the time spent watching television and on screens of computer/tablet (302% and 43.5% in those without NCDs and 196.5% and 30.6% with NCDs, respectively); consumption of frozen meals (43.6% in those without NCDs and 53.7% with NCDs), snacks (42.3% without NCDs and 31.2% with NCDs), and chocolate (14.8% without NCDs). During the pandemic, patients with NCDs were less active (PRadj = 0.77; 95%CI 0.65 - 0.92), had greater habit of watching TV (PRadj = 1.16; 95%CI 1.08 - 1.26), and consumed less vegetables (PRadj = 0.88; 95%CI 0.81 - 0.96). CONCLUSION: It was evident that adults with NCDs had their lifestyles more altered during the COVID-19 pandemic.

5.
Am J Prev Med ; 2021 May 02.
Artículo en Inglés | MEDLINE | ID: mdl-33952412

RESUMEN

INTRODUCTION: Zika virus is primarily transmitted through mosquito bites. Because Zika virus infection during pregnancy can cause serious birth defects, reproductive-aged women need protection from Zika virus infection. This report describes Zika virus prevention behaviors among women aged 18-49 years and assesses whether pregnancy status and healthcare provider counseling increases Zika virus prevention behaviors. METHODS: A population-based cell phone survey of women aged 18-49 years living in Puerto Rico was conducted in July-November 2016. Data were analyzed in 2018-2019. Prevalence estimates and 95% CIs were calculated for Zika virus prevention behaviors. Adjusted prevalence ratios were estimated to examine the association of pregnancy status with healthcare provider counseling on Zika virus prevention behaviors, controlling for age, education, and health insurance status. RESULTS: Most women reported using screens on open doors/windows (87.7%) and eliminating standing water in/around their homes (92.3%). Other Zika virus prevention behaviors were less common (<33%). In adjusted analysis, pregnant women were more likely than women not at risk for unintended pregnancy to report using mosquito repellent every/most days (adjusted prevalence ratio=1.44, 95% CI=1.13, 1.85). Healthcare provider counseling was associated with receiving professional spraying/larvicide treatment (adjusted prevalence ratio=1.42, 95% CI=1.17, 1.74), sleeping under a bed net (adjusted prevalence ratio=2.37, 95% CI=1.33, 4.24), using mosquito repellent (adjusted prevalence ratio=1.57, 95% CI=1.40, 1.77), and wearing long sleeves/pants (adjusted prevalence ratio=1.32, 95% CI=1.12, 1.55). CONCLUSIONS: Receipt of healthcare provider counseling was more consistently associated with Zika virus prevention behaviors than pregnancy status. Healthcare provider counseling is an important strategy for increasing the uptake of Zika virus prevention behaviors among women aged 18-49 years.

6.
J Nutr Sci Vitaminol (Tokyo) ; 67(2): 135-138, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33952735

RESUMEN

Lifestyle plays an important role in the development of noncommunicable diseases such as diabetes, hypertension, dyslipidemia, and obesity, in addition to a poor diet loaded with simple carbohydrates and saturated fats. This was a trial with a randomized, analytical, longitudinal, and prospective quasi-experimental design, which was divided into 2 phases: the first with healthy subjects with an age range between 18 to 30 y and normal BMI (18.5-24.9). The second phase was subjected with familial hypercholesterolemia aged between 18 to 45 y and overweight (25-29.9). For those subjects who frequently consumed vegetable oil of both Vitis vinifera L., or Persea americana L. (10 mL), they presented a significant reduction in anthropometric measures and in biochemical variables such as capillary glucose and increased HDLc. The vegetable oils of Persea americana L., and Vitis vinifera L., can act as adjuvants for the treatment of noncommunicable diseases.

7.
Arq. Ciênc. Vet. Zool. UNIPAR (Online) ; 24(1, cont.): 1-6, jan-jun. 2021.
Artículo en Portugués | LILACS-Express | LILACS | ID: biblio-1222347

RESUMEN

A raiva é uma antropozoonose viral que se desenvolve de forma progressiva e aguda podendo apresentar até 100% de letalidade. O seu agente etiológico é o vírus rábico do gênero Lyssavirus pertencente à família Rhabdoviridae. O presente trabalho teve como objetivo divulgar informações acerca da ocorrência da raiva em humanos em virtude da sua expressiva importância para saúde pública e analisar a percepção da população sobre a raiva humana, de forma a obter dados relacionados a conhecimentos básicos sobre a doença. Para isso, foi criada uma página informativa denominada "@contraraiva_" na rede social Instagram para a realização de postagens interativas sobre o tema abordado, e uso de um questionário criado a partir da plataforma Google Forms em diferentes mídias sociais para a obtenção e coleta de dados. Foram obtidas 1.075 respostas, provenientes de diferentes localidades. O questionário alcançou todas as regiões brasileiras, todos 26 estados e o Distrito Federal. As informações publicadas pela página criada ajudaram a sanar dúvidas relacionadas aos principais aspectos da doença. Os dados obtidos a partir do questionário contribuem para o planejamento de ações voltadas para a educação em saúde de forma mais estratégica, visando contribuir para os pontos em que a população tem menos conhecimentos.


Rabies is a viral anthropozoonosis that is developed in a progressive and acute way and can present up to 100% lethality. Its etiologic agent is the rabies virus of the Lyssavirus gene belonging to the Rhabdoviridae family. This study aimed at disseminating information about the occurrence of rabies in humans due to its expressive importance for public health, and at analyzing the population perception on human rabies in order to obtain data related to basic knowledge about the disease. For that purpose, an information page called "@ contraraiva _" was created on the social network Instagram for providing interactive posts on the topic, and a questionnaire was created from the Google Forms platform on different social media to obtain and collect data. A total of 1,075 responses were obtained from different locations. The questionnaire included all Brazilian regions, all 26 states and the Federal District. The information published on the created page helped to clarify doubts related to the main aspects of the disease. The data obtained from the questionnaire contribute towards the planning of actions aimed at health education in a more strategic way, aiming at contributing to the points where the population is less knowledgeable.


La rabia es una antropozoonosis viral que se desarrolla de forma progresiva y aguda y puede presentar hasta un 100% de letalidad. Su agente etiológico es el virus de la rabia del género Lyssavirus perteneciente a la familia Rhabdoviridae. Este estudio tuvo como objetivo difundir informaciones sobre la ocurrencia de la rabia en humanos en virtud de su importancia expresiva para la salud pública, y analizar la percepción de la población sobre la rabia humana, con el fin de obtener datos relacionados a los conocimientos básicos sobre la enfermedad. Para ello, se creó una página de información denominada "@ contraraiva _" en la red social Instagram para realizar publicaciones interactivas sobre el tema abordado, y utilizar un cuestionario creado a partir de la plataforma Google Forms en diferentes redes sociales para la obtención y recolección de datos. Se obtuvieron 1.075 respuestas de diferentes lugares. El cuestionario llegó a todas las regiones brasileñas, a los 26 estados y al Distrito Federal. Las informaciones publicadas en el sitio web creado, ayudaron a sanar dudas relacionadas a los principales aspectos de la enfermedad. Los datos obtenidos del cuestionario contribuyen a la planificación de acciones orientadas a la educación para la salud de forma más estratégica, con el objetivo de contribuir a los puntos donde la población tiene menos conocimientos.

8.
Artículo en Inglés | PAHO-IRIS | ID: phr-53908

RESUMEN

[ABSTRACT]. Objective. To assess the association between drinking behaviors during the COVID-19 pandemic and quarantine, anxiety symptoms, and sociodemographic characteristics in Latin America and the Caribbean (LAC). Method. Data was collected through a cross‐sectional online survey (non-probabilistic sample) conducted by the Pan American Health Organization between May 22 and June 30, 2020, in 33 countries and two territories of LAC. Participants were 18 years of age or older and must not have traveled outside of their country since March 15, 2020 (n= 12 328, M age= 38.1 years, 65% female). Four drinking behaviors (online socializing drinking [OSD], drinking with child present [DCP], drinking before 5 p.m. [DB5]), heavy episodic drinking [HED]) were response variables, and quarantining, anxiety symptoms and sociodemographic covariables were explanatory variables. Results. Quarantine was positively associated with a higher frequency of OSD and with DCP, but negatively associated with a higher frequency of HED. Anxiety symptoms were associated with a higher frequency of HED, more OSD, and DB5. Higher incomes seemed to be more associated with all the studied drinking behaviors. Women tended to report less DB5 and less HED during the pandemic. Conclusions. Quarantine during the COVID-19 pandemic seems to affect drinking behavior and mental health indicators like anxiety symptoms. This study is the first effort to measure the consequences of the quarantine on alcohol consumption and mental health in LAC during the COVID-19 pandemic. Considering the associations found, screenings and brief interventions targeting alcohol consumption and mental health are recommended.


[RESUMEN]. Objetivo. Evaluar la asociación entre comportamientos relacionados con el consumo de alcohol durante la pandemia de COVID-19 y la cuarentena, los síntomas de ansiedad y las características sociodemográficas en América Latina y el Caribe. Método. Se recopilaron datos mediante una encuesta transversal en línea (muestra no probabilística) realizada por la Organización Panamericana de la Salud entre el 22 de mayo y el 30 de junio del 2020 en 33 países y 2 territorios de América Latina y el Caribe. Los participantes tenían 18 años o más y no tenían que haber viajado fuera de su país después del 15 de marzo del 2020 (n= 12 328, edad M= 38,1 años, 65% mujeres). Las variables de respuesta eran cuatro comportamientos relacionados con el consumo de alcohol: beber socializando en línea, beber en presencia de niños, beber antes de las 5 de la tarde o consumo excesivo episódico. La cuarentena, los síntomas de ansiedad y las covariables sociodemográficas fueron las variables explicativas. Resultados. La cuarentena se relacionó positivamente con una mayor frecuencia de consumo de alcohol socializando en línea y en presencia de niños, pero negativamente con una mayor frecuencia de consumo excesivo episódico. Los síntomas de ansiedad se relacionaron con una mayor frecuencia de consumo excesivo de alcohol, un mayor consumo de alcohol socializando en línea y con beber antes de las 5 de la tarde. Aparentemente los ingresos más altos estuvieron más asociados con todos los comportamientos relacionados con el consumo del alcohol estudiados. Las mujeres tendieron a notificar menos consumo de alcohol antes de las 5 de la tarde y menos consumo excesivo episódico de alcohol durante la pandemia. Conclusiones. La cuarentena durante la pandemia de COVID-19 parece afectar el comportamiento relacionado con el consumo de alcohol y los indicadores de salud mental, como los síntomas de ansiedad. Este estudio es la primera iniciativa para medir las consecuencias de la cuarentena sobre el comportamiento relacionado con el consumo de alcohol y la salud mental en América Latina y el Caribe durante la pandemia de COVID-19. Dadas las asociaciones encontradas, se recomienda llevar a cabo pruebas de tamizaje e intervenciones breves para abordar el consumo del alcohol y la salud mental.


[RESUMO]. Objetivo. Avaliar a associação entre comportamentos relacionados ao uso de álcool durante a pandemia de COVID-19 e quarentena, sintomas de ansiedade e características sociodemográficas na América Latina e no Caribe (ALC). Métodos. Os dados foram coletados em uma pesquisa transversal online (amostra não probabilística) realizada pela Organização Pan-Americana da Saúde (OPAS) em 33 países e dois territórios da ALC entre 22 de maio e 30 de junho de 2020. Participaram da pesquisa pessoas com 18 anos ou mais de idade que não haviam feito viagens ao exterior desde 15 de março de 2020 (n = 12 328, mediana [M] de idade = 38,1 anos, 65% do sexo feminino). Quatro comportamentos relacionados ao uso de álcool (socialização online com o uso de álcool, uso de álcool na presença de crianças, uso de álcool antes das 5 da tarde e episódios de consumo excessivo de álcool) foram as variáveis de resposta e quarentena, sintomas de ansiedade e covariáveis sociodemográficas foram as variáveis explicativas. Resultados. A quarentena teve uma associação positiva com uma maior frequência de socialização online com o uso de álcool e o uso de álcool na presença de crianças, mas demonstrou uma associação negativa com uma maior frequência de episódios de consumo excessivo de álcool. Sintomas de ansiedade foram associados a uma maior frequência de episódios de consumo excessivo de álcool, socialização online com uso de álcool e uso de álcool antes das 5 da tarde. Houve uma aparente associação entre maior nível de renda e todos os comportamentos relacionados ao uso de álcool estudados. As mulheres em geral relataram menos uso de álcool antes das 5 da tarde e menos episódios de consumo excessivo de álcool durante a pandemia. Conclusões. A quarentena durante a pandemia de COVID-19 parece influenciar o comportamento relacionado ao uso de álcool e indicadores de saúde mental, como sintomas de ansiedade. Este é o primeiro estudo que procurou dimensionar a repercussão da quarentena no uso de álcool e na saúde mental das pessoas na ALC durante a pandemia de COVID-19. Diante das associações observadas, recomenda-se rastrear problemas relacionados ao uso de álcool e de saúde mental e oferecer intervenções breves.


Asunto(s)
Alcoholismo , Consumo de Bebidas Alcohólicas , Ansiedad , Cuarentena , Infecciones por Coronavirus , Pandemias , Salud Mental , Américas , Alcoholismo , Consumo de Bebidas Alcohólicas , Ansiedad , Cuarentena , Infecciones por Coronavirus , Pandemias , Salud Mental , Américas , Alcoholismo , Consumo de Bebidas Alcohólicas , Ansiedad , Cuarentena , Infecciones por Coronavirus , Salud Mental , Américas
9.
PLoS One ; 16(5): e0250059, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33939707

RESUMEN

BACKGROUND: More than 85% of the malaria cases in Panama occur in poor, rural and indigenous regions like Darien Province. Vector diversity, infection rate and spatial distribution are important entomological parameters of malaria transmission dynamics. Their understanding is crucial for the development of effective disease control strategies. The objective of this study was to determine the composition of Anopheles species, their natural infection rate and their geographic distribution to better understand the malaria transmission dynamics in Darién, Panama. METHODS: Anophelines mosquitoes were captured during the rainy and dry season of 2016. We selected five communities where adult anophelines were collected using CDC light-traps, and through protective human-baited traps. Detection of natural infection and Plasmodium genotype were detected via nested PCR through the amplification of ssrRNA and the circumsporozoite protein gene (csp), respectively. RESULTS: A total of 1,063 mosquitoes were collected mosquitoes were collected for the detection of natural infection with Plasmodium spp. Nine Anophelines species were identified, with the predominant species being: An. (Nys.) darlingi (45.0%) and An. (Nys.) albimanus (42.6%). Natural infection in An. (Nys.) albimanus with P. vivax was detected in one mosquito pool from the community Pueblo Tortuga (0.6%), three from Marraganti (1.7%), two from Bajo Chiquito (1.1%) and three pools from Alto Playona 3 (1.7%). For An. (Nys.) darlingi mosquitoes, we detected seven positive pools from the community Bajo Chiquito (4.0%), two pools from Marraganti (1.1%) and two pools from Alto Playona (1.1%). The P. vivax allelic variant VK210 was detected in infected mosquitoes. CONCLUSION: The results from this study provide new information on the transmission dynamics associated with anophelines vectors in the Darién region. This is the first report of natural P. vivax infection in An. (Nys.) darlingi and its incrimination as a potential malaria vector in this region of Panama. Additional studies are necessary to expand our knowledge and determine crucial parameters in malaria transmission in Darién, which in turn will aid the National Malaria Program in attaining an adequate malaria control strategy towards malaria elimination.

10.
Infect Dis Poverty ; 10(1): 61, 2021 May 07.
Artículo en Inglés | MEDLINE | ID: mdl-33962699

RESUMEN

BACKGROUND: Cutaneous leishmaniasis (CL), endemic in Guatemala, mostly affects poor people living in the northern region. A national control program that includes surveillance, diagnose, and treatment offered free of cost by the Ministry of Health (MoH) has been in place since 2003. However, the incidence is increasing and treatment rates are not optimal, suggesting that current efforts are not being effective. This study aimed to understand barriers and facilitators of CL control in Guatemala as experienced and perceived by key stakeholders in order to comprehend what works well and does not and suggest evidence-informed interventions. METHODS: The study was conducted in the Cobán municipality, the most endemic of Guatemala, situated in the Department of Alta Verapaz. Data were collected during May and June 2019 via focus groups and semi-structured interviews with key stakeholders, including local and national health personnel and residents of four communities of the endemic region. Thematic and content analysis of the collected data was conducted using NVIVO. RESULTS: Three overarching issues hamper the effectiveness of current CL efforts: resource scarcity, treatment challenges, and knowledge-action gaps. Scarce economic resources from the MoH and community residents negatively impact incidence, detection of cases and treatment rates in that preventive action is insufficient and healthcare access is low. In addition, local health workers often lack specialized CL training and access to the national CL control guidelines. With regards to the population living in the study area, misunderstanding of disease causation, shame associated with CL lesions, treatment pain fear, and long (often uncertain) waiting times for diagnose and treatment negatively affect people's willingness to seek help, treatment adherence, and their trust on the healthcare provided. CONCLUSIONS: Culturally sensitive CL preventive action must be developed. Given the scarce economic resources available for CL control in the country, the involvement of trained community health workers and the inclusion of thermotherapy as a treatment option is also advised. Other cost-effective actions include: ensuring all health workers receive CL training and have access to national CL control guidelines, improving national procurement system to avoid treatment shortages, and provision of motorized vehicles to increase active surveillance and treatment rates.

11.
Am J Trop Med Hyg ; 2021 May 03.
Artículo en Inglés | MEDLINE | ID: mdl-33939643

RESUMEN

Cutaneous leishmaniasis (CL) is firmly established in South America. We aimed to assess the detection of IgG antibodies against 14 and/or 16 kDa antigens by immunoblot (IB) for CL serological diagnosis in French Guiana, an area where many endemic pathogens could interfere with it. This study was performed retrospectively on sera from 141 patients at the Cayenne tertiary hospital: 30 were patients with confirmed CL, 71 were diagnosed with various other endemic pathogens, 11 were diagnosed with an autoimmune disease, and 29 controls had no history of CL. Antibodies bound to the 14 and/or 16 kDa antigens in 27 of the 30 CL patients' sera and in 39 of the 111 non-CL patients' sera (26 from the infectious diseases group, four from the autoimmune diseases group, and nine from the dermatology department). The method tested showed a high sensitivity (90%) and a low specificity (66%), and a diagnosis odds ratio of 17.5 (95% CI [4.6-78.0]). This IB may be helpful to exclude the diagnosis of CL, prompting physicians to look for another diagnosis in the case of a negative IB.

12.
Eur J Transl Myol ; 2021 Apr 29.
Artículo en Inglés | MEDLINE | ID: mdl-33942601

RESUMEN

This study aimed to compare the practice of physical activity in groups of people with chronic diseases with and without medication, before and during the pandemic. 298 Brazilian individuals with chronic non-communicable diseases such as cardiovascular, metabolic / endocrine, respiratory, orthopedic, gastrointestinal diseases, anxiety and depression were separated into two groups: with and without medication. A questionnaire with 14 questions was applied, tracing the behavioral profile in relation to physical exercises before and during isolation, interpreted through descriptive analysis, and the groups were compared through Mann-Whitman's statistics. The drop in the percentage of active individuals with or without medication occurred when comparing the scenarios before and during quarantine. However, the difference in the prevalence of active individuals between the groups was significant, showing that the group with medication remained more active. The fear of contamination, the measures of distance and the lack of adherence of the population to classes by videoconference reduced the frequency of physical activities in the general sample population. However, people who used medication showed greater concern about the practice of physical activity to optimize treatment. The isolation period had a negative impact on the practice of physical activity, regardless of the presence of some chronic disease or the use of medication.

13.
Artículo en Inglés | MEDLINE | ID: mdl-33944623

RESUMEN

A clinical and entomological investigation was performed to identify flavivirus infections in humans and mosquitoes in impoverished areas of Guerrero, a coastal state in southwestern Mexico. A total of 639 patients with acute febrile illness and 830 resting female mosquitoes in low-income communities of Guerrero in 2019 were tested for evidence of flavivirus infection. Sera were collected from all patients and screened at a dilution of 1:20 by plaque reduction neutralization test (PRNT) using dengue virus (DENV)2. A total of 431 (67.4%) patients were seropositive. Sera from a subset of seropositive patients (n = 263) were tested for flavivirus NS1 by enzyme-linked immunosorbent assay. Forty-eight (18.3%) sera contained viral antigen. All NS1-positive sera were titrated and further tested by PRNT using DENV-1 to -4, St. Louis encephalitis virus, West Nile virus, and Zika virus (ZIKV). Seven patients were seropositive for DENV-1, five patients were seropositive for DENV-2, one patient was seropositive for DENV-3, and two patients each were seropositive for DENV-4 and ZIKV. The remainder had secondary flavivirus infections or antibodies to an undetermined flavivirus. Comparative PRNTs were also performed on 60 randomly selected NS1-negative sera, identifying patients seropositive for DENV-2, DENV-3, and ZIKV. The entomological investigation yielded 736 Aedes aegypti and 94 Culex quinquefasciatus that were sorted into 183 pools and 20 pools, respectively. Mosquitoes were assayed for flavivirus RNA by RT-PCR and Sanger sequencing. DENV-2 RNA was detected in three pools of A. aegypti. In summary, we provide evidence for the concurrent circulation of all four DENVs and ZIKV in Guerrero, Mexico. The public health authorities reported no cases of DENV-3, DENV-4, and ZIKV in Guerrero in 2019 and thus, we provide evidence of under-reporting in the region.

14.
Malar J ; 20(1): 208, 2021 Apr 30.
Artículo en Inglés | MEDLINE | ID: mdl-33931091

RESUMEN

BACKGROUND: In malaria elimination settings, available metrics for malaria surveillance have been insufficient to measure the performance of passive case detection adequately. An indicator for malaria suspected cases with malaria test (MSCT) is proposed to measure the rate of testing on persons presenting to health facilities who satisfy the definition of a suspected malaria case. This metric does not rely on prior knowledge of fever prevalence, seasonality, or external denominators, and can be used to compare detection rates in suspected cases within and between countries, including across settings with different levels of transmission. METHODS: To compute the MSCT, an operational definition for suspected malaria cases was established, including clinical and epidemiological criteria. In general, suspected cases included: (1) persons with fever detected in areas with active malaria transmission; (2) persons with fever identified in areas with no active transmission and travel history to, or residence in areas with active transmission (either national or international); and (3) persons presenting with fever, chills and sweating from any area. Data was collected from 9 countries: Belize, Colombia (in areas with active transmission), Costa Rica, Dominican Republic, El Salvador, Guatemala, Honduras, Nicaragua, and Panama (September-March 2020). A sample of eligible medical records for 2018 was selected from a sample of health facilities in each country. An algorithm was constructed to assess if a malaria test was ordered or performed for cases that met the suspected case definition. RESULTS: A sample of 5873 suspected malaria cases was obtained from 239 health facilities. Except for Nicaragua and Colombia, malaria tests were requested in less than 10% of all cases. More cases were tested in areas with active transmission than areas without cases. Travel history was not systematically recorded in any country. CONCLUSIONS: A statistically comparable, replicable, and standardized metric was proposed to measure suspected malaria cases with a test (microscopy or rapid diagnostic test) that enables assessing the performance of passive case detection. Cross-country findings have important implications for malaria and infectious disease surveillance, which should be promptly addressed as countries progress towards malaria elimination. Local and easy-to-implement tools could be implemented to assess and improve passive case detection.

15.
Braz. j. biol ; 81(2): 237-240, Jan.-May 2021. tab
Artículo en Inglés | LILACS-Express | LILACS | ID: biblio-1153345

RESUMEN

Abstract Dengue is a viral disease which is serious health concern from last few decades and the infection transmitted through mosquito bite into human. This study was conducted to carry out prevalence of dengue fever in District Swabi. A total of 196 blood sample were collected from patients with age ranges (0-80 years) having dengue fever on the basis of physical symptoms from Bacha Khan Medical Complex Swabi during August to October 2017. Serological test were performed for detection of IgM, IgG and NS1 (Non structural protein antigen of virus) against dengue. Out of total 196 confirmed dengue cases the most prone gender was male 123(62%) while 73(38%) were female. Among the age groups; 21-30 years group 62 (31.6%) was found the most predominated age group. The higly affected areas in district Swabi were Topi (40.8%) followed by Main Swabi (27%), Maneri (8.2%), Marghuz (6%), Shawa Ada (5.1%), Shah Mansoor (5.1%), Gohati (4.1%), and Chota Lahore (3.6%). Therefore, the health department should take actions by educating the public about basic cleanliness of the environment. The community should be encouraged to participate in the control of such vector based diseases/infections.


Resumo A dengue é uma doença viral que é um sério problema de saúde das últimas décadas e a infecção transmitida através da picada de mosquito em humanos. Este estudo foi realizado para realizar a prevalência da dengue no distrito de Swabi. Foram coletadas 196 amostras de sangue de pacientes com faixa etária (0 a 80 anos) com dengue com base nos sintomas físicos do Complexo Médico Bacha Khan de Swabi, no período de agosto a outubro de 2017. Foram realizados testes sorológicos para detecção de IgM, IgG e NS1 (antígeno proteico não estrutural do vírus) contra a dengue. Do total de 196 casos confirmados de dengue, o sexo mais propenso foi o masculino 123 (62%), enquanto 73 (38%) eram do sexo feminino. Entre as faixas etárias; A faixa etária de 21 a 30 anos 62 (31,6%) foi a faixa etária mais predominante. As áreas altamente afetadas no distrito de Swabi foram Topi (40,8%), seguidas por Main Swabi (27%), Maneri (8,2%), Marghuz (6%), Shawa Ada (5,1%), Shah Mansoor (5,1%), Gohati (4,1%) e Chota Lahore (3,6%). Portanto, o departamento de saúde deve tomar ações educando o público sobre a limpeza básica do meio ambiente. A comunidade deve ser incentivada a participar do controle de tais doenças / infecções baseadas em vetores.

16.
Recurso de Internet en Portugués | LIS - Localizador de Información en Salud | ID: lis-48179

RESUMEN

A Organização Pan-Americana da Saúde (OPAS) participou nesta segunda-feira (12) do lançamento da campanha de vacinação contra a gripe no Brasil. O Ministério da Saúde do país vai distribuir 80 milhões de doses da vacina influenza trivalente, produzida pelo Instituto Butantan, para imunizar um público-alvo de 79,7 milhões de pessoas. A campanha vai até o dia 9 de julho.


Asunto(s)
Programas de Inmunización , Vacunación , Brasil , Vacunas contra la Influenza/inmunología
17.
PLoS One ; 16(4): e0246215, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33831004

RESUMEN

Vale do Rio Juruá in western Acre, Brazil, is a persistent malaria transmission hotspot partly due to fish farming development that was encouraged to improve local standards of living. Fish ponds can be productive breeding sites for Amazonian malaria vector species, including Nyssorhynchus darlingi, which, combined with high human density and mobility, add to the local malaria burden.This study reports entomological profile of immature and adult Ny. darlingi at three sites in Mâncio Lima, Acre, during the rainy and dry season (February to September, 2017). From 63 fishponds, 10,859 larvae were collected, including 5,512 first-instar Anophelinae larvae and 4,927 second, third and fourth-instars, of which 8.5% (n = 420) were Ny. darlingi. This species was most abundant in not-abandoned fishponds and in the presence of emerging aquatic vegetation. Seasonal analysis of immatures in urban landscapes found no significant difference in the numbers of Ny. darlingi, corresponding to equivalent population density during the rainy to dry transition period. However, in the rural landscape, significantly higher numbers of Ny. darlingi larvae were collected in August (IRR = 5.80, p = 0.037) and September (IRR = 6.62, p = 0.023) (dry season), compared to February (rainy season), suggesting important role of fishponds for vector population maintenance during the seasonal transition in this landscape type. Adult sampling detected mainly Ny. darlingi (~93%), with similar outdoor feeding behavior, but different abundance according to landscape profile: urban site 1 showed higher peaks of human biting rate in May (46 bites/person/hour), than February (4) and September (15), while rural site 3 shows similar HBR during the same sampling period (22, 24 and 21, respectively). This study contributes to a better understanding of the larvae biology of the main malaria vector in the Vale do Rio Juruá region and, ultimately will support vector control efforts.

18.
Mil Med ; 2021 Apr 16.
Artículo en Inglés | MEDLINE | ID: mdl-33861353

RESUMEN

INTRODUCTION: Leptospirosis and rickettsial diseases are global zoonotic diseases. In severe infection cases, mortality can range from 10% to 30%. Currently most epidemiological data available are based on outbreak investigations and hospital-based studies from endemic countries. The U.S. soldiers at military bases in these countries are highly vulnerable due to the fact that most of them are immunologically naïve to these pathogens. No risk assessment of leptospirosis and rickettsial diseases among U.S. military personnel in Honduras is currently available. This study was aimed at determining the prevalence of leptospirosis and rickettsial diseases in U.S. military personnel deployed to Honduras using serological assays. MATERIALS AND METHODS: A cohort of pre- and post-deployment sera from the most recent 1,000 military personnel stationed in Honduras for at least 6 months between 2000 and 2016 was identified for this study. Serum specimens from these eligible subjects were retrieved. All post-deployment serum specimens were screened at a dilution of 1:100 for the presence of IgG antibodies to Leptospira and Rickettsia pathogens. The pre-deployment sera from those individuals with post-deployment IgG antibodies above cutoff (i.e., seropositive) were tested to determine seroconversion. Seroconversion was defined as conversion of an optical density value from below the cutoff (i.e., negative) in a pre-deployed specimen to above the cutoff (i.e., positive) in a post-deployed specimen at a titer of 100. RESULTS: The seropositive post-deployment specimens for antibodies against Leptospira (causing leptospirosis), Rickettsia typhi (causing murine typhus [MT]), spotted fever group rickettsioses (SFGR, causing SFG Rickettsia), Orientia tsutsugamushi (causing scrub typhus [ST]), and Coxiella burnetii (causing Q fever [QF]) were 11.6%, 11.3%, 6%, 5.6%, and 8.0%, respectively. The seroconverted rate in those assigned to Honduras from 2000 to 2016 was 7.3%, 1.9%, 3.9%, 4.3%, and 2.7% for leptospirosis, MT, SFGR, ST, and QF, respectively. Among the seroconverted specimens, 27 showed seroconversion of at least two antibodies. These seroconverted individuals accounted for 8.8% (3 out of 34) of the personnel who looked for medical attention during their deployment. CONCLUSIONS: Our results suggest a leptospirosis seroconversion rate of 7.3%, which is higher than the 0.9% and 3.9% seroconversion in Korea and Japan, respectively. The higher rate of seroconversion indicates potential risk of Leptospira exposure. Additional testing of water samples in the pools and pits around the training sites to locate the infected areas is important to eliminate or reduce future exposure to Leptospira during trainings. The rates of seroconversion for ST, MT, spotted fever Rickettsia, and QF were 4.3%, 1.9%, 3.9%, and 2.7%, respectively, indicating the potential exposure to a variety of rickettsial-related pathogens. Testing of vectors for rickettsial pathogens in the areas could inform effective vector control countermeasures to prevent exposure. Proper precaution and protective measures are needed to better protect military personnel deployed to Honduras.

19.
BMJ Open ; 11(4): e045258, 2021 04 01.
Artículo en Inglés | MEDLINE | ID: mdl-33795308

RESUMEN

INTRODUCTION: The COVID-19 pandemic and its control measures have impacted health and healthcare provision in various levels. Physical distancing measures, for instance, may affect sexual health, impacting access to HIV prevention supplies and changing sexual behaviour, as well as mental health, increasing feelings of unsafety and weakening community support ties. These effects can be worsened among socially marginalised groups, such as men who have sex with men (MSM) and transgender women (TGW). Brazil is among the countries most affected by COVID-19 in the world, where control measures have been inconsistently implemented. We aim to investigate the effects of the COVID-19 pandemic on the sexual and mental health of adolescent and adult MSM and TGW in Brazil. METHODS: Convergent mixed-method prospective cohort study, nested in two ongoing HIV pre-exposure prophylaxis (PrEP) cohorts in Brazil, named PrEP1519 and Combina. Participants will be invited to answer, at baseline and after 6 months, a questionnaire about the effects of the COVID-19 pandemic on sexual behaviour, HIV prevention and mental health. Data on HIV infection and sexually transmitted infections (STI) will be collected as part of routine follow-up from the cohorts. Main outcome measures (HIV infection, STI and depression symptoms) will be observed within 12 months after baseline. Sample size is estimated at 426 participants. Complementarily, 50 participants will be invited to in-depth interviews through video calls or interactive voice response, and 20 will be invited to chronicle their lives during the pandemic through digital diaries. Triangulation will be done across qualitative methods and with the quantitative data. ETHICS AND DISSEMINATION: The study was approved by Research Ethics Committees from the Brazilian Universities coordinating the study. Findings will be published in scientific journals and presented at meetings. Informative flyers will be elaborated to communicate study findings to participants and key stakeholders.


Asunto(s)
Infecciones por VIH/prevención & control , Salud Mental , Profilaxis Pre-Exposición , Minorías Sexuales y de Género/psicología , Personas Transgénero/psicología , Adolescente , Adulto , Anciano , Brasil/epidemiología , Estudios de Cohortes , Femenino , Infecciones por VIH/epidemiología , Humanos , Masculino , Persona de Mediana Edad , Pandemias , Estudios Prospectivos , Adulto Joven
20.
Lancet Planet Health ; 5(4): e209-e219, 2021 04.
Artículo en Inglés | MEDLINE | ID: mdl-33838736

RESUMEN

BACKGROUND: Temperature and rainfall patterns are known to influence seasonal patterns of dengue transmission. However, the effect of severe drought and extremely wet conditions on the timing and intensity of dengue epidemics is poorly understood. In this study, we aimed to quantify the non-linear and delayed effects of extreme hydrometeorological hazards on dengue risk by level of urbanisation in Brazil using a spatiotemporal model. METHODS: We combined distributed lag non-linear models with a spatiotemporal Bayesian hierarchical model framework to determine the exposure-lag-response association between the relative risk (RR) of dengue and a drought severity index. We fit the model to monthly dengue case data for the 558 microregions of Brazil between January, 2001, and January, 2019, accounting for unobserved confounding factors, spatial autocorrelation, seasonality, and interannual variability. We assessed the variation in RR by level of urbanisation through an interaction between the drought severity index and urbanisation. We also assessed the effect of hydrometeorological hazards on dengue risk in areas with a high frequency of water supply shortages. FINDINGS: The dataset included 12 895 293 dengue cases reported between 2001 and 2019 in Brazil. Overall, the risk of dengue increased between 0-3 months after extremely wet conditions (maximum RR at 1 month lag 1·56 [95% CI 1·41-1·73]) and 3-5 months after drought conditions (maximum RR at 4 months lag 1·43 [1·22-1·67]). Including a linear interaction between the drought severity index and level of urbanisation improved the model fit and showed the risk of dengue was higher in more rural areas than highly urbanised areas during extremely wet conditions (maximum RR 1·77 [1·32-2·37] at 0 months lag vs maximum RR 1·58 [1·39-1·81] at 2 months lag), but higher in highly urbanised areas than rural areas after extreme drought (maximum RR 1·60 [1·33-1·92] vs 1·15 [1·08-1·22], both at 4 months lag). We also found the dengue risk following extreme drought was higher in areas that had a higher frequency of water supply shortages. INTERPRETATION: Wet conditions and extreme drought can increase the risk of dengue with different delays. The risk associated with extremely wet conditions was higher in more rural areas and the risk associated with extreme drought was exacerbated in highly urbanised areas, which have water shortages and intermittent water supply during droughts. These findings have implications for targeting mosquito control activities in poorly serviced urban areas, not only during the wet and warm season, but also during drought periods. FUNDING: Royal Society, Medical Research Council, Wellcome Trust, National Institutes of Health, Fundação Carlos Chagas Filho de Amparo à Pesquisa do Estado do Rio de Janeiro, and Conselho Nacional de Desenvolvimento Científico e Tecnológico. TRANSLATION: For the Portuguese translation of the abstract see Supplementary Materials section.

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