Anxiety/fear of dental treatment during pregnancy: use of the Modified Dental Anxiety Scale.

BACKGROUND: Despite advances in the control of anxiety and fear, dental treatment (DT) continues to be a stressful event, especially during pregnancy. There are several instruments to measure anxiety and fear about DT (AFDT). However, few are validated for use in Brazil. Our objective was to validate the Modified Dental Anxiety Scale (MDAS) for use in Brazil and to evaluate the association between AFDT and the use of oral health services (OHS) during pregnancy. METHODS: This is a cross-sectional study nested in a prospective cohort. We conducted a face, content, and construct validation. The Visual Analogue Scale (VAS) was the comparison instrument with MDAS. Sociodemographic and behavioral characteristics were also assessed. Associations were estimated by odds ratios (OR) and 95% confidence intervals (95%CI) in multiple logistic regression analysis (alpha = 5%). RESULTS: There were no difficulties in the translation/back-translation process. The reproducibility of the instrument was 0.54 (P=0.01). The correlation of MDAS with VAS was 0.71 (P=0.003). The reliability of the instrument was high (Cronbach's alpha: 0.79 to 0.87). After validation, the instrument was administered to 486 women. Mild or moderate AFDT was reported by 81.3% of pregnant women and at higher levels, by 8.2%. There was no association between the use of OHS and AFDT at moderate levels (OR=2.03; 95%CI: 0.45-9.09) or high (OR=1.35; 95%CI: 0.20-9.13). CONCLUSIONS: MDAS is a valid instrument for measuring AFDT. The prevalence of AFDT among pregnant women is high, but this event does not seem to be associated with the use of OHS.

Trypanosomes of vectors and domestic dogs in Trypanosoma cruzi transmission areas from Brazilian southwestern amazon: New mammalian host for Trypanosoma janseni.

Trypanosoma cruzi is a widespread protozoan in Latin America causing Chagas disease in humans and able to infect several other mammal species. The objective of this study was to investigate the T. cruzi infection in triatomine fauna as well as in dogs from distinct areas of Acre, western Brazilian Amazonia, which recently reported acute cases of human CD as well as an area that have not notify this disease recently. Triatomines were collected and the intestinal contents were evaluated for the presence of trypanosomatids by optical microscopy and polymerase chain reaction (PCR) targeting the mini-exon gene. Blood smear, hemoculture, PCR and serology were performed in the studied mammals. Fecal content of four triatomines were positive (11.6%) in the fresh examination. Molecular analysis identified Trypanosoma cruzi TCI in two specimens. Blood samples from 90 dogs were obtained. Trypanosoma sp. was observed in six blood smears (6/83, 7.22%). Seropositivity for T. cruzi was 8/89 (8.98). One dog's hemoculture was obtained and characterized as T. rangeli. PCR reactions in blood clots resulted in one positive dog (1/75, 1.3%) infected by T. janseni, providing a new mammalian host for a recently described Trypanosoma species. The results demonstrate the low exposition and prevalence for T. cruzi suggesting that dogs are not important to T. cruzi transmission cycle in the studied áreas.