A molecular and morphological study of Ascaris suum in a human-pig contact scenario in northeastern Brazil.

The aim of the present study was to assess morphologic and genetic data on ascariasis in swine (Sus scrofa domesticus) and humans in low-resource rural and periurban communities in the state of Piauí, Brazil. Our cross-sectional survey included 100 fecal samples obtained from swine and 682 samples from humans. Fifteen pigs were necropsied. Human and porcine fecal samples were examined to identify Ascaris eggs. Parasites obtained in the swine necropsies were studied using scanning electron microscopy (SEM), and the mitochondrial gene encoding the cytochrome oxidase 1 (cox1) enzyme was partially amplified and sequenced for molecular taxonomy and phylogenetic analyses. The overall prevalence of Ascaris eggs in the swine fecal samples was 16/100 (16%). No Ascaris eggs were identified in the human fecal samples. SEM of six worms recovered from pigs demonstrated morphological characteristics of A. suum. Cox1 sequences were compatible with A. suum reference sequences. Original and reference (GenBank) nucleotide sequences were organized into clusters that did not segregate the parasites by host species or and region. The largest haplogroups were dominated by haplotypes H01, H02 and H31. In the communities studied, there was no epidemiological evidence of the zoonotic transmission of ascariasis at the human-swine interface.

A molecular and morphological study of Ascaris suum in a human-pig contact scenario in northeastern Brazil / Estudo molecular e morfológico de Ascaris suum em um cenário de contato entre suínos e humanos no nordeste brasileiro

The aim of the present study was to assess morphologic and genetic data on ascariasis in swine (Sus scrofa domesticus) and humans in low-resource rural and periurban communities in the state of Piauí, Brazil. Our cross-sectional survey included 100 fecal samples obtained from swine and 682 samples from humans. Fifteen pigs were necropsied. Human and porcine fecal samples were examined to identify Ascaris eggs. Parasites obtained in the swine necropsies were studied using scanning electron microscopy (SEM), and the mitochondrial gene encoding the cytochrome oxidase 1 (cox1) enzyme was partially amplified and sequenced for molecular taxonomy and phylogenetic analyses. The overall prevalence of Ascaris eggs in the swine fecal samples was 16/100 (16%). No Ascaris eggs were identified in the human fecal samples. SEM of six worms recovered from pigs demonstrated morphological characteristics of A. suum. Cox1 sequences were compatible with A. suum reference sequences. Original and reference (GenBank) nucleotide sequences were organized into clusters that did not segregate the parasites by host species or and region. The largest haplogroups were dominated by haplotypes H01, H02 and H31. In the communities studied, there was no epidemiological evidence of the zoonotic transmission of ascariasis at the human-swine interface.(AU)

O presente estudo teve como objetivo acessar dados morfológicos e genéticos sobre a ascaridíase em suínos (Sus scrofa domesticus) e humanos, em comunidades rurais e periurbanas no estado do Piauí. O estudo transversal incluiu 100 amostras fecais de suínos e 682 amostras obtidas de humanos. Quinze suínos foram necropsiados. Amostras fecais suínas e humanas foram examinadas para detecção de ovos de Ascaris. Os parasitas adultos, obtidos nas necropsias, foram estudados através de microscopia eletrônica de varredura (MEV), e o gene mitocondrial codificante da enzima citocromo oxidase 1 (cox1) foi parcialmente amplificado e sequenciado para análises filogenéticas e de taxonomia molecular. A prevalência de Ascaris em amostras fecais de suínos foi 16/100 (16%), não sendo identificado nenhum caso de infecção por este parasita em humanos. A análise por MEV de parasitas recuperados de suínos demonstrou características morfológicas de Ascaris suum. As sequências nucleotídicas de cox1 foram compatíveis com A. suum. As sequências originais e de referência (obtidas no GeneBank) foram organizadas em clusters que não segregaram os parasitas por hospedeiro ou região geográfica. Os maiores haplogrupos foram dominados pelos haplótipos H01, H02 e H31. Nas comunidades estudadas, não foi evidenciada transmissão zoonótica de A. suum na interface suíno-humana.(AU)

Cytochrome c oxidase subunit 1 gene reveals species composition and phylogenetic relationships of Oesophagostomum spp. infecting pigs in northeastern Brazil.

Helminths of the genus Oesophagostomum cause enteric diseases and affect domestic animals such as pigs. The aim of this study was to explore the species composition and genetic diversity of Oesophagostomum spp. infecting pigs in close contact with humans in the state of Piauí, Brazil. Eighty-seven fecal samples were collected for parasitological tests and molecular analysis. Through microscopy, the overall positivity rate for strongyliform eggs was 81.6% among the pigs studied. Forty-two strongyliform egg samples were subjected to PCR and six cox1 sequences (637 bp) were identified for the genus Oesophagostomum. The sequences were identified as Oesophagostomum dentatum, O. quadrispinulatum and O. columbianum. In the phylogenetic tree and haplotype network, 89 sequences were separated into seven clusters, which also included reference sequences from GenBank. Oesophagostomum dentatum and O. quadrispinulatum were seen to be closely related species and formed a monophyletic group related to O. aculeatum. Oesophagostomum columbianum showed similarity with sequences from parasites infecting small ruminants and the clade was positioned closer to O. bifurcum. High interspecific diversity was found and intraspecific diversity varied according to the species. This was the first study to characterize Oesophagostomum DNA sequences obtained from pigs in Brazil.

Conhecimento de adolescentes e jovens sobre questões relacionadas ao sexo, em uma escola pública de Monte Alegre do Piauí-PI / Knowledge of adolescents and young people on issues related to sex, in a public school in Monte Alegre do Piauí-PI

O presente estudo objetivou avaliar o conhecimento de adolescentes e jovens sobre questões relacionadas ao sexo, na cidade de Monte Alegre do Piauí (PI). Para isso, utilizou-se o método descritivo quantitativo por meio de questionário semiestruturado aplicado a 81 estudantes, com idade entre 16 a 23 anos, da escola Ginásio Estadual Senador Chagas Rodrigues. A coleta de dados evidenciou que 97,5% (n=79) dos participantes já haviam praticado sexo, tendo iniciado com idade média de 15,5 anos. O preservativo foi o método contraceptivo mais conhecido, no entanto, observou-se que os adolescentes e jovens não se preveniram em todas as relações sexuais, mesmo cientes das consequências da não prevenção. Percebeu-se fragilidade dialógica entre os indivíduos, família e escola; a conversação sobre o assunto no âmbito familiar e escolar ainda era receosa e pouco atrativa. Como conclusão deste estudo, sugere-se como necessário a implementação eficaz de políticas públicas que envolvam de forma educativa a escola, os jovens, seus familiares e amigos.

This present study aimed to assess the knowledge of adolescents and young people on issues related to sex, in the city of Monte Alegre do Piauí (PI). For this, the quantitative descriptive method was used through a semi-structured questionnaire applied to 81 students, aged between 16 and 23 years old, from the school Ginásio Estadual Senador Chagas Rodrigues. The data collection showed that 97.5% (n = 79) of the participants had already had sex, having started with an average age of 15,5 years. The condom was the most known contraceptive method; however, it was observed that adolescents and young people did not prevent themselves in all sexual intercourse, even though they were aware of the consequences of non-prevention. Dialogical fragility was noticed among individuals, family and school; the conversation on the subject in the family and school environment was still fearful and unattractive. As a conclusion of this study, it is suggested as necessary the effective implementation of public policies that involve the school, young people, their families and friends in an educational way.

Perfil epidemiológico e conhecimento de gestantes sobre aleitamento materno em um município do nordeste brasileiro / Epidemiological profile and knowledge of pregnant women regarding breastfeeding in a city in northeastern Brazil

O aleitamento materno exclusivo propicia saúde ao recém-nascido e à mulher, fortalece o vínculo mãe e filho e leva à redução na mortalidade infantil. Objetivo: Identificar o perfil e os conhecimentos sobre aleitamento materno de gestantes atendidas em Unidades Básicas de Saúde, durante o pré-natal, no município de Gilbués, Piauí, Brasil. Material e Métodos: Trata-se de um estudo descritivo e abordagem quantitativa, com coleta de dados por meio de um formulário sobre as características sociodemográficas e conhecimentos em relação ao aleitamento materno. O estudo foi realizado com 40 gestantes nas Unidades Básicas de Saúde dos bairros São José e Santo Antônio. Resultados: Das gestantes, 75% estavam na segunda gestação ou mais e 47,5% no segundo trimestre gestacional. A maioria apresentou idade entre 18 e 30 anos, era solteira, possuía o ensino fundamental, não exercia atividade profissional e possuía renda familiar de até um salário mínimo. Quanto aos conhecimentos sobre aleitamento materno, houve orientação no pré-natal, porém, com pouca incorporação acerca dos benefícios que essa prática pode proporcionar à mãe. Apontaram-se, ainda, dúvidas e/ou inseguranças das gestantes sobre a quantidade de leite produzido e sua capacidade de nutrição, surgimento de fissuras na mama e transmissão de doenças por meio da amamentação. Conclusão: As atividades de educação em saúde no pré-natal são fundamentais para a saúde da criança e da mulher, promovendo estratégias de promoção, apoio e incentivo ao aleitamento materno.

Exclusive breastfeeding provides health to both the newborn and the mother, strengthening the bond between mother and child and leading to a reduction in infant mortality. Objective: Identify the profile and knowledge about breastfeeding of pregnant women attended at the Basic Health Units during prenatal care in the city of Gilbués, Piauí, Brazil. Methodology: This is a descriptive study, with a quantitative approach collected through a form on sociodemographic characteristics and knowledge regarding breastfeeding. The study was performed considering 40 pregnant women seen at the UBSs in the São José and Santo Antônio neighborhood. Results: Among the patients, 75% were in their second pregnancy or more, and 47.5% in the second gestational trimester. Most of them were aged between 18 and 30 years old, single, had only elementary education, did not work, and had family income up to a minimum wage. Regarding the knowledge about breastfeeding, they received guidance in the prenatal care, but with little emphasis on the benefits that exclusive breastfeeding can also provide to the mother. The doubts and/or insecurities of pregnant women were related to the amount of milk produced and its nutritional capacity, the appearance of cracks on the breast, and the transmission of diseases through breastfeeding. Conclusions: Prenatal health education activities are essential for the health of the child and the pregnant woman by providing strategies to promote, support, and encourage breastfeeding.

Interactions between malnutrition, soil-transmitted helminthiasis and poverty among children living in periurban communities in Maranhao State, Northeastern Brazil.

Poverty, malnutrition and neglected tropical diseases such as soil-transmitted helminthiases (STHs) interact in a multi-causal feedback network. This study aimed to assess the relationships between STHs, income and nutritional status of children in impoverished communities in the city of Caxias, Maranhao State, Northeastern Brazil. A cross-sectional survey (n=259 children) was carried out with the collection of fecal samples and assessment of sociodemographic, anthropometric, dietary and sanitation data. Hookworm infection and ascariasis presented prevalence rates of 14.3% and 9.3%, respectively. The logistic regression analysis showed that hookworm infection was more frequent in males (odds ratio [OR]=3.43; 95% confidence interval [CI]=1.45-8.08), children aged 11-15 years old (OR=3.72; 95% CI=1.19-11.62), children living in poor families (OR=2.44; 95% CI=1.04-5.68) and those living in rented houses (OR=5.74; 95%CI=1.91-17.25). Concerning ascariasis, living in the Caldeiroes community (OR=0.01; 95%CI=0-0.17) and belonging to the 11-15 years age group (OR=0.21; 95%CI=0.04-1.02) were protection factors. Poor children have a significantly lower frequency of consumption of meat, milk, vegetables, tubers and fruits than not poor children. The frequent consumption of meat, milk and tubers was associated with significant higher values in the parameter height-for-age, whereas the consumption of meat and milk positively influenced the weight-for-age. The frequencies of stunting, underweight and wasting were 8.1%, 4.9% and 2.9%, respectively. The multivariate model demonstrated that stunting was significantly associated with economic poverty (OR=2.82; 95%CI=1.03-7.70) and low weight was associated with male sex (OR=6.43; 95% CI=1.35-30.68). In conclusion, the study describes the interactions between the dimensions of development represented by income, STHs and nutritional status revealing the importance of raising income levels to improve the living conditions of families in impoverished communities in Northeastern Brazil.

Spatial distribution of synanthropic triatomines in Piaui State, Northeastern Brazil.

This study aimed to describe the spatial distribution and assess entomological indicators of synanthropic triatomines in Piaui State, Northeastern Brazil. We used surveillance data on the detection, identification and assessment of natural infection with trypanosomatids from triatomines in the State from 2014 to 2017. The State was divided into four macroregions. In relation to the dispersion rates of triatomines, they were much lower in the North, when compared to Southwest, Southeast and Central North macroregions. Infestation rates were higher in the Southwest and Southeast and intradomicile infestation rates varied during the study period, reaching high values in all regions. Insects belonging to the species Triatoma brasiliensis complex, Triatoma pseudomaculata, Triatoma sordida, and to the genus Panstrongylus spp. and Rhodnius spp. were collected during this period. T. brasiliensis was collected from all four regions of the State, but more frequently in those located in the Southeast. A similar pattern was observed for T. pseudomaculata. T. sordida was detected in the municipalities in the Southeast and Southwest regions, and less frequently in the Central North municipalities. Rhodnius spp. was detected in the Central North and North regions, and Panstrongylus spp. in the Central North and Southeast regions. The highest trypanosomatid-positivity rate of T. brasiliensis and Panstrongylus spp. was in the Southeast region. A significant proportion of the municipalities of Piaui State presents entomological parameters that indicate a risk of Chagas disease by vector transmission.

Ocorrência de triatomíneos no Estado do Ceará, Brasil / Occurrence of triatomines in the state of Ceará, Brazil

Esta revisão integrativa tem como objetivo analisar as publicações científicas nos últimos doze anos sobre triatomíneos encontrados no Estado do Ceará. Para tal, nos bancos de dados da Biblioteca Virtual em Saúde (BVS) foi realizada uma busca com associação dos descritores "Doença de Chagas", "Triatomíneos" e "Brasil". Após aplicação dos critérios de inclusão, exclusão e da análise dos seus conteúdos, oito artigos realizados no Estado do Ceará foram selecionados para a análise do estudo. Algumas espécies de triatomíneos encontradas no Nordeste são de extrema importância epidemiológica para o homem, pois estão associadas com domicílios humanos. As espécies mais predominantes com maior importância epidemiológica, com distribuição ampla no Ceará e presente no ambiente peridoméstico foram: Triatoma brasiliensis, Triatoma pseudomaculata, Panstrogylus megistus, Panstrogylus lutzi e Rhodnius nasutus. Várias espécies de triatomíneos tem a capacidade de transmitir Trypanosoma cruzi e de se adaptar com o ambiente peridoméstico e doméstico tornando o homem mais suscetível a infecção, sendo assim necessário estratégias de vigilância e controle do vetor. (AU)

This integrative review aims to analyze the scientific publications in the last twelve years on triatomines found at Ceará State. For this, a search was performed in the Biblioteca Virtual em Saúde (BVS) databases with association of the descriptors "Chagas Disease", "Triatomines" and "Brazil". After applying the inclusion, exclusion criteria and analysis of their content, eight articles were selected for the analysis and discussion. Some species of triatomines found in the Northeast region are of extreme epidemiological importance since they are associated with human households. The most prevalent species with epidemiological importance due to their large distribution in Ceará and presence in the peridomestic environment are: Triatoma brasiliensis, Triatoma pseudomaculata, Panstrogylus megistus, Panstrogylus lutzi and Rhodnius nasutus. Several species of triatomines have the capacity to transmit T. cruzi and the ability to adapt to the peridomestic and domestic environment turning humans more susceptible to infection, thus requiring surveillance and vector control strategies. (AU)

Ocorrência de triatomíneos no Estado do Ceará, Brasil / Occurrence of triatomines in the state of Ceará, Brazil

Esta revisão integrativa tem como objetivo analisar as publicações científicas nos últimos doze anos sobre triatomíneos encontrados no Estado do Ceará. Para tal, nos bancos de dados da Biblioteca Virtual em Saúde (BVS) foi realizada uma busca com associação dos descritores “Doença de Chagas”, “Triatomíneos” e “Brasil”. Após aplicação dos critérios de inclusão, exclusão e da análise dos seus conteúdos, oito artigos realizados no Estado do Ceará foram selecionados para a análise do estudo. Algumas espécies de triatomíneos encontradas no Nordeste são de extrema importância epidemiológica para o homem, pois estão associadas com domicílios humanos. As espécies mais predominantes com maior importância epidemiológica, com distribuição ampla no Ceará e presente no ambiente peridoméstico foram: Triatoma brasiliensis, Triatoma pseudomaculata, Panstrogylus megistus, Panstrogylus lutzi e Rhodnius nasutus. Várias espécies de triatomíneos tem a capacidade de transmitir Trypanosoma cruzi e de se adaptar com o ambiente peridoméstico e doméstico tornando o homem mais suscetível a infecção, sendo assim necessário estratégias de vigilância e controle do vetor.

This integrative review aims to analyze the scientific publications in the last twelve years on triatomines found at Ceará State. For this, a search was performed in the Biblioteca Virtual em Saúde (BVS) databases with association of the descriptors “Chagas Disease”, “Triatomines” and “Brazil”. After applying the inclusion, exclusion criteria and analysis of their content, eight articles were selected for the analysis and discussion. Some species of triatomines found in the Northeast region are of extreme epidemiological importance since they are associated with human households. The most prevalent species with epidemiological importance due to their large distribution in Ceará and presence in the peridomestic environment are: Triatoma brasiliensis, Triatoma pseudomaculata, Panstrogylus megistus, Panstrogylus lutzi and Rhodnius nasutus. Several species of triatomines have the capacity to transmit T. cruzi and the ability to adapt to the peridomestic and domestic environment turning humans more susceptible to infection, thus requiring surveillance and vector control strategies.

Clinical and epidemiological aspects of microcephaly in the state of Piauí, northeastern Brazil, 2015-20166 / Aspectos clínicos e epidemiológicos da microcefalia no Estado do Piauí, Nordeste do Brasil, 2015-2016

Abstract Objectives: To describe aspects of the microcephaly epidemic in the state of Piauí. Methods: All cases of congenital microcephaly confirmed in the state between 2015 and 2016 were included (n = 100). Investigation forms of the Regional Reference Center for Microcephaly were reviewed. Discarded cases (n = 63) were used as a comparison group. Results: In October, November, and December 2015 incidence rates reached 4.46, 6.33 and 3.86/1000 live births, respectively; 44 cases were reported in the state capital. Among the mothers of confirmed and discarded cases, the frequency of skin rash during pregnancy was 50/97 (51.5%) and 8/51 (15.7%), respectively (p < 0.001); 33 confirmed cases (35.9%) had a head circumference z-score between −2 and −3, 23 (25%) between −3 and −4, and 8 (8.7%) had a z-score of less than −4. Head computer tomography scans revealed calcifications in 78/95 (82.1%) cases. Lissencephaly, hydrocephalus and agenesis of the corpus callosum were also frequently observed. Ophthalmic findings included retinal pigment epithelium rarefaction and atrophy. Absence of otoacoustic emissions was observed in 21/70 cases. One newborn also presented lower limb muscle atrophy. There were no significant differences in vaccination rates for influenza, diphtheria-tetanus-acellular pertussis, and hepatitis B in either group. Conclusions: The state of Piauí, like others in the northeastern region, faced an epidemic of congenital microcephaly between 2015 and 2016, presumably related to congenital Zika virus infection, more intense in the capital. Current challenges include the improvement of vector control, basic research, scaling-up of diagnostic tools for pre-natal screening of Zika virus, vaccines, and health care for affected children.

Resumo Objetivos: Descrever os aspectos da epidemia de microcefalia no Estado do Piauí. Métodos: Foram incluídos todos os casos de microcefalia congênita confirmados no estado entre 2015-2016 (n = 100). Os formulários de investigação do Centro Regional de Referência em Microcefalia foram analisados. Os casos descartados (n = 63) foram usados como grupo de comparação. Resultados: Em outubro, novembro e dezembro de 2015, as taxas de incidência atingiram 4,46, 6,33 e 3,86/1.000 nascidos vivos, respectivamente; 44 casos foram relatados na capital do estado. Entre as mães de casos confirmados e descartados, a frequência de erupção cutânea durante a gravidez foi 50/97 (51,5%) e 8/51 (15,7%), respectivamente (p < 0,001); 33 casos confirmados (35,9%) apresentaram um escore z de perímetro cefálico entre -2 e -3, 23 (25%) entre -3 e -4 e 8 (8,7%) apresentaram escore z inferior a -4. As tomografias computadorizadas cerebrais revelaram calcificações em 78/95 (82,1%) dos casos. Lisencefalia, hidrocefalia e agenesia do corpo caloso também foram observadas com mais frequência. Os achados oftalmológicos incluíram rarefação e atrofia do epitélio pigmentar da retina. Foram observadas ausência de emissões otoacústicas em 21/70 casos. Um recém-nascido também apresentou atrofia muscular dos membros inferiores. Não houve diferenças significativas nas taxas de vacinação para gripe, vacina difteria tétano e coqueluche acelular e hepatite B em qualquer grupo. Conclusões: O Estado do Piauí, como outros na região Nordeste, enfrentou, entre 2015 e 2016, uma epidemia de microcefalia congênita, supostamente relacionada à infecção congênita pelo vírus Zika, mais intensa na capital. Os desafios atuais incluem melhora do controle de vetores, pesquisa básica, ampliação de ferramentas de diagnóstico para exame pré-natal do vírus Zika, vacinas e cuidados de saúde para crianças afetadas.

Mitochondrial DNA reveals species composition and phylogenetic relationships of hookworms in northeastern Brazil.

Hookworm infection persists focally in rural communities in Brazil. In this study, we analyze the mitochondrial nucleotide sequences obtained from hookworms infecting humans in order to characterize species composition and assess their genetic diversity and phylogenetic relationships. Field expeditions and cross-sectional surveys were carried out in three Brazilian municipalities from 2013 to 2017: Nossa Senhora de Nazaré (n = 605) and Teresina (n = 297), in the state of Piauí, and Russas (n = 213) in the State of Ceará. Parasitological methods were used to evaluate fecal samples. Hookworm-positive samples had a partial mtDNA cox1 amplified and sequenced. Maximum-likelihood and Bayesian analysis demonstrated two strongly-supported clades, including Group A, corresponding to Necator americanus, and Groups B and C, corresponding to Necator sp. Group A was divided into three main clusters: A1 grouped with Asian sequences, A2 grouped with African sequences, and A3 had only Asian sequences. Group B was closely related to Necator sp., showing a sequence similarity of 98%-99% with African samples circulating zoonotically among humans and non-human primates. Twenty three N. americanus haplotypes were identified. N. americanus Median-Joining network revealed three distinct groups, designated again as A1, A2, and A3. Group A1 presented a star-like shape, with one dominant haplotype. The molecular dating suggested that the two clades dividing N. americanus and Necator sp. began to diverge during the middle Pleistocene. The most recent common ancestor among N. americanus groups was dated to the late Pleistocene. Hookworms circulating in the studied communities are structured in well-defined subpopulations presenting both Asian and African genetic backgrounds. This reveals a double origin for hookworms in northeastern Brazil and opens up new possibilities in phylogeographic, evolutionary, and molecular epidemiological studies in regions where hookworms persists focally, despite control efforts. The presence of potentially zoonotic species and the specific identification of Necator sp. should be further investigated.

Clinical and epidemiological aspects of microcephaly in the state of Piauí, northeastern Brazil, 2015-2016.

OBJECTIVES: To describe aspects of the microcephaly epidemic in the state of Piauí. METHODS: All cases of congenital microcephaly confirmed in the state between 2015 and 2016 were included (n=100). Investigation forms of the Regional Reference Center for Microcephaly were reviewed. Discarded cases (n=63) were used as a comparison group. RESULTS: In October, November, and December 2015 incidence rates reached 4.46, 6.33 and 3.86/1000 live births, respectively; 44 cases were reported in the state capital. Among the mothers of confirmed and discarded cases, the frequency of skin rash during pregnancy was 50/97 (51.5%) and 8/51 (15.7%), respectively (p<0.001); 33 confirmed cases (35.9%) had a head circumference z-score between -2 and -3, 23 (25%) between -3 and -4, and 8 (8.7%) had a z-score of less than -4. Head computer tomography scans revealed calcifications in 78/95 (82.1%) cases. Lissencephaly, hydrocephalus and agenesis of the corpus callosum were also frequently observed. Ophthalmic findings included retinal pigment epithelium rarefaction and atrophy. Absence of otoacoustic emissions was observed in 21/70 cases. One newborn also presented lower limb muscle atrophy. There were no significant differences in vaccination rates for influenza, diphtheria-tetanus-acellular pertussis, and hepatitis B in either group. CONCLUSIONS: The state of Piauí, like others in the northeastern region, faced an epidemic of congenital microcephaly between 2015 and 2016, presumably related to congenital Zika virus infection, more intense in the capital. Current challenges include the improvement of vector control, basic research, scaling-up of diagnostic tools for pre-natal screening of Zika virus, vaccines, and health care for affected children.

Chagasic infection among blood donors in Brazil: an integrative review

ABSTRACT Based on the literature, this work aimed to discuss infection by Chagas disease among blood donors in Brazil. Studies on the prevalence of Trypanosoma cruzi infection in donors or candidates for blood donation in Brazil are important. The prevalence of infection appears to be a sensitive indicator and can be a true marker of the risk of the transmission of Chagas disease by blood transfusion. Moreover, it serves as a marker of the level of transmission of the disease in a region, as well as a tool to characterize the epidemiological profile of individuals affected by the disease. The present study is an integrative review of the literature on chagasic infection among blood donors. An evaluation of the literature identified the epidemiological profile of blood donors infected by T. cruzi, which is characterized in general as men, over 30 years old, with a low level of schooling, low income and mainly coming from rural areas.

Chagasic infection among blood donors in Brazil: an integrative review.

Based on the literature, this work aimed to discuss infection by Chagas disease among blood donors in Brazil. Studies on the prevalence of Trypanosoma cruzi infection in donors or candidates for blood donation in Brazil are important. The prevalence of infection appears to be a sensitive indicator and can be a true marker of the risk of the transmission of Chagas disease by blood transfusion. Moreover, it serves as a marker of the level of transmission of the disease in a region, as well as a tool to characterize the epidemiological profile of individuals affected by the disease. The present study is an integrative review of the literature on chagasic infection among blood donors. An evaluation of the literature identified the epidemiological profile of blood donors infected by T. cruzi, which is characterized in general as men, over 30 years old, with a low level of schooling, low income and mainly coming from rural areas.

Focal persistence of soil-transmitted helminthiases in impoverished areas in the State of Piaui, Northeastern Brazil.

This study aims to describe the prevalence, distribution, and factors associated with soil-transmitted helminthiases (STHs) in rural localities in Piaui, Brazil. Two cross-sectional surveys (n=605 subjects; 172 families) were carried out in order to obtain socio-demographic, anthropometric, spatial and parasitological data. Parasites were evaluated using Kato-Katz and centrifugal sedimentation techniques. Eggs were measured to assess infection with zoonotic Strongylida parasites. Kernel maps were constructed with Q-GIS. The prevalence of hookworm infection was 12.4% (75/605). Other helminthes found were Trichuris trichiura (n=1; 0.2%) and Hymenolepis nana (n=1; 0.2%). The hookworm positivity rate was significantly lower among subjects who had used albendazole when compared with individuals who had not used anthelmintics or had used antiprotozoal drugs in the last 6 months (8/134 [6.0%] vs. 59/415 [14.2%]; p=0.009). A total of 39/172 (22.7%) families had at least one infected member. The association between the number of dwellers and hookworm positivity in the family was present in a logistic regression multivariate model. Assessment of worm burdens showed 92.2% light, 6.2% moderate, and 1.6% heavy infections. Hookworm eggs (n=34) measured 57.2 - 75.4 µm in length and 36.4 - 44.2 µm in width (mean ± SD = 65.86 ± 4.66 µm L and 40.05 ± 1.99 µm W), commensurate with human hookworms. Hotspots suggest that transmission has a focal pattern. STHs persist in impoverished rural areas in Northeastern Brazil where currently available control strategies (mass drug administration) apparently do not allow the elimination of the infection.

Entomological survey in the state of Piauí, Northeastern Brazil, reveals intradomiciliary colonization of Triatoma brasiliensis macromelasoma.

This survey aimed to assess the presence of triatomine vectors of Chagas disease within the rural communities of São João do Piauí, Northeast Brazil. Intradomiciliary and peridomiciliary collection strategies were implemented wherein 279 specimens of Triatoma brasiliensis macromelasoma, both nymph and adult were found in 15 (50%) of the studied homes. Of the intradomiciliary insects, 73 (67.6%) were identified as nymph instars (1st instar [N1]= 6, N2= 14, N3= 28, N4= 7 and N5= 18). In the studied communities, a continuous interaction between triatomine bugs and humans could be shown. It is therefore urgent that suitable strategies for the control of the triatomine vector are implemented in this area.

Entomological survey in the state of Piauí, Northeastern Brazil, reveals intradomiciliary colonization of Triatoma brasiliensis macromelasoma

ABSTRACT This survey aimed to assess the presence of triatomine vectors of Chagas disease within the rural communities of São João do Piauí, Northeast Brazil. Intradomiciliary and peridomiciliary collection strategies were implemented wherein 279 specimens of Triatoma brasiliensis macromelasoma, both nymph and adult were found in 15 (50%) of the studied homes. Of the intradomiciliary insects, 73 (67.6%) were identified as nymph instars (1st instar [N1]= 6, N2= 14, N3= 28, N4= 7 and N5= 18). In the studied communities, a continuous interaction between triatomine bugs and humans could be shown. It is therefore urgent that suitable strategies for the control of the triatomine vector are implemented in this area.

Frequência de estruturas parasitárias em banheiros e salas de aula de escolas públicas de Teresina, Piauí / Frequency of parasitic structures in bathrooms and classrooms in public schools in Teresina - PI, Brazil

No cenário atual, as infecções por helmintos e protozoários estão entre as mais frequentes, apresentando elevadas taxas de prevalência, sobretudo em localidades onde há grande fluxo de pessoas e precárias condições sanitárias. Com base nestas informações, propôs-se a realização de um levantamento das estruturas parasitárias mais frequentes em banheiros e salas de aula de escolas públicas na cidade de Teresina-PI. As coletas foram realizadas em 24 escolas públicas de Teresina, sendo 12 escolas estaduais e 12 municipais. A técnica de swab adaptada para superfícies foi utilizada para a verificação das estruturas parasitárias dos objetos em cada escola. Nas escolas municipais, foram analisadas 105 lâminas, das quais 22 (20,9%) apresentaram algum tipo de estrutura parasitária. Nas escolas da rede estadual de educação, foram analisadas 102 lâminas e, destas, 25 (24,5%) apresentaram positividade para algum tipo de estrutura parasitária. A maior frequência foi de ovos de Ascaris sp. (88,9%), seguidos de cisto de Balantidium sp. (5,6%), ovos de Enterobius sp. (2,8%) e ovos de Taenia sp. (1,9%). Foi encontrado um total de 107 parasitos nas estruturas escolares da rede pública de educação

Frequency and molecular characterisation of Entamoeba histolytica, Entamoeba dispar, Entamoeba moshkovskii, and Entamoeba hartmanni in the context of water scarcity in northeastern Brazil.

This study aimed to estimate the frequency, associated factors, and molecular characterisation of Entamoeba histolytica, Entamoeba dispar, Entamoeba moshkovskii, andEntamoeba hartmanni infections. We performed a survey (n = 213 subjects) to obtain parasitological, sanitation, and sociodemographic data. Faecal samples were processed through flotation and centrifugation methods.E. histolytica, E. dispar, E. moshkovskii, and E. hartmanni were identified by nested-polymerase chain reaction (PCR). The overall prevalence of infection was 22/213 (10.3%). The infection rate among subjects who drink rainwater collected from roofs in tanks was higher than the rate in subjects who drink desalinated water pumped from wells; similarly, the infection rate among subjects who practice open defecation was significantly higher than that of subjects with latrines. Out of the 22 samples positive for morphologically indistinguishableEntamoeba species, the differentiation by PCR was successful for 21. The species distribution was as follows: 57.1% to E. dispar, 23.8% to E. histolytica, 14.3% toE. histolytica and E. dispar, and 4.8% E. dispar and E. hartmanni. These data suggest a high prevalence of asymptomatic infection by the group of morphologically indistinguishable Entamoeba histolytica/dispar/moshkovskiicomplex and E. hartmanni species. In this context of water scarcity, the sanitary and socioenvironmental characteristics of the region appear to favour transmission.

Frequency and molecular characterisation of Entamoeba histolytica, Entamoeba dispar, Entamoeba moshkovskii, and Entamoeba hartmanni in the context of water scarcity in northeastern Brazil

This study aimed to estimate the frequency, associated factors, and molecular characterisation of Entamoeba histolytica, Entamoeba dispar, Entamoeba moshkovskii, andEntamoeba hartmanni infections. We performed a survey (n = 213 subjects) to obtain parasitological, sanitation, and sociodemographic data. Faecal samples were processed through flotation and centrifugation methods.E. histolytica, E. dispar, E. moshkovskii, and E. hartmanni were identified by nested-polymerase chain reaction (PCR). The overall prevalence of infection was 22/213 (10.3%). The infection rate among subjects who drink rainwater collected from roofs in tanks was higher than the rate in subjects who drink desalinated water pumped from wells; similarly, the infection rate among subjects who practice open defecation was significantly higher than that of subjects with latrines. Out of the 22 samples positive for morphologically indistinguishableEntamoeba species, the differentiation by PCR was successful for 21. The species distribution was as follows: 57.1% to E. dispar, 23.8% to E. histolytica, 14.3% toE. histolytica and E. dispar, and 4.8% E. dispar and E. hartmanni. These data suggest a high prevalence of asymptomatic infection by the group of morphologically indistinguishable Entamoeba histolytica/dispar/moshkovskiicomplex and E. hartmanni species. In this context of water scarcity, the sanitary and socioenvironmental characteristics of the region appear to favour transmission.