Serological evidence of Bartonellosis in an indigenous community in the Brazilian Legal Amazonia.

BACKGROUND: Due to immunological susceptibility, close contact with the environment and way of life, indigenous communities are in a highly vulnerable condition to be affected by zoonoses, such as bartonellosis. METHODS: Seventy three paired serum samples were collected from indigenous people from a region of the Brazilian Legal Amazon, in cohorts carried out in 2014 and 2015, with the performance of serological tests by indirect immunofluorescence to detect anti-Bartonella IgG antibodies. The interviews and laboratory results were double entered in the EpiInfo 7 software, and the data processing was performed in the MiniTab 17 software. RESULTS: 5.47% of the indigenous people were seroreagent. The female gender was predominant (65.75%), aged between 20 and 39 years old (39.73%) with complete elementary school (42.47%). As for housing, wooden residences predominated (50.68%). Rodents were seen by 46.58% of the interviewees, and 55.88% of them reported that the animal was close to or inside the house. It was identified that each indigenous family, in its majority, had four to six cats, for the function of hunters of rodents. CONCLUSION: The high concentration of domestic cats, the close contact of indigenous people with wild rodents and the lack of care and poor hygiene of both are aspects that imply the possibility of infection by Bartonella sp. Health surveillance through seroepidemiological studies is essential to find evidence of the circulation of bartonellosis in these populations.

Exposure to pesticides and acute intoxication in a region of intense agricultural production in Mato Grosso, Brazil, 2013. / Exposição aos agrotóxicos e intoxicações agudas em região de intensa produção agrícola em Mato Grosso, 2013.

OBJECTIVE: to estimate the prevalence of acute poisoning by pesticides and associated factors in Mato Grosso, Brazil. METHODS: this was a cross-sectional study, the outcome of which was acute intoxication in the month prior to the interview, as diagnosed by a physician; multivariate analysis was performed using Poisson regression. RESULTS: we interviewed 753 individuals; acute intoxication occurred at a rate of 17%; the main associated factors were living near plantations (PR=2.81 - 95%CI 1.79;4.41), having incomplete high school education or less (PR=1.80 - 95%CI 1.22;2.71), living less than 500 meters from maize crops (PR=1.57 - 95%CI 1.05;2.35) and cotton plantations (PR=1.43 - 95%CI 1.02;2.02). CONCLUSION: Individuals living near to corn and cotton plantations reported higher occurrence of acute intoxication.

Natural transovarial transmission of dengue virus 4 in Aedes aegypti from Cuiabá, State of Mato Grosso, Brazil.

INTRODUCTION: Dengue is the most prevalent arboviral disease in tropical areas. In Mato Grosso, outbreaks are reported every year, but studies on dengue in this state are scarce. METHODS: Natural transovarial infection of Aedes aegypti by a flavivirus was investigated in the Jardim Industriário neighborhood of Cuiabá, Mato Grosso. Eggs were collected with ovitraps during the dry, intermediate, and rainy seasons of 2012. After the eggs hatched and the larvae developed to adulthood, mosquitoes (n = 758) were identified and allocated to pools of 1-10 specimens according to the collection location, sex, and climatic period. After RNA extraction, multiplex semi-nested RT-PCR was performed to detect the four dengue virus (DENV) serotypes, yellow fever virus, West Nile virus and Saint Louis encephalitis virus. RESULTS: DENV-4 was the only flavivirus detected, and it was found in 8/50 pools (16.0%). Three of the positive pools contained females, and five contained males. Their nucleotide sequences presented 96-100% similarity with DENV-4 genotype II strains from Manaus, Amazonas. The minimum infection rate was 10.5 per 1000 specimens, and the maximum likelihood estimator of the infection rate was 11.6 (95% confidence interval: 4.8; 23.3). CONCLUSIONS: This study provides the first evidence of natural transovarial infection by DENV-4 in Ae. Aegypti in Mato Grosso, suggesting that this type of infection might serve as a mechanism of virus maintenance during interepidemic periods in Cuiabá, a city where dengue epidemics are reported every year. These results emphasize the need for efficient vector population control measures to prevent arbovirus outbreaks in the state.

Natural transovarial transmission of dengue virus 4 in Aedes aegypti from Cuiabá, State of Mato Grosso, Brazil

INTRODUCTION: Dengue is the most prevalent arboviral disease in tropical areas. In Mato Grosso, outbreaks are reported every year, but studies on dengue in this state are scarce. METHODS: Natural transovarial infection of Aedes aegypti by a flavivirus was investigated in the Jardim Industriário neighborhood of Cuiabá, Mato Grosso. Eggs were collected with ovitraps during the dry, intermediate, and rainy seasons of 2012. After the eggs hatched and the larvae developed to adulthood, mosquitoes (n = 758) were identified and allocated to pools of 1-10 specimens according to the collection location, sex, and climatic period. After RNA extraction, multiplex semi-nested RT-PCR was performed to detect the four dengue virus (DENV) serotypes, yellow fever virus, West Nile virus and Saint Louis encephalitis virus. RESULTS: DENV-4 was the only flavivirus detected, and it was found in 8/50 pools (16.0%). Three of the positive pools contained females, and five contained males. Their nucleotide sequences presented 96-100% similarity with DENV-4 genotype II strains from Manaus, Amazonas. The minimum infection rate was 10.5 per 1000 specimens, and the maximum likelihood estimator of the infection rate was 11.6 (95% confidence interval: 4.8; 23.3). CONCLUSIONS: This study provides the first evidence of natural transovarial infection by DENV-4 in Ae. Aegypti in Mato Grosso, suggesting that this type of infection might serve as a mechanism of virus maintenance during interepidemic periods in Cuiabá, a city where dengue epidemics are reported every year. These results emphasize the need for efficient vector population control measures to prevent arbovirus outbreaks in the state. .

Avaliação da assistência pré-natal em unidades selecionadas de Saúde da Família de município do Centro-Oeste brasileiro, 2008-2009* / Evaluation of antenatal care in selected Family Health Centres in a Midwest Brazilian municipality, 2008-2009

Objetivo: avaliar a implementação da assistência pré-natal em unidades de Saúde da Família (SF) no município de Cuiabá-MT, Brasil. Métodos: estudo de avaliação normativa, com estratégia de pesquisa de estudo de caso realizado em duas unidades de SF – caso I e caso II –; adotou-se a dimensão de conformidade do pré-natal ao Programa de Humanização no Pré-natal e Nascimento (PHPN); utilizaram-se parâmetros para classificação do grau de implementação – implementado (≥80 por cento), parcialmente implementado (40 a 79,9 por cento) e implementação crítica (<40 por cento). Resultados: participaram do estudo 69 gestantes; 19/30 (caso I) e 17/39 (caso II) tiveram seis ou mais consultas de pré-natal; 27/30 (caso I) e 10/39 (caso II) tiveram VDRL realizado na 1ª consulta; os casos I e II apresentaram, respectivamente, 67,9 por cento e 64,3 por cento de implementação no elemento ‘insumo’, e 69,7 por cento e 70,0 por cento no elemento ‘atividade’. Conclusão: a assistência pré-natal apresentou implementação parcial nos dois casos, sinalizando necessidade de melhorar sua qualidade.

Objective: to evaluate antenatal care implementation in Family Health (FH) facilities in Cuiabá/MT. Methods: normative evaluation study using two FH centres as case studies (Case I and Case II). The extent of antenatal compliance was evaluated according to Antenatal and Birth Humanization Program standards. Degree of implementation was classified using the following parameters: Implemented: ≥80%; Partially implemented: 40 per cent-79.9 per cent; Implementation Critical: <40 per cent. Differences between cases were checked using Fisher’s exact test. Results: 69 pregnant women were recruited. 19/30 (Case I) and 17/39 (Case II) had six or more antenatal consultations. 27/30 (Case I) and 10/39 (Case II) had VDRL screening at the 1st consultation. Case I had 67.9 per cent ‘input’ implementation and 69.7 per cent ‘activity’ implementation. Case II had 64.3 per cent and 70 per cent, respectively. Conclusion: antenatal care was partially implemented in both cases, indicating the need to adopt measures to improve its quality.

Vigilância epidemiológica no plano de intensificação das ações de controle de malária no estado de Mato Grosso: estudo de caso / Epidemiologic surveillance in the plan for intensification of malaria control actions in the state of Mato Grosso: a case study

Este estudo tem como objetivo analisar a vigilância epidemiológica no Plano de Intensificação das Ações de Controle de Malária (PIACM), nos dezoito municípios mato-grossenses, de 1999 a 2002. Realizou-se uma pesquisa avaliativa do tipo análise de implantação. A análise foi realizada através do Modelo Lógico de Avaliação, considerando quatro dimensões de análise - contexto externo e político, contexto organizacional, implementação e efetividade - e cinco bases de evidências, sendo três de dados primários e os outros secundários. Os municípios foram denominados de CASOS. Os dados foram coletados por questionários semi-estruturados. A implementação das ações do PIACM apresentou-se adequada apenas em 5,6 por cento dos CASOS. A efetividade das ações em apenas um CASO e nenhum CASO teve condição adequada nas características contextuais. Os fatores que mais influenciaram a implementação foram: rotatividade dos gestores municipais e profissionais de saúde; capacitação fragmentada e esporádica; promoção e prevenção à saúde limitada aos profissionais da atenção básica. Conclui-se que a vigilância epidemiológica, no PIACM, mostrou-se desarticulada, com problemas de ordem estrutural, o que vem dificultando o pleno desenvolvimento das ações.

The objective of this study is to analyze the epidemiologic surveillance in the Malaria Control Actions Intensification Plan (PIACM) in the 18 cities of the state of Mato Grosso, from 1999 to 2002. An evaluative research of the type implantation analysis was conducted. The analysis was carried out using a logic model considering 4 dimensions - external and political context, organizational context, implementation and effectiveness - and 5 evidence bases, 3 of primary data and 2 of secondary data. The cities are called CASE. The data were collected using semi-structured questionnaires. The implementation of the PIACM actions was found adequate in only 5,6 percent of CASES. The effectiveness of the actions was adequate in only one CASE and none of the CASES showed adequate contextual characteristics. The principal factors affecting the implementation were: frequent changes of the local health managers and professionals, fragmented and sporadic training and health promotion and prevention actions limited to the primary care team. In conclusion, structural problems and lack of articulation of epidemiologic surveillance hamper the full development of the PIACM actions.

Introdução à Estatística Espacial para a Saúde Pública

O livro pretende ir além dos mapas coropléticos (temáticos), mostrando ao leitor os primeiros passos dos pressupostos estatísticos nas abordagens espaciais. As técnicas estatísticas apresentadas ampliam as análises de modo a permitir a realização de inferências e de testes de hipóteses geradas pelos profissionais de saúde pública para responder questões sobre a distribuição de eventos no seu dia-a-dia. O livro pertence a série: Textos básicos em saúde e Capacitação e atualização em geoprocessamento em saúde (v. 3).