Experimental Hybrids of the Triatoma brasiliensis Species Complex Show Higher Susceptibility to the Trypanosoma cruzi Infection Than Their Parentals.

The Triatoma brasiliensis species complex is a monophyletic group encompassing two subspecies and six species. Recently, a hybrid zone of members of this complex was recorded in the state of Pernambuco. Questions concerning the capability of the hybrids to become infected with Trypanosoma cruzi have been raised. This study aimed to compare the susceptibility of Triatoma b. brasiliensis, Triatoma juazeirensis, and their experimental hybrids to infection with T. cruzi. We infected the parentals and their experimental hybrids (obtained through reciprocal crosses) through artificial feeding with citrated rabbit blood, to which the TcI 0354 strain of T. cruzi had been added. The insects were weighed before and after feeding on the rabbit blood, and then they were dissected on the 10th, 20th, and 30th day after infection. Both the hybrids and the parentals remained infected throughout the experiment. The parasite was mostly found in the epimastigote form. The number of epimastigotes was significantly lower in the stomach and small intestine of T. juazeirensis than in the hybrids or in T. b. brasiliensis. A significantly higher percentage of metacyclic trypomastigotes was detected in the small intestine and rectum of the hybrids. Hybrids demonstrated higher susceptibility to the TcI 0354 strain than their parentals, opening up new avenues to be investigated.

Anjos da enfermagem: o lúdico como instrumento de cidadania e humanização na saúde / Nursing angels: the playfulness as an instrument of citizenship and humanization in health

Objetivo: identificar a percepção dos acompanhantes e/ou responsáveis quanto à importância dos Anjos daEnfermagem no tratamento para crianças/adolescentes com câncer. Método: estudo descritivo, exploratório,com abordagem quantitativa. Dados coletados a partir de entrevista com 38 acompanhantes e/ouresponsáveis no setor de oncologia de um hospital universitário. A análise e processamento dos dados foramprocessados em computador no programa Microsoft Office Excel e Word 2010, apresentado em e tabelas eanalisados com estatística descritiva. Resultados: quando ao sentimento dos entrevistados após a visita dosAnjos da Enfermagem, (44,73%) disseram sentisse feliz. Todos os acompanhantes (100%) foram unânimes aodizer que as atividades lúdicas desenvolvidas pelo grupo de voluntários agem de forma positiva no tratamentodos pacientes. Conclusão: ao final do estudo, os acompanhantes demonstraram perceber os impactospositivos que as atividades lúdicas desenvolvidas pelos Anjos da Enfermagem trazem para o tratamento docâncer pediátrico, o qual muda completamente a dinâmica familiar e hospitalar.

Mortalidade infantil relacionada a diversos tipos de acidentes por causas externas / Infant mortality related to various types of accidents from external causes

Objetivo: analisar os óbitos por injúrias não intencionais em crianças entre 0 aos 9 anos. Método: estudo transversal, exploratório, descritivo com abordagem quantitativa. A coleta de dados foi realizada por meio deum questionário. Os dados foram analisados no programa Microsoft Office Excel/Word 2010, apresentados em figuras e uma tabela, analisados com estatística descritiva. Resultados: constatou-se que 58% das vítimas eram do sexo masculino e (64%) dos óbitos ocorrem na Região Metropolitana do Recife. Conclusão: os dados encontrados suscitam a necessidade da elaboração de campanhas de orientação para os pais/responsáveis e melhoria de políticas públicas para redução da mortalidade infantil.

Biology of Triatoma sherlocki (Hemiptera: Reduviidae) Under Laboratory Conditions: Biological Cycle and Resistance to Starvation.

Triatoma sherlocki Papa, Jurberg, Carcavallo, Cerqueira & Barata was described in 2002, based on specimens caught in the wild in the municipality of Gentio do Ouro, Bahia, Brazil. In 2009, nymphs and adults were detected inside homes and sylvatic specimens were positive for Trypanosoma cruzi (Chagas). No information on the bionomics of T. sherlocki exists, although such data are considered essential to estimate its vector and colonization potential in domestic environments. Herein, the biological cycle of T. sherlocki was studied based on 123 eggs, with nymphs and adults fed on Mus musculus (Linnaeus). Nymphal development time phases, number of meals consumed, and stage-specific mortality rates were analyzed. Survival time under starvation conditions was measured between ecdysis and death among 50 nymphs (first to fifth instar) and 50 male and female adults. The median development time from egg to adult was 621.0 (CI: 489-656) d. The number of meals consumed ranged from 1 to 20 for nymphs of the first to fifth instar. The fifth instar showed the greatest resistance to starvation, with a mean of 156.5 d. The high number of meals consumed by T. sherlocki favored infection with and transmission of T. cruzi. The full development of this species under laboratory conditions with a low mortality rate indicates that this vector presents biological characteristics that may contribute to its adaptation to artificial human ecotopes. Its high resistance to starvation emphasizes the importance of entomological surveillance for this species.

Triatomine bugs, their microbiota and Trypanosoma cruzi: asymmetric responses of bacteria to an infected blood meal.

BACKGROUND: Triatomine bugs (Hemiptera: Reduviidae) are vectors of the flagellate Trypanosoma cruzi, the causative agent of Chagas disease. The study of triatomine gut microbiota has gained relevance in the last years due to its possible role in vector competence and prospective use in control strategies. The objective of this study is to examine changes in the gut microbiota composition of triatomines in response to a T. cruzi-infected blood meal and identifying key factors determining those changes. RESULTS: We sampled colony-reared individuals from six triatomine vectors (Panstrongylus megistus, Rhodnius prolixus, Triatoma brasiliensis, T. infestans, T. juazeirensis and T. sherlocki) comparing experimentally T. cruzi strain 0354-challenged and non-challenged insects. The microbiota of gut and gonad tissues was characterized using high throughput sequencing of region V3-V4 of bacterial 16S rRNA gene. The triatomine microbiota had a low intra-individual diversity, and a high inter-individual variation within the same host species. Arsenophonous appeared as the dominant triatomine bacterial symbiont in our study (59% of the total 16S coverage), but there were significant differences in the distribution of bacterial genera among vectors. In Rhodnius prolixus the dominant symbiont was Pectobacterium. CONCLUSIONS: Trypanosoma cruzi-challenge significantly affects microbiota composition, with challenged vectors harbouring a significantly more diverse bacterial community, both in the gut and the gonads. Our results show that blood-feeding with T. cruzi epimastigotes strongly affects microbiota composition in a species-specific manner. We suggest that triatomine-adapted enterobacteria such as Arsenophonus could be used as stable vectors for genetic transformation of triatomine bugs and control of Chagas disease.

Perfil das mulheres que realizam a coleta cervicouterina em uma unidade básica de saúde / Profile of women undergoing uterine cervical collection in a basic health unit / El perfil de las mujeres sometidas a la colección de cuello uterino en una unidad básica de salud

Objetivo: identificar o perfil das mulheres que realizam o exame Papanicolau em uma unidade de saúde. Método: estudo descritivo exploratório, com abordagem quantitativa. Os dados foram coletados a partir de entrevistas com 71 mulheres, em uma Unidade de Saúde da Família do Distrito Sanitário VI, localizado no bairro de Brasília Teimosa do Recife/PE. Os dados foram analisados pela estatística descritiva, e apresentados em figuras e tabelas. Resultados: a maioria das mulheres tinha 46 anos ou mais, casadas, ensino médio completo, menarca entre 11 a 14 anos, tiveram início da atividade sexual entre 15 e 19 anos, não faziam uso de contraceptivos e nem de tabaco. Conclusão: o êxito do rastreamento da coleta cervicouterina dependerá da capacitação dos profissionais de saúde da qualidade e continuidade das ações de prevenção e controle da doença.(AU)

Objective: to identify the profile of women undergoing Pap test at a health facility. Method: descriptive exploratory study, with a quantitative approach. Data were collected from interviews with 71 women at a Family Health Unit of the Health District VI, located in the district of Brasília Teimosa in Recife/PE. Data were analyzed using descriptive statistics and presented in figures and tables. Results: most women were 46 years old or older, married, completed high school, menarche between 11 and 14 years, initiated sexual activity between 15 and 19 years, were not using contraceptives or tobacco. Conclusion: the success of tracking uterine cervical collection will depend on the training of health professionals, on the quality and continuity of prevention and disease control.(AU)

Objetivo: identificar el perfil de las mujeres sometidas a la prueba de Papanicolaou en un centro de salud. Método: estudio exploratorio descriptivo con un enfoque cuantitativo. Los datos fueron recogidos a partir de entrevistas con 71 mujeres en una Unidad de Salud de la Familia del Distrito de Salud VI, en el distrito de Brasília Teimosa en Recife/PE. Los datos fueron analizados utilizando estadística descriptiva y se presentan en las figuras y tablas. Resultados: la mayoría de las mujeres tenían 46 años de edad o más, eran casadas, terminaron la escuela secundaria, la menarquia ocurrió entre los 11 y los 14 años, iniciaron la actividad sexual entre los 15 y los 19 años, no estaban usando un método anticonceptivo o tabaco. Conclusión: el éxito de lo rastreo de la colección de cuello uterino dependerá de la formación de los profesionales de la salud, de la calidad y continuidad del control y la prevención de la enfermedad.

A assistência de enfermagem aos portadores de hanseníase assistidos pelo Programa de Saúde da Família / Nursing care for leprosy patients assisted by the Family Health Program / Atención de enfermería a pacientes con lepra atendidos por el Programa de Salud Familiar

Objetivo: analisar a assistência de enfermagem utilizada no atendimento de portadores de hanseníase. Método: estudo retrospectivo, prospectivo, com abordagem quantitativa, realizada em postos de saúde da família no município de Tamandaré/PE, com 60 prontuários do período de 2010 a 2014 e 14 profissionais de enfermagem. A coleta de dados foi realizada com um questionário e analisados no software SSPS, Excel, apresentados em tabelas. Resultados: constatou-se que a assistência de enfermagem no combate e controle da hanseníase, onde 93% dos entrevistados mencionaram a consulta de enfermagem sendo a metodologia mais importante realizada nesta unidade de saúde. Conclusão: o índice de portadores de hanseníase existente no programa de saúde é pouco expressivo segundo o Ministério da Saúde, entretanto merece a devida atenção e rever o papel da promoção e prevenção de enfermagem em relação doença.(AU)

Objective: analyze the nursing care used in the care of leprosy patients. Method: retrospective, prospective study, with a quantitative approach, carried out in family health centers in the municipality of Tamandaré/PE, with 60 records from 2010 to 2014 and 14 nursing professionals. Data collection was performed with a questionnaire and analyzed using SPSS software, Excel, presented in tables. Results: one found that nursing care to combat and control Hansen's disease, where 93% of respondents mentioned that nursing consultation is the most important method performed in this health unit. Conclusion: the index of existing leprosy patients in the health program is little expressive according to the Ministry of Health; however, it deserves due attention and review of the role of nursing promotion and prevention in relation to the disease.(AU)

Objetivo: analizar los cuidados de enfermería utilizados en el cuidado de los enfermos de lepra. Método: Estudio retrospectivo, prospectivo, de enfoque cuantitativo, llevado a cabo en los centros de salud de la familia en el municipio de Tamandaré/PE, con 60 registros de 2010 a 2014 y 14 profesionales de enfermería. La recolección de datos se realizó con un cuestionario y fueron analizados utilizando el software SPSS, Excel, y presentados en las tablas. Resultados: se encontró que los cuidados de enfermería para combatir y control de la lepra, donde el 93% de los entrevistados mencionaron que la consulta de enfermería es el método más importante realizado en esta unidad de salud. Conclusión: el índice de enfermos de lepra existentes en el programa de salud es poco expresivo de acuerdo con el Ministerio de Salud; sin embargo, merece la debida atención y revisión del papel de promoción y prevención de enfermería en relación a la enfermedad.(AU)

Revalidation and redescription of Triatoma brasiliensis macromelasoma Galvão, 1956 and an identification key for the Triatoma brasiliensis complex (Hemiptera: Reduviidae: Triatominae).

Triatoma brasiliensis macromelasoma is revalidated based on the results of previous multidisciplinary studies on the Triatoma brasiliensis complex, consisting of crossing experiments and morphological, biological, ecological and molecular analyses. These taxonomic tools showed the closest relationship between T. b. macromelasoma and Triatoma brasiliensis brasiliensis. T. b. macromelasoma is redescribed based on specimens collected in the type locality and specimens from a F1 colony. The complex now comprises T. b. brasiliensis, T. b. macromelasoma, Triatoma melanica, Triatoma juazeirensis and Triatoma sherlocki. An identification key for all members of the complex is presented. This detailed comparative study of the morphological features of T. b. macromelasoma and the remaining members of the complex corroborates results from multidisciplinary analyses, suggesting that the subspecific status is applicable. This subspecies can be distinguished by the following combination of features: a pronotum with 1+1 narrow brownish-yellow stripes on the submedian carinae, not attaining its apex, hemelytra with membrane cells darkened on the central portion and legs with an incomplete brownish-yellow ring on the apical half of the femora. Because the T. brasiliensis complex is of distinct epidemiological importance throughout its geographic distribution, a precise identification of its five members is important for monitoring and controlling actions against Chagas disease transmission.

Revalidation and redescription of Triatoma brasiliensis macromelasoma Galvão, 1956 and an identification key for the Triatoma brasiliensis complex (Hemiptera: Reduviidae: Triatominae)

Triatoma brasiliensis macromelasoma is revalidated based on the results of previous multidisciplinary studies on the Triatoma brasiliensis complex, consisting of crossing experiments and morphological, biological, ecological and molecular analyses. These taxonomic tools showed the closest relationship between T. b. macromelasoma and Triatoma brasiliensis brasiliensis. T. b. macromelasoma is redescribed based on specimens collected in the type locality and specimens from a F1 colony. The complex now comprises T. b. brasiliensis, T. b. macromelasoma, Triatoma melanica, Triatoma juazeirensis and Triatoma sherlocki. An identification key for all members of the complex is presented. This detailed comparative study of the morphological features of T. b. macromelasoma and the remaining members of the complex corroborates results from multidisciplinary analyses, suggesting that the subspecific status is applicable. This subspecies can be distinguished by the following combination of features: a pronotum with 1+1 narrow brownish-yellow stripes on the submedian carinae, not attaining its apex, hemelytra with membrane cells darkened on the central portion and legs with an incomplete brownish-yellow ring on the apical half of the femora. Because the T. brasiliensis complex is of distinct epidemiological importance throughout its geographic distribution, a precise identification of its five members is important for monitoring and controlling actions against Chagas disease transmission.

Cross-mating experiments detect reproductive compatibility between Triatoma sherlocki and other members of the Triatoma brasiliensis species complex.

Phylogenetic approaches based on mitochondrial DNA variation (fragments of Cyt B and 16S ribosomal RNA) have revealed Triatoma sherlocki as the most recent species addition to the Triatoma brasiliensis species complex; a monophyletic group which includes T. brasiliensis, Triatoma melanica, and Triatoma juazeirensis. T. sherlocki is the most differentiated among all species of this complex: it is unable to fly, possesses longer legs than the other members, and has reddish tonality in some parts of its exochorion. We question whether these species are reproductively compatible because of this pronounced morphological differentiation, and therefore, we present a series of cross breeding experiments that test compatibility between T. sherlocki and other members of the T. brasiliensis complex. We extended our analyses to include crosses between T. sherlocki and Triatoma lenti, because the latter has been suggested as a possible member of this complex. T. sherlocki male×T. lenti female pairs failed to produce hybrids. All other crosses of T. sherlocki and members of T. brasiliensis species complex, as well as backcrosses, produced viable offspring through the third generation. This study stresses the importance of searching for the features that may isolate members of the T. brasiliensis species complex.

Dispersion capacity of Triatoma sherlocki, Triatoma juazeirensis and laboratory-bred hybrids.

Flight dispersion is recognized as one of the most important mechanisms for triatomine house infestation. Triatoma sherlocki and T. juazeirensis are closely related species that occur within the same ecotope and their possible reproductive boundaries are unknown. T. sherlocki has shorter wings than T. juazeirensis; a characteristic that possibly implies in reduced flight dispersion, however, this species has been found to invade and colonize homes in Bahia, Brazil. Here, we tested the flight potential of T. sherlocki, compared to that of T. juazeirensis and laboratory-bred hybrids. Insects were kept in an apparatus designed to distinguish flyers from nonflyers. Fifty-one and 53% of T. juazeirensis and hybrids were flyers respectively, whereas no T. sherlocki were recorded to fly. Morphometric analysis of the main structures associated with the locomotor abilities showed that hybrids exhibited intermediate size for most of characters. The width of pronotum of both hybrids and T. juazeirensis was significantly larger than T. sherlocki. We suggested that lack of flight ability of T. sherlocki is possibly a result of reduced wing size and distinct shape, combined with undeveloped flight muscles in a shorter thoracic box. The mobility of T. sherlocki might be compensated by its significantly longer legs, and may possibly increase its ability to invade human dwellings by active dispersion. What is more, this study showed that hybrids between T. sherloki and T. juazeirensis have intermediate morphological characters that may give them higher fitness than their parents, and thus may advance the process of house infestation by either fight or walking in case of an eventual natural hybridization.