First report of Rhodnius stali Lent, Jurberg & Galvão, 1993 (Hemiptera: Reduviidae: Triatominae), vector of Trypanosoma cruzi (TcI) and Trypanosoma rangeli (TrA), in Rondônia, Southwestern Brazilian Amazonia.

Triatomines are hematophagous insects of epidemiological importance as they are vectors of Chagas disease. The first report of Rhodnius stali Lent, Jurberg & Galvão, 1993 in Rondônia, Brazil, is described. The insects were captured on palm trees of the genus Oenocarpus sp. Two adult male specimens of R. stali were identified and were found to be infected with Trypanosoma cruzi and Trypanosoma rangeli. The confirmation of this Rhodnius species in Rondônia increases the number of triatomines from nine to ten species in this state.

Monitoring the Establishment of VOC Gamma in Minas Gerais, Brazil: A Retrospective Epidemiological and Genomic Surveillance Study.

Since its first identification in Brazil, the variant of concern (VOC) Gamma has been associated with increased infection and transmission rates, hospitalizations, and deaths. Minas Gerais (MG), the second-largest populated Brazilian state with more than 20 million inhabitants, observed a peak of cases and deaths in March-April 2021. We conducted a surveillance study in 1240 COVID-19-positive samples from 305 municipalities distributed across MG's 28 Regional Health Units (RHU) between 1 March to 27 April 2021. The most common variant was the VOC Gamma (71.2%), followed by the variant of interest (VOI) zeta (12.4%) and VOC alpha (9.6%). Although the predominance of Gamma was found in most of the RHUs, clusters of Zeta and Alpha variants were observed. One Alpha-clustered RHU has a history of high human mobility from countries with Alpha predominance. Other less frequent lineages, such as P.4, P.5, and P.7, were also identified. With our genomic characterization approach, we estimated the introduction of Gamma on 7 January 2021, at RHU Belo Horizonte. Differences in mortality between the Zeta, Gamma and Alpha variants were not observed. We reinforce the importance of vaccination programs to prevent severe cases and deaths during transmission peaks.

Reason for referrals to neurology: a community-based study in Brazil / Motivos de derivación a neurología: un estudio de base comunitaria en Brasil / Motivos de encaminhamentos para neurologia: um estudo de base comunitária no Brasil

Objective:to quantify the reasons for referrals of primary care physicians to neurology in Belo Horizonte, Brazil. Method:cross-sectional study evaluating referrals from Primary Care to the specialty of Neurology in Belo Horizonte, registered in the NOVO SISREG regulatory system, from March 2019 to July 2020. Neurologists or family physicians from the Regula Mais Brasil project, with experience in referral protocols for neurology, carried out the evaluation of the main diagnoses. Results:13,844 referrals to neurology were identified, with an average of 814.35 referrals per month. Headache, epilepsy and cerebrovascular disorders were the most common reasons, accounting for 55.5% of referrals. Other neurological conditions identified less frequently were parkinsonism, tremor, syncope and vertigo, responsible for 10.9% of referrals. Conclusion:most referrals did not prioritize only neurology expertise. It is possible that cultural aspects and the routine of physicians, health services and the community itself determined these referrals, raising awareness about the high demand, waiting time and possible clinical conditions that are soon ceasing to be managed by other specialties that also share these skills.

Objetivo:cuantificar los motivos de derivación de médicos de atención primaria a neurología en Belo Horizonte, Brasil. Método:estudio transversalque evaluó las derivaciones de la Atención Primaria a la especialidad de Neurología en Belo Horizonte, registradas en el sistema regulatorio NOVO SISREG, de marzo de 2019 a julio de 2020. Neurólogos o médicos de familia del proyecto Regula Mais Brasil, con experiencia en protocolos de derivación para neurología, realizó la evaluación de los principales diagnósticos. Resultados:se identificaron 13.844 derivaciones a neurología, con una media de 814,35 derivaciones al mes. La cefalea, la epilepsia y los trastornos cerebrovasculares fueron los motivos más frecuentes, representando el 55,5% de las derivaciones. Otras condiciones neurológicas identificadas con menor frecuencia fueron parkinsonismo, temblor, síncope y vértigo, responsables del 10,9% de las derivaciones. Conclusión: la mayoría de las referencias no priorizaron solo la experiencia en neurología. Es posible que los aspectos culturales y la rutina de los médicos, los servicios de salud y la propia comunidad determinaran estas derivaciones, concientizando sobre la alta demanda, tiempo de espera y posibles cuadros clínicos que pronto están dejando de ser manejados por otras especialidades que también comparten estas habilidades.

Objetivo:quantificar os motivos de encaminhamentos de médicos da Atenção Primária para neurologia em Belo Horizonte, Brasil. Método:estudo transversal com avaliação de encaminhamentos da Atenção Básica para especialidade de Neurologia em Belo Horizonte, registrados no sistema de regulação NOVO SISREG, no periodo de março de 2019 a julho de 2020. Neurologistas ou médicos de família do projeto Regula Mais Brasil, com experiência em protocolos de encaminhamentos para neurologia, realizaram a avaliação dos principais diagnósticos. Resultados:foram identificados 13.844 encaminhamentos para neurologia, com uma média de 814,35 encaminhamentos por mês. Cefaleia, epilepsia e distúrbios cerebrovasculares foram os motivos mais comuns, representando 55,5% dos encaminhamentos. Outras condições neurológicas identificadas em menor frequência foram o parkinsonismo, tremor, síncope e vertigem, responsáveispor 10,9% dos encaminhamentos. Conclusão:a maioria dos encaminhamentos não priorizou somente a expertise da neurologia. É possível que aspectos culturais e a rotina de médicos, serviços de saúde e da própria comunidade determinaram esses encaminhamentos, ascendendo alerta quanto a alta demanda, tempo de espera e possíveis condições clínicas que estão deixando de ser brevemente manejadas por outras especialidades que também compartilham dessas competências.

Molecular characterization of a new SARS-CoV-2 recombinant cluster XAG identified in Brazil.

Recombination events have been described in the Coronaviridae family. Since the beginning of the SARS-CoV-2 pandemic, a variable degree of selection pressure has acted upon the virus, generating new strains with increased fitness in terms of viral transmission and antibody scape. Most of the SC2 variants of concern (VOC) detected so far carry a combination of key amino acid changes and indels. Recombination may also reshuffle existing genetic profiles of distinct strains, potentially giving origin to recombinant strains with altered phenotypes. However, co-infection and recombination events are challenging to detect and require in-depth curation of assembled genomes and sequencing reds. Here, we present the molecular characterization of a new SARS-CoV-2 recombinant between BA.1.1 and BA.2.23 Omicron lineages identified in Brazil. We characterized four mutations that had not been previously described in any of the recombinants already identified worldwide and described the likely breaking points. Moreover, through phylogenetic analysis, we showed that the newly named XAG lineage groups in a highly supported monophyletic clade confirmed its common evolutionary history from parental Omicron lineages and other recombinants already described. These observations were only possible thanks to the joint effort of bioinformatics tools auxiliary in genomic surveillance and the manual curation of experienced personnel, demonstrating the importance of genetic, and bioinformatic knowledge in genomics.

First report of Rhodnius montenegrensis (Hemiptera: Reduviidae: Triatominae) in Bolivia.

BACKGROUND: The subfamily Triatominae, which comprises 157 species, carries the protozoan Trypanosoma cruzi, the etiological agent of Chagas disease. This short communication reports for the first time the occurrence of Rhodnius montenegrensis in Bolivia. METHODS: Active searches were carried out on palm trees of the genus Oenocarpus in Beni district, Bolivia. RESULTS: Fifteen R. montenegrensis specimens were collected from a rural area of the Beni district, Bolivia, and tested positive for T. cruzi. CONCLUSIONS: This new report expands the geographic distribution of the species in Latin America. Due to their ability to transmit trypanosomatids, the species deserves the attention of vector control programs.

First report of Rhodnius montenegrensis (Hemiptera: Reduviidae: Triatominae) in Bolivia

ABSTRACT Background: The subfamily Triatominae, which comprises 157 species, carries the protozoan Trypanosoma cruzi, the etiological agent of Chagas disease. This short communication reports for the first time the occurrence of Rhodnius montenegrensis in Bolivia. Methods: Active searches were carried out on palm trees of the genus Oenocarpus in Beni district, Bolivia. Results: Fifteen R. montenegrensis specimens were collected from a rural area of the Beni district, Bolivia, and tested positive for T. cruzi. Conclusions: This new report expands the geographic distribution of the species in Latin America. Due to their ability to transmit trypanosomatids, the species deserves the attention of vector control programs.

First report of Rhodnius montenegrensis (Hemiptera, Reduviidae, Triatominae) in Amazonas, Brazil.

INTRODUCTION: Triatomines are hematophagous insects of epidemiological importance because they are vectors of Chagas disease. We present here the first report of Rhodnius montenegrensis in Amazonas, Brazil. METHODS: Triatomines were collected from Attalea butyracea palm trees in the municipality of Guajará. RESULTS: Two adult female R. montenegrensis specimens were identified. CONCLUSIONS: The present study confirms that the number of triatomine species within the Amazon has increased from 10 to 11, and the number of Brazilian states with R. montenegrensis has increased from two to three.

First report of Rhodnius montenegrensis (Hemiptera, Reduviidae, Triatominae) in Amazonas, Brazil

Abstract INTRODUCTION: Triatomines are hematophagous insects of epidemiological importance because they are vectors of Chagas disease. We present here the first report of Rhodnius montenegrensis in Amazonas, Brazil. METHODS: Triatomines were collected from Attalea butyracea palm trees in the municipality of Guajará. RESULTS: Two adult female R. montenegrensis specimens were identified. CONCLUSIONS: The present study confirms that the number of triatomine species within the Amazon has increased from 10 to 11, and the number of Brazilian states with R. montenegrensis has increased from two to three.

Epidemiological overview of chagas disease in the state of Amazonas, from 2004 to 2014 / Panorama epidemiológico da doença de chagas no estado do Amazonas, no período de 2004 a 2014 / Panorama epidemiológico de la enfermedad de chagas en el estado de Amazonas, en el período de 2004 a 2014

Justificativa e Objetivos: A doença de Chagas (DC), causada pelo Trypanosma cruzi, protozoário flagelado, descoberto a mais de 100 anos, sendo ela difundida nas américas, principalmente na américa do Sul, acometendo milhões de pessoas pelo mundo. É cada vez mais crescente o número de indivíduos acometidos com a DC na região da Amazônia Ocidental e estão relacionados a diversos fatores, porém o consumo de bebida contaminada é a principal parcela de contribuição para a elevação nos registros da doença na região. Este estudo tem como objetivo descrever e analisar o panorama epidemiológico da doença de Chagas no estado do Amazonas de 2004 a 2014. Métodos: Trata-se de um estudo ecológico, onde foram utilizados somente dados secundários obtidos do Sinan referentes aos casos notificados de infecção por T. cruzi em todo o estado do Amazonas. Resultados: Constatou-se que no período de 2004 a 2014 que no estado do Amazonas ocorreram um total de 100 casos de DC, tendo maior ocorrência nos anos de 2007 e 2010, durante os meses de abril e dezembro, com maior frequência da faixa etária de 20-39 e no gênero feminino. Conclusão: Constatou-se a necessidade de implementar um serviço de controle epidemiológico eficaz para monitoramento da via de transmissão DC e de seus vetores, pois trata-se de um problema de saúde pública que pode estar ligada a determinantes sociais e culturais, sendo indicado a promoção de atividades educativas para a conscientização da comunidade a respeito desta enfermidade.(AU)

Background and Objectives: Chagas disease (CD), caused by Trypanosoma cruzi, a flagellate protozoan, was discovered over 100 years ago, spread throughout the Americas, mainly in South America, affecting millions of people around the world. CD affects several people in the Western Region of Amazonia, with increasingly frequent numbers due to several factors that contribute to the increase of cases in the region. but the consumption of contaminated drink is the main way of transmission of the disease in the region. This study aims to describe and analyze the epidemiological panorama of Chagas disease in the state of Amazonas, from 2004 to 2014. Methods: This is an ecological study, where only secondary data obtained from Sinan referring to reported cases of T. cruzi infection in the entire state of Amazonas were used. Results: a total of 100 cases of CD were reported in the state of Amazonas, from 2004 to 2014, , with a higher occurrence in 2007 and 2010, during April and December, with a higher frequency in the 20-39 age group and in women. Conclusion: the need to implement an effective epidemiological control service to monitor the CD transmission route and its vectors was identified, because it is a public health problem that may be linked to social and cultural determinants. The promotion of educational activities to raise awareness of the community of this disease.(AU)

Justificación y Objetivos: La enfermedad de Chagas (EC), causada por Trypanosoma cruzi, protozoario flagelado, descubierto hace más de 100 años, siendo difundida principalmente en América del Sur, afectando a millones de personas por el mundo. EC está afectando varias personas en la Amazonía Occidental con cifras cada vez más frecuentes debido a varios factores que contribuyen a la elevación en los casos en la región, uno de los principales es la forma oral. Este estudio analizó el panorama epidemiológico de la EC en el estado de Amazonas, de 2004-2014. Métodos: Se trata de un estudio poblacional, retrospectivo y descriptivo ejecutando colecta y análisis de datos referentes a los casos relatados de infección por T. cruzi en, el estado de Amazonas, datos secundarios provenientes del Sistema de Información de Agravios de Notificación del Sistema Único de Salud, través del Banco de Datos del Sistema Único de Salud. Resultados: Se constató que de 2004-2014 en el estado de Amazonas ocurrieron un total de 100 casos de EC, teniendo mayor ocurrencia en los años de 2007-2010, durante los meses de abril y diciembre, con mayor frecuencia del grupo de edad de 20-39 y en género femenino. Conclusiones: Se constató la necesidad de implementar un servicio de control epidemiológico eficaz para monitoreo de la vía de transmisión EC y de sus vectores, pues se trata de un problema de salud pública que puede estar vinculada a determinantes sociales y culturales, promoción de actividades educativas para la concientización de la comunidad acerca de esta enfermedad.(AU)

Retrospective study of the epidemiological overview of the transmission of Chagas disease in the State of Acre, South-Western Amazonia, from 2009 to 2016

INTRODUCTION: Chagas disease (CD), also known as American Trypanosomiasis, is an infectious parasitic disease caused by the etiologic agent Trypanosoma cruzi. It is considered endemic in the low-income population and is classified by the WHO as a neglected tropical disease. In the state of Acre, there is almost no scientific data regarding the epidemiology of CD, even though the first autochthonous case was registered in the 1980s OBJECTIVE: To analyze the epidemiological panorama of the transmission of Chagas disease in the State of Acre, Brazil, from 2009 to 2016 METHODS: A survey of the occurrence of Chagas disease in the State of Acre was performed using public domain secondary data from the Brazil's Notifiable Diseases Information System of SUS (publicly funded health care system), and from the SUS Database of the Health Surveillance Foundation of the State of Acre. Data were collected from the following variables: gender, age group, form of contagion, distribution by region and municipality, perimeter and seasonality RESULT: Forty-two cases of CD were confirmed, with an increase of more than 300% from 2015 to 2016 and a frequency coefficient of 3.06 cases per 100,000 people, and in the Tarauacá/Envira region, the probability of a person contracting CD was 600% higher than the state mean CONCLUSION: We found that in the state of Acre, in the period from 2009 to 2016, most cases of CD occurred in 2016, in the Tarauacá/Envira region, mainly in the municipality of Feijó, in the rural zone, from July to October, in the age group of 0 to 30 years, being the oral form the main route of transmission and presenting no statistical difference between men and women

INTRODUÇÃO: A doença de Chagas (DC), também conhecida como Tripanossomíase Americana, é uma doença infecciosa e parasitária, causada pelo agente etiológico Trypanosoma cruzi, sendo considerada endêmica em população de baixa renda e classificada pela Organização Mundial da Saúde como uma doença tropical negligenciada. No estado do Acre, quase não há dados científicos sobre a epidemiologia da DC, embora o primeiro caso autóctone tenha sido registrado na década de 1980 OBJETIVO: Analisar o panorama epidemiológico da transmissão da DC no Estado do Acre, no período de 2009 a 2016 MÉTODO: O levantamento da ocorrência da DC no Estado do Acre foi realizado utilizando dados secundários de domínio público do Sistema de Informação de Agravos de Notificação do SUS e do Banco de Dados do SUS da Fundação de Vigilância Sanitária do Estado do Acre. Foram coletados dados das seguintes variáveis: sexo, faixa etária, forma de contágio, distribuição por região e município, perímetro e sazonalidade RESULTADO: Quarenta e dois casos de DC foram confirmados, com um aumento de mais de 300% de 2015 a 2016 e um coeficiente de frequência de 3,06 casos por 100.000 pessoas, e na região de Tarauacá / Envira, a probabilidade de uma pessoa contrair CD foi de 600% maior que a média do estado CONCLUSÃO: Constatamos que no estado do Acre, no período de 2009 a 2016, a maioria dos casos de DC ocorreu em 2016, na região de Tarauacá/Envira, principalmente no município de Feijó, na zona rural, de julho a outubro, em faixa etária de 0 a 30 anos, sendo a via oral a principal via de transmissão e sem diferença estatística entre homens e mulheres