Characterisation of an area of coexistent visceral and cutaneous leishmaniasis transmission in the State of Piauí, Brazil.

BACKGROUND: In Brazil, transmission of visceral and cutaneous leishmaniasis has expanded geographically over the last decades, with both clinical forms occurring simultaneously in the same area. OBJECTIVES: This study characterised the clinical, spatial, and temporal distribution, and performed entomological surveillance and natural infection analysis of a leishmaniasis-endemic area. METHODS: In order to characterise the risk of leishmaniasis transmission in Altos, Piauí, we described the clinical and socio-demographic variables and the spatial and temporal distribution of cases of American visceral leishmaniasis (AVL) and American cutaneous leishmaniasis (ACL) cases and identified potential phlebotomine vectors. FINDINGS: The urban area concentrated almost 54% of ACL and 86.8% of AVL cases. The temporal and spatial distribution of AVL and ACL cases in Altos show a reduction in the number of risk areas, but the presence of permanent disease transmission foci is observed especially in the urban area. 3,808 phlebotomine specimens were captured, with Lutzomyia longipalpis as the most frequent species (98.45%). Of the 35 females assessed for natural infection, one specimen of Lu. longipalpis tested positive for the presence of Leishmania infantum and Leishmania braziliensis DNA. MAIN CONCLUSION: Our results indicate the presence of risk areas for ACL and AVL in the municipality of Altos and highlight the importance of entomological surveillance to further understand a possible role of Lu. longipalpis in ACL transmission.

Characterisation of an area of coexistent visceral and cutaneous leishmaniasis transmission in the State of Piauí, Brazil

BACKGROUND In Brazil, transmission of visceral and cutaneous leishmaniasis has expanded geographically over the last decades, with both clinical forms occurring simultaneously in the same area. OBJECTIVES This study characterised the clinical, spatial, and temporal distribution, and performed entomological surveillance and natural infection analysis of a leishmaniasis-endemic area. METHODS In order to characterise the risk of leishmaniasis transmission in Altos, Piauí, we described the clinical and socio-demographic variables and the spatial and temporal distribution of cases of American visceral leishmaniasis (AVL) and American cutaneous leishmaniasis (ACL) cases and identified potential phlebotomine vectors. FINDINGS The urban area concentrated almost 54% of ACL and 86.8% of AVL cases. The temporal and spatial distribution of AVL and ACL cases in Altos show a reduction in the number of risk areas, but the presence of permanent disease transmission foci is observed especially in the urban area. 3,808 phlebotomine specimens were captured, with Lutzomyia longipalpis as the most frequent species (98.45%). Of the 35 females assessed for natural infection, one specimen of Lu. longipalpis tested positive for the presence of Leishmania infantum and Leishmania braziliensis DNA. MAIN CONCLUSION Our results indicate the presence of risk areas for ACL and AVL in the municipality of Altos and highlight the importance of entomological surveillance to further understand a possible role of Lu. longipalpis in ACL transmission.

Eficácia da ivermectina e atazanavir no tempo de recuperação dos sintomas de covid-19: uma coorte prospectiva / Effectiveness of ivermectin and atazanavir on time to resolution from covid-19 symptoms: a prospective cohort / Eficacia de ivermectina y atazanavir en el tiempo hasta lá resolución de los síntomas de covid-19: una cohorte prospectiva

Objetivo: avaliar a eficácia da Ivermectina e do Atazanavir em comparação com placebo no tempo de resolução dos sintomas e no tempo de duração da doença por COVID-19. Método: estudo observacional, de coorte prospectivo, longitudinal, descritivo e analítico com pacientes sintomáticos ambulatoriais, acompanhados por 06 meses em duas Unidades Básicas de Saúde para atendimento de COVID-19 em Teresina- Piauí, Brasil, no período de novembro a abril de 2021 identificados por amostragem aleatória 1:1:1. Foram realizados exames Reverse transcription polymerase chain reaction (RT-PCR) para confirmação laboratorial da suspeita de infecção pelo novo coronavírus e avaliação sociodemográfica e clínica. Resultados: dos 87 pacientes randomizados, 62,1% (n=54) eram do sexo masculino, com média de idade de 35,1 anos, possuíam companheira (53,9%), baixa renda (50,6%), eutróficos (40,7%) e sem comorbidades de saúde (78,2%). Não houve diferença entre o tempo médio para resolução dos sintomas, que foi de 21 dias (IQR, 8-30) no grupo atazanavir, 30 dias (IQR, 5-90) no grupo ivermectina em comparação com 14 dias (IQR, 9-21) no grupo controle. No dia 180, houve resolução dos sintomas em 100% no grupo placebo, 93,9% no grupo atazanavir e 95% no grupo ivermectina. A duração mediana da doença foi de 08 dias em todos os braços do estudo. Conclusão: o tratamento com atazanavir (6 dias) e ivermectina (3 dias) não reduziu o tempo de resolução dos sintomas e nem o tempo de duração da doença entre os pacientes ambulatoriais com COVID-19 leve em comparação com o grupo placebo. Os resultados não suportam o uso de ivermectina e atazanavir para tratamento de COVID-19 leve a moderado.

Objective: to evaluate the effectiveness of Ivermectin and Atazanavir compared to placebo in the time to resolution of symptoms and duration of illness due to COVID-19. Method: observational, prospective, longitudinal, descriptive and analytical cohort study with symptomatic outpatients, followed for 06 months in two Basic Health Units for COVID-19 care in Teresina-Piauí, Brazil, from November to April 2021 identified by 1:1:1 random sampling. Reverse transcription polymerase chain reaction (RT-PCR) tests were performed for laboratory confirmation of suspected infection with the new coronavirus and sociodemographic and clinical evaluation. Results: of the 87 randomized patients, 62.1% (n=54) were male, with a mean age of 35.1 years, had a partner (53.9%), low income (50.6%), eutrophic (40.7%) and without health comorbidities (78.2%). There was no difference between the median time to resolution of symptoms, which was 21 days (IQR, 8-30) in the atazanavir group, 30 days (IQR, 5- 90) in the ivermectin group compared with 14 days (IQR, 9- 21) in the control group. At day 180, there was resolution of symptoms in 100% in the placebo group, 93.9% in the atazanavir group, and 95% in the ivermectin group. The median duration of illness was 8 days in all study arms. Conclusion: Treatment with atazanavir (6 days) and ivermectin (3 days) did not reduce the time to symptom resolution or the duration of illness among outpatients with mild COVID-19 compared to the placebo group. The results do not support the use of ivermectin and atazanavir for the treatment of mild to moderate COVID-19.

Objetivo: evaluar la efectividad de Ivermectina y Atazanavir en comparación con placebo en el tiempo de resolución de los síntomas y duración de la enfermedad por COVID-19. Método: estudio de cohorte observacional, prospectivo, longitudinal, descriptivo y analítico con pacientes ambulatorios sintomáticos, seguidos durante 06 meses en dos Unidades Básicas de Salud para atención de COVID-19 en Teresina-Piauí, Brasil, de noviembre a abril de 2021 identificados por 1:1:1 muestreo aleatorio. Se realizaron pruebas de reacción en cadena de la polimerasa con transcriptasa inversa (RT-PCR) para confirmación de laboratorio de sospecha de infección por el nuevo coronavirus y evaluación sociodemográfica y clínica. Resultados: de los 87 pacientes aleatorizados, 62,1% (n=54) eran del sexo masculino, con una edad media de 35,1 años, tenían pareja (53,9%), bajos ingresos (50,6%), eutróficos (40,7%) y sin comorbilidades de salud (78,2%). No hubo diferencia entre la mediana de tiempo hasta la resolución de los síntomas, que fue de 21 días (RIC, 8-30) en el grupo de atazanavir, 30 días (RIC, 5- 90) en el grupo de ivermectina en comparación con 14 días (RIC, 9 - 21) en el grupo control. En el día 180, hubo una resolución de los síntomas del 100 % en el grupo de placebo, del 93,9 % en el grupo de atazanavir y del 95 % en el grupo de ivermectina. La mediana de duración de la enfermedad fue de 8 días en todos los brazos del estudio. Conclusión: El tratamiento con atazanavir (6 días) e ivermectina (3 días) no redujo el tiempo de resolución de los síntomas ni la duración de la enfermedad entre los pacientes ambulatorios con COVID-19 leve en comparación con el grupo placebo. Los resultados no respaldan el uso de ivermectina y atazanavir para el tratamiento de la COVID-19 de leve a moderada.

Teleconsulta de enfermagem: desenvolvimento de plataforma para atendimento de casos de Covid-19 / Nursing teleconsultation: development of a platform for Covid-19 case management / Telecosulta en enfermería: desarrollo de una plataforma para el manejo de casos de Covid-19

Objetivo: Desenvolver uma plataforma virtual de Teleconsulta para atendimento a casos suspeitos de Síndromes Gripais e infecção por COVID-19. Metodologia: Trata-se de um estudo de natureza aplicada, com desenvolvimento de produção tecnológica e inovadora, prospectivo, ecológico, descritivo, de série temporal. A população do estudo foi formada por qualquer pessoa sintomática para Síndromes Gripais por COVID-19, suspeitos ou confirmados, de qualquer local do Brasil. Este estudo foi realizado em duas etapas, a saber: Etapa I: Desenvolvimento da Aplicação para Plataforma de Teleconsulta. Etapa II: atendimento por meio de Teleconsulta de Casos suspeitos de COVID-19 e Sindromes Gripais. A metodologia utilizada para o desenvolvimento da aplicação proposta foi a modelagem por prototipação evolucionária. Resultados: Foram realizados 209 atendimentos na Plataforma de Teleconsulta, sendo 151 (70%) do sexo feminino e 65 (30%) do sexo masculino, com prevalência de idade variando de 20 a 29 anos (41%). Quanto ao risco de infecção por COVID-19, 42 (20%) tinham alto risco, 75 (36%) médio risco e 92 (44%) baixo risco. Os sintomas mais prevalentes foram: secreção nasal ou espirros (53%), dores no corpo (49%), dor de cabeça (47%), dor de garganta (46%), tosse seca (35%), Febre (31%), falta de ar (25%) e diarreia (23%). Inicialmente o teleatendimento foi composto por teletriagem com classificação de risco com base na sintomatologia dos pacientes que foram codificados com pontuações conforme a gravidade do sintoma para formas graves de COVID-19. A classificação de risco categorizou os pacientes em risco baixo (1 a 9 pontos), risco médio (10 a 19 pontos) e risco alto (20 a 36 pontos). Em seguida, a teleconsulta foi agendada conforme disponibilidade do paciente por meio do método SBAR para comunicação efetiva e ao término do atendimento um plano de cuidados com Sistematização da Assistência de Enfermagem ­ SAE era encaminhado ao paciente por meio de WhatsApp ou e-mail. Conclusão: A plataforma de teleconsulta possibilitou a triagem dos pacientes, reduziu as visitas desnecessárias às unidades de emergência, permitiu a avaliação e monitoramento dos casos, bem como o acompanhamento de pacientes ambulatoriais que não necessitam de avaliação presencial.

Objective: To develop a virtual Teleconsultation platform for care of suspected cases of influenza syndromes and infection by COVID-19. Methodology: This is a study of applied nature, with development of technological and innovative production, prospective, ecological, descriptive, time series. The study population was made up of any person symptomatic for COVID-19 influenza syndromes, suspected or confirmed, from any location in Brazil. This study was conducted in two stages, namely: Stage I: Development of the Application for Teleconsultation Platform. Stage II: care through Teleconsultation of suspected cases of COVID-19 and influenza syndromes. The methodology used to develop the proposed application was evolutionary prototyping modeling. Results: There were 209 consultations in the Teleconsultation Platform, 151 (70%) were female and 65 (30%) were male, with prevalence of age ranging from 20 to 29 years (41%). As for the risk of infection by COVID-19, 42 (20%) had high risk, 75 (36%) medium risk and 92 (44%) low risk. The most prevalent symptoms were: nasal discharge or sneezing (53%), body aches (49%), headache (47%), sore throat (46%), dry cough (35%), fever (31%), shortness of breath (25%), and diarrhea (23%). Initially, the telecare was composed of teletry with risk classification based on the symptomatology of the patients who were coded with scores according to symptom severity for severe forms of COVID-19. The risk classification categorized patients into low risk (1 to 9 points), medium risk (10 to 19 points), and high risk (20 to 36 points). Then, the teleconsultation was scheduled according to the patient's availability through the SBAR method for effective communication and at the end of the service a care plan with Nursing Assistance Systematization - SAE was forwarded to the patient through WhatsApp or e-mail. Conclusion: Teleconsultation platform enabled patient triage, reduced unnecessary visits to emergency units, allowed the evaluation and monitoring of cases, as well as the follow- up of outpatients who do not need face-to-face evaluation.

Objetivo: Desarrollar una plataforma de Teleconsulta virtual para atender casos sospechosos de síndromes gripales e infección por COVID-19. Metodología: Se trata de un estudio aplicado, con desarrollo de producción tecnológica e innovadora, prospectivo, ecológico, descriptivo, con serie de tiempo. La población de estudio estuvo formada por cualquier persona sintomática de síndromes gripales por COVID-19, sospechada o confirmada, de cualquier localidad de Brasil. Este estudio se realizó en dos etapas, a saber: Etapa I: Desarrollo de Aplicaciones para la Plataforma de Teleconsulta. Etapa II: atención mediante teleconsulta de casos sospechosos de COVID-19 y síndromes gripales. La metodología utilizada para el desarrollo de la aplicación propuesta fue el modelado por prototipo evolutivo. Resultados: Se realizaron 209 consultas en la Plataforma de Teleconsulta, 151 (70%) del sexo femenino y 65 (30%) del masculino, con prevalencia de edades entre 20 a 29 años (41%). En cuanto al riesgo de infección por COVID-19, 42 (20%) fueron de alto riesgo, 75 (36%) de riesgo medio y 92 (44%) de bajo riesgo. Los síntomas más prevalentes fueron: secreción nasal o estornudos (53%), dolor de cuerpo (49%), dolor de cabeza (47%), dolor de garganta (46%), tos seca (35%), fiebre (31%), falta de aliento (25%) y diarrea (23%). Inicialmente, la teleasistencia consistía en teleselección con clasificación de riesgo en función de la sintomatología de los pacientes a los que se codificaba con puntuaciones según la gravedad del síntoma para formas graves de COVID-19. La clasificación de riesgo clasificó a los pacientes en riesgo bajo (1 a 9 puntos), riesgo medio (10 a 19 puntos) y riesgo alto (20 a 36 puntos). Luego, se programó la teleconsulta de acuerdo a la disponibilidad del paciente a través del método SBAR para una comunicación efectiva y al final de la atención se remitió al paciente un plan de cuidados con Sistematización de Atención de Enfermería - SAE vía WhatsApp o correo electrónico. Conclusión: La plataforma de teleconsulta posibilitó el triaje de pacientes, redujo las visitas innecesarias a las unidades de emergencia, permitió la evaluación y seguimiento de casos, así como el seguimiento de pacientes ambulatorios que no requieren evaluación presencial.

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.

Study on Morphological Changes and Interference in the Development of Aedes aegypti Caused by Some Essential Oil Constituents.

Dengue, Chikungunya and Zika are arboviruses, transmitted by the mosquito Aedes aegypti, that cause high mortality and serious health consequences in human populations. Efforts to control Ae. aegypti are important for preventing outbreaks of these diseases. Essential oil constituents are known to exhibit many activities, such as their use as larvicides. Given their potential, the present study aimed to characterize the larvicidal effect of dihydrojasmone, p-cymene, carvacrol, thymol, farnesol and nerolidol on the larvae of Ae. aegypti and their interference over the morphology of the mosquitos. The essential oil constituents were dissolved in dimethylsulfoxide at concentrations of 1-100 µg/mL and were applied in the breeding environment of third-stage larvae. The larvae from bioassays were fixed, dehydrated and embedded. Ultrathin sections were contrasted using 5% uranyl acetate and 1% lead citrate for observation through transmission electron microscopy. The oil with the highest larvicidal efficiency was found to be nerolidol, followed by farnesol, p-cymene, carvacrol, thymol and dihydrojasmone, with an LC50 of 11, 21, 23, 40, 45 and 66 µg/mL, respectively. The treated Ae. aegypti larvae caused alteration to the tegument or internal portions of larvae. The present study demonstrated which of these oils-dihydrojasmone, farnesol, thymol, p-cymene, carvacrol and nerolidol-have effective larvicidal activity.

Association between the potential distribution of Lutzomyia longipalpis and Nyssomyia whitmani and leishmaniasis incidence in Piauí State, Brazil.

BACKGROUND: Leishmaniases are vector borne diseases caused by Leishmania spp. parasites transmitted by female sandflies (Diptera: Psychodidae) whose geographic distribution is influenced by environmental factors. Among the main tools for studying the distribution of vector species, modeling techniques are used to analyze the influence of climatic and environmental factors on the distribution of these insects and their association with human cases of the disease. METHODOLOGY/PRINCIPAL FINDINGS: Here, we used a multiscale ecological niche modeling approach to assess the environmental suitability of sandfly vectors of the etiological agents of Visceral (VL) and American Cutaneous Leishmaniasis (ACL) in Piauí state, northeastern Brazil, and then evaluated their relationship with human disease incidence. For this, we obtained the geographic coordinates of the vector species Lutzomyia longipalpis and Nyssomyia whitmani through literature review, online databases and unpublished records. These data were used for the development of predictive models of the distribution of both sandflies species based on climatic and environmental variables. Finally, the environmental suitability for the presence of these vectors was compared with the incidence of both the diseases at the municipality level. The final models for each sandfly species showed good predictive powers with performance metric values of 0.889 for Lu. longipalpis and 0.776 for Ny. whitmani. The areas with greater environmental suitability for the presence of these species were concentrated in the central-north region of Piauí and coincide with the location of those municipalities presenting higher incidences of VL and ACL, situated in the central-north and extreme north of the state, respectively. The south and southeast regions of Piauí state have low incidence of these diseases and presented low environmental suitability for the presence of both vectors. CONCLUSIONS/SIGNIFICANCE: We discuss how predictive modeling can guide entomological and epidemiological surveillances and recommend an increased supervision and control activities in Teresina (capital of the state of Piaui), Altos and Pedro II, in addition to other municipalities with similar social and environmental characteristics.

Characterization of External Female Genitalia in Five Triatoma Laporte Species of South America (Hemiptera: Reduviidae: Triatominae).

Currently, there are 158 valid species of triatomines, all of which are potential vectors of Trypanosoma cruzi, the etiological agent of Chagas disease. The correct taxonomic identification of triatomines is essential since each species hos a different epidemiological importance. The aim of the study is to compare five species of South American Triatoma. Here we present a comparative study of terminal abdominal segments in females by scanning electron microscopy (SEM) of the species Triatoma delpontei, T. jurbergi, T. infestans var. melanosoma, T. platensis, and T. vandae. The results showed diagnostic characters for the studied species. The dorsal view featured more valuable characters, with seven informative characters. Similarities were observed among T. delpontei, T. infestans var. melanosoma, and T. platensis, and between T. jurbergi and T. vandae, correlating with previous studies. Thus, female genital characters proved to be reliable and useful in the diagnosis of the Triatoma species studied here; additional studies, along with other sets of behavioral, morphological, and molecular data, helped to reinforce the hypotheses found here.

A Novel Model of Pathogenesis of Metarhizium anisopliae Propagules through the Midguts of Aedes aegypti Larvae.

We assessed the effect of the entomopathogenic fungus Metarhizium anisopliae against Aedes aegypti. Conidia of M. anisopliae strains CG 489, CG 153, and IBCB 481 were grown in Adamek medium under different conditions to improve blastospore production. Mosquito larvae were exposed to blastospores or conidia of the three fungal strains at 1 × 107 propagules mL-1. M. anisopliae IBCB 481 and CG 153 reduced larval survival by 100%, whereas CG 489 decreased survival by about 50%. Blastospores of M. anisopliae IBCB 481 had better results in lowering larval survival. M. anisopliae CG 489 and CG 153 reduced larval survival similarly. For histopathology (HP) and scanning electron microscopy (SEM), larvae were exposed to M. anisopliae CG 153 for 24 h or 48 h. SEM confirmed the presence of fungi in the digestive tract, while HP confirmed that propagules reached the hemocoel via the midgut, damaged the peritrophic matrix, caused rupture and atrophy of the intestinal mucosa, caused cytoplasmic disorganization of the enterocytes, and degraded the brush border. Furthermore, we report for the first time the potential of M. anisopliae IBCB 481 to kill Ae. aegypti larvae and methods to improve the production of blastospores.

Species-specific differences in the egg exochorium of the sympatric taxa Triatoma costalimai and Triatoma jatai (Hemiptera: Reduviidae: Triatominae).

Triatoma costalimai and Triatoma jatai are related species, which occur in sympatry in Paranã, Tocantins, Brazil, in rocky outcrops and in peridomicile and intradomicile environments. This study compared morphologic and morphometric aspects of the eggs of these species using optical microscopy (OM) and scanning electron microscopy (SEM). Operculum cells (OP) and egg body (EB) were drawn and photographed, their surfaces were measured, and spots were quantified. Statistical analyses were performed using ANOVA and t-tests. OM showed an egg exochorium with spots in T. costalimai and a predominance of short lines in T. jatai. We found significant differences in egg length and width, which were larger in T. costalimai. SEM analysis showed that the operculum of both species had cells with straight and/or rounded rims, with a smooth aspect, random spots, and predominantly pentagonal shape. In the EB, hexagonal cells were predominant, with indices exceeding 60% in both species. Triatoma costalimai cells were flat, with a discrete definition of the rims, whereas T. jatai cells were smooth with well-defined rims. Statistical tests showed significant differences for EB, where T. costalimai cells were larger and have more spots than T. jatai. The eggs can thus be differentiated, thereby contributing to integrative taxonomy.

Monthly abundance and diversity of mosquitoes (Diptera: Culicidae) in an Atlantic Forest area of Rio de Janeiro, Brazil.

Several mosquito species in the Atlantic Forest are yellow fever vectors; therefore, this biome can represent a potential risk to the human population. Studies on mosquitoes from predominantly sylvatic areas produce valuable data for understanding the emergence of new epidemics. In addition, they can elucidate environmental components favoring or hindering biodiversity and species distribution. Our study aimed to evaluate the monthly distribution, composition, diversity, and influence of seasonal periods (dry and rainy) on the mosquito fauna. We used CDC light traps at different levels in a forest area bordering a Conservation Unit of Nova Iguaçu in the state of Rio de Janeiro, Brazil. Specimens were collected from August 2018 to July 2019 by installing traps in sampling sites under different vegetation covers. We detected some species of epidemiological importance in terms of arbovirus transmission. A total of 4,048 specimens representing 20 different species were collected. Among them, Aedes (Stg.) albopictus Skuse, 1894 showed recurrent association with the closest level to human residences and Haemagogus (Con.) leucocelaenus Dyar and Shannon, 1924 with the most distant levels. Since these mosquitoes are possible vectors of yellow fever, monitoring the area is extremely important. Under the studied conditions, the mosquito populations were directly influenced by dry and rainy periods, posing a risk to the nearby resident population.

Beauveria bassiana interacts with gut and hemocytes to manipulate Aedes aegypti immunity.

BACKGROUND: Mosquito-borne diseases affect millions of people. Chemical insecticides are currently employed against mosquitoes. However, many cases of insecticide resistance have been reported. Entomopathogenic fungi (EPF) have demonstrated potential as a bioinsecticide. Here, we assessed the invasion of the EPF Beauveria bassiana into Aedes aegypti larvae and changes in the activity of phenoloxidase (PO) as a proxy for the general activation of the insect innate immune system. In addition, other cellular and humoral responses were evaluated. METHODS: Larvae were exposed to blastospores or conidia of B. bassiana CG 206. After 24 and 48 h, scanning electron microscopy (SEM) was conducted on the larvae. The hemolymph was collected to determine changes in total hemocyte concentration (THC), the dynamics of hemocytes, and to observe hemocyte-fungus interactions. In addition, the larvae were macerated to assess the activity of PO using L-DOPA conversion, and the expression of antimicrobial peptides (AMPs) was measured using quantitative Real-Time PCR. RESULTS: Propagules invaded mosquitoes through the midgut, and blastopores were detected inside the hemocoel. Both propagules decreased the THC regardless of the time. By 24 h after exposure to conidia the percentage of granulocytes and oenocytoids increased while the prohemocytes decreased. By 48 h, the oenocytoid percentage increased significantly (P < 0.05) in larvae exposed to blastospores; however, the other hemocyte types did not change significantly. Regardless of the time, SEM revealed hemocytes adhering to, and nodulating, blastospores. For the larvae exposed to conidia, these interactions were observed only at 48 h. Irrespective of the propagule, the PO activity increased only at 48 h. At 24 h, cathepsin B was upregulated by infection with conidia, whereas both propagules resulted in a downregulation of cecropin and defensin A. At 48 h, blastospores and conidia increased the expression of defensin A suggesting this may be an essential AMP against EPF. CONCLUSION: By 24 h, B. bassiana CG 206 occluded the midgut, reduced THC, did not stimulate PO activity, and downregulated AMP expression in larvae, all of which allowed the fungus to impair the larvae to facilitate infection. Our data reports a complex interplay between Ae. aegypti larvae and B. bassiana CG 206 demonstrating how this fungus can infect, affect, and kill Ae. aegypti larvae.

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)

Uso de Ivermectina e Atazanavir no tratamento da Covid-19: uma revisão de escopo / Use of Ivermectin and Atazanavir in the treatment of Covid-19: a scoping review / Uso de Ivermectina y Atazanavir en el tratamiento de Covid-19: una revisión de alcance

Objetivo: Examinar e mapear as evidências científicas sobre a eficácia do uso de ivermectina e atazanavir no tratamento de COVID-19. Metodologia: Scoping Review, baseado nos procedimentos recomendados pelo Instituto Joanna Briggs. Estabeleceu-se a pergunta norteadora: "Quais são as evidências científicas sobre o uso de ivermectina e atazanavir no tratamento de pacientes com sintomas leves de COVID-19?". Foram realizadas buscas em seis bases de dados nacionais e internacionais, sobre trabalhos publicados até dezembro de 2022. Dos 357 estudos encontrados, 22 foram selecionados para leitura na íntegra, resultando em uma amostra final de 11 estudos analisados. Resultados: As 11 publicações analisadas foram publicadas de 2020 a 2022 durante período pandêmico, de âmbito nacional e internacional com delineamento de estudos experimentais, do tipo ensaio clínico com randomização. Apenas 03 estudos (25%) testaram o atazanavir como intervenção conjugada a outras drogas, não evidenciando melhorias significativas em relação ao seu uso. Já no tratamento com Ivermectina, dos oito (75%) estudos que a testaram, apenas três (37,5%) recomendaram seu uso e cinco (62,5%) não suportam seu uso para tratamento de COVID-19 leve. O tempo de resolução dos sintomas variou de 8 a 10 dias nos braços tratados com ivermectina e em média 07 dias no tratamento com atazanavir. Não se detectou eventos adversos graves relacionados ao uso das duas drogas. Conclusão: As evidências que recomendavam o uso de ivermectina datam do início do período pandêmico, 2020, mas posteriormente, com a realização de ensaios clínicos robustos e controlados, novas evidências não suportam o uso de ivermectina e atazanavir no tratamento de COVID-19 leve mostrando que não houve diferença no tempo de resolução dos sintomas, na taxa de mortalidade, taxa de internação na UTI e tempo de hospitalização.

Objective: To examine and map the scientific evidence on the effectiveness of using ivermectin and atazanavir in the treatment of COVID-19. Methodology: Scoping Review, based on the procedures recommended by the Joanna Briggs Institute. The guiding question was established, "What is the scientific evidence on the use of ivermectin and atazanavir in the treatment of patients with mild symptoms of COVID-19?" Searches were conducted in six national and international databases on papers published until December 2022. Of the 357 studies found, 22 were selected for reading in full, resulting in a final sample of 11 studies analyzed. Results: The 11 publications analyzed were published from 2020 to 2022 during pandemic period, of national and international scope with experimental study design, of clinical trial type with randomization. Only 03 studies (25%) tested atazanavir as a combined intervention with other drugs, showing no significant improvements in relation to its use. As for the treatment with Ivermectin, of the eight (75%) studies that tested it, only three (37.5%) recommended its use and five (62.5%) did not support its use for treating mild COVID-19. The time to symptom resolution ranged from 8 to 10 days in the ivermectin-treated arms and on average 07 days in the atazanavir treatment. No serious adverse events related to the use of the two drugs were detected. Conclusion: evidence recommending the use of ivermectin dates back to the beginning of the pandemic period, 2020, but subsequently, with robust controlled clinical trials, new evidence does not support the use of ivermectin and atazanavir in the treatment of mild COVID-19 showing that there was no difference in time to symptom resolution, mortality rate, ICU admission rate, and length of hospital stay.

Objetivo: Examinar y mapear la evidencia científica sobre la eficacia del uso de ivermectina y atazanavir en el tratamiento de COVID-19. Metodología: Scoping Review, basada en los procedimientos recomendados por el Instituto Joanna Briggs. La pregunta guía era: "¿Cuál es la evidencia científica sobre el uso de ivermectina y atazanavir en el tratamiento de pacientes con síntomas leves de COVID-19? Se realizaron búsquedas en seis bases de datos nacionales e internacionales, en artículos publicados hasta diciembre de 2022. De los 357 estudios encontrados, se seleccionaron 22 para su lectura completa, lo que dio lugar a una muestra final de 11 estudios analizados. Resultados: Las 11 publicaciones analizadas fueron publicadas entre 2020 y 2022 durante el periodo pandémico, de ámbito nacional e internacional con diseño de estudio experimental, de tipo ensayo clínico con aleatorización. Apenas 03 estudios (25%) probaron el atazanavir como intervención combinada con otras drogas, sin evidenciar mejoras significativas en relación con su uso. En cuanto al tratamiento con Ivermectina, de los ocho (75%) estudios que la probaron, sólo tres (37,5%) recomendaron su uso y cinco (62,5%) no apoyaron su uso para tratar la COVID-19 leve. El tiempo transcurrido hasta la resolución de los síntomas osciló entre 8 y 10 días en los brazos tratados con ivermectina y una media de 07 días en el tratamiento con atazanavir. No se detectaron acontecimientos adversos graves relacionados con el uso de los dos fármacos. Conclusión: las pruebas que recomiendan el uso de ivermectina se remontan al inicio del periodo pandémico, 2020, pero posteriormente, con ensayos clínicos controlados sólidos, las nuevas pruebas no apoyan el uso de ivermectina y atazanavir en el tratamiento de la COVID-19 leve, lo que demuestra que no hubo diferencias en el tiempo hasta la resolución de los síntomas, la tasa de mortalidad, la tasa de ingreso en la UCI y la duración de la estancia hospitalaria.

Cladomorphus petropolisensis, a New Species of Stick Insect from the Atlantic Forest, Rio de Janeiro, Brazil.

Cladomorphus petropolisensis sp. nov., a new species of stick insect from Petrópolis, Rio de Janeiro, Brazil, is herein described and compared to the other sympatric species, C. phyllinus Gray, 1835 (Phasmatidae, Cladomorphinae). The description of the new species is supported by morphological and molecular evidence. Kimura-2-parameter (K2P) intraspecific COI divergences among the holotype of C. petropolisensis sp. nov. and C. phyllinus individuals ranged from 2.9% to 4.4%, which are suggestive of distinct species, especially when considering that all Cladomorphus individuals studied were collected in the Petrópolis municipality. The new species can be distinguished from C. phyllinus Gray, 1835 by several characteristics: smaller size, the presence of two spines on the hind femora, the relative longer length of the ovipositor, and spiny tegument, especially in the mesonotum, sculpturing of the operculum of the egg.

Entomopathogenic fungi and Schinus molle essential oil: The combination of two eco-friendly agents against Aedes aegypti larvae.

Aedes aegypti transmits arbovirus, which is a public health concern. Certain filamentous fungi have the potential to control the disease. Here, the effects of Metarhizium anisopliae s.l. CG 153, Beauveria bassiana s.l. CG 206 and Schinus molle L. were investigated against Aedes aegypti larvae. In addition, the effect of essential oil on fungal development was analyzed. Fungal germination was assessed after combination with essential oil at 0.0025 %, 0.0075 %, 0.005 %, or 0.01 %; all of the oil concentrations affected germination except 0.0025 % (v/v). Larvae were exposed to 0.0025 %, 0.0075 %, 0.005 %, or 0.01 % of the essential oil or Tween 80 at 0.01 %; however, only the essential oil at 0.0025 % achieved similar results as the control. Larvae were exposed to fungi at 107 conidia mL-1 alone or in combination with the essential oil at 0.0025 %. Regardless of the combination, M. anisopliae reduced the median survival time of mosquitoes more than B. bassiana. The cumulative survival of mosquitoes exposed to M. anisopliae alone or in combination with essential oil was 7.5 % and 2 %, respectively, and for B. bassiana, it was 75 % and 71 %, respectively. M. anisopliae + essential oil had a synergistic effect against larvae, whereas B. bassiana + essential oil was antagonistic. Scanning and transmission electron microscopy, and histopathology confirmed that the interaction of M. anisopliae was through the gut and hemocoel. In contrast, the mosquito's gut was the main route for invasion by B. bassiana. Results from gas chromatography studies demonstrated sabinene and bicyclogermacrene as the main compounds of S. molle, and the in-silico investigation found evidence that both compounds affect a wide range of biological activity. For the first time, we demonstrated the potential of S. molle and its interaction with both fungal strains against A. aegypti larvae. Moreover, for the first time, we reported that S. molle might be responsible for significant changes in larval physiology. This study provides new insights into host-pathogen interplay and contributes to a better understanding of pathogenesis in mosquitoes, which have significant consequences for biological control strategies.

Entomological surveillance of mosquitoes (Diptera: Culicidae), vectors of arboviruses, in an ecotourism park in Cachoeiras de Macacu, state of Rio de Janeiro-RJ, Brazil.

Arboviruses are arthropod-dependent viruses to complete their zoonotic cycle. Among the transmitting arthropods, culicids stand out, which participate in the cycle of several arboviruses that can affect humans. The present study aimed to identify species of culicidae and to point out the risk of circulation, emergency, or reemergence of pathogenic arboviruses to humans in the region of the Jequitibá headquarters of the Parque Estadual dos Três Picos (PETP), in Cachoeiras de Macacu, state of Rio de Janeiro, Brazil. Sampling was carried out at five Sample Points (SP) demarcated on trails from the headquarters, with CDC light traps, HP model with dry ice attached to the side, for 48 hours of activity each month. Additionally, active catches were made with a castro catcher in the period of one hour per day in the field, from six to eleven o'clock in the morning, in each PM. After the captures, thematic map was assembled using the ArcGIS 10 software and performing a multidimensional scaling (MDS). A total of 1151 specimens were captured and the presence of culicids already incriminated as vectors of arboviruses circulating in the region was observed: Aedes fluviatilis Lutz, 1904 (71 specimens); Aedes scapularis Rondani, 1848 (55 specimens); Haemagogus leococelaenus Dyar and Shannon, 1924 (29 specimens). In addition to the subgenus Culex (culex) spp. (163 specimens). In this sense, we highlight the importance of strengthening the actions of continuous entomological surveillance of the emergence and re-emergence of new arboviruses in ecotourism visitation parks.

Near infrared spectroscopy accurately detects Trypanosoma cruzi non-destructively in midguts, rectum and excreta samples of Triatoma infestans.

Chagas disease is a neglected tropical disease caused by Trypanosoma cruzi parasite with an estimated 70 million people at risk. Traditionally, parasite presence in triatomine vectors is detected through optical microscopy which can be low in sensitivity or molecular techniques which can be costly in endemic countries. The aim of this study was to evaluate the ability of a reagent-free technique, the Near Infrared Spectroscopy (NIRS) for rapid and non-invasive detection of T. cruzi in Triatoma infestans body parts and in wet/dry excreta samples of the insect. NIRS was 100% accurate for predicting the presence of T. cruzi infection Dm28c strain (TcI) in either the midgut or the rectum and models developed from either body part could predict infection in the other part. Models developed to predict infection in excreta samples were 100% accurate for predicting infection in both wet and dry samples. However, models developed using dry excreta could not predict infection in wet samples and vice versa. This is the first study to report on the potential application of NIRS for rapid and non-invasive detection of T. cruzi infection in T. infestans in the laboratory. Future work should demonstrate the capacity of NIRS to detect T. cruzi in triatomines originating from the field.

Bionomy of Mosquitoes in Bamboo Internodes in an Atlantic Forest Remnant of the State of Rio De Janeiro, Brazil.

Living bamboo stalks are one of the most specialized habitats for mosquito oviposition and immature development. Most of the mosquito species that breed in these habitats are sylvatic, and some are of importance for public health as possible vectors of pathogens. Perforated internodes are a very specialized environment due to the difficulty of access. Furthermore, due to their relatively simple fauna, they represent a valuable model for ecological studies that may be applicable to more complex environments. This study aims to assess the mosquito bionomics of species raised in bamboo internodes. Therefore, the diversity of mosquito species and the influence of abiotic variables (pH and temperature) on the distribution of mosquitoes that breed in this habitat were analyzed. The study area is a fragment of Atlantic Forest within the Association of da Armada (ATA) in Nova Iguaçu, state of Rio de Janeiro, Brazil. Immature mosquitoes were sampled with suction tubes (mouth aspirators) between August 2017 and July 2018. A total of 3,170 larvae were collected in 5 bamboo plants, each with 8 stalks perforated. Of these, 688 larvae reached the adult stage, representing 10 genera and 19 species. The most common species were Culex neglectus (43%), Trichoprosopon digitatum (22%), Culex iridescens (8%), Sabethes identicus (7%), and Orthopodomyia albicosta (7%). The richness of the immatures collected in the ATA was 19 species, with a diversity of 1.10 and Shannon evenness of 0.57. A diverse composition of Culicidae in bamboo stalks was found, although dominance was low.