Your browser doesn't support javascript.
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 14.994
Filtrar
1.
Recurso na Internet em Português | LIS - Localizador de Informação em Saúde, LIS-bvsms | ID: lis-LISBR1.1-46796

RESUMO

Essa vacina terá o potencial de proteger uma quantidade cada vez maior de pessoas com apenas uma dose e terá eficácia contra os 4 sorotipos dos vírus da dengue.


Assuntos
Dengue , Vacinas , Vacinas contra Dengue
2.
Rev Inst Med Trop Sao Paulo ; 61: e46, 2019 Sep 12.
Artigo em Inglês | MEDLINE | ID: mdl-31531624

RESUMO

The Asian tiger mosquito ( Aedes albopictus, Diptera: Culicidae) has spread rapidly in the last 30 years from its native region in Southeast Asia. In Argentina, studies on its potential distribution suggest that this species could be found in temperate zones of the province of Buenos Aires. However, since its initial detection in 1998 Ae. albopictus is bounded to the subtropical province of Misiones. To evaluate the presence and abundance of Ae. albopictus in the Northeast of Argentina, we preliminarily evaluated the presence of this vector by analyzing its presence in tires of 20 cities belonging to the province of Misiones and four cities in Northern Corrientes, and then performed an evaluation of the vector in the towns where the vector was detected. Aedes albopictus was present only in two cities of Misiones: Eldorado and Colonia Aurora. Aedes aegypti and Ae . albopictus accounted for 86% of the individuals collected in the domiciles of both towns. In Colonia Aurora both species were in similar abundances suggesting a co-dominance. The present study extends the austral distribution of Ae. albopictus in Argentina to the city of Colonia Aurora where the highest abundance recorded in Argentina was detected. Nevertheless, the reasons of its bounded distribution in the region are not known.


Assuntos
Aedes/classificação , Mosquitos Vetores/classificação , Animais , Argentina , Dengue/transmissão , Densidade Demográfica
3.
Acta Virol ; 63(3): 292-300, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31507195

RESUMO

Dengue, considered the most important arthropod-borne viral disease affecting humans, is transmitted by the bite of mosquitoes of the genus Aedes and caused by one of the four distinct serotypes of dengue virus (DENV-1, -2, -3 and -4). Infection with one of the four serotypes provides lifelong homotypic immunity. However, immunity against the heterologous serotypes is transient. As a consequence, secondary infection may lead to severer manifestations due to cross-reactivity of antibodies and T-cells. Over 500,000 people are hospitalized every year and around 2,5 million, living in endemic areas, are at risk of infection. Given the background, the development of vaccines and anti-DENV drugs is of the utmost importance, as is the characterization of an animal model for testing them. The purpose of this study was to investigate ultrastructural alterations caused by DENV secondary infection in BALB/c mice heart. To achieve our goal, six BALB/c mice were infected with DENV-1 and, 4 months later, reinfected with DENV-2. Uninfected mice were used as negative controls. Heart samples were collected and processed for ultrastructural and histopathological analysis. Our results showed edema, endothelium activation characterized by the presence of transport vesicles, free platelets in interstitium, mitochondria presenting rarefied matrix and degenerated cristae, and disorganization of muscle fibers. These results point not only to BALB/c mice susceptibility to DENV infection, but also to the fact that, although it is not an often reported occurrence, dengue can lead to heart damage. Keywords: dengue; experimental model; reinfection; BALB/c mice.


Assuntos
Coinfecção , Vírus da Dengue , Dengue , Miocárdio , Animais , Dengue/patologia , Dengue/virologia , Modelos Animais de Doenças , Coração/virologia , Camundongos , Camundongos Endogâmicos BALB C , Miocárdio/patologia
4.
BMC Public Health ; 19(1): 1148, 2019 Sep 16.
Artigo em Inglês | MEDLINE | ID: mdl-31522680

RESUMO

BACKGROUND: A clear understanding of the epidemiology of malaria and dengue co-infection is essential for informed decisions on appropriate control strategies for dengue and malaria. This systematic review synthesized evidence on the relationship of malaria and dengue co-infection and related it to alterations in platelet, hemoglobin, hematocrit, aspartate aminotransferase (AST), and alanine aminotransferase (ALT) levels when compared to malaria mono-infection. METHODS: A systematic review in accordance with PRISMA guidelines was conducted. All published articles available in PubMed and Web of Science (ISI) databases before October 21, 2017 were recruited. All epidemiological studies except case reports on the prevalence or incidence of malaria and dengue co-infection among patients visiting hospitals with febrile illness were included. Studies that involved conference abstracts, protocols, systematic reviews, only mono-dengue or mono-malaria infections, and only animal or in vitro studies were excluded after screening the titles, abstracts, and body texts. Studies were additionally excluded after full text review when they lacked epidemiologic data on malaria and dengue co-infection. Two reviewers independently screened, reviewed, and assessed all the studies. Cochrane Q (Chi-square) and Moran's I2 were used to assess heterogeneity, and the funnel plot was used to examine publication bias. The summary odds ratio (OR) and 95% confidence intervals (CI) were estimated using a fixed-effects model. Thirteen cross-sectional and two retrospective studies were eligible to be included in the systematic review and meta-analysis. RESULTS: Out of the 2269 citations screened, 15 articles were eligible to be included in the systematic review and meta-analysis. The 15 studies involved 13,798 (10,373 cases with malaria and 3425 with dengue) patients in 9 countries. Thirteen studies compared the incidence and odds of Plasmodium sp. infection, five studies compared the odds of mean platelet, three studies compared Plasmodium parasite density, and four studies compared the odds of hemoglobin, hematocrit, AST, and ALT levels among co-infected groups and single-malaria-infected groups. CONCLUSIONS: This study showed that dengue and malaria co-infection was associated with decreased odds of malaria infection, malaria parasitemia, AST, and ALT levels when compared to malaria mono-infection. However, malaria and dengue co-infection was associated with increased odds of platelet and hemoglobin levels when compared to malaria mono-infection.


Assuntos
Coinfecção , Dengue , Malária , Animais , Coinfecção/epidemiologia , Estudos Transversais , Dengue/diagnóstico , Dengue/epidemiologia , Hematócrito , Hospitais , Humanos , Laboratórios , Malária/diagnóstico , Malária/epidemiologia , Razão de Chances , Parasitemia , Prevalência , Estudos Retrospectivos
5.
Rev Soc Bras Med Trop ; 52: e20190232, 2019 Sep 05.
Artigo em Inglês | MEDLINE | ID: mdl-31508784

RESUMO

INTRODUCTION: Dengue is an endemic and epidemic disease in Brazil, with a high burden of disease. Amazonas State has a high risk of transmission. This study aimed to assess the self-reported prevalence of dengue in adults living in Manaus Metropolitan Region. METHODS: A cross-sectional study was conducted with adults living in Manaus Metropolitan Region in 2015. We performed a three-phase probabilistic sampling to collect participants' clinical and sociodemographic data. Self-reported dengue infection in the previous year was the primary outcome. Descriptive statistics and Poisson regression analysis with robust variance were used to calculate the prevalence ratio (PR) of dengue infections with 95% confidence intervals (95% CIs). Multilevel analysis including city and neighborhood variables was calculated. All analyses considered the complex sampling. RESULTS: Among the 4,001 participants, dengue in the previous year was self-reported by 7.0% (95% CI 6.3%-7.8%). Dengue was more frequent in women(PR 1.51; 95% CI 1.06-2.13), elderly participants (≥60 years old, PR 2.54; 95% CI 1.19-5.45), White and Asian participants (PR, 1.57; 95% CI, 1.11-2.23), and individuals who had not received endemic agent visits (PR, 2.28; 95% CI, 1.31-3.99). After multilevel analysis, sex was no longer a significant variable, with the remaining associations still significant. CONCLUSIONS: Seven out of 100 inhabitants of Manaus Metropolitan Region reported dengue in the previous year. Dengue was predominantly observed in women, elderly individuals, White and Asian individuals, and individuals who did not receive endemic agent visits. The setting plays an important role in dengue infections.


Assuntos
Dengue/epidemiologia , Autorrelato/estatística & dados numéricos , Adolescente , Adulto , Brasil/epidemiologia , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Fatores Socioeconômicos , População Urbana , Adulto Jovem
6.
Rev Soc Bras Med Trop ; 52: e20190304, 2019 Sep 05.
Artigo em Inglês | MEDLINE | ID: mdl-31508787

RESUMO

INTRODUCTION: Human parvovirus B19 (B19V) is a common pathogen, which on infection causes variety of clinical conditions from benign self-limiting exanthematous disease and other similar pathologies to fetal death. METHODS: We collected 341 serum samples between the first and fourth day after the onset of symptoms from all patients suspected of dengue fever who were attended at Regional Hospital of Tefé. Initially, patients were screened for malaria by blood smear test and negative samples were sent to Fundação de Medicina Tropical Doutor Heitor Vieira Dourado (FMT-HVD) situated in Manaus (AM) for dengue testing using semi-nested multiplex PCR. Further, we investigated 44 malaria and dengue-negative samples of children for B19V DNA by nested-PCR. Positive samples were analyzed by BLAST against entire public non-redundant nucleotide database and genotyped by phylogenetic analyses using neighbor-joining clustering method. RESULTS: Eight samples (18.2%) were found to be PCR positive. Fever, headache, ocular pain, and/or muscle pain were reported as the most frequent symptoms by the patients and none were diagnosed with rash at the time of sample collection. Phylogenetic analysis of major capsid protein 2 (VP2) and VP3 coding region showed high similarity with B19V genotype 1. CONCLUSIONS: Our results reveal the spread of B19V genotype 1 in Tefé. Moreover, our results emphasize the significance of laboratorial differential diagnosis using molecular techniques in patients with acute febrile, and thereby aid the health surveillance system in improving patient care even in the remote areas of Amazon.


Assuntos
DNA Viral/sangue , Dengue/diagnóstico , Infecções por Parvoviridae/diagnóstico , Infecções por Parvoviridae/virologia , Parvovirus B19 Humano/genética , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Brasil , Criança , Pré-Escolar , Feminino , Genótipo , Humanos , Lactente , Masculino , Pessoa de Meia-Idade , Filogenia , Reação em Cadeia da Polimerase , Adulto Jovem
7.
Recurso na Internet em Português | LIS - Localizador de Informação em Saúde, LIS-bvsms | ID: lis-LISBR1.1-46744

RESUMO

A Organização Mundial da Saúde (OMS) estima que 40% da população mundial está em risco de contrair o vírus da dengue: são cerca de 390 milhões de infecções por ano. Em 2019, foram registrados 1.281.759 casos prováveis de dengue no país.


Assuntos
Dengue , Vacinas
8.
Mem. Inst. Invest. Cienc. Salud (Impr.) ; 17(2): 6-15, ago. 2019. tab, ilus
Artigo em Espanhol | LILACS, BDNPAR | ID: biblio-1008344

RESUMO

Este trabajo quiere contribuir con otra perspectiva a la solución del problema del Dengue en México. El objetivo fue determinar tipos de criadero de Aedes aegypti, condiciones de la vivienda e identificar dimensiones que determinen la enfermedad con enfoque integral social en la colonia centro de Mazatepec, Morelos. El estudio es de corte transversal descriptivo, se llevó a cabo en temporada de sequía (2015), se realizó colecta entomológica para identificar criaderos del vector, aplicación de Índice de Condición de Vivienda (ICV) y cuestionario con perspectiva de la Determinación Social de la Salud a 80 casas. Se detectaron 3,221 recipientes sin agua y 655 con agua, 25.34% tratables (tanques, tinacos), 9.46% controlables (botes y cubetas) y 4.7% diversos chicos, el ICV identificó 14 casas positivas (57.69%-tratables), 47.5% de medio riesgo para crecimiento del vector, el 83.3% atribuyó el problema a condiciones de vida y posesión de recursos, 40.83% responsabilizó a la comunidad, falta de interés y mala organización. Las estrategias y políticas en salud deben de tomar en cuenta la perspectiva social y análisis de las comunidades, mejorar las condiciones de vivienda, trabajo y organización comunitaria para preservar la salud(AU)


This work aims to contribute to the solution to the dengue problem in Mexico with a different approach. The objectives of the research were to determine the types of hatcheries for Aedes aegypti and housing conditions, as well as to identify the dimensions that determine the disease with an integral social approach in the Colonia Centro of Mazatepec, Morelos, Mexico. This is a descriptive cross-sectional studycarried out during the dry season in 2015, an entomological collection was made to identify the vector hatcheries, the Housing Condition Index (HCI) and a questionnaire were applied to establish the Social Determinants of Health for 80 houses. A total of 3,221 containers without water and 655 with water were detected, out of these 25.34% were tagged as manageable (water tanks), 9.46% as controllable (buckets and cans) and 4.7% as various small items. The HCI identified 14 positive houses (57.69% as manageable), 47.5% as medium risk for the development of the vector. Eighty three point three percent of the questionnaire participants attributed the problem to life conditions and resources property, 40.83% to the community, the lack of interest and disorganization as responsible. Health strategies and policies must take into account the social approach and analysis of the communities, improving housing, work and community organization conditions to preserve health(AU)


Assuntos
Animais , Dengue , Determinantes Sociais da Saúde , Epidemiologia , Estudos Transversais
10.
Rev Inst Med Trop Sao Paulo ; 61: e40, 2019 Aug 19.
Artigo em Inglês | MEDLINE | ID: mdl-31432989

RESUMO

Several arboviruses have emerged and/or re-emerged in North, Central and South-American countries. Viruses from some regions of Africa and Asia, such as the Zika and Chikungunya virus have been introduced in new continents causing major public health problems. The aim of this study was to investigate the presence of RNA from Zika, Dengue and Chikungunya viruses in symptomatic patients from Rondonia, where the epidemiological profile is still little known, by one-step real-time RT-PCR. The main clinical signs and symtoms were fever (51.2%), headache (78%), chills (6.1%), pruritus (12.2%), exanthema (20.1%), arthralgia (35.3%), myalgia (26.8%) and retro-orbital pain (19.5%). Serum from 164 symptomatic patients were collected and tested for RNA of Zika, Dengue types 1 to 4 and Chikungunya viruses, in addition to antibodies against Dengue NS1 antigen. Direct microscopy for Malaria was also performed. Only ZIKV RNA was detected in 4.3% of the patients, and in the remaining 95.7% of the patients RNA for Zika, Dengue and Chikungunya viruses were not detected. This finding is intriguing as the region has been endemic for Dengue for a long time and more recently for Chikungunya virus as well. The results indicated that medical and molecular parameters obtained were suitable to describe the first report of symptomatic Zika infections in this region. Furthermore, the low rate of detection, compared to clinical signs and symptoms as the solely diagnosis criteria, suggests that molecular assays for detection of viruses or other pathogens that cause similar symptoms should be used and the corresponding diseases could be included in the compulsory notification list.


Assuntos
Febre de Chikungunya/epidemiologia , Vírus Chikungunya/genética , Vírus da Dengue/genética , Dengue/epidemiologia , Infecção por Zika virus/epidemiologia , Zika virus/genética , Brasil/epidemiologia , Febre de Chikungunya/diagnóstico , Dengue/diagnóstico , Humanos , Vírus de RNA/genética , Reação em Cadeia da Polimerase em Tempo Real , Infecção por Zika virus/diagnóstico
11.
Rev Lat Am Enfermagem ; 27: e3160, 2019 Aug 19.
Artigo em Português, Inglês, Espanhol | MEDLINE | ID: mdl-31432916

RESUMO

OBJECTIVE: to analyze the trend and spatial distribution of some diseases that require compulsory notification in pregnant women. METHOD: ecological study, with data from the National Notifiable Diseases Surveillance System, of the incidence of the six most frequent diseases that, require compulsory notification, in pregnant women. The Prais-Winsten model was used to analyze the trend classified as stable, decreasing and increasing, according to macro-regions. For the spatial analysis, the incidences distributed in percentiles, in choropleth maps, by Health Regions were calculated. RESULTS: the most frequent infections were syphilis, dengue, Human Immunodeficiency Virus, influenza, hepatitis and toxoplasmosis. Incidence increased by 30.8%, 30.4%, 15.4% and 2.6%, on average, for syphilis, toxoplasmosis, dengue and Human Immunodeficiency Virus, respectively. On average, the incidence of syphilis increased by 40.5% in Macro-regional North and 38% in Macro-regional Northwest. The spatial analysis showed, in the last four years, high incidence of dengue, syphilis and infection by Human Immunodeficiency Virus, which reached 180.2, 141.7 and 100.8 cases per 10,000 live births, respectively. CONCLUSION: there were increased incidences of infection in pregnant women due to syphilis, toxoplasmosis and Human Immunodeficiency Virus, with differences in their spatial distribution, indicating that these diseases should be a priority in the care of pregnant women in more affected regions.


Assuntos
Complicações Infecciosas na Gravidez/epidemiologia , Brasil/epidemiologia , Dengue/epidemiologia , Notificação de Doenças , Feminino , Infecções por HIV/epidemiologia , Hepatite/epidemiologia , Humanos , Incidência , Influenza Humana/epidemiologia , Gravidez , Análise Espaço-Temporal , Sífilis/epidemiologia , Fatores de Tempo , Toxoplasmose/epidemiologia
12.
Mikrobiyol Bul ; 53(3): 348-353, 2019 Jul.
Artigo em Turco | MEDLINE | ID: mdl-31414637

RESUMO

The frequency of travel-related infections in the world has increased due to the easily and widespread use of travel facilities in the 21st century. Vector-borne diseases are an important part of infectious diseases. Dengue fever is one of the travel-related infections that has been reported increasingly in recent years through the development of diagnostic methods. The aim of this report was to present two Dengue fever cases originating from travel. There was a story of mosquito bite during a trip to Sri Lanka travel in our first case. The patient was 30 years old and maculopapular rash appeared on the fifth day of contact. Three days after the onset of the rash, she has admitted to our clinic, complaining with fever and chills. Increased leukopenia and muscle enzymes were detected in the laboratory analysis. Real-time reverse transcriptase polimerase chain reaction (RT-PCR) was positive in the serum sample. The patient was followed up with supportive care and discharged by improvement. The second case, a 24-year-old male, had a story of mosquito bite during his trip to Malaysia. After the patient complained of fever, chills, fever, nausea, vomiting and muscle pain, the Dengue virus (DENV) NS1 antigen test performed in this country was found to be positive. In the second case, there was no maculopapular rash and laboratory analysis showed an increase in leukopenia, thrombocytopenia and muscle enzymes. RT-PCR positivity was detected in the serum sample. The patient was followed up with supportive treatment and discharged with cure. DENV infections are caused by DENV which is common in the tropical areas of the world. There are four DENV-1, DENV-2, DENV-3 and DENV-4 serotypes. DENV infections can present different clinical manifestations such as asymptomatic disease, viral syndrome, Dengue haemorrhagic fever, and Dengue shock syndrome. Dengue fever is often accompanied by arthritis, maculopapular rash and high fever. Our cases were defined as Dengue fever according to this definition. In the diagnosis of the disease, it is necessary first to be suspicious of the disease and the travel history must be questioned. In the definitive diagnosis, virus isolation, antigen, nucleic acid detection and serological tests are used. The virus can be isolated from blood, serum, urine and tissues. In the first five days after beginning of the symptoms associated with DENV infections, serum RT-PCR and Dengue NS1 antigen test may be positive.


Assuntos
Vírus da Dengue , Dengue , Doença Relacionada a Viagens , Adulto , Dengue/complicações , Dengue/diagnóstico , Dengue/patologia , Dengue/virologia , Vírus da Dengue/classificação , Exantema/etiologia , Feminino , Humanos , Malásia , Masculino , Sri Lanka , Resultado do Tratamento , Adulto Jovem
13.
; Fiocruz.
Recurso na Internet em Português | LIS - Localizador de Informação em Saúde, LIS-bvsms | ID: lis-LISBR1.1-46679

RESUMO

As doenças negligenciadas são aquelas causadas por agentes infecciosos ou parasitas e são consideradas endêmicas em populações de baixa renda.


Assuntos
Doenças Negligenciadas , Pobreza , Medicina Tropical , Malária , Doença de Chagas , Tripanossomíase Africana , Leishmaniose Visceral , Filariose Linfática , Dengue , Tuberculose , Esquistossomose
14.
Rev. argent. salud publica ; 39(9): 38-41, Julio 2019.
Artigo em Espanhol | LILACS, BINACIS, ARGMSAL | ID: biblio-1007593

RESUMO

: INTRODUCCIÓN: En Argentina desde 1998 ocurrieron brotes de dengue todos los años excepto 2001 y 2005 en diferentes áreas, en 15 jurisdicciones, con identificación de los 4 serotipos. El objetivo de este estudio fue identificar poblaciones con mayor riesgo de desarrollar formas graves de la enfermedad como insumo para la posible introducción de una estrategia de prevención. METODOS: Se realizó un estudio retrospectivo descriptivo de los casos de dengue confirmados autóctonos a partir de publicaciones oficiales, notificaciones al SNVS e información aportada por las áreas de epidemiología provinciales. Se elaboró una estratificación del riesgo de dengue grave por departamento para el período 1998-2018. RESULTADOS: Se elaboraron 5 criterios de estratificación de riesgo: registro de casos autóctonos en al menos 2 de los 5 cinco últimos años, registro de 2 o más serotipos causantes del 10% o más de los casos cada uno, incidencia acumulada mayor a 500 casos por 100 mil habitantes, incidencia acumulada mayor a 5 casos por mil menores de 15 años y registro de casos graves o fallecidos. Se obtuvieron 60 departamentos con 1 criterio, 19 con 2, 8 con 3, 4 con 4, 1 con 5 y 129 no cumplieron criterios. DISCUSION: Solo 13 departamentos sumaron 3 criterios o más, resultado del predominio de DENV-1, la baja incidencia en menores de 15 años y el bajo número de casos graves y fatales. La estratificación del riesgo poblacional con criterios de registro sistemático se orienta a obtener una herramienta de evaluación de los escenarios de dengue que puedan presentarse en el futuro.


Assuntos
Humanos , Dengue/epidemiologia , Sistema de Vigilância Sanitária , Argentina/epidemiologia , Epidemiologia Descritiva , Estudos Retrospectivos , Dengue/prevenção & controle
15.
Rev Soc Bras Med Trop ; 52: e20180341, 2019 Jun 27.
Artigo em Inglês | MEDLINE | ID: mdl-31271613

RESUMO

INTRODUCTION: Areas at risk of transmission of arboviruses have been monitored using ovitraps. This study aimed to evaluate the spatial distribution of Aedes aegypti in vulnerable areas for the transmission of arboviruses and assess the influence of climatic conditions on the infestation of these culicids. METHODS: Ovitraps were installed in Agrestina, Pernambuco, Northeastern Brazil. RESULTS: Overall, 44,936 eggs were collected, and the indexes of infestation varied. Relative humidity was significantly associated with the infestations. CONCLUSIONS: Using ovitraps, entomologic indexes and analysis of climatic factors might be good strategies for monitoring vulnerable areas for the transmission of arboviruses.


Assuntos
Arbovirus , Febre de Chikungunya/prevenção & controle , Dengue/prevenção & controle , Controle de Mosquitos/métodos , Oviposição , Infecção por Zika virus/prevenção & controle , Aedes/fisiologia , Animais , Brasil , Febre de Chikungunya/transmissão , Dengue/transmissão , Humanos , Umidade , Mosquitos Vetores/fisiologia , Chuva , Características de Residência , Estações do Ano , Análise Espacial , Temperatura Ambiente , Infecção por Zika virus/transmissão
16.
Washington, D. C.; PAHO; 2019-07-21.
em Inglês | PAHO-IRIS | ID: phr-51375

RESUMO

[Introduction]. The Region of the Americas has a long history of vector-borne disease control. The evidence reveals the success of various programs in the past. The control of yellow fever and malaria in Cuba and Panama under the direction of William Gorgas (1901–1910), the elimination of Anopheles gambiae in Brazil (1940), the elimination of Aedes aegypti between 1950 and 1960 led by Fred Soper under the auspices of PAHO, the elimination of transmission of Chagas disease by Triatoma infestans in Brazil and Uruguay, and the recent elimination of onchocerciasis from 11 of the 13 endemic foci in Colombia, Ecuador, Mexico, and Guatemala (2013–2016) are recent examples of interventions that have combined the use of insecticides, sanitary engineering, and effective vaccines or medicines, supported by community participation and other control methods… It is estimated that nearly half the world’s current population lives in areas at risk for dengue. Transmission is occurring in more than 100 countries and between 300 and 500 million people are infected annually, 96 million of whom have clinical manifestations and 500,000 have severe cases, with around 25,000 deaths. The infection is endemic in the Americas and in the Southeast Asia, Western Pacific, Africa, and Eastern Mediterranean regions. In the last 50 years the incidence has increased thirtyfold, a trend that shows no sign of abating. The epidemiological scenario reveals that the number of cases is increasing, that outbreaks are larger and longer-lasting, and that the affected areas and populations are continually expanding. Achieving the WHO goal of reducing mortality by 50% and morbidity by 25% by 2020 will be a challenge, given the lack of good surveillance systems that can correctly quantify the burden of disease and the deficiencies of vector control programs in the endemic countries…


Assuntos
Aedes , Mosquitos Vetores , Controle de Mosquitos , Dengue , Wolbachia , Epidemiologia
17.
Washington, D. C.; OPAS; 2019-07-21.
em Português | PAHO-IRIS | ID: phr-51374

RESUMO

[Introdução]. A história do controle das doenças transmitidas por vetores nas Américas é muito extensa, e as evidências mostram que, no passado, vários programas foram exitosos. O controle da febre amarela e do paludismo em Cuba e no Panamá, sob a direção de William Gorgas (1901-1910); a eliminação de Anopheles gambiae no Brasil (1940); a eliminação de Aedes aegypti entre 1950 e 1960, promovida pela OPAS e dirigida por Fred Soper; a eliminação da transmissão da doença de Chagas por Triatoma infestans no Brasil e no Uruguai; e a recente erradicação da oncocercose de 11 dos 13 focos endêmicos na Colômbia, no Equador, no México e na Guatemala (2013-2016) são exemplos recentes de intervenções que combinaram o uso de inseticidas, da engenharia sanitária e a disponibilidade de vacinas ou medicamentos efetivos, apoiados pela participação comunitária e outros métodos de controle... Hoje em dia, estima-se que cerca de metade da população mundial viva em áreas em risco de dengue. Além disso, mais de 100 países apresentam transmissão e são produzidas entre 300 e 500 milhões de infecções anuais, das quais 96 milhões apresentam manifestações clínicas e 500.000 são casos severos, com aproximadamente 25.000 mortes. A infecção é endêmica nas regiões das Américas, Ásia Sul-Oriental, Pacífico Ocidental, África e Mediterrâneo Oriental, e nos últimos 50 anos a incidência cresceu 30 vezes, sem que haja sinais de reversão dessa tendência. O cenário epidemiológico mostra que o número de casos vem aumentando, que os surtos apresentam maior duração e magnitude e que as áreas afetadas e as populações expostas se encontram em constante expansão. A meta da OMS, para o 2020, de reduzir a mortalidade em 50% e a morbidade em 25% é considerada um desafio diante da carência de bons sistemas de vigilância que quantifiquem corretamente a carga de doença e as deficiências dos programas de controle de vetores nos países endêmicos...


Assuntos
Aedes , Mosquitos Vetores , Controle de Mosquitos , Dengue , Wolbachia , Zika virus , Vírus Chikungunya , Febre Amarela
18.
BMC Infect Dis ; 19(1): 572, 2019 Jul 03.
Artigo em Inglês | MEDLINE | ID: mdl-31269906

RESUMO

BACKGROUND: We conducted a diagnostic surveillance study to identify Plasmodium, dengue virus, chikungunya virus, and Orientia tsutsugamushi infections among febrile patients who underwent triage for malaria in the outpatient department at Ispat General Hospital, Rourkela, Odisha, India. METHODS: Febrile patients were enrolled from January 2016-January 2017. Blood smears and small volumes or vacutainers of blood were collected from study participants to carry out diagnostic assays. Malaria was diagnosed using rapid diagnostic tests (RDT), microscopy, and PCR. Dengue, chikungunya, and scrub typhus infections were identified using rapid diagnostic test kits and ELISA. RESULTS: Nine hundred and fifty-four patients were prospectively enrolled in our study. The majority of patients were male (58.4%) and more than 15 years of age (66.4%). All 954 enrollees underwent additional testing for malaria; a subset of enrollees (293/954) that had larger volumes of plasma available was also tested for dengue, chikungunya and scrub typhus by either RDT or ELISA or both tests. Fifty-four of 954 patients (5.7%) were positive for malaria by RDT, or microscopy, or PCR. Seventy-four of 293 patients (25.3%) tested positive for dengue by either RDT or ELISA, and 17 of 293 patients (5.8%) tested positive for chikungunya-specific IgM by either ELISA or RDT. Ten of 287 patients tested (3.5%) were positive for scrub typhus by ELISA specific for scrub typhus IgM. Seventeen patients among 290 (5.9%) with results for ≥3 infections tested positive for more than one infection. Patients with scrub typhus and chikungunya had high rates of co-infection: of the 10 patients positive for scrub typhus, six were positive for dengue (p = 0.009), and five of 17 patients positive for chikungunya (by RDT or ELISA) were also diagnosed with malaria (p < 0.001). CONCLUSIONS: Dengue, chikungunya and scrub typhus are important etiologies of non-malarial febrile illness in Rourkela, Odisha, and comorbidity should be considered. Routine febrile illness surveillance is required to accurately establish the prevalence of these infections in this region, to offer timely treatment, and to implement appropriate methods of control.


Assuntos
Febre de Chikungunya/etiologia , Dengue/etiologia , Febre/etiologia , Tifo por Ácaros/etiologia , Adolescente , Adulto , Idoso , Febre de Chikungunya/diagnóstico , Febre de Chikungunya/epidemiologia , Criança , Pré-Escolar , Dengue/diagnóstico , Ensaio de Imunoadsorção Enzimática , Feminino , Febre/epidemiologia , Humanos , Índia/epidemiologia , Lactente , Malária Falciparum/diagnóstico , Malária Falciparum/epidemiologia , Malária Falciparum/etiologia , Masculino , Pessoa de Meia-Idade , Pacientes Ambulatoriais , Reação em Cadeia da Polimerase , Prevalência , Kit de Reagentes para Diagnóstico , Tifo por Ácaros/diagnóstico , Tifo por Ácaros/epidemiologia
19.
BMC Infect Dis ; 19(1): 580, 2019 Jul 04.
Artigo em Inglês | MEDLINE | ID: mdl-31272403

RESUMO

BACKGROUND: Transcriptomic profiling has generated extensive lists of genes that respond to viral infection in mosquitoes. These gene lists contain two types of genes; (1) those that are responsible for the insect's natural antiviral defense mechanisms, including some known innate immunity genes, and (2) genes whose change in expression may occur simply as a result of infection. As genetic modification tools for mosquitoes continue to improve, the opportunities to make refractory insects via allelic replacement or delivery of small RNAs that alter gene expression are expanding. Therefore, the ability to identify which genes in transcriptional profiles may have immune function has increasing value. Arboviruses encounter a range of mosquito tissues and physiologies as they traverse from the midgut to the salivary glands. While the midgut is well-studied as the primary tissue barrier, antiviral genes expressed in the subsequent tissues of the carcass offer additional candidates for second stage intervention in the mosquito body. METHODS: Mosquito lines collected recently from field populations exhibit natural genetic variation for dengue virus susceptibility. We sought to use a modified full-sib breeding design to identify mosquito families that varied in their dengue viral load in their bodies post infection. RESULTS: By delivering virus intrathoracically, we bypassed the midgut and focused on whole body responses in order to evaluate carcass-associated refractoriness. We tested 25 candidate genes selected for their appearance in multiple published transcriptional profiles and were able to identify 12 whose expression varied with susceptibility in the genetic families. CONCLUSIONS: This method, using natural genetic variation, offers a simple means to screen and reduce candidate gene lists prior to carrying out more labor-intensive functional studies. The extracted RNA from the females across the families represents a storable resource that can be used to screen subsequent candidate genes in the future. The aspect of vector competence being assessed could be varied by focusing on different tissues or time points post infection.


Assuntos
Aedes/virologia , Vírus da Dengue/genética , Dengue/virologia , Variação Genética , Imunidade Inata/genética , Mosquitos Vetores/virologia , Animais , Vírus da Dengue/isolamento & purificação , Feminino , Perfilação da Expressão Gênica , Masculino , Carga Viral
20.
J Assoc Physicians India ; 67(4): 30-34, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-31299835

RESUMO

Introduction: Dengue fever management is guided by WHO guideline, the recent one being 2009; however, compliance to the guideline is difficult to assess and in India there is no data on it. The present study, a longitudinal pre-post interventional quality improvement study, was done to determine the compliance to the guideline on dengue patients before and after resident physicians' training during two peak seasons and their impact on survival. Methods: This study was conducted in a tertiary health care centre in North India over 18 months. Data of hospitalized patients who admitted with dengue fever diagnosis in a peak season was collected in the form of quality indicators as described by the WHO-2009 guideline on dengue. Resident physicians were then given appropriate training about the guideline during the off season. Data of new dengue patients in next peak season after resident training was collected and compared with the baseline by standard statistical tests. Results: The post-intervention compliances of all components increased (total mean score by giving one point to each of the quality indicators reached 7.9 from 6.4). The compliance to individual indicator also increased: the admission criteria (baseline, 44% to post-intervention, 52%, p = 0.37), classification criteria (91.7% to 96%, p = 0.33), correct staging/triage (42.9% to 86%, p <0.001), vitals monitoring (85.7% to 92%, p = 0.28), correct usage of bolus fluids (34.3% to 69.5%, p <0.001), crystalloid as choice of fluid (100% in both groups), proper fluid titration (26.2% to 56%, p <0.001), hematocrit monitoring (95.2% to 98%, p = 0.42), platelet transfusion when indicated (65.5% to 58%, p = 0.39), antibiotic use when required (61.5% to 80%, p = 0.03), and discharge criteria (100% in both groups). The mortality decreased from 7.1% (baseline) to zero (post-intervention). The median duration of hospital stay also reduced by 1 day. Conclusion: The study affirms that the compliance to WHO guideline on dengue management in India can be further improved by regular physician training on the guideline. Simultaneously, this educational intervention not only improves patient outcomes but also direct proper resource utilization especially platelet transfusion and antibiotic use. Furthermore, every hospital/institute should have an internal quality improvement program like this to improve the management of dengue patients. Future studies are needed to understand various barriers to 100% implementation of the guideline.


Assuntos
Dengue/terapia , Cooperação do Paciente , Melhoria de Qualidade , Fidelidade a Diretrizes , Guias como Assunto , Hospitais , Humanos , Índia , Organização Mundial da Saúde
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA