Euthanasia of infected dogs is one of the measures adopted in Brazil to control visceral leishmaniasis (VL) in endemic areas. To detect infected dogs, animals are screened with the rapid test DPP® Visceral Canine Leishmaniasis for detection of antibodies against K26/K39 fusion antigens of amastigotes (DPP). DPP-positives are confirmed with an immunoenzymatic assay probing soluble antigens of promastigotes (ELISA), while DPP-negatives are considered free of infection. Here, 975 dogs from an endemic region were surveyed by using DPP, ELISA and real-time PCR (qPCR) for the diagnosis of VL. When DPP-negative dogs were tested by qPCR applied in blood and lymph node aspirates, 174/887 (19·6%) were positive in at least one sample. In a second sampling using 115 cases, the DPP-negative dogs were tested by qPCR in blood, lymph node and conjunctival swab samples, and 36/79 (45·6%) were positive in at least one sample. Low-to-moderate pairwise agreement was observed between all possible pair of tests. In conclusion, the official diagnosis of VL in dogs in Brazilian endemic areas failed to accuse an expressive number of infected animals and the impact of the low accuracy of serological tests in the success of euthanasia-based measure for VL control need to be assessed.

Although a national programme for control of visceral leishmaniosis (VL) is being run in Brazil, the disease continues to spread. This programme is essentially based on culling infected dogs from endemic regions. Thus, there is an urgent need to develop other control measures against VL to deter its advance. Here, a subunit vaccine, a recombinant vaccine, an insecticide-impregnated collar and the associations between these measures were evaluated for reducing the incidence of Leishmania infection in dogs. This was through a cohort study conducted in an endemic region of Brazil, considering the incidence and time of total exposure over a period of 1 year. The incidence of VL was estimated by means of serological and molecular diagnostic tests, 180 and 360 days after the application of the control measures. The estimates of the effectiveness (EF) were not significant in any cohort. The EF of the subunit vaccine, the recombinant vaccine and the collar were 26.4%, 32.8% and 57.7% and the upper limit of the 95% confidence interval for EF were 63.7%, 67.9% and 82.5%, respectively. In conclusion, under the conditions of this study, none of the immunogens for VL control was sufficiently effective to protect dogs against infection. On the other hand, use of collars impregnated with insecticide seems to constitute a method with better prognosis, corroborating other studies in this field.

i Visceral leishmaniasis (VL) is a zoonotic disease that is endemic to Brazil, where dogs are the main domestic parasite reservoirs, and the percentages of infected dogs living in regions where canine VL (CVL) is endemic have ranged from 10% to 62%. Despite technological advances, some problems have been reported with CVL serodiagnosis. The present study describes a sequential subtractive selection through phage display technology from polyclonal antibodies of negative and positive sera that resulted in the identification of potential bacteriophage-fused peptides that were highly sensitive and specific to antibodies of CVL. A negative selection was performed in which phage clones were adhered to purified IgGs from healthy and Trypanosoma cruzi-infected dogs to eliminate cross-reactive phages. The remaining supernatant nonadhered phages were submitted to positive selection against IgG from the blood serum of dogs that were infected with Leishmania infantum. Phage clones that adhered to purified IgGs from the CVL-infected serum samples were selected. Eighteen clones were identified and their reactivities tested by a phage enzyme-linked immunosorbent assay (phage-ELISA) against the serum samples from infected dogs (n ‫؍‬ 31) compared to those from vaccinated dogs (n ‫؍‬ 21), experimentally infected dogs with cross-reactive parasites (n ‫؍‬ 23), and healthy controls (n ‫؍‬ 17). Eight clones presented sensitivity, specificity, and positive and negative predictive values of 100%, and they showed no crossreactivity with T. cruzi-or Ehrlichia canis-infected dogs or with dogs vaccinated with two different commercial CVL vaccines in Brazil. Our study identified eight mimotopes of L. infantum antigens with 100% accuracy for CVL serodiagnosis. The use of these mimotopes by phage-ELISA proved to be an excellent assay that was reproducible, simple, fast, and inexpensive, and it can be applied in CVL-monitoring programs.

RESUMO O presente estudo teve como objetivo determinar a prevalência e a distribuição espacial da leishmaniose visceral em cães (LVC) do município de Juatuba, Minas Gerais

RESUMOO objetivo desta pesquisa foi descrever as análises da série cronológica e determinar a tendência da leishmaniose visceral em humanos e cães para o município de Belo Horizonte, de 1993. De 1994

Resumo Este artigo é resultado de um trabalho descritivo e exploratório realizado com os coordenadores e professores dos cursos de Enfermagem e de Nutrição de duas instituições de ensino superior do município de Divinópolis, Minas Gerais. Buscase detectar e avaliar as mudanças na formação dos profissionais de saúde, mediante a observação do que ocorre nesse município, além de caracterizar a formação do profissional de saúde, à luz da legislação pertinente e com ênfase na política e programas de saúde pública propostos pelas Diretrizes Curriculares Nacionais para os cursos de saúde. Problemas com as ações interdisciplinares e os princípios, diretrizes e conceitos relacionados ao Sistema Único de Saúde estão entre as principais dificuldades relatadas pelos entrevistados. É um trabalho científico que pretende somar ao conhecimento já produzido e servir de apoio às discussões que coordenadores, professores e alunos queiram fazer sobre a necessária atualização dos saberes e fazeres profissionais de enfermagem e nutrição, segundo o novo modelo de saúde em desenvolvimento no Brasil. Palavras-chave formação; saúde; diretrizes curriculares. A FORMAÇÃO DE PROFISSIONAIS DE SAÚDE EM INSTITUIÇÕES DE ENSINO SUPERIOR DE DIVINÓPOLIS, MINAS GERAIS THE TRAINING OF HEALTH PROFESSIONALS IN INSTITUTIONS OF HIGHER EDUCATION IN DIVINÓPOLIS, MINAS GERAIS Juliano Teixeira Moraes 1 Eliane Marta Teixeira Lopes 2Abstract This article is the result of a descriptive and exploratory study conducted with the coordinators and teachers of the Nursing and Nutrition courses from an institution of higher education in the city of Divinópolis, in Minas Gerais state. The aim is to detect and assess changes in the training of health professionals by observing what happens in this city and to characterize the training of health professionals in the light of relevant legislation and with an emphasis on policy and public health programs proposed by the National Curriculum Guidelines for health courses. Problems with the disciplinary actions and principles, guidelines and concepts related to the National Health System are among the main difficulties reported by the interviewees. It is a scientific article that intends to contribute to the already produced knowledge and to provide support to the discussions that coordinators, teachers, and students wanted to have about the necessary updating of the knowledge and practices of nursing and nutrition professionals, according to the new model of health development in Brazil.

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