There is a clear opportunity for reducing the burden of congenital syphilis by promoting syphilis screening and treatment in women with previous stillborn births. In addition, the potential impact of more general policies addressing social determinants of health, such as those improving education, must not be overlooked.

The emergence of zoonotic visceral leishmaniasis (ZVL) in Latin America is a growing public health problem. The urbanization of ZVL has been observed in different countries around the world, and there are a growing number of reports drawing attention to the emergence of this infection in new locations, as well as its increase in previously established areas of endemicity. In the city of Posadas, Misiones province, Northeastern Argentina, the transmission of ZVL associated with canines and Lutzomyia longipalpis was first reported in 2006. In the city of Puerto Iguazú, also in Misiones province, the first human case of ZVL was reported in February 2014. From 209 surveyed dogs, 15 (7.17%) were identified as positive by serological and/or parasitological methods. Amplification was observed in 14 samples and in all cases the species implicated was Leishmania infantum. To the authors’ knowledge, this is the first molecular characterization of L. infantum from dogs in this area.

Objective: to analyze how the social isolation measures and closed borders affected the health and economy in an international border region. Method: descriptive cross-sectional study conducted in the western region of Paraná, Brazil, using an electronic form created using Google® forms. A sample of 2,510 people was addressed. Descriptive analysis and the Chi-square test were performed, with a level of significance established at 5%. This public opinion survey, addressing unidentified participants, is in accordance with Resolutions 466/2012 and 510/2016. Results: the participants were 41.5 years old on average, most were women and worked in the education sector; 41.9% reported that the closing of borders/commercial businesses negatively influenced income; 17.7% reported the possibility of losing their jobs; 89.0% consider that a larger number of people would be sick if the borders/commercial had not been closed; 63.7% believe the health services are not prepared to deal with the pandemic; 74.9% realize that the Brazilian Unified Health System may not have sufficient service capacity; 63.4% reported anxiety; and 75.6% of commercial workers will experience changes in their income level. Conclusion: the closing of international borders and commercial businesses was related to a perception of physical and mental changes, job loss, and decreased income.

Objetivo: caracterizar o perfil clínico epidemiológico e a distribuição espacial da incidência dahanseníase em territórios fronteiriços da América do Sul.Método: trata-se de um estudo ecológico. O estudo compreendeu a Província de Misiones naArgentina e a Região Sul do Brasil. A população foi composta por 10.319 casos novos de hanseníase,diagnosticados entre 2010 e 2016.Resultados: o estado do Paraná foi o mais endêmico, representando 70,2% (n=7,247) doscasos. Houve predomínio da classificação operacional multibacilar (79,8%, n=8.233) e Grau 0de incapacidade física (50,6%, n=5.223). Em Misiones 18,9% utilizaram esquema de tratamentosubstitutivo. No período, notou-se uma situação hiperendêmica em 780 (65,5%) dos municípios/departamentos estudados.Conclusão: o estudo mostrou que as regiões estudadas apresentam alta endemicidade, transmissãoativa e diagnóstico tardio da hanseníase. Essas tendências entrelaçadas à força de morbidade e detransmissão recente e persistente da doença, ampliam a relevância da hanseníase como problemade saúde pública na região.

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Introducción. La leishmaniosis cutánea por Leishmania braziliensis ha sido tradicionalmente endémica en Argentina y se han sido descritos casos de compromiso visceral después de una leishmaniosis cutánea inicial. La leishmaniosis visceral emergió en Argentina en el año 2006 en la ciudad de Posadas, provincia de Misiones, afectando tanto a humanos como a perros.Objetivo. Identificar el agente etiológico a nivel de especie de los pacientes diagnosticados con leishmaniosis visceral en Misiones y describir sus características clínicoepidemiológicas.Materiales y métodos. Se estudió una serie de 24 pacientes con diagnóstico confirmado de leishmaniosis visceral en la provincia de Misiones en el período 2009 al 2016. Para la identificación de Leishmania spp., los pacientes fueron sometidos a estudios diagnósticos indirectos (serológicos) y directos (microscopía, detección de ADN y secuenciación). También, se estudiaron variables como edad, sexo, lugar de residencia, y signos y síntomas clínicos indicativos de leishmaniosis visceral.Resultados. De los 24 pacientes estudiados, 18 (75 %) eran hombres y 6 (25 %) eran menores de cuatro años. La manifestación clínica más frecuente fue el síndrome febril prolongado en 21 (87,5 %) de los pacientes, seguido de esplenomegalia en 17 (70,8 %). Se identificó la especie Leishmania infantum en todos los pacientes estudiados.Conclusión. Este hallazgo constituye la primera identificación de la especie L. infantum en pacientes autóctonos de la provincia de Misiones. El estudio evidenció la importancia de la PCR para el manejo epidemiológico de la leishmaniosis visceral en Argentina.

Objective The aim was to analyze the spatial association and relative risk (RR) of leprosy cases diagnosed in southern Brazil and in the Argentinean province of Misiones during 2010 to 2016. Methods This ecological-type epidemiological study analyzed data from the Health Ministries of both countries. The analysis included frequency measures, spatial autocorrelation, RR cluster analysis and map construction. Results A hyperendemic occurrence was identified in all study regions, in the state of Paraná 71.2% of the municipalities were hyperendemic and in Misiones, Argentina 41.2%. The GI* statistical analysis showed clusters of high incidence rates in the state of Paraná and low-risk clusters in much of the state of Rio Grande do Sul, both in Brazil. The analysis indicated an area with RR equal to 3.87 - (p < .0001) when considering the entire territory and an RR of 2.80 - (p < .0001) excluding the state of Paraná, with the number of departments of Misiones, Argentina included in the risk clusters increasing significantly. Conclusions The findings indicate a high probability of similar illness in adjacent areas, according to their relative position in space, as the occurrence of the disease is influenced by neighboring clusters.

Background: Visceral leishmaniasis (VL) is one of the most important parasitic diseases in the world. The domestic dog is the main reservoir of zoonotic VL and a high prevalence of canine leishmaniasis (CanL) is associated with transmission of infection to humans. Here we describe the methodology used to obtain a rapid and representative sample of domestic dogs in the city of Posadas, Misiones, and compare the prevalence of Leishmania infection with a sample of shelter dogs.Methodology: We used the city land registry to make a random selection of homes and systematically recruited 349 domestic dogs from the selected properties. We also included all dogs from the main canine shelter within the city. Dogs were examined by two experienced veterinarians who recorded the presence of clinical signs common in CanL using a standardized protocol. We extracted a blood sample from each dog and performed four different serological tests to reveal the presence of anti-Leishmania antibodies.Results: After clinical examination, 145 domestic dogs (41.5%) and 63 (90%) shelter dogs had clinical signs compatible with CanL (p &lt; 0.001). The seroprevalence among domestic dogs was 20.1% (95% CI 16.1–24.6) which was significantly lower than among the abandoned dogs (38.6%, 95% CI 27.7–50.6, p &lt; 0.001). The spatial distribution of infected dogs was fairly homogenous throughout the city. Among domestic dogs, we observed a positive association between where the dog slept and presence of anti-Leishmania antibodies (p = 0.034). Of the seropositive domestic dogs 38 (54.4%) were asymptomatic.Conclusions: Our findings demonstrate how seroprevalence results can be highly influenced by sampling methodology. We demonstrate how the land registry can be used to estimate the prevalence of CanL in representative sample of domestic dogs in an urban setting, allowing decision makers to deepen their understanding the epidemiology of CanL in a timely and efficient manner for the development of plans to address both human and canine disease.