This 15-year study aimed to determine the role of the main viruses responsible for acute infantile gastroenteritis cases in a day care center in the city of Rio de Janeiro, Brazil. From 1994 to 2008, 539 fecal samples were obtained from 23 outbreaks as well as sporadic cases that occurred in this period. The detection of Rotavirus group A (RVA), norovirus (NoV) and astrovirus (AstV) was investigated both by classical and molecular methods of viral detection. RVA was detected by enzymatic immune assay and/or polyacrylamide gel electrophoresis and genotyped by using semi-nested multiplex PCR. NoV and AstV were subsequently tested by real time PCR in all RVA-negative samples and genotyped throughout genome sequencing. Three protocols for molecular characterization of NoV nucleotide sequencing were performed with the partial nucleotide sequencing of genomic regions known as region B (polymerase gen), C and D (capsid gen).Viruses were identified in 47.7% (257/539) of the cases, and the detection rates of RVA, NoV and AstV in16.1% (87/539), 33.4% (151/452), and 6.3% (19/301), respectively. Most gastroenteritis cases were reported in autumn and winter, although NoV presented a broader monthly distribution. Viruses' detection rates were significantly higher among children aged less than 24 months old, although NoV cases were detected in all age groups. RVA genotypes as G1P[8], G9P[8], G2P[4], G3P[8] and G1+G3P[8] and RVA was no longer detected after 2005. NoV characterization revealed genotypes variability circulating in the period as GI.2, GI.3, GI.8 GII.2, GII.3, GII.4, GII.4 variants 2001 and 2006b, GII.6, GII.7, GII.12 and GII.17. AstV genotypes 1, 2, 4 and 5 were also characterized. Those data demonstrate the impact of NoV infection in cases of infantile gastroenteritis, surpassing RVA infection responsible for high morbidity rate in children under five years old.

Background Chagas disease (CD) remains an important endemic disease in Latin America. However, CD became globalized in recent decades. The majority of the chronically infected individuals did not receive etiologic treatment for several reasons, among them the most conspicuous is the lack of access to diagnosis. The impact of trypanocidal treatment on CD chronic phase, without cardiac involvement (indeterminate form ICF), is yet to be determined. We aimed to evaluate the effect of trypanocidal treatment with benznidazole (BZN) on the rate of progression to Chagas heart disease in patients with ICF. Methods This is a retrospective cohort observational study including patients with ICF treated with BZN and compared to a group of non-treated patients matched for age, sex, region of origin, and the year of cohort entry. We reviewed the medical charts of all patients followed from May 1987 to June 2020 at the outpatient center of the Evandro Chagas National Institute of Infectious Diseases (INI) of the Oswaldo Cruz Foundation (Fiocruz), Rio de Janeiro, Brazil. Patients’ follow-up included at least one annual medical visit and one annual electrocardiogram (ECG). Echocardiographic exams were performed at baseline and during the follow-up. Disease progression from ICF to cardiac form was defined by changes in baseline ECG. Cumulative incidence and the incidence rate were described in the incidence analysis. Cox proportional hazards models were used to estimate hazard ratios and 95% confidence intervals for the association between BZN and CD progression, cardiovascular events or death. Findings One hundred and fourteen treated patients met the study inclusion criteria. A comparison group of 114 non-treated patients matched for age, sex, region of origin, and the year of cohort entry was also included, totalizing 228 patients. Most patients included in the study were male (70.2%), and their mean age was 31.3 (+7.4) years. Over a median follow-up of 15.1 years (ranging from 1.0 to 32.4), the cumulative CD progression incidence in treated patients was 7.9% vs. 21.1% in the non-treated group ( p = 0.04) and the CD progression rate was 0.49 per 1.000 patients/year in treated patients vs. 1.10 per 1.000 patients/year for non-treated patients ( p = 0.02). BZN treatment was associated with a decreased risk of CD progression in both unadjusted (HR 0.46; 95%CI 0.21 to 0.98) and adjusted (HR 0.43; 95%CI 0.19 to 0.96) models and with a decreased risk of occurrence of the composite of cardiovascular events only in the adjusted (HR 0.15; 95%CI 0.03 to 0.80) model. No association was observed between BZN treatment and mortality. Interpretation In a long-term follow-up, BZN treatment was associated with a decreased incidence of CD progression from ICF to the cardiac form and also with a decreased risk of cardiovascular events. Therefore, our results indicate that BZN treatment for C...

Discutir a partir da produção cientifica nacional e internacional o perfil clínico epidemiológico da hanseníase. Método: Trata-se de uma Revisão Integrativa de literatura em que foi utilizado como estratégia de identificação e seleção dos artigos o levantamento de estudos indexados nos bancos de dados disponíveis na Biblioteca Virtual de Saúde -BVS: Lilacs, Medline levando-se em consideração a produção científica no período estudado de 2007 a 2016. Neste levantamento bibliográfico realizado pela internet utilizaram-se os descritores baseados nos Descritores em Ciências da Saúde (DeCS): "Hanseníase (Leprosy), Doenças negligenciadas (Neglected diseases), Vigilância epidemiológica (Epidemiological surveillance). Resultados e Discussão: Baseado nas informações que foram extraídas a partir dos dados obtidos deste estudo, observou-se que o período de publicação variou entre o ano 2009 e 2016, com predominância de 40% dos estudos (06 artigos) no ano de 2015 e 27% (04 artigos) em 2016. O periódico que apresentou o maior número de publicações neste trabalho foi a Revista Hansenologia Internacionalis, com 05 estudos (33%). Para melhor delineamento das informações extraídas dos artigos propostos, dois aspectos temáticos foram levados em consideração: "A Clínica da Hanseníase" e "A Epidemiologia da Hanseníase" Conclusão: Descritores: Hanseníase; Doenças negligenciadas; Vigilância epidemiológica. SUMMARYObjective: Discuss from the national and international scientific production the epidemiological clinical profile of leprosy. Method: This is an integrative review of literature that were used as identification strategy and selection of articles raising indexed studies in the databases available on the Virtual Health Library -VHL: Lilacs, Medline taking into account the scientific production during the study period from 2007 to 2016. in this literature review conducted by the internet used the descriptors based on descriptors in Health Sciences (from CS): "Leprosy (Leprosy), neglected diseases (neglected Diseases), epidemiological surveillance (Epidemiological surveillance). Results and Discussion: Based on the information that has been extracted from the data obtained from this study, it was observed that the publication period was between 2009 and 2016, especially 40% of the studies (06 articles) in 2015 and 27% (04 articles) in 2016. the journal that had the highest number of publications in this work was the Journal Hansenologia Internationalis, with 05 trials (33%). To better design the extracted information of the items, two thematic aspects were taken into account: "The Clinic of leprosy" and "The Epidemiology of Leprosy" Conclusion:

Human astrovirus (HAstV) represents the third most common virus associated with acute diarrhea (AD). This study aimed to estimate the prevalence of HAstV infection in Brazilian children under 5 years of age with AD, investigate the presence of recently described HAstV strains, through extensive laboratory-based surveillance of enteric viral agents in three Brazilian coastal regions between 2005 and 2011. Using reverse transcription-polymerase chain reaction (RT-PCR), the overall HAstV detection rate reached 7.1% (207/2.913) with percentage varying according to the geographic region: 3.9% (36/921) in the northeast, 7.9% in the south (71/903) and 9.2% in the southeast (100/1.089) (p < 0.001). HAstV were detected in cases of all age groups. Detection rates were slightly higher during the spring. Nucleotide sequence analysis of a 320-bp ORF2 fragment revealed that HAstV-1 was the predominant genotype throughout the seven years of the study. The novel AstV-MLB1 was detected in two children with AD from a subset of 200 samples tested, demonstrating the circulation of this virus both the in northeastern and southeastern regions of Brazil. These results provide additional epidemiological and molecular data on HAstV circulation in three Brazilian coastal regions, highlighting its potential to cause infantile AD.