BackgroundHuman papillomavirus (HPV) is a member of the Papillomaviridae family. The prevalence of HPV genotypes may vary according to the region and the population studied. Quilombo communities are ethnic and racial groups with difficult access to health services compared to the general population in Brazil. The aim of this study was to identify specific HPV types correlating with sociodemographic/behavioral characteristics and cervical smear cytological abnormalities in Quilombola women.MethodsThis cross-sectional study included 395 Quilombola women users of the Unified Health System of the Municipalities of Maranhão for the screening of cervical cancer. The samples were analyzed for the presence of cytological abnormalities by conventional methods and tested for 37 HPV genotypes using polymerase chain reaction with primers PGMY09/11 followed by reverse line blot hybridization performed with the Linear Array HPV Genotyping Test kit by Roche Molecular System®. The association between HPV types and cytological diagnosis was investigated according to the different age groups.ResultsHPV infection was detected in 12.6% (50/395) of the women. Infections by high-risk HPV types were more frequent. Genotypes 68 (26.0%); 58 and 52 (20.0%); 31 (10.0%) and 62 (8.0%) were the most prevalent. The highest prevalence (42.0%) of HPV infection occurred in women diagnosed with high-grade squamous intraepithelial lesion. There was a statistically significant association between HPV infection and the detection of cytological abnormalities in all age groups except in women over 60 years. There was a statistically significant association between the municipality of origin and the number of partners with HPV infection.ConclusionsIt is important to incorporate new cervical cancer screening techniques incorporating the cervical-vaginal cytology. For further studies, it is necessary to determine the level of knowledge of Quilombola population on health-related issues including HPV infection and cervical cancer. This will contribute to the continuous improvement of healthcare coverage among the population and enhance the implementation of cancer care in the state of Maranhão.
As some factors associated with the tropical environment can modify the expression of atopie disease, various indicators of allergic reactivity were compared between allergic and non-allergic subjects of different socio-economic level in Caracas, Venezuela (Lat. 10°N). The socio-economic levels considered were high (HSEL), medium-high (MSEL) or low (LSEL). As generally found in temperature climates, in the HSEL the total serum IgE levels of allergic patients were significantly greater than those of nonallergic individuals (geometric means of 274 vs 126 IU/ml, respectively), as were also the specific serum IgE antibody levels (55-6 vs 23-8% positive, respectively, for house dust). These results correlated closely with the skin-test reactivity of these subjects (60-3 vs 17-5% positive for house dust). In this group, the degree of intestinal helminthic infection was low (5-6% positive for Ascaris). In contrast, for the MSEL where the degree of parasitic infection was higher (13-0%), the total serum IgE levels were elevated in both allergic and non-allergic subjects (602 vs 363 IU/ml). Similarly, positivity for specific IgE antibody was high, and comparable between allergies and non-allergies of this group (61-5 vs 54-2%), as was also the case for skin-test reactivity (71-9 vs 60-4%). In the LSEL, parasitic infection was prevalent (47-6%), and the total serum IgE levels were markedly elevated, with little difference occurring between allergic and non-allergic individuals (2269 vs 1981 IU/ml). The positivity for specific IgE antibody was high, and effectively independent of the allergic state (75-6 vs 53-7%), but in contrast the skin test reactivity was relatively low (22-0 vs 9-8%). The lack of correlation between skin test and specific IgE results in this group appeared to have Correspondence: Dr Neil R. Lynch, Instituto de Biomedicina, Aptdo. 4043, Caracas lOlOA, Venezuela. N. R. Lynch et al. two causes. Firstly, although the frequency of positivity in specific IgE was high, only low grade antibody activity was detected. Secondly, studies ofskin reactivity indicated that some form of interference to target cell sensitization was occurring. The possible participation of helminth-induced polyclonally-increased IgE synthesis in the modification of allergic reactivity is discussed.
A prospective study was undertaken in 1,520 children less than 15 years of age in São José de Ribamar, Maranhão, Brazil, from June 1994 to January 1995, to evaluate the prevalence and characteristics (socioeconomic, environmental, and behavioral) associated with infection by Leishmania chagasi. Montenegro skin test (MST) and enzyme-linked immunosorbent assay (ELISA-rK39 and CRUDE) test were used to detect infection. The statistical analysis used the chi2 test with Yates correction and a p value less than 0.05 was considered statistically significant. Prevalence of infection was 61.7% as measured by MST, 19.4% according to ELISA (rK39), and 19.7% by ELISA (CRUDE). Association was detected between leishmaniasis in the family, water supply, application of insecticide, and infection by L. chagasi using MST. No association with infection by L. chagasi was detected using ELISA rK39 or CRUDE. More effective control measures are needed to reduce prevalence and to detect asymptomatic cases in this high percentage of infected children.
The patients followed the socioeconomic and demographic profile of Maranhão. Most had menarche and menopause in appropriate periods, showed no positive family history of osteoporosis, did not usually drink alcohol, were sedentary and the caffeine intake was high.
Introduction: In this paper, we report the ecology of Lutzomyia longipalpis in Caxias City, located in the eastern part of State of Maranhão, Brazil and highlight its seasonal and geographical distribution by environment. In addition, we discuss natural Leishmania infection and its relationship with visceral leishmaniasis. Methods: Between September 2007 and August 2009, the collection of sandfl ies was performed using Center for Disease Control (CDC) light traps from 15 houses in 5 selected neighborhoods. Results: Lutzomyia longipalpis was present in all zones of the city. We also found that Lu. longipalpis was regularly detected both inside and around the house, predominantly in outdoor areas. In urban areas, Lu. longipalpis was present in both the dry and rainy seasons, with a higher density present in the latter. One female specimen of Lu. longipalpis was observed to have natural Leishmania infection. Conclusions: The presence of Lu. longipalpis was observed throughout the year during 2 seasonal periods, with a predominance in the rainy season. A low rate of natural Leishmania infection was observed in urban areas during the rainy season.
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