Hepatitis C virus (HCV) is endemic worldwide and according to the World Health Organization (WHO), there are about 150 million chronic carriers worldwide. The infection is a leading cause of liver diseases like cirrhosis and hepatocellular carcinoma (HCC); thus, HCV infection constitutes a critical public health problem. There are increasing efforts worldwide in order to reduce the global impact of hepatitis C through the implementation of programmatic actions that may increase the awareness of viral hepatitis and also improve surveillance, prevention, and treatment. In Brazil, about 1,5 million people have been chronically infected with HCV. The country has a vast territory with uneven population density, and hepatitis C incidence rates are variable with the majority of cases concentrated in the most populated areas. Currently, the main priorities of Brazilian Ministry of Health's strategies for viral hepatitis management include the prevention and early diagnosis of viral hepatitis infections; strengthening of the healthcare network and lines of treatment for sexually transmitted diseases, viral hepatitis, and AIDS; improvement and development of surveillance, information, and research; and promotion of universal access to medication. This review aims to summarize the available data on hepatitis C epidemiology and current status of efforts in prevention and infection control around the world and in Brazil.

Antimicrobial activity of natural pigments produced by Monascus ruber CCT 3802 in submerged fermentation were studied. The pigments were screened for antimicrobial activity against three foodborne bacteria: Staphylococcus aureus, Escherichia coli and Salmonella enteritidis. The orange pigment presented antimicrobial activity against S. aureus ATCC 25923 and red pigments against S. aureus ATCC 25923 and E. coli ATCC 25922. S. enteritidis ATCC 13076 was not inhibited for orange and red pigments. The minimum inhibitory concentration values, which were sensitive to the pigments produced by M. ruber, were in the range of 10 to 20 mg/mL. These results suggest a possibility of inhibiting the growths of pathogenic microorganisms during processing and storage of food products. In conclusion, in addition to the use as a functional food ingredient, the Monascus pigments may be selected as an inhibitor to preserve food products where a natural preservative is desired. Practical Applications The results of this study indicate the possibility of using the pigments as natural colorant and food preservatives, and show the potential these sources have to act as antibacterial ingredients for the food and pharmaceutical industry. The observation of bacteriostatic effects has lead to the consideration that besides the tinctorial properties, the pigments of M. ruber have a preservative value.

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Antimicrobial resistance has increased rapidly in Brazil and worldwide during the past few years, giving rise to a growing necessity for antimicrobial resistance surveillance programs. These programs have been instituted in order to monitor bacterial resistance in various regions, and to guide empirical antimicrobial therapy. We evaluated the use of molecular typing in multicenter surveillance programs. We also studied the dissemination modes of selected resistance profiles. Antimicrobial susceptibility to various antimicrobial agents was evaluated by the reference broth microdilution method. Bacterial isolates with selected susceptibility patterns were characterized by pulsed field-gel electrophoresis (PFGE). A total of 119 Gram-negative bacteria were molecularly typed, including 22 imipenem-resistant Pseudomonas aeruginosa, 26 ESBL-producing Escherichia coli, 27 cefoxitin-resistant-ESBL-producing Klebsiella pneumoniae, 33 Enterobacter spp., 8 Citrobacter spp., and 3 S. marcescens isolates resistant to ceftazidime. The isolates were from clinically apparent bacteremia of patients hospitalized in medical centers located in 13 cities of 11 Brazilian states. Our molecular typing results revealed a great genetic diversity among isolates of the same species. However, some major PFGE patterns were found in more than one isolate. All repeated PFGE patterns were detected in only 2 isolates, which were isolated within the same institutions or in different medical centers. We conclude that the ability to characterize organisms phenotypically and genotypically is a powerful epidemiologic tool and it provides unique information that is very important for multicenter surveillance programs.

Pesquisa realizada em cozinhas hospitalares e institucionais do Município de Florianópolis, SC (Brasil) sobre a presença de Campylobacter em fezes de manipuladores de alimentos, demonstrou que a média de portadores foi de 6,2%. De um total de 177 indivíduos pesquisados, os manipuladores assintomáticos, em cozinhas institucionais apresentaram índice de contaminação superior àquele registrado em cozinhas hospitalares, ou seja, 10,5 e 2,2%, respectivamente. Dentre os portadores, constatou-se uma estreita relação entre manipuladores do sexo masculino e faixa etária, que ficou entre 20 e 35 anos de idade. Observou-se forte indicativo, sugerindo maior prevalência de Campylobacter spp em fezes de manipuladores do sexo masculino do que aquele do sexo feminino. Constatou-se, igualmente, uma certa tendência vinculando o grau de escolaridade do manipulador com seu estado de portador. Campylobacter IntroduçãoVêm sendo amplamente estudadas nos últimos anos algumas espécies do goner Campylobacter, notadamente C. jejuni, C. coli e C. landis, devido ao papel que desempenham no contexto das doenças humanas provocadas pelo consumo de alimentos contaminados 32 .Nos países desenvolvidos, o Campylobacter jejuni não é normalmente encontrado como participante da flora. Ao contrário do que se observa em países em desenvolvimento, onde o saneamento básico é precário, e este microrganismo é isolado com freqüência bastante elevada de indivíduos assintomáticos 4,7,16 .No Brasil também tem sido observada a presença de C. jejuni e C. coli em indivíduos sem sintomatologia clínica, demonstrando a existência de portadores assintomáticos desses microrganismos 13,19 .O aumento do número de doenças de origem alimentar deve-se, por um lado, à demanda elevada e constante de alimentos nos grandes centros urbanos e, por outro, à crescente necessidade de mão-de-obra, não raro, desqualificada. Soma-se a isso a introdução de novos tipos de produtos alimentícios e de embalagens, bem como a tendência atual de se consumir alimentos crus ou pouco cozidos visando à manutenção da qualidade nutricional e organoléptica dos mesmos.Por tudo isso, os alimentos têm sido responsabilizados em muitos casos de toxinfecção, freqüente-mente ocorrendo em pequenos grupos de pessoas; porém essas evidências são circunstanciais, uma vez que o cozimento é capaz de destruir a grande maioria de patógenos contaminantes de alimentos.

Background: Caregivers' satisfaction is one of the most frequently used outcome measures for quality of care offered by routine immunization (RI) service providers. It has been shown to positively influence compliance of caregivers with subsequent RI visits. This study assessed caregivers' satisfaction with RI services in primary, secondary and tertiary health facilities in Sokoto metropolis, Nigeria Materials and method: A descriptive cross-sectional study was conducted in three health facilities in Sokoto metropolis. A structured questionnaire was used to collect data from 217 caregivers who were selected via multistage sampling technique. Results: Mean age of respondents was 27 years ±5.49 and majority were Hausa-Fulani [183(84.3%)]. Majority of the caregivers in all the three categories of health facilities (HFs) surveyed spent more than 30 minutes to immunize their children (median total clinic wait time = 48 minutes). Caregivers were largely satisfied with most activities of the clinics; overall, 91.7% (n=199) of them were satisfied. Several factors were associated with caregivers' satisfaction; however, the significant predictors were tribe, providing adequate information about vaccine given to the child and availability of vaccines at all times (p<0.05). Conclusion: Up to three-fourth of the caregivers spent more than half an hour to receive RI services however, the overall satisfaction was excellent. The main predictors of caregivers' satisfaction were tribe, provision of information regarding the vaccine and availability of vaccines at all times. There is need for more efforts to be made by heads of the HFs and service providers to reduce waiting time at the RI clinics and also ensure vaccines are available at all times.