the results show the burden of dengue in pregnant women and their vulnerability to worsening of the disease and death.
Recebido para publicação em 06�08�2009 �ceito em 27�10�2009 � infecção pelo vírus linfotrópico de células T humanas 1 (HTLV�1) está associada com desenvolvimento de doenças graves como a leucemia�linfoma de células T do adulto (�TL) e mielopatia associada ao HTLV�1�paraparesia espástica tropical (H�M�TSP), além de síndromes inflamatórias e complicações infecciosas 24 ABSTRACTThis study aimed to determine the prevalence of HTLV�1 infection among remnant black quilombo communities in Central Brazil. � total of 1,837 individuals were evaluated, among whom nine were HTLV�1�2 seropositive according to ELIS�. �ll of them were positive for HTLV�1 by means of Western blot and�or PCR, thus resulting in a prevalence of 0.5% (95% CI: 0.2�1.0). The HTLV�1 infected individuals ranged in age from 11 to 82 years. The majority of them were females. Regarding risk characteristics, histories of breastfeeding, blood transfusion, multiple sexual partners and sexually transmitted diseases were reported by these individuals. The findings from this study indicate the importance of identifying HTLV�1 infected individuals, as a strategy for infection control and prevention in these remnant quilombos.Key-words: Human T�cell lymphotropic virus 1. Remnant quilombo. Central Brazil. Prevalence.observadas em algumas regiões como o sudoeste do Japão, Melanésia, África equatorial, Caribe e �mérica do Sul 20 . O Brasil é o país com maior número absoluto de indivíduos infectados por HTLV�1, possuindo cerca de dois milhões de portadores 3 . Essa infecção é endêmica em Salvador, Bahia, onde uma prevalência de 1,8% foi encontrada 8 . Segundo �lcântara e cols 1 , a introdução do HTLV�1 nesse estado ocorreu com o tráfico de escravos africanos. Estudo sobre HTLV�1�2, realizado em doadores de sangue nas capitais dos Estados brasileiros e Distrito Federal, obteve soroprevalência de 0,1% a 1%, sendo superior nas Regiões �orte e �ordeste, e inferior no sul do Brasil. �a Região Centro�Oeste, a prevalência verificada nessa população variou de 0,2% a 0,7% 4 . Em gestantes, uma prevalência de 0,1% foi observada para o HTLV�1 em Mato Grosso do Sul e Goiás 7 18 , e de 0,2% para HTLV�1�2 em Mato Grosso 25 . �s comunidades remanescentes de quilombos semi�isoladas no Brasil Central foram fundadas por africanos escravizados, que fugiram para locais de difícil acesso, e instituíram sociedades alternativas conhecidas como quilombos 21 . Considerando a possível origem africana do HTLV�1 e a escassez de estudos
Worldwide, it is estimated that about 1.5 million clinical cases of hepatitis A occur each year (Lavanchy 2002). Transmission of hepatitis A virus (HAV) usually occurs by the faecal-oral route either through personto-person contact or ingestion of contaminated water or food. In developed countries, low prevalence of HAV infection has been found while in many developing ones; low income, low educational level, crowding and lack of access to safe drinking water, and sanitation facilities are associated with increased HAV infection prevalence. However, recent studies have shown a decline in anti-HAV seroprevalence in Latin America, which has generally been explained by improvements in sanitary conditions, particularly in the access to clear water and to sewerage systems (Tapia-Conyer et al.1999, Tanaka 2000, Jacobsen & Koopman 2004.In Brazil, although hepatitis A is considered an endemic infection, some studies have shown a shift from high to intermediate endemicity in HAV infection epidemiological pattern, especially in South and Southeast regions (Vitral et al. 1998, Clemens et al. 2000, Santos et al. 2002. Furthermore, within this country, seroprevalence rates may vary by age, socioeconomic status, urbanization level and access to clean water as sanitation facilities (Vitral et al. 2006). African individuals were introduced in Brazil by slave trade. Some of them escaped from gold mines or farms, setting in remote valleys, to escape their masters. These runaway-slave descendants stayed in isolated communities, called "quilombos". The epidemiological status of HAV infection of these communities remains unknown. In this study, the prevalence of HAV infection among isolated African-descendant communities in Central Brazil was sought.This study included 947 individuals living in all 12 isolated afro-descendants communities existing in the state of Mato Grosso do Sul, Central Brazil. Among them, seven communities were in rural areas: Furnas dos Dionísios, Jaraguari county (n = 197), Furnas da Boa Sorte, Corguinho county (n = 121), Malaquias, Camapuã county (n = 83), Jerônimos, Terenos county (n = 70), São Miguel, Maracaju county (n = 49), Furnas dos Baianos, Aquidauana county (n = 42) and Quintinos, Pedro Gomes county (n = 37); and five in urban areas: São Benedito, Campo Grande county (n = 199), Orolândia, Rio Negro county (n = 49), São Miguel, Nioaque county (n = 48), Amarelinhos, Sidrolândia county (n = 25), and Morro do Limão, Campo Grande county (n = 27).The population ranged in age from less than 1 to 108 years (average 29.8 years). Four hundred forty-nine were females and 498 were males. All these individuals had low socioeconomic (families with monthly income less than US$ 200) and education levels (76% had less than 8 years of formal education). In rural communities, the majority lived basically on subsistence agriculture or cattle-rising, and their houses had no sewage system, tap water service and access to electric power. The inhabitants of Amarelinhos community lived in rural area, but recently they have ...
RESUMOObjetivo: analisar os aspectos clínicos e epidemiológicos da hanseníase. Método: trata-se de um estudo quantitativo, descritivo, transversal, envolvendo 35.853 casos de hanseníase, no período de 2005 a 2015. Informa-se que a análise dos dados adveio do Sistema de Informação de Agravos de Notificação, e os resultados foram apresentados em forma de tabela e figura. Resultados: registraram-se 35.853 casos de hanseníase, sendo a maioria do sexo masculino na faixa etária entre 40-59 anos, de cor parda, com nível fundamental incompleto e residente em zona urbana. Revela-se que a forma clínica dimorfa, multibacilar e o grau zero de incapacidade física foram os mais incidentes, e o modo de entrada mais frequente foi o de casos novos; a cura foi a principal forma de saída, a baciloscopia não foi realizada na maioria dos casos e o esquema terapêutico inicial foi a poliquimioterapia para multibacilares. Conclusão: conclui-se que a hanseníase é endêmica e ainda constitui um problema de saúde pública, e é fundamental que sejam desenvolvidas atividades educativas de forma permanente, sobretudo para a população vulnerável. Deve-se fundamentar esta ação na compreensão da representação social que esses grupos populacionais têm acerca da hanseníase. Descritores: Doenças Negligenciadas; Mycobacterium leprae; Hanseníase; Saúde Pública; Epidemiologia; Infecção.ABSTRACT Objective: to analyze the clinical and epidemiological aspects of leprosy. Method: this is a quantitative study, descriptive, cross-sectional, involving 35,853 cases of leprosy in the period from 2005 to 2015. Informs you that the analysis of the data came from the Information System of Reportable Diseases, and the results were presented in the form of table and figure. Results: it was registered 35,853 cases of leprosy, the majority being male aged between 40-59 years old, brown color, with incomplete primary education and residing in the urban area. It turns out that the dimorphic clinical form, multibacillary leprosy and the zero degree of physical disability were the most incidents, and the mode of entry more frequent was the new cases; the cure was the main form of output, the sputum smear microscopy was not performed in the majority of cases and the initial therapeutic regimen was the polychemotherapy for multibacillary patients. Conclusion: it is concluded that leprosy is endemic and still constitutes a public health problem, and it is essential to be developed educational activities on a permanent basis, especially for the vulnerable population. You must substantiate this action in the understanding of the social representation that these population groups have about leprosy. Descriptors: Neglected Diseases; Mycobacterium leprae; Leprosy; Public Health; Epidemiology; Infection.RESUMEN Objetivo: analizar los aspectos clínicos y epidemiológicos de la lepra. Método: se trata de un estudio cuantitativo, descriptivo y transversal que envuelven 35,853 casos de lepra en el período de 2005 a 2015. Le informa de que el análisis de los datos proviene del Sistema de Información de Agravios de Notificación, y los resultados se presentaron en forma de tablas y figuras. Resultados: se registraron 35,853 casos de lepra, la mayoría son varones con edades comprendidas entre 40-59 años, de color marrón, con primaria incompleta y que residen en el área urbana. Resulta que la forma clínica dimorfa, lepra multibacilar y el grado cero de la discapacidad física fueron la mayoría de los incidentes, y el modo de entrada más frecuente fue el de casos nuevos; la curación fue la principal forma de producción, la baciloscopía no se llevó a cabo en la mayoría de los casos y la pauta terapéutica inicial fue la poliquimioterapia para pacientes multibacilares. Conclusión: se concluye que la lepra es endémica y aún constituye un problema de salud pública y es esencial que se desarrollen actividades educativas sobre una base permanente, especialmente para la población más vulnerable. Debe justificar esta acción en la comprensión de la representación social que estos grupos de población tienen acerca de la lepra. Descriptores: Enfermedades Olvidadas; Mycobacterium leprae; lepra; Salud Pública; Epidemiología; Infección.
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