Resumo Objetivo: Analisar a distribuição espacial da tuberculose em indivíduos menores de 15 anos de idade e fatores socioeconômicos na Paraíba, Brasil, 2007-2016. Métodos: Estudo ecológico, com dados do Sistema de Informação de Agravos de Notificação, sendo o município a unidade de análise. Realizou-se distribuição espacial da incidência, aplicou-se o método bayesiano empírico local e a estatística de Moran. Dados socioeconômicos foram cruzados, para identificação das áreas de prosperidade social. Resultados: Foram notificados 426 casos, com incidência média de 4,5/100 mil habitantes. O índice de Moran foi de 0,59 (p-valor=0,010). O Moran Map revelou concentração de casos em menores de 15 anos em 38 municípios com alta prioridade da atenção, em conglomerados nos padrões alto-alto e baixo-baixo, nas regiões leste e noroeste do estado, coincidindo com áreas de baixa prosperidade social. Conclusão: Houve clusters com maior transmissão da tuberculose, apontando áreas prioritárias para abordagem da tuberculose.

The present study describes the use of fucoidan, a negative sulfated polysaccharide, as a coating material for the development of liposomes targeted to macrophages infected with Mycobacterium tuberculosis. First, fucoidan was chemically modified to obtain a hydrophobized-fucoidan derivative (cholesteryl-fucoidan) using a two-step microwave-assisted (μW) method. The total reaction time was decreased from 14 hours to 1 hour while maintaining the overall yield. Cholesterylfucoidan was then used to prepare surface-modified liposomes containing usnic acid (UA-LipoFuc), an antimicrobial lichen derivative. UA-LipoFuc was evaluated for mean particle size, polydispersity index (PDI), surface charge (ζ), and UA encapsulation efficiency. In addition, a cytotoxicity study, competition assay and an evaluation of antimycobacterial activity against macrophages infected with M. tuberculosis (H37Ra) were performed. When the amount of fucoidan was increased (from 5 to 20 mg), vesicle size increased (from 168 ± 2.82 nm to 1.18 ± 0.01 μm). Changes in from +20 ± 0.41 mV for uncoated liposomes to −5.41 ± 0.23 mV for UA-LipoFuc suggested that the fucoidan was placed on the surface of the liposomes. UA-LipoFuc exhibited a lower IC50 (8.26 ± 1.11 μM) than uncoated liposomes (18.37 ± 3.34 μM), probably due to its higher uptake. UA-LipoFuc5 was internalized through the C-type carbohydrate recognition domain of the cell membrane. Finally, usnic acid, both in its free form and encapsulated in fucoidan-coated liposomes (UA-LipoFuc5), was effective against infected macrophages. Hence, this preliminary investigation suggests that encapsulated usnic acid will aid in further studies related to infected macrophages and may be a potential option for tuberculosis treatment.

Background Brazil has the fourth highest prevalence of malaria of all countries in the Americas, with an estimated 42 million people at risk of contracting this disease. Although most cases occur in the Amazon region, cases of an autochthonous nature have also been registered in the extra-Amazonian region where Anopheles aquasalis and An. albitarsis are the mosquito species of greatest epidemiological interest. In 2019, the municipality of Conde (state of Paraíba) experienced an epidemic of autochthonous cases of malaria. Here we present preliminary results of an entomological and case epidemiology investigation, in an attempt to correlate the diversity and spatial distribution of species of Anopheles with the autochthonous cases of this outbreak of malaria. Methods Case data were collected using case report forms made available by the Conde Municipal Health Department. The entomological survey was carried out from July to November 2019. The various methods of capture included the use of battery-powered aspirators, mouth aspirators, Shannon traps, BG-Sentinel traps (with and without dry ice) and CDC light traps. Captured mosquitoes were separated, packaged and sent to the laboratory for sexing and molecular identification of the various species of anophelines. The data were tabulated and analyzed using Microsoft Excel. Spatial analysis of the data was performed using ArcGis 10 software. Results In 2019, 20 autochthonous cases and one imported case of malaria caused by Plasmodium vivax were diagnosed, with three cases of relapses. A total of 3713 mosquitoes were collected, of which 3390 were culicines and 323 were anophelines. Nine species of genus Anopheles were identified, with the most abundant being An. aquasalis (38.9%), followed by An. minor (18.2%) and An. albitarsis (9.0%). Spatial analysis of the data showed that the area could be considered to be at risk of malaria cases and that there was a high prevalence of Anopheles. Conclusions The results presented indicate that this extra-Amazonian region has an environment conducive to maintenance of the malaria transmission cycle owing to the wide diversity of Anopheles species. This environment in combination with the high influx of people from endemic areas to the study area provides a perfect setting for the occurrence and maintenance of malaria.

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The tuberculosis (TB) is a disease caused by Mycobacterium tuberculosis (Mtb) and is considered a worldwide public health problem, classified as the leading cause of death by a single infectious agent. The conventional treatment is performed through the combination of drugs that exhibit precocious or sterilizing bactericidal activity. The commonly used drugs (knowing as first line drugs) are: izoniazide (INH), rifampicin (RIF), pyrazinamide (PZA) and ethambutol (ETH). However, the number of resistant TB cases (classified as RR-TB, MDR-TB and XDR-TB) to drugs has been growing in concern over the years. Of the total cases registered in 2016, about 600 thousand were resistant to one or more drugs used in the treatment. Resistance of Mtb strains to antituberculosis drugs is closely related to mutations in different bacillus genes. Multidrugresistant tuberculosis is a worldwide problem. A better understanding of the molecular mechanisms associated with the resistance to first-line drugs used in the TB treatment is of great importance for the development of new drugs, directly helping to reduce the number of resistant cases and bringing great benefits to public health. A review of the mechanisms of action of first-line drugs used in the treatment regimen to sensitive tuberculosis, as well as the main associated resistance mechanisms are.

Introduction: Laboratory and clinical features of childhood tuberculosis (TB) are non-specific and establishing an accurate diagnosis remains a challenge. This study evaluated a Single tube nested-PCR (STNPCR) to detect genomic DNA of Mycobacterium tuberculosis complex in blood and urine. Methods: Biological samples were obtained from children (<15 years old) with clinical suspicion of pulmonary and extrapulmonary TB at public hospitals in Recife-Pernambuco, Brazil. Cultures yielded negative results in a majority of childhood TB cases, which are generally paucibacillary. A set of clinical, epidemiological, radiological, and laboratory criteria with evident clinical improvement after anti-TB treatment were frequently used to define childhood TB cases. Results: Ninety children with clinical suspicion were enrolled in this study (44 with TB and 46 without TB). The pulmonary TB group had 20 confirmed cases and 46 negative controls, while the extrapulmonary TB group had 24 confirmed cases. The STNPCR showed sensitivities to pulmonary and extrapulmonary TB of 47.4% and 52.2% (blood) and 38.8% and 20% (urine), respectively. Considering the low performance of STNPCR on separate samples, we decided to perform a combined analysis (parallel sensitivity analysis) of the results from blood and urine samples. The parallel sensitivity increased to 65% in blood and 62.5% in urine. The specificity in both samples ranged from 93.5-97.8%. Conclusions: Although STNPCR showed moderate sensitivity, the specificity is high; therefore, the test can be used as an auxiliary tool to diagnose TB in children. It is a rapid test that demonstrated better performance than other diagnostic tests in paucibacillary samples as it does in childhood tuberculosis.