the majority of the cases bore the characteristics of congenital infection; the clinical condition of the majority of mothers suggested Zika virus infection during pregnancy.
Summaryobjectives To identify the aetiological agents of cutaneous leishmaniasis and to investigate the genetic polymorphism of Leishmania (Viannia) parasites circulating in an area with endemic cutaneous leishmaniasis (CL) in the Atlantic rainforest region of northeastern Brazil.methods Leishmania spp. isolates came from three sources: (i) patients diagnosed clinically and parasitologically with CL based on primary lesions, secondary lesions, clinical recidiva, mucocutaneous leishmaniasis and scars; (ii) sentinel hamsters, sylvatic or synanthropic small rodents; and (iii) the sand fly species Lutzomyia whitmani. Isolates were characterised using monoclonal antibodies, multilocus enzyme electrophoresis (MLEE) and polymerase chain reaction-restriction fragment length polymorphism of the internal transcribed spacer region rDNA locus.results Seventy-seven isolates were obtained and characterised. All isolates were identified as Leishmania (Viannia) braziliensis serodeme 1 based on reactivity to monoclonal antibodies. MLEE identified 10 zymodemes circulating in the study region. Most isolates were classified as zymodemes closely related to L. (V.) braziliensis, but five isolates were classified as Leishmania (Viannia) shawi. All but three of the identified zymodemes have so far been observed only in the study region. Enzootic transmission and multiclonal infection were observed.conclusions Our results confirm that transmission cycle complexity and the co-existence of two or more species in the same area can affect the level of genetic polymorphism in a natural Leishmania population. Although it is not possible to make inferences as to the modes of genetic exchange, one can speculate that some of the zymodemes specific to the region are hybrids of L. (V.) braziliensis and L. (V.) shawi.keywords Leishmania, leishmaniasis, MLEE, molecular typing, L. (V.) braziliensis, L. (V.) shawi
Objectives:To analyze the factors related to the occupational stress of a Mobile Emergency Care Service (Samu) nursing team. Methods: This is a descriptive study, with a quantitative approach, performed with nursing professionals from Samu service of a city of Pernambuco. A sociodemographic questionnaire and the Lipp's Stress Symptom Inventory were used. Results: The participants presenting stress (24.6%) were classified in the phases: resistance (19.7%), exhaustion (4.4%) and near exhaustion (0.5%). It was also observed an association of stress level with the following factors: gender, sleep quality, professional autonomy restriction, emotional exhaustion with work performed and work in inadequate or unhealthy physical facilities. Conclusions: Although showing low occurrence of stress, this study pointed out the profile that presents the highest risk of developing occupational stress, through the factors significantly associated with stress in the studied population. RESUMOObjetivos: Analisar os fatores relacionados ao estresse ocupacional da equipe de enfermagem de um Serviço de Atendimento Móvel de Urgência (Samu). Métodos: Estudo descritivo, com abordagem quantitativa, realizado com profissionais de enfermagem do Samu de um município de Pernambuco. Foram utilizados um questionário sociodemográfico e o Inventário de Sintomas de Stress de Lipp. Resultados: Os participantes que apresentaram estresse (24,6%) foram classificados nas fases: de resistência (19,7%), de exaustão (4,4%) e de quase exaustão (0,5%). Observou-se, ainda, associação do nível de estresse relacionado com os seguintes fatores: sexo, qualidade de sono, restrição da autonomia profissional, desgaste emocional com o trabalho que realiza e trabalho em instalações físicas inadequadas ou insalubres. Conclusões: Apesar de evidenciar baixa ocorrência de estresse, este estudo apontou qual o perfil que apresenta maior chance de risco de desenvolver estresse ocupacional, por meio dos fatores que estiveram associados, significativamente, com o estresse na população estudada. RESUMENObjetivos: Evaluar los factores asociados al estrés laboral del personal de enfermería de un Servicio de Atención Móvil de Urgencia (Samu). Métodos: Estudio descriptivo, con abordaje cuantitativo, en el cual participaron profesionales de enfermería del Samu de un municipio de Pernambuco (Brasil). Se utilizaron un cuestionario sociodemográfico y el Inventario de Síntomas de Estrés de Lipp. Resultados: Los participantes que presentaron estrés (24,6%) fueron clasificados en las fases: de resistencia (19,7%), de agotamiento (4,4%) y de cuasiagotamiento (0,5%). Además, se observó una asociación entre el nivel de estrés y los siguientes factores: sexo, calidad de sueño, restricción de la autonomía profesional, desgaste emocional con el trabajo que realiza y trabajo en instalaciones físicas inadecuadas o insalubres. Conclusiones: A pesar de apuntar una baja ocurrencia de estrés, el presente estudio muestra el perfil que presenta una mayor probabilidad de riesgo de desarrollar estrés la...
BackgroundThe possibility that a multi-host wildlife reservoir is responsible for maintaining transmission of Leishmania (Viannia) braziliensis causing human cutaneous and mucocutaneous leishmaniasis is tested by comparative analysis of infection progression and infectiousness to sandflies in rodent host species previously shown to have high natural infection prevalences in both sylvatic or/and peridomestic habitats in close proximity to humans in northeast Brazil.MethodsThe clinical and parasitological outcomes, and infectiousness to sandflies, were observed in 54 colonized animals of three species (18 Necromys lasiurus, 18 Nectomys squamipes and 18 Rattus rattus) experimentally infected with high (5.5×106/ml) or low (2.8×105/ml) dose L. (V.) braziliensis (MBOL/BR/2000/CPqAM95) inoculum. Clinical signs of infection were monitored daily. Whole animal xenodiagnoses were performed 6 months post inoculation using Lutzomyia longipalpis originating from flies caught in Passira, Pernambuco, after this parasite evaluation was performed at necropsy. Heterogeneities in Leishmania parasite loads were measured by quantitative PCR in ear skin, liver and spleen tissues.ResultsAll three rodent species proved to establish infection characterized by short-term self-resolving skin lesions, located on ears and tail but not on footpads (one site of inoculation), and variable parasite loads detected in all three tissues with maximum burdens of 8.1×103 (skin), 2.8×103 (spleen), and 8.9×102 (liver). All three host species, 18/18 N. lasiurus, 10/18 N. squamipes and 6/18 R. rattus, also proved infectious to sandflies in cross-sectional study. R. rattus supported significantly lower tissue parasite loads compared to those in N. lasiurus and N. squamipes, and N. lasiurus appeared to be more infectious, on average, than either N. squamipes or R. rattus.ConclusionsA multi-host reservoir of cutaneous leishmaniasis is indicated in this region of Brazil, though with apparent differences in the competence between the rodent species. The results provide preliminary insights into links between sylvatic and peri-domestic transmission cycles associated with overlaps in the rodent species’ ecological niches.
These issues can be resolved with management improvements, systematization of permanent education activities, and definition of care flows that enable early diagnosis. Besides the diagnosis, care lines should be created for people living with HIV and AIDS who use the HCs for early health care process.
it is evident the importance of encouraging religious activity and RCOPE strategies, seen in the past as inappropriate interventions in clinical practice.
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