Trypanosoma terena and Trypanosoma ralphi are known species of the South American crocodilians Caiman crocodilus, Caiman yacare and Melanosuchus niger and are phylogenetically related to the tsetse-transmitted Trypanosoma grayi of the African Crocodylus niloticus. These trypanosomes form the Crocodilian clade of the terrestrial clade of the genus Trypanosoma. A PCR-survey for trypanosomes in caiman blood samples and in leeches taken from caimans revealed unknown trypanosome diversity and frequent mixed infections. Phylogenies based on SSU (small subunit) of rRNA and gGAPDH (glycosomal Glyceraldehyde Phosphate Dehydrogenase) gene sequences revealed a new trypanosome species clustering with T. terena and T. ralphi in the crocodilian clade and an additional new species nesting in the distant Aquatic clade of trypanosomes, which is herein named Trypanosoma clandestinus n. sp. This new species was found in Caiman yacare, Caiman crocodilus and M. niger from the Pantanal and Amazonian biomes in Brazil. Large numbers of dividing epimastigotes and unique thin and long trypomastigotes were found in the guts of leeches (Haementeria sp.) removed from the mouths of caimans. The trypanosomes recovered from the leeches had sequences identical to those of T. clandestinus of caiman blood samples. Experimental infestation of young caimans (Caiman yacare) with infected leeches resulted in long-lasting T. clandestinus infections that permitted us to delineate its life cycle. In contrast to T. terena, T. ralphi and T. grayi, which are detectable by hemoculturing, microscopy and standard PCR of caiman blood, T. clandestinus passes undetected by these methods due to very low parasitemia and could be detected solely by the more sensitive nested PCR method. T. clandestinus n. sp. is the first crocodilian trypanosome known to be transmitted by leeches and positioned in the aquatic clade closest to fish trypanosomes. Our data show that caimans can host trypanosomes of the aquatic or terrestrial clade, sometimes simultaneously.

BackgroundGestation is a period that can positively or negatively influence the life of a woman in the pregnancy-puerperal cycle. Thus, evaluating the quality of life of this population can redirect the implementation of innovative practices, with the goal of making them more effective and practical or the promotion of humanized care. The present study aimed to evaluate the predictors that influence the health-related quality of life of low-risk pregnant women, as well as to describe the main areas affected in the quality of life of pregnant women.MethodsA correlational, quantitative and cross-sectional study was carried out in two public units that provide prenatal care services and a private unit in the city of Fortaleza, a municipality in the Northeast of Brazil. The sample consisted of 261 pregnant women who were interviewed from September to November 2014. The collection instruments were a questionnaire covering sociodemographic, obstetric and quality of life variables, in addition to the Brazilian version of the Mother-Generated Index (MGI). The data were compiled and analyzed through the Statistical Package for the Social Sciences (SPSS) software, version 20.0. A descriptive analysis was performed through the application of Pearson’s chi-square test, Fisher’s exact test and one-way ANOVA. Maternal predictors for the quality of life of pregnant woman were identified through a multivariate analysis/multiple regression.ResultsThe response rate was 100%, corresponding to 261 respondents. Occupation, parity, partner support, marital status and persons with whom the women live were the predictors that positively interfered in the quality of life of pregnant women. In contrast, gestational age, type of housing, occupation, use of illicit drugs, non-receipt of partner support and maternal age were the predictors that negatively influenced quality of life.ConclusionOur results indicate that happiness to become a mother and body image were areas with the greatest positive and negative influence on health-related quality of life, which suggests being relevant aspects in the planning and implementation of actions aimed at its improvement.

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A dinâmica da produção de estigma relacionado à AIDS entre gestantes vivendo com HIV/AIDS no Rio de Janeiro, Brasil La dinámica en la generación del estigma, relacionado con el SIDA, entre gestantes viviendo con VIH/SIDA en Río de Janeiro, Brasil

Prevalence of Hepatozoon caimani has been reported in 76% of caimans Caiman yacare from the Pantanal region. Culex (Melanoconion) spp. mosquitoes were recently identified as natural vectors of this parasite. However, culicids are not typically eaten by crocodilians, suggesting that the main transmission route is through ingestion of insectivorous vertebrates, such as anurans. The susceptibility of wild frogs Leptodactylus chaquensis, Leptodactylus podicipinus and Scinax nasicus to infection by H. caimani was verified. Wild-caught anurans were force fed with sporulated oocysts from laboratory-bred Culex (Melanoconion) mosquitoes. Frogs were killed 30 days postinfection, and their internal organs were fed to caimans C. yacare and Caiman latirostris. Cystozoites were identified in fresh liver impression smears of L. chaquensis. C. yacare fed on anuran organ presented gametocytes in peripheral blood circulation between 74 and 80 days postinoculation (dpi). Gametocytes were also verified in C. latirostris fed on the internal organs of L. podicipinus and S. nasicus between 60-70 and 69-75 dpi, respectively. Since frogs used in experiment are sympatric with C. yacare and C. latirostris and may occur in the diet of these caimans, the results suggest these amphibians are paratenic hosts in the natural transmission cycle of H. caimani in Pantanal.

The study objectives were to characterize the morphology of the parasitic forms and describe the prevalence and intensity of Haemogregarina spp. in a population of the turtle Podocnemis unifilis as well as to examine the relationships between parasitism and turtle variables such as gender, size, and weight. Samples were taken in the Tapajós and Jamanxim rivers, Itaituba, Pará state, Brazil. Blood was collected from the tail vein of 72 P. unifilis specimens, including 35 males, 36 females, and one unsexed juvenile. The prevalence of Haemogregarina spp. was 98% (n = 71). The mean parasite intensity of Haemogregarina spp. was 118 (1-582) parasites/2000 blood cells (6%). There was no significant difference in the mean parasite intensity between male (137.68 ± 121.8, n = 35) and female turtles (101.42 ± 123.59, n = 35). There was no relationship between parasite intensity and carapace length. Although the relationship between parasite intensity and host body weight was significant, the relationship was weak. This is the first study on Haemogregarina parasitism with a relatively high number of turtles in Brazil.

This study aimed to conduct a systematic literature review in order to identify how recent studies have addressed the interaction between social inequality and the processes of exclusion and marginalisation related to HIV/AIDS stigma and discrimination. The review was conducted using PubMed and Scopus databases and included publications from 2008 to 2011. Of 497 summaries found in the review, 42 were selected and classified based on topic, population, axes of inequality employed, conceptualisation of stigma and relationship between stigma and vulnerability. Results demonstrated that there is a predominance of research on stigma and discrimination towards people living with HIV/AIDS, sexual and racial/ethnic minorities and migrants. The axes of inequality examined in the literature were linked to specific cultural and socio-economic dimensions and analysed as factors that behave synergistically to increase social groups' vulnerability to HIV. Half of the 42 articles viewed expression of stigma/discrimination to be the result of power dynamics that reinforce the processes of social exclusion. The other half of the articles tended to describe stigma as intrinsic to social interaction. Some researchers are making a visible effort to devise consistent theoretical and methodological approaches in order to understand stigma as a complex social process produced at the intersection of different axes of inequality. These efforts provide vital information that can inform how best to address HIV/AIDS stigma.

Investigou-se o não retorno de usuários para conhecimento da sorologia para HIV em um Centro de Testagem e Aconselhamento do Estado do Rio de Janeiro em 2009. Trata-se de estudo socioantropológico que integra a Pesquisa CTA-RJ, a qual analisou motivações e repercussões da testagem para prevenção de DST/Aids. Utilizaram-se quatro fontes de dados: a etnografia das sessões de aconselhamento pré-teste; 384 questionários aplicados aleatoriamente em usuários que procuraram o serviço para fazer o teste em 2009; o banco de dados SI-CTA no período entre 2008-2009; e 14 entrevistas semiestruturadas com jovens usuários (18 a 28 anos) de diferentes perfis (escolaridade, sexo, orientação sexual, sorologia, raça/cor). Entre 2008-2009, 62% dos usuários, excluindo-se as gestantes, não resgataram resultados de seus testes nesse CTA. As circunstâncias que determinam o não retorno referem-se à dinâmica de funcionamento do serviço (acolhimento precário ao usuário e não garantia de direitos como anonimato e confidencialidade, por exemplo), às dificuldades operacionais (como atraso na entrega de resultados) e também perpassam a trajetória pessoal do usuário (medo, ansiedade, representações negativas da testagem, discriminação). As propostas no âmbito do Ministério da Saúde para reduzir as taxas de "falha no retorno" apontam testes rápidos e aconselhamento pré-teste facultativo. A observação etnográfica do CTA indica que a qualidade da interação entre profissional de saúde e usuário influencia sobremaneira a adesão ao serviço.