Malaria-enteroparasitic co-infections are known for their endemicity. Although they are prevalent, little is known about their epidemiology and effect on the immune response. This study evaluated the effect of enteroparasite co-infections with malaria caused by Plasmodium vivax in a border area between Brazil and French Guiana. The cross sectional study took place in Oiapoque, a municipality of Amapá, on the Amazon border. Malaria was diagnosed using thick blood smears, haemoglobin dosage by an automated method and coproparasitology by the Hoffman and Faust methods. The anti-PvMSP-119 IgG antibodies in the plasma were evaluated using ELISA and Th1 (IFN-γ, TNF-α and IL-2), and Th2 (IL-4, IL-5 and IL-10) cytokine counts were performed by flow cytometry. The participants were grouped into those that were monoinfected with vivax malaria (M), vivax malaria-enteroparasite co-infected (CI), monoinfected with enteroparasite (E) and endemic controls (EC), who were negative for both diseases. 441 individuals were included and grouped according to their infection status: [M 6.9% (30/441)], [Cl 26.5% (117/441)], [E 32.4% (143/441)] and [EC 34.2% (151/441)]. Males prevailed among the (M) 77% (23/30) and (CI) 60% (70/117) groups. There was a difference in haemoglobin levels among the different groups under study for [EC-E], [EC-Cl], [E-M] and [Cl-M], with (p < 0.01). Anaemia was expressed as a percentage between individuals [CI-EC (p < 0.05)]. In terms of parasitaemia, there were differences for the groups [CI-M (p < 0.05)]. Anti-PvMSP-119 antibodies were detected in 51.2% (226/441) of the population. The level of cytokines evaluation revealed a large variation in TNF-α and IL-10 concentrations in the co-infected group. In this study we did not observe any influence of coinfection on the acquisition of IgG antibodies against PvMSP119, as well as on the profile of the cytokines that characterize the Th1 and Th2 patterns. However, co-infection increased TNF-α and IL-10 levels.
BackgroundPlasmodium vivax malaria is an important public health issue in the Amazon region, and it accounts for approximately 84 % of cases of the disease. Migration across the border between Brazil and French Guiana contributes to the maintenance of the disease. The aim of this study was to evaluate the therapeutic and parasitological responses of patients with P. vivax malaria treated with chloroquine and primaquine in the socio-environmental context of cross-border interactions between Brazil and French Guiana. The factors controlled were diagnostic agreement, adherence, adjustment of primaquine doses for patient weight, and quality of the drugs used. MethodsA prospective study was conducted in 2011 with 103 individuals aged 10–60 years with a positive diagnosis of P. vivax treated with chloroquine (10 mg base/kg on the first day, followed by 7.5 mg/kg on the second and third days) and primaquine for 7 days, who were followed for 28 days. The primaquine doses were adjusted for the patients’ weight. A number of factors were determined: epidemiological characteristics, origin of patients, signs and symptoms, initial parasitaemia and parasitaemia clearance time, blood concentrations of chloroquine and primaquine, quality of anti-malarial drugs and diagnostic agreement.ResultsNinety-five patients were followed for 28 days. There was a 100 % agreement in microscopic diagnosis between field laboratory and reference centre. The adhesion to the treatment was 100 %. Of these patients, 32.6 % received a weight-adjusted dose of primaquine. The chloroquine and primaquine tablets were consistent with the optimal quality limits for human consumption. The investigated patients achieved optimal blood exposure to anti-malarial drugs. The parasitological and therapeutic response was adequate in 99.0 % of cases.ConclusionsIn the municipality of Oiapoque, the therapeutic regime used for the treatment of P. vivax malaria using chloroquine combined with primaquine remains effective, when external factors are controlled, such as the quality of anti-malarial drugs, the adhesion to the treatment prescribed, the correct diagnostic and the adjustment of primaquine dose for patient body weight.
Objetivo: Traçar o perfil epidemiológico da Leshimaniose Visceral no Brasil de 2013 a 2017. Métodos: Estudo epidemiológico, retrospectivo, descritivo e analítico, nas regiões brasileiras, utilizando as variáveis sexo, raça, idade, escolaridade e evolução, em dados secundários coletados no DATASUS, tabulados em planilhas do programa Microsoft Excel 2010, para confecção e análise dos gráficos e tabelas. Resultados: Total de 18.733 notificações, com menor registro em 2016 (3.455 - 18,44%) e maior em 2017 (4.515 - 29,10%). A região nordeste totalizou 10.635 (56,77%), o sudeste 3.660 (19,53%), o norte 2.989 (15,95%), o centro-oeste 1.396 (7,45%) e o Sul com 53 (0,28%) casos. Quanto ao gênero, 12.191 (65,07%) eram homens e 6.541 (34,91%) mulheres, pardos (13.291-70,94%), predominando as idades entre 0 e 19 anos com 9.539 (50,92%) casos em quatro das cinco regiões e, a maioria com ensino fundamental (5.176 -27,63%), não tendo sido informado o grau de escolaridade em 11.703 (60,35%). A evolução clínica mostrou cura em 12.639 (67,46%) pacientes, óbito em 1.355 (7,23%) e 2.923 (15,60%) teve desfecho clínico ignorado ou em branco. Conclusão: Profissionais da saúde devem ser capacitados a intervir de forma preventiva, curativa e cuidadosa para que haja evolução favorável da doença, bem como notificação fidedigna dos casos.
Objetivo: Analisar o perfil epidemiológico de gestantes portadoras do HIV atendidas no Hospital da Mulher Mãe Luzia (HMML) na cidade de Macapá-AP no período de 2008 a 2018 Metodologia: Trata-se de um estudo descritivo, de cunho documental e natureza quantitativa. O local de estudo é o HMML, para a obtenção dos dados, utilizou-se informações de documentos secundários, contidas nas fichas de notificação do Sistema de Informação de Agravos de Notificação (SINAN), que foram disponibilizadas pela Superintendência de Vigilância em Saúde (SVS). Resultados: No período de 2008 a 2018, foram registradas 253 notificações de gestantes com HIV no HMML, sendo que a maioria tinha idade entre 20 e 29 anos, era da cor parda (75,1%), possuíam o ensino fundamental completo ou incompleto (39,5%), era proveniente da capital Macapá, realizou o pré-natal (81,8%) e teve seu diagnóstico durante o pré-natal (40,7%).Considerações finais: o conhecimento das características que permeiam este grupo específico pode subsidiar a elaboração de políticas e ações de combate ao HIV/AIDS em mulheres com o mesmo perfil e para o incremento na prevenção da transmissão vertical do vírus através da detecção precoce e adesão em tempo ao tratamento adequado.
Realizar análise microbiológica da água de consumo distribuídos via tubulação hidráulica para as residências localizadas em um bairro alagado do município de Macapá - AP. Métodos: Estudo transversal, descritivo, quantitativo, realizado através de coletas de amostras de água de 23 residências em duplicata identificadas como (A e B), totalizando 46 amostras analisadas. Para a análise das coletas foi utilizado o método de Número Mais Provável, que estabelece a quantidade de coliformes por 100 mL, fornecendo informações a respeito da potabilidade da água. Resultados: A análise microbiológica das amostras coletadas das 23 residências revelou que 8 casas (34,8%) tiveram resultados positivos para coliformes totais e 6 casas (26.1%), positivos para coliformes termotolerantes. Em relação as bactérias heterotróficas, 13 casas (56,5) apresentaram resultados positivos, sendo que 11 dessas casas (84,6%) apresentaram resultados superiores a 500 UFC/mL. Foi observado a contaminação da água por coliformes fecais de algumas residências, em decorrência das encanações submersas e das precárias condições das instalações hidráulicas. Conclusão: Embora as casas sejam servidas por água da rede de abastecimento de tratamento da cidade, a falta de manutenção nas encanações e o contato com a água da área alagada, pode ser um dos fatores contribuidores para essas contaminações.
Objective: to describe the profile and incidence of malaria cases among indigenous and non-indigenous people on the Brazil-French Guiana border, between 2007 and 2016. Methods: this is a descriptive study based on analysis of cases notified on the Malaria Epidemiological Surveillance Information System (SIVEP-Malaria), organized using Tableau 10.3. Results: a total of 21,729 cases were notified in the period; the highest annual number of notifications was 3,637 (16.7%) in 2009, 1,956 (53.8%) of which related to indigenous people, representing annual parasite incidence (API) of 261/1,000; higher risk of infection was found in the Kumenê base area (API between 13 and 534/1,000) and the Manga base area (API between 55 and 448/1,000); children accounted for 20.0 to 40.0% of notified cases, while pregnant women accounted for 2.0% among non-indigenous people and 1.0% among the indigenous. Conclusion: malaria case distribution was unequal between indigenous and non-indigenous people, with greater occurrence among the indigenous.
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