A Leishmaniose Tegumentar Americana (LTA) é uma doença causada por protozoários do gênero Leishmania, transmitida ao homem pela picada de mosquitos flebotomíneos (Ordem Diptera; Família Psychodidae; Sub-Família Phlebotominae). No Brasil existem atualmente 6 espécies de Leishmania responsáveis pela doença humana, e mais de 200 espécies de flebotomíneos implicados em sua transmissão. Trata-se de uma doença que acompanha o homem desde tempos remotos e que tem apresentado, nos últimos 20 anos, um aumento do número de casos e ampliação de sua ocorrência geográfica, sendo encontrada atualmente em todos os Estados brasileiros, sob diferentes perfis epidemiológicos. Estima-se que, entre 1985 e 2003, ocorreram 523.975 casos autóctones, a sua maior parte nas regiões Nordeste e Norte do Brasil. Neste estudo, são discutidos aspectos relacionados ao tratamento e ao controle dessa doença, assim como também as dificuldades para a implementação dessas medidas. São apontadas alternativas que passam pela estruturação dos serviços de saúde, com respeito ao diagnóstico, no desenvolvimento de drogas de aplicação tópica ou por via oral, no desenvolvimento de vacinas, no controle diferenciado de vetores e no aprofundamento de estudos relacionados à biologia celular do parasita.

Abstract. Therapy for mansonelliasis is challenging because there is no standard drug recommended for its treatment. This non-randomized study was conducted to evaluate the effectiveness of a single dose of 0.15 mg/kg of ivermectin to reduce Mansonella ozzardi microfilaraemia in infected persons. A total of 74 patients were studied within the municipality of Lá brea, which is located in Amazonas State, Brazil. The patients were treated with ivermectin after detection of the parasite by blood examination. Significant microfilaraemia reduction was observed and its residual effect was maintained for at least 12 months. There was no significant change in the laboratory blood count, hepatic metabolites, and nitrogen-bounding compound excreta dosage values that could compromise the use of this drug, demonstrating that ivermectin has a low toxicity level.

Chromoblastomycosis is a chronic subcutaneous disease caused by human contact with melanized fungi occurring mainly in tropical and subtropical zones worldwide. This study assessed 12 patients with chromoblastomycosis from Rondônia, Brazil, Amazon region. In sum, 83.3% were men, 41.6% were from Monte Negro city, median age was 52.9 years, and median time to disease progression was 12.2 years. Lesions were located on the lower limbs (75%), and verruciform was prevalent form (66.6%). After 3 years of treatment with itraconazole, two patients were considered cured. The etiological agents were identified by the molecular sequence of the ribosomal internal transcribed spacer ITS1, 5.8S, and ITS2 region and β-tubulin genes. Eight strains were identified as Fonsecaea pedrosoi, two were F. nubica, and two were Rhinocladiella similis. The antifungal activity of five drugs was evaluated, and the most active drug was terbinafine (range minimal inhibitory concentration [MIC] 0.015–0.12 μg/ml), itraconazole (range MIC 0.03–0.5 μg/ml) and voriconazole (range MIC 0.06–0.5 μg/ml). The highest MIC was 5-fluorocytosine (range MIC 2–32 μg/ml), and amphotericin B (range MIC 0.25–2 μg/ml). In conclusion, the present study expanded the epidemiological disease database and described for the first time F. nubica and R. similis as chromoblastomycosis agents in the Brazilian Amazon region. Our results confirmed the importance of using molecular methods to identify the melanized fungi and stimulate the recognition of the disease in other places where no cases have been reported.

Introduction:Toxoplasma gondii infection is widely prevalent in humans and other animals worldwide. Information on the prevalence of T. gondii infection is scarce in some regions of Brazil, including riverside communities along the Amazon River basin. Methods: The prevalence of T. gondii in 231 people, aged 1-85 years, who were living in four riverside communities along the Purus River, Lábrea, State of Amazonas, Brazil, was determined. Antibodies against T. gondii were assayed using a commercial enzyme-linked immunosorbent assay (ELISA) kit. The hearts and brains of 50 chickens, which were raised freerange in the communities, were pooled according to the community of origin and bioassayed in mice. The isolates were genotyped using polymorphisms at 12 nuclear markers (SAG1, 5' and 3'-SAG2, alt.SAG2, SAG3, BTUB, GRA6, c22-8, c29-2, L358, PK1, Apico and CS3). Results: The overall seroprevalence of T. gondii was 56.7% (131/231). IgG antibodies were presented by 117 (89.3%) and IgM by 14 (10.7%) of the 131 positive individuals. No association between age group and gender with prevalence was observed (chi-square test, p > 0.05); however, the comparison between localities showed that the seroprevalence of T. gondii was signifi cantly lower among the individuals living in the Boca do Ituxi (p < 0.05) community. Five isolates of T. gondii were obtained in the mouse bioassay, and genotyping revealed two complete genotypes that had not been described previously and three mixed isolates. Conclusions: These results support previous fi ndings that T. gondii population genetics are highly diverse in Brazil and that T. gondii infection is active in these riverside communities.

Mosquito nets treated with long-lasting insecticide (LLINs), when used in compliance with guidelines of the World Health Organization, may be effective for malaria vector control. In 2012, approximately 150,000 LLINs were installed in nine municipalities in the state of Rondônia. However, no studies have assessed their impact on the reduction of malaria incidence. This study analyzed secondary data of malaria incidence, in order to assess the impact of LLINs on the annual parasite incidence (API). The results showed no statistically significant differences in API one year after LLIN installation when compared to municipalities without LLINs. The adoption of measures for malaria vector control should be associated with epidemiological studies and evaluations of their use and efficiency, with the aim of offering convincing advantages that justify their implementation and limit malaria infection in the Amazon Region.

INTRODUCTION: Mansonelliasis is caused by Mansonella ozzardi. It is widespread in the Amazon region, with a high prevalence. The common exam of thick blood smears stained with Giemsa shows low efficacy levels and has been an obstacle to diagnosing individuals with low blood parasitemia. METHODS: In order to increase diagnosis efficacy, the PCR technique was improved. RESULTS AND CONCLUSIONS: PCR demonstrated the best performance, with sensitivity and negative predictive values (NPV) of 100%, followed by blood filtration through membrane filters, which showed a sensitivity of 88.9% and a NPV of 84.6%, when compared to thick blood smears.

Introduction:Mansonella ozzardi is a widely distributed fi laria worm in the Amazon region. This study aimed to determine the prevalence of M. ozzardi infection in riverine communities of Lábrea municipality, Amazonas State, Brazil. Methods: A diagnostic blood fi ltration method in a polycarbonate membrane was used. Results: M. ozzardi was found in 50.3% of the sample, with the highest prevalence in farmers/fi shermen (69.4%; χ 2 = -19.14, p<0.001). The prevalence was higher in longerterm residents (≥11 years; 60.2%). Conclusions: M. ozzardi infection rates are high near the Purus River, much greater than those previously reported based on diagnosis using thick blood smears.Keywords: Mansonelliasis. Mansonella ozzardi. Brazilian Amazon.Mansonella ozzardi is a widely distributed fi laria worm that parasitizes humans in Amazonas State, Brazil, with high prevalences detected in residents of some regions of the Solimões, Negro, and Purus Rivers (1) (2) (3) (4) (5) . Simuliidae (blackfl ies) are the only vector of M. ozzardi in Brazil (6) (7) .An endemic region for M. ozzardi in Brazil is in the municipality of Lábrea, in the Purus River region, Amazonas, where it has been detected since the fi rst survey in the 1950s (1) . Subsequent studies conducted in the 1970s and 1980s confi rmed the wide distribution of M. ozzardi in this region (8) (9) . More recently, the prevalence of the infection had reportedly increased in riverine communities located near the Purus and Ituxi Rivers (2) (3) (4) .In the Purus River region, only Adami et al. (10) utilized the concentration method by Knott to diagnose mansonelliasis. Therefore, the present study aimed to determine the prevalence of M. ozzardi infection in riverine communities of the Lábrea municipality using a diagnostic blood fi ltration method in a polycarbonate membrane, which is more sensitive than thick blood smears (11) .This study was conducted in the riverside communities of the Purus River (Cassianã, Bacural, Jucuri, Buraco, Santa Rosa, Jurucuá and Samaúma), located approximately 200km from the municipality of Lábrea communities (S: 07º15' 34" and W: 64º47'59"), State of Amazonas, Brazil (Figure 1). The sample consisted of volunteer men, women, and children aged 5-60 years selected using convenience sampling. Data and blood samples were collected after signing the free and informed consent form by the individual or the legal guardian. Of the estimated 350 inhabitants in the included communities, 171 (48.6%) inhabitants were present at the time of the study and agreed to participate.To estimate the prevalence of Mansonella ozzardi, blood was filtrated in a polycarbonate membrane (12) . First, 1mL venous blood was collected from each individual, diluted in 10mL 0.9% saline, and fi ltered in a polycarbonate membrane (Nucleopore Corporation, Pleasanton, CA, USA) with a 3µm pore diameter. Then, the membranes were removed from the fi lters and mounted on microscope slides, fi xed in methanol, stained with a Panoptic kit ® , and examined under an optical micros...

Introduction: Malaria is one of the major parasitic diseases in the State of Rondônia, located in the western Brazilian Amazon. The basic treatment scheme for this disease is chloroquine and primaquine. This study evaluated the epidemiological profile of malaria in Rondônia between 2008 and 2012. Methodology: The epidemiological data were provided by the Health Surveillance Agency from the State of Rondônia, and socioeconomic indicators were obtained from the Brazilian Institute of Geography and Statistics, Department of Informatics of the Unified Health System, and from the National Institute for Space Research. The analyzed variables included year of diagnosis, gender, age group, main activity performed in the 15 days previous to the diagnosis, parasite species, level of parasitemia, number of relapse/recrudescence cases, and socioeconomic and environmental data for Rondônia. Results: A total of 238,626 cases of malaria were recorded in Rondônia during the study period. Of this total, 65.6% were men and the most prevalent age group was 20-39 years. Plasmodium vivax was the most common parasite (89.8%), followed by Plasmodium falciparum (9.4%). An average of 30.9% of the individuals who were tested presented with relapse/recrudescence malaria. The API value was highest in 2008 and lowest in 2012, corresponding to 42.3 cases and 19.2 cases per 1,000 inhabitants, respectively. Conclusions: A 58% reduction in the number of malaria cases and a 36.2% reduction in the number of relapse/recrudescence malaria cases were observed, due to increases in the economy, improvements in the health system, and reduction of deforestation in this region.