Peri-urban visceral leishmaniasis (VL) caused by Leishmania chagasi is emerging in a new epidemiologic pattern in Brazilian cities. We studied peri-urban VL in endemic neighborhoods surrounding Natal, Brazil, identified through hospitalized individuals with VL. Clinical and environmental information obtained for 1106 members of 216 families living in endemic neighborhoods enabled us to identify 4 groups: VL: individuals with current or prior symptomatic visceral leishmaniasis (n = 135); DTH+: individuals with positive delayed-type hypersensitivity response with no history of VL (n = 390); Ab +: individuals with negative DTH response and seropositive (n = 21); DTH -: individuals with negative DTH and seronegative (n = 560). The mean +/-SD age of VL was 9.3+/-12.3 y. The gender distribution was nearly equal below age 5, but skewed toward males at higher ages. Acutely infected VL subjects had significantly lower hematocrits, neutrophils, and eosinophils than other categories. AB+ subjects also had lower eosinophil counts than others, a possible immune marker of early infection. VL was not associated with ownership of dogs or other animals, raising the question whether the reservoir differs in peri-urban settings. This new pattern of L. chagasi infection enables us to identify epidemiological and host factors underlying this emerging infectious disease.

Resumo Objetivou-se descrever os principais indicadores entomológicos relacionados aos triatomíneos na mesorregião Oeste do Rio Grande do Norte. Trata-se de estudo descritivo, transversal e retrospectivo, desenvolvido com base em análise histórica de informações sobre a captura de triatomíneos realizada pelo Programa de Controle de doença de Chagas, no período de 2008 a 2013. Foram capturadas cinco espécies, das quais se destacaram a Triatoma brasiliensis e a Triatoma pseudomaculata, pela ocupação do ambiente domiciliar e peridomiciliar, sequencialmente, e a Panstrongylus lutzi, pelo maior índice de infecção natural. Observou-se prevalência de ninfas dentre os exemplares capturados, maior densidade triatomínica no peridomicílio, índices de infestação, colonização e infecção natural de 5,6%, 49,6% e 0,8%, respectivamente, diferença significativa na distribuição de espécimes entre os municípios investigados e ausência de declínio dos índices de infestação e colonização entre os anos de 2009 e 2012. Os achados sugerem a necessidade de vigilância contínua, possibilitada pela associação entre as equipes de campo e as comunidades, com ênfase na proposta de educação em saúde para o reconhecimento e notificação dos triatomíneos pela população.

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Parasitic diseases are a human health problem mainly in low-income areas. The drugs available for the treatment of these diseases are far from satisfactory due to high costs, toxicity, and drug resistance. Sulfated polysaccharides are a complex group of bioactive polymers and can be obtained from seaweeds. The heterofucans from Sargassum filipendula (SF) present strong antiproliferative and antioxidant activities. However, their immunomodulatory and antimicrobial capacity have not been evaluated until now. In this study, five sulfated fucose-rich fractions were isolated (named SF0.5V, SF0.7V, SF1.0V, SF1.5V, and SF2.0V). The chemical composition showed slight differences among polysaccharides and, consequently, biological activity of these polymers. Three fractions (SF0.5V, SF0.7V, and SF1.0V) showed a strong immunomodulatory activity enhancing the release of nitric oxide (NO) by murine macrophages (RAW 264.7), though only SF0.5V was able to induce interleukin-6 (IL-6) and TNF-α release from RAW cells. The sugar to sulfate ratio was not correlated with these activities. Meanwhile, the contents of xylose (P = 0.98 for NO; P = 0.98 for IL-6; P = 0.96 for TNF-α) and glucuronic acid (P = 0.91 for NO; P = 0.9190 for IL-6; P = 0.79 for TNF-α) were strongly positively correlated. SF0.7V and SF1.0V inhibited biofilm formation by Klebsiella pneumoniae (4.2 and 6.8%, respectively), whereas SF0.5V