Abstract:Auxílio financeiro: CNPq (APQ -processo 465099/2000-9, PIBIC/FIOCRUZ) e OPAS (ASC 00/ 0168-0).
ResumoNo Brasil, estima-se que 49 mil pessoas estejam infectadas pela Wuchereria bancrofti, residindo em três áreas consideradas endêmicas: Maceió-AL, Belém-PA e Região Metropolitana do Recife-PE; esta última apresenta a maior casuística no país. Este estudo tem como objetivo identificar o limite entre municípios com e sem transmissão ativa, em Pernambuco. Para tal foi realizado um estudo seccional no município de Mo… Show more
“…Table 1 shows the reports of autochthonous cases in the municipalities of Abreu e Lima [13], Cabo de Santo Agostinho [13, 14], Camaragibe [13], and Ilha de Itamaracá [6]. Cases of filarial morbidity were detected in Moreno [17] and Cabo de Santo Agostinho [14]. The allochthonous cases identified in Cabo de Santo Agostinho [14], Camaragibe [13], Ilha de Itamaracá [6], and Moreno [17] were from Recife, Jaboatão dos Guararapes, and Olinda.…”
Section: Resultsmentioning
confidence: 99%
“…Nine other municipalities (Abreu e Lima, Cabo de Santo Agostinho, Camaragibe, Igarassu, Ilha de Itamaracá, Ipojuca, Itapissuma, Moreno, and São Lourenço da Mata) are part of the Metropolitan Region of Recife and are areas that adjoin the endemic sites [10]. Evidence in these municipalities is limited to historical data based on case reports [6,11–17]; thus, the epidemiology of LF in these areas is uncertain [18].…”
BackgroundThe objective of the Global Program to Eliminate Lymphatic Filariasis (GPELF) is to phase out this endemic disease as a public health problem by 2020. Validation of elimination is obtained from the World Health Organization through evidence of non-transmission in countries that have already been subjected to mass drug administration (MDA) and in places adjoining these endemic areas. While three municipalities in Brazil have completed MDA, the epidemiological situation remains uncertain in nine adjoining municipalities. To determine the epidemiological status, this study was to perform a review of the literature and a school-based survey to describe the past and recent endemicity of lymphatic filariasis (LF) theses nine municipalities in Brazil.Methodology/Principle findingsFor review of the literature, both formal and informal literature sources were accessed since the first reports of filariasis in the Metropolitan Region of Recife, Brazil. We conducted a school-based survey in 2016 using immunochromatographic card tests (ICTs) among schoolchildren aged 6–10 years living in nine municipalities contiguous with the endemic areas in which MDA was conducted. Our review of the literature identified eight studies involving surveys demonstrating that microfilariae had been circulating in eight of the municipalities since 1967, with a low prevalence of microfilaremia, isolated autochthonous cases, and treatment of individual cases. The school-based survey included 17,222 children in 185 urban schools in the nine areas of Brazil with uncertain endemicity. One child affected by allochthonous transmission was antigen positive based on ICT and lived in a municipality adjacent to Recife; this child’s family came from Recife, but no other case was diagnosed within the family.Conclusions/SignificanceThe study results suggest that there is no transmission of LF in the municipalities investigated. However, these areas have population migration and socioenvironmental conditions favorable to mosquito breeding grounds; therefore, surveillance is strongly recommended in these areas.
“…Table 1 shows the reports of autochthonous cases in the municipalities of Abreu e Lima [13], Cabo de Santo Agostinho [13, 14], Camaragibe [13], and Ilha de Itamaracá [6]. Cases of filarial morbidity were detected in Moreno [17] and Cabo de Santo Agostinho [14]. The allochthonous cases identified in Cabo de Santo Agostinho [14], Camaragibe [13], Ilha de Itamaracá [6], and Moreno [17] were from Recife, Jaboatão dos Guararapes, and Olinda.…”
Section: Resultsmentioning
confidence: 99%
“…Nine other municipalities (Abreu e Lima, Cabo de Santo Agostinho, Camaragibe, Igarassu, Ilha de Itamaracá, Ipojuca, Itapissuma, Moreno, and São Lourenço da Mata) are part of the Metropolitan Region of Recife and are areas that adjoin the endemic sites [10]. Evidence in these municipalities is limited to historical data based on case reports [6,11–17]; thus, the epidemiology of LF in these areas is uncertain [18].…”
BackgroundThe objective of the Global Program to Eliminate Lymphatic Filariasis (GPELF) is to phase out this endemic disease as a public health problem by 2020. Validation of elimination is obtained from the World Health Organization through evidence of non-transmission in countries that have already been subjected to mass drug administration (MDA) and in places adjoining these endemic areas. While three municipalities in Brazil have completed MDA, the epidemiological situation remains uncertain in nine adjoining municipalities. To determine the epidemiological status, this study was to perform a review of the literature and a school-based survey to describe the past and recent endemicity of lymphatic filariasis (LF) theses nine municipalities in Brazil.Methodology/Principle findingsFor review of the literature, both formal and informal literature sources were accessed since the first reports of filariasis in the Metropolitan Region of Recife, Brazil. We conducted a school-based survey in 2016 using immunochromatographic card tests (ICTs) among schoolchildren aged 6–10 years living in nine municipalities contiguous with the endemic areas in which MDA was conducted. Our review of the literature identified eight studies involving surveys demonstrating that microfilariae had been circulating in eight of the municipalities since 1967, with a low prevalence of microfilaremia, isolated autochthonous cases, and treatment of individual cases. The school-based survey included 17,222 children in 185 urban schools in the nine areas of Brazil with uncertain endemicity. One child affected by allochthonous transmission was antigen positive based on ICT and lived in a municipality adjacent to Recife; this child’s family came from Recife, but no other case was diagnosed within the family.Conclusions/SignificanceThe study results suggest that there is no transmission of LF in the municipalities investigated. However, these areas have population migration and socioenvironmental conditions favorable to mosquito breeding grounds; therefore, surveillance is strongly recommended in these areas.
“…In Moreno, a rate of 0.08% microfilaremia was found, but none of the cases were autochthonous, indicating that filariasis transmission is not a problem [47]. In Cabo de Santo Agostinho, in the late 1990s, an autochthonous case of LF was found.…”
Since the World Health Assembly’s (Resolution WHA 50.29, 1997) call for the elimination of lymphatic filariasis by the year 2020, most of the endemic countries identified have established programmes to meet this objective. In 1997, a National Lymphatic Filariasis Elimination Plan was drawn up by the Ministry of Health of Brazil, creating local programs for the elimination of Bancroftian filariasis in areas with active transmission. Based on a comprehensive bibliographic search for available studies and reports of filariasis epidemiology in Brazil, current status of this parasitic infection and the outlook for its elimination in the country were analysed. From 1951 to 1958 a nationwide epidemiological study conducted in Brazil confirmed autochthonous transmission of Bancroftian filariasis in 11 cities of the country. Control measures led to a decline in parasite rates, and in the 1980s only the cities of Belém in the Amazonian region (Northern region) and Recife (Northeastern region) were considered to be endemic. In the 1990s, foci of active transmission of LF were also described in the cities of Maceió, Olinda, Jaboatão dos Guararapes, and Paulista, all in the Northeastern coast of Brazil. Data provide evidence for the absence of microfilaremic subjects and infected mosquitoes in Belém, Salvador and Maceió in the past few years, attesting to the effectiveness of the measures adopted in these cities. Currently, lymphatic filariasis is a public health problem in Brazil only in four cities of the metropolitan Recife region (Northeastern coast). Efforts are being concentrated in these areas, with a view to eliminating the disease in the country.
“…In Brazil, it is estimated that three million individuals live in areas considered to be at risk and approximately 49,000 people are infected with W. bancrofti. The largest sample is in the metropolitan area of Recife, in the northeastern region 4,8,19,20,21 .…”
SUMMARYLymphatic filariasis (LF) causes a wide range of clinical signs and symptoms, including urogenital manifestations. Transmission control and disability/morbidity management/control are the two pillars of the overall elimination strategy for LF. Lymph scrotum is an unusual urological clinical presentation of LF with important medical, psychological, social and economic repercussions. A retrospective case series study was conducted on outpatients attended at the National Reference Service for Filariasis, in an endemic area for filariasis (Recife, Brazil), between 2000 and 2007. Over this period, 6,361 patients were attended and seven cases with lymph scrotum were identified. Mean patient age was 45 years (range, 26 to 64 years). Mean disease duration was 8.5 years (range, two to 15 years). All patients had evidence of filarial infection from at least one laboratory test (parasitological, antigen investigation or "filarial dance sign" on ultrasound). Six patients presented histories of urological surgery. The authors highlight the importance of the association between filarial infection and the inadequate surgical and clinical management of hydrocele in an endemic area, as risk factors for lymph scrotum. Thus, filarial infection should be routinely investigated in all individuals presenting urological morbidity within endemic areas, in order to identify likely links in the transmission chain.
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