Colera em Mocambique no seculo XIX : II. tratamento utilizado na epoca

Este e o segundo artigo de uma serie de tres; relativa a epidemia de colera que assolou a Ilha de Mocambique; de Fevereiro a Marco no ano de 1859. No presente artigo apresentam-se e analisam-se aspectos relacionados com o diagnostico e tipo de tratamento utilizado; os recursos humanos e materiais existentes e o estabelecimento de um sistema de organizacio sanitaria onde participaram para alem do pessoal de saude; elementos da comunidade para apoio ao tratamento domiciliar dos casos. O aspecto mais importante; tendo em conta outras epidemias ocorridas durante o mesmo periodo na Europa e America; foi a participacio activa da populacio em relacio as medidas de tratamento preconizado palas autoridades de saude

Dinamica da malaria numa area de saude da Cidade de Maputo : parte II

The authors present the results of study of the dynamics of endemic malaria in the catchment area of Jose Macamo Health Centre. They established a malaria clinic in this centre; integrated in a pilot project designed to test malaria control using health centres as base. Data was collected in this clinic from July 1993; covering two periods in which the epidemiological characteristics of malaria were determined by different rainfall patterns. In the first year; there was a severe drought; despite this; a focal outbreak occurred in January 1992 in suburbs situated along the drainage system of the influence valley. Through data collected on residence of patients with malaria; we detected a greater incidence in some suburbs and; within these suburbs; areas with differing incidences. An environmental survey in these areas showed numerous breeding sites of the malaria vector. These were small wells; dug by the population to obtain water for their fields. A parasitological survey in February 1992 showed a high prevalence (38) of malaria in the same areas; confirming a relationship between breeding sites and prevalence rates. A new peak occurred later in April-May; coinciding with a period of heavy rainfall. During the first year; 6011 patients with malaria were observed; 1.102 in the period of low transmission (July-December 1991) and 4.909 from January to June; 1992. In the second year; the pattern was very different; above average rainfall gave rise to an epidemic which covered a larger area. 23.028 patients were observed in this period; of whom 17.151 during the higher transmission period. The geographic transmission of the reported cases was higher during the 2 study period; but most patients came from suburbs adjoining the health centre. We analyse the possible causes of this epidemic; principally the relationship between the seasonal characteristics of endemic malaria and the immunity of the population. We consider that the implementation of a similar system of data collection in other health centres with good quality microscopy could; in the future; permit the development of efficient epidemiological surveillance for endemic malaria

Avaliacao e seleccao de tecnicas de diagnostico directo na malaria

A eficacia; rapidez e custo de diversas tecnicas directas; foram comparadas; com a tecnica actualmente padronizada em Mocambique; para o diagnostico da malaria.Realizaram-se diluicoes; desde 1/2 ate 1/1024; de sangue de um doente parasitado; com sangue nao parasitado. Determinou-se a percentagem da parasitemia para cada tecnica e demonstraram-se valores estatisticamente significativos na tecnica de fluorescencia com Laranja de Acridina e Walkerpara 10 e 5 minutos de colaboracao. Nao foram encontradas diferencas estatisticamente significativas com a tecnica controle; no que concerne a qualidade da colaboracao; nas tecniucas de Walker 5 para 10 e 5 minutos e as tecnicas de Giemsa 5 para 10 e 5 minutos. A tecnica de Laranja de Acridina resultpou ser a mais barata que a anterior; apresentou outros aspectos mais vantajosos que as restantes tecnicas; portanto sugere-se a mesma como a mais adequada para os estudos clinicos e epidemiologicos da malaria