ABSTRACT
Abstract This study comprised the application of a survey in São Paulo, Brazil, in 2 different periods of 2020: the beginning of the covid-19 pandemic and the disease's first peak (from March to April, 100 interviews) to the time of stability in case fatality rates (from May to July, 100 interviews); the questionnaire included was composed of 14 multiple-choice questions to evaluate the importance of mass communication channels, including social media, and the level of importance attributed to preventive measures at the beginning of the pandemic. The changes in people's behavior, even in a group with more schooling, which initially considered preventive measures to be very important (91%) but, in the second survey, was reduced to 82%. The reinforcement of preventive measures to reduce cases and deaths by covid-19 in Brazil is urgent, allied to recommendations with clear information on the importance of vaccination to avoid low rates as the current situation of vaccine coverage for preventable diseases.
Resumo Foi conduzida uma pesquisa em São Paulo, no Brasil, em 2 períodos distintos de 2020: sendo o primeiro no início da pandemia do covid-19 com um elevado pico de incidência da doença (de março a abril, foram realizadas 100 entrevistas) até o momento de estabilidade nas taxas de letalidade (de maio a julho, foram realizadas outras 100 entrevistas), composto por 14 questões de múltipla escolha para avaliar a importância dos canais de comunicação em massa (incluindo as redes sociais) e o nível de importância atribuído às medidas preventivas no início da pandemia. As mudanças no comportamento das pessoas, mesmo dentro de um grupo de nível educacional alto, que inicialmente considerava as medidas preventivas muito importantes (91%), apresenta considerável queda na segunda pesquisa realizada (redução para 82%). Há a necessidade urgente de reforço de medidas preventivas para redução de casos e óbitos por covid-19 no Brasil, aliadas a recomendações com informações claras como a importância da vacinação para evitar baixas taxas de cobertura vacinal que se apresentam em outras doenças preveníveis por vacinas.
Subject(s)
Humans , Male , Female , Immunization Programs , Communication , Transtheoretical Model , COVID-19 , COVID-19/prevention & control , Health Policy , Mass MediaABSTRACT
OBJECTIVES: COVID-19 is a public health emergency of international concern whose detection in recovered asymptomatic patients is dependent on accurate diagnosis as it enables the estimation of the susceptibility of the population to the infection. This demand has resulted in the development of several commercial assays employing recombinant proteins, but the results of these assays are not reliable as they do not involve comparison with natural viral antigens. We independently used the SARS-CoV-2 whole viral antigen (WVA) and recombinant nucleocapsid protein (rNP) to develop in-house ELISAs for IgG detection; the results of these ELISAs were then compared to obtain reliable results. METHODS: WVA and rNP ELISAs were performed on COVID-19 negative sera from patients before the pandemic in Brazil, and on RT-qPCR-positive or SARS-CoV-2-IgG against rNP and IgG against WVA-positive samples from recently infected patients in Sao Paulo, Brazil. RESULTS: Both ELISAs detected a large fraction of infected patients but exhibited certain drawbacks. Higher signals and lower numbers of false-negatives were observed in rNP ELISA; however, a higher fraction of false-positives was observed in control groups. A high number of false-negatives was observed with WVA ELISA. Correlating the results of rNP and WVA ELISAs resulted in improved performance for COVID-19 diagnosis. CONCLUSION: The choice of antigen is an important aspect in optimizing the laboratory diagnosis of COVID-19. The use of rNP ELISA for the detection of anti-SARS-CoV-2 IgG antibodies seems promising, but comparison of the results with those of WVA ELISA is crucial for accurate test development prior to commercialization. IgG serology using several assays, and with the spectral patterns of SARS-CoV-2, resulted in confusing information that must be clarified before the establishment of diagnostic serology criteria.
Subject(s)
Humans , SARS-CoV-2 , COVID-19 , Brazil , Sensitivity and Specificity , Clinical Laboratory Techniques , COVID-19 Testing , Antibodies, Viral , Antigens, ViralSubject(s)
Humans , Public Health , Global Health , Communicable Diseases/transmission , Time Factors , Travel , Brazil , Disease Outbreaks , Risk FactorsABSTRACT
SUMMARY Toxoplasmosis, a worldwide highly prevalent zoonotic infection, is transmitted either by the oocysts, from water and soil, or the tissue cysts, in raw or undercooked infected meat, of Toxoplasma gondii. An ongoing debate is whether there are differences between the clinical and epidemiological characteristics of the outbreaks due to one or the other infective form of the agent. We performed a systematic review, recovering 437 reported outbreaks of which 38 were selected. They were complete reports containing ascribed Toxoplasma infecting form, and clinical and demographic data. There was no gender or age group selection in the outbreaks, which were described more often in the Americas. A large number of individuals were affected when oocysts, associated with soil and water contaminated with cat feces, were considered the transmission source. Onset of symptoms occurred early when the infection was ascribed to meat tissue cysts (11.4 ± 6.7 days) with sharpened temporal distribution of cases, while a broader and prolonged appearance of new cases was observed when oocysts in water were the source of the infection (20 ± 7 days, p < 0.001). Such information may be useful in the design and implementation of control strategies.
RESUMO Toxoplasmose, infecção zoonótica altamente prevalente no mundo, é transmitida pela ingestão de oocistos em água e solo ou cistos teciduais em carne crua ou mal cozida. Um debate em andamento é se há diferenças nas características clínicas e epidemiológicas de surtos devido a uma ou outra forma infectante do agente. Realizamos revisão sistemática a partir de 437 relatos de surtos da doença, selecionando 38 artigos completos que descreveram a forma infectante do Toxoplasmacom dados clínicos e epidemiológicos. Não houve seleção por gênero ou faixa etária nos surtos, descritos mais frequentemente nas Américas. Quantidade maior de indivíduos foi afetada quando oocistos, associados com solo ou água contaminados com fezes de gato, foram considerados a fonte de transmissão. O início dos sintomas ocorreu mais precocemente quando a infecção foi atribuída a cistos na carne (11,4 ± 6,7 dias) com distribuição temporal nítida de casos, embora um aspecto mais amplo e prolongado de novos casos foi observado quando oocistos na água foram a fonte de infecção (20 ± 7 dias, p< 0.001). Essas informações podem ser úteis no desenvolvimento e implantação de estratégias de controle.
Subject(s)
Animals , Cats , Female , Humans , Male , Disease Outbreaks , Toxoplasmosis/epidemiology , Toxoplasmosis/transmission , Food Parasitology , Feces/parasitology , Meat/parasitology , Oocysts , Toxoplasma , Water/parasitologyABSTRACT
OBJECTIVE: Hereditary angioedema is a serious medical condition caused by a rare autosomal dominant genetic disorder and it is associated with deficient production or dysfunction of the C1 esterase inhibitor. In most cases, affected patients experience unexpected and recurrent crises of subcutaneous, gastrointestinal and laryngeal edema. The unpredictability, intensity and other factors associated with the disease impact the quality of life of hereditary angioedema patients. We evaluated the quality of life in Brazilian hereditary angioedema patients. METHODS: Patients older than 15 years with any severity of hereditary angioedema and laboratory confirmation of C1 inhibitor deficiency were included. Two questionnaires were used: a clinical questionnaire and the SF-36 (a generic questionnaire). This protocol was approved by the Ethics Committee of Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo. RESULTS: The SF-36 showed that 90.4% (mean) of all the patients had a score below 70 and 9.6% had scores equal to or higher than 70. The scores of the eight dimensions ranged from 51.03 to 75.95; vitality and social aspects were more affected than other arenas. The internal consistency of the evaluation was demonstrated by a Cronbach's alpha value above 0.7 in seven of the eight domains. CONCLUSIONS: In this study, Brazilian patients demonstrated an impaired quality of life, as measured by the SF-36. The most affected domains were those related to vitality and social characteristics. The generic SF-36 questionnaire was relevant to the evaluation of quality of life; however, there is a need for more specific instruments for better evaluation.
Subject(s)
Adult , Female , Humans , Male , Middle Aged , Young Adult , Angioedemas, Hereditary/psychology , Quality of Life , Angioedemas, Hereditary/physiopathology , Brazil , Complement C1 Inhibitor Protein , Reference Values , Severity of Illness Index , Surveys and QuestionnairesABSTRACT
Leishmaniasis is an endemic and tropical disease that afflicts mainly the developing . The limited and highly toxic therapeutic arsenal for leishmaniasis..