Profile of patients diagnosed with AIDS at age 60 and above in Brazil, from 1980 until June 2009, compared to those diagnosed at age 18 to 59

OBJECTIVES: The aim of this study was to learn more about people diagnosed with acquired immunodeficiency syndrome (AIDS) at age 60 and above in Brazil, and to compare them with people diagnosed at a younger age. METHODS: This study was based on the analysis of secondary data from the Brazilian AIDS Program. The study population consisted of people diagnosed with AIDS at age 60 and above. The comparison group was comprised of a 20% random sample of people diagnosed at age 18 to 59, frequency-matched by year of diagnosis. RESULTS: 544,846 cases of AIDS were reported in Brazil from 1980 until June 2009. Over 90% of cases were diagnosed between 18 and 59 years of age, and 13,657 (2.5%) at age 60 and above. The first case of AIDS among the elderly was reported in 1984. The comparison group consisted of 101,528 patients. Gender proportion was similar for both groups, and the proportion of people identified with AIDS after death in the Brazilian Mortality Information System (SIM) was 4% higher among the elderly. Both groups were also similar regarding the region of residence; a markedly higher proportion lived in Southeastern Brazil. Older people were more likely to have lower education and to have contracted AIDS by heterosexual contact, and less likely to be intravenous drug users. Male to female ratio among those diagnosed with AIDS at or above age 60 decreased over the years, in the same way as observed for the whole cohort. Mortality was higher among men in both groups. CD4 category (taken closest to the date of AIDS diagnosis) was very similar in both groups. CONCLUSION: The characteristics of the epidemic among the elderly show similarities to the younger group considering gender distribution and CD4 category, but differ regarding educational level and exposure category. Also, the elderly were more likely not to have their AIDS condition promptly diagnosed.

Biting behavior and seasonal variation in the abundance of Anopheles minimus species A and C in Thailand.

We measured the seasonal abundance and bloodfeeding behavior of species A and C of the mosquito Anopheles minimus Theobald 1901 in an endemic malarious area of western Thailand. An. minimus s.l. is a major vector of human malarial and filarial parasites in Southeast Asia. Mosquitos were collected once a month for one year using four collection methods: human-baiting indoors, human-baiting outdoors, human-baiting in the forest, and cow-baiting. We found that both species A and C tend to feed from cows rather than humans; we did not find any preference for indoor, outdoor or forest-biting in either species. Both species had a peak biting density in October/November, at the end of the rainy season, and species C showed a second, smaller peak at the end of the cool season. These findings are discussed in relation to previous reports of the behavior of An. minimus s.l., particularly in light of suggestions that An. minimus s.l. has changed its feeding behavior in response to DDT spraying.