Doenças negligenciadas no município de sabará: casos, portadores e percepções / Neglected diseases in the city of sabará (mg): cases, affected people and perceptions

As doenças negligenciadas (DNs) são causadas por agentes infecciosos e parasitários, e na maioria das vezes acometem populações de baixa renda. A atenção primária à saúde (APS) atende, aproximadamente, 85% dos problemas de saúde da população, incluindo parte dos serviços relacionados aos portadores das DNs. Sabará, Minas Gerais, vem registrando um aumento no número de notificações para várias DNs transmitidas por vetores e/ou com hospedeiros intermediários envolvidos em seu ciclo. Nessa perspectiva, o presente trabalho teve como objetivo levantar o número de notificações de DNs transmitidas por vetores e/ou com hospedeiros intermediários envolvidos em seu ciclo entre os anos 2008 a 2014 no município, analisar o perfil sociodemográfico dos portadores e avaliar a percepção de profissionais da Estratégia de Saúde da Família (ESF) sobre aspectos relacionados a essas doenças. Para o levantamento das DNs e do perfil sociodemográfico de seus portadores foram analisadas as fichas de notificação compulsória das DNs. As DNs transmitidas por vetores e/ou com hospedeiros intermediários envolvidos em seu ciclo com maior número de notificações em Sabará foram: dengue, esquistossomose, leishmaniose visceral e leishmaniose tegumentar americana (LTA). Em relação à idade, a leishmaniose visceral acometeu, fundamentalmente, crianças, e a dengue, a LTA e a esquistossomose, adultos. Para a avaliação da percepção dos profissionais da ESF sobre as DNs foram aplicados questionários estruturados aos enfermeiros, Agentes Comunitários de Saúde (ACSs) e auxiliares/técnicos de enfermagem de 09 programas de saúde. Através desse instrumento pode-se evidenciar um desconhecimento sobre as principais endemias, vetores e hospedeiros intermediários, ausência de conhecimento sobre o fluxo de atendimento das DNs, insuficiente articulação entre Atenção Primária a Saúde e demais níveis de atenção, e insipiência de informações disponibilizadas pela APS à população. Reforça-se que Sabará é um município endêmico para várias DNs transmitidas por vetores e/ou com hospedeiros intermediários envolvidos em seu ciclo, e que os profissionais da APS do município desconhecem essa realidade.

Neglected diseases (NDs) are caused by infectious and parasitic agents, and most often affect low-income populations. Primary health care (PHC) covers approximately 85% of the population's health issues, including part of the services related to those affected with NDs. The city of Sabará in Minas Gerais (Brazil) has registered an increase in the number of notifications for various NDs transmitted by vectors and/or intermediate hosts involved in its cycle. In this perspective, this study aims at raising the number of notifications regarding NDs transmitted by vectors and/or intermediate hosts between the years 2008-2014 in the city by analyzing the socio-demographic profile of patients and evaluating the perception of professionals in the Family Health Strategy (FHS) on aspects related to these diseases. In order to collect data related to the NDs and patient socio-demographics, ND compulsory notification records were analyzed. The NDs transmitted by vectors and/or intermediate hosts with the highest number of notifications in Sabará were dengue fever, schistosomiasis, visceral leishmaniasis and American cutaneous leishmaniasis. Regarding age, visceral leishmaniasis occurred mainly in children, whereas dengue fever, American cutaneous leishmaniasis and schistosomiasis occurred in adults. In order to evaluate the perception of the FHS professionals on NDs, structured questionnaires were applied to nurses, community health workers (CHWs) and nursing assistants/technicians of nine health programs. Through this tool, it was possible to show the lack of knowledge about the major endemic diseases and vectors, lack of knowledge about the flow of care of NDs, insufficient coordination between Primary Health Care and other levels of attention, and lack of information provided from PHC to the population. It must be emphasized that the city of Sabará is an endemic municipality for several NDs transmitted by vectors and/or intermediate hosts, and PHC professionals are not aware of that reality.

Molecular investigation of Neorickettsia risticii in trematodes and snails in a region with serological evidence of this agent in horses, state of Rio de Janeiro / Pesquisa molecular de Neorickettsia risticii em trematódeos e moluscos em região com evidência sorológica do agente em equinos, estado do Rio de Janeiro

In Brazil, some studies have indicated that Neorickettsia risticii circulates in horses, but it is unclear which are the possible intermediate vectors of this bacterium in the country. The aim of this study was to use molecular techniques in order to analyze the presence of N. risticii in snails and larval stages of trematodes in farms in a region with a history of seroreactive horses towards this bacterium, in Rio de Janeiro, Brazil. Convenience sampling was used in the studied region. The collected snails were exposed to incandescent light (60W) for 2-4 hours in order to investigate trematodes in larval forms. Deoxyribonucleic acid (DNA) was extracted from snail tissue and trematode. Real-time PCR (qPCR) technique was used to investigate the presence of a 16S rRNA gene fragment of N. risticii. Snail specimens (n=410) were collected from 11 horse-breeding farms, and the following species were identified: Melanoides tuberculata, Pomacea sp., Biomphalaria tenagophila, Physa acuta, Drepanotrema anatinum and Biomphalaria straminea. Only 3.17% (n=13/410) of the collected snails were infected by trematodes. The cercariae obtained from these snails were classified as Megalourous cercariae, Pleurolophocercus cercariae and Furcocercous cercariae. There was no amplification of the target DNA of N. risticii in the snail and trematode samples tested by qPCR. Based on these data, the transmission of N. risticii by trematodes using these snail species in this region does not appear to occur or occurs at very low rates. Thus, further studies are needed in order to clarify which species of invertebrate hosts are infected by this bacterium and potentially participate in the transmission chain of equine neorickettsiosis in the state of Rio de Janeiro, Brazil.(AU)

No Brasil, estudos apontam a circulação de Neorickettsia risticii em equinos, contudo não estão claros quais os possíveis vetores intermediários dessa bactéria no país. O objetivo do presente estudo foi analisar a presença de N. risticii, utilizando-se técnicas moleculares, em caramujos e estágios larvais de trematódeos em propriedades rurais de uma região com histórico de equinos sororreativos para essa bactéria, no Rio de Janeiro, Brasil. Uma amostragem por conveniência foi utilizada na região de estudo. Os caramujos coletados foram expostos à luz incandescente (60W) durante duas-quatro horas para a investigação de trematódeos nas formas larvais. A extração de ácido desoxirribonucleico (DNA) foi realizada em tecidos de caramujos e trematódeos. A técnica de PCR em tempo real (qPCR) foi utilizada para investigar a presença de um fragmento do gene 16S rRNA de N. risticii. Foram coletados 410 espécimes de caramujos de 11 propriedades com criações de equinos, sendo identificadas as seguintes espécies: Melanoides tuberculata, Pomacea sp., Biomphalaria tenagophila, Physa acuta, Drepanotrema anatinum e Biomphalaria straminea. Apenas 3,17% (n=13/410) dos caramujos identificados estavam infectados por trematódeos. As cercárias obtidas desses caramujos foram classificadas em Megalourous cercariae, Pleurolophocercus cercariae e Furcocercous cercariae. Não foi observada a amplificação do DNA-alvo de N. risticii, por meio da qPCR, em nenhuma das amostras de caramujos e trematódeos testadas. Com base nesses dados, a transmissão de N. risticii por trematódeos que utilizam as espécies de caramujos nessa região parece não ocorrer ou ocorre a taxas muito reduzidas. Portanto, novos estudos são necessários para elucidar quais espécies de hospedeiros invertebrados se infectam por essa bactéria e potencialmente participam da cadeia de transmissão da neorickettsiose equina no estado do Rio de Janeiro, Brasil.(AU)

Experimental evaluation of Odonata nymph in the biocontrol of schistosomiasis intermediate hosts

Objective To evaluate the predatory potential of the Odonata nymph on freshwater snails that serve as intermediate hosts for Schistosoma species (Bulinus truncatus and Biomphalaria alexandrina). Methods Observations on the searching, attacking and devouring of the two snail types with series of laboratory-based predation experiments, whose aims were to determine daily predation rate, differential predation, prey preference considering small-, medium- and large-sized snails were conducted. Results Laboratory evaluation revealed that, the Odonata nymph could kill and consume the two intermediate hosts. The number of snails consumed differed according to the snail type, size and density. The times taken for searching and handling times were dependent on the snail size, type and satiation of the predator. The predation rate varied also with respect to snail type, size and density. This study also evaluated that Odonata nymphs consumed more Bulinus truncatus than Biomphalaria alexandrina per unit time, and that there may be a preference for smaller than larger snails. Conclusions According to our observation, the predator, Hemianax ephippiger nymph may be a suitable biocontrol agent in connection with Schistosoma intermediate hosts.

Angiostrongylus cantonensis infection in molluscs in the municipality of São Gonçalo, a metropolitan area of Rio de Janeiro, Brazil: role of the invasive species Achatina fulica in parasite transmission dynamics

The aim of this study was to analyse the infection dynamics ofAngiostrongylus cantonensisin its possible intermediate hosts over two years in an urban area in the state of Rio de Janeiro where the presence ofA. cantonensis had been previously recorded in molluscs. Four of the seven mollusc species found in the study were exotic.Bradybaena similariswas the most abundant, followed byAchatina fulica, Streptaxissp., Subulina octona, Bulimulus tenuissimus, Sarasinula linguaeformisand Leptinaria unilamellata. Only A. fulicaand B. similariswere parasitised by A. cantonensis and both presented co-infection with other helminths. The prevalence of A. cantonensisin A. fulicawas more than 50% throughout the study. There was an inverse correlation between the population size ofA. fulicaand the prevalence of A. cantonensisand abundance of the latter was negatively related to rainfall. The overall prevalence of A. cantonensisin B. similariswas 24.6%. A. fulicawas the most important intermediary host of A. cantonensisin the studied area andB. similariswas secondary in importance for A. cantonensistransmission dynamics.

Potential of Hemianax ephippiger (Odonata-Aeshnidae) nymph as predator of Fasciola intermediate host, Lymnaea natalensis

Objective: To evaluate the predatory capacity of the Odonata, Hemianax ephippiger nymph as a biocontrol agent for the freshwater snail Lymnaea natalensis, intermediate host of Fasciola gigantica. Methods: Observations on the searching, attacking and devouring of the snails with a series of laboratory-based predation experiments, whose aims were to determine daily predation rate, differential predation on small-, medium- and large-sized snails were carried out. Results: Laboratory evaluation revealed that, the Odonata nymph could kill and consume all three sizes of snails. Searching and handling time of the predator differed depending on snail size and predator vulnerability. The predation rate varied also with respect to snail size and density. Conclusions: Our observations suggested that the predator Hemianax ephippiger may be a suitable bio-control agent of Lymnaea natalensis snail population.