Amebíase no contexto da emergência: análise do perfil de internações e morbimortalidade nos Estados brasileiros em 5 anos / Amebiasis in the context of emergency: an analysis of the profile of hospitalizations and morbidity/mortality in the states of Brazil in 5 years

Objetivo: Trazer um panorama atualizado acerca dos índices de internações e mortalidade por amebíase nos últimos 5 anos pelo sistema de saúde público brasileiro. Métodos: As informações analisadas foram pesquisadas no banco de dados do Departamento de Informática do Sistema Único de Saúde, considerandose as seguintes variáveis: amebíase; internações e mortalidade; sexo; faixa etária; e período de 2012 a 2016. Resultados: De 14.268 internações por amebíase em todo o Brasil, 4.252 foram em 2012, 3.248 em 2013, 2.552 em 2014, 2.033 em 2015 e 2.183 em 2016. Na Região Norte, encontraram-se os dois Estados com maior e menor número de internações da região e do país: o Pará, com 4.379 casos, e Roraima, com 5. Na Região Nordeste, o Maranhão foi o Estado com mais notificações (4.114) e o segundo maior do Brasil. Na Região Sudeste, Minas Gerais apresentou maior número de registros (793); no Sul, foi o Paraná (325) e, no Centro-Oeste, Goiás (731). Dos Estados com registro de mortalidade, na Região Norte, o Amazonas obteve maior valor (1,02); no Nordeste, foi o Sergipe (5,26); no Sudeste, o Rio de Janeiro (7,81); no Sul, o Rio Grande do Sul (5,26); e, no Centro-Oeste, o Mato Grosso (1,22). Conclusão: Apesar de uma redução no número de internações, as estatísticas para a amebíase ainda continuam altas, principalmente, considerando- se que se trata de uma patologia que poderia ser evitada. É necessário investir em mais medidas educativas, que ensinem a população a evitar a contaminação pelo Entamoeba spp., bem como que seja promovidas ações de saneamento básico e abastecimento de água potável adequados para todas as regiões do Brasil. (AU)

Objective: To provide an updated picture of the hospitalization rates, and mortality due to amebiasis in the last 5 years in the Brazilian public health system. Methods: The information analyzed was searched in the Informatics Department of the Unified Health System database, considering the following variables: amebiasis; hospitalizations and mortality; gender; age group; and period from 2012-2016. Results: Of 14,268 hospitalizations for amebiasis throughout Brazil, 4,252 were in 2012, 3,248 in 2013, 2,552 in 2014, 2,033 in 2015, and 2,183 in 2016. In the North Region, there were the two states with the highest and lowest number of hospitalizations in the region and in the country: the state of Pará, with 4,379 cases, and of Roraima with 5. In the Northeast region, the state of Maranhão was the one with more notifications (4,114), and the second largest one in Brazil. In the Southeast region, the stat of Minas Gerais presented the highest number of records (793); in the South region, it was the state of Paraná (325); and in Center-West, Goiás (731). Of the states with mortality records, in the North region Amazonas reached the highest value (1.02); in the Northeast, Sergipe (5,26); in the Southeast, Rio de Janeiro (7.81); in the South, Rio Grande do Sul (5.26); and in the Center-West region, Mato Grosso (1,22). Conclusion: Despite a reduction in the number of hospitalizations, the statistics for amebiasis are still high, mainly considering that it is a pathology that could be avoided. It is necessary to invest in more educational measures, which teach the population how to avoid contamination by Entamoeba spp., as well as to promote basic sanitation actions, and drinking water supply suitable for all regions of Brazil. (AU)

Identification of differentially expressed cDNAs in Acanthamoeba culbertsoni after mouse brain passage

Free-living amoebae of the genus Acanthamoeba are causative agents of granulomatous amebic encephalitis and amebic keratitis. Because the virulence of Acanthamoeba culbertsoni cultured in the laboratory is restored by consecutive brain passages, we examined the genes induced in mouse brain-passaged A. culbertsoni by differential display reverse transcriptase polymerase chain reaction (DDRT-PCR). Enhanced A. culbertsoni virulence was observed during the second mouse brain passage, i.e., infected mouse mortality increased from 5% to 70%. Ten cDNAs induced during mouse brain passage were identified by DDRT-PCR and this was confirmed by northern blot analysis. BlastX searches of these cDNAs indicated the upregulations of genes encoding predictive NADH-dehydrogenase, proteasomal ATPase, and GDP-mannose pyrophosphorylase B, which have previously been reported to be associated with A. culbertsoni virulence factors.

Estado actual de la amibiasis / Actual statement of the amebiasis

Objetivo. Realizar una investigación documental bibliográfica y epidemiológica para valorar la situación actual de la amibiasis, en especial su comportamiento biológico, su morbilidad, mortalidad y modalidades de terapia médico/quirúrgico. Metodología. Inicialmente se realiza una revisión documental bibliográfica, para ubicar la situación epidemiológica nacional en el contexto internacional. Posteriormente se realiza una investigación epidemiológica en base de la revisión de 20 años que permite establecer el canal endémico en el Estado de México; para finalizar, analizando los alcances que ha tenido el grupo de investigadores mexicanos en el Centro de Estudios sobre Amibiasis. Conclusiones: el grupo médico en nuestro país ha logrado grandes avances en el abatimiento de la morbilidad de la amibiasis, sin lograr erradicarla, puesto que corresponde a los grandes planes nacionales y la introducción de medidas drásticas de saneamiento ambiental hecho único que abatiría por completo la presencia de la amibiasis en México

La amibiasis y el absceso hepático amibiano en México, un problema de salud pública de actualidad / The amebiasis and the amebic liver abscess in Mexico, a present time public health problem

Antecedentes: La amibiasis continúa siendo un problema de salud pública a nivel mundial. En México es un motivo de consulta frecuente y tan sólo en el Instituto Mexicano del Seguro Social se atienden más de medio millón de casos al año. La información epidemiológica en México es aún incompleta. Objetivo: Describir el comportamiento secular de la amibiasis en todas sus formas de presentación clínica y del abseco hepático amibiano, en la población mexicana y en la amparada por IMSS-Solidaridad. Métodos: Se realizó un estudio ecológico de tendencia. Se graficaron las tasas de incidencia de la amibiasis en todas sus formas, así como del absceso hepático amibiano por cada uno de los años de período analizado. Resultados: La incidencia de amibiasis en todas sus formas mostró una tendencia estable en el período de estudio, situación similar a lo observado con el absceso hepático amibiano. La amibiasis es más frecuente durante el primer año de vida. Por el contrario, el absceso hepático amibiano muestra un patrón de "J" invertida, es decir, la ocurrencia es mayor en los extremos de la vida. La letalidad ha mostrado una tendencia al descenso constante: Conclusiones: La amibiasis en México es un reflejo de las condiciones socioeconómicas y de la cultura inacabada mexicana. Es necesario propiciar la educación para la salud, al igual que el mejor diagnóstico y detección de portadores asintomáticos. Con las madres portadoras debieran redefinirse las políticas de salud, dada la elevada frecuencia de amibiasis y absceso hepático amibiano en los menores de un año.

Amebiasis in the epidemiologic transition in Mexico: its morbidity and mortality trends in the Mexican Institute of Social Security

Amebiasis is one of the most common parasite-related diseases and one of those with the greatest impact on health. At the Instituto Mexicano del Seguro Social (Mexican Institute of Social Security-IMSS) approximately half a million cases per year are currently treated. Of these, more than 2500 correspond to the form wich invades the live. Within the process of epidemiologic transition which Mexico undergoing, a progressive reduction has been observed in incidence of, and mortality due to, invading amebiasis in all its clinical forms. In turn, there is a significant decrese in its fatality rate. The social and economic development and improved sanitary conditions observed in Mexico, particularly in the second half of this century, may have conditioned this process. The improvement in availability, accessibility and utilization of medical care services could also explain the reduction which has been noted in its fatality rate and mortality. The model for epidemiologic transition proposed by Omran and adapted for Mexico by Frenk, offers a plausible explanation for the changes observed in the occurrence and mortality of invanding amebiasis in Mexixo

The pathogenicity of a Philippine isolate of Naegleria sp. in mice: effects of dose levels and routes of infection.

The pathogenicity of a Philippine isolate of Naegleria sp. was evaluated using 3-4 week-old mice as experimental animals. Results showed that only the massive doses of 10(6) and 10(7) amebae/mouse inoculated intranasally could successfully establish ameba infection in the brain and cause death after 2-6 days. The effect of the ameba on the mortality rate of inoculated mice was dose-dependent. The amebae were recovered in the brain when inoculated through intracerebral and intranasal routes and in the lungs, liver, and intestines when administered through intranasal and oral routes. By intraperitoneal inoculation, recovery of amebae was positive in all major organs except in the heart. Intravenous inoculation resulted to positive recovery in the lungs, spleen, liver, and heart. Infectivity of the ameba isolate in major organs was route-dependent.