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1.
Medicina (B.Aires) ; 81(1): 1-5, mar. 2021. graf
Article in Spanish | LILACS | ID: biblio-1287233

ABSTRACT

Resumen La principal infección viral transmisible por sangre es actualmente la debida al virus de hepatitis C (VHC). Uno de los mayores obstáculos para el logro de su control en la Argentina se relaciona con las dificultades de acceso al diagnóstico y tratamiento oportuno de las personas infectadas. Este estudio se realizó con el objetivo de caracterizar a los pacientes infectados con VHC que iniciaron tratamiento con antivirales de acción directa (AAD) y describir la experiencia vinculada al tratamiento. Se seleccionaron las historias clínicas de 82 pacientes, 44 (53.7%) de sexo masculino, 37 (45.1%) de sexo femenino, y uno (1.2%) transgénero. La media de edad fue de 49 años. Se halló una frecuencia de cirrosis de 39%, 32 pacientes, coinfección con HIV en 48 (58.5%) y con VHB en 27 (32.9%). En 52 (63.4%) no se observó ningún factor de riesgo claramente asociado a infección. Todos completaron la terapia, de ellos 72 (87.8%) efectuaron el control para confirmar respuesta viral sostenida (RVS), que fue de 98.6%. Concluimos que el testeo universal debe implementarse por sobre el testeo con enfoque de riesgo, y que debe promoverse un criterio de atención simplificado y descentralizado, reservando la atención especializada para pacientes con cirrosis descompensada y cáncer de hígado.


Abstract Hepatitis C virus (HCV) infection is currently the main blood-borne viral infection. One of the main obstacles to achieving its control in Argentina is related to difficulties in accessing the diagnosis and timely treatment of infected people. We carried out this study with the aim of characterizing the HCV-infected patients who started treatment with direct-acting antivirals (DAAs) and to describe the experience related to treatment. The medical records of 82 patients, 44 (53.7%) male, 37 (45.1%) female, and one (1.2%) transgender, were selected. The mean age was 49 years. We report a frequency of cirrhosis, 39%, in 32 patients, coinfection with HIV in 48 (58.5%) and with HBV in 27 (32.9%). In 52 patients (63.4%), no risk factor clearly associated with infection was observed. All completed the therapy, of them 72 (87.8%) carried out the control to confirm sustained viral response (SVR), that attained 98.6%. We conclude that universal testing should be implemented over testing based on a risk approach, and that a simplified and decentralized care criterion should be promoted, reserving specialized care for patients with decompensated cirrhosis and liver cancer.


Subject(s)
Humans , Male , Female , Middle Aged , Antiviral Agents/therapeutic use , HIV Infections/drug therapy , Hepatitis C/diagnosis , Hepatitis C/drug therapy , Hepatitis C/epidemiology , Hepatitis C, Chronic/drug therapy , Coinfection/epidemiology , Argentina/epidemiology , Hepacivirus , Liver Cirrhosis
2.
Pesqui. vet. bras ; 40(8): 593-597, Aug. 2020. tab
Article in English | ID: biblio-1135667

ABSTRACT

Reproductive tests in cattle are of great economic importance, given the impact it can have on the production system and may be caused by agents. Neospora caninum and Bovine Viral Diarrhea virus (BVDV) are considered of great importance as reproductive and should be considered responsible for keeping animals persistently infected. The present study included 479 calf serum samples for export in the state of Rio Grande do Sul (RS). All samples were screened for BVDV by an ELISA antigen. BVDV antigen-positive ELISA samples were isolated from BVDV in cell culture. An indirect immunofluorescence (IFT) technique was used to detect anti-N. caninum antibodies. Of the 479 export-treated serum samples, 361 were positive for BVDV antigens by ELISA and/or viral isolation test (361/479-75.36%), and 109 IFT-positive samples for N. caninum (109/479-22.75%). Despite detection of antibodies anti-N. caninum did not differ statistically between naturally infected BVDV and non-BVDV infected animals suggesting that there is no interference of BVDV infection on infection or detection rate of animals with N. caninum, positive animals in viral isolation and high DO in BVDV-Ag ELISA. may present active disease and consequent immunosuppression, contributing to a potential reactivation of N. caninum.(AU)


Testes reprodutivos em bovinos são de grande importância econômica, dado o impacto que podem ter no sistema de produção e podem ser causados por agentes. O Neospora caninum e o vírus da Diarreia Viral Bovina (BVDV) são considerados de grande importância como reprodutivos e devem ser considerados responsáveis por manter os animais persistentemente infectados. O presente estudo incluiu 479 amostras de soro de bezerro para exportação no estado do Rio Grande do Sul (RS). Todas as amostras foram rastreadas para BVDV por um antígeno ELISA. As amostras de ELISA positivas para o antigénio BVDV foram isoladas a partir de BVDV em cultura de células. Uma técnica de imunofluorescência indireta (IFT) foi utilizada para detectar anticorpos anti-N caninum. Das 479 amostras de soro tratadas para exportação, 361 foram positivas para antígenos de BVDV por ELISA e/ou teste de isolamento viral (361/479-75,36%) e 109 amostras positivas para IFT para N. caninum (109/479-22,75%). Apesar da detecção de anticorpos anti-N. caninum não diferiu estatisticamente entre animais infectados naturalmente BVDV e não BVDV sugerindo que não há interferência da infecção pelo BVDV na infecção ou taxa de detecção de animais com N. caninum, animais positivos em isolamento viral e alta DO em BVDV-Ag ELISA, pode apresentar doença ativa e consequente imunossupressão, contribuindo para uma potencial reativação de N. caninum.(AU)


Subject(s)
Animals , Cattle , Coccidiosis/veterinary , Diarrhea Viruses, Bovine Viral/isolation & purification , Neospora/isolation & purification , Coinfection/veterinary , Coinfection/epidemiology
3.
Rev. méd. Chile ; 148(5): 618-625, mayo 2020. tab, graf
Article in Spanish | LILACS | ID: biblio-1139346

ABSTRACT

Background: Tuberculosis (TB)/HIV coinfection has a high mortality rate. Aim: To describe socio-epidemiological characteristics of tuberculosis (TB)-HIV coinfection, and aspects associated with its prevalence, from 2005 to 2018. Material and Methods: Analysis of the registry of the tuberculosis control and elimination program of three public health services of metropolitan Santiago. The variables considered were: TB/HIV coinfection, age, sex, location of tuberculosis, bacteriological confirmation, incarceration, commune of residence, country of origin and effectiveness of the tuberculosis therapy. Results: We analyzed 7507 TB cases, of whom 12% corresponded to cases of coinfection. The number of coinfections doubled in the last 6 years. In 2018, 45% of coinfection cases occurred in migrants. Of the total cases evaluated, 53% were successfully treated and 28% died. Conclusions: The remarkable increase in TB/HIV coinfection, urgently demands new prevention and control strategies, aimed at the most vulnerable groups.


Subject(s)
Humans , Male , Female , Tuberculosis/epidemiology , HIV Infections/epidemiology , Coinfection/epidemiology , Socioeconomic Factors , Chile/epidemiology , Prevalence , Cities/epidemiology
4.
Rev. saúde pública (Online) ; 54: e112, 2020. tab, graf
Article in English | LILACS, BBO, SES-SP | ID: biblio-1139483

ABSTRACT

ABSTRACT OBJECTIVE To describe the spatial and temporal distribution of TB-HIV co-infection, as well as the profile of the characteristics of the co-infected population in the municipality of São Paulo. METHODS This is an ecological and time series study with data from the Tuberculosis Patient Control System (TBWeb), including all new cases of tuberculosis co-infected individuals with HIV living in the municipality from 2007 to 2015. Time trends of the disease were analyzed using Prais-Winsten regression. The cases were geocoded by the address of residence for the elaboration of maps with the incidence rates smoothed by the local empirical Bayesian method. The global and local Moran indexes evaluated spatial autocorrelation. Individuals' profiles were described and the characteristics of the cases with and without fixed residence were compared by Pearson's chi-square or Fisher's exact tests. RESULTS We analyzed 6,092 new cases of TB-HIV co-infection (5,609 with fixed residence and 483 without fixed residence). The proportion of TB-HIV co-infection ranged from 10.5% to 13.7%, with a drop of 3.0% per year (95%CI -3.4 - -2.6) and was higher in individuals without fixed residence. Incidence rates decreased by 3.6% per year (95%CI -4.4% - -2.7%), declining from 7.0 to 5.3 per 100,000 inhabitants/year. Co-infection showed positive and significant spatial autocorrelation, with heterogeneous spatial pattern and a high-risk cluster in the central region of the municipality. Cure was achieved in 55.5% of cases with fixed residence and in 32.7% of those without a fixed residence. CONCLUSIONS The data indicate an important advance in the control of TB-HIV co-infection in the period analyzed. However, we identified areas and populations that were unequally affected by the disease and that should be prioritized in the improvement of actions to prevent and control co-infection.


RESUMO OBJETIVO Descrever a distribuição espacial e temporal da coinfecção TB-HIV, assim como o perfil das características da população coinfectada no município de São Paulo. MÉTODOS Estudo ecológico e de série temporal com dados do Sistema de Controle de Pacientes com Tuberculose (TBWeb), incluindo todos os casos novos de tuberculose coinfectados pelo HIV residentes no município no período de 2007 a 2015. Tendências temporais do agravo foram analisadas por regressão de Prais-Winsten. Os casos foram geocodificados pelo endereço de residência para a elaboração de mapas com as taxas de incidência suavizadas pelo método bayesiano empírico local. Os índices de Moran global e local avaliaram a autocorrelação espacial. O perfil dos indivíduos foi descrito e as características dos casos com e sem residência fixa foram comparadas pelos testes de qui-quadrado ou exato de Fisher. RESULTADOS Foram analisados 6.092 casos novos de coinfecção TB-HIV (5.609 com residência fixa e 483 sem residência fixa). A proporção de coinfecção TB-HIV variou de 10,5% a 13,7%, com queda de 3,0% ao ano (IC95% -3,4 - -2,6), e foi maior nos indivíduos sem residência fixa em todo o período. As taxas de incidência apresentaram diminuição de 3,6% ao ano (IC95% -4,4% - -2,7%), declinando de 7,0 para 5,3 por 100 mil habitantes/ano. A coinfecção apresentou autocorrelação espacial positiva e significativa, com padrão espacial heterogêneo e um aglomerado de alto risco na região central do município. A cura foi alcançada em 55,5% dos casos com residência fixa e em 32,7% daqueles sem residência. CONCLUSÕES Os dados indicam um importante avanço no controle da coinfecção TB-HIV no período analisado. Todavia, foram identificadas áreas e populações que se apresentaram desigualmente afetadas pelo agravo, e que devem ser priorizadas no aprimoramento das ações de prevenção e controle da coinfecção.


Subject(s)
Humans , Male , Female , Infant, Newborn , Infant , Child, Preschool , Child , Adolescent , Adult , Young Adult , Tuberculosis/epidemiology , HIV Infections/epidemiology , Coinfection/epidemiology , Brazil/epidemiology , HIV Infections/complications , Bayes Theorem , Cities , Spatial Analysis , Middle Aged
5.
Rev. panam. salud pública ; 44: e43, 2020. tab, graf
Article in English | LILACS | ID: biblio-1101758

ABSTRACT

ABSTRACT Objective. To inform about the most recent epidemiological trends and integrated programmatic response to tuberculosis (TB) and HIV coinfection in Latin America and the Caribbean (LAC). Methods. A descriptive review analyzed the most relevant indicators on TB/HIV coinfection in 33 countries in LAC with a cross-sectional and time-trend approach. Data were obtained from publicly available databases and analyzed through simple proportions, weighted means, and risk ratios. Results. In LAC, during 2017, 80.8% of TB patients were actively screened for HIV, with a 25.6% increase between 2011 and 2017. In the same year, the proportion of TB patients with HIV-positive status was 11.2%, with a small but progressive reduction of 5% since 2011. The provision of antiretroviral therapy and anti-TB medication among TB/HIV coinfected patients for 2017 was at 60%. Only one-third of people living with HIV had access to isoniazid preventive therapy. Overall, the mortality in the TB/HIV cohort has not changed since 2012, hovering at around 20%. Conclusions. TB/HIV collaborative activities, as the backbone to address TB/HIV coinfection, are being scaled up in LAC and some indicators show a tendency toward improvement; nevertheless, our review shed light on the need to keep strengthening integration of service delivery, joint monitoring and evaluation, and data quality.(AU)


RESUMEN Objetivo. Informar sobre las tendencias epidemiológicas más recientes y la respuesta programática integrada frente a la coinfección por tuberculosis (TB) y VIH en América Latina y el Caribe. Métodos. En una revisión descriptiva se analizaron los indicadores más pertinentes sobre la coinfección por TB y VIH en 33 países de América Latina y el Caribe, por medio de un enfoque transversal y de tendencias en el tiempo. Los datos se obtuvieron de bases de datos disponibles públicamente y se analizaron mediante proporciones sencillas, medias ponderadas y cociente de riesgos. Resultados. En el 2017, en América Latina y el Caribe se sometió a 80,8% de los pacientes con TB a un tamizaje activo del VIH, lo que representó un aumento de 25,6% entre el 2011 y el 2017. En ese mismo año, la proporción de pacientes con TB e infección por el VIH fue de 11,2%, lo cual demuestra una pequeña reducción, aunque progresiva, de 5% desde el 2011. El suministro de tratamiento antirretroviral y de fármacos contra la TB a los pacientes con la coinfección en el 2017 fue del 60%. Solo un tercio de las personas con VIH tuvieron acceso al tratamiento preventivo con isoniacida. En términos generales, la tasa de mortalidad de las personas con coinfección por TB y VIH no ha cambiado desde el 2012, y ha permanecido en torno al 20%. Conclusiones. Se está aumentando la escala de las actividades de colaboración entre los servicios de TB y VIH en América Latina y el Caribe, como el tratamiento de base para abordar los casos de coinfección, y algunos indicadores muestran una tendencia positiva. No obstante, nuestra revisión muestra la necesidad de seguir fortaleciendo la integración de la prestación de servicios, las actividades conjuntas de seguimiento y evaluación, y la comprobación de la calidad de los datos.(AU)


RESUMO Objetivo. Informar sobre as últimas tendências epidemiológicas e a resposta programática integrada à coinfecção por tuberculose (TB) e HIV na América Latina e Caribe (ALC). Métodos. Uma revisão descritiva analisou os indicadores mais relevantes sobre a coinfecção por TB/HIV em 33 países da ALC, usando uma abordagem transversal e de tendências temporais. Os dados foram obtidos em bases de dados disponíveis publicamente e analisados através de proporções simples, médias ponderadas e razões de risco. Resultados. Na ALC, em 2017, 80,8% dos pacientes com TB realizaram o rastreamento ativo para HIV, o que representou um aumento de 25,6% entre 2011 e 2017. No mesmo ano, a proporção de pacientes com TB com status HIV positivo foi de 11,2%, demonstrando uma pequena redução progressiva de 5% desde 2011. Em 2017, a oferta de terapia antirretroviral e medicação anti-TB aos pacientes coinfectados por TB/HIV foi de 60%. Somente um terço das pessoas que vivem com HIV teve acesso à terapia preventiva com isoniazida. A mortalidade geral na coorte coinfectada por TB/HIV não mudou desde 2012, oscilando em torno de 20%. Conclusões. As atividades colaborativas para TB/HIV, que são a espinha dorsal para combater esta coinfecção, estão sendo ampliadas na ALC, e alguns indicadores mostram uma tendência positiva; no entanto, a nossa revisão destaca a necessidade de continuar fortalecendo a integração da prestação de serviços, as atividades conjuntas de monitoramento e avaliação e a qualidade dos dados.(AU)


Subject(s)
Humans , Tuberculosis/epidemiology , HIV Infections/epidemiology , Coinfection/epidemiology , Health Policy , Latin America/epidemiology
6.
Einstein (Säo Paulo) ; 18: eRC6048, 2020. tab, graf
Article in English | LILACS | ID: biblio-1142875

ABSTRACT

ABSTRACT We report the clinical case of an infant with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection with gastrointestinal signs and symptoms, predominantly vomiting. The patient also had colic, poor feeding, mild diarrhea and mild rhinorrhea without fever. The child had evidence of altered coagulation, increased interleukin 10, moderate dehydration and she was admitted to the pediatric intensive care unit. Simultaneously, the patient was diagnosed as Clostridioides difficile infection, which possibly may have facilitated the persistence of SARS-CoV-2 in feces, for more than 27 days, even after the nasopharyngeal test turned negative. This coinfection might exacerbate the gastrointestinal signs and symptoms and increased the possibility of fecal-oral transmission of SARS-CoV-2 and Clostridioides . The patient was breastfed and received complementary infant formula, hydrated with intravenous fluid, and was discharged without complications, 4 days after admission.


RESUMO Relatamos o caso clínico de uma lactente com infecção por coronavírus da síndrome respiratória aguda grave 2 (SARS-CoV-2) com sinais e sintomas gastrintestinais - predominantemente vômitos. A paciente apresentou, adicionalmente, cólica, dificuldade para mamar, evacuações amolecidas e rinorreia leve, sem febre. Houve evidências de alterações da coagulação, aumento de interleucina 10 e desidratação moderada, que justificaram internação na unidade de terapia intensiva. Simultaneamente, a paciente foi diagnosticada com infecção por Clostridioides difficile , que pode ter facilitado a persistência do SARS-CoV-2 nas fezes por mais de 27 dias, mesmo após negativação do teste nasofaríngeo. Essa coinfecção pode ter exacerbado os sinais e sintomas gastrintestinais e aumentado a possibilidade da transmissão do SARS-CoV-2 e Clostridioides . A paciente foi mantida em aleitamento materno e complemento com fórmula infantil, recebeu hidratação intravenosa e teve alta hospitalar, sem complicações, após 4 dias de internação.


Subject(s)
Humans , Female , Infant , Coinfection/epidemiology , COVID-19 , Clostridium , Clostridioides , SARS-CoV-2
7.
Rev. Soc. Bras. Med. Trop ; 52: e20180430, 2019. tab
Article in English | LILACS | ID: biblio-1041553

ABSTRACT

Abstract INTRODUCTION: We avaluated the clinical features, epidemiology, opportunistic infections and coinfections of HIV/AIDS patients. METHODS: We analyzed the records of 143 patients receiving antiretroviral therapy at a public center in the Midwest of Santa Catarina, south of Brazil, from December 2014 to September 2015. RESULTS: Most were male, Caucasian, married, with low education level, and aged 31-50 years. Heterosexual transmission was the most common infection route. Regarding coinfection, 3.5% had hepatitis C, 2.1% hepatitis B, 4.2% syphilis, and 4.9% tuberculosis; 38.5% had opportunistic infections. CONCLUSIONS: HIV infection follows the national trend, but hepatitis B and C coinfection rates were higher, while tuberculosis rate was lower.


Subject(s)
Humans , Male , Adult , Opportunistic Infections/classification , HIV Infections/diagnosis , HIV Infections/epidemiology , Acquired Immunodeficiency Syndrome/diagnosis , Acquired Immunodeficiency Syndrome/epidemiology , Socioeconomic Factors , Tuberculosis , Brazil/epidemiology , Incidence , Cross-Sectional Studies , Cohort Studies , Hepatitis C/epidemiology , Coinfection/epidemiology , Hepatitis B/epidemiology , Middle Aged
8.
Rev. gaúch. enferm ; 40: e20180033, 2019. tab
Article in Portuguese | LILACS, BDENF | ID: biblio-1004082

ABSTRACT

Resumo OBJETIVO Analisar como o pertencimento a certos grupos sociais contribui para a constituição das vulnerabilidades associadas ao adoecimento pela coinfecção tuberculose/HIV/aids. METODOLOGIA Pesquisa qualitativa realizada em Porto Alegre-RS, em regiões de alta vulnerabilidade social. Foram entrevistadas 20 pessoas coinfectadas em serviços especializados de saúde, entre agosto e dezembro de 2016. A análise teve como aporte os referenciais The Sound of Silence e Vulnerabilidade e Direitos Humanos. RESULTADOS Condições socioeconômicas foram decisivas para constituição das condições de vulnerabilidade. Processos de invisibilização das pessoas e silenciamento de suas vozes, em um cenário marcado por desigualdades econômicas, raciais e de gênero contribuíam para que suas necessidades de saúde não fossem compreendidas e efetivamente levadas em consideração nas ações dos serviços. CONSIDERAÇÕES FINAIS Quanto mais efetivas forem as estratégias para legitimar as vozes e compreender as necessidades das pessoas afetadas pela coinfecção, maiores serão as chances de que as respostas programáticas para o problema sejam exitosas.


Resumen OBJETIVO Analizar cómo la pertenencia a ciertos grupos sociales contribuye a la constitución de las vulnerabilidades asociadas al padecimiento de coinfección tuberculosis/VIH/SIDA. METODOLOGÍA Investigación cualitativa realizada en Porto Alegre-RS/Brasil, en zonas de alta vulnerabilidad social. Fueron entrevistadas 20 personas coinfectadas en servicios especializados de salud, entre agosto y diciembre de 2016. Análisis con aporte de referenciales The Sound of Silence y Vulnerabilidad y Derechos Humanos. RESULTADOS Las condiciones socioeconómicas resultaron decisivas para constituir las condiciones de vulnerabilidad. Los procesos de invisibilización de las personas y el silenciamiento de sus voces contribuían a que sus necesidades de salud no fuesen comprendidas y efectivamente consideradas en las acciones de los servicios. CONSIDERACIONES FINALES Cuanto más efectivas sean las estrategias para legitimar las voces y comprender las necesidades de los afectados por la coinfección, mayores serán las posibilidades para que las respuestas programáticas al problema resulten exitosas.


Abstract OBJECTIVE To analyze how belonging to certain social groups contributes to constituting the vulnerabilities associated with illnesses due to tuberculosis/HIV/AIDS coinfection. METHODOLOGYThis is a qualitative study carried out in the city of Porto Alegre, state of Rio Grande do Sul, in regions of high social vulnerability. Twenty coinfected people were interviewed in specialized health services between August and December 2016. The analysis was based on the frameworks The Sound of Silence and Vulnerability and Human Rights. RESULTS Socioeconomic conditions were decisive for the constitution of the vulnerability conditions. Processes of people invisibilization, and the silencing of their voices, in a scenario marked by economic, racial and gender inequalities, contributed for their health needs not to be understood and effectively taken into account in the services actions. FINAL CONSIDERATIONS The more effective strategies are to legitimize voices and to understand the needs of those affected by coinfection, the greater the chances that programmatic responses to the problem will be successful.


Subject(s)
Humans , Male , Female , Adult , Social Class , Tuberculosis, Pulmonary/epidemiology , HIV Infections/epidemiology , Vulnerable Populations/statistics & numerical data , Coinfection/epidemiology , Socioeconomic Factors , Tuberculosis, Pulmonary/therapy , Brazil , HIV Infections/therapy , Acquired Immunodeficiency Syndrome/therapy , Acquired Immunodeficiency Syndrome/epidemiology , Needs Assessment , Qualitative Research , Middle Aged
9.
Rev. Soc. Bras. Med. Trop ; 51(5): 578-583, Sept.-Oct. 2018. tab
Article in English | LILACS | ID: biblio-957468

ABSTRACT

Abstract INTRODUCTION: Here, we conducted an epidemiological study of hepatitis B virus (HBV) mono-infected and asymptomatic malaria/HBV coinfected immigrants and further discussed the possibility of malaria disease modifying the clinical presentation of HBV infection. METHODS: A total of 195 African immigrants were examined for HBV infection or coinfection with HBV and asymptomatic malaria. HBV infection was diagnosed using serological tests and confirmed by PCR; furthermore, we performed a pan-Plasmodium-specific-nucleic-acid-sequence-based-amplification (NASBA) assay to detect asymptomatic malaria infection. The stage/grade of the liver disease was determined using echotomography and elastometry. RESULTS: PCR-NASBA results confirmed that 62 of 195 subjects (31.8%) were positive for Plasmodium infection, whereas 41 of 195 subjects (21%) tested positive for HBV chronic hepatitis (HBV-DNA positive). Among the HBV-positive subjects, 26 (63.4%) of them were mono-infected patients (Group A), whereas 15 (36.6%) patients had HBV chronic hepatitis and asymptomatic malaria coinfections (Group B). The HBV-DNA median levels were 1.4×105IU/mL in HBV-mono-infected patients and 2.0×105IU/mL in coinfected patients. Echotomography and hepatic elastometry presented similar findings for both groups of patients. CONCLUSIONS: Coinfected patients seem to present with the same clinical symptoms of the liver disease as HBV mono-infected patients.


Subject(s)
Humans , Male , Female , Adolescent , Adult , Young Adult , Emigrants and Immigrants/statistics & numerical data , Asymptomatic Infections/epidemiology , Coinfection/epidemiology , Hepatitis B/epidemiology , Malaria/epidemiology , Cohort Studies , Africa South of the Sahara/ethnology , Hepatitis B/diagnosis , Italy/epidemiology , Malaria/diagnosis
10.
Rev. pesqui. cuid. fundam. (Online) ; 10(4): 1026-1031, out.-dez. 2018. graf, tab
Article in English, Portuguese | LILACS, BDENF | ID: biblio-915957

ABSTRACT

Objetivo: Analisar os fatores associados à coinfecção tuberculose/HIV e determinar a prevalência máxima e mínima da positividade do teste anti-HIV entre casos de tuberculose no Maranhão, no período de 2001 a 2011. Métodos: Estudo transversal realizado mediante consulta aos dados do Sistema de Informação de Agravos de Notificação. Para identificar associações, utilizou-se a regressão de Poisson com ajuste robusto da variância. Resultados: A prevalência da coinfecção tuberculose/HIV foi de 15,1%. Na análise bruta, as associações significativas para coinfecção foram sexo masculino, faixas etárias de 20 a 39 anos e de 40 a 59 anos, escolaridade inferior a oito anos, entrada por transferência e encerramento por abandono/óbito. Na análise ajustada, sexo masculino, faixa etária de 29 a 30 anos, escolaridade inferior a oito anos e encerramento por abandono/óbito permaneceram associados à coinfecção. Conclusão: Foi observada alta taxa de coinfecção tuberculose/HIV no estado do Maranhão e associações com diversos fatores relacionados à saúde


Objective: To analyze the factors associated with Tuberculosis/HIV coinfection and to determine the maximum and minimum prevalence of HIV test positivity among tuberculosis cases in Maranhão from 2001-2010. Methods: Cross-sectional study of data from the Notifiable Diseases Information System. Poisson regression was used with robust variance adjustment to identify associations. Results: Tuberculosis/ HIV coinfection prevalence was 15.1%. In the raw analysis, the significant associations for coinfection were male sex, age groups from 20-39 years and from 40-59 years, schooling less than 8 years, entry by transfer and closure by abandonment/death. In the adjusted analysis, male gender, age range of 29 to 30 years, schooling less than 8 years and closure due to abandonment/death remained associated with coinfection. Conclusion: Tuberculosis/HIV coinfection rate was high in the state of Maranhão and associations with several factors related to health


Objetivo: Analizar los factores asociados a la coinfección TB/VIH y determinar la prevalencia máxima y mínima de la prueba del VIH positiva entre los casos de TB en Maranhao, de 2001 a 2011. Métodos: Estudio transversal, realizado en consulta con los datos del Sistema de Información de Agravios y Notificaciones. Para identificar asociaciones, se utilizó regresión de Poisson con ajuste robusto de la varianza. Resultados: La prevalencia de la coinfección TB/VIH fue del 15,1%. En el análisis crudo, asociaciones significativas para la coinfección fueron sexo masculino, edades de 20-39 años y 40-59 años, educación menos de ocho años y cierre de la entrada por abandono/muerte. En el análisis ajustado, sexo, edad 29-30 años, educación menos de 8 años y final por abandono/ muerte se mantuvo asociado con la coinfección. Conclusión: Hubo una alta tasa de coinfección TB/VIH en el estado de Maranhão y asociaciones con diversos factores relacionados a la salud


Subject(s)
Humans , Male , Adult , Middle Aged , Coinfection/epidemiology , Comorbidity , HIV Infections/epidemiology , Tuberculosis/epidemiology , Brazil
11.
Braz. j. microbiol ; 49(2): 401-406, Apr.-June 2018. tab, graf
Article in English | LILACS | ID: biblio-889246

ABSTRACT

Abstract Introduction The present study attempts to examine the microbial profile and antibiotic susceptibility of diabetic foot infections in the intensive care unit of a tertiary referral centre for diabetic foot. As part of the study, we also attempted to find the prevalence of blaNDM-like gene among carbapenem-resistant gram negative infections. Methodology A prospective study of 261 patients with diabetic foot infections was performed during the period between January 2014 and June 2014. Results A total of 289 isolates were obtained from 178 tissue samples from 261 patients, 156 (59.7%) males and 105 (40.2%) females, with a mean age of 58 years (-15 years), having diabetic foot infection. No growth was seen in thirty eight (17.6%) tissue samples. Out of the total samples, 44.3% were monomicrobial and 55.7% were polymicrobial. Gram negative pathogens were predominant (58.5%). Seven of the total isolates were fungal; 0.7% showed pure fungal growth and 1.7% were mixed, grown along with some bacteria. The most frequently isolated bacteria were Staphylococcus aureus (26.9%), followed by Pseudomonas aeruginosa (20.9%). Of the 58.5% gram negative pathogens, 16.5% were Enterobacteriaceae resistant to carbapenems. Among these isolates, 4 (25%) were positive for blaNDM-like gene. Among the rest, 18.6% were carbapenem-resistant Pseudomonas, among which 4 (36.3%) were blaNDM. Among the Staphylococci, 23.7% were methicillin-resistant Staphylococcus aureus. Conclusions Our results support the recent view that gram negative organisms, depending on the geographical location, may be predominant in DFIs. There is an increase in multidrug-resistant pathogens, especially carbapenem resistance and this is creeping rapidly. We need to be more judicious while using empiric antibiotics.


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Bacterial Infections/epidemiology , Diabetic Foot/complications , Gram-Negative Bacteria/isolation & purification , Gram-Positive Bacteria/isolation & purification , Mycoses/epidemiology , Bacterial Infections/microbiology , Bacterial Proteins/genetics , beta-Lactamases/genetics , Coinfection/epidemiology , Coinfection/microbiology , Gram-Negative Bacteria/classification , Gram-Positive Bacteria/classification , India , Methicillin Resistance , Microbial Sensitivity Tests , Mycoses/microbiology , Prevalence , Prospective Studies , Tertiary Care Centers
12.
Rev. cuba. med. trop ; 70(1): 0-0, ene.-abr. 2018. tab
Article in Spanish | LILACS, CUMED | ID: biblio-960611

ABSTRACT

Introducción: la leptospirosis es una enfermedad zoonótica transmitida por varias especies de animales domésticos y silvestres que actúan como reservorios del agente causal y que afecta humanos que habitan áreas urbanas y rurales en el mundo. Objetivo: determinar la seroprevalencia de anticuerpos contra Leptospira sp. y los serogrupos dominantes, en pacientes con síndrome febril no palúdico del departamento del Meta, Colombia. Métodos: se realizó un estudio prospectivo de corte trasversal. La población la conformó todo paciente febril que asistiera a un hospital en la ciudad de Villavicencio, entre mayo de 2013 y junio de 2014. Los sueros pareados fueron procesados utilizando la prueba de microaglutinación con los serogrupos: Australis, Ballum, Bataviae, Canicola, Cynopteri, Panama, Pyrogenes, Sejroe, Semaranga. Se practicaron pruebas para diagnóstico de dengue (detección de anticuerpos IgM e IgG por ELISA), rickettsiosis (detección de anticuerpos IgG por inmunofluoresencia indirecta), hantavirosis (detección de anticuerpos IgG por ELISA). Resultados: de los 100 sueros estudiados, 29 resultaron positivos para leptospirosis. Los serogrupos más prevalentes fueron Canicola y Ballum. Conclusiones: los resultados de la prevalencia de leptospirosis muestran que esta enfermedad es subregistrada en la zona, por lo que sería recomendable que estuviera dentro del diagnóstico diferencial de los síndromes febriles(AU)


Introduction: leptospirosis is a zoonotic disease transmitted by several species of wild and domestic animals, which serve as reservoirs of the causative agent. The disease affects humans from urban and rural areas of the world. Objective: determine Leptospira sp. antibody seroprevalence and dominant serogroups in patients with non-malarial febrile syndrome from Meta Department in Colombia. Methods: across-sectional prospective study was conducted. The study population was all the febrile patients attending a hospital in the city of Villavicencio from May 2013 to June 2014. The paired sera were processed using the microagglutination test with the following serogroups: Australis, Ballum, Bataviae, Canicola, Cynopteri, Panama, Pyrogenes, Sejroe and Semaranga. Diagnostic tests were performed for dengue (IgM and IgG antibody detection by ELISA), rickettsiosis (IgG antibody detection by indirect immunofluorescence), and hantaviral disease (IgG antibody detection by ELISA). Results: of the 100 sera studied, 29 were positive for leptospirosis. The most prevalent serogroups were Canicola and Ballum. Conclusions: prevalence results for leptospirosis show that the disease has been under-recorded in the area. It is thus advisable to include it in the differential diagnosis of febrile syndromes(AU)


Subject(s)
Humans , Fever/drug therapy , Coinfection/epidemiology , Leptospirosis/epidemiology , Seroepidemiologic Studies , Cross-Sectional Studies , Prospective Studies , Colombia/epidemiology
13.
Rev. bras. epidemiol ; 21: e180019, 2018. tab
Article in Portuguese | LILACS | ID: biblio-958831

ABSTRACT

RESUMO: Introdução: A tuberculose (TB) é um dos graves problemas da saúde pública mundial. A vigilância epidemiológica tem se mostrado uma importante ferramenta para auxiliar em ações de controle e prevenção de doenças transmissíveis, como a TB e a aids. O objetivo do presente estudo foi estimar a proporção e os fatores associados à subnotificação da tuberculose em Pernambuco, entre os casos de coinfecção TB/aids, com base nos dados do Sistema de Informação de Agravos de Notificação da TB e da aids. Métodos: Realizou-se um estudo de corte seccional, baseado nos registros dos Sistemas de Notificação de TB e aids, para identificação de casos de subnotificação de TB no período de estudo, mediante a realização de linkage probabilístico utilizando o software RecLink III. Resultados: Verificou-se proporção de 29% de subnotificação de TB, e os fatores associados à subnotificação foram: apresentar forma clínica da TB pulmonar cavitária ou não especificada, ou ter os dois tipos de TB ao mesmo tempo; e ser atendido fora do Recife e em serviços que não são especializados para vírus da imunodeficiência humana (HIV)/aids. Discussão: A proporção de subnotificação encontrada em nosso estudo foi menor do que a observada em outras pesquisas brasileiras que levaram em consideração a subnotificação haja vista os dados de mortalidade. Conclusão: As variáveis associadas à subnotificação de TB referem-se, em sua maioria, à rede de atenção, e não às características individuais, o que aponta para a necessidade de capacitação dos profissionais de saúde para efetuar a notificação aos sistemas de informação.


ABSTRACT: Introduction: Tuberculosis (TB) is one of the world's major public health problems. Epidemiological surveillance has proved to be an important tool to assist in the control and prevention of communicable diseases such as TB and AIDS. This study aimed to estimate the rate and factors associated with the underreporting of TB among cases of coinfection with human immunodeficiency virus (HIV)/AIDS in the state of Pernambuco, based on data from the TB and Aids Notifiable Diseases Information System (Sinan TB and Sinan AIDS). Methods: A cross-sectional study was carried out based on the records of the TB and AIDS Notification System to identify cases of TB underreporting in the study period. In order to identify underreporting, a probabilistic linkage was undertaken using RecLink III software. Results: The rate of TB underreporting was 29%, and the factors associated were: presenting a clinical form of TB as cavitary or unspecified pulmonary TB or having both kinds of TB at the same time; being treated outside the municipality of Recife; and being treated at health services not specialized for HIV/AIDS. Discussion: The proportion of underreporting found in our study was lower than that observed in other Brazilian studies that took into account underreporting from mortality data. Conclusion: The variables associated with underreporting of TB were mostly related to the healthcare system rather than to individual characteristics, which points to the need for training of health professionals in order to notify the information systems correctly.


Subject(s)
Humans , Male , Female , Adult , Information Systems/statistics & numerical data , Acquired Immunodeficiency Syndrome/epidemiology , Coinfection/epidemiology , Tuberculosis/epidemiology , Brazil/epidemiology , Medical Record Linkage , Population Surveillance/methods , Cross-Sectional Studies , Disease Notification , Epidemiological Monitoring
15.
Rio de Janeiro; s.n; 2018. 61 f p. tab, graf, il.
Thesis in Portuguese | LILACS | ID: biblio-966936

ABSTRACT

A cada ano ocorrem aproximadamente 50 a 90 mil novos casos de leishmaniose visceral (LV). Mais de 90% dos casos de LV ocorrem em sete países no mundo: Brasil, Etiópia, Índia, Quênia, Somália, Sudão do Sul e Sudão. Na América Latina, 96% ocorrem no Brasil. A coinfecção LV-HIV tem sido considerada como doença emergente em várias regiões do mundo em função da superposição geográfica das duas infecções como consequência da urbanização das leishmanioses e da interiorização da infecção por HIV. A coinfecção LV-HIV geralmente resulta em respostas desfavoráveis ao tratamento, frequentes recidivas e óbitos prematuros. Este estudo teve como objetivo descrever e analisar o perfil clínicoepidemiológico e a distribuição espacial e temporal da coinfecção da LV-HIV em Teresina/PI, de 2006 a 2015. Trata-se de um estudo seccional, com dimensão temporal, desenvolvido a partir de dados espaciais georreferenciados para o endereço do domicílio de residência referentes aos casos de LV e LV-HIV notificados e confirmados no Sistema de Informação de Agravos de Notificação (SINAN). Do total de casos de LV notificados no período do estudo (737), 19,4% eram de coinfecção LV-HIV. A proporção de casos da coinfecção LV-HIV em relação aos casos de LV foi de 8,6%, em 2006 e 47,7% em 2015, o coeficiente de incidência foi de 0,87 casos por 100.000 habitantes e 2,49 casos por 100.00 habitantes, para os mesmos períodos. Destaca-se a diferença entre o diagnóstico clínico e laboratorial entre os dois grupos sendo fraqueza, emagrecimento, quadro infeccioso e fenômenos hemorrágicos as manifestações clínicas mais frequentes nos casos com LV-HIV. A letalidade e a recidiva foram, aproximadamente, duas vezes maiores nesse grupo, 11,4% e 13,3%, respectivamente. Foi evidenciada maior agregação espacial dos casos LV-HIV em relação àquela observada para os casos de LV. Os resultados apresentados neste estudo contribuem para o conhecimento sobre o diagnóstico clínicoepidemiológico e o processo de ocorrência da coinfecção LV-HIV, potencializando ações de prevenção e planejamento em saúde


Each year occur approximately 50 to 90 thousand new cases of visceral leishmaniasis (VL). More than 90% of the cases of VL occur in seven countries of the world: Brazil, Ethiopia, India, Kenya, Somalia, Sudan and South Sudan. In Latin America, 96% occur in Brazil. The VL-HIV coinfection has been considered as emerging disease in several regions of the world depending on the geographical overlap of both infections as a result of leishmaniasis urbanization and HIV infection interiorization. The VL-HIV coinfection usually results in unfavorable treatment responses, frequent relapses and premature deaths. The objective of this study was to describe and analyze the clinical and epidemiologic profiles and the spatial and temporal distribution of VL-HIV coinfection in Teresina/PI, from 2006 to 2015. It is a cross-sectional study, with temporal dimension, developed from geo-referenced data for the address of residence domicile concerning notified and confirmed VL and VL-HIV cases in the Brazilian Disease Information System. From the total number of cases of LV notified within the period of the study (737), 19.4% were of VL-HIV coinfection. The proportion of VL-HIV cases coinfection in relation to LV cases was 8.6% in 2006 and 47.7% in 2015, the coefficient of incidence was 0.87 cases per 100,000 inhabitants and 2.49 cases per 100.00 inhabitants, in the same periods. Highlights the clinical and laboratory diagnosis difference between the two groups with weakness, weight loss, infection and hemorrhagic phenomena the most frequent clinical manifestations in patients with LV-HIV. The mortality and recurrence were approximately two times higher in this group, 11.4% and 13.3%, respectively. It was evidenced greater VL-HIV spatial aggregation cases in relation to that observed for LV cases. The results presented in this research contributes to the knowledge about the clinical and epidemiological diagnosis and the process of VL-HIV coinfection occurrence, potentiating prevention and health planning actions


Subject(s)
Humans , Brazil , Epidemiologic Studies , Public Health , HIV , Geographic Information Systems/statistics & numerical data , Coinfection/epidemiology , Health Information Systems/statistics & numerical data , Leishmaniasis, Visceral/transmission
16.
Rev. Soc. Bras. Med. Trop ; 50(5): 613-620, Sept.-Oct. 2017. tab
Article in English | LILACS | ID: biblio-897008

ABSTRACT

Abstract INTRODUCTION: Visceral leishmaniasis (VL) and human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) co-infection has been a research topic of interest worldwide. In Brazil, it has been observed that there is a relative underreporting and failure in the understanding and management of this important association. The aim of this study was to analyze epidemiological and clinical aspects of patients with VL with and without HIV/AIDS. METHODS: We conducted an observational and analytical study of patients with VL followed in a Reference Service in the State of Maranhão, Brazil from 2007-2013. RESULTS: In total 126 patients were enrolled, of which 61 (48.4%) were co-infected with HIV/AIDS. There were more males among those with HIV/AIDS (85.2%, P>0.05) or with VL only (81.5%, P>0.05). These findings significantly differed based on age group (P<0.003); the majority of patients were aged 31-40 years (41.0%) and 21-30 years (32.3%) among those with and without HIV/AIDS co-infection, respectively. The incidence of diarrhea and splenomegaly significantly differed between the two groups (P=0.0014 and P=0.019, respectively). The myelogram parasitic examination was used most frequently among those with HIV/AIDS (91.8%), followed by those with VL only (69.2%). VL recurrences and mortality were significantly higher in the HIV/AIDS co-infected patients (P<0.0001 and P=0.012, respectively). CONCLUSIONS: Patients with VL with or without HIV/AIDS co-infection were mostly adult men. Diarrhea was more frequent in HIV/AIDS co-infected patients, whereas splenomegaly was more common in patients with VL only. In the group of HIV/AIDS co-infected patients, there was a higher rate of VL recurrence and mortality.


Subject(s)
Humans , Male , Female , Child, Preschool , Child , Adolescent , Adult , Aged , Young Adult , Acquired Immunodeficiency Syndrome/epidemiology , Coinfection/epidemiology , Leishmaniasis, Visceral/epidemiology , Socioeconomic Factors , Splenomegaly/etiology , Splenomegaly/epidemiology , Blood Cell Count , Brazil/epidemiology , Acquired Immunodeficiency Syndrome/complications , Acquired Immunodeficiency Syndrome/physiopathology , Sex Distribution , Age Distribution , Viral Load , Diarrhea/etiology , Diarrhea/epidemiology , Coinfection/physiopathology , Leishmaniasis, Visceral/complications , Leishmaniasis, Visceral/physiopathology , Middle Aged
17.
Rev. Soc. Bras. Med. Trop ; 50(5): 670-674, Sept.-Oct. 2017. tab
Article in English | LILACS | ID: biblio-1041424

ABSTRACT

Abstract INTRODUCTION: This study aimed to draw clinical and epidemiological comparisons between visceral leishmaniasis (VL) and VL associated with human immunodeficiency virus (HIV) infection. METHOD: Retrospective study. RESULTS: Of 473 cases of VL, 5.5% were coinfected with HIV. The highest proportion of cases of both VL and VL/HIV were found among men. A higher proportion of VL cases was seen in children aged 0-10 years, whereas coinfection was more common in those aged 18-50 years. CONCLUSIONS: VL/HIV coinfected patients presented slightly differently to and had a higher mortality rate than those with VL only.


Subject(s)
Humans , Male , Female , Infant , Child, Preschool , Child , Adolescent , Adult , Young Adult , HIV Infections/epidemiology , Coinfection/epidemiology , Leishmaniasis, Visceral/epidemiology , Recurrence , Socioeconomic Factors , Brazil/epidemiology , HIV Infections/physiopathology , HIV Infections/drug therapy , Incidence , Retrospective Studies , Age Factors , Treatment Outcome , Sex Distribution , Age Distribution , Coinfection/physiopathology , Coinfection/drug therapy , Leishmaniasis, Visceral/physiopathology , Leishmaniasis, Visceral/drug therapy , Middle Aged
18.
Braz. j. biol ; 77(2): 388-395, Apr.-June 2017. tab, graf
Article in English | LILACS | ID: biblio-888748

ABSTRACT

Abstract Despite the ubiquity of domestic dogs, their role as zoonotic reservoirs and the large number of studies concerning parasites in urban dogs, rural areas in Brazil, especially those at the wildlife-domestic animal-human interface, have received little attention from scientists and public health managers. This paper reports a cross-sectional epidemiological survey of gastrointestinal parasites of rural dogs living in farms around Atlantic Forest fragments. Through standard parasitological methods (flotation and sedimentation), 13 parasite taxa (11 helminths and two protozoans) were found in feces samples from dogs. The most prevalent were the nematode Ancylostoma (47%) followed by Toxocara (18%) and Trichuris (8%). Other less prevalent (<2%) parasites found were Capillaria, Ascaridia, Spirocerca, Taeniidae, Acantocephala, Ascaris, Dipylidium caninum, Toxascaris, and the protozoans Cystoisospora and Eimeria. Mixed infections were found in 36% of samples, mostly by Ancylostoma and Toxocara. Previous deworming had no association with infections, meaning that this preventive measure is being incorrectly performed by owners. Regarding risk factors, dogs younger than one year were more likely to be infected with Toxocara, and purebred dogs with Trichuris. The number of cats in the households was positively associated with Trichuris infection, while male dogs and low body scores were associated with mixed infections. The lack of associations with dog free-ranging behavior and access to forest or villages indicates that infections are mostly acquired around the households. The results highlight the risk of zoonotic and wildlife parasite infections from dogs and the need for monitoring and controlling parasites of domestic animals in human-wildlife interface areas.


Resumo Apesar da ubiquidade dos cães domésticos, de seu papel como reservatório de doenças, e do grande número de estudos sobre parasitas de cães urbanos, as áreas rurais no Brasil, especialmente aquelas na interface entre animais silvestres - animais domésticos - humanos, tem recebido pouca atenção de cientistas e gestores de saúde pública. Este artigo relata um estudo epidemiológico seccional de parasitas gastrointestinais de cães rurais em propriedades no entorno de fragmentos de Mata Atlântica. Através de métodos parasitológicos como flutuação e sedimentação, 13 táxons de parasitas (11 helmintos e dois protozoários) foram encontrados em amostras de fezes dos cães. O mais prevalente foi o nematóide Ancylostoma (47%), seguido por Toxocara (18%) e Trichuris (8%). Outros parasitas menos prevalentes (<2%) encontrados foram Capillaria, Ascaridia, Spirocerca, Taeniidae, Acantocephala, Ascaris, Dipylidium caninum, Toxascaris, e os protozoários Cystoisospora and Eimeria. Infecções mistas foram detectadas em 36% das amostras, a maioria por Ancylostoma e Toxocara. Vermifugações prévias não foram associadas a infecções, indicando que esta medida preventiva está sendo realizada incorretamente pelos proprietários. Com relação aos fatores de risco, cães com menos de um ano tiveram maior probabilidade de infecção por Toxocara, e os cães de raça pura por Trichuris. O número de gatos na propriedade foi associado positivamente com a infecção por Trichuris, enquanto cães machos e baixos escores corporais foram associados a infecções mistas. A ausência de associações com comportamento de vida livre e acesso a florestas ou vilas pelos cães indica que as infecções estão sendo predominantemente adquiridas nas propriedades. Os resultados destacam o risco de infecções parasitárias zoonóticas e para animais silvestres a partir dos cães, e a necessidade de monitorar e controlar os parasitas de animais domésticos em áreas de interface entre humanos e a vida selvagem.


Subject(s)
Animals , Male , Female , Dogs , Coccidia/isolation & purification , Coccidiosis/epidemiology , Dog Diseases/epidemiology , Helminthiasis, Animal/epidemiology , Helminths/isolation & purification , Brazil/epidemiology , Zoonoses/epidemiology , Coccidiosis/parasitology , Conservation of Natural Resources , Dog Diseases/parasitology , Coinfection/parasitology , Coinfection/veterinary , Coinfection/epidemiology , Rainforest , Helminthiasis, Animal/parasitology
19.
Rev. Soc. Bras. Med. Trop ; 50(3): 383-387, May-June 2017. tab, graf
Article in English | LILACS | ID: biblio-1041411

ABSTRACT

Abstract INTRODUCTION: This cross-sectional study analyzed the spatial distribution of hepatitis B or C virus (HBV/HBC) and schistosomiasis coinfection. METHODS: Serum samples were collected from patients with Schistosoma mansoni infection. These were tested for serological markers of HBV/HCV infection. The spatial distribution of coinfection was analyzed using intensity kernel estimation. RESULTS: Overall, 9.4% of individuals had contact with HBV and 1.7% of samples tested positive for anti-HCV antibodies. We identified clusters of risk located in the central region. CONCLUSIONS: Spatial analysis allowed visualization of high-risk areas, leading to a definition of priority areas to be targeted for intensification of control interventions.


Subject(s)
Humans , Male , Female , Infant, Newborn , Infant , Child, Preschool , Child , Adolescent , Adult , Aged , Young Adult , Schistosomiasis mansoni/epidemiology , Hepatitis C/epidemiology , Coinfection/epidemiology , Hepatitis B/epidemiology , Brazil/epidemiology , Prevalence , Cross-Sectional Studies , Risk Factors , Spatial Analysis , Middle Aged
20.
Mem. Inst. Oswaldo Cruz ; 112(4): 275-280, Apr. 2017. tab, graf
Article in English | LILACS | ID: biblio-841781

ABSTRACT

BACKGROUND Despite public health efforts to reduce the global burden of leprosy, gaps remain in the knowledge surrounding transmission of infection. Helminth co-infections have been associated with a shift towards the lepromatous end of the disease spectrum, potentially increasing transmission in co-endemic areas. OBJECTIVES Using this biologically plausible association, we conducted a geographic information systems (GIS) study to investigate the spatial associations of schistosomiasis and leprosy in an endemic area of Minas Gerais (MG), Brazil. METHODS Data on new cases of Mycobacterium leprae and Schistosoma mansoni infections from 2007-2014 were retrieved from the Brazilian national notifiable diseases information system for seven municipalities in and surrounding Vespasiano, MG. A total of 139 cases of leprosy and 200 cases of schistosomiasis were mapped to a municipality level. For one municipality, cases were mapped to a neighborhood level and a stratified analysis was conducted to identify spatial associations. FINDINGS A relative risk of 6.80 [95% confidence interval (CI) 1.46 - 31.64] of leprosy was found in neighborhoods with schistosomiasis. Incidence rates of leprosy increased with corresponding incidence rates of schistosomiasis, and the temporal trends of both infections were similar. CONCLUSIONS The associations found in this project support the hypothesis that helminth infections may influence the transmission of leprosy in co-endemic areas.


Subject(s)
Humans , Male , Female , Child, Preschool , Child , Adolescent , Adult , Middle Aged , Aged , Aged, 80 and over , Schistosomiasis mansoni/epidemiology , Endemic Diseases , Geographic Information Systems , Neglected Diseases/epidemiology , Coinfection/epidemiology , Leprosy/epidemiology , Brazil/epidemiology , Incidence , Risk Factors , Spatio-Temporal Analysis
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