First report of Myxobolus (Cnidaria: Myxozoa) spores in human feces in Brazil / Primeiro relato de esporos de Myxobolus (Cnidaria: Myxozoa) em fezes humanas no Brasil

Most species of Myxobolus (Cnidaria: Myxozoa) infect freshwater and marine fish, and cause sporozoosis. Passage of myxozoan parasites into human feces has been described occasionally. We examined fecal samples from 97 dwellers of a riverine community in Amazonas State (Brazil), which revealed Myxobolus sp. in 13 (13%) samples. The discovery probably does not represent true parasitism as the myxospores - most likely ingested through the consumption of infected fish - were eliminated unchanged after passing through the gastrointestinal tract. This discovery represents the first report of this myxosporean in human fecal samples in Brazil. (AU)

A maioria das espécies de Myxobolus (Cnidaria: Myxozoa) infecta principalmente peixes de água doce e marinhos, nos quais produz esporozoose. A passagem de parasitos mixozoários em fezes humanas tem sido ocasionalmente descrita. Nós examinamos amostras fecais de 97 moradores de uma comunidade ribeirinha no estado do Amazonas e identificamos Myxobolus sp. em 13 (13%) delas. O achado provavelmente não representa um parasitismo verdadeiro, uma vez que os mixosporos − mais provavelmente ingeridos ao consumir peixes infectados − foram eliminados inalterados após a passagem pelo trato gastrointestinal. O achado representa o primeiro relato deste mixosporídeo em amostras fecais humanas no Brasil.(AU)

Leishmaniose visceral e sua relação com fatores climáticos e ambientais no Estado do Tocantins, Brasil, 2007 a 2014 / Visceral leishmaniasis and its relationship with climate and environmental factors in the State of Tocantins, Brazil, from 2007 to 2014 / Leishmaniasis visceral y su relación con factores climáticos y ambientales en el Estado de Tocantins, Brasil, 2007 a 2014

Resumo: A leishmaniose visceral (LV) pode ser influenciada por fatores climáticos e ambientais. Tocantins é o estado com mais incidência no Brasil, contribuindo para o aumento dos casos na macrorregião Norte. Este estudo tem objetivo de identificar a correlação entre a taxa de incidência de LV e fatores climáticos e ambientais, nos municípios do Estado do Tocantins de 2007 a 2014. As correlações entre a taxa de incidência bruta de LV e as variáveis elevação, precipitação, Índice de Vegetação Melhorado (EVI - Enhanced Vegetation Index) e temperatura foram testadas por meio dos índices de Moran Global e Local, identificando também clusters de incidência de LV. A análise de variância para tendência linear foi testada entre as médias das variáveis em cada categoria da taxa. Os resultados apontam aumento nas taxas de incidência, na medida em que aumentam os valores de precipitação anual, umidade, EVI e temperatura noturna; e uma relação inversa para a elevação e temperatura diurna. Os clusters identificados evidenciam que variáveis climáticas e ambientais se relacionam à incidência de LV, devendo haver outros estudos que ajustem os fatores associados aos sujeitos, a fim de dimensionar o quanto o ambiente ou a influência do homem nele impacta na doença.

Abstract: Visceral leishmaniasis (VL) may be influenced by climate and environmental factors. Tocantins is the state with the highest incidence in Brazil, contributing to the increase in the number of cases in the North macro-region. This study seeks to identify the correlation between VL incidence rates and climate and environmental factors in the municipalities of the State of Tocantins between 2007 and 2014. Correlations between crude VL incidence rates and the variables elevation, precipitation, Enhanced Vegetation Index (EVI) and temperature were tested using the Global and Local Moran Indexes, while also identifying clusters of VL incidence. We tested a variance analysis for linear trend between variable means in each rate category. Results show an increase in incidence rates with an increase in values of annual precipitation, humidity, EVI and nighttime temperature; and an inverse relationship with elevation and daytime temperature. The clusters we identified show that climate and environmental variables are related to VL incidence. Other studies are needed that adjust for individual-related factors in order to gauge how much the environment, or human influence over it, impact the disease.

Resumen: La leishmaniasis visceral (LV) puede estar influenciada por factores climáticos y ambientales. Tocantins es el estado con más incidencia en Brasil, contribuyendo al aumento de casos en la macrorregión Norte. Este estudio tiene como objetivo identificar la correlación entre la tasa de incidencia de LV y los factores climáticos y ambientales, en municipios del Estado de Tocantins de 2007 a 2014. Las correlaciones entre la tasa de incidencia bruta de LV y las variables elevación, precipitación, Índice Mejorado de Vegetación (EVI - Enhanced Vegetation Index) y temperatura se comprobaron mediante los Índices de Moran Global y Local, identificando también clústeres de incidencia de LV. El análisis de varianza para la tendencia lineal se probó entre las medias de las variables en cada categoría de la tasa. Los resultados apuntan un aumento en las tasas de incidencia, a medida que aumentan los valores de precipitación anual, humedad, EVI y temperatura nocturna; y una relación inversa respecto a la elevación y temperatura diurna. Los clústeres identificados evidencian qué variables climáticas y ambientales se relacionan con la incidencia de LV, para lo que deben existir otros estudios que ajusten los factores asociados a los sujetos, con el fin de dimensionar lo mucho que el ambiente o la influencia del hombre impacta en la enfermedad.

Changes in the epidemiology of visceral leishmaniasis in Brazil from 2001 to 2014

Abstract INTRODUCTION Visceral leishmaniasis (VL) is a neglected disease, with territorial expansion and regional differences in Brazil that require explanation. This study aimed to describe changes in the epidemiology of VL in Brazil from 2001 to 2014. METHODS The incidence rates, sociodemographic and clinical data, and case evolution were subgrouped from 2001 to 2006 and from 2007 to 2014 and presented descriptively. Spatial distribution of disease incidence rates and changes in the spatial and temporal pattern were examined. RESULTS: In total, 47,859 VL cases were reported in Brazil between 2001 and 2014, with predominance in the Northeast macroregion (55%), though the incidence rate in this region declined between the two study periods. The State of Tocantins had the highest crude rate (26.2/100,000 inhabitants), which was responsible for VL increasing in the North macroregion. VL predominated in the urban zone (70%), in children under 4 years (34%); however, an increase in the incidence of VL in adults older than 40 years was identified, with 12.3% and 31% in the first and second period, respectively. The mapping of crude rates and autochthonous canine cases showed territorial expansion. The temporal distribution of VL was consistent in Brazil in general, with no pattern observed, but regional differences were found. CONCLUSIONS: The incidence of VL is increasing in Brazil. In addition to the State of Tocantins, which had the highest rate, new outbreaks of VL have occurred in the South macroregion of Brazil with small decreases identified in the incidence rate in the Northeast.