A critical analysis of the decreasing trends in tuberculosis cure indicators in Brazil, 2001-2022.

OBJECTIVE: To analyze the temporal trend of tuberculosis cure indicators in Brazil. METHODS: An ecological time-series study using administrative data of reported cases of the disease nationwide between 2001 and 2022. We estimated cure indicators for each federative unit (FU) considering individuals with pulmonary tuberculosis, tuberculosis-HIV coinfection, and those in tuberculosis retreatment. We used regression models using joinpoint regression for trend analysis, reporting the annual percentage change and the average annual percentage change. RESULTS: For the three groups analyzed, we observed heterogeneity in the annual percentage change in the Brazilian FUs, with a predominance of significantly decreasing trends in the cure indicator in most FUs, especially at the end of the time series. When considering national indicators, an average annual percentage change of -0.97% (95% CI: -1.23 to -0.74) was identified for the cure of people with pulmonary tuberculosis, of -1.11% (95% CI: -1.42 to -0.85) for the cure of people with tuberculosis-HIV coinfection, and of -1.44% (95% CI: -1.62 to -1.31) for the cure of people in tuberculosis retreatment. CONCLUSIONS: The decreasing trends of cure indicators in Brazil are concerning and underscore a warning to public authorities, as it points to the possible occurrence of other treatment outcomes, such as treatment discontinuity and death. This finding contradicts current public health care policies and requires urgent strategies aiming to promote follow-up of patients during tuberculosis treatment in Brazil.

A critical analysis of the decreasing trends in tuberculosis cure indicators in Brazil, 2001-2022

ABSTRACT Objective: To analyze the temporal trend of tuberculosis cure indicators in Brazil. Methods: An ecological time-series study using administrative data of reported cases of the disease nationwide between 2001 and 2022. We estimated cure indicators for each federative unit (FU) considering individuals with pulmonary tuberculosis, tuberculosis-HIV coinfection, and those in tuberculosis retreatment. We used regression models using joinpoint regression for trend analysis, reporting the annual percentage change and the average annual percentage change. Results: For the three groups analyzed, we observed heterogeneity in the annual percentage change in the Brazilian FUs, with a predominance of significantly decreasing trends in the cure indicator in most FUs, especially at the end of the time series. When considering national indicators, an average annual percentage change of −0.97% (95% CI: −1.23 to −0.74) was identified for the cure of people with pulmonary tuberculosis, of −1.11% (95% CI: −1.42 to −0.85) for the cure of people with tuberculosis-HIV coinfection, and of −1.44% (95% CI: −1.62 to −1.31) for the cure of people in tuberculosis retreatment. Conclusions: The decreasing trends of cure indicators in Brazil are concerning and underscore a warning to public authorities, as it points to the possible occurrence of other treatment outcomes, such as treatment discontinuity and death. This finding contradicts current public health care policies and requires urgent strategies aiming to promote follow-up of patients during tuberculosis treatment in Brazil.

Análise comparativa do conhecimento de estudantes de enfermagem sobre hiv/aids e sífilis / Análisis comparativo del conocimiento de los estudiantes de enfermería sobre el vih/sida y la sífilis / Comparative analysis of the knowledge of nursing students on hiv/aids and syphilis

Objetivo: analisar o conhecimento de estudantes de enfermagem de diferentes séries da graduação em relação ao HIV/aids e sífilis. Método: pesquisa descritivo-exploratória, desenvolvida com 65 acadêmicos de enfermagem de uma universidade do Sul do Brasil. Os dados foram coletados por instrumento adaptado da Organização Mundial da Saúde. Aplicou-se teste de Kruskal-Wallis e da diferença mínima significativa de Fisher para a comparação. Resultados: houve diferença significativa do conhecimento entre as séries em aspectos específicos das infecções, como: janela imunológica do HIV, fisiopatologia da aids, modo de transmissão da sífilis, método indetectável = intransmissível do HIV e caracterização das fases da sífilis. Conclusão: a aquisição de saberes sobre HIV/aids e sífilis entre estudantes de enfermagem tende a evoluir ao longo da graduação, visto que as últimas séries apresentaram melhores escores. Todavia, o conhecimento prévio dos estudantes das séries iniciais ficou evidente e, por vezes, não se inferiorizou em relação às demais.

Objetivo: analizar el conocimiento de los estudiantes de enfermería de diferentes grados de pregrado en relación con el VIH/SIDA y la sífilis. Método: investigación descriptiva-exploratoria, desarrollada con 65 estudiantes de enfermería de una universidad del sur de Brasil. Los datos fueron recolectados por un instrumento adaptado de la Organización Mundial de la Salud. Se aplicó la prueba de Kruskal-Wallis y la diferencia mínima significativa del pescador para la comparación. Resultados: hubo una diferencia significativa en el conocimiento entre las series en aspectos específicos de las infecciones, tales como: ventana inmunológica del VIH, fisiopatología del sida, modo de transmisión de la sífilis, método indetectable = intransferible del VIH y caracterización de las fases de sífilis. Conclusión: la adquisición de conocimientos sobre VIH/SIDA y sífilis entre los estudiantes de enfermería tiende a evolucionar a lo largo de la graduación, ya que los últimos grados presentaron mejores puntajes. Sin embargo, el conocimiento previo de los alumnos de las notas iniciales era evidente y, en ocasiones, no era inferior en relación a los demás.

Objective: to analyze the knowledge of nursing students from different undergraduate grades in relation to HIV/AIDS and syphilis. Method: descriptive-exploratory research, developed with 65 nursing students from a university in southern Brazil. Data were collected by an instrument adapted from the World Health Organization. Kruskal-Wallis test and fisher significant minimum difference was applied for comparison. Results: there was a significant difference in knowledge between the series in specific aspects of infections, such as: HIV immunological window, aids pathophysiology, mode of transmission of syphilis, undetectable method = non-transferable of HIV and characterization of syphilis phases. Conclusion: the acquisition of knowledge about HIV/AIDS and syphilis among nursing students tends to evolve throughout graduation, since the last grades presented better scores. However, the previous knowledge of the students of the initial grades was evident and, at times, it was not inferior in relation to the other ones.

Extreme mito-nuclear discordance in a peninsular lizard: the role of drift, selection, and climate.

Nuclear and mitochondrial genomes coexist within cells but are subject to different tempos and modes of evolution. Evolutionary forces such as drift, mutation, selection, and migration are expected to play fundamental roles in the origin and maintenance of diverged populations; however, divergence may lag between genomes subject to different modes of inheritance and functional specialization. Herein, we explore whole mitochondrial genome data and thousands of nuclear single nucleotide polymorphisms to evidence extreme mito-nuclear discordance in the small black-tailed brush lizard, Urosaurus nigricaudus, of the Peninsula of Baja California, Mexico and southern California, USA, and discuss potential drivers. Results show three deeply divergent mitochondrial lineages dating back to the later Miocene (ca. 5.5 Ma) and Pliocene (ca. 2.8 Ma) that likely followed geographic isolation due to trans-peninsular seaways. This contrasts with very low levels of genetic differentiation in nuclear loci (FST < 0.028) between mtDNA lineages. Analyses of protein-coding genes reveal substantial fixed variation between mitochondrial lineages, of which a significant portion comes from non-synonymous mutations. A mixture of drift and selection is likely responsible for the rise of these mtDNA groups, albeit with little evidence of marked differences in climatic niche space between them. Finally, future investigations can look further into the role that mito-nuclear incompatibilities and mating systems play in explaining contrasting nuclear gene flow.

The complete mitochondrial genome of the black-tailed brush lizard Urosaurus nigricaudus (Reptilia, Squamata, Phrynosomatidae).

Previous studies using mitochondrial DNA (mtDNA) genes suggest the black-tailed brush lizard, Urosaurus nigricaudus, which is a small-sized lizard from the peninsula of Baja California, Mexico, has 4 deeply isolated mtDNA lineages with sequence divergence ranging from 4% to 11.2%. We present its complete mitochondrial genome. This genome is 17,298 bp long and comprises 2 rRNAs, 22 tRNAs, 13 protein-coding genes, 1 L-strand origin of replication and 1 control region. The overall nucleotide content is A = 34.2%; C = 26.8%; G = 13.5%; T = 25.5%. The gene organization and features agree with the general vertebrate organization and that found in other lizards. The control region is 1909 bp long and is located between tRNAPro and tRNAPhe.

Herpetofauna do Parque Estadual Carlos Botelho, São Paulo, Brasil / Herpetofauna of the Carlos Botelho State Park, São Paulo State, Brazil

O presente trabalho consiste em um inventário da herpetofauna do Parque Estadual Carlos Botelho (PECB), localizado na região da Serra de Paranapiacaba, Estado de São Paulo. Os dados foram obtidos por meio de coletas em seis áreas dentro do PECB durante um período de 76 dias distribuídos em um ano, e também por meio de consulta a coleções científicas para obtenção de dados secundários. São apresentados resultados sobre a biologia e ocorrência das espécies no PECB e no Brasil, além de fotografias das diferentes espécies que compõem a herpetofauna do PECB. A herpetofauna do PECB pode ser considerada uma das mais diversificadas de São Paulo, com 65 espécies de anfíbios confirmadas e 59 espécies de répteis registrados neste trabalho. Das 65 espécies de anfíbios, 84 por cento (55 spp.) são endêmicas das formações florestais da Mata Atlântica. Devido às características do relevo do PECB, foram encontrados diferentes padrões altitudinais para os anfíbios: 46 por cento das espécies foram registradas apenas em altitudes acima de 500 m, enquanto que 9 por cento são exclusivas das regiões abaixo de 400 m e 45 por cento ocorrem em todas as áreas amostradas do Parque. Das 59 espécies de répteis do PECB, foram registradas 10 espécies de lagartos, 48 de serpentes e um quelônio. Dentre as serpentes coletadas no PECB, a jararaca Bothrops jararaca foi a mais frequente, com 26,9 por cento (N = 14) do total registrado. Espécies de difícil amostragem, como Echinanthera cephalostriata (13,5 por cento; N = 7) e Taeniophallus affinis (7,7 por cento; N = 4), também foram numerosas no PECB. Dentre os lagartos, Enyalius iheringii foi a espécie mais abundante, com 50 por cento (N = 16) de registros. Uma análise de agrupamento entre 25 taxocenoses de anfíbios brasileiras, incluindo o PECB, resultou na formação de quatro agrupamentos principais. A anurofauna do PECB é mais relacionada com as taxocenoses do Parque Estadual Jacupiranga (0,68) e do Parque Estadual Intervales (0,66). Estes Parques se encontram geograficamente próximos e constituem um dos maiores fragmentos preservados de Mata Atlântica no Brasil. Este trabalho é o primeiro a apresentar a lista de répteis do PECB, alem de complementar o conhecimento em relação a fauna de anfíbios do PECB.

The present work is a survey of the herpetofauna of Carlos Botelho State Park (CBSP), located in the region of Serra de Paranapiacaba, State of São Paulo, Brazil. Data were gathered from specimens collected in six areas within the park during a period of 76 days distributed in one year, and from three Brazilian scientific collections. We also offer photographs and information on the biology and occurrence of species within the park and among Brazilian biomes. The herpetofauna of CBSP may be considered one of the most diverse in the State of São Paulo, with 65 species of amphibians and 59 species of reptiles recorded in the present study. From the 65 species of amphibia recorded, 84 percent (55 spp.) are endemic from forested areas of the Atlantic forest. We also distinguished different altitudinal patterns within the amphibian assemblage, with 46 percent being recorded only at altitudes above 500 m, while 9 percent are exclusive of areas under 400 m and 45 percent occur in all altitudes within the park. The reptile fauna of PECB is composed of 59 species, including 10 species of lizards, 48 snakes, and one chelonian. Among the snakes collected at the CBSP, the Lancehead Bothrops jararaca was the most frequent, with 26,9 percent (N = 14) of the total of the collected specimens. Species that are considered difficult to sample, such as Echinanthera cephalostriata (13,5 percent; N = 7) and Taeniophallus affinis (7,7 percent; N = 4), were also numerous in PECB. Among lizards, Enyalius iheringii was the most abundant species, representing 50 percent (N = 16) of sampled specimens. We also performed a cluster analysis comparing 25 amphibian assemblages from different localities in the Atlantic Forest, and including the PECB, which resulted in the clustering of four main groups. The anurofauna of PECB presented high similarity with the assemblages of Jacupiranga (0,68) and Intervales (0,66) State Parks. These places are geographically close and constitute one of the largest preserved forest fragments of Atlantic rainforest in Brazil. The present work provides at the first time a list of reptiles for the CBSP, and complements the knowledge about the amphibian fauna at the CBSP.