Prevalence of multidrug-resistant tuberculosis in prisons: Systematic review and meta-analysis.

BACKGROUND: In the context of prisons, multidrug-resistant tuberculosis (MDR-TB) is a major problem. In this article, we estimate the prevalence of MDR-TB among the population deprived of freedom from countries in South America, Europe, Asia and Africa. METHODS: The articles were retrieved through systematic search at four databases (EMBASE, CINAHL, LILACS and MEDILINE). The meta-analysis was developed by the random effect model, using the Mantel-Haenszel method, with presentation of the aggregated results through the forest plot. The degree of heterogeneity between the studies was verified using Cochran's Q test and I2. RESULTS: Of the 102 articles analyzed, 21 were included in this systematic review. The analysis showed heterogeneity indicated by the Q test (P â€‹< â€‹0.001) and I2 statistics (I2 â€‹= â€‹50.52%). The funnel graph and Egger test (P â€‹< â€‹0.830) showed symmetry between investigations. The grouped prevalence of MDR-TB was 0.48% (95% CI: 0.02 to 1.32), advancing to 1.15 (95% CI: 0.15 to 2.73) when culture and sensitivity test were considered by the authors. No specific characteristics were significantly associated with differences in prevalence rates in the population deprived of freedom. CONCLUSION: The study reaffirms the magnitude of MDR-TB in the population deprived of freedom in the world context. Political and technical-scientific efforts should be mobilized to mitigate TB and MDR-TB in prisons and for successful national and international disease control programs.

Spiders in Brazil: from arachnidism to potential therapeutic use of their venom part 1 of 2

Spider envenomation, generically known as arachnidism, is described in many places around the world. In terms of medical importance, the following genera of animals stand out as the main origin of the morbid condition: Atrax (Sidney funnel web spider), Steatoda (false black widow), Latrodectus (black widow), Loxosceles (brown spider) and Phoneutria (armed spider), the last three causing accidents involving spiders in Brazil. This article, part 1 of 2, aims to present the main aspects of arachnidism in the country, with an emphasis on the biology and geographical distribution of spiders, biochemistry of the venom, pathogenesis and epidemiology of arachnidism, as well as prevention of the morbid condition.

Leptospirosis, a clinical update regarding a neglected infectious disease

Leptospirosis is one of the neglected infectious diseases locally widespread and extremely significant in tropical areas due to its great epidemic potential. It is a worldwide public health problem in view of the emergence and reemergence of the disease due to lack of sanitation and negligence, among other factors. In fact, leptospirosis infects more than 1 million people per year, resulting in almost 60,000 deaths. Human infection generally takes place after skin exposure to soil and/or water contaminated with urine of chronically infected mammals. The clinical presentations of the disease vary from a slight fever, goosebumps and flu-like symptoms to the acute forms of the disease. Understanding the main aspects of the disease is paramount due to the many unspecific signs and symptoms as well as frequently mistaken diagnosis. In this article, we discuss the epidemiological, immunopathogenic, clinical and prophylactic aspects of this condition with the purpose of clarifying an up to date panorama of the subject.

Meningococcal disease, a clinical and epidemiological review.

Meningococcal disease is the acute infection caused by Neisseria meningitidis, which has humans as the only natural host. The disease is widespread around the globe and is known for its epidemical potential and high rates of lethality and morbidity. The highest number of cases of the disease is registered in the semi-arid regions of sub-Saharan Africa. In Brazil, it is endemic with occasional outbreaks, epidemics and sporadic cases occurring throughout the year, especially in the winter. The major epidemics of the disease occurred in Brazil in the 70's caused by serogroups A and C. Serogroups B, C and Y represent the majority of cases in Europe, the Americas and Australia. However, there has been a growing increase in serogroup W in some areas. The pathogen transmission happens for respiratory route (droplets) and clinically can lead to meningitis and sepsis (meningococcemia). The treatment is made with antimicrobial and supportive care. For successful prevention, we have some measures like vaccination, chemoprophylaxis and droplets' precautions. In this review, we have described and clarify clinical features of the disease caused by N. meningitidis regarding its relevance for healthcare professionals.

Diversity and distribution of the endophytic bacterial community at different stages of Eucalyptus growth.

The relationships between plants and endophytic bacteria significantly contribute to plant health and yield. However, the microbial diversity in leaves of Eucalyptus spp. is still poorly characterized. Here, we investigated the endophytic diversity in leaves of hybrid Eucalyptus grandis x E. urophylla (Eucalyptus "urograndis") by using culture-independent and culture-dependent approaches, to better understand their ecology in leaves at different stages of Eucalyptus development, including bacteria with N2 fixation potential. Firmicutes, Proteobacteria (classes alpha-, beta- and gamma-) and Actinobacteria were identified in the Eucalyptus "urograndis" endophytic bacterial community. Within this community, the species Novosphingobium barchaimii, Rhizobium grahamii, Stenotrophomonas panacihumi, Paenibacillus terrigena, P. darwinianus and Terrabacter lapilli represent the first report these bacteria as endophytes. The diversity of the total endophytic bacteria was higher in the leaves from the 'field' (the Shannon-Wiener index, 2.99), followed by the indices obtained in the 'clonal garden' (2.78), the 'recently out from under shade (2.68), 'under shade' (2.63) and 'plants for dispatch' (2.51). In contrast, for diazotrophic bacteria, the highest means of these indices were obtained from the leaves of plants in the 'under shade' (2.56), 'recently out from under shade (2.52)' and 'field' stages (2.54). The distribution of the endophytic bacterial species in Eucalyptus was distinct and specific to the development stages under study, and many of the species had the potential for nitrogen fixation, raising the question of whether these bacteria could contribute to overall nitrogen metabolism of Eucalyptus.