Etiology of Diarrhea in Children Younger Than 5 Years Attending the Bengo General Hospital in Angola.

BACKGROUND: Diarrheal disease is among the leading causes of death in children younger than 5 years, especially in developing countries. The aim of this study was to investigate the most frequent etiological agents of diarrhea and its associated factors in children younger than 5 years attending the Bengo General Hospital in Angola. METHODS: From September 2012 through December 2013, stool samples were collected from 344 children presenting with diarrhea to investigate the presence of viral, bacterial and parasitic agents. Relevant sociodemographic and clinical data were obtained from parents and caregivers. RESULTS: An enteric pathogen was detected in 66.6% of stool samples: Cryptosporidium spp. (30.0%), rotavirus (25.1%), Giardia lamblia (21.6%), diarrheagenic Escherichia coli (6.3%), Ascaris lumbricoides (4.1%), adenovirus (3.8%), Strongyloides stercoralis (3.5%), astrovirus (2.6%), Hymenolepis nana (1.7%), Entamoeba histolytica/dispar (0.9%), Taenia spp. (0.6%), Trichuris trichiura (0.3%) and Entamoeba histolytica (0.3%). Children younger than 12 months were more frequently infected with Cryptosporidium spp. compared with older children (age: 12-59 months), independently of sex, season, lethargy and wasting [odds ratio (OR): 3.5, 95% confidence interval (95% CI): 2.0-6.2]. Age (OR: 5.0, 95% CI: 2.6-9.3), vomiting (OR: 2.7, 95% CI: 1.5-4.8) and type of admission (inpatients, OR: 0.5, 95% CI: 0.3-0.9) were significantly associated with rotavirus infection. CONCLUSIONS: This study demonstrates high rates of infection with an enteric pathogen, particularly in children younger than 12 months, emphasizing the need to address diarrheal disease in this age group.

Assessing therapeutic management of vaginal and urethral symptoms in an anonymous HIV testing centre in Luanda, Angola.

INTRODUCTION: This study aimed to estimate the prevalence of Neisseria gonorrhoeae and Chlamydia trachomatis infections and to assess the therapeutic management of vaginal/urethral discharge and dysuria in patients with human immunodeficiency virus in Luanda, Angola, taking into account World Health Organization recommendations for sexually transmitted infection syndromic management. METHODOLOGY: Socio-demographic and medical data were obtained from 436 individuals, and clinical examinations were performed in 104 women and 8 men. Vaginal/cervical and urethral specimens were collected from 112 individuals for observation of Trichomonas vaginalis, yeasts and bacterial vaginosis, while urine samples were obtained from 415 patients (221 symptomatic and 194 asymptomatic). Diagnosis of Neisseria gonorrhoeae and Chlamydia trachomatis was performed by polymerase chain reaction assay. RESULTS: The prevalence of N. gonorrhoeae and C. trachomatis was 8.4% (35/415) and 7.9%, (33/415) respectively. Eight of the 35 N. gonorrhoeae positive cases were treated. All men and women (79) who presented a positive wet mount/Gram stain were etiologically treated according to microscopy results. In contrast, 53.3% of the female patients (16/30) and 33.3% (1/3) of the male patients who presented microscopy negative results were treated for urinary tract infection or by syndromic approach. Among non-examined patients, 15% of women (12/80) and 52.5% of men (21/40) were treated without an etiological result. Syndromic treatment was preferentially given to non-examined males (19/40-47.5%) over females (12/80-15%) (p<0.01). CONCLUSIONS: The prevalence of N. gonorrehaea and C. trachomatis found in this study was high. WHO-recommended syndromic management of vaginal/urethral discharge is not being consistently and correctly applied.

Prevalence and Level of Antibodies Anti-Plasmodium spp. in Travellers with Clinical History of Imported Malaria.

In this study, we show that 40.29% of travellers with a possible history of malaria exposure were positive for anti-Plasmodium spp. antibodies, while these individuals were negative by microscopy. The antibody test described here is useful to elucidate malaria exposure in microscopy-negative travellers from endemic countries.

Biosensors as rapid diagnostic tests for tropical diseases.

Effective diagnosis of infectious pathogens is essential for disease identification and subsequent adequate treatment, to prevent drug resistance and to adopt suitable public health interventions for the prevention and control of epidemic outbreaks. Particular situations under which medical diagnostics operate in tropical environments make the use of new easy-to-use diagnostic tools the preferred (or even unique) option. These diagnostic tests and devices, usually based on biosensing methods, are being increasingly exploited as promising alternatives to classical, "heavy" lab instrumentation for clinical diagnosis, allowing simple, inexpensive and point-of-care testing. However, in many developing countries the lack of accessibility and affordability for many commercial diagnostic tests remains a major cause of high disease burden in such regions. We present a comprehensive overview about the problems of conventional medical diagnosis of infectious pathologies in tropical regions, while pointing out new methods and analytical tools for in-the-field and decentralized diagnosis of current major infectious tropical diseases. The review includes not only biosensor-based rapid diagnostic tests approved by regulatory entities and already commercialized, but also those at the early stages of research.

Children, health assets and poverty in a recent post-war scenario: the Angola case

Angola é um país de língua oficial Portuguesa que enfrentou recentemente uma guerra civil depois de décadas de ocupação colonial. O bem-estar econômico, as preocupações com a saúde e a escolarização são ainda um privilégio de poucos. Um estudo em meio escolar foi realizado em quatro escolas em Benguela (Sul de Angola). 22 Escolas foram aleatoriamente seleccionadas, incluindo 701 alunos do oitavo e o 10º ano de escolaridade, 55.2

Angola is a Portuguese-speaking country that faced a recent civil war, after decades of colonial occupation and conflict, and still exhibits a scenario of poverty. Well-fare, health concerns and schooling are still a privilege. A school-based survey was carried out in all four schools in Benguela (South of Angola), 22 randomly classes were selected, including 701 pupils, attending 8th and 10th grade, being 55.2

dos participantes eram rapazes. A idade média foi 17.5 anos, com um DP de 3.25. Uma análise descritiva seguida de uma análise multivariada revelou que a percepção de bem-estar econômico da família foi sobretudo associada com aspectos positivos da saúde: consumo de frutas, percepção de competência escolar, o nível de instrução da mãe e o número de amigos. A satisfação com a vida associou-se ao bem-estar econômico da família, bem como ao nível de instrução da mãe, ao consumo de fruta e à percepção de segurança na escola. Identificar e mapear os “trunfos para a saúde” parece pois uma visão promissora. Sublinha-se a necessidade de focar aspectos positivos da vida das pessoas, tais como a escolarização, o capital social, a alimentação saudável, na promoção da saúde e bem -estar dos jovens.

boys. Mean age in the present study was 17.5 years old, SD 3.25. Descriptive and multi-variated analysis revealed that the perception of family well fare is mainly associated with positive aspects of health: fruit intake, perception of school competence, mother instruction level and number of friends. Life satisfaction was associated with family well fare, as well as with mother level of instruction, fruit intake and perception of safety in school. The health assets’ perspective seems thus to propose a new way of identifying and fulfilling needs in a developing country. Present results suggest a focus on positive issues such as schooling, social capital/friends, and healthy food, as relevant factors to promoting teens’ health and well-being, in a country in a recent post-war scenario.

Sexually transmitted infections in an African migrant population in Portugal: a base-line study.

BACKGROUND: For geographical and recent historic reasons, Portugal is a gateway and home for immigration from sub-Saharan countries. Misconceptions related to these populations often lead to consider them as high-frequency clusters for dissemination of sexually transmitted infections (STIs). Epidemiological evidence-based data is needed to elucidate these issues and baseline prevalence studies are the starting point for this. METHODOLOGY: A prospective study was conducted in 220 African migrants (171 men and 49 women), recently arrived in Portugal, at the time of their first consultation. The presence of STIs was evaluated using a clinical syndromic approach and biological confirmation for gonorrhoea, Chlamydia trachomatis genital infection, syphilis, Hepatitis B and Human Immunodeficiency Virus (HIV) infection. RESULTS: Global prevalence of the targeted infections were 1.8% for gonorrhoea, 0 % for Chlamydia infection, 4.1% for Syphilis, 5.9% for HBsAg presence and 7.3% for HIV infection. Globally, 16.4% of the studied persons had at least one sexually transmitted infection. CONCLUSIONS: We concluded that prevalence rates encountered in this population is similar to that of non-migrant Portuguese populations with a high risk for sexually transmitted diseases. Therefore migration from sub-Saharan Africa doesn't seem to constitute a particularly critical isolated factor for public health risk of STIs in the community.

[Mycoplasmas: what is the role in human infections?]. / Micoplasmas: que papel nas infecções humanas?

Mycoplasmas, the common denomination of the Mycoplasma and Ureaplasma genera, represent a unique and complex group of microorganisms that has been ignored by the majority of diagnostic laboratories, not only because of its fastidious growth, absence of commercial media and of procedures for a rapid diagnosis, but most of all due to a clinical perception established for many years that these microorganisms are of minor importance. Recently, this situation has changed, because there s a better understanding of mycoplasmas clinical importance, they have been recently associated with Human Immunodeficiency Virus (HIV), complications in pregnant women and their neonates and with rheumatological disorders, resulting in a need to cure infected persons. The development of laboratory techniques that allows their culture and identification has contributed for a clarification of the role of these microorganisms as etiological agents or as co-factor of specific diseases. This article wishes to be, not only a revision of the main characteristics of the human mycoplasmas, but also to contribute for a better understanding of the diseases to which these fascinating microorganisms are associated and of the available diagnostic methods by the health professionals.