Efetividade do uso de capas em reservatórios de água para prevenção de aedes aegypti / Effectiveness of the use of covers to protect water reservoirs to prevent Aedes aegypti

Introdução: a intermitência ou deficiência da oferta de água pode ser considerada uma condição de vulnerabilidade para a reprodução do Aedes aegypti. Objetivo: avaliar a efetividade do uso de capas para proteção de reservatório de água, como estratégia de controle do Aedes aegypti. Metodologia: estudo de intervenção não controlado, realizado entre os anos 2015 e 2016, em um bairro do município de Riachão do Jacuípe, localizado na macrorregião centro-leste do estado da Bahia, Brasil. A coleta de dados aconteceu em quatro momentos: visita inicial para avaliação da necessidade de capas e pesquisa de larvas nos reservatórios existentes, seguida de três visitas para monitoramento e inspeção dos reservatórios de água beneficiados com as capas protetoras. O tratamento químico foi aplicado, quando necessário. As visitas foram realizadas durante nove meses, com intervalos de 45 a 60 dias. O estudo foi aprovado pelo CEP/UNEB, Parecer número 1.066.424, CAAE 33095114.0.0000.0057. Resultados: foram pesquisados 273 reservatórios de água (capacidade de 200L, 250L, 500L e 1000L) destes, 87,2% permaneceram com as capas em todas as três visitas de monitoramento. Entre os que apresentaram larvas de mosquitos, incluindo Aedes aegypti, 55,6% não apresentavam capa ou estavam dispostas de maneira inadequada. Observou-se, também, incremento de positividade da presença de larvas entre aqueles que se encontravam com capas colocadas, adequadamente, no momento da visita. Discussão: a aplicação de capas de poliéster em reservatórios de água como estratégia de controle vetorial pode não ser efetiva se não ocorrer uma vigilância constante sobre o uso correto.

Introduction: Intermittency or deficiency in water supply can be considered as a condition of vulnerability for reproduction of Aedes aegypti. Objective: To evaluate the effectiveness of the use of covers to protect the water reservoirs as a control strategy against Aedes aegypti. Methodology: An intervention study, with no control group, carried out between 2015 and 2016, in a neighborhood of the municipality of Riachão do Jacuípe, located in the central-eastern macro-region of the state of Bahia, Brazil. Data collection took place in four events: an initial visit to assess the need for covers and search for larvae in the existing reservoirs, followed by three visits to monitor and inspect the water reservoirs benefited by the protective layers. Chemical treatment was applied when necessary. The visits were carried out during nine months, with intervals of 45 to 60 days in between. The study was approved by CEP/UNEB, number 1.066.424, CAAE 33095114.0.0000.0057. Results: A total of 273 water reservoirs (200L, 250L, 500L and 1,000L capacity) were researched, of these 87.2% remained with the covers in all three monitoring visits. Among those who had mosquito larvae, including Aedes aegypti, 55.6% did not have covers or were inappropriately placed at the time of the visit. There was also an increase in positivity of the presence of larvae among those who had their covers properly placed at the time of the visit. Discussion: The application of polyester covers in water reservoirs as a vector control strategy may not be effective if there is not constant surveillance to ensure its correct use.

Leishmaniasis as a Manifestation of Immune Reconstitution Inflammatory Syndrome (IRIS) in HIV-Infected Patients: A Literature Review.

INTRODUCTION: After the onset of highly active antiretroviral therapy (HAART), some HIV-infected patients present a severe inflammation in response to a latent or a previously treated opportunistic pathogen termed immune reconstitution inflammatory syndrome (IRIS). Few reports of tegumentary and visceral leishmaniasis have been described in association with IRIS. METHODS: A systematic literature review of IRIS in association with leishmaniasis identified 34 reported cases. RESULTS AND DISCUSSION: The majority of these occurred in males 4 months following the onset of HAART. The mean CD4 count before HAART was 94 ± 77 cells/mm³ increasing to 5 times the initial value between the onset of HAART and IRIS presentation. Visceral leishmaniasis and post-kala-azar dermal leishmaniasis were the most commonly reported clinical manifestations, followed by tegumentary leishmaniasis and uveitis. CONCLUSIONS: Commonly found characteristics included cutaneous involvement, regardless of Leishmania species; appearance of lesions unrelated to time of probable Leishmania infection; rapid recovery of CD4 count following HAART; and rapid progression.