Factors associated with migration in individuals affected by leprosy, Maranhão, Brazil: an exploratory cross-sectional study

In Brazil, leprosy is endemic and concentrated in high-risk clusters. Internal migration is common in the country and may influence leprosy transmission and hamper control efforts. We performed a cross-sectional study with two separate analyses evaluating factors associated with migration in Brazil’s Northeast: one among individuals newly diagnosed with leprosy and the other among a clinically unapparent population with no symptoms of leprosy for comparison. We included 394 individuals newly diagnosed with leprosy and 391 from the clinically unapparent population. Of those with leprosy, 258 (65.5%) were birth migrants, 105 (26.6%) were past five-year migrants, and 43 (10.9%) were circular migrants. In multivariate logistic regression, three independent factors were found to be significantly associated with migration among those with leprosy: (1) alcohol consumption, (2) separation from family/friends, and (3) difficulty reaching the healthcare facility. Separation from family/friends was also associated with migration in the clinically unapparent population. The health sector may consider adapting services to meet the needs of migrating populations. Future research is needed to explore risks associated with leprosy susceptibility from life stressors, such as separation from family and friends, access to healthcare facilities, and alcohol consumption to establish causal relationships

Avaliação de métodos de controle da infecção pelo vírus da leucose enzoótica bovina Appraisal methods for controlling the infection by enzootic bovine leukosis

Foram avaliadas três alternativas de controle da infecção pelo vírus da Leucose Bovina: a) eliminação dos animais soropositivos: b) segregação dos animais soropositivos: c) manejo misto dos animais, com adoção de medidas recomendadas para evitar a transmissão do vírus. O primeiro teste sorológico realizado em oito propriedades leiteiras revelou a presença da infecção com índices que variaram entre 2,5% (1/40) e 58,1% (18/31). Duas propriedades com baixo nível de infecção inicial (<10%) optaram pela eliminação total dos animais positivos. Uma dessas propriedades apresentou resultados imediatos, com taxa de incidência nula (0/39) durante o período de doze meses, enquanto a outra, que não eliminou prontamente o animal positivo, apresentou incidência de 20,0% (3/15) no mesmo período. A eliminação dos animais reagentes, nas propriedades que apresentaram um baixo nível de infecção, demonstrou ser uma forma eficiente para a erradicação da infecção. A segregação dos animais soropositivos, com a formação de dois rebanhos, foi implantada em uma propriedade, onde apenas um animal soroconverteu durante o experimento, observando-se uma incidência de 4,5% (1/22) ao final do estudo. As propriedades que adotaram o programa de controle através do manejo misto de animais infectados e não infectados apresentaram resultados muito variados, demostrando índices de soroconversão entre 2,6% (1/38) a 50,0% (4/8), indicando que esse tipo de controle necessitaria de um tempo maior para alcançar os objetivos. Foi possível a obtenção de descendentes soronegativos através da substituição ou motivação pelo calor do leite materno administrado aos torneiros. A redução dos níveis de infecção em um rebanho, sem a necessidade do descarte imediato dos animais infectados, é possível a partir da substituição de ventres pelas novilhas da própria granja.<br>Three procedures for the control of bovine leukemia vírus infection (BLV) were evaluated: a) elimination of seropositive animals: b) segregation of animals into seropositive and seronegative groups: c) combined management and use of strict procedures to minimize viral transmission. The first serological testing in eight dairy farms demonstrated a prevalence ranging of 2.5% (1/40) to 58.1% (18/31). Two farms with a low prevalence (<10%) decided to cull the seropositive animals. In one of these farms, the culting of positive animals resulted in eradication of the infection, demonstrated by the absence of seropositive reactors in the following tests. In the second farm, where the only seropositive animal was kept in the herd, the incidence reached 20% (3/15) in a six months period. The culling of the reactors in farms with low levels of infection seemed to be the most efficient procedure for eradication the infection. Segregation of reactors and negative animals into two groups was adopted in one farm, where only one animal seroconverted during the experiment, resulting in an incidence of 4.5% (1/22). The farms where a combined management was adopted presented a incidence ranging between 2.6% (1/38) and 50% (4/8). These resulls suggested that this procedure woutd require a longer period of observation in order to evaluate its efficacy. It has been possible to obtain seronegative offspring from positive dams when a substitutive or heat-inactivated milk was used. The reduction of the level of infection in a herd, without immediately culling the infected animals may be possible by replacing older animais with heifers bom in the samefarm