School-based health education intervention to increase knowledge on rheumatic heart disease: the provar study

Introduction: Rheumatic Heart Disease (RHD) remains an important cause of morbidity and mortality in Brazil and other low- and middle-income countries (LMIC). Lack of public awareness of the causes and prevention of RHD limit the efficacy of primary and secondaryprevention programs. Objectives: To evaluate the efficacy of knowledge transfer that results from a structured public-school educational program on RHD. Methods: A prospective, cohort study was conducted over 8 months (9/2014-4/2015) in 6 randomly selected low-income public schools in Belo Horizonte, Brazil. All enrolled and present students received education. A nurse and an imaging technician utilized 2 custom educational curriculums, targeting children in grades 6 - 11 (aged 11-17). Pre-tests, taken immediately prior to educational curriculum queried students’ knowledge of the causes, prevention, diagnosis, and treatment of RHD. Post-tests, 1-3 weeks following education assessed the efficacy of knowledge transfer and retention. Results: Education was delivered to 3700 students. Of these, 1176 were randomly selected to participate in pre- and post-testing including 404 (34%) in 6th/7th grades (G1), 511 (44%) in 8th/9th (G2), and 261 (22%) of in 10th/11th grades (G3). The mean interval between pre and post-tests was 1010 days. Prior to the intervention, general knowledge regarding RHD was universally low (median score 46.7%, 40.0-60.0). Children in higher grades (G3) knew more about RHD than those in lower grades (60% vs. 43.3% G1/46.7% G2), p<0.001.Children showed significant gains in the post-test, raising the median score by 20% (60%, 40.0-73.3). Again, children in higher grades showed higher overall scores (73.3%, 60.0-80.0 G3; 60%, 40.0-73.3 G2; 53.3%, 33.3-66.7 G1), p<0.001. However, the percent increase was similar between groups (6.9% G1, 7.9% G2, 8.5% G3), p¼0.53. Conclusion: School-based RHD education resulted in consistent but modest gains in knowledge. Novel educational techniques and use of technology to engage young learners may lead to improved knowledge gains and retention. Further studies are needed to determine if increased knowledge leads to behavioral changes that could decrease theburden of RHD in LMIC

Practical Science and Environmental Education Workshop in Manaus, Brazil

It is an unequivocal fact that Amazonian tropical forest is the largest remaining primary forest in the world. The ecosystem in the region is e tremely comple with high biodiversity (Peres et al. 2010). Conservation and protection of the dynamic forest and river regions is e tremely important not only for the natural environments, but also for the economy and social dependence of benefits from such abundant natural environments. Important natural parameters that affect status of the natural environments include light (natural sunlight), soil, and water, which abundantly e ist in the Amazon region. Solar energy is the primary energy source for the majority of living organisms in both terrestrial and aquatic ecosystems, and drives the diurnal and seasonal cycles of biogeochemical processes (Monteith & Unsworth 2013). In particular, in situ light data remains one of the most underappreciated data measurements although having a significant impact on the physical, chemical and biological processes in the ecosystem (Johnsen 2012). Soil provides the fundamental basis for all terrestrial living organisms including the Amazonian forests as well as life-sustaining infrastructure for human society. Water is the most essential single entity to constitute all organisms from a single cell to the earth. Understanding of importance and roles of each factor and interaction of such comple dynamics in the natural environments can serve as fundamental platform for natural scientists, particularly for young scientists such as university students. The objective of this workshop was to provide hand- on scientific and environmental education for university students in Manaus, Amazonas, Brazil through practical field measurements using the three most important parameters in the natural ecosystem composed of natural sunlight, soil, and water. The workshop was divided into a series of lectures, in situ field sampling, and data processing, analysis and interpretation with the ultimate goal of empowering the undergraduate students with research-centered environmental education and e perience of developing international collaboration.departmental bulletin pape

Detection of virulence-associated genes of Pasteurella multocida isolated from cases of fowl cholera by multiplex-PCR

The current systems of breeding poultry, based on high population density, increase the risk of spreading pathogens, especially those causing respiratory diseases and those that have more than one host. Fowl Cholera (FC) is one such pathogen, and even though it represents one of several avian diseases that should be considered in the differential diagnosis of notifiable diseases that present with sudden death, the pathogenesis and virulence factors involved in FC are still poorly understood. The objective of this study was to investigate twelve genes related to virulence in 25 samples of Pasteurella multocida isolated from FC cases in the southern region of Brazil through the development of multiplex PCR protocols. The protocols developed were capable of detecting all of the proposed genes. The ompH, oma87, sodC, hgbA, hgbB, exBD-tonB and nanB genes were present in 100% of the samples (25/25), the sodA and nanH genes were present in 96% (24/25), ptfA was present in 92% (23/25), and pfhA was present in 60% (15/25). Gene toxA was not identified in any of the samples studied (0/25). Five different genetic profiles were obtained, of which P1 (negative to toxA) was the most common. We concluded that the multiplex-PCR protocols could be useful tools for rapid and simultaneous detection of virulence genes. Despite the high frequency of the analyzed genes and the fact that all samples belonged to the same subspecies of P. multocida, five genetic profiles were observed, which should be confirmed in a study with a larger number of samples

Mapping subnational HIV mortality in six Latin American countries with incomplete vital registration systems

BackgroundHuman immunodeficiency virus (HIV) remains a public health priority in Latin America. While the burden of HIV is historically concentrated in urban areas and high-risk groups, subnational estimates that cover multiple countries and years are missing. This paucity is partially due to incomplete vital registration (VR) systems and statistical challenges related to estimating mortality rates in areas with low numbers of HIV deaths. In this analysis, we address this gap and provide novel estimates of the HIV mortality rate and the number of HIV deaths by age group, sex, and municipality in Brazil, Colombia, Costa Rica, Ecuador, Guatemala, and Mexico.MethodsWe performed an ecological study using VR data ranging from 2000 to 2017, dependent on individual country data availability. We modeled HIV mortality using a Bayesian spatially explicit mixed-effects regression model that incorporates prior information on VR completeness. We calibrated our results to the Global Burden of Disease Study 2017.ResultsAll countries displayed over a 40-fold difference in HIV mortality between municipalities with the highest and lowest age-standardized HIV mortality rate in the last year of study for men, and over a 20-fold difference for women. Despite decreases in national HIV mortality in all countries-apart from Ecuador-across the period of study, we found broad variation in relative changes in HIV mortality at the municipality level and increasing relative inequality over time in all countries. In all six countries included in this analysis, 50% or more HIV deaths were concentrated in fewer than 10% of municipalities in the latest year of study. In addition, national age patterns reflected shifts in mortality to older age groups-the median age group among decedents ranged from 30 to 45years of age at the municipality level in Brazil, Colombia, and Mexico in 2017.ConclusionsOur subnational estimates of HIV mortality revealed significant spatial variation and diverging local trends in HIV mortality over time and by age. This analysis provides a framework for incorporating data and uncertainty from incomplete VR systems and can help guide more geographically precise public health intervention to support HIV-related care and reduce HIV-related deaths.Peer reviewe

Percentual de suplementação de fonte taninífera na ração concentrada de caprinos jovens sobre o desempenho e carga parasitária

O presente estudo buscou determinar o percentual de adição de torta de pimenta rosa (TPR) na dieta de caprinos jovens sobre o desempenho e carga parasitária. Foram utilizados 25 caprinos jovens da raça Saanen, distribuídos em um delineamento inteiramente casualizado em grupos de cinco tratamentos e cinco repetições, constituídos por grupos: não suplementados com TPR; suplementados com 15% TPR; suplementados com 30% TPR; suplementado com 45% TPR; e suplementado com 60% TPR. O aumento dos níveis de suplementação de pimenta rosa resultou em efeito quadrático sobre o consumo voluntário de matéria seca (CVMS), peso metabólico e ganho em peso diário (P≤0,05). Para o CVMS, o comportamento quadrático (P≤0,05) revelou ponto de mínimo de 67,1g kg0,75 dia-1 no percentual de 59,8% de TPR; para o peso metabólico, um ponto máximo de 8,5kg0,75 no percentual de 15,5% de TPR; e, para o ganho em peso diário, um ponto máximo de 0,107g dia-1 no percentual de 19,6% de TPR na dieta. Em relação à influencia da TPR sobre a carga parasitária, observou-se efeito quadrático dos níveis de suplementação de TPR na contagem de ovos por grama de fezes (OPG) (P≤0,05), com ponto de mínimo estimado em 1,0Log10 no nível de 35,8% TPR na dieta, representando o limite de resposta do TPR. Além da redução no OPG, houve um decréscimo linear na contagem de oocistos por grama de fezes (OOPG) com o incremento nos níveis de TPR da dieta. Conclui-se que a adição de 20-30% TPR possibilitou o controle de parasitos gastrointestinais com máximo desempenho animal