COVID-Inconfidentes - SARS-CoV-2 seroprevalence in two Brazilian urban areas during the pandemic first wave: study protocol and initial results

Background: A population study is an important tool that can be used to understand the actual epidemiological scenario of the Covid-19 in different territories, identify its magnitude, understand its transmission dynamics, and its demographic, geographical, and social distribution. Objective: The aim of this study was to determine the prevalence and dynamics of SARS-CoV-2 infection in the population of two Brazilian cities during the pandemic first wave and subsequent socioeconomic and health effects. Materials & methods: This paper described the methodological procedures adopted and the prevalence of the SARS-CoV-2 infection in the population. A household survey was conducted between October and December 2020, in two historic cities of Brazil's mining region. Anti-SARS-CoV-2 antibody was detected using the Wondfo® rapid test. The face-to-face interview consisted of administration of a questionnaire containing registration data, sociodemographic and economic variables, living habits, general health condition, mental health, sleep habits, and eating and nutrition. Results: We evaluated 1,762 residents, of which 764 (43.4%) were in Mariana and 998 (56.6%) in Ouro Preto. For both cities, 51.9% of the interviewees were female, with a predominance of the age range 35 to 59 years old (47.2%). The prevalence of the SARS-CoV-2 infection was 5.5% in all cities, 6.2% in Ouro Preto, and 4.7% in Mariana. The prevalence was similar between cities (P>0.05). Conclusion: The study was effective in verifying the seroprevalence of infection by the virus and its findings will enable further analyses of the health conditions of the population related to social isolation and the risk of infection with SARS-CoV-2

Fratura periprotética de quadril - Vancouver tipo A: Periprosthetic hip fracture - Vancouver type A

Introdução: As  fraturas  periprotéticas  de  quadril  são uma  complicação  grave e com elevado índice de morbimortalidade observadas  após abordagens   cirúrgicas,   como   artroplastia   de   quadril   e  cirurgias   de   revisão. Ocorrem mais frequentemente ao redor do componente femoral em relação ao acetabular. Essa complicação  está  relacionada  a  fatores  que  são  avaliados  por  meio  do  sistema  de Vancouver,   possibilitando   definir   a   melhor   forma   de   abordagem   e   cuidados   da complicação. Apresentação do caso: Paciente do sexo feminino, 60 anos de idade, admitida no Hospital Universitário Risoleta Tolentino Neves (UFMG), com uma fratura tipo A, que tem localização trocantérica e pode se manifestar no trocanter femoral maior ou menor. Discussão: Com o aumento da longevidade, a idade média da população vem aumentando, e com isso o número de intervenções cirúrgicas também aumentam, principalmente as artroplastias de quadril. O que leva a um maior número de situações que envolvem complicações pós-cirúrgicas. Com mais episódios de fraturas periprotéticas, torna-se importante uma melhor avaliação dos quadros para melhor conduta e elucidação de eventuais complicações. Conclusão: Ao se constatar uma fratura periprotética de quadril, deve-se classificar a mesma seguindo o sistema de Vancouver que é dividido em três tipos A, B e C. Essa classificação vai ditar como será a abordagem mais assertiva para  resolução do quadro do pacient

Síndrome de Dubowitz: Dubowitz syndrome

Introdução: a síndrome de Dubowitz é uma síndrome rara herdada de forma autossômica recessiva e o diagnóstico é realizado por exclusão, foi primeiramente descrita no ano de 1965 e possui um grande espectro fenótico, podendo afetar inúmeros  sistemas. Apresentação do caso: paciente do sexo masculino, branco, sete anos, admitido no Hospital das Clínicas da UFG, após encaminhamento de UB. Nasceu de parto normal a termo, sem intercorrências, pesando 2.200 g, PIG (pequeno para idade gestacional), estatura de 46 cm, Apgar de 9 e 10. A mãe relata ter realizado todas consultas de pré-natal e nega qualquer infecção, uso de bebida alcoólica, cigarro ou drogas ilícitas durante a gravidez. Discussão: a apresentação  clínica mais comumente encontrada está relacionada ao retardo do crescimento, baixo peso ao nascer, microcefalia, alterações faciais e físicas características, desempenho intelectual diminuído, oligofrenia discreta. Conclusão: a Síndrome de Dubowitz ainda é bastante desconhecida. Com base nas bibliografias pesquisadas percebeu-se que há muito para ser explorado

COVID-19 outcomes in people living with HIV: Peering through the waves

Objective: To evaluate clinical characteristics and outcomes of COVID-19 patients infected with HIV, and to compare with a paired sample without HIV infection. Methods: This is a substudy of a Brazilian multicentric cohort that comprised two periods (2020 and 2021). Data was obtained through the retrospective review of medical records. Primary outcomes were admission to the intensive care unit, invasive mechanical ventilation, and death. Patients with HIV and controls were matched for age, sex, number of comorbidities, and hospital of origin using the technique of propensity score matching (up to 4:1). They were compared using the Chi-Square or Fisher's Exact tests for categorical variables and the Wilcoxon for numerical variables. Results: Throughout the study, 17,101 COVID-19 patients were hospitalized, and 130 (0.76%) of those were infected with HIV. The median age was 54 (IQR: 43.0;64.0) years in 2020 and 53 (IQR: 46.0;63.5) years in 2021, with a predominance of females in both periods. People Living with HIV (PLHIV) and their controls showed similar prevalence for admission to the ICU and invasive mechanical ventilation requirement in the two periods, with no significant differences. In 2020, in-hospital mortality was higher in the PLHIV compared to the controls (27.9% vs. 17.7%; p = 0.049), but there was no difference in mortality between groups in 2021 (25.0% vs. 25.1%; p > 0.999). Conclusions: Our results reiterate that PLHIV were at higher risk of COVID-19 mortality in the early stages of the pandemic, however, this finding did not sustain in 2021, when the mortality rate is similar to the control group

Conocimiento sobre gastroenteritis viral por parte de los profesionales de salud de un hospital materno infantil de referencia en el Estado de Pará, Brasil

Fundação Santa Casa de Misericórdia do Pará. Belém, PA, Brasil / Universidade do Estado do Pará. Belém, PA, Brasil.Ministério da Saúde. Secretaria de Vigilância em Saúde. Instituto Evandro Chagas. Ananindeua, PA, Brasil.Ministério da Saúde. Secretaria de Vigilância em Saúde. Instituto Evandro Chagas. Programa de Pós-graduação em Virologia. Ananindeua, PA, Brasil.Ministério da Saúde. Secretaria de Vigilância em Saúde. Instituto Evandro Chagas. Ananindeua, PA, Brasil.Fundação Santa Casa de Misericórdia do Pará. Setor de Neonatologia. Belém, PA, Brasil.As gastroenterites agudas (GA) de origem viral são consideradas como uma das principais causas de morbimortalidade em crianças menores de 5 anos de idade, e os rotavírus, norovírus e astrovírus apontados como os principais responsáveis. Este trabalho visou verificar o conhecimento de que dispõem os médicos e enfermeiros dos setores de neonatologia e pediatria de um hospital materno-infantil de referência no Estado do Pará, Brasil, acerca dos vírus relacionados ao quadro de GA, da sua forma de transmissão, e das principais medidas de prevenção e controle. Realizou-se uma pesquisa descritiva-exploratória em 2011, por meio de questionário envolvendo perguntas relacionadas ao perfil dos participantes e referentes ao tema proposto. Após aplicação de teste estatístico, foi feita a seleção randômica de 60 participantes. Verificou-se que, durante quadro de diarreia, a lavagem das mãos e a conduta terapêutica de hidratação já estão bem instituídas pelos profissionais, assim como isolamento dos pacientes acometidos por GA. Constatou-se que a maioria dos participantes detém conhecimento sobre a vacina para rotavírus, a quantidade de doses e idades de aplicação. Dentre os procedimentos a serem realizados em caso de surto nosocomial, a coleta das amostras visando a definição etiológica e o uso de proteção pessoal foram as mais citadas. Quanto às principais fontes de transmissão desses vírus, a contaminação fecal-oral foi a mais mencionada, seguida por manipulação de fômites. Considerando que a GA é uma das principais causas de consulta, internação e letalidade infantis, é imprescindível a conscientização dos profissionais da saúde sobre a fácil transmissão desses vírus, para evitar sua disseminação, contribuindo para a diminuição da morbidade ocasionada por esses patógenos.The acute gastroenteritis (AGE) of viral origin is considered a major cause of morbidity and mortality in children under 5 years old, and rotavirus, norovirus and astrovirus are indicated as the main viruses. This study aimed to verify the knowledge available to the doctors and nurses of neonatal and pediatric sectors of a referral maternity and child health hospital in Pará State, Brazil, about viruses related to the AGE, its mode of transmission, and main prevention and control. It was conducted a descriptive exploratory survey in 2011, using a questionnaire involving questions related to the profile of participants and about the proposed topic. After applying statistical test, a random selection of 60 participants was done. It was found that, during the presence of diarrhea, hand washing and the hydration therapy are already well established by professionals, as well as isolation of patients affected by AGE. It was found that most of the participants has knowledge about the rotavirus vaccine, the number of doses and age of application. Among the procedures to be performed in case of nosocomial outbreak, the collection of samples for etiological definition and the use of personal protection were the most mentioned procedures. Fecal-oral route and manipulation of fomites were most mentioned main sources of transmission of these viruses. Whereas AGE is a major cause of medical consultations, hospitalization and infant mortality, it is essential the awareness of health professionals about the easy transmission of these viruses to prevent their dissemination, contributing to morbidity reduction caused by these pathogens

Astrovírus infection in hospitalized children: molecular, clinical and epidemiological features

Ministério da Saúde. Secretaria de Vigilância em Saúde. Instituto Evandro Chagas. Ananindeua, PA, Brasil.Ministério da Saúde. Secretaria de Vigilância em Saúde. Instituto Evandro Chagas. Ananindeua, PA, Brasil.Ministério da Saúde. Secretaria de Vigilância em Saúde. Instituto Evandro Chagas. Programa de Pós-Graduação em Virologia. Ananindeua, PA, Brasil.Ministério da Saúde. Secretaria de Vigilância em Saúde. Instituto Evandro Chagas. Programa de Pós-Graduação em Virologia. Ananindeua, PA, Brasil.Ministério da Saúde. Secretaria de Vigilância em Saúde. Instituto Evandro Chagas. Ananindeua, PA, Brasil.Ministério da Saúde. Secretaria de Vigilância em Saúde. Instituto Evandro Chagas. Ananindeua, PA, Brasil.Ministério da Saúde. Secretaria de Vigilância em Saúde. Instituto Evandro Chagas. Ananindeua, PA, Brasil.Ministério da Saúde. Secretaria de Vigilância em Saúde. Instituto Evandro Chagas. Ananindeua, PA, Brasil.Background: Astrovirus (HAstV) is a common viral pathogen that causes gastroenteritis worldwide. It is classified into eight classical human types (HAstV-1/8) and seven other less prevalent types, described as HAstV VA1, VA2, VA3, VA4, MLB-1, MLB-2 and MLB-3. During outbreaks, the elderly and children are the most affected, and the spread of the virus is associated with person-to-person contact, food ingestion and contaminated water. Objectives: The aim of the present study was to investigate the prevalence of infection and genetic diversity of HAstV strains. Samples were collected from children with acute gastroenteritis admitted to a large pediatric hospital during a surveillance period of three years (2008–2011) in Belém city, Pará State, Amazon Region, Northern Brazil. Study design: Screening and genotyping tests were conducted using RT-PCR to detect the classical and non-classical HAstV types using specific primers. A semi-nested RT-PCR protocol was developed to improve viral detection in samples with a low viral load. Results: The overall positivity observed in this study was 3.9% (19/483). The age distribution showed a high prevalence of positive cases in children under one year old (5.3%). We found vomiting associated with 75% of the positive cases, fever with 82.3%, and dehydration with 76.9%. Most patients with positive cases demonstrated two to five days of diarrhea, two to three episodes of vomiting during hospitalization, and three bowel movements per day. Co-infection with HAstV and norovirus was observed in three cases (15.8%), and no pattern of seasonality or any relationship between the HAstV positivity rate and climate variables was observed. Eighteen positive samples (94.7%–18/19) were genotyped based on the ORF 2 region, and the greatest prevalence was of HAstV-1a (66.6%–12/18), followed by HAstV-2 (22.2%–4/18, comprising two type-2b and two type-2c genotypes), HAstV-3c (5.6%–1/18) and HAstV-4c (5.6%–1/18). No non-classical types were detected in the clinical samples analyzed. Conclusions: The present study showed that although HAstV infections occur at low frequency, they are involved in severe pediatric cases of acute gastroenteritis presenting with a high diversity of strains, including the lineages 3c and 4c, which were never before detected in Brazil

Group A rotavirus and norovirus display sharply distinct seasonal profiles in Belém, northern Brazil

Several viruses have been associated with acute gastroenteritis (AGE), and group A rotavirus (RVA) and nor-ovirus (NoV) are the most prevalent. This study aimed to assess their prevalence among children hospitalised for diarrhoea during a three-year surveillance study. From May 2008-April 2011, overall positivity rates of 21.6% (628/2904) and 35.4% (171/483) were observed for RVA and NoV, respectively. The seasonality observed indicated distinct patterns when both viruses were compared. This finding may explain why hospitalisation for AGE remains constant throughout the year. Continuous AGE monitoring is needed to better assess the patterns of infection

Norovirus infection in children admitted to hospital for acute gastroenteritis in Belém, Pará, Northern Brazil

Coordination of Improvement of Higher Education Personnel (CAPES) Evandro Chagas Institute, SVS, MSFederal University of Pará State. Tropical Medicine Center. Postgraduate Program in Tropical Diseases. Belém, PA, Brazil.Ministério da Saúde. Secretaria de Vigilância em Saúde. Instituto Evandro Chagas. Ananindeua, PA, Brasil.Federal University of Pará State. Institute of Health Sciences. Belém, PA, Brazil.University of the Pará State. Postgraduate Program in Parasite Biology in the Amazon, Center for Biological and Health Sciences. Belém, PA, Brazil.Ministério da Saúde. Secretaria de Vigilância em Saúde. Instituto Evandro Chagas. Ananindeua, PA, Brasil.Ministério da Saúde. Secretaria de Vigilância em Saúde. Instituto Evandro Chagas. Ananindeua, PA, Brasil.Federal University of Pará State. Tropical Medicine Center. Belém, PA, Brazil.Ministério da Saúde. Secretaria de Vigilância em Saúde. Instituto Evandro Chagas. Ananindeua, PA, Brasil.Ministério da Saúde. Secretaria de Vigilância em Saúde. Instituto Evandro Chagas. Ananindeua, PA, Brasil.Ministério da Saúde. Secretaria de Vigilância em Saúde. Instituto Evandro Chagas. Ananindeua, PA, Brasil.Noroviruses are the leading cause of epidemic, non-bacterial outbreaks of acute gastroenteritis, and are also a major cause of sporadic acute gastroenteritis in infants. The aim of the present study was to identify norovirus infections in children not infected by rotavirus admitted to hospital for acute gastroenteritis in Belém. A total of 348 fecal specimens were obtained from children with diarrhea aged less than 5 years, all of whom had tested negative for rotavirus, between May 2008 and April 2010. Fecal samples were screened for norovirus antigen using enzyme-immunoassay (EIA). Specimens were subjected to reverse-transcription polymerase chain reaction (RT-PCR) using the primers Mon432/434-Mon431/433 for detection of the GI and GII norovirus strains, respectively. Based on both methods, the overall norovirus positivity rate was 36.5% (127/348). Of the 169 samples collected in the first year, 44.4% (n = 75) tested positive for norovirus using both methods, 35.5% (n = 60) by EIA and 40.8% (n = 69) by RT-PCR. Using RT-PCR as a reference standard, a sensitivity of 78.3%, specificity of 94%, and agreement of 87.6% were recorded. Genome sequencing was obtained for 22 (31.9%) of the 69 positive samples, of which 90.9% (20/22) were genotype GII.4d and 9.1% (2/22) were genotype GII.b. Norovirus infection was most frequent in children under 2 years of age (41.5%-115/277). The peak incidence (62.1%) of norovirus-related acute gastroenteritis in these patients (not infected by rotavirus) was observed in February 2010. These findings emphasize the importance of norovirus as a cause of severe acute gastroenteritis among children in Belém, Pará, Northern Brazil

First record of rainbow shrimp, exotic species Mierspenaeopsis sculptilis (Heller, 1862), in the Brazilian coastal amazon, validated by DNA barcode

Abstract Background This is the first record of the alien shrimp Mierspenaeopsis sculptilis in Brazil. The invasion was detected within Marine Extractive Reserves based on eight specimens accidentally caught by local fishermen using trawlnets focused on fisheries of native species. These specimens were transported to the Laboratory of Applied Genetics and morphologically identified as Mierspenaeopsis sculptilis (rainbow shrimp). The taxonomic status of analyzed samples was confirmed by DNA barcoding using a 627-bp fragment of the Cytochrome C Oxidase Subunit I (COI) gene. Results A single haplotype was recovered from the eight specimens, being identical to a haplotype reported in India, where this species naturally occurs, and in Mozambique, where the rainbow shrimp is considered an invasive species. The present analyses indicated a putative invasive route (i.e., India-Mozambique-Brazil) mediated by shipping trade. Conclusions This study presents the first record of Mierspenaeopsis sculptilis in Brazil, in areas of extractive reserves on the Amazon coast. Notably exotic species can cause imbalance in the ecosystem, harming native species. In view of this, the registration of new invasions is essential as they contribute to the implementation of control plans

Group A rotavirus and norovirus display sharply distinct seasonal profiles in Belém, northern Brazil

Several viruses have been associated with acute gastroenteritis (AGE), and group A rotavirus (RVA) and nor-ovirus (NoV) are the most prevalent. This study aimed to assess their prevalence among children hospitalised for diarrhoea during a three-year surveillance study. From May 2008-April 2011, overall positivity rates of 21.6% (628/2904) and 35.4% (171/483) were observed for RVA and NoV, respectively. The seasonality observed indicated distinct patterns when both viruses were compared. This finding may explain why hospitalisation for AGE remains constant throughout the year. Continuous AGE monitoring is needed to better assess the patterns of infection