FIRST CASE OF AUTOCHTHONOUS HUMAN VISCERAL LEISHMANIASIS IN THE URBAN CENTER OF RIO DE JANEIRO: CASE REPORT

Visceral leishmaniasis is an anthropozoonosis that is caused by protozoa of the genus Leishmania, especially Leishmania (Leishmania) infantum, and is transmitted to humans by the bite of sandflies of the genus Lutzomyia, such as Lutzomyia longipalpis. There are many reservoirs, including Canis familiaris. It is a chronic infectious disease with systemic involvement that is characterized by three phases: the initial period, the state period and the final period. The main symptoms are fever, malnutrition, hepatosplenomegaly, and pancytopenia. This article reports a case of a patient diagnosed with visceral leishmaniasis in the final period following autochthonous transmission in the urban area of Rio de Janeiro. The case reported here is considered by the Municipal Civil Defense and Health Surveillance of Rio de Janeiro to be the first instance of autochthonous visceral leishmaniasis in humans in the urban area of this city. The patient was discharged and is undergoing a follow-up at the outpatient clinic, demonstrating clinical improvement

O perfil da violência contra crianças e adolescentes, segundo registros de Conselhos Tutelares: vítimas, agressores e manifestações de violência The profile of violence against children and adolescents according to Child Protection Council records: victims, aggressors and patterns of violence

OBJETIVO: estimar a prevalência das formas de violência contra crianças e adolescentes, registradas nos Conselhos Tutelares, e a associação dessas violências por faixas etárias das vítimas e vínculo com agressores, em 2003-2004. MÉTODO: foram coletados dados dos prontuários e calculadas as prevalências e associação entre variáveis, através da razão de prevalência (RP), com nível crítico de 5%. RESULTADOS: totalizaram 1.293 registros de violência, sendo 1.011 (78,1%) originados no domicílio. As violências mais freqüentes foram a negligência (727), por omissão de cuidados básicos (304) e abandono (259); a violência física (455), por espancamento (392), nas faixas de 2 a 13 anos; a violência psicológica (374), por amedrontamento (219); a violência sexual (68), por abuso (58), principalmente entre adolescentes. A principal forma de denúncia foi anônima, 398 (30,8%); os agressores para negligência foram os pais; para violência física, a madrasta e "outros agressores"; para violência sexual, o padrasto, "outros familiares/ agressores"; a violência psicológica foi prevalente entre todas categorias de agressores. CONCLUSÕES: Os resultados apontam para a necessidade de divulgação do "Disque Denúncia"; a formação de conselheiros, quanto ao registro adequado, assim como a implementação de políticas de prevenção da violência contra crianças e adolescentes.<br>OBJECTIVE: To estimate the prevalence of violence against children and adolescents through the records of Child Protection Councils, associating this violence with the age of the victims and their links with the aggressor. METHOD: Data were collected from the records and the prevalence rates were calculated through the Prevalence Ratio (PR), together with the associations among variables, with a critical level of 5%. RESULTS: Out of 1,293 records of violence, 1,011 (78.1%), originated in the home. The most frequent types of violence were: neglect (727), failure to provide basic care (304) and abandonment (259); physical violence (455), beatings (392) between 2 and 13 years old; psychological violence (374) through threats (219); sexual violence (68) through abuse (58), mainly among adolescents. Denunciations were mainly (398) anonymous (30.8%); the aggressors through neglect were the parents; through physical violence, the stepmother and "other aggressors"; through sexual violence, the stepfather and "other relatives / aggressors"; psychological violence was prevalent among all aggressor categories. CONCLUSIONS: The findings indicate the need to extend the Anti-Violence Hot-line facilities, training Council Members in terms of keeping proper records, and implementing policies designed to prevent violence against children and adolescents