DESCONSTRUINDO PRECONCEITOS, REDIFININDO CONCEITOS: TRABALHADORES DE SAÚDE EM ANGOLA

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Estudo da produção de Polihidroxibutirato por Herbaspirillum seropedicae SmR1 e seu mutante ntrC em diferentes fontes de carbono e relações carbono/nitrogênio

Orientador : Prof. Dr. Marcelo Müller dos SantosDissertação (mestrado) - Universidade Federal do Paraná, Setor de Ciências Biológicas, Programa de Pós-Graduação em Ciências : Bioquímica. Defesa: Curitiba, 25/08/2014Inclui referênciasResumo: Estudos com a finalidade de produzir bioplásticos, como polihidróxialcanoatos (PHA), têm crescido nas últimas décadas por ser uma alternativa sustentável para a produção de plásticos biodegradáveis e, portanto, uma alternativa ambientalmente viável para a substituição dos processos petroquímicos utilizados massivamente nos dias de hoje. Herbaspirillum seropedicae tem um grande potencial biotecnológico quanto à produção de PHA, sendo que essa capacidade já foi reportada sobdiferentes condições de cultivo. O objetivo principal do presente estudo foi avaliar a produção de PHB na estirpe parental H. seropedicae SmR1 e no seu mutante ntrC, defectivo na expressão de NtrC, um importante regulador do metabolismo de nitrogênio em diversas bactérias. A estratégia desenhada nos permitiu avaliar a produção em alta e baixa relação carbono/nitrogênio (C/N) utilizando NH4Cl como fonte de nitrogênio e monossacarídeos ou ácidos carboxílicos como fontes de carbono. Entre os ácidos carboxílicos avaliados, o citrato se mostrou o mais promissor, já que a produção de polihidroxibutirato atingida foi de 47,1% de PHB/psc para H. seropedicae SmR1 e 76% de PHB/psc para o mutante ntrC. Entre os monossacarídeos testados, a D-frutose se destacou como a melhor fonte de carbono deste grupo, atingindo produções de 30,5% e 65,8% de PHB para SmR1 e o mutante ntrC, respectivamente. Interessantemente, a fonte de carbono em que H. seropedicae teve o melhor desempenho quanto a produção de PHB foi o glicerol. As produções de PHB atingidas foram de 74,4% e 78% para H. seropedicae SmR1 e mutante ntrC, respectivamente. De modo geral, observou-se que independente da fonte de carbono utilizada, as maiores produções de PHB foram obtidas quando as concentrações de amônio no meio eram menores que 5mM/L, o que indica que altas relações C/N favorecem a síntese de PHB em H. seropedicae. O mutante ntrC demonstrou em todas as condições avaliadas produzir entre 20 a 100% mais PHB do que a estirpe parental SmR1. A complementação do mutante ntrC com uma cópia integra do gene ntrC de H. seropedicae SmR1 reverteu sua maior produção de PHB, retornando aos níveis da estirpe SmR1. Este resultado indica que a proteína NtrC está regulando o processo de síntese de PHB em H. seropedicae. As principais conclusões deste trabalho são: (i) a produção de PHB depende da natureza da fonte de carbono e provavelmente da sua via de metabolização e da produção de metabólitos como acetil-CoA e equivalentes reduzidos(NADPH e NADH); (ii), o mutante ntrC em todas as condições testadas apresentou maior produção de PHB, indicando que a ausência de NtrC pode afetar o balanço metabólico em H. seropedicae favorecendo a produção de PHA. Palavras chaves: Herbaspirillum seropedicae, Pohidroxibutirato (PHB), razão carbono/nitrogênio, sistema NTR, ntrC.Abstract: Studies aiming to produce bioplastics such as polyhydroxyalkanoates (PHA) has grown in recent decades to be a sustainable alternative for production of biodegradable plastics is therefore an environmentally feasible alternative to the substitution of petrochemical processes use in massively days today. Herbaspirillum seropedicae has great biotechnological potential for the production of PHA, and this ability has been reported under different culture conditions. The main objective of this study was to evaluate the production of PHB in the parental strain H. seropedicae SmR1 and its ntrC mutant, defective in the expression of NtrC, an important regulator of nitrogen metabolism in various bacteria. The strategy allowed us to evaluate the production in high and low carbon/nitrogen (C/N) using NH4Cl as a nitrogen source and monosaccharides or carboxylic acids as carbon sources compared. Among the tested monosaccharides, D-fructose emerged as the best source of carbon this group, reaching yields of 30.5% and 65.8% PHB for SMR1 and ntrC, respectively. Interestingly, the carbon source that seropedicae H. had the best performance as PHB production was glycerol. The PHB production was achieved of 74.4% and 78% for H. seropedicae SMR1 and mutant ntrC, respectively. In general, it was observed that independent of the carbon source used, the highest production of PHB were obtained when the concentration of ammonia in the medium were lower than 5mM / L, indicating that high C/N ratios favoring the synthesis of PHB H. seropedicae. The ntrC mutant demonstrated in all conditions evaluated to produce between 20 and 100% higher than PHB SMR1 parental strain. The complementation of mutant ntrC integrates with a copy of the ntrC gene of H. seropedicae SmR1 reversed its largest production of PHB, returning to levels of strain SmR1. The complementation of mutant ntrC integrates with the copy of the ntrC gene of H. seropedicae SmR1 reversed its largest production of PHB, returning to levels of strain SmR1. This result indicates that indeed the NtrC protein is regulating the process of synthesis of PHB in H. seropedicae. The main conclusions are: (i) the production of PHB depends on the nature of the carbon source and probably its route of metabolism and the production of metabolites such as acetyl-CoA and reduced equivalnetes (NADPH and NADH); (ii) the ntrC mutant under all conditions tested showed higher production of PHB, indicating that the absence of NtrC can affect the metabolic balance in H. seropedicae favoring the production of PHA. Key words: Herbaspirillum seropedicae, Pohidroxibutirato (PHB), carbon/nitrogen ratio, NTR system, ntrC. XII

Prevalence and risk factors of SARS-CoV-2 infection among parturients and newborns from Luanda, Angola

SARS-CoV-2 emerged in China in December 2019, creating a massive public health concern. Although previous studies have identified SARS-CoV-2 in pregnant women, the possibility of transmission to newborns remains uncertain. Herein, we investigated SARS-CoV-2 infection and risk factors among parturients and newborns. This was a cross-sectional study carried out with 3633 parturients from Luanda, Angola, between January and April 2021, with an age ranging from 13 to 48 years. SARS-CoV-2 infection of the parturients was further confirmed with RT-PCR after COVID-19 Ag Rapid Testing. About 0.4% of parturients tested positive on the day of delivery. Surprisingly, parturients from urbanized areas (OR: 0.18, p = 0.025) had a low chance of infection. None of the newborns tested positive in the first 24 h after birth, while one (9.1%, 1/10) of the newborns tested positive with pharyngeal swabs seven days after birth. However, whether the case was due to vertical transmission from mother to child remains to be confirmed. The mother’s residence, education level, antenatal follow-up, and delivery category were related to SARS-CoV-2 transmission (p < 0.05). Our findings showed a relatively low SARS-CoV-2 infection from parturients to newborns, regardless of the severity of the maternal disease. Furthermore, these findings are an early assessment of COVID-19 cases in late pregnancy, which could indicate the need for intensive management of SARS-CoV-2 infection among parturients in Angola. Further studies are needed on the consequences of SARS-CoV-2 among pregnant women and neonates from Angola.info:eu-repo/semantics/publishedVersio

The impact of the ABO/Rh blood group on susceptibility and severity among COVID-19 patients in Luanda, Angola

SARS-CoV-2 is a public health concern worldwide. Identification of biological factors that could influence transmission and worsen the disease has been the subject of extensive investigation. Herein, we investigate the impact of the ABO/Rh blood group on susceptibility and severity among COVID-19 patients in Luanda, Angola. This was a multicentric cohort study conducted with 101 COVID-19 patients. Chi-square and logistic regression were calculated to check factors related to the worsening of the disease and deemed significant when p<0.05. Blood type O (51.5%) and Rh-positive (93.1%) were the most frequent. Patients from blood type O had a high risk to severe disease [OR: 1.33 (95% CI: 0.42 - 4.18), p=0.630] and hospitalization [OR: 2.59 (95% CI: 0.84 - 8.00), p=0.099]. Also, Rh-positive blood type presented a high risk for severe disease (OR: 10.6, p=0.007) and hospitalization (OR: 6.04, p=0.026). We find a high susceptibility, severity, hospitalization, and mortality, respectively, among blood group O and Rh-positive patients, while blood group AB presented a low susceptibility, severity, hospitalization, and mortality, respectively. Our findings add to the body of evidence suggesting that ABO/Rh blood groups play an important role in the course of SARS-CoV-2 infection.info:eu-repo/semantics/publishedVersio

Clinical features related to severity and mortality among COVID-19 patients in a pre-vaccine period in Luanda, Angola

Background: Infection due to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is associated with clinical features of diverse severity. Few studies investigated the severity and mortality predictors of coronavirus disease 2019 (COVID-19) in Africa. Herein, we investigated the clinical features of severity and mortality among COVID-19 patients in Luanda, Angola. Methods: This multicenter cohort study involved 101 COVID-19 patients, between December 2020 and April 2021, with clinical and laboratory data collected. Analysis was done using independent-sample t-tests and Chi-square tests. The results were deemed significant when p < 0.05. Results: The mean age of patients was 51 years (ranging from 18 to 80 years) and 60.4% were male. Fever (46%), cough (47%), gastrointestinal symptoms (26.7%), and asthenia (26.7%), were the most common symptoms. About 64.4% of the patients presented coexistent disorders, including hypertension (42%), diabetes (17%), and chronic renal diseases (6%). About 23% were non-severe, 77% were severe, and 10% died during hospitalization. Variations in the concentration of neutrophil, urea, creatinine, c-reactive protein, sodium, creatine kinase, and chloride were independently associated with severity and/or mortality (p < 0.05). Conclusion: Several factors contributed to the severity and mortality among COVID-19 patients in Angola. Further studies related to clinical features should be carried out to help clinical decision-making and follow-up of COVID-19 patients in Angola.info:eu-repo/semantics/publishedVersio

Evaluation of blood cell count parameters as predictors of treatment failure of malaria in Angola: An observational study

Background- Despite the guidelines provided by the World Health Organization for the treatment of malaria, treatment failure occurs in many hospitalized patients. Objective- Evaluate whether blood cell count parameters may serve as predictors for malaria treatment. Methodology- A cross-sectional study with a quantitative approach. Results- Of the 219 patients, 21.5% showed failure to antimalarial treatment, Patient with 21 and 40 years (72.6%), male (53.4%), from peri-urban area (47.5%), with high parasitemia (59.8%), treated with Arthemeter (90.9%) and the mortality were 5.9%. Significant associations were observed between occupation, level of parasitemia and outcome with resistance to antimalarial treatment (p<0.05). Patients with normal Hb [OR: 0.75 (95% CI: 0.39–1.44), p = 0.393], RBC [OR: 0.83 (95% CI: 0.40–1.72), p = 0.632], RDW [OR: 0.54 (95% CI: 0.27–1.09), p = 0.088], MCV [OR: 0.61 (95% CI: 0.28–1.31), p = 0.204] were less likely to have malaria treatment failures after artemisinin-based therapy failure. In contrast, those with normal values of segmented neutrophils [OR: 0.32 (95% CI: 0.11–0.96), p = 0.042] and lymphocyte counts [OR: 0.24 (95% CI: 0.05–1.04), p = 0.055]. We also found that patients with significant low levels of Hct [OR: 0.31 (95% CI: 0.15–0.64) p = 0.002], and high leukocytes [OR: 8.88 (95% CI: 2.02–37.2), p = 0.004] and normal platelet values [OR: 1.42 (95% CI: 0.73–2.95), p = 0.280] demonstrated high probability of treatment failure. Conclusion- The importance of blood cell count parameters in monitoring malaria therapy necessitates the urgent need to re-evaluate Artemether-based therapy. Future studies involving more participants in different settings are needed to provide further evidence

Community Pharmacy Services in Malanje City, Angola: A Survey of Practices, Facilities, Equipment, and Staff

A community pharmacy, also known as a retail pharmacy, is the most common type of pharmacy that allows the public access to their medications and advice about their health. The conditions existing in the community pharmacy, as well as the qualification of the staff who work there, are fundamental for the compliance of good pharmacy practices. Objective: To assess the practices, facilities, equipment, and personnel of community pharmacies in the Municipality of Malanje. Methods: A cross-sectional observational study with a quantitative and qualitative approach. Through a simple random sampling technique, 20 pharmacies were selected from a universe of 73 reported by official authorities. Results: no pharmacist was acting in the local pharmacies, and their activity was supported by other professionals, particularly intermediate nursing technicians (57%). Most pharmacies were in the peri-urban area, and their functional areas, equipment, and utilities were not in accordance with Angolan law. In addition, the distribution of some drugs that are not over-the-counter was observed. Conclusion: community pharmacies in Malanje develop their activity in disregard of the law, constituting a considerable weakness that affects the observance of pharmacy service standards

A retrospective study

Funding Information: Thanks to the research team of INIS/CISA (Joana Sebastião, Joltim Quivinja, Joana Paixão, António Mateus, and Zinga David), Instituto Nacional de Sangue (Eunice Manico, Alberto Sozinho, and Deodete Machado), and Clínica Girassol (Alice Teixeira, Domingos Alfredo, and Ngueza Loureiro) for the data collection, technical/administrative support, and testing. Publisher Copyright: © 2023 The Authors. Health Science Reports published by Wiley Periodicals LLC.Background and Aims: Hypertension is a public health concern, mainly in resource-limited countries. We investigated the characteristics and risk factors related to high blood pressure in healthy blood donors from, Luanda, the capital city of Angola. Methods: This was a retrospective study that included 343 healthy donors from December 2019 to September 2020. Results: The mean age was 32 ± 9 years. Men represented 93% of the population. Mean systolic blood pressure (SBP) was 131 ± 12.3 mmHg (ranging from 100 to 160 mmHg) and diastolic blood pressure (DBP) was 80.1 ± 9.72 mmHg (from 56.0 to 100 mmHg). DBP was related to age and gender (p 140/90 mmHg). Age between 20 and 40 years (odds ratio [OR]: 2.52, p = 0.043), women (OR: 1.87, p = 0.548), nonurbanized areas (OR: 0.39, p = 0.067), high educational level (OR: 0.76, p = 0.637), employed (OR: 0.49, p = 0.491), voluntary donors (OR: 0.87, p = 0.799), blood group B (OR: 2.06, p = 0.346), and Rh- (OR: 0.26, p = 0.104), were potentially related with high-pressure. The high-pressure cases increased from December 2019 (4%) to September 2020 (28%) (p = 0.019). Conclusion: We showed high pressure among the healthy blood donors population. Demographic characteristics, ABO/Rh blood group, and year period are features that should be considered in cardiovascular disease control strategies. Biological and nonbiological features related to blood pressure changes should be considered for further studies in the Angolan population.publishersversionpublishe

Early Evidence of Circulating SARS-CoV-2 in Unvaccinated and Vaccinated Measles Patients, September 2019–February 2020

Funding Information: This study was funded as a donation from the Ministry of Health, Angola. Publisher Copyright: © 2022 Paixao et al.Background: The global emergence of coronavirus disease 2019 (COVID-19) has challenged healthcare and rapidly spread over the globe. Early detection of new infections is crucial in the control of emerging diseases. Evidence of early recorded COVID-19 cases outside China has been documented in various countries. In this study, we aimed to identify the time of SARS-CoV-2 infection circulation by retrospectively analyzing sera of measles patients, weeks before the reported first COVID-19 cases in Angola. Materials and Methods: We examined the humoral response against SARS-CoV-2 by using an enzyme-linked immunosorbent assay (ELISA)-based assay on a combined two-step sandwich enzyme immunoassay method. In total, we received 568 study patients with blood specimens collected from 23 September 2019 to 28 February 2020, 442 sera samples that met the criteria of the study were withdrawn and selected from the overall 568 received samples. In this study, we considered seropositives, patients who tested positive for SARS-CoV-2 immunoglobulin G (IgG) and M (IgM) antibodies with the index value >1. Results: Of the 442 sera samples that met the criteria of the study, 204 were measles seropositive. Forty out of 204 were confirmed reactive to SARS-CoV-2 viral proteins using IgG and IgM more than 2 weeks before the first reported case in Angola. The humoral response analysis showed significant differences (p = 0.01) between the IgG and IgM indexes in the unvaccinated measles patients. Similarly, a significant difference (p = 0.001) was seen between the IgG and IgM indexes in the vaccinated measles patients. Conclusion: Here, using the humoral response analysis, we report the identification of early circulation SARS-CoV-2 infection weeks before the first recognized cases in the Republic of Angola.publishersversionpublishe

Fatores associados ao baixo apgar em recém-nascidos angolanos

Objetivo: avaliar os fatores associados ao baixo Apgar em recém-nascidos de Angola. Método: estudo analítico e transversal, quali-quantitativo, em um Hospital Geral de Luanda, Angola, entre março e maio de 2021. Realizou-se entrevistas em sala de observação e consulta aos prontuários das parturientes. Os dados foram analisados pelo teste qui-quadrado (X2) e regressão logística. Resultados: prevaleceu parturientes entre 19-35 anos (70,0%), 7º-9º ano (57,5%), multíparas (75%), multigestas (75,0%), sem histórico de aborto (72,5%), idade gestacional de 40 semanas (60,0%), usuárias de bebidas alcoólicas (77,5%), baixa frequência de consultas pré-natais (52,5%), com parto natural (82,5%) e recém-nascidos com peso normal (52,5%). Mulheres de região periurbana [OR:6,85 (95% CI:0.65-71,2), p=0,108] e rural [OR:4,47 (95% CI:0.47-48,4), p=0,184] apresentaram maior chance de terem recém-nascidos com baixo Apgar, assim como as usuárias de álcool [OR:3,28 (95% CI:0,58-18,3), p=0,176] e recém-nascidos que nasceram com peso normal [OR:1,75 (95% CI:0,49–6,22), p=0,387]. Não houve associação estatística entre os dados sociodemográficos e maternos. Conclusão: a faixa etária, local de residência, consumo de álcool materno e peso do recém-nascido podem implicar em baixo Apgar