Prevalence of chronic noncommunicable diseases and their associated factors in adults over 39 years in riverside population in the western brazilian amazon region

The prevalence of Chronic Noncommunicable Disease (CND) are rocketting over the world, including in young adults. The WHO estimates that more than half of the deaths in the world are caused by CND. A cross-sectional study was carried out from  june to november 2016. The researchers visited 16 communities, with a sample size of 183 adult individuals performed for convenience. The patients went through  screening and verified: weight, height, abdominal circumference, blood pressure, clinical-epidemiological history and performed physical and laboratory examination. Prevalence ratios were calculated with confidence intervals of 95% and with statistical significance with p<0.05. This study aims to estimate the prevalence of  CND and its associated factors in the elderly riverside population of the Rio Madeira in Humaitá, Amazonas State, Western Brazilian Amazon. The prevalence of systemic arterial hypertension (SAH) was 44.7%, 52.6% in female. Of the individuals with SAH, 77.5% did not use medication. About 51.5% of them had Grade I SAH. The prevalence of type 2 diabetes mellitus  was 16.4%, where no patient used medication and about 40.4% of the studied population fits in the glucose intolerance range. Metabolic syndrome presented a prevalence of 24.0%, with a higher frequency in females (33.8%) (p=0.007). Concerning chronic kidney disease, a prevalence of 12.1% was observed in both genders. The associated factors found were alcoholism, smoking, sedentary lifestyle and obesity, and more than 45% of the patients had at least two associated factors. The population  had a high prevalence of  CND and associated factors, low frequency of medication use, revealing inefficiency of the local health system. Increased coverage of the Governmental Family Health Strategy (GFHS) and the increase in number of trained Community Health Assistants , together with health education actions can increase the population’s health standard.O objetivo do estudo é estimar a prevalência de doença crônica não transmissível (DCNT) e seus fatores de risco em população ribeirinha do rio Madeira em Humaitá, Amazonas. Utilizou-se método observacional de estudo de prevalência. Foram visitadas 16 comunidades, com tamanho amostral de 183 indivíduos adultos, amostra realizada por conveniência, onde passaram por uma triagem e verificados: peso, altura, circunferência abdominal, pressão arterial, história clínico-epidemiológica e realizados o exame físico e laboratoriais. As análises de prevalência e as razões de prevalência foram calculadas com intervalos de confiança com significância estatística de 95% e p<0,05. A prevalência de hipertensão arterial sistêmica (HAS) foi de 44,7%, destes, 52,6% do gênero feminino. Dos indivíduos hipertensos, 77,5% não usavam medicação. Cerca 51,5% dos hipertensos tem HAS Grau I. A prevalência de diabetes mellitus tipo 2, foi de 16,4%, onde nenhum paciente utilizava medicação e cerca de 40,4% da população estudada se encaixa na faixa de intolerância à glicose. Síndrome metabólica apresentou prevalência de 24,0%, maior frequência no gênero feminino (33,8%) (p=0,007). Em relação à disfunção renal, observou-se uma prevalência de 12,1%, nos dois gêneros. Os fatores de risco encontrados foram alcoolismo, tabagismo e obesidade, e mais de 45% apresentou ao menos dois fatores de risco. A população possui elevadas prevalências de DCNT e fatores de risco, baixa frequência de uso de medicamentos, revelando ineficiência do sistema de saúde local. Aumento da cobertura da Estratégia Saúde da Família, aliada a ações de educação em saúde podem incrementar o padrão de saúde da população

Capillariaisis (Trichurida, Trichinellidae, Capillaria hepatica) in the Brazilian Amazon: low pathogenicity, low infectivity and a novel mode of transmission

<p>Abstract</p> <p>Background</p> <p>Human capillariasis caused by <it>Capillaria hepatica (syn. Calodium hepaticum) </it>is a rare disease with no more than 40 cases registered around the world. Classically, the disease has severe symptoms that mimic acute hepatitis. Natural reservoirs of <it>C. hepatica </it>are urban rodents (<it>Mus musculus </it>and <it>Rattus novergicus</it>) that harbor their eggs in the liver. After examining the feces of 6 riverine inhabitants (Rio Preto area, 8° 03'S and 62° 53' W to 8° 14'S and 62° 52'W) of the State of Rondonia, Brazil, and identifying <it>C. hepatica </it>eggs in their feces, the authors decided to investigate the real dimension of these findings by looking for two positive signals.</p> <p>Methods</p> <p>Between June 1^stand 15^th, 2008, 246 out of 304 individuals were clinically examined. Blood samples were collected, kept under -20°C, and test by the indirect immunofluorescence technique.</p> <p>Results</p> <p>The first positive signal was the presence of specific antibodies at 1:150 dilution, which indicates that the person is likely to have been exposed to eggs, most likely non-infective eggs, passing through the food chain or via contaminated food (total prevalence of 34.1%). A second more specific signal was the presence of antibodies at higher titers, thus indicating true infection.</p> <p>Conclusions</p> <p>The authors concluded that only two subjects were really infected (prevalence of 0.81%); the rest was false-positives that were sensitized after consuming non-embryonated eggs. The present study is the first one carried out in a native Amazonian population and indicates the presence of antibodies against <it>C. hepatica </it>in this population. The results further suggest that the transmission of the parasite occurs by the ingestion of embryonated eggs from human feces and/or carcasses of wild animals. The authors propose a novel mode of transmission, describing the disease as a low pathogenic one, and showing low infectivity.</p

Verme subconjuntival da espécie Loa loa: primeiro caso no Brasil

We report the first case of ocular infestation by Loa loa in Brazil. Loiasis is caused by infestation with Loa loa, a filarial parasite originally found in the rainforests of western and central Africa. It is transmitted by the bite of the fly Chrysops and has been recently described in other places other than Africa, in African immigrants or travellers. Our case is a 33 year-old woman from Cameroon who was living in São Paulo, Brazil, for 5 years. She was asymptomatic until one morning she started feeling something moving in the left eye. Under topical anesthesia, on the slit lamp, a moving worm was removed from the subconjunctival space, which later was confirmed to be a male Loa loa adult specimen. Blood tests revealed microfilaraemia of 129 mf/mL. The patient was treated with 400 mg oral albendazole for 3 weeks and 60 mg prednisone. This report illustrates an unusual ocular disease, which is extremely rare outside of Africa, but easily diagnosed and treated. Ophthalmologists should be aware of it, in face of an increasingly globalized world.Este é o primeiro relato na literatura nacional e internacional de infestação ocular por Loa loa no Brasil. A loíase é uma filariose causada pelo parasita Loa loa, encontrado nas florestas tropicais da África equatorial. A transmissão se dá pela picada do mosquito Chrysops e casos têm sido descritos em países não africanos, em imigrantes e viajantes. O presente caso trata-se de uma paciente de 33 anos natural de Camarões e residente em São Paulo, Brasil, há 5 anos. Até então assintomática, uma manhã sentiu algo se mexendo em seu olho esquerdo. Sob anestesia tópica, na lâmpada de fenda, um verme altamente móvel foi removido do espaço subconjuntival e enviado para identificação, que confirmou tratar-se de um espécime macho adulto de Loa loa. Testes sanguíneos revelaram microfilaremia de 129 mf/mL. A paciente foi tratada com albendazol 400 mg e prednisona 60 mg esquema regressivo por 3 semanas. Este relato ilustra uma doença excepcionalmente rara no Brasil, e praticamente desconhecida dos oftalmologistas em nosso país.Universidade Federal de São Paulo (UNIFESP) Department of OphthalmologyFaculdade São Lucas Department of MedicineUniversidade de São Paulo Biomedical Science Institute 5UNIFESP, Department of OphthalmologySciEL

Alta ocorrência de Entamoeba histolytica nos municípios de Ariquemes e Monte Negro, estado de Rondônia, Amazônia Ocidental, Brasil

Introdução: Infecções por Entamoeba histolytica foram investigadas em moradores dos municípios de Ariquemes e Monte Negro, Rondônia, Brasil. Métodos: Amostras de fezes de 216 indivíduos foram processadas por microscopia óptica para detecção de cistos do complexo E. histolytica/E. dispar, seguido pelo método de imunoensaio utilizando kit de ensaio imunoenzimático para detecção específica de antígeno de E. histolytica. Resultados: Cistos de E. histolytica/E. dispar estavam presentes em 61% e 44% das amostras de Ariquemes e Monte Negro, respectivamente com diferença significativa na ocorrência da infecção entre as duas populações [p < 0,05; χ2 = 5,2; Odds relativa = 2,0 (1,1 - 3,6)]. A taxa de detecção de antígenos de E. histolytica nas amostras provenientes de Ariquemes foi de 36,6% e de 19,41% nas amostras de Monte Negro, sendo a ocorrência de amebíase significativamente maior na população de Ariquemes [p < 0,05; χ2 = 7,8; Odds relativa = 2,4 (1,2 - 4,7)]. Discussão: A elevada frequência da infecção por E. histolytica em residentes na região, bem como a indisponibilidade de avaliação clínica por testes específicos para distinção entre as duas espécies de Entamoeba, deve promover uma reflexão sobre o tratamento de infecções pelo complexo E. histolytica/E. dispar. Conclusão: Nas populações avaliadas foram detectadas elevadas ocorrências de E. histolytica.Introduction: Entamoeba histolytica infections were investigated in residents of the Ariquemes and Monte Negro municipalities in Rondônia State, Brazil. Methods: Stool samples of 216 individuals were processed by the spontaneous sedimentation method and analyzed by microscopy for detection of the E. histolytica/E. dispar complex, followed by the immunoassay method using an enzyme-linked immunosorbent assay-based kit for the E. histolytica stool antigen. Results: E. histolytica/E. dispar cysts were present in 61% (50/82) and 44% (59/134) of the samples from Ariquemes and Monte Negro respectively, with a significant difference in the occurrence of infection between the two populations [p < 0.05; χ2 = 5.2; odds ratio = 2.0 (1.1 - 3.6)]. The E. histolytica antigen detection rate was 36.6% (30/82) for stool samples from Ariquemes, and 19.4% (26/134) for stool taken from the residents of Monte Negro. The rate of the occurrence of amoebiasis was significantly higher in the population from Ariquemes [p < 0.05; χ2 = 7.8; odds ratio = 2.4 (1.2 - 4.7)]. Discussion: Due to the high occurrence of E. histolytica infected residents diagnosed in the region and the unavailability in local clinics of a test to distinguish between the two Entamoeba species, physicians should consider treating E. histolytica/E.dispar infections. Conclusion: The results indicate that E. histolytica infection is highly endemic in the studied areas

Adequação da técnica da PCR para diagnóstico de infecção de Mansonella ozzardi

Introduction: Mansonelliasis is caused by Mansonella ozzardi. It is widespread in the Amazon region, with a high prevalence. Te common exam of thick blood smears stained with Giemsa shows low efficacy levels and has been an obstacle to diagnosing individuals with low blood parasitemia. Methods: In order to increase diagnosis efcacy, the PCR technique was improved. Results and Conclusions: PCR demonstrated the best performance, with sensitivity and negative predictive values (NPV) of 100%, followed by blood fltration through membrane filters, which showed a sensitivity of 88.9% and a NPV of 84.6%, when compared to thick blood smears

High occurence of Entamoeba histolytica in the municipalities of Ariquemes and Monte Negro, state of Rondônia, Western Amazonia, Brazil

Introduction: Entamoeba histolytica infections were investigated in residents of the Ariquemes and Monte Negro municipalities in Rondônia State, Brazil. Methods: Stool samples of 216 individuals were processed by the spontaneous sedimentation method and analyzed by microscopy for detection of the E. histolytica/E. dispar complex, followed by the immunoassay method using an enzyme-linked immunosorbent assay-based kit for the E. histolytica stool antigen. Results: E. histolytica/E. dispar cysts were present in 61% (50/82) and 44% (59/134) of the samples from Ariquemes and Monte Negro respectively, with a significant difference in the occurrence of infection between the two populations [p < 0.05; χ2 = 5.2; odds ratio = 2.0 (1.1 - 3.6)]. The E. histolytica antigen detection rate was 36.6% (30/82) for stool samples from Ariquemes, and 19.4% (26/134) for stool taken from the residents of Monte Negro. The rate of the occurrence of amoebiasis was significantly higher in the population from Ariquemes [p < 0.05; χ2= 7.8; odds ratio = 2.4 (1.2 - 4.7)]. Discussion: Due to the high occurrence of E. histolytica infected residents diagnosed in the region and the unavailability in local clinics of a test to distinguish between the two Entamoeba species, physicians should consider treating E. histolytica/E.dispar infections. Conclusion: The results indicate that E. histolytica infection is highly endemic in the studied areas.Instituto Nacional de Genética Médica Populacional (INAGEMP)Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq

Survey of trypanosoma (Kinetoplastida: Trypanosomatidae) infection in monte negro municipality, state of rondônia, western amazon, with first record of t. evansi in the state

Introduction: Trypanosomes can infect humans and animals. This is the first record of the occurrence of Trypanosoma evansi in Rondônia. Methods: Blood samples were collected from 7 dogs and 22 humans. Furthermore, triatomines and tabanids were collected. Results: It was observed that 42.8% of the dogs tested positive for T. evansi and 14.3% presented mixed infection; 15% of the triatomines tested positive for flagellates identified as T. cruzi TCI (3 specimens), T. cruzi TCI, and T. rangeli (1 specimen), and one with T. cruzi TCV. Two tabanids were infected with T. theileri. Conclusions: These findings may benefit vector control strategies. © 2019, Sociedade Brasileira de Medicina Tropical. All rights reserved

Survey of Bancroftian filariasis infection in humans and Culex mosquitoes in the western Brazilian Amazon region: implications for transmission and control

Introduction: The aim of this work was to identify possible lymphatic filariasis foci in the western Brazilian Amazonian that could be established from the reports of Rachou in the 1950s. The study was conducted in three cities of the western Brazilian Amazon region - Porto Velho and Guajará-Mirim (State of Rondônia) and Humaitá (State of Amazonas). Methods: For human infection evaluation thick blood smear stained with Giemsa was used to analyze samples collected from 10pm to 1am. Polymerase chain reaction (PCR) was used to examine mosquito vectors for the presence of Wuchereria bancrofti DNA. Humans were randomly sampled from night schools students and from inhabitants in neighborhoods lacking sanitation. Mosquitoes were collected from residences only. Results: A total 2,709 night students enrolled in the Program for Education of Young Adults (EJA), and 935 people registered in the residences near the schools were examined, being 641 from Porto Velho, 214 from Guajará-Mirim and 80 from Humaitá. No individual examined was positive for the presence of microfilariae in the blood stream. A total of 7,860 female Culex quinquefasciatus specimens examined were negative by PCR. Conclusions: This survey including human and mosquito examinations indicates that the western Amazon region of Brazil is not a focus of Bancroftian filariasis infection or transmission. Therefore, there is no need to be included in the Brazilian lymphatic filariasis control program.Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP) Proj no. 2007/00848-