Trend of morbidity and mortality indicators due to acute diarrheal disease in children under five years old in the State of Piauí (2000–2019)

Abstract Objectives: to analyze the trend of morbidity and mortality indicators due to acute diarrheal diseases in children under five years old in Piauí. Methods: ecological study with data from the Information Technology Department at the Public Health System. The indicators of hospitalization rate and coefficient of mortality from the disease between 2000 and 2019 were calculated. A descriptive analysis of the indicators was carried out in the studied period and by the macro-regions in the State. For trend analysis, the simple linear regression model with log-transformation was used. Trends were classified as increasing, decreasing and stable, with a significance level of 5%. Results: the average on hospitalization rate was higher in the semi-arid macro-region (36.6/1000 children under five years old) and lower in Teresina (14.9/1000 children under five years old). The mean mortality coefficients were higher in the coastal macro-region (0.98/1000 live births) and lower in Teresina (0.47/1000 live births). The indicators showed a downward trend in all analyzed locations (p<0.05). A turning point was noted from 2009, with a significant reduction in hospitalization rates in the savanna and semi-arid macro-regions. Conclusion: indicators of morbidity and mortality due to acute diarrheal diseases in children under five years old showed a downward trend in Piauí between 2000 and 2019, with differences in trends between the evaluated macro-regions

Focal persistence of soil-transmitted helminthiases in impoverished areas in the State of Piaui, Northeastern Brazil

This study aims to describe the prevalence, distribution, and factors associated with soil-transmitted helminthiases (STHs) in rural localities in Piaui, Brazil. Two cross-sectional surveys (n=605 subjects; 172 families) were carried out in order to obtain socio-demographic, anthropometric, spatial and parasitological data. Parasites were evaluated using Kato-Katz and centrifugal sedimentation techniques. Eggs were measured to assess infection with zoonotic Strongylida parasites. Kernel maps were constructed with Q-GIS. The prevalence of hookworm infection was 12.4% (75/605). Other helminthes found were Trichuris trichiura (n=1; 0.2%) and Hymenolepis nana (n=1; 0.2%). The hookworm positivity rate was significantly lower among subjects who had used albendazole when compared with individuals who had not used anthelmintics or had used antiprotozoal drugs in the last 6 months (8/134 [6.0%] vs. 59/415 [14.2%]; p=0.009). A total of 39/172 (22.7%) families had at least one infected member. The association between the number of dwellers and hookworm positivity in the family was present in a logistic regression multivariate model. Assessment of worm burdens showed 92.2% light, 6.2% moderate, and 1.6% heavy infections. Hookworm eggs (n=34) measured 57.2 - 75.4 µm in length and 36.4 - 44.2 µm in width (mean ± SD = 65.86 ± 4.66 µm L and 40.05 ± 1.99 µm W), commensurate with human hookworms. Hotspots suggest that transmission has a focal pattern. STHs persist in impoverished rural areas in Northeastern Brazil where currently available control strategies (mass drug administration) apparently do not allow the elimination of the infection

Lower Richness of Small Wild Mammal Species and Chagas Disease Risk

A new epidemiological scenario involving the oral transmission of Chagas disease, mainly in the Amazon basin, requires innovative control measures. Geospatial analyses of the Trypanosoma cruzi transmission cycle in the wild mammals have been scarce. We applied interpolation and map algebra methods to evaluate mammalian fauna variables related to small wild mammals and the T. cruzi infection pattern in dogs to identify hotspot areas of transmission. We also evaluated the use of dogs as sentinels of epidemiological risk of Chagas disease. Dogs (n = 649) were examined by two parasitological and three distinct serological assays. kDNA amplification was performed in patent infections, although the infection was mainly sub-patent in dogs. The distribution of T. cruzi infection in dogs was not homogeneous, ranging from 11–89% in different localities. The interpolation method and map algebra were employed to test the associations between the lower richness in mammal species and the risk of exposure of dogs to T. cruzi infection. Geospatial analysis indicated that the reduction of the mammal fauna (richness and abundance) was associated with higher parasitemia in small wild mammals and higher exposure of dogs to infection. A Generalized Linear Model (GLM) demonstrated that species richness and positive hemocultures in wild mammals were associated with T. cruzi infection in dogs. Domestic canine infection rates differed significantly between areas with and without Chagas disease outbreaks (Chi-squared test). Geospatial analysis by interpolation and map algebra methods proved to be a powerful tool in the evaluation of areas of T. cruzi transmission. Dog infection was shown to not only be an efficient indicator of reduction of wild mammalian fauna richness but to also act as a signal for the presence of small wild mammals with high parasitemia. The lower richness of small mammal species is discussed as a risk factor for the re-emergence of Chagas disease

Diagnóstico diferencial entre a febre maculosa brasileira e ao dengue no contexto das doenças febris agudas

Made available in DSpace on 2015-05-22T18:42:44Z (GMT). No. of bitstreams: 2 license.txt: 1914 bytes, checksum: 7d48279ffeed55da8dfe2f8e81f3b81f (MD5) kerla_monteiroetal_IOC_2014.pdf: 197743 bytes, checksum: ddef232eccc9959186c8dcd244947564 (MD5) Previous issue date: 2014Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Laboratório de Hantaviroses e Rickettioses. Rio de Janeiro, RJ, Brasil.Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Laboratório de Hantaviroses e Rickettioses. Rio de Janeiro, RJ, Brasil.Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Laboratório de Hantaviroses e Rickettioses. Rio de Janeiro, RJ, Brasil.Doenças febris agudas são comuns e frequentemente associadas com agentes infecciosos em países tropicais como o Brasil. Com manifestações clínicas inespecíficas de difícil diferenciação de uma série de doenças endêmicas como dengue, leptospirose e outras doenças graves, a febre maculosa brasileira raramente tem sido considerada no diagnóstico. Este fato tem retardado o tratamento antimicrobiano específico e, por isso, determinado a elevada letalidade frequentemente observada no País. Neste artigo, discute-se a dificuldade do diagnóstico diferencial entre a febre maculosa brasileira e o dengue, uma das doenças infecciosas mais importantes e frequentes no Brasil e causadora de epidemias relatadas periodicamente, visto que a possibilidade de erros no diagnóstico em virtude da semelhança clínica é uma realidade.Acute febrile diseases are common and often associated with infectious agents in tropical countries such as Brazil. As it has nonspecific clinical manifestations and is hard to differentiate from a number of endemic diseases such as dengue, leptospirosis, and other fatal diseases, Brazilian spotted fever (FMB) has rarely been considered in diagnosis, a fact that has lead to a consequent delay in the specific antimicrobial treatment, and has determined the high lethality often observed in this country. In this article the authors discuss the difficulty of the differential diagnosis of FMB and dengue, one of the most important and frequent infectious diseases in Brazil, where epidemics are reported regularly and the possibility of errors in diagnosis due to clinical similarity is a reality

Parasitoses intestinais e fatores associados no estado do Piauí: uma revisão integrativa

Submitted by JÉSSICA SANTOS ([email protected]) on 2018-07-07T15:22:14Z No. of bitstreams: 1 ve_Polyanna_Bacelar_et_al_2018.pdf: 216234 bytes, checksum: 48f3d4160653ec63eda2fc4d54ed6aa0 (MD5)Approved for entry into archive by JÉSSICA SANTOS ([email protected]) on 2018-07-07T15:34:15Z (GMT) No. of bitstreams: 1 ve_Polyanna_Bacelar_et_al_2018.pdf: 216234 bytes, checksum: 48f3d4160653ec63eda2fc4d54ed6aa0 (MD5)Made available in DSpace on 2018-07-07T15:34:16Z (GMT). No. of bitstreams: 1 ve_Polyanna_Bacelar_et_al_2018.pdf: 216234 bytes, checksum: 48f3d4160653ec63eda2fc4d54ed6aa0 (MD5) Previous issue date: 2018-05Universidade Federal do Piauí. Departamento de Parasitologia e Microbiologia. Teresina, PI, Brasil.Escritório Técnico Regional. Teresina, PI, Brasil.Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Laboratório de Epidemiologia e Sistemática Molecular. Rio de Janeiro, RJ, Brasil.Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Laboratório de Epidemiologia e Sistemática Molecular. Rio de Janeiro, RJ, Brasil.Faculdade de Ciências e Tecnologia do Maranhão. Caxias, MA, Brasil.Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Programa de Pós-Graduação em Medicina Tropical. Rio de Janeiro, RJ, Brasil / Fundação Oswaldo Cruz. Escritório Regional Fiocruz Piauí. Teresina, PI, Brasil.Objetivo: Fornecer e discutir informações detalhadas sobre os fatores associados, prevalência e distribuição das parasitoses intestinais no estado do Piauí, Brasil. Métodos: Trata-se de uma revisão integrativa da literatura na qual foram selecionados estudos científicos sobre parasitoses intestinais, realizados no Piauí, a partir da BVS, PubMed, SciELO e Google Acadêmico. A busca ocorreu no período de 2 e 5 de janeiro de 2018, através da definição dos Descritores em Ciências da Saúde: “Parasitoses”, “Saúde Pública”, “Saneamento Básico”. Dos 1.286 artigos encontrados e após a aplicação dos critérios de inclusão, exclusão e avaliação dos seus conteúdos, 7 foram selecionados. Resultados e Discussão: As populações abrangidas pelas pesquisas foram de indivíduos do sexo masculino e feminino, com faixa etária relativa a crianças com idade de 5 a 14 anos, adolescentes, adultos e idosos com idade igual ou superior a 89 anos. Dentre as faixas etárias que demonstraram alta prevalência de enteroparasitoses no estado, destacam-se as compreendidas entre 0-5 anos; 6-12; 20-49 e 46-59 anos. Os protozoários mais citados foram Entamoeba coli, Endolimax nana, Entamoeba histolytica/díspar e Giardia sp. No grupo dos helmintos, os parasitos mais prevalentes foram Ascaris lumbricoides, ancilostomídeos e Schistosoma mansoni. Quanto aos fatores associados que aumentam o risco de infecções parasitárias foram relatadas as condições higiênico-sanitárias e socioeconômicas. Conclusão: As parasitoses intestinais se apresentaram com variações quanto à região e os fatores associados. Diante a escassez de estudos acerca da temática, no estado, contribuiu-se com a disseminação de informações consolidadas e para um melhor conhecimento do perfil das enteroparasitoses

Frequency and molecular characterisation of Entamoeba histolytica, Entamoeba dispar, Entamoeba moshkovskii, and Entamoeba hartmanni in the context of water scarcity in northeastern Brazil

This study aimed to estimate the frequency, associated factors, and molecular characterisation of Entamoeba histolytica, Entamoeba dispar, Entamoeba moshkovskii, andEntamoeba hartmanni infections. We performed a survey (n = 213 subjects) to obtain parasitological, sanitation, and sociodemographic data. Faecal samples were processed through flotation and centrifugation methods.E. histolytica, E. dispar, E. moshkovskii, and E. hartmanni were identified by nested-polymerase chain reaction (PCR). The overall prevalence of infection was 22/213 (10.3%). The infection rate among subjects who drink rainwater collected from roofs in tanks was higher than the rate in subjects who drink desalinated water pumped from wells; similarly, the infection rate among subjects who practice open defecation was significantly higher than that of subjects with latrines. Out of the 22 samples positive for morphologically indistinguishableEntamoeba species, the differentiation by PCR was successful for 21. The species distribution was as follows: 57.1% to E. dispar, 23.8% to E. histolytica, 14.3% toE. histolytica and E. dispar, and 4.8% E. dispar and E. hartmanni. These data suggest a high prevalence of asymptomatic infection by the group of morphologically indistinguishable Entamoeba histolytica/dispar/moshkovskiicomplex and E. hartmanni species. In this context of water scarcity, the sanitary and socioenvironmental characteristics of the region appear to favour transmission

Socioenvironmental Factors Influencing Distribution and Intensity of Soil-Transmitted Helminthiasis in the Brazilian Amazon: Challenges for the 2030 Agenda

Soil-transmitted helminthiasis (STHs) are poverty-related diseases with high prevalence rates in developing countries. The present study aims to describe the epidemiological scenario of STHs in an urban population in the Brazilian Amazon. A cross-sectional survey (n = 349 children aged 1–15 years) was carried out to obtain faecal samples and sociodemographic and sanitation data. Among the children, 143 (41%) were positive for at least one STH. Prevalence rates of infections by A. lumbricoides, T. trichiura, and hookworms were 24.4%, 42.6%, and 9%, respectively. A logistic regression multivariate model showed that infection with A. lumbricoides is significantly more frequent in children aged 11–15 years (odds ratio [OR] = 2.38; 95% confidence interval [CI] = 1.15–4.94; p=0.018) and the presence of latrines inside houses is a protection factor against ascariasis (OR = 0.38; 95% CI = 0.17–0.85; p=0.019). Positivity for T. trichiura is higher in the 5–10 (OR = 3.31; 95% IC = 1.85–5.89; p=0.001) and 11–15 age groups (OR = 3.16; 95% IC = 1.66–6.00; p=0.001), in children living in poor families (OR = 1.78; 95% IC = 1.01–3.14; p=0.045) and practicing open evacuation (OR = 2.07; 95% IC = 1.07–3.99; p=0.029). Hookworm infection is more frequent in children aged 11–15 years (OR = 6.70; 95% IC = 1.91–23.43; p=0.002), males (OR = 6.35; 95% IC = 2.00–20.14; p=0.002), and those living in stilt houses (OR = 3.52; 95% IC = 1.22–10.12; p=0.019). The use of albendazole in the last six months was a protection factor against hookworm infection (OR = 0.31; 95% IC = 0.10–0.96; p=0.042). The proportion of mild, moderate, and severe infections was 55.2%, 37.8%, and 7%, respectively, for A. lumbricoides, 72.4%, 24.3%, and 3.3% for T. trichiura, and 93.8%, 3.1%, and 3.1% for hookworms. Significantly higher worm burdens in T. trichiura and hookworm infections were associated with practicing open defecation and living in stilt houses. The data points to the need to improve sanitation infrastructure in Amazonian cities with similar sociodemographic and environmental characteristics

Giardia intestinalis infection associated with malnutrition in children living in northeastern Brazil

Submitted by Sandra Infurna ([email protected]) on 2017-11-14T16:55:10Z No. of bitstreams: 1 beatriz_nunes_etal_IOC_2017.pdf: 1288946 bytes, checksum: 3feb9602f461a112f57676a2f0f90632 (MD5)Approved for entry into archive by Sandra Infurna ([email protected]) on 2017-11-16T09:48:35Z (GMT) No. of bitstreams: 1 beatriz_nunes_etal_IOC_2017.pdf: 1288946 bytes, checksum: 3feb9602f461a112f57676a2f0f90632 (MD5)Made available in DSpace on 2017-11-16T09:48:35Z (GMT). No. of bitstreams: 1 beatriz_nunes_etal_IOC_2017.pdf: 1288946 bytes, checksum: 3feb9602f461a112f57676a2f0f90632 (MD5) Previous issue date: 2017Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Laboratório de Epidemiologia e Sistemática Molecular. Rio de Janeiro, RJ. Brasil.Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Laboratório de Epidemiologia e Sistemática Molecular. Rio de Janeiro, RJ. Brasil.Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Laboratório de Epidemiologia e Sistemática Molecular. Rio de Janeiro, RJ. Brasil.Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Laboratório de Epidemiologia e Sistemática Molecular. Rio de Janeiro, RJ. Brasil.Escritório Municipal de Saúde Nossa Senhora de Nazaré. Coordenação de Cuidados de Saúde Primária. Nossa Senhora de Nazaré, Brasil.Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Laboratório de Biologia dos Tripanossomatídeos. Rio de Janeiro, RJ. Brasil.Fred Hutchinson Cancer Research Center. Seattle, WA, USA.Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Laboratório de Eco-Epidemiologia da Doença de Chagas. Rio de Janeiro, RJ. Brasil.Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Laboratório de Biologia e Parasitologia de Mamíferos Silvestres Reservatórios. Rio de Janeiro, RJ. Brasil.Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Laboratório de Epidemiologia e Sistemática Molecular. Rio de Janeiro, RJ. Brasil / Fundação Oswaldo Cruz. Escritório Regional no Piauí. Teresina, PI, Brasil.Introduction: The present study aimed to determine the prevalence and factors associated with Giardia intestinalisinfection, verifying its impact on the nutritional status of children in northeastern Brazil. Methodology:A cross-sectional study was conducted to obtain parasitological, sociodemographic, and anthropometric data in two municipalities in the states of Piauí and Ceará, northeastern Brazil. Results: Prevalence of giardiasis was 55/511 (10.8%). G. intestinaliswas more frequent in people living in poverty (30/209 [14.4%], p = 0.041), performing open evacuation (26/173 [15%], p = 0.034), and drinking rainwater stored in cisterns (9/56 [16.1%], p = 0.005). The proportion of stunting and being underweight in children infected with G. intestinaliswas significantly higher than that in uninfected children (5/23 [21.7%] vs. 10/179 [5.6%], p = 0.017, OR = 4.69, 95% confidence interval [CI] = 1.44–15.25 and 5/23 [21.7%] vs. 13/179 [7.3%], p = 0.038, OR = 3.54, 95% CI = 1.13–11.09, respectively). Infection with G. intestinalisremained significantly associated with stunting and being underweight after adjustment for poverty, municipality, sex, and age in a logistic regression multivariate model. Conclusions: In rural areas in northeastern Brazil, giardiasis has acquired great public health importance in the soil-transmitted helminths control era, impacting the nutritional status of children and requiring new approaches to diagnosis and treatment and translational research that could generate applicable solutions at the community level

Mapping of lower richness of wild mammal species.

<p>A geospatial analysis by the map algebra of the association of <i>T. cruzi</i> infection in dogs (response variable) with covariables: (<b>A</b>) species richness (DS) of small wild mammals; (<b>B</b>) abundance (NM) of small wild mammals; (<b>C</b>) serological prevalence (IFAT) of small wild mammals; (<b>D</b>) parasitological prevalence (THC) of small wild mammals.</p