Epidemiological situation of bovine brucellosis in the State of São Paulo, Brazil

Realizou-se um estudo para caracterizar a situação epidemiológica da brucelose bovina no Estado de São Paulo. O Estado foi estratificado em sete circuitos produtores de bovinos, e 150 rebanhos com atividade reprodutiva foram aleatoriamente selecionados em cada um deles. No total, foram amostrados 1.073 rebanhos. Foram aletoriamente coletadas amostras de soro de 10 ou 15 fêmeas bovinas com idade ³24 meses, totalizando 8.761 animais. Os soros foram submetidos a um protocolo de testes em série, tendo o teste do antígeno acidificado tamponado como método de triagem e o da fixação de complemento como confirmatório. A prevalência estimada de rebanhos com pelo menos um animal soropositivo foi de 9,7% [7,8-11,6%], enquanto a prevalência estimada de animais soropositivos foi de 3,8% [0,7-6,9%], no Estado. Em cada rebanho foi aplicado um questionário epidemiológico para avaliar o grau de associação de possíveis fatores de risco (odds ratio, OR) com a doença. Propriedades com 87 ou mais bovinos (OR= 2,25) e compra de reprodutores (OR= 1,56) foram as variáveis mais associadas à condição de foco de brucelose. ____________________________________________________________________________________________________________ ARQUIVOA study to characterize the epidemiological situation of bovine brucellosis in the State of São Paulo was carried out. The state was stratified in seven cattle production regions and 150 herds with reproductive activity were randomly selected within each one. A total of 1,073 herds were sampled. In a second stage, 10 or 15 cows older than 24 month age (in herds with <100 cows and herds ≥100 cows, respectively) were bled at random. A total of 8,761 animals were bled. Sera were tested using a serial testing procedure with the Rose Bengal test as the screening method and the Complement Fixation as the confirmatory method. The estimated prevalence of herds with at least one positive animal was 9.7% [7.8-11.6%], whereas the estimated prevalence of positive cattle was 3.8% [0.7-6.9%] in São Paulo State. An epidemiological questionnaire was applied in each farm, allowing the evaluation of the association of selected risk factors with the disease. The characteristics associated with the brucellosis infected herds were farms with more than 87 bovines (OR= 2.25) and introduction of breeding cattle (OR= 1.56)

Epidemiologic situation of bovine brucellosis in the State of Mato Grosso, Brazil

Caracterizou-se a brucelose bovina em Mato Grosso por meio de um estudo transversal realizado em 2003 para auxiliar na implementação do Programa Nacional de Controle e Erradicação da Brucelose e Tuberculose. No Estado, estratificado em quatro circuitos pecuários, foram amostrados 13.684 animais, provenientes de 1.152 rebanhos. O protocolo de testes utilizado foi o da triagem com o teste do antígeno acidificado tamponado e os soros reagentes foram testados pelo 2-mercaptoetanol (ME) e concomitantemente retestados pelo teste de Rosa Bengala para resultado conclusivo. As prevalências de focos e de animais infectados foram: 41,2% [38,0-44,4%] e 10,2% [7,4-13,1%], respectivamente. Nos circuitos produtivos, as prevalências de focos foram 36,9% [29,2-45,2%], 27,2% [22,8-32,1%], 40,4% [38,8-46,2%] e 50,3% [44,5-56,1%]; e as prevalências de animais 7,9% [3,0-12,9%], 4,1% [2,8-5,4%], 8,1% [5,2-11,1%] e 15,3% [9,2-21,3%], respectivamente, para os circuitos 1, 2, 3 e 4. Os fatores de risco (odds ratio, OR) associados à condição de foco no Estado foram: exploração de gado de corte (OR= 1,8 [1,2-2,5]), exploração mista (OR=1,8 [1,2-2,7]), número de fêmeas no rebanho de 11 a 50 (OR=4,8 [1,1-20,8]), número de fêmeas no rebanho acima de 51 (OR=6,8 [1,6-29,0]), ocorrência de aborto (OR=1,7 [1,3-2,2]). A brucelose está homogeneamente distribuída no Estado, o que permite uniformidade de medidas sanitárias. Adicionalmente, sugere-se a intensificação da vacinação de fêmeas para todo o Estado. _______________________________________________________________________________________________________ ABSTRACTA study to characterize bovine brucellosis in the State of Mato Grosso was carried out in 2003 in order to support the implementation of the National Program for the Control and Eradication of Bovine Brucellosis. The State was divided into four productive regions, and 13,684 bovines from 1,152 herds were sampled. The serum samples were screened for antibodies to Brucella spp. by the Rose-Bengal test (RBT) and all RBT-positive sera were re-tested by the 2-mercaptoethanol test (2-ME), and again by RBT for confirmation. The prevalence of infected herds and animals in the State of Mato Grosso were 41.2% [38.0-44.4%] and 10.2% [7.4-13.1%], respectively. In the productive regions, the prevalence of infected herds were 36.9% [29.2-45.2%], 27.2% [22.8-32.1%], 40.4% [38.8-46.2%], and 50.3% [44.5-56.1%], respectively; and the prevalence of infected animals were 7.9% [3.0-12.9%], 4.1% [2.8-5.4%], 8.1% [5.2-11.1%], and 15.3% [9.2-21.3%], respectively, for regions 1, 2, 3, and 4. The risk factors (odds ratio, OR) associated with the presence of the infection in the State were: beef cattle farming (OR=1.8 [1.2-2.5]), mixed (beef and dairy) cattle farming (OR=1.8 [1.2-2.7]), farms with 11 to 50 females (OR=4.8 [1.1-20.8]), farms with more than 51 females (OR=6.8 [1.6-29.0]), and occurrence of abortion (OR=1.7 [1.3-2.2]). Given that brucellosis is homogeneously distributed in the State, uniform sanitary measures might be adopted. As a homogeneous additional measure for the State, the intensification of female vaccination is suggested

Epidemiological situation of bovine brucellosis in the State of Rio Grande do Sul, Brazil

Realizou-se um estudo para caracterizar a situação epidemiológica da brucelose bovina. O Estado foi dividido em sete regiões. Em cada região foram amostradas aleatoriamente cerca de 300 propriedades, e dentro dessas foi escolhido de forma aleatória um número pré-estabelecido de animais, dos quais foi obtida uma amostra de sangue. No total foram amostrados 16.072 animais, provenientes de 1.957 propriedades. Em cada propriedade amostrada foi aplicado um questionário epidemiológico para verificar o tipo de exploração e as práticas zootécnicas e sanitárias que poderiam estar associadas ao risco de infecção pela doença. O protocolo de testes utilizado foi o da triagem com o teste do antígeno acidificado tamponado e o reteste dos positivos com o teste do 2-mercaptoetanol. O rebanho foi considerado positivo se pelo menos um animal foi reagente às duas provas sorológicas. Para o Estado, as prevalências de focos e de animais infectados foram, respectivamente, 2,1% [1,5-2,6%] e 1,0% [0,60-1,4%]. Para os circuitos, a prevalência de focos e a de animais foram, respectivamente: circuito 1, 3,1% [1,4-5,7%] e 0,95% [0,0-2,0%]; circuito 2, 7,7% [4,9-11,3%] e 1,0% [0,40-1,7%]; circuito 3, 5,7% [3,4-8,8%] e 2,1% [0,41-3,8%]; circuito 4, 0,66% [0,08-2,4%] e 0,66% [0,0-1,8%]; circuito 5, 0,66% [0,08-2,4%] e 0,05% [0,0-0,13%]; circuito 6, 0,0% [0,0-1,3%] e 0,0% [0,0-0,25%]; circuito 7, 5,4% [2,5-10,1%] e 2,9% [0,49-5,3%]. Os fatores de risco (odds ratio, OR) associados à condição de foco foram: exploração de corte (OR= 4,27 [1,82-10,01]) e histórico de aborto (OR=3,27,1,71-6,25]). ____________________________________________________________________________________________________________ ABSTRACTA study to characterize the epidemiological status of bovine brucellosis was carried out in the State of Rio Grande do Sul. The State was divided in seven regions. Three hundred herds were randomly sampled in each region and a pre-established number of animals were sampled in each of these herds. A total of 16,072 serum samples from 1,957 herds, were collected. In each herd, it was applied an epidemiological questionnaire focused on herd traits as well as husbandry and sanitary practices that could be associated with the risk of infection. The serum samples were screened for antibodies against Brucella spp. by the Rose-Bengal Test and all positive sera were re-tested by the 2-mercaptoethanol test. The herd was considered positive if at least one animal was positive on both tests. The prevalences of infected herds and animals in the State were, respectively 2.1% [1.5-2.6%] and 1.0% [0.60-1.4%]. In the regions, the prevalences of infected herds and animals were, respectively: region 1, 3.1% [1.4-5.7%] and 0.95% [0.0-2.0%]; region 2, 7.7% [4.9-11.3%] and 1.0% [0.40-1.7%]; region 3, 5.7% [3.4-8.8%] and 2.1% [0.41-3.8%]; region 4, 0.66% [0.08-2.4%] and 0.66% [0.0-1.8%]; region 5, 0.66% [0.08-2.4%] and 0.05% [0.0-0.13%]; region 6, 0.0% [0.0-1.3%] and 0.0% [0.0-0.25%]; and region 7, 5.4% [2.5-10.1%] and 2.9% [0.49-5.3%]. The risk factors (odds ratio, OR) associated with the presence of infection were: beef herd (OR= 4.27 [1.82-10.01]) and recent history of abortion (OR= 3.27-1.71-6.25])

Lower serum IgA is associated with COPD exacerbation risk in SPIROMICS

Background Decreased but measurable serum IgA levels (70 mg/dL) have been associated with risk for infections in some populations, but are unstudied in COPD. This study tested the hypothesis that subnormal serum IgA levels would be associated with exacerbation risk in COPD. Methods Data were analyzed from 1,049 COPD participants from the observational cohort study SPIROMICS (535 (51%) women; mean age 66.1 (SD 7.8), 338 (32%) current smokers) who had baseline serum IgA measured using the Myriad RBM biomarker discovery platform. Exacerbation data was collected prospectively (mean 944.3 (SD 281.3) days), and adjusted linear, logistic and zero-inflated negative binomial regressions were performed. Results Mean IgA was 269.1 mg/dL (SD 150.9). One individual had deficient levels of serum IgA (<7 mg/dL) and 25 (2.4%) had IgA level 70 mg/dL. Participants with IgA 70 mg/dL were younger (62 vs. 66 years, p = 0.01) but otherwise similar to those with higher IgA. In adjusted models, IgA 70 mg/dL was associated with higher exacerbation incidence rates (IRR 1.71, 95% CI 1.01-2.87, p = 0.044) and greater risk for any severe exacerbation (OR 2.99, 95% CI 1.30-6.94, p = 0.010). In adjusted models among those in the lowest decile (<120 mg/ dL), each 10 mg/dL decrement in IgA (analyzed continuously) was associated with more exacerbations during follow-up (β 0.24, 95% CI 0.017-0.46, p = 0.035). Conclusions Subnormal serum IgA levels were associated with increased risk for acute exacerbations, supporting mildly impaired IgA levels as a contributing factor in COPD morbidity. Additionally, a dose-response relationship between lower serum IgA and number of exacerbations was found among individuals with serum IgA in the lowest decile, further supporting the link between serum IgA and exacerbation risk. Future COPD studies should more comprehensively characterize immune status to define the clinical relevance of these findings and their potential for therapeutic correction

Anemia and adverse outcomes in a chronic obstructive pulmonary disease population with a high burden of comorbidities an analysis from SPIROMICS

Rationale: Chronic obstructive pulmonary disease (COPD) is a common cause of morbidity and associated with a significant burden of comorbidities. Although anemia is associated with adverse outcomes in COPD, its contribution to outcomes in individuals with other comorbid chronic diseases is not well understood. Objectives: This study examines the association of anemia with outcomes in a large, well-characterized COPD cohort, and attempts to understand the contribution of anemia to outcomes and phenotypes in individuals with other comorbidities. Methods: Participants with COPD from SPIROMICS (the Subpopulations and Intermediate Outcome Measures in COPD Study) were analyzed in adjusted models to determine the associations of normocytic anemia with clinical outcomes, computed tomographic measures, and biomarkers. Analysis was additionally performed to understand the independence and possible interactions related to cardiac and metabolic comorbidities. Results: A total of 1,789 individuals with COPD from SPIROMICS had data on hemoglobin, and of these 7.5% (n = 135) were found to have normocytic anemia. Anemic participants were older with worse airflow obstruction, a higher proportion of them were African Americans, and they had a higher burden of cardiac and metabolic comorbidities. Anemia was strongly associated with 6-minute walk distance (b, 261.43; 95% confidence interval [CI], 285.11 to 237.75), modified Medical Research Council dyspnea questionnaire (b, 0.27; 95% CI, 0.11-0.44), and St. George's Respiratory Questionnaire (b, 3.90; 95% CI, 1.09-6.71), and these adjusted associations were stronger among those with two or more cardiac and metabolic comorbidities. Anemia was associated with higher levels of serum C-reactive protein, soluble receptor for advanced glycosylation endproducts, and epithelial cadherin-1, findings that persisted when in those with a high burden of comorbidities. Conclusions: Anemia is associated with worse exercise capacity, greater dyspnea, and greater disease severity among adults with COPD, particularly among those with comorbid chronic cardiac and metabolic diseases. The biomarkers found in anemic individuals suggest inflammation, lung tissue injury, and oxidative stress as possible pathways for the adverse correlations of anemia with outcomes in COPD; however, substantial further study is required to better understand these potential mechanisms

Rural residence and chronic obstructive pulmonary disease exacerbations: Analysis of the SPIROMICS cohort

Rationale: Rural residence is associated with poor outcomes in several chronic diseases. The association between rural residence and chronic obstructive pulmonary disease (COPD) exacerbations remains unclear. Objectives: In this work, we sought to determine the independent association between rural residence and COPD-related outcomes, including COPD exacerbations, airflow obstruction, and symptom burden. Methods: A total of 1,684 SPIROMICS (Subpopulations and Intermediate Outcome Measures in COPD Study) participants with forced expiratory volume in 1 second/forced vital capacity <, 0.70 had geocoding-defined rural-urban residence status determined (N = 204 rural and N = 1,480 urban). Univariate and multivariate logistic and negative binomial regressions were performed to assess the independent association between rurality and COPD outcomes, including exacerbations, lung function, and symptom burden. The primary exposure of interest was rural residence, determined by geocoding of the home address to the block level at the time of study enrollment. Additional covariates of interest included demographic and clinical characteristics, occupation, and occupational exposures. The primary outcome measures were exacerbations determined over a 1-year course after enrollment by quarterly telephone calls and at an annual research clinic visit. The odds ratio (OR) and incidence rate ratio (IRR) of exacerbations that required treatment with medications, including steroids or antibiotics (total exacerbations), and exacerbations leading to hospitalization (severe exacerbations) were determined after adjusting for relevant covariates. Results: Rural residence was independently associated with a 70% increase in the odds of total exacerbations (OR, 1.70 [95% confidence interval (CI), 1.13-2.56]; P = 0.012) and a 46% higher incidence rate of total exacerbations (IRR 1.46 [95% CI, 1.02-2.10]; P = 0.039). There was no association between rural residence and severe exacerbations. Agricultural occupation was independently associated with increased odds and incidence of total and severe exacerbations. Inclusion of agricultural occupation in the analysis attenuated the association between rural residence and the odds and incidence rate of total exacerbations (OR, 1.52 [95% CI, 1.00-2.32]; P = 0.05 and IRR 1.39 [95% CI, 0.97-1.99]; P = 0.07). There was no difference in symptoms or airflow obstruction between rural and urban participants. Conclusions: Rural residence is independently associated with increased odds and incidence of total, but not severe, COPD exacerbations. These associations are not fully explained by agriculture-related exposures, highlighting the need for future research into potential mechanisms of the increased risk of COPD exacerbations in the rural population