Detection of Trypanosoma cruzi DTUs TcI and TcIV in two outbreaks of orally-transmitted Chagas disease in the Northern region of Brazi

This study describes the laboratory investigation of two acute Chagas disease outbreaks that occurred in the riverside communities of Marimarituba and Cachoeira do Arua, in the Santarem municipality, Para State, located in the Northern region of Brazil, and occurred in March 2016 and August 2017, respectively. The generation of data regarding the diversity of Trypanosoma cruzi parasites circulating in the Amazon region is key for understanding the emergence and expansion of Chagas disease. This study aimed to identify T. cruzi Discrete Typing Units (DTUs) involved in two outbreaks of acute Chagas disease (ACD) directly from the patient’s biological sample. Nested and multiplex PCR targeting the 24Sα (rRNA) and mini-exon genes, respectively, were used to identify T. cruzi DTU in blood samples from patients diagnosed with ACD. The samples with positive cPCR were submitted for analysis for T. cruzi DTUs, which included 13 samples from the patients with ACD by oral transmission and two samples collected from two newborns of two women with ACD, from Marimarituba and Cachoeira do Arua. The samples were classified as T. cruzi TcIV, from Marimarituba’s outbreak, and T. cruzi TcI, from Cachoeira do Arua’s outbreak. The molecular identification of T. cruzi may increase understanding of the role of this parasite in Chagas disease’s emergence within the Amazon region, contributing to the improvement of the management of this important, but also neglected, diseas

Suspected vertical transmission of Chagas disease caused by DTU TcIV in an infection probably transmitted orally, during anoutbreak in the Brazilian Amazo

This study describes difficulties in the monitoring of a child born during an oral outbreak of Chagas disease, in which there are several indications that the transmission occurred through the congenital route: 1. the mother was in the third trimester of pregnancy when she was infected; 2. She presented high parasitemia at the time of delivery; 3. In both, the mother and her daughter, T. cruzi was classified as DTU TcIV. The parasites were not found in the blood at birth and the infection was detected only three months later in an asymptomatic infant. As the mother and her child live in a highly endemic area, vector transmission could not be excluded during this period

Caracterização de uma população pediátrica durante a pandemia da COVID-19 em um Cancer Center Brasileiro: Characterization of a pediatric population during the COVID-19 pandemic in a Brazilian Cancer Center

Introdução:  Existe divergência entre a gravidade e taxa de mortalidade nas crianças oncológicas dependendo do país ou do centro de saúde estudado, mediante isso, identificou-se a necessidade de desenvolver um estudo, com o objetivo de caracterizar esta população e identificar o motivo pelo qual o paciente é submetido ao exame para pesquisa da COVID-19 e seu desfecho clínico. Métodos: Estudo descritivo, retrospectivo realizado entre fevereiro de 2020 a fevereiro de 2022. Foram incluídos pacientes com idade inferior a 18 anos, durante o tratamento em um Cancer Center brasileiro. Resultados: Foram identificados 668 pacientes. Divididos em dois grupos: Grupo 1, 122 (18%) apresentando sintomas clínicos e Grupo 2, com 546 (82%) pacientes que foram submetidos à coleta do exame antes do procedimento cirúrgico e/ou exame de imagem. A mediana da idade entre os grupos foi de 9 e 7 anos, respectivamente. Quase a totalidade dos pacientes do Grupo 1, apresentou sintomas relacionados à COVID-19 e todos que apresentaram neutropenia febril pertenciam a este grupo. Tumores hematológicos foram prevalentes no Grupo 1, já no Grupo 2, foram identificados a mal formação venosa. Do total, 27 (4%) pacientes apresentaram resultado positivo e apenas um paciente evoluiu a óbito. Conclusão: A COVID-19 atingiu ambos os gêneros e a sua gravidade foi independente da doença de base ou idade. As medidas de proteção e prevenção ao longo do período da pandemia, permitiram que a baixa taxa de contaminação e mortalidade nos pacientes deste estudo não interrompessem o tratamento