The magnitude of syphilis: from prevalence to vertical transmission

Introduction: In 2013, the World Health Organization (WHO) reported that 1.9 million pregnant women were infected with syphilis worldwide, of which 66.5% had adverse fetal effects in cases of untreated syphilis. Congenital syphilis contributes significantly to infant mortality, accounting for 305,000 perinatal deaths worldwide annually. Aim: To estimate the prevalence of syphilis in parturients, the incidence of congenital syphilis and the vertical transmission rate. Material and methods: a cross-sectional study with data collected from 2041 parturients who had undergone treatment between 2012 and 2014 in the maternity section of the Pedro Ernesto Hospital of the State University of Rio de Janeiro, in the metropolitan area of Rio de Janeiro. The inclusion criterion was positive VDRL and treponemal test in a hospital environment. Results: the prevalence of syphilis in pregnant women was 4.1% in 2012, 3.1% in 2013 and 5% in 2014, with official reporting of 15.6%, 25.0% and 48.1%, respectively. The incidence of congenital syphilis (CS) was 22/1,000 in live births (LB) in 2012; 17/1,000 LB in 2013 and 44.8/1,000 LB in 2014. CS underreporting during the period was 6.7%. Vertical transmission occurred in 65.8% of infants from infected mothers. It was concluded that, in 34.6% of the CS cases, maternal VDRL titers were = 1/4. Conclusion: Results demonstrate the magnitude of the disease, fragility of the reporting system in the assessment of the actual prevalence, impact on perinatal outcomes, and they are a warning about the real situation of syphilis, which is still underestimated in the State

Prevalência, fatores de risco e genótipos da hepatite C entre usuários de drogas

OBJECTIVE: To estimate prevalence of hepatitis C virus (HCV) infection and identify risk factors associated and circulating HCV genotypes and subtypes. METHODS: Study conducted including 691 drug users attending 26 charitable, private and public drug treatment centers in Goiânia and Campo Grande, central-western Brazil, between 2005 and 2006. Sociodemographic characteristics and risk factors for HCV infection were collected during interviews. Blood samples were tested for HCV antibodies (anti-HCV). Positive samples were submitted to HCV RNA detection by PCR with primers complementary to 5' NC and NS5B regions of viral genome and genotyped by line probe assay (LiPA) and direct nucleotide sequencing followed by phylogenetic analysis. The prevalence and odds ratio were calculated with 95% confidence intervals. Risk factors were first estimated in the univariate analysis (pOBJETIVO: Estimar la prevalencia y factores asociados a la infección por el virus de la hepatitis C en usuarios de drogas e identificar los genotipos y subtipos virales circulantes. MÉTODOS: Estudio realizado con 691 usuarios de drogas de 26 centros de tratamiento de uso de drogas filantrópicos, particulares y públicos de Goiania y Campo Grande (Centro-Oeste), entre 2005 y 2006. Datos sociodemográficos y factores de riesgo para infección por el HCV fueron obtenidos por medio de entrevistas. Muestras sanguíneas fueron evaluadas para la detección de anticuerpos para el HCV. Las muestras positivas fueron sometidas a la detección de RNA-HCV por la reacción en cadena de polimerasa con iniciadores complementarios a las regiones 5' NC y NS5B del genoma viral y genotipadas por el line probe assay (LiPA) y por secuenciación directa, seguido del análisis filogenético. Prevalencia y odds ratio fueron calculados con intervalo de 95% de confianza. Los factores de riesgo con pOBJETIVO: Estimar a prevalência e fatores associados à infecção pelo vírus da hepatite C em usuários de drogas e identificar os genótipos e subtipos virais circulantes. MÉTODOS: Estudo realizado com 691 usuários de drogas de 26 centros de tratamento de uso de drogas filantrópicos, particulares e públicos de Goiânia (GO) e Campo Grande (MS), entre 2005 e 2006. Dados sociodemográficos e fatores de risco para infecção pelo HCV foram obtidos por meio de entrevistas. Amostras sangüíneas foram testadas para a detecção de anticorpos para o HCV. As amostras positivas foram submetidas à detecção do RNA-HCV pela reação em cadeia da polimerase com iniciadores complementares às regiões 5' NC e NS5B do genoma viral e genotipadas pelo line probe assay (LiPA) e por seqüenciamento direto, seguido de análise filogenética. Prevalência e odds ratio foram calculados com intervalo de 95% de confiança. Os fatores de risco com

Insatisfação com o corpo, auto estima e preocupação com o peso em escolares de 8 a 11 de Porto Alegre : estudo piloto

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Leprosy among Patient Contacts: A Multilevel Study of Risk Factors

Leprosy is an infectious disease that can lead to physical disabilities, social stigma, and great hardship. Transmitted from person to person, it is still endemic in developing countries, like Brazil and India. Effective treatment has been available since 1960, but early diagnosis of the disease remains the most effective way to stop the transmission chain and avoid late diagnoses and subsequent disabilities. Knowledge of the risk factors for leprosy can facilitate early detection; therefore, our study aimed to investigate the factors presented by leprosy patients and their contacts, who are considered at highest risk of contracting the disease. We studied 6,158 contacts of 1,201 patients under surveillance from 1987 to 2007 in a Public Health Care Center in the City of Rio de Janeiro, Brazil. We evaluated the ways patient and contact demographics and epidemiological characteristics were associated with the detection of leprosy. Statistical analyses took into account both individual and group characteristics and their interrelationships. The main characteristics facilitating the contraction of leprosy among contacts were shown to be consanguinity and household association. Conversely, the bacillary load index of leprosy patients was the principle factor leading to disease among their contacts