Investigação de arbovírus (gênero flavivírus) de interesse à saúde pública em primatas não humanos nos Estados do Paraná e Mato Grosso do Sul

Orientadora : Profª. Drª. Eliane Carneiro GomesOrientador : Prof. Dr. Walfrido Kühl SvobodaDissertação (mestrado) - Universidade Federal do Paraná, Setor de Ciências da Saúde, Programa de Pós-Graduação em Ciências Farmacêuticas. Defesa: Curitiba, 21/02/2014Inclui referênciasÁrea de concentração: Insumos, medicamentos e correlatosResumo: Os arbovírus de maior interesse em saúde pública pertencem à família Flaviviridae, gênero Flavivirus. Os Flavivirus são transmitidos por vetores artrópodes hematófagos e têm nos animais vertebrados, como os primatas não humanos e o homem, os seus hospedeiros. Estes vírus representam um sério problema de saúde pública no Brasil e no mundo devido ao seu potencial epidêmico e por serem responsáveis por elevadas taxas de morbidade e mortalidade. Esta situação requer estudos para identificação destes vírus nos seus hospedeiros e vetores, possibilitando a previsão de epidemias em humanos. A implementação de metodologias virológicas como a reação de transcrição reversa seguida da reação em cadeia da polimerase pode desempenhar um importante papel no diagnóstico de Flavivirus. O objetivo deste trabalho foi investigar a presença de arbovírus (gênero Flavivirus) de interesse em saúde pública em primatas não humanos nos estados do Paraná e Mato Grosso do Sul, aplicando técnicas de biologia molecular a fim de fornecer subsídios aos serviços de saúde pública para contribuir na prevenção e controle de epizootias e epidemias a partir das informações epidemiológicas sobre a circulação de Flavivirus nas regiões estudadas. Foram utilizadas amostras de sangue (46) e soro (34) de 80 primatas não humanos de três diferentes gêneros: Alouatta, Callithrix e Sapajus que viviam em regiões onde havia a possibilidade de contato com seres humanos. Todas as amostras (80) foram provenientes de animais visivelmente saudáveis, caracterizando uma ação de vigilância ativa de epizootias. As amostras foram analisadas no período de dezembro de 2012 a agosto de 2013. Para o processamento destas amostras foi estabelecido e padronizado um protocolo inédito utilizando a técnica de transcrição reversa seguida da reação em cadeia da polimerase. Posteriormente, as amostras foram submetidas à eletroforese em gel de poliacrilamida e sequenciamento genético quando necessário, porém, não foi evidenciada a presença de Flavivirus em nenhuma amostra. Estes resultados, mesmo sendo negativos, contribuem com informações epidemiológicas sobre a não circulação destes vírus neste grupo de primatas não humanos durante o período analisado e o protocolo laboratorial inédito empregado foi considerado adequado. Desta forma, se fazem necessárias ações de investigação mais abrangentes, contemplando um maior número de indivíduos bem como outros hospedeiros destes vírus. Pesquisas sobre a circulação de Flavivirus em grupos de animais que vivem em regiões próximas a seres humanos podem auxiliar os serviços de saúde pública na elaboração de estratégias de prevenção e controle destas doenças.Abstract: The arboviruses that are most relevant to public health belong to the Flaviviridae family, Flavivirus genus. The flaviviruses are transmitted by blood-sucking arthropod vectors and the vertebrate animals as nonhuman primates and man are their hosts. These viruses represent a serious public health problem in Brazil and worldwide in view of their epidemic potential and high morbidity and mortality rates. Thus, studies are needed to identify these viruses in their hosts and vectors, enabling a prediction of epidemics in humans. The implementation of virological methods such as reverse transcription reaction followed by the polymerase chain reaction may play an important role in the diagnosis of Flavivirus. The aim of this study was to investigate the presence of arboviruses (Flavivirus genus) of interest in public health in nonhuman primates in the states of Paraná and Mato Grosso do Sul, applying molecular biology techniques to provide subsidies to public health services to contribute to prevention and control of animal diseases and epidemics from epidemiological information on the movement of flaviviruses in the studied region. Samples of 80 nonhuman primates: blood samples (46) and serum samples (34) from three different genera Alouatta, Callithrix and Sapajus living in locations close to human populations were used. All samples (80) were obtained from visibly healthy animals, featuring an action of active surveillance of animal diseases. The samples were analyzed from December 2012 to August 2013. To process these samples was established and standardized a novel protocol using the technique of reverse transcription followed by polymerase chain reaction. Subsequently, the samples were subjected to electrophoresis in polyacrylamide gel and genetic sequencing when needed, however, was not detected the presence of Flavivirus in any sample. These results, even negative, contribute with epidemiological information on the non-circulation of these viruses in this group of nonhuman primates during the period analyzed and the novel laboratory protocol used was considered adequate. Thus, actions for more comprehensive research are needed, covering a larger number of individuals as well as other hosts of these viruses. Researches of Flavivirus circulation in groups of animals living near humans regions can assist public health services in strategies to prevent and control these diseases

PERCEPÇÕES DE MÃES SOBRE A PRÁTICA DO ALEITAMENTO MATERNO E DA INTRODUÇÃO DA ALIMENTAÇÃO COMPLEMENTAR

O objetivo deste estudo foi identificar as percepções de mães sobre a prática do aleitamento materno e da introdução da alimentação complementar. A coleta de dados ocorreu no período de novembro a dezembro de 2016 e utilizou-se de entrevista semiestruturada, com mães acompanhadas pelo Centro de Saúde e Comunidade no município de Palmas/Tocantins, tendo como eixo perguntas norteadoras, previamente elaboradas pelos pesquisadores, cujas respostas foram gravadas e posteriormente transcritas para análise dos resultados. Das entrevistadas que tiveram consulta de pré-natal, 73,91% das mães relataram receber orientações sobre a importância do aleitamento materno e alimentação complementar. Em relação à prática das orientações recebidas nas consultas de pré-natal, a mais comentada pelas mães foi sobre a pega da mama e a importância da amamentação exclusiva até 6 meses. O grupo relacionou o aleitamento materno exclusivo com a proteção à saúde da criança, além dos benefícios nutritivos do leite humano e que apesar de terem recebido orientações e informações durante as consultas de pré-natal no período gestacional, é possível observar que as mães têm conhecimento limitado referente ao aleitamento materno exclusivo até os 6 meses de idade da criança. Além disso, as entrevistadas possuem um conhecimento empírico quando analisadas as percepções sobre alimentação complementar. Existe um distanciamento entre as informações que estão sendo transmitidas sobre amamentação e alimentação complementar, que deveriam ser explicadas e trabalhadas com mais clareza por profissionais de saúde a fim de promover ações de amamentação e alimentação complementar de forma mais efetiva.

SEROLOGICAL DETECTION OF HEPATITIS A VIRUS IN FREE-RANGING NEOTROPICAL PRIMATES (Sapajus spp., Alouatta caraya) FROM THE PARANÁ RIVER BASIN, BRAZIL

Nonhuman primates are considered as the natural hosts of Hepatitis A virus (HAV), as well as other pathogens, and can serve as natural sentinels to investigate epizootics and endemic diseases that are of public health importance. During this study, blood samples were collected from 112 Neotropical primates (NTPs) (Sapajus nigritus and S. cay, n = 75; Alouatta caraya, n = 37) trap-captured at the Paraná River basin, Brazil, located between the States of Paraná and Mato Grosso do Sul. Anti-HAV IgG antibodies were detected in 4.5% (5/112) of NTPs, specifically in 6.7% (5/75) of Sapajus spp. and 0% (0/37) of A. caraya. In addition, all samples were negative for the presence of IgM anti-HAV antibodies. These results suggest that free-ranging NTPs were exposed to HAV within the geographical regions evaluated

SEROLOGICAL DETECTION OF HEPATITIS A VIRUS IN FREE-RANGING NEOTROPICAL PRIMATES (Sapajus spp., Alouatta caraya) FROM THE PARANÁ RIVER BASIN, BRAZIL

Nonhuman primates are considered as the natural hosts of Hepatitis A virus (HAV), as well as other pathogens, and can serve as natural sentinels to investigate epizootics and endemic diseases that are of public health importance. During this study, blood samples were collected from 112 Neotropical primates (NTPs) (Sapajus nigritus and S. cay, n = 75; Alouatta caraya, n = 37) trap-captured at the Paraná River basin, Brazil, located between the States of Paraná and Mato Grosso do Sul. Anti-HAV IgG antibodies were detected in 4.5% (5/112) of NTPs, specifically in 6.7% (5/75) of Sapajus spp. and 0% (0/37) of A. caraya. In addition, all samples were negative for the presence of IgM anti-HAV antibodies. These results suggest that free-ranging NTPs were exposed to HAV within the geographical regions evaluated

Home-based exercise program in the indeterminate form of Chagas disease (PEDI-CHAGAS study): A study protocol for a randomized clinical trial

BackgroundChagas disease (CD) is a neglected endemic disease with worldwide impact due to migration. Approximately 50–70% of individuals in the chronic phase of CD present the indeterminate form, characterized by parasitological and/or serological evidence of Trypanosoma cruzi infection, but without clinical signs and symptoms. Subclinical abnormalities have been reported in indeterminate form of CD, including pro-inflammatory states and alterations in cardiac function, biomarkers and autonomic modulation. Moreover, individuals with CD are usually impacted on their personal and professional life, making social insertion difficult and impacting their mental health and quality of life (QoL). Physical exercise has been acknowledged as an important strategy to prevent and control numerous chronic-degenerative diseases, but unexplored in individuals with the indeterminate form of CD. The PEDI-CHAGAS study (which stands for “Home-Based Exercise Program in the Indeterminate Form of Chagas Disease” in Portuguese) aims to evaluate the effects of a home-based exercise program on physical and mental health outcomes in individuals with indeterminate form of CD.Methods and designThe PEDI-CHAGAS is a two-arm (exercise and control) phase 3 superiority randomized clinical trial including patients with indeterminate form of CD. The exclusion criteria are <18 years old, evidence of non-Chagasic cardiomyopathy, musculoskeletal or cognitive limitations that preclude the realization of exercise protocol, clinical contraindication for regular exercise, and regular physical exercise (≥1 × per week). Participants will be assessed at baseline, and after three and 6 months of follow-up. The primary outcome will be QoL. Secondary outcomes will include blood pressure, physical fitness components, nutritional status, fatigability, autonomic modulation, cardiac morphology and function, low back pain, depression and anxiety, stress, sleep quality, medication use and adherence, and biochemical, inflammatory and cardiac biomarkers. Participants in the intervention group will undergo a home-based exercise program whilst those in the control group will receive only general information regarding the benefits of physical activity. Both groups will receive the same general nutritional counseling consisting of general orientations about healthy diets.ConclusionThe findings from the present study may support public health intervention strategies to improve physical and mental health parameters to be implemented more effectively in this population.Clinical trial registration[https://ensaiosclinicos.gov.br/rg/RBR-10yxgcr9/], identifier [U1111-1263-0153]

Pervasive gaps in Amazonian ecological research

Biodiversity loss is one of the main challenges of our time,1,2 and attempts to address it require a clear un derstanding of how ecological communities respond to environmental change across time and space.3,4 While the increasing availability of global databases on ecological communities has advanced our knowledge of biodiversity sensitivity to environmental changes,5–7 vast areas of the tropics remain understudied.8–11 In the American tropics, Amazonia stands out as the world’s most diverse rainforest and the primary source of Neotropical biodiversity,12 but it remains among the least known forests in America and is often underrepre sented in biodiversity databases.13–15 To worsen this situation, human-induced modifications16,17 may elim inate pieces of the Amazon’s biodiversity puzzle before we can use them to understand how ecological com munities are responding. To increase generalization and applicability of biodiversity knowledge,18,19 it is thus crucial to reduce biases in ecological research, particularly in regions projected to face the most pronounced environmental changes. We integrate ecological community metadata of 7,694 sampling sites for multiple or ganism groups in a machine learning model framework to map the research probability across the Brazilian Amazonia, while identifying the region’s vulnerability to environmental change. 15%–18% of the most ne glected areas in ecological research are expected to experience severe climate or land use changes by 2050. This means that unless we take immediate action, we will not be able to establish their current status, much less monitor how it is changing and what is being lostinfo:eu-repo/semantics/publishedVersio