Health and disease among Panará (Kreen-Akarôre) Indians in Central Brazil after twenty-five years of contact with our World, with an emphasis on tuberculosis

The Panará, who had previously lived in isolation from Brazilian national society in the Amazon forest, were first contacted in 1973. Two years later they were moved to another area in Central Brazil. During this same period they were reduced to 82 members, the survivors of a population of 400 to 500 in the mid-1960s. In 1995 they returned to a small area in their old territory still not occupied by outsiders. There, three years later, a health survey showed a presumed diagnosis of tuberculosis in 15 individuals out of a population of 181. Further tests in the town of Colider, based on clinical data and chest X-rays, confirmed the diagnosis in 10 Panará (6 children under 10 years of age and 4 adults from 40 to 50 years old). BCG scars were present in the entire population. The nutritional status of Panará children was better than that of other indigenous groups in the Amazon region. The following measures were introduced for Tb control: a) treatment follow-up in the village, under direct supervision by both a nurse and the local indigenous health worker; b) compliance with defined criteria for ending treatment; c) periodic control of contacts and non-contacts; c) and establishment of a reference system with the health services in Colider.Em 1973, houve a quebra do estado de isolamento dos Panará (Kren-Akarore) no interior da floresta amazônica. Dois anos após estavam reduzidos a 82 indivíduos, de uma população estimada em 400 a 500 em meados dos anos 60. Em 1998, o exame dos Panará, nas cabeceiras do rio Iriri, sul do Pará, levou ao diagnóstico presuntivo de tuberculose em 15 indivíduos, dos quais 10 foram confirmados na cidade de Colider com base em dados clínicos e radiológicos. Desses 10 casos, 6 eram menores de 10 anos de idade e 4 tinham de 40 a 50 anos. Todos da tribo apresentavam cicatriz vacinal do BCG. Em crianças, a prevalência de desnutrição crônica e de anemia ferropriva foi menor do que a relatada em outros grupos indígenas da região amazônica. As medidas de controle da Tb, a nível local, incluíram: a) continuidade do tratamento dos pacientes, na aldeia, sob supervisão do Auxiliar de Enfermagem e do Agente Indígena de Saúde; b) observância dos critérios de cura; c) acompanhamento clínico de comunicantes e não-comunicantes dada a elevada prevalência da doença; d) implantação de sistema de referência e contra-referência com serviços de saúde de Colider.Universidade Federal de São Paulo (UNIFESP) Escola Paulista de Medicina Departamento de Medicina PreventivaCentro Universitário São CamiloUNIFESP, EPM, Depto. de Medicina PreventivaSciEL

LITERARTE NA MALA PANTANEIRA: ABORDAGENS INTERDISCIPLINARES EM EXPERIÊNCIAS FABULOSAS

....

LITERARTE NA MALA PANTANEIRA: ABORDAGENS INTERDISCIPLINARES EM EXPERIÊNCIAS FABULOSAS

....

Hepatitis E virus seroprevalence among schistosomiasis patients in Northeastern Brazil

Background: Hepatitis E virus (HEV) can cause chronic infection with rapid progression to liver cirrhosis in immunocompromised patients. HEV seroprevalence in patients with Schistosoma mansoni in Brazil is unknown. We evaluated the prevalence of past or present HEV infection in schistosomiasis patients in Recife, Pernambuco, Brazil. A total of 80 patients with Schistosoma mansoni were consecutively enrolled in a cross-sectional study. Serum samples were tested for the presence of anti-HEV IgG antibodies by enzyme immunoassay (Wan tai anti-HEV IgG, Beijing, China) and for the presence of HEV RNA using real time reverse transcriptase-polymerase chain reaction with primers targeting the HEV ORF2 and ORF3. Clinical and laboratory tests as well as abdominal ultrasound were performed at the same day of blood collection. Results: Anti-HEV IgG was positive in 18.8% (15/80) of patients with SM. None of the samples tested positive for anti-HEV IgM or HEV-RNA. Patients with anti-HEV IgG positive presented higher levels of alanine aminotranferase (p = 0.048) and gama-glutamil transferase (p = 0.022) when compared to patients without anti-HEV IgG antibodies. Conclusion: This study demonstrates that the seroprevalence of HEV is high in patients with Schistosoma mansoni in Northeastern of Brazil. Past HEV infection is associated with higher frequency of liver enzymes abnormalities. HEV infection and its role on the severity of liver disease should be further investigated among patients with Schistosoma mansoni. (C) 2016 Elsevier Editora Ltda.Fundacao de Amparo a Pesquisa do Estado de Sao PauloUniv Fed Sao Paulo Unifesp, Div Infect Dis, Sao Paulo, SP, BrazilFleury SA Grp, Sao Paulo, BrazilUniv Fed Sao Paulo Unifesp, Div Gastroenterol, Sao Paulo, BrazilUniv Fed Pernambuco UFPE, Div Gastroenterol, Recife, PE, BrazilUniv Fed Sao Paulo Unifesp, Div Infect Dis, Sao Paulo, SP, BrazilUniv Fed Sao Paulo Unifesp, Div Gastroenterol, Sao Paulo, BrazilFAPESP: 2012/22925-3FAPESP: 2013/03701-0Web of Scienc

GENETIC DIVERSITY OF MEASLES VIRUS - RESURGENCE OF NEW GENOTYPE D8 IN São Paulo, BRAZIL

Letter to the Edito

The implementation of a structured specialized consultation for psoriasis management

Objectives: Psoriasis is a chronic skin disease requiring a multidimensional approach, given its varying appearance, presence of comorbidities and complex treatment regimens. Psoriasis care is however often performed fragmented and, in case of flares, reactive with little integrated information on and for the patient. Literature suggests a multileveled approach of psoriasis, but the effects of its implementation have not yet been validated. The aim of this study is to analyze the impact of a multileveled psoriasis consultation format, named PsoPlus, which has been implemented since 2012 in the Department of Dermatology at Ghent University Hospital in Belgium. Methods: The patient population was divided into two groups: one following the regular consultation and one following the PsoPlus format. Demographic data, clinical outcome and treatment approach of psoriasis patients were compared. Results: Patients who opted for the specialized PsoPlus consultation were younger and had longer disease duration. Decision parameters such as disease severity and quality of life were reported more often in the PsoPlus group. In the latter, a higher rate of patients were started on systemic therapy compared to the regular consultation group, and reporting on adverse events was done more frequently. Conclusion: The implementation of a specialized consultation with comprehensive guidance facilitates documentation on disease-relevant parameters such as disease severity and quality of life. This format can be seen as a guidance for capturing data in a structured manner, with evidence showing that it significantly impacts treatment decision, treating not only psoriasis but the patient as a whole

MOLECULAR EPIDEMIOLOGY OF A MEASLES VIRUS IN SAO PAULO, BRAZIL: AN IMPORTED CASE

Made available in DSpace on 2015-10-02T12:45:07Z (GMT). No. of bitstreams: 2 license.txt: 1914 bytes, checksum: 7d48279ffeed55da8dfe2f8e81f3b81f (MD5) marilda_siqueira_etal_IOC_2013.pdf: 124463 bytes, checksum: adaa9d6892ca08363d203a2f07d20c4f (MD5) Previous issue date: 2013Instituto Adolfo Lutz. Centro de Virologia. São Paulo, SP, BrasilInstituto Adolfo Lutz. Centro de Virologia. São Paulo, SP, BrasilInstituto Adolfo Lutz. Centro de Virologia. São Paulo, SP, BrasilFundação Oswaldo Cruz. Instituto Oswaldo Cruz. Rio de Janeiro, RJ, Brasil.Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Rio de Janeiro, RJ, Brasil.Centro de Vigilância Epidemiológica do Estado de São Paulo,Instituto Adolfo Lutz. Centro de Virologia. São Paulo, SP, Brasi

Investigation of vaccinia virus in bovines and buffaloes from the Marajó region, Brazil: standardization of a diagnostic test

The genus Orthopoxvirus (OPXV), belongs to the family Poxviridae and has 12 species, including Vaccinia virus (VACV) and Smallpox virus (VARV). Clinically, lesions in cattle are mostly seen on the teats and udders of lactating cows, which appear as bloody sores. The course of infection to complete healing takes two to four weeks. In humans, infections are currently occupational zoonoses. Little is still known about the ecoepidemiology of these viral agents, requiring further studies to seek alternatives for infection prevention and control. We sought to evaluate the epidemiology of VACV in asymptomatic buffaloes and cattle from farms on Marajó region, Brazil. Serum samples of 247 animals were tested collected in 2009. Viral DNA was extracted using commercial kits and detection was performed by the Polymerase Chain Reaction (PCR), targeting the growth factor gene of Vaccinia (VGF), followed by Nested PCR. Samples were undetectable to VACV by the methods used in the animals studied, requiring continuous epidemiological surveillance in the region, especially considering previous reports of outbreaks involving poxviruses in the country