Habitat suitability of Anopheles vector species and association with human malaria in the Atlantic Forest in south-eastern Brazil

Every year, autochthonous cases of Plasmodium vivax malaria occur in low-endemicity areas of Vale do Ribeira in the south-eastern part of the Atlantic Forest, state of São Paulo, where Anopheles cruzii and Anopheles bellator are considered the primary vectors. However, other species in the subgenus Nyssorhynchus of Anopheles (e.g., Anopheles marajoara) are abundant and may participate in the dynamics of malarial transmission in that region. The objectives of the present study were to assess the spatial distribution of An. cruzii, An. bellator and An. marajoara and to associate the presence of these species with malaria cases in the municipalities of the Vale do Ribeira. Potential habitat suitability modelling was applied to determine both the spatial distribution of An. cruzii, An. bellator and An. marajoara and to establish the density of each species. Poisson regression was utilized to associate malaria cases with estimated vector densities. As a result, An. cruzii was correlated with the forested slopes of the Serra do Mar, An. bellator with the coastal plain and An. marajoara with the deforested areas. Moreover, both An. marajoara and An. cruzii were positively associated with malaria cases. Considering that An. marajoara was demonstrated to be a primary vector of human Plasmodium in the rural areas of the state of Amapá, more attention should be given to the species in the deforested areas of the Atlantic Forest, where it might be a secondary vector.FAPESPCNP

Mosquito (Diptera: Culicidae) assemblages associated with Nidularium and Vriesea bromeliads in Serra do Mar, Atlantic Forest, Brazil

<p>Abstract</p> <p>Background</p> <p>The most substantial and best preserved area of Atlantic Forest is within the biogeographical sub-region of Serra do Mar. The topographic complexity of the region creates a diverse array of microclimates, which can affect species distribution and diversity inside the forest. Given that Atlantic Forest includes highly heterogeneous environments, a diverse and medically important Culicidae assemblage, and possible species co-occurrence, we evaluated mosquito assemblages from bromeliad phytotelmata in Serra do Mar (southeastern Brazil).</p> <p>Methods</p> <p>Larvae and pupae were collected monthly from <it>Nidularium </it>and <it>Vriesea </it>bromeliads between July 2008 and June 2009. Collection sites were divided into landscape categories (lowland, hillslope and hilltop) based on elevation and slope. Correlations between bromeliad mosquito assemblage and environmental variables were assessed using multivariate redundancy analysis. Differences in species diversity between bromeliads within each category of elevation were explored using the Renyi diversity index. Univariate binary logistic regression analyses were used to assess species co-occurrence. </p> <p>Results</p> <p>A total of 2,024 mosquitoes belonging to 22 species were collected. Landscape categories (pseudo-F value = 1.89, p = 0.04), bromeliad water volume (pseudo-F = 2.99, p = 0.03) and bromeliad fullness (Pseudo-F = 4.47, p < 0.01) influenced mosquito assemblage structure. Renyi diversity index show that lowland possesses the highest diversity indices. The presence of <it>An. homunculus </it>was associated with <it>Cx. ocellatus </it>and the presence of <it>An. cruzii </it>was associated with <it>Cx. neglectus, Cx. inimitabilis fuscatus </it>and <it>Cx. worontzowi. Anopheles cruzii </it>and <it>An. homunculus </it>were taken from the same bromeliad, however, the co-occurrence between those two species was not statistically significant.</p> <p>Conclusions</p> <p>One of the main findings of our study was that differences in species among mosquito assemblages were influenced by landscape characteristics. The bromeliad factor that influenced mosquito abundance and assemblage structure was fullness. The findings of the current study raise important questions about the role of <it>An. homunculus </it>in the transmission of <it>Plasmodium </it>in Serra do Mar, southeastern Atlantic Forest.</p

Avaliação de modelos de predição para ocorrência de malária no estado do Amapá, 1997-2016: um estudo ecológico

Objective. To evaluate predictive power of different time-series models of malaria cases in the state of Amapá, Brazil, in the period 1997-2016. Methods. This is an ecological study of time series with malaria cases registered in the state of Amapá. Ten 3 deterministic or stochastic statistical models were used for simulation and testing in 3, 6, and 12 month forecast horizons. Results. The initial test showed that the series is stationary. Deterministic models performed better than stochastic models. The ARIMA model showed absolute errors of less than 2% on the logarithmic scale and relative errors 3.4-5.8 times less than the null model. The prediction of future cases of malaria in the horizons of 6 and 12 months in advance was possible. Conclusion. It is recommended the use of the ARIMA model to predict future scenarios and to anticipate planning in state health services in the Amazon Region.Objetivo. Avaliar a capacidade preditiva de diferentes modelos de série temporal de casos de malária no estado do Amapá, Brasil, no período 1997-2016. Métodos. Estudo ecológico de séries temporais com casos de malária registrados no Amapá. Foram utilizados dez modelos estatísticos determinísticos ou estocásticos para simulação e teste em horizontes de previsão de 3, 6 e 12 meses. Resultados. O teste inicial mostrou que a série é estacionária. Os modelos determinísticos apresentaram melhor desempenho do que os modelos estocásticos. O modelo ARIMA apresentou erros absolutos menores do que 2% na escala logarítmica e erros relativos 3,4-5,8 vezes menores em relação ao modelo nulo. A predição de casos futuros de malária nos horizontes de 6 e 12 meses de antecedência foi possível. Conclusão. Recomenda-se o uso de modelo ARIMA para a previsão de cenários futuros e para a antecipação do planejamento nos serviços de saúde dos estados da Região Amazônica

Drinking water and rural schools in the Western Amazon: an environmental intervention study

Background Although water and sanitation are considered human rights, worldwide approximately three of 10 people (2.1 billion) do not have access to safe drinking water. In 2016, 5.6 million students were enrolled in the 34% of Brazilian schools located in rural areas, but only 72% had a public water supply network. The objective was to evaluate effectiveness of environmental intervention for water treatment in rural schools of the Western Amazonia, and determine the efficacy of water treatment using a simplified chlorinator on potability standards for turbidity, fecal coliforms and Escherichia coli. Methods A simplified chlorinator was installed for treatment of potable water in 20 public schools in the rural area of Rio Branco municipality, Acre state, Brazil. Results Before the intervention, 20% (n = 4), 100% (n = 20) and 70% (n = 14) of schools had water that failed to meet potability standards for turbidity, fecal coliforms and E. coli, respectively. However, after intervention, 70% (p = 0.68), 75% (p < 0.001) and 100% (p < 0.001) of schools complied with potability standards. Discussion This intervention considerably improved schools’ water quality, thus decreasing children’s health vulnerability due to inadequate water. Ancillary activities including training, educational lectures, installation of equipment, supply of materials and supplies (65% calcium hypochlorite and reagents) were considered fundamental to achieving success full outcomes. Installation of a simplified chlorinator in rural schools of the Western Amazon is therefore proposed as a social technology aiming at social inclusion, as well as economic and environmental sustainability

Avaliação da cultura de segurança do paciente na Amazônia Ocidental

Introdução: A cultura de segurança do paciente é fator contribuinte para a manutenção do bem-estar do usuário no sistema de saúde, pois por meio dela obtém-se uma sistematização organizada e de qualidade do cuidado ao paciente, prevenindo possíveis intercorrências que possam trazer danos. Objetivo: Analisar a Cultura de Segurança do Paciente (CSP) na perspectiva dos profissionais de saúde no Hospital de Referência do Alto Rio Juruá, na Amazônia Ocidental Brasileira. Método: Trata-se de um estudo transversal desenvolvido em um hospital público de médio porte em um município da Amazônia Ocidental. O questionário Hospital Survey on Patient Safety Culture, da Agency for Healthcare Research and Quality foi aplicado em 280 profissionais, no período dezembro de 2016 a fevereiro de 2017. Foi realizada a análise descritiva dos dados e a consistência interna do instrumento. Resultados: Os resultados apontam as melhores avaliações nas dimensões de Trabalho em equipe nos âmbitos das unidades (60%) e Aprendizado organizacional (60%). Os aspectos com os piores resultados foram as dimensões de Respostas não punitivas aos erros (18%) e Frequência de eventos relatados (32%). A análise de confiabilidade interna (Alpha de Cronbach) das dimensões variou entre 0,35 a 0,90. Conclusão: A cultura do medo parece predominar nesse hospital, contudo o estudo demonstrou que há possibilidades de melhoria em todas as dimensões da CSP. Os valores do Alpha de Cronbach apresentaram semelhança com os resultados obtidos pelo processo de validação.Introduction: The safety culture of the patient is a contributing factor for the maintenance of the user’s well-being in the health system because, through it, an organized systematization and quality of patient care are obtained, preventing possible intercurrences that can cause damages. Objective: To analyze the Patient Safety Culture (PSC) from the perspective of health professionals at the Reference Hospital of the Upper Juruá River, in the Brazilian Western Amazon. Methods: This is a cross-sectional study developed in a medium-sized public hospital in a municipality in Western Amazonia. The Survey for Patient Safety Culture survey of the Agency for Healthcare Research and Quality was applied to 280 professionals from December 2016 to February 2017. Descriptive analysis of the data and the internal consistency of the instrument were performed. Results: The results indicate the best evaluations in the dimensions of Teamwork in the scopes of the units (60%) and Organizational learning (60%). The aspects with the worst results were the dimensions of non-punitive responses to errors (18%) and frequency of events reported (32%). The internal reliability (Cronbach’s Alpha) analysis of the dimensions ranged from 0.35 to 0.90. Conclusion: The "culture of fear" seems to predominate in this hospital, however, the study showed that there is scope for improvement in all dimensions of CSP. The values of Cronbach’s Alpha presented similarity to the results obtained by the validation process

Análise espacial e sazonal da leptospirose no município de São Paulo, SP, 1998 a 2006

OBJECTIVE: To analyze the spatial and seasonal distribution of leptospirosis and identify possible ecological and social components of its transmission. METHODS: A total of 2,490 cases registered in each district of the municipality of São Paulo, Southeastern Brazil, between 1998 and 2006, were georeferenced. The data were obtained from the Notifiable Diseases Information System. Thematic maps were made, showing the variables of incidence rate, lethality rate, literacy rate, average monthly income, number of residents per household, water supply and sewage system. To identify spatial patterns (dispersed, clustered or random), these variables were analyzed using the global and local Moran indices. Spearman's correlation coefficient was used to test associations between variables with clustered spatial patterns. RESULTS: Clustered spatial patterns were observed for the variables of leptospirosis incidence, literacy rate, average monthly income, number of residents per household, water supply and sewage system. There were 773 notified cases in the dry season and 1,717 cases in the rainy season. The incidence and lethality rates correlated with the population's socioeconomic conditions, independently of the period. CONCLUSIONS: Leptospirosis is spread throughout the municipality of São Paulo, and its incidence increases during the rainy season. In the dry season, the localities where cases appear coincide with the areas of poorest housing conditions. In the rainy season, it also increases in other districts, probably due to the proximity of rivers and streams.OBJETIVO: Analizar la distribución espacial y estacional de la leptospirosis, identificando posibles componentes ecológicos y sociales para su transmisión. MÉTODOS: Fueron georeferenciados 2.490 casos en cada distrito del municipio de Sao Paulo, en sureste de Brasil, registrados de 1998 a 2006. Los datos fueron obtenidos del Sistema de Información de Agravios de Notificación. Fueron realizados mapas temáticos con las variables tasa de incidencia, letalidad, tasa de alfabetización, renta promedio mensual, número de moradores por domicilio, abastecimiento de agua y red de cloacas. Para identificar el patrón espacial (disperso, en aglomerado o azaroso), fueron analizados por el Índice de Moran global y local. Fue utilizado el coeficiente de correlación de Spearman para evaluar asociaciones entre las variables con patrón espacial en aglomerados. RESULTADOS: El patrón espacial en aglomerados fue observado en las variables tasa de incidencia de leptospirosis, tasa de alfabetización, renta promedio mensual, número de moradores por domicilio, abastecimiento de agua y red de cloacas. Fueron notificados 773 casos en el período seco y 1.717 en el húmedo. La incidencia y la letalidad están correlacionadas con las condiciones socioeconómicas de la población, independientemente del período. CONCLUSIONES: La leptospirosis está distribuida por todo el municipio de Sao Paulo y su incidencia aumenta en el período de lluvias. En el período seco, los locales de aparecimiento de los casos coinciden con las áreas de peores condiciones de vivienda y, durante el período húmedo, también aumenta en otros distritos, probablemente debido a la proximidad de ríos y riachuelos.OBJETIVO: Analisar a distribuição espacial e sazonal da leptospirose, identificando possíveis componentes ecológicos e sociais para a sua transmissão. MÉTODOS: Foram georreferenciados 2.490 casos em cada distrito do município de São Paulo, SP, registrados de 1998 a 2006. Os dados foram obtidos do Sistema de Informação de Agravos de Notificação. Foram realizados mapas temáticos com as variáveis taxa de incidência, letalidade, taxa de alfabetização, renda média mensal, número de moradores por domicilio, abastecimento de água e rede de esgoto. Para identificar o padrão espacial (disperso, em aglomerado ou randômico), foram analisadas pelo Índice de Moran global e local. Foi utilizado o coeficiente de correlação de Spearman para testar associações entre as variáveis com padrão espacial em aglomerados. RESULTADOS: O padrão espacial em aglomerados foi observado nas variáveis taxa de incidência de leptospirose, taxa de alfabetização, renda média mensal, número de moradores por domicílio, abastecimento de água e rede de esgoto. Foram notificados 773 casos no período seco e 1.717 no úmido. A incidência e a letalidade estão correlacionadas com as condições socioeconômicas da população, independentemente do período. CONCLUSÕES: A leptospirose está distribuída por todo o município de São Paulo e sua incidência aumenta no período das chuvas. No período seco, os locais de aparecimento dos casos coincidem com as áreas de piores condições de moradia e, durante o período úmido, também aumenta em outros distritos, provavelmente devido à proximidade de rios e córregos

Forest disturbance and vector transmitted diseases in thelowland tropical rainforest of central Panama

objective To explore possible changes in the community attributes of haematophagous insects as afunction of forest disturbance. We compare the patterns of diversity and abundance, plus thebehavioural responses of three epidemiologically distinct vector assemblages across sites depictingvarious levels of forest cover.methods Over a 3-year period, we sampled mosquitoes, sandflies and biting-midges in forestedhabitats of central Panama. We placed CDC light traps in the forest canopy and in the understorey togather blood-seeking females.results We collected 168 405 adult haematophagous dipterans in total, including 26 genera and 86species. Pristine forest settings were always more taxonomically diverse than the disturbed forest sites,confirming that disturbance has a negative impact on species richness. Species of Phlebotominae andCulicoides were mainly classified as climax (i.e. forest specialist) or disturbance-generalist, which tendto decrease in abundance along with rising levels of disturbance. In contrast, a significant portion ofmosquito species, including primary and secondary disease vectors, was classified as colonists (i.e.disturbed-areas specialists), which tend to increase in numbers towards more disturbed forest habitats.At pristine forest, the most prevalent species of Phlebotominae and Culicoides partitioned the verticalniche by being active at the forest canopy or in the understorey; yet this pattern was less clear indisturbed habitats. Most mosquito species were not vertically stratified in their habitat preference.conclusion We posit that entomological risk and related pathogen exposure to humans is higher inpristine forest scenarios for Culicoides and Phlebotominae transmitted diseases, whereas forestdisturbance poses a higher entomological risk for mosquito-borne infections. This suggests that theDilution Effect Hypothesis (DEH) does not apply in tropical rainforests where highly abundant, yetunrecognised insect vectors and neglected zoonotic diseases occur. Comprehensive, community levelentomological surveillance is, therefore, the key for predicting potential disease spill over in scenariosof pristine forest intermixed with anthropogenic habitats. We suggest that changes in forest qualityshould also be considered when assessing arthropod-borne disease transmission risk.objective To explore possible changes in the community attributes of haematophagous insects as afunction of forest disturbance. We compare the patterns of diversity and abundance, plus thebehavioural responses of three epidemiologically distinct vector assemblages across sites depictingvarious levels of forest cover.methods Over a 3-year period, we sampled mosquitoes, sandflies and biting-midges in forestedhabitats of central Panama. We placed CDC light traps in the forest canopy and in the understorey togather blood-seeking females.results We collected 168 405 adult haematophagous dipterans in total, including 26 genera and 86species. Pristine forest settings were always more taxonomically diverse than the disturbed forest sites,confirming that disturbance has a negative impact on species richness. Species of Phlebotominae andCulicoides were mainly classified as climax (i.e. forest specialist) or disturbance-generalist, which tendto decrease in abundance along with rising levels of disturbance. In contrast, a significant portion ofmosquito species, including primary and secondary disease vectors, was classified as colonists (i.e.disturbed-areas specialists), which tend to increase in numbers towards more disturbed forest habitats.At pristine forest, the most prevalent species of Phlebotominae and Culicoides partitioned the verticalniche by being active at the forest canopy or in the understorey; yet this pattern was less clear indisturbed habitats. Most mosquito species were not vertically stratified in their habitat preference.conclusion We posit that entomological risk and related pathogen exposure to humans is higher inpristine forest scenarios for Culicoides and Phlebotominae transmitted diseases, whereas forestdisturbance poses a higher entomological risk for mosquito-borne infections. This suggests that theDilution Effect Hypothesis (DEH) does not apply in tropical rainforests where highly abundant, yetunrecognised insect vectors and neglected zoonotic diseases occur. Comprehensive, community levelentomological surveillance is, therefore, the key for predicting potential disease spill over in scenariosof pristine forest intermixed with anthropogenic habitats. We suggest that changes in forest qualityshould also be considered when assessing arthropod-borne disease transmission risk

Concepts, Capabilities, and Limitations of Global Models : A Review

International audienceFor researchers wishing to generate an understanding of complex plasma systems, global models often present an attractive first step, mainly due to their ease of development and use. These volume averaged models are able to give descriptions of plasmas with complex chemical kinetics, and without the computationally intensive numerical methods required for spatially resolved models. This paper gives a tutorial on global modeling, including development and techniques, and provides a discussion on the issues and pitfalls that researchers should be aware of. Further discussion is provided in the form of two reviews on methods of extending global modeling techniques to encompass variations in either time or space

Antenna subtraction with massive fermions at NNLO: Double real initial-final configurations

We derive the integrated forms of specific initial-final tree-level four-parton antenna functions involving a massless initial-state parton and a massive final-state fermion as hard radiators. These antennae are needed in the subtraction terms required to evaluate the double real corrections to $t\bar{t}$ hadronic production at the NNLO level stemming from the partonic processes $q\bar{q}\to t\bar{t}q'\bar{q}'$ and $gg\to t\bar{t}q\bar{q}$.Comment: 24 pages, 1 figure, 1 Mathematica file attache

Finding connections in the unexpected detection of Plasmodium vivax and Plasmodium falciparum DNA in asymptomatic blood donors: a fact in the Atlantic Forest

Abstract\ud A recent paper in Malaria Journal reported the observation of unexpected prevalence rates of healthy individuals carrying Plasmodium falciparum (5.14%) or Plasmodium vivax (2.26%) DNA among blood donors from the main transfusion centre in the metropolitan São Paulo, a non-endemic area for malaria. The article has been challenged by a group of authors who argued that the percentages reported were higher than those found in blood banks of the endemic Amazon Region and also that that paper had not considered the literature on the classical dynamics of malaria transmission in the Atlantic Forest, which involves Anopheles (Kerteszia) cruzii and bromeliad malaria, due to P. vivax and Plasmodium malariae parasites, but not P. falciparum. The present commentary paper responds to this challenge and brings evidence and literature data supporting that the observed prevalence ratios may indicate a proportion of individuals that are exposed to Plasmodium transmission in permissive environments; that blood carrying parasite DNA may not be necessarily infective if used in transfusion; and that in the literature, there are examples supporting the circulation of P. falciparum in the area.FAPES