Reply: Genetic polymorphisms and cerebrovascular disease in children with sickle cell anemia from Rio de Janeiro, Brazil

The aim of the present work was to examine possible genetic risk factors related to the occurrence of cerebrovascular disease (CVD) in Brazilian population, the frequency of βS-globin gene haplotypes and co-inheritance with α-thalassemia (-α3.7kb) and single nucleotide polymorphism of methylenetetrahydrofolate reductase (MTHFR-C677T), Factor V Leiden (FV-G1691A) and prothrombin (PT-G20210A) genes in children from Rio de Janeiro. Ninety four children with sickle cell anemia (SCA) were included, 24 patients with cerebrovascular involvement and 70 patients without CVD as control group. The mean age of children at the time of the cerebrovascular event was similar to the control group. The frequency of -α3.7kb thalassemia was similar in both groups (p=0.751). Children with Bantu/Atypical βS-globin gene haplotype presented 15 times more chance (OR=15.4 CI 95% 2.9-81.6) of CVD than the other βS-globin gene haplotypes. The C677T polymorphism of MTHFR gene was similar in both groups (p=0.085). No mutation in the FV Leiden or PT genes was found. A large study seems necessary to establish the role of these genetic polymorphisms in Brazilian miscegenated population

Análise espaço-temporal da doença de Chagas e seus fatores de risco ambientais e demográficos no município de Barcarena, Pará, Brasil

To the Federal University of Pará (UFPA), to the Laboratory of Epidemiology and Geoprocessing (EpiGeo) of the University of the State of Pará (UEPA), to the Laboratory of Geoprocessing of the Evandro Chagas Institute (LabGeo/IEC), to the Health Department of the Municipality of Barcarena (SESMUB), to the Coordination for the Improvement of Higher Education Personnel (CAPES) and the National Council for Scientific and Technological Development (CNPq).Universidade do Estado do Pará. Belém, PA, Brazil.Universidade do Estado do Pará. Belém, PA, Brazil.Universidade do Estado do Pará. Belém, PA, Brazil.Universidade do Estado do Pará. Belém, PA, Brazil.Ministério da Saúde. Secretaria de Vigilância em Saúde. Instituto Evandro Chagas. Ananindeua, PA, Brasil.Secretaria Municipal de Saúde de Barcarena. Barcarena, PA, Brazil.Universidade do Estado do Pará. Belém, PA, Brazil.Universidade do Estado do Pará. Belém, PA, Brazil.Introduction: Chagas disease is a parasitosis considered a serious problem of public health. In the municipality of Barcarena, Pará, from 2007 to 2014, occurred the highest prevalence of this disease in Brazil. Objective: To analyze the disease distribution related to epidemiological, environmental and demographic variables, in the area and period of the study. Methods: Epidemiological and demographic data of Barcarena Health Department and satellite images from the National Institute For Space Research (INPE) were used. The deforestation data were obtained through satellite image classification, using artificial neural network. The statistical significance was done with the χ2 test, and the spatial dependence tests among the variables were done using Kernel and Moran techniques. Results: The epidemiological curve indicated a disease seasonal pattern. The major percentage of the cases were in male, brown skin color, adult, illiterate, urban areas and with probable oral contamination. It was confirmed the spatial dependence of the disease cases with the different types of deforestation identified in the municipality, as well as agglomerations of cases in urban and rural areas. Discussion: The disease distribution did not occur homogeneously, possibly due to the municipality demographic dynamics, with intense migratory flows that generates the deforestation. Conclusion: Different relationships among the variables studied and the occurrence of the disease in the municipality were observed. The technologies used were satisfactory to construct the disease epidemiological scenarios