Seroprevalence and spatial distribution dynamics of Yersinia pestis antibodies in dogs and cats from plague foci in the State of Ceará, Northeastern Brazil

<div><p>Abstract INTRODUCTION: In Brazil, the plague is established in several foci located mainly in the northeastern part of the country, where it alternates between active and quiescent periods. These foci in the State of Ceará have high epidemiological importance. In addition to other plague detection activities, plague areas can be monitored through serological surveys of dogs and cats (domestic carnivores), which, following feeding on plague-infected rodents, can develop mild to severe forms of the disease and produce long-lasting antibodies. This study aimed to characterize the circulation dynamics and spatial distribution of Yersinia pestis antibodies in dogs and cats in plague foci areas of Ceará. METHODS: An ecological study was conducted to analyze the temporal series and spatial distribution of secondary data obtained from domestic carnivore serum surveillance in Ceará’s plague areas from 1990 to 2014. RESULTS: Joinpoint analysis revealed that the overall trend was a reduction in antibody-positive animals. The mean proportion of antibody-positivity during the whole study period was 1.5% (3,023/203,311) for dogs, and 0.7% (426/61,135) for cats, with more than 4% antibody-positivity in dogs in 1997 and 2002. Antibody titers ranging from 1/16 to 1/64 were frequent. Despite fluctuations and a significant reduction, in recent years, there were antibody-positive animals annually throughout the study period, and the localities containing antibody-positive animals increased in number. CONCLUSION: Yersinia pestis is actively circulating in the study areas, posing a danger to the human population.</p></div

Is the recent increment in attributable deaths to type-2 diabetes (T2D) associated with the latest chikungunya outbreak in a major epidemic area in Brazil?

<div><p>Abstract INTRODUCTION: Chikungunya virus (CHIKV) can negatively influence outcomes in patients with pre-existing conditions. We investigated the association between the recent CHIKV outbreak and increased type 2 diabetes (T2D)-attributable deaths. METHODS: Monthly averages of T2D-attributable deaths between 2001 and 2016 were determined and compared to the equivalent data for 2017 and the recent CHIKV outbreak. RESULTS: CHKV outbreak peaked in April 2017 with 4,394.4 cases/100,000 inhabitants, while T2D-attributable deaths in the same period increased by 35.2%. CONCLUSIONS: T2D-attributable deaths significantly increased compared to the previous data, which overlapped with CHIKV incidence. The pathophysiology of this association warrants further investigations.</p></div

Prevalence and Associated Factors of Alcohol Consumption and Smoking among Medical Students in Northeastern Brazil

<p></p><p>ABSTRACT Introduction Tobacco and alcohol consumption is considered a major cause of diseases and disorders in the world. In Brazil, there has been increased consumption of these drugs among young people, especially university students. Objective To discover the prevalence of and factors associated to smoking and alcohol consumption among medical students, as well as their level of knowledge about techniques to stop smoking at different times of their academic life. Methods Analytical study of prevalence among medical students in Fortaleza, Ceará, Brazil. The study sample included all the city’s medical schools and their first year (S1/S2) and fourth year (S7/S8) students and students in the final year of their internship (I3/I4). The sample was calculated considering an expected smoker frequency of 10%, with a 3% margin of error, estimating 726 students in the four institutions. A structured questionnaire containing 46 questions was applied. Data were analyzed using Stata 11.2 software. Results 1,035 students were interviewed, distributed proportionally in the three periods: 392 (37.87%) from the first year (S1 / S2), 319 (30.82%) from the fourth year (S7/S8) and 324 (31.30%) interns (I3/I4). 553 students (53.4%) were female; most of the students were single (993; 96.3%), born in Fortaleza (748; 72.4%), living with their parents (896; 86.8%) and with a household income of more than 10 minimum wages (652; 61.8%). In total, 533 (51.5%) were students at private institutions. Of the total, 254 (24.6%) had smoked. This consumption was significantly higher among males (p = 0.025), with no difference in relation to marital status (p = 0.247) or household income (p = 0.191). All the students who reported having experienced any tobacco derivative also reported using alcohol in their lifetime (p < 0.000). Alcohol consumption was reported by more than 80% of the students, and was higher among those whose family income was more than nine times the minimum wage (p = 0.001). Alcoholic intoxication was reported by over 70% of the students – where this had occurred before the age of 18 years. Beer and vodka are the most consumed beverages. Only 39.5% said they were inclined to advise a patient to avoid alcoholic beverages and only 28.4% had received training on the subject at their university. Conclusion The prevalence of alcohol consumption is very high among medical students, especially among those who reported smoking. These issues are addressed in a primitive manner in their training. We must strengthen these aspects in the training of future health professionals.</p><p></p