ABSTRACT Background: Chagas disease (CD) is caused by Trypanosoma cruzi and transmitted by triatomines. Historical information from the 20th century demonstrates T. cruzi records in the metropolitan region of Salvador (MRS), the third largest urban agglomeration in the Brazilian Northeast and the eighth largest in Brazil, an area with intense migratory activity from CD-endemic regions. Therefore, this study aimed to evaluate CD indicators (prevalence and mortality) in the MRS. Methods: A mixed ecological and descriptive study was conducted using secondary data. We analyzed data from 2008 to 2015: deaths due to CD, self-reported cases of CD, and blood donors that were non-negative for T. cruzi infection. Results: São Francisco do Conde was one of the municipalities with the highest mortality rates due to CD. The seroprevalence rates varied by year and municipality; those with the highest values were 2008: Vera Cruz, 2009: Mata de São João, 2010: Dias D'Ávila, 2011 and 2015: São Francisco do Conde, 2012: São Sebastião do Passé, and 2013 and 2014: Pojuca. Spatial correlations between the municipalities were not detected. Conclusions: We conclude that CD is present in the MRS. The indicators analyzed in the MRS are below-state-level data. Given the importance of indicator analysis for the surveillance and control of CD at the state and national levels, it is important to strengthen the surveillance program at the municipal level, including the regions classified as low risk for T. cruzi vector transmission.

ABSTRACT Background: Neglected tropical diseases are a growing threat to global health, and endemic Chagas disease has emerged as one of the most important health problems in America. The main strategy to prevent Trypanosoma cruzi transmission is chemical control of vectors. This study presents a descriptive analysis of synanthropic triatomines before and after the implementation of a vector-control program in Bahia, Brazil. Methods: Descriptive analysis and geospatial statistics were performed on triatomine data, (1) the relative abundance and (2) proportional spatial distribution, from Bahia during two periods: (A) 1957 to 1971 and (B) 2006 to 2019. Results: We observed a decrease in the relative abundance of Panstrongylus megistus (A: n=22.032, 61.9%; B: n=1.842, 1.0%) and Triatoma infestans (A: n=1.310, 3.7%; B: n=763, 0.43%), as well as an increase in the relative abundance of T. sordida (A: n=8.314, 23.4%, B: n=146.901, 81.6%) and T. pseudomaculata (A: n=894, 2.5%, B: n=16.717, 9.3%). Conclusions: Our results indicate a clear reduction in the occurrence of P. megistus and T. infestans (last record in 2015) and an increase in the relative abundance and geographical distribution of T. sordida and T. pseudomaculata after 40 years of the vector-control program. The high frequency of other triatomine species in the municipalities of the state of Bahia and their abundance in recent years highlight the need to reinforce permanent entomological surveillance actions to prevent Chagas disease.

Resumo A doença de Chagas é uma das principais doenças tropicais negligenciadas causadas pelo Trypanosoma cruzi, e em seu tratamento utilizam-se medicamentos como o nifurtimox e o benzonidazol, que causam vários efeitos colaterais. O mercado de produtos naturais tem aumentado consideravelmente nos últimos anos, e o uso das plantas continua sendo uma alternativa para o desenvolvimento de novos medicamentos para cura de doenças. Portanto, este estudo aborda a composição química do óleo essencial dos frutos verdes de Protium ovatum e a avaliação de seus potenciais tripanocida e citotóxico. O óleo essencial foi obtido por hidrodestilação, utilizando o aparato do tipo Clevenger. A composição química foi determinada por cromatografia gasosa acoplada ao espectrômetro de massas (CG-EM). Os principais compostos encontrados no óleo essencial dos frutos verdes de P. ovatum foram: ß-mirceno (62,0 %), a-pineno (11,3 %) e limoneno (7,3 %). Este é o primeiro relato da composição química do óleo essencial obtido a partir de frutos verdes de P. ovatum. Os resultados mostraram que o óleo essencial analisado apresenta forte atividade tripanocida contra as formas tripomastigota da cepa Y do Trypanosoma cruzi (IC50 = 1,2 µg/mL). O óleo essencial exibiu ainda moderada citotoxidade frente à linhagem LLCMK2 na concentração avaliada (CC50 = 550,3 µg/mL). Em suma, o óleo essencial dos frutos verdes de P. ovatum pode ser considerado uma fonte alternativa para o desenvolvimento de novos medicamentos antiparasitários.

Abstract Chagas disease is a major neglected tropical disease caused by Trypanosoma cruzi. It has been treated with the antiparasitic drugs nifurtimox and benzonidazole, which cause several side effects. The market for natural products has considerably grown lately and the use of plants has become an alternative to the development of novel drugs to cure the disease. Therefore, this study aimed at describing the chemical analysis of the essential oil from green fruits of Protium ovatum and evaluating their trypanocidal and cytotoxic potential. The essential oil was obtained by Clevenger hydrodistillation whereas its chemical composition was determined by gas chromatography coupled to mass spectrometry (GC-MS). The major compounds found in the essential oil from green fruits of P. ovatum were ß-myrcene (62.0 %), a-pinene (11.3 %) and limonene (7.3 %). To the best of our knowledge, this was the first time that the chemical composition of the essential oil from green fruits of P. ovatum was described. Results showed that the essential oil had strong trypanocidal activity against trypomastigote forms of theY strain of Trypanosoma cruzi (IC50 = 1.2 µg/mL). In addition, the essential oil from green fruits of P. ovatum did not display cytotoxicity against LLCMK2 adherent epithelial cell at the concentration range under analysis (CC50 = 550.3 µg/mL). As a result, it is an excellent option for the development of novel antiparasitic drugs.

Objetivou-se neste estudo apresentar uma revisão histórica sobre a cegueira noturna, um indicador funcional da deficiência de vitamina A. Realizou-se uma revisão da literatura científica publicada no período de 1929 a 2005, nas bases de dados Medline, Lilacs, SciELO e dos comitês nacionais e internacionais de saúde e de micronutrientes, utilizando-se os termos night blindness, xerophthalmia, pregnancy, post partum women, newborn, children, vitamin A deficiency, micronutrient, deficiência de vitamina A, micronutriente, cegueira noturna, gestação, xeroftalmia. O reconhecimento da importância do indicador funcional da deficiência de vitamina A foi consagrado em 1996 pela Organização Mundial de Saúde, a partir da recomendação de uma entrevista padronizada para investigação da cegueira noturna. O método se caracteriza por apresentar facilidades operacionais, ser de baixo custo, além de permitir a sua aplicação tanto para o monitoramento do estado nutricional de pessoas e comunidades, quanto para a avaliação da eficácia de programas de intervenção. Entre gestantes e nutrizes, estudos recentes sugerem a utilidade deste indicador no diagnóstico dos casos de deficiência de vitamina A ainda no estágio subclínico da deficiência, sendo grande a sua concordância com indicadores bioquímicos. Ao longo dos anos, verifica-se também o reconhecimento deste indicador como um instrumento importante para a predição do risco de morbimortalidade no grupo materno-infantil.

The aim of this study was to provide a historical review of night blindness, a functional indicator of vitamin A deficiency. The scientific literature published in the period from 1929 to 2005 was reviewed, using Medline, Lilacs, SciELO, National and International Health and Micronutrients Comities databases. The key words used were: night blindness, xerophthalmia, pregnancy, postpartum women, newborn, children, vitamin A deficiency, micronutrient. The importance of the functional indicator of vitamin A deficiency has been consecrated in 1996 by the World Health Organization through the recommendation of a standardized interview to investigate cases of night blindness. The method is characterized by methodological easiness, low cost and it allows the monitoring of the nutritional status of people and communities, and evaluation of the efficacy of interventions. Recent studies suggest that this indicator is also useful for diagnosing subclinical vitamin A deficiency among pregnant women and postpartum women, since the agreement with biochemical indicators is expressive. Along the years, this indicator has also been recognized as an important instrument to predict the risk of morbidity and mortality in the mother-child dyad.