Pesquisa | SciELO

RESUMO Objetivo: Inquérito nacional de cobertura vacinal aos 12 e 24 meses de idade foi realizado para investigar as quedas nas coberturas a partir de 2016. Métodos: Amostra de 37.836 nascidos vivos das coortes de 2017 e 2018 residentes nas capitais, Distrito Federal (DF) e 12 cidades com mais de 100 mil habitantes, acompanhados nos primeiros 24 meses por registros nas cadernetas de vacinação. Setores censitários foram estratificados segundo condições socioeconômicas, e o mesmo número de crianças foi incluído para cada estrato. Calcularem-se coberturas vacinais de cada vacina e coberturas completas aos 12 e 24 meses, doses aplicadas, válidas e oportunas. Fatores familiares, maternos e da criança associados à cobertura foram pesquisados. Os motivos para não vacinar analisados foram: contraindicações médicas, dificuldades de acesso, problemas no funcionamento do programa e hesitação vacinal. Resultados: Os resultados preliminares mostram que menos de 1% das crianças não foram vacinadas, as coberturas pelo esquema completo são menores que 75% em todas as capitais e no DF, as vacinas com mais de uma dose perdem cobertura progressivamente, há diferenças entre os estratos socioeconômicos, favoráveis aos estratos mais altos em algumas cidades e aos estratos mais baixos em outras. Conclusão: Houve realmente redução da cobertura vacinal em todas as capitais e no DF para as crianças nascidas em 2017 e 2018, denotando piora na execução do Programa Nacional de Imunizações durante os anos de 2017 a 2019. O inquérito realizado não mensurou os impactos da pandemia de COVID-19 que podem ter reduzido ainda mais as coberturas vacinais.

ABSTRACT Objective: The national vaccination coverage survey on full vaccination at 12 and 24 months of age was carried out to investigate drops in coverage as of 2016. Methods: A sample of 37,836 live births from the 2017 or 2018 cohorts living in capital cities, the Federal District, and 12 inner cities with 100 thousand inhabitants were followed for the first 24 months through vaccine record cards. Census tracts stratified according to socioeconomic levels had the same number of children included in each stratum. Coverage for each vaccine, full vaccination at 12 and 24 months and number of doses administered, valid and timely, were calculated. Family, maternal and child factors associated with coverage were surveyed. The reasons for not vaccinating analyzed were: medical contraindications, access difficulties, problems with the program, and vaccine hesitancy. Results: Preliminary results showed that less than 1% of children were not vaccinated, full coverage was less than 75% at all capitals and the Federal District, vaccines requiring more than one dose progressively lost coverage, and there were inequalities among socioeconomic strata, favorable to the highest level in some cities and to the lowest in others. Conclusion: There was an actual reduction in full vaccination in all capitals and the Federal District for children born in 2017 and 2018, showing a deteriorating implementation of the National Immunization Program from 2017 to 2019. The survey did not measure the impacts of the COVID-19 pandemic, which may have further reduced vaccination coverage.

https://doi.org/10.1590/1980-549720230031

Simultaneous Detection of Mycobacterium tuberculosis and Mycobacterium avium Complex by a Multiplex PCR
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Souza, Mariana Quaresma de

; Busatto, Caroline

; Reis, Ana Julia

; Groll, Andrea von

; Silva, Pedro Eduardo Almeida da

; Ramis, Ivy Bastos

Brazilian Archives of Biology and Technology

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2023, Volume 66 elocation e23220262

Resumo: En | Texto: En | PDF: En

Abstract Infection disease caused by nontuberculous mycobacteria (NTM) have been increasingly reported and often manifest with the same symptoms of tuberculosis (TB). The identification of the causative agent is fundamental for the determination of an appropriate therapy, since each species of mycobacteria requires a specific treatment. Thus, rapid and accurate tests to identify mycobacteria of medical interest, such as Mycobacterium tuberculosis complex (MTBC) and Mycobacterium avium complex (MAC), are necessary in the clinical routine. The present study evaluated an in-house multiplex PCR to detect, in reference and clinical strains, the genus Mycobacterium and also M. tuberculosis and MAC. To identify the Mycobacterium genus, M. tuberculosis and MAC, it was amplified a fragment of hsp65 gene, esat-6 gene, and the internal transcribed spacer between the 16S and 23S rRNA genes, respectively. In total, 87 mycobacteria strains were used, being 10 reference and 77 clinical strains, previously identified as MTBC (n = 66), M. avium (n = 8) or other NTM specie (n = 13). The hsp65 gene fragment was amplified for all mycobacteria strains evaluated (87/87). This multiplex PCR presented sensitivity of 100% and specificity of 95.2% for M. tuberculosis detection, and sensitivity of 100% and specificity of 100% for MAC detection. The multiplex PCR evaluated is an important tool for the differentiation between M. tuberculosis and NTM, as well as for the identification of MAC, a complex composed by species with high prevalence in the world.

https://doi.org/10.1590/1678-4324-2023220262

National Vaccine Coverage Survey 2020: methods and operational aspects
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Barata, Rita Barradas

; França, Ana Paula

; Guibu, Ione Aquemi

; Vasconcellos, Maurício Teixeira Leite de

; Moraes, José Cássio de

; Teixeira, Maria da Gloria Lima Cruz

; Domingues, Carla Magda Alan

; Borges, Maria Fernanda de Souza Oliveira

; de Azevedo, Roberta Nogueira Calandrini

; de Oliveira, Consuelo Silva

; Oliveira, Andrea de Nazaré Marvão

; Canales, Ivy Thereza

; Nascimento, Valdir

; Queiroz, Rejane Christine de Souza

; Lima, Luísa Helena de Oliveira

; Ramos Jr, Alberto Novaes

; Barbosa, Jaqueline Caracas

; Mirabal, Isabelle Ribeiro Barbosa

; Meira, Meiruska

; Antunes, Maria Bernadete de Cerqueira

; Teixeira, Maria Denise de Castro

; Gurgel, Ricardo Queiroz

; de Carvalho, Martha Suely Itaparica

; Cesar, Tayñana

; Maciel, Ethel Leonor Noia

; da Gama, Silvana Granado Nogueira

; Luhm, Karin Regina

; Boing, Antônio Fernando

; Mengue, Sotero Serrate

; de Oliveira, Sandra Maria do Valle Leone

; Lima, Jaqueline Costa

; Teles, Sheila Araújo

; Caetano, Karlla Antonieta Amorim

; de Araújo, Wildo Navegantes

Revista Brasileira de Epidemiologia

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2023, Volume 26 elocation e230031

Resumo: En Pt | Texto: En Pt | PDF: En | PDF: Pt

https://doi.org/10.1590/1980-549720230031

Completude dos dados do sistema de informações de tuberculose de pessoas privadas de liberdade do Rio Grande do Sul, Brasil
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Busatto, Caroline

; Jarczewski, Carla Adriane

; Dotta, Renata Maria

; Ely, Karine Zenatti

; Silva, Pedro Eduardo Almeida da

; Ramis, Ivy Bastos

; Possuelo, Lia Gonçalves

Ciência & Saúde Coletiva

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Dez 2022, Volume 27 Nº 12 Páginas 4461 - 4466

Resumo: Pt En | Texto: Pt En | PDF: Pt | PDF: En

Resumo A tuberculose (TB) apresenta incidências elevadas em todo o mundo, sendo ainda mais grave em pessoas privadas de liberdade (PPL). Foi avaliada a completude das notificações de TB de PPL no SINAN realizadas por equipes de atenção primária prisional (eAPP) ou por outros estabelecimentos de saúde do RS. Estudo descritivo, transversal, utilizando dados de notificações de PPL feitas no SINAN TB pelas eAPP ou por outros estabelecimentos de saúde, de janeiro de 2014 a novembro de 2018. Foi analisado o percentual de completude das variáveis: sexo, raça/cor, escolaridade, HIV, tipo de entrada, baciloscopia de escarro, cultura do escarro, Aids, tratamento antirretroviral durante o tratamento para a TB, tratamento diretamente observado (TDO), baciloscopia de 6º mês e situação de encerramento. Praticamente 53% dos casos de TB em PPL foram notificados por eAPP, e 47,1% foram notificados por outros estabelecimentos de saúde. Oitenta por cento das variáveis foram classificadas na categoria 4 (75,1% a 100% de completude). No entanto, as variáveis TDO e baciloscopia de 6º mês foram classificadas na categoria 3 (50,1% e 75% de completude). Embora não comprometa a notificação da TB no SINAN, a ausência de dados pode prejudicar a qualidade das informações sobre a doença.

Abstract Tuberculosis (TB) has a high incidence in several countries and is even more severe in prisoners. We evaluated the completeness of prisoners TB notifications in the Notifiable Disease Information System (SINAN) carried out by prison primary care teams (eAPP) or by other health facilities in the state of Rio Grande do Sul (RS). This descriptive cross-sectional study used prisoners data notifications in the SINAN TB by the eAPP or other health facilities from January 2014 to November 2018. We analyzed the percentage of completeness of the variables: gender, ethnicity, schooling, HIV, entry type, sputum smear, sputum culture, AIDS, ART during TB treatment, directly observed treatment (DOT), sixth-month smear, and closure status. Around 52.9% of TB cases in prisoners were reported by eAPP, and other health facilities reported 47.1% of the cases. Eighty percent of the variables were classified in category 4 (75.1% to 100% completeness). However, the DOT and sixth-month smear variables were classified into category 3 (50.1% and 75% completeness). While it does not compromise the notification of TB in the SINAN, the lack of data can impair the quality of information about the disease.

https://doi.org/10.1590/1413-812320222712.10162022

Are reduced internal nasal dimensions a risk factor for obstructive sleep apnea syndrome?
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Trindade, Sergio Henrique Kiemle

; Trindade, Inge Elly Kiemle

; Silva, Andressa Sharllene Carneiro da

; Araújo, Bruna Mara Adorno Marmontel

; Trindade-Suedam, Ivy Kiemle

; Sampaio-Teixeira, Ana Claudia Martins

; Weber, Silke Anna Theresa

Brazilian Journal of Otorhinolaryngology

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Jun 2022, Volume 88 Nº 3 Páginas 399 - 405

Resumo: Pt En | Texto: Pt En | PDF: Pt | PDF: En

Resumo Introdução A síndrome da apneia obstrutiva do sono é uma desordem de elevada prevalência na população. Estudos constataram possível associação entre obstrução nasal e síndrome da apneia obstrutiva do sono, porém a existência de uma relação entre a intensidade da obstrução nasal e a gravidade da síndrome da apneia obstrutiva do sono ainda não foi comprovada. Objetivo Avaliar as dimensões internas nasais de adultos com ronco primário e síndrome da apneia obstrutiva do sono por meio de rinometria acústica e correlacionar os achados com a gravidade da síndrome da apneia obstrutiva do sono. Método Foram avaliados 21 indivíduos com queixas de ronco e/ou pausas respiratórias durante o sono, gênero masculino, entre 18 e 60 anos, brancos. Após avaliação clínica, exame físico otorrinolaringológico e nasofaringolaringoscopia flexível, todos foram submetidos à polissonografia tipo III. Os participantes foram divididos em dois grupos de acordo com a gravidade dos sintomas: grupo 1, ronco primário e/ou síndrome da apneia obstrutiva do sono leve (n = 9) e grupo 2, síndrome da apneia obstrutiva do sono moderada/grave (n = 12). Dimensões internas nasais foram aferidas por rinometria acústica, foram consideradas para análise as áreas de secção transversa mínima e os volumes de três diferentes segmentos nasais. Resultados O índice de eventos respiratórios correspondeu a 8,1 ± 4,0 no grupo 1 e 47,5 ± 19,1 no grupo 2. No grupo 1, os valores de área de secção transversa, em cm2, corresponderam a: área de secção transversa 1 = 1,1 ± 0,4; área de secção transversa 2 = 2,1 ± 0,9; área de secção transversa 3 = 3,5 ± 1,8. No grupo 2: área de secção transversa 1 = 1,2 ± 0,3, área de secção transversa 2 = 2,0 ± 0,5; áre de secção transversa 3 = 2,8 ± 0,7. No grupo 1 os valores do volume, em cm3, corresponderam a: volume 1 = 3,5 ± 1,0; volume 2 = 9,3 ± 5,0; volume 3 = 40,2 ± 21,5 e no grupo 2 a: volume 1 = 3,6 ± 0,5; V2 = 7,6 ± 1,5; volume 3 = 31,5 ± 6,7. Os valores de área de secção transversa e volume não diferiram entre os grupos. Conclusão Não foram demonstradas diferenças significantes quanto às áreas seccionais transversas e os volumes nasais entre indivíduos com ronco primário e síndrome da apneia obstrutiva do sono leve e síndrome da apneia obstrutiva do sono moderada-grave. Contrariamente à hipótese levantada, os resultados sugerem não existir relação entre as dimensões internas nasais e o nível de gravidade da síndrome da apneia obstrutiva do sono.

Abstract Introduction Obstructive sleep apnea syndrome is a high-prevalence disorder found in the population. Studies have shown a possible association between nasal obstruction and obstructive sleep apnea syndrome, but the existence of a association between the degree of nasal obstruction and obstructive sleep apnea syndrome severity has not yet been proven. Objective To evaluate the internal nasal dimensions of adults with primary snoring and obstructive sleep apnea syndrome by acoustic rhinometry and to correlate the findings with obstructive sleep apnea severity. Methods Twenty-one male Caucasian subjects with complaints of snoring and/or respiratory pauses during sleep, aged between 18 and 60 years of age, were evaluated. After clinical evaluation, otorhinolaryngological examination and flexible nasopharyngolaryngoscopy, all patients underwent type III polysomnography. The participants were divided into two groups according to symptom severity: group 1, primary snoring and/or mild obstructive sleep apnea syndrome(n = 9) and group 2, moderate/severe obstructive sleep apnea syndrome (n = 12). Internal nasal dimensions were measured by acoustic rhinometry, analyzing minimum cross sectional area (CSA) and three nasal segment volumes. Results The respiratory event index corresponded to 8.1 ± 4.0 in group 1 and 47.5 ± 19.1 in group 2. In group 1, the cross-sectional areas values, in cm2, corresponded to: CSA 1 = 1.1 ± 0.4; CSA 2 = 2.1 ± 0.9; CSA 3 = 3.5 ± 1.8 and, in group 2: CSA 1 = 1.2 ± 0.3, CSA 2 = 2.0 ± 0.5; CSA 3 = 2.8 ± 0.7. In group 1, volumes (V), in cm3, corresponded to: V1 = 3.5 ± 1.0; V2 = 9.3 ± 5.0; V3 = 40.2 ± 21.5 and in group 2 a: V1 = 3.6 ± 0.5; V2 = 7.6 ± 1.5; V3 = 31.5 ± 6.7. Cross-sectional area and volume did not differ between groups. Conclusion There were no significant differences in the cross-sectional areas and nasal volumes between individuals with primary snoring-mild obstructive sleep apnea syndrome and moderate-severe obstructive sleep apnea syndrome. Differently to the raised hypothesis, our results suggest that there is no association between internal nasal dimensions and severity of obstructive sleep apnea syndrome.

https://doi.org/10.1016/j.bjorl.2020.06.014

Thesis and dissertations examining tuberculosis in Brazil between 2013 and 2019: an overview
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Reis, Ana Júlia

; Pizzol, Juliana Lemos Dal

; Gattelli, Rúbia

; Groll, Andrea von

; Ramos, Daniela Fernandes

; Ramis, Ivy Bastos

; Kritski, Afrânio

; Silva, José Roberto Lapa e

; Silva, Pedro Eduardo Almeida da

Revista da Sociedade Brasileira de Medicina Tropical

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2022, Volume 55 elocation e0198-2022

Resumo: En | Texto: En | PDF: En

ABSTRACT Background: Tuberculosis (TB) remains a serious public health problem, with approximately 10 million new cases reported annually. Knowledge about the quantitative evolution of theses and dissertations (T&Ds) examining human TB in Brazil can contribute to generating strategic planning for training professionals in this field and disease control. Therefore, this study highlights the role of T&Ds on TB in national scientific disclosures. Methods: An integrative review related to TB was performed, including T&Ds produced in Brazil and completed between 2013 and 2019. Results: A total of 559,457 T&Ds were produced, of which 1,342 were associated with TB, accounting for 0.24% of the total number of T&Ds in Brazil. This was evidenced by a predominance of themes such as attention/health care, epidemiology, and TB treatment, and 80.2% of the T&Ds on TB were related to the large areas of health and biological sciences. Only 19.7% of T&Ds were associated with groups of patients considered at risk for TB, and 50.9% were produced in southeastern Brazil. The 1,342 T&Ds on TB were developed in 416 postgraduate programs linked to 121 higher education institutions (HEIs). We highlight that 72.7% of T&Ds on TB were produced in federal HEIs, 27.4% in state HEIs, and 8.5% in private HEIs. Conclusions: Strategic themes, such as TB control, require public policies that aim to increase the number of doctors and masters with expertise in TB, with geographic uniformity, and in line with the priorities for disease control.

https://doi.org/10.1590/0037-8682-0198-2022

Telehealth in Oral Medicine: report of an experience from public health care in a southern Brazilian state
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Cardozo, Ivy

; Silva, Victor Cordeiro da

; Perdoncini, Nicole Nichele

; Torres-Pereira, Cassius Carvalho

Brazilian Oral Research

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2022, Volume 36 elocation e031

Resumo: En | Texto: En | PDF: En

Abstract: This study aimed to describe the telediagnosis of oral lesions through a telehealth program offered in the State of Paraná, southern Brazil. This report included all oral medicine-related teleconsultations between January 2015 and December 2019. Primary care dentists from the public health services of the state were trained to use the Telessaúde Brasil Redes platform, a national telehealth program that provides telediagnostic support through teleconsultations with specialists. Clinical information and images of oral lesions were solicited to each teleconsultation request. An oral medicine specialist evaluated the cases and provided diagnostic hypotheses, management, and referral suggestions. Finally, dentists were invited to evaluate the services. A total of 162 cases were submitted by 44 dentists. The patient's main complaint was described in 98.8% of cases, while the duration/evolution and the type of lesions were 64.81% and 40.12%, respectively. No images were attached to 19 (11.70%) patients. The information sent was sufficient for diagnostic reasoning in 125 (77.16%) requests. The specialist considered 78 cases (48.1%) to be resolved in primary care. Among respondents (45.7%), dentists considered that the teleconsultation “totally attended” their needs in 92% of requests. The description of the telehealth platform usage in oral medicine in Paraná showed the need to improve the participation of primary care dentists and the quality of clinical information provided as barriers to be overcome, aiming for the best usage of the platform.

https://doi.org/10.1590/1807-3107bor-2022.vol36.0031

Epidemiology and control strategies for tuberculosis in countries with the largest prison populations
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Busatto, Caroline

; Bierhals, Dienefer Venske

; Vianna, Julia Silveira

; Silva, Pedro Eduardo Almeida da

; Possuelo, Lia Gonçalves

; Ramis, Ivy Bastos

Revista da Sociedade Brasileira de Medicina Tropical

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2022, Volume 55 elocation e0060-2022

Resumo: En | Texto: En | PDF: En

ABSTRACT Tuberculosis (TB) is a serious infectious disease, and its control is considered a challenge, especially among vulnerable populations such as prisoners. The occurrence of TB in prisons is an alarming public health problem in many countries. This integrative review aims to describe the epidemiology of TB and control strategies for this disease in countries with the largest prison populations. Studies have shown that it is essential to know the prevalence of TB in prisons of each country. This is because it can serve as an indication of the need for action in prisons to reduce TB rates, including improving the structure of prison environments, rapidly and accurately diagnosing new cases, identifying drug-resistant strains, and implementing effective and directly observed treatment for TB.

https://doi.org/10.1590/0037-8682-0060-2022

Completude dos dados do sistema de informações de tuberculose de pessoas privadas de liberdade do Rio Grande do Sul, Brasil
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Busatto, Caroline

; Jarczewski, Carla Adriane

; Dotta, Renata Maria

; Ely, Karine Zenatti

; Silva, Pedro Eduardo Almeida da

; Ramis, Ivy Bastos

; Possuelo, Lia Gonçalves

Ciência & Saúde Coletiva

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2022, Volume 27 Nº 12 Páginas 4461 - 4466

Resumo: En Pt | Texto: En Pt | PDF: En | PDF: Pt

https://doi.org/10.1590/1413-812320222712.10162022

10.

Tuberculosis in prison inmates in Southern Brazil: investigating the epidemiological and operational indicators
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Busatto, Caroline

; Mespaque, Julia

; Schwarzbold, Pauline

; Souza, Camilo Darsie de

; Jarczewski, Carla Adriane

; Meucci, Rodrigo Dalke

; Andrews, Jason

; Croda, Julio

; Silva, Pedro Eduardo Almeida da

; Ramis, Ivy Bastos

; Possuelo, Lia Gonçalves

Revista da Sociedade Brasileira de Medicina Tropical

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2022, Volume 55 elocation e0052-2022

Resumo: En | Texto: En | PDF: En

ABSTRACT Background: Tuberculosis is a worldwide public health problem and is more prevalent in specific populations, such as prisoners. The aim of this study was to analyze the epidemiological and operational indicators of tuberculosis in prisoners in a southern region of Brazil. Methods: This was a descriptive, observational study, utilizing secondary data from the Notifiable Diseases Information System on tuberculosis cases diagnosed in prisoners in the state of Rio Grande do Sul, southern Brazil, from 2014 to 2018. Prisoner data used to calculate incidence were extracted from reports by the National Penitentiary Department. Results: From 2014 to 2018, 3,557 tuberculosis cases were reported in Rio Grande do Sul prisoners. The incidence rate of tuberculosis in prisoners was 1,235/100,000 individuals in 2014 and 1,430/100,000 individuals in 2018. The proportion of new TB cases tested for HIV was high, 83.4% in this period; among those tested, 12.9% were HIV coinfected. The proportion of new cases of pulmonary tuberculosis confirmed by laboratory criteria was 52.6% in this period. In total, 18.4% of new pulmonary tuberculosis cases were initiated on directly observed treatment in this period, and 36.4% of contacts of new cases of pulmonary tuberculosis with laboratory confirmation were examined. Among retreatment pulmonary tuberculosis cases, 82.4% were laboratory-confirmed. Conclusions: Tuberculosis incidence is increasing on a per-capita and absolute basis in Rio Grande do Sul. Laboratory confirmation, HIV testing, directly observed treatment, and contact investigation rates were all low, indicating the need to improve medical and public health measures for tuberculosis control in prisons.

https://doi.org/10.1590/0037-8682-0052-2022

11.

Infecção por COVID-19 em Gestante Cardiopata
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Holanda, Lucianna Serfaty de

; Vieira, Laíses

; Campos, Maria Talita

; Holanda, Vitor Bruno Teixeira de

; Silva, Ivy Almeida Cavalcante e

; Serfaty, Daniel

; Vieira Junior, Feliciano Mendes

Arquivos Brasileiros de Cardiologia

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Nov 2020, Volume 115 Nº 5 Páginas 936 - 938

Resumo: Pt En | Texto: Pt En | PDF: Pt | PDF: En

https://doi.org/10.36660/abc.20200517 1934 downloads

12.

Does pulmonary rehabilitation decrease plasma myostatin levels in patients with COPD?
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Araujo, Cintia Laura Pereira de

; Silva, Ivy Reichert Vital da

; Lago, Pedro Dal

Jornal Brasileiro de Pneumologia

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2020, Volume 46 Nº 6 elocation e20200043

Resumo: Pt En | Texto: Pt En | PDF: Pt | PDF: En

https://doi.org/10.36416/1806-3756/e20200043 352 downloads

13.

Laboratory diagnosis for Covid-19: A mini-review
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Pizzol, Juliana Lemos Dal

; Hora, Vanusa Pousada da

; Reis, Ana Júlia

; Vianna, Júlia

; Ramis, Ivy

; Groll, Andrea von

; Silva, Pedro Almeida da

Revista da Sociedade Brasileira de Medicina Tropical

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2020, Volume 53 elocation e20200451

Resumo: En | Texto: En | PDF: En

Abstract Coronavirus disease (COVID-19) is a pandemic caused by a new coronavirus, called SARS-CoV-2. This disease was first identified in December 2019 and rapidly developed into a challenge to the public health systems around the world. In the absence of a vaccine and specific therapies, disease control and promotion of patient health are strongly dependent on a rapid and accurate diagnosis. This review describes the main laboratory approaches to making a diagnosis of COVID-19 and identifying those previously infected with SARS-CoV-2.

https://doi.org/10.1590/0037-8682-0451-2020 4856 downloads

14.

Nontuberculous mycobacteria in patients with suspected tuberculosis and the genetic diversity of Mycobacterium avium in the extreme south of Brazil
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Busatto, Caroline

; Vianna, Júlia Silveira

; Silva, Ana Barbara Scholante

; Basso, Rossana

; Silveira, Jussara

; Groll, Andrea Von

; Ramis, Ivy Bastos

; Silva, Pedro Eduardo Almeida da

Jornal Brasileiro de Pneumologia

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2020, Volume 46 Nº 2 elocation e20190184

Resumo: Pt En | Texto: Pt En | PDF: Pt | PDF: En

RESUMO Objetivo: As micobactérias não tuberculosas (MNT) são um grupo heterogêneo de bactérias amplamente distribuídas na natureza e relacionadas com infecções oportunistas em seres humanos. Os objetivos deste estudo foram identificar MNT em pacientes com suspeita de tuberculose e culturas positivas e avaliar a diversidade genética de cepas identificadas como Mycobacterium avium. Métodos: Foram estudadas amostras pulmonares e extrapulmonares provenientes de 1.248 pacientes. As amostras que apresentaram resultado positivo em cultura e negativo para o complexo M. tuberculosis na identificação molecular foram avaliadas por meio da detecção dos genes hsp65 e rpoB e de sequenciamento de fragmentos conservados desses genes. Todas as cepas identificadas como M. avium foram genotipadas pelo método mycobacterial interspersed repetitive unit-variable-number tandem-repeat com oito loci. Resultados: Das 332 micobactérias isoladas, 25 (7,5%) eram MNT. Dessas 25, 18 (72%) eram M. avium, 5 (20%) eram M. abscessus, 1 (4%) era M. gastri e 1 (4%) era M. kansasii. As 18 cepas de M. avium apresentaram alta diversidade, e apenas duas eram geneticamente relacionadas. Conclusões: Esses resultados mostram a necessidade de considerar a investigação de MNT em pacientes com suspeita de tuberculose ativa e culturas positivas e de avaliar a diversidade genética de cepas de M. avium.

ABSTRACT Objective: Nontuberculous mycobacteria (NTM) are a heterogeneous group of bacteria that are widely distributed in nature and associated with opportunistic infections in humans. The aims of this study were to identify NTM in patients with suspected tuberculosis who presented positive cultures and to evaluate the genetic diversity of strains identified as Mycobacterium avium. Methods: We studied pulmonary and extrapulmonary samples obtained from 1,248 patients. The samples that tested positive on culture and negative for the M. tuberculosis complex by molecular identification techniques were evaluated by detection of the hsp65 and rpoB genes and sequencing of conserved fragments of these genes. All strains identified as M. avium were genotyped using the eight-locus mycobacterial interspersed repetitive unit-variable-number tandem-repeat method. Results: We found that NTM accounted for 25 (7.5%) of the 332 mycobacteria isolated. Of those 25, 18 (72%) were M. avium, 5 (20%) were M. abscessus, 1 (4%) was M. gastri, and 1 (4%) was M. kansasii. The 18 M. avium strains showed high diversity, only two strains being genetically related. Conclusions: These results highlight the need to consider the investigation of NTM in patients with suspected active tuberculosis who present with positive cultures, as well as to evaluate the genetic diversity of M. avium strains.

https://doi.org/10.36416/1806-3756/e20190184 734 downloads

15.

Evaluation of insecticide resistance in Aedes aegypti populations connected by roads and rivers: the case of Tocantins state in Brazil
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Sá, Eric Luiz Rodrigues de

; Rodovalho, Cynara de Melo

; Sousa, Nilciane Pinto Ribeiro de

; Sá, Ivy Luizi Rodrigues de

; Bellinato, Diogo Fernandes

; Dias, Luciana dos Santos

; Silva, Luana Carrara da

; Martins, Ademir Jesus

; Lima, José Bento Pereira

Memórias do Instituto Oswaldo Cruz

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2019, Volume 114 elocation e180318

Resumo: En | Texto: En | PDF: En

BACKGROUND The longstanding application of insecticides for vector control without periodic monitoring of the population response to these chemicals can directly drive the selection of resistant populations of vector mosquitoes. Tocantins is the newest state of the Brazilian Federation. Despite a historically high number of dengue cases, studies and monitoring data concerning insecticide resistance in the state are lacking. OBJECTIVES To verify the resistance status of Aedes aegypti from 10 populations distributed throughout the state connected by rivers and roads. METHODS Between 50 and 150 ovitraps were installed in house gardens within each municipality. Collection points were established based on the importance of the towns and on geographic aspects. Dose response bioassays were performed in accordance with World Health Organization guidelines. Molecular assays were conducted to detect kdr mutations, which are related to pyrethroid resistance. FINDINGS Of the 3,200 ovitrap paddles analysed, 25.8% contained eggs, with a total of 55,687 eggs collected. With the exception of Caseara, all evaluated populations were considered to be resistant to temephos. The data showed different levels of resistance to deltamethrin among the samples. Caseara and Guaraí showed the lowest RR95 values. On average, the NaVR1 kdr allele was most frequent (40.3%), followed by NaVS (38.1%), and NaVR2 (21.6%). Palmas, the capital of the state, had the highest frequency of kdr alleles (87.5%). MAIN CONCLUSIONS With the exception of Palmas, the towns with the highest indexes (ovitrap positivity, number and density of eggs), as well with high levels of resistance and kdr alleles were located along the BR-153 road, indicating that the flow of people and cargo can contribute to the dispersion of the vector and potentially resistance. This study contributes substantially to knowledge regarding the insecticide resistance profile of Tocantins mosquito populations; the data generated via the study could facilitate the judicious use of insecticides by vector control programs.

https://doi.org/10.1590/0074-02760180318 1688 downloads

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