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Memórias do Instituto Oswaldo Cruz, Volume: 89, Número: 3, Publicado: 1994
  • Henrique de Beaurepaire Rohan Aragão: 21.12.1879-25.02.1956

    Coura, José Rodrigues
  • The epidemiological importance of Triatoma nigromaculata (Stal, 1859) colonizing human dwellings of the Venezuelan Andes

    V. Scorza, José; Solarte, Yezid; Moreno, Elio
  • Living and avoiding malaria infection in endemic areas of the amazon basin

    Balthazar-Guedes, Helena Cristina; Ferreira-da-Cruz, Maria de Fátima; Daniel-Ribeiro, Claudio Tadeu
  • Observations on some Avian Coccidia (Apicomplexa: Eimeriidae) in Amazonian Brazil

    Lainson, Ralph

    Resumo em Inglês:

    Oocysts of Eimeria porphyrulae n. sp. are described in faeces of Porphyrula martinica (Aves: Gruiformes: Rallidae). They are ellipsoidal to oval, 22.4 x 17.7 (20.0-23.7 x 16.2-18.7) µm, shape-index (length/width) 1.3. Oocyst wall about 1.25 µm thick, colourless, with two layers: inner one prominently striated. Micropyle and sub-micropylar granule present: no oocyst residuum. Sporocysts 17.5 x 9.0 (17.0-19.0 x 8.0-10.0) µm, shape-index 1.9, with inconspicuous Stieda/sub-Stieda bodies. Sporocyst residuum of scattered granules, sometimes a compact mass: sporozoites with two refractile bodies. Eimeria crypturelli n. sp. is described in faeces of Crypturellus soiu (Tinamiformes: Tinamidae). Oocysts ellipsoidal-oval, 20.75 x 14.5 (17.5-25.0 x 11.25-21.25) µm, shape-index 1.4. Oocysts wall about 1.25 µm thick and bi-layered: inner layer faintly striated. Micropyle present, with oocyst residuum immediately below: single polar body rarely present. Sporocysts 13.0 x 7.5 (12.5-13.75 x 7,5-8.1) µm, shape-index 1.7, with a Stieda body but seemingly no sub-Stieda. Sporocyst residuum compact: sporozoites with two refractile bodies. Isospora cacici n. sp. is recorded from faeces of Cacicus cela cela (Passeriformes: Icteridae). Oocysts subspherical-spherical, 26.5 x 23.7 (22.5-27.5 x 20.0-26.2) µm, shape-index 1.1. Wall a single, colourless layer about 1.5 µm thick. No micropyle or oocyst residuum: 1-2 polar bodies. Sporocysts ellipsoidal, 17.7 x 12.5 (17.5-18.75 x 11.25-13.75) µm, shape-index 1.4, with pronounced Stieda/sub-Stieda bodies: residuum compact and sporozoites with two refractile bodies. Isospora thraupis n. sp. is described from faeces of Thraupis palmarum melanoptera (Passeriformes: Thraupidae). Oocysts subspherial-spherical, 19.9 x 19.0 (18.7-21.2 x 18.75-20.0) µm, shape-index 1.0. Wall about 0.6 µm thick, smooth, colourless and a single layer: no micropyle, oocyst residuum or polar bodies. Sporocysts 14.2 x 9.2 (13.7-16.2 x 8.7-10.0) µm, shape-index 1.5: Stied/sub-Stieda bodies inconspicuous. Residuum compact: sporozoites with two refractile bodies.
  • Expanded description of the female of Lernaeenicus longiventris Wilson, 1917, (Copepoda, Siphonostomatoida, Pennellidae) based on specimens from Mugil platanus Günter, 1880 (Perciformes, Mugilidae) of the state of Rio de Janeiro, Brazil

    Knoff, Marcelo; Boeger, Walter A.

    Resumo em Inglês:

    The description of Lernaeenicus longiventris is expanded and revised, based on specimens collected from the skin and fins of mullets, Mugil platanus Gunther, 1880, from 21 locations in coastal waters of the state of Rio de Janeiro, Brazil.
  • Description of a new species of sand fly Lutzomyia (Pressatia) mamedei n. sp. (Diptera: Psychodidae) from Rio de Janeiro, Brazil

    Oliveira, Sandra Maria; Afonso, Rosenilde C. de Holanda; Dias, Cristina Maria Giordano; Brazil, Reginaldo P.

    Resumo em Inglês:

    A new species of sand fly from Santa Cruz, state of Rio de Janeiro, Brazil is described as Lutzomyia (Pressatia) mamedei.
  • A preliminary checklist and key to the genera and subgenera of Tabanidae (Diptera) of Bolivia with particular reference to Santa Cruz Department

    Chainey, Jonh E.; Hall, Martin Junior; Aramayo B., José L.; Bettella, Paolo

    Resumo em Inglês:

    This paper documents 32 genera and 167 species of Tabanidae reported from Bolivia. All available data are cited for each species. A key to genera and subgenera is presented and includes illustrations. This preliminary checklist and key is intended as a baseline for further study, the aim of which is to establish which species are of greatest economic importance.
  • Revalidação do gênero Mepraia, Mazza, Gajardo & Jorg, 1940 (Hemiptera, Reduviidae, Triatominae)

    Lent, Herman; Jurberg, José; Galvão, Cleber

    Resumo em Inglês:

    The authors revalidate the genus Mepraia, described in 1940 by Mazza, Gajardo & Jörg. The genus is monotypic and represented by the species M. spinolai (Porter, 1934). Based on the characteres described below the authors considered the separation of the genus Triatoma Laporte, 1832 and the return of the genus Mepraia. Strongly alar polymorphism, the abdomen of female with connexivum like in genus Dipetalogaster Usinger 1939, seven testicular follicles, like in Triatoma, however with a different relation of lenghts; external male genitalia showing a big and foliar process of the conjunctiva, vesica with an arch-shape, struts and endosoma process absent.
  • Triatoma melanosoma, novo status para Triatoma infestans melanosoma Martinez, Olmedo & Carcavallo, 1987 (Hemiptera: Reduviidae)

    Lent, Herman; Jurberg, José; Galvão, Cleber; Carcavallo, Rodolfo Ubaldo

    Resumo em Inglês:

    Triatoma infestans melanosoma was described in 1987 by Martinez, Olmedo & Carcavallo. In the present work the authors make a redescription, adding new characters, and based on biological and morphological aspects raise up to the level of species and being identified as Triatoma melanosoma. A detailed morphological study of the external male genitalia was made.
  • Nematode parasites of brazilian accipitrid and Falconid birds (Falconiformes)

    Pinto, Roberto Magalhães; Vicente, J. Julio; Noronha, Dely
  • Parasites of the chilean jack mackerel Trachurus symmetricus murphyi (Pisces: Carangidae)

    Oliva, Marcelo E.
  • ELISA for the detection of human leptospirosis

    Obregon Fuentes, Ana Margarita; Otero Gonzalez, Anselmo; Laferte Serrano, Jose
  • Detection of Trypanosoma cruzi and Leishmania using the polymerase chain reaction

    Degrave, Win; Fernandes, Octavio; Thiemann, Otavio; Wincker, Patrick; Britto, Constança; Cardoso, Angélica; Pereira, José Borges; Bozza, Marcelo; Lopes, Ulisses; Morel, Carlos
  • Prevalence of antibodies against an immunodominant region of the HIV-1 envelope glycoprotein gp41 in sera from HIV-1 infected individuals in Brazil

    Bongertz, Vera; Morgado, Mariza Gonçalves
  • Electrocardiographic alteration among first degree relatives with serologic evidence of Trypanosoma cruzi infection: a sibship study

    C. Morini, Julio; Berra, Héctor; O. Dávila, Héctor; F. Pividori, Juan; A. Botasso, Oscar

    Resumo em Inglês:

    To analyze whether electrocardiographic alterations (ECGA) in patients with antibodies to Trypanosoma cruzi showed a patttern of familial aggregation, a sample of 379 young adults (166 men and 213 women) distributed in sibships, were assessed for the presence of anti-T.cruzi antibodies, and subjected to a complete clinical examination and a standard resting electrocardiogram (ECG). Positive T. cruzi serology was detected in 165 individuals, 48 of them showing an abnormal ECG (overall prevalence 29 por cento). One hundred and eleven seropositive individuals were distributed in 45 sibships, each of them constituted by more than one seropositive sib, with ECGA being present in 34 out of these patients. Seropositive subjects with ECGA were detected in 27 sibships. Since the index case within each sibship is counted exactly once, affected individuals selected at random as propositi were extracted to calculate the prevalence of ECGA among first degree relatives of probands. Abnormal ECGs were recorded in 7 out of 45 sibs yielding a prevalence that did not differ from estimations registered in the general population or seropositive sibs. Data from the present sample show no familial aggregation for the occurrence of ECGA in patients with T.cruzi infection.
  • Hepatitis B vaccination in leprosy patients

    Rosa, Heitor; Pedrosa, Suelene; Cardoso, Divina D. P.
  • Morphological aspects of the myocarditis and myositis in Calomys callosus experimentally infected with Trypanosoma cruzi: fibrogenesis and spontaneous regression of fibrosis

    Andrade, Sonia G.; Kloetzel, Judith K.; Borges, Monamaris M.; Ferrans, Victor J.

    Resumo em Inglês:

    Calomys callosus a wild rodent, is a natural host of Trypanosoma cruzi. Twelve C. callosus were infected with 10(5) trypomastigotes of the F strain (a myotropic strain) of T. cruzi. Parasitemia decreased on the 21 st day becoming negative around the 40th day of infection. All animals survived but had positive parasitological tests, until the end of the experiment. The infected animals developed severe inflammation in the myocardium and skeletal muscle. This process was pronounced from the 26 th to the 30th day and gradually subsided from the 50 th day becoming absent or residual on the 64 th day after infection. Collagen was identified by the picro Sirius red method. Fibrogenesis developed early, but regression of fibrosis occurred between the 50th and 64th day. Ultrastructural study disclosed a predominance of macrophages and fibroblasts in the inflammatory infiltrates, with small numbers of lymphocytes. Macrophages had active phagocytosis and showed points of contact with altered muscle cells. Different degrees of matrix expansion were present, with granular and fibrilar deposits and collagen bundles. These alterations subsided by the 64th days. Macrophages seem to be the main immune effector cell in the C. callosus model of infection with T. cruzi. The mechanisms involved in the rapid fibrogenesis and its regression deserve further investigation.
  • Ultrastructural study on experimental infection of rotavirus in a murine heterologous model

    Majerowicz, Selma; Kubelka, Claire Fernandes; Stephens, Paulo; Barth, Ortrud Monika

    Resumo em Inglês:

    Viral replication, histopathological and ultrastructural changes were observed for a period of nine days in the small intestine of suckling mice infected with a simian rotavirus (SA11). Samples taken from duodenum, jejunun and ileum were prepared for light microscopy, transmission and scanning electron microscopy analysis. Histopathologic effect could be detected within 8 hr post-infection, when only a few altered cells were observed. Damage was extensive after 16 hr post-infection, showing swollen enterocytes and reduced and irregularly oriented microvilli at intestinal villi tips. Virus particles were detected at 16 and 48 hr post-infection, budding from the viroplasm into the rough endoplasmic reticulum cisternae in ileum enterocytes. Clear evidence of viral replication, observed by electron microscopy was not described before in heterologous murine models. Regeneration of the intestinal villi began at the third day post-infection. Despite some differences observed in clinical symptoms and microscopic analysis of homologous and heterologous rotavirus infections, we concluded that mechanisms of heterologous rotavirus infection in mice follow similar patterns to those observed in the homologous models.
  • Effects of the spore-endotoxin complex of a strain of Bacillus thuringiensis serovar morrisoni upon Triatoma vitticeps (Hemiptera: Reduviidae) under laboratory conditions

    Lima, Marli Maria; Santos, Lúcia Maria Matos dos; Silva, Maria Helena Luz da; Rabinovitch, León
  • Eurytrema coelomaticum (Digenea, Dicrocoeliidae): the effect of infection on carbohydrate contents of its intermediate snail host, Bradybaena similaris (Gastropoda, Xanthonychidae)

    Pinheiro, Jairo; Amato, Suzana B.

    Resumo em Inglês:

    The interface Eurytrema coelomaticum/Bradybaena similaris was studied by quantifying the amount of glucose on the hemolymph and the content of glycogen in the cells of the digestive gland and the cephalopedal mass of infected and uninfected snails. Samples were analyzed on days 0, 30, 90 and 150 post-infection. The infected snails had less glucose in the hemolymph, with a reduction of 67.05 por cento at 30 days, and 62.09 por cento at 90 days post-infection. The reduction in glycogen content was 86.41 por cento in the digestive gland and 79.1 por cento in the cephalopedal mass at 30 days, and 92.71 por cento and 90.89 por cento in these organs respectively at 90 days post-infection. It is proposed that the sporocysts absorb glucose directly from the hemolymph.
  • Host-induced morphological changes of Schistosoma mansoni Sambon, 1907 male worms

    Machado-Silva, José Roberto; Galvão, Cleber; Presgrave, Octavio Augusto França; Rey, Luis; Gomes, Delir Corrêa

    Resumo em Inglês:

    In order to evaluate the permissiveness of Nectomys squamipes to Schistosoma mansoni and the influence of the albino mice on the morphological aspects of adult worms derived from a population isolated from N. squamipes, the morphology of adult S. mansoni Sambon, 1907 male worms was studied using a digital image analyser (MOP VIDEOPLAN) and light microscopy. Their sources were as follows: (1) recovered from the wild rodent N. squamipes Brants naturally infected from Sumidouro, RJ, Brazil; (2) recovered from albino mice experimentally infected with the strain derived from N. squamipes; (3) recovered after the isolation of a strain derived from aboriginal human infections in Sumidouro. Worms recovered from N. squamipes (group 1) showed body lenght and distance between suckers significantly bigger than those of the specimens maintained in mice (groups 2 and 3). The number of tests in group 1 was statistically less than of groups 2 and 3. Group 2 strains which were maintained in mice, presented the lenght of the worms as the only significant different character. Data show that: (1) N. squamipes is a more suitable host for the development of S. mansoni when compared to the albino mice; (2) a strain of S. mansoni isolated from a natural host undergoes morphological changes after its passage in the white mouse.
  • Observation on the host parasitoid interaction between Periplaneta americana, the American cockroach and Tetrastichus hagenowii, an oothecal parasitoid

    Srinivasan, R.; Panicker, K. N.

    Resumo em Inglês:

    Investigations were carried out on the host parasitoid interaction between Periplaneta americana, the American cockroach and Tetrastichus hagenowii, an oothecal parasitoid. This gregarious female parasitoid infected and or oviposited in only one host and caused 100 por cento mortality of the infected host. However, increase in parasitoid density decreased the progeny production and influenced the sex ratio. The progenies produced were male biased. When host preference was tested by offering oothecae of different species of cockroaches, T. hagenowii showed a predilection towards the oothecae of P. americana, suggestings its host specificity.
  • Longevity of adults of Peckia chrysostoma and Adiscochaeta ingens (Diptera: Sarcophagidae) reared with and without protein

    Ferraz, Marisa Vianna

    Resumo em Inglês:

    With access to a proteic source in the diet the mean longevity and lethal time (MLT) of Peckia chrysostoma was 52.6 ± 5.5 and 30.3 ± 5.9 days, respectively. With an isolated protein source, the mean longevity was 49.1 ± 2.6 days and the MLT was 28.5 ± 0.8 days. Without a proteic source the mean longevity and the MLT lowered to 37.4 ± 4.0 and 18.1 ± 1.3 days, respectively. For Adiscochaeta ingens the mean longevity with access to a proteic source in the diet was 29.0 ± 6.0 days and the MLT was 16.7 ± 2.7 days. The figures with an isolated proteic source were 26.9 ± 4.8 and 14.9 ± 2.0 days, and without a proteic source were 24.7 ± 4.2 and 13.3 ± 1.4 days, respectively. These results show that in P. chrysostoma the longevity is higher than in A. ingens and that the access to the proteic source increase the longevity in both species.
  • Foreword

    Brandão-Filho, Sinval P.
  • Endemic leishmaniasis in Brazil: future implications

    Marsden, Philip Davis

    Resumo em Inglês:

    Some predictions are made as to how work on leishmaniaisis and its control will develop in Brazil in the future.
  • Ecoepidemiological aspects of american cutaneous leishmaniasis in the state of São Paulo, Brazil

    Tolezano, José Eduardo

    Resumo em Inglês:

    The aim of this study is to review some of the ecoepidemiological aspects of american cutaneous leishmaniasis (ACL) in the state of São Paulo, Brazil. During the first half of this century ACL occured in São Paulo, predominantly on the bank of the Tietê river, where there were railroad constructions and there was inevitable contact between and forested areas. Man's activities resulted in a drastic reduction of the forested regions of the state and molded the present landscape found in São Paulo, which brought a gradual change in the epidemiology of ACL during this century. Currently ACL can be considered as an endemic disease. Nowadays, ACL is found in different regions of São Paulo state, and is no longer limited to the bank of the Tietê river. The disease occurs in all age groups and sexes. Lack of knowledge about wild reservoir hosts of Leishmania (V.) braziliensis has simulated speculation about the possible role played by domestic animals (dogs and equines). Man's activities also favoured Lutzomyia intermedia a sandfly species which can clearly thrive in changed environments L. (V.) braziliensis continues to be transmitted, even after decades of forest destruction in São Paulo.
  • The dermal leishmaniases of Brazil, with special reference to the eco-epidemiology of the disease in Amazonia

    Lainson, R.; Shaw, J. J.; Silveira, F. T.; Souza, A. A. A. de; Braga, R. R.; Ishikawa, E. A. Y.

    Resumo em Inglês:

    Six species of Leishmania are at present known to cause cutaneous and/or mucocutaneous leishamniasis in Brazil, and they are all to be found in the Amazon region of this country. The eco-epidemiology of each is discussed, with the observation that the Amazonian leishmaniases are all zoonoses, with their source in silvatic mammals and phlebotomine sandfly vectors. With man's destruction of the natural forest in southern Brazil, some sandfly species have survived by adapting to a peridomestic or domiciliary habitat in rural areas. Some domestic animals, such as dogs and equines are seemingly now involved in the epidemiology of the disease. No such process has yet been reported in the Amazon region, but may well take place with the continuing devastation of its forest.
  • American cutaneous leishmaniasis in Pernambuco, Brazil: eco-epidemiological aspects in "Zona da Mata" region

    Brandão-Filho, Sinval P.; Carvalho, Francisco G. de; Brito, Maria E. F. de; Almeida, Francisco de A.; Nascimento, Luciano A.

    Resumo em Inglês:

    American cutaneous leishmaniasis (ACL) has been increasing in Pernambuco, thus becoming an important problem for Public Health. The incindence is predominant in the region called "Zona da Mata", in the east of this state. This region corresponds geographically to the primitive area of the Atlantic forest. In order to characterize the eco-epidemiology expression of ACL in this region, two localities situated in the municipalities of Amaraji e Cortes have been selected by the criterion of higher incindence of human cases. Five stocks of patients were characterized and identified on the basis of enzyme profiles as a new variant of Leishmania (V.) braziliensis. A survey of wild and domestic animals was carried out by means of a parasitological and serological diagnosis. Through the analysis of the spleen and liver imprints, were detected amastigotes compatible with Leishmania in five Nectomys s. squamipes, five Bolomys l. pixuna, two Rattus r. alexandrinus and one Rattus r. frugivorus. For two years we carried out monthly sandflies captures using CDC light traps as well as manual captures. Lutzomyia whitmani was predominant, which accounted for 97.4 por cento of the total. These data indicate a strong evidence on the vector and the potential reservoirs of L. braziliensis in this region.
  • Vectors control importance on leishmaniasis transmission

    Oliveira Filho, Alfredo M.; Melo, Marli T. V.

    Resumo em Inglês:

    We reviewed the control of transmission of leishmaniasis regarding chemotherapy, reservoirs elimination, vaccination and insect control through the use of chemical insecticides. We also discussed complementary measures like monitoring traps, impregnated bednets and curtains, repelents, pheromones, biological control, etc. A cost comparison of insecticide interventions through the use of products belonging to the four main chemical groups was also alone, comparing together conventional formulations versus a slow-release insecticide developed by the Núcleo de Pesquisas de Produtos Naturais, Universidade Federal do Rio de Janeiro. We finally did recommendations on the situation that would justify an insecticide intervention to control sandflies.
  • Sand fly vectorial ecology in the state of São Paulo

    Gomes, Almério de Castro

    Resumo em Inglês:

    Ecological aspect of sand fly distribution in the state of São Paulo, Brazil are described. The main man-biting species are Lutzomyia whitmani, Lu.pessoai, Lu.intermedia, Lu.migonei and Lu.fischeri. Their primary habitat is the forest but latter three of the above species are also encountered in domiciliary environment. Sylvatic species such as Lu.flaviscutellata bite man only rarely and Psychodopygus ayrozai seems to be more anthropophilic. The survival of sand flies in the residual forest and in cultivated areas where man has nearly destroyed the forest almost completely is analyzed. Over the last ten years the incidence of human American cutaneous leishmaniasis (ACL) has been increasing: human cases occurring within several municipalities in which there is overlapping with the distributon of domiciliary Lu.intermedia. New ACL microfoci are appearing in the state of São Paulo and these call for further study.
  • The chemical control of vectors of leishmaniasis

    Oliveira Filho, Alfredo M.; Melo, Marli T. V.
  • Use of molecular probes and PCR for detection and typing of Leishmania - a mini-review

    Degrave, Win; Fernandes, Octavio; Campbell, David; Bozza, Marcelo; Lopes, Ulisses

    Resumo em Inglês:

    The use of molecular tools to detect and type Leishmania species in humans, reservoirs or sandflies has been pursued using different approaches. The polymerase chain reaction provided sensitivity to case this task, since the use of hybridization procedures alone employing specifics probes is hampered due to the low detection limit. In this report, we describe the different molecular targets used in our laboratory, aiming at the detection and specific typing of these protozoa. Different kits based on hybridization assays and PCR amplification using kinetoplast and nuclear targets are described and the results obtained from their use are reported.
  • Taxonomy of the genus Leishmania: present and future trends and their implications

    Shaw, Jeffrey J.

    Resumo em Inglês:

    The application of different taxonomic methods (Cladistic, Evolutionary Taxonomy and Numerical Taxonomy) to the taxonomy of the Genus Leishmania are reviewed. The major groupings of the most recent classifications obtained using the cladistical approach agree with the major divisions of previous classifications which used traditional taxonomy (Evolutionary Taxonomy). The advantage of the cladistical approach is that it produces cladograms whose branches indicate more accurately levels of relationships between the different taxa. Numerical Taxonomy is useful for identification but not as good as the cladistical approach for classification. The ancient division of this monophyletic genus into two major evolutionary lines supports the use of the subgeneric names Leishmania and Viannia.
  • Exploitation of parasite derived antigen in therapeutic success of human cutaneous leishmaniasis in Brazil

    Monjour, Loic; Neogy, Asit B.; Vouldoukis, Ioannis; Silva, Otamires A.; Boisnic, Sylvie; Brito, Maria Edileuza F.; Lesot, Annette; Vignot, Nicole; Martins, Jane S.; Jardim, Marcio L.

    Resumo em Inglês:

    In a complete study in 25 patients with American cutaneous leishmaniasis, caused by Leishmania braziliensis complex, immunotherapeutic efficacy of parasite derived antigen (94-67 KD) has been compared to antimonial therapy. Additionally, to delineate the mechanism of therapeutic success, microscopical features of immune response in active lesions and healed or non-healed lesions following therapy were analyzed. The results showed that cure rates in immunotherapy and chemoterapy were equal (>83 por cento). The immunohistochemical changes in two therapeutic groups were also largely similar. The analysis of humoral and cellular immune response suggest that appropriate stimulation of T helper cells in the lesion site, in association with one or more cytokines, play a key role in the healing process.
  • Personal experience with diagnostic and therapeutic aspects of human Leishmania (Viannia) braziliensis in Três Braços

    Marsden, Philip D.

    Resumo em Inglês:

    Diagnostic and therapeutic aspects of human infection with Leishmania (Viannia) braziliensis found in the littoral forest of the state of Bahia are reviewed. There is pressing need for alternative cheap oral drug therapy.
  • The brazilian leishmaniasis control program

    Lacerda, Mariza Mendes

    Resumo em Inglês:

    The control methods used in Brazil for both cutaneous and visceral leishmaniasis by the Ministry of Health's National Health Foundation (Fundação Nacional de Saúde) are presented. Data referring to the programme between 1980 and 1991 is presented. There was an increase in the total number of notified cases of cutaneous leishmaniasis until 1987 and from this date onwards the number has remained between 23,000 and 26,000 per year. There were significantly fewer cases of visceral leishmaniasis during the same period and until 1991 the greatest number of cases reported in one year was 2,511 in 1985. The overall picture is that it is difficult to evaluate to what extent the control methods employed have reduced the number of cases of either form of the disease. It is suggested that there is an urgent need for a closer approximation of research and health workers to review the actual control strategies and to define procedures capable of assessing accurately their impact.
Instituto Oswaldo Cruz, Ministério da Saúde Av. Brasil, 4365 - Pavilhão Mourisco, Manguinhos, 21040-900 Rio de Janeiro RJ Brazil, Tel.: (55 21) 2562-1222, Fax: (55 21) 2562 1220 - Rio de Janeiro - RJ - Brazil
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