Revista da Sociedade Brasileira de Medicina Tropical最新文献

Background: Owing to the recent spread of the yellow fever virus in Brazil and imminent risk of its establishment in previously disease-free areas in the northeast of the country, epidemiological surveillance actions are necessary, including knowledge of non-human primate populations and the vectors that inhabit risk areas. The objective of this study was to evaluate the movement of sylvatic and urban yellow fever vectors between an Atlantic Forest fragment and its surrounding areas.

Methods: The study site was the Mata do Junco Wildlife Refuge Conservation Unit (CU) in Capela, Sergipe, Brazil. Immatures were collected using ovitraps in the forested area and in peridomestic environments surrounding the CU.

Results: Fourteen species were recorded, six of which were epidemiologically relevant. The main vectors of yellow fever in Brazil were present in the CU. Aedes albopictus (Skuse, 1894) was the most abundant species and was present in all studied environments. Aedes aegypti (Linnaeus, 1762) was not collected from forested areas. Among the native species, Haemagogus leucocelaenus (Dyar & Shannon, 1924) and Haemagogus janthinomys (Dyar, 1921) were collected only in the forested area of the CU, whereas Haemagogus spegazzinii (Brètes, 1921) was collected both in the forest and in the area around the CU.

Conclusion: Exotic species circulate between wild and urban areas for feeding and oviposition, but circulation to the urban area is limited among native species.

Background: Surveillance of non-human primate (NHP) deaths is vital for the early detection of yellow fever (YF) and prevention of its spread to the human population. This study assessed the YF surveillance system for NHPs in the Brazilian Federal District (FD) from 2008 to 2022.

Methods: A retrospective analysis of the aggregated data from 15 years of outbreak surveillance involving NHP deaths was conducted. The analyzed variables included spatiotemporal distribution, species, sex, age, sample collection, cause of death, and YF test results.

Results: In total, 1,175 outbreaks involving 1,353 NHP deaths were recorded, averaging 1.35 animals per outbreak, in urban and peri-urban areas. Twenty YF-positive outbreaks were confirmed in 2008, 2015, and 2020, affecting 27 animals, mainly adult Callithrix spp., with an overall YF positivity rate of 2%. Surveillance coverage expanded across all administrative regions of FD, with 96.7% of NHP deaths sampled for YF and pathological analysis. Over the last 5 years, the rate of conclusive diagnoses has increased by 60%, with trauma and infectious diseases being the most common causes of death.

Conclusions: The strategic location of FD reinforces the need for ongoing NHP death surveillance as an early warning tool for patients with YF. Continued enhancement of the diagnostic capacity and data integration is essential for strengthening the prevention and control efforts of YF in Brazil.

Background: Sea urchins inhabit rocky areas and lagoons near tourist bathing sites. These animals have sharp spicules on their surfaces that cause injuries to bathers.

Methods: Over 24 months, the author identified sea urchin species and mapped the beaches where injuries occurred. Samples of spicules were stored. In some patients, spicules were extracted using fine watchmaker's forceps. The intensity of pain and late infections were also recorded.

Results: Sixty-two patients (48 men, 77.42%) experienced injuries. The plantar regions were affected in 58 (93.55%) patients. In 26 cases, spicules were collected, being of the species Echinometra lucunter, which is not venomous. Twenty patients were randomly selected for spicule extraction using No. 10 watchmaker's forceps. Larger fragments were easily and practically painlessly removed; however, the forceps were not fully effective for small fragments.

Conclusions: Injuries caused by black sea urchins were the most common among those caused by marine animals in bathers. The unique species was Echinometra lucunter, which is not venomous. The penetration of spicules occurs mainly in the plantar regions and is a significant traumatic factor, with the possibility of secondary infections and foreign body granulomas. The use of No. 10 (watchmaker's) forceps was equivalent to the needle method but much less painful and traumatic. The creation of leaflets and the placement of posters at beaches with sea urchin colonies could prevent these wounds and should be attempted by the City Councils of coastal cities.

In this review, we examine dengue outbreak prediction and warning systems, highlighting their methodologies, variables, key findings, and existing gaps in the literature. The study was conducted in five stages: a literature survey, definition of thematic scope and eligibility criteria, exploratory review, systematization and categorization of findings, critical analysis, and comparative narrative synthesis. We selected 14 articles on prediction and seven on warning systems, encompassing statistical models, machine learning, and deep learning, as well as systems applied in various countries, with a particular focus on Brazil. The results indicated that meteorological and climatic variables are the most frequently used, followed by epidemiological and entomological data. Models such as Random Forest and Long Short-Term Memory demonstrated superior predictive performance, especially for short-term forecasts of up to 1 week. Among the warning systems, classical methods, such as the Early Aberration Reporting System, offer simplicity and speed but provide shorter lead times. In contrast, systems such as EWARS-TDR and ADSEWS excel by integrating multiple data sources and providing longer lead times (up to 13 weeks). Despite considerable advancements, challenges related to data quality and availability, model replicability across different contexts, and implementation persist in public health systems.

Background: This study aimed to present historical trends and key epidemiological indicators of congenital syphilis in São Paulo, Brazil, from 1986 to 2023.

Methods: This retrospective cross-sectional study used secondary data.

Results: A total of 56,547 cases and 690 deaths from congenital syphilis were reported. The incidence rate steadily increased over time. The number of stillbirths and miscarriages also rose. Most cases of maternal syphilis infection were identified during prenatal care, and the rate of inadequate maternal treatment remained high. Partner treatment led to modest improvements.

Conclusion: Despite improvements in prenatal care coverage and earlier diagnosis, the persistent rise in congenital syphilis incidence and mortality highlights ongoing gaps in maternal and partner treatment.

Background: Leishmaniasis undergoes geographic expansion in the Neotropical regions, driven by ecological and socioeconomic factors that contribute to urban and peri-urban outbreaks. Roadkilled wild mammals represent a potential source of eco-epidemiological data, and polymerase chain reaction (PCR)-based detection provides a sensitive tool for the surveillance of Leishmania spp.

Methods: This study investigated the occurrence of Leishmania spp. in 40 roadkilled wild mammals collected along highways in the central-western and northern coastal regions of São Paulo State, Brazil between 2020 and 2022. Necropsies were performed on all specimens, and ear skin samples were collected for molecular detection of Leishmania spp. using primers targeting kinetoplast DNA (kDNA). Positive samples were further analyzed for species identification by PCR-restriction fragment length polymorphism (RFLP) targeting the hsp70 gene. Restriction patterns were compared with reference strains to confirm Leishmania species identity.

Results: Leishmania spp. kDNA was detected by molecular diagnosis in skin tissue samples from several roadkilled wild mammals collected in the state of São Paulo. Subsequent species-level identification using hsp70 PCR-RFLP detected Leishmania infantum chagasi in a maned wolf (Chrysocyon brachyurus) and Leishmania amazonensis in a raccoon (Procyon cancrivorus).

Conclusions: Wild mammals could be exposed to distinct Leishmania species across diverse ecological contexts, and examining roadkilled animals, combined with the molecular detection of parasites, proved to be an effective tool for passive Leishmania surveillance, highlighting the need for integrated investigations within a One Health framework.