Revista de Patologia Tropical
ISSN / EISSN : 0301-0406 / 1980-8178
Published by: Universidade Federal de Goias (10.5216)
Total articles ≅ 738
Latest articles in this journal
Revista de Patologia Tropical, Volume 50, pp 87-106; https://doi.org/10.5216/rpt.v50i2.67480
Myasthenia gravis (MG) is an autoimmune disease involving neuromuscular transmission and possible respiratory failure when concomitant with COVID-19. The aim of this study was to analyze the need for ventilatory support (VS), length of hospital stay (LOS) and mortality in patients diagnosed with MG and COVID-19. In this systematic review, PubMed, SciELO, LILACS, MEDLINE and IBECS databases were searched for primary studies published from January 2010 to March 2021, with no language restrictions. Fourteen eligible studies were identified. The main factor associated with the need for VS was the use of antibiotics other than azithromycin (AZM) for the treatment of COVID-19 (RR 1.60; 95% CI 1.20–2.91; p = 0.009). Patients who used hydroxychloroquine (HCQ) and AZM had almost twice the risk of needing invasive ventilatory support (IVS) (RR 1.94; 95% CI 1.07-3.52; p = 0.16). There were nonsignificant trends towards less need for IVS in patients who used intravenous immunoglobulin (IVIg) and corticosteroid therapy (RR 0.54; 95% CI 0.09–3.26; p = 0.60). There was a trend towards shorter LOS in patients who received therapy with IVIg and corticosteroid therapy [8 (5 - 8) vs 19 (12.2–23.7); p = 0.007]. 10.3% (n = 4/39) died and 100% did not use IVIg or IVIg and prednisone. There was a non-significant trend towards higher mortality in patients who used AZM (RR 2.55; 95% CI 0.26–30.02; p = 0.60). IVIg and corticotherapy presented themselves as a favorable alternative in relation to the outcomes.KEY WORDS: Coronavirus infections; length of stay; Myasthenia gravis; Respiratory insufficiency.
Revista de Patologia Tropical, Volume 50, pp 150-162; https://doi.org/10.5216/rpt.v50i2.67661
This study aimed to characterize the prevalence, mean abundance, and mean intensity of potential fish-borne zoonotic nematode larvae infecting the predator fish Hoplias aff. malabaricus from the Tapajós River, in the municipality of Santarém, in the Brazilian Amazon. After capture, the specimens of H. aff. malabaricus were analyzed for infection by Contracaecum sp. and Eustrongylides sp. third-stage larvae, and the prevalence, mean abundance, and mean intensity were calculated. A literature search was carried out to clarify the relationship between these indicators and eventual human cases of infection in the Amazon region. Third-stage larvae of nematodes of the Contracaecum and Eustrongylides genera were found in the specimens of H. aff. malabaricus sampled from the Tapajós River. The prevalence of Contracaecum larvae was 100%, while its mean abundance and mean intensity were both 54.8 larvae/fish. The prevalence of Eustrongylides larvae was 62.9%, and its mean abundance and mean intensity were 1.8 and 2.8 larvae/fish, respectively. Despite the high prevalence and intensity values, there are no cases of human infection by these nematode larvae in the Brazilian Amazon reported. The absence of human infections by these nematode larvae in the Brazilian Amazon despite the high prevalence/intensity of Contracaecum and Eustrongylides larvae and the high consumption of fish in the region, is most probably due to the fact that the local populations do not eat raw or undercooked fish. However, it is noteworthy that the absence of zoonotic cases in the region is based only on the examination of the available published papers. A better knowledge of the situation would require surveying hospitals and clinics, and data from the region’s medical treatment facilities. However, the authors consider that cases of human infection, if any, are extremely rare, mainly due to the eating habits of the local population. KEY WORDS: Amazon basin; freshwater fish; public health; parasitic infection; zoonosis.
Revista de Patologia Tropical, Volume 50, pp 121-134; https://doi.org/10.5216/rpt.v50i2.69303
Captive animals, despite the constant care provided, are susceptible to infections from different sources. We herein report the natural trypanosome infection of 11 (28.2% positive) out of 39 non-human primates from 13 different species, in a Brazilian zoological park. Immunofluorescent antibody test (IFAT) and conventional polymerase chain reaction (cPCR) ruled out Trypanosoma cruzi, the etiological agent of Chagas disease. However, sequencing performed with positive samples employing hsp70 primers revealed similarities from 86% to 88% to diverse trypanosomes, including T. cruzi, Trypanosoma grayi, Trypanosoma lewisi, Trypanosoma rangeli and Trypanosoma vivax. We believe that the low similarity values obtained by sequencing reflect the difficulties in the molecular identification of trypanosomes, which share a large portion of their genetic material; this similarity may also preclude the diagnosis of co-infection by more than one trypanosome species. Thus, our study demonstrates the presence of diverse trypanosomes in primates, which are susceptible to infection by these parasites. Mechanical devices such as windows and bed nets, etc., are required to avoid vector insects in these environments, in addition to preventive quarantining of animals recently introduced into zoos. Therefore, investigation of the parasites in both the animals already residing in the zoo and those being introduced is of paramount importance, although no easy task. KEY WORDS: Non-human primates; monkey; diagnosis; trypanosomes.
Revista de Patologia Tropical, Volume 50, pp 135-149; https://doi.org/10.5216/rpt.v50i2.67508
Toxoplasmosis is a zoonosis caused by Toxoplasma gondii, a protozoan that has a cosmopolitan geographic distribution and low specificity for intermediate hosts. Domestic chickens are among the most important hosts in toxoplasmosis epidemiology, since they are potential sources of infection for humans, in addition to indicating environmental contamination by protozoa. In this work, we studied the prevalence of T. gondii infection in chickens in different breeding systems from distinct mesoregions of Rio Grande do Norte and Paraiba States: broiler chickens from commercial farms and free-range chickens from small farms. Indirect fluorescent antibody test (IFAT) and ELISA techniques were used for detecting specific antibodies in blood samples from the birds. There were no seropositive samples among the broilers tested, indicating that intensive management limited the chances of infection for these animals. Amongthe free-range chickens, the frequency of IgG anti-T. gondii detected by IFAT and ELISA were 37.9% and 40.4% respectively. Among the seropositive samples by IFAT, 33 (27.1%) were positive at a dilution of 1:16; in 1:32, 31 (25.4%); in 1:64, 24 (19.7%); 15 (12.3%) in 1:128, and 19 presented titers greater than or equal to 1:256 (15.6%). The substantial concordance observed between IFAT and ELISA signifies these methods are effective methodologies for the diagnosis of avian toxoplasmosis. The high prevalence of specific antibodies among poultry in the studied region highlights the potential risk of T. gondii transmission to humans through consumption of infected meat.KEY WORDS: Toxoplasma gondii; chicken infection; toxoplasmosis transmission; seroprevalence.
Revista de Patologia Tropical, Volume 50, pp 79-85; https://doi.org/10.5216/rpt.v50i2.69473
The COVID-19 pandemic that began in early 2020 is currently the subject of thousands of articles on the various aspects of its epidemiology. One recurrent theme is the phenomenon of herd immunity or herd effect. In this article, I present a short history of the concept, the arguments around its nomenclature, and the ecologist’s view of the herd effect, using the case history of the sleeping sickness control in Africa. KEY WORDS: Herd immunity; convergence; ecology; sleeping sickness.
Revista de Patologia Tropical, Volume 50, pp 163-178; https://doi.org/10.5216/rpt.v50i2.67673
Studies linking human health to environmental conditions are essential since parasitic diseases are connected to environmental and sanitary aspects. This study identified the prevalence of enteric parasites in an academic community in the municipality of Santo Antônio de Jesus, Bahia, Brazil. The purpose was to determine the existence, or not, of links between infections and socio-epidemiological variables, such as personal hygiene habits, the presence of sewage systems and the environment. Participants answered a questionnaire and received universal collectors for fecal samples. Spontaneous sedimentation methods and Rugai were used for diagnosis. One hundred twenty-one samples were analyzed, in which a 38.8% parasite prevalence was detected as well as a 61.7% rate of monoparasitism, as well as a predominance of protozoa Endolimax nana (78.7%) and Giardia duodenalis (21.3%). Among parasitized individuals, 97.9% lived in the Recôncavo Baiano region. The following statistical significance stands out in the findings, with p<0.05: individuals who had already bathed in the local river were more likely to be parasitized than those who had not (p = 0.034) and individuals who washed their hands more frequently before meals proved to be less prone to intestinal parasitic infections (p = 0.018). Results evidenced the presence of enteric parasites in a number of participants in spite of their being university students. The socio-epidemiological variables analyzed brought to light characteristics that favor the establishment of the epidemiological infection triad, such as improper packaging of household waste on disposal and no records of regular domestic water tank cleaning. KEY WORDS: Enteric parasites; environment; diagnosis; health education.
Revista de Patologia Tropical, Volume 50, pp 107-119; https://doi.org/10.5216/rpt.v50i2.69589
Invasive aspergillosis (IA) increases dramatically when there is potential risk in many patient groups, in particular with hematological malignancies. The purpose of the study was to trace the epidemiological profile of patients who underwent galactomannan test by ELISA with suspected IA and to determine the factors that contribute to the development of the disease. We evaluated 264 patients who underwent galactomannan test with suspected IA from 2013 to 2015.The clinical-epidemiological characteristics were determined using descriptive statistics. The variables were evaluated using the chi-square test (χ2) and the G-test, with p-value considered significant below 0.05. According to the classification for IA by the European Organization for Research and Treatment of Cancer, the disease was considered proven in 7.3%, defined by positive culture for the fungus, 6.4% as probable through detection of galactomannan and the presence of pulmonary infiltrates and 5.1% as possible by radiological alterations suggestive of IA and negative galactomannan test. The mortality rate was 31.6% of all patients and 61.3% for proven / probable / possible IA indicating that the disease was significantly associated with the risk of death. According to these result indications and considering the high mortality rate caused by the development of IA, as well as the fact that early therapy promotes significant improvement in the patients’ prognosis, we conclude that the detection of galactomannan may be considered an effective method to aid the identification of IA. KEY WORDS: Invasive pulmonary aspergillosis; neutropenia; enzyme-liked immunosorbent assay; ELISA test searching for Aspergillus; galactomannan.
Revista de Patologia Tropical, Volume 50, pp 61-72; https://doi.org/10.5216/rpt.v50i1.67885
The purpose of this study was to verify the occurrence of head lice in children at a public hospital in Uberlândia, MG and factors associated with pediculosis such as sex, age, hair characteristics and socioeconomic conditions, as well as obtaining information from their parents/guardians regarding the epidemiology, its transmission, prevention and control. To obtain the data, direct hair inspection and a characterization sheet and questionnaire were utilized. An occurrence rate of 6.1 % was found in 230 children examined in a public hospital, 111 females and 119 males with the highest rates observed in female children aged 4-8 with medium to long hair. Income, level of education, hair washing, hair type, color and thickness did not seem to influence the distribution of pediculosis in the children seen in the hospital in Uberlândia. The questionnaire answered by parents/guardians indicated that the children had had at least one infestation in their lifetime. The use of fine comb and pesticides were the most usual control methods adopted. The most frequent symptom was severe itching on the scalp. Although the occurrence of head pediculosis is declining, it is still a prevalent public health problem in the child population of Uberlândia, MG. Pediculosis may be associated with sex, age and hair characteristics. Variations in the degree of these influencing factors depend on the profile of the population studied. Additional studies are required in population groups over time, particularly in those that are inadequately assisted or lack state education and health assistance.KEY WORDS: Pediculosis; ocurrence; Minas Gerais; Brazil.
Revista de Patologia Tropical, Volume 50, pp 21-39; https://doi.org/10.5216/rpt.v50i1.67007
A single dose of simvastatin and of artesunate monotherapy cause damage to the reproductive system of schistosomes as well as severe tegumental damage in male worms recovered from mice fed high-fat chow. This study aims to investigate whether treatment with multipledose regimes may offer more antischistosomal activity advantages than single daily dosing in mice fed high-fat chow. For this purpose, nine weeks post-infection, Swiss Webster mice were gavaged with simvastatin (200 mg/kg) or artesunate (300 mg/kg) for five consecutive days and euthanized two weeks post-treatment. Adult worms were analyzed using brightfieldmicroscopy, confocal microscopy and scanning electron microscopy, presenting damages caused by simvastatin and artesunate to the reproductive system of males and females as well as tegument alterations, including peeling, sloughing areas, loss of tubercles, tegumental bubbles and tegument rupture exposing subtegumental tissue. The overall findings in this study revealed the potential antischistosomal activity of simvastatin and artesunate against Schistosoma mansoni adult worms, in addition to showing that multiple doses of either monotherapy caused severe damage to the tegument.KEY WORDS: Schistosoma mansoni; hyperlipidemia; simvastatin; artesunate; microscopy.
Revista de Patologia Tropical, Volume 50, pp 1-6; https://doi.org/10.5216/rpt.v50i1.68023
This paper argues the risks of the humanization programs in hospitals which allow visits by pets. The issue of hospital-acquired infections and the risks posed by the introduction of parasites, including viruses, bacteria and helminths, is here discussed. We highlight the difficulties inherent to the implementation of guidelines to prevent infections in the nosocomial environmentKEY WORDS: Hospitals; infections; humanization; pets.