Anophelines in Belém, Pará, Brazil: current and retrospective data

We present the results of anopheline captures in Belém, Pará, Brazil, from 1995-2004, and a comparison with captures from 1930-1999. In the earlier period, 20 species were identified: Anopheles albitarsis s.l., An. aquasalis, An. argyritarsis, An. braziliensis, An. darlingi, An. eiseni, An. evansae, An. galvaoi, An. intermedius, An. kompi, An. mediopunctatus, An. nimbus, An. nuneztovari, An. oswaldoi, An. peryassui, An. punctimacula, An. shannoni, An. strodei, An. thomasi, and An. triannulatus. Seven of these species were not found in 1995-2004 (An. argyritarsis, An. eiseni, An. galvaoi, An. kompi, An. nimbus, An. punctimacula, and An. thomasi). The persistence of so many species is probably due to the local preservation of forest areas. Two species are of vectorial importance (An. darlingi and An. aquasalis). An. aquasalis is still the most abundant species (46.26% of adults, 99.21% of larvae) and the only one detected in all capture sites. There is thus a potential risk of malaria transmission in the entire municipality of Belém.     

Dengue epidemic in Belém, Pará, Brazil, 1996-97

We describe clinical and epidemiologic findings during the first epidemic of dengue fever in Belém, Pará State, Brazil, in 1996-97. Of 40,237 serum samples, 17,440 (43%) were positive for dengue by virus isolation or serologic testing. No hemorrhagic cases or deaths were reported. Mycobacterium tuberculosis     

Seroepidemiological survey for influenza virus in Belém, Pará, Brazil, 1992-1993

A seroepidemiological study was carried out from 1992 to 1993 to estimate the prevalence of antibody to prevailing influenza virus strains circulating among patients attending the IEC Virology Laboratory in Belem, Northern Brazil. A total of 179 (11%) of serum samples were obtained during the post-epidemic period and processed by the hemagglutination inhibition test against the A/Taiwan/1/86 (H1N1), A/Beijing/353/89 (H3N2), and B/Yamagata/16/88 types of influenza virus. The serological results indicate circulation of viruses antigenically related to all three strains during the two-year study period. In 1992, the overall prevalence rates of HI antibodies to H1N1 and H3N2 were 84% and 56%, respectively. Presence of antibodies to both strains was detected in all age groups, suggesting intense viral activity that year. Antibodies to influenza B were detected at lower levels in all patients during this period. Similar prevalence to the H1N1 virus was noted in 1993, indicating that this strain occurred in both years. However, an increase in prevalence rates for the H3N2 virus was seen in 1993, suggesting that this strain (or a related virus) circulated intensively during this year. Influenza B activity also increased in 1993, causing infection mainly among young adults.     

Diagnosis of intestinal amebiasis using coproscopic and immunological methods in a population sample in greater metropolitan Belém, Pará, Brazil

We compare diagnostic methods for Entamoeba histolytica in fecal samples from the city of Belém, Pará, Brazil. We analyze stool samples from children and adults (Group I); stool and serum samples from adults (Group II); and stool samples from children (Group III). In groups I and III, we used direct examination with lugol (DM), Faust et al (FM), and ELISA (detection of E. histolytica anti-GIAP coproantigen) and in group II, DM, iron hematoxylin staining (IHS), FM, ELISA, and the indirect immunofluorescence test (IFAT) for detection of IgG antibodies. Positivity was 10.50% by DM plus FM and 28.99% by ELISA. There was no correlation between positivity and age group. In Group II (n = 87), the positive rate was 4.59% by DM plus FM, 8.04% by IHS, 4.59% by IFAT, and 21.83% by ELISA. The ELISA test was the most sensitive for all groups. IFAT alone is still not a useful tool for diagnosis of E. histolytica infection. The ELISA test is simple, performed in one-third of cases used for IHS and IFAT, and greatly improves quality of diagnosis. We recommend this as the method of choice for diagnosis of suspected E. histolytica infection.     

Validation of food and beverage indicators obtained by telephone survey in Belém, Pará State, Brazil

The aim of this study was to evaluate the relative validity of indicators of food and beverage intake obtained from the telephone interview surveillance system (VIGITEL). A random sample (n = 100) was evaluated from the total sample of approximately two thousand adults studied by the system in 2009 in Belém, Pará State, Brazil. The indicators were protective factors (adequate consumption of fruit, vegetables, and leafy vegetables) and risk factors (consumption of saturated fat, soft drinks, and alcoholic beverages) for chronic non-communicable diseases. The telephone interview results were compared with those of three 24-hour recalls (reference standard). The reference standard showed underestimation in the indicators' frequency, except for soft drinks and alcoholic beverages. The mean consumption frequencies were generally higher in the exposed group interviewed by the VIGITEL system. We cannot conclude that the VIGITEL system is not a good indicator of consumption, since the reference standard also shows limitations. Nevertheless, its use as a surveillance tool in Brazil is justifiable.     

Risk factors for cancer of the uterine cervix in Propriá, Sergipe, Brazil

Cervical cancer is highly incident in poor regions of developing countries. It is related to lifestyle factors that lead to human papillomavirus (HPV) infection. The aim of the study was to assess which factors are important in the development of HPV infection and consequent cervical cancer in the community of Propriá, Sergipe, Brazil. To analyze the risk factors related to cervical cancer, a case-control study was performed, matching cases and controls for age, place of residence, and socioeconomic status. Twenty cases of carcinoma of the uterine cervix and 80 controls were identified. Cases had more pregnancies and a higher proportion of women who had not done Pap smears. Women in the two groups lived with promiscuous partners, had deficient knowledge about cervical cancer and its risk factors, and were predominantly illiterate. We concluded that in the community of Propriá, multiple pregnancies and failure to have Pap smears were associated with the occurrence of cervical cancer.     

Prevalence and factors associated with iron deficiency in infants treated at a primary care center in Belém, Pará, Brazil

The objective was to verify the occurrence of iron deficiency and associated factors in infants. This cross-sectional study included 365 infants (defined here as 6-24 months of age) treated at a primary care center in Belém, Pará, Brazil. Iron-deficiency anemia (hemoglobin < 11 g/dl and ferritin < 12 microg/l) was diagnosed in 55.1% of the sample, depletion of body iron reserves (hemoglobin < 11 g/dl and ferritin < 12 microg/l) in 15.3%, and iron sufficiency (hemoglobin < 11 g/dl and ferritin < 12 microg/l) in 18.1%. The results of the logistic regression model showed associations between iron deficiency (ferritin < 12 microg/l) and: 6-12 month age group, OR (odds ratio) = 3.67 and 95% CI: 1.93-7.04; non-utilization of iron-fortified formula as the first milk used after interrupting breastfeeding, OR = 1.93 and 95%CI: 1.04-3.60; and per capita income < or = 1 minimum wage, OR = 2.69 and 95%CI: 1.30-5.59. The occurrence of iron deficiency was high, showing the need to adopt effective measures to prevent this important public health problem.     

Occurrence of Aedes albopictus in the state of Pará, Brazil

It is first reported the detection of Aedes (Stg) albopictus mosquitoes in state of Par , Brazil, in the urban area of Medicil ndia, a municipality far 90 km from Altamira, where 42 adult mosquitoes were baited using human attraction. All mosquitoes were pooled and inoculated into C6/36 and suckling mice in attempts for virus isolation. No virus was isolated. The occurrence of Aedes albopictus in urban areas of the Amazon region is of concern since dengue and yellow fever viruses are endemic in the Amazon and thus there is a potential risk for this mosquito species to become infected with both viruses.     

"Be someone in life": a socio-anthropological analysis of adolescent pregnancy and motherhood in Belém, Pará State, Brazil

Focused on a group of low-income youth in Belém, Pará State, Brazil, this study discusses the issue of adolescent pregnancy and motherhood from a socio-anthropological perspective. Aimed at an understanding of the cultural meanings of this event in this context, the study suggests that for adolescent girls, it does not mean a break with life projects. On the contrary, pregnancy and motherhood are valued to the extent that they produce changes in social status for the girls, in terms of affirmation of projects for social mobility in the future, thus justifying the continuity of studies in the face of difficulties imposed by the situation.     

Assessment of DDT and Metabolites in Soil and Sediment of Potentially Contaminated Areas of Belém,Amazon Region,Brazil

The aim of this study was to evaluate the distribution of DDT and metabolites in surface soils and soil profiles from two areas containing deposits of obsolete pesticides in Belém, Amazon Region, Brazil. DDT and metabolites were extracted by microwave assisted extraction and analyzed by gas chromatography with electron capture detection. Concentrations of total DDT in surface soil samples ranged from 64.22 mg?kg^?1 in area 1 (A1) to 447.84 mg?kg^?1 in area 2 (A2). Lower levels were found in soil profiles than at the surface (6.21–21.17 mg?kg^?1 in A1 and 36.13–113.66 mg?kg^?1 in A2). pp’-DDT, pp′-DDE and pp′-DDD were detected in sediments at levels of 2.01, 0.96 and 0.35 mg?kg^?1, respectively. The ratio (DDE?+?DDD)/ΣDDT was low indicating the recent introduction of DDT to the environment in the two study areas, through the volatilization and atmospheric deposition of the obsolete pesticides.     

Mercury exposures in riverside Amazon communities in Pará, Brazil

Cross-sectional studies were conducted in three riverside communities in the state of Pará in the Amazon Region of Brazil. Two of these communities, Brasília Legal and S?o Luís do Tapajós, are located in a watershed exposed to mercury pollution from artisanal gold mining, and the third, Santana do Ituqui, is outside this area. The studies were based upon a community census and included all persons volunteering for participation in each community. All participants were surveyed by questionnaire for health history, occupation, residence, and diet. Clinical evaluations were also done on each subject, along with collection of blood, urine, feces, and hair. Fish samples were collected to represent the most frequently consumed species. Mercury was measured in hair and fish. Although no signs or symptoms of overt mercury intoxication were observed, persons in Brasília Legal and S?o Luís do Tapajós had higher levels of mercury in hair than residents of Santana de Ituqui, located out of the risk area. Levels of mercury in fish were below Brazilian health guidance limits, but the high rates of fish consumption among these populations raise concerns for the possible effects of chronic exposure, especially among young children and women of childbearing age.     

Mercury exposure in Munduruku Indians from the community of Sai Cinza,State of Pará, Brazil

The objective of this cross-sectional study was to evaluate mercury exposure and health status among Munduruku Indians from the community of Sai Cinza, State of Pará, Brazil. The population studied included 330 indians, who submitted to a questionnaire, clinical exams, and collection of hair, blood, urine, and feces. Mercury was measured in hair and fish. Although no person was found to have overt mercury intoxication, the mean levels of mercury in hair were elevated (14.45 micrograms/g for children from 7 to 12 years old, 15.70 micrograms/g for women between 14 and 44 years old, and 14.1 micrograms/g for the remaining population). Mercury levels in fish were below levels recommended by the World Health Organization, but rates of fish consumption were high. These results place this indigenous populations as a group under risk of mercury toxicity from the gold production.     

Reliability and validity of the PedsQL™ Multidimensional Fatigue Scale in Japan

Purpose  

To examine the reliability and validity of the Japanese-language version of the PedsQL™ Multidimensional Fatigue Scale and to investigate the agreement between child self-reported fatigue and parent proxy-reported fatigue.     

Descriptive study of fall among children under the age of 15 in the municipality of Londrina (Paraná, Brazil)

This study aims at analyzing, from the epidemiological point of view, occurrences of falls among children under the age of 15 who live in Londrina, Paraná, and were treated at emergency departments, hospitalized or passed away due to such event in 2001. Data were obtained from registries of general hospitals and from the Mortality Information Nucleus. 2,991 children victims of falls were analyzed, representing an incidence rate of 25.3 per 1000 children. Non-fatal hospitalization rate was 3.9%; one death occurred in an emergency department. The risk of suffering falls was higher among boys, except with children aged less than one year. Most frequently injured by falls were the groups of one year old (coefficient of 46.0 per 1000 children) and of two years old (coefficient of 38.4 per 1000 children). The most affected body region was head/neck (55.2%) and superficial traumatism was the most frequent kind of injury (46.4%). Falls occurred mainly from bed/cradle, furniture/couch, tricycle/skates, staircase/degrees, playground equipment, wall/gate/roof/balcony, hammock, tree and stroller. Findings show a high falls incidence among children and adolescents and contribute to increasing epidemiological knowledge of such events and so grounding the planning of preventive and control measures.     

Mercury and selenium concentrations in fish samples from Cachoeira do PiriáMunicipality, ParáState, Brazil

Mercury is a major public health concern because of its widespread occurrence in the environment and its toxic effects on humans, mainly through fish ingestion. On the other hand, selenium is known by its antioxidant effect. For this reason, the knowledge of the correlation between mercury and selenium concentrations in fish samples can bring important information allowing a better understanding of mercury equilibrium in the inhabitants of the Amazon region. In this paper, total mercury and selenium levels were measured in carnivorous (47), omnivorous (44), and herbivorous (4) fish species caught in rivers and in an artificial lake in Cachoeira do PiriáMunicipality, situated in ParáState, Amazon region. The mercury concentration ranged from 1.15 to 13.44 nmol g(-1) and selenium from 2.44 to 14.56 nmol g(-1) for carnivorous species. For noncarnivorous species, mercury concentration ranged from 0.08 to 2.03 nmol g(-1) and selenium from 1.27 to 15.32 nmol g(-1). The molar ratios between mercury and selenium contents obtained for carnivorous and noncarnivorous species were 0.65 and 0.14, respectively. Mercury and selenium levels were positively correlated with fish body mass (weight) only for Hoplias malabaricus (n=35, R2=0.565, P<0.005 and R2=0.608, P<0.005, respectively). Selenium and mercury concentrations were statistically positively correlated only for H. malabaricus (n=35, R2=0.787, P=0.005) and Leporinus sp. (n=38, R2=0.485, P<0.005) known locally as Traíra (carnivorous) and Aracu (omnivorous), respectively.     

Health evaluation of gold miners living in a mercury-contaminated village in Serra Pelada, Pará, Brazil

Serra Pelada is a village in the Amazon region of Brazil where most of the inhabitants are former gold miners. Of 235 individuals evaluated, 219 were males (93.19%), 16 were females (6.80%), and the mean age was 52.07 years (standard deviation = 11.57). Most were heavy drinkers (62.44%) and smokers (70.30%), and 85.53% had previously suffered from malaria. Reported symptoms included fatigue (30.60%), irritability (35.62%), excitability (14.16%), insomnia (34.48%), memory loss (61.80%), visual field constriction (4.18%), paresthesia (64.93%), partial hearing loss (16.35%), and gingivitis (18.01%). After an examination of the residents, the authors observed several neurological symptoms: tremors (22.80%), involuntary ocular movement (2.20%), visual field constriction (4.18%), Romberg syndrome (2.33%), involuntary tongue movement (2.19%), dysdiadochokinesia (0.43%), failure of a finger-nose test (10.96%), failure of a knee-heel test (4.84%), inability to complete a tandem march (6.25%), muscular weakness (2.27%), and damage to sensory organs (24.66%). The authors concluded that these neurological changes possibly resulted from mercury toxicity; however, they could not determine a significant correlation with the mercury levels detected in participants' urine.     

Completeness of data on live birth certificates and death certificates for early neonatal and fetal deaths in the Ribeirão Preto Region, São Paulo State, Brazil, 2000-2007

This study aimed to evaluate the completeness of data on nine items included in both the certificate of live birth (CLB) and death certificate (DC), as well as the retrieval of data on early neonatal deaths. The study assessed live birth and early neonatal and fetal death records in municipalities in the Ribeir?o Preto Region, S?o Paulo State, Brazil, from 2000 to 2007. Database matching for live births and deaths allowed retrieving data on early neonatal deaths. Data completion was good on the CLB and poor on the DC. Retrieval of data related to mortality was satisfactory, except for maternal schooling, number of live born children, and stillbirths. The findings highlight the need to improve completion of the DC and showed that the retrieval process improved the completeness of data from the database on early neonatal deaths. The use of reports on local investigation of deaths is recommended as a strategy to make mortality databases more complete.