Trypanosoma cruzi strains from triatomine collected in Bahia and Rio Grande do Sul,Brazil

OBJECTIVE

Collection of triatomines in domestic, peridomestic and sylvatic environments in states of Bahia and Rio Grande do Sul, Northeastern and Southern Brazil respectively, and isolation of Trypanosoma cruzi strains.

METHODS

First, the captured triatomines were identified using insect identification keys, then their intestinal content was examined by abdominal compression, and the samples containing trypanosomatid forms were inoculated in LIT medium and Swiss mice.

RESULTS

Six triatomine species were collected in cities in Bahia, namely Panstrongylus geniculatus (01), Triatoma melanocephala (11), T. lenti (94), T. pseudomaculata (02), T. sherlocki (26) and T. sordida (460), and two in cities in Rio Grande do Sul, namely T. circummaculata (11) and T. rubrovaria (115). Out of the specimens examined, T. cruzi was isolated from 28 triatomine divided into four different species: T. melanocephala (one), T. lenti (one), T. rubrovaria (16) and T. sordida (10). Their index of natural infection by T. cruzi was 6.4%.

CONCLUSIONS

The isolation of T. cruzi strains from triatomines found in domestic and peridomestic areas shows the potential risk of transmission of Chagas disease in the studied cities. The maintenance of those T. cruzi strains in laboratory is intended to promote studies that facilitate the understanding of the parasite-vector-host relationship.     

Temporal trends and spatial distribution of unsafe abortion in Brazil, 1996-2012

OBJECTIVE

To analyze temporal trends and distribution patterns of unsafe abortion in Brazil.

METHODS

Ecological study based on records of hospital admissions of women due to abortion in Brazil between 1996 and 2012, obtained from the Hospital Information System of the Ministry of Health. We estimated the number of unsafe abortions stratified by place of residence, using indirect estimate techniques. The following indicators were calculated: ratio of unsafe abortions/100 live births and rate of unsafe abortion/1,000 women of childbearing age. We analyzed temporal trends through polynomial regression and spatial distribution using municipalities as the unit of analysis.

RESULTS

In the study period, a total of 4,007,327 hospital admissions due to abortions were recorded in Brazil. We estimated a total of 16,905,911 unsafe abortions in the country, with an annual mean of 994,465 abortions (mean unsafe abortion rate: 17.0 abortions/1,000 women of childbearing age; ratio of unsafe abortions: 33.2/100 live births). Unsafe abortion presented a declining trend at national level (R²: 94.0%, p < 0.001), with unequal patterns between regions. There was a significant reduction of unsafe abortion in the Northeast (R²: 93.0%, p < 0.001), Southeast (R²: 92.0%, p < 0.001) and Central-West regions (R²: 64.0%, p < 0.001), whereas the North (R²: 39.0%, p = 0.030) presented an increase, and the South (R²: 22.0%, p = 0.340) remained stable. Spatial analysis identified the presence of clusters of municipalities with high values for unsafe abortion, located mainly in states of the North, Northeast and Southeast Regions.

CONCLUSIONS

Unsafe abortion remains a public health problem in Brazil, with marked regional differences, mainly concentrated in the socioeconomically disadvantaged regions of the country. Qualification of attention to women’s health, especially to reproductive aspects and attention to pre- and post-abortion processes, are necessary and urgent strategies to be implemented in the country.     

Seroprevalence of rubella in Colombia: a birth-year cohort analysis

OBJECTIVE

To estimate the seroprevalence of rubella and associated factors.

METHODS

Population-based seroprevalence study in a random sample of 2,124 individuals, aged six to 64 years, representative by age, sex and area in Medellín, Colombia, 2009. Biological and socioeconomic variables were analyzed for their association with serum protection against rubella, according to birth-year cohort; those born before (1954-1990) and after (1991-2003) the introduction of universal immunization. Titer of IgG antibodies against the rubella virus was detected using a high sensitivity (AxSYM^®Rubella IgG – Abbott Laboratories) and a high specificity test (VIDAS RUB IgG II^®– BioMerieux Laboratories). Proportions and weighted averages derived from a complex sample, including a correction factor for differences in gender participation, were estimated. Association with protection for groups of biological and social variables according to birth cohort was analyzed using a logistic regression model.

RESULTS

Titers of IgG antibodies were higher in those born before (mean 110 UI/ml, 95%CI 100.5;120.2) compared to those born after (mean 64 UI/ml; 95%CI 54.4;72.8; p = 0.000) the introduction of mass immunization. The proportion of protection increased from 88.9% in those born 1990-1994, to 89.2% in those born 1995-1999 and to 92.1% in those born between 2000 and 2003, possibly due to boosters being administered from 1998 onwards. In those born before the introduction of the immunization, seroprotection was associated with previous contact with cases (OR 2.6; 95%CI 1.1;5.9), self- perceived health status (OR 2.5; 95%CI 1.05;6.0), educational level (OR 0.2; 95%CI 0.08;0.8) and years of residence in the neighborhood (RD 0,96; 95%CI 0.98;1.0) after adjusting for all variables. In those born after, serum protection was associated with effective sleep time (OR 1,4; 95%CI 1.09;1.8) and self-perceived health status (OR 5.5; 95%CI 1.2;23.8).

CONCLUSIONS

The seroprevalence profile changed with the mass immunization plan, with higher titers of IgG antibodies in those born before the start of the immunization. It is recommended that the level of long-term protection be monitored and concerted action taken to improve potentially associated socioeconomic conditions.     

Model for the evaluation of drug-dispensing services in primary health care

OBJECTIVE

To develop a model for evaluating the efficacy of drug-dispensing service in primary health care.

METHODS

An efficacy criterion was adopted to determine the level of achievement of the service objectives. The evaluation model was developed on the basis of a literature search and discussions with experts. The applicability test of the model was conducted in 15 primary health care units in the city of Florianópolis, state of Santa Catarina, in 2010, and data were recorded in structured and pretested questionnaires.

RESULTS

The model developed was evaluated using five dimensions of analysis for analysis. The model was suitable for evaluating service efficacy and helped to identify the critical points of each service dimension.

CONCLUSIONS

Adaptations to the data collection technique may be required to adjust for the reality and needs of each situation. The evaluation of the drug-dispensing service should promote adequate access to medications supplied through the public health system.     

Evaluation of dengue fever reports during an epidemic,Colombia

OBJECTIVE

To assess the validity of dengue fever reports and how they relate to the definition of case and severity.

METHODS

Diagnostic test assessment was conducted using cross-sectional sampling from a universe of 13,873 patients treated during the fifth epidemiological period in health institutions from 11 Colombian departments in 2013. The test under analyses was the reporting to the National Public Health Surveillance System, and the reference standard was the review of histories identified by active institutional search. We reviewed all histories of patients diagnosed with dengue fever, as well as a random sample of patients with febrile syndromes. The specificity and sensitivity of reports were estimated for this purpose, considering the inverse of the probability of being selected for weighting. The concordance between reporting and the findings of the active institutional search was calculated using Kappa statistics.

RESULTS

We included 4,359 febrile patients, and 31.7% were classified as compatible with dengue fever (17 with severe dengue fever; 461 with dengue fever and warning signs; 904 with dengue fever and no warning signs). The global sensitivity of reports was 13.2% (95%CI 10.9;15.4) and specificity was 98.4% (95%CI 97.9;98.9). Sensitivity varied according to severity: 12.1% (95%CI 9.3;14.8) for patients presenting dengue fever with no warning signs; 14.5% (95%CI 10.6;18.4) for those presenting dengue fever with warning signs, and 40.0% (95%CI 9.6;70.4) for those with severe dengue fever. Concordance between reporting and the findings of the active institutional search resulted in a Kappa of 10.1%.

CONCLUSIONS

Low concordance was observed between reporting and the review of clinical histories, which was associated with the low reporting of dengue fever compatible cases, especially milder cases.     

Impact of "+Contigo" training on the knowledge and attitudes of health care professionals about suicide

OBJECTIVES:

to evaluate the results of "+Contigo" training, developed by nurses and directed at 66 health professionals of integrated school health teams in Primary Health Care.

METHOD:

quantitative with data collection through the Suicide Behavior Attitude Questionnaire, administered before and after the training.

RESULTS:

significant increases were observed in suicide prevention knowledge and in changing attitudes of health professionals towards individuals with suicidal behavior.

CONCLUSION:

these results allow us to affirm that nurses hold scientific and pedagogical knowledge that grant them a privileged position in the health teams, to develop training aimed at health professionals involved in suicide prevention.     

Comparison of two methodologies for detection of Giardia spp. cysts and Cryptosporidium spp. oocysts in activated sludge samples from a sewage treatment plant in the city of Campinas, Sao Paulo State, Brazil

Giardia spp. and Cryptosporidium spp. are recognized worldwide as highly infectious protozoan parasites that can cause severe gastrointestinal disease in humans and animals. The detection of these pathogens in activated sludge samples becomes interesting since there is an increasing trend for the use of sewage sludge (biosolids) in agriculture. A total of 22 samples were collected and evaluated by means of Centrifugal – Concentration, followed or not followed by a purification process (ether clarification and sucrose flotation). Student t tests for comparison of the two procedures indicated a higher recovery rate of Giardia cysts with Centrifugal – Concentration; with regard to Cryptosporidium oocysts, no significant differences were found between the two methods, as only two samples were positive. The Centrifugal – Concentration procedure was shown to be the simplest and cheapest to perform, as emphasized by the efficiency recovery results.     

Effect of Omega-3 Supplementation on Self-Regulation in Typically Developing Preschool-Aged Children: Results of the Omega Kid Pilot Study—A Randomised,Double-Blind,Placebo-Controlled Trial

Supplementation of omega-3 long chain polyunsaturated fatty acids (n-3 LCPUFA) may enhance self-regulation (SR) and executive functioning (EF) in children of preschool age. The aim of the Omega Kid Study was to investigate the effect of n-3 LCPUFA supplementation on SR and EF in typically developing preschool-aged children. A double-blind placebo-controlled pilot trial was undertaken, the intervention was 12 weeks and consisted of 1.6 g of eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) per day compared to placebo. The HS-Omega-3 Index^® was assessed by capillary blood samples at baseline and post-intervention. Seventy-eight children were enrolled and randomised to either the n-3 LCPUFA treatment (n = 39) or placebo (n = 39) group. Post intervention, there was a significant three-fold increase in the HS-Omega-3 Index^® in the n-3 LCPUFA group (p < 0.001). There were no improvements in SR or EF outcome variables for the n-3 LCPUFA group post intervention compared to the placebo group determined by linear mixed models. At baseline, there were significant modest positive Spearman correlations found between the HS-Omega-3 index^® and both behavioural self-regulation and cognitive self-regulation (r = 0.287, p = 0.015 and r = 0.242, p = 0.015 respectively). Although no treatment effects were found in typically developing children, further research is required to target children with sub-optimal self-regulation who may benefit most from n-3 LCPUFA supplementation.     

Dietary–Physical Activity Patterns in the Health Context of Older Polish Adults: The ‘ABC of Healthy Eating’ Project

The study aimed to analyze the dietary–physical activity patterns (D-PAPs) in the health context of Polish people aged 60+ years. A total of 418 respondents across Poland were recruited; however, the final analysis included 361 women and men aged 60–89 years old. D-PAPs were derived using a principal component analysis (PCA); input variables were the frequency of consumption of 10 food groups and physical activity. Finally, three D-PAPs were identified: ‘Pro-healthy eating and more-active’, ‘Sweets, fried foods and sweetened beverages’, and ‘Juices, fish and sweetened beverages’. We developed the Functional Limitations Score (FLS) using the Mini Nutritional Assessment (MNA^®). A logistic regression was applied to verify the association between the D-PAPs and health-condition outcomes. Older adults were more likely to adhere to the upper tertile of the ‘Pro-healthy eating and more-active’ pattern, with good/better self-reported health status in comparison with their peers (OR = 1.86) or with good/very good self-assessed appetite (OR = 2.56), while this was less likely for older adults with malnutrition risk (OR = 0.37) or with a decrease in food intake (OR = 0.46). Subjects with a decrease in food intake (OR = 0.43), who declared a recent weight loss (OR = 0.49), or older adults in the upper tertile of the FLS (OR = 0.34) were less likely to adhere to the upper tertile of the ‘Sweets, fried foods and sweetened beverages’ pattern. The decrease in food intake due to a loss of appetite or chewing or swallowing difficulties was inversely associated with the ‘Pro-healthy eating and more-active’ pattern characterized by a relatively high frequency of consumption of vegetables, fruit, water, dairy, and grains and a high physical activity. In the interest of the good nutritional status and health of older adults, special attention should be paid to removing limitations in meal consumption, including improved appetite.     

Food Sources of Key Nutrients,Meal and Dietary Patterns among Children Aged 4–13 Years in Ibadan,Nigeria: Findings from the 2019 Kids Nutrition and Health Study

This study examined the contribution of food to nutrient intake, meal and dietary patterns among children aged 4–8 and 9–13 years in the city of Ibadan, Nigeria. Multi-pass 24-hour dietary recalls were used to assess intakes. Prudent and traditional Southwestern Nigerian dietary patterns were identified among children. The top foods and beverages were defined by frequency and amount consumed. Meal patterns were described by the eating occasions, while cluster analysis probed dietary patterns. About 88% of children had at least three meals including breakfast (95%), lunch (85%), dinner (92%) and midmorning meals (48%), while about 60% ate snacks at least once daily. Sources of energy and key nutrients were limited (yam, cassava, rice, maize, bread and beans/peas/legumes). The amount consumed per consumer of cassava products (192.2, 256.0 g), yam (169.7, 256.0 g), legumes (115.3, 150.7 g), corn/maize (160.4, 195.2), and rice (138.4, 182.3 g) were high, while beef (15.2, 17.9 g), eggs (50.6, 49.2 g), fish (27.5, 30.6 g), milk (24.2, 27.0 g) and nuts and seeds (18.2, 19.7 g) were low for children ages 4–8 and 9–13 years, respectively. In conclusion, while the frequency of meals suggests a healthy pattern, the top foods could not provide adequate nutrient (especially micronutrient) intake, which is key to the development of the target population.     

Effect and Tolerability of a Nutritional Supplement Based on a Synergistic Combination of β-Glucans and Selenium- and Zinc-Enriched Saccharomyces cerevisiae (ABB C1®) in Volunteers Receiving the Influenza or the COVID-19 Vaccine: A Randomized,Double-Blind,Placebo-Controlled Study

A single-center, randomized, double-blind, placebo-controlled study was conducted in 72 volunteers who received a synergistic combination of yeast-based ingredients with a unique β-1,3/1,6-glucan complex and a consortium of heat-treated probiotic Saccharomyces cerevisiae rich in selenium and zinc (ABB C1^®) or placebo on the next day after getting vaccinated against influenza (Chiromas^®) (n = 34) or the COVID-19 (Comirnaty^®) (n = 38). The duration of treatment was 30 and 35 days for the influenza and COVID-19 vaccine groups, respectively. Mean levels of CD4+T cells increased from 910.7 at baseline to 1000.2 cells/µL after the second dose of the COVID-19 vaccine in the ABB C1^® group, whereas there was a decrease from 1055.1 to 929.8 cells/µL in the placebo group. Changes of CD3+T and CD8+T lymphocytes showed a similar trend. In the COVID-19 cohort, the increases in both IgG and IgM were higher in the ABB C1^® supplement than in the placebo group. Serum levels of selenium and zinc showed a higher increase in subjects treated with the active product than in those receiving placebo. No serious adverse events related to ABB C1^® or tolerance issues were reported. The study findings validate the capacity of the ABB C1^® product to stimulate trained immunity.