Wild, synanthropic and domestic hosts of Leishmania in an endemic area of cutaneous leishmaniasis in Minas Gerais State, Brazil

Domestic, synanthropic and wild hosts of Leishmania spp. parasites were studied in an area endemic for American tegumentary leishmaniasis (ATL), specifically in northern Minas Gerais State, Brazil. Domestic dogs and small forest mammals are reservoir hosts for L. (Leishmania) infantum. However, the role that these animals play in the transmission cycle of the Leishmania spp. that cause cutaneous leishmaniasis is not well known. This study evaluated 72 rodents, 25 marsupials and 98 domestic dogs found in two villages of the Xakriabá Indigenous Territory, an area of intense ATL transmission. A total of 23 dogs (23.47%) were shown to be positive according to at least one test; 8 dogs (8.16%) tested positive in a single serological test and 15 dogs (15.31%) tested positive by IFAT and ELISA. Eleven dogs were euthanised to allow for molecular diagnosis, of which nine (81.8%) tested positive by PCR for Leishmania in at least one tissue. Seven animals were infected only with L. (L.) infantum, whilst two displayed a mixed infection of L. (L.) infantum and L. (V.) braziliensis. Isoenzymatic characterisation identified L. (L.) infantum parasites isolated from the bone marrow of two dogs. Of the 97 small mammals captured, 24 tested positive for Leishmania by PCR. The results showed that L. (V.) braziliensis, L. (L.) infantum and L. (V.) guyanensis are circulating among wild and synanthropic mammals present in the Xakriabá Reserve, highlighting the epidemiological diversity of ATL in this region.     

Differences in prenatal care between health services under the Family Health Strategy and traditional primary care clinics in Rio Grande, Rio Grande do Sul State, Brazil

This study aimed to evaluate differences in prenatal care between services under the Family Health Strategy (FHS) and traditional public primary care clinics in Rio Grande, Rio Grande do Sul State, Brazil. A cross-sectional study was performed with all women who gave birth from January 1st to December 31st, 2007, and who received prenatal care in the municipal health system. The procedures recommended by the Ministry of Health were compared according to model of care. Among the 961 pregnant women, those treated under the FHS received a higher percentage of some forms of care (use of ferrous sulfate, tetanus vaccination, and HIV and syphilis tests). Other procedures were also more frequent under the FHS, but failed to reach the recommended levels (breast examination and Pap smear). Measurement of blood pressure, uterine height, and weight were quite frequent in both groups. Identification of pregnant women in the first trimester failed to reach 70%. Women under the FHS received better care, but some procedures still fell short of expected levels, and efforts are thus needed to improve the quality of prenatal care.     

Smoking among adolescents and young adults in Belo Horizonte, Minas Gerais State, Brazil: the influence of family setting and social group

The study aimed to estimate smoking prevalence in Belo Horizonte, Minas Gerais State, Brazil, and related risk factors among adolescents. We used data from the household survey conducted by the Brazilian National Cancer Institute (2002-2003). The following variables were analyzed: demographic data; physical activity; smoking; and alcohol consumption. The study included information on 630 adolescents (15-24 years of age) living in Belo Horizonte. Multivariate logistic regression analyses were carried out, with hierarchical entry of variables into the model and the generalized estimating equation (GEE) method. Overall smoking prevalence was 11.7%. The following factors were associated with smoking: alcohol consumption (OR = 20.6), older age (OR = 1.2), paternal smoking (OR = 4.0), sibling smoker (OR = 2.5), and best friend smoker (OR = 5.2). Smoking prevalence among adolescents was high, increasing with age and alcohol consumption.     

Knowledge, attitude and practice related to the pap smear test among users of a primary health unit

This KAP (knowledge, attitude and practice) study, carried out from February to June 2008, aimed to evaluate the knowledge, attitude and practice regarding the Pap smear test among users of a primary health unit (PHU) and to verify any association with sociodemographic variables. The sample was comprised of 250 women. The knowledge, attitude and practice related to the examination were adequate in 40.4%, 28% and 67.6% of respondents, respectively. The results demonstrate higher proportions of adequate knowledge and attitude with schooling (>9 years) and age (>35 years). It is essential to seek specific answers regarding this issue in order to direct integrated actions of health education, thus ensuring greater access, adhesion and return of the women for the examination results.     

Validity and reliability of clinical tests for assessing hip passive stiffness

Inadequate levels of hip passive joint stiffness have been associated with the occurrence of movement dysfunction, development of pathologies and reduction in performance. Clinical tests, designed to evaluate hip joint stiffness, may allow the identification of improper stiffness levels. The purpose of this study was to determine the concurrent validity as well as the intra- and inter-examiners reliabilities of clinical measures used to assess hip passive stiffness during internal rotation. Fifteen healthy participants were subjected to test-retest evaluations by two examiners. Two clinical measures were performed: 'position of first detectable resistance' and 'change in passive resistance torque'. The results of these tests were compared to the passive stiffness measured with an isokinetic dynamometer (gold standard measure). A significant correlation was found between the stiffness measured with the isokinetic dynamometer and the clinical measures of 'position of first detectable resistance' (r=-0.85 to -0.86, p<0.001) and 'change in passive resistance torque' (r=0.78 to 0.84, p≤0.001). The Intraclass Correlation Coefficients for intra- and inter-examiners reliabilities varied from 0.95 to 0.99. Thus, the results demonstrated that the clinical measures have adequate validity and reliability for obtaining information on hip passive stiffness during internal rotation.