DEMSC - Departamento de Medicina de Família, Saúde Mental e Coletiva
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Item Diagnosis of human toxoplasmosis by a dot enzyme-linked immunosorbent assay.(1995) Elsaid, Mohamed Mohamed Anwar; Bahia, Maria Terezinha; Coelho, George Luiz Lins Machado; Vitor, Ricardo Wagner de AlmeidaItem Validity of serology for american trypanosomiasis with eluates from filter paper.(1995) Coelho, George Luiz Lins Machado; Vitor, Ricardo Wagner de Almeida; Chiari, Cléa de Andrade; Antunes, Carlos Mauricio de FigueiredoItem Utilização do eluato de sangue dessecado em papel de filtro no diagnóstico sorológico da toxoplasmose caprina.(1995) Bahia, Maria Terezinha; Vitor, Ricardo Wagner de Almeida; Coelho, George Luiz Lins Machado; Caldas, Rogério Pinheiro; Antunes, Carlos Mauricio de Figueiredo; Chiari, Cléa de AndradeFoi realizada pesquisa de anticorpos anti-Toxoplasmagondii em 183 amostras de sangue dessecado em papel de filtro utilizando as reações de imunofluorescência indireta ELISA e dot-ELIS A, tomando como referência os resultados obtidos nos soros. A análise dos resultados demonstrou que papéis com sangue dessecado podem ser conservados por um período mínimo de 45 dias à temperatura ambiente e por seis meses a 4°C, desde que mantidos livres de umidade pela utilização de agentes dessecantes como a síüca-gel. A reprodutibilidade das reações, avaliada por meio da curva dos títulos de anticorpos no decorrer do tempo após a coleta do sangue em papéis de filtro, demonstrou uma concordância de 97 a 100% entre os resultados obtidos nos soros e eluatos. Os títulos de anticorpos permaneceram estáveis durante o período observado. Os resultados obtidos com eluato de sangue dessecado foram semelhantes na RIFI, ELISA e dot-ELISA, indicando que qualquer uma das três reações pode ser utilizada em eluatos de sangue dessecado para o diagnóstico da toxoplasmose caprina.Item Descentralização da saúde e poder local em Minas Gerais.(1998) Figueiredo, Adriana Maria de; Abreu, Daisy Maria Xavier de; França, Susete Barboza; Somarriba, Maria das Mercês Gomes; Belisário, Soraya AlmeidaA associação positiva que se faz entre a estratégia de descentralização e a democratização do espaço público local, através de um controle maior por parte dos cidadãos, nem sempre se verificam nas experiências concretas, especialmente nos pequenos municípios. Nesta perspectiva, este artigo apresenta os principais resultados de uma pesquisa realizada em três municípios mineiros sobre o processo de descentralização da saúde diante da estrutura de poder local vigente. O estudo procurou considerar os interesses e influências dos atores individuais e coletivos no processo de descentralização da saúde, que tendem a se mobilizar em direção à defesa, modificação ou rejeição das propostas de mudanças no setor saúde. As características político-administrativas do Estado influem nas condições de implementação de políticas de descentralização, que encontram, no nível local, peculiaridades que não podem ser desconsideradas e que atuam sobre os determinantes do processo de descentralização do setor saúde.Item American cutaneous leishmaniasis in Southeast Brazil : space-time clustering.(1999) Coelho, George Luiz Lins Machado; Assunção, Renato; Mayrink, Wilson; Caiaffa, Waleska TeixeiraItem A flea-associated rickettsia pathogenic for humans.(2001) Raoult, Didier; Scola, Bernard La; Enea, Maryse; Fournier, Pierre Edouard; Roux, Véronique; Fenollar, Florence; Galvão, Márcio Antônio Moreira; Lamballerie, Xavier deA rickettsia named the ELB agent, or “Rickettsia felis,” was identified by molecular biology techniques in American fleas in 1990 and later in four patients from Texas and Mexico. We attempted to isolate this rickettsia from infected fleas at various temperatures and conditions. A representative isolate of the ELB agent, the Marseille strain, was characterized and used to develop a microimmunofluorescence test that detected reactive antibodies in human sera. The ELB agent was isolated from 19 of 20 groups of polymerase chain reaction-proven infected fleas. The microimmunofluorescence results provided serologic evidence of infection by the ELB agent in four patients with fever and rash in France (2) and Brazil (2), supporting the pathogenic role of this rickettsia. Our successful isolation of this rickettsia makes it available for use in serologic tests to determine its clinical spectrum, prevalence, and distribution.Item Vaccination of C57BL/10 mice against cutaneous leishmaniasis using killed promastigotes of different strains and species of Leishmania.(2002) Mayrink, Wilson; Santos, Gilmara Cristina dos; Toledo, Vicente de Paulo Coelho Peixoto de; Guimarães, Tânia Mara Pinto Dabés; Coelho, George Luiz Lins Machado; Genaro, Odair; Costa, Carlos Alberto daAntigenic extracts from five Leishmania stocks were used to vaccinate C57BL/10 mice. The Leishvacinand PH8 monovalent vaccine yielded the highest IFN-levels in the supernatants of spleen cell culture from vaccinated animals. Each single strain immunized group showed evidence of protective immunity six months after the challenge with promastigotes of Leishmania (Leishmania) amazonensis. No differences were detected between the vaccinated groups. It can be concluded that vaccines composed of single Leishmania stocks can provide protection to C57BL/10 mice against L. (L.) amazonensis infection.Item Trypanosoma cruzi recombinant complement regulatory protein : a novel antigen for use in an enzyme-linked immunosorbent assay for diagnosis of chagas’ disease.(2002) Meira, Wendell Sérgio Ferreira; Galvão, Lúcia Maria da Cunha; Gontijo, Eliane Dias; Coelho, George Luiz Lins Machado; Norris, Karen; Chiari, EglerCurrently, diagnosis of Chagas’ disease is based on serological methods, but due to the high occurrence of inconclusive results, more reliable methods are needed. The use of recombinant antigens for serodiagnosis of Chagas’ disease is recommended in order to increase the sensitivity and specificity of the serological tests. The Trypanosoma cruzi complement regulatory protein (CRP) is a surface glycoprotein present on the trypomastigote forms of the parasite, and the recombinant CRP (rCRP) was cloned in a mammalian expression system and purified by affinity chromatography. The purified recombinant protein was used as an antigen in an enzyme-linked immunosorbent assay (rCRP ELISA) in order to verify its sensitivity and specificity compared with other established methods. In this evaluation, a panel of 184 serum samples distributed among chronic chagasic patients (n 65), blood bank donors (n 100), and patients infected with Leishmania spp. (n 19) was used. The sensitivity and specificity of the rCRP ELISA were 100% when compared to conventional serology and complement-mediated lysis tests from these groups. When hemoculture and PCR tests were evaluated for diagnosis of chronic chagasic patients, using the rCRP ELISA as a reference test, the positivities were found to be 64.62 and 81.54%, respectively, showing a higher degree of sensitivity of the test. The data demonstrate that rCRP ELISA was able to discriminate between chronic chagasic patients and nonchagasic individuals, such as blood donors and patients with leishmaniasis. Thus, the rCRP is an excellent antigen for use in Chagas’ disease diagnosis, due to the absence of false-negative or false-positive results.Item Rickettsioses emergentes e reemergentes numa região endêmica do Estado de Minas Gerais, Brasil.(2002) Galvão, Márcio Antônio Moreira; Lamounier, Joel Alves; Bonomo, Élido; Tropia, Margarete S.; Rezende, Eliane Garcia; Calic, Simone Berger; Chamone, Chequer Buffe; Machado, Mirtes C.; Otoni, Márcia E. A.; Leite, Romário Cerqueira; Caram, Camila; Mafra, Cláudio Lísias; Walker, David HughesO trabalho descreve um inquérito sorológico para rickettsioses em escolares e cães de Novo Cruzeiro, Minas Gerais, Brasil, em 1998. Trezentos e trinta e um escolares pertenciam a uma área endêmica e 142 a uma área não endêmica do município. Trinta e nove (10,1%) soros foram reativos à Reação de Imunofluorescência Indireta (RIFI) para Rickettsia rickettsii no título de 1:64, sendo que dentre esses reativos, 35 eram de estudantes de escolas de área endêmica. Dentre os 73 cães analisados quanto à presença de anticorpos anti R. rickettsii, anti Ehrlichia chaffeensis e anti Ehrlichia canis à RIFI no título de 1:64, 3 (4,11%), 11 (15,07%) e 13 (17,81%) desses animais foram reativos respectivamente aos antígenos testados. Conclui-se que, a sororeatividade para R. rickettsii em indivíduos sadios sem história prévia de febre maculosa brasileira, uma doença marcante por sua alta letalidade, e a presença de sororeatividade para Ehrlichia com potencial patogênico para o homem em cães, nos leva a indagar sobre a transmissão ao homem de outras espécies da família Rickettsiae na área estudada.Item Fatal spotted fever rickettsiosis, Minas Gerais, Brazil.(2003) Galvão, Márcio Antônio Moreira; Dumler, J. Stephen; Mafra, Cláudio Lísias; Calic, Simone Berger; Chamone, Chequer Buffe; Cesarino Filho, Gracco; Olano, Juan Pablo; Walker, David HughesThe emergence and reemergence of a serious infectious disease are often associated with a high case-fatality rate because of misdiagnosis and inappropriate or delayed treatment. The current reemergence of spotted fever rickettsiosis caused by Rickettsia rickettsii in Brazil has resulted in a high proportion of fatal cases. We describe two familial clusters of Brazilian spotted fever in the state of Minas Gerais, involving six children 9 months to 15 years of age; five died. Immunohistochemical investigation of tissues obtained at necropsy of a child in each location, Novo Cruzeiro and Coronel Fabriciano municipalities, established the diagnosis by demonstration of disseminated endothelial infection with spotted fever group rickettsiae. The diagnosis in the two fatal cases from Coronel Fabriciano and the surviving patient from Novo Cruzeiro was further supported by immunofluorescence serologic tests.Item Spotted fever rickettsiosis in Coronel Fabriciano, Minas Gerais State.(2003) Galvão, Márcio Antônio Moreira; Calic, Simone Berger; Chamone, Chequer Buffe; Siqueira, Cláudio Lísias Mafra de; Cesarino Filho, Gracco; Olano, Juan Pablo; Walker, David HughesWe report cases of spotted fever rickettsiosis in Coronel Fabriciano Municipality of Minas Gerais State, Brazil. The cases occurred in May and June of 2000. During this period there were two deaths among children from an area named Pedreira in a periurban area of this municipality. In a boy who died with clinical manifestations of Brazilian spotted fever, a necropsy revealed the presence of a spotted fever group Rickettsia. The serological results confirm the difficulty in the differential diagnosis of patients with symptoms of rickettsial diseases.Item Epidemiology of canine visceral leishmaniasis in the endemic area of Montes Claros Municipality, Minas Gerais State, Brazil.(2003) Silva, João Carlos França da; Costa, Roberto Teodoro da; Siqueira, Ari M.; Coelho, George Luiz Lins Machado; Costa, Carlos Alberto da; Mayrink, Wilson; Vieira, Edvá P.; Silva, Jaime Costa daThe Montes Claros City is located in an endemic area for visceral leishmaniosis in the Minas Gerais State, Brazil.With the implementation of a program for the control of visceral leishmaniosis in 1994, a sectional study was carried out to evaluate the infection by viscerotropic Leishmania in the population of dogs from Montes Claros, basically using indirect immunofluorescence antibody test (IFAT). Blood samples were collected on filter paper from 33,937 dogs, representing 96.1% of the canine local population. The prevalence for visceral leishmaniosis was found to be 9.7% in the municipality, being 9.9% in the urban area and 8.8% in the rural area. The annual incidence showed to be 64.3/1000 dogs. Prevalence of infection was not correlated with dogs age. The most affected breeds were: Boxer (24.6%) and Cocker (26.9%); Mongrel dogs had a prevalence of 7.8%. Short-hair animals had a prevalence of 11.9%, while long-furred animals had a prevalence of 8.9%. The isoenzymatic profile indicated that Leishmania (Leishmania) chagasi was the visceral leishmaniosis etiological agent in Montes Claros City, Minas Gerais State, Brazil. The main geographical areas for the parasite transmission were identified, and control measures were immediately started. The role of the dog as a reservoir for L. chagasi was confirmed. It was demonstrated that short-furred animals are at a higher risk of acquiring visceral leishmaniosis than the long-furred dogs.Item Rickettsiosis of the genus rickettsia in South America.(2003) Galvão, Márcio Antônio Moreira; Mafra, Cláudio Lísias; Moron, Cecília; Anaya, Elisabeth; Walker, David HughesIn South America, human cases of infection by the genus Rickettsia have been described in several countries in the last twenty years. The role of international organizations, such as the Centers for Disease Control and Prevention in Atlanta, Georgia, USA and the World Health Organization Collaborating Center for Tropical Diseases at the University of Texas Medical Branch at Galveston, Texas, USA, was very important in the last twenty years for the development of surveillance systems and for the increase in notification of rickettsial diseases by the countries of South America. We hope that the next goal will be prevention and control of rickettsial diseases in the countries of South America, as well as maintaining the programs developed during the last twenty years, so that a good health system and improved social conditions will be possible.Item Risk factors for mucosal manifestation of American cutaneous leishmaniasis.(2003) Coelho, George Luiz Lins Machado; Caiaffa, Waleska Teixeira; Genaro, Odair; Magalhães, Paulo Araújo; Mayrink, WilsonA case-comparison study was carried out to identify risk factors for mucosal manifestations of American cutaneous leishmaniasis (ACL) in southeast Brazil, using a series of 2820 patients, diagnosed with ACL between 1966 and 1999. The significant factors independently associated with mucosal leishmaniasis were: gender, age, nutritional status and length of disease. Mucosal leishmaniasis occurred 1.7 times more frequently among males than females; twice as often in individuals older than 22 years compared with the younger group; almost four times as often in individuals with severe malnutrition compared with those who were well nourished; and almost four times more frequently in individuals reporting the disease for more than 4 months compared with those reporting a shorter duration of the disease. Among individuals older than 22 years the risk of mucosal leishmaniasis increased significantly (from 1.9 to 9.6) as the nutritional status decreased, when compared with younger and well-nourished patients. The characteristics herein described and correlated with severe forms could be used as diagnostic markers as part of clinical screening in areas endemic for ACL.Item Talcose entre artesãos em pedra-sabão em uma localidade rural do Município de Ouro Preto, Minas Gerais, Brasil.(2003) Bezerra, Olívia Maria de Paula Alves; Dias, Elizabeth Costa; Galvão, Márcio Antônio Moreira; Carneiro, Ana Paula ScaliaA talcose é uma pneumoconiose ainda pouco estudada em nosso meio. Sua ocorrência foi investigada no Distrito de Mata dos Palmitos, Ouro Preto, Minas Gerais, Brasil, entre artesãos em pedra-sabão, que trabalham em produção de base familiar, de caráter informal. Na localidade, vivem cerca de 180 habitantes, dos quais 108 se ocupam com o artesanato em pedra-sabão e 15 alternam a produção de peças artesanais com as atividades nas minas. Foram realizados exames clínicos, enfatizando a história ocupacional; questionário padronizado de sintomas respiratórios; radiografia de tórax (padrão OIT) e espirometria. Observou-se baixa prevalência de queixas respiratórias, e a dispnéia foi o sintoma mais freqüente. A ocorrência de bronquite crônica foi identificada em 12 trabalhadores adultos. O exame radiológico de tórax evidenciou pequenas opacidades pulmonares em cinco trabalhadores, e 11 foram considerados suspeitos. Um trabalhador apresentou espessamento pleural em placa. Alterações na espirometria foram observadas em sete trabalhadores. O estudo da composição da poeira revelou a presença de fibras respiráveis de asbesto do grupo dos anfibólios (tremolita-actinolita). Esses resultados sugerem a ocorrência de talcoasbestose entre os artesãos em pedra-sabão.Item Prevalence of antibodies to spotted fever group rickettsiae in humans and domestic animals in a brazilian spotted fever−endemic area in the state of São Paulo, Brazil : serologic evidence for infection by Rickettsia rickettsii and another spotted fever group rickettsia.(2004) Horta, Maurício Cláudio; Labruna, Marcelo Bahia; Sangioni, Luis Antônio; Vianna, Manoella Campostrini Barreto; Gennari, Solange Maria; Galvão, Márcio Antônio Moreira; Mafra, Cláudio Lísias; Vidotto, Odilon; Schumaker, Teresinha T. S.; Walker, David HughesIn serum samples obtained from all the healthy humans, horses, dogs, and donkeys present on three farms in the Pedreira Municipality, an endemic area for Brazilian spotted fever, an indirect immunofluorescence assay (IFA) detected antibodies against Rickettsia rickettsii in 17 (77.3%) horses, 5 (31.3%) dogs (titers ranging from 64 to 4,048), and none of 4 donkeys or 50 humans. Five canine and eight equine sera with high antibody titers to R. rickettsii were also tested by IFA against R. bellii, R. akari, and R. africae antigens. Sera from two horses and two dogs that showed similar high antibody titers against two rickettsial antigens were evaluated after cross-absorption. Sera from seven horses and two dogs contained antibodies specific for R. rickettsii, and one dog serum had antibodies against a Rickettsia species very closely related to R. africae. The latter may have been caused by infection with the recently identified COOPERI strain.Item Clinical and laboratorial evidence of Rickettsia felis infections in Latin America.(2004) Galvão, Márcio Antônio Moreira; Mafra, Cláudio Lísias; Chamone, Chequer Buffe; Calic, Simone Berger; Zavala Velazquez, Jorge Ernesto; Walker, David HughesAfter the discovery and initial characterization of Rickettsia felis in 1992 by Azad and cols, and the subsequent first description of a human case of infection in 1994, there have been two communications of human rickettsiosis cases caused by Rickettsia felis in Latin America. The first one was published in 2000 by Zavala-Velazquez and cols in Mexico. In 2001 Raoult and cols described the occurrence of two human cases of Rickettsia felis rickettsiosis in Brazil. In the present discussion these two articles were compared and after the description of the principal signs and symptoms, it was concluded that more studies are needed with descriptions of a greater number of patients to establish the true frequency of the clinical signs and symptoms present in Rickettsia felis rickettsiosis.Item Human ehrlichioses in Brazil : first suspect cases.(2004) Calic, Simone Berger; Galvão, Márcio Antônio Moreira; Bacellar, Fátima; Rocha, Christiane Maria Barcellos Magalhães da; Mafra, Cláudio Lísias; Leite, Romário Cerqueira; Walker, David HughesBrazilian spotted fever (BSF) rickettsiosis is the most common and recognized of the human rickettsioses in Brazil. It is difficult to establish the diagnosis of human rickettsiosis infection by routine microbiologic methods, creating a false idea that Rickettsia and Ehrlichia infections are rare and without importance. New tick-borne diseases, like Human Granulocytic Anaplasmosis (HGA) and Human Monocytic Ehrlichiosis (HME), have been described in many countries. These diseases can present symptoms similar to rickettsioses of the spotted fever group, and they are transmitted by ixodid ticks. The first two suspected cases of human ehrlichiosis in Brazil were first considered to be cases of BSF. The differential diagnosis was made at the Minas Gerais Rickettsiosis Public Health Laboratory. The clinical and laboratory findings, with positive serology for the HME agent, indicated suspected cases of human ehrlichioses in Brazil.Item Rickettsial diseases in Brazil and Portugal : occurrence, distribution and diagnosis.(2005) Galvão, Márcio Antônio Moreira; Silva, Luiz Jacintho da; Nascimento, Elvira Maria Mendes; Calic, Simone Berger; Sousa, Rita de; Bacellar, FátimaThe present study is an update review on the occurrence and diagnosis of rickettsial diseases in Brazil and Portugal, aiming at promoting their epidemiological surveillance in both countries. A literature review was carried out and unpublished data of laboratories and surveillance systems were presented. The results described the occurrence of rickettsial diseases and infections in Brazil and Portugal, including other new and still poorly understood rickettsial infections. Current diagnostic methods were discussed. As in many other countries, rickettsial diseases and infections seem to be an emerging public health problem. Treated as a minor problem for many decades, the interest in these infections has increased in both countries but further studies are needed to establish their role as a public health problem.Item Importance of Lutzomyia longipalpis in the dynamics of transmission of canine visceral leishmaniasis in the endemic area of Porteirinha Municipality, Minas Gerais, Brazil.(2005) Silva, João Carlos França da; Barata, Ricardo Andrade; Costa, Roberto Teodoro da; Michalsky, Érika Monteiro; Coelho, George Luiz Lins Machado; Vieira, Edvá P.; Prata, Aluízio; Mayrink, Wilson; Nascimento, Edvaldo; Dias, Consuelo Latorre Fortes; Silva, Jaime C.; Dias, Edelberto SantosA study of Lutzomyia longipalpis (Lutz and Neiva, 1912) (Diptera: Psychodidae), the primary vector of American visceral leishmaniasis (AVL), and the canine form of the disease, was carried out in Porteirinha. The city is situated in the northern part of the Brazilian State of Minas Gerais and is an endemic area of AVL. Systematic phlebotomine captures were performed in seven districts with previously reported cases of canine visceral leishmaniasis, during 2 years (January 2000– December 2001). A total of 2328 specimens of L. longipalpis were captured. The association between the local climate variables and the population density of L. longipalpis was evaluated and rainfall was determined to be a major factor, with increased populations during the rainy season (October–March). At the same time period, blood samples from every dog domiciled in the same seven districts, in total 14,077 animals, were analyzed for infection by viscerotropic Leishmania using indirect immunofluorescence assay (IFA). Accumulated incidence rates of canine VL per district varied from 3.40 to 14.34 for the 2-year period. A positive correlation between the population density of L. longipalpis and the canine cases of visceral leishmaniasis in Porteirinha was observed.