How climate variability modes influenced the fires in South America during the extreme droughts of 2023-2024.

Oropouche virus (OROV) is an emerging arbovirus primarily transmitted by the Culicoides mosquito species. It was first identified in 1955 in the Amazon region of Brazil and has since been recognized as a cause of viral fever outbreaks, particularly in Latin America. The virus typically causes an illness characterized by fever, headache, muscle and joint pain, rash, retro- orbital pain, conjunctivitis, and gastrointestinal symptoms like nausea and vomiting. Neurological manifestations, including confusion and, in rare cases, encephalitis, can also occur. Outbreaks of OROV have been reported, especially in areas with poor vector control and high mosquito populations. Diagnosis is confirmed through laboratory tests, including reverse transcription polymerase chain reaction (RT-PCR) and serological assays to detect antibodies or viral RNA. This review provides a fresh view and insight into the OROV research arena by drawing attention to several major issues important for advancing research and public health response. One major topic that the review brings out is the sudden increase in reports of outbreaks and cases in Brazil, Peru, and Bolivia. This seems to contribute to the growing recognition of OROV as a big public health threat. Emphasizing the potential new transmission routes by OROV, there are calls for further studies, and monitoring should be strengthened to avert further spread. The molecular and structural approaches have been discussed in this review, thereby providing knowledge about the OROV at the biological level. The information about the segmented RNA genome and the proteins encoded by the three segments helps the understanding of molecular attributes contributing to viral replication and infectivity in host cells. A detailed analysis of the virus's structure will form a fundamental basis for further research directed toward therapeutics and vaccine development. Finally, the review highlights the need for urgent vaccine development and enhanced prevention strategies. Until now, no approved vaccines or antiviral treatment options have been available; therefore, the review promotes further research into uptake-based vaccine approaches and enhanced vector control. Emphasis on practicable prevention measures encompassing the use of insect repellents, mosquito nets, and curtailing breeding grounds allows public health personnel and communities to take concrete measures to intercept the virus's further spread. Middle of these recommendations, bolstered by increasing evidence about the virus's epidemiology, makes the review a timely call for action to address this emerging threat.

Filarial infections—lymphatic filariasis, onchocerciasis, and mansonellosis—persist as neglected tropical diseases in Latin America despite control efforts. Comparing filarial trends over time is challenging because studies use different diagnostic methods such as microscopy, antigen tests, serology, and molecular assays that vary in sensitivity, specificity, and whether they detect active infection or past exposure, while also sampling different populations such as adults in endemic communities versus children in transmission assessment surveys. Transmission is also highly focal, so prevalence can vary substantially even between nearby communities. We searched MEDLINE, Embase, CENTRAL, LILACS, Web of Science, SciELO, and Global Health (1946–2025) to summarize reported epidemiology and burden of filarial infections in Latin America before and after mass drug administration (MDA) scale-up. For lymphatic filariasis, the Dominican Republic’s La Ciénaga focus (Santo Domingo) declined from 10.7% circulating filarial antigen (CFA) positivity in 2002 to 0% CFA-positive children (aged 6–7 years) in a 2014 transmission assessment survey (TAS) using the immunochromatographic test after three MDA rounds (2004–2006). In Haiti, Nippes Department surveys detected 1.5% CFA positivity in 2019, while pooled TAS results across 54 implementation units during 2017–2022 found 0.19% CFA positivity among children aged 6–7 years. For onchocerciasis, Guatemala’s San Vicente Pacaya focus reported 31% Onchocerca volvulus skin microfilarial positivity by skin-snip microscopy in 1976–1977, whereas Huehuetenango reported 0% OV16 IgG4 seropositivity in children in 2007–2008. In Ecuador’s Esmeraldas focus (Cayapas River area), early surveys documented 83% infection by skin-snip microscopy. In comparison, post-MDA monitoring showed 0% vector infectivity (O-150 PCR) by 2008 and 0% OV16 IgG4 seropositivity in children and adolescents (2001–2008), supporting MDA cessation in 2009. For Mansonellosis, prevalence in the Brazilian Amazon ranged from 6.3% in Tefé Riverine communities to 13.6% overall in Tefé municipality surveys (both in 2012; thick blood smear microscopy), and reached 43.4% in another Amazonian cohort (2009–2010; blood microfilariae detection by microscopy). In Colombia’s Amazonas Department (Leticia/Puerto Nariño), whole-blood loop-mediated isothermal amplification (LAMP) detected ~40% Mansonella ozzardi positivity in 2021–2023, compared with 12.7% by blood smear microscopy in the same study, illustrating diagnostic sensitivity differences. The reviewed data show clear reductions in lymphatic filariasis and onchocerciasis after MDA scale-up, whereas mansonellosis remains common in several Amazonian regions. Reported prevalence varies across studies due to differences in diagnostic approaches, surveyed populations, and localized transmission patterns.

The letter to the editor analyzes and comments the study by Cardoso et al. that evaluated the functionality of the upper limbs, fatigue and quality of life of women submitted to breast cancer surgical treatment at a reference hospital in the Amazon region. The author acknowledges the clinical relevance and highlights the combined use of self- reported measures (QuickDASH, FACT-B+4, FACT-F) and an objective measure (isokinetic dynamometry) aligned with the current recommendations for multimodal evaluation. However, it argues that the choice of the instruments can limit the full understanding of functional sequelae, particularly in relation to lymphedema and its specific psychosocial impact. There are alternative and complementary PROMs as ULFI, SPADI, LYMQOL-Arm, ULL-27, LYMPH-Q and PROMIS Upper Extremity that capture comprehensively lymphedema-related functional aspects, specific symptoms and quality of life. The manuscript analyzes the advantages and limitations of the instruments utilized in the original study and emphasizes that the dynamometry, although objective, does not always reflect the functional performance of the activities of the daily life. Ultimately, the author proposes practical recommendations for future clinical records and studies, highlighting the combination of general and specific PROMs with objective measures as well as the importance of the longitudinal follow-up and adjusted analyzes to strengthen the clinical and scientific applicability of the investigation in this area.

The açaí palm (Euterpe oleracea) is a key economic resource in the Amazon region. Despite this, studies on its floral visitors in Amazonas state remains scarce, outdated, lack species identifications and inferences about their role as pollinators. This study aimed to identify the floral visitor community and potential pollinators of an açaí crop in the central Amazon. From August 2018 to May 2019, we monitored the visits on 14 pistillate and 11 staminate inflorescences from 20 plants and calculated two indices: relative importance and pollen-transport efficiency, to identify the main potential pollinators. We collected 1656 insects from 111 species, mainly stingless bees (45.77%) and other native bees (33.32%). Ranking values identified Trigona williana Friese and Partamona ferreirai Pedro & Camargo as the principal contributors to pollen flow, followed by Trigona dallatorreana Friese and Frieseomelitta trichocerata Moure. This ranking method represents a key innovation of our study. Using these indices, we identify species contributing most to pollen flow while retaining information on the importance and efficiency of all taxa. Our findings reinforce the role of native bees in açaí pollination and provide potential target species for regional management.

The potential risks posed by microplastics (MPs) to anuran tadpoles remain poorly studied in the Brazilian Amazon region. Therefore, the aim of this study was to analyze MP contamination in Scinax x-signatus tadpoles at two developmental stages, as well as to characterize and quantify MPs. In addition, we evaluated MP concentrations in surface water and their relationship with environmental characteristics. The study was conducted at the Gunma Ecological Park, Santa Bárbara, Pará, Brazil, across five sampling sites during April 2025. We identified MP contamination in both surface water and tadpoles from all sampled sites. Environmental characteristics showed no direct relationship with MP contamination in tadpoles. However, tadpoles in the pre-metamorphic stage exhibited higher levels of MP contamination than those in the pro-metamorphic stage. A correlation was observed between tadpole body weight (g) and MP concentration, indicating that MP ingestion decreased as body weight increased. This study is the first to report in situ MP contamination in anuran tadpoles from the Amazon region, demonstrating the susceptibility of these organisms to contamination by this pollutant.

Globalization and environmental change are reshaping infectious disease dynamics, including reverse zoonotic transmission from humans to wildlife. We assessed hepatitis B virus (HBV) infection in wild New World primates from two Brazilian Amazon regions: an anthropogenically impacted area in southwestern Amazonia (Rondonia and Mato Grosso states) and a remote, minimally impacted area along the upper Japurá River (Amazonas state). Blood or liver samples from 88 primates representing 28 species were examined for HBV. HBV was detected in 17 of 49 primates (34.7%) from disturbed areas but in none of the 39 primates from the remote site. Human population density significantly predicted infection, and viral genotypes matched locally circulating human HBV strains, supporting human-to-primate spillover driven by deforestation and encroachment.

Mesh size efficiency in estuarine benthos sampling: impact on community composition and the performance of ecological indicators in the Amazon region

Taxanes are drugs commonly used in the treatment of breast cancer. Despite their proven therapeutic efficacy, they can induce severe toxicities, which can be investigated by pharmacogenomics. In this context, the aim of this study was to investigate 26 molecular biomarkers in 17 pharmacogenes (CYP2C8, ABCB1, CYP1A1, CYP1B1, CYP19A1, CYP3A5, ERCC1, ERBB2, VEGFA, ERCC2, MDM2, MTHFR, RAD51, SOD2, TP53, TANC1 and XRCC1), in women with Breast Cancer undergoing Taxane treatment in the Brazilian Amazon region. This study was carried out with 279 women diagnosed with BC, undergoing antineoplastic chemotherapy treatment based on Taxanes (Docetaxel and Paclitaxel), in Brazilian Amazon region. 26 pharmacogenetic markers located in 17 genes involved in the metabolic pathway of Taxanes and related toxicities were selected. Single nucleotide variants were genotyped by allelic discrimination using TaqMan OpenArray Genotyping technology. The study population showed significant associations of Taxane toxicities with ten variants of nine genes: CYP1A1, CYP19A1, CYP3A5, ERCC1, VEGFA, ERCC2, MTHFR, TANC1 and XRCC1. Notably, variants in TANC1 and XRCC1, previously associated with radiotoxicity, were also implicated in Taxane-induced toxicities. The study demonstrated that novel biomarkers may be important for investigating Taxane-induced toxicities in breast cancer. These findings represent a unique contribution to the field, potentially enabling more precise chemotherapy selection, particularly for populations such as Amazonian women.

With an aging population, muscle health, encompassing locomotion and metabolic function, has become a public health priority. Handgrip strength is a validated surrogate measure of general muscle strength, but measurement may not be feasible in low-resource settings. The SARC-F questionnaire (Strength, Assistance in walking, Rise from a chair, Climb stairs, and Falls) provides a simple, low-cost, and practical tool for sarcopenia screening, though its optimal cut-off remains debated. To evaluate the predictive validity of SARC-F cut-off scores in identifying low muscle strength among community-dwelling older adults in a low-income population. We included 733 participants (221 men, 512 women; aged 60-95years) from the Amazonas region of Brazil. All completed the SARC-F and underwent handgrip strength testing. Low handgrip strength was based on EWGSOP2 criteria (<27kg men, <16kg women). Agreement, sensitivity, specificity, predictive values, and ROC curves were calculated for cut-offs ≥4 and≥2, stratified by sex. Low handgrip strength was highly prevalent (47.1% in men, 94.1% in women). Agreement between SARC-F and muscle weakness was generally poor (κ <0.4), except for men at the ≥4 threshold (κ=0.41). Sensitivity was higher in men than in women (≥4: 48% vs 37%; ≥2: 70% vs 69%). Lowering the cut-off to ≥2 improved sensitivity but reduced specificity (65.8% men, 56.7% women). ROC analysis identified ≥2 as the optimal threshold, with AUC 0.68 in men and 0.63 in women. A SARC-F cut-off of ≥2 improves sensitivity for detecting probable sarcopenia and may be more suitable for screening in low-income settings. Longitudinal validation is warranted across diverse populations.

As malaria approaches elimination in Ecuadorian Amazonia, dengue virus (DENV) has emerged as the dominant vector-borne disease. A recent study documented circulation of DENV in the Putumayo northern border region, but could not determine whether transmission extended beyond road-connected areas into remote riverine communities. We conducted a community-based assessment to quantify dengue virus transmission across an urban-riverine gradient. This repeated cross-sectional community-based survey screened in total 293 asymptomatic individuals in four communities with, in total, an estimated 4.240 inhabitants along the Putumayo River during the 2023 rainy season. Participants were tested using an NS1/IgM/IgG combination rapid diagnostic test. Acute or recent infection was defined as NS1 and/or IgM positivity; past exposure as IgG-only positivity. Overall, 8.5% (25/293) of asymptomatic participants had acute or recent DENV infection, and 28.7% (84/293) showed any serological evidence of exposure. The road-connected hub Puerto El Carmen had the highest total prevalence (50.9%), predominantly representing past infection (IgG-only: 42.5%). In contrast, remote riverine communities showed lower overall exposure but a higher proportion of acute/recent infections among positives-reaching 60% in Puerto Rodríguez-suggesting recent viral introduction into immunologically naïve populations. Dengue virus transmission in the Putumayo Amazonia region extends beyond hospital-detected cases into river-access-only communities. The inverted ratio of acute-to-past infection between urban and riverine settlements suggests source-sink dynamics with ongoing viral movement along fluvial networks. As malaria elimination progresses, integrated arboviral surveillance incorporating community-based RDT screening and field laboratories is essential to detect emerging viral transmission invisible to facility-based systems.

BackgroundIn the Amazonian region, vampire bats are the primary reservoir of rabies virus, causing sporadic and lethal human rabies cases that often remain unnoticed. Managing human cases in this region is challenging and further complicated by atypical clinical forms and the potential exposure to various toxic compounds, particularly among gold miners.MethodsWe carried out clinical, electrical, biological and histological analysis of concurrent cases of progressive motor neuronopathy and fatal encephalitis in a context of regular exposure to bat bites of gold miners living in a small and remote gold mine camp in Amazonia, in French Guiana, South America.FindingsWe analyzed a spatio-temporal cluster of three suspected rabies cases in 2024 with a fatal outcome, with concomitant onset of acute bilateral lower-limb paralysis without demyelination, two of which occurred presumably two weeks after a bat-bite. Electroneuromyography suggested the involvement of the anterior horn of the spinal cord, as described in furious forms of rabies. None of the cases exhibited other cardinal signs of the furious form. Confirmation of rabies was obtained for them on sera and brain biopsies collected ante- and post-mortem respectively.InterpretationThe concurrent occurrence of disease, the axonal motor neuropathy mimicking the motor form of Guillain Barré syndrome in the context of paralytic rabies, lead to diagnostic-wandering. This underscores the importance of thinking about vampire bat rabies virus in the presence of any atypical neurological picture in patients living in exposed areas in Latin America.

Malaria and Acute Chagas disease (ACD) are neglected tropical diseases with distinct epidemiological profiles in Brazil. Although malaria transmission is concentrated in the Amazon region and ACD has historically been associated with areas of sustained vectorial transmission, both conditions pose significant challenges in non-endemic settings, where delayed diagnosis and higher severity may occur. We conducted an ecological study using secondary data from the Brazilian Notifiable Diseases Information System (SINAN), including confirmed malaria and ACD cases reported between 2007 and 2024 in non-endemic areas of Brazil. Sociodemographic, clinical, and diagnostic variables were analyzed descriptively. Temporal trends were assessed using Prais-Winsten regression, and future projections were estimated with ARIMA models. Spatial autocorrelation and clustering were evaluated using the Getis-Ord Global and local statistics. A total of 10,146 confirmed cases were analyzed (9,755 malaria; 391 ACD). Malaria predominated among males (78%) and adults aged 20-39 years (47.8%), with most cases classified as non-autochthonous (89.7%). ACD cases were slightly more frequent among females (50.1%) and individuals aged ≥40 years (37.1%), with oral transmission accounting for 53.2% of reported routes. Malaria showed a significant decreasing temporal trend (β = -0.0174; p = 0.0397), whereas ACD demonstrated a significant increasing trend (β = 0.0342; p = 0.0267). Spatial analysis identified five malaria hotspots in southeastern and southern states (Global G = 0.0797; p < 0.001) and one ACD hotspot in Piauí (Gi* = 2.09; p = 0.0366), without significant global clustering for ACD. Forecast models indicated stable incidence for both diseases through 2030, with no evidence of sustained growth. Despite low endemicity, malaria and ACD remain epidemiologically relevant in non-endemic regions, exhibiting distinct demographic profiles, temporal trajectories, and spatial clustering patterns. Strengthening surveillance systems, enhancing clinical awareness, and adapting infection control strategies to non-endemic healthcare settings are essential to mitigate morbidity and prevent severe outcomes.

Communication through scent-marking plays a crucial role in animal fitness, particularly for solitary species such as the Andean bear, in which it fulfills the function of advertising individual attributes to conspecifics and managing social interactions. However, research on the scent-marking behavior of Andean bears and the impact of free-ranging dogs on their chemical communication remains limited. This paper aims to characterize Andean bears’ scent-marking behavior and to study the overlap of their daily activity patterns with free-ranging dogs in a key biological corridor linking the Andes to the Amazon region. We collected data using camera traps in front of 10 trees selected for rubbing by Andean bears. Cameras were deployed in the Guácharos-Puracé Biological Corridor Regional Natural Park (PNRGP), Colombia, from April 2023 to April 2024. We determined the transition probabilities of marking behaviors using finite Markov chains. We compared the time budget for the behaviors displayed by Andean bears at rub trees by age and sex. Finally, we described the temporal overlap of Andean bears and free-ranging dogs and analyzed whether it differed between rainfall seasons. Results revealed significant intersexual differences in the time budget of scent-marking, with adult males investing more time on marking than females and subadults. This behavior was prevalent during the dry season. The daily activity patterns of Andean bears and free-ranging dogs were predominantly diurnal. Both species showed high temporal overlap during the dry season (77%), decreasing during the general analysis (75%) and the wet season (69%). We also suggest an increased potential for interspecific interactions between Andean bears and free-ranging dogs that could negatively impact the former, through competition, altered communication patterns and the potential transmission of diseases. We emphasize the need for further studies on the impact of free-ranging dogs on wildlife, particularly on the intraspecific communication of Andean bears.

ABSTRACT The provenance, antiquity, duration of production, animal husbandry and geographical location of materials used to make one of the largest feather art objects ever produced are explored via analysis of four stable isotopes (δ 2H, δ 18O, δ 13C and δ 15N) combined with radiocarbon measurements. We document the monotonously fed rearing of thousands of captive macaws in the Amazon region and the acquisition of camelid fibres from the high Andes to produce ninety-six large feather panels. Multiple radiocarbon dates from both feathers and fibres confirm the Wari (600–100 AD) origin of the panels and suggest a short and intensive production schedule. Stable isotopes document the collection of materials that took the artisans over hundreds of kilometres from the Amazon to near the Pacific coast.

Urban expansion has impacted watersheds that supply water to cities. This study analyzes land use and land cover changes from 1984-2023 in the Belém Metropolitan Region in Amazon Region, using Geographic Object-Based Image Analysis (GEOBIA) applied to Landsat imageries. Five land cover classes were mapped: lakes, aquatic macrophytes, urban areas, forest, and pasture. Results show a 13.4% increase in forest due to protected areas, a 3.7% reduction in lake surface area from macrophyte proliferation, and a 3.2% increase in urban expansion. Major transitions occurred in the boundaries of the watershed. The conversions of pasture to urban areas were most intense between 1984-1989, with 138.1 ha converted. The most significant land-use change in the study area was from pasture to forest, totaling 528 ha and to urban areas (274 ha) between 1984-2023. The overall accuracy of classification exceeded 88%. The study demonstrates GEOBIA’s effectiveness for long-term watershed monitoring using Landsat imagery.

Quilombola communities in the Brazilian Amazon face persistent social and territorial inequities that shape health outcomes and access to care. Geographic isolation, limited transportation, centralization of specialized services, and socioeconomic disadvantages contribute to unequal opportunities for timely diagnosis and treatment. Understanding how these determinants interact with patterns of multimorbidity is essential for guiding equiTable health policies and strengthening primary care in remote territories. A cross-sectional epidemiological study was conducted with 518 adults from nine quilombola communities in Santarém, Pará. Data were collected through household surveys addressing sociodemographics, self-reported diseases, service utilization and resolvability. Geographic coordinates of communities and health services were mapped to classify accessibility as high, medium or low. Diseases were converted into a binary matrix to estimate prevalence and identify multimorbidity (≥2 conditions). Statistical analyses included chi-square tests, ANOVA, Spearman correlations and heatmap visualization. A Composite Access Index (CAI) integrating geographic distance, epidemiological burden and service-use indicators was developed. A Random Forest model was used to identify conditions most strongly associated with multimorbidity. Communities showed marked territorial heterogeneity. Pérola do Maicá had the highest accessibility, while Ituqui, Tiningu and Murumuru presented substantial geographic and logistical barriers. Service utilization ranged from 42.9% to 95.0%, and most communities relied on care outside their territory (70-95%). Complete problem resolution was reported by 72.5% of participants, though with variation among communities. The CAI identified Ituqui (0.550), Tiningu (0.480) and Murumurutuba (0.331) as the most vulnerable territories. The Random Forest model achieved 93.6% accuracy, with hypertension, diabetes, musculoskeletal diseases, arthritis/rheumatism and heart disease emerging as key predictors of multimorbidity. Findings indicate that social and territorial determinants are strongly associated with inequities in access to health services, continuity of care, and disease burden across quilombola communities. Geographic barriers and the distribution of health services are associated with distinct patterns of multimorbidity and health service access among quilombola populations. Strengthening primary care, transportation, and diagnostic support may help mitigate inequities and improve health conditions in remote Amazonian territories.

Ants are present in different environments and regions of the planet, showing little-known biodiversity in the Neotropics, especially among fungus-growing ants (the subtribe Attina). Recent studies seek to combine morphological analysis with other methods, such as cytogenetics, to better define and differentiate species. In this sense, cytogenetic analyses have been important for the study of ants, characterizing chromosome number and morphology, and mapping rDNA genes and microsatellites, which generate important information about the evolution and taxonomy in Attina species. In the Amazon region, there are still few studies that include cytogenetics in their research. In this study, we cytogenetically characterized five fungus-growing ants, belonging to the genera Cyphomyrmex Mayr, 1862 and Apterostigma Mayr, 1865, from the northernmost region of Amapá state within the Guiana Shield region of Brazil. The nests were captured by active search, and the larvae had their brain ganglia extracted to provide metaphase chromosomes. The karyotypes were determined using Giemsa or DAPI staining, and 18S ribosomal DNA (rDNA) and (GA)n microsatellite repetitive sequences were physically mapped with FISH technique with specific probes. Cyphomyrmextransversus Emery, 1894 had 2n = 24 chromosomes (18m+6sm) and Cyphomyrmexlaevigatus Weber, 1938 n = 7, all metacentrics. In both species, the rDNA clusters were restricted to a single chromosome pair. In C.transversus the rDNA clusters were mapped to the long arm of the larger submetacentric chromosome pair, while in C.laevigatus they were on the short arm of the fifth chromosome (haploid individuals). These data are aligned to Cyphomyrmex species previously studied from this region. Although the FISH protocol was successfully applied to Cyphomyrmex species, it was unable to localize rDNA sites in the chromosomes of all three Apterostigma species, suggesting that methodological adjustments are required for an effective application to this genus. In Apterostigma, the largest chromosome number of the genus was identified in Apterostigmatropicoxa Lattke, 1997, with 2n = 54 chromosomes, while A.jubatum Wheeler, 1925 and A.andense Lattke, 1997 had 2n = 22 and n = 11 respectively but were strikingly diverse in their karyotype configurations. In C.laevigatus and C.transversus the microsatellite (GA)n clusters were scattered on all chromosomes. While A.jubatum also had a scattered distribution pattern of this microsatellite on all chromosomes, the other Apterostigma species showed more complex patterns. In A.andense these microsatellite sequences were more concentrated at the ends of some chromosomes, while in Apterostigmatropicoxa they were almost absent in the short arms of several submetacentric and subtelocentric chromosomes. The cytogenetic data for Amazonian species in this study highlight the chromosomal diversity among fungus-growing ants, particularly within the genus Apterostigma, providing useful insights into the karyotype evolution of these ants and paving the way for further cytogenetic research in the Amazon region.

Chronic myeloid leukemia (CML) is a myeloproliferative neoplasm caused by the t(9;22)(q34;q11.2) translocation, known as the Philadelphia chromosome (Ph+), which generates the BCR::ABL1 fusion oncogene central to CML pathogenesis. The disease accounts for approximately 15% of adult leukemias, predominantly affects males, and has a median age at diagnosis of around 57 years. CML typically presents in the chronic phase and may progress to advanced disease phases, with prognostic risk stratification guiding treatment decisions. Tyrosine kinase inhibitors (TKIs) are the cornerstone of therapy, aiming to achieve durable molecular disease control and, in selected patients, sustained deep molecular response and treatment-free remission. This study evaluated the demographic, clinical, and molecular response profiles of patients with Ph + CML treated with first- and second-line TKIs at the Fundação Hospitalar de Hematologia e Hemoterapia do Amazonas (HEMOAM). This retrospective, longitudinal study analyzed medical records of 176 patients diagnosed with Ph + CML between 2011 and 2020. Demographic characteristics, clinical data, and laboratory findings were extracted from medical records. Longitudinal molecular response was assessed in patients with available BCR::ABL1 monitoring. Among the 176 patients identified, 122 were included in the analysis of treatment outcomes. The mean age at diagnosis was 49.6 years, with a slight male predominance. Most patients were diagnosed in the chronic phase, and high-risk Sokal score was the most frequent prognostic category among evaluable cases. The e14a2 (b3a2) transcript was the most prevalent molecular subtype. Clinically meaningful molecular responses were observed in both first- and second-line treatment settings, although response assessment was influenced by real-world constraints, including incomplete molecular monitoring and heterogeneous follow-up. These findings provide real-world insights into the epidemiological, clinical, and molecular response characteristics of Ph + CML patients treated in the Amazon region. The study highlights the challenges of implementing guideline-based molecular monitoring in geographically constrained settings and supports the need for adapted strategies to optimize long-term CML management in routine clinical practice.

Oropouche virus (OROV) is an arbovirus endemic to the Amazon region since the 1950s that re-emerged in late 2023, causing a major epidemic across Central and South America. Here we investigated the transmission dynamics of the 2023-2024 epidemic in Manaus City (Amazonas state, Brazil), a major metropolitan hub in the Amazon, and estimated OROV infections across Latin America and the Caribbean. OROV re-emergence in Manaus resulted in an increase of IgG seroprevalence from 11.4% in November 2023 to 25.7% in November 2024. The neutralizing capacity of OROV-specific IgG antibodies from individuals collected before and after the re-emergence demonstrated a median plaque reduction neutralization test 50% titer of 640 against both the historical and contemporary OROV isolates. A historical reconstruction of OROV circulation in Manaus indicated a continuous low-level transmission with two major outbreaks of comparable seasonality and magnitude in 1980-1981 and 2023-2024. We estimate approximately 336,000 OROV infections in the Amazon region under a scenario of continuous endemic transmission without major outbreaks and over 9.4 million OROV infections during major outbreaks from 1960 to 2025. Collectively, our findings provide a comprehensive assessment of OROV transmission in Manaus and contribute to a better understanding of the OROV burden.