Clinical-epidemiological Profile Research Articles

Clinical, epidemiological, and laboratory profiles of bacterial infection or colonization among patients hospitalized in COVID-19 and non-COVID-19 intensive care units (ICUs) in Southeast Pará

Objectives: To compare the clinical, epidemiological, and laboratory profiles of bacterial infection or colonization among patients hospitalized in COVID-19 and non-COVID-19 intensive care units (ICUs) in Southeast Pará, Brazil. Methods: This was a retrospective analytical study based on the analyses of electronic medical records and microbiological reports of patients admitted to the ICU of a regional hospital located in Pará in the Brazilian Amazon due to complications associated with COVID-19 and other causes from March 2020 to December 2021. The sample consisted of data from the medical records of 343 patients collected after approval by the ethics and research committee (opinion number 5281433)was granted. The data extracted from the bacteriological and antibiogram culture reports were analyzed to characterize the clinical-epidemiological profile of the patients. The data were transferred and tabulated in Microsoft Excel 2019 to conduct a descriptive analysis, and the associated statistical analyses were performed using Stata 17.0 statistical software. Results: Of the total patients, 59.5% were hospitalized in the COVID-19 ICU and 40.5% were hospitalized in the non-COVID-19 ICU. Most individuals admitted to the COVID-19 ICU and non-COVID-19 ICU were aged between 66 and 78 years and between 54 and 66 years, respectively. The hospitalization duration in the COVID-19 ICU was fewer than 15 days, whereas that in the non COVID-19 ICU was 15 to 30 days. Deaths were more frequent in the Covid-19 ICU compared to the non-Covid-19 ICU (64% versus 41%). In contrast, hospital discharge was more frequent in the non-Covid-19 ICU (58.3% versus 34.8%).The most prevalent comorbidity in both ICUs was circulatory system disease. Gram-negative bacteria were the most frequent etiological agent in both groups and were present in 63.1% of the cultures analyzed. Regarding the phenotypic profile of resistance, carbapenemase production was detected in 43.0% of the cultures analyzed. Multidrug resistance against antimicrobial drugs was more frequent in the non-COVID-19 ICU(55.7%). Most of the antimicrobial drug prescriptions for were empirical. Conclusions: The recurrence of secondary infections and bacterial colonization in both COVID-19 and non-COVID-19 ICU patients should not be underestimated. The clinical, microbiological, and bacterial resistance profiles elucidated in this study highlight the need to develop and implement holistic and assertive strategies to control and mitigate these problems. Which will contribute to an improved prognosis for patients and quality of life patients.

Clinical-epidemiological aspects and prognostic factors associated with death from visceral leishmaniasis between the years 2010 to 2019 in the Central-West region of Brazil

In Brazil, the fatality rate for visceral leishmaniasis is high, and it is important to investigate its associated factors. The aim of this study was to analyze the clinical-epidemiological profile and prognostic factors associated with death from visceral leishmaniasis (VL) in the Central-West region of Brazil, between 2010 and 2019. A study of series of VL cases was carried out using data obtained from the Sistema Nacional de Agravos de Notificação (SINAN). Multivariate logistic regression was performed to identify variables associated with deaths. Male (64.96%); age group ≤5 years (28.51%); mixed race/color (59.20%); and level of education incomplete primary education (45.16%) were the most affected. The most frequent symptoms were fever (87.65%), weakness (77.56%), enlarged spleen (70.22%) and liver (67.33%), weight loss (67.22%) and pallor (63.41%). Co-infection with HIV was observed in 15.84% of patients. The parasitological diagnosis was positive in 74.17% and the Indirect Immunofluorescence (IIF) in 82.80%. The drug most used for treatment was pentavalent antimony (41.96%). Regarding the evolution of VL, cure was recorded for 82.90% of patients and death from VL in 8.30%. Factors associated with death from VL were: age group ≥20 and < 60 (OR 2.95; 95% CI 1.98–4.38) and ≥ 60 (OR 5.84; 95% CI 3.63–9.38), edema (OR 2.27; 95% CI 1.64–3.13), pallor (OR 1.53; 95% CI 1.06–2.20), infectious condition (OR 1.56; 95% CI 1.12–2.15) and hemorrhagic phenomena (OR 2.87; 95% CI 2.02–4.08). New studies are needed in order to better manage VL control, monitoring, prevention and primary care strategies.

Clinical-epidemiological profile of COVID-19 and its relationship with chronic diseases in the state of Pernambuco/Brazil

Objective: To analyze the clinical-epidemiological and laboratory profile of COVID-19 and the relationship with chronic diseases in Pernambuco/Brazil. Methodology: Descriptive and analytical study of the population affected by COVID-19, in Pernambuco, between 08/28-18/11/2020. Results: There was a prevalence of COVID-19 between 31 and 60 years (p&lt;0.0001); with higher records in Health Units (E-SUS) for women (57.58%; p&lt;0.0001) and Emergency Care (F-SUS) for men (51.73%; p&lt;0.0001). Among symptomatic patients in the E-SUS, cough (26.2%), fever (22.3%) and odynophagia (19.4%) prevailed - mild profile (78.5%; p&lt;0.0001); and, in the F-SUS, saturation &lt;95% (36.3%) and dyspnea (28.6%) - severe profile (63.8%; p&lt;0.0001). In clinical evolution, patients under 60 years of age had a favorable outcome in the absence of comorbidities (79.6%; p&lt;0.0001); in those over 60 years of age, the outcome was death among those without comorbidity (61.2%; p0.0083), two comorbidities (72.9%; p0.0001), three or more comorbidities (81.8%; p0.0005) and for cardiovascular diseases (63.6%; p0.0036). Conclusion: It was possible to observe a distinct clinical profile between E-SUS and F-SUS care, and vulnerability in &gt;60 years with or without comorbidity.&#x0D; Keywords: COVID-19; Comorbidity; Pernambuco

HIV AND SYPHILIS CO-INFECTION IN NORTHEAST BRAZIL: A GENDER ASSESSMENT

Introduction: The human immunodeficiency virus (HIV) and syphilis co-infection is highly common, especially in Brazil, which recorded a high number of cases in 2020. Due to its high prevalence and morbidity, this study aimed to determine the frequency and the clinical-epidemiological profile of HIV and syphilis co-infection between genders in specialized care services in Northeast Brazil. Methods: An analytical cross-sectional study was conducted with secondary data from 171 individuals with HIV and syphilis co-infection. Data were collected in a reference center for acquired immunodeficiency syndrome (AIDS) in Northeast Brazil from 2015 to 2020. Welch’s test compared the means of independent samples; the chi-square and Fisher’s exact test assessed the association between categoric variables. The significance level was set at 5%. This study has ethical approval. Results: The HIV and syphilis co-infection frequency was 15.4%. Individuals with co-infection had a mean age of 34.2 (± 11.0) years and were predominantly men. The women sample started their sex life earlier, had a lower education level and per capita family income, used more illicit drugs, and were mostly heterosexual, married or in a stable union, and unemployed. Men had more anal sex. Moreover, most individuals had syphilis in the asymptomatic phase and HIV with undetectable viral load; CD4 T cells were greater than 350 cells/mm³. Conclusion: The high prevalence of HIV and syphilis co-infection in specialized care services, especially in MSM, highlights the need to improve counseling to reduce sexual risk behavior and improve prevention and care strategies to control these diseases.

Pulmonary mycobacteriosis: clinicalepidemiological profile of patients, treatment management, clinical outcome, and its species in the state of Mato Grosso, Brazil (2013-2020)

This study aimed to describe the clinical-epidemiological profile of patients in the State of Mato Grosso, who were affected by non-tuberculous mycobacteria (NTM), treatment management, clinical outcomes, and the species most commonly isolated from clinical samples. Between 2013 and 2020, the study analyzed 37 medical records from the Health Pulmonology sector of the Reference Center for Medium and High Complexity and it searched the Laboratory Environment Manager (GAL) system of the Central Public Health Laboratory of Mato Grosso. Patients with mycobacteriosis were predominantly diagnosed with MAC complex (avium-intracellulare complex) (n= 23.6%), with an average age of 62 years old; 51.4% were male, Caucasian (62%), and predominantly immunocompetent (HIV-negative). Most patients with comorbidities were older adults, they had sequelae of previous tuberculosis (56.8%), they were smokers (62.2%), and they had a low body mass index (29.7%) due to weight loss. Other patients had bronchiectasis (81.1%) and cavitary lesions (48.6%), with a lower incidence of chronic obstructive pulmonary disease (COPD). The municipalities with the highest rates of nontuberculous mycobacteria were Cuiabá (14 cases), Várzea Grande (five cases), Sinop (two cases), Nova Mutum (two cases), and Rondonópolis (two cases). This study presented data from the region, with a clinical, epidemiological profile, diversity of NTM species, and treatment management according to the patient’s response to the specific treatment of the identified Mycobacterium and various outcomes. KEY WORDS: Non-tuberculous mycobacteria; MAC complex Mycobacterium; comorbidities; tuberculosis; mycobacteriosis.

Profile and Outcomes of Hospitalized COVID-19 Patients during the Prevalence of the Omicron Variant According to the Brazilian Regions: A Retrospective Cohort Study from 2022.

We investigated the clinical-epidemiological profile and outcomes of COVID-19 patients hospitalized in 2022, during the Omicron variant/subvariant prevalence, in different Brazilian regions to identify the most vulnerable subgroups requiring special attention. Data from COVID-19 patients were extracted from the national Information System for Epidemiological Surveillance of Influenza (SIVEP-Gripe database), and analyses stratified by region and age group were conducted. The constructed dataset encompassed clinical-epidemiological information, intensive care unit admission, invasive and non-invasive ventilation requirements, vaccination status, and evolution (cure or death). It was observed that there were significant differences in the vaccination rates between regions, in the occurrence of unfavorable outcomes, and in the pattern of comorbidities in young patients. The north region had higher rates of unvaccinated patients and a lower percentage of those vaccinated with three doses in all age groups compared to other regions. The northeast region had the highest rates of patients admitted to the ICU for all age groups, while the north and northeast were the most affected by IMV requirements and in-hospital death in all age groups. This study showed that extended vaccination coverage, especially booster doses, can protect different population segments from developing severe disease since lower vaccination coverage was observed in regions with higher fatality rates.

Breast Cancer: Clinical-Epidemiological Profile and Toxicities of Women Receiving Treatment with Taxanes in the Amazon Region.

Breast cancer is the most common malignant disease and the leading cause of mortality among women worldwide. Antineoplastic chemotherapy is one of its primary treatments, typically based on the class of drugs known as taxanes. Despite their proven therapeutic efficacy, these drugs can induce severe toxicities, leading to dose limitations or even treatment discontinuation. The objective of this study was to describe the clinical-epidemiological profile, risk factors, and toxicities of taxane-based chemotherapy treatment in women with breast cancer in the Amazon region. This is a cross-sectional, quantitative, and descriptive study conducted with 300 women diagnosed with breast cancer undergoing taxane treatment. Most patients were in the 40-49 age range, of brown ethnicity, and had completed elementary school. The majority of patients had risk factors such as alcoholism and a sedentary lifestyles. Most women had their first pregnancy between the ages of 18 and 21, breastfed their children, had menarche between the ages of 12 and 13, and were pre-menopausal and with a family history of cancer. The most frequent histological type was non-special invasive carcinoma and the Luminal B subtype. Most participants in this study showed taxane toxicity, with neurotoxicity being the most frequent. These findings reveal the importance of early detection, comprehensive risk factors, and effective management of treatment toxicities to improve patient outcomes in breast cancer care in the Amazon region.

Clinical Epidemiological Profile of De Novo Postpartum Hypertensive Disorder in BP Koirala Institute of Health Sciences, a Tertiary Care Center in Eastern Nepal

Clinical Epidemiological Profile of De Novo Postpartum Hypertensive Disorder in BP Koirala Institute of Health Sciences, a Tertiary Care Center in Eastern Nepal

Gabapentin-Associated Movement Disorders: A Literature Review.

Gabapentin (GBP)-induced movement disorders (MDs) are under-recognized adverse drug reactions. They are commonly not discussed with patients, and their sudden occurrence can lead to misdiagnosis. This literature review aims to evaluate the clinical-epidemiological profile, pathological mechanisms, and management of GBP-associated MD. Two reviewers identified and assessed relevant reports in six databases without language restriction between 1990 and 2023. A total of 99 reports of 204 individuals who developed a MD associated with GBP were identified. The MDs encountered were 135 myoclonus, 22 dyskinesias, 7 dystonia, 3 akathisia, 3 stutterings, 1 myokymia, and 1 parkinsonism. The mean and median ages were 54.54 (SD: 17.79) and 57 years (age range: 10-89), respectively. Subjects were predominantly male (53.57%). The mean and median doses of GBP when the MD occurred were 1324.66 (SD: 1117.66) and 1033 mg/daily (GBP dose range: 100-9600), respectively. The mean time from GBP-onset to GBP-associated MD was 4.58 weeks (SD: 8.08). The mean recovery time after MD treatment was 4.17 days (SD: 4.87). The MD management involved GBP discontinuation. A total of 82.5% of the individuals had a full recovery in the follow-up period. Myoclonus (GRADE A) and dyskinesia (GRADE C) were the most common movement disorders associated with GBP.

Epidemiological clinical profile and closure of chronic plantar ulcers in patients with leprosy sequelae undergoing orthopedic surgery in a municipality in western Amazon.

Chronic plantar ulcers in leprosy are lesions resulting from motor and sensory alterations caused by Mycobacterium leprae. They are lesions refractory to conventional dressings and present high recurrence rates. To evaluate the epidemiological clinical profile of patients with chronic plantar ulcers associated with bony prominences in the lesion bed and to evaluate the efficacy of orthopedic surgical treatment of these lesions. This is a descriptive and analytical retrospective study with the evaluation of medical records of patients undergoing surgical treatment of chronic plantar ulcers from 2008 to 2018. The surgical technique applied consisted of corrective resection of bone prominences and the primary closure of the lesion with bipediculated local flap. 234 patients were submitted to surgery, 55.1% male with an average age of 69.5 years old. Of these, 82.9% were illiterate; and 88.5% with open lesions over 10 years. After surgical treatment, total wound healing occurred in an average time of 12 weeks. The variables that contributed to shorter healing time were: Patients' lower age group; regular use of orthopedic shoes and insoles and dressings performed by nurse aides in health units before surgery. Obesity was the factor that correlated with the delay of healing time. A higher incidence was observed in males and male and female illiterate patients. The regular use of shoes and insoles and dressings performed by nurse aides in health units contributed to shorter postoperative healing time. Orthopedic surgical treatment with corrective resection of bony prominences proved to be an efficient therapeutic method for the closure of chronic plantar ulcers. It is a reproducible method, justifying the importance of the orthopedic surgeon in the context of the multidisciplinary team to cope with these complex lesions.

Ankyloglossia in Monochorionic Diamniotic and Dichorionic Diamniotic Twins: A Cross-Sectional Study.

Objective: To determine the prevalence of ankyloglossia in diamniotic monochorionic and diamniotic dichorionic twins, as well as to verify the relationship between gender and type of pregnancy. Study Design: A cross-sectional observational study, carried out with 52 pairs of dichorionic/diamniotic twins and 49 monochorionic/diamniotic pairs. The data collection was carried out through the analysis of medical records and the results of the Neonatal Screening of the Tongue Frenulum Assessment Protocol in Babies, and corresponded to the period of 2 years (2020-2022). Statistical analysis of data was performed, considering the significance value of 5%. The study was approved by the Human Research Ethics Committee of the institution. Results: The statistical analysis of multiple logistic regression between the two groups of twins (Mono/Di and Di/Di) according to the socioeconomic, demographic, and clinical-epidemiological profile was statistically significant for some variables. The prevalence of ankyloglossia, according to the type of twin pregnancy, showed a statistically significant difference. There was no statistical difference in relation to sex and ankyloglossia, or between couples diagnosed with ankyloglossia according to the type of pregnancy. Conclusion: Monochorionic/diamniotic twins had a higher prevalence of ankyloglossia, regardless of gender.

Clinical-epidemiological profile of the canine population in a shelter, Minas Gerais, Brazil, 2019-2020

ABSTRACT The aim of this study was to analyze the demographic, clinical, and hematological aspects of the population in a dog shelter located in the municipality of Lavras, Brazil. All animals were microchipped and evaluated by veterinarians. Whole blood samples were obtained from 329 dogs in the months of July–August 2019 and from 310 dogs in the months of January–February 2020. Most of the dogs were of mixed breed, received anti-rabies and polyvalent vaccines (100%), were dewormed (100%), and were spayed/neutered (98.59%), with a predominance of adult (86.51%), short-hair (67.51%), normal body condition (65.57%), medium-size (62.57%), and female (62.36%). The main clinical alterations detected were enlarged lymph nodes (38.69%), skin lesions (31.50%), overweight (23.32%), obesity (6.07%), elevated temperature (17.05%), and ear secretion (15.72%). Regarding hematological alterations, thrombocytopenia (36.31%), leukopenia (15.92%), anemia with decreased hemoglobin values (10.60%), hematocrit (9.70%), and red blood cells (5.14%) were observed. Most of the shelter dogs were apparently healthy, but specific measures for nutritional, dermatological, otological and disease management should be implemented once the health changes are verified, as they impact the general state of the population and adoptions.

Severe Acute Respiratory Syndrome (SARS) in the Context of the COVID-19 Pandemic Among Indigenous Peoples of Brazil: Epidemiology and Risk Factors Associated with Death.

Severe Acute Respiratory Syndrome (SARS) represents a serious public health problem for the indigenous peoples of Brazil, since acute respiratory infections are the main causes of morbidity and mortality in thispopulation. To assess cases of SARS in Brazilian indigenous peoples in the context of the COVID-19 pandemic, as well as sociodemographic and health factors associated with deaths from SARS in this population. Ecological study carried out based on secondary data from the Brazilian Database for Epidemiological Surveillance of Influenza referring to the Brazilian indigenous population with SARS in 2020. The variables included sociodemographic factors and health conditions. Statistical analyses were carried out considering absolute (n) and relative (%) frequencies and logistic regression with odds ratios (OR), with death as the outcome of interest. A total of 3062 cases were reported in the analyzed period. Of these, there was a predominance of men (54.6%), adults (41.4%), with comorbidities (52.3%), with low levels of schooling (67.4%) and residents of rural areas (55.8%). Cases and deaths were concentrated in the states of Amazonas and Mato Grosso do Sul, states in the North and Midwest of Brazil. A greater chance of death was observed in elderly indigenous people (OR = 6.29; 95%CI 4.71-8.39), with low levels of schooling (OR = 1.72; 95%CI 1.22-2.28), residents of rural areas (OR = 1.35; 95%CI 1.12-1.62), and with comorbidities (OR = 1.87; 95%CI 1.42-2.46), especially obesity (OR = 2.56; 95%CI 1.07-6.11). The study was able to trace the clinical-epidemiological profile, as well as identify the groups of indigenous people most vulnerable to SARS as a result of COVID-19 and evolution to death in Brazil. The findings show the high impact on the morbidity and mortality of the Brazilian indigenous population exposed to SARS and are relevant for epidemiological health surveillance, since they can guide preventive public policy actions and quality of life measures for this ethnic group in Brazil.

A Multicentre Study of the Clinical and Epidemiological Profile of Inflammatory Bowel Disease in Northeast Brazil.

Ulcerative colitis (UC) and Crohn's disease (CD) are inflammatory bowel diseases (IBDs) with multifactorial causes. They are becoming more prevalent in developing countries such as Brazil; however, relevant studies in poorer regions of the country are limited. Here, we report the clinical-epidemiological profile of patients with IBD treated at reference centers in three states of Northeast Brazil. This was a prospective cohort study involving patients at referral outpatient clinics for IBD from January 2020 through December 2021. Of 571 patients with IBD, 355 (62%) had UC, and 216 (38%) had CD. The patients were predominantly women (355, 62%) for both UC and CD. Extensive colitis was the pattern present in 39% of the UC cases. For CD, ileocolonic disease was the predominant manifestation (38%), with 67% of cases showing penetrating and/or stenosing behavior. The majority of patients were diagnosed between the ages of 17 and 40, corresponding to 60.2% in CD and 52.7% in UC. The median time between symptom onset and diagnosis was 12 months for CD and 8 months for UC (p=0.042). Joint involvement was the most frequent extraintestinal manifestation, with arthralgia and arthritis present in 41.9% and 18.6% of the patients, respectively. Biological therapy was prescribed to 73% of CD patients and 26% of UC patients. A progressive increase in new cases was observed in every 5-year interval over the last five decades, with 58.6% being diagnosed in the last 10 years. More extensive disease behavior patterns predominated in UC, while forms associated with complications were prevalent in CD. A prolonged time to diagnosis may have contributed to these findings. A progressive increase in IBD incidence was observed and may be related to greater urbanization and better access to specialized outpatient clinics, resulting in improvements in diagnosis.

Measures to Contain the Transmission of Hepatitis C in a Chronic Kidney Care Hospital Unit in the Triângulo Mineiro in Brazil: A Case Study.

Objectives: Hepatitis C virus elimination is complex. The objective was to analyze measures to eliminate virus transmission in a hemodialysis unit. Methods: Case study composed of multiple units of analysis. The scenario is the hemodialysis unit of a Brazilian public hospital. Population composed of health service records. Descriptive analyzes were performed and the beginning of the event was considered as the moment of increased incidence of HCV. The intentional and purposeful collection of information for understanding the event and implementing interventions. Results: The subunits of analysis were related to: clinical-epidemiological profile, active search, transmission routes, management protocol and results achieved. In August 2019, out of 45 patients, six were reactive for anti-HCV. All received treatment. Patients had exposure to contaminated medical equipment, objects or hands of professionals. Preventive measures were adopted and routine techniques were corrected. Situational Analysis Committee guided the management of the event. No new cases were detected. Conclusions: Strategies for the microelimination of the C virus in a dialysis environment are demonstrated and it shows the multidisciplinary efforts in conducting the event.

Fluoroquinolone-Associated Movement Disorder: A Literature Review.

Fluoroquinolones (FQNs) are related to several central nervous system side effects. This review aims to evaluate the clinical-epidemiological profile, pathophysiological mechanisms, and management of FQNs-associated movement disorders (MDs). Two reviewers identified and assessed relevant reports in six databases without language restriction between 1988 and 2022. A total of 45 reports containing 51 cases who developed MDs secondary to FQNs were reported. The MDs included 25 myoclonus, 13 dyskinesias, 7 dystonias, 2 cerebellar syndromes, 1 ataxia, 1 tic, and 2 undefined cases. The FQNs reported were ciprofloxacin, ofloxacin, gatifloxacin, moxifloxacin, levofloxacin, gemifloxacin, and pefloxacin. The mean and median age were 64.54 (SD: 15.45) and 67 years (range: 25-87 years). The predominant sex was male (54.16%). The mean and median time of MD onset were 6.02 (SD: 10.87) and 3 days (range: 1-68 days). The mean and median recovery time after MD treatment was 5.71 (SD: 9.01) and 3 days (range: 1-56 days). A complete recovery was achieved within one week of drug withdrawal in 80.95% of the patients. Overall, 95.83% of the individuals fully recovered after management. Future cases need to describe the long-term follow-up of the individuals. Additionally, FQN-induced myoclonus should include electrodiagnostic studies.

Clinical and Epidemiological Characteristics of Neurocryptococcosis Associated with HIV in Northeastern Brazil.

Cryptococcal meningitis is a serious infection of the central nervous system that is predominant in developing countries, caused by fungi of the genus Cryptococcus, and which affects immunosuppressed patients, especially those with HIV. Here, we aim to diagnose and characterize the clinical-epidemiological profile of cryptococcosis in patients admitted to two tertiary public hospitals in northeastern Brazil. The study is divided into three moments: (1) the isolation of fungus and diagnosis from biological samples collected between 2017 and 2019, (2) a description of the clinical and epidemiological characteristics of the patients, and (3) the experimental tests related to an in vitro susceptibility antifungal profile. The species were identified by MALDI-TOF/MS. Among the 100 patients evaluated, 24 (24.5%) were diagnosed with cryptococcosis based on positive culture. Clinical-epidemiological analysis showed a slightly higher prevalence in men between 30 and 39 years. When comparing the date of HIV diagnosis and the development of cryptococcosis, it was observed that 50% received the diagnosis of infection by cryptococcosis after or equal to a period of 12 months from being diagnosed with HIV; the other 50% received it within the first 30 days of the HIV diagnosis. Neurocryptococcosis was the most prevalent clinical form, and, at the time of hospital admission, the most common clinical signs were high fever (75%), intense headache (62.50%), and neck stiffness (33.33%). The cerebrospinal fluid showed 100% sensitivity and positivity for direct examination by India ink, and fungal culture. The mortality rate in this study was 46% (11/24), a lower rate than in the other literature. An antifungigram showed that 20 (83.33%) isolates were susceptible to amphotericin B and 15 (62.5%) to fluconazole. Mass spectrometry identified 100% of the isolates as Cryptococcus neoformans. In Brazil, this infection is not mandatory notifiable. Therefore, although there is little information on the subject, it is obsolete and does not express the reality of the facts, mainly in the northeast region, where this information is insufficient. The data obtained in this research contribute to the epidemiological knowledge of this mycosis in Brazil and will serve as a basis for future globally comparative epidemiological studies.

Seasonality of sporotrichosis in Brazil: A modelled analysis of the epidemic in São Paulo, 2011-2020.

Sporotrichosis is an endemic subcutaneous mycosis classically caused by the Sporothrix schenckii species complex. Recently, sporotrichosis has emerged in Brazil as a cat-transmitted epidemic caused by a new species, Sporothrix brasiliensis. To survey the clinical-epidemiological profile of all sporotrichosis cases diagnosed between 2011 and 2020 at a reference hospital in São Paulo metropolitan area and evaluate the annual distribution of cases in relation to seasonality. Patients' demographic and clinical-epidemiological data were surveyed. A generalized linear model was fitted to relate the quarterly number of sporotrichosis cases detected between 2015 and 2019 with precipitation and temperature series. Prediction of the number of cases from 2011 to 2014 was attempted based on the fitted model without the trend component that appears from 2015. Among 271 suspected cases admitted during 2011-2020, 254 were confirmed by fungal isolation and/or clinical-epidemiological criteria. We observed that 2015 onwards the number of cases regularly increased during Autumn and Winter, the driest and coldest stations of the year. We verified that temperature series affected the number of cases (p = .005) because an increase of 1°C in the temperature series was associated with a 14.24% decrease in the average cases number, with the average number of cases increasing by 10.96% (p < .0001) every quarter, corresponding to an annual increase of 52%. Between 2011 and 2014, the predicted number of sporotrichosis cases averaged 10-12 per year, with 33%-38% occurring in the winter. We hypothesize that sporotrichosis seasonality is associated with the felines' oestrus cycle, which may provide alternative, cat-directed approaches to the sporotrichosis epidemic control.

Epidemiological and Clinical Profile of Sickle Cell Patients in the Bla Health District

To study the epidemiological-clinical profile of sickle cell patients in the health district of Bla. Method: This was a prospective and descriptive study over 1 year, from February 2021 to January 2022; relating to all patients who were screened with the TDR_Sikle Scan and/or followed up during the study period. Results: We performed the TDR in 982 patients from all the consultations (N= 2976). The mean age was 29.6 ± 3.8 years. SS and SC sickle cell disease represent 8.04% (79 cases). Children 23.52% (28 patients) and women 64.35% (51 patients). SS married couples represented (13.92%). Anemia was the most common reason for consultation (47%), followed by bone and joint pain (29%). 33% of the patients (26 cases) had a complication, of which 15 patients had had a CVO and 6 patients (23%) a worsening of the anemia. We have recorded 1 death. Conclusion: regular medical follow-up of sickle cell patients considerably improves the vital prognosis. The frequency of sickle cell traits remains high including SS and SC forms.

Epidemiological characteristics of leprosy from 2000 to 2019 in a state with low endemicity in southern Brazil

BackgroundLeprosy is an infectious and contagious disease caused by Mycobacterium leprae and is mainly characterized by lesions in the skin and peripheral nerves. In Brazil, it is a public health problem due to its high endemicity. However, the state of Rio Grande do Sul presents low endemicity of this disease. ObjectiveTo characterize the epidemiological profile of leprosy in the state of Rio Grande do Sul from 2000 to 2019. MethodsThis was a retrospective observational study. Epidemiological data were collected from the Notifiable Diseases Information System (SINAN, Sistema de Informação de Agravos de Notificação). ResultsAmong the 497 municipalities in the state, 357 (71.8%) registered cases of leprosy in the assessed period, with an average of 212 (81.5%) new cases per year. The average detection rate was 1.61 new cases per 100,000 inhabitants. The male sex was predominant (51.9%) and the mean age was 50.4 years. Regarding the epidemiological clinical profile; 79.0% of the patients were multibacillary; 37.5% presented the borderline clinical form; 16% had grade 2 physical disability at diagnosis and bacilloscopy was positive in 35.4% of cases. As for treatment, 73.8% of the cases were treated with the standard multibacillary therapeutic regimen. Study limitationsThere were missing/inconsistent data in the database available. ConclusionsThe findings observed in this study indicate that the state presents a low endemicity profile of the disease and these results can support adequate health policies relevant to the reality of Rio Grande do Sul, inserted in a national scenario of highly endemic leprosy.