Different Geographical Regions Of Brazil Research Articles

Clinical and molecular characterization of patients with hereditary hemorrhagic telangiectasia from two different regions of Brazil

Hereditary hemorrhagic telangiectasia (HHT) is a vascular dysplasia characterized hemorrhagic diseases described in consensus clinical diagnostic criteria (Curaçao). We describe the clinical and molecular characteristics of HHT patients from two different geographic regions of Brazil (São Paulo and Manaus). Demographic and clinical data were obtained from the electronic medical records and molecular analysis was performed by Sanger sequencing. We present here the first clinical characterization concomitantly with a molecular study of patients with THH in Brazil. These clinical characterizations may reveal differences in the molecular pathophysiology of HHT in Brazil - that our phenotypic database opens the way to be studied, or indicate limitations in the care of these patients, who need a multidisciplinary attention to prevent and treat the complications of this condition. Our results, combined with our previous data with patients presenting mutation rate to 93,75% (n=15/16) in Brazilians patients with a confirmed clinical diagnosis. Also emphasize the higher numbers of intronic mutations and three large deletions 5ÙTR regions and the predominance of ACVRL1 over ENG mutations.

Specialized outpatient care for maternal and child health in PlanificaSUS areas.

To describe the organization of specialized outpatient clinics, according to the Secondary Outpatient Care Unit (SOCU) model according to the health care planning (HCP) methodology. This is a descriptive and cross-sectional study, which used secondary data from the PlanificaSUS project. It was carried out in 16 outpatient clinics specialized in maternal and child care, distributed in the five Brazilian geographic regions. A structured questionnaire was used for self-assessment on the implementation of 12 parameters in two moments, in 2019 and in 2020. These parameters are related to the care, educational, and supervisory functions set out in the SOCU model. In 2019, only 37.5% (six) of the outpatient clinics completed at least one parameter related to the care function, most frequently the multiprofessional team with interdisciplinary action (completed in 18.8% of the outpatient clinics). No parameters from the educational and supervisory functions were completed at this initial stage. In 2020, on the other hand, parameters related to the care function also showed higher frequency, higlighting the use of the same criterion by primary care teams and outpatient clinics for risk stratification (completed in 68.8% of the outpatient clinics). In the educational and supervisory functions, parameters related to the encounter between primary care teams and outpatient clinics for case management development, integrated training promotion, and close communication bond among these professionals also increased. Completion of these three parameters was identified in 25%, 25%, and 37.5% of the outpatient clinics, respectively. The planning methodology fostered reflection and discussion about the (re)organization of the work process and contributed to changes in maternal and child health care practices within specialized outpatient care, integrated with primary health care (PHC), from the perspective of care networks. We believe that such advances enhance access and equitable care for high-risk pregnant women and children in different geographical regions of Brazil.

Human N-acetyltransferase 2 (NAT2) gene variability in Brazilian populations from different geographical areas.

Introduction: Several polymorphisms altering the NAT2 activity have already been identified. The geographical distribution of NAT2 variants has been extensively studied and has been demonstrated to vary significantly among different ethnic population. Here, we describe the genetic variability of human N-acetyltransferase 2 (NAT2) gene and the predominant genotype-deduced acetylation profiles of Brazilians. Methods: A total of 964 individuals, from five geographical different regions, were genotyped for NAT2 by sequencing the entire coding exon. Results: Twenty-three previously described NAT2 single nucleotide polymorphisms (SNPs) were identified, including the seven most common ones globally (c.191G>A, c.282C>T, c.341T>C, c.481C>T, c.590G>A, c.803A>G and c.857G>A). The main allelic groups were NAT2*5 (36%) and NAT2*6 (18.2%), followed to the reference allele NAT2*4 (20.4%). Combined into genotypes, the most prevalent allelic groups were NAT2*5/*5 (14.6%), NAT2*5/*6 (11.9%) and NAT2*6/*6 (6.2%). The genotype deduced NAT2 slow acetylation phenotype was predominant but showed significant variability between geographical regions. The prevalence of slow acetylation phenotype was higher in the Northeast, North and Midwest (51.3%, 45.5% and 41.5%, respectively) of the country. In the Southeast, the intermediate acetylation phenotype was the most prevalent (40.3%) and, in the South, the prevalence of rapid acetylation phenotype was significantly higher (36.7%), when compared to other Brazilian states (p < 0.0001). Comparison of the predicted acetylation profile among regions showed homogeneity among the North and Northeast but was significantly different when compared to the Southeast (p = 0.0396). The Southern region was significantly different from all other regions (p < 0.0001). Discussion: This study contributes not only to current knowledge of the NAT2 population genetic diversity in different geographical regions of Brazil, but also to the reconstruction of a more accurate phenotypic picture of NAT2 acetylator profiles in those regions.

Biogenic amines and stable isotopes in the quality and authenticity of honeys from Brazil.

The identification of biogenic amines and some precursor amino acids and the adulteration through stable isotopes was carried out in 114 honey from different geographic regions in Brazil (states of São Paulo (SP) and Santa Catarina (SC)) as support for evaluating quality control and food safety. Serotonin was detected in all samples, while melatonin was quantified in 92.2% of honey from SP and in 94% of SC. l-Dopa, dopamine and histamine appeared at higher levels in honey from SP. Cadaverine, putrescine, spermidine and spermine, varied little according to botanical source. Three honey from the metropolitan region of SP were considered adulterated (C4SUGARS>7%), 92 were authentic samples (C4SUGARS-7 to 7%) and 19 unadulterated (C4SUGARS less than-7%), with isotopic values of δ13CH and δ13CP>7%. The data were important for differentiating quality as a function of biogenic amines and stable isotope technique was important in detecting honey adulteration.

Molecular detection of Burkholderia mallei in different geographic regions of Brazil.

Glanders is a contagious disease of equids caused by the Gram-negative bacterium Burkholderia mallei. In Brazil, the disease is considered to be reemerging and has been expanding, with records of equids with positive serology in most of the federative units. However, there are few reports describing the genotypic detection of the agent. This study demonstrated the detection of B. mallei by species-specific PCR directly from tissues or from bacterial cultures, followed by amplicon sequencing in equids (equines, mules, and asinines) with positive serology for glanders in all five geographic regions of Brazil. The molecular evidence of B. mallei infection in serologically positive equids in this study expands the possibility of strain isolation and the conduction of epidemiological characterizations based on molecular information. The microbiological detection of B. mallei in cultures from nasal and palate swabs, even in equids without clinical manifestations, raises the possibility of environmental elimination of the agent.

Serological survey of leptospirosis in horses with historical displacement through different geographic regions in Brazil

Leptospirosis has worldwide occurrence and shows higher incidence in tropical areas. Equines can present several serovars according to geographic region and it is important analyze de possible contribution of animal displacement on the Leptospira spp. strains occurrence. This research aimed to conduct a serological investigation in an equine regiment belonging to the Brazilian Army Guard Cavalry, resident in an urban area of Rio de Janeiro municipality, but with history of displacement between different regions in Brazil. A microscopic agglutination test was performed in a serum bank of 197 horses using 29 Leptospira spp. strains. The test showed 94.92% positivity, with 90.36% of the animals presenting a positive result for two or more serovars. Higher titers (?1:400) could be detected in 54.31% of horses for at least one serovar, whereas seropositivity for more than one bacterial type occurred mostly at lower titers (&lt;1:400). All animals were clinically healthy. Occurrence of serogroup Icterohaemorraghiae in urban areas was confirmed; however, equine serovars Bratislava and Australis presented low frequencies. The serovars Hardjo, Wolffi, and Canicola were detected, and indicated the presence of ruminants and dogs as reservoirs in proximity in some of the places frequented by the animals. It is suggested that travel history has contributed to the high frequency found and a possible greater contact with different types of Leptospira spp. Therefore, veterinarians should consider the history of geographic displacement and other animal species coexistence with horses when conducting their clinical investigation.

Ancestry, diversity, and genetics of health-related traits in African-derived communities (quilombos) from Brazil.

Brazilian quilombos are communities formed by enslaved Africans and their descendants all over the country during slavery and shortly after its abolition. Quilombos harbor a great fraction of the largely unknown genetic diversity of the African diaspora in Brazil. Thus, genetic studies in quilombos have the potential to provide important insights not only into the African roots of the Brazilian population but also into the genetic bases of complex traits and human adaptation to diverse environments. This review summarizes the main results of genetic studies performed on quilombos so far. Here, we analyzed the patterns of African, Amerindian, European, and subcontinental ancestry (within Africa) of quilombos from the five different geographic regions of Brazil. In addition, uniparental markers (from the mtDNA and the Y chromosome) studies are analyzed together to reveal demographic processes and sex-biased admixture that occurred during the formation of these unique populations. Lastly, the prevalence of known malaria-adaptive African mutations and other African-specific variants discovered in quilombos, as well as the genetic bases of health-related traits, are discussed here, together with their implication for the health of populations of African descent.

Construction of a nutritional assessment tool for the pediatric cancer population (ANPEDCancer): content validation using the Delphi method.

ABSTRACTObjective:To develop and establish content validation of a nutritional assessment tool for pediatric cancer patients using the Delphi method.Methods:A literature review was performed and the nutritional assessment in pediatrics and cancer construct was discussed with experts. Forty-six nutrition experts from Brazil with experience in oncology participated in the panel. Rounds were held to discuss and judge the items that should be included in this tool. With the aid of an algorithm, it was possible to simultaneously consider the adequacy, relevance and measurement of the items. The consensus was reached with an agreement equal to or greater than 80% among the experts.Results:From the 7 domains suggested by the literature, the first round generated 81 items, which were assessed for adequacy, relevance and the possibility of being measured in the routine of nutritional assessment, by specialists in the following two rounds. The percentage of specialists who responded to each round was high (above 90%) and the dropout rate between the stages was relatively low. After applying the algorithm, the ANPEDCancer tool had 36 items considered appropriate by specialists from the five different geographical regions of Brazil.Conclusions:The Delphi method allowed the construction and content validation of the nutritional assessment tool for children and adolescents with cancer, providing the first stage for use in the Brazilian hospital setting.

Milk quality and characterization of different geographic regions of Brazil: a literature review

Milk is a rich source of nutrients that are important for human health. Due to its high nutritional value, it is considered an ideal substrate for the proliferation of pathogenic and deteriorating micro-organisms. Therefore, some control measures are necessary to guarantee the quality of milk and dairy products. The aim of this review is to present the main quality parameters in accordance with Brazilian legislation, as well as to provide data and studies on the characteristics and quality of milk in different regions of Brazil. For this purpose, besides consulting the legislation, articles were used located by the following keywords: "Milk quality", "Milk preservation" and "Milk storage", in the databases "Google Scholar", "SciELO" and "LILACs". It was found that even with control and regulation of dairy farming, failures can still occur in the various regions of the country, which can be minimised with technical assistance and rural extension.

COVID-19 and the Mental Health of Nursing Professionals in Brazil: Associations between Social and Clinical Contexts and Psychopathological Symptoms.

The COVID-19 pandemic has had an important negative psychological impact on people worldwide, especially nursing professionals who seem to be more vulnerable to the development of psychopathological symptoms. Objective: To analyze relationships between variables from the social and clinical contexts with psychopathological symptoms in nursing professionals from different geographic regions of Brazil during the COVID-19 pandemic. Methods: Cross-sectional study carried out with 1737 nursing professionals from the five regions of Brazil. Data collection was carried out online with a questionnaire made available via Google Forms containing sociodemographic, occupational, and clinical questions, and the Symptom Assessment Scale-40-R, for the assessment of psychopathological symptoms. Differences between mean scores for the severity of psychopathological symptoms were assessed using the Mann–Whitney and Kruskall–Wallis tests. Results: There was a significant difference in the psychoticism domain scores according to Brazilian geographic region, with greater severity among professionals from the North and Northeast regions when compared with those from the South region. Social context variables (gender, age group, and marital status) and clinical variables (psychological and psychiatric follow-up; psychological or emotional support by the institution; family member, friend, neighbor, or co-worker with COVID-19, and death among them; use of psychiatric medication without a medical prescription; and taking steps to take care of their mental health) were significantly related to psychopathological symptoms. Conclusions: The results point to the importance of mental health promotion strategies for professionals through psychological or emotional support, as evidence indicates that this support can be a predictor of reduced psychological distress.

COVID-19 pandemic and physical inactivity in Brazilian university students: a multicenter study

The aim of this study was to investigate the prevalence of physical inactivity during the COVID-19 pandemic and its association with variables of the pandemic context in Brazilian university students. A cross-sectional, multicentric study was carried out in five public universities in different geographic regions of Brazil. The study included 5,720 students, aged 18 or over, between September 2020 and May 2021. Data collection was performed through a self administered online questionnaire on the REDCap platform. The dependent variable was physical inactivity. The independent variables were the aspects related to the pandemic. The prevalence of physical inactivity was 48.8% (95%CI: 47.5%; 50.1%), ranging from 26.3% for those who went out every or almost every day for non-essential activities and 64.9 % for those who stayed at home all the time. University students who reported continuing to work normally and who were afraid of the pandemic were more likely to be physically inactive. The groups that were less likely to have the outcome were those with a reduction in income, those who left home more often for essential and non-essential activities, those who started working at home, those who complied with the social distancing, and those who had a risk factor for COVID-19. The findings indicate that one in two Brazilian university students are physically inactive and the main risk factors were isolation and fear of the pandemic. Interventions are recommended to promote physical activity, especially for the groups most affected by the COVID-19 pandemic.

Inequalities in Temporal Effects on Cervical Cancer Mortality in States in Different Geographic Regions of Brazil: An Ecological Study.

Cervical cancer is a public health issue with high disease burden and mortality in Brazil. The objectives of the present study were, firstly, to analyze age, period, and cohort effects on cervical cancer mortality in women 20 years old or older from 1980 to 2019 in the North, South, and Southeast Regions of Brazil; and secondly, to evaluate whether the implementation of a national screening program and the expansion of access to public health services impacted the examined period and reduced the risk of death compared with previous years and among younger cohorts. The effects were estimated by applying Poisson regression models with estimable functions. The highest mortality rate per 100,000 women was found in Amazonas (24.13), and the lowest in São Paulo (10.56). A positive gradient was obtained for death rates as women’s age increased. The states in the most developed regions (South and Southeast) showed a reduction in the risk of death in the period that followed the implementation of the screening program and in the cohort from the 1960s onwards. The North Region showed a decreased risk of death only in Amapá (2000–2004) and Tocantins (1995–2004; 2010–2019). The findings indicate that health inequities remain in Brazil and suggest that the health system has limitations in terms of decreasing mortality associated with this type of cancer in regions of lower socioeconomic development.

Karyotypic variation in the stingless bee Trigona spinipes (Hymenoptera: Apidae: Meliponini) from different geographical regions of Brazil

Molecular cytogenetic reveal details of fine chromosomal structure that are useful in studies of chromosomal diversification, genome organization, and evolution. However, these techniques have rarely been used to describe population-level variations in the tribe Meliponini. In the present study, we compared the karyotype, number, and localization of rDNA clusters and the distribution of a repetitive DNA sequence in the genome of T. spinipes from nine locations. Although karyotypes with 2n = 34 were found in all cases, five different karyotypic formulae were detected. The heterochromatin was preferentially associated with centromeric regions. The microsatellite probe (GA)15 signals were localized mainly in the euchromatic regions of all chromosomes in most of the analyzed populations. The 18S rDNA clusters were present in four chromosomal pairs, except for the population from Palotina, which showed only two rDNA clusters. Analyses revealed a karyotypic variation in T. spinipes along the geographic distribution, proving that cytogenetic variations were not detected when scattered colonies were analyzed.

Reaction of Sweet Cassava Genotypes to Xanthomonas phaseoli pv. manihotis From Three Regions of Brazil

Xanthomonas phaseoli pv. manihotis (Xpm) is the causal agent of Cassava Bacterial Blight (CBB), one of the most important cassava diseases. The aim of this study was to evaluate the susceptibility of sweet cassava genotypes to strains of Xpm from three different geographic regions of Brazil in greenhouse conditions. The inoculation of 14 genotypes of cassava was made by cutting leaflets using scissors previously soaked in a bacterial suspension with 1 &amp;times; 108 UFC ml-1 and also by inserting a soaked toothpick into the bud of the oldest leaf. The results showed significant differences when the cassava genotypes were individually evaluated in relation to the Xpm strains used; however, the relationship between cassava genotypes and Xpm strains was significant for wilt symptom. The UnB 1111 strain was more aggressive than the UnB 1386 strain based on the average value of the reaction grade, showing the variation that exists between the bacterial isolates from different regions. Considering the reaction of cassava germplasm&amp;rsquo;s resistance to the three strains used in the study, the BGMC 434 genotype was the only one classified as resistant based on the average reaction grade. The genotypes BGMC 753, BGMC 1289, BGMC 982 and the elite clones BRS 396, BRS 397, BRS 398, 259/08 and BRS 399 were classified as moderately resistant, which indicates the possibility of recommending them for disease favorable regions.

Blood groups in Native Americans: a look beyond ABO and Rh.

The study presents comparisons between blood group frequencies beyond ABO and Rh blood systems in Native American populations and previously published data from Brazilian blood donors. The frequencies of Diego (c.2561C>T, rs2285644), Kell (c.578C>T, rs8176058), Duffy (c.125A>G, rs12075, c.1−67T>C, rs2814778) and Kidd (c.838A>G, rs1058396) variants in Kaingang (n=72) and Guarani (n=234) populations from Brazil (1990-2000) were obtained and compared with data from these populations sampled during the 1960s and with individuals of different Brazilian regions. Data showed high frequencies of DI*01 and FY*01 alleles: 11.8% and 57.6% in Kaingang and 6.8% and 75.7% in Guarani groups, respectively. The main results indicated: (1) reduction in genetic distance over time of Kaingang and Guarani in relation to other Brazilian populations is suggestive of ongoing admixture; (2) significant differences in some frequencies of blood group markers (especially Diego, Kidd and Duffy) in relation to Native Americans and individuals from different geographical regions of Brazil. Our study shows that the frequency of red blood cell polymorphisms in two Native American groups is very different from that of blood donors, when we evaluated blood groups different from ABO and Rh systems, suggesting that a better ethnic characterization of blood unit receptors is necessary.

Advantages and Disadvantages of Medical Abortion, According to Brazilian Residents in Obstetrics and Gynaecology.

To find out which was the opinion of residents in obstetrics and gynecology about the advantages and disadvantages of medical abortion as compared with surgical procedures. Cross-sectional multicenter study among residents in obstetrics and gynecology from 21 maternity hospitals located in 4 different geographical regions of Brazil, using a self-responded questionnaire with 31 questions related to their opinion and experience on providing abortion services. Most residents agreed that "being less invasive" (94.7%), "does not require anesthesia" (89.7%), "can be accompanied during the process" (89.1%), "prevents physical trauma" (84.4%) were the main advantages of medical abortion. Residents perceived both clinical and personal issues as advantages of medical abortion.

Sexual reproduction parameters in Fusarium verticillioides populations from maize in Brazil

Fusarium verticillioides is an important plant pathogen causing infections on ears and/or stalks of maize. This study aimed to compare sexual reproduction parameters in populations of F. verticillioides from distinct regions in the different Brazilian climatic zones where maize is grown. Fertility and effective population size were calculated from data generated by crossing field isolates with female fertile testers. Three hundred fungi isolates were obtained from maize kernels with Fusarium ear rot symptoms in different geographic regions of Brazil in the years 2012 and 2013. For the entire population, 231 out of 300 isolates were cross-fertile with tester isolates. MAT1–1 and MAT1–2 idiomorphs of the fertile isolates segregated in a 105:126 ratio. Female isolates (hermaphrodites) accounted for 96 out of 231 fertile isolates, while 135 were male-only isolates. The ratio of mating types within the population [Ne(mt)] was 99% of the count for the Brazilian population when the mating type idiomorphs were used as predictors to estimate the population size. However, when this calculation was made on the basis of the female fertile isolates, the Ne(f) was 83%. When the total population was divided by geographical/climatic regions, the frequencies of female fertile isolates were 33 out of 80 fertile isolates from the Northeast (equatorial tropical climate); 49 out of 73 fertile isolates from the Central-West (tropical climate); and only 14 out of 78 fertile isolates from the South (temperate climate), indicating that the sexual reproduction in F. verticillioides is likely favored by a tropical climate in Brazil. Brazilian populations of F. verticillioides show high fertility and high effective population size, suggesting the possibility of frequent sexual reproduction in the field, especially in populations from Tropical Climate regions of Brazil.

Genetic structure analyses of the tomato-infecting crinivirus Tomato chlorosis virus indicates low genetic variability in the p22 gene and evidence of segregation based on sampling location in Brazil

One of the most important virus diseases in tomatoes in Brazil is caused by isolates of tomato chlorosis virus (ToCV, Tomato chlorosis virus, genus Crinivirus, family Closteroviridae). ToCV has a bipartite genome which is encapsidated in filamentous particles. RNA1 encodes an RNA silencing suppressor, the protein p22, that has been described as a highly variable region for members of the family. Here, we examined the genetic variability of the p22 gene in ToCV isolates from tomato plants collected from three different geographical regions of Brazil and compared them with other data sets representing the ToCV p22 population from South Korea and Spain. A low genetic diversity was found for the ToCV p22 gene, and negative selection was likely predominant in all analyzed populations. In a phylogenetic analysis, the Brazilian isolates form a monophyletic group with strong evidence of population structuring based on sampling location. Our results indicate a possibility, in the future, for the emergence of ToCV subpopulations with specific genetic characteristics that reflect the conditions of the ecological niche where they are inserted.

Exploring the parasite load and molecular diversity of Trypanosoma cruzi in patients with chronic Chagas disease from different regions of Brazil.

Chagas disease is still a major public health issue in many Latin American countries. One of the current major challenges is to find an association between Trypanosoma cruzi discrete typing units (DTUs) and clinical manifestations of the disease. In this study, we used a multilocus conventional PCR and quantitative real time PCR (qPCR) approaches to perform the molecular typing and parasite load quantification directly from blood specimens of 65 chronic Chagas disease patients. All patients were recruited at the same health center, but their place of birth were widely distributed in different geographic regions of Brazil. Of the 65 patients, 35 (53.8%) presented positive amplification by real time qPCR, being 20 (30.7%) with the clinical indeterminate form and 15 (23.1%) with the cardiac form of the disease. The parasite load median for all positive patients was 2.54 [1.43–11.14] parasite equivalents/mL (par. Eq./mL), with the load ranging from 0.12 to 153.66 par. Eq./mL. Noteworthy, the parasite load was significantly higher in patients over 70 years old (median 20.05 [18.29–86.86] par. Eq./mL). Using guanidine-EDTA blood samples spiked with reference T. cruzi strains, belonging to the six DTUs, it was possible to genotype the parasite up to 0.5 par. Eq./mL, with high specificity. Of the patients with positive qPCR, it was possible to identify the T. cruzi DTU in 28 patients (80%). For the remaining patients (20%), at least a partial result was obtained. Analysis of specimens showed prevalences of TcVI, TcII and mixed infection TcVI+TcII equal to 40%, 17.1% and 14.3%, respectively. In addition, two patients were infected by TcV, and one patient was coinfected by TcIII+TcVI, These last three patients were in stage A of chronic chagasic cardiomyopathy (CCC), and they were born at the Bahia State (northeast region of Brazil). When T. cruzi genotypes were compared with the parasite load, more elevated parasite loads were observed in patients infected by TcII in general (parasite load median of 7.56 par. Eq./mL) in comparison to patients infected by TcVI (median of 2.35 par. Eq./mL). However, while the frequency of CCC was 50% in patients infected by TcVI and TcV, only 16.7% of patients infected by TcII evolved to CCC. Taking together, our results contribute to update the epidemiological knowledge of T. cruzi DTUs in Brazil, and highlight the age of patient and infection by TcII as important features that lead to the observation of higher parasitemia levels.

Human polyomavirus KI, WU, BK, and JC in healthy volunteers.

Despite the growing importance of infections caused by the human polyomaviruses (HPyVs), information about their transmission, pathogenesis, and epidemiology is scarce. The objective of this work was to evaluate the excretion and distribution of HPyV (HPyV1-HPyV4 [former BKPyV, JCPyV, KIPyV, and WUPyV, respectively]) among asymptomatic individuals from different geographic regions in Brazil, in order to verify the existence of distinct epidemiologic patterns among the Brazilian population. Saliva samples from 889 healthy volunteers living in nine locations in Brazil were analyzed by real-time polymerase chain reaction (PCR) to detect HPyV1-4. Among 889 participants, 346 (39%) had evidence of infection with one or more HPyV species: 127 (14.3%) had HPyV1 only; 70 (7.9%) had HPyV3 only; 60 (6.7%) had HPyV4 only, and 25 (2.8%) had HPyV2 only. Coinfections were detected in 64 participants (7.3%). Although HPyV excretion was detected in samples from all locations, the frequency and distribution of viral species varied significantly. The epidemiologic findings presented demonstrate that the four HPyV species studied are circulating in five geographic regions of Brazil. Salivary excretion of these viruses appears common among healthy Brazilians. The distribution of viral species varies considerably between regions as well as within regions.