Western Brazilian Amazon Research Articles

Quality of life of older adults participating in community groups in the Brazilian Western Amazon: a cross-sectional study

Resumo Objetivo comparar a qualidade de vida de pessoas idosas participantes e não participantes de grupos comunitários de uma região da Amazônia Ocidental Brasileira. Método Estudo observacional, de corte transversal. Participaram 424 pessoas idosas cadastradas na Estratégia Saúde da Família. Para coleta dos dados, utilizou-se questionário sociodemográfico e instrumentos de avaliação da qualidade de vida da Organização Mundial da Saúde, WHOQOL-BREF e WHOQOL-OLD. Os participantes foram estratificados conforme a participação em três diferentes grupos comunitários: Grupo 1: grupo de exercício físico; Grupo 2: grupo de exercício físico e educação em saúde; Grupo 3: Grupo de atividades religiosas e/ou associação comunitária; e não participantes. Utilizou-se os testes qui-quadrado e regressão multinominal para analisar a qualidade de vida entre os grupos. Nível de significância de 5%. Resultados Amostra com faixa etária média de 69,86 anos; participantes de grupos comunitários (44,22%); e predominância do sexo feminino (66,75%). Observou-se diferença significativa (p<0,05) na qualidade de vida dos participantes de grupos comunitários quando comparados aos não participantes. Grupo 1: domínios Psicológico (OR=0,21); Meio Ambiente (OR=0,16; OR=0,21) e Participação Social (OR= 0,35). Grupo 2: domínios Meio Ambiente (OR=0,29; OR=0,19); Autonomia (OR=0,12; OR=0,26); Atividades Passadas, Presentes e Futuras (OR=0,44); Participação Social (OR=0,27) e Escore Geral (OR=0,46). Grupo 3: domínios Meio Ambiente (OR=0,31); Autonomia (OR=0,56) e Participação Social (OR=0,10; OR=0,47). Conclusão A participação em grupos comunitários foi associada a melhores escores de qualidade de vida, confirmando que o engajamento social permite ganhos importantes para a saúde e qualidade de vida, contribuindo para um envelhecimento saudável.

Effects of age, period, and cohort on mortality by prostate cancer among men in the state of Acre, in the Brazilian Western Amazon.

The present study aimed to analyze the effects of age, time period, and birth cohort on the temporal evolution of mortality rates due to prostate cancer in men from the state of Acre, Brazil, in the period of 1990 to 2019. This is an ecological study in which the temporal trend was evaluated by the joinpoint method, estimating the annual percentage variations of the mortality rates. The age-period-birth cohort effects were calculated by using the Poisson Regression method, using estimation functions. The mortality rates showed an increase of 2.20% (95%CI: 1.00-3.33) in the period studied, tended to increase with age. A relative risk (RR) of 0.67 (95%CI: 0.59-0.76) was observed between 2005 and 2009, 0.76 (95%CI: 0.67-0.87) from 2005 on, and 1.44 (95%CI: 1.25-1.68) from 2015 on. The cohorts from 1910 to 1924 presented a risk reduction (RR < 1), when compared to the reference cohort (1935). Regarding the time period, the creation of public policies and the establishment of guidelines are suggested as factors which may have contributed to more access to diagnosis, in consonance with the cohort effect. These findings can contribute to a better understanding of the epidemiological scenario of prostate cancer in regions that are more vulnerable in terms of socioeconomic conditions.

Predictor variables effect on the development of Burnout Syndrome in higher education professor.

to correlate the development of Burnout Syndrome in higher education professors with the following variables: sociodemographic, economic, work, sleep pattern, level of anxiety and quality of life. observational, analytical, cross-sectional study with a quantitative approach. Data collection took place from August to November 2022, with 140 professors from a private higher education institution in the Western Brazilian Amazon. professors who carried out activities outside institutional hours and who had sleep duration < 5 hours, presented lower scores in the personal fulfillment dimension of burnout, with (p=0.002) and (p=0.001), respectively. The higher the scores for the physical (p=0.001), psychological (p=0.000) and social relationships (p=0.002) domains of quality of life, the lower the personal fulfillment scores for the syndrome. through linear regression, it was evidenced that several variables explain the development of burnout. Institutional and governmental actions can minimize the negative influence of these variables.

Flying to the moon: Impactful accounts of triatomines invasion from the 2nd to the 13th floor of an urban residential building in the municipality of Rio Branco, Acre, Brazil.

Vectorial transmission through hematophagous triatomine insects remains the primary mode of Chagas Disease contagion. These insects have become increasingly common in urban environments. Therefore, this study aimed to report an encounter of triatomines with trypanosomatid infection in a vertical residential condominium in Rio Branco, the capital of the state of Acre, in the western Brazilian Amazon. Triatomines were collected from residents and sent to the municipality's Entomological Surveillance sector. Trypanosomatid positivity was evaluated using optical microscopy, followed by species and genotype identification using molecular biology techniques. Twenty-five adult triatomine specimens were collected from two of three condominium buildings invading apartments from the 2nd to 13th floors. Six specimens were identified as Rhodnius sp. and 19 as R. montenegrensis. Among these, molecular tests were conducted on seven specimens, with five testing positive for Trypanosoma cruzi, all belonging to genotype TcI. These findings underscore the need for further studies to better understand the invasive capacity of these insects in these environments and the mechanisms involved in this process.

Molecular genetic association of rs8099917 and rs1800795 polymorphisms in the progression of hepatitis Delta virus liver disease.

The relationship between viral infections and host factors holds high hopes for identifying the role of Interferon Lambda 3 (IFNL3) and Interleukin 6 (IL-6) polymorphisms in the development of Chronic Liver Disease (CLD) in patients infected with hepatitis Delta virus (HDV) in the Western Brazilian Amazon. Cross-sectional study conducted with a cohort of 40 chronic HDV patients, 27 with CLD and 13 without evident liver damage. Biological samples from the participants were analyzed using the polymerase chain reaction (PCR) technique, followed by sequencing by the automated Sanger method. The rs8099917 T allele, from the IFNL3 gene, showed a higher frequency in both groups; however, it was not possible to establish an association with HDV infection [OR = 1.42 (0.42 - 4.75; p = 0.556 (95% CI). For IL-6, the rs1800795 G allele was superior to rs1800795 C. Analyzing both distributions in the studied groups, any association with HDV was absent (p > 0.05). The results suggest that the rs8099917 T/G (IFNL3) and rs1800795 G/C (IL-6) polymorphisms are not associated with the evolution of HDV in the studied population.

Qualidade de vida de pessoas idosas participantes de grupos comunitários na Amazônia Ocidental Brasileira: um estudo transversal

Abstract Objective To compare the quality of life of older adult participants and non-participants of community groups in a region of the Brazilian Western Amazon. Method An observational, cross-sectional study was conducted. A total of 424 older adult users of the Family Health Strategy were included. Data collection was performed using a sociodemographic questionnaire and the WHOQOL-BREF and WHOQOL-OLD scales for measuring quality of life by the World Health Organization. Participants were stratified according to participation in 3 different community groups: Group 1: physical exercise group; Group 2: physical exercise and health education group; Group 3: religious activities and/or community association group; and non-participants in community groups. The chi-square and multinomial regression tests were used to compare quality of life (QoL) among the groups. A 5% level of significance was adopted. Results The sample had a mean age of 69.86 years, community group participation of 44.22%, and predominance of females (66.75%). There was a statistically significant difference (p&lt;0.05) in QoL between community group participants and non-participants. Group 1: Psychological (OR=0.21); Environment (OR=0.16; OR=0.21) and Social Participation (OR= 0.35) domains. Group 2: Environment (OR=0.29; OR=0.19); Autonomy (OR=0.12; OR=0.26); Past, Present and Future Activities (OR=0.44); Social Participation (OR=0.27) and General Score (OR=0.46) domains. Group 3: Environment (OR=0.31); Autonomy (OR=0.56) and Social Participation (OR=0.10; OR=0.47) domains. Conclusion Participation in community groups was associated with better QoL score, confirming that social engagement confers important benefits for health and QoL and contributes to healthy aging.

Orchid bees enhance seed set production of an understory herb in the Western Brazilian Amazon

Bee pollination is an important ecosystem service related to the maintenance of many flowering plants. We evaluated the relationship between orchid bee foraging time and the density of flowering plants and whether visitation varied according to the sex and size class of bees, using Calathea mansonis as a model species. We monitored 10 plots between December 2009 and November 2010 in a forest fragment in Senador Guiomard, Acre, Brazil. We counted the number of flowering plants and flowers per plant and the behaviour of the observed bees. Additionally, we compared the bagged and exposed inflorescences for self-compatibility analysis. We sampled 173 orchid bees from 13 species, with Eulaema cingulata as the most abundant visitor. Eulaema (large bees) were more effective pollinators than Euglossa (small bees). We also found Eulaema polyzona individuals feeding on a Marantaceae species for the first time. The time spent by the bees visiting flowers did not differ with the density of flowering plants or the number of flowers per plant. However, flowers exposed to visitors produced 35% more seeds and 15% heavier seeds than bagged flowers. Considering plant–bee interactions, orchid bees may increase gene flow and compensate for the clonal reproduction of this herb.

Hypertensive disorders of pregnancy in Western Brazilian Amazon: Associated factors and neonatal outcomes.

Hypertensive disorders of pregnancy (HDP) are responsible for several maternal and fetal complications. This study investigated the occurrence of HDP, associated factors, and neonatal complications in women living in the Western Brazilian Amazon. This is a population-based cross-sectional study with 1521 mother-child pairs enrolled in the Maternal and Child Health and Nutrition in Acre birth cohort (MINA-Brazil study). All parturients with HDP (registered in the medical records) were identified. Crude and adjusted prevalence ratios were calculated in Poisson regression models with robust variance. The prevalence of HDP was 11.0% (95% CI: 9.5-12.7). Factors associated with the prevalence of HDP were maternal age ≥ 35 years (PR: 1.9; 95% CI: 1.3-3.0), primigravida status (PR: 2.0; 95% CI: 1.5-2.7), pre-pregnancy obesity (PR: 2.7; 95% CI: 1.9-4.0), higher gestational weight gain (highest quartile RP: 2.5; 95% CI: 1.6-3.8), chronic hypertension (RP: 3.6; 95% CI: 2.7-4.9), and diabetes in pregnancy (RP: 1.9; 95% CI: 1.1-3.2). HDP was associated with risk for caesarean delivery (PR: 1.8; 95% CI: 1.6-2.0) and prematurity (PR: 2.0; 95% CI: 1.3-3.2). Gestational malaria was not associated with HDP in Amazonian pregnant women. Evaluating risk factors before pregnancy and during the prenatal period is essential for reducing adverse maternal and neonatal outcomes.

Internal consistency of the Strengths and Difficulties Questionnaire in Amazonian children.

To describe the frequency of behavioral problems and the internal consistency of the parent version of the Strengths and Difficulties Questionnaire (SDQ-P) in Amazonian preschool children during the covid-19 pandemic. Data from the Maternal and Child Health and Nutrition in Acre (MINA-Brazil) study, a population-based birth cohort in the Western Brazilian Amazon, were used. The SDQ-P was applied in 2021 at the five-year follow-up visit to parents or caregivers of 695 children (49.4% of which were girls). This instrument is a short behavioral screening questionnaire composed of 25 items reorganized into five subscales: emotional symptoms, conduct problems, hyperactivity/inattention, peer relationship problems, and prosocial behavior. Cases of behavioral problems were defined according to the original SDQ cut-offs based on United Kingdom norms. Moreover, cut off points were estimated based on the SDQ-P percentile results of our study sample. Internal consistency was assessed by calculating Cronbach's alpha coefficient and McDonald's omega for each scale. According to the cut-offs based on our studied population distribution, 10% of all children had high or very high total difficulty scores, whereas it was almost twice when the original SDQ cut-offs based on United Kingdom norms, were applied (18%). Differences were also observed in the other scales. Compared to girls, boys showed higher means of externalizing problem and lower means of prosocial behavior. The five-factor model showed a moderate internal consistency of the items for all scales (0.60 ≤ α ≤ 0.40), except for total difficulty scores, which it considered substantial (α > 0.61). Our results support the usefulness of SDQ in our study population and reinforce the need for strategies and policy development for mental health care in early life in the Amazon.

Maternal depression and offspring mental health at age 5: MINA-Brazil cohort study.

To identify longitudinal patterns of maternal depression between three months and five years after child's birth, to examine predictor variables for these trajectories, and to evaluate whether distinct depression trajectories predict offspring mental health problems at age 5 years. We used data from the Maternal and Child Health and Nutrition in Acre (MINA-Brazil) study, a population-based birth cohort in the Western Brazilian Amazon. Maternal depressive symptoms were assessed with the Edinburgh Postnatal Depression Scale (EPDS) at 3 and 6-8 months, and 1 and 2 years after delivery. Mental health problems in 5-year-old children were evaluated with the Strengths and Difficulties Questionnaire (SDQ) reported by parents. Trajectories of maternal depression were calculated using a group-based modelling approach. We identified four trajectories of maternal depressive symptoms: "low" (67.1%), "increasing" (11.5%), "decreasing" (17.4%), and "high-chronic" (4.0%). Women in the "high/chronic" trajectory were the poorest, least educated, and oldest compared with women in the other trajectory groups. Also, they were more frequently multiparous and reported smoking and having attended fewer prenatal consultations during pregnancy. In the adjusted analyses, the odds ratio of any SDQ disorder was 3.23 (95%CI: 2.00-5.22) and 2.87 (95%CI: 1.09-7.57) times higher among children of mothers belonging to the "increasing" and "high-chronic" trajectory groups, respectively, compared with those of mothers in the "low" depressive symptoms group. These differences were not explained by maternal and child characteristics included in multivariate analyses. We identified poorer mental health outcomes for children of mothers assigned to the "chronic/severe" and "increasing" depressive symptoms trajectories. Prevention and treatment initiatives to avoid the adverse short, medium, and long-term effects of maternal depression on offspring development should focus on women belonging to these groups.

Fish endoparasite metacommunity in environments with different degrees of conservation in the western Brazilian Amazon.

Parasite communities correspond to the definition of metacommunity, as species interact and disperse within hosts. The present study evaluated parasite metacommunities in a tropical floodplain. The study was conducted in the Western Amazon around the municipalities of Cruzeiro do Sul, state of Acre, and Guajará, state of Amazonas, Brazil. Six sampling sites were selected and grouped into conserved and degraded environments. Fish were caught between periods of drought and flood, using passive and active sampling methods; in the laboratory, they were measured weighed, and necropsied. Parasites found were fixed, evaluated, and identified. Physical and chemical variables and environmental conservation characteristics were measured in all sites. Diversity index, ANOVA, Tukey, local contribution to beta diversity (LCBD), species contribution to beta diversity by individual species (SCBD), and variance partitioning were summarized. The α species diversity increased in conserved environments and varied between seasonal periods, mainly in detritivorous and omnivorous hosts. Local contributions to beta diversity showed significantly higher values in conserved environments for the endoparasite fauna of piscivorous and omnivorous hosts, indicating that these environments presented unique parasite infracommunities and revealing the conservation status of these environments. Variations in infracommunities were explained mainly by niche-based processes, including environmental conditions, degree of conservation, and host characteristics. Thus, these data will serve as a tool to understand the way parasite communities are structured, which is important information for the management and conservation of aquatic environments.

Multidrug-resistant Acinetobacter spp. from hospital intensive care units in Brazilian Amazon

Acinetobacter spp. are one of the main pathogens responsible for healthcare-associated infections and are associated with high rates of morbidity and mortality globally, mainly because of their high capacity to present and develop resistance to antimicrobials. To identify species of the Acinetobacter and their resistance profiles from samples collected from hospitalized patients, health professionals and hospital environmental sources in the intensive care units of different public reference hospitals in Porto Velho City, Rondônia, Western Brazilian Amazon. Isolates were identified using microbiological and molecular techniques. The antimicrobial susceptibility profile was determined by disk diffusion. A total of 201 Acinetobacter spp. isolates were identified, of which 47.3% originated from hospital structures, 46.8% from patients and 6% from healthcare professionals. A. baumannii and A. nosocomialis were the most prevalent, with frequency of 58.7% and 31.8%, respectively. Regarding the susceptibility profile, it was observed that 56.3% were classified as multidrug-resistant and 76.2% of the samples belonging to A. baumannii were resistant to carbapenems. In contrast, 96.9% were susceptible to polymyxin B and 91.3% to doxycycline. The data presented here can be used to guide and strengthen the control of multidrug-resistant infections caused by Acinetobacter spp., in addition to improving providing information from a traditionally unassisted region of Brazil.

Minimum acceptable diet in a cohort of children aged between 6 and 15 months: Complementary feeding assessment and associated factors in the Brazilian western Amazon

ObjectiveThe goal of the article was to assess complementary feeding patterns, and associated factors, of children between 6 and 15-month old in Rio Branco-Acre, Brazil, based on the minimum acceptable diet indicator. MethodsThis study was cross-sectional, including 857 children between ages 6 and 15 mo, from a 2015 birth cohort of Rio Branco, Brazil. The prevalence of complementary feeding indicators, minimum meal frequency, minimum dietary diversity, and minimum acceptable diet was estimated based on the recommendations of the World Health Organization. Sociodemographic characteristics, infant and maternal habits, prenatal information, birth characteristics, breastfeeding, and complementary feeding were evaluated. Differences between the proportions were evaluated by the χ2 test and univariate and multiple logistic regression analyses, to determine associated factors with child minimum acceptable diet. ResultsThe minimum frequencies of meals and dietary diversity were observed in 81.0% and 51.8% of the children, respectively. The minimum acceptable diet prevalence was 47.1%. Also, minimum acceptable diet was inversely associated with C, D, and E social classes (adjusted odds ratio = 0.49; 95% CI, 0.33–0.72), number of living siblings (adjusted odds ratio for two or three children = 0.69; 95% CI, 0.48–0.98, and adjusted odds ratio for ≥ 4 children = 0.56; 95% CI, 0.37–0.84). Maternal regular consumption of fruits, vegetables, and legumes (adjusted odds ratio = 2.62; 95% CI, 1.69–4.05), child age from 12 to 15 mo (adjusted odds ratio = 2.05; 95% CI, 1.32–3.18), and receiving guidance regarding complementary feeding during postnatal consultations (adjusted odds ratio = 1.38; 95% CI, 1.03–1.86) were directly associated with minimum acceptable diet. ConclusionsFewer than 50% of the children received adequate food with adequate frequency and diversity. Low socioeconomic status and having ≥ 2 living siblings reduced the chance of minimum acceptable diet, whereas maternal healthy diet, child age (12–15 mo), and complementary feeding counseling during postnatal appointments increased the chance of minimum acceptable diet.

Snakebite envenomations and access to treatment in communities of two indigenous areas of the Western Brazilian Amazon: A cross-sectional study.

The indigenous populations of Brazil present poor health indicators and a disproportionate prevalence and case-fatality rate of neglected tropical diseases, including snakebite envenomations (SBEs). This study aims to estimate access to medical care for SBEs and analyze the barriers that prevent victims from accessing healthcare in indigenous communities in two health districts located in the Western Brazilian Amazon. This cross-sectional study used semi-structured interviews to collect data from individuals who experienced SBEs in the Upper Rio Solimões and Upper Rio Negro indigenous health districts. Of the 187 participants, 164 (87.7%) reported that they had access to healthcare and received assistance in a hospital in the urban area of the municipalities. Frequency was 95.4% in the Upper Rio Solimões SIHD, and 69.6% in the Upper Rio Negro SIHD (P<0.0001). The study found that the availability of indigenous medicine as the only choice in the village was the main reason for not accessing healthcare (75%), followed by a lack of financial resources and means of transportation (28.1%). Four deaths were reported from SBEs, resulting in a case-fatality rate of 2.1%. In the study areas, there are records of SBE patients who did not receive medical attention. Availability of pre-hospital emergency transport using motorboats, a greater number of hospitals and better navigability of the Solimões River and its tributaries would make access easier for indigenous people living in the region of the Upper Solimões River. The implementation of cross-cultural hospital care needs to be considered in order to reduce the resistance of indigenous populations in relation to seeking treatment for SBEs.

Path of fear: Experiences of health professionals in the fight against COVID-19.

This study aimed to understand the expressions of fear in the journeys of health professionals who worked in the confrontation of coronavirus disease 2019 (COVID-19), in the city of Manaus, in the Brazilian Western Amazon. This is an exploratory qualitative study that adopts interpretive description as a method to generate informed knowledge responsive to the needs of the practice. We included 56 participants, comprising 23 health managers and 33 health workers (middle and higher level) of different professional categories. The results revealed three circles of experience: (1) knowledge and professional experience in dealing with the disease (unknown-known-experienced); (2) the growing proximity to death and loss (predicted-witnessed-suffered); and (3) the involvement and proximity to whatever affects the individual, their emotions, and personal transformations in the face of the threat (the collective, the neighbor, and oneself). Our results suggest that health professionals who worked during the COVID-19 pandemic in Manaus experienced insecurity, dread, and fear, illustrating the complexity of developing their activities in the front line of care and management during the different phases of the pandemic. A contribution of the study is precisely that of capturing this complexity, which suggests the impossibility of analyzing fear only in its simple manifestation, or in each circle of experience.

Endoparasite Communities of Fish at Different Trophic Levels in the Western Brazilian Amazon: Human, Environmental and Seasonal Influence.

The composition of the fish parasite community depends on several factors related to the environment, the host and its biology. This study aimed to evaluate the influence of environmental factors in anthropized and conserved areas on the endoparasite community structure in fish at different trophic levels, in addition to verifying that some species of Digenea are indicators of conserved environments. The study was carried out in the Upper Juruá River region, Western Amazon, Brazil. Six sampling sites were selected in this region and grouped in conserved and degraded environments. Fish were caught from periods of drought and flood, using passive and active sampling methods. Fish collected were measured, weighed, necropsied and the parasites found were counted, fixed, and subjected to morphological analysis. Physical and chemical variables and environmental characteristics were measured in all sites. The present study demonstrated that environmental variables in a floodplain system can influence the richness, diversity, composition and abundance of endoparasites in hosts at different trophic levels. In addition, anthropized environments may favor the abundance of some generalist parasites and present a more homogeneous biota between seasonal periods compared to conserved environments. Study contributed with information supporting the importance of conservation of aquatic environments, and demonstrated that fish parasites can be excellent indicators of environments.

Agrobiodiversidade do povo indígena Huni Kuin do Alto Juruá, Amazônia Ocidental Brasileira

O povo indígena Huni Kuin maneja desde tempos imemoriais agroecossistemas itinerantes. O trabalho objetivou identificar espécies e variedades que compõem a agrobiodiversidade da Terra Indígena Kaxinawá do Baixo Rio Jordão/AC. Buscou-se ainda compreender a interação entre o corpus material e simbólico sobre as espécies cultivadas e a práxis relativa às técnicas de cultivo. Utilizou-se as metodologias: observação participante, entrevistas abertas e trilhas guiadas em unidades produtivas. Levantaram-se 18 espécies com 96 variedades cultivadas nos roçados tradicionais. Há variedades ameaçadas de desuso devido sobretudo às transformações históricas que o povo enfrenta desde o período de contato com a sociedade não-indígena. É preciso valorizar os saberes relacionados à agrobiodiversidade para reverter esse quadro. Sugere-se fortalecer políticas públicas de salvaguarda de sistemas agrícolas e programas de apoio à alimentação escolar regionalizada e à geração de renda com produtos dos roçados.

Association of CYP2C19, CYP2D6 and CYP3A4 Genetic Variants on Primaquine Hemolysis in G6PD-Deficient Patients.

In the Amazon, the treatment for Plasmodium vivax is chloroquine plus primaquine. However, this regimen is limited due to the risk of acute hemolytic anemia in glucose-6-phosphate dehydrogenase deficiency. Primaquine is a prodrug that requires conversion by the CYP2D6 enzyme to be effective against malaria. A series of cases were performed at an infectious diseases reference hospital in the Western Brazilian Amazon. The STANDARD G6PD (SD Biosensor®) assay was used to infer G6PD status and real-time PCR to genotype G6PD, CYP2C19, CYP2D6 and CYP3A4. Eighteen patients were included, of which 55.6% had African A- variant (G202A/A376G), 11.1% African A+ variant (A376G), 5.6% Mediterranean variant (C563T) and 27.8% were wild type. CYP2C19, CYP2D6 and CYP3A4 genotyping showed no statistically significant differences in the frequency of star alleles between the groups G6PD deficient and G6PD normal. Elevated levels of liver and kidney markers in the G6PDd patients were observed in gNM, gRM and gUM of CYP2C19 and CYP2D6 (p < 0.05). Furthermore, in this study there was no influence of CYPs on hemolysis. These findings reinforce the importance of studies on the mapping of G6PD deficiency and genetic variations of CYP2C19, CYP2D6 and CYP3A4. This mapping will allow us to validate the prevalence of CYPs and determine their influence on hemolysis in patients with malaria, helping to decide on the treatment regimen.

Acute Chagas disease associated with ingestion of contaminated food in Brazilian western Amazon.

To describe clinical, epidemiological and management information on cases of acute Chagas disease (ACD) by oral transmission in the state of Amazonas in western Amazon. Manual and electronic medical records of patients diagnosed with ACD at the Fundação de Medicina Tropical Doutor Heitor Vieira Dourado (FMT-HVD) were included. There were 147 cases of acute CD registered from 10 outbreaks that occurred in the state of Amazonas between 2004 and 2022. The transmission pathway was through oral route, with probable contaminated palm fruit juice (açaí and/or papatuá), and involved people from the same family, friends or neighbours. Of 147 identified cases, 87 (59%) were males; cases were aged 10 months to 82 years. The most common symptom was the febrile syndrome (123/147; 91.8%); cardiac alterations were present in 33/100 (33%), (2/147; 1.4%) had severe ACD with meningoencephalitis, and 12 (8.2%) were asymptomatic. Most cases were diagnosed through thick blood smear (132/147; 89.8%), a few (14/147; 9.5%) were diagnosed by serology and (1/147; 0.7%) by polymerase chain reaction (PCR) and blood culture. In all these outbreaks, 74.1% of the patients were analysed by PCR, and Trypanosoma cruzi TcIV was detected in all of them. No deaths were recorded. The incidence of these foci coincided with the fruit harvest period in the state of Amazonas. The occurrence of ACD outbreaks in the Amazon affected individuals of both sexes, young adults, living in rural and peri-urban areas and related to the consumption of regional foods. Early diagnosis is an important factor in surveillance. There was a low frequency of cardiac alterations. Continuous follow-up of most patients was not carried out due to difficulty in getting to specialised centres; therefore, little is known about post-treatment.

Detection of Rickettsia tamurae-like and other spotted fever group rickettsiae in ticks (Acari: Ixodidae) associated with wild birds in the Western Amazon, Brazil

Ticks are vectors for several pathogens, including bacteria belonging to the Rickettsia genus, such as Rickettsia rickettsii and Rickettsia parkeri, the causative agents of spotted fever. The aim of the present study was to investigate the tick species richness and rickettsial agents associated with wild birds captured in the Humaita Forest Reserve, Acre, in the Western Amazon region. Wild birds were captured with ornithological nets for visual inspection with the purpose of collecting ticks, which were identified through morphological analyses and molecular tests for several genes (12S rDNA, 16S rDNA, gltA, ompA, and sca4). A total of 607 wild birds were captured, 12% of which were parasitized by 268 ticks of the Amblyomma genus, with new host-parasite associations reported for Amblyomma calcaratum, Amblyomma geayi, Amblyomma longirostre, Amblyomma naponense, Amblyomma nodosum, and Amblyomma varium. Of the total ticks collected, 113 were tested for the presence of rickettsial DNA fragments, with 19 testing positive for R. parkeri in A. geayi, Rickettsia tamurae-like in Amblyomma sp., and Rickettsia amblyommatis in A. geayi, A. longirostre, and Amblyomma sp. We detected R. tamurae-like in Amblyomma larvae for the first time in the Western Brazilian Amazon biome, and registered spotted fever group rickettsiae, although the relevance of the detected species in a public health context should be further explored in South America, as well as new host-parasite interactions in this underexplored region.