The objective of the present study was to estimate the prevalence of soil-transmitted helminthiasis and evaluate the sanitary conditions and the role of a mass treatment campaign for control of these infections in Santa Isabel do Rio Negro. A cross-sectional survey was carried out in 2002, to obtain data related to the sanitary conditions of the population and fecal samples for parasitological examination in 308 individuals, followed by a mass treatment with albendazole or mebendazole with coverage of 83% of the city population in 2003. A new survey was carried out in 2004, involving 214 individuals, for comparison of the prevalences of intestinal parasitosis before and after the mass treatment. The prevalences of ascariasis, trichuriasis and hookworm infection were 48%; 27% and 21% respectively in 2002. There was a significant decrease for the frequency of infections by Ascaris lumbricoides (p < 0.05; OR / 95% CI = 0.44 / 0.30 - 0.65), Trichuris trichiura (p < 0.05; OR / 95% CI = 0.37 / 0.22 - 0.62), hookworm (p < 0.05; OR / 95% CI = 0.03 / 0.01 - 0.15) and helminth poliparasitism (p < 0.05; OR / 95% CI = 0.16 / 0.08 - 0.32). It was also noticed a decrease of prevalence of infection by Entamoeba histolytica / dispar (p < 0.05; OR / 95% CI = 0.30 / 0.19 - 0.49) and non-pathogenic amoebas. It was inferred that a mass treatment can contribute to the control of soil-transmitted helminthiasis as a practicable short-dated measure. However, governmental plans for public health, education and urban infrastructure are essential for the sustained reduction of prevalences of those infections. ; O presente trabalho objetivou avaliar a prevalência e o papel de um tratamento em massa das helmintíases intestinais em Santa Isabel do Rio Negro, Estado do Amazonas, Brasil. Foi realizado em 2002 um estudo seccional, incluindo inquérito copro-parasitológico, objetivando a obtenção das prevalências das parasitoses intestinais e dados sobre as condições sanitárias do local, estudando-se uma amostra de 308 indivíduos. Em 2003 foi realizada intervenção para tratamento em massa das helmintíases intestinais com administração de albendazol (ou mebendazol para crianças entre 12 e 24 meses) na sede do município, alcançando-se 83% de cobertura. Novo inquérito copro-parasitológico foi realizado em 2004, para comparação das prevalências antes a após o tratamento. As prevalências das infecções por Ascaris lumbricoides, Trichuris trichiura e ancilostomídeos foram 48%, 27% e 21%, respectivamente em 2002. Em 2004 observou-se redução significativa das infecções por Ascaris lumbricoides (p < 0,05; OR / 95% IC = 0,44 / 0,30 - 0,65), Trichuris trichiura (p < 0,05; OR / 95% IC = 0,37 / 0,22 - 0,62), ancilostomídeos (p < 0,05; OR / 95% IC = 0,03 / 0,01 - 0,15) e poliparasitismo por helmintos intestinais (p < 0,05; OR / 95% IC = 0,16 / 0,08 - 0,32). Foi também observada redução da prevalência de infecção por Entamoeba histolytica/dispar (p < 0,05; OR / 95% CI = 0,30 / 0,19 - 0,49). Concluiu-se que o tratamento em massa pode auxiliar o controle das helmintíases intestinais, porém ações governamentais em infraestrutura urbana e educação são essenciais para uma redução sustentada das prevalências destas infecções.
Background: There are few studies on HIV subtypes and primary and secondary antiretroviral drug resistance (ADR) in community-recruited samples in Brazil. We analyzed HIV clade diversity and prevalence of mutations associated with ADR in men who have sex with men in all five regions of Brazil.Methods: Using respondent-driven sampling, we recruited 3515 men who have sex with men in nine cities: 299 (9.5%) were HIV-positive; 143 subjects had adequate genotyping and epidemiologic data. Forty-four (30.8%) subjects were antiretroviral therapy-experienced (AE) and 99 (69.2%) antiretroviral therapy-naive (AN). We sequenced the reverse transcriptase and protease regions of the virus and analyzed them for drug resistant mutations using World Health Organization guidelines.Results: the most common subtypes were B (81.8%), C (7.7%), and recombinant forms (6.9%). the overall prevalence of primary ADR resistance was 21.4% (i.e. among the AN) and secondary ADR was 35.8% (i.e. among the AE). the prevalence of resistance to protease inhibitors was 3.9% (AN) and 4.4% (AE); to nucleoside reverse transcriptase inhibitors 15.0% (AN) and 31.0% (AE) and to nonnucleoside reverse transcriptase inhibitors 5.5% (AN) and 13.2% (AE). the most common resistance mutation for nucleoside reverse transcriptase inhibitors was 184V (17 cases) and for nonnucleoside reverse transcriptase inhibitors 103N (16 cases).Conclusions: Our data suggest a high level of both primary and secondary ADR in men who have sex with men in Brazil. Additional studies are needed to identify the correlates and causes of antiretroviral therapy resistance to limit the development of resistance among those in care and the transmission of resistant strains in the wider epidemic. ; Ministry of Health/Secretariat of Health Surveillance/Department of STD, AIDS and Viral Hepatitis through Brazilian Government ; Ministry of Health/Secretariat of Health Surveillance/Department of STD, AIDS and Viral Hepatitis through United Nations Office on Drugs and Crime-UNODC ; Department of STD, AIDS and Viral Hepatitis of the Ministry of Health ; Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP) ; Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES) ; Univ Fed Ceara, Dept Saude Comunitaria, BR-60430971 Fortaleza, Ceara, Brazil ; Universidade Federal de São Paulo, São Paulo, Brazil ; Tulane Univ, Sch Publ Hlth & Trop Med, New Orleans, LA USA ; Univ Fed Minas Gerais, Belo Horizonte, MG, Brazil ; Univ Fed Bahia, Inst Saude Colet, BR-41170290 Salvador, BA, Brazil ; Univ Fed Rio de Janeiro, Rio de Janeiro, Brazil ; Univ Brasilia, BR-70910900 Brasilia, DF, Brazil ; Univ Calif San Francisco, San Francisco, CA 94143 USA ; Univ São Paulo, LIM 03, São Paulo, Brazil ; Universidade Federal de São Paulo, São Paulo, Brazil ; Ministry of Health/Secretariat of Health Surveillance/Department of STD, AIDS and Viral Hepatitis through Brazilian Government: AD/BRA/03/H34 ; Ministry of Health/Secretariat of Health Surveillance/Department of STD, AIDS and Viral Hepatitis through United Nations Office on Drugs and Crime-UNODC: AD/BRA/03/H34 ; Department of STD, AIDS and Viral Hepatitis of the Ministry of Health: CSV 234/07 ; FAPESP: 2004/15856-9 ; CAPES: BEX 3495/06-0 ; Web of Science
