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Pelotas, Brazil

Pinheiro R.O.,Oswaldo Cruz Foundation | de Oliveira E.B.,Oswaldo Cruz Foundation | dos Santos G.,Helio Fraga Reference Center | Sperandio da Silva G.M.,Evandro Chagas Institute of Clinical Research | And 7 more authors.
Clinical and Experimental Immunology | Year: 2013

Previous studies have demonstrated that cells from both multi-drug-resistant tuberculosis (MDR-TB) and non-tuberculous mycobacteria (NTM) patients respond poorly to mycobacterial antigens in vitro. In the present study, we compared the in vitro response of cells isolated from sensitive TB (NR-TB)-, MDR-TB- and NTM-infected patients. Analysis of T cell phenotype ex vivo revealed that both MDR-TB and NTM patients present an increased percentage of CD4+CD25+- forkhead box protein 3 (FoxP3)+ and CD4+CD25+CD127- regulatory T (Treg) cells when compared to NR-TB. Increased numbers of Treg cells and interleukin (IL)-10 serum levels were detected in MDR-TB, whereas elevated serum transforming growth factor (TGF)-β was found in the NTM group. Cells of MDR-TB patients stimulated with early secretory antigenic target (ESAT)-6, but not purified protein derivative (PPD), showed a lower frequency of CD4+/interferon (IFN)-γ+ T cells and enhanced CD4+CD25+FoxP3+, CD4+CD25+CD127- and CD4+CD25+IL-10+ T cell population. In addition, increased IL-10 secretion was observed in cultured MDR-TB cells following ESAT-6 stimulation, but not in NR-TB or NTM patients. In vitro blockade of IL-10 or IL-10Rα decreased the CD4+CD25+FoxP3+ frequencies induced by ESAT-6 in MDR-TB, suggesting a role of IL-10 on impaired IFN-γ responses seen in MDR-TB. Depletion of CD4+CD25+ T lymphocytes restored the capacity of MDR-TB T cells to respond to ESAT-6 in vitro, which suggests a potential role for Treg/T regulatory 1 cells in the pathogenesis of MDR-TB. Together, our results indicate that although the similarities in chronicity, NTM- and MDR-TB-impaired antigenic responses involve different mechanisms. © 2012 British Society for Immunology.


Kamadjeu R.,World Health Organization | Assegid K.,World Health Organization | Naouri B.,World Health Organizations | Mirza I.R.,Health Unit | And 5 more authors.
Journal of Infectious Diseases | Year: 2011

Despite enormous challenges, Somalia has been successfully implementing accelerated measles control activities since 2005. Through innovative strategies and with the support of local and international partners, the country has shown potentials of implementing measles mortality reduction activities in complex emergencies. Measles incidence has been reduced by >80% after the measles catch-up campaigns of 2005-2007, and national reported measles routine immunization coverage with first dose measles containing vaccine has reached 59% for the first time in 2009. However, the near collapse of the health care system and the ongoing insecurity continue to hamper the implementation of recommended measles control and elimination strategies in some parts of the country, making these achievements fragile. Somalia exemplifies the challenges in meeting measles elimination goals in the World Health Organization Eastern Mediterranean region. As the region is entering its 2010 measles elimination goals, it appears necessary to establish realistic and flexible interim goals for measles control in Somalia that will take into consideration the specificities of the country. Maintaining flexibility in conducting field operations, securing financial resources, multiplying opportunities for measles vaccination, and improving disease monitoring systems will remain vital to sustain and improve current achievements. © The Author 2011. Published by Oxford University Press on behalf of the Infectious Diseases Society of America. All rights reserved.


Alamo S.T.,Reach Out Mbuya Parish HIV AIDS Initiative | Colebunders R.,Institute of Tropical Medicine | Colebunders R.,University of Antwerp | Ouma J.,Management science for Health | And 4 more authors.
Journal of Acquired Immune Deficiency Syndromes | Year: 2012

Objectives: To understand reasons for lost-to-follow-up (LTFU) from a community-based antiretroviral therapy program in Uganda. Study Design: Retrospective cohort of patients LTFU between May 31, 2001, to May 31, 2010, was examined. A representative sample of 579 patients traced to ascertain their outcomes. Methods: Mixed methods were used. Using "stopped care" as the hazard and "self-transferred" as the comparator, we examined using Cox proportional multivariable model risk factors for stopping care. Results: Overall, 2933 of 3954 (74.0%) patients were LTFU. Of 579 of 2933 (19%) patients sampled for tracing, 32 (5.5%) were untraceable, 66(11.4 %) were dead, and 481 (83.0%) found alive. Of those found alive, 232 (40.0%) stopped care, 249 (43.0%) selftransferred, whereas 61 (12.7%) returned to care at Reach Out Mbuya HIV/AIDS Initiative. In adjusted hazards ratios, born-again religion, originating from outside Kampala, resident in Kampala for〈5 years but〉1 year, having school-age children who were out of school, non-HIV disclosure, CD4 counts >250 cells per cubic millimeter and pre-antiretroviral therapy were associated with increased risk of stopping care. Qualitative interviews revealed return to a normal life as a key reason for LTFU.Of 61 patients who returned to care, their median CD4 count at LTFU was higher than on return into care (401/mm 3 vs. 205/mm 3, P<0.0001). Conclusions: Many patients become LTFU during the course of years, necessitating the need for effective mechanisms to identify those in need of close monitoring. Efforts should be made to improve referrals and mechanisms to track patients who transfer to different facilities. Additionally, tracing of patients who become LTFU is required to convince them to return. Copyright © 2012 by Lippincott Williams & Wilkins.


Santos P.C.,Polytechnic Institute of Porto | Santos P.C.,University of Porto | Abreu S.,University of Porto | Moreira C.,University of Porto | And 8 more authors.
Journal of Sports Sciences | Year: 2014

The aims of the this prospective study were to analyse physical activity (PA) engagement during the first and second trimesters, considering the different guidelines published on PA, to document the individual characteristics associated with the accomplishment of these guidelines and to examine pregnant women's perceived barriers to leisure PA, using a socioecological framework. A sample of 133 pregnant women in two stages - at 10-12 weeks' gestation (T1) and 20-22 weeks' gestation (T2) - were evaluated. PA was assessed by accelerometry during the T1 and T2 evaluation stages. Socio-demographic characteristics, lifestyle factors and barriers to leisure PA were assessed via questionnaire. A large proportion of women (ranging from 32% to 96%) did not reach the levels of PA recommended by the guidelines. There were no significant differences between T1 and T2 with regard to compliance with PA recommendations. A decrease in PA levels from T1 to T2 was noted for all recommendations. No associations were found between participants' characteristics and adherence to the recommendations in T1 and T2. No significant differences were found in barriers to leisure PA between T1 and T2. The most commonly reported barriers to leisure PA were intrapersonal, not health related. Our results indicate that there were no differences between trimesters regarding compliance of PA recommendations, and perceived barriers were similar in both trimesters. © 2014 © 2014 Taylor & Francis.


Lockyear K.M.,Health Unit | MacDonald S.E.,York University | Waddell W.T.,Point Defiance Zoo and Aquarium | Goodrowe K.L.,Point Defiance Zoo and Aquarium
Theriogenology | Year: 2016

An evaluation of a large database of red wolf fresh ejaculate characteristics (n = 427 ejaculates from 64 wolves) was undertaken to increase knowledge of seminal characteristics in the red wolf and evaluate possible relationships between inbreeding, age, and seminal quality. Phase microscopy analysis of electroejaculates collected over 14 natural breeding seasons was compared with animal ages and inbreeding coefficients. Ejaculate volume increased and sperm concentration and total count decreased as wolves aged (P < 0.01, 0.001, and 0.05, respectively), and the proportion of sperm cell morphological abnormalities was greater in animals with higher coefficients of inbreeding (P < 0.001), particularly for older animals (P < 0.001). Moreover, the mean coefficient of inbreeding of animals that had failed to reproduce given at least one opportunity during their lifetimes was significantly greater than that of wolves with proven fertility, and wolves of proven fertility exhibited higher sperm concentrations and total counts than nonproven wolves. Thus, as the captive red wolf population becomes more inbred, the maximum age of reproduction is likely to decrease; an important finding to consider when projecting population dynamics and determining pairing recommendations. © 2016 Elsevier Inc.

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