Pharmaceutical services for endemic situations in the Brazilian Amazon: Organization of services and prescribing practices for Plasmodium vivax and Plasmodium falciparum non-complicated malaria in high-risk municipalities
Suarez-Mutis M.C.,Instituto Oswaldo Cruz Fundacao Oswaldo Cruz |
De Souza P.P.,Nucleo de Assistencia Farmaceutica |
Freitas L.F.,Nucleo de Assistencia Farmaceutica |
Miranda E.S.,Federal University of Fluminense |
And 2 more authors.
Malaria Journal | Year: 2011
Background: In spite of the fact that pharmaceutical services are an essential component of all malaria programmes, quality of these services has been little explored in the literature. This study presents the first results of the application of an evaluation model of pharmaceutical services in high-risk municipalities of the Amazon region, focusing on indicators regarding organization of services and prescribing according to national guidelines. Methods. A theoretical framework of pharmaceutical services for non-complicated malaria was built based on the Rapid Evaluation Method (WHO). The framework included organization of services and prescribing, among other activities. The study was carried out in 15 primary health facilities in six high-risk municipalities of the Brazilian Amazon. Malaria individuals ≥ 15 years old were approached and data was collected using specific instruments. Data was checked by independent reviewers and fed to a data bank through double-entry. Descriptive variables were analyzed. Results: A copy of the official treatment guideline was found in 80% of the facilities; 67% presented an environment for receiving and prescribing patients. Re-supply of stocks followed a different timeline; no facilities adhered to forecasting methods for stock management. No shortages or expired anti-malarials were observed, but overstock was a common finding. On 86.7% of facilities, the average of good storage practices was 48%. Time between diagnosis and treatment was zero days. Of 601 patients interviewed, 453 were diagnosed for Plasmodium vivax; of these, 99.3% received indications for the first-line scheme. Different therapeutic schemes were given to Plasmodium falciparum patients. Twenty-eight (4.6%) out of 601 were prescribed regimens not listed in the national guideline. Only 5.7% individuals received a prescription or a written instruction of any kind. Conclusions: The results show that while diagnostic procedure is well established and functioning in the Brazilian malaria programme, prescribing is still an activity that is actually not performed. The absence of physicians and poor integration between malaria services and primary health services make for the lack of a prescription or written instruction for malaria patients throughout the Brazilian Amazon. This fact may lead to a great number of problems in rational use and in adherence to medication. © 2011 Suárez-Mutis et al; licensee BioMed Central Ltd.
Faria A.R.,Federal University of Minas Gerais |
Costa M.M.,Federal University of Minas Gerais |
Giusta M.S.,Federal University of Minas Gerais |
Grimaldi Jr. G.,Instituto Oswaldo Cruz Fundacao Oswaldo Cruz |
And 4 more authors.
PLoS Neglected Tropical Diseases | Year: 2011
Background: Visceral leishmaniasis is the most severe form of leishmaniasis. Approximately 20% of zoonotic human visceral leishmaniasis worldwide is caused by Leishmania infantum, which is also known as Leishmania chagasi in Latin America, and disease incidence is increasing in urban and peri-urban areas of the tropics. In this form of disease, dogs are the main reservoirs. Diagnostic methods used to identify Leishmania infected animals are not able to detect all of the infected ones, which can compromise the effectiveness of disease control. Therefore, to contribute to the improvement of diagnostic methods for canine visceral leishmaniasis (CVL), we aimed to identify and test novel antigens using high-throughput analysis. Methodology/Principal Findings: Immunodominant proteins from L. infantum were mapped in silico to predict B cell epitopes, and the 360 predicted peptides were synthesized on cellulose membranes. Immunoassays were used to select the most reactive peptides, which were then investigated with canine sera. Next, the 10 most reactive peptides were synthesized using solid phase peptide synthesis protocol and tested using ELISA. The sensitivity and specificity of these peptides were also compared to the EIE-LVC Bio-Manguinhos kit, which is recommended by the Brazilian Ministry of Health for use in leishmaniasis control programs. The sensitivity and specificity of the selected synthesized peptides was as high as 88.70% and 95.00%, respectively, whereas the EIE-LVC kit had a sensitivity of 13.08% and 100.00% of specificity. Although the tests based on synthetic peptides were able to diagnose up to 94.80% of asymptomatic dogs with leishmaniasis, the EIE-LVC kit failed to detect the disease in any of the infected asymptomatic dogs. Conclusions/Significance: Our study shows that ELISA using synthetic peptides is a technique with great potential for diagnosing CVL; furthermore, the use of these peptides in other diagnostic methodologies, such as immunochromatographic tests, could be beneficial to CVL control programs. © 2011 Faria et al.
PubMed | Federal University of Paraná, Instituto Oswaldo Cruz Fundacao Oswaldo Cruz, University of Texas at El Paso and National University of Singapore
Type: | Journal: Cellular microbiology | Year: 2016
Extracellular vesicles released from pathogens may alter host cell functions. We previously demonstrated the involvement of host cell-derived microvesicles (MVs) during early interaction between Trypanosoma cruzi metacyclic trypomastigote (META) stage and THP-1 cells. Here, we aim to understand the contribution of different parasite stages and their extracellular vesicles in the interaction with host cells. First, we observed that infective host cell-derived trypomastigote (tissue culture-derived trypomastigote [TCT]), META, and noninfective epimastigote (EPI) stages were able to induce different levels of MV release from THP-1 cells; however, only META and TCT could increase host cell invasion. Fluorescence resonance energy transfer microscopy revealed that THP-1-derived MVs can fuse with parasite-derived MVs. Furthermore, MVs derived from the TCT-THP-1 interaction showed a higher fusogenic capacity than those from META- or EPI-THP-1 interaction. However, a higher presence of proteins from META (25%) than TCT (12%) or EPI (5%) was observed in MVs from parasite-THP-1 interaction, as determined by proteomics. Finally, sera from patients with chronic Chagas disease at the indeterminate or cardiac phase differentially recognized antigens in THP-1-derived MVs resulting only from interaction with infective stages. The understanding of intracellular trafficking and the effect of MVs modulating the immune system may provide important clues about Chagas disease pathophysiology.
PubMed | Federal University of Health Sciences, Porto Alegre, Instituto Oswaldo Cruz Fundacao Oswaldo Cruz, Hospital Sanatorio Partenon, University of California at Berkeley and Federal University of Rio Grande do Sul
Type: Journal Article | Journal: PloS one | Year: 2016
In Mycobacterium tuberculosis (MTB) infection, the complex interaction of host immune system and the mycobacteria is associated with levels of cytokines production that play a major role in determining the outcome of the disease. Several single-nucleotide polymorphisms (SNPs) in cytokine genes have been associated with tuberculosis (TB) outcome. The aim of this study was to evaluate the association between previously reported SNPs IL2-330 T>G (rs2069762); IL4-590 C>T (rs2243250); IL6-174 G>C (rs1800795); IL10-592 A>C (rs1800872); IL10-1082 G>A (rs1800896); IL17A -692 C>T (rs8193036); IL17A -197 G>A (rs2275913); TNF -238 G>A (rs361525); TNF -308 G>A (rs1800629) and IFNG +874 T>A (rs2430561) and pulmonary TB (PTB) susceptibility. We conducted a case-control study in individuals from Southern Brazil who were recruited between February 2012 and October 2013 in a high incidence TB city. We performed a multiplex genotyping assay in 191 patients with PTB and 175 healthy subjects. Our results suggest a decreased risk for PTB development associated with the IL17A -197A allele (OR = 0.29; p = 0.04), AA genotype (OR = 0.12; p = 0.04) and A carrier (AG/AA) (OR = 0.29; p = 0.004) and IL6 -174C carrier (CC/CG) (OR = 0.46; p = 0.04). We could not properly analyze IL17A -692 C>T (rs8193036) and IFNG +874T>A due to genotypic inconsistencies and found no evidence of association for the IL2, IL4, IL10 and TNF polymorphisms and PTB. In conclusion, our results show a protective effect of IL17 and IL6 polymorphisms on PTB outcome in Southern Brazilian population.
Guterres A.,Instituto Oswaldo Cruz |
Guterres A.,Laboratorio Nacional Of Computacao |
de Oliveira R.C.,Instituto Oswaldo Cruz |
Fernandes J.,Instituto Oswaldo Cruz |
And 11 more authors.
Infection, Genetics and Evolution | Year: 2013
The purpose of this study was to investigate the phylogenetic relationship of the Juquitiba virus (JUQV) carried by Oligoryzomys nigripes in endemic and non-endemic areas of Brazil. Wild rodents infected with the Juquitiba virus (JUQV) were sampled from a non-Hantavirus Cardiopulmonary Syndrome endemic area in Brazil. Three strains from O. nigripes were identified by the sequencing of the complete S segment and compared to previous studies of JUQV available in GenBank. The phylogenetic analysis of the complete S segment revealed two distinct clades; the first clade was composed of the JUQV from two non-endemic areas in Brazil and the second clade contained JUQV strains from Argentina, Paraguay and other Brazilian endemic areas. © 2013 .
Palmeira V.F.,Federal University of Rio de Janeiro |
Kneipp L.F.,Instituto Oswaldo Cruz Fundacao Oswaldo Cruz |
Alviano C.S.,Federal University of Rio de Janeiro |
dos Santos A.L.S.,Federal University of Rio de Janeiro
Mycopathologia | Year: 2010
Fonsecaea pedrosoi is the major etiologic agent of chromoblastomycosis. The virulence of F. pedrosoi is a meagerly explored phenomenon. The ability to interact with host cells and the production of hydrolytic enzymes are thought to be important virulence mechanisms of fungal pathogens. Here, we measured the production of two distinct lipolytic enzymes, phospholipase and esterase, by three clinical strains of F. pedrosoi isolated from chromoblastomycosis lesions, as well as their capabilities to interact with epithelial cells. All the strains were excellent esterase producers, generating elevated hydrolytic halos after 5 days of growth. Conversely, phospholipase activity was detected only after 10 days, except for the most recent strain of F. pedrosoi (Magé) in which measurable phospholipase activity was detected on day 5. The ability to interact with epithelial cells was also investigated. Regarding the adhesion capability, an indirect connection was observed in relation to the adaptation time of each strain in axenic culture, in which Magé strain showed the best adhesion ability followed by LDI 11428 and 5VPL strains. Both 5VPL and Magé strains were also detected inside the epithelial cells, while the LDI 11428 strain was rarely detected in cytoplasmatic vacuolar compartments. Moreover, these F. pedrosoi strains were able to cause injury in epithelial cells. © 2010 Springer Science+Business Media B.V.
Ferrao-Filho A.S.,Instituto Oswaldo Cruz Fundacao Oswaldo Cruz |
Soares M.C.S.,Federal University of Juiz de fora |
Lima R.S.,Federal University of Rio de Janeiro |
Magalhaes V.F.,Federal University of Rio de Janeiro
Environmental Toxicology and Chemistry | Year: 2014
The present study aimed to test the effects of raw water samples from a eutrophic reservoir and of a saxitoxin-producing strain of Cylindrospermopsis raciborskii on the swimming behavior of 2 key herbivore species of Daphnia. Two complementary approaches were used, acute bioassays and behavioral assays using an automated movement tracking system for measuring the following activity parameters: swimming time, resting time, distance traveled, and mean velocity. In both assays, animals were exposed to field samples or to toxic filaments in different concentrations and observed for 2h to 3h. In the acute bioassays, there was a decrease in the number of swimming individuals during the exposure period and a recovery following removal from toxic algae. A significant relationship was found between median effective concentration and the saxitoxin content of seston (r2=0.998; p=0.025) in the acute bioassays with raw water samples. Behavioral assays also showed significant effects in the activity parameters with both field samples and the strain of C. raciborskii, with some recovery during the exposure period. Both approaches corroborated previous research on the effects of neurotoxic C. raciborskii on the swimming activity of Daphnia, and these effects are compatible with the mechanism of action of saxitoxins. The present study showed that activity parameters of aquatic organisms may be a useful tool in the evaluation of sublethal toxicity and detection of neurotoxins in raw water. © 2013 SETAC.
PubMed | Federal Rural University of Rio de Janeiro and Instituto Oswaldo Cruz Fundacao Oswaldo Cruz
Type: Journal Article | Journal: Brazilian journal of microbiology : [publication of the Brazilian Society for Microbiology] | Year: 2016
Staphylococcus spp. play an important role in the etiology of bovine mastitis. Staphylococcus aureus is considered the most relevant species due to the production of virulence factors such as slime, which is required for biofilm formation. This study aimed to evaluate biofilm production and its possible relation to beta-lactamic resistance in 20 S. aureus isolates from bovine mastitic milk. The isolates were characterized by pheno-genotypic and MALDI TOF-MS assays and tested for genes such as icaA, icaD, bap, agr RNAIII, agr I, agr II, agr III, and agr IV, which are related to slime production and its regulation. Biofilm production in microplates was evaluated considering the intervals determined along the bacterial growth curve. In addition, to determine the most suitable time interval for biofilm analysis, scanning electron microscopy was performed. Furthermore, genes such as mecA and blaZ that are related to beta-lactamic resistance and oxacillin susceptibility were tested. All the studied isolates were biofilm producers and mostly presented icaA and icaD. The Agr type II genes were significantly prevalent. According to the SEM, gradual changes in the bacterial arrangement were observed during biofilm formation along the growth curve phases, and the peak was reached at the stationary phase. In this study, the penicillin resistance was related to the production of beta-lactamase, and the high minimal bactericidal concentration for cefoxitin was possibly associated with biofilm protection. Therefore, further studies are warranted to better understand biofilm formation, possibly contributing to our knowledge about bacterial resistance in vivo.
de Oliveira L.F.G.,Instituto Oswaldo Cruz Fundacao Oswaldo Cruz |
Pereira B.A.S.,Instituto Oswaldo Cruz Fundacao Oswaldo Cruz |
Gilbert B.,Laboratorio Of Produtos Naturais |
Correa A.L.,Federal University of Fluminense |
And 2 more authors.
Phytochemistry Reviews | Year: 2016
The interest in phytopharmaceutical products and herbal medicines has been a trend in recent years and this approach may be useful as basis for developing new treatment against leishmaniasis. In this review, we discuss the perspectives of leishmaniasis treatment based on natural products and phytotherapy and compare it to the advantages and disadvantages of using the current drugs of first- and second-choice against leishmaniasis. The reports gathered herein reinforce the leishmanicidal effects of medicinal plants and its derivatives, such as Kalanchoe pinnata, Plumbago scandens, Physalis angulata, Piper aduncum, Peschiera (Tabernaemontana) australis, Phyllanthus amarus, and Artemisia annua, and indicates their use as possible alternative or complementary treatments against leishmaniasis. The data presented here support the use of medicinal plants as safe and inexpensive treatments for leishmaniasis. © 2016 Springer Science+Business Media Dordrecht
PubMed | Instituto Oswaldo Cruz Fundacao Oswaldo Cruz
Type: Journal Article | Journal: Environmental toxicology and chemistry | Year: 2013
The present study aimed to test the effects of raw water samples from a eutrophic reservoir and of a saxitoxin-producing strain of Cylindrospermopsis raciborskii on the swimming behavior of 2 key herbivore species of Daphnia. Two complementary approaches were used, acute bioassays and behavioral assays using an automated movement tracking system for measuring the following activity parameters: swimming time, resting time, distance traveled, and mean velocity. In both assays, animals were exposed to field samples or to toxic filaments in different concentrations and observed for 2h to 3h. In the acute bioassays, there was a decrease in the number of swimming individuals during the exposure period and a recovery following removal from toxic algae. A significant relationship was found between median effective concentration and the saxitoxin content of seston (r(2) =0.998; p=0.025) in the acute bioassays with raw water samples. Behavioral assays also showed significant effects in the activity parameters with both field samples and the strain of C. raciborskii, with some recovery during the exposure period. Both approaches corroborated previous research on the effects of neurotoxic C. raciborskii on the swimming activity of Daphnia, and these effects are compatible with the mechanism of action of saxitoxins. The present study showed that activity parameters of aquatic organisms may be a useful tool in the evaluation of sublethal toxicity and detection of neurotoxins in raw water.