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INTRODUCTION We investigated the association between demographic and behavioral factors and non-adherence to antimalarial therapy. METHODS A demographic questionnaire and 5-item self-reported questionnaire regarding non-adherence were completed by 135 patients after treatment for Plasmodium vivax. RESULTS Treatment interruption, but not demographic factors, was significantly associated with non-adherence to therapy. The likelihood of non-adherence was 5.16 times higher when the patients felt better than when they felt worse. The relative risk of parasitic resurgence was 3.04 times higher in non-adherent patients. CONCLUSIONS Treatment interruption is significantly associated with treatment adherence.

Introduction: The immune response caused by Mycobacterium leprae is a risk factor for the development of oxidative stress (OS) in leprosy patients. This study aimed to assess OS in leprosy patients before the use of a multidrug therapy., Methods: We evaluated the nitric oxide (NO) concentration; antioxidant capacity; levels of malondialdehyde, methemoglobin and reduced glutathione; and the activity of catalase and superoxide dismutase (SOD) in leprosy patients., Results: We observed lower SOD activity in these leprosy patients; however, the NO levels and antioxidant capacity were increased., Conclusions: The infectious process in response to M. leprae could primarily be responsible for the OS observed in these patients.

Introduction: Primaquine can produce adverse reactions as toxicity to blood when used in the treatment of vivax malaria. This work aimed to determine methemoglobinemia in patients with vivax malaria receiving oral therapy with primaquine., Methods: Spectrophotometric quantification of methemoglobinemia and qualitative assay for glucose-6-phosphate dehydrogenase., Results: Methemoglobinemia ranged from 2.85 to 5.45% in male patients and 3.77 to 7.34% in female patients., Conclusions: A statistically significant increase in methemoglobinemia was observed following oral therapy with primaquine, with no clinical manifestations, and independent of sex and the qualitative expression of glucose-6-phosphate dehydrogenase.

Introduction: Thalidomide is a drug currently used in Brazil for treating erythema nodosum leprosum., Methods: This was a prospective study to follow up clinical evolution, record adverse events and determine plasma thalidomide levels from a dose of 100 mg/day, among 20 patients with clinical manifestations of erythema nodosum leprosum, divided into two groups: during or after leprosy multidrug therapy., Results: No significant differences between the groups were seen during the study, either in relation to favorable clinical evolution among the patients (70% and 90%), or in relation to the adverse events recorded, which were dizziness and somnolence. The plasma thalidomide levels on D7 and D14 were 0.82 + or - 0.4 microg/ml and 0.79 + or - 0.3 microg/ml in group 1 and 0.82 + or - 0.4 and 1.55 + or - 1.0 in group 2, respectively., Conclusions: In this sample, the multidrug therapy had no effect on the clinical evolution, incidence of adverse events and plasma thalidomide levels.

Evaluation of total human exposure to mercury and methylmercury was effected in riverine villages along the Tapajos river and in the metropolitan area of Belem city, state of Para, Brazil, by using total mercury and methylmercury concentrations in hair samples in 1994 and 1995. It was observed that average concentrations of total mercury are in a range from 2 +/- 1 microg/g-1 to 20.5 +/- 12. 1 microg/g-1. While methylmercury average concentration varies from 1. 4 +/- 0.7 microg/g-1 to 18.5 +/- 11 microg/g-1. These results confirm mercury contamination in the Tapajos river and possible appearance of mercury intoxication symptoms, and recommends the monitoring of compounds in hair samples as well as the need for epidemiological and clinical studies for human health prevention and control of mercury intoxication.

This study evaluates human exposure to methylmercury in fishermen and their families in four villages on the Tapajós river: Rainha, Barreiras, São Luís do Tapajós and Paraná-Mirim. Hair analyses were performed with atomic absorption spectophotometry. Total hair mercury levels varied between 2.9mg/g and 71.5mg/g. Paraná-Mirim showed the lowest level. The highest level was found in São Luís do Tapajós and Barreiras. The hair mercury was six to seven times higher than the established safe limit of 10mg/g. No statistically significant difference was found between the mean level of total mercury taken from the inhabitants living downstream and upstream in Itaituba village (p > 0.05). These results confirm that human exposure to methylmercury is occurring on the Tapajós river and suggest that continued fish ingestion in that region is a potential risk factor for the appearance of symptoms and signs of Minamata disease. An immediate epidemiological survey program is recommended.