Search

The inclusion of race/skin color in Health Information Systems makes it possible to measure health inequities. Brazil and South Africa correspond to countries marked by profound inequalities, multiracial constituted that suffered from the historical process of colonization, and had racism legitimized as a structuring model of state development. The objective is to compare the information systems of Brazil and South Africa regarding the configuration and implementation of the item race/skin color. This is a qualitative, descriptive study, based on the content analysis proposed by Bardin. A survey on race/skin color was carried out in health department documents and ministerial sites in both countries. The collected material was processed and analyzed utilizing the IRAMUTEQ R software, version 0.7 alpha 2, with a test × 2 > 3.80 (p < 0.05), and by the TABNET application version 4.14 and Excel software, version 2016. In Brazil and Africa South, several health information systems did not include race/skin color. In both countries, health information systems were boosted in the mid-1990s. In Brazil, of the systems that provide data by race/skin color, the inclusion occurred after claims by the black movement. In South Africa, through the creation of the respective systems. The historical configuration of the question of race/skin color in both countries was guided by political and ideological references. In multiracial and unequal countries, race/skin color is a central political category to promote health equity.

Objective: This study aimed to explore trends in cervical cancer (CC) incidence and mortality rates according to race/skin color in Brazil focusing on the seriousness of the racial disparity., Methods: Data from Brazilian Population-Based Cancer Registries (PBCRs) were analyzed for trends in incidence between 2010 and 2015. For mortality, data from the National Mortality Information System were retrieved between 2000 and 2020. A self-declaration on race/skin color was collected following the classification proposed by the Brazilian Institute of Geography and Statistics - white, black, brown/mixed race, yellow, or indigenous. For the analysis, black and brown/mixed race were grouped as black., Results: Between 2010 and 2015, 10,844 new cases of CC were registered in the participating PBCRs, distributed among white women (49.6%), black (48.0%), and other race/skin color (2.3%). Compared with white counterparts, black women had a 44% higher risk of incident CC. As for mortality, between 2000 and 2020, 108,590 deaths from CC occurred nationwide. The mean age-adjusted mortality rates according to race/skin color were 3.7/100,000 for white, 4.2/100,000 for black, 2.8 for yellow, and 6.7 for indigenous women. Taking the mortality rates in white women as a reference, there was a 27% increase in death risk in black women (RR = 1.27) and 82% in indigenous women (RR = 1.82)., Conclusion: These findings suggest that the higher rates of incidence and mortality from CC in vulnerable populations of black and more impactfully indigenous women in Brazil remain alarming. More efficient HPV vaccination strategies synchronized with well-conducted Pap smear-based screening should be prioritized in these more vulnerable populations., (© 2023. W. Montague Cobb-NMA Health Institute.)

This study aims to assess the association between economic class, race/skin color, and food consumption among Brazilian college students. A cross-sectional web-based survey was conducted with college students from all over Brazil. Demographic data, economic class, self-reported race/skin color, anthropometry, and food consumption markers from the Brazilian Food and Nutrition Surveillance System were collected. The final sample comprised 5843 participants with a mean age of 24.1 (SD: 6.3) years, 4292 (73.5%) were female, and 810 (13.9%) in the highest economic stratum. We observed a progressive decrease in the frequency of fresh fruits and vegetables consumption from higher to lower economic classes (p < 0.01 for both). Contrarily, there was a progressive increase in the frequency of consumption of beans from higher to lower economic classes (p < 0.01). The frequency consumption of vegetables was also associated with race/skin color (p < 0.01), being lower in brown (PR: 0.94; CI 95%: 0.90; 0.98), and black (PR: 0.91; 95% CI: 0.85; 0.98) individuals, compared to white individuals. Brown individuals showed higher frequency consumption of beans (PR: 1.10; 95% CI: 1.05; 1.15) than whites. When compared to individuals of white race/skin color, brown (PR: 1.07; 95% CI: 1.01; 1.13) and black (PR: 1.15; 95% CI: 1.07; 1.23) individuals showed higher frequency consumption of sweetened beverages. Economic class and race/skin color were independent factors associated with the food consumption of Brazilian college students., (© 2022. W. Montague Cobb-NMA Health Institute.)

Statins are inhibitors of 3-hydroxy-3-methylglutaryl-CoA reductase, a key enzyme in cholesterol biosynthesis, that are highly effective in reducing plasma low-density lipoprotein (LDL) cholesterol and decreasing the risk of cardiovascular events. In recent years, a multitude of variants in genes involved in pharmacokinetics (PK) and pharmacodynamics (PD) have been suggested to influence the cholesterol-lowering response. However, the vast majority of studies have analyzed the pharmacogenetic associations in populations in Europe and the USA, whereas data in other populations, including Brazil, are mostly lacking. This narrative review provides an update of clinical studies on statin pharmacogenomics in Brazilian cohorts exploring lipid-lowering response, adverse events and pleiotropic effects. We find that variants in drug transporter genes (SLCO1B1 and ABCB1) positively impacted atorvastatin and simvastatin response, whereas variants in genes of drug metabolizing enzymes (CYP3A5) decreased response. Furthermore, multiple associations of variants in PD genes (HMGCR, LDLR and APOB) with statin response were identified. Few studies have explored statin-related adverse events, and only ABCB1 but not SLCO1B1 variants were robustly associated with increased risk in Brazil. Statin-related pleiotropic effects were shown to be influenced by variants in PD (LDLR, NR1H2) and antioxidant enzyme (NOS3, SOD2, MTHFR, SELENOP) genes. The findings of these studies indicate that statin pharmacogenomic associations are distinctly different in Brazil compared to other populations. This review also discusses the clinical implications of pharmacogenetic studies and the rising importance of investigating rare variants to explore their association with statin response., (© 2021. Maj Institute of Pharmacology Polish Academy of Sciences.)

In Antarctica, human activities have been reported to be the major cause of the accumulation of heavy metal contaminants. A comprehensive bibliometric analysis of publications on heavy metal contamination in Antarctica from year 2000 to 2020 was performed to obtain an overview of the current landscape in this line of research. A total of 106 documents were obtained from Scopus, the largest citation database. Extracted data were analysed, and VOSviewer software was used to visualise trends. The result showed an increase in publications and citations in the past 20 years indicating the rising interest on heavy metal contamination in the Antarctic region. Based on the analysis of keywords, the publications largely discuss various types of heavy metals found in the Antarctic water and sediment. The analysis on subject areas detects multiple disciplines involved, wherein the environmental science was well-represented. The top countries and authors producing the most publication in this field were from Australia, China, Brazil and Chile. Numerous efforts have been exercised to investigate heavy metal pollution and its mitigation approaches in the region in the past decades. This paper not only is relevant for scholars to understand the development status and trends in this field but also offers clear insights on the future direction of Antarctic heavy metal contamination and remediation research., (© 2023. The Author(s) under exclusive licence to Sociedade Brasileira de Microbiologia.)

Sporotrichosis is a cosmopolitan subcutaneous mycosis caused by Sporothrix species. Recently, this mycosis has gained notoriety due to the appearance of new endemic areas, recognition of new pathogenic species, changes in epidemiology, occurrence of outbreaks, and increasing numbers of cases. The purpose of this study is to analyze the peculiarities of sporotrichosis cases in Brazil since its first report in the country until 2020. In this work, ecological, epidemiological, clinical, and laboratorial characteristics were compiled. A systematic review of human sporotrichosis diagnosed in Brazil and published up to December 2020 was performed on PubMed/MEDLINE, SciELO, Web of Science, and LILACS databases. Furthermore, animal sporotrichosis and environmental isolation of Sporothrix spp. in Brazil were also evaluated. The study included 230 papers, resulting in 10,400 human patients. Their ages ranged from 5 months to 92 years old and 55.98% were female. The lymphocutaneous form was predominant (56.14%), but systemic involvement was also notably reported (14.34%), especially in the lungs. Besides, hypersensitivity manifestations (4.55%) were described. Most patients had the diagnosis confirmed by isolation of Sporothrix spp., mainly from skin samples. Sporothrix brasiliensis was the major agent identified. HIV infection, cardiovascular diseases, and diabetes were the most common comorbidities. Cure rate was 85.83%. Concerning animal sporotrichosis, 8538 cases were reported, mostly in cats (90.77%). Moreover, 13 Sporothrix spp. environmental strains were reported. This review highlights the burden of the emergent zoonotic sporotrichosis in Brazil, reinforcing the importance of "One Health" based actions to help controlling this disease., (© 2021. Sociedade Brasileira de Microbiologia.)

Participation of racial/ethnic minority and immigrant populations in research studies is essential to understand and address health disparities. Nonetheless, these populations are often underrepresented in research because of limited participation that may be due to barriers to participation such as fear and mistrust of research, lack of or limited access to healthcare and social services, time and employment constraints, participation-associated costs (e.g., travel costs), language barriers, undocumented status, and cultural differences. Brazilians comprise a rapidly growing immigrant population group in the United States (US), and there is a need to identify and understand factors affecting the health status of Brazilian immigrants that are amenable to intervention. Therefore, this paper presents effective strategies and lessons learned from outreach and recruiting Brazilian immigrants living in the US to enroll in maternal and child health research studies. Using a data recruitment log, we collected quantitative and qualitative data on recruitment strategies that were employed to recruit pregnant women and parents into six health research studies. Direct recruitment strategies included personal contacts of research staff and recruiting partners, and on-site, in-person outreach and recruitment at faith- and community-based events (e.g., meeting participants after church services, at faith-based community events), and private and social events (e.g., household parties) conducted by bilingual, bicultural research assistants who were members of the priority population. We also used snowball sampling as a recruitment strategy by asking enrolled participants to share information about our studies and encourage their family and friends to participate. Indirect recruitment methods included posting flyers at local businesses, social service agencies, faith-based and healthcare organizations, and posting announcements on social media (Facebook). Direct recruitment methods in combination with snowball sampling were the most successful strategies for recruiting Brazilian immigrant parents, while social media was an effective indirect method for recruiting first-time pregnant women. In addition, analyses of qualitative data found that research staff's understanding of the sociocultural context of the target population combined with the use of linguistically and culturally sensitive recruitment strategies tailored to meet the needs of Brazilian immigrants was important for overcoming barriers to participation and facilitating successful recruitment and enrollment of participants. Study findings provide information on a suite of effective strategies and lessons learned for reaching, recruiting, and enrolling Brazilian immigrants in maternal and child health research. Future studies should continue to purposefully collect information on recruitment strategies and disseminate the findings, which will be instrumental in researchers' efforts to increase participation of ethnic minority and immigrant populations such as Brazilians in health research.

This paper investigates continuities and changes in the definition of sickle cell disease in 1950s Brazil, taking into account that diseases have a history and are recognized as such according to the knowledge and perceptions available in a certain historical period and specific location. In the post-war era, new diagnostic tools, inheritance theories and, in particular, discussions on the concepts of race and racial relations, both nationally and internationally, were changing previous racialist and racist views. Nonetheless, the Brazilian medical interpretations of sickle cell disease continued to racialize it and even use deep-rooted racist formulations to explain its symptoms or the existence of the disease. It is argued that the celebration of racial mixture and racial democracy might have concealed racist presumptions biasing the study of sickle cell disease. Although race as a biological concept gradually gave way to other genetic expressions, in Brazilian medical papers on sickle cell disease, race continued to influence the interpretation of the disease, along with the persistence of concepts of heredity through blood mixture.

This paper characterizes the pattern of ectoparasite and endoparasite communities in an assemblage of 35 sympatric fish from different trophic levels in a tributary from the Amazon River system, northern Brazil. In detritivorous, carnivorous, omnivorous and piscivorous hosts, the species richness consisted of 82 ectoparasites and endoparasites, but protozoan ectoparasites such as Ichthyophthirius multifiliis, Piscinoodinium pillulare and Tripartiella sp. were dominant species predominated, such that they were present in 80% of the hosts. The taxon richness was in the following order: Monogenea > Nematoda > Digenea > Crustacea > Protozoa > Acanthocephala = Cestoda > Hirudinea. Among the hosts, the highest number of parasitic associations occurred in Satanoperca jurupari, Aequidens tetramerus, Hoplerythrinus unitaeniatus, Hoplosternum littorale, Cichlasoma amazonarum, Chaetobranchus flavescens, Squaliforma emarginata, Chaetobranchopsis orbicularis and Hoplias malabaricus. A weak positive correlation between ectoparasite abundance and length of the hosts was observed. Ectoparasite communities of detritivorous, carnivorous and omnivorous hosts were similar, but these differed from the communities of piscivorous hosts. Larval endoparasite species with low host specificity were the main determinants of the parasite infracommunity structure of the fish assemblage. Fish assemblage had few species of helminth that were specialist endoparasites, while many were parasites at the larval stage, infecting intermediate and paratenic hosts. Finally, carnivorous and omnivorous hosts harbored endoparasite communities that were more heterogeneous than those of detritivorous and piscivorous hosts. This result lends supports to the notion that the feeding habits of the host species are a significant factor in determining the endoparasites fauna.

In Brazilian folk medicine, Tetradenia riparia (Hochst.) Codd. (Lamiaceae) is used to treat toothaches and dental abscesses and diseases induced by worms, bacteria, or fungi. This paper aims to investigate the chemical composition and the antibacterial effects of the essential oil obtained from Tetradenia riparia leaves (TR-EO) grown in Southeastern Brazil against a representative panel of oral pathogens. We evaluated the antibacterial activity of TR-EO in terms of the minimal inhibitory concentration (MIC). We identified aromadendrene oxide (14.0%), (E,E)-farnesol (13.6%), dronabinol (12.5%), and fenchone (6.2%) as the major constituents of TR-EO. TR-EO displayed MIC values between 31.2 and 500 μg/mL, with the lowest MIC value being obtained against Streptococcus mitis (31.2 μg/mL), S. mutans (62.5 μg/mL), S. sobrinus (31.2 μg/mL), and Lactobacillus casei (62.5 μg/mL). In time-kill experiments, TR-EO demonstrated bactericidal activity against S. mutans within the first 12 h, resulting in a curve profile similar to that of chlorhexidine. These results revealed that the essential oil of Tetradenia riparia displays promising activity against most of the selected cariogenic bacteria, including Streptococcus mutans.

A new species of Cacatuocotyle is described from the external surface of Astyanax aff. fasciatus and Astyanax jacuhiensis from Lake Guaíba, State of Rio Grande do Sul, Brazil. It differs from the other three species of the genus, recorded from Mexico and the State of Paraná, Brazil, by possessing an accessory piece with a long proximal portion, a U-shaped bar with irregular posterior margin in its midportion, and a haptor containing two circular thickenings with muscular anterior margins. Only one monogenean species, Urocleidoides astyanacis (= Characithecium costaricensis) was recorded for the host Astyanax aff. fasciatus, whereas none were known for A. jacuhiensis. This paper records a new host (A. jacuhiensis) for monogeneans in southern Brazil and extends southward with the geographical distribution of the genus Cacatuocotyle to the State of Rio Grande do Sul, Brazil.

Milk is widely consumed in Brazil and can be the vehicle of agent transmission. In this study, was evaluated the occurrence of Mycobacterium bovis and non-tuberculous mycobacteria (NTM) in raw and pasteurized milk consumed in the northwestern region of Paraná, Brazil. Fifty-two milk samples (20 pasteurized and 32 raw) from dairy farms near the municipality of Maringa, Parana State, Brazil were collected. Milk samples were decontaminated using 5% oxalic acid method and cultured on Lowenstein-Jensen and Stonebrink media at 35 °C and 30 °C, with and without 5-10% CO2. Mycobacteria isolates were identified by morphological features, PCR-Restriction Fragment Length Polymorphism Analysis (PCR-PRA) and Mycolic acids analysis. Thirteen (25%) raw and 2 (4%) pasteurized milk samples were positive for acid fast bacilli growth. Nine different species of NTM were isolated (M. nonchromogenicum, M. peregrinum, M. smegmatis, M. neoaurum, M. fortuitum, M. chelonae, M. flavescens, M. kansasii and M. scrofulaceum). M. bovis was not detected. Raw and pasteurized milk may be considered one source for NTM human infection. The paper reinforces the need for intensification of measures in order to avoid the milk contamination and consequently prevent diseases in the south of Brazil.

In this paper we report the occurrence of zoonotic species of Cryptosporidium (C. ubiquitum and C. parvum subtype IIaA15G2R1) and the host-specific Giardia duodenalis genotype E in a sheep farm from Brazil. Fecal specimens were collected from 100 animals and screened for the presence of G. duodenalis and Cryptosporidium spp. by enzyme immunoassay (EIA) and polymerase chain reaction (PCR). Restriction fragment length polymorphism (RFLP) and sequence analysis of selected samples was used to confirm the species and to characterize the isolates. Of 100 specimens, 34 were positive for Giardia (34%) and 25 were positive for Cryptosporidium (25%). The prevalence of Giardia and Cryptosporidium was higher in lambs than in ewes. Co-infection was observed in 14% of animals. All G. duodenalis isolates belonged to genotype E. The genetic characterization performed in 22 Cryptosporidium-positive samples revealed the presence of zoonotic C. ubiquitum and C. parvum in 76% (19/25) and 12% (3/25) of infected animals, respectively. The presence of zoonotic Cryptosporidium subtypes in lambs was of epidemiological and public health relevance.

This paper compares anti-hookworm campaigns conducted in the early twentieth century in France, Germany, Brazil and West India. The populations that suffer from hookworm are not identical in the North and in the South. In tropical and semi-tropical regions hookworm is mainly found among poor peasants and is related to lack of hygiene, while in temperate climates hookworm was a professional disease of miners, a highly organized professional segment. Nevertheless, major disparities in the pattern of hookworm control did not reflect the North-South divide, but a difference between campaigns. These aimed at the eradication of hookworm infection (Germany and West-India) and at alleviating the effects of this infection on populations (France and Brazil). Maps that represented the prevalence of hookworm mirrored the aims of the sanitary campaign in which they were used: eradication of parasitic worms versus the reduction of the handicap induced by these worms. In public health as well, representing is intervening. And vice versa: patterns of intervention shape representations.

This paper attempts to show how leading contemporary disciplines influenced the discovery of Chagas' disease and the formation of the early disease concept. Chagas was among the first generation of Brazilian trained scientists who incorporated modern principles of tropical medicine in its research. Thus, Chagas was familiar with characteristics of vector borne tropical diseases such as malaria and yellow fever. The detection of a hitherto unknown trypanosome in the gut of a reduviid bug prompted him to search for a related vector borne disease. Among the disciplines that were influential on Chagas' discovery and early disease description were pathology, entomology and parasitology. Parasitology as a new discipline was of crucial importance to tropical medicine and had a political dimension in the context of colonial medicine. Hence, leading scientists in tropical medicine were located in European countries and in the United States of America. One of these was the German Schaudinn School of Protozoology. The early description of American Trypanosomiasis can also be seen as a reflection of the Schaudinn School of Protozoology which dominated Chagas' scientific orientation towards parasitology with regard to the interpretation of the observed phenomena of the life cycle and the morphology and biology of T. cruzi. The first Chagas' disease concept was based on research of the biology and entomology of the trypanosome and its vector as well as on pathological studies of fatal cases. This concept was characterized by a confusion of some of the chronic forms of the disease, as iodine deficiency and goitre were endemic in some rural regions in Brazil. Therefore, early concepts of the disease faced strong opposition and even raised doubts about its existence.