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Vários indicadores de saúde têm sido utilizados como instrumento para o monitoramento da qualidade de vida das populações. Entre estes indicadores, a taxa de mortalidade infantil é um dos principais, pois revela a qualidade dos serviços de saúde, saneamento básico e educação de uma determinada região. Essa taxa é apresentada por meio de dados epidemiológicos que quantificam as mortes no primeiro ano de vida, dentre todos os nascidos vivos no mesmo espaço de tempo. O presente trabalho avaliou a mortalidade infantil nos 16 municípios que integram a microrregião da Serra Geral de Minas Gerais, localizada em sua totalidade no norte do estado. O estudo foi do tipo ecológico, realizado sob uma perspectiva observacional com abordagem quantitativa. Os dados foram coletados no período de 2008 a 2016, mostrando que 469 crianças morreram. A maioria dos óbitos ocorreram em crianças do sexo masculino, após o parto, no período neonatal e em ambiente hospitalares. As principais causas de mortalidade foram afecções perinatais e as malformações congênitas, deformidades e anomalias cromossômicas. Os municípios que apresentaram maior taxa de mortalidade infantil foram Pai Pedro e Manga, sendo esta taxa considerada como média, conforme classificação da Organização Mundial de Saúde. Os resultados mostraram que mesmo com diminuição nas taxas de mortalidade infantil nos municípios da microrregião da Serra Geral, ainda existem óbitos infantis por causas evitáveis. Tal fato pode sinalizar a necessidade de investimentos na assistência à saúde nesta região.

O objetivo do estudo foi refletir sobre o contexto da implantação da Escola Normal Rural Dom Joaquim Silvério de Souza, no distrito de Conselheiro Mata, município de Diamantina, seu funcionamento e a formação das normalistas para o meio rural. Foi realizada uma pesquisa nas bibliotecas da Universidade Federal de Minas Gerais e da Universidade Federal dos Vales do Jequitinhonha e Mucuri, sendo encontradas duas dissertações e duas teses, que foram a base da presente análise. Esta análise pontuou os acontecimentos políticos que estimularam a reestruturação da educação rural, como também a forma como as normalistas eram preparadas para a atuação no meio rural. Foram abordadas questões relativas à renovação teórica e instrumental na formação do professor primário para o meio rural, identificação e compreensão das relações entre práticas tradicionais e práticas escolares de saúde das populações rurais e a investigação das práticas de escrita por meio da análise dos diários produzidos na escola. Esses estudos são de grande valia para os educadores, pois a forma de abordagem das disciplinas faz aparecer particularidades educacionais e sociais de cada época, que podem tentar acobertar as diferenças e diversidades como também incutir pensamentos de acordo com os interesses da política vigente.

Background This retrospective case-control study aimed to investigate the factors associated with the occurrence of human visceral leishmaniasis (VL) in the municipality of Rondonópolis, which is a highly endemic area for VL in Central-Western Brazil. Methods All VL cases reported in Rondonópolis from 2011 to 2016 were included. For each case, two neighborhood- and age-matched controls with the absence of past and present history of VL and negative rk39-based immunochromatographic test, were recruited. Data were retrospectively collected through interviews that assessed socioeconomic aspects, housing features, backyard characteristics, presence of animals and daily habits. A multivariate conditional logistic regression analysis was used to identify factors associated with human VL. Results During the study period, 81 VL cases were reported in Rondonópolis, of which 37 (45.7%) were included in this study. Seventy controls were also included. The variables associated with VL occurrence were the outdoor location of a bathroom and/or kitchen separated from the rest of the house (OR 7.8; 95% CI 2.1 to 29.5), the presence of a vegetable garden (OR 5.3; 95% CI 1.3 to 21.2) and the presence of decaying fruits (OR 10.7; 95% CI 2.0 to 52.1) in the backyard. Conclusions Our findings suggest an association between backyard characteristics and VL. This may be useful in guiding preventive and control measures against zoonotic VL worldwide.

Background In Brazil, the transmission of Leishmania infantum in urban settings is closely related to infection among dogs, with occasional transmission to humans. Serological screening of dogs for Leishmania spp. infection on requests of their owners (passive case detection) represents a frequent, but little studied, practice within the scope of Brazilian public health. This study identified factors associated with canine visceral leishmaniasis (CVL) diagnosis-seeking behavior of dog owners in Rondonópolis (236,000 inhabitants), a municipality in Central-Western Brazil where VL is endemic. Also, we evaluated the profile of dog owners and their animals screened on free demand. Methodology/Principal findings Using mixed effects negative binomial regression, we modelled the number of dogs screened for Leishmania infection on free demand per neighborhood from 2011 to 2016 as a function of time-dependent predictors (current or recent canine seropositivity and human VL incidence), distance to the screening site, and demographic variables. We assessed potential delays in the effect of time-dependent predictors on the outcome. Among 12,536 dogs screened for Leishmania infection, 64.2% were tested during serosurveys and 35.8% were tested on free demand. Of these, 63.9% were positive. Uptake of screening under free demand was strongly associated with higher levels of canine seropositivity in the neighborhood (current or recent) and decreasing distance to the screening site. A subsample of dog owners (n = 93) who sought CVL screening between 2016 and 2017 were interviewed in more detail. Owners with better socioeconomic status and dogs with apparent CVL clinical manifestations prevailed among them. Conclusions/Significance To support timely CVL management, passive case detection along with awareness activities aimed at dog owners should be encouraged in endemic areas. Screening sites should be prioritized in accessible zones, as well as in socio-economically disadvantage areas. In parallel, CVL active case detection should be continued as a surveillance tool to guide control actions., Author summary In Brazil, visceral leishmaniasis (VL) occurs typically in urban settings, where dogs play a role as reservoirs and control efforts have failed to reduce disease occurrence. Active screening for Leishmania spp. canine infection by serosurveys is an important pillar of the national VL control program. However, many municipalities also detect cases passively by testing animals on request of individual dog owners. For a VL-endemic municipality in Brazil, we show how the number of dogs tested on free demand in the area increased from 2011 to 2016, with seropositivity consistently exceeding 47%. Increased diagnosis-seeking behavior within neighborhoods was associated with a decrease in the distance to the screening site and higher (recent) levels of canine seropositivity in the neighborhood. The data also suggested that dog owners with better socioeconomic status and animals with clinical signs of canine VL (CVL) predominated among those who sought screening. As passive case detection contributes to timely diagnosis of CVL, it should be encouraged in VL endemic areas. Diagnosis seeking-behavior could be increased by setting up screening sites in multiple accessible areas and especially in areas that are most affected by CVL. In parallel, population-based serosurveys must continue as surveillance tools to guide VL control actions.

The factors associated with Leishmania spp. infection in dogs are still poorly understood. This study aimed to identify such factors among domestic dogs from the Brazilian municipality of Rondonopolis, which recently emerged as an endemic area with intense transmission of human visceral leishmaniasis (VL). It was a household-based cross-sectional study conducted between 2016 and 2017. Interviews were conducted with 405 dog owners considering their socioeconomic characteristics, and environmental aspects of the household and its adjacent areas. In addition, 600 dogs were evaluated regarding physical characteristics, behavior, and care provided by the owner. Seropositive animals were those that showed reactivity in a rapid immunochromatographic test and enzyme-linked immunosorbent assay, which are currently recommended for canine visceral leishmaniasis (CVL) diagnosis in Brazil. A multivariable logistic regression analysis was employed to determine the associated factors. Low social class [OR = 2.0; 95% CI = (1.2–3.2)], presence of acerola tree ( Malpighia emarginata ) in the yard [OR = 2.2; 95% CI = (1.2–4.1)], presence of more than one dog in the household [OR = 2.0; 95% CI = (1.3–3.3)], horse and/or cattle breeding [OR = 12.0; 95% CI = (1.9–73.6)], existence of houses with yard adjacent to the home [OR = 4.0; 95% CI = (1.3–12.2)], presence of apparent signs consistent with CVL [OR = 10.6; 95% CI = (5.8–19.4)], dog staying mostly in the yard during the day [(OR = 4.8; 95% CI = (1.1–21.4)], and lack of cleaning of the dog's shelter [(OR = 1.9; 95% CI = (1.1–3.2)] were identified as the factors associated with Leishmania spp. infection. These results support the importance of socioeconomic and environmental aspects in the occurrence of Leishmania spp. infection. In addition, they may be useful in guiding control strategies in areas where zoonotic VL is endemic.

In this ecological study, we investigated spatial patterns of human visceral leishmaniasis (VL) incidence, its correlation with socioeconomic aspects, environmental indices (obtained through remote sensing) and canine VL during 2011–2016 in the municipality of Rondonopolis, a relevant endemic area for VL in Central-Western Brazil. Human VL cases were georeferenced and point patterns were analyzed by univariate Ripley's K function and Kernel density estimation (KDE). Poisson-based scan statistics were used to investigate spatial and spatiotemporal clusters of human VL incidence at the neighborhood level. Socioeconomic and environmental characteristics were compared between neighborhoods within and outside spatial human VL clusters. Also, we assessed the correlation between smoothed human VL incidence and canine VL seropositivity rates within and between neighborhoods. Human VL cases were clustered up to 2000 m; four hotspots were identified by KDE in peripheral areas. Spatial and spatiotemporal low-risk clusters for human VL were identified in central and southern areas. Neighborhoods within spatial low-risk cluster presented higher mean income, literacy rate, sanitary sewage service coverage and lower altitude, compared to the rest of the municipality. A positive correlation was found between the occurrence of human and canine VL. On the northern outskirts, high human VL incidence was spatially correlated with high canine VL seropositivity in surrounding neighborhoods. In conclusion, human VL demonstrated a heterogeneous, aggregated and peripheral spatial pattern. This distribution was correlated with intra-urban socioeconomic differences and canine VL seropositivity at the neighborhood level.

Introduction: This cross-sectional study evaluated the impact of socioeconomic status on the knowledge, attitudes, and practices (KAP) concerning zoonotic visceral leishmaniasis (VL) among dog owners from the municipality of Rondonópolis—a highly endemic area for the disease in Central-Western Brazil. Methodology: Data were collected between 2016 and 2017 during a household survey. A probabilistic sample of 404 dog owners were interviewed assessing sociodemographic characteristics, previous occurrence of VL cases, and KAP about human VL, vector, and canine VL. Responses regarding KAP were compared among social classes, which are indicators of socioeconomic status. Correct/appropriate answers were scored, and a multivariate Poisson regression analysis evaluated the impact of social class on scoring. Results: The overall KAP regarding VL was limited. Dog owners from higher social classes differed from those of the lower classes regarding the recognition of abdominal distension (p = 0.026) and skin lesions (p < 0.001) as clinical manifestations of human and canine VL, respectively, knowledge of VL transmission (p = 0.020), use of topical repellents (p < 0.001), use of insecticide-impregnated collars (p = 0.003), and previous attempts of treatment for canine VL (p = 0.005). Higher scores were associated with the upper social classes (IRR = 1.18; CI = 1.08-1.29) adjusted by the age (IRR = 1.13; CI = 1.04-1.24) and the previous occurrence of human (IRR = 1.21; CI = 1.07-1.36) and canine (IRR = 1.25; CI = 1.14-1.36) VL in the household/neighbourhood of the respondents. Conclusions: Improved KAP concerning VL was associated with better socioeconomic status of dog owners.

Introduction: birth defects and congenital anomalies include a variety of pathologies that affect 2-3% of all newborns, with craniofacial birth defects (CFBD) such as neural tube defects (NTD) and orofacial clefts (OFC), being some of the most prevalent congenital anomalies in children. Since an individual may be exposed to pollutants present in the workplace, and at the same time, the population may be exposed to multiple sources of environmental contamination (for example water, soil and air) and socioeconomic deprivation, assess the possible association between environmental exposures, both at the individual and area level, it could improve the understanding of how these variables would affect pregnant women and the developing fetus. To provide an overview about updated information related to those factors and its association with NTD and OFC, we consider performing a scoping review. The aim of this publication is to present a scoping review protocol about the relationship between environmental exposures and the etiology of CFBD. Methods and analysis: the identification of the papers for this review was done through a search strategy using MeSH vocabulary, in the electronic database PUBMED MEDLINE and SCIELO. Additionally, we performed a gray literature search using Google Scholar. All the selected studies for the review were subjected to methodological quality assessment, according to the Joanna Briggs Institute protocol for scoping reviews. Ethics and dissemination: a paper summarizing the findings from this review will be published in a peer-reviewed journal. Ethical approval is not required.

The Brazilian municipality of Rondonópolis is an emerging urban focus of intense transmission of visceral leishmaniasis (VL), where few investigations have addressed canine reservoirs. This study assessed the seroprevalence and spatial distribution of canine visceral leishmaniasis (CVL) in the urban area of Rondonópolis. A CVL serosurvey was conducted between October 2016 and February 2017 using an immunochromatographic rapid test and enzyme-linked immunosorbent assay. Domestic dogs were sampled from 25 heterogeneous regions previously defined by the Spatial ‘K’luster Analysis by Tree Edge Removal algorithm, which considered the socioeconomic and environmental features from the last demographic census. The CVL spatial distribution was analyzed by kernel density estimation (KDE) and spatial scan statistic. All the autochthonous human VL cases reported between 2014 and 2016 were georeferenced. Of the 600 dogs tested, 115 were seropositive in both tests. The overall CVL prevalence was 19.2% (95%CI: 16.1–22.3%), which varied widely among the evaluated regions (0.0–35.1%). Almost 25% of the sampled households (n = 405) had at least one infected dog. KDE demonstrated that positive CVL households were concentrated in the peripheral areas of the city. Spatial scan statistics detected a spatial cluster with significantly low CVL prevalence in the central region (relative risk = 0.37; p = 0.04), where only one human VL case was reported. Thus, we demonstrated a high prevalence of CVL in domestic dogs from diverse socioeconomic and environmental urban contexts in Rondonópolis. The CVL cases were peripherally distributed and occurred more frequently in areas that had reported human VL.

Objective: To investigate the prevalence of intestinal parasitic infections and the associated risk factors in children attending preschools located in areas with different socioeconomic and structural features in the city of Rondonópolis, State of Mato Grosso, Brazil. Methods: A cross-sectional survey was conducted between 2015 and 2016 among four-to-five years old children. Initially, urban neighborhoods with preschools were classified into five risk strata for parasitic infections, which were defined on the basis of socioeconomic and structural variables. Then, one school from each stratum was randomly chosen for data collection. After obtaining the written informed consent from parents or guardians, the children provided stool samples for examination. Interviews were conducted with parents or guardians to determine the associated risk factors. Results: Coproparasitological tests were performed on 215 (46.5%) preschoolers, and the overall prevalence was 22.8%. The occurrence of such infections increased with the increase in risk stratum of the neighborhood. Protozoa infections, mainly by Entamoeba coli (11.2%) and Giardia duodenalis (9.8%), were the most frequent. The consumption of tap water (OR = 3.56, P = 0.002), no washing of fruits and vegetables before consumption (OR = 3.44, P = 0.002), and no hand washing before eating (OR = 2.63, P = 0.004) were associated with these infections. Conclusions: The prevalence of intestinal parasites among Rondonópolis preschoolers is relevant and associated with precarious hygienic–sanitary behavior, especially in areas with poor socioeconomic and structural conditions.

Objective: The present study aimed to evaluate the presence of helminthes and intestinal protozoa in vegetables commercialized in Diamantina, a municipality located at Jequitinhonha Valley, one of the poorest regions of the world. Methods: A total of 108 specimens, including lettuce, green onion and rocket, were monthly collected from the most popular open street market, green grocery and supermarket of the municipality. The samples were processed by a concentration method and evaluated by light microscopy for parasitological identification. Results: The percentage of contamination was 50.9% (55/108), with predominance of nematode larvae (36.5%), cysts of Entamoeba coli (26.0%) and eggs of hookworms/Strongyloides spp. (12.9%). Lettuce showed greater contamination rate (61.1%) and samples from the open street market were more contaminated (77.8%). Information collected at each point of sale pointed the field cultivation as the critical step for such contaminations. Conclusion: Vegetables marketed in Diamantina presents a wide variety of intestinal parasites, which may represent a potential risk to the health of consumers of fresh vegetables.

Background Timely diagnosis is recommended by the Brazilian Visceral Leishmaniasis (VL) Surveillance and Control Program to reduce case fatality. Attempts at assessing this topic in Brazil are scarce. Objective This study aimed to describe where, when, and how the diagnosis of VL has been performed in a Brazilian endemic setting. Methods Data of all autochthonous cases confirmed between 2011 and 2016 (N = 81) were recorded. The care-seeking itinerary until the confirmation of VL diagnosis was assessed among 57 patients. Findings The majority of VL cases (79.1%) were reported by referral hospitals. The patients mainly sought primary health care centres at the onset of symptoms. However, they had to visit seven health services on average to achieve a confirmed diagnosis. The time from the onset of symptoms to the diagnosis of VL (TD) ranged from 1-212 (median, 25) days. The TD was longer among adult patients. There was a direct correlation between the patient's age and TD (r = 0.22; p = 0.047) and a higher occurrence of deaths due to the disease among older patients (p = 0.002). Almost all the patients (98.9%) underwent laboratory investigation, and the VL diagnosis was mainly confirmed based on clinical-laboratory criteria (92.6%). Positive results for the indirect fluorescence antibody test (22.7%) and parasitological examination plus rk39-based immunochromatographic tests (21.3%) were commonly employed. Main conclusions VL diagnosis was predominantly conducted in hospitals with a long TD and wide application of serology. These findings may support measures focused on early diagnosis, including a greater involvement of the primary health care system.

Autoimmune diseases lead to numerous limiting conditions. Their incidence and prevalence are known to be affected by several factors; and there is an absence of data in areas of economic vulnerability. The aim of this study was to access the epidemiological profile of autoimmune diseases in the public health system of the microregion of health of Águas Formosas, and to evaluate possible factors involved in the development of these diseases. This was an epidemiological study with a cross-sectional, survey-type, descriptive and exploratory. All patients were selected according to the inclusion criteria, and individual interview was conducted during home visits to apply a sociodemographic questionnaire with 20 variables associated with autoimmune diseases. In this study, it was observed that the municipalities of Machacalis, Umburatiba and Crisólita exhibited prevalence of autoimmune diseases above 90 cases per 10,000 of the population, and the other municipalities showed prevalence between 50 and 60 cases. In the microregion, a total of 407 cases of autoimmune diseases were observed, distributed in 24 different diseases, with a general prevalence of 673.69/100,000 of the population. Hashimoto's Thyroiditis, Graves' Disease, Vitiligo, Rheumatoid Arthritis, Psoriasis, Type 1 Diabetes Mellitus and Systemic Lupus Erythematosus, represent 47% of the cases. This was the first study that addresses the prevalence of autoimmune diseases in the microregion. The lack of registration or diagnosis is a factor that needs to be overcome in new studies to improve the knowledge of autoimmune diseases in this region. Las enfermedades autoinmunes conducen a numerosas condiciones limitantes. Se sabe que su incidencia y prevalencia se ven afectadas por varios factores; y hay una ausencia de datos en áreas de vulnerabilidad económica. El objetivo de este estudio fue acceder al perfil epidemiológico de las enfermedades autoinmunes en el sistema de salud pública de la microrregión de salud de Águas Formosas, y evaluar posibles factores involucrados en el desarrollo de estas enfermedades. Se trata de un estudio epidemiológico de tipo transversal, tipo “survey”, descriptivo y exploratorio. Todos los pacientes fueron seleccionados de acuerdo con los criterios de inclusión y se realizó una entrevista individual durante las visitas domiciliarias para aplicar un cuestionario sociodemográfico con 20 variables asociadas a enfermedades autoinmunes. En este estudio se observó que los municipios de Machacalis, Umburatiba y Crisólita exhibieron prevalencias de enfermedades autoinmunes por encima de 90 casos por 10,000 de la población, y los demás municipios mostraron prevalencias entre 50 y 60 casos. En la microrregión se observaron un total de 407 casos de enfermedades autoinmunes, distribuidos en 24 enfermedades diferentes, con una prevalencia general de 673,69 / 100.000 habitantes. Tiroiditis de Hashimoto, Enfermedad de Graves, Vitiligo, Artritis Reumatoide, Psoriasis, Diabetes Mellitus Tipo 1 y Lupus Eritematoso Sistémico, representan el 47% de los casos. Este fue el primer estudio que aborda la prevalencia de enfermedades autoinmunes en la microrregión. La falta de registro o diagnóstico es un factor que debe superarse en nuevos estudios para mejorar el conocimiento de las enfermedades autoinmunes en esta región. As doenças autoimunes levam a várias condições limitantes. Sabe-se que sua incidência e prevalência são afetadas por vários fatores; e há uma ausência de dados em áreas de vulnerabilidade econômica. O objetivo deste estudo foi acessar o perfil epidemiológico das doenças autoimunes no sistema público de saúde da microrregião de saúde de Águas Formosas, e avaliar os possíveis fatores envolvidos no desenvolvimento dessas doenças. Trata-se de um estudo epidemiológico de corte transversal, do tipo survey, descritivo e exploratório. Todos os pacientes foram selecionados de acordo com os critérios de inclusão, sendo realizada entrevista individual em visita domiciliar para aplicação de questionário sociodemográfico com 20 variáveis associadas a doenças autoimunes. Neste estudo, observou-se que os municípios de Machacalis, Umburatiba e Crisólita exibiram prevalências de doenças autoimunes acima de 90 casos por 10.000 habitantes, e os demais municípios apresentaram prevalências entre 50 e 60 casos. Na microrregião, foram observados 407 casos de doenças autoimunes, distribuídos em 24 doenças diferentes, com prevalência geral de 673,69 / 100.000 na população. Tireoidite de Hashimoto, Doença de Graves, Vitiligo, Artrite Reumatoide, Psoríase, Diabetes Mellitus tipo 1 e Lúpus Eritematoso Sistêmico representam 47% dos casos. Este foi o primeiro estudo que abordou a prevalência de doenças autoimunes na microrregião. A falta de registro ou diagnóstico é um fator que precisa ser superado em novos estudos para aprimorar o conhecimento das doenças autoimunes nessa região.

Reports of triatomine infestation in urban areas have increased. We analysed the spatial distribution of infesta-tion by triatomines in the urban area of Diamantina, in the state of Minas Gerais, Brazil. Triatomines were obtainedby community-based entomological surveillance. Spatial patterns of infestation were analysed by Ripley?s K func-tion and Kernel density estimator. Normalised difference vegetation index (NDVI) and land cover derived from sat-ellite imagery were compared between infested and uninfested areas. A total of 140 adults of four species were cap-tured (100 Triatoma vitticeps, 25 Panstrongylus geniculatus, 8 Panstrongylus megistus, and 7 Triatoma arthurneivaispecimens). In total, 87.9% were captured within domiciles. Infection by trypanosomes was observed in 19.6% of 107examined insects. The spatial distributions of T. vitticeps, P. geniculatus, T. arthurneivai, and trypanosome-positivetriatomines were clustered, occurring mainly in peripheral areas. NDVI values were statistically higher in areasinfested by T. vitticeps and P. geniculatus. Buildings infested by these species were located closer to open fields,whereas infestations of P. megistus and T. arthurneivai were closer to bare soil. Human occupation and modificationof natural areas may be involved in triatomine invasion, exposing the population to these vectors. Fil: Dias, João Victor Leite. Instituto Oswaldo Cruz; Brasil Fil: Queiroz, Dimas Ramon Mota. Universidade Federal dos Vales do Jequitinhonha e Mucuri; Brasil Fil: Martins, Helen Rodrigues. Universidade Federal dos Vales do Jequitinhonha e Mucuri; Brasil Fil: Gorla, David Eladio. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Córdoba. Instituto Multidisciplinario de Biología Vegetal. Universidad Nacional de Córdoba. Facultad de Ciencias Exactas Físicas y Naturales. Instituto Multidisciplinario de Biología Vegetal; Argentina Fil: Pires, Herton Helder Rocha. Universidade Federal dos Vales do Jequitinhonha e Mucuri; Brasil Fil: Diotaiuti, Liléia. Instituto Oswaldo Cruz; Brasil

The Brazilian municipality of Rondonópolis, Mato Grosso State, represents an important visceral leishmaniasis (VL) endemic area. This study described epidemiological and clinical aspects of the occurrence, VL/HIV coinfection and lethality related to VL in Rondonópolis. Data from autochthonous cases reported between 2011 and 2016 were obtained from official information systems. During this period, 81 autochthonous cases were reported, with decreasing incidence through 2016. Contrastingly, the lethality rate was 8.6% overall, but varied widely, reaching a peak (20%) in 2016. Almost 10% of patients had VL/HIVcoinfection. The occurrence of VL prevailed among men (56.8%), brown-skinned (49.4%), urban residents (92.6%), aged 0-4 years (33.3%). Housewives or retired (29.6%) were the most affected occupational groups. Lower age was the main difference among the total VL cases and those who were coinfected or died. Clinically, fever, weakness and splenomegaly were more frequent among all VL cases and VL/HIV coinfected individuals. Bacterial infections (p=0.001) and bleeding (p

Introduction This work aimed to analyze the triatomine infestation scenario in Jaboticatubas after 30 years of the uninterrupted actions of the Program of Chagas Disease Control. Methods From 2007 to 2010, household unit infestation was researched, and an exploratory analysis of the localities infested with Panstrongylus megistus was performed. Results In total, 613 triatomines were captured in 78 households, the majority of which were Panstrongylus megistus and were captured mainly in chicken houses, but they were also found to be colonizing human houses. Conclusions The epidemiological importance of Panstrongylus megistus was confirmed in Jaboticatubas, and capability to colonize indoors has been demonstrated, as has its proximity to humans. Its distribution is aggregated in the northern and in central-eastern regions of the municipality.

Com a queda na mortalidade, têm-se investido no monitoramento do crescimento e desenvolvimento infantil. Este estudo objetivou investigar o crescimento, desenvolvimento e condições sanitárias peridomiciliares por meio do geoprocessamento. Participaram 92 crianças de 24 a 36 meses, de creches públicas de um município do Jequitinhonha O índice Estatura/Idade representou o crescimento e os domínios cognitivo e linguagem do Bayley III foram os indicadores para desenvolvimento. As casas e creches foram georeferenciadas e um mapa do território da sede municipal, dividido em áreas de Estratégia de Saúde da Família, foi criado. Dados do Sistema de Informação de Atenção Básica definiram as condições sanitárias das áreas e um questionário socioeconômico traçou o perfil das famílias. Predominaram famílias da classe econômica D, cujos pais não completaram o segundo grau. Identificou-se um percentual de 15,2% déficit de crescimento, 28,3% e 28,5% respectivamente, de desenvolvimento cognitivo e de linguagem expressiva abaixo da média. Não houve coincidência entre a distribuição geográfica dos agravos crescimento e desenvolvimento com as áreas de pior condição sanitária. Porém, foi possível visualizar os territórios desassistidos por creches públicas, aqueles que necessitam de maior intervenção quanto aos agravos investigados e áreas com ambientes sanitários precários. O geoprocessamento confirmou-se como ferramenta importante para uso de gestores municipais de saúde.

INTRODUCTION: Triatomines are targeted for the control of Chagas disease in endemic areas of Brazil. METHODS: Data regarding triatomines captured during 2001-2008 in 34 municipalities in the Northeast of Minas Gerais were analyzed. RESULTS: In total, 11,187 triatomines from eight species were captured, mostly in henhouses and bedrooms. Trypanosomes were found in 203 samples. Main species were Triatoma sordida, Panstrongylus megistus, and Triatoma vitticeps. The number of P. megistus adults was positively correlated with temperature and precipitation, whereas the number of nymphs followed the inverse pattern. CONCLUSIONS: Occurrence of triatomines in domiciles indicates the need for sustained entomological surveillance.

This study aimed to analyse the spatial distribution of human (2007-2013) and canine (2013) visceral leishmaniasis (VL) in the city of Araçuaí, Minas Gerais, Brazil, and identify the socio-environmental factors related to their occurrence. The spatial distribution of human and canine cases was analysed by kernel density estimation (KDE) and the K function. The KDE values were analysed for correlation between human and canine LV and for normalised difference vegetation index (NDVI). Socio-environmental aspects of household structures and surroundings were evaluated. The spatial distribution of human and canine VL cases exhibited a significant aggregated pattern in distances greater than 350 and 75 m, respectively. The higher occurrence of human and canine infection occurred in the central area of the city. A positive correlation between the densities of human and canine cases was observed, as well as a negative correlation between NDVI and densities of human and canine cases. Socio-environmental analysis revealed that the large amount of animals, organic material from trees and deficiencies in environmental sanitation are possibly contributing to the continuation of the transmission cycle of Leishmania infantum in Araçuaí. These results can contribute to the planning by competent agencies to reduce the incidence of infection in the city.

Community participation is the main strategy to sustainability of Chagas disease entomological surveillance. The purpose of this study was to evaluate the level of knowledge on triatomine insects and Chagas disease among the residents from eight localities of Diamantina, in Minas Gerais, with a view to observing any associations between their knowledge and infestations by triatomines. In order to evaluate this knowledge, questionnaires were used containing both closed and open questions. They were applied to 583 residents who were ten years old or over. To establish if they could recognize the triatomine insect, they were given samples to look at. The responses to the closed questions were analyzed with reference to any frequencies of and associations with infestations involving this insect. The responses to the questions were organized into different thematic areas and were descriptively analyzed. Although the resident’s ability to recognize the triatomine insect was not associated with the infestation of the localities, the residents in the areas that had higher infestations showed that they had a good knowledge of the available support services and the need to send the insects to them. We did not observe any associations between triatomine infestations and knowledge of Chagas disease. The results of this study can provide guidance on education that can be given by the health services to the community in order to encourage them to provide notifications of the triatomine insects.

O presente relato apresenta reflexões sobre as ações desenvolvidas ao longo de oito por Grupo de Extensão e Pesquisa da Universidade Federal dos Vales do Jequitinhonha e Mucuri em uma comunidade remanescente de quilombo do município de Diamantina, Minas Gerais. As atividades propostas permitiram o envolvimento direto da equipe envolvida no cotidiano da comunidade, sendo esse convívio constante reconhecido pelos moradores que, por sua vez demonstram confiança nos integrantes do grupo e os acolhem como mais que puramente pesquisadores, antes como entes contribuintes para a comunidade. Essa relação de confiança brindou a equipe com a incumbência de organizar a festa dos padroeiros, honraria até então partilhada somente entre os moradores ou pessoas com ascendência local.Finalmente, discute-se a importância de um vínculo de longo prazo e o retorno das informações como ações junto à comunidade em projetos de natureza extensionista.

Community participation is the main strategy to sustainability of Chagas disease entomological surveillance. The purpose of this study was to evaluate the level of knowledge on triatomine insects and Chagas disease among the residents from eight localities of Diamantina, in Minas Gerais, with a view to observing any associations between their knowledge and infestations by triatomines. In order to evaluate this knowledge, questionnaires were used containing both closed and open questions. They were applied to 583 residents who were ten years old or over. To establish if they could recognize the triatomine insect, they were given samples to look at. The responses to the closed questions were analyzed with reference to any frequencies of and associations with infestations involving this insect. The responses to the questions were organized into different thematic areas and were descriptively analyzed. Although the resident's ability to recognize the triatomine insect was not associated with the infestation of the localities, the residents in the areas that had higher infestations showed that they had a good knowledge of the available support services and the need to send the insects to them. We did not observe any associations between triatomine infestations and knowledge of Chagas disease. The results of this study can provide guidance on education that can be given by the health services to the community in order to encourage them to provide notifications of the triatomine insects.

Control of Chagas disease is based on insecticide spraying in domiciles in order to exterminate triatomine populations. However, since the vectors differ in susceptibility to currently used insecticides, the screening of the toxic potential of Brazilian flora may identify new molecules lethal to triatomines. This study evaluated the toxicity of ethanolic extract of Ageratum fastigiatum (Gardner) R.M. King & H. Rob., Asteraceae, on Rhodnius nasutus, a known vector of Chagas disease. Ethanolic extracts of the aerial parts of A. fastigiatum were prepared at 25 and 50 mg/mL concentrations, and 5 μL was applied to fifth-instar nymphs of R. nasutus (n=30). Controls included nymphs that were treated with 5 μL ethanol (n=30) or left untreated (n=30). The percentage of dead insects in each group was observed at 24, 48, 72, 96 and 120 h after application. The extracts of A. fastigiatum showed a mortality rate of about 37% and 77% after 120 h, at concentrations of 25 and 50 mg/mL, respectively. In control groups, the mortality rate remained under 7%. The extract of A. fastigiatum contains a coumarin, a molecule with recognized toxicity in insects, and which may be responsible for killing the triatomines. Keywords: Ageratum fastigiatum ;insecticidal activity ;Triatominae