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Os Programas de Planejamento Familiar vêm se preocupando predominantemente com a população feminina. Este estudo objetivou determinar o grau de conhecimento dos homens de uma comunidade rural do Estado da Bahia, Brasil, sobre os métodos contraceptivos. Dentre os 179 entrevistados, a preocupação com a prevenção de gravidez indesejada foi referida como responsabilidade do casal por 39,7% (n = 71) e do homem por 26,8% (n = 48). Os métodos mais conhecidos foram a "camisinha" (98,9%) e a pílula (96,6%), sendo os mais usados a "camisinha" (22,9%), a laqueadura (21,2%) e a pílula anticoncepcional (12,8%). A maioria (56,4%) referiu "sempre" utilizar contraceptivo. A opção pelo método é feita pelo homem em 45,6% dos casais. Estes resultados indicam a necessidade da promoção do maior número de métodos contraceptivos, possibilitando ao casal a melhor opção que se adeque ao comportamento sexual do mesmo. Também, há necessidade de priorizar a participação do casal nos Programas de Planejamento Familiar, na medida em que ainda são os homens quem predominantemente acabam determinando o método contraceptivo utilizado.

Em amostra da população da cidade de Rio Branco (Acre), foi pesquisada a freqüência de portadores de anticorpos contra os arbovírus, mais prevalentes na região amazônica, e o vírus vacinal da febre amarela, antes e após a imunização com a vacina 17D. Das 390 pessoas incluídas na primeira fase do estudo (agosto de 1999), somente 190 compareceram em janeiro de 2000, três meses após a aplicação da vacina 17D (outubro de 1999). Nas amostras da primeira fase, as freqüências de soropositivos (IH) para os vírus estudados foram: 17D (27,2%); Dengue-1 (0,3%); Dengue-2 (4,1%); Dengue-3 (0%); Dengue-4 (0%), entre outros 8 vírus. Nas amostras séricas de janeiro (2000), a soroconversão para o 17D foi de 89,7% (130/145) e 3,2% (6/190) passaram a ter anticorpos contra o sorotipo 3 (DEN-3). Em conclusão, por conta da elevada taxa de cobertura vacinal e de soroconversão há redução significativa do risco de urbanização do vírus da febre amarela na cidade de Rio Branco, apesar de não ser desprezível a possibilidade de uma nova epidemia de dengue, pelo DEN-3, a semelhança da registrada em 2000 e 2001 pelos sorotipos 1 e 2.

Objetivando verificar a freqüência de enterovírus (EV), leptospiras e arbovírus como agentes causais da síndrome da meningite asséptica (SMA), em períodos não-epidêmicos, e comparar os pacientes com e sem diagnóstico etiológico determinado, foram selecionados 112 pacientes de idade entre 3 meses e 15 anos, com suspeita clínica de SMA, referenciados para Hospital Couto Maia, especializado em Doenças Infecciosas e Parasitárias (Salvador, Bahia), Em 44,6% (n=50) a etiologia foi determinada: enterovírus em 37,7% (n=42) dos casos, pelo teste de PCR Amplicor, por cultura do líquor e/ou de fezes; a Leptospira sp. em 7,1% (n=8), pelo método da micro-aglutinação, e nenhum caso de arbovírus foi detectado (inibição da hemaglutinação passiva). Entre os 14 enterovírus dos 22 isolados, foram identificados seis diferentes sorotipos, sendo o Echovirus-4 predominante (27,2%; 6/22) entre outros (Coxsackie B2, B3, B6 e B9; EV 71). Conclui-se que, os enterovírus foram os agentes mais freqüentes, e que a leptospirose deve ser lembrada no diagnóstico diferencial da SMA. Uma vez que as características clínicas e liquóricas dos pacientes dos grupos com e sem determinação do agente etiológico foram semelhantes, pode-se supor que o diagnóstico presuntivo de SMA é de provável etiologia viral ou pela leptospira.

Evaluating tetanus immune status is not yet the usual clinical practice regarding patients with chronic ulcers or myasis. However, of 858 tetanus patients at Hospital Couto Maia (Salvador, Bahia, Brazil) aged 1 year or above, 2 had pressure ulcers and 17 had chronic ulceration of the lower limbs where these skin lesions were the ports of entry for Clostridium tetani. In these 19 cases, the following predisposing factors were described: venous insufficiency (n=6), sickle cell anemia (n=2), Hansen's disease (n=1), malnutrition (n=1), diabetes mellitus (n=1), trauma (n=1) and unknown factors (n=7). In 6 other cases, in addition to the Hansen's disease patient, the port of entry for tetanus was the site of extraction of Tunga penetrans larvae. In these 25 cases, the majority of patients (68%) were over 40 years old (17/25) and all of these patients stated that they had either not followed a tetanus toxoid vaccination regimen (19/25), or had partially completed such a regimen, or did not give precise information (6/25). Among the same series studied, over half (52%) of the patients died (13/25). We conclude that tetanus prevention must be included in the treatment of chronic skin ulcer patients, vaccination coverage should be increased among older people, and strategies aimed at improving coverage for all age groups must be reviewed.

A ocorrência de casos de febre amarela (FA) e a ampla distribuição do A. aegypti no Brasil, motivou o estudo da estimativa da proteção imune contra o vírus amarílico vacinal (17D) em moradores de duas cidades do Estado da Bahia, Ipupiara (n = 461) e Prado (n = 228). Nesta área não-endêmica de FA, a pesquisa de anticorpos séricos contra o 17D (Ac17D) e contra 18 outros arbovírus, foi realizada pelo método da inibição da hemaglutinação (IH). Somente 1,2% (8/689) dos indivíduos apresentaram Ac17D, sendo seis com resposta monotípica. A resposta sorológica do tipo heterotípica para Flavivírus (FLV) foi interpretada também como associada à resposta imune ao 17D, sendo mais freqüente em Prado (30,3%) do que em Ipupiara (23,2%). A idade > ou = 50 anos e moradia em outros Estados foram associadas com a soropositividade para FLV, do mesmo modo que a história de vacinação (17D). Mas, a história de vacinação apresentou baixos percentuais de sensibilidade (£ 45,4%) e de valor preditivo-positivo ( ou = 70,8%) e do valor preditivo-negativo ( > ou = 78,8%). Em conclusão, foi baixa a freqüência (1,2%) de moradores com Ac17D, apesar da freqüência maior (25,5%) de portadores de anticorpos FLV, o que significa que 26,7% da população estudada pode apresentar proteção contra o vírus da FA.

Realizou-se inquérito sorológico para pesquisar anticorpos neutralizantes contra o vesiculovírus Piry, na cidade de Catolândia-Bahia-Brasil. Duas técnicas de vírus-neutralização foram comparadas em cultura das células C6/36, com revelação pelo método imunoenzimático ( TN-C6/36) e em camundongos recém-nascidos (TN-camundongos), que é considerada a prova maior. Em 204 soros, dos 1 .274 colhidos, a concordância das duas técnicas foi de 98,7% (K= 0,9853). Com este resultado do TN-C6/36, que também é mais exeqüível, decidiu-se desenvolver o estudo soro-epidemiológico do vesiculovírus Piry, em Catolândia, baseado nesta nova técnica.

The World Health Organization (WHO) issued guidelines for the regulatory evaluation of biosimilars in 2009 and has provided considerable effort toward helping member states implement the evaluation principles in the guidelines into their regulatory practices. Despite this effort, a recent WHO survey (conducted in 2019-2020) has revealed four main remaining challenges: unavailable/insufficient reference products in the country; lack of resources; problems with the quality of some biosimilars (and even more with noninnovator products); and difficulties with the practice of interchangeability and naming of biosimilars. The following have been identified as opportunities/solutions for regulatory authorities to deal with the existing challenges: (1) exchange of information on products with other regulatory authorities and accepting foreign licensed and sourced reference products, hence avoiding conducting unnecessary (duplicate) bridging studies; (2) use of a "reliance" concept and/or joint review for the assessment and approval of biosimilars; (3) review and reassessment of the products already approved before the establishment of a regulatory framework for biosimilar approval; and (4) setting appropriate regulatory oversight for good pharmacovigilance, which is essential for the identification of problems with products and establishing the safety and efficacy of interchangeability of biosimilars., (© 2020 The Authors. Annals of the New York Academy of Sciences. The World Health Organization retains copyright and all other rights in the manuscript of this article as submitted for publication.)

Context and Objective: The lack of a clear definition for human "race" and the importance of this topic in medical practice continue to create doubt among scholars. Here, we evaluate the use of the variable "race" by medical students in Salvador, Brazil., Design and Setting: Cross-sectional study at a Brazilian federal public university., Methods: 221 randomly selected subjects were included. A semi-structured questionnaire was used for data collection. The results were expressed as means and standard deviations of the mean, proportions and frequencies. The χ2 (chi-square) test was used for the statistical calculations., Results: Approximately half of the students (45.4%) used the racial group variable in their studies on clinical practice. Of these, 86.8% considered it to be relevant information in the medical records and 92.7%, important for diagnostic reasoning; 95.9% believed that it influenced the cause, expression and prevalence of diseases; 94.9% affirmed that it contributed towards estimating the risk of diseases; 80.5% thought that the therapeutic response to medications might be influenced by racial characteristics; 41.9% considered that its inclusion in research was always recommendable; and 20.3% thought it was indispensable. The main phenotypic characteristics used for racial classification were: skin color (93.2%), hair type (45.7%), nose shape (33.9%) and lip thickness (30.3%)., Conclusions: Despite the importance of different racial groups in medical practice, the majority of the professionals do not use or know how to classify them. It is necessary to add to and/or expand the discussion of racial and ethnic categories in medical practice and research.

Objective: To evaluate the Brazilian journals cited by the four CAPES medical areas, qualified as 'A' national or 'I' international, regarding the relevance given to ethics in the instructions for authors., Methods: The instructions for authors of twenty Brazilian journals were studied and 36 types of ethical concerns were identified allowing the following categorization: I - Ethics in human research; II - Scientific integrity; III - Editorial policy., Results: The results on Category I show that the most frequent instructions (50%) requires previous approval of the research by a institutional Ethics Committee (CEP), followed by indication on how to cite this approval in the body of the article (35%), plus presentation of a copy of the CEP approval (30%). However, none advert on the importance of the CEP being recognized by the CONEP. On Category II, 55% of the journal require declarations of conflict of interest, and 40% of them inquire about the type of interest; however, all (100%) journal do not mention prevention conflict of interests between authors and peer reviewers, neither on frauds, plagiarisms or data fabrication. Finally, in Category III, 65% of the journals require the authors to transfer publications rights to them, while the remaining 35% do not mention copyright, Conclusion: These results are discussed in relations to the Brazilian present situation regarding ethics in the scientific production of researches using human subjects for the prevention of scientific dishonesty.

To determine the seroprevalence of HTLV-1 in Brazil, and to review the virus molecular epidemiology in this Amazon population (Rio Branco-Acre), 219 blood donors were screened for HTLV-1. Only one case of infection (0.46% seroprevalence) was detected during July 2004 screening at the Acre Hospital Foundation (FUNDACRE). Neighbor-joining and Maximum Likelihood phylogenetic analyses of two (n = 2) complete LTR region sequences were performed with the PAUP* software. Since the HTLV-1 envelope surface (gp46) and transmembrane (gp21) glycoproteins are important for virus fitness, three envelope glycoproteins sequences (n = 3) were analyzed using the Prosite tool to determinate potential protein sites. Phylogenetic analysis demonstrated that the new isolate described in this study, and the unpublished LTR strain described in a previous report belong to the Transcontinental subgroup of the Cosmopolitan subtype, inside the Latin American cluster. A similar result was obtained when submitting, to the Automated Genotyping System, three LTR partial sequences from a previous study of the seroprevalence of HTLV-1 in the same Amazon population. In all analyzed env sequences, the potential protein site was found: two PKC phosphorylation sites at amino acid (aa) positions 310-312 and 342-344, one CK2 phosphorylation site at 194-197aa, three N-glycosylation sites at 222-225aa, 244-247aa and 272-275aa, and a single N-myristylation site at 327-338aa. In conclusion, potential protein sites described in HTLV-1 gp46 and gp21 confirm the presence of conserved sites in the HTLV-1 envelope proteins, likewise phylogenetic analysis suggests a possible recent introduction of the virus into North Brazil., (2008 Wiley-Liss, Inc.)

A sentinel study on viral hepatitis is currently being carried out in the village of Cavunge in a semiarid rural region of the state of Bahia, northeastern Brazil. This study has identified individuals in whom anti-HBc IgG was the only serological marker for hepatitis B virus (HBV). This serological pattern may constitute evidence of occult HBV infection. This study Investigated the possibility of occult hepatitis B virus infection in individuals in a rural community who tested positive for anti-HBc IgG alone. A cross-sectional population-based study. ELISA III was performed on serum samples to test for serological viral markers, and ultrasensitive PCR (US-PCR) was used to assess viremia. Among the 1,536 serum samples, 3.6% (n=55) were positive for anti-HBc alone. Four years after this first serological survey, 31 of those 55 individuals (56.3%) were retested, and 11 (35.5%) remained anti-HBc positive alone. Two of these 31 (6.5%) were HBV-DNA positive based on US-PCR, with normal aminotransferase levels in both cases. Cases of occult hepatitis B infection were identified in this semiarid rural community of northeastern Brazil, where endemicity of HBV is moderate.

Unlabelled: Visceral Leisshimaniosis or Kalazar is a parasitic infection caused by Leishimania Donovani subspecies. It is transmitted by phlebotomineos and may lead to liver and spleen enlargements as well as immunological impairment. Sometimes it is described liver injury simulating acute or chronic viral hepatitis and even portal hypertension. The liver injury makes difficult the diffencial diagnosis of Kalazar and other liver diseases in endemic regions., Objective: To define and clarify the liver injury spectrum described in published cases reports., Methods: Systematic revision of published data on Kalazar and liver injury using the following databank: LILACS, MEDLINE and EMBASE. Only paper published in French, English, Portuguese and Spanish were taken into consideration. The procedures for systematic review recommended by the NHS Centre for Reviews and Dissemination, University of Cork, were adopted. The paper quality classification was based on the number of reported variables previously defined in our study, Results: Only 11/28 (55%) publications were included in our analysis because they filled the minimal required data. Acute and chronic liver disease were well documented in these articles. Serum albumin and prothombine time were associated with severity of liver disease (P < .05)., Conclusion: "Liver involvement, even when it is severe, may occur at tha begining of the disease. Kalazar should be considered as a differential diagnosis of cholestasis, acute and chronic liver injury as well as portal hypertension in children.

This work presents the dynamic simulation of the thermal decomposition of nitrogen trichloride (NCl(3)) during electrolytic chlorine (Cl(2)) production, using an industrial plant as a case study. NCl(3) is an extremely unstable and explosive compound and the decomposition process has the following main problems: changeability of the reactor temperature and loss of solvent. The results of this work will be used to establish a more efficient and safe control strategy and to analyze the loss of solvent during the dynamic period. The implemented model will also be used to study the use of a new solvent, considering that currently used solvent will be prohibited from commercial use in 2010. The process was simulated by using the commercial simulator Aspen and the simulations were validated with plant data. From the results of the simulation it can be concluded that the rate of decomposition depends strongly on the temperature of the reactor, which has a stronger relationship to the liquid Cl(2) (reflux) and gaseous Cl(2) flow rates which feed the system. The results also showed that the loss of solvent changes strongly during the dynamic period.

In the village of Cavunge, located in a dry tropical, semiarid rural region of the state of Bahia, Brazil, a sentinel study on viral hepatitis is underway. We report on the first part of the study. The objective of this study was to determine the prevalence of serological markers for hepatitis A, B and C in the village. Cross sectional study. Blood samples were tested for serological markers of hepatitis A (HAV), B (HBV) and C (HCV) through ELISA-III assay. In HBsAg and anti-HCV carriers, HCV-RNA and HBV-DNA were checked by PCR. The prevalence of anti-HAV IgG was 83.3% (1,210/1,452), being higher among residents from the village (87.4%) than in residents from the rural area (79.5%); it also higher among individuals older than 10 years of age. The prevalence of HBsAg was 2.6% (38/1,476), 9.3% anti-HBc (137/1,476) and 10.5% (155/1,476) anti-HBs of. In more than half (58.1%; 90/155) of anti-HBs carriers, this was the only serological marker found. In 3.7% of the population, (55/1,476), anti-HBc was the only serological marker found. All HBV carriers were infected by genotype A. Only 0.4% (6/1,536) presented anti-HCV antibodies and only one of them was viremic, being infected with genotype 1. The prevalence of patients with antibodies against hepatitis A virus in the village of Cavunge was high, but the prevalence of B virus was moderate, with only genotype A among HBV carriers. The prevalence of C virus was very low, contrasting with the situation in large Brazilian urban centers.

In the Subúrbio Ferroviário region of Salvador (Bahia, Brasil) occurrences of schistosomiasis were found. This fact motivated the investigation of the prevalence of the eggs in a group of 268 resident students in one of its neighborhoods (São Bartolomeu). The parasitological test analyzed by the Kato-Katz methodology, showed positive results in 30.2% of the children, ranging from 24 to 2,160 eggsSchistosoma mansoni/gram of feces. Infection was predominant in boys and in those 10 years old and over. Observation revealed that infection predominated in children that live close to natural water bodies. This region was where the three registered cases of hepatosplenicos occurred. Moreover, all the 81 children infected with Schistosoma mansoni eggs were born and live in the study area. Since this neighborhood presents all the elements of the epidemiological chain of Schistosoma mansoni, the evidences strongly suggests the urban transmission of this infection.

In Brazil, hepatitis delta virus (HDV) is only reported in Western Amazonia, where severe cases of acute and chronic HDV hepatitis have been described. The study area was chosen in the States of Acre and Rondonia where most cases of hepatitis B virus (HBV)/HDV are reported. From December 2003 to October 2004, 40 HBsAg carriers with anti-HDV IgM were selected. An epidemiologic questionnaire, including demographic and clinical/epidemiologic variables was filled out. HDV amplification and genotyping were performed. Genotype I was detected in 22 patients (55.0%), whereas genotype III was identified in 18 (45.0%). Patients who were infected with genotype I were older (45.1 +/- 17.8 years) than patients infected with genotype III (32.8 +/- 10.9 years; P = 0.01). No symptoms were reported by 21 (52.5%) patients. Otherwise, 19 (47.5%) had symptoms (fatigue, abdominal pain, weight loss, and decompensated liver disease) that motivated them to seek medical care. Genotype III carriers were more symptomatic, but no statistical significance was achieved. Our preliminary results show that HDV genotypes I and III are present in Brazilian Amazonia and that HDV genotype III is not limited to the Amerindian population.

Background: Hepatitis B is endemic in the Amazon region., Methods: Serological markers for hepatitis B virus (HBV) were determined in 266 household members for hepatitis B surface antigen (HBsAg)-positive women (G1) and 395 household members for HBsAg-negative women (G2), randomly selected in Acre State Women's Medical Care Program, in order to evaluate the prevalence of HBV in this population. Before blood sample collection an epidemiological questionnaire was applied., Results: The overall prevalence of HBV carriers (HBsAg) and exposed individuals (anti-HBc, IgG) was, respectively, 21.1% and 60.5% in G1 and 2.8% and 27.4% in G2 (P < 0.0000001). The frequency of HBsAg was higher among siblings from group G1 (75%) compared to the absence of any HBsAg-positive sibling in G2 (P < 0.00006). The HBV markers in other family members was as follows: G1 parents, 27.3% vs 4.5% (P < 0.03), sexual partners, 21.1% vs 2.5% (P < 0.04), and offspring, 10.4% vs 1.5% (P < 0.04). A low prevalence of HBsAg and anti-HBc (IgG) was observed for the last offspring of G2 mothers compared to the high prevalence among children of G1 mothers (0% vs 18.2%, P < 0.01 and 2.3% vs 59.1%, P < 0.0000005, respectively), with children younger than 1 year being the most affected. The frequency of the habit of sharing toothbrushes and the presence of at least one HBsAg carrier were higher in G1 than in G2 (P < 0.0001 and P < 0.000002), respectively. Genotypes A, D and G were found to be predominant by Innolipa test. There were cases that reacted to more than one genotype., Conclusion: Intrafamilial transmission of HBV is evident in the present study and is possibly associated with the presence of more than one HBV carrier in the family and the shared use of toothbrushes among household contacts. Genotype analysis confirms intrafamilial transmission.

In Cavunge community, a rural village of the dry tropic in Bahia State, Brazil, a sentinel study on viral hepatitis was developed to characterize the seroprevalence of hepatitis A. The presence of IgG anti-HAV was analyzed in 891 citizens and 85.9% were positive. The prevalence was similar between genders and increased with age.

Infectious meningeal syndromes represent a serious medical emergency whose clinical-epidemiologic diagnosis must be immediately established for early initiation of appropriate treatment. However, in many cases data from the clinical exam are insufficient to confirm or rule out the diagnosis. Therefore, the aim of this work was to assess the value of the ocular globe compression sign in 57 patients with suspicion of infectious meningeal syndrome, both male and female and aged four years or older. The sensitivity (34.5%), specificity (78.6%) and positive (62.5%) and negative (53.7%) predictive values of ocular globe compression sign were similar to nuchal rigidity, and the agreement between two independent observers was fair (Kappa=0.65). Ocular globe compression sign in conjunction with other findings of the clinical examination could be of great value in the diagnostic process of patients with infectious meningeal syndromes.

The levels of amines in soybeans as affected by cultivar in two consecutive years and by germination were investigated. Spermidine, spermine, putrescine, agmatine, and cadaverine were detected, whereas tyramine, histamine, tryptamine, serotonine, and phenylethylamine were not. Spermidine was the predominant amine followed by spermine. High concentrations of these amines confirmed soybean as a rich source. Cadaverine was confirmed to be inherent to soybean. The percent contribution of spermidine and spermine to total levels was not affected by cultivar in either years. However, amine levels were affected by cultivars in different ways in the consecutive years. Cadaverine was affected more by the cultivar, whereas spermidine, spermine, and agmatine were affected by harvest year. During germination the levels of amines from soybean increased significantly, except for agmatine. Spermidine and spermine accumulated in the cotyledon, whereas cadaverine and putrescine accumulated in the radicle and hypocotyl.

With the objective of isolating and identifying enteroviral serotypes, which are the most frequent etiologic agents of aseptic meningitis syndrome, cerebrospinal fluid samples were studied from patients referred to the health unit in the City of Belém (State of Pará, Brazil), from March 2002 to March 2003. The samples were inoculated in RD and HEp-2 cells line, and the positive were identified by neutralization test or indirect immunofluorescence. Out of 249 samples, 33 (13.2%) were positive 57.6% (n = 19) in patients under 11 years of age (p < 0.03) and predominantly (72.7%) in males (p < 0.008). The serotypes isolated were: Echovirus 30 (n = 31), Coxsackievirus B5 (n = 1) and Echovirus 30 and 4. In conclusion, this type of study also serves to determine the national picture, which is still little defined, regarding the most prevalent viral agents in AMS cases.

The association of hepatitis C virus infection and the hepatosplenic form of schistosomiasis mansoni has been claimed to result in the concomitant evolution of the two pathologies, with a poor prognosis due to aggravated liver disease. Recently, however, some authors have begun to reject the hypothesis of a higher susceptibility of hepatosplenic schistosomal patients to HCV. The aim of the present transverse study carried out between July and August 1990 was to determine the possible association between SM and HCV markers in residents of Catolândia, Bahia State. Anti-HCV markers were assayed by ELISA-II and RIBA-II in serum samples obtained from 1,228 residents (85.8%). The anti-HCV antibody (ELISA-II) was positive in six (0.5%) individuals, eight (0.6%) cases were inconclusive and 1,214 (98.9%) were negative. However, only in one ELISA-positive serum sample (0.08%) were antibodies confirmed by RIBA-II, while two other samples assayed by RIBA-II were indeterminate. These three patients presented the hepatointestinal form of SM during the follow-up period (1976 to 1996). In conclusion, no association was observed between HCV and SM in the endemic area studied, especially among patients with the hepatosplenic form of the disease.

This study aimed to determine the clinical epidemiological profile of the snake bites attended at the reference hospital of Acre. One hundred-forty four patients were studied prospectively, from January to December 2002. One hundred-thirteen (78.5%) cases were classified as accidents by venomous snakes. The genera Bothrops, Lachesis and Micrurus were responsible, respectively, for 75.7%, 2.1% e 0.7% cases. The accidents predominated in males (78.5%), rural workers (51.4%) and between 10 and 29 years old (43.8%). The distribution according to the severity of poisoning by genera Bothrops was: moderate (48.6%), mild (31.2%) or severe (20.2%). Two cases of Bothrops accident did not receive serum therapy. However, the antivenom was administered in twenty-three patients without envenoming. In conclusion, the results obtained were different of the observed by another authors with respect to the severity of accidents and suitable treatment.

Family planning programs have traditionally concentrated on women. This study aimed to determine men's knowledge of contraceptive methods in a rural community in Bahia State, Brazil. Mean age of interviewees was 40.0 (+/-17.6) years. Avoiding unwanted pregnancy was reported as a responsibility of the couple by 39.7% of the male interviewees (n = 71) and as the man's responsibility by 26.8% (n = 48). The most widely known methods were condoms (98.9%) and the pill (96.6%). Condoms (22.9%), female sterilization (21.2%), and the pill (12.8%) were the most widely used methods. The majority of the interviewees (56.4%) reported that they "always" use some method. The men chose the method in 45.6% of the couples. The results indicate that more options for contraceptive methods should be offered, thereby facilitating the best choice of methods by the couple. Still, since in this study men chose the method in nearly half of the cases, it is necessary to prioritize couples' participation in family planning programs.

During a yellow fever vaccination campaign among residents of Rio Branco (Acre State), the frequency of HI antibodies to the most prevalent arboviruses in the Amazon region and to yellow fever virus was determined before and three months after immunization with YF 17D vaccine. From 390 inhabitants included in the first phase of serologic survey (August 1999), only 190 provided a second serum sample, after the use of 17D vaccine (January 2000). Among first phase samples, the frequency of HI antibodies was: 17D (27.2%); Ilheus (5.9%); Mayaro (5.4%); Caraparu (4.9%); Dengue-2 (4.1%); Oropouche (2.3%); and Dengue-1 (0.3%). In the second study phase, the serologic conversion to YF reached 89.7% among previously negative persons. Serologic conversions were also observed to Ilheus (6.2%); Dengue-3 (3.2%); Mayaro (1.1%); and Oropouche (1.1%) viruses. In conclusion, considering the high YF antibody rate after vaccination, the risk of urban yellow fever seems insignificant, although the lower prevalence of HI antibodies to dengue viruses, is of concern and inhabitants are under high risk of dengue outbreaks, especially to DEN-3 recently introduced in Brazil, as was observed in 2000 and 2001 with DEN-1 and DEN-2.

Objectives: To describe and compare indicators of the quality of epidemiological surveillance for acute flaccid paralysis (AFP) before Brazil's certification as a poliomyelitis-free area (1990 through 1994) and after that certification (1995 through 2000)., Methods: The following variables were studied: minimum prevalence (reporting annually at least 1 case of AFP per 100 000 individuals younger than 15 years), negative reporting (weekly reporting of the absence of AFP cases by at least 80% of the reporting units in each region), time of investigation (investigating at least 80% of the AFP cases within 48 hours of their being reported), and diagnostic investigation (collection of two stool samples for viral culture in the 2 weeks following the onset of paralysis in 80% or more of the AFP cases). The results were categorized as adequate if they were equal to or higher than the value considered as being effective, or as inadequate if they were below this value. The percentage rate of adequate values was calculated for each of Brazil's 27 federal political divisions (26 states plus the Federal District) in each year, for each of the two periods studied. The final means per period, per federal political division, and per region were also calculated., Results: For Brazil overall, minimum prevalence decreased from 1.3 per 100 000 individuals younger than 15 years in the precertification period to 0.9 per 100 000 in the postcertification period, but the difference was not statistically significant (P > 0.08). While negative reporting was adequate in both periods (87% and 84%, respectively), the percentage rate of effectiveness was 6.6% lower in the postcertification period (P > 0.21). The effectiveness in the time required to investigate AFP cases increased from 60.7% to 71.6% (P > 0.06). The collection of stool samples was inadequate both before and after certification (54% and 52%, respectively)., Conclusions: Despite the absence of indigenous wild virus poliomyelitis cases in Brazil in the postcertification period, the quality of epidemiological surveillance indicators is still less than desirable. This may delay the detection and investigation of AFP cases and compromise the global poliomyelitis eradication effort. New information strategies that are being made available for the health system in Brazil may improve the effectiveness of the national poliomyelitis control program.

The response of patients with uncomplicated falciparum malaria to quinine plus doxycycline was studied in an open clinical trial. The majority (76.2%; n = 16) had plasmodia sensitive to the treatment and 23.8% (n = 5) were resistant. This therapeutic scheme appears to be a good option in uncomplicated falciparum malaria.

Between December 1998 and March 2001, for each HTLV-I/II seropositive blood donor (ELISA, Abbott), two HTLV-I/II seronegative blood donors were also chosen. The blood samples were re-tested by ELISA (Murex), and those seropositives were also tested by Western Blot and PCR. Of the 11, 121 blood samples, 73 (0.66%) were positives (Abbott), but only 12 (0.11%) remained positives (Murex), whereas the 146 seronegatives were confirmed, even though the concordance index between these two ELISA tests was hopeless. The Western Blot confirmed the twelve blood samples as seropositives: 8 (0.07%) HTLV-I; two (0.02%) HTLV-II and two (0.02%) indeterminate, being by PCR, one HTLV-I and the other HTLV-II. Concluding, in this Western Amazon population the HTLV-I/II seroprevalence was too low, in spite of the greater prevalence of HTLV-II expected due to a great indigenous racial mixture.

Case sheets of 44 patients with neurocysticercosis, coming from Campina Grande and others cities of Para ba state, examined between 1990 - 2001 were analyzed. The average age (SD +/-) was 20.6 +/- 14.3 years old, of which 54.5% were male. Thirty eight patients (86.2%) came from urban area. The initial symptom was convulsion in 90.9% of the cases and headaches in 9.1%. The epileptical form was present in 63.6% of the cases and the combined form in 22.3%. Computerized tomography of the skull was compatible with neurocysticercosis in 100% of the cases, showing calcification in (59.1%), integral cysts in (18.2%) and in degenerating in (20.4%), isolated or associated. The LCR performed on 29 patients showed alterations in 25 (86.2%) cases, predominating linfomonocitary pleocitose in 100% of the cases and positive immunological reactions in 64.3% of the cases. In conclusion neurocysticercosis is a frequent cause for convulsions in children and young adults in this region, and the ocorrence in urbane and rural areas denote the poor control of the taeniases/cistycercosis complex in this state.