The microcephaly epidemic in Brazil generated intense debate regarding its causality, and one hypothesised cause of this epidemic, now recognised as congenital Zika virus syndrome, was the treatment of drinking water tanks with pyriproxyfen to control Aedes aegypti larvae. We present the results of a geographical analysis of the association between the prevalence of microcephaly confirmed by Fenton growth charts and the type of larvicide used in the municipalities that were home to the mothers of the affected newborns in the metropolitan region of Recife in Pernambuco, the state in Brazil where the epidemic was first detected. The overall prevalence of microcephaly was 82 per 10,000 live births in the three municipalities that used the larvicide Bti (Bacillus thuringiensis israelensis) instead of pyriproxyfen, and 69 per 10,000 live births in the eleven municipalities that used pyriproxyfen. The difference was not statistically significant. Our results show that the prevalence of microcephaly was not higher in the areas in which pyriproxyfen was used. In this ecological approach, there was no evidence of a correlation between the use of pyriproxyfen in the municipalities and the microcephaly epidemic.

Este estudo teve como objetivo analisar características clínicas, epidemiológicas e bacteriológicas de 60 pacientes com tuberculose pulmonar infectados pelo HIV(+) comparando-as às de 120 pacientes com TB pulmonar/HIV(-). Analisou-se as características em relação ao sexo, idade, hábitos de vida, antecedentes de contato ou tratamento anterior para tuberculose, características clínicas e bacteriológicas e resultado do tratamento. Os doentes co-infectados foram predominantemente do sexo masculino (p=0,001), referiram com maior freqüência perda >10 quilos (p<0,001), apresentaram maior freqüência de teste tuberculínico não reatores (p<0,001), baciloscopia negativa (p=0,001) e cultura de escarro negativa (p<0,001). O insucesso do tratamento foi mais significante naqueles HIV(+) (p<0,001). Não se encontrou uma maior freqüência de resistência aos tuberculostáticos associada à co-infecção (p=0,407). A tuberculose extrapulmonar associada à tuberculose pulmonar foi mais freqüente nos soropositivos que nos HIV (-), 30% e 1,6% respectivamente. Estes achados evidenciam predominância de características clínico-laboratoriais atípicas nos pacientes com co-infecção, alertando para a possibilidade deste diagnóstico.

The aim of this study was to analyse the clinical, epidemiological and bacteriological features present in 60 pulmonary tuberculosis patients who were also infected with human immunodeficiency virus (HIV) and to compare these with 120 TB patients who were not infected with HIV. The patients with pulmonary tuberculosis and HIV coinfection were mostly male (p = 0.001), showed a higher frequency of weight loss >10 kilos (p <0.001), had a higher rate of non-reaction result to the tuberculin skin test (p <0.001), a higher frequency of negative sputum smear examination for acid-fast bacilli (p = 0.001) and negative sputum culture for Mycobacterium tuberculosis (p = 0.001). Treatment failure was more common in those who were HIV positive (p <0.000). No higher frequency of resistance to antituberculosis drugs was found to be associated with TB/HIV coinfection (p = 0.407). Association between extrapulmonary and pulmonary tuberculosis was more frequent in those seropositive to HIV than those without HIV virus, 30% and 1.6% respectively. These findings showed a predominance of atypical clinical laboratory features in co-infected patients, and suggest that health care personnel should consider the possibility this diagnosis.