Resumen: Los objetivos de este estudio fueron evaluar la reticencia a la vacunación contra la influenza estacional y analizar los factores asociados entre los profesores de las escuelas municipales de Teresina, Piauí, Brasil. Se aplicó un cuestionario en línea adaptado del Modelo de Creencias en Salud y se incluyeron a 449 profesores. La mayoría de los participantes viven en la capital Teresina (373, 83,26%), son mujeres (360, 80,54%), de entre 23 y 50 años de edad (306, 81,38%), nacidos en el estado de Piauí (382, 86,82%), de color pardo (289, 64,65%), casados (254, 56,70%) y con título de posgrado (327, 72,99%). El 33,18% del total se consideró reticente a la vacunación, y se definió como reticentes a aquellos profesores que no se vacunaron contra la gripe en 2020. Las variables asociadas a la reticencia fueron: no haberse vacunado contra la gripe (influenza) en 2019; no considerar oportuna la vacuna contra la gripe; considerar muchos riesgos asociados a la vacuna contra la gripe y preocuparse por las reacciones a esta vacuna. La pandemia del nuevo coronavirus impactó la relación entre el acto de vacunarse y una mayor adherencia a la vacunación tras enterarse de sus posibles beneficios en los medios de comunicación. En el análisis de regresión, solo las variables no vacunarse contra la influenza en 2019 y el cambio del comportamiento después de la pandemia fueron significativas. La vacunación sigue siendo el principal método de prevención y control de enfermedades relacionadas con los virus de la gripe, lo que requiere una mayor adherencia por parte de los profesores, un público prioritario que está en constante contacto con los estudiantes de distintos orígenes y que representa una importante fuente de propagación del virus.

Resumo: Os objetivos deste estudo foram avaliar a frequência de hesitação à vacina contra influenza sazonal e analisar os fatores associados entre professores da rede municipal de ensino de Teresina, Piauí, Brasil. Foi aplicado um questionário online, adaptado do Modelo de Crenças em Saúde e foram incluídos 449 docentes. Do público entrevistado, a maioria reside na capital Teresina (373, 83,26%), são mulheres (360, 80,54%), com idade entre 23 e 50 anos (306, 81,38%), naturais do Estado do Piauí (382, 86,82%), de cor parda (289, 64,65%), casados (254, 56,7%) e com pós-graduação lato sensu (327, 72,99%). Um total de 33,18% foram considerados hesitantes à vacinação, sendo definidos como hesitantes aqueles professores que não se vacinaram contra influenza em 2020. As variáveis associadas à hesitação nesse grupo foram: não terem se vacinado contra a gripe (influenza) em 2019, acreditarem que a vacina contra a gripe não é conveniente, existem muitos riscos associados à vacina da gripe, e preocupação com reações à vacina da gripe, a pandemia do novo coronavírus mudou a relação com o ato de vacinar e uma maior adesão à vacina após ouvir informações sobre seus benefícios nos meios de comunicação. No entanto, na análise de regressão, somente as variáveis de não se vacinar contra influenza em 2019 e a modificação do comportamento após a pandemia foram significativas. As vacinas seguem sendo o principal método de prevenção e controle de uma série de doenças relacionadas aos vírus da influenza, sendo necessária uma maior adesão por parte dos professores, público prioritário que está em constante contato com alunos de diversas origens e representam uma importante fonte de disseminação do vírus.

Abstract: The objectives of this study were to evaluate the frequency of vaccine hesitancy against seasonal influenza and to analyze the associated factors among teachers in the municipal school system of Teresina, Piauí State, Brazil. An online questionnaire was applied, adapted from the Health Belief Model, and 449 teachers were included. Of the public interviewed, most live in the capital Teresina, (373, 83.26%), are women (360, 80.54%), aged between 23 and 50 years (306, 81.38%), born in the state of Piauí (382, 86.82%), brown (289, 64.65%), married (254, 56.70%) and with a lato sensu graduate degree (327, 72.99%). In total, 33.18% were considered hesitant, and hesitancy was defined as teachers who were not vaccinated against influenza in 2020. The variables associated with hesitancy in this group were: not being vaccinated against influenza in 2019, the flu vaccine is not convenient, there are many risks associated with it, and concern about reactions to the flu vaccine, the new coronavirus pandemic changed the relationship with the act of vaccinating and greater adherence to the vaccine after hearing information about its benefits in the media. However, in the regression analysis, only the variables “not being vaccinated against influenza in 2019” and “the change in behavior after the pandemic” were significant. Vaccines continue to be the main method of prevention and control of a series of diseases related to influenza viruses, requiring greater adherence by teachers, a priority population that is in constant contact with students from different backgrounds, representing an important source of virus dissemination.

Resumen: Los objetivos de este estudio fueron evaluar la reticencia a la vacunación contra la influenza estacional y analizar los factores asociados entre los profesores de las escuelas municipales de Teresina, Piauí, Brasil. Se aplicó un cuestionario en línea adaptado del Modelo de Creencias en Salud y se incluyeron a 449 profesores. La mayoría de los participantes viven en la capital Teresina (373, 83,26%), son mujeres (360, 80,54%), de entre 23 y 50 años de edad (306, 81,38%), nacidos en el estado de Piauí (382, 86,82%), de color pardo (289, 64,65%), casados (254, 56,70%) y con título de posgrado (327, 72,99%). El 33,18% del total se consideró reticente a la vacunación, y se definió como reticentes a aquellos profesores que no se vacunaron contra la gripe en 2020. Las variables asociadas a la reticencia fueron: no haberse vacunado contra la gripe (influenza) en 2019; no considerar oportuna la vacuna contra la gripe; considerar muchos riesgos asociados a la vacuna contra la gripe y preocuparse por las reacciones a esta vacuna. La pandemia del nuevo coronavirus impactó la relación entre el acto de vacunarse y una mayor adherencia a la vacunación tras enterarse de sus posibles beneficios en los medios de comunicación. En el análisis de regresión, solo las variables no vacunarse contra la influenza en 2019 y el cambio del comportamiento después de la pandemia fueron significativas. La vacunación sigue siendo el principal método de prevención y control de enfermedades relacionadas con los virus de la gripe, lo que requiere una mayor adherencia por parte de los profesores, un público prioritario que está en constante contacto con los estudiantes de distintos orígenes y que representa una importante fuente de propagación del virus. Resumen Brasil 44 373, 373 (373 83,26%, 8326 83,26% , 83 26 83,26%) 360, 360 (360 80,54%, 8054 80,54% 80 54 80,54%) 2 5 306, 306 (306 81,38%, 8138 81,38% 81 38 81,38%) 382, 382 (382 86,82%, 8682 86,82% 86 82 86,82%) 289, 289 (289 64,65%, 6465 64,65% 64 65 64,65%) 254, 254 (254 56,70% 5670 56 70 327, 327 (327 72,99%. 7299 72,99% . 72 99 72,99%) 3318 33 18 33,18 2020 (influenza comunicación regresión 201 significativas 4 37 (37 832 83,26 8 36 (36 805 80,54 30 (30 813 81,38 3 (38 868 86,82 28 (28 646 64,65 6 25 (25 56,70 567 7 32 (32 729 72,99 9 331 1 33,1 202 20 (3 83,2 80,5 81,3 86,8 (2 64,6 56,7 72,9 33, ( 83, 80, 81, 86, 64, 56, 72,

Abstract: The objectives of this study were to evaluate the frequency of vaccine hesitancy against seasonal influenza and to analyze the associated factors among teachers in the municipal school system of Teresina, Piauí State, Brazil. An online questionnaire was applied, adapted from the Health Belief Model, and 449 teachers were included. Of the public interviewed, most live in the capital Teresina, (373, 83.26%), are women (360, 80.54%), aged between 23 and 50 years (306, 81.38%), born in the state of Piauí (382, 86.82%), brown (289, 64.65%), married (254, 56.70%) and with a lato sensu graduate degree (327, 72.99%). In total, 33.18% were considered hesitant, and hesitancy was defined as teachers who were not vaccinated against influenza in 2020. The variables associated with hesitancy in this group were: not being vaccinated against influenza in 2019, the flu vaccine is not convenient, there are many risks associated with it, and concern about reactions to the flu vaccine, the new coronavirus pandemic changed the relationship with the act of vaccinating and greater adherence to the vaccine after hearing information about its benefits in the media. However, in the regression analysis, only the variables “not being vaccinated against influenza in 2019” and “the change in behavior after the pandemic” were significant. Vaccines continue to be the main method of prevention and control of a series of diseases related to influenza viruses, requiring greater adherence by teachers, a priority population that is in constant contact with students from different backgrounds, representing an important source of virus dissemination. Abstract Teresina State Brazil applied Model 44 included interviewed 373, 373 (373 83.26%, 8326 83.26% , 83 26 83.26%) 360, 360 (360 80.54%, 8054 80.54% 80 54 80.54%) 2 5 306, 306 (306 81.38%, 8138 81.38% 81 38 81.38%) 382, 382 (382 86.82%, 8682 86.82% 86 82 86.82%) 289, 289 (289 64.65%, 6465 64.65% 64 65 64.65%) 254, 254 (254 56.70% 5670 56 70 327, 327 (327 72.99%. 7299 72.99% . 72 99 72.99%) total 3318 33 18 33.18 hesitant 2020 2019 convenient it media However analysis significant viruses backgrounds dissemination 4 37 (37 832 83.26 8 36 (36 805 80.54 30 (30 813 81.38 3 (38 868 86.82 28 (28 646 64.65 6 25 (25 56.70 567 7 32 (32 729 72.99 9 331 1 33.1 202 201 (3 83.2 80.5 81.3 86.8 (2 64.6 56.7 72.9 33. 20 ( 83. 80. 81. 86. 64. 56. 72.

Resumo: Os objetivos deste estudo foram avaliar a frequência de hesitação à vacina contra influenza sazonal e analisar os fatores associados entre professores da rede municipal de ensino de Teresina, Piauí, Brasil. Foi aplicado um questionário online, adaptado do Modelo de Crenças em Saúde e foram incluídos 449 docentes. Do público entrevistado, a maioria reside na capital Teresina (373, 83,26%), são mulheres (360, 80,54%), com idade entre 23 e 50 anos (306, 81,38%), naturais do Estado do Piauí (382, 86,82%), de cor parda (289, 64,65%), casados (254, 56,7%) e com pós-graduação lato sensu (327, 72,99%). Um total de 33,18% foram considerados hesitantes à vacinação, sendo definidos como hesitantes aqueles professores que não se vacinaram contra influenza em 2020. As variáveis associadas à hesitação nesse grupo foram: não terem se vacinado contra a gripe (influenza) em 2019, acreditarem que a vacina contra a gripe não é conveniente, existem muitos riscos associados à vacina da gripe, e preocupação com reações à vacina da gripe, a pandemia do novo coronavírus mudou a relação com o ato de vacinar e uma maior adesão à vacina após ouvir informações sobre seus benefícios nos meios de comunicação. No entanto, na análise de regressão, somente as variáveis de não se vacinar contra influenza em 2019 e a modificação do comportamento após a pandemia foram significativas. As vacinas seguem sendo o principal método de prevenção e controle de uma série de doenças relacionadas aos vírus da influenza, sendo necessária uma maior adesão por parte dos professores, público prioritário que está em constante contato com alunos de diversas origens e representam uma importante fonte de disseminação do vírus. Resumo Brasil online 44 docentes entrevistado 373, 373 (373 83,26%, 8326 83,26% , 83 26 83,26%) 360, 360 (360 80,54%, 8054 80,54% 80 54 80,54%) 2 5 306, 306 (306 81,38%, 8138 81,38% 81 38 81,38%) 382, 382 (382 86,82%, 8682 86,82% 86 82 86,82%) 289, 289 (289 64,65%, 6465 64,65% 64 65 64,65%) 254, 254 (254 56,7% 567 56 7 pósgraduação pós graduação 327, 327 (327 72,99%. 7299 72,99% . 72 99 72,99%) 3318 33 18 33,18 vacinação 2020 (influenza conveniente comunicação entanto regressão 201 significativas 4 37 (37 832 83,26 8 36 (36 805 80,54 30 (30 813 81,38 3 (38 868 86,82 28 (28 646 64,65 6 25 (25 56,7 32 (32 729 72,99 9 331 1 33,1 202 20 (3 83,2 80,5 81,3 86,8 (2 64,6 56, 72,9 33, ( 83, 80, 81, 86, 64, 72,

ABSTRACT Background: Haiti is one of the Caribbean countries where malaria persists. More than 99% of malaria cases are caused by Plasmodium falciparum, the main vector being the mosquito Anopheles albimanus. In this paper, we describe the epidemiological profile of malaria in Haiti between 2009 and 2018. Methods We analyzed information on cases reported by the Ministry of Health of Haiti and the World Health Organization (WHO). Results: Between 2009 and 2018, 232,479 malaria cases were reported by the Ministry of Public Health and Population (MSPP); an increase in the incidence of malaria in the country in 2010, followed by a decrease in 2011, was primarily observed. Due to recent efforts to reduce malaria by 2020, its incidence declined from 60,130 cases in 2010 to 8,978 cases in 2018. Controversially, in terms of the number of reported cases, the MSPP and WHO report conflicting data. However, the results from both datasets present the same trend in Haiti from 2009 to 2018. The results also illustrate the endemicity of the disease throughout Haiti, both in rural and urban areas, especially along the coast. Conclusions: This study emphasizes the need to promote official data collection and analyses, as well as the application of epidemiological surveillance of malaria at the municipal level, for a better understanding of the real impact of malaria on the Haitian population and to create more appropriate interventions.

Imported malaria is a malaria infection diagnosed outside the area where it was acquired and is induced by human migration and mobility. This retrospective study was performed based on secondary data from 2007 to 2015. In total, 736 cases of imported malaria (79.7% of 923 cases) were recorded in Rio de Janeiro state. Of the imported cases, 55.3% came from abroad, while 44.7% came from other regions of Brazil. Most cases of imported malaria in Brazil (85.5%) originated in Amazônia Legal, and Burundi (Africa) accounted for 59% of the cases from abroad. Analyses of the determinants of imported malaria in Rio de Janeiro state must be continued to understand the relationship between the origin and destination of cases.

The lethality of malaria in the extra-Amazonian region is more than 70 times higher than in Amazonia itself. Recently, several studies have shown that autochthonous malaria is not a rare event in the Brazilian southeastern states in the Atlantic Forest biome. Information about autochthonous malaria in the state of Rio de Janeiro (RJ) is scarce. This study aims to assess malaria cases reported to the Health Surveillance System of the State of Rio de Janeiro between 2000-2010. An average of 90 cases per year had parasitological malaria confirmation by thick smear. The number of malaria notifications due to Plasmodium falciparum increased over time. Imported cases reported during the period studied were spread among 51% of the municipalities (counties) of the state. Only 35 cases (4.3%) were autochthonous, which represents an average of 3.8 new cases per year. Eleven municipalities reported autochthonous cases; within these, six could be characterised as areas of residual or new foci of malaria from the Atlantic Forest system. The other 28 municipalities could become receptive for transmission reintroduction. Cases occurred during all periods of the year, but 62.9% of cases were in the first semester of each year. Assessing vulnerability and receptivity conditions and vector ecology is imperative to establish the real risk of malaria reintroduction in RJ.

Infecção assintomática por Plasmodium é um novo desafio para a saúde pública no Brasil. A reação em cadeia da polimerase (PCR) é o melhor método para detectar baixas parasitemias presentes em pacientes com infecção assintomática. Nas áreas endêmicas, a coleta de sangue total é dificultada pela distancia geográfica, transporte e adequada armazenagem das amostras. A coleta de sangue em papel de filtro pode ser uma alternativa nessas áreas de difícil acesso. Neste estudo foram comparados três diferentes métodos de extração de ADN a partir de papel de filtro usando como controle extração a partir de sangue total. O protocolo Chelex®-Saponina foi o que obteve o melhor resultado quando comparado com os outros três protocolos. No entanto a sensibilidade foi de 66,7% para o P. falciparum e 31,6% para o P. vivax. Conclui-se que em caso de infecção assintomática o papel de filtro não é ainda uma boa alternativa para coleta de amostras.

Asymptomatic Plasmodium infection is a new challenge for public health in the American region. The polymerase chain reaction (PCR) is the best method for diagnosing subpatent parasitemias. In endemic areas, blood collection is hampered by geographical distances and deficient transport and storage conditions of the samples. Because DNA extraction from blood collected on filter paper is an efficient method for molecular studies in high parasitemic individuals, we investigated whether the technique could be an alternative for Plasmodium diagnosis among asymptomatic and pauciparasitemic subjects. In this report we compared three different methods (Chelex®-saponin, methanol and TRIS-EDTA) of DNA extraction from blood collected on filter paper from asymptomatic Plasmodium-infected individuals. Polymerase chain reaction assays for detection of Plasmodium species showed the best results when the Chelex®-saponin method was used. Even though the sensitivity of detection was approximately 66% and 31% for P. falciparum and P. vivax, respectively, this method did not show the effectiveness in DNA extraction required for molecular diagnosis of Plasmodium. The development of better methods for extracting DNA from blood collected on filter paper is important for the diagnosis of subpatent malarial infections in remote areas and would contribute to establishing the epidemiology of this form of infection.

A study of crepuscular and night-biting mosquitoes was conducted at remote settlements along the Padauiri River, middle Negro River, state of Amazonas, Brazil. Collections were performed with human bait and a CDC-light trap on three consecutive days per month from June 2003-May 2004. In total, 1,203 h of collection were performed, of which 384 were outside and 819 were inside houses. At total of 11,612 specimens were captured, and Anophelinae (6.01%) were much less frequent than Culicinae (93.94%). Anopheles darlingi was the most frequent Anophelinae collected. Among the culicines, 2,666 Culex (Ae.) clastrieri Casal & Garcia, 2,394 Culex. (Mel.) vomerifer Komp, and 1,252 Culex (Mel.) eastor Dyar were the most frequent species collected. The diversity of insects found reveals the receptivity of the area towards a variety of diseases facilitated by the presence of vectors involved in the transmission of Plasmodium, arboviruses and other infectious agents.