ABSTRACT Background: The riverine communities of the Amazon comprise different social groups that inhabit the rural areas on the banks of rivers and lakes. Residents usually travel by river to rural and urban areas and are then exposed to urbanized diseases such as those caused by arbovirus infection. In Brazil, emerging diseases such as dengue, Zika, chikungunya, and those caused by infection with Oropouche and Mayaro viruses necessitate epidemiological surveillance. This study was aimed at determining the frequency of positivity for immunoglobulin (Ig)G and IgM antibodies against Zika, chikungunya, and dengue viruses and performing molecular analyses to detect viral RNA for the Zika, chikungunya, dengue virus, Oropouche, and Mayaro viruses, in the same serum samples obtained from riverside populations. Methods: This cross-sectional study was conducted in a riverside population in the Humaitá municipality of the Brazilian Amazon. More than 80% of the local population participated in this study. Entomological samples were collected to identify local mosquito vectors. Results: Analysis of 205 human serological samples revealed IgG antibodies against the dengue virus in 85 individuals. No molecular positivity was observed in human samples. Entomological analyses revealed 3,187 Diptera species, with Mansonia being the most frequent genus. Aedes aegypti and Aedes albopictus were not detected in the two collections. Conclusions: IgG antibodies against the dengue virus were highly prevalent, suggesting previous exposure. The absence of the arbovirus vectors Aedes aegypti and Aedes albopictus in the samples supports the hypothesis that the infections recorded likely occurred outside the riverside communities investigated. Background lakes Brazil Zika chikungunya surveillance Ig G populations Methods crosssectional cross sectional 80 Results 20 8 individuals 3187 3 187 3,18 species genus collections Conclusions prevalent exposure investigated 2 318 18 3,1 31 1 3,

ABSTRACT Background: Vectorial transmission through hematophagous triatomine insects remains the primary mode of Chagas Disease contagion. These insects have become increasingly common in urban environments. Therefore, this study aimed to report an encounter of triatomines with trypanosomatid infection in a vertical residential condominium in Rio Branco, the capital of the state of Acre, in the western Brazilian Amazon. Methods: Triatomines were collected from residents and sent to the municipality's Entomological Surveillance sector. Trypanosomatid positivity was evaluated using optical microscopy, followed by species and genotype identification using molecular biology techniques. Results: Twenty-five adult triatomine specimens were collected from two of three condominium buildings invading apartments from the 2nd to 13th floors. Six specimens were identified as Rhodnius sp. and 19 as R. montenegrensis. Among these, molecular tests were conducted on seven specimens, with five testing positive for Trypanosoma cruzi, all belonging to genotype TcI. Conclusions: These findings underscore the need for further studies to better understand the invasive capacity of these insects in these environments and the mechanisms involved in this process. Background contagion Therefore Branco Acre Amazon Methods municipalitys municipality s sector microscopy techniques Results Twentyfive Twenty nd th floors sp 1 R montenegrensis cruzi TcI Conclusions process

ABSTRACT Background: Triatomines infest atypical public spaces in the Western Amazon. Methods: Frequent visitors to these spaces captured the insects in the state of Acre, Brazil (Rio Branco and Cruzeiro do Sul). Results: Six insects were found in a penitentiary, a church, a school, a university, a hospital, and a health center. Five of the insects were adults (three positive for Trypanosoma cruzi) and one was a nymph. Conclusions: This is the first report of triatomine occurrence in schools or churches. These data are important for implementing surveillance strategies and alerting individuals about possible changes in Chagas disease transmission dynamics. Background Amazon Methods Acre Rio Sul. Sul . Sul) Results penitentiary church school university hospital center three cruzi nymph Conclusions churches dynamics

Resumo O objetivo do presente estudo foi relatar a ocorrência de parasitismo por carrapatos Amblyomma rotundatum em duas espécies de lagartos Teiidae, e testar a presença de riquétsias nos carrapatos coletados, na região da Amazônia Ocidental brasileira. Os carrapatos foram coletados em julho de 2019, em um fragmento de floresta de terra firme no município de Senador Guiomard, Acre, Brasil. Dois lagartos infestados por estágios imaturos de carrapatos foram capturados com rede de neblina e armadilhas Tomahawk. Os ectoparasitos foram coletados manualmente, e os espécimes de lagartos foram identificados e soltos no mesmo local onde foram capturados. Três ninfas e 49 larvas foram coletadas de Ameiva ameiva, enquanto 25 ninfas e nove larvas foram coletadas de Tupinambis cuzcoensis, ambas da família Teiidae. Os carrapatos foram identificados morfologicamente como pertencentes ao gênero Amblyomma. As ninfas foram identificadas em nível de espécie por meio de análise molecular, resultando na espécie de carrapato Amblyomma rotundatum. Este é o primeiro registro de parasitismo pelo carrapato A. rotundatum em lagarto T. cuzcoensis, e o primeiro relato de associação entre A. rotundatum e as espécies de lagartos A. ameiva e T. cuzcoensis, no Acre, na parte ocidental da região amazônica. Teiidae brasileira 2019 Guiomard Acre Brasil Tomahawk manualmente 4 2 cuzcoensis molecular A T amazônica 201 20

Abstract The aim of the present study was to report on the occurrence of parasitism by Amblyomma rotundatum ticks on two species of Teiidae lizards and test the presence of rickettsiae in the collected ticks, in the western Brazilian Amazon region. Ticks were collected in July 2019, from a fragment of terra firme forest in the municipality of Senador Guiomard, Acre, Brazil. Two lizards that were infested by immature stages of ticks were caught using mist net and Tomahawk traps. Ectoparasites were collected manually, and the lizard specimens were identified and released at the same location where they had been caught. Three nymphs and 49 larvae were collected from Ameiva ameiva, while 25 nymphs and nine larvae were collected from Tupinambis cuzcoensis, which are both in the family Teiidae. The ticks were identified morphologically as belonging to the genus Amblyomma. Nymphs were identified at species level through molecular analysis, resulting in the tick species Amblyomma rotundatum. This is the first record of parasitism by the tick A. rotundatum on T. cuzcoensis lizard, and the first report of an association between A. rotundatum and the lizard species A. ameiva and T. cuzcoensis in Acre, in the western part of the Amazon region. region 2019 Guiomard Acre Brazil traps manually 4 2 analysis A T 201 20

BACKGROUND Erythema nodosum leprosum (ENL) is an acute and systemic inflammatory reaction of leprosy characterised by painful nodules and involvement of various organs. Thalidomide is an immunomodulatory and anti-inflammatory drug currently used to treat this condition. Cereblon (CRBN) protein is the primary target of thalidomide, and it has been pointed out as necessary for the efficacy of this drug in others therapeutics settings. OBJECTIVES In this study, we aimed to evaluate the influence of CRBN gene variants on the dose of thalidomide as well as its adverse effects during treatment of ENL. METHODS A total of 103 ENL patients in treatment with thalidomide were included in this study. DNA samples were obtained from saliva and molecular analysis of CRBN gene were performed to investigate the variants rs1620675, rs1672770 and rs4183. Different genotypes of CRBN variants were evaluated in relation to their influence on the dose of thalidomide and on the occurrence of adverse effects. FINDINGS No association was found between CRBN variants and thalidomide dose variation. However, the genotypes of rs1672770 showed association with gastrointestinal effects (p = 0.040). Moreover, the haplotype DEL/C/T (rs4183/rs1672770/rs1620675) was also associated with gastrointestinal adverse effects (p = 0.015). MAIN CONCLUSIONS Our results show that CRBN variants affect the treatment of ENH with thalidomide, especially on the adverse effects related to the drug.

Resumo O estado do Acre está localizado na Amazônia ocidental brasileira e apresenta poucos estudos envolvendo carrapatos. O presente estudo objetivou relatar, pela primeira vez, a ocorrência da espécie Amblyomma latepunctatum e o segundo registro de Ixodes luciae no estado do Acre, Brasil. A coleta de carrapatos foi realizada em outubro de 2020 no interior de uma floresta aberta no município de Rio Branco, capital do estado do Acre. Carrapatos ixodídeos foram identificados de acordo com suas características morfológicas externas. Três espécimes foram encontrados sobre a vegetação pelo método de inspeção visual e identificados como as espécies Amblyomma scalpturatum (um macho e uma fêmea) e Amblyomma latepunctatum (um macho); e outro foi encontrado parasitando uma fêmea de Didelphis marsupialis que foi capturada por uma armadilha Tomahawk, e identificado como Ixodes luciae (um macho). Este primeiro relato de A. latepunctatum no estado do Acre aumenta o número de espécies registradas aqui para 22. Além disso, a presença de I. luciae é confirmada no estado do Acre (segundo registro), na região da Amazônia ocidental brasileira.

Abstract The state of Acre is in the western part of the Brazilian Amazon region and few studies involving ticks are available. The aim of the present study was to provide the first report of occurrence of Amblyomma latepunctatum and the second record of Ixodes luciae in Acre. Ticks were collected in October 2020 inside an open forested area in the municipality of Rio Branco, the state capital of Acre. Ixodid ticks were identified according to their external morphological characteristics. Three specimens were found on the vegetation by means of a visual search and were identified as Amblyomma scalpturatum (one male and one female) and Amblyomma latepunctatum (one male). Another specimen was found parasitizing a Didelphis marsupialis female that was caught using a Tomahawk trap; this was identified as Ixodes luciae (one male). This first report of A. latepunctatum in the state of Acre increases the number of species recorded here to 22. In addition, presence of I. luciae is confirmed in this state (second record), in the western Brazilian Amazon region.

Abstract INTRODUCTION: Triatomines are hematophagous insects that are important to public health since they are the vectors of American Trypanosomiasis. The objective of this study was to describe the occurrence of triatomines in homes in Cruzeiro do Sul, Acre, Brazil. METHODS The specimens were collected by an active search inside homes and also by a passive search by the residents. RESULTS: A total of 55 triatomines were captured comprising of 5 species each of the genera Rhodnius, Eratyrus, and Panstrongylus. No colonies were detected, ruling out the possibility of domiciliation. CONCLUSIONS: Information on regional epidemiological dynamics contributes to the prevention and control of disease.

Abstract INTRODUCTION: Triatomines are insect vectors of Trypanosoma cruzi, the etiological agent of Chagas disease. METHODS: Triatomines were collected from households and by dissecting palm trees in the peri-urban areas of Cruzeiro do Sul (Acre); they were identified using a specific key and via genital analyses. Trypanosomatid infection was determined through microscopy and polymerase chain reaction. RESULTS: In total, 116 triatomines of the species Eratyrus mucronatus, Rhodnius pictipes, R. stali, and R. montenegrensis were collected, of which 13.8% were positive for T. cruzi. CONCLUSIONS: Four species of triatomines presented an infection rate above 13% in the Boca do Moa community.

Abstract The present study aims to describe the occurrence of triatomines and their infection rate by Trypanosoma cruzi, in an area of Chagas disease outbreak in Rodrigues Alves municipality, Acre state, Brazil. Collections were performed by passive search (capture of specimens by local people) and dissection of palm trees (Attalea butyracea and Mauritia flexuosa). Thirty two triatomines belonging to four species grouped into two genera (Rhodnius and Eratyrus) had T. cruzi infection rate of 15.6%. Only in A. butyracea triatomines were captured. The passive search was the most effective method for collection. The Nova Cintra triatomine fauna comprises four species and it is important to carry out future studies to understand the biology of these triatomines.

Resumen El presente estudio tiene como objetivo describir la aparición de triatominos y la infección causada por Trypanosoma cruzi, en un área de brote de la enfermedad de Chagas en el municipio de Rodrigues Alves, estado de Acre, Brasil. Las recolecciones se realizaron mediante búsqueda pasiva y disección en palmeras (Attalea butyracea y Mauritia flexuosa). Treinta y dos triatominos pertenecientes a cuatro especies agrupadas en dos géneros (Rhodnius y Eratyrus) tenían una tasa de infección por T. cruzi del 15,6%. Solo en A. butyracea se capturaron triatominos. La búsqueda pasiva fue el método más efectivo para la recolección. La fauna triatomina de Nova Cintra comprende cuatro especies, es importante realizar futuros estudios para comprender su biología.

Abstract INTRODUCTION: Triatomines are hematophagous insects of epidemiological importance because they are vectors of Chagas disease. We present here the first report of Rhodnius montenegrensis in Amazonas, Brazil. METHODS: Triatomines were collected from Attalea butyracea palm trees in the municipality of Guajará. RESULTS: Two adult female R. montenegrensis specimens were identified. CONCLUSIONS: The present study confirms that the number of triatomine species within the Amazon has increased from 10 to 11, and the number of Brazilian states with R. montenegrensis has increased from two to three.

Abstract We present the first recent reported case of traumatic injury caused by catfish in the Americas. Although 66.2% of fish-related injuries occur in the Amazon Region, they are scarcely reported. We report a traumatic injury in a 2-year-old boy who entered Madeira River. The use of traditional methods to treat the injury and his incomplete vaccination history reflect the weakness of the health system. Further, the fact that it was the second time that such an incident had occurred in the locality in 3 weeks during the dry season suggests that this could be a frequent occurrence during this period.

Resumo A maioria das espécies de água doce de Cymothoidae está distribuída na Sul e foi registrada principalmente nas regiões Leste e Oeste da bacia do Rio Amazonas. Entretanto, nesse ecossistema, a biodiversidade desse grupo pode ser maior se toda a bacia amazônica for considerada. Nesse sentido, o objetivo do presente estudo foi fornecer uma lista atualizada de espécies de isópodes da família Cymothoidae que são encontrados em peixes na Região Amazônica brasileira e relatar novas ocorrências de peixes hospedeiros, ampliando as distribuições geográficas para isópodes cimotoides que parasitam peixes na região Sudoeste da Amazônia brasileira. Os parasitos encontrados em espécimes de peixes coletados foram analisados e posteriormente identificados. Foram encontradas oito espécies de Cymothoidae parasitando diferentes espécies de peixes hospedeiros na região Sudoeste da Amazônia. No entanto, foram encontradas 14 espécies de Cymothoidae em toda a Região Amazônica brasileira. Três novos relatos de espécies foram observados, o que aumenta o número de espécies de Cymothoidae nessa região para 17. Essas espécies relatadas, também são novos registros para o Brasil. Portanto, este estudo ajudou a expandir o conhecimento sobre a distribuição e diversidade de Cymothoidae na bacia amazônica.

Abstract Most freshwater species of Cymothoidae are distributed in South America. They have mainly been recorded in the eastern and western regions of the Amazon River basin. However, in this ecosystem, the biodiversity of this group may be greater if the entire Amazon basin is considered. In this regard, the aim of the present study was to provide an updated list of isopod species of the family Cymothoidae that are found in fish in the Brazilian Amazon region and to report on new fish host occurrences and expanded geographical distributions for cymothoid isopods that parasitize fish in the southwestern Brazilian Amazon region. The parasites found in fish specimens were collected, fixed and identified later. We found eight species of Cymothoidae parasitizing different host fish species in the southwestern Amazon region. However, we found 14 species of Cymothoidae throughout the Brazilian Amazon region. Three additional species are thus reported here, which increases the number of species of Cymothoidae in this region to 17. These additional species are also new records for Brazil. Therefore, this study has contribute to expand the knowledge about the distribution and diversity of Cymothoidae in the Amazon basin.

ABSTRACT The etiological agent of American trypanosomiasis is the protozoan Trypanosoma cruzi , typically transmitted by triatomines. The aim of this study was to investigate the triatomine fauna and trypanosomiasis infections in Acre State , Western Brazilian Amazon. Insect collection was performed by dissecting palm trees and installing traps. We found that T. cruzi infection rate was 24.5% and Rhodnius pictipes (57.1%) was the most abundant triatomine species. Health education as well as epidemiological and entomological surveillance are necessary to diagnose and prevent new cases of Chagas disease in the region.

Abstract INTRODUCTION: This communication reports the first occurrence of Panstrongylus lignarius in the State of Acre, Brazil. METHODS: A specimen of P. lignarius was collected from a residence in a rural area of the municipality of Rio Branco, Acre, Western Amazon. RESULTS: This new report of P. lignarius extends the distribution of this species to eight Brazilian states, and also increases the number of species of Triatominae described from the state of Acre from nine to ten. CONCLUSIONS: The occurrence of P. lignarius deserves attention, since this species has the potential for domiciliation and transmitting Trypanosoma cruzi.