ABSTRACT OBJECTIVE: Viral hepatitis and sexually transmitted infections disproportionally affect men who have sex with men (MSM) and transgender women (TGW). However, only a few studies have evaluated the prevalence of hepatitis in these populations, especially in youths and adolescents. This study aimed to estimate the prevalence of biomarkers for hepatitis A, B, and C among young and adolescent MSM and TGW in three Brazilian municipalities. METHODS: Baseline data were collected from a combination of HIV prevention cohort of young and adolescent MSM (AMSM) and TGW (ATGW) aged 15-19 years in three Brazilian municipalities. A social behavioral questionnaire was applied, and immunoassays were performed to detect antibodies against hepatitis A (anti- HAV IgG and IgM), hepatitis B (anti-HBc and anti-HBs), and hepatitis C virus (anti-HCV); testing for the active hepatitis B marker, HBsAg, was also performed. The prevalence of reactive tests and 95% confidence interval (CI) for proportions were measured. RESULTS: The prevalence of naturally or artificially acquired immunity for hepatitis A totaled 17.7% (95%CI: 15.4-20.4), whereas that of acute infection, 0.4% (95%CI: 0.2-1.2). For hepatitis B and C, prevalence rates totaled 2.8% (95%CI: 1.8-4.4) and 0.2% (95%CI: 0.1-1.1), respectively. About 25.7% (95%CI: 22.4-29.4) of participants were non-reactive for anti-HBc and reactive for anti-HBs, the latter being a vaccine marker for hepatitis B. CONCLUSIONS: The investigation of viral hepatitis biomarkers among vulnerable populations enables the early identification of infections, the provision of timely treatment, and an opportunity to point out the need to expand vaccination coverage. OBJECTIVE (MSM TGW. . (TGW) However adolescents municipalities METHODS AMSM (AMSM ATGW (ATGW 1519 15 19 15-1 applied anti (anti IgM, IgM , IgM) antiHBc HBc antiHBs, antiHBs HBs anti-HBs) antiHCV HCV (anti-HCV) HBsAg 95 CI (CI measured RESULTS 177 17 7 17.7 95%CI 95CI (95%CI 15.420.4, 154204 15.4 20.4 4 20 15.4-20.4) infection 04 0 0.4 0.21.2. 0212 0.2 1.2 2 1 0.2-1.2) 28 8 2.8 1.84.4 1844 1.8 4.4 1.8-4.4 02 0.11.1, 0111 0.1 1.1 0.1-1.1) respectively 257 25 25.7 22.429.4 224294 22.4 29.4 22 29 22.4-29.4 nonreactive non HBs, anti-HBs CONCLUSIONS treatment coverage (TGW 151 15- (anti-HCV 9 17. 420 15.420.4 15420 154 15. 204 20. 15.4-20.4 0. 21 0.21.2 021 12 1. 0.2-1.2 2. 84 1.84. 184 18 44 4. 1.8-4. 11 0.11.1 011 01 0.1-1.1 25. 429 22.429. 22429 224 22. 294 29. 22.4-29. 42 15.420. 1542 15.4-20. 0.21. 0.2-1. 1.84 1.8-4 0.11. 0.1-1. 22.429 2242 22.4-29 15.420 15.4-20 0.21 0.2-1 1.8- 0.11 0.1-1 22.42 22.4-2 15.42 15.4-2 0.2- 0.1- 22.4- 15.4-

ABSTRACT OBJECTIVE: Viral hepatitis and sexually transmitted infections disproportionally affect men who have sex with men (MSM) and transgender women (TGW). However, only a few studies have evaluated the prevalence of hepatitis in these populations, especially in youths and adolescents. This study aimed to estimate the prevalence of biomarkers for hepatitis A, B, and C among young and adolescent MSM and TGW in three Brazilian municipalities. METHODS: Baseline data were collected from a combination of HIV prevention cohort of young and adolescent MSM (AMSM) and TGW (ATGW) aged 15-19 years in three Brazilian municipalities. A social behavioral questionnaire was applied, and immunoassays were performed to detect antibodies against hepatitis A (anti- HAV IgG and IgM), hepatitis B (anti-HBc and anti-HBs), and hepatitis C virus (anti-HCV); testing for the active hepatitis B marker, HBsAg, was also performed. The prevalence of reactive tests and 95% confidence interval (CI) for proportions were measured. RESULTS: The prevalence of naturally or artificially acquired immunity for hepatitis A totaled 17.7% (95%CI: 15.4-20.4), whereas that of acute infection, 0.4% (95%CI: 0.2-1.2). For hepatitis B and C, prevalence rates totaled 2.8% (95%CI: 1.8-4.4) and 0.2% (95%CI: 0.1-1.1), respectively. About 25.7% (95%CI: 22.4-29.4) of participants were non-reactive for anti-HBc and reactive for anti-HBs, the latter being a vaccine marker for hepatitis B. CONCLUSIONS: The investigation of viral hepatitis biomarkers among vulnerable populations enables the early identification of infections, the provision of timely treatment, and an opportunity to point out the need to expand vaccination coverage.

Resumo O contexto brasileiro de desigualdades sociais e barreiras no acesso aos serviços de saúde pode agravar a situação da pandemia de COVID-19, que já afeta todos os estados da federação, com a curva crescente de aumento de casos confirmados e mortes. O governo dos países e os agentes do campo científico têm buscado evidências para as melhores práticas de prevenção e controle da transmissão, e cuidado da infecção e doença, incluindo medidas de diagnóstico, tratamento e de atenção à saúde. A estratégia de testagem em larga escala, visando o diagnóstico precoce, quarentena dos casos leves identificados, bem como dos contactantes, e cuidado adequado dos casos graves, tem sido revisada e indicada como uma das medidas eficientes para o controle da pandemia em vários países do mundo. O artigo tem como objetivo discutir os desafios da testagem e do diagnóstico de COVID-19 no Brasil.

Abstract The Brazilian context of social inequalities and barriers in accessing health services may deteriorate the situation of the COVID-19 pandemic, which already affects all Brazilian federative states, with the growing curve of increasing confirmed cases and deaths. National governments and scientific field agents have been looking for evidence for the best practices of prevention and control of transmission, and care of infection and disease, including diagnosis, treatment, and health care measures. The large-scale testing strategy, aimed at early diagnosis, quarantine of the mild cases identified, as well as those of the contacts, and adequate care of severe cases, has been revised and indicated as one of the efficient pandemic control measures in several countries in the world. This paper aims to discuss the challenges of COVID-19 testing and diagnosis in Brazil.

Resumo O contexto brasileiro de desigualdades sociais e barreiras no acesso aos serviços de saúde pode agravar a situação da pandemia de COVID-19, que já afeta todos os estados da federação, com a curva crescente de aumento de casos confirmados e mortes. O governo dos países e os agentes do campo científico têm buscado evidências para as melhores práticas de prevenção e controle da transmissão, e cuidado da infecção e doença, incluindo medidas de diagnóstico, tratamento e de atenção à saúde. A estratégia de testagem em larga escala, visando o diagnóstico precoce, quarentena dos casos leves identificados, bem como dos contactantes, e cuidado adequado dos casos graves, tem sido revisada e indicada como uma das medidas eficientes para o controle da pandemia em vários países do mundo. O artigo tem como objetivo discutir os desafios da testagem e do diagnóstico de COVID-19 no Brasil.

Abstract The Brazilian context of social inequalities and barriers in accessing health services may deteriorate the situation of the COVID-19 pandemic, which already affects all Brazilian federative states, with the growing curve of increasing confirmed cases and deaths. National governments and scientific field agents have been looking for evidence for the best practices of prevention and control of transmission, and care of infection and disease, including diagnosis, treatment, and health care measures. The large-scale testing strategy, aimed at early diagnosis, quarantine of the mild cases identified, as well as those of the contacts, and adequate care of severe cases, has been revised and indicated as one of the efficient pandemic control measures in several countries in the world. This paper aims to discuss the challenges of COVID-19 testing and diagnosis in Brazil.

ABSTRACT Maternal Toxoplasma gondii (T. gondii) infection can lead to spontaneous abortion, fetal malformation, and numerous sequelae in the newborn, including visual and hearing impairment. T. gondii serology was determined in pregnant women and their newborns who were referred to Climério de Oliveira Maternity, Federal University of Bahia, and the possible associations with the risk factors for maternal infection were investigated. This cross-sectional study was conducted from January to December 2014 and included 712 pregnant women, aged 15 to 49 years, and 235 newborns. Seroprevalence was determined by the detection of T. gondii-specific immunoglobulin (Ig) M (IgM) and IgG antibodies using enzyme-linked immunoassay. In addition, mothers completed a questionnaire that focused on socioeconomic aspects, and survey data were tabulated using the SPSS statistical software program (version 21.0 for Windows). The seroprevalence rate for specific IgG antibodies was 51% (362) among mothers and 93% (219) among neonates. All the mothers and their newborns were negative for specific-IgM antibodies. Higher age group and lower maternal education were the only risk factors statistically associated with the presence of specific IgG. In summary, high levels of specific IgG antibodies were observed in pregnant women. The knowledge of risk factors for toxoplasmosis can help in the orientation of newly pregnant women.

RESUMO Este estudo avaliou a capacidade anti-helmíntica in vivo do extrato aquoso de folhas de C. mollis, administrado por via oral em caprinos naturalmente infectados com nematódeos gastrintestinais. Para isto, os animais foram aleatoriamente distribuídos em três grupos (grupo não tratado, grupo controle tratado com doramectina (1mL/50 kg de peso corpóreo) e grupo tratado com o extrato aquoso de C. mollis (2,5mg/ kg de peso corpóreo). Amostras de sangue e fezes foram colhidas de cada animal nos dias 0 e 30 após o tratamento para verificar parâmetros imunológicos e parasitológicos. Uma redução significativa na oviposição (61,1%) e um aumento dos níveis de IgA e eosinófilos foram observados no grupo tratado com o extrato aquoso, em comparação aos grupos controle (não tratado e tratado com doramectina). Considerando que nematódeos gastrintestinais de pequenos ruminantes causam perdas econômicas ao nível mundial, devido ao custo e à resistência aos anti-helmínticos disponíveis, além do efeito residual nos derivados animais para consumo humano, os extratos vegetais apresentam-se como uma fonte alternativa de anti-helmínticos. Assim, Cratyliamollis Mart. ExBenth é uma planta usada no semi-áridodo Nordeste brasileiro para tratardoenças e como forragem. Portanto, os resultados indicaram o potencial anti-helmíntico do extrato, embora mais estudos sejam necessários para validar seu uso para fins terapêuticos.

SUMMARY The present study assessed the in vivo anthelmintic activity of the C. mollis leaf decoction extract when administered orally to naturally infected goats with gastrointestinal nematodes. To this, animals were randomized into three groups:non-treated, control (treated with doramectin 1mL/50 kg b.w.) and C. mollis extract treated groups (2.5mg/kg b.w.). Blood and faecal samples were collected from each animal at day 0, and 30th day posttreatment to monitor immunological and parasitological parameters. A significant faecal egg reduction (61.1%) and an increase in IgA and eosinophils levels were observed in the C. mollis extract treated group, in comparison to the untreated and doramectin groups. Considering that gastrointestinal nematode infections in small ruminants are serious problems in the world, causing economic losses worldwide, associated to high anthelmintic cost, resistance to available anthelmintics and residue problems in meat and milk for human consumption, the plant extract use is an area of interest to search new anthelmintic agents. Thus, Cratyliamollis Mart. Ex Benth, an important medicinal plant from Brazilian Northeast semiarid region, is used to treat different types of diseases, and as forage supplementation. Therefore, the data indicated the potential anthelmintic activity of C. mollis extract; further research is thereby warranted to assess its value for therapeutic purposes.

INTRODUÇÃO: O vírus linfotrópico da célula T humana (HTLV) é um retrovírus de prevalência elevada em Salvador, Bahia, quando comparado a outras capitais brasileiras. O estudo de seus fatores de risco é muito importante para se entender a dinâmica da infecção no município. OBJETIVO: Avaliar a soroprevalência e alguns fatores de risco para a infecção por HTLV-I/II em indivíduos assistidos pelo Programa Saúde da Família (PSF) no município de Salvador, Bahia, Brasil. MATERIAIS E MÉTODOS: Amostras biológicas foram obtidas em postos do PSF do município de Salvador. Foram realizados imunoensaios do tipo ELISA para a detecção de anticorpos anti-HTLV-I/II. Dados retrospectivos sobre alguns fatores de risco para a infecção pelo HTLV foram obtidos por meio de questionário. RESULTADOS: Foram testadas 765 amostras, 529 (69,2%) do sexo feminino e 236 (30,8%) do masculino. A soroprevalência geral para HTLV-I/II foi de 1,96%, aumentando de acordo com a idade. Observou-se soroprevalência de 2,16% e 1,89% para os sexos masculino e feminino, respectivamente (p = 0,833). Entre os indivíduos com idade inferior a 30 anos (n = 161), não houve soropositivos para HTLV-I/II. Entre os soropositivos, 84,6% relataram ter parceiro sexual fixo e 61,5% não utilizam preservativo com frequência em suas relações sexuais, semelhante ao observado entre os soronegativos, com 76,5% e 67,4%, respectivamente. CONCLUSÃO: A soroprevalência encontrada é considerada alta em comparação a outros municípios brasileiros. Os fatores de risco analisados não foram estatisticamente diferentes entre os grupos soronegativos e soropositivos para HTLV-I/II. A transmissão vertical não se mostrou como importante fator na manutenção do vírus.

INTRODUCTION: HTLV is a retrovirus with high prevalence in Salvador, Bahia, when compared to other Brazilian capitals. The study of its risk factors is very important in order to understand the infection dynamics in the municipality. OBJECTIVE: To assess the prevalence and some risk factors for HTLV-I/II infection among people assisted by the Family Health Program (FHP) in Salvador, Bahia, Brazil. MATERIALS AND METHODS: Biological samples were obtained from FHP health centers in Salvador city. Immunoassays were performed by ELISA method for HTLV antibody detection. Retrospective data about potential risk factors to HTLV infection were obtained through questionnaire. RESULTS: 765 samples were tested, 529 (69.2%) females and 236 (30.8%) males. The overall HTLV-I/II seroprevalence was 1.96%, increasing according to age. HTLV-I/II seroprevalence was 2.16% and 1.89% for males and females, respectively (p = 0.833). Among seropositive individuals, 84.6% reported having a steady sexual partner and 61.5% do not use condoms frequently in their sexual intercourses, what similarly was observed among seronegative with 76.5% and 67.4%, respectively. CONCLUSION: The seroprevalence found is considered high compared to other Brazilian municipalities. The analyzed risk factors were not statistically different between HTLV-I/II seronegative and seropositive groups. The vertical transmission was not an important factor for virus maintenance.

INTRODUÇÃO: A leishmaniose visceral (LV) é uma importante zoonose para os sistemas de saúde pública, sendo os cães o principal reservatório doméstico. Este estudo teve como objetivo investigar a ocorrência de LV canina (LVC) em Dias D'Ávila, Estado da Bahia, Brasil. MÉTODOS: A prevalência foi avaliada através de exames clínicos e laboratoriais em uma população de 312 cães domésticos de 23 localidades da cidade, utilizando-se imunofluorescência indireta e ensaio imunoenzimático. RESULTADOS: Dentre os animais examinados, 3.2% e 6.7% apresentaram sinais de LV, confirmados por imunofluorescência indireta e ensaio imunoenzimático, respectivamente, com distribuição de 29.9% (24 cães) na zona rural e 4.9% (288 cães) na área urbana (p=0,001). A avaliação clínica de cães soropositivos apresentou animais assintomáticos (2,4%) e sintomáticos (47,6%), além de outras alterações (e.g., anemia normocítica e normocrômica, com leucocitose e trombocitopenia). Observações relativas a características fenotípicas (e.g. sexo, idade, raça e pelo) não apresentaram significância estatística, embora uma soropositividade alta entre machos, animais de pelo curto e de raça indefinida tenha sido observada. CONCLUSÕES: Os achados indicam que a LV é uma zoonose predominantemente rural e que o convívio de aves e cães domésticos aumenta significativamente o risco da infecção canina na região.

INTRODUCTION: Visceral leishmaniasis (VL) is an important zoonosis in relation to public health systems. Dogs are the main domestic reservoir. This study aimed to investigate occurrences of canine VL in Dias D'Ávila, State of Bahia, Brazil. METHODS: The prevalence was evaluated by means of clinical and laboratory tests on a population of 312 domestic dogs from 23 localities in this municipality, using indirect immunofluorescence and immunoenzymatic assays. RESULTS: Among the animals examined, 3.2% and 6.7% showed signs of VL, confirmed by indirect immunofluorescence and immunoenzymatic assays, respectively, with a distribution of 29.9% (24 dogs) in the rural zone and 4.9% (288 dogs) in the urban zone (p = 0.001). The clinical evaluation on seropositive dogs showed both asymptomatic animals (2.4%) and symptomatic animals (47.6%), along with other abnormalities (e.g. normocytic and normochromic anemia, with leukocytosis and thrombocytopenia). Observations relating to phenotypic characteristics (e.g. sex, age, breed and hair) did not present statistical significance, although high seropositivity among male, short-haired and mixed-breed dogs was observed. CONCLUSIONS: The findings showed that VL was a predominantly rural zoonosis and that close contact between poultry and domestic dogs significantly increased the risk of canine infection in this region.

O HTLV-I foi descoberto no início dos anos 1980 e associado a leucemia/linfoma de células T (LLTA) e paraparesia espástica tropical (PET). O HTLV pertence à família Retroviridae e tem um genoma de RNA de fita simples com uma estrutura genética similar à dos demais retrovírus, possuindo os genes gag, pol, env e pX. Este último contém os genes reguladores tax e rex. Tax e Rex são as principais proteínas reguladoras do genoma viral, sendo que Tax regula a transcrição do genoma proviral indiretamente ao interagir com diferentes proteínas regulatórias celulares, principalmente genes de citocinas e protoncogenes, e Rex atua como um regulador pós-transcricional do genoma do HTLV-I ao controlar o processamento (splicing) do RNAm viral. Essa infecção é endêmica em diversas regiões do mundo, tais como Japão, vários países da África, Caribe e América do Sul. No Brasil, Salvador é a cidade de maior prevalência, atingindo 1,7% da população geral. A maioria dos indivíduos infectados pelo HTLV-I permanece assintomática no decorrer de suas vidas, correspondendo a aproximadamente 95%. Dos indivíduos sintomáticos, alguns desenvolvem PET e outros, LLTA, sem que suas fisiopatogenias estejam perfeitamente esclarecidas. O diagnóstico rotineiro da infecção causada pelo HTLV-I baseia-se na detecção sorológica de anticorpos específicos para antígenos das diferentes porções do vírus ou através da pesquisa de seqüências genômicas provirais em células mononucleares periféricas. Ainda não existe nenhum estudo epidemiológico com bases populacionais e com metodologias adequadas sobre a infecção pelo HTLV-I que permita conhecer sua real prevalência no Brasil.

Human T-cell lymphotropic virus type I (HTLV-I) has been identified as the causative agent of both adult T-cell leukemia (ATL) and HTLV-I-associated myelopathy/tropical spastic paraparesis (HAM/TSP). Similar to other retroviruses, HTLV-I has a positive strand RNA diploid genome consisting of four genes: gag, pol, env and pX. The pX region codes for the two regulatory proteins tax and rex. Tax protein is essential for efficient virus expression and plays an important role for activation of cellular genes, such as cytokine genes and protooncogenes. Rex protein induces the expression of unspliced and single spliced mRNAs and regulates a fine balance between the levels of expression of the viral proteins. HTLV-I is widely spread throughout the world. It is endemic in Japan, Africa, the Caribbean and South America. In Brazil, Salvador city shows the highest HTLV-I prevalence rate (1.7%) of the country. It has been established that a vast majority (nearly 95%) of HTLV-I-infected individuals will remain asymptomatic throughout their life. The mechanisms by which HTLV-I causes diseases are not fully elucidated. The HTLV-I diagnosis is based on serologic detection of specific antibodies against several antigens of the virus or through amplification of proviral sequences in the peripheral blood mononuclear cells. However, there is not an epidemiological study with populational bases and suitable methodology in order to estimate its real prevalence in Brazil.