ABSTRACT Background: This cross-sectional study compared the general impact of cutaneous leishmaniasis (CL) and patient satisfaction with treatment and health services as perceived by those undergoing different therapeutic regimens in an endemic region in South-Eastern Brazil. We also investigated the factors associated with both outcomes (general impact and satisfaction). Methods: We included 84 patients with CL treated between 2018 and 2019 with intravenous meglumine antimoniate, liposomal amphotericin B, or intralesional meglumine antimoniate therapy. Data were collected through interviews that assessed sociodemographic characteristics, comorbidity status, access and use of health services for CL diagnosis and treatment, and the items of the Cutaneous Leishmaniasis Impact Questionnaire (CLIQ). The CLIQ is a psychometric questionnaire previously validated to assess the general impact of CL on patient satisfaction with treatment and health services. Multivariate logistic regression analysis was used to identify the factors associated with high CL impact and low patient satisfaction. Results: The general impact of CL and patient satisfaction with treatment and health services were not significantly associated with the therapeutic regimen. High CL impact was associated with low family income (odds ratio [OR]:3.3; 95% confidence interval [CI]:1.0-10.3), occurrence of complications/adverse effects during treatment (OR:7.7; 95%CI:2.4-25.6), and additional costs during diagnosis and/or treatment (OR:12.1; 95% CI:2.8-52.4). Low satisfaction was associated with high disease impact (OR: 9.5; 95% CI:2.7-33.9), occurrence of complications/adverse effects (OR:4.2; 95% CI:1.3-13.0), and high family income (OR:7.1; 95%CI:1.7-28.2). Conclusions: Our data support public health policies aimed at reducing the impact of CL and its treatment as well as the use of therapy with fewer adverse effects.

ABSTRACT Introduction: Intestinal parasitosis by helminths and protozoa is still today a global public health problem mainly affecting people living in conditions of social vulnerability, including rural communities. Objective: Describe human intestinal parasitosis and environmental contamination with helminths and protozoa in the Quilombola community of Quartel do Indaiá (of African descent) in the State of Minas Gerais, Brazil. Methods: A cross-sectional study was conducted of stool and soil samples by spontaneous sedimentation, and of plant samples by centrifugation sedimentation, to detect intestinal helminths and protozoa. Water samples were analyzed for total and fecal coliforms. Results: Helminths and protozoa were found in 45.5% of the people (n = 66). The species detected were Ascaris lumbricoides (18.2 %), Entamoeba coli (18.2%), Endolimax nana (18.2 %), ancylostoma (6.1 %), Iodamoeba butschlii (4.6 %), Giardia duodenalis (3%) and Trichuris trichiura (1.5 %). More than one species were present in 19.7 % of the samples. In 18 of the 39 sites sampled, the soil was contaminated with E. coli, E. nana, A. lumbricoides, I. butschlii and/or Enterobius vermicularis. Vegetables (n = 135) were contaminated in 75 samples with 7 of the 8 species analyzed. The contaminants were E. coli cysts, A. lumbricoides eggs and ancylostoma. All water samples were contaminated with total and fecal coliforms. Conclusions: The Quilombola community of Quartel do Indaiá had high levels of human infection and high environmental contamination with intestinal parasites or protozoa, probably due to lack of appropriate sanitary conditions. It is necessary to improve the access to treated water and sanitation.

RESUMEN Introducción: El parasitismo intestinal por helmintos y protozoarios todavía es un problema de salud pública mundial, que afecta sobre todo personas en condiciones de vulnerabilidad social, incluso las comunidades rurales. Objectivo: Describir la infección humana y la contaminación ambiental por parásitos/comensales intestinales en una comunidade ‘quilombola’ Quartel do Indaiá (descendentes de esclavos) del Estado de Minas Gerais, Brasil. Métodos: Estudio de corte transversal con análisis de muestras fecales y de tierra por sedimentación espontánea, y de vegetales por sedimentación con centrifugación para detección de parásitos o comensales intestinales. Se analizaron muestras de agua para detección de coliformes totales y fecales. Resultados: Se observó la ocurrencia de parásitos o comensales en 45.5 % de las personas (n = 66). Las especies detectadas fueron Ascaris lumbricoides (18,2 %), Entamoeba coli (18,2 %), Endolimax nana (18,2 %), anquilostomas (6.1 %), Iodamoeba butschlii (4,6 %), Giardia duodenalis (3 %), and Trichuris trichiura (1,5 %). Para 19,7 % de las muestras se detectaron más de una especie. El suelo estuvo contaminado en 18 de los 39 sitios muestreados, con presencia de E. coli, E. nana, A. lumbricoides, I. butschlii y/o Enterobius vermicularis. Los vegetales (n = 135) presentaron contaminación en 75 muestras de 7, entre 8 especies analizadas. Sus contaminantes fueron quistos de E. coli y huevos de A. lumbricoides y anquilostoma. Todas las muestras de agua estaban contaminadas por coliformes totales y fecales. Conclusiones: La comunidad ‘quilombola’ Quartel do Indaiá presentó alta infección humana y alta contaminación ambiental por parásitos o comensales intestinales, lo que se debe probablemente a la falta de condiciones sanitarias. Se necesita mejorar el acceso para agua tratada y estructuras de saneamiento.

Abstract: INTRODUCTION: Triatomines are targeted for the control of Chagas disease in endemic areas of Brazil. METHODS: Data regarding triatomines captured during 2001-2008 in 34 municipalities in the Northeast of Minas Gerais were analyzed. RESULTS: In total, 11,187 triatomines from eight species were captured, mostly in henhouses and bedrooms. Trypanosomes were found in 203 samples. Main species were Triatoma sordida, Panstrongylus megistus, and Triatoma vitticeps. The number of P. megistus adults was positively correlated with temperature and precipitation, whereas the number of nymphs followed the inverse pattern. CONCLUSIONS: Occurrence of triatomines in domiciles indicates the need for sustained entomological surveillance.

This study aimed to analyse the spatial distribution of human (2007-2013) and canine (2013) visceral leishmaniasis (VL) in the city of Araçuaí, Minas Gerais, Brazil, and identify the socio-environmental factors related to their occurrence. The spatial distribution of human and canine cases was analysed by kernel density estimation (KDE) and the K function. The KDE values were analysed for correlation between human and canine LV and for normalised difference vegetation index (NDVI). Socio-environmental aspects of household structures and surroundings were evaluated. The spatial distribution of human and canine VL cases exhibited a significant aggregated pattern in distances greater than 350 and 75 m, respectively. The higher occurrence of human and canine infection occurred in the central area of the city. A positive correlation between the densities of human and canine cases was observed, as well as a negative correlation between NDVI and densities of human and canine cases. Socio-environmental analysis revealed that the large amount of animals, organic material from trees and deficiencies in environmental sanitation are possibly contributing to the continuation of the transmission cycle of Leishmania infantum in Araçuaí. These results can contribute to the planning by competent agencies to reduce the incidence of infection in the city.

Resumo A participação comunitária é a principal estratégia para a manutenção da vigilância entomológica da doença de Chagas. O objetivo deste estudo foi avaliar conhecimentos sobre triatomíneos e a doença de Chagas entre moradores de oito localidades de Diamantina, Minas Gerais, atentando a uma eventual relação entre os conhecimentos e a infestação vetorial. Para avaliação dos conhecimentos foi aplicado questionário com questões fechadas e abertas a 583 moradores com idade igual ou superior a dez anos e, para avaliar a capacidade de reconhecimento de triatomíneos, foi apresentado mostruário com insetos. As respostas às questões fechadas foram analisadas quanto à frequência e associação com a infestação triatomínica. As respostas às questões abertas foram organizadas em eixos temáticos e analisadas descritivamente. Embora a capacidade de reconhecer os triatomíneos não tenha sido associada à infestação das localidades, os residentes em áreas com maior infestação demonstraram conhecer melhor os serviços de referência e a necessidade de encaminhar os insetos a estes. Não foi observada associação entre a infestação triatomínica e os conhecimentos sobre a doença de Chagas. Os resultados ora apresentados podem orientar ações de educação em saúde voltadas para a participação da comunidade na notificação de triatomíneos.

Abstract Community participation is the main strategy to sustainability of Chagas disease entomological surveillance. The purpose of this study was to evaluate the level of knowledge on triatomine insects and Chagas disease among the residents from eight localities of Diamantina, in Minas Gerais, with a view to observing any associations between their knowledge and infestations by triatomines. In order to evaluate this knowledge, questionnaires were used containing both closed and open questions. They were applied to 583 residents who were ten years old or over. To establish if they could recognize the triatomine insect, they were given samples to look at. The responses to the closed questions were analyzed with reference to any frequencies of and associations with infestations involving this insect. The responses to the questions were organized into different thematic areas and were descriptively analyzed. Although the resident’s ability to recognize the triatomine insect was not associated with the infestation of the localities, the residents in the areas that had higher infestations showed that they had a good knowledge of the available support services and the need to send the insects to them. We did not observe any associations between triatomine infestations and knowledge of Chagas disease. The results of this study can provide guidance on education that can be given by the health services to the community in order to encourage them to provide notifications of the triatomine insects.

Resumo A participação comunitária é a principal estratégia para a manutenção da vigilância entomológica da doença de Chagas. O objetivo deste estudo foi avaliar conhecimentos sobre triatomíneos e a doença de Chagas entre moradores de oito localidades de Diamantina, Minas Gerais, atentando a uma eventual relação entre os conhecimentos e a infestação vetorial. Para avaliação dos conhecimentos foi aplicado questionário com questões fechadas e abertas a 583 moradores com idade igual ou superior a dez anos e, para avaliar a capacidade de reconhecimento de triatomíneos, foi apresentado mostruário com insetos. As respostas às questões fechadas foram analisadas quanto à frequência e associação com a infestação triatomínica. As respostas às questões abertas foram organizadas em eixos temáticos e analisadas descritivamente. Embora a capacidade de reconhecer os triatomíneos não tenha sido associada à infestação das localidades, os residentes em áreas com maior infestação demonstraram conhecer melhor os serviços de referência e a necessidade de encaminhar os insetos a estes. Não foi observada associação entre a infestação triatomínica e os conhecimentos sobre a doença de Chagas. Os resultados ora apresentados podem orientar ações de educação em saúde voltadas para a participação da comunidade na notificação de triatomíneos.

Abstract Community participation is the main strategy to sustainability of Chagas disease entomological surveillance. The purpose of this study was to evaluate the level of knowledge on triatomine insects and Chagas disease among the residents from eight localities of Diamantina, in Minas Gerais, with a view to observing any associations between their knowledge and infestations by triatomines. In order to evaluate this knowledge, questionnaires were used containing both closed and open questions. They were applied to 583 residents who were ten years old or over. To establish if they could recognize the triatomine insect, they were given samples to look at. The responses to the closed questions were analyzed with reference to any frequencies of and associations with infestations involving this insect. The responses to the questions were organized into different thematic areas and were descriptively analyzed. Although the resident’s ability to recognize the triatomine insect was not associated with the infestation of the localities, the residents in the areas that had higher infestations showed that they had a good knowledge of the available support services and the need to send the insects to them. We did not observe any associations between triatomine infestations and knowledge of Chagas disease. The results of this study can provide guidance on education that can be given by the health services to the community in order to encourage them to provide notifications of the triatomine insects.

Reports of triatomine infestation in urban areas have increased. We analysed the spatial distribution of infestation by triatomines in the urban area of Diamantina, in the state of Minas Gerais, Brazil. Triatomines were obtained by community-based entomological surveillance. Spatial patterns of infestation were analysed by Ripley’s K function and Kernel density estimator. Normalised difference vegetation index (NDVI) and land cover derived from satellite imagery were compared between infested and uninfested areas. A total of 140 adults of four species were captured (100 Triatoma vitticeps, 25Panstrongylus geniculatus, 8 Panstrongylus megistus, and 7 Triatoma arthurneivai specimens). In total, 87.9% were captured within domiciles. Infection by trypanosomes was observed in 19.6% of 107 examined insects. The spatial distributions ofT. vitticeps, P. geniculatus, T. arthurneivai, and trypanosome-positive triatomines were clustered, occurring mainly in peripheral areas. NDVI values were statistically higher in areas infested by T. vitticeps and P. geniculatus. Buildings infested by these species were located closer to open fields, whereas infestations of P. megistus andT. arthurneivai were closer to bare soil. Human occupation and modification of natural areas may be involved in triatomine invasion, exposing the population to these vectors.

INTRODUÇÃO: As capturas de triatomíneos em meio silvestre são laboriosas e demoradas. Algumas armadilhas podem auxiliar nessa tarefa. Relata-se novo modelo de armadilha e captura de exemplar de espécie de triatomíneo raramente encontrada. MÉTODOS: Duas armadilhas luminosas foram instaladas em Diamantina, Estado de Minas Gerais e acompanhadas, semanalmente, durante um ano. RESULTADOS: Uma fêmea de Triatoma arthurneivai foi capturada além de outros triatomíneos. CONCLUSÕES: Um novo modelo de armadilha poderá ser empregado na captura de triatomíneos principalmente em áreas de baixa densidade. Presume-se que o centro de endemismo de Triatoma arthurneivai seja a Cordilheira do Espinhaço.

INTRODUCTION: Triatomine bug captures in the wild are laborious and time-consuming. Some traps may assist in this task. We report a new trap design and the capture of a specimen of a triatomine rarely found. METHODS: Two luminous traps were installed in the city of Diamantina, State of Minas Gerais, and surveyed weekly for a year. RESULTS: A Triatoma arthurneivai female and other triatomine bugs were caught. CONCLUSIONS: A new trap design may be used in triatomine bugs field captures, mainly in low density areas. We assume the center of endemism of Triatoma arthurneivai is the Espinhaço Mountain range.

The factors affecting the sexual behaviour of Panstrongylus megistus were studied under laboratory conditions. A general description of mating behaviour is presented for this species. The effect of the time elapsed after the first imaginal feeding on the mating frequency, the motivation of males to mate and the rejection behaviour by females, were analyzed. We also determined the number of copulas accepted by females of this species. Finally, the possible existence of a sexual chemical signal promoting male aggregation around mating couples was evaluated. Results showed that mating frequency increased with the time elapsed since the first adult meal. Despite the number of male copulatory attempts did not change as a function of time, the rejection behaviour of females became gradually less frequent. Females rejected mating by means of body flattening on the substrate, abdominal movements, evasion or stridulation. After a single copula, females did not usually accept to mate again. Neither male nor female aggregation around mating couples was observed, suggesting the absence of a sexual assembling pheromone in P. megistus.

Eye colour of Triatoma infestans is controlled at a single autosomal locus, with black-eye as the dominant gene and red-eye as the recessive. Inheritance of these characters follows a classical Mendelian system, enabling eye colour to be used as a marker for studies of mating frequency. We found no significant differences in oviposition rates and egg hatching rates irrespective of parental phenotypes. Different mating schedules between red-eye and black-eye parents showed that eye colour did not affect mating competence. Females mated with a single male or with different males together or in succession produced similar numbers of fertile eggs, with the eye colour of the offspring reflecting exposure to the different males. We conclude that although a single mating can provide sufficient sperm for the whole reproductive life of the female, multiple matings can result in balanced assortative sperm usage from the spermatheca.

The triatomine bug Triatoma infestans probably originated in Bolivia and dispersed passively over wide areas of South America, where it is the principal vector of Trypanosoma cruzi. In the region of its probable origin this species shows colonization in two different ecotopes, so that it may be encountered in sylvatic as well as in artificial habitats. The sylvatic colonization pattern is not observed in the rest of its range, where T. infestans is exclusive to man-made habitats. The objective of this study was to compare several aspects of two T. infestans populations, one from Minas Gerais (Brazil) and the other from the Cochabamba Valley (Bolivia), with a view to elucidate the factors associated with the different colonization patterns observed for this species. The differences between the developmental cycle, weight, capacity to ingest blood and mortality rate of first instar nymphs should indicate more fragility of Brazilian population that may be related to its elimination possibility.

Triatoma infestans is the triatomine that presents the greatest dispersion area in South America. However, it is not known whether the original characteristics of this insect remained in its long dispersion process. The purpose of this work was to study comparatively the external male genitalia of insects from different populations of T. infestans, two from Brazil (Minas Gerais and Bahia) and one from Bolivia (Cochabamba Valley), and to investigate the correlation between the morphological and behavioral variations. Differences were observed in one of the structures of the external genitalia (endosoma process) that could be used to characterize the insects from the three populations studied.