ABSTRACT Background: This study aimed to describe the kinetics of Leishmania parasite load determined using kinetoplast DNA (kDNA)-based quantitative polymerase chain reaction (qPCR) in visceral leishmaniasis (VL) patients. Methods: Parasite load in blood was assessed by qPCR at five time points, up to 12 months post-diagnosis. Sixteen patients were followed up. Results: A significant reduction in the parasite load was observed after treatment (P < 0.0001). One patient had an increased parasite load 3 months post-treatment and relapsed clinically at month six. Conclusions: We have described the use of kDNA-based qPCR in the post-treatment follow-up of VL cases.

Abstract Background Data on post-acute COVID-19 in autoimmune rheumatic diseases (ARD) are scarce, focusing on a single disease, with variable definitions of this condition and time of vaccination. The aim of this study was to evaluate the frequency and pattern of post-acute COVID-19 in vaccinated patients with ARD using established diagnosis criteria. Methods Retrospective evaluation of a prospective cohort of 108 ARD patients and 32 non-ARD controls, diagnosed with SARS-CoV-2 infection (RT-PCR/antigen test) after the third dose of the CoronaVac vaccine. Post-acute COVID-19 (≥ 4 weeks and > 12 weeks of SARS-CoV-2 symptoms) were registered according to the established international criteria. Results ARD patients and non-ARD controls, balanced for age and sex, had high and comparable frequencies of ≥ 4 weeks post-acute COVID-19 (58.3% vs. 53.1%, p = 0.6854) and > 12 weeks post-acute COVID-19 (39.8% vs. 46.9%, p = 0.5419). Regarding ≥ 4 weeks post-acute COVID-19, frequencies of ≥ 3 symptoms were similar in ARD and non-ARD controls (54% vs. 41.2%, p = 0.7886), and this was also similar in > 12 weeks post-acute COVID-19 (68.3% vs. 88.2%, p = 0.1322). Further analysis of the risk factors for ≥ 4 weeks post-acute COVID-19 in ARD patients revealed that age, sex, clinical severity of COVID-19, reinfection, and autoimmune diseases were not associated with this condition (p > 0.05). The clinical manifestations of post-acute COVID-19 were similar in both groups (p > 0.05), with fatigue and memory loss being the most frequent manifestations. Conclusion We provide novel data demonstrating that immune/inflammatory ARD disturbances after third dose vaccination do not seem to be a major determinant of post-acute COVID-19 since its pattern is very similar to that of the general population. Clinical Trials platform (NCT04754698).

RESUMO: Carrapatos são importantes parasitos de cães nos trópicos, onde patógenos transmitidos por carrapatos são altamente prevalentes, especialmente em áreas onde as medidas de controle de carrapatos são frequentemente negligenciadas. O estudo investigou a soroprevalência e as anormalidades hematológicas associadas à Ehrlichia canis em cães encaminhados para um hospital veterinário-escola no Centro-oeste do Brasil. Dos 264 cães testados para anticorpos anti-Ehrlichia canis por meio da reação de imunofluorescência indireta (RIFI), 59.1% (156/264) foram positivos. A soropositividade foi associada significativamente à anemia e trombocitopenia, isoladamente ou em combinação, e à leucopenia. Por outro lado, não houve diferenças quanto à soroprevalência segundo sexo, raça e idade. Este estudo demonstrou que cães encaminhados a um hospital veterinário-escola na região Centro-oeste do Brasil são altamente expostos à E. canis, e que cães soropositivos têm maior probabilidade de apresentar alterações hematológicas, principalmente anemia, trombocitopenia e leucopenia. Para o nosso conhecimento, este é o primeiro estudo sobre a detecção de anticorpos anti-E. canis por meio da RIFI em cães do estado de Goiás. Essas descobertas destacam a necessidade de aumentar a conscientização entre os proprietários de cães em relação às medidas de controle do carrapato no Centro-oeste do Brasil, em última análise, para reduzir o risco de exposição ao E. canis e outros patógenos transmitidos por carrapatos.

ABSTRACT: Ticks are significant parasites of dogs in the tropics, where tick-borne pathogens are highly prevalent, especially in areas where tick control measures are frequently neglected. This study investigated the seroprevalence and hematological abnormalities associated with Ehrlichia canis in dogs referred to a veterinary teaching hospital in Central-western Brazil. Out of 264 dogs tested for anti-Ehrlichia canis antibodies by an indirect immunofluorescence assay (IFA), 59.1% (156/264) were positive. Seropositivity was significantly associated to anemia and thrombocytopenia, alone or in combination, and to leukopenia. Conversely, there were no differences in terms of seroprevalence according to sex, breed and age. This study demonstrated that dogs referred to a veterinary teaching hospital in Central-western Brazil are highly exposed to E. canis and that seropositive dogs are more likely to present hematological abnormalities, particularly anemia, thrombocytopenia and leukopenia. To our knowledge, this is the first study on detection of anti-E. canis antibodies by means of IFA among dogs in the state of Goiás. These findings highlighted the need for increasing awareness among dog owners regarding tick control measures in Central-western Brazil, ultimately to reduce the risk of exposure to E. canis and other tick-borne pathogens.

Resumo O objetivo deste estudo foi investigar o nível de exposição à infecção por Leishmania em cães errantes de uma área de transmissão intensa de leishmaniose visceral no estado de Pernambuco. Amostras de sangue de 178 cães foram avaliadas por testes sorológicos e moleculares: teste imunocromatográfico (IC), ensaio imunoenzimático (ELISA), teste de imunofluorescência de anticorpos (RIFI), reação em cadeia da polimerase convencional e quantitativa (cPCR e qPCR). Os valores de positividade obtidos com os testes sorológicos foram 71,4% (127/178), 70,2% (125/178) e 50,6% (90/178) com IC, ELISA e RIFI, respectivamente. E com 38,8% (69/178) dos cães mostraram-se simultaneamente positivos aos três testes. Os valores de positividade obtidos por cPCR e qPCR foram 20,2% (36/178) e 38,8% (69/178), respectivamente. E com 11,8% (21/178) dos cães foram positivos em ambos os testes moleculares. No geral, 87,1% (155/178) foram positivos para anticorpos anti-Leishmania spp. e/ou material genético de Leishmania spp. A positividade a um ou mais testes foi estatisticamente associada à linfonodomegalia, lesões cutâneas, linfocitose, anemia e hiperproteinemia. Os resultados do estudo revelam um alto nível de exposição à Leishmania spp. em cães errantes em uma área de transmissão intensa de leishmaniose visceral humana, sugerindo que eles podem desempenhar um papel como reservatórios no ciclo de transmissão dessa zoonose.

Abstract The aim of this study was to investigate the level of exposure to Leishmania infection in stray dogs in an area of intense visceral leishmaniasis transmission in the state of Pernambuco, Brazil. Blood samples from 178 dogs were analyzed using serological and molecular assays: rapid immunochromatographic test (ICT), enzyme-linked immunosorbent assay (ELISA), immunofluorescence antibody test (IFAT), and conventional and quantitative polymerase chain reaction (cPCR and qPCR). Positivity values obtained with serological tests were 71.4% (127/178), 70.2% (125/178), and 50.6% (90/178) using ICT, ELISA, and IFAT, respectively, with 38.8% (69/178) of the dogs were simultaneously positive for all three tests. The positivity values obtained with cPCR and qPCR were 20.2% (36/178) and 38.8% (69/178), respectively, with 11.8% (21/178) testing positive in both molecular assays. Overall, 87.1% (155/178) were positive for anti-Leishmania spp. antibodies and/or Leishmania spp. DNA. Positivity to one or more tests was statistically associated with lymphadenomegaly, skin lesions, lymphocytosis, anemia and hyperproteinemia. The results of this study revealed a high level of exposure to Leishmania in stray dogs in an area of intense human visceral leishmaniasis transmission, suggesting that dogs play a role as reservoirs in the transmission cycle of this zoonosis.

ABSTRACT This study has estimated the risk of Leishmania transmission via blood transfusion in one of the largest blood banks in Northeastern Brazil, where visceral leishmaniasis is endemic. Five hundred blood samples from donors were tested for circulating Leishmania spp. DNA by real-time PCR. Positive samples were tested by a species-specific conventional PCR targeting Leishmania infantum . Overall, 6.2% (95% CI: 4.1–8.3%) of the samples carried Leishmania DNA and in one sample the species was confirmed as L. infantum . No statistically significant differences were found in relation to gender, sex, education level, incomeas well as the place of residence between positive and negative blood donors. Our results confirm the presence of asymptomatic Leishmania carriers among blood donors in a large blood bank in Northeastern Brazil. Considering the studied population, we estimate that for every 1,000 blood donors screened, 41 to 83 will be positive for Leishmania DNA. This finding reinforces the urgent need for elaborating specific Blood bank guidelines to allow the early detection of asymptomatic Leishmania carriers among blood donors before their blood products are transfused to uninfected individuals.

Visceral leishmaniasis is a life-threatening disease of great public health relevance in Brazil. The municipality of Petrolina is an endemic area in the State of Pernambuco, Brazil. This study was designed to assess the recent expansion of VL in the municipality of Petrolina, Pernambuco. Patients data were obtained from the Brazilian National Information System for Notifiable Diseases (SINAN). A total of 111 records from 2007 to 2013 were investigated, of which 69 were residents in Petrolina. The disease has predominantly affected 1-4 year old children (34.8%). Most of the patients were males (59.4%). Co-infection with human immunodeficiency virus occurred in 14.5% of the cases. The criterion most frequently used was the clinical and epidemiological confirmation (59.4%), with clinical cure in 78.3% of cases and one fatal outcome. Visceral leishmaniasis is endemic in Petrolina with transmission levels varying from moderate to high. The present study has shown the precariousness of the use of diagnostic tests in primary healthcare units, and this misuse has interfered with the diagnosis and treatment of cases.

Vários flebotomíneos têm sido considerados como possíveis vetores suspeitos ou comprovados de parasitas do gênero Leishmania no Brasil, mas os dados para região nordeste continuam incipientes. Neste estudo, 600 flebotomíneos foram agrupados em grupos de 10 espécimes e testados por uma PCR específica para o gênero Leishmania e por outra PCR para Leishmania (Leishmania) infantum. Quatorze dos 60 grupos foram positivos por PCR gênero-específica, sendo cinco de L. migonei, sete L. complexa, um de L. sordellii e um de L. naftalekatzi, o que corresponde a uma taxa mínima de infecção de 2,3% (14/600). Nossos resultados, associados à antropofilia e abundância dessas espécies, sugerem a participação de L. migonei e L. complexa como vetores de Leishmania no nordeste do Brasil. Notavelmente, a detecção de DNA de Leishmania em L. sordellii e L. naftalekatzi é relatada pela primeira vez no Brasil, mas futuros estudos são necessários para compreender melhor o significado desses achados.

Several phlebotomine sand fly species have been regarded as putative or proven vectors of parasites of the genus Leishmania in Brazil, but data for the northeastern region remains incipient. In this study, a total of 600 phlebotomine sand flies were grouped in pools of 10 specimens each and tested by a Leishmania genus-specific PCR and by a PCR targeting Leishmania (Leishmania) infantum. Fourteen out of 60 pools were positive by the genus-specific PCR, being five pools of L. migonei, seven of L. complexa, one of L. sordellii and one of L. naftalekatzi, which correspond to a minimal infection rate of 2.3% (14/600). Our results, associated with their known anthropophily and their abundance, suggest the participation of L. migonei and L. complexa as vectors of Leishmania in northeastern Brazil. Remarkably, this is the first time in this country that the detection of Leishmania DNA in L. sordellii and L. naftalekatzi has been reported, but future studies are necessary to better understand the significance of these findings.

Muitos carrapatos argasídeos são conhecidos somente por descrições larvais, nas quais a quetotaxia associada a outros caracteres morfológicos tem sido usada para separar gêneros e espécies. No entanto, as ilustrações sobre esses caracteres são baseadas somente em microscopia óptica e muitos deles não estão claramente definidos. Devido às dificuldades em determinar estágios larvais e ninfais de alguns gêneros, elaboramos chaves ilustradas para os estágios imaturos de argasídeos, incluindo uma lista atualizada de espécies conhecidas da região Neotropical. Incluímos também uma chave ilustrada para larvas das espécies de Ornithodoros do Brasil baseada em microscopia eletrônica de varredura.

Many argasid tick species are known only through their larval descriptions, in which the chaetotaxy, together with other external morphological characteristics, has been used to separate genera and species. However, the illustrations of these features are based on optical microscopy alone and many of these features are not clearly defined. Because of the difficulties in determining the larval and nymph stages of some genera, we have prepared illustrated keys for the immature stages of argasids, including an up-to-date list of the known species of the Neotropical region. We have also included an illustrated key for larvae of the Ornithodoros species from Brazil, based on scanning electron microscopy.

A leishmaniose cutânea canina causada por Leishmania braziliensis é uma doença negligenciada, mas disseminada entre cães na America do Sul. Este artigo descreve alterações clínicas e hematológicas em 17 cães infectados por L. braziliensis do Brasil. As alterações hematológicas mais comuns foram trombocitopenia (82,4%), anemia (70,6%), baixo valor de hematócrito (52,9%) e eosinofilia (41,2%). Doze (70,6%) cães apresentaram pelo menos uma alteração física; 11 (64,7%) apresentaram lesões cutâneas, quatro (23,5%) perda de peso e dois (11,8%) onicogrifose. Cães infectados por L. braziliensis apresentaram alterações clínicas e hematológicas inespecíficas que são comumente observadas em cães infectados por outros patógenos. Isso indica que veterinários e profissionais de saúde pública não deveriam considerar a presença de tais sinais clínicos como critério de diagnóstico para leishmaniose visceral em cães, em áreas endêmicas, no intuito de evitar um diagnóstico equivocado e a subsequente eliminação de cães infectados por L. braziliensis.

Canine cutaneous leishmaniasis by Leishmania braziliensis is a neglected, but widespread disease of dogs in South America. This paper describes clinical and hematological alterations in 17 L. braziliensis-infected dogs from Brazil. The most common hematological findings were thrombocytopenia (82.4%), anemia (70.6%), low packed cell volume (52.9%) and eosinophilia (41.2%). Twelve (70.6%) dogs displayed at least one evident physical alteration; 11 dogs (64.7%) presented skin lesions, four (23.5%) had weight loss and two (11.8%) onychogryphosis. L. braziliensis-infected dogs present clinical and hematological signs often observed in dogs infected by other pathogens. This indicates that veterinarians and public health workers should not consider the presence of non-specific clinical signs as diagnostic criteria for visceral leishmaniasis in dogs living endemic areas to avoid misdiagnosis and subsequent elimination of dogs infected by L. braziliensis.

A leishmaniose cutânea americana (LCA) é uma doença complexa com características clínicas e epidemiológicas que podem variar de região para região. De fato, pelo menos, sete diferentes espécies de Leishmania, incluindo Leishmania (Viannia) braziliensis, Leishmania (Viannia) guyanensis, Leishmania (Viannia) lainsoni, Leishmania (Viannia) naiffi, Leishmania (Viannia) shawi, Leishmania (Viannia) lindenbergi e Leishmania (Leishmania) amazonensis, têm sido incriminadas na etiologia da LCA no Brasil, e numerosas espécies de flebotomíneos do gênero Lutzomyia, foram considerados vetores suspeitos ou comprovados. Devido ao seu caráter focal, a compreensão da dinâmica da LCA a nível local é imprescindível para a implementação de medidas de controle eficazes. Este trabalho consiste de uma revisão narrativa sobre a epidemiologia da LCA em Pernambuco, nordeste do Brasil. Além disso, se enfatiza a necessidade de maior efetividade no diagnóstico, tratamento, controle e estratégias de prevenção para as populações afetadas. Este artigo fornecerá aos pesquisadores uma avaliação crítica da LCA em Pernambuco. Espera-se também contribuir com as autoridades de saúde pública no aprimoramento das estratégias atuais de controle da LCA nos níveis estaduais e nacional.

American cutaneous leishmaniasis (ACL) is a complex disease with clinical and epidemiological features that may vary from region to region. In fact, at least seven different Leishmania species, including Leishmania (Viannia) braziliensis, Leishmania (Viannia) guyanensis, Leishmania (Viannia) lainsoni, Leishmania (Viannia) naiffi, Leishmania (Viannia) shawi, Leishmania (Viannia) lindenbergi, and Leishmania (Leishmania) amazonensis, have been implicated in the etiology of ACL in Brazil, and numerous phlebotomine sandfly species of the genus Lutzomyia have been regarded as putative or proven vectors. Because ACL is a focal disease, understanding the disease dynamics at the local level is essential for the implementation of more effective control measures. The present paper is a narrative review about the ACL epidemiology in Pernambuco, northeastern Brazil. Furthermore, the need for more effective diagnosis, treatment, control and prevention strategies for the affected populations is highlighted. This paper will provide researchers with a critical appraisal of ACL in Pernambuco. Hopefully, it will also be helpful for public health authorities to improve current control strategies against ACL at the state and country levels.

INTRODUÇÃO: Flebotomíneos são pequenos insetos de grande importância médica e veterinária. Este artigo apresenta uma lista atualizada dos flebotomíneos que ocorrem no Estado de Pernambuco, Brasil. MÉTODOS: Uma revisão da literatura publicada desde a década de 40 até maio de 2010 foi realizada e material testemunho depositado em coleções de referência foi estudado. RESULTADOS: Um total de 37 espécies de flebotomíneos foram previamente relatadas como presentes em Pernambuco, mas o registro de seis delas necessita de confirmação. CONCLUSÕES: Esse trabalho fornece uma lista atualizada de flebotomíneos de Pernambuco, com algumas notas sobre a sua taxonomia, ecologia, distribuição e relevância epidemiológica.

INTRODUCTION: Phlebotomine sand flies are small insects of great medical relevance. This article presents an updated list of the phlebotomine sand flies occurring in the State of Pernambuco, Brazil. METHODS: A review of literature published since the 1940s up to May 2010 was conducted and voucher material deposited in reference collections were studied. RESULTS: A total of 37 phlebotomine species have previously been reported as occurring in Pernambuco, but the record of six species needs confirmation. CONCLUSIONS: This work provides an updated list of phlebotomine sand flies of Pernambuco, with some notes on their taxonomy, ecology, distribution and epidemiological relevance.

The phlebotomine sand fly fauna of the State of Minas Gerais is presented based on an extensive review of the literature. The fauna, which is a rich one, is currently known to consist of at least 93 species included in 16 genera. The genus Evandromyia (16 spp.) is the most representative one, followed by Micropygomyia (13 spp.), Psathyromyia (12 spp.), Brumptomyia (11 spp.), Pintomyia (9 spp.), Lutzomyia (7 spp.), Psychodopygus (7 spp.), Martinsmyia (4 spp.), Nyssomyia (3 spp.), Deanemyia (2 spp.), Expapillata (2 spp.), Pressatia (2 spp.), and Sciopemyia (2 spp.). The genera Bichromomyia, Trichopygomyia, and Migonemyia are represented by only one species. An updated list of phlebotomine sand fly species occurring in Minas Gerais is provided. Finally, the importance of the species of public health concern is discussed.

INTRODUÇÃO: Desconhecida a realidade da leishmaniose visceral canina em Garanhuns, objetivou-se investigar a ocorrência de anticorpos antileishmania spp em cães domiciliados e semidomiciliados e os possíveis fatores de risco envolvidos. MÉTODOS: Em uma primeira etapa foram coletadas 256 amostras de sangue de cães que foram submetidas à reação de imunofluorescência indireta (RIFI) na diluição 1:40. Adicionalmente, 23 amostras positivas na RIFI foram testadas com um teste rápido imunocromatográfico. Em uma segunda etapa, novas amostras de sangue de 18 cães positivos na RIFI na primeira fase do estudo foram coletadas, retestadas pela RIFI (1:40 e 1:80) e, adicionalmente, pela reação em cadeia da polimerase para pesquisa de DNA de Leishmania infantum. Ademais, 16 dessas amostras foram retestadas pelo teste rápido imunocromatográfico. RESULTADOS: Na primeira etapa, 16% das amostras foram positivas na RIFI (1:40) e apenas três (13%) foram positivas no teste rápido imunocromatográfico. Na segunda etapa, 12 amostras foram positivas na RIFI na diluição 1:40 e sete também na diluição 1:80. Nenhuma amostra foi positiva na reação em cadeia da polimerase e no teste rápido imunocromatográfico. Sinais clínicos de leishmaniose visceral ocorreram em 4,9% dos cães positivos. Não houve diferença estatística entre idade, sexo e status clínico dos cães, porém entre seus locais de origem. CONCLUSÕES: Os cães domiciliados e semidomiciliados de Garanhuns apresentam anticorpos antileishmania spp, sendo, em sua grande maioria, assintomáticos.

INTRODUCTION: Considering the unknown situation regarding canine visceral leishmaniasis in Garanhuns, this study had the aim of investigating occurrences of anti-Leishmania spp antibodies in domesticated and partially domesticated dogs, and the possible risk factors involved. METHODS: In the first phase of the study, 256 blood samples were collected from dogs and subjected to the indirect fluorescent antibody test (IFAT) reaction at a dilution of 1:40. Additionally, 23 IFAT-positive samples were tested using an immunochromatographic dipstick test. In the second phase, new blood samples were collected from 18 dogs that were IFAT-positive in the first phase. These animals were retested using IFAT (1:40 and 1:80) and, additionally, by means of the polymerase chain reaction to investigate the Leishmania infantum DNA. Furthermore, 16 of these samples were retested using the immunochromatographic dipstick test. RESULTS: In the first phase of the study, 16% of the samples were IFAT-positive (1:40) and only three (13%) were positive in the immunochromatographic dipstick test. In the second phase, 12 samples were IFAT-positive at the dilution of 1:40, and seven were also positive at 1:80. None of the samples were positive in the polymerase chain reaction testing or in the immunochromatographic dipstick test. Clinical signs suggestive of visceral leishmaniasis were observed in 4.9% of the IFAT-positive dogs. There were no statistical differences in relation to age, sex or clinical status of the dogs, but there was a difference in relation to place of origin. CONCLUSIONS: The domesticated and partially domesticated dogs living in Garanhuns present anti-Leishmania spp antibodies, but are mostly asymptomatic.