Visceral Leishmaniasis (VL) has spread to many urban centers worldwide. Dogs are considered the main reservoir of VL, because canine cases often precede the occurrence of human cases. Detection and euthanasia of serologically positive dogs is one of the primary VL control measures utilized in some countries, including Brazil. Using accurate diagnostic tests can minimize one undesirable consequence of this measure, culling false-positive dogs, and reduce the maintenance of false-negative dogs in endemic areas. In December 2011, the Brazilian Ministry of Health replaced the ELISA (EIE CVL) screening method and Indirect Immunofluorescence Test (IFI CVL) confirmatory method with a new protocol using the rapid DPP CVL screening test and EIE CVL confirmatory test. A study of diagnostic accuracy of these two protocols was done by comparing their performance using serum samples collected from a random sample of 780 dogs in an endemic area of VL. All samples were evaluated by culture and real time PCR; 766 out of the 780 dogs were tested using the previous protocol (IFI CVL + EIE CVL) and all 780 were tested using the current protocol (DPP CVL + EIE CVL). Performances of both diagnostic protocols were evaluated using a latent class variable as the gold standard. The current protocol had a higher specificity (0.98 vs. 0.95) and PPV (0.83 vs. 0.70) than the previous protocol, although sensitivity of these two protocols was similar (0.73). When tested using sera from asymptomatic animals, the current protocol had a much higher PPV (0.63 vs. 0.40) than the previous protocol (although the sensitivity of either protocol was the same, 0.71). Considering a range of theoretical CVL prevalences, the projected PPVs were higher for the current protocol than for the previous protocol for each theoretical prevalence value. The findings presented herein show that the current protocol performed better than previous protocol primarily by reducing false-positive results.

BackgroundVisceral leishmaniasis (VL) is a serious public health challenge in Brazil and dogs are considered to be the main urban reservoir of the causative agent. The culling of animals to control VL in some countries makes the accurate diagnosis of canine VL (CVL) essential. Recombinant antigens rLci1A and rLci2B were selected from a cDNA library of Leishmania infantum amastigotes due to their strong potential as candidates in diagnostic testing for CVL. The present multicentric study aimed to evaluate the sensitivity of a prototype test using these antigens (DPP rLci1A/rLci2B) against 154 sera obtained from symptomatic dogs within three endemic areas of VL in Brazil. The specificity was evaluated using 40 serum samples from negative dogs and dogs infected with other pathogens. Sensitivity and specificity rates of DPP rLci1A/rLci2B prototype were compared to rates from other diagnostic tests currently in use by the Brazilian Ministry of Health, including DPP®LVC, EIE®LVC.FindingsDPP rLci1A/rLci2B prototype offered similar performance to that offered by DPP®LVC rapid test, as follows: sensitivity of 87% (CI 81–91) and 88% (CI 82–93) and specificity of 100% (CI 91–100) and 97% (CI 87–100), respectively for DPP rLci1A/rLci2B and DPP®LVC. When results of these two tests were considered concomitantly, sensitivity increased to 93.5% (CI 89–96).ConclusionsThe recombinant antigens rLci1A and rLci2B represent promising candidates for use in a multi-antigen rapid test for CVL. The inclusion of novel antigens to the DPP rLci1A/rLci2B prototype model could offer additionally enhanced sensitivity to detect animals infected by L. infantum.

Quercetin (Q) is a bioflavonoid with biological potential; however, poor solubility in water, extensive enzymatic metabolism and a reduced bioavailability limit its biopharmacological use. The aim of this study was to perform structural modification in Q by acetylation, thus, obtaining the quercetin pentaacetate (Q5) analogue, in order to investigate the biological potentials (antioxidant, antileishmania, anti-inflammatory and cytotoxicity activities) in cell cultures. Q5 was characterized by FTIR, 1H and 13C NMR spectra. The antioxidant potential was evaluated against the radical ABTS•+. The anti-inflammatory potential was evaluated by measuring the pro-inflammatory cytokine tumor necrosis factor (TNF) and the production of nitric oxide (NO) in peritoneal macrophages from BALB/c mice. Cytotoxicity tests were performed using the AlamarBlue method in cancer cells HepG2 (human hepatocarcinoma), HL-60 (promyelocytic leukemia) and MCR-5 (healthy human lung fibroblasts) as well as the MTT method for C6 cell cultures (rat glioma). Q and Q5 showed antioxidant activity of 29% and 18%, respectively, which is justified by the replacement of hydroxyls by acetyl groups. Q and Q5 showed concentration-dependent reductions in NO and TNF production (p < 0.05); Q and Q5 showed higher activity at concentrations > 40µM when compared to dexamethasone (20 µM). For the HL-60 lineage, Q5 demonstrated selectivity, inducing death in cancer cells, when compared to the healthy cell line MRC-5 (IC50 > 80 µM). Finally, the cytotoxic superiority of Q5 was verified (IC50 = 11 µM), which, at 50 µM for 24 h, induced changes in the morphology of C6 glioma cells characterized by a round body shape (not yet reported in the literature). The analogue Q5 had potential biological effects and may be promising for further investigations against other cell cultures, particularly neural ones.

A doença de Chagas, conhecida como tripanossomíase americana, é causada pelo protozoário T. cruzi e endêmica da América Latina, no qual representa um dos principais problemas socioeconômicos da região. As vias de transmissão podem ser vetorial, via oral, por transfusão sanguínea, transplante de órgãos, transmissão congênita ou acidentes laboratoriais. A transmissão oral destaca-se por ser uma das principais causas da doença de Chagas Aguda (DCA) em algumas regiões. Dessa maneira, o trabalho visa descrever os principais surtos epidemiológicos de infecção com o T. cruzi por contaminação oral com base na literatura e identificar as principais fontes, locais e medidas preventivas tomadas frente a estes surtos causados por contaminação oral. A revisão bibliográfica foi realizada nos bancos de dados: Literatura Latino-Americana e do Caribe em Ciências da Saúde (LILACS), portal Scientific Electronic Library Online (SCIELO) e PubMed. Ao fim da seleção, 13 artigos foram utilizados para o desenvolvimento do estudo. Os trabalhos mostraram que os principais alimentos associados à infecção aguda chagásica foram caldo de cana-de-açúcar, açaí, suco de açaí, água contaminada, suco de palmito e suco de goiaba. As principais localidades acometidas foram o Brasil, Pará, Amapá e Amazonas, e outros países latinos americanos como a Guiana Francesa e Venezuela. Além disso, os estudos apontaram às práticas de controle sanitárias, o processo de cozimento, à adoção de medidas estruturais básicas combinadas com a não utilização de iluminação artificial como possíveis medidas à redução do risco de contaminação nessas áreas. Por fim, esse trabalho traz um levantamento que favorece uma melhor caracterização da importância da transmissão oral da doença de Chagas nos últimos 12 anos na América Latina.