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Urban dengue fever is now considered a major public health threat in most American countries. A household survey was conducted in the city of Goiania in central Brazil in 2001 to assess prevalence of dengue infection and individual and area-based risk factors. Spatial point pattern analysis was performed using the dual Kernel method. A total of 1,610 households were surveyed; 1,585 individuals more than five years old had blood and data collected. Sera were tested for IgM/IgG antibodies by an enzyme-linked immunoassay. Area-based indicators derived from census data were linked to geocoded residential address. The seroprevalence of dengue was 29.5% and the estimate prevalence surface reached 50% in the outskirts areas. The risk of infection was significantly associated with older age (P < 0.01), low education (odds ratio [OR] = 3.45, 95% confidence interval [CI] = 1.82-6.55), and low income (OR = 1.32, 95% CI = 1.02-1.71) in multivariate analysis. This study highlighted the heterogeneity of dengue transmission within the city and can assist in spatial targeting control interventions.

Abstract. Data from a six-year follow-up of Trypanosoma cruzi−infected adolescents enrolled in a randomized, double-blind, clinical trial of benznidazole showed successful chemotherapy in 64.7% (95% confidence interval [CI] ‫ס‬ 50.2−78.7) and 84.7% (95% CI ‫ס‬ 66.8−92.9), respectively, by intention-to treat and by per protocol analysis measured by seronegativity in a chemiluminescent enzyme-linked immunosorbent assay with a purified trypomastigote mucin antigen. No incident case of cardiomyopathy was detected by electrocardiogram assessment in this cohort of adolescents who had been infected in childhood. The persistent and consistently long-term negative serologic reactions suggest the absence of the parasite in the treated patients and reinforces the recommendation of early benznidazole chemotherapy for T. cruzi-infected infants as a public health policy in endemic areas.While the elimination of Chagas disease has been considered a reasonable public health goal, 1 controversies remain about the efficiency of trypanocidal chemotherapy, especially in chronic asymptomatic individuals. Currently, there is a need to find appropriate drugs or therapeutic regimens with existing drugs that can be used in Trypanosoma cruzi−infected individuals to prevent development of severe clinical forms of Chagas disease. In a previous randomized, double-blind, clinical trial carried out among infants in Brazil, we showed that a 60 day-course of benznidazole in patients with early chronic infections with T. cruzi was safe and effective in 55.8% of the children, as shown by seronegative conversion of specific antibodies after a 38-month follow-up, when compared with the placebo group.2 In addition, a short-term effect of benznidazole on the prevention of cardiac damage was also observed. A similar efficacy (62%) for benznidazole was also observed in a study conducted in Argentinean children.

Investigations regardingAlthough SCCmec type V was recovered from one healthy child who had been exposed to known risk factors for hospital-associated MRSA, its genetic background was compatible with community-related MRSA. Our data suggest that DCC attendees could be contributing to MRSA cross-transmission between health care and community settings.

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