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BackgroundDengue is a reportable disease in Brazil; however, pregnancy has been included in the application form of the Brazilian notification information system only after 2006. To estimate the severity of maternal dengue infection, the available data that were compiled from January 2007 to December 2008 by the official surveillance information system of the city of Rio de Janeiro were reviewed.Methods and Principal FindingsDuring the study period, 151,604 cases of suspected dengue infection were reported. Five hundred sixty-one women in their reproductive age (15–49 years) presented with dengue infection; 99 (18.1%) pregnant and 447 (81.9%) non-pregnant women were analyzed. Dengue cases were categorized using the 1997 WHO classification system, and DHF/DSS were considered severe disease. The Mann-Whitney test was used to compare maternal age, according to gestational period, and severity of disease. A chi-square test was utilized to evaluate the differences in the proportion of dengue severity between pregnant and non-pregnant women. Univariate analysis was performed to compare outcome variables (severe dengue and non-severe dengue) and explanatory variables (pregnancy, gestational age and trimester) using the Wald test. A multivariate analysis was performed to assess the independence of statistically significant variables in the univariate analysis. A p-value<0.05 was considered statistically significant.A higher percentage of severe dengue infection among pregnant women was found, p = 0.0001. Final analysis demonstrated that pregnant women are 3.4 times more prone to developing severe dengue (OR: 3.38; CI: 2.10–5.42). Mortality among pregnant women was superior to non-pregnant women.ConclusionPregnant women have an increased risk of developing severe dengue infection and dying of dengue.

Objectives: To analyze the prevalence and the factors associated with intestinal parasites infections in children and adolescents enrolled in elementary schools from São João del-Rei, Southeast Brazil.Methods: In this sectional study, coproscopic examinations were performed by spontaneous sedimentation and Kato-Katz techniques in 1,172 schoolchildren. Multivariate logistic regression models were adjusted for the study of factors associated with infections in general and separately for helminthes and protozoon.Results: The prevalence of infection was 29%, ranging from 7 to 83% between schools of lower and higher occurrence respectively. The presence of toilets in the home was associated with a lower prevalence of helminths; the increasing age of the students was associated with a higher rates of protozoon and parasites in general, while the presence of water filter and living in urban area were associated with a lower prevalence of the three outcomes. In all regions, the consumption of preventive medication against helminths was recorded. Conclusions:Inequalities in living conditions have changed the prevalence of parasitosis differently among the study regions. The study underscores the need to promote the use of water filters in endemic areas houses and to evaluate the preventive use of anti-helminthic drugs in the dynamic of individual health. Control measures that take into account the factors described should be a priority.Key-words: protozoan infections; helminths; /epidemiology; risk factors; health inequalities. RESUMOObjetivos: Analisar a prevalência de infecções por parasitos intestinais em crianças e adolescentes matriculados em escolas de ensino fundamental no município de São João del-Rei, Minas Gerais, e os fatores associados à infecção.Métodos Factors associated with intestinal parasites in a population of children and adolescents múltipla para o estudo dos fatores associados às infecções em geral e, separadamente, por helmintos e por protozoários.Resultados: A prevalência de infecções foi de 29%, havendo uma variação de 7 a 83%, respectivamente, entre as escolas de menor e maior ocorrência. A presença de instalação sanitária no domicílio foi associada a uma ocorrência menor de helmintos; o aumento na idade dos escolares associou-se a uma maior ocorrência de protozoários e de parasitos em geral; enquanto a presença de filtro de água e a localização do domicílio em área urbana mostraram-se associadas a uma ocorrência menor dos três desfechos analisados. Em todas as regiões, foi registrado o consumo de medicação preventiva contra helmintos.Conclusões: Desigualdades nas condições de vida tornaram as prevalências diferenciadas entre as regiões do estudo. O estudo ressalta a necessidade de promover o uso de filtros de água nas residências de áreas endêmicas e de avaliar o consumo preventivo de medicamentos anti-helmínticos na dinâmica e na saúde dos indivíduos. Medidas de controle que levem em conta os fatores descritos devem ser prioritárias em nível de Saúde Pública.Palavras-chave: infecções p...

Identification of factors associated with Leishmania infection in dogs is essential for targeting visceral leishmaniasis control actions. Thus, the present study analyzed some of these factors in a population of dogs in a Brazilian municipality, along with the limitations of control strategies implemented there. The association between the exposure variables and occurrences of infection was analyzed through logistic regression models. The disease control interventions were treated qualitatively. Out of the 755 animals examined, 13.6% (103/755) were seropositive. Of these, 23.3% (24/103) were asymptomatic and 76.7% (79/103) presented at least one clinical sign possibly associated with visceral leishmaniasis. With weak associations, purebred, shorthaired, over 5 years of age, male and large dogs were more prone to infection. The latter two variables formed the final regression model and the association with dog size was statistically significant. The control strategies developed presented limitations and a great number of seronegative dogs was culled. The data presented contribute towards better understanding of the dynamics of infection in canine visceral leishmaniasis and indicate that actions aimed towards adequate implementation of Visceral Leishmaniasis control program in Brazilian endemic areas should be prioritized.

The effects of urban growth on dengueLos efectos del crecimiento urbano sobre la dengue RESUMO Objetivo: Analisar a dinâmica espacial e temporal da dengue em Coronel Fabriciano, Minas Gerais, Brasil, e associar os casos ao crescimento das áreas urbanas e à perda de áreas naturais nos últimos anos. Métodos: Trata-se de um estudo descritivo, exploratório, de abordagem quantitativa. Os casos de dengue relativos a 2009 foram obtidos na Secretaria Municipal, incluindo-se os suspeitos e os confirmados. Obtiveram-se shape files contendo informações sobre o limite municipal, limite da área urbana, setores censitários, áreas com construções e áreas naturais. Com base na distribuição dos casos, o estimador de Kernel foi utilizado para medir sua dispersão. Resultados: Casos de dengue notificados foram georreferenciados em ambiente SIG (Sistema de Informações Geográficas). A paisagem mostrou mudanças nas unidades de zona urbana e pastagem, assim como crescimento urbano sobre a matriz de pastagem. Não foram observadas alterações nas áreas de floresta remanescente e eucalipto. Há casos distribuídos espacialmente com uma tendência a formar aglomerados. Conclusão: Observaram-se casos de dengue espacialmente agrupados na região norte da cidade, onde novos bairros surgiram nos últimos anos, acompanhando o crescimento populacional sem estrutura adequada de urbanização e planejamento. Além disso, o crescimento urbano reduziu a margem de cursos d'água e forneceu um solo nu, adequado para o acúmulo de lixo e a formação de criadouros de mosquitos. Fica mais uma vez constatado que políticas públicas eficientes e planejamento urbano adequado podem reduzir o impacto da dengue em regiões endêmicas.