Background Female sex workers (FSWs) are an especially vulnerable group for syphilis and other sexually transmitted infection (STIs). This study determined the prevalence of syphilis in FSWs and factors associated with this disease in the Marajó Archipelago (northern Brazil), as well as the frequency of point mutations (A2058G and A2059G) in the 23S rRNA gene of Treponema pallidum and coinfections with hepatitis B virus (HBV), hepatitis C virus (HCV) and hepatitis D virus (HDV). Methods FSWs were diagnosed using a rapid qualitative test and the isolates were evaluated for the presence of point mutations by real-time PCR. Blood samples with T. pallidum were tested for the presence of HBV, HCV and HDV by ELISA and confirmed by real-time PCR. The factors associated with syphilis were identified using Poisson regression models. Results Overall, 41.1% FSWs tested positive for syphilis and 23.5% were infected with strains having A2058G/A2059G point mutations. HBV (23.0%) and HCV (8.1%) were detected among FSWs with syphilis. Six factors were associated with syphilis: low levels of education, reduced income, drug use, unprotected sex, a lengthy career in prostitution and a lack of regular medical check-ups. Conclusions These findings indicate an urgent need for implementation of effective strategies to diagnose, prevent and treat syphilis, as well as other STIs, in this Brazilian region.

People who use crack-cocaine (PWUCC) have numerous vulnerabilities and pose a challenge to health and social assistance services. The exposure to pathogens and risk situations occur differently according to each individual, region and social group. This study identified the presence, genotypes and factors associated with hepatitis E virus (HEV) exposure among a community-recruited cohort of 437 PWUCC in northern Brazil. Epidemiological information was collected through community-based assessments and interviews. Thereafter, blood and fecal samples were collected and tested for HEV using an immunoenzymatic assay, and the genotype was identified by PCR. Logistic regressions were used to identify the risk factors independently associated with exposure to HEV. In total, 79 (18.1%) PWUCC were exposed to HEV: 73 (16.7%) for IgG and six for IgG + IgM. HEV RNA was detected in six fecal samples and in two blood samples from PWUCC with IgM + IgG. Subtype 3c was identified in all of the samples. The factors associated with exposure to HEV were low monthly income, unstable housing (e.g., homelessness), crack-cocaine use ≥40 months, and the shared use of crack-cocaine equipment. The current study provides unique initial insights into HEV status and risk factors among PWUCC in a remote area in Brazil, with diverse implications for urgently improved diagnosis, prevention, and treatment intervention needs.

Marijuana is the most used illicit drug worldwide. The frequent use of marijuana in adolescence is very worrying, as it is associated with health problems. In Brazil, surveys on the use of psychotropic drugs with adolescent students were conducted in large cities. This study determined the prevalence and factors associated with marijuana use among adolescent students in the Brazilian city of Soure, Pará, in the Amazon region. In this cross-sectional study, 736 high school adolescent students provided information through a structured form at the three schools in Soure in November 2019. Marijuana use, in life and frequent (last 30 days), was calculated. Logistic regression models identified factors associated with different marijuana use. The rates of marijuana use in life and frequent were 17.7% and 7.1%, respectively. The behavioral pattern of the adolescents' coexistence nucleus (parents, relatives, and friends) was fundamental for marijuana use in life. Also, the lack of interference or reduced participation of the family in the adolescent's life, the inadequate family structure, and the continuous example of friends were associated with the frequent use of marijuana. Measures to control and prevent marijuana use are necessary and should be available to adolescents, their families, and friends in this remote area of the Amazon region.

O uso de drogas psicotrópicas, como álcool, é um dos fatores que limitam o desenvolvimento saudável, tanto no âmbito físico quanto psicossocial dos adolescentes. No norte do Brasil, o cenário epidemiológico sobre uso de álcool ainda é pouco conhecido, principalmente na área rural. Desse modo, este estudo determinou prevalências e os fatores associados ao uso de álcool entre adolescentes na área rural do município de Bragança (Pará), assim como identificou uma estratégia para prevenção a ser utilizada no ambiente escolar. Este estudo transversal foi composto por informações relacionadas ao uso de álcool, desempenho escolar e características demográficas e socioeconômicas de estudantes adolescentes oriundos de escolas públicas em comunidades rurais do município de Bragança, Pará. Modelos de regressão logística identificaram fatores associados ao uso de álcool na vida e nos últimos 30 dias. As prevalências de uso de álcool pelo menos uma vez na vida e nos últimos 30 dias foram de 35,7% e 17,6%, respectivamente. Sexo masculino, repetência escolar, nenhuma ou pouca participação dos pais na vida escolar, reduzida escolaridade da mãe, pais usarem alguma droga psicotrópica, amigos usarem alguma droga psicotrópica, todos ou a maioria dos amigos usarem droga psicotrópica, e envolvimento em conflitos foram associados ao uso de álcool. Palestras e conversas informais foram as duas estratégias de prevenção mais indicadas pelos adolescentes. Em suma, essas taxas de uso de álcool na área rural são semelhantes às registradas na área urbana do Pará e indicam a necessidade de ações para promoção da saúde dos adolescentes.