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Article ; Online: The clinical course of hospitalized moderately ill COVID-19 patients is mirrored by routine hematologic tests and influenced by renal transplantation

Paula M. Peçanha-Pietrobom / Giuseppe Gianini Figueirêdo Leite / James Hunter / Paulo R. Abrão Ferreira / Marcelo N. Burattini / Nancy Bellei / Jaquelina Sonoe Ota-Arakaki / Reinaldo Salomao

PLoS ONE, Vol 16, Iss

2021 Volume 11

Abstract: Several studies of patients with COVID-19 have evaluated biological markers for predicting outcomes, most of them retrospectively and with a wide scope of clinical severity. We followed a prospective cohort of patients admitted in hospital wards with ... ...

Abstract	Several studies of patients with COVID-19 have evaluated biological markers for predicting outcomes, most of them retrospectively and with a wide scope of clinical severity. We followed a prospective cohort of patients admitted in hospital wards with moderate COVID-19 disease, including those with a history of kidney transplantation, and examined the ability of changes in routine hematologic laboratory parameters to predict and mirror the patients’ clinical course regarding the severity of their condition (classified as critical vs. non-critical) and in-hospital mortality or hospital discharge. Among the 68 patients, 20 (29%) were kidney transplanted patients (KT), and they had much higher mortality than non-kidney transplanted patients in this cohort (40% X 8.3%). Lymphocytes, neutrophils and neutrophils/lymphocytes ratio (NLR) at admission and platelets as well as the red blood cells parameters hemoglobin, hematocrit, and RDW by the time of hospital discharge or death clearly differentiated patients progressing to critical disease and those with clinical recovery. Patients with deteriorating clinical courses presented elevated and similar NLRs during the first week of hospitalization. However, they were dramatically different at hospital discharge, with a decrease in the survivors (NLR around 5.5) and sustained elevation in non-survivors (NLR around 21). Platelets also could distinguish survivors from non-survivors among the critical patients. In conclusion, routine hematologic tests are useful to monitor the clinical course of COVID-19 patients admitted with moderate disease. Unexpectedly, changes in hematologic tests, including lymphopenia, were not predictive of complicated outcomes among KT recipients.
Keywords	Medicine ; R ; Science ; Q
Subject code	610
Language	English
Publishing date	2021-01-01T00:00:00Z
Publisher	Public Library of Science (PLoS)
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: The clinical course of hospitalized moderately ill COVID-19 patients is mirrored by routine hematologic tests and influenced by renal transplantation.

Paula M Peçanha-Pietrobom / Giuseppe Gianini Figueirêdo Leite / James Hunter / Paulo R Abrão Ferreira / Marcelo N Burattini / Nancy Bellei / Jaquelina Sonoe Ota-Arakaki / Reinaldo Salomao

PLoS ONE, Vol 16, Iss 11, p e

2021 Volume 0258987

Abstract	Several studies of patients with COVID-19 have evaluated biological markers for predicting outcomes, most of them retrospectively and with a wide scope of clinical severity. We followed a prospective cohort of patients admitted in hospital wards with moderate COVID-19 disease, including those with a history of kidney transplantation, and examined the ability of changes in routine hematologic laboratory parameters to predict and mirror the patients' clinical course regarding the severity of their condition (classified as critical vs. non-critical) and in-hospital mortality or hospital discharge. Among the 68 patients, 20 (29%) were kidney transplanted patients (KT), and they had much higher mortality than non-kidney transplanted patients in this cohort (40% X 8.3%). Lymphocytes, neutrophils and neutrophils/lymphocytes ratio (NLR) at admission and platelets as well as the red blood cells parameters hemoglobin, hematocrit, and RDW by the time of hospital discharge or death clearly differentiated patients progressing to critical disease and those with clinical recovery. Patients with deteriorating clinical courses presented elevated and similar NLRs during the first week of hospitalization. However, they were dramatically different at hospital discharge, with a decrease in the survivors (NLR around 5.5) and sustained elevation in non-survivors (NLR around 21). Platelets also could distinguish survivors from non-survivors among the critical patients. In conclusion, routine hematologic tests are useful to monitor the clinical course of COVID-19 patients admitted with moderate disease. Unexpectedly, changes in hematologic tests, including lymphopenia, were not predictive of complicated outcomes among KT recipients.
Keywords	Medicine ; R ; Science ; Q
Subject code	610
Language	English
Publishing date	2021-01-01T00:00:00Z
Publisher	Public Library of Science (PLoS)
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: High prevalence of symptoms among Brazilian subjects with antibodies against SARS-CoV-2

Ana M. B. Menezes / Cesar G. Victora / Fernando P. Hartwig / Mariângela F. Silveira / Bernardo L. Horta / Aluísio J. D. Barros / Marilia A. Mesenburg / Fernando C. Wehrmeister / Lúcia C. Pellanda / Odir A. Dellagostin / Cláudio J. Struchiner / Marcelo N. Burattini / Fernando C. Barros / Pedro C. Hallal

Scientific Reports, Vol 11, Iss 1, Pp 1-

2021 Volume 8

Abstract: Abstract Since the beginning of the pandemic of COVID-19, there has been a widespread assumption that most infected persons are asymptomatic. Using data from the recent wave of the EPICOVID19 study, a nationwide household-based survey including 133 ... ...

Abstract	Abstract Since the beginning of the pandemic of COVID-19, there has been a widespread assumption that most infected persons are asymptomatic. Using data from the recent wave of the EPICOVID19 study, a nationwide household-based survey including 133 cities from all states of Brazil, we estimated the proportion of people with and without antibodies for SARS-CoV-2 who were asymptomatic, which symptoms were most frequently reported, number of symptoms and the association with socio-demographic characteristics. We tested 33,205 subjects using a rapid antibody test previously validated. Information was collected before participants received the test result. Out of 849 (2.7%) participants positive for SARS-CoV-2 antibodies, only 12.1% (95% CI 10.1–14.5) reported no symptoms, compared to 42.2% (95% CI 41.7–42.8) among those negative. The largest difference between the two groups was observed for changes in smell/taste (56.5% versus 9.1%, a 6.2-fold difference). Changes in smell/taste, fever and body aches were most likely to predict positive tests as suggested by recursive partitioning tree analysis. Among individuals without any of these three symptoms, only 0.8% tested positive, compared to 18.3% of those with both fever and changes in smell or taste. Most subjects with antibodies against SARS-CoV-2 are symptomatic, even though most present only mild symptoms.
Keywords	Medicine ; R ; Science ; Q
Subject code	150
Language	English
Publishing date	2021-06-01T00:00:00Z
Publisher	Nature Portfolio
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Social distancing patterns in nine municipalities of Rio Grande do Sul, Brazil

Revista de Saúde Pública, Vol

the Epicovid19/RS study

2020 Volume 54

Abstract: ABSTRACT OBJECTIVE To describe social distancing practices in nine municipalities of the state of Rio Grande do Sul, Brazil, stratified by gender, age, and educational attainment. METHODS Two sequential cross-sectional studies were conducted in the ... ...

Abstract	ABSTRACT OBJECTIVE To describe social distancing practices in nine municipalities of the state of Rio Grande do Sul, Brazil, stratified by gender, age, and educational attainment. METHODS Two sequential cross-sectional studies were conducted in the municipalities of Canoas, Caxias do Sul, Ijuí, Passo Fundo, Pelotas, Porto Alegre, Santa Cruz do Sul, Santa Maria, and Uruguaiana to estimate the population prevalence of COVID-19. The study was designed to be representative of the urban population of these municipalities. A questionnaire including three questions about social distancing was also administered to the participants. Here, we present descriptive analyses of social distancing practices by subgroups and use chi-square tests for comparisons. RESULTS In terms of degree of social distancing, 25.8% of the interviewees reported being essentially isolated and 41.1% reported being quite isolated. 20.1% of respondents reported staying at home all the time, while 44.5% left only for essential activities. More than half of households reported receiving no visits from non-residents. Adults aged 20 to 59 reported the least social distancing, while more than 80% of participants aged 60 years or older reported being essentially isolated or quite isolated. Women reported more stringent distancing than men. Groups with higher educational attainment reported going out for daily activities more frequently. CONCLUSIONS The extremes of age are more protected by social distancing, but some groups remain highly exposed. This can be an important limiting factor in controlling progression of the COVID-19 pandemic.
Keywords	Coronavirus Infections ; prevention & control ; Health Knowledge ; Attitudes ; Practice ; Health Risk Behaviors ; Socioeconomic Factors ; Public aspects of medicine ; RA1-1270
Subject code	300
Language	English
Publishing date	2020-07-01T00:00:00Z
Publisher	Universidade de São Paulo
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Control of multi-resistant bacteria and ventilator-associated pneumonia

Elisa M. Jukemura / Marcelo N. Burattini / Carlos A.P. Pereira / Alfésio L.F. Braga / Eduardo A.S. Medeiros

Brazilian Journal of Infectious Diseases, Vol 11, Iss 4, Pp 418-

is it possible with changes in antibiotics?

2007 Volume 422

Abstract: Potent antimicrobial agents have been developed as a response to the development of antibiotic-resistant bacteria, which especially affect patients with prolonged hospitalization in Intensive Care Units (ICU) and who had been previously treated with ... ...

Abstract	Potent antimicrobial agents have been developed as a response to the development of antibiotic-resistant bacteria, which especially affect patients with prolonged hospitalization in Intensive Care Units (ICU) and who had been previously treated with antimicrobials, especially third-generation cephalosporins.This study was to determine how changes in the empirical treatment of infections in ICU patients affect the incidence of Gram-negative bacteria species and their susceptibility to antimicrobials, and examine the impact of these changes on nosocomial infections. A prospective interventional study was performed in a university hospital during two periods: 1) First period (September 1999 to February 2000); and 2) Second period (August 2000 to December 2000); empirical treatment was changed from ceftriaxone and/or ceftazidime in the first period to piperacillin/tazobactam in the second. ICU epidemiological and infection control rates, as well as bacterial isolates from upper airways were analyzed. Ceftazidime consumption dropped from 34.83 to 0.85 DDD/1000 patients per day (p=0.004). Piperacillin/tazobactam was originally not available; its consumption reached 157.07 DDD/1000 patients per day in the second period (p=0.0002). Eighty-seven patients and 66 patients were evaluated for upper airway colonization in the first and second periods, respectively. There was a significant decrease in the incidence of K. pneumoniae (p=0.004) and P. mirabilis (p=0.036), restoration of K. pneumoniae susceptibility to cephalosporins (p<0.0001) and reduction of ventilator-associated pneumonia rates (p<0.0001). However, there was an increase in P. aeruginosa incidence (p=0.005) and increases in ceftazidime (p=0.003) and meropenem (p<0.0001) susceptibilities. Changing antimicrobial selective pressure on multi-resistant Gram-negative bacteria helps control ventilator-associated pneumonia and decreases antimicrobial resistance.
Keywords	Ventilator associated pneumonia ; multi-resistant bacteria ; infection control ; Infectious and parasitic diseases ; RC109-216 ; Internal medicine ; RC31-1245 ; Medicine ; R ; DOAJ:Internal medicine ; DOAJ:Medicine (General) ; DOAJ:Health Sciences
Subject code	616
Language	English
Publishing date	2007-08-01T00:00:00Z
Publisher	Brazilian Society of Infectious Diseases
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Diabetes melutus associated with pentamidine isethionate in diffuse cutaneous leishmaniasis

Jackson Mauricio Lopes Costa / Marta Solange C. Moraes / Ana Cristina R. Saldanha / Aldina Barral / Marcelo N. Burattini

Revista da Sociedade Brasileira de Medicina Tropical, Vol 28, Iss 4, Pp 405-

1995 Volume 407

Abstract: The authors report a case of a male patient from Bacabal, MA with diffuse cutaneous leishmaniasis (DCL), for at least nine years, with 168 lesions on his body. These were tumour-like nodules with some ulceratmi. He usedpentavalent antimonial (glucantime®) ...

Abstract	The authors report a case of a male patient from Bacabal, MA with diffuse cutaneous leishmaniasis (DCL), for at least nine years, with 168 lesions on his body. These were tumour-like nodules with some ulceratmi. He usedpentavalent antimonial (glucantime®) and an association of gamma interferon plus glucantime with improvement of the lesions but relapsed later. Recently, pentamidine isethionate (pentacarinat®) was given a dosage of 4mg/kg/weight/day on alternate days for 20 applications. After 3 months a similar course of 10 application was given 2 times. Later he developed diabetic signs with weight loss of 10kg, polydypsia, polyuria and xerostomia. The lower limbs lesions showed signs of activity. Blood glucose levels normalised and remain like this at moment. Attention is drawn to the fact that pentamidine isethionate should be used as a therapy option with care, obeyng rigorous laboratory controls including a glucose tolerance test.
Keywords	Leishmaniose cutânea difusa ; Isotionato de pentamidina ; Diabetes mellitus ; Estado do Maranhão ; Arctic medicine. Tropical medicine ; RC955-962
Language	English
Publishing date	1995-12-01T00:00:00Z
Publisher	Sociedade Brasileira de Medicina Tropical (SBMT)
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Diabetes melutus associated with pentamidine isethionate in diffuse cutaneous leishmaniasis

Jackson Mauricio Lopes Costa / Marta Solange C. Moraes / Ana Cristina R. Saldanha / Aldina Barral / Marcelo N. Burattini

Revista da Sociedade Brasileira de Medicina Tropical, Vol 28, Iss 4, Pp 405-

1995 Volume 407

Abstract	The authors report a case of a male patient from Bacabal, MA with diffuse cutaneous leishmaniasis (DCL), for at least nine years, with 168 lesions on his body. These were tumour-like nodules with some ulceratmi. He usedpentavalent antimonial (glucantime®) and an association of gamma interferon plus glucantime with improvement of the lesions but relapsed later. Recently, pentamidine isethionate (pentacarinat®) was given a dosage of 4mg/kg/weight/day on alternate days for 20 applications. After 3 months a similar course of 10 application was given 2 times. Later he developed diabetic signs with weight loss of 10kg, polydypsia, polyuria and xerostomia. The lower limbs lesions showed signs of activity. Blood glucose levels normalised and remain like this at moment. Attention is drawn to the fact that pentamidine isethionate should be used as a therapy option with care, obeyng rigorous laboratory controls including a glucose tolerance test. Os autores relatam o caso de um paciente procedente de Bacabal, MA, portador de leishmaniose cutânea difusa (LCD) há 9 anos, apresentando um total de 168 lesões distribuídas pelo corpo, de caráter nódulo tumoral e algumas ulceradas, tendo sido submetido a tratamentos anteriores á base de antimonial pentavalente (gluc antime®) e associação interferom gamma+glucantime® com melhora e posterior recidiva das lesões. Recentemente quando da utilização do medicamento isotianato de pentamidina (pentacarinat® ) na dose de 4mg/kg/peso/dia, aplicados 1M em dias alternados em 3 séries de 20, 10, 10 aplicações com intervalos entre as séries de 3 meses. Na evolução do tratamento desenvolveu um quadro de perda de peso 10kg, polidpsia, poliúria, xerostomia, lesões de membros inferiores com sinais de atividade. Glicemia em jejum 420mg/dl, presença de glicose e corpos cetônicos na urina. Instituída insulinoterapia houve melhora do quadro e retorno dos níveis glicêmicos permanecendo estãvel até o presente momento. Alerta-se os clínicos que devido a disponibilidade da pentamidina como opção ...
Keywords	Leishmaniose cutânea difusa ; Isotionato de pentamidina ; Diabetes mellitus ; Estado do Maranhão ; Diffuse cutaneous leishmaniasis ; Pentamidine isethionate ; Maranhão State ; Arctic medicine. Tropical medicine ; RC955-962
Language	English
Publishing date	1995-12-01T00:00:00Z
Publisher	Sociedade Brasileira de Medicina Tropical (SBMT)
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Leishmaniose visceral no estado do Maranhão, Brasil

Jackson M. L. Costa / Graça Maria C. Viana / Ana Cristina R. Saldanha / Maria D. S. B. Nascimento / Aymoré C. Alvim / Marcelo N. Burattini / Antonio R. da Silva

Cadernos de Saúde Pública, Vol 11, Iss 2, Pp 321-

a evolução de uma epidemia Visceral leishmaniasis in the State of Maranhão, Brazil: evolution of an epidemic

1995 Volume 324

Abstract: Os autores fazem um breve relato da evolução histórica da leishmaniose visceral no Estado do Maranhão, Brasil, avaliando as possíveis causas da expansão da referida doença no Estado, assim como as medidas de controle adotadas pelo Ministério da Saúde ... ...

Abstract	Os autores fazem um breve relato da evolução histórica da leishmaniose visceral no Estado do Maranhão, Brasil, avaliando as possíveis causas da expansão da referida doença no Estado, assim como as medidas de controle adotadas pelo Ministério da Saúde objetivando a diminuição da incidência da mesma. The authors provide a brief report on the historical evolution of visceral leishmaniasis in the State of Maranhão, Brazil, evaluating possible factors for growth of the disease in the State and control measures by the Brazilian Ministry of Health to integrate health services finto the maintenance of control programs.
Keywords	Leishmaniose Visceral ; Urbanização ; Medidas de Controle ; Visceral Leishmaniasis ; Urbanization ; Control Measures ; Medicine ; R ; Public aspects of medicine ; RA1-1270
Language	English
Publishing date	1995-06-01T00:00:00Z
Publisher	Escola Nacional de Saúde Pública, Fundação Oswaldo Cruz
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Estudo comparativo da leishmaniose tegumentar americana em crianças e adolescentes procedentes das áreas endêmicas de Buriticupu (Maranhão) e Corte de Pedra (Bahia), Brasil Comparative study of american tegumentary leishmaniasis between childhood and teenagers from the endemics areas Buriticupu (Maranhão) and Corte de Pedra (Bahia), Brazil

Jackson M.L. Costa / Ivelise Theresa A. Balby / Eduardo José S. Rocha / Antonio Rafael da Silva / José Manuel M. Rebêlo / Luiz Alves Ferreira / Mônica Elinor A. Gama / Maria dos Remédios F.C. Branco / Marcelo N. Burattini / Nivaldo de Jesus S. Soares

Revista da Sociedade Brasileira de Medicina Tropical, Vol 31, Iss 3, Pp 279-

1998 Volume 288

Abstract: Analisou-se o comportamento da LTA em crianças e adolescentes na faixa etária de 0-15 anos, provenientes das áreas endêmicas de Buriticupu (MA) e Corte de Pedra (BA). Nestas regiões, foram cadastrados 214 pacientes no periodo de 1982 a 1993, sendo 78 (36, ...

Abstract	Analisou-se o comportamento da LTA em crianças e adolescentes na faixa etária de 0-15 anos, provenientes das áreas endêmicas de Buriticupu (MA) e Corte de Pedra (BA). Nestas regiões, foram cadastrados 214 pacientes no periodo de 1982 a 1993, sendo 78 (36,4%) oriundos de Corte de Pedra e 136 (63,6%) de Buriticupu. Em Corte de Pedra a faixa etária predominante foi de 0-5 anos com 29 (37,2%) casos. Destes, 62% pertenciam ao sexo masculino. Na região de Buriticupu, 88 (64,7%) casos ocorreram na faixa etária de 11-15 anos, sendo 73,8% do sexo masculino. Nas regiões estudadas, houve predomínio da cor parda com 65,4% em Corte de Pedra, e 75% em Buriticupu. Vinte e seis (33,3%) crianças provenientes de Corte de Pedra eram lavradores, sendo o sexo masculino maioria (57,7%), existindo diferença estatística significante (c2 = 11,21 p = 0,05). Vinte e um (80,8%) casos da ocupação lavrador pertenciam a faixa etária de 11-15 anos. Em Buriticupu 37,5% das crianças eram estudantes, destes 30,2% foram lavradores, todos do sexo masculino (c2 = 32,3 p = 0,05). A maioria dos lavradores, 39 (44,3%) casos eram da faixa etária de 11-15 anos. Tanto em Buriticupu como Corte de Pedra houve predomínio da lesão única, 57,7% e 53,7% dos casos, respectivamente. A duração das lesões destacou-se no período de 1 a 3 meses, com 54 (69,2%) casos em Corte de Pedra e 83 (61%) em Buriticupu (c2 = 11,82 p = 0,05). Quanto a localização das lesões, observou-se que nas duas regiões estudadas os MMII foram predominantes com 58,9% em Corte de Pedra e 77,2% em Buriticupu (c2 = 27,9 p = 0,05), havendo maior ocorrência de lesão ulcerada nas duas regiões. IDRM foi positiva em 61 (78,2%) crianças provenientes de Corte de Pedra, não havendo diferença estatística significativa entre as faixas etárias e a positividade do teste (c2 = 0,0669 p = 0,05). A comparative study on children aged 0-15 years, with American tegumentary leishmaniasis (ATL), in the endemic regions of Buriticupu (MA) and Corte de Pedra (BA), whereby 214 cases were detected between 1982 and 1993, 78 (36.4%) of them originated from Corte de Pedra and 136 (63.6%) from Buriticupu. In Corte de Pedra, most cases were observed in patients aged between 0-5 years. Twenty nine (37.2%) cases; 62% of those were male. In the Buriticupu region, 88 (64.7%) cases occured in patients of 11-15 years of age, where in 73.8% consisted of male. In both researched regions, brunetts were predominant, with a ratio of 65.4% in Corte de Pedra and 75% in Buriticupu. Twenty six (33.3%) children in the village of Corte de Pedra were farmers, predominantly male (57.7%), generating statistical significance (c2 = 11.21). Twenty one (80.8%) farmers were aged 11-15 years. Thirty seven and a half per cent of the children from Buriticupu were students, however, 41 (30.2%) were farmers, representing 39 (44.3%) cases; all of them male. Both in Buriticupu and Corte de Pedra, the unique wound was predominant, corresponding to 57.7% and 53.7%, respectively. The wounding time stood out from one to three months, with 45 (69.2%) cases in Corte de Pedra and 73 (61%) in Buriticupu (c2 = 11.82). As to the wound locations, it has been observed that they were most constantly present on the lower limbs, with 77.2% in Corte de Pedra and 58.9% in Buriticupu (c2 = 27.9). The cutaneous case mostly found in Corte de Pedra was the ulcerous one (91%). IDRM was positive in 61 (78.2%) children originated from Corte de Pedra, wherein no statistical difference was detected between age ratio and positivity of the test (c2 = 0.0669).
Keywords	Leishmaniose tegumentar americana ; Crianças ; Adolescentes ; Buriticupu ; Corte de Pedra ; American tegumentary leishmaniasis ; Childhood ; Teenagers ; Medicine (General) ; R5-920 ; Medicine ; R ; DOAJ:Medicine (General) ; DOAJ:Health Sciences
Language	Portuguese
Publishing date	1998-06-01T00:00:00Z
Publisher	Sociedade Brasileira de Medicina Tropical - SBMT
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Aspectos epidemiológicos determinantes na manutenção da leishmaniose visceral no Estado do Maranhão - Brasil

Maria do Desterro S.B. Nascimento / Jackson M.L Costa / Blanca Inez P. Fiori / Graça Maria C. Viana / Manuel Sebastião G. Filho / Aymoré de C. Alvim / Othon C. Bastos / Maria Nakatani / Steven Reed / Roberto Badaró / Antonio R. da Silva / Marcelo N. Burattini

Revista da Sociedade Brasileira de Medicina Tropical, Vol 29, Iss 3, Pp 233-

1996 Volume 240

Abstract: Analisou-se o comportamento da leishmaniose visceral (LV) no Estado do Maranhão-Brasil, no período de 1982 a 1993. A enfermidade vem ocorrendo predominantemente na Ilha de São Luís-MA em áreas periurbanas, destacando, no período epidêmico, a capital São ... ...

Abstract	Analisou-se o comportamento da leishmaniose visceral (LV) no Estado do Maranhão-Brasil, no período de 1982 a 1993. A enfermidade vem ocorrendo predominantemente na Ilha de São Luís-MA em áreas periurbanas, destacando, no período epidêmico, a capital São Luís como principal área endêmica. A maior freqüência de casos ocorreu em 1993, apesar do uso de inseticidas e controle dos cães. Houve predomíyiio na faixa etária de 0 a 4 anos de idade com 58,4% dos casos. Nem a doença humana nem o índice pluviométrico apresentaram variações sazonais significativas, entretanto estiveram moderadamente correlacionados, havendo quase sempre elevação do número de casos após o período de maior precipitação chuvosa. A partir deste estudo, poderão ser levantadas questões para o controle mais eficaz, consoante á urbanização da doença, aliada aos fatores da dinâmica de transmissão em áreas endêmicas do Estado.
Keywords	Leishmaniose visceral ; Aspectos epidemiológicos ; Estado do Maranhão ; Arctic medicine. Tropical medicine ; RC955-962
Language	English
Publishing date	1996-06-01T00:00:00Z
Publisher	Sociedade Brasileira de Medicina Tropical (SBMT)
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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