Potential of Biomphalaria tenagophila from Pampulha lake, Belo Horizonte, MG, as a host of Schistosoma mansoni

Biomphalaria tenagophila snails, from a population originally obtained from "Pampulha" lake, Belo Horizonte, Minas Gerais State, Brazil, were exposed to miracidia from four strains of Schistosoma mansoni: "LE" and "HK" from Belo Horizonte, "AL" from Alagoas and "SJ" from S?o José dos Campos, S?o Paulo. The "LE", "AL" and "SJ" strains are maintained in the laboratory and the "HK" strain was obtained from feces of a patient residing near to "Pampulha" lake. Infection rates were of 4% ("LE" strain), 6% ("HK" strain), 30% ("SJ" strain) and 40% ("AL" strain). These infection rates were similar to those obtained by others authors for B. tenagophila from Minas Gerais. Experimentally infected snails when compared to B. glabrata of the control group and B. tenagophila naturally infected in "Pampulha" lake shed similar number of cercariae (2000 cercariae/snail). The high density of B. tenagophila in the "Pampulha" lake, the number of cercariae shed by naturally infected snails, the great number of persons who use the water for fishing and swimming, and the water contamination with human feces, are favourable factors for growing the Schistosomiasis focus in the lake.     

Ectoparasites of rodents of the urban region of Belo Horizonte, MG. I. Interaction between ectoparasites and hosts

A rodent ectoparasite survey was made in the city of Belo Horizonte, Minas Gerais, Brazil, from June 1980 to September 1982. The species of ectoparasites captured from 950 Rattus norvegicus norvegicus were: Xenopsylla cheopis, Ctenocephalides felis felis, Polyplax spinulosa, Laelaps nuttalli, Echinolaelaps echidninus and Atricholaelaps glasgowi, the last species only represented by three specimens interchanged with wild rodent. P. spinulosa and L. nuttalli, although cosmopolitan, are recorded for the first time in State of Minas Gerais. The sex ratio of the ectoparasites, as well as the prevalence of fleas, mites and lice on the separate sexes of rodents are presented. 66.9% of the rats were infested by mites, almost twice more than infestations by fleas and louse jointly (39%). L. nuttalli was found in great numbers and presented the highest index of infestation: 55.1%. Single infestations are as common as associated ones. P. spinulosa, contrary to L. nuttalli, rarely occurs in single infestation. Data on the distribution of the ectoparasites on the rodents are also reported. The infestation observed in Belo Horizonte is confronted with those obtained by other authors in different places.     

Ectoparasites in rodents of the urban region of Belo Horizonte, MG. III. Fleas, Anoplura and Acari indices in Rattus norvegicus norvegicus

The total and specific indices of fleas, lice and mites were determined for ectoparasites on Rattus norvegicus norvegicus capture in urban areas of Belo Horizonte, Minas state, Brazil, from June 1980 to September 1982. In view of the limiting or critical values attributed to flea indices above all the "cheopis" index, proposed by several authors as a complementary measure for bubonic plague surveillance, the community of Belo Horizonte would have been exposed to this infection. The annual total indices ranged from 0.3 to 2.4 and the prevalent flea was Xenopsylla cheopis (99.2%), with the highest indices coinciding with the late dry-cool season. On two occasions, in this period, the community would have remained highly exposed to infection, since the index-limits were superseded: 8.8 (October 1980) and 6.2 (September 1982). It is suggested that preventive measures, such as protection against rat insecticide treatment may be efficiently applied in the late dry-cool season, or previous to the rainy season, before the elimination of rats. Reports on indices of lice and mites are important as they may establish index-limits for certain infections exclusive to rodents.     

Prevalence of Trypanosoma lewisi in Rattus norvegicus from Belo Horizonte,State of Minas Gerais,Brazil

From April 1984 to March 1985, a Trypanosoma lewisi prevalence of 21.7% was found in 429 Rattus norvegicus trapped in Belo Horizonte, State of Minas Gerais, Brazil. The infection rates were higher in male and young rats and could be attributed to ecological and behavioral factors. T. lewisi was observed in rats measuring between 60 and 250 mm. Data about monthly T. lewisi infections throughout the year are presented for the first time in Brazil, with the highest prevalences observed in the warm-rainy season (October to March).     

Study on phlebotomine sand fly (Diptera: Psychodidae) fauna in Belo Horizonte, state of Minas Gerais, Brazil

A study on the phlebotomine sand fly fauna in Belo Horizonte city, state of Minas Gerais, Brazil, was carried out. From April 2001 to March 2003, monthly systematic collections were performed in three houses from each of the nine regions of the city, using CDC light traps for four consecutive days. The traps were set into the houses and in peridomestic areas totaling 54 traps. A number of 3871 sand fly specimens of the genera Lutzomyia and Brumptomyia were collected. Sixty eight percent of the specimens were L. longipalpis and 16% L. whitmani, insect vectors of visceral and American cutaneous leishmaniasis, respectively. Environmental factors such as temperature, humidity, and frequency of precipitation suggest that the number of insects increases after rainy periods. During the same period mentioned above, seasonal captures were carried out in parks and green areas of Belo Horizonte, using Shannon trap. A total of 579 phlebotomine sand flies were collected from which 398 (68.7%) were females with the predominance of L. whitmani and L. monticola. Those specimens were used for natural infection examination, by polymerase chain reaction. No Leishmania DNA was present in any of the specimens tested.     

Epidemiology of visceral leishmaniasis through spatial analysis, in Belo Horizonte municipality, state of Minas Gerais, Brazil

The geographic information system approach has permitted integration between demographic, socio-economic and environmental data, providing correlation between information from several data banks. In the current work, occurrence of human and canine visceral leishmaniases and insect vectors (Lutzomyia longipalpis) as well as biogeographic information related to 9 areas that comprise the city of Belo Horizonte, Brazil, between April 2001 and March 2002 were correlated and georeferenced. By using this technique it was possible to define concentration loci of canine leishmaniasis in the following regions: East; Northeast; Northwest; West; and Venda Nova. However, as for human leishmaniasis, it was not possible to perform the same analysis. Data analysis has also shown that 84.2% of the human leishmaniasis cases were related with canine leishmaniasis cases. Concerning biogeographic (altitude, area of vegetation influence, hydrographic, and areas of poverty) analysis, only altitude showed to influence emergence of leishmaniasis cases. A number of 4673 canine leishmaniasis cases and 64 human leishmaniasis cases were georeferenced, of which 67.5 and 71.9%, respectively, were living between 780 and 880 m above the sea level. At these same altitudes, a large number of phlebotomine sand flies were collected. Therefore, we suggest control measures for leishmaniasis in the city of Belo Horizonte, giving priority to canine leishmaniasis foci and regions at altitudes between 780 and 880 m.     

Visceral leishmaniasis in the Metropolitan Region of Belo Horizonte, State of Minas Gerais, Brazil

In the last few years the number of human cases of American visceral leishmaniasis in the Metropolitan Region of Belo Horizonte (MRBH), Minas Gerais, Brazil has increased, indicating an elevation in the transmission rate of the disease. The total number of notified human cases in the MRBH since 1994, when the first case was identified, up to 1999 was 345 of which 223 (65%) were from the city itself, indicating an urbanization of the disease in this region of Minas Gerais. The age distribution of visceral leishmaniasis cases in the MRBH shows a higher prevalence in children from 0-4 years old, responsible for 28.9% of the notifications. Clinical and immunological findings from dogs infected with Leishmania chagasi are described. The majority of these animals showed no sign of the disease. Sera from all infected dogs showed detectable Leishmania-induced high titles of antibodies based on the results of an indirect fluorescent antibody test. Samples of isolated Leishmania from human and dogs were characterized as L. (L.) chagasi by biochemical and molecular techniques.     

Endosymbionts of Ctenocephalides felis felis (Siphonaptera: Pulicidae) obtained from dogs captured in Belo Horizonte, Minas Gerais, Brazil

Specimens of fleas Ctenocephalides felis felis (1052 female symbol/448 male symbol), obtained from 150 dogs in Centro de Controle de Zoonoses de Belo Horizonte, Minas Gerais, Brazil, were dissected and examined for endosymbionts. Three protozoan, Nolleria pulicis, a gregarine (Actinocephalidae) and Leptomonas sp., together with one cestode, Dipylidium caninum were identified. Infections by N. pulicis and Leptomonas sp. occurred mainly in the warm-rainy period. The prevalence and distribution of these endosymbionts in fleas derived from Brazil and South America, and the their variation according to sex and season, are reported for the first time.     

Acute schistosomiasis outbreak in the metropolitan area of Belo Horizonte, Minas Gerais: alert about the risk of unnoticed transmission increased by growing rural tourism

The present article describes the occurrence of 17 cases of acute schistosomiasis in the metropolitan area of Belo Horizonte, state of Minas Gerais, Brazil. All individuals affected took a bath in a swimming pool of a holiday resort that was provided with water from a nearby brook. The apparently clean water and the absence of snails in the pool gave the wrong impression that there was no risk for infection. During a malacological survey at the site snails of the species Biomphalaria glabrata were found and tested positive for Schistosoma mansoni. All the patients live in the middle-class area of Barreiro, metropolitan area of Belo Horizonte and have medium grade school education. The difficulties in establishing the right diagnosis is expressed by the search for medical attention in 17 different medical facilities, the wide range of laboratory test and the inadequate treatment administration. A lack of knowledge about the disease was found in all groups studied. The booming rural tourism in endemic areas is identified as a probable risk factor for infection, especially for individuals of the non-immune middle and upper class parts of the society in urban centers. Special attention is given to a multidisciplinary approach to the complex issue of disease control and prevention.     

Factors affecting biochemical composition of seston in an eutrophic reservoir (Pampulha Reservoir, Belo Horizonte, MG)

Sestonic biochemical composition (lipids, proteins and carbohydrates) may change with varying environmental fluctuations. These changes and the effects in the nutritional status of algae consists of an actual increasing source of interest. The aims of this work were to establish the relationship between biochemical composition of seston and 1) a range of physical, chemical and climatological factors, and 2) the natural fluctuation in the species composition in phytoplankton assemblages of the Pampulha Reservoir, an urban eutrophic lake located in Belo Horizonte, MG. Seasonal changes in the biochemical composition were observed in this study. None of the considered abiotic factors alone seem to affect the biochemical composition. So the effects could only be understood by interactions among different environmental factors. On the other hand, the dominant algal groups probably have some influence in the observed changes in biochemical composition of seston.     

Determinants of human immunodeficiency virus (HIV) prevalence in homosexual and bisexual men screened for admission to a cohort study of HIV negatives in Belo Horizonte,Brazil: Project Horizonte

Project Horizonte, an open cohort of homosexual and bisexual human immunodeficiency virus (HIV-1) negative men, is a component of the AIDS Vaccine Program, in Belo Horizonte, Minas Gerais, Brazil. The objective of this study was to compare volunteers testing HIV positive at cohort entry with a sample of those who tested HIV negative in order to identify risk factors for prevalent HIV infection, in a population being screened for enrollment at Project Horizonte. A nested case-control study was conducted. HIV positive volunteers at entry (cases) were matched by age and admission date to three HIV negative controls each. Selected variables used for the current analysis included demographic factors, sexual behavior and other risk factors for HIV infection. During the study period (1994-2001), among the 621 volunteers screened, 61 tested positive for HIV. Cases were matched to 183 HIV negative control subjects. After adjustments, the main risk factors associated with HIV infection were unprotected sex with an occasional partners, OR = 3.7 (CI 95% 1.3-10.6), receptive anal intercourse with an occasional partner, OR = 2.8 (95% CI 0.9-8.9) and belonging to the negro racial group, OR = 3.4 (CI 95% 1.1-11.9). These variables were associated with an increase in the risk of HIV infection among men who have sex with men at the screening for admission to an open HIV negative cohort.     

Occurrence and biology of Rhodnius neglectus Lent, 1954 in palm trees of suburban areas of Belo Horizonte, Minas Gerais

Eighty-one "macaubeiras" palm-trees (Acrocomia sclerocarpa) from the periphery of Belo Horizonte city were cut down and dissected between April 1979 and July 1980. 60.5% of the trees were positive for R. neglectus and 463 specimens of this insect were collected, providing a mean rate of 9,45 individuals for positive palm-trees. R. neglectus seems to present a single annual generation in this region, but evidence was obtained that two generations may occur. Its spawn period is related to the hot months of the year, when younger insects prevail over the adults. This observation suggests that higher population densities are related to better feeding conditions and to minor densities of specific predators such as Telenomus sp., ants, spiders, hemipters, scorpions and pseudo scorpionidae. The Trypanosoma cruzi infection index was 15,9%, suggesting that R. neglectus is a very important vector of silvatic infections in the region. Marsupials are the main vertebrate source of T. cruzi infection. R. neglectus is strongly associated with palm-trees in the area, and with the various species of birds that haunt them. So far, there is no evidence suggesting R. neglectus to be an important vector of human Chagas' disease in the region.     

Hepatitis C and hepatitis B virus infection in different hemodialysis units in Belo Horizonte,Minas Gerais,Brazil

The prevalence, virological and epidemiological aspects of the hepatitis C virus (HCV) and the hepatitis B virus (HBV) infections vary among hemodialysis patients in different countries. Aiming at analyzing these aspects of HCV and HBV infections in hemodialysis patients in Belo Horizonte, MG, Brazil, we studied three hemodialysis units including 434 patients. Serology was used to detect anti-HCV and HBsAg. Reverse trancriptase nested polymerase chain reaction (RT-nested-PCR) of the 5'-noncoding region was used to detect circulating HCV RNA and restriction fragment length polymorphism analysis for genotyping. Seroprevalence varied from 26.5% to 11.1% for hepatitis C and from 5.9% to 0% for hepatitis B. Risk factors observed for HBV and/or HCV infections were the number of patients per dialysis unit, duration of treatment, number of clinics attended, number of blood units transfused, and lower level scholarity. Alanine aminotransferase levels were altered with a higher frequency in HBV or HCV seropositive patients. Half of ten patients, negative for anti-HCV, had detectable viremia by RT-nested-PCR, indicating that this technique should be used to confirm infections in this group of patients. The HCV genotype 1 was the most frequently observed, followed by the genotype 2, but no correlation was detected between genotype and clinical or epidemiological data.     

Prevalence of nits and lice in samples of cut hair from floors of barbershops and beauty parlors in Belo Horizonte, Minas Gerais State, Brazil

A louse survey based on samples of cut hair collected from floors of barbershops and beauty parlors was conducted in Belo Horizonte, Minas Gerais State, Brazil, from October 1984 to April 1985, as an alternative way to determine the prevalence of pediculosis capitis in the population. Of 475 samples examined for nits, nymphs, or adults of Pediculus capitis, 140 were infested (29.5%). A total of 58 lice and 3,553 nits were found in 33,632.9 g of hair collected, giving a ratio of 0.10 nit/g. Almost 29% of the nits were viable and capable of being transmitted after hatching. There was significant difference among the infestation rates by socioeconomic levels, and samples from barbershops with male customers were the most infested. Based upon the number of haircuts in each sample, we estimated that 5 or 6% of the population might be infested by this species.     

The impact of highly active antiretroviral therapy on the survival of vertically HIV-infected children and adolescents in Belo Horizonte, Brazil

The use of highly active antiretroviral therapy (HAART) for human immunodeficiency virus (HIV)-infected patients has reduced the number of acquired immune deficiency syndrome-related deaths worldwide. This study assessed the impact of HAART on the survival and death rates of vertically HIV-infected children and adolescents in Belo Horizonte, Brazil. Data were obtained from a historic cohort of vertically HIV-infected children and adolescents aged zero-19 years old who were admitted from March 1989-December 2004 and were followed until June 2006. Patients who used HAART were included if they were treated for at least 12 weeks. Of 359 patients, 320 patients met the inclusion criteria. The overall mortality rate was 9.7% [31/320; 95% confidence interval (CI): 6.0-13%]. The median survival for the non-HAART and HAART groups was 31.5 and 55.9 months, respectively (log rank = 22.11, p < 0.0001). In the multivariate analysis, the statistically significant variables were HAART and the weight-for-age Z score < -2, with HAART constituting a protective factor [relative risk (RR): 0.13; CI 95%: 0.05-0.33] and malnutrition constituting a risk factor (RR: 3.44; CI 95%: 1.60-7.40) for death. The incidence of death was 5.1/100 person-years in the non-HAART group and 0.8/100 person-years in the HAART group (p < 0.0001).     

Ectoparasites of rodents of the urban region of Belo Horizonte, MG. II. Variations of the infestation indices in Rattus norvegicus norvegicus

The indices of infestation by the mites Echinolaelaps echidninus and Laelaps nuttalli, the louse Popyplax spinulosa and the flea Xenopsylla cheopis, obtained monthly, from June 1980 to September 1982, on Rattus norvegicus norvegicus in the city of Belo Horizonte, Minas Gerais state, Brazil were related to seasonal period, sex of the host and area of capture. Mites and insects showed different behaviour in relation to these factors. Only the fleas and lice exhibit significant association between the rodents' infestation and the seasonal period, or between the infestation and the rodents' sex or else a variation of the distribution by the three main areas of capture. The fleas showed the highest indices of infestation in the warm-rainy season (October to March) while the infestation by the lice was more prevalent in the dry-cool season. The climatic factors most related with the hosts' infestation were, in decreasing order, rainfall, temperature and relative humidity. Fleas and lice preferentially infested male rodents, being infestation by X. cheopis highly significant.     

Determinants and trends in perinatal human immunodeficiency virus type 1 (HIV-1) transmission in the metropolitan area of Belo Horizonte, Brazil: 1998 - 2005

Significant decrease in human immunodeficiency virus type 1 (HIV-1) vertical transmission has been observed worldwide in centers where interventions such as antiretroviral therapy (ART), elective cesarean section, and avoidance of breastfeeding have been implemented. This prospective cohort study aimed to assess the determinants of and the temporal trends in HIV-1 vertical transmission in the metropolitan area of Belo Horizonte, Brazil from January 1998 to December 2005. The rate of HIV-1 vertical transmission decreased from 20% in 1998 to 3% in 2005. This decline was associated with increased use of more complex ART regimens during pregnancy. Multivariate analysis restricted to clinical variables demonstrated that non ART, neonatal respiratory distress/sepsis and breastfeeding were independently associated with HIV-1 vertical transmission. When laboratory parameters were included in the model, high maternal viral load and non maternal ART were associated with HIV-1 vertical transmission. The results from this study confirm the impact of ART in the reduction of HIV-1 vertical transmission and indicate the need for improvement in the care and monitoring of mother and infant pairs affected by HIV-1.     

Study of the cytogenetic effects of occupational exposure to pesticides on sanitation workers in Belo Horizonte, Brazil

Sanitation workers handling pesticides in the control of disease vectors constitute an occupationally exposed population to genotoxic substances. The aim of the present study was to investigate the relation between the occupational exposure to various pesticides and the presence of cytogenetic damage. Fifty-nine men were selected (29 sanitation workers and 30 control individuals) with ages varying between 18-57 years who lived and worked in the same area in Belo Horizonte (Brazil). The following parameters were determined for all individuals using the cytokinesis-block micronucleus (MN) assay in peripheral blood lymphocytes: MN/1000 binucleated cells (BC), BC with MN (BCMN)/1000 BC, nucleoplasmic bridges (NB)/1000 BC, apoptotic and necrotic cells/500 cells and nuclear division index. The analysis of covariance showed significantly higher (p < 0.05) mean frequencies of MN (15.81 +/- 1.31 vs 4.71 +/- 0.42), BCMN (15.10 +/- 1.22 vs 4.62 +/- 0.44), NB (4.59 +/- 0.76 vs 1.00 +/- 0.34), and necrotic cells (12.07 +/- 1.45 vs 5.17 +/- 0.70) in the exposed group when compared to the control group. There was no significant difference in the apoptotic cell frequency between the two groups, while the nuclear division index was significantly lower (1.49 +/- 0.02 vs 1.61 +/- 0.02) in the control group. Neither the time of exposure nor the smoking or alcohol drinking habit influenced the cytogenetic parameters examined. According to these results, occupational exposure to pesticides induced genotoxic and cytotoxic effects in sanitation workers.     

Risk factors for tuberculosis among human immunodeficiency virus-infected persons. A case-control study in Belo Horizonte, Minas Gerais, Brazil (1985-1996)

The objective of this study was to identify tuberculosis risk factors and possible surrogate markers among human immunodeficiency virus (HIV)-infected persons. A retrospective case-control study was carried out at the HIV outpatient clinic of the Universidade Federal de Minas Gerais in Belo Horizonte. We reviewed the demographic, social-economical and medical data of 477 HIV-infected individuals evaluated from 1985 to 1996. The variables were submitted to an univariate and stratified analysis. Aids related complex (ARC), past history of pneumonia, past history of hospitalization, CD4 count and no antiretroviral use were identified as possible effect modifiers and confounding variables, and were submitted to logistic regression analysis by the stepwise method. ARC had an odds ratio (OR) of 3.5 (CI 95% - 1.2-10.8) for tuberculosis development. Past history of pneumonia (OR 1.7 - CI 95% 0.6-5.2) and the CD4 count (OR 0.4 - CI 0. 2-1.2) had no statistical significance. These results show that ARC is an important clinical surrogate for tuberculosis in HIV-infected patients. Despite the need of confirmation in future studies, these results suggest that the ideal moment for tuberculosis chemoprophylaxis could be previous to the introduction of antiretroviral treatment or even just after the diagnosis of HIV infection.     

Sexually transmitted diseases in homosexual and bisexual males from a cohort of human immunodeficiency virus negative volunteers (Project Horizonte), Belo Horizonte, Brazil

Sexually transmitted diseases (STD) are very frequent in the whole world. Males who do not use a condom during their sexual relations are at great risk. We report cases of STD during six months of observation, among homosexual/bisexual males who participate in the Project Horizonte. There were 16 cases of genital warts, 6 cases of human immunodeficiency virus infection, 24 cases of unspecific urethritis, 28 cases of herpes simplex virus infection, 30 cases of syphilis, 58 cases of gonorrhea and 84 cases of pediculosis. We concluded that a condom must be used in all sexual relations and new counseling techniques are needed, to avoid this situation.