Teses em Doenças Tropicais (Doutorado) - PPGDT/NMT
URI Permanente para esta coleçãohttps://repositorio.ufpa.br/handle/2011/3560
O Doutorado Acadêmico em Doenças Tropicais iniciou em 2007 e pertence ao Programa de Pós-Graduação em Doenças Tropicais do Núcleo de Medicina Tropical (NMT) da Universidade Federal do Pará (UFPA).
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Item Acesso aberto (Open Access) Diversidade clínica e peculiaridades da transmissão do vírus Linfotrópico-T humano em famílias da Região Metropolitana de Belém-Pará(Universidade Federal do Pará, 2016-06-23) COSTA, Carlos Araújo da; SOUSA, Maisa Silva de; http://lattes.cnpq.br/1775363180781218The human T-lymphotropic virus type 1 (HTLV-1) and type 2 (HTLV-2), were the first retrovirus discovered in humans and named as such because they inhabit the T-lymphocytes. Both mainly transmitted by being transferred from mother to child due infected lymphocytes in breastfeeding or from a man to a woman by semen. HTLV-1 is the causative agent of an incapacitating myelopathy (HAM/TSP) and Adult T-cell leukemia / lymphoma (ATLL), among other diseases. The high endemicity of such viruses in households of the metropolitan area of Belém-Pará requires investigations to better characterize this viral spread and morbidity. This study was developed in order to identify and characterize the clinical diversity and peculiarities the HTLV transmission in families of the metropolitan region of Belém-Pará. Between 2007 and 2015, we investigated 178 family groups that are confirmed carriers of the virus (index cases). From these families, 140 have HTLV-1 and 38 have HTLV-2, of which 433 members were spontaneously subjected to serologic testing of anti-HTLV-1/2 antibodies. Such test consists on the ELISA method and the detection test of proviral DNA in the blood (PCR). Routes of infection and clinical aspects were evaluated in all individuals and families. From the 611 surveyed 64.6% are female and 37.9% male with, mean age of 41 years. The transmission of HTLV occurred in 92 families (51.8%) with occurrence of three to four infected per family. The infection was more prevalent in females (p< 0.0001) and sexual contact was greater than the vertical (p = 0.0002). 44.3% (62/140) from the index cases of HTLV-1 and 9.9% of their family contacts (11/111) were recognized as symptomatic. The most common diagnostic modalities were neurological (21.4%) and dermatological (19.3%), with a prevalence of neuromuscular osseous symptoms, dysautonomia and skin changes. The main diseases caused by the HTLV-1, out of the 251 infected cases, were: HAM/TSP 7.2% (18); Lymphoproliferative Diseases 2.6 % (6); Strongyloides hyper infection 1.6% (4); Dermatitis Infective in 1.2% (3) and uveitis in 0.4% (1). The parenteral route was the most common form of transmission of HTLV-1 in the causation of neurological diseases (HAM/TSP) whereas the vertical route was the most common form in lymphoproliferative diseases (including ATLL). In some families, HTLV-1 was inlaid spread for generations in a "sui generis" form, mimicking a genetic factor, differentiating itself from other pathogens. It was also observed unmistakable versatility of HTLV-1 to cause a variety of clinical diseases in human bodies, many of them setting well-defined diseases as the causal virus.Item Acesso aberto (Open Access) Epidemiologia molecular das infecções por adenovírus em crianças com gastrenterite aguda grave, após a introdução da vacina contra rotavírus na cidade de Belém, Pará(Universidade Federal do Pará, 2017-02-10) MÜLLER, Elza Caroline Alves; LINHARES, Alexandre da Costa; http://lattes.cnpq.br/3316632173870389; SOUSA, Maisa Silva de; http://lattes.cnpq.br/1775363180781218Gastroenteritis are the third cause of infant morbidity and mortality worldwide, especially among children under 5 years old. Adenoviruses (HAdV) are icosahedral non-enveloped viruses, possess 240 proteins "hexon" specific and a double-stranded DNA. They belong to the Adenoviridae family, Mastadenovirus genus, and are assigned to 7 species (A to G) and 57 serotypes. Epidemiological studies found that HAdVs account for 2-14% of cases of acute childhood diarrhea in hospitals and outpatient units. The aim of this study was to determine the prevalence and to assess the epidemiological features of of HAdV infection, as well as the occurrence of types in 842 children under three years of age, hospitalized for acute gastroenteritis in Belém, Brazil. All of these children had been vaccinated against rotavirus.These children were selected from a previous rotavirus vaccine case-control study conducted at Instituto Evandro Chagas, Belém, Pará, from May 2009 to April 2011. ELISA and immunochromatography were used for HAdV screening in stool samples and PCR and oligonucleotide sequencing for typing and molecular characterisation. HAdVs were found in 7.2% (61/842) of the tested samples, with the enteric adenoviruses (EAD) accounting for 50.8% (31/61) of the HAdV positive cases. The distribution of HAdV according to the gender showed that 7.7% (28/362) of whom were female and 6.8% (33/480) were male. The highest prevalence rates of HAdV infection were seen among patients older than 24 months of age, corresponding to 8.9% (16/178) of all positive cases. In regards to the temporal distribution, the highest prevalence rate was observed in June, representing 11.4% (8/70) of cases overall. The oligonucleotide sequencing showed that HAdV species F was predominant in our region, accounting for 64.5% (29/45) of the sequenced samples. These samples included HAdV types 41 and 40, detected at rates of 69% (20/29) cases and 31% (9/29), respectively. The results of this study indicate that HAdV accounts for a significant proportion of gastroenteritis among hospitalized children aged less than 3 years, during a post-rotavirus vaccine introduction period in Belém, Pará state, Brazil.