NMT - Núcleo de Medicina Tropical

URI Permanente desta comunidadehttps://repositorio.ufpa.br/handle/2011/2211

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Epidemiological, clinical and evolutionary aspects of tuberculosis among elderly patients of a university hospital in Belém, Pará
(Universidade Federal do Pará, 2017-02) CHAVES, Emanuele Cordeiro; CARNEIRO, Irna Carla do Rosário Souza; SANTOS, Maria Izabel Penha de Oliveira; SARGES, Nathália de Araújo; NEVES, Eula Oliveira Santos das
Objective: To evaluate the epidemiological, clinical and evolutionary aspects of tuberculosis in elderly patients of a university hospital in Belém, Pará. Method: A cross-sectional study was conducted in a university hospital, where 82 records of cases of tuberculosis in elderly patients were analyzed. The data was analyzed by applying the G-test, assuming a level of α=0.05 (5%) and a value of p=0.05. Results: Most of the elderly patients were male (64.6%), aged 60-69 years, especially among men (64.2%). Most were new cases of tuberculosis (95.1%), with a pulmonary clinical form (75.6%), associated diseases (69.5%) and a length of stay exceeding 21 days. Fever (67.1%), dyspnea (64.6%), weight loss (61.0%), productive cough (59.8%), chest pain (51.2%) were the main signs and symptoms. Regarding treatment, there was a high percentage of adverse reactions (50%), predominantly gastrointestinal events (70.7%). Most patients were cured (59.8%), but mortality from tuberculosis was considered high (15.9%). In terms of the exposure variables and outcome, there was a statistically significant difference for the age group (p=0.017), length of stay (p=0.000) and adverse reactions (p=0.018) only. Conclusion: The clinical presentation and therapeutic management of tuberculosis among the elderly has characteristics peculiar to this group, making it important to strengthen strategies that facilitate early identification of suspected cases of TB among elderly persons in the community, which should take place mainly through the primary care system.
Acesso aberto (Open Access)
HCV infection through perforating and cutting material among candidates for blood donation in Belém, Brazilian Amazon
(Universidade Federal do Pará, 2014-12) VALOIS, Rubenilson Caldas; PEREIRA, Luciana Maria Cunha Maradei; CRESCENTE, Jose Angelo Barletta; OLIVEIRA FILHO, Aldemir Branco de; LEMOS, José Alexandre Rodrigues de
This study evaluated epidemiological factors for HCV infection associated with sharing perforating and cutting instruments among candidates for blood donation (CBD) in the city of Belém, Pará, Brazilian Amazon. Two definitions of HCV infection cases were used: anti-HCV positivity shown by EIA, and HCV-RNA detection by PCR. Infected and uninfected CBD completed a questionnaire about possible risk factors associated with sharing perforating and cutting instruments. The information was evaluated using simple and multiple logistic regressions. Between May and November 2010, 146 (1.1%) persons with anti-HCV antibodies and 106 (0.8%) with HCV-RNA were detected among 13,772 CBD in Belém. Risk factors associated with HCV infection based on the EIA (model 1) and PCR (model 2) results were: use of needles and syringes sterilized at home; shared use of razors at home, sharing of disposable razors in barbershops, beauty salons etc.; and sharing manicure and pedicure material. The models of HCV infection associated with sharing perforating and cutting instruments should be taken into account by local and regional health authorities and by those of other countries with similar cultural practices, in order to provide useful information to guide political and public strategies to control HCV transmission.
Acesso aberto (Open Access)
Prevalence of human papillomavirus infection and cervical cancer screening among riverside women of the brazilian Amazon
(Universidade Federal do Pará, 2017-07) DUARTE, Daniel Valim; VIEIRA, Rodrigo Covre; BRITO, Elza Baía de; PINHEIRO, Maria da Conceição Nascimento; MONTEIRO, Jeniffer do Socorro Valente; VALENTE, Mário Diego Rocha; ISHIKAWA, Edna Aoba Yassui; FUZII, Hellen Thais; SOUSA, Maísa Silva de
Purpose: the aim of this study was to evaluate the overall and type-specific prevalence of human papillomavirus (HPV) infection among females living in riverside communities in the state of Pará, in the Eastern Brazilian Amazon. These communities are inhabited by low-income people, and are accessible only by small boats. Cervical cytology and risk factors for HPV infection were also assessed. Methods: cervical samples from 353 women of selected communities were collected both for Papanicolau (Pap) test and HPV detection. Conventional polymerase chain reaction (PCR) and real-time PCR were used to assess the overall and type-specific prevalence of HPV-16 and HPV-18, the main oncogenic types worldwide. Epidemiological questionnaires were used for the assessment of the risk factors for HPV infection. Results: the mean age of the participants was 37 years (standard deviation [SD] ± 13.7). Most were married or with a fixed sexual partner (79%), and had a low educational level (80%) and family monthly income (< U$ 250; 53%). Overall, HPV prevalence was 16.4% (n = 58), with 8 cases of HPV-16 (2.3%) and 5 of HPV-18 (1.4%). Almost 70% of the women surveyed had never undergone the Pap test. Abnormal cytology results were found in 27.5% (n = 97) of the samples, with higher rates of HPV infection according to the severity of the lesions (p = 0.026). Conclusions: the infections by HPV-16 and HPV-18 were not predominant in our study, despite the high prevalence of overall HPV infection. Nevertheless, the oncogenic potential of these types and the low coverage of the Pap test among women from riverside communities demonstrate a potential risk for the development of cervical lesions and their progression to cervical cancer, since the access to these communities is difficult and, in most cases, these women do not have access to primary care and public health services.

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