Dissertações em Doenças Tropicais (Mestrado) - PPGDT/NMT

URI Permanente para esta coleçãohttps://repositorio.ufpa.br/handle/2011/3559

O Mestrado Acadêmico em Doenças Tropicais iniciou em 2004 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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Aspectos clínicos e epidemiológicos da infecção genital pelo Papilomavírus humano (HPV) em adolescentes da região metropolitana de Belém
(Universidade Federal do Pará, 2012-05-10) CAMPOS, Ana Carla Araújo; FUZII, Hellen Thais; http://lattes.cnpq.br/0026958665547973
Adolescence is a period of a woman’s life marked by biological and psychological transformations that intensely influence future health. These women are more susceptible to STD. HPV infection is one of the most frequent STD, it is important to evaluate its prevalence because its link to uterine cancer. This study evaluated the prevalence of the HPV genital infection in the adolescent female population in Belém. These data were correlate to sociodemographic factors including social conduct, and reproductive behavior. A transversal study was conducted between August 2009 and August 2011 with 134 women between 13 and 19 years of age who visited the Maternal Unit for Children and Adolescents of Belém for Pap screening tests. The selected patients answered a questionnaire on sociodemographic data, behavioral and reproductive. Cervicovaginal material was collected for conventional cytology and for DNA HPV test by polymerase chain reaction (PCR) technique. The association of HPV infection and selected risk factors was assessed using the chi-square 2χ and/or the Fisher exact test, all with an alpha level of 0.05. The HPV genital infection had a prevalence of 22%, HPV 58 being the most prevalent with 31% and the least common HPV 11 with 3.4%. Among the HPV positive adolescents, there were 51% HPV infections that were not included in the quadrivalent vaccine (6, 11, 6, and 18). 72,2% had infection with at least one of the HPVs in the high risk group. There were cytological changes in 6.2% of pap smears. Risk factors associated with genital HPV infection in this study were schooled for more than eight years, with first sexual intercourse after 14 years, use of oral contraceptives for more than a year, and current use of oral contraceptives, pregnancy at 14 years or less, and abnormal cytological findings. The study results showed the prevalence of high risk HPV in non-immune-preventable cervical samples, demonstrates the need for new policies for primary and secondary prevention involving adolescents through instruction and guidance thus motivating them to actively participate in promoting their own health.
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Aspectos clínicos, epidemiológicos e moleculares do papilomavírus genital em adolescentes gestantes
(Universidade Federal do Pará, 2013-08-14) CAVALCANTE, José Carlos Wilkens; FUZII, Hellen Thais; http://lattes.cnpq.br/0026958665547973
Cervical cancer represents the third most common cancer in the world. Its etiologic agent is HPV. HPV is the most prevalent sexual transmissible disease in the world, affecting mostly young women. Adolescence is a time of behavioral, social and body changes, which reflects on the adolescent’s conscious awakening for sex, that can lead to contact with sexual transmissible diseases and early pregnancy. Being so, it is a time when the woman is more susceptible to infection, such as HPV. This project was dedicated to estimate the prevalence of HPV and to evaluate factors associated to this infection in pregnant adolescents in the Health Unique System, Pará State. It was a prospective transversal study including 257 pregnant women aging 12 to 19 attended at municipal (Curió and Tapanã) and state (Mother-child Reference Unit and Woman’s ambulatory of Holy House of Mercy of Pará Foundation Hospital) health units. The selected patients were submitted to a clinical-epidemiological questionnaire and to harvest of cervical-vaginal material for detection of DNA-HPV through polymerase chain reaction (PCR). The association of HPV infection and risk factors was evaluated through chi-square test (χ2) and/or Fisher’s exact test, with an alpha significance level of 0,05. HPV prevalence was 38.1% (98/257), affecting preferentially pregnant adolescents on the third gestational trimester (44.4%; p = 0.0312), between 11 and 14 years-old, with less than 6 years of schooling and those who did not have a mate. The risk factors associated to HPV infection in the population, also varied according to the gestational trimester, were “two or more sexual partners in life”, “first pregnancy” and “genital problems”. These findings show the adolescents susceptibility to HPV infection and, consequently, to the development of pre-neoplastic and malignant lesions. Therefore, there is the need of educational public measures in health promotion.
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Fatores prognósticos de letalidade na meningoencefalite criptocócica em crianças e adolescentes no estado do Pará
(Universidade Federal do Pará, 2016) CARNEIRO, Rose Sheyla Rodrigues; SOUSA, Rita Catarina Medeiros; http://lattes.cnpq.br/3560941703812539; RODRIGUES, Anderson Raiol; http://lattes.cnpq.br/4030747999301402
Introduction: Cryptococcosis is a systemic fungal infection that often affects adults, especially those who have an alteration in their cellular immunity. Its frequency in children is low. Objective: to describe the clinical, epidemiological, radiological and laboratorial profile of children with meningitis cryptococcal, and to evaluate what are the circumstances that affect the evolution of these patients and increase the fatality rates of the disease. Materials and methods: we performed a retrospective review of medical records in which we evaluated the prognostic factors of 62 children less than 16 years old, diagnosed with cryptococcal meningoencephalitis, admitted in the at João de Barros Barreto Hospital, reference for patients with infectious diseases in Belém-PA, from 1999-2013. Results: Ages ranged from less than 4 to 15 years. The average age was 10 and 66% were male. The Para state microregions, presented by order of decreasing frequency, showed: Cametá (29%), Guamá (12,9%), Belém (12,9%), Tomé-Açu (11,3%), Bragantina (9,7%) and others (39%). The predominant clinical presentation was the subacute form, represented by 50% of the cases. The most frequent clinical manifestations were headache (98,4%), fever (91,9%) and vomiting (88,7%). A skull tomography was performed in 54 patients, and abnormalities were reported in 43 (79,6%). Hydrocephalus was described in 27 cases. Cryptococcus gattii was the main agent involved, identified in 35 children (71,4%). In total, 91,9% of the patients were treated with amphotecicin B (AmB) alone. Conclusions: Rate of lethality from 19,3%; Seizure was a prognostic factor of lethality. In the State of Pará, where cryptococcosis by Cryptococcus gattii is endemic, the disease in children is relatively frequent. However, studies in this population are still scarce and there are no own management guides. New studies are needed to improve the management of children by this fungal infection.
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Investigação da prevalência da amebíase em escolares do município de Imperatriz-MA
(Universidade Federal do Pará, 2012) BELFORT, Marcia Guelma Santos; ISHIKAWA, Edna Aoba Yassui; http://lattes.cnpq.br/3074963539505872
Amoebiasis is an infection caused by Entamoeba histolytica and an important cause of morbidity and mortality worldwide. Studies have reported a high prevalence of in tropic amebiasis al regions, especially in communities living in poor sanitary conditions. The epidemiological study of amoebiasis has been reevaluated since E. histolytica, pathogenic form, was distinct from E. dispar, non-pathogenic form. The aim of this study was to estimate the prevalence of E. histolytica in the population of the municipal city Imperatriz (MA). We conducted a cross-sectional study involving 405 students. By the screening of the complex E. histolytica / E.dispar parasitological examination was performed using the sedimentation method. The positive samples for E.histolytica/ E.dispar complex were subjected to polymerase chain reaction (PCR) for species differentiation. For initial amplification by the PCR we used a outer primer set E1 and E2 that amplified a 1076 bp fragment and followed by a multiplex PCR using inner primer set Ed-L/Ed-R and Eh-L/Eh-R E.histolytica and E.dispar respectively. No sample showing positivity for E. histolytica The prevalence of E.dispar in the population was 2.7% (11/405). The PCR proved important tool for the differential diagnosis of Entamoebas. However, studies on the prevalence of amoebiasis should be conducted in population with different characteristics, in order to contribute effectively to define the epidemiological situation of this infection in Imperatriz city.
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Malária por Plasmodium vivax na infância e na adolescência - aspectos epidemiológicos, clínicos e laboratoriais
(Universidade Federal do Pará, 1997-12-16) VENTURA, Ana Maria Revorêdo da Silva; SOUZA, José Maria de
Worldwide malaria affects both children and adults, and it is known that clinical picture varies considerably in severity depending upon the immune status (particularly among children) and the infecting Plasmodium species. In the present investigation it was attempted to assess epidemiological, clinical, and laboratorial parameters of Plamodium vivax malaria during childhood and adolescence. In this study, between January, 1995 and November, 1996, it was enrolled 100 patients (both sexes), aged 0 to 14 years, who sought for medical treatment in the attendance outpacient unit of the Malaria Program of Evandro Chagas Institute, in Belem, Para State. All patients had a P. vivax-positive thick blood film. Regarding age, malaria were more frequently seen in adolescents, accounting for 37.0% of them. The fact that 34.0% of patients were identified as autochthonous cases of malaria indicates that disease is progressing in urban settings of the Amazon Region. Fever was found to be the earliest more frequent symptom in the course of illness, being recorded in 88.0% of children. At the first patients's attendance (Day 0, DO), fever, chill and headache (malarial triad) were noted in 97.0%, 91.0% and 85.0% of cases, respectively; while, hepatomegaly and splenomegaly were recorded in 29.0% and 46.0% of them, respectively. Pallor was found to be significantly associated with anaemia (p< 0.05), in that 89.2% of pale children had low haemoglobin values. It is likely that anaemia has developed mainly as a result of haemolysis; although the delay in making the malaria diagnosis (an average of 12.5 days after onset of clinical symptoms) and concurrent hookworm intestinal parasitism may also have played a role in its pathogenesis. An additional finding from this study was that malnutrition seemed not to be associated with anaemia. Once treatment had iniciated, the malarial triad began to subside and asexual parasitaemia levels tended to decrease. The former parameter, however, was shown to be more evident than the latter one. Other clinical symptoms such as pallor, weakness, arthralgia, headache and dark urine lasted longer than did malarial triad, usually persisting for up to 14 days. During or soon after finishing treatment, complications were noted in 5.0% of children including: pneumonia, bronchopneumonia, impetigo, gastroenteritis and a rash of unknown etiology. A finding of practical interest is that ultrasonography was shown to be more sensitive than abdominal palpation in the detection of hepatoesplenomegaly. The start of drug therapy was followed by a progressive increase in haemoglobin levels, reticulocyte count and mean corpuscular haemoglobin concentration (MCHC) from DO (first day of treatment) to 07 (eighth day of treatment). Conversely, the mean corpuscular haemoglobin concentration values decreased significantly from D0 to 07, probably because iron was present in bone marrow in decreased amounts.
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Perfil epidemiológico e prevalência de doenças sexualmente transmissíveis em escolares da área urbana no município de Porto Velho - Rondônia
(Universidade Federal do Pará, 2003-12-16) FREITAS, Virgina Tereza Neta; ISHAK, Ricardo; http://lattes.cnpq.br/5621101706909450
Sexually Transmitted Diseases (STD) are widespread public health concern, majority among adolescents, because they are most susceptible in respect of the sexuality. Early sexual initiation, multiple sex partners, and lack of condom use are considered risk factors and contribute to the increase in the number of STD cases. In order to better understand high-risk sexual behavior among students, a crosssectional study based on a self-answered anonymous questionnaire was conducted in Joaquim Vicente Rondon High School, a public school of Porto Velho city, Brazil. To verify STD's prevalence, samples of blood, urethral and vaginal discharge had been analyzed. A total of 122 students aged 11 to 19 years participated in the study. 84% known what is a STD, 82,8% informed always using condoms during sex, 11,5% didn't make use of condom, and 5,7% selected their sexual partner. To identify STD variety an enzyme-linked immunosorbent assay (ELISA test) and bacterioscopia by method of gram had been applied. 83 blood samples had been analyzed by ELISA test, and 41 smear tests had been stained by method of gramo The incidence to Chlamydia was observed in 65,3% of females, and 34,6% of young men. Gardnerella vaginalis, Candida albicans and Trichomonas vaginalis were more common pathogenic microorganisms found.
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Prevalência de anticorpos anti-vírus da hepatite A em escolares no município de Porto Velho, Rondônia
(Universidade Federal do Pará, 2002-06-25) MOREIRA, Lucinda Maria Dutra de Souza; AMORIM, Cláudio Sérgio Carvalho de; http://lattes.cnpq.br/8144230236195341
The evaluation of antibodies prevalence against the virus of Hepatitis A was perforrned frorn September to December of 2000, in one hundred eighty-five students from different socioeconomic levels, including an age group from six to fifteen years, in two schools in the municipal district of Porto Velho, Rondônia, through commercial ELlSA tests (Dia Sorin) for detection Total and IgM anti-HAV antibodies. It was evaluated ninety students of medium and high socioeconomic level came from private school and ninety-five students of low socioeconomic level came from public school. Forty-five of the ninety students (50%) from private school presented positiveness in the test for detection Total anti-HAV antibodies and four of them (8,9%) were positive to IgM anti-HAV too, while, in those came from public school, ninety students (94,7%) presented Total anti-HAV antibodies and only one of them (1,1%) was positive for IgM anti-HAV (p < 0,05). Factors, such as family income, destiny of domiciliation dejections and quality of consumed water were also studied and compared to the anti-HAV prevalence, presenting significant differences among the groups. The results of this study indicated that HAV is endemic in the area and that measures, such as improvement in the sanitary conditions of the municipal district, are necessary to reduce the propagation of HAV in the population.
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Sepse e choque séptico: avaliação de fatores preditivos em crianças portadoras de doenças oncológicas admitidas na unidade de terapia intensiva pediátrica
(Universidade Federal do Pará, 2009-12-18) ALCOCER, Victor Nelson Pacheco; QUARESMA, Juarez Antônio Simões; http://lattes.cnpq.br/3350166863853054
This is a prospective study that analyzed predictive factors related with the evolution of sepsis and the septic shock, regarding patients carrying oncologic lymphoproliferative disorder and solid tumorations which where admitted in the Pediatric Intensive Care Unit of the Hospital Ophir Loyola, and also validated the PRISM III score in order to predict the evolution of these patients. The study included patients in the age bracket of 30 days – 16 years hospitalized between December 2007 and March 2008 whom survived for the first 24 hours. The data of the patients consisted in epidemiologic, clinical and laboratorial parameters, treatment received and evolution to death or recovery, that were collected from a clinical chart, as well as the PRISM score collected in the first 24 hours since admitted in the unit. The logistic regression statistics analysis was performed through the epidemiologic, clinical and laboratorial variables. The results demonstrated that the average age of the patients was 72.8 months, of whom 66.18% were male with a hospitalization average time of 12.10 days, and also that the major percentage (69.12%) came from the countryside and other states. The most common cause of admission was sepsis (41.18%); more than half of the patients presented neutropenic fever (55.88%) and required inotropic-vasoactive drugs (55.88%); used mechanic ventilation (47.06%) with 51.47 % of the cases concluding in death. The univariate logistic regression evidenced as significant risk factor for death the time of hospitalization, utilization of inotropic-vasoactive drugs and mechanic ventilation. The analysis of the death related to the PRISM score was also significant. The multivariate analysis presented as the most significant risk factors for death the utilization of inotropic-vasoactive drugs, the use of mechanic ventilation and the PRISM III score. The untimely start of the intensive treatment for children with cancer presenting sepsis and septic shock can be a factor capable to influence the mortality of these patients.
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Tendência da incidência de hanseníase em menores de 15 anos em Jacundá - Pará e sua relação com a implantação dos serviços de saúde
(Universidade Federal do Pará, 2010-09-28) COELHO JÚNIOR, José Maria dos Santos; XAVIER, Marília Brasil; http://lattes.cnpq.br/0548879430701901
Leprosy is an infectious disease caused by Mycobacterium leprae which constitutes serious public health problem in Brazil, mainly in the North. The annual detection rate of leprosy in children under 15 years is used by the Health Ministery of Brazil to assess the spreading of transmission in a given population. The study aimed to investigate and analyze the incidence of leprosy in children under 15 years in the city of Jacundá - Pará State, in a historical series (1999-2008) and its relation to the implantation of services of surveillance. The study found 210 cases that were reported during the period. The research was conducted in the information system database of Health department in the city searching for data from two instruments: Type of notification and follow-up report. It was observed that in the year followed by deployment of health services, an increase in the detection rate and the city remained hyperendemic in the last nine years of the series (> 1.0/ ten thousand inhabitants), however in the last three years, decline in the incidence presented with evidence that the deployment of new services contributed to the new scenario. Most patients included in the age group between 10 and 14 years (64.76%), male (50.5%), coming from the urban area (84.3%) with predominance of dimorphous (42 4%) at diagnosis. It was observed that according to the operational classification, the paucibacillary form was predominant (52,9%), which can be attributed to the improvement of the diagnosis in early stages. It was concluded, based on the gauge of the study, there is declining trend in the disease in the city.

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