Doutorado em Medicina Tropical e Saúde Pública (IPTSP)
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Item Prevalência de infecções de transmissão vertical: toxoplasmose, rubéola, hepatite B, sífilis, infecção pelo citomegalovirus e pelo vírus da imunodeficiência humana em gestantes atendidas em Caxias, Maranhão(Universidade Federal de Goiás, 2014-05-30) Câmara, Joseneide Teixeira; Castro, Ana Maria de; http://lattes.cnpq.br/9232309971000621; Castro, Ana Maria de; Vinaud, Marina Clare; Araújo, Telma Maria Evangelista de; Campelo, Viriato; Pinheiro, Valéria Cristina SoaresThe vertical transmission of infection from mother to child, and may increase morbidity and mortality of both mother and child, when not diagnosed and by suitably dealest, causing a serious public health problem. This study aimed to estimate the prevalence of antibodies to toxoplasmosis, rubella, cytomegalovirus, hepatitis B, syphilis and HIV among pregnant women in Caxias, Maranhão, Brazil and identify the main factors associated with seropositivity for Toxoplasma gondii infection in pregnant women attending two referral centers Caxias, MA. Descriptive, observational, cross-sectional study of 561 pregnant women who received prenatal care at two clinics reference to prenatal high risk in the period July 2011 to December 2012, the outpatient clinics of Maternity Carmosina Coutinho (MCC) and the Specialized Center for Maternal and Child Care (CEAMI). Serological tests for toxoplasmosis, rubella, cytomegalovirus, hepatitis B were performed by a laboratory conveniado to the municipality by the same trained technician, and for syphilis and HIV were performed in the Counseling and Testing Center (ATC) in the city laboratory. And a small sample of whole blood from five pregnant IGM reagent for Toxoplasma gondii and their respective newborns was processed at the Institute of Tropical Pathology and Public Health in the Department of Parasitology UFG for performing Polymerase Chain Reaction (PCR). Statistical analysis was performed using SPSS version 20.0 Windows, using the chi-square tests of association and Odds Ratio (95%CI), considering a significance level of 5%. It was found to be positive for HIV was 0.4%, 2.0% syphilis, rubella and cytomegalovirus IgG reactivity were 93.6% and 87.8% respectively without reactive IgM, HBsAg was negative for all pregnant women in the sample tested. Regarding toxoplasmosis in 437 (77%), 124 susceptibility (22.1%) and 5 (0.9%) women with active infection. Found no significant association between toxoplasmosis susceptibility and age, location, income, education, sewerage, number of pregnancies and gestational age. Variables with significant association (p≤0.05) were seropositive pregnant women who are multiparous (p=0.036), living with dogs stuck at home (p=0.001), and consumption of raw kibbeh (p=0.036). The frequency of seropositivity of these infectious diseases of vertical transmission in pregnant women seen at antenatal care in the city of Caxias-MA is considered high, but are similar to those described in other regions of Brazil. Pregnant women who are multiparous who perform consumption of raw kibbeh and live with dogs that do not wobble on the street, had more chance of becoming infected with Toxoplasma gondii, thus guidance on primary prevention measures and quarterly serological monitoring should be strengthened these infections of pregnant women, since it is important to identify and/or prevent congenital infection measured.Item Epidemiologia molecular de isolados de toxoplasma Gondii na região metropolitana de Goiânia, Goiás, Brasil(Universidade Federal de Goiás, 2018-01-12) Rezende, Hanstter Hallison Alves; Vinaud, Marina Clare; http://lattes.cnpq.br/1921551651088660; Castro, Ana Maria de; http://lattes.cnpq.br/9232309971000621; Castro, Ana Maria de; Fernandes, Everton Kort Kamp; Rocha, Thiago Lopes; Cardoso, Cléver Gomes; Soave, Danilo FigueiredoThe protozoan Toxoplasma gondii is the etiological agent of toxoplasmosis and its definitive hosts are domestic cats (Felis catus) and other wild felids. Within the cities, stray cats are responsible for the dissemination of the parasite in the environment as they release oocysts which are the infective forms for humans and other animals. Backyard chickens (Gallus gallus) are in constant contact with the environment and feed directly from the soil. Therefore they are important indicators of environmental conditions. The knowledge regarding prevalence, biological and genetic characteristics of T. gondii are of utmost importance for the comprehension of the complex host-parasite relationship. Thus the aim of this study was to evaluate the concordance of laboratory techniques used to detect the parasite; to determine the prevalence, biology and molecular epidemiology of T. gondii isolated from stray cats and backyard chickens from the metropolitan region of Goiania, in order to better comprehend the infection. This is the first performed study to determine the genetic and biologic characterization of T. gondii in the state of Goias. This study used 24 stray cats captured by the Center for the Zoonosis Control in Goiania and 50 backyard chickens from the Metropolitan Region of Goiania, Goias. The serologic triage was performed by IHA and showed positivity of 87.4% (21/24) cats and 96% (48/50) backyard chickens for T. gondii. The bioassay was performed using the brain and hearts of the cats and chickens obtained after euthanasia of the animals. After the peptic digestion the homogenate tissues was intraperitoneally inoculated in groups of three Swiss mice each which were daily observed in order to detect signs of acute toxoplasmosis. The asymptomatic mice were euthanized after 60 days followed by serologic analysis through indirect immunofluorescence. Fragments of brain from these animals were observed under optic microscopy in order to visualize tissue cysts. Part of the homogenate was submitted to DNA extraction and polymerase chain reaction (PCR) in which 75% (18/24) cats and 64% (32/50) backyard chickens were positive. The correlation between IHA and PCR from both animals was considered weak. It was not possible to obtain isolate strains from cats. From the chickens it was possible to obtain 15 isolates strains from which 8 presented tachyzoites (acute toxoplasmosis) and 7 presented brain tissues (chronic toxoplasmosis). After the DNA extraction from the isolates the RFLP-PCR was performed using the following primers SAG1, 5’-3’ SAG2, altSAG, SAG3, BTUB, GRA6, c22-8, c29-2, L358, PK1, Apico and CS3. It was possible to define the genotype from 9 isolates. According to ToxoDB seven isolates corresponded to genotype #65 and two isolates have not been described previously. The genetic analysis showed high diversity and variability. The virulence essays showed that the mortality rate in mice in seven isolates that presented tachyzoites, from the same genotype, detected high virulence in 4 isolates and intermediary virulence in 3. The morphometry analysis of the tachyzoites of these isolates showed statistical difference in at least one of the analyzed variables such as length or nuclei-apical complex distance. These phenotypic differences in isolates from the same genotype show the need to the continuity of the genetic characterization of the parasite using other primers which could be related to the isolated phenotype. The study demonstrated the importance of knowledge about the molecular epidemiology of T. gondii in the metropolitan region of Goiânia, which presents high rates of seroprevalence in hosts.Item Fatores epidemiológicos e triagem neonatal associados à toxoplasmose gestacional e congênita em Gurupi, Tocantins(Universidade Federal de Goiás, 2014-12-10) Silva, Marcos Gontijo da; Castro, Ana Maria de; http://lattes.cnpq.br/9232309971000621; Castro, Ana Maria de; Cardoso, Clever Gomes; Barbosa, Alverne Passos; Vinaud, Marina Clare; Soares, Joanna Darc Aparecida HerzogINTRODUCTION: Toxoplasmosis is a parasitic disease caused by the protozoan Toxoplasma gondii. This disease becomes important when present in pregnant women because of the imminent risk of congenital transmission and can promote immediate and late sequelae of concepts, among which stand out the neurological and ocular manifestations. Knowledge of the prevalence and risk factors for its spread are of great relevance. OBJECTIVES: To evaluate the prevalence of gestational and congenital toxoplasmosis and risk factors for transmission of toxoplasmosis in pregnant women Gurupi, Tocantins. METHODS: The study population consisted of 487 pregnant women of which were extracted using a standardized form, sociodemographic, dietary and cultural habits. It was also made of peripheral blood collection performed by serological anti-anti IgM and IgG ELISA. PCR and IgG avidity levels in women and their newborn babies where the mother was IgM was performed. Data were analyzed by comparing the seropositivity with risk factors by means of the odds ratio. RESULTS: The prevalence of IgG antibodies was 68.37% and 5.75% for IgM antibodies. The sociodemographic characteristics associated with risk for toxoplasmosis were; education greater than or equal to eight years, family income at or below minimum wage. Regarding eating habits, there was a significant association between seropositivity and the variables: eating meat, cut raw meat and do not wash the knife and board before cutting the vegetables and frequent intake of vegetables. There were seven cases of vertical transmission and a case of abortion. DISCUSSION: The results confirm the studies carried out in Brazil and abroad as the prevalence of toxoplasmosis and as to the factors involved in the transmission, where the variables studied, meat intake, intake of raw vegetables and use the unwashed cutting board and knife after cutting raw meat, are important risk factors for the pregnant woman acquires toxoplasmosis during pregnancy. CONCLUSION: Gurupi proved to be a municipality with high endemicity of this parasite.Item Prevalência da doença de Chagas em gestantes em Goiânia-GO e integração de minicírculos de kDNA de Trypanosoma cruzi em lactentes de mães infectadas(Universidade Federal de Goiás, 2013-03-05) Siriano, Liliane da Rocha; Hecht, Mariana Machado; Castro, Ana Maria de; http://lattes.cnpq.br/9232309971000621; Nitz, Nadjar; Cardoso, Cléver Gomes; Ostermayer, Alejandro Luquetti; Barbosa, Alverne Passos; Oliveira, Ênio Chaves deAfter more than a century the discovery of Chagas disease, which etiological agent parasite is called Trypanosoma cruzi, there is still much to be revealed about this disease. Polymorphism, how to play, the correlation between strain and the clinical, serological and molecular methods, gene transfer and its clinical consequences, treatment and cure are topics that involve major issues still not completely understood by researchers of this enigmatic disease. The control of donors in blood banks and the reduction of vector transmissions rates caused the congenital transmission to gain greater importance. In this study, monitoring women during pregnancy allowed the accompaniment of the newborn to nine months of age, at which stage it is expected that maternal antibodies have disappeared completely. To know the population of pregnant women infected by Trypanosoma cruzi, in the service of a Maternity Hospital, 1979 records were analyzed at an interval of three years (2010 to 2012). Socioeconomic and demographic profiles, as well as reproductive and serological features were studied. Had positive serology for American trypanosomiasis 3.1% of women (61/1.979) and a few of them reported abortions. Studies have shown that abortion in infected mothers who failed to transmit their infection to the fetus had no greater frequency of miscarriage, prematurity and perinatal mortality, but there was a greater tendency to stillbirth in mothers who transmitted the infection to their children. Thirty-eight infected by T. cruzi pregnant women (two with twin pregnancies) and their fetuses (forty) participated in a survey to verify integration of kDNA minicircle of this protozoan in their children. For serological diagnosis the three conventional techniques of ELISA, IFA and HAI were performed on all samples. All mothers confirmed the positivity of Chagas disease by serology. Two children had positive serological, parasitological and molecular diagnosis of Trypanosoma cruzi, featuring congenital transmission, in addition to horizontal gene transfer. The polymerase chain reactions (PCR) were performed to identify the presence of nuclear DNA (nDNA) and mitochondrial (kDNA) in the samples studied. The amplifications were performed in triplicate with each primer pair for diagnostic confirmation. Amplification of nuclear material of T. cruzi occurred in 92.1% of mothers and 10% of children (4/40). In 70% of children and 92.1% of the mothers was no amplification of kinetoplast DNA of the parasite. Most integration events of minicircle kDNA occurred through mobile elements, with most of them the LINE-1 retrotransposon. The largest number of integrations was observed on chromosome X.Item Identificação de biomarcadores para o diagnóstico da toxoplasmose aguda e congênita(Universidade Federal de Goiás, 2020-11-27) Storchilo, Heloisa Ribeiro; Castro, Ana Maria de; http://lattes.cnpq.br/9232309971000621; Borges, Clayton Luiz; Alves, Daniella de Sousa Mendes Moreira; Rezende, Hanstter Hallison Alves; Paccez, Juliano Domiraci; Castro, Ana Maria deIntroduction: The diagnosis of congenital toxoplasmosis is complex and might take months to confirm since most newborns do not present symptoms and levels of undetected IgM and IgA anti-Toxoplasma gondii antibodies. Besides, pregnant women may have residual IgM, making it difficult to diagnose acute infection during pregnancy. Despite the various serological tests developed, there are few studies about biomarkers that can assist in the diagnosis of acute and congenital toxoplasmosis. Objective: Analyze the immunoreactivity profile of T. gondii protein with the potential to be biomarkers for the diagnosis of acute toxoplasmosis and the diagnosis and prognosis of congenital toxoplasmosis. Methods: Serum samples were selected from children with symptomatic and asymptomatic congenital toxoplasmosis and women of childbearing age or pregnant women with acute and chronic acquired toxoplasmosis. These samples were grouped according to the patients' laboratory and clinical results. Sodium Dodecyl Sulfate - Polyacrylamide Gel Electrophoresis (SDS-PAGE) was used to separate T. gondii proteins. The Immunoblotting technique was applied to the analysis of immunoreactive bands profile by IgG antibodies, using nitrocellulose membranes sensitized with parasite proteins. Results: One hundred and sixteen samples were analyzed. When comparing immunoreactive bands profile for antibodies present in samples from different groups and subgroups, the 150, 18.5, and 16.96 kDa proteins were more immunoreactive by the antibodies present in serum samples from the acquired infection group. The 343, 189, 150, 75, and 42 kDa proteins showed more chance to be detected by the symptomatic congenital infection subgroup, while the 61, 50, and 16.96 kDa proteins were significantly immunoreactive by the acute infection subgroup. Conclusions: Before obtained results, it was possible to identify potential biomarkers that may assist in early diagnosis and treatment of toxoplasmosis, avoiding the appearance of clinical manifestations throughout the life of children congenitally infected.