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Said RDC, Assy JGPL, Silva KV, Brandão ADS, Pinheiro OC, Esper HR, Gryschek ALDFPL, Bertolozzi MR, Amato VS, Boulos M, Segurado AAC, Gryschek RCB, França FODS. Twenty years of successful academic outreach at Núcleo de Medicina Tropical (NACE-NUMETROP/USP) in Santarém, Pará. Rev Soc Bras Med Trop 2021; 54:e0404-2020. [PMID: 33759918 PMCID: PMC8008915 DOI: 10.1590/0037-8682-0404-2020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2020] [Accepted: 10/07/2020] [Indexed: 11/21/2022] Open
Affiliation(s)
- Renato do Carmo Said
- Universidade de São Paulo, Faculdade de Medicina, Núcleo de Medicina Tropical, Departamento de Moléstias Infecciosas e Parasitárias, São Paulo, SP, Brasil.,Secretaria Municipal de Saúde de Santarém, Hospital Municipal de Santarém, Santarém, PA, Brasil
| | - João Guilherme Pontes Lima Assy
- Universidade de São Paulo, Faculdade de Medicina, Núcleo de Medicina Tropical, Departamento de Moléstias Infecciosas e Parasitárias, São Paulo, SP, Brasil.,Secretaria Municipal de Saúde de Santarém, Hospital Municipal de Santarém, Santarém, PA, Brasil
| | - Kamila Vieira Silva
- Universidade de São Paulo, Faculdade de Medicina, Núcleo de Medicina Tropical, Departamento de Moléstias Infecciosas e Parasitárias, São Paulo, SP, Brasil
| | - Alisson Dos Santos Brandão
- Universidade de São Paulo, Faculdade de Medicina, Núcleo de Medicina Tropical, Departamento de Moléstias Infecciosas e Parasitárias, São Paulo, SP, Brasil.,Secretaria Municipal de Saúde de Santarém, Hospital Municipal de Santarém, Santarém, PA, Brasil
| | - Olívia Campos Pinheiro
- Universidade de São Paulo, Faculdade de Medicina, Núcleo de Medicina Tropical, Departamento de Moléstias Infecciosas e Parasitárias, São Paulo, SP, Brasil.,Secretaria Municipal de Saúde de Santarém, Hospital Municipal de Santarém, Santarém, PA, Brasil
| | - Helena Rangel Esper
- Universidade de São Paulo, Faculdade de Medicina, Núcleo de Medicina Tropical, Departamento de Moléstias Infecciosas e Parasitárias, São Paulo, SP, Brasil
| | | | - Maria Rita Bertolozzi
- Universidade de São Paulo, Escola de Enfermagem, Departamento de Enfermagem em Saúde Coletiva, São Paulo, SP, Brasil
| | - Valdir Sabbaga Amato
- Universidade de São Paulo, Faculdade de Medicina, Núcleo de Medicina Tropical, Departamento de Moléstias Infecciosas e Parasitárias, São Paulo, SP, Brasil
| | - Marcos Boulos
- Universidade de São Paulo, Faculdade de Medicina, Núcleo de Medicina Tropical, Departamento de Moléstias Infecciosas e Parasitárias, São Paulo, SP, Brasil
| | - Aluísio Augusto Cotrim Segurado
- Universidade de São Paulo, Faculdade de Medicina, Núcleo de Medicina Tropical, Departamento de Moléstias Infecciosas e Parasitárias, São Paulo, SP, Brasil.,Universidade de São Paulo, Faculdade de Medicina, Hospital das Clínicas, Laboratório de Protozoologia, Bacteriologia e Resistência Antimicrobiana (LIM49-IMT2), São Paulo, SP, Brasil
| | - Ronaldo César Borges Gryschek
- Universidade de São Paulo, Faculdade de Medicina, Núcleo de Medicina Tropical, Departamento de Moléstias Infecciosas e Parasitárias, São Paulo, SP, Brasil.,Universidade de São Paulo, Faculdade de Medicina, Hospital das Clínicas, Laboratório de Imunopatologia da Esquistossomose e outras Parasitoses (LIM06-IMT2), São Paulo, SP, Brasil
| | - Francisco Oscar de Siqueira França
- Universidade de São Paulo, Faculdade de Medicina, Núcleo de Medicina Tropical, Departamento de Moléstias Infecciosas e Parasitárias, São Paulo, SP, Brasil.,Universidade de São Paulo, Faculdade de Medicina, Hospital das Clínicas, Laboratório de Investigação Médica em Imunologia (LIM48-IMT2), São Paulo, SP, Brasil
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Komninakis SV, Mota ML, Hunter JR, Diaz RS. Late Presentation HIV/AIDS Is Still a Challenge in Brazil and Worldwide. AIDS Res Hum Retroviruses 2018; 34:129-131. [PMID: 28797184 DOI: 10.1089/aid.2015.0379] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Despite all the efforts to contain the HIV/AIDS epidemics, there still are individuals of unknown diagnosis. These present high risk of mortality and after diagnosis respond very poorly to treatment. Late testing also represents a reduced opportunity in controlling the transmission of HIV and causes an indirect increase in the transmission rates of other diseases, such as tuberculosis. In European countries, as well as in the United States, a great number of people, represented especially by illegal immigrants, black individuals, and women, markedly present at a later state of infection. In 1996, Brazil was the very first developing country to offer free and universal access to antiretroviral therapy, as well as easy access to HIV testing and care. Nonetheless, there is still a significant number of young and adult subjects who look for HIV/AIDS services and hospitals at later stage of infection by HIV (late presenters). Here we discuss important aspects related to the late diagnosis of HIV in Brazil and worldwide.
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Affiliation(s)
- Shirley V. Komninakis
- Postgraduate Program in Health Science, FMABC, Santo André, São Paulo, Brazil
- Retrovirology Laboratory, Federal University of São Paulo, São Paulo, Brazil
| | - Magaly Lima Mota
- Postgraduate Program in Health Science, FMABC, Santo André, São Paulo, Brazil
| | | | - Ricardo Sobhie Diaz
- Retrovirology Laboratory, Federal University of São Paulo, São Paulo, Brazil
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Benzaken AS, Sabidó M, Brito I, Bermúdez XPD, Benzaken NS, Galbán E, Peeling RW, Mabey D. HIV and syphilis in the context of community vulnerability among indigenous people in the Brazilian Amazon. Int J Equity Health 2017; 16:92. [PMID: 28583173 PMCID: PMC5460420 DOI: 10.1186/s12939-017-0589-8] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2017] [Accepted: 05/23/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Contextual factors shape the risk of acquiring human immunodeficiency virus (HIV) and syphilis. We estimated the prevalence of both infections among indigenous people in nine indigenous health districts of the Brazilian Amazon and examined the context of community vulnerability to acquiring these infections. METHODS We trained 509 health care workers to screen sexually active populations in the community for syphilis and HIV using rapid testing (RT). We then assessed the prevalence of HIV and syphilis using RT. A multivariable analysis was used to identify factors associated with syphilis infection (sociodemographic, condom use, intrusion, population mobility, and violence). RESULTS Of the 45,967 indigenous people tested, the mean age was 22.5 years (standard deviation: 9.2), and 56.5% were female. Overall, for HIV, the prevalence was 0.13% (57/43,221), and for syphilis, the prevalence was 1.82% (745/40,934). The prevalence in men, women, and pregnant women for HIV was 0.16%, 0.11%, and 0.07%, respectively, and for syphilis, it was 2.23%, 1.51%, and 1.52%, respectively. The district Vale do Javari had the highest prevalence of both infections (HIV: 3.38%, syphilis: 1.39%). This district also had the highest population mobility and intrusion and the lowest availability of prenatal services. Syphilis infection was independently associated with age (odds ratio [OR] 1.04, 95% confidence interval [CI]: 1.03-1.05), male sex (OR 1.32, 95% CI: 1.14-1.52), and mobility (moderate: OR: 7.46, 95% CI: 2.69-20.67; high: OR 7.09, 95% CI: 3.79-13.26). CONCLUSIONS The large-scale integration of RT in remote areas increased case detection among pregnant women, especially for syphilis, in districts with higher vulnerability. Mobility is an important risk factor, especially in districts with higher vulnerability. Contextually appropriate approaches that address this factor could contribute to the long-term success of HIV and syphilis control programs.
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Affiliation(s)
- Adele Schwartz Benzaken
- Department of STI, AIDS and Viral Hepatitis, Secretary for Health Surveillance, Ministry of Health Brazil, Brasília, DF, Brazil.,Tropical Medicine Foundation Doctor Heitor Vierira Dourado, Manaus, Brazil
| | - Meritxell Sabidó
- Department of STI, AIDS and Viral Hepatitis, Secretary for Health Surveillance, Ministry of Health Brazil, Brasília, DF, Brazil. .,Pan American Health Organization, Brasília, Brazil. .,TransLab. Department of Medical Sciences, Universitat de Girona, Catalonia, Spain. .,CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain.
| | - Ivo Brito
- Department of STI, AIDS and Viral Hepatitis, Secretary for Health Surveillance, Ministry of Health Brazil, Brasília, DF, Brazil
| | - Ximena Pamela Díaz Bermúdez
- Pan American Health Organization, Brasília, Brazil.,Departamento de Saúde Coletiva, Universidade de Brasília, Brasília, Brazil
| | | | | | - Rosanna W Peeling
- Department of Clinical Research, London School of Hygiene and Tropical Medicine, London, UK
| | - David Mabey
- Department of Clinical Research, London School of Hygiene and Tropical Medicine, London, UK
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