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Vila-Farinas A, Pérez-Ríos M, Montes-Martínez A, Ahluwalia JS, Mourino N, Rey-Brandariz J, Triñanes-Pego Y, Candal-Pedreira C, Ruano-Ravina A, Gómez-Salgado P, Miguez-Varela C, Tajes-Alonso M, Loureiro-Fuentes I, Riesgo-Martín J, Valverde-Trillo A, Fernández-Lema I, Rey-Arijón M, Freiría-Somoza I, Rodríguez-Pampín M, Varela-Lema L. Perception of pregnant individuals, health providers and decision makers on interventions to cease substance consumption during pregnancy: a qualitative study. BMC Public Health 2024; 24:990. [PMID: 38594646 PMCID: PMC11003004 DOI: 10.1186/s12889-024-18397-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2023] [Accepted: 03/20/2024] [Indexed: 04/11/2024] Open
Abstract
BACKGROUND Despite multiple recommendations and strategies implemented at a national and international level, cigarette smoking, alcohol consumption, and cannabis use during pregnancy remains high in most countries. The objective of this study was to examine key stakeholders' perception of the treatment interventions adopted in Spain, to identify political, organizational and personal factors associated with successful implementation, and to propose strategies for improvement. METHODS A qualitative study with a phenomenological approach was conducted in 2022. The target groups were: (1) clinical decision makers in the field of addiction science, (2) health professionals who carry out treatment interventions, and (3) pregnant individuals who use tobacco, alcohol or cannabis. Two focus groups and eight in-depth interviews were conducted, recorded, and transcribed. Exploratory analysis and inductive open coding was performed, codes were merged into categories, and subcategories were identified. RESULTS The analysis resulted in 10 subcategories which were further merged into three main categories: (1) Degree of adoption and utility of treatment interventions implemented; (2) Needs and demands with respect to the organization of treatment interventions; and, (3) Personal barriers to and facilitators for treatment. Respondents reported that despite multiple national and regional cessation initiatives, treatment interventions were rarely adopted in clinical practice. Health care administrators demanded reliable records to quantify substance use for better planning of activities. Health care professionals advocated for additional time and training and both echoed the importance of integrating cessation interventions into routine prenatal care and creating in-house specialized units. The difficulty in quitting, lack of awareness of risk for foetus and child and the controversial advice were identified as barriers by pregnant individuals. CONCLUSIONS Consistent with previous work, this study found that cessation strategies implemented by the health authorities are not effective if they are not accompanied by organizational and behavioral changes. The current study identifies a set of factors that could be pivotal in ensuring the success of treatment interventions targeting tobacco, alcohol and cannabis use among pregnant individuals.
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Affiliation(s)
- Andrea Vila-Farinas
- Department of Preventive Medicine and Public Health, University of Santiago de Compostela, A Coruna, Spain
| | - Mónica Pérez-Ríos
- Department of Preventive Medicine and Public Health, University of Santiago de Compostela, A Coruna, Spain.
- Consortium for Biomedical Research in Epidemiology and Public Health, [CIBER en Epidemiología y Salud Pública/CIBERESP], A Coruna, Spain.
- Health Research Institute of Santiago de Compostela [Instituto de Investigación Sanitaria de Santiago de Compostela - IDIS], A Coruna, Spain.
| | - Agustín Montes-Martínez
- Department of Preventive Medicine and Public Health, University of Santiago de Compostela, A Coruna, Spain
- Consortium for Biomedical Research in Epidemiology and Public Health, [CIBER en Epidemiología y Salud Pública/CIBERESP], A Coruna, Spain
- Health Research Institute of Santiago de Compostela [Instituto de Investigación Sanitaria de Santiago de Compostela - IDIS], A Coruna, Spain
| | - Jasjit S- Ahluwalia
- Departament of Behavioral and Social Sciences, Brown University School of Public Health, Providence, RI, USA
| | - Nerea Mourino
- Department of Preventive Medicine and Public Health, University of Santiago de Compostela, A Coruna, Spain
| | - Julia Rey-Brandariz
- Department of Preventive Medicine and Public Health, University of Santiago de Compostela, A Coruna, Spain
- Consortium for Biomedical Research in Epidemiology and Public Health, [CIBER en Epidemiología y Salud Pública/CIBERESP], A Coruna, Spain
| | - Yolanda Triñanes-Pego
- Scientific-technical Assessment Unit [Avalia-t]. Galician Health Knowledge Management Agency, Agencia Gallega de Conocimiento en Salud/ACIS, A Coruna, Spain
| | - Cristina Candal-Pedreira
- Department of Preventive Medicine and Public Health, University of Santiago de Compostela, A Coruna, Spain
- Consortium for Biomedical Research in Epidemiology and Public Health, [CIBER en Epidemiología y Salud Pública/CIBERESP], A Coruna, Spain
| | - Alberto Ruano-Ravina
- Department of Preventive Medicine and Public Health, University of Santiago de Compostela, A Coruna, Spain
- Consortium for Biomedical Research in Epidemiology and Public Health, [CIBER en Epidemiología y Salud Pública/CIBERESP], A Coruna, Spain
- Health Research Institute of Santiago de Compostela [Instituto de Investigación Sanitaria de Santiago de Compostela - IDIS], A Coruna, Spain
| | - Patricia Gómez-Salgado
- Scientific-technical Assessment Unit [Avalia-t]. Galician Health Knowledge Management Agency, Agencia Gallega de Conocimiento en Salud/ACIS, A Coruna, Spain
| | - Carmen Miguez-Varela
- Department of Clinical Psychology and Psychobiology, University of Santiago de Compostela, A Coruna, Spain
| | - María Tajes-Alonso
- Mental Health Department, Regional Health Authority, Galician Regional Authority [Xunta de Galicia], A Coruna, Spain
| | - Isabel Loureiro-Fuentes
- Ordes Health Center, Galician Health Service [Servicio Galego de Saúde/SERGAS], A Coruna, Spain
| | - Juan Riesgo-Martín
- Catalonian Health Institute, Institut Català de la Salut/ICS, Barcelona, Spain
| | - Araceli Valverde-Trillo
- Department of Health, Catalonian Public Health Agency, Catalonian Regional Authority [Generalitat de Cataluña], A Coruna, Spain
| | | | - Mercedes Rey-Arijón
- Santiago de Compostela University Clinical Teaching Hospital, Galician Health Service, A Coruna, Spain
| | - Isabel Freiría-Somoza
- Santiago de Compostela University Clinical Teaching Hospital, Galician Health Service, A Coruna, Spain
| | - María Rodríguez-Pampín
- Santiago de Compostela University Clinical Teaching Hospital, Galician Health Service, A Coruna, Spain
| | - Leonor Varela-Lema
- Department of Preventive Medicine and Public Health, University of Santiago de Compostela, A Coruna, Spain
- Consortium for Biomedical Research in Epidemiology and Public Health, [CIBER en Epidemiología y Salud Pública/CIBERESP], A Coruna, Spain
- Health Research Institute of Santiago de Compostela [Instituto de Investigación Sanitaria de Santiago de Compostela - IDIS], A Coruna, Spain
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Li Z, Tucker CM, Odahowski CL, Eichelberger KY, Zhang J, Hung P. Co-occurrence of mental illness and substance use among US pregnant individuals, 2012-2021. Psychiatry Res 2024; 334:115820. [PMID: 38422868 DOI: 10.1016/j.psychres.2024.115820] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Revised: 02/19/2024] [Accepted: 02/23/2024] [Indexed: 03/02/2024]
Abstract
AIM Substance use disorders are increasingly prevalent among pregnant individuals, with evident risks of adverse perinatal outcomes. This study examines substance use (tobacco, alcohol and marijuana) among pregnant individuals with mental illness. METHODS A national representative sample of pregnant individuals were derived from 2012 to 2021 National Survey of Drug Use and Health data. Associations of past-year mental illness with past-month polysubstance use and each substance use were analyzed by logistic regression models, with complex sampling weights and survey year. RESULTS Among 6801 pregnant individuals, 16.4% reported having any mental illness (AMI) in 2012 and 2013, increasing to 23.8% in 2020-2021; and SMI increased from 3.3% to 9.4%. Polysubstance use increased disproportionately among those with severe mental illness (SMI), from 14.0% to 18.6%. Pregnant individuals with greater severity of mental illness had higher odds of polysubstance use (Adjusted Odds Ratio, 95% CI: AMI but no SMI vs. without AMI: 1.59 [1.04, 2.44]; SMI vs. without AMI: 5.48 [2.77, 10.82]). CONCLUSIONS Pregnant individuals with greater severity of mental illness were more likely to engage in substance use. Evidence-based educational, screening and treatment services, and public policy changes are warranted to mitigate the harmful health outcomes of substance use among US pregnant individuals with mental illness.
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Affiliation(s)
- Zhong Li
- Department of Public Administration, School of Health Policy and Management, Nanjing Medical University, Nanjing, Jiangsu, China; Department of Health Services Policy and Management, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - Curisa M Tucker
- Department of Biobehavioral Health & Nursing Science, College of Nursing, University of South Carolina, Columbia, SC, USA
| | - Cassie L Odahowski
- Rural and Minority Health Research Center, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - Kacey Y Eichelberger
- Department of Obstetrics and Gynecology, University of South Carolina School of Medicine Greenville, Prisma Health, Greenville, SC, USA
| | - Jiajia Zhang
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - Peiyin Hung
- Department of Health Services Policy and Management, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA; Rural and Minority Health Research Center, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA.
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Gomes KJ, Ragsdale P, Vadlamudi NK. Pharmacists' Role in Maternal Immunization. J Am Pharm Assoc (2003) 2024:102060. [PMID: 38432478 DOI: 10.1016/j.japh.2024.102060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Revised: 02/23/2024] [Accepted: 02/26/2024] [Indexed: 03/05/2024]
Abstract
Maternal immunization is an important strategy to safeguard infants against vaccine-preventable diseases such as pertussis, which poses a significant economic burden on the healthcare system. Although the Tetanus, Diphtheria, and Pertussis (Tdap) vaccine has been recommended for pregnant individuals since 2018, uptake varies widely across Canadian provinces. As 4.5 million Canadians do not have access to a regular physician, there is a need to find alternate ways of informing pregnant individuals about maternal immunization schedules. Given the wide accessibility of pharmacists across Canada, they should have a leading role in informing pregnant individuals about maternal vaccines. Training guidelines for pharmacists would ensure informative and effective conversations about vaccinations and promote vaccine safety and benefits, facilitating administration. Increased participation from pharmacists can significantly contribute to improving maternal and child health outcomes, with the goal of reducing the burden of vaccine-preventable diseases in Canada.
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Affiliation(s)
- Kyle J Gomes
- Research Assistant: Vaccine Evaluation Center, BC Children's Hospital Research Institute, University of British Columbia, Vancouver, British Columbia, Canada
| | - Parkash Ragsdale
- Lecturer and Coordinator, Practice Innovation Primary Care: Faculty of Pharmaceutical Sciences, University of British Columbia, Vancouver, British Columbia, Canada
| | - Nirma Khatri Vadlamudi
- Postdoctoral Research Fellow: Vaccine Evaluation Center, BC Children's Hospital Research Institute, University of British Columbia, Vancouver, British Columbia, Canada; Postdoctoral Research Fellow:Department of Pediatrics, Faculty of Medicine, The University of British Columbia, British Columbia, Canada; Adjunct Professor: School of Population and Public Health, Faculty of Medicine, The University of British Columbia, British Columbia, Canada.
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Gasparyan L, Duc J, Claustre L, Bosson-Rieutort D, Bouchard M, Bouchard MF, Owens-Beek N, West Moberly First Nations Chief And Council, Caron-Beaudoin É, Verner MA. Density and proximity of oil and gas wells and concentrations of trace elements in urine, hair, nails and tap water samples from pregnant individuals living in Northeastern British Columbia. Environ Int 2024; 184:108398. [PMID: 38237504 DOI: 10.1016/j.envint.2023.108398] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Revised: 12/15/2023] [Accepted: 12/18/2023] [Indexed: 02/23/2024]
Abstract
BACKGROUND Oil and gas exploitation can release several contaminants in the environment, including trace elements, with potentially deleterious effects on exposed pregnant individuals and their developing fetus. Currently, there is limited data on pregnant individuals' exposure to contaminants associated with oil and gas activity. OBJECTIVES We aimed to 1)measure concentrations of trace elements in biological and tap water samples collected from pregnant individuals participating in the EXPERIVA study; 2)compare with reference populations and health-based guidance values; 3)assess correlations across matrices; and 4)evaluate associations with the density/proximity of oil and gas wells. METHODS We collected tap water, hair, nails, and repeated urine samples from 85pregnant individuals, and measured concentrations of 21trace elements. We calculated oil and gas well density/proximity (Inverse Distance Weighting [IDW]) for 4buffer sizes (2.5 km, 5 km, 10 km, no buffer). We performed Spearman's rank correlation analyses to assess the correlations across elements and matrices. We used multiple linear regression models to evaluate the associations between IDWs and concentrations. RESULTS Some study participants had urinary trace element concentrations exceeding the 95th percentile of reference values; 75% of participants for V, 29% for Co, 22% for Ba, and 20% for Mn. For a given trace element, correlation coefficients ranged from -0.23 to 0.65 across matrices; correlations with tap water concentrations were strongest for hair, followed by nails, and urine. Positive (e.g., Cu, Cr, Sr, U, Ga, Ba, Al, Cd) and negative (e.g., Fe) associations were observed between IDW metrics and the concentrations of certain trace elements in water, hair, and nails. SIGNIFICANCE Our results suggest that pregnant individuals living in an area of oil and gas activity may be more exposed to certain trace elements (e.g., Mn, Sr, Co, Ba) than the general population. Association with density/proximity of wells remains unclear.
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Affiliation(s)
- Lilit Gasparyan
- Department of Occupational and Environmental Health, School of Public Health, Université de Montréal, Montreal, QC, Canada; Centre de recherche en santé publique, Université de Montréal et CIUSSS du Centre-Sud-de-l'Île-de-Montréal, Montreal, QC, Canada
| | - Juliette Duc
- Centre de recherche en santé publique, Université de Montréal et CIUSSS du Centre-Sud-de-l'Île-de-Montréal, Montreal, QC, Canada; Department of Health Policy, Management and Evaluation, School of Public Health, Université de Montréal, Montreal, QC, Canada
| | - Lucie Claustre
- Department of Occupational and Environmental Health, School of Public Health, Université de Montréal, Montreal, QC, Canada; Centre de recherche en santé publique, Université de Montréal et CIUSSS du Centre-Sud-de-l'Île-de-Montréal, Montreal, QC, Canada
| | - Delphine Bosson-Rieutort
- Centre de recherche en santé publique, Université de Montréal et CIUSSS du Centre-Sud-de-l'Île-de-Montréal, Montreal, QC, Canada; Department of Health Policy, Management and Evaluation, School of Public Health, Université de Montréal, Montreal, QC, Canada
| | - Michèle Bouchard
- Department of Occupational and Environmental Health, School of Public Health, Université de Montréal, Montreal, QC, Canada; Centre de recherche en santé publique, Université de Montréal et CIUSSS du Centre-Sud-de-l'Île-de-Montréal, Montreal, QC, Canada
| | - Maryse F Bouchard
- Department of Occupational and Environmental Health, School of Public Health, Université de Montréal, Montreal, QC, Canada; Institut national de la recherche scientifique, Laval, QC, Canada; Sainte-Justine Hospital Research Center, Montreal, QC, Canada
| | | | | | - Élyse Caron-Beaudoin
- Department of Health and Society, Department of Physical and Environmental Sciences, University of Toronto Scarborough, Toronto, ON, Canada; Center for Clinical Epidemiology and Evaluation, Vancouver Coastal Health Research Institute, University of British Columbia, Vancouver, BC, Canada
| | - Marc-André Verner
- Department of Occupational and Environmental Health, School of Public Health, Université de Montréal, Montreal, QC, Canada; Centre de recherche en santé publique, Université de Montréal et CIUSSS du Centre-Sud-de-l'Île-de-Montréal, Montreal, QC, Canada.
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Chen L, Dai J, Fei Z, Liu X, Zhu Y, Rahman ML, Lu R, Mitro SD, Yang J, Hinkle SN, Chen Z, Song Y, Zhang C. Metabolomic biomarkers of the mediterranean diet in pregnant individuals: A prospective study. Clin Nutr 2023; 42:384-393. [PMID: 36753781 PMCID: PMC10029322 DOI: 10.1016/j.clnu.2023.01.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Revised: 12/14/2022] [Accepted: 01/08/2023] [Indexed: 01/15/2023]
Abstract
BACKGROUND AND AIMS Metabolomic profiling is a systematic approach to identifying biomarkers for dietary patterns. Yet, metabolomic markers for dietary patterns in pregnant individuals have not been investigated. The aim of this study was to identify plasma metabolomic markers and metabolite panels that are associated with the Mediterranean diet in pregnant individuals. METHODS This is a prospective study of 186 pregnant individuals who had both dietary intake and metabolomic profiles measured from the Fetal Growth Studies-Singletons cohort. Dietary intakes during the peri-conception/1st trimester and the second trimester were accessed at 8-13 and 16-22 weeks of gestation, respectively. Adherence to the Mediterranean diet was measured by the alternate Mediterranean Diet (aMED) score. Fasting plasma samples were collected at 16-22 weeks and untargeted metabolomics profiling was performed using the mass spectrometry-based platforms. Metabolites individually or jointly associated with aMED scores were identified using linear regression and least absolute shrinkage and selection operator (LASSO) regression models with adjustment for potential confounders, respectively. RESULTS Among 459 annotated metabolites, 64 and 41 were individually associated with the aMED scores of the diet during the peri-conception/1st trimester and during the second trimester, respectively. Fourteen metabolites were associated with the Mediterranean diet in both time windows. Most Mediterranean diet-related metabolites were lipids (e.g., acylcarnitine, cholesteryl esters (CEs), linoleic acid, long-chain triglycerides (TGs), and phosphatidylcholines (PCs), amino acids, and sugar alcohols. LASSO regressions also identified a 10 metabolite-panel that were jointly associated with aMED score of the diet during the peri-conception/1st trimester (AUC: 0.74; 95% CI: 0.57, 0.91) and a 3 metabolites-panel in the 2nd trimester (AUC: 0.68; 95% CI: 0.50, 0.86). CONCLUSION We identified plasma metabolomic markers for the Mediterranean diet among pregnant individuals. Some of them have also been reported in previous studies among non-pregnant populations, whereas others are novel. The results from our study warrant replication in pregnant individuals by future studies. CLINICAL TRIAL REGISTRATION NUMBER This study was registered at ClinicalTrials.gov.
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Affiliation(s)
- Liwei Chen
- Department of Epidemiology, Fielding School of Public Health, University of California Los Angeles, Los Angeles, CA, 90095, USA.
| | - Jin Dai
- Department of Epidemiology, Fielding School of Public Health, University of California Los Angeles, Los Angeles, CA, 90095, USA.
| | - Zhe Fei
- Department of Biostatistics, Fielding School of Public Health, University of California Los Angeles, Los Angeles, CA, 90095, USA.
| | - Xinyue Liu
- Department of Epidemiology, Fielding School of Public Health, University of California Los Angeles, Los Angeles, CA, 90095, USA.
| | - Yeyi Zhu
- Division of Research, Kaiser Permanente Northern California, Oakland, CA, 94612, USA.
| | - Mohammad L Rahman
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Rockville, MD, USA.
| | - Ruijin Lu
- Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institute of Health, Bethesda, MD, USA.
| | - Susanna D Mitro
- Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institute of Health, Bethesda, MD, USA.
| | - Jiaxi Yang
- Global Center for Asian Women's Health, and Bia-Echo Asia Centre for Reproductive Longevity & Equality, Yong Loo Lin School of Medicine, National University of Singapore, 117549, Singapore; Department of Obstetrics and Gynecology, Yong Loo Lin School of Medicine, National University of Singapore, 119228, Singapore.
| | - Stefanie N Hinkle
- Department of Biostatistics, Epidemiology, and Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA.
| | - Zhen Chen
- Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institute of Health, Bethesda, MD, USA.
| | - Yiqing Song
- Department of Epidemiology, Indiana University Richard M. Fairbanks School of Public Health, Indianapolis, IN, USA.
| | - Cuilin Zhang
- Global Center for Asian Women's Health, and Bia-Echo Asia Centre for Reproductive Longevity & Equality, Yong Loo Lin School of Medicine, National University of Singapore, 117549, Singapore; Department of Obstetrics and Gynecology, Yong Loo Lin School of Medicine, National University of Singapore, 119228, Singapore.
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dos Anjos Pinheiro Bogoevich Morais R, Lima do Carmo E, Carneiro Bichara CN, Ramos dos Santos B, Silva da Silveira KW, Marins Póvoa M. Seroprevalence and risk factors associated with T. gondii infection in pregnant individuals from a Brazilian Amazon municipality. Parasite Epidemiol Control 2020; 9:e00133. [PMID: 31993513 PMCID: PMC6974787 DOI: 10.1016/j.parepi.2020.e00133] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2019] [Revised: 12/07/2019] [Accepted: 12/31/2019] [Indexed: 11/26/2022] Open
Abstract
The aim of this study was to determine the prevalence and to identify the risk factors associated with T. gondii infection in pregnant individuals living in the Ponta de Pedras municipality, Marajó Archipelago, State of Pará, where an outbreak of toxoplasmosis occurred in 2013. From 2014 to March 2017, a cross-sectional study was conducted, including 555 pregnant individuals aged 13- to 42-years-old. Serological tests (enzyme immunoassays) were performed, and socioenvironmental and behavioral information were obtained through the application of a questionnaire. A prevalence of 68.3% was detected, and older age, having contact with soil and living in an urban area were the risk factors associated with seropositivity. The study confirmed the high prevalence of infection among pregnant individuals in the region. The association of the infection with the variables of residential area and contact with soil indicates that there was environmental contamination by T. gondii oocysts in the municipality.
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Affiliation(s)
- Rafaela dos Anjos Pinheiro Bogoevich Morais
- Curso de Pós-graduação em Biologia de Agentes Infecciosos e Parasitários, Instituto de Ciências Biológicas da Universidade Federal do Pará, Belém, Pará, Brazil
- Seção de Parasitologia, Instituto Evandro Chagas/SVS/MS, Ananindeua, Pará, Brazil
| | | | | | - Bruna Ramos dos Santos
- Seção de Parasitologia, Instituto Evandro Chagas/SVS/MS, Ananindeua, Pará, Brazil
- Programa Institucional de Bolsas de Iniciação Científica, Instituto Evandro Chagas, CNPq, Ananindeua, Pará, Brazil
| | - Kaio Willy Silva da Silveira
- Seção de Parasitologia, Instituto Evandro Chagas/SVS/MS, Ananindeua, Pará, Brazil
- Programa Institucional de Bolsas de Iniciação Científica, Instituto Evandro Chagas, CNPq, Ananindeua, Pará, Brazil
| | - Marinete Marins Póvoa
- Curso de Pós-graduação em Biologia de Agentes Infecciosos e Parasitários, Instituto de Ciências Biológicas da Universidade Federal do Pará, Belém, Pará, Brazil
- Seção de Parasitologia, Instituto Evandro Chagas/SVS/MS, Ananindeua, Pará, Brazil
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