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Hansen s disease is a milenar, contagious disease, with a high frequency of for disability, which is still considered an important public health problem in Brazil. It occurs mainly among adults and, when the occurrence is among under the age of 15 years it represents recent transmission and occult endemia. The objective of this study is to describe the epidemiological and clinical profile of new cases of leprosy among 15 year-old minors notified at the SESAU-AL during the period of 1990-2007. This is a descriptive and sectional study; he data were collected using notification files of the new cases of leprosy under 15 year-old minors during 1990-2007, contained in SINAN s database. The same method was used to collect data of general detection of leprosy, in the same period, to analyze the proportion of leprosy s 15 year-old minor patients. The results of this study indicate that 8.9% of the new cases of leprosy recorded in Alagoas during 1990-2007, occurred among 15 year-old minors. The epidemiological indicator reveals high endemia in this State and hiperendemicity in some municipal districts. Operationally, the discovery of these cases was predominantly by passive demand, the medical examination of the household contacts was also regularly realized. The physical incapacity degree at diagnosis was mostly zero (69.6%) and 3.8% of case present physical incapacity degree was grade II. The occurrence of leprosy cases in this age group represents an epidemiological indicator of great importance, suggesting the need for reassessment of ongoing actions to control the disease.

A hanseníase é doença milenar, infectocontagiosa, com alto poder incapacitante, que ainda continua sendo grave problema de Saúde Pública no Brasil. Acomete principalmente a população adulta e, quando ocorre em menores de 15 anos, indica transmissão recente e endemia oculta. O objetivo deste estudo é descrever o perfil epidemiológico e clínico da ocorrência de casos novos de hanseníase em menores de 15 anos notificados à SESAU-AL. Estudo descritivo e transversal; os dados foram coletados por meio das fichas de notificação de casos novos de hanseníase em menores de 15 anos durante o período de 1990-2007, contidas no banco de dados do SINAN. Da mesma forma foram coletados dados quanto à detecção geral da hanseníase nesse período, para se observar a proporção de pacientes de hanseníase na faixa etária referida. Os resultados mostram que 8,9% dos casos novos detectados de hanseníase em Alagoas, no período de 1990-2007, são em menores de 15 anos. Os indicadores epidemiológicos apontam alta endemia no estado e em alguns municípios com hiperendemicidade. Operacionalmente, observa-se que as descobertas dos casos foi predominantemente de demanda passiva, o exame de comunicantes intradomiciliares foi realizado regularmente (58,4%). O grau de incapacidade física no diagnóstico foi, na maioria, igual a zero, representando 69,60% e 3,8% dos casos apresentaram grau de incapacidade física igual a II, nessa faixa etária. A ocorrência de casos de hanseníase, nessa…

Advisors/Committee Members: Miranda, Claudio Torres de, CPF:58659765834, MIRANDA, C. T., Tomimori, Jane, CPF:07087561820, TOMIMORI, J..

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Fundação de Amparo a Pesquisa do Estado de Alagoas

A desnutrição infantil é uma doença que tem suas raízes na pobreza, ocasionada por deficiências nutricionais decorrentes da insuficiente ingestão de macro e/ou micronutrientes e infecções repetidas. Nos países em desenvolvimento ainda se constitui em um grande problema de saúde pública tornando-se um dos grandes vilões da morbidade e mortalidade infantil. Nesse estudo procurou-se investigar se há associação entre paternidade e desnutrição infantil crônica. Trata-se de um estudo caso-controle em que casos são famílias com crianças desnutridas crônicas moderadas e graves, na faixa etária entre dezoito e sessenta meses de idade. A amostra foi composta por 60 famílias casos e 61 famílias controles. Dentre as variáveis relacionadas à paternidade, a não paternidade biológica (OR 3,10; IC95% 1 9,67) e escolaridade paterna (OR 3,30; IC 1,33 8,22) se mostraram como fatores de risco para a desnutrição infantil, quando analisadas individualmente. Após a regressão logística apenas a não paternidade biológica permaneceu como um fator de risco independente para a desnutrição (OR 7,13; IC95% 1,76 30,40). Dentre as variáveis sócio-demográficas estudadas evidenciou-se associação entre a desnutrição infantil crônica e a classe econômica baixa(OR 3,43; IC95% 1,04 11,32), número elevado de residentes no domicílio (OR 3,63; IC95% 1,66 7,92) e número de filhos (OR 2,84; IC95% 1,33 6,08), quando analisadas individualmente. Contudo apenas o número elevado de residentes no domicílio permaneceu como fator de risco independente para desnutrição crônica (OR 8,44; IC95% 2,58 27,59) quando as variáveis são consideradas simultaneamente na regressão logística. Encontrou-se, nesse estudo, associação entre fatores ligados à paternidade e desnutrição infantil com destaque para a não paternidade biológica.

Advisors/Committee Members: Miranda, Claudio Torres de, CPF:58659765834, MIRANDA, C. T., Florêncio, Telma Maria de Menezes Toledo, CPF:34831410497, FLORÊNCIO, T. M. M. T., Wyszomirska, Rozangela Maria de Almeida Fernandes, CPF:30984529491, WYSZOMIRSKA, R. M. A. F..

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Common mental disorders (CMD) are the result of multiple factors interaction (biological, psychological and social) and have a high prevalence, being more frequent among women. Several studies show the association between CMD and child malnutrition, particularly in the 2 first years of life, when the interaction with the mother is essential for child growth. Recent evaluations indicate that intervention focus should shift from food provision to the change of mother´s behavior. One of the approach components´ is maternal mental health. The Alagoas State semi-arid region is very poor and the population is exposed to food and nutritional insecurity. The objective of this dissertation is to investigate the association between maternal CMD and child malnutrition in children 6 to 24 months old in urban and rural environments. It will be done considering socio demographic variables and the mothers´ nutritional status. Two papers are the result of this Project. The first is entitled Factors related to mothers´ mental health in the semi-arid region of Alagoas: the role of the urban/rural environment . In this study we observed that the prevalence of CMD in the rural area was 56.2% vs 43.8% in urban area (OR = 1.03 CI 95% 0.64-1.63). Regarding urban area, education was the variable that remained significant in the logistic regression (OR = 2.2 95% CI 1.03-4.6) while in the rural area, lack of partner was the variable that remained associated to TMC (OR = 2. 6 95% CI 1.01-6.7). The second article was entitled "Mental health and maternal nutritional status of children in the semiarid region of Alagoas, Brazil. The overall prevalence of CMD was 44.3%. In mothers of malnourished children was 42.0% while in mothers of eutrophic children it was 44.6%. In the logistic regression found that the significant variables were: birth weight OR = 3.6 (95% CI 1.08-12.4) and breastfeeding OR = 6.7 (95% CI 1.76 to 25.5). In this study was not observed association between maternal CMD and child malnutrition. The high prevalence of CMD in this population may have hampered the detection of a possible association between CMD and child malnutrition. These results suggest the need to focus planning of maternal mental health care in order to reduce the burden both of mothers and their children.

Os transtornos mentais comuns (TMC) resultam da interação de múltiplos fatores (biológicos, psicológicos e sociais), apresentando alta prevalência, sobretudo em mulheres. Vários estudos mostram associação entre TMC e a desnutrição de seus filhos, particularmente nos 2 primeiros anos de vida, quando uma boa interação com a mãe é indispensável para o seu adequado crescimento. Avaliações recentes referem que a ênfase das intervenções deveria deslocar-se da provisão de alimentos para um esforço no sentido de mudar o comportamento das mães. Um dos componentes desta abordagem é a saúde mental materna. O semi-árido alagoano é uma região muito pobre e sua população está mais exposta à insegurança alimentar e nutricional. O objetivo desta dissertação foi…

Advisors/Committee Members: Miranda, Claudio Torres de, CPF:58659765834, MIRANDA, C. T., Ferreira, Haroldo da Silva, CPF:16802420406, FERREIRA, H. S., Santos, Darci Neves dos, CPF:06154344520, http://lattes.cnpq.br/1651604821137195.

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Maternal mental disorders may influence the adequacy of care that a mother should have with their children, affecting their growth and development, increasing the risk for malnutrition or other nutritional problems. This study aimed to investigate the existence of association between maternal common mental disorders (CMD) and child nutrition. Cross-sectional study was conducted with 596 children 6-60 months of age and their mothers in 39 quilombolas communities of Alagoas. The maternal mental health was assessed by the Self Report Questionnaire (SRQ-20). We collected data on anthropometric, socioeconomic, demographic, health, use of public services and presence of comorbidities. The nutritional status was determined by anthropometric standards of World Health Organization (WHO) and diagnosed with short stature when Z <-2 for index height for age (H/A), and overweight/obesity when Z ≥ 2 for weight for height (W/H). To assess the nutritional status of mothers was used Body Mass Index (BMI) according parameter of the WHO. The findings found no association between maternal CMD and child nutritional status, but showed 65.3% of CMD among mothers of children under five years old, indicating a need for more studies that emphasize the role of maternal mental health as a possible risk to the child growth and development. However, we observed a high prevalence of nutritional deficiencies that persist as major public health problems in the state besides the strong presence of the nutritional transition, where malnutrition and obesity coexist with equal magnitude. Thus, interventions are needed in order to prevent, control and combat obesity and malnutrition, since both are health hazards.

Fundação de Amparo a Pesquisa do Estado de Alagoas

Os transtornos mentais maternos podem influenciar na adequação dos cuidados que uma mãe deve ter com seus filhos, afetando no seu crescimento e desenvolvimento, aumentando o risco para desnutrição ou outros agravos nutricionais. Este estudo teve como objetivo investigar a existência de associação entre o Transtorno Mental Comum (TMC) materno e o estado nutricional infantil. Realizou-se estudo transversal com 596 crianças de 6 a 60 meses de idade e suas respectivas mães em 39 comunidades quilombolas de Alagoas. A saúde mental materna foi avaliada pelo Self Report Questionnaire (SRQ-20). Foram coletados dados referentes às variáveis antropométricas, demográficas, socioeconômicas, de saúde, de utilização de serviços públicos e presença de morbidades. O estado nutricional infantil foi determinado pelo padrão antropométrico da World Health Organization (WHO) e diagnosticado com déficit estatural quando Z < -2 para o índice A/I e, sobrepeso/obesidade quando Z ≥ 2 para o índice P/A. Para avaliação do estado nutricional das mães foi utilizado o Índice de Massa Corporal (IMC) segundo os parâmetros da WHO. Os achados não encontraram associação entre TMC materno e estado nutricional infantil, mas mostrou 65,3% de TMC em mães de crianças com até cinco anos de idade, indicando necessidade…

Advisors/Committee Members: Miranda, Claudio Torres de, CPF:58659765834, MIRANDA, C. T., Ferreira, Haroldo da Silva, CPF:16802420406, FERREIRA, H. S., Paula, Cristiane Silvestre de, CPF:06958764811, Paula CS, Vasconcelos, Sandra Mary Lima, CPF:33257329415, VASCONCELOS, S. M. L..

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Fundação de Amparo a Pesquisa do Estado de Alagoas

A provável associação existente entre a desnutrição crônica infantil e o transtorno mental comum (TMC) materno não tem uma relação causal estabelecida. Existem diversas possibilidades entre as quais uma seria que, nos casos em que a TMC esteja associada a uma redução da capacidade materna para realização de suas atividades, isto tenha repercussões no estado nutricional de seus filhos. O objetivo do estudo foi investigar a associação entre a desnutrição infantil e a incapacidade decorrente de TMC materno levando em conta a possível interação com algumas variáveis selecionadas incluindo o suporte social.Trata-se de um estudo caso-controle, que foi realizado no Centro de Recuperação e Educação Nutricional (CREN) em Maceió com mães de crianças desnutridas (casos) e teve como grupo controle mães de crianças eutróficas matriculadas em uma creche próxima ao CREN. Foi aplicado o Self Report Questionnaire (SRQ20) para o rastreamento de TMC dessas mães, além da Sheehan Disability Scale (SDS), para avaliar sua incapacidade decorrente do TMC e o Medical Outcomes Study Questions Social Support Survey (MOS-SSS) para avaliar o suporte social. Também foi aplicado um questionário para verificar as variáveis sócio-demográficas. A coleta de dados foi realizada após assinatura do termo de consentimento livre e esclarecido pelas participantes do estudo. Na análise estatística univariada foi utilizado o teste ﻼ ² para comparação entre as variáveis categóricas, com o p<0,05 e OR com intervalo de confiança de 95% para verificação da associação entre desnutrição da criança e incapacidade materna e interação com variáveis selecionadas. Finalmente utilizou-se a regressão logística em que a variável dependente foi a desnutrição infantil e variáveis independentes foram incapacidade materna decorrente de TMC, suporte social e fatores sócio-demográficos. Foi aplicado o teste de Likelihood ratio para comparar o teste inicial e o final. A amostra final foi composta por 125 duplas mãe-criança, sendo 55 casos e 70 controles. A média de idade das mães foi de 31,7 anos (±10,05 DP) e das crianças de 4,2 anos (±12,9 DP), e 54,4% das crianças eram do sexo feminino. Apresentaram TMC com incapacidade associada 20 mães (58,8%) de desnutridos e 14 mães (41,2%) de eutróficos. Verificou-se a existência de provável associação entre desnutrição infantil e incapacidade associada ao TMC materno (OR = 2,28 IC: 95% 1,02 5,1). Além disso, observou-se na análise bivariada diferença estatisticamente significante entre casos e controles nas variáveis: 1) ausência do marido ou companheiro da mãe no mercado de trabalho (OR = 3,18 IC: 95% 1,14 9,04); 2) número de residentes na casa (OR = 2,67 IC: 95% 1,17 6,11); 3) a presença do pai biológico na casa (OR = 3,14 IC: 95% 1,01 9,95). O escore de suporte social global não apresentou diferença significativa entre os grupos (p= 0,53). Na regressão logística, as variáveis independentes que permanecem no modelo final em relação à variável dependente desnutrição…

Advisors/Committee Members: Miranda, Claudio Torres de, CPF:58659765834, MIRANDA, C. T., Santos, Darci Neves dos, CPF:06154344520, http://lattes.cnpq.br/1651604821137195, Vasconcelos, Sandra Mary Lima, CPF:33257329415, VASCONCELOS, S. M. L..

▼ Lymphatic filariasis is a neglected disease popularly known as elephantiasis because of one of its chronic clinical manifestation. In Maceió, filariasis transmission is restricted to a well defined area in the city including the contiguous and central ditricts of Feitosa, Jacintinho and Pitanguinha, at the edge of Canal do Reginaldo. In order to assess the epidemiological situation of lymphatic filariasis in Maceió after the implementation of the "Program to Eliminate Lymphatic Filariasis" (PELF) in the city in 1999, hemoscopic and immunological surveys were conducted. For the hemoscopic survey (HS) blood sample was collected by the thick smear (TS) technique after after 9h30 pm, and examined for the presence of circulating microfilariae (mf). Using this technique 53,857 individuals in the endemic area and 9.880 inhabitants in the neighbouring area were examined, aged four years or older. Immunological survey (IS) was carried out using a rapid immunochromatographic card test ("ICT card test") to examine 414 inhabitants of the endemic area and 2,541 in the neighbouring area, being 2,214 individuals between 15 and 25 years and 327 children between 5 and 10 years old. By TS, 182 (0,32%) out of the 53,857 examined individuals in the endemic area presented microfilariae, being the prevalence significantly higher among male than female. It was observed along the years the following frequencies of microfilaraemic carriers: 1999 0.76%; 2000 0.57%; 2001 0.49%; 2002 0.11%; 2003 0.13%; 2004 0.06%. Among 9,880 individuals examined in the neighbouring area, only one (0,01%) microfilaremic carrier was detected. Only one (0,24%) filarial antigen carrier out of 414 examined, were detected. In neighbouring area, 327 children were examined for the "ICT card test", all being antigen-negative, while 2,214 young adults examined, eight (0,36%) presented soluble antigens. The average of microfilariae density of 93.8 ± 149.1 mf/mL blood, is significantly lower than that observed in the same area, in the past decade of 580.5 ± 786 mf/mL. During the study carried out since the implementation of the PELF in Maceió, from 1999 until 2006, the prevalence rates of microfilaraemic diagnosed by TS in the endemic area presented a significant decrease. Analysing the results of examined individuals from the neighbourhood of the endemic area it is evident that filariasis do not spread to the contiguous districts of the endemic focus. The IS carried out in individuals above five years of age in the general population of the endemic area detected very low antigenaemia for Wuchereria bancrofti in 2003. The IS in the neighbouring area carried out in children of 5-10 years old did not detect any individual with circulating antigen of W. bancrofti, whereas in the group of young adults (15-25 years), in this same area, eight individuals were found antigenpositive, being six amicrofilaraemic and two with low microfilaraemia when examined by TS usually employed in big surveys. The results of this study prove that measures used for the elimination of… Advisors/Committee Members: Fontes, Gilberto, CPF:35764376653, FONTES, Gilberto, Rocha, Abraham Cézar de Brito, CPF:34940316491, ROCHA, A. C. B., Miranda, Claudio Torres de, CPF:58659765834, MIRANDA, C. T..

▼ Common problems in the developing countries includes protein-energy undernutrition and iron deficiency anemia. These nutritional deficiencies are commonly associated with intestinal parasites, causing damage to growth and development and increasing the risk to morbidity-mortality. However, studies have shown controversy about this relationship. This study aimed to evaluate the association between parasitic, nutritional status, food intake and social indicators in children and adolescents, living in a slum area of Maceio, Alagoas. A cross-sectional was taken in a public with 367 individuals under 16 years old, living in a substandard settlement in Maceio, Alagoas. Parasitological, socioeconomic and nutritional evaluations were performed. Sedimentation concentration method and Kato-Katz techniques were used for stool examinations. Socioeconomic data was collected through the use of questionnaires addressing issues relating to housing conditions, economic characteristics and behaviors related to sanitation education. The nutritional evaluation included dietary assessment, biochemical examinations and anthropometric measurements. The dietary evaluation used the method of Estimated Average Requirement (EAR) as a cutoff point, and the data collected through 24 hour recall, adjusted for intrapersonal variability. Serum concentrations of hemoglobin (Hb), iron (SI) and ferritin (SF) were measured to assess the organic iron status. Anthropometric measurements were evaluated using the height-for-age index and body mass index for age, expressed as Z scores in relation to anthropometric growth patterns of WHO 2005/2006. The association between variables was performed by bivariate followed by multivariate logistic regression analysis. In all the tests a 5% statistical level of significance was adopted. The population studied lacked basic sanitation and most had an income lower or equal to the minimum salary. The frequency of enteroparasitosis in children and adolescents was 68.0% with 63.7% having polyparasitosis. Of the total number of individuals assessed by anthropometry, 12.3% presented with stature deficit and 3.5% with low weight. The frequencies of short stature and overweight (13.4%) were equivalent. Levels lower than the reference values were found for SF, SI and Hb in 15,9%, 33,2% and 10% of individuals, respectively. With respect to food intake, 5.6% presented with excessive and 3.7% with insufficient energy intake. The frequency of inadequate protein intake ranged from 28.6% to 47.8% between age groups, and consumption of micronutrients was more deficient in the age group from 1 to 3 years. Concerning association between variables, it was not possible to build a final multivariate logistic model for short stature and low weight, because no association was found with these anthropometric deficits and the other variables. The serum concentrations of SF and SI and economic class were associated with anemia. Intestinal parasitosis was associated with economic class and overcrowded living conditions. Because of morbidity… Advisors/Committee Members: Rocha, Eliana Maria Mauricio da, CPF:25703218691, ROCHA, E. M. M., Villar, Betzabeth Slater, CPF:17332994836, SLATER, B., Vasconcelos, Sandra Mary Lima, CPF:33257329415, VASCONCELOS, S. M. L., Miranda, Claudio Torres de, CPF:58659765834, MIRANDA, C. T..

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Bancroftian lymphatic filariasis is a neglected parasitic illness, known popularly as elephantiasis, because it is one of its chronic clinical manifestations. It is an anthroponotic disease caused by a nematode helminth of the species Wuchereria bancrofti (Cobbold, 1877) (Spirurida: Onchocercidae). Bancroftian filariasis occurs in 83 countries localized in tropical and subtropical regions and is considered by the World Health Organization as the second leading cause, worldwide, of work disability. With the objective to ascertain the current distribution of lymphatic filariasis in Maceio, based upon previous studies, hemoscopic and entomological surveys were conducted in the city. The hemoscopic surveys were performed using a thick blood smear (TBS) in a random sample of 20,025 students of night schools, enrolled in the 143 public schools that cover the 50 districts of the city, a sample of 1418 employees of the same public night schools and of 546 soldiers of the Brazilian Army s 59th Motorized Infantry Battalion. Also evaluated by TBS was the family of the sole microfilaremic person found, composed of four individuals and 239 families of current and former neighbors of this patient, with a total of 943 individuals. The entomological survey, for which the methodology of xenomonitoring was adopted, was conducted in an area of the city where they found the microfilaremic person diagnosed during the study. For this, in the residences of microfilaraemic person and his neighbors, 478 engorged female mosquitos of the species Culex quinquefasciatus (Say, 1823) (Diptera: Culicidae) were caught and examined by PCR. No microfilaremia was diagnosed in the hemoscopic surveys conducted among the night school students and soldiers of the Army. Among the employees of the schools just an individual microfilaremic person was diagnosed living in the Benedito Bentes district, locality considered free of lymphatic filariasis, however he was a past resident of the Jacintinho district which is endemic for the disease. The sole microfilaremic found in the study had microfilaremia considered very low (4 mf/mL of blood). The hemoscopic survey conducted among the current neighbors (Benedito Bentes 336 individuals) and the previous neighbors in the endemic area (Jacintinho 607 individuals) did not detect microfilaremia. The entomologic survey revealed that there were no examples of mosquitos with W. bancrofti DNA in the home of the person or the surrounding region. It was demonstrated that the sole microfilaremic person, that lived in a non-endemic area for 10 years, could not be epidemiologically important as a source of infection (reservoir) possibly due to his low level of microfilaremia. These results, associated with recently released data that report a significant reduction of the disease in endemic areas of the city, suggests that there is no transmission of Bancroftian lymphatic filariasis in the city of Maceio.

A filariose linfática bancroftiana é uma doença parasitária, negligenciada, conhecida popularmente como elefantíase,…

Advisors/Committee Members: Fontes, Gilberto, CPF:35764376653, FONTES, Gilberto, Luz, Zélia Maria Profeta da, CPF:39107590600, Luz, Zélia Maria Profeta da, Pedrosa, Celia Maria Silva, CPF:06021980468, PEDROSA, C. M. S., Miranda, Claudio Torres de, CPF:58659765834, MIRANDA, C. T..

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It is estimated that in developing countries, about 30% of the population of children under 5 years of age are malnourished. According to UNICEF the causes of malnutrition include other factors besides availability of food and family violence have been cited as a risk factor for child malnutrition. In order to check whether there is an association between violence and moderate or severe malnutrition in children it was conducted a case-control study in a community of the city of Maceió, Alagoas. Cases were 65 pairs of mother malnourished child (children with moderate or severe malnutrition, aged between six and sixty months of age), attended at the Center for Nutritional Rehabilitation and Education (CREN) - Maceió, and controls were 64 pairs of mother- eutrophic child in the same age and without malnourished siblings. We used the questionnaire Brazilian version of the WorldSAFE to detect violence against women and against children and anthropometric evaluation to detect child malnutrition. Data were analyzed utilizing the chi square test and the odds ratio (OR). It was utilizaed the value of p ≤ 0.05 and confidence interval of 95%. The results showed that both severe physical violence against children by parents, and as physical violence against women by the husband or partner in the last twelve months were very high in both groups. It was higher among cases, but without statistical significance. For children, the threat of abandonment was the type of violence higher among malnourished. For mothers, the threat with a firearm was the type of violence higher among malnourished. Among the socio-demographic variables low maternal schooling (OR = 2.1, CI: 1.0 - 4.2), low paternal schooling (OR = 4.2, CI: 1.8 - 9.8), number of children (OR = 4.3, CI: 1.9 - 10), greater number of residents in the home (OR = 2.8, CI: 1.3 - 5.9) and low economic class (OR = 3.4, CI: 1.1 - 9.9) were associated with malnutrition. The study concluded that there was no association between violence and moderate or severe chronic malnutrition and that other studies are needed for a better understanding of the relationship between child malnutrition and violence.

Estima-se que nos países em desenvolvimento, cerca de 30% da população de crianças menores de 5 anos de idade sofre de desnutrição. De acordo com a UNICEF as causas da desnutrição estão além do baixo consumo de alimentos e neste cenário a violência intrafamiliar tem sido citada como fator de risco para a desnutrição infantil. Com objetivo de verificar se existe associação entre violência intrafamiliar e a desnutrição moderada ou grave em crianças foi realizado um estudo caso-controle em uma comunidade da cidade de Maceió, Alagoas. Os casos foram 65 duplas de mãe - criança desnutrida (criança com desnutrição moderada ou grave, na faixa etária entre seis e sessenta meses de idade), atendidas no Centro de Recuperação e Educação Nutricional (CREN) - Maceió, e os controles foram 64 duplas de mãe-criança eutrófica na mesma faixa etária dos casos e sem irmãos com desnutrição oriundos da…

Advisors/Committee Members: Miranda, Claudio Torres de, CPF:58659765834, MIRANDA, C. T., Florêncio, Telma Maria de Menezes Toledo, CPF:34831410497, FLORÊNCIO, T. M. M. T., Paula, Cristiane Silvestre de, CPF:06958764811, Paula CS, Wyszomirska, Rozangela Maria de Almeida Fernandes, CPF:30984529491, WYSZOMIRSKA, R. M. A. F..

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A total of 60% of the area of Alagoas / Brazil is considered endemic to the occurrence of schistosomiasis and is not known the classification of clinical forms of the disease. This work has the objective of evaluating an endemic Schistosomiasis population in Alagoas, taking into account the prevalence, classification of the clinical forms and the results of laboratorial analysis. The sample was made of people from endemic areas of Rio Largo/Alagoas. The participants were submitted to a stool examination by Kato-Katz technique and the diagnostic was made after the reading of two microscopic slides for each sample. The patients positive for schistosomiasis mansoni were submitted to a clinical examination and blood collection. The positivity for Schistosomiasis observed in the population under study was of 8.11%. The medium parasite load was of 79,1+174,3 eggs. The clinical forms found were intestinal (90.57%) and hepatointestinal (9.43%), statistically significant at p<0.001. There were not found serious clinical forms. The present study shows results which update information on Schistosomiasis in the city of Rio Largo, data that, although referring to only three locations of this place, suggest the decrease of the parasite load and the clinical forms as well.

Em torno de 60% do território do estado de Alagoas é considerado área endêmica para esquistossomose mansoni, sendo observadas áreas de moderada a alta prevalência com mais de dois milhões de indivíduos expostos à infecção, não sendo conhecido o atual estadiamento das formas clínicas da parasitose. Este trabalho tem o objetivo de avaliar a população de uma área endêmica de esquistossomose no Estado de Alagoas em relação à prevalência, estadiamento das formas clínicas e dados de exames laboratoriais. A amostra foi constituída de moradores de três áreas endêmicas (Ilha Angelita, Lourenço de Albuquerque e Fazenda Riachão) do município de Rio Largo, Estado de Alagoas. Foram realizados 3.082 exames parasitológico de fezes através da técnica Kato-Katz, sendo o diagnóstico firmado após a leitura de duas lâminas para cada amostra. Do total das amostras, 249 foram positivos para Schistosoma mansoni , correspondendo a uma prevalência de 8,11%. Estes pacientes foram submetidos a exame clínico e coleta de sangue para realização de exames laboratoriais. A média da carga parasitária encontrada foi de 79,1+174,3 ovos. As formas clínicas encontradas foram a intestinal (90,57%) e hepatointestinal (9,43%) sendo uma diferença estatisticamente significativa (p<0,001). Não foram encontradas formas clínicas graves. O presente estudo apresenta resultados que atualizam dados sobre a esquistossomose mansônica no município de Rio Largo e embora sejam referentes a três localidades, sugerem haver uma diminuição da carga parasitária e das formas clínicas graves.

Advisors/Committee Members: Wyszomirska, Rozangela Maria de Almeida Fernandes, CPF:30984529491, WYSZOMIRSKA, R. M. A. F., Soares, Elza Cotrim, CPF:02432803949, SOARES, E. C., Miranda, Claudio Torres de, CPF:58659765834, MIRANDA, C. T., Barreto, Emiliano de Oliveira, CPF:04552293761, Barreto, E. O..

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Amebiasis is a severe infection caused by the protozoan parasite Entamoeba histolytica (Schaudinn, 1903). This species is morphologically indistinguishable from Entamoeba dispar (Brumpt, 1925), considered to be non-pathogenic and unable to cause invasive illness. The differentiation between these two species by immunological and molecular biology techniques is important to determine the epidemiological situation, therapeutic intervention, and profilaxis of invasive amebiasis. The aim of this study was to discriminate infection caused by E. histolytica and E.dispar in schoolchildren population in the city of Maceió, Alagoas. A cross-sectional study was carried out among 1,003 students in state public schools. Stool examination by sedimentation technique was conducted in order to evaluate frequency of enteroparasites, and for screening of students infected with E. histolytica/E. dispar complex. Positive exams for Entamoeba cysts were further submitted to antigen detection assay by enzyme-linked immunosorbent assay (ELISA), and polymerase chain reaction (PCR), for specific diagnosis of the infection. Frequency of intestinal parasites among the examined population was high, being detected 54.8% (550/1,003) students harbouring at least one species of helminth or protozoan parasites. Most of the students families (57.5%), belonged to class D economic level according to the Brazilian Economic Classification Criteria. Of the total assessed 83.1% had an income ≤ 1 minimum wage and lived in households with 2-5 residents. Polymerase chain reaction (PCR) was standardized extracting DNA from the stool using Stool Kit PSP (Invitek ®). The primers selected by in silico analysis based on virtual performance for amplification of E. histolytica and E. dispar were p11plus/p12plus and p13plus/p14plus, respectively. The prevalence of amebiasis among schoolchildren diagnosed by ELISA was 3.0% (30/1,003) and by PCR 2.8% (28/1,003), but the difference was not statistically significant (p> 0.05). The overall prevalence of E. dispar in schoolchildren was 5.0% (50/1,003). Both techniques (ELISA and PCR) were appropriate for differential diagnosis of E. histolytica and E. dispar. However, ELISA has advantages such as its rapid and easy execution. The results indicates the importance of specific diagnostic techniques for amoebiasis detection in the population.

Conselho Nacional de Desenvolvimento Científico e Tecnológico

A amebíase é uma infecção severa que tem como agente etiológico o protozoário Entamoeba histolytica (Schaudinn, 1903). Esta espécie é morfologicamente indistinguível da Entamoeba dispar (Brumpt, 1925), considerada apatogênica, incapaz de provocar a forma invasiva da doença. A diferenciação entre as duas espécies através de técnicas de diagnóstico imunológico e de biologia molecular, é fundamental para determinação da situação epidemiológica da amebíase, estabelecimento da conduta terapêutica adequada, e consequentemente prevenção da doença invasiva. O objetivo do presente estudo foi discriminar a infecção causada…

Advisors/Committee Members: Rocha, Eliana Maria Mauricio da, CPF:25703218691, ROCHA, E. M. M., Miranda, Claudio Torres de, CPF:58659765834, MIRANDA, C. T., Silva, Eduardo Sergio da, CPF:60087641615, SILVA, E. S., Silva, Luiz Antonio Ferreira da, CPF:18269427004, SILVA, L. A. F..

▼ This study aimed to evaluate laboratory aspects (total IgE and eosinophils) in patients with Schistosoma mansoni and geohelminths in three localities in Rio Largo, Alagoas. Coprological survey was conducted in 3030 subjects and examined two slides for each stool sample by the Kato-Katz technique, blood count to determine the absolute and relative number of eosinophilic and quantification of serum total IgE using the automated chemiluminescence system (Automated Chemiluminescence Systems) ACS: 180 SIEMENS, adapted to the System II and MAGIC LITE using commercial kits in 547 individuals from three localities infested by the snail Biomphalaria glabrata, close to the river Mundaú and environmental similarities. The subjects were divided into four groups, G1 (co-infected with S. mansoni and geohelminths): n = 115 (21.02%) with mean age 21.18 ± 13.08 years, G2 (infected only by S. mansoni): n = 127 (23.22%) with mean age 29.59 ± 16.54 years; G3 (infected only by geohelminths): n = 149 (27.24%) with mean age 23.99 ± 15.52 years and G4 (negative for S. mansoni and geohelminths, the control group): n = 156 (28.52%) with mean age 25.44 ± 14.60 years. The parasitic load of S. mansoni was quantified and classified according to intensity of infection by the number of eggs per gram of feces detected. The study was approved by the Ethics Committee of the Federal University of Alagoas and implemented in accordance with the resolution MS-CNS 196/96. For processing and data analysis used the software SPSS 11.5. In all analysis was considered the 5% level of significance. The descriptive statistical analysis of qualitative and quantitative variables were performed by the distribution of relative frequencies and absolute position measurements (mean) and dispersion (standard deviation). He applied the normality test, t test, analysis of variance oneway (ANOVA), chi-square test, Fisher exact test, Pearson and Spearman correlation and linear regression. Of the 3030 samples, 1,209 (39.90%) were positive for any helminth, and 679 (22.41%) positive for A. lumbricoides, 546 (18.02%) for T. Trichiura, 220 (7.26%) to Ancyostomatidae and 242 (8.0%) for S. mansoni. There was no statistically significant difference (p>0.05) of individuals positive for S. mansoni separated by gender, age and locality, the mean parasite burden was moderate and 111 epg (minimum 24 and maximum of 4,080 epg). Eosinophils increased significantly with increasing parasite load (p<0.05). The absolute and relative eosinophilia appear to have greater significance in relation to group coinfected, because presented more frequently than the other groups. There were no significant differences (p>0.05) between worm burden of S. mansoni and total IgE levels, nor between serum total IgE and age. Thus the total IgE test was not considered relevant to the diagnosis of Schistosomiasis mansoni. There was no correlation between markers of total IgE and geohelminth infections, whether they are co-infected with S. mansoni. The results suggest the importance of including eosinophil counts… Advisors/Committee Members: Wyszomirska, Rozangela Maria de Almeida Fernandes, CPF:30984529491, WYSZOMIRSKA, R. M. A. F., Calheiros, Cláudia Maria Lins, CPF:55389104404, CALHEIROS, C. M. L., Lacet, Celina Maria Costa, CPF:90192125834, LACET, CMC, Miranda, Claudio Torres de, CPF:58659765834, MIRANDA, C. T..

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During early childhood the family ties, mainly with their mothers are essential to the development of the child. One of the risk factors for child development is the impairment of maternal adequate mental health. Our hypothesis is that there is an association between child development and disability from common mental disorders (CMD). Cross-sectional study in which participants were children aged 2 to 6 years of age enrolled in two day care centers and their mothers. The two nurseries are located in the 7th district of the city of Maceió, Alagoas. The children had their development assessed by the Denver II in their personal - social and language dimensions of and the mothers had their mental health assessed by the SRQ-20 and disability associated with the SDS. In addition, a questionnaire was applied for evaluation of the socio-demographic variables and selected risk factors. The percentage of mothers with CMD was high (23.9%), and the percentage of delay in child development was also high (personal social 26.8% and language 52.1%), but there was no statistical association. There was no association between delays in social and personal development as well as development of language with disability associated with maternal CMD (p = 0.99 and p = 0.57 respectively). Logistic regression showed a significant association between delay in social and personal development "age of the child" (OR = 8.07, 95% CI = 2.49 to 26.12). With regard to the delay in language development were significant associations with the variables "number of children" (OR = 4.58 95% CI = 1.03 to 20.27) and "maternal age" (OR = 2.47 95% CI = 0.87 to 6.96). These results infer a percentage of delay in the social personal development and of language in the sample of children attending the daycare. It is suggested to carry out further studies to prove the existence of this high percentage of delay children developmental that may have important implications in the lives of these people.

Durante a primeira infância os vínculos familiares, principalmente com a mãe são fundamentais ao desenvolvimento da criança. Um dos fatores de risco para o desenvolvimento infantil adequado é o comprometimento da saúde mental materna. A hipótese deste estudo é que exista associação entre o desenvolvimento da criança e a incapacidade resultante de Transtornos Mentais Comuns (TMC). Foi um estudo do tipo transversal em que os participantes foram crianças de 2 a 6 anos de idade matriculados em duas creches e suas respectivas mães. As duas creches estão localizadas no 7ºdistrito da cidade de Maceió, Alagoas. As crianças tiveram seu desenvolvimento avaliado pelo Denver II em suas dimensões pessoal social e de linguagem e as mães tiveram sua saúde mental avaliada pelo SRQ-20 e a incapacidade associada pelo SDS. Além disso, foi aplicado questionário de variáveis sócio-demográficas e fatores de risco selecionados. A percentagem de TMC nas mães avaliadas foi alta (23,9%), a percentagem do atraso no desenvolvimento infantil encontrado nas creches avaliadas também foi…

Advisors/Committee Members: Miranda, Claudio Torres de, CPF:58659765834, MIRANDA, C. T., Santos, Almira Alves dos, CPF:13345087472, http://lattes.cnpq.br/2389264304369432, Wyszomirska, Rozangela Maria de Almeida Fernandes, CPF:30984529491, WYSZOMIRSKA, R. M. A. F., Teixeira, Geraldo Magella, CPF:03809844403, http://lattes.cnpq.br/0553089994592057.

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Conselho Nacional de Desenvolvimento Científico e Tecnológico

Os agrotóxicos são substâncias químicas usadas, entre outras coisas, para o controle de pragas ou doenças das plantas e animais. Utilizados desde a Grécia clássica, esses produtos foram difundidos em vários países após a Segunda Guerra Mundial e no Brasil a partir da década de 60. Atualmente o Brasil é o maior consumidor de agrotóxicos no mundo. O uso inadequado dos agrotóxicos tem se constituído um problema para saúde humana e ambiental. Especialmente os trabalhadores da agricultura estão expostos aos efeitos danosos desses produtos. Na fumicultura, associados aos problemas causados pela exposição aos agrotóxicos os trabalhadores rurais ainda estão expostos a intoxicação causada pela nicotina presente na folha do tabaco. Em Arapiraca, importante produtor de tabaco no cenário nacional, a fumicultura destaca-se pela excessiva utilização de agrotóxicos, fato que contribui para ocorrência de agravos à saúde dos trabalhadores, principalmente pelas condições inadequadas de trabalho e desrespeito às normas de segurança. Esse trabalho objetivou caracterizar o perfil ocupacional dos fumicultores de Arapiraca-AL e sua exposição a agrotóxico e nicotina. Trata-se de um estudo transversal, do tipo descritivo, onde 70 trabalhadores do cultivo do tabaco foram entrevistados, utilizando-se um questionário semi-estruturado para obter informações acerca do perfil ocupacional. Os resultados mostraram que, 41,4% dos trabalhadores entrevistados possuíam idade entre 30-45 anos e 55,7% tinha ensino fundamental incompleto ou eram analfabetos. Também se observou que 37,1% eram proprietários da terra e 58% tinham renda per capita até um quarto de salário mínimo. Quase metade dos agricultores (47,1%) iniciou o trabalho na fumicultura até os 8 anos de idade e 48,6% tinham entre 11-30 anos de trabalho. A maioria, 54,3%, relatou trabalhar até 8 horas/dia, sendo que 61% trabalhavam seis dias da semana. Também a maioria dos trabalhadores, (62,9%) aplicava agrotóxicos e destes 43,2% gastava entre 5-8 horas diárias na aplicação. O pulverizador costal manual era utilizado por 72,7% dos aplicadores. Dentre os agrotóxicos utilizados o Confidor foi o mais citado. Quanto ao uso de medidas de proteção durante a mistura do agrotóxico, 56,8% não usava nenhuma medida e 34,1% justificava devido ao custo elevado. A maioria lavava as mãos (93,2%) e tomava banho (79,5%) frequentemente logo após aplicar agrotóxicos. Dois terços (61,3%) dos agricultores nunca ingeriam líquido durante a aplicação do agrotóxico e 75% nunca comiam durante o mesmo procedimento. Enquanto 40,9% dos entrevistados já passaram mal após aplicar agrotóxicos, 72,7% referiram nunca ter tido intoxicação por agrotóxico. Dor de cabeça, náusea e vômito foram sinais e sintomas mais referidos. Quanto à exposição à nicotina, 84,3% dos entrevistados referiram contato da pele com a folha do tabaco e 71,5% tinham este contato sempre. O uso de luvas durante a colheita e a lavagem das mãos após a colheita foi referida por 57,1% e 85,7% dos…

Advisors/Committee Members: Barreto, Emiliano de Oliveira, CPF:04552293761, Barreto, E. O., Bedor, Cheila Nataly Galindo, CPF:02646687400, http://lattes.cnpq.br/2164253878550042, Miranda, Claudio Torres de, CPF:58659765834, MIRANDA, C. T., Andrade, Tiago Gomes de, CPF:02697210458, De ANDRADE, T. G..