Doutorado em Doenças Infecciosas

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    Transmissão vertical da infecção pelo HIV e da sífilis na faixa de fronteira terrestre do Brasil de 2010 a 2020
    (Universidade Federal do Espírito Santo, 2024-01-29) Lannoy, Leonor Henriette de; Co-orientador1; https://orcid.org/; http://lattes.cnpq.br/; Co-orientador2; https://orcid.org/; http://lattes.cnpq.br/; Co-orientador3; https://orcid.org/; http://lattes.cnpq.br/; Co-orientador4; ID do co-orientador4; Lattes do co-orientador4; Miranda, Angelica Espinosa Barbosa ; https://orcid.org/0000-0002-5556-8379; http://lattes.cnpq.br/5842271060162462; Orientador2; https://orcid.org/; http://lattes.cnpq.br/; https://orcid.org/0000-0002-9520-8538; http://lattes.cnpq.br/0999758340503440; Díaz Bermúdez, Ximena Pamela Claudia ; https://orcid.org/0000-0002-3771-7684; http://lattes.cnpq.br/1598351909460233; Brito, Ana Maria de ; https://orcid.org/; http://lattes.cnpq.br/0105337613337822; Teixeira, Carlos Graeff; https://orcid.org/0000-0003-2725-0061; http://lattes.cnpq.br/0464152494769261; Cerutti Junior, Crispim ; https://orcid.org/0000-0002-9485-4191; http://lattes.cnpq.br/4257067087979999; 5º membro da banca; https://orcid.org/; http://lattes.cnpq.br/; 6º membro da banca; https://orcid.org/; http://lattes.cnpq.br/; 7º membro da banca; https://orcid.org/; http://lattes.cnpq.br/
    Introduction: Mother-to-child (MTCT) of HIV and syphilis (congenital syphilis) are diseases that persist as public health issues in several parts of the world, and have been scarcely studied at the Brazilian land border strip (LBS). Measures to prevent MTCT of HIV and syphilis are widely known and Brazil has the necessary resources and technologies available. The Brazilian LBS is the 3rd largest land border in the world and, for the purposes of planning and promoting regional development, the National Regional Development Policy (PNDR) established the division of the region into three major arcs: North, Central and South. In turn, borders are unique spaces with potential and challenges that require differentiated programmatic public policies that take into account the specificity of each territory. Understanding the epidemiological situation of the problem in the region aims to contribute to the implementation of public policies and support the strategy of eliminating MTCT of HIV and congenital syphilis. Objectives: Understand MTCT of HIV and syphilis and analyze the provision of health services at the Brazilian LBS from 2010 to 2020. Methods: A quantitative, ecological, and cross-sectional evaluation study was conducted using secondary data from cases of HIV/AIDS, HIV in pregnant women, acquired syphilis (AS), syphilis in pregnant women (PS), and congenital syphilis (CS) registered in the Notifiable Diseases Information System (SINAN) between 2010 and 2020 and living in the Brazilian border municipalities. Information from the Live Birth Information System (SINASC), the Primary Care Health Information System (SISAB), the e-Gestor and the Medicines Logistic Control System (SICLOM Managerial) were also used. The variables studied included sociodemographic characteristics, prenatal and delivery data, as well as the availability of services and procedures. Detection rates of AS, PS, AIDS, HIV infection in children under 5 years old, HIV in pregnant women, and the incidence of CS were calculated. The MTCT rate of HIV was estimated based on the number of children infected with HIV per year of birth divided by the number of HIV-infected pregnant women reported by year of delivery. Trends in detection and incidence rates were calculated for the analyzed period. Thematic maps were constructed for spatial distribution analysis of detection rates and incidences using Quantum GIS (QGIS) version 2.18.6, and spatial analysis was evaluated local autocorrelation (local index of spatial association—LISA) by means of Local Moran’s I index, calculated using R software version x64 3.4.0. Results: In the LBS, among pregnant women diagnosed with syphilis, 23.7% were 15 to 19 years old, 34.2% were illiterate or had 14 only primary education, 7% were black, and 47% were of mixed race. Among pregnant women with HIV infection, 15.6% were 15 to 19 years old, 34.0% were illiterate or attended only primary education, 10.1% were black, and 42.1% were of mixed race. It was verified that in 2019 and 2020 approximately 90% of pregnant women in the LBS had four or more prenatal consultations. However, in the Northern arc, this proportion was only 82% in 2019 and 79% in 2020. Information on rapid testing (RT) for syphilis in the SISAB was available on 84% of the municipalities while RT performance for HIV was available on 92% of them. Sixty-eight percent of the municipalities recorded the administration of penicillin for syphilis treatment and 17% of them had Medication Dispensing Units. The time series analysis in the LBS showed a 48% average annual increase in PS case detection rates from 2010 to 2020, being 59.6% in the Northern arc, 28.8% in the Central arc, and 67.2% in the Southern arc. Regarding CS, there was an average increase of 38.4% in the LBS, being 18.3% in the Northern arc, and 65.7% in the Southern arc. The Central Arc showed no statistically significant upward trend in the incidence of CS. The annual variation rate in the detection of pregnant women with HIV infection in the LBS was 9.1%, with an increase of 19.6% in the Northern Arc, 11.4% in the Central Arc and 6.1% in the Southern Arc. On the other hand, the AIDS trend in children under 5 years old showed a reduction in the period analyzed; in the FFT it was -16.1%, in the Northern Arc -8.3%, in the Central Arc -19.2% and in the Southern Arc -17.7%. The spatial analysis by LISA showed that in 2019 there were clusters of high PS rates in municipalities of Acre, Mato Grosso do Sul, and Rio Grande do Sul. Clusters of CS and pregnant women living with HIV in Rio Grande do Sul, and transition areas (high-low) of AIDS in children under 5 in municipalities of Pará, Amazonas, Rondônia, and Mato Grosso do Sul, were also found. Conclusion: The study's findings reveal that MTCT of HIV and congenital syphilis persist as a major problem in Brazilian LBS and disproportionately affect women with low levels of schooling, adolescents and black women. However, its distribution is not homogeneous between the arcs, especially in the control of MTCT of HIV. There is a need to expand access to prenatal care and create mechanisms to guarantee the quality of care in general. To this end, public policies that contemplate inter-sectorial practices aimed at transforming specific social determinants of each arc and supporting binational mechanisms and agreements with legal instruments of integration are essential
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    AVALIAÇÃO CLÍNICA E TOMOGRÁFICA DA REGIÃO RINOMAXILAR EM PESSOAS AFETADAS PELA HANSENÍASE
    (Universidade Federal do Espírito Santo, 2022-10-06) Santo, Rachel Bertolani do Espirito; Deps, Patricia Duarte; https://orcid.org/; http://lattes.cnpq.br/9820695143683631; https://orcid.org/0000000237560402; http://lattes.cnpq.br/; Teixeira, Carlos Graeff; https://orcid.org/0000000327250061; http://lattes.cnpq.br/0464152494769261; Palaci, Moises; https://orcid.org/0000000320136071; http://lattes.cnpq.br/2602694352713051; Ramos, Bernardo Faria; https://orcid.org/; http://lattes.cnpq.br/; Gomes, Ciro Martins
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    VIOLÊNCIA SEXUAL, INFECÇÕES SEXUALMENTE TRANSMISSÍVEIS E GRAVIDEZ: RETROSPECTIVA DE DEZ ANOS EM SERVIÇO DE REFERÊNCIA EM VITÓRIA, ESPÍRITO SANTO, BRASIL.
    (Universidade Federal do Espírito Santo, 2022-09-30) Souza, Chiara Musso Ribeiro de Oliveira; Miranda, Angelica Espinosa Barbosa; https://orcid.org/0000-0002-5556-8379; http://lattes.cnpq.br/5842271060162462; https://orcid.org/; http://lattes.cnpq.br/5365777575405354; Spano, Liliana Cruz; https://orcid.org/0000000262056988; http://lattes.cnpq.br/7451382455806895; Boldrini, Neide Aparecida Tosato; https://orcid.org/0000-0003-1140-5057; http://lattes.cnpq.br/7621144748479516; Bermudez, Ximena Pamela Claudia Diaz; https://orcid.org/0000-0002-3771-7684; http://lattes.cnpq.br/1598351909460233; Menezes, Maria Luiza Bezerra; https://orcid.org/0000-0001-7001-2005; http://lattes.cnpq.br/8014227256305140
    Introduction: Sexually transmitted infections (STI) and pregnancy can be consequences of sexual violence. In Brazil, around 50% of women victims of sexual violence do not undergo STI prophylaxis or emergency contraception. Objectives: To describe the demographic, behavioral and clinical aspects of adolescent and adult women in situations of sexual violence, assisted at a reference clinic in Vitoria, ES, over a one decade period. Patients and Methods: This 10-year retrospective cohort study (2010-2019) describes the socio-demographic and epidemiological profile, and frequencies of clinical procedures, STI, pregnancy and legal abortion in 915 women assisted in a sexual violence assistance center in Brazil. Results: A total of 93.29% (842/915) were resident in the Metropolitan Area of the capital, brown-skinned and white 80.83% (733/915); 42.40% (388/915) were adolescents (12-17 years old), 80.44% (736/915) were single, most had no children, average of 1.8 (± 1,0 DP) children. About one-third (313/915) had not had previous sexual intercourse,1.60% (10/653) were pregnant. Rape predominated with 92% (841/915), of which 51.48% (471/915) involved a known or related aggressor, mostly an acquaintance, followed by stepfather or father. Recurrent cases were 24% (227/915). Clinical procedures: 42.62% (390/915) were attended within 72 hours; received STI prophylaxis 43.36% (392/904), emergency contraception 38.60% (394/904), blood collection 71.57% (647/904). Prevalence: syphilis 0.32% (2/653), hepatitis B 0.16% (1/653), pregnancy 1.60% (10/653). Incidences: syphilis 1.10% (7/663), hepatitis B 0.78% (5/633), hepatitis C 0.64% (4/633), pregnancy 27.17% (172/633). There were no HIV cases. Trichomoniasis 1.9% (2/108), HPV-induced cytological lesions 4.7% (5/108) and bacterial vaginosis 20% (21/108) were found on cervicovaginal samples. There were 129 legal abortions. Conclusions: The sociodemographic aspects and characteristics of aggressions in the studied population are similar to those described in Brazilian national database, including the remarkable number of adolescents, which brings reflections on early sexualization, rape culture, and adult victims’ invisibility. Both STI prophylaxis and emergency contraception were performed in less than half of the women. The frequencies of STI were low, associated with three or more aggressors, number of sexual partners and the age of coitarche. The incidence of pregnancy was high, associated with firearm use and age group, and protected by STI prophylaxis. The frequency of legal abortion was higher than national data. Public policies ensuring access to sexual and reproductive health rights and strategies to improve the quality of care for women in sexual violence situations as well education improvement may decrease vulnerability to STI and unintended pregnancies.
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    Vetores na epidemia de febre amarela silvestre no estado do Espírito Santo, Brasil, 2017
    (Universidade Federal do Espírito Santo, 2023-02-07) Stanzani, Luciana Matos de Abreu; Falqueto, Aloisio; https://orcid.org/0009-0009-8044-5504; http://lattes.cnpq.br/7897153591613337; https://orcid.org/0000-0002-2274-6108; http://lattes.cnpq.br/0784346689554133; Teixeira, Carlos Graeff; https://orcid.org/0000000327250061; http://lattes.cnpq.br/0464152494769261; Rocha, Nildimar Honorio; https://orcid.org/0000-0002-2535-3844; http://lattes.cnpq.br/1219057751301378; Nunes Neto, Joaquim Pint; https://orcid.org/0000-0001-5981-0065; http://lattes.cnpq.br/2340850717453533; Cerutti Junior, Crispim; https://orcid.org/0000000294854191; http://lattes.cnpq.br/4257067087979999
    Yellow fever is an acute mosquito-borne infectious disease that can occur in an urban or sylvatic cycle. Evidence of sylvatic yellow fever was first reported in Atlantic Forest areas “without Aedes aegypti” in Espírito Santo (ES), Brazil, during a yellow fever virus (YFV) outbreak from 1931 to 1940. This study investigated the mosquito species involved in YFV transmission during the 2017 outbreak, ~80 years after the last YFV case in ES. An entomological survey was conducted in six forest areas during and after the peak of the epidemic. We collected 10,658 mosquitoes comprising 14 genera and 78 species. Species of the tribe Sabethini were the most abundant (80.67%) and diverse (51 taxa), followed by Aedini (16.62% of the specimens collected, comprising 14 taxa). Haemagogus leucocelaenus and Hg. janthinomys/capricornii were considered the main vectors as they had a relatively high abundance, co-occurred in essentially all areas, and showed the highest YFV infection rates (minimum infection rate [MIR] = 32.5, maximum likelihood estimate [MLE] = 32.1; MIR = 54.1, MLE = 35.8, respectively). Sabethes chloropterus, Sa. soperi, Sa. identicus, Aedes aureolineatus, and Shannoniana fluviatilis were also found to be naturally infected and may have a secondary role in transmission. This is the first report confirming the infection of Sa. identicus, Ae. aureolineatus, and Sh. fluviatilis with the YFV. Our study emphasizes the importance of monitoring mosquito communities in the Atlantic Forest and maintenance of high vaccination coverage in receptive areas to YFV transmission.
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    AVALIAÇÃO DA INFLUÊNCIA DA PRECOCIDADE DA ANTIBIOTICOPROFILAXIA NO RISCO DE INFECÇÃO EM FRATURAS EXPOSTAS
    (Universidade Federal do Espírito Santo, 2022-11-16) Marchiori, Joao Guilherme Tavares; Nunes, Ana Paula Ferreira; https://orcid.org/; http://lattes.cnpq.br/7851528667690358; https://orcid.org/; http://lattes.cnpq.br/; Spano, Liliana Cruz; https://orcid.org/0000000262056988; http://lattes.cnpq.br/7451382455806895; Meira, Debora Dummer; https://orcid.org/; http://lattes.cnpq.br/; Neto, Lauro Ferreira da Silva Pinto; https://orcid.org/; http://lattes.cnpq.br/; Junior, Charbel Jacob
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