Navegando por Autor "Silva, Alexandre Rotondo da"
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Item Descriptive study of American tegumentary leishmaniasis in the urban area of the Municipality of Governador Valadares, Minas Gerais State, Brazil.(2011) Miranda, Thiago Mourão de; Malaquias, Luiz Cosme Cotta; Escalda, Patrícia Maria Fonseca; Ramalho, Katiuscia Cardoso; Vital, Wendel Coura; Silva, Alexandre Rotondo da; Oliveira, Rodrigo Corrêa de; Reis, Alexandre BarbosaTo understand the emergence and re-emergence pattern of American tegumentary leishmaniasis (ATL), the clinical and epidemiological profiles and the spatial distribution of the disease were evaluated between 2001 and 2006 in an endemic area located in the Rio Doce valley in the north-eastern part of the Minas Gerais State, Brazil. The number of reported cases increased from six in the first year to 111 in the last year during this period. Disease cases predominated in the urban area (75.9%) and affected males and females equally in all age groups. The transmission of ATL occurred within dwellings and the surrounding areas, with the largest number of reported cases originating from poor areas, particularly those located on the margins of the Rio Doce lacking suitable sanitary infrastructure. Diagnosis was based on clinical criteria and the Montenegro skin test, with most patients (93.8%) exhibiting the cutaneous form of ATL. First-line treatment involved administration of pentavalent antimonial drugs (99.1%), and these provided a cure for > 75% of patients. The prevalence of ATL varied between 11.38 and 15.99 cases per 100,000 inhabitants, which is high in comparison with the national average. Urgent measures, including improved means of diagnosis at the local health units, education of schoolchildren and motivation of the general population, are required to decrease transmission and control the disease.Item Posttherapeutic cure criteria in Chagas disease : conventional serology followed by supplementary serological, parasitological, and molecular tests.(2012) Assis, Girley Francisco Machado de; Silva, Alexandre Rotondo da; Bem, Vitor Antônio Lemos do; Bahia, Maria Terezinha; Martins Filho, Olindo Assis; Dias, João Carlos Pinto; Viñas, Pedro Albajar; Torres, Rosália Morais; Lana, Marta deWe performed a critical study of conventional serology, followed by supplementary serological, parasitological, and molecular tests, to assess the response to etiologic treatment of Chagas’ disease. A group of 94 Chagas’ disease patients treated with benznidazole at least 10 years earlier were evaluated from the laboratory and clinical points of view. When conventional serology (enzyme- linked immunosorbent assay [ELISA], indirect immunofluorescence [IIF], and indirect hemagglutination [IHA]) and classic criteria (consistent results with any two of the three tests) or more rigorous criteria (consistent results from the three tests) were used, 10.6% and 8.5% of patients were considered treated and cured (TC) by classic and rigorous criteria, respectively. Patients were then evaluated using supplementary (recombinant ELISA and Trypanosoma cruzi excreted-secreted antigen blotting [TESA-blot]), parasitological (hemoculture), and molecular (PCR) tests. The results of recombinant ELISA were similar to those with the rigorous criterion (three consistent test results). The TESA-blot group showed a higher percentage (21.3%) of negative results than the groups defined by either cure criterion. Hemoculture and PCR gave negative results for all treated and cured (TC) patients, regardless of the criterion used. Recombinant ELISA and TESA-blot tests showed negative results for 70% and 87.5% of the patients categorized as TC by the classic and three-test criteria, respectively. For patients with discordant conventional serology, the supplementary serological and molecular tests were the decisive factor in determining therapeutic failure. Clinical evaluation showed that 62.5% of TC patients presented with the indeterminate form of the disease. Additionally, treated patients with negative TESA-blot results should be reevaluated later with all methodologies used here to verify whether TESAblot is a reliable way to determine early parasitological cure of Chagas’ disease.