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Visceral leishmaniasis affects various organs including the kidneys; which can lead to renal failure and death. In order to verify this renal involvement, material was evaluated from 100 dogs naturally infected and with serological diagnosis of canine visceral leishmaniasis (CVL). Inflammatory changes were present in 25.3% of the tubules, in 67.0% of interstitium and in 52.0% of glomeruli. There was no significant difference (p > 0.05) between the presence of glomerulonephritis in symptomatic and oligosymptomatic dogs. The membranous and membranoproliferative glomerulonephritis were the most frequent, both with 18.0% frequency, followed by focal segmental glomerulosclerosis with 14.0%. Changes such as cylindruria, tubular and fibrosis hypertrophy, periglomerular inflammatory infiltrate, and multifocal and diffuse peritubular inflammatory infiltrate were observed. The findings are consistent with those of other authors indicating that renal involvement is common in CVL and the standards of membranous and membranoploriferative glomerulonephritis, as well as the tubulointerstitial involvement, are frequent.

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Visceral leishmaniasis affects various organs including the kidneys; which can lead to renal failure and death. In order to verify this renal involvement, material was evaluated from 100 dogs naturally infected and with serological diagnosis of canine visceral leishmaniasis (CVL). Inflammatory changes were present in 25.3% of the tubules, in 67.0% of interstitium and in 52.0% of glomeruli. There was no significant difference (p > 0.05) between the presence of glomerulonephritis in symptomatic and oligosymptomatic dogs. The membranous and membranoproliferative glomerulonephritis were the most frequent, both with 18.0% frequency, followed by focal segmental glomerulosclerosis with 14.0%. Changes such as cylindruria, tubular and fibrosis hypertrophy, periglomerular inflammatory infiltrate, and multifocal and diffuse peritubular inflammatory infiltrate were observed. The findings are consistent with those of other authors indicating that renal involvement is common in CVL and the standards of membranous and membranoploriferative glomerulonephritis, as well as the tubulointerstitial involvement, are frequent.

A leishmaniose visceral acomete vários órgãos entre eles os rins; o que pode levar a insuficiência renal e a morte. Com o objetivo de verificar este acometimento renal foram avaliados materiais de 100 cães naturalmente infectados e com diagnósticos sorológicos de leishmaniose visceral canina - LVC. As alterações inflamatórias estavam presentes em 25,3% dos túbulos, em 67,0% do interstício e em 52,0% dos glomérulos. Não houve diferença significativa (p > 0,05) entre a presença de glomerulonefrite em cães sintomáticos e oligossintomáticos. As glomerulonefrites membranosa e membrano proliferativa foram as mais freqüentes, ambas com 18,0% de freqüência seguidas da glomeruloesclerose segmentar e focal com 14,0%. Foram observadas alterações como cilindrúria, hipertrofia tubular e fibrose e infiltrados inflamatórios periglomerulares e peritubulares multifocais e difusos. Os achados concordam com os de outros autores indicando que o acometimento renal é comum na LVC e que os padrões de glomerulonefrites membranoploriferativa e membranosa; assim como o acometimento tubulointersticial são freqüentes.

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INTRODUCTION: This study sought to describe the profile and geographic distribution of reported cases of visceral leishmaniasis (VL) in the City of Campo Grande, State of Mato Grosso do Sul (MS), Brazil, from 2002 to 2009. METHODS: Human data were collected from the Brazilian National Information System for Notifiable Diseases. Canine cases and entomological data were obtained from the Information Service for Canine Visceral Leishmaniasis Control/Campo Grande, MS. RESULTS: A total of 951 records from 2002 to 2009 were investigated. The number of reported cases of VL in males was significantly higher (p < 0.0001) than that in females. The higher frequency observed among males was associated with age (p < 0.0001), which increased in individuals aged 40 years and older. The overall fatality rate was 7.4%. Entomological surveys conducted in 2006, 2007, and 2009 showed the insect vector Lutzomyia longipalpis to be present in all urban regions of the county. CONCLUSIONS: VL cases in humans and dogs, as well as in vectors, occurs in all urban regions of Campo Grande. Despite not observing tendencies of increase or reduction in the incidence of the disease due to aging, the major incidence in men is higher in those aged 40 years or above.

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INTRODUCTION: This study sought to describe the profile and geographic distribution of reported cases of visceral leishmaniasis (VL) in the City of Campo Grande, State of Mato Grosso do Sul (MS), Brazil, from 2002 to 2009. METHODS: Human data were collected from the Brazilian National Information System for Notifiable Diseases. Canine cases and entomological data were obtained from the Information Service for Canine Visceral Leishmaniasis Control/Campo Grande, MS. RESULTS: A total of 951 records from 2002 to 2009 were investigated. The number of reported cases of VL in males was significantly higher (p < 0.0001) than that in females. The higher frequency observed among males was associated with age (p < 0.0001), which increased in individuals aged 40 years and older. The overall fatality rate was 7.4%. Entomological surveys conducted in 2006, 2007, and 2009 showed the insect vector Lutzomyia longipalpis to be present in all urban regions of the county. CONCLUSIONS: VL cases in humans and dogs, as well as in vectors, occurs in all urban regions of Campo Grande. Despite not observing tendencies of increase or reduction in the incidence of the disease due to aging, the major incidence in men is higher in those aged 40 years or above.

INTRODUÇÃO: O objetivo deste trabalho foi descrever o perfil e a distribuição geográfica de casos notificados de leishmaniose visceral, na Cidade de Campo Grande, Mato Grosso do Sul (MS), Brasil, entre os anos de 2002 e 2009. MÉTODOS: Os dados de casos humanos foram obtidos a partir da Ficha de Notificação do Sistema Nacional de Agravos de Notificação. Os casos caninos e dados entomológicos foram obtidos do Sistema de Controle de Leishmaniose/Campo Grande, MS. RESULTADOS: Foram notificados 951 casos de leishmaniose visceral entre 2002 e 2009. A ocorrência destes nos indivíduos do sexo masculino foi significativamente maior (p<0,0001) do que nos do sexo feminino. Essa superioridade na frequência de notificações em homens associou-se à idade (p<0,0001), sendo mais intensa nos indivíduos com idade igual ou superior a 40 anos. O coeficiente de letalidade foi de 7,4%. O levantamento entomológico feito em 2006, 2007 e 2009 demonstrou dispersão do vetor em todas as regiões urbanas do município com captura de L. longipalpis nos três anos. CONCLUSÕES: Casos de LV em humanos e em cães assim como o vetor ocorrem em todas as regiões urbanas Campo Grande. Embora não haja tendência de aumento, nem de redução na incidência da doença à medida que a idade dos indivíduos aumenta, a superioridade na incidência em homens é maior no grupo de pessoas com idade igual ou superior a 40 anos.

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Entre os métodos de controle da verminose gastrintestinal em ovinos, a utilização de produtos químicos é o mais empregado. Porém, o uso indiscriminado e continuado desses produtos tem selecionado populações de helmintos resistentes aos anti-helmínticos, fenômeno relatado no mundo todo. Este trabalho teve como objetivo identificar as espécies de parasitos gastrintestinais e diagnosticar a situação da resistência anti-helmíntica em ovinos no Estado de Mato Grosso do Sul. Foram realizados testes de redução na contagem de ovos por grama de fezes (OPG) em rebanhos de dezesseis propriedades rurais; as sete formulações utilizadas continham as seguintes bases farmacológicas: Albendazol, Ivermectina, Levamisole, Triclorfon, Moxidectina, Closantel e uma contendo as três primeiras associadas. As espécies identificadas nas necropsias, em ovinos adultos, foram: Haemonchus contortus, Trichostrongylus colubriformis, Cooperia curticei, C. punctata, C. pectinata e Oesophagostomum columbianum; em ordem de prevalência. As formulações contendo Albendazol e Ivermectina não apresentaram eficácia na redução de OPG nos rebanhos testados, com médias de redução de 0,7 e -19,6 por cento, respectivamente. Closantel apresentou eficácia média de 6,7 por cento; Levamisole, Moxidectina e Triclorfon de 28,7, 26,8 e 65 por cento, respectivamente; a associação das três bases (Albendazol, Ivermectina e Levamisole), uma média de eficácia de 55,8 por cento. As percentagens médias de larvas infectantes recuperadas nas coproculturas, tanto no pré como no pós-tratamento, foram semelhantes; indicando que a resistência às bases testadas está presente em todas as espécies citadas, em maior ou menor intensidade. Os dois gêneros predominantemente resistentes são Haemonchus sp., com 86,9 por cento; seguido por Trichostrongylus sp., com média de 47,5 por cento; Strongyloides sp. 33,6 por cento; Oesophagostomum, sp. 21,4 por cento e Cooperia sp. 19,7 por cento.(AU)

Among the methods of control of gastrointestinal worms in sheep, the use of chemicals is the most common. However, the continued, and indiscriminate, use of these products has selected populations of resistant helminths to anthelmintics, a phenomenon reported in the whole world. This study aimed to identify the species of gastrointestinal parasites and diagnose the status of anthelmintic resistance in sheep in the State of Mato Grosso do Sul Brazil. Feacal egg count reduction tests (FECRT) were performed in flocks of sixteen farms, and the seven formulations used contained the following pharmacological bases: Albendazole, Ivermectin, Levamizol, Trichlorfon, Moxidectin, Closantel and one containing the first three in association. The species identified at necropsy, in adult sheep, were: Haemonchus contortus, Trichostrongylus colubriformis, Cooperia curticei, C. punctata, C. pectinata and Oesophagostomum columbianum, in order of prevalence. The formulations containing Albendazole and Ivermectin did not show efficacy in reducing the EPG in the flocks tested, with average reductions of 0.7 and -19.6 percent, respectively. Closantel presented an average efficacy of 6.7 percent; Levamisolee, Moxidectin and Trichlorfon, 28.7, 26.8 and 65 percent respectively, the combination of three bases (Albendazole, Ivermectin and Levamizol), an average efficacy of 55.8 percent. The average percentages of infective larvae recovered in the faecal cultures, pre and post treatment were similar, indicating that resistance to the bases tested is present in all species cited, to a greater or lesser degree. The two genera predominantly resistant are Haemonchus sp., with 86.9 percent, followed by Trichostrongylus sp., with an average of 47.5 percent, Strongyloides sp. 33.6 percent, Oesophagostomum sp. 21.4 percent and Cooperia sp. 19.7 percent.(AU)

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Entre os métodos de controle da verminose gastrintestinal em ovinos, a utilização de produtos químicos é o mais empregado. Porém, o uso indiscriminado e continuado desses produtos tem selecionado populações de helmintos resistentes aos anti-helmínticos, fenômeno relatado no mundo todo. Este trabalho teve como objetivo identificar as espécies de parasitos gastrintestinais e diagnosticar a situação da resistência anti-helmíntica em ovinos no Estado de Mato Grosso do Sul. Foram realizados testes de redução na contagem de ovos por grama de fezes (OPG) em rebanhos de dezesseis propriedades rurais; as sete formulações utilizadas continham as seguintes bases farmacológicas: Albendazol, Ivermectina, Levamisole, Triclorfon, Moxidectina, Closantel e uma contendo as três primeiras associadas. As espécies identificadas nas necropsias, em ovinos adultos, foram: Haemonchus contortus, Trichostrongylus colubriformis, Cooperia curticei, C. punctata, C. pectinata e Oesophagostomum columbianum; em ordem de prevalência. As formulações contendo Albendazol e Ivermectina não apresentaram eficácia na redução de OPG nos rebanhos testados, com médias de redução de 0,7 e -19,6 por cento, respectivamente. Closantel apresentou eficácia média de 6,7 por cento; Levamisole, Moxidectina e Triclorfon de 28,7, 26,8 e 65 por cento, respectivamente; a associação das três bases (Albendazol, Ivermectina e Levamisole), uma média de eficácia de 55,8 por cento. As percentagens médias de larvas infectantes recuperadas nas coproculturas, tanto no pré como no pós-tratamento, foram semelhantes; indicando que a resistência às bases testadas está presente em todas as espécies citadas, em maior ou menor intensidade. Os dois gêneros predominantemente resistentes são Haemonchus sp., com 86,9 por cento; seguido por Trichostrongylus sp., com média de 47,5 por cento; Strongyloides sp. 33,6 por cento; Oesophagostomum, sp. 21,4 por cento e Cooperia sp. 19,7 por cento.

Among the methods of control of gastrointestinal worms in sheep, the use of chemicals is the most common. However, the continued, and indiscriminate, use of these products has selected populations of resistant helminths to anthelmintics, a phenomenon reported in the whole world. This study aimed to identify the species of gastrointestinal parasites and diagnose the status of anthelmintic resistance in sheep in the State of Mato Grosso do Sul Brazil. Feacal egg count reduction tests (FECRT) were performed in flocks of sixteen farms, and the seven formulations used contained the following pharmacological bases: Albendazole, Ivermectin, Levamizol, Trichlorfon, Moxidectin, Closantel and one containing the first three in association. The species identified at necropsy, in adult sheep, were: Haemonchus contortus, Trichostrongylus colubriformis, Cooperia curticei, C. punctata, C. pectinata and Oesophagostomum columbianum, in order of prevalence. The formulations containing Albendazole and Ivermectin did not show efficacy in reducing the EPG in the flocks tested, with average reductions of 0.7 and -19.6 percent, respectively. Closantel presented an average efficacy of 6.7 percent; Levamisolee, Moxidectin and Trichlorfon, 28.7, 26.8 and 65 percent respectively, the combination of three bases (Albendazole, Ivermectin and Levamizol), an average efficacy of 55.8 percent. The average percentages of infective larvae recovered in the faecal cultures, pre and post treatment were similar, indicating that resistance to the bases tested is present in all species cited, to a greater or lesser degree. The two genera predominantly resistant are Haemonchus sp., with 86.9 percent, followed by Trichostrongylus sp., with an average of 47.5 percent, Strongyloides sp. 33.6 percent, Oesophagostomum sp. 21.4 percent and Cooperia sp. 19.7 percent.

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Tuberculosis was investigated regarding its clinical presentation, treatment outcome and sociodemographic profile among HIV patients attended at a referral center in Mato Grosso do Sul, in 2003-2005. Sixty-six medical files on patients over 14 years of age and data from the Brazilian National Information System for Notifiable Diseases relating to tuberculosis and from the Mortality Information System were analyzed. Most of the patients were male, white, of low schooling level and from urban areas. Increased extrapulmonary clinical presentation was found and it correlated with the degree of immunological competence. The main reasons for ceasing treatment were cure (reached after longer-than-expected follow-up) and death (of six patients at the beginning of the tuberculosis treatment). Information gaps were found in the tuberculosis notification records and medical files. The study revealed the need for early diagnosis of tuberculosis among HIV-positive patients, improvements in medical records and follow-up beyond the recommended duration, because of changes to the clinical evolution of tuberculosis in cases of comorbidity with HIV.

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Investigou-se a tuberculose quanto à apresentação clínica, desfecho de tratamento e perfil sociodemográfico dos infectados pelo vírus da imunodeficiência humana atendidos em 2003-2005 em um serviço de referência sulmatogrossense. Analisaram-se 66 prontuários de pacientes maiores de 14 anos e informações do Sistema de Informação Nacional de Agravos de Notificação para Tuberculose e do Sistema de Informações de Mortalidade. Predominaram indivíduos do sexo masculino, cor branca, pouca escolaridade e procedência do meio urbano. Identificou-se incremento da apresentação clínica extrapulmonar e sua relação com o comprometimento imunológico. Sobressaíram-se como formas de encerramento da tuberculose a cura (alcançada com acompanhamento mais longo que o previsto) e o óbito (de seis pacientes no início do tratamento da tuberculose). Observaram-se lacunas de preenchimento nas notificações de tuberculose e nos prontuários. Detectou-se a necessidade de diagnosticar precocemente a tuberculose em soropositivos para HIV, de aperfeiçoar os registros nos prontuários e de acompanhar os casos além do período recomendado, por alteração da evolução clínica da tuberculose em co-morbidade com a infecção pelo vírus da imunodeficiência adquirida.

Tuberculosis was investigated regarding its clinical presentation, treatment outcome and sociodemographic profile among HIV patients attended at a referral center in Mato Grosso do Sul, in 2003-2005. Sixty-six medical files on patients over 14 years of age and data from the Brazilian National Information System for Notifiable Diseases relating to tuberculosis and from the Mortality Information System were analyzed. Most of the patients were male, white, of low schooling level and from urban areas. Increased extrapulmonary clinical presentation was found and it correlated with the degree of immunological competence. The main reasons for ceasing treatment were cure (reached after longer-than-expected follow-up) and death (of six patients at the beginning of the tuberculosis treatment). Information gaps were found in the tuberculosis notification records and medical files. The study revealed the need for early diagnosis of tuberculosis among HIV-positive patients, improvements in medical records and follow-up beyond the recommended duration, because of changes to the clinical evolution of tuberculosis in cases of comorbidity with HIV.

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Objetivo: buscar melhor entendimento das alterações clínico-laboratoriais da Leishmaniose Visceral Americana e posterior uso deste no manejo clínico desta doença. Método: estudo retrospectivo de dados de prontuários de 163 pacientes com LVA, tratados no Hospital Universitário/Universidade Federal de Mato Grosso do Sul, entre 1999 e 2005. Resultados: As manifestações clínicas relatadas na admissão, de febre, esplenomegalia, hepatomegalia e emagrecimento, que foram mais comuns nos adultos, e o aumento de volume abdominal foi mais comum nas crianças (p<0,001). Houve uma diferença significativa (p<0,05) entre a presença de alterações na ureia e leucócitos e nos linfócitos (p<0,001) entre os pacientes adultos e crianças. O risco de persistência da creatinina sérica >1,3mg/dL após o tratamento foi maior em pacientes que já apresentavam na admissão seu nível elevado (RR=3,8, IC 95%), nos que havia presença de proteinúria (RR=7,4, IC 95%), naqueles com a associação de ambas (RR=7,1, IC 95%), e os tratados com anfotericina B vs antimonial (RR=8,9, IC 95%). Conclusão: Sendo assim, é importante o conhecimento da função renal basal e a criação de um protocolo a ser seguido quando do diagnóstico da LVA, uma vez que a doença renal pode aumentar a morbimortalidade destes pacientes.

Objective: To seek out a better understanding of clinical and laboratory alterations in American Visceral Leishmaniose (AVL), for subsequent use in clinical management of the disease. Methods: a retrospective study of medical records from 163 patients with AVL, treated at the University Hospital of the Federal University of Mato Grosso do Sul, from 1999 to 2005. Results: Of the clinical manifestations upon admission, fever, splenomegalia, hepatomegalia and weight loss, were the most common among adults; and an increase in abdominal volume was the most common in children (p<0.001). There was a significant difference (p<0.05) between the presence of alterations in urea and leukocytes and in lymphocytes (p<0.001) between adults and patients. The risk of serum creatinine remaining >1.3 mg/dL after treatment was greater in patients that presented a high level upon admission (RR=3.8, CI 95%), those that presented proteinurea (RR=7.4, CI 95%), those with an association of both (RR=7.1, CI 95%), and those treated with anphotericin B vs.antimony (RR=8.9, CI 95%). Conclusion: Accordingly, it is important to thoroughly understand basal renal function and to create a protocol for diagnosis of AVL, since renal disease can increase morbidity and mortality for these patients.

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This retrospective study describes the epidemiological profile of infant mortality in 2000-2002 in 16 counties in Mato Grosso do Sul State, Brazil, and evaluates the preventability of such deaths, using the International Statistical Classification of Diseases and Related Health Problems (ICD-10) and the List of Causes of Death Preventable by Interventions in the Setting of the Brazilian Unified National Health System in Children Under Five Years. Perinatal causes accounted for 54.3% of the 1,537 deaths, according to the Mortality Information System; congenital anomalies 14.9%; infectious and parasitic diseases 9.4%; and respiratory disorders 7%. A full 73.1% of deaths were preventable, and most (69.5%) resulted from inadequate prenatal, obstetric, and neonatal care. Additional causes were related to vaccine prevention (0.7%), diagnosis and treatment (10.4%), and health promotion (11.2%). Causes not entirely avoidable accounted for 24.3% of deaths. The findings emphasize the relevance of monitoring adverse maternal-infant conditions and events, particularly to reduce early neonatal mortality (<7 days of life).

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