The presence of El Niño Southern Oscillation (ENSO) implies the presence of fluctuating rains in coastal areas and these changes influence the occurrence of febrile syndromes outbreaks. In Peru, Aedes aegypti is the vector responsible for various viruses such as the dengue, Zika, chikungunya, which is distributed in 18 Peruvian departments. These viruses cause similar clinical characteristics in the host and for this reason rapid, sensitive and specific diagnostic tests are needed so that the patient can receive timely treatment. / Revisión por pares

Glucose-6-phosphate dehydrogenase (G6PD) is a cytoplasmic enzyme with an important function in cell oxidative damage prevention. Erythrocytes have a predisposition towards oxidized environments due to their lack of mitochondria, giving G6PD a major role in its stability. G6PD deficiency (G6PDd) is the most common enzyme deficiency in humans; it affects approximately 400 million individuals worldwide. The overall G6PDd allele frequency across malaria endemic countries is estimated to be 8%, corresponding to approximately 220 million males and 133 million females. However, there are no reports on the prevalence of G6PDd in Andean communities where bartonellosis is prevalent.

Submitted by Ana Maria Fiscina Sampaio (fiscina@bahia.fiocruz.br) on 2012-07-19T21:14:03Z No. of bitstreams: 1 Helana Cristina Alves V Lima Incidencia e fatores de risco associados... 2011.pdf: 793768 bytes, checksum: a96bd31b1f3f1ee9dcf815c3bc18e379 (MD5) / Made available in DSpace on 2012-07-19T21:14:03Z (GMT). No. of bitstreams: 1 Helana Cristina Alves V Lima Incidencia e fatores de risco associados... 2011.pdf: 793768 bytes, checksum: a96bd31b1f3f1ee9dcf815c3bc18e379 (MD5) Previous issue date: 2011 / Fundação Oswaldo Cruz. Centro de Pesquisas Gonçalo Moniz. Salvador, Bahia, Brasil / A leptospirose é um problema de saúde pública em comunidades carentes do Brasil. As formas leves são subdiagnosticadas por causa da inespecificidade da apresentação clínica. São necessários estudos para determinar a frequência da leptospirose em comunidades carentes e identificar características que permitam predizer o risco de leptospirose entre pacientes com síndrome febril aguda (SFA). Este trabalho tem como objetivos determinar a prevalência da leptospirose em pacientes atendidos por SFA, determinar a incidência das formas leves e graves e identificar fatores preditores para a doença. Para tanto, de 01 de abril de 2009 a 31 de março de 2010, foi estabelecida uma vigilância de base populacional para atendimentos por SFA na comunidade de Pau da Lima, em Salvador, Bahia. Uma amostragem dos casos de SFA identificados foi investigada para leptospirose com o uso de microaglutinação (MAT) em amostras de sangue pareadas. Formas graves foram identificadas por um sistema de vigilância hospitalar. Os casos de SFA positivos e negativos foram comparados quanto ao perfil sociodemográfico, clínico e epidemiológico para identificar características preditoras da doença. A vigilância identificou 5.712 atendimentos por SFA em moradores com idade≥5 anos, sendo 1.729 (30%) recrutados e 1.479 (85%) avaliados quanto ao diagnóstico. Os recrutados foram semelhantes aos não recrutados quanto às características demográficas e clínicas. Dos pacientes avaliados, 1% foi confirmado como caso de leptospirose, sendo 14 casos leves autolimitados e 1 caso grave. A incidência anual de leptospirose leve estimada para a comunidade foi de 84/100.000 habitantes. No mesmo período foram identificados nove casos de leptospirose grave em residentes da comunidade estudada. A incidência de leptospirose grave foi de 14/100.000 habitantes. As seguintes características sociodemográficas e exposições ambientais nos 30 dias que precederam a doença foram associadas ao diagnóstico de leptospirose nos pacientes com SFA: sexo masculino; receber Bolsa Família; ter contato peridomiciliar com lama, com lixo, com esgoto; residir até 10 metros de esgoto aberto; presença de ratos no peridomicílio; ter contato ocupacional com esgoto; e trabalhar como agente de limpeza. Concluiu-se que carga da leptospirose é maior do que a identificada apenas com base nos casos graves. Características demográficas, clínicas e epidemiológicas devem ser utilizadas para predizer o risco de leptospirose. / Leptospirosis is a public health problem in Brazil's poor communities. The mild forms are underdiagnosed because of nonspecific clinical presentation. Studies are required to determine the incidence of leptospirosis in poor communities and identify characteristics that allow to predict the risk of leptospirosis among patients with acute febrile syndrome (AFS). This work aims to determine the prevalence of leptospirosis in patients served by AFS, determine the incidence of serious and light shapes and identify factors predictors for the disease. To this end, of the March 31, 2010, April 1, 2009 was established a population-based surveillance for attendances by SFA in the community of Pau da Lima, Salvador, Bahia. A sampling of cases identified SFA was investigated for leptospirosis using micro-agglutination test (MAT) in paired blood samples. Severe forms have been identified by a hospital surveillance system. The AFS cases were positive and negative compared to socio-demographic profile, to identify clinical and epidemiological characteristics of predictives of the disease. The surveillance identified 5,712 attendances by AFS in residents aged ≥ 5 years, 1,729 (30) recruited and 1,479 (85) evaluated with diagnosis. The recruited were similar to those not recruited as clinical and demographic characteristics. Of patients evaluated, 1% was confirmed as cases of leptospirosis, of which 14 being mild and 1 severe. The annual incidence of leptospirosis estimated for a community was light of 84/100.000 inhabitants. There is no same period were identified nine serious cases of leptospirosis in residents of the community studied. A severe leptospirosis incidence was of 14/100.000 inhabitants. As the following socio-demographic characteristics and environmental exposures. The following socio-demographic characteristics and environmental exposures during the 30 days preceding the disease were associated with the diagnosis of leptospirosis in patients with AFS: male, receiving Bolsa Familia, peridomestic have contact with mud, garbage, sewage, living within 10 meters of open sewage, presence of rats in animal sheds have contact with sewage occupational and work as a cleaning agent. In conclusions, the burden of leptospirosis is higher than identified based only in severe cases. Demographic, clinical and epidemiological research should be used to predict the risk of leptospirosis