Diagnostic tools were developed and utilised to detect Toxoplasma gondii infection in a range of Australian marsupial species and identify epidemiological trends. An ELISA was developed to detect anti-T. gondii IgG in macropod marsupials. When compared with the commercially available MAT (modified agglutination test), the ELISA was in high agreement and yielded a ê coefficient of 0.96. Of 18 western grey kangaroos (Macropus fuliginosus) tested for the presence of T. gondii DNA by PCR, the 9 ELISA positive kangaroos tested PCR positive and the 9 ELISA negative kangaroos tested PCR negative indicating that the ELISA protocol was both highly specific and sensitive and correlated 100% with the more labour intensive PCR assay. A T. gondii seroprevalence study was undertaken on free ranging Australian marsupials. There was a T. gondii seroprevalence of 15.5% (95%CI: 10.7-20.3) in western grey kangaroos located in the Perth metropolitan area. The T. gondii seroprevalence in male western grey kangaroos was significantly less than their female counterparts (p=0.038), which may be related to behavioural differences causing differences in exposure to oocysts or recrudescence of T. gondii infection in pregnant females. Marsupial populations located in islands free from felids had a low overall T. gondii seroprevalence. A case control study determined that marsupials located in areas where felids may roam are 14.20 (95%CI: 1.94-103.66) times more likely to be T. gondii seropositive than marsupials located on felid-free islands. PCR, immunohistochemistry and serological techniques were used to detect T. gondii infection in marsupial dams and their offspring. T. gondii DNA was detected in the pouch young of chronically infected western grey kangaroos and a woylie (Bettongia penicillata). T. gondii DNA was also identified in the mammary gland of the woylie dam suggesting that infection of the woylie pouch young was from suckling milk from the mammary gland. Results of the study demonstrate that vertical transmission of T. gondii occurs in Australian marsupials and may be of importance in the maintenance of T. gondii infection in Australian marsupial populations. Animal tissue and meat from Australia, predominately from Australian marsupials, were screened for T. gondii DNA using PCR primers for the multi-copy, T. gondii specific B1 gene. Sequencing of the B1 gene revealed atypical genotypes in 7 out of 13 samples from Australia. These 7 isolates contained single nucleotide polymorphisms (SNPs) in the B1 gene that could not be matched with known sequences from strains I, II, III and X. Six unique genotypes were identified out of the 7 atypical isolates; two out of the 7 isolates had the same unique sequence at the B1 gene whereas the other 5 isolates each had different combinations of SNPs at the B1 gene. A majority of T. gondii isolates sampled from native Australian marsupials were of an atypical genotype. The discovery of atypical strains of T. gondii in Australia leads to further questions regarding the origin and transmission of these atypical strains. Additional studies linking atypical strains with their clinical manifestation are also warranted.

No description available.

Esta pesquisa teve como objetivo avaliar a evolução de crianças nascidas de mães positivas para o HIV ou com AIDS no Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto, durante o período compreendido entre 1986 e 2001. Foram levantadas informações relativas a profilaxia pré-natal e da criança ao nascer, assim como à reversão sorológica, soropositividade e sobrevida. Dos 680 participantes, 67 (9,8%) se infectaram, 520 (76,5%) não se infectaram e 93 (13,7%) ficaram sem informação devido ao abandono de seguimento. Profilaxia durante a gestação ocorreu em 144 mulheres com o uso de uma droga (21,2%) e em 77 com a utilização de duas ou mais drogas (11,3%), não tendo se verificado em 459 gestantes (67,5%). Entre os recém nascidos, 205 (30,1%) receberam apenas AZT, 134 (19,7%) foram medicados com AZT+SMX/TMP e 341 (50,1%) não foram tratados. Ocorreu óbito de 39 crianças (5,7%), com 559 (82,2%) tendo permanecido vivas e 82 (12,0%) cuja informação foi perdida. O percentual de óbito foi consideravelmente mais elevado entre os que não receberam profilaxia (9,7%), em relação aos que receberam apenas AZT (2,9%). Não se verificou nenhuma morte entre as 134 crianças em uso AZT+SMX/TMP. As proporções de óbitos variaram de acordo com o tempo, atingindo 9,5% no período pré-profilaxia (1986/1995) e caindo para 2,7% entre os anos de 1996 e 2001. Entre os 67 indivíduos infectados pelo HIV foram verificadas 22 mortes (33,8%), valor muito superior ao encontrado entre os 520 não infectados, nos quais ocorreram apenas 4 óbitos (0,8%). Os tempos medianos de reversão sorológica foram iguais a 589 dias para os nascidos de 1986 a 1995, e 451 dias, para os que nasceram no período 1996 a 2001. As curvas de sobrevivência demonstraram o evidente favorecimento dos indivíduos que foram submetidos a algum tipo de profilaxia, indicando que a intervenção terapêutica trouxe ganhos inquestionáveis para os recém nascidos de gestantes positivas para o HIV ou com AIDS. / The objective of the present study was to evaluate the evolution of children born to HIV-positive mothers or mothers with AIDS at the University Hospital, Faculty of Medicine of Ribeirão Preto, during the period from 1986 to 2001. Information was obtained about prenatal prophylaxis and infant prophylaxis at birth, and about serologic reversal, seropositivity and survival. Of the 680 participants, 67 (9.8%) were infected, 520 (76.5%) were not infected, and no information was available for 93 (13.7%) infants who were lost to follow-up. Prophylaxis during pregnancy occurred in 144 women with the use of mono prophylaxis (21.2%) and in 77 with the use of two or more drugs (11.3%), and 459 (67.5%) received no prophylaxis. Among the newborns, 205 (30.1%) received only AZT, 134 (19.7%) were medicated with AZT+SMX/TMP, and 341 (50.1%) had not carried trough prophylaxis. Thirty-nine children died (5.7%), 559 (82.2%) continued to live, and for 82 (120%) the information was lost. The death rate was considerably more elevated among the children who did not receive prophylaxis (9.7%) compared to those who received only AZT (2.9%). No death occurred among the 134 children had prophylaxis with AZT+SMX/TMP. Death rates varied according to time, reaching 9.5% during the preprophylaxis period (1986/1995) and falling to 2.7% between 1996 and 2001 Twenty-two deaths occurred among the 67 HIV-infected individuals (33.8%), a much higher value than detected among the 520 non-infected individuals (4 deaths, 0.8%). The median times for serological reversal were 589 days for the infants born between 1986 and 1995 and 451 days for those born from 1996 to 2001. The survival curves demonstrated an evident favoring of individuals submitted to some type of prophylaxis, indicating that therapeutic intervention has brought unquestionable gains for infants born to HIV-positive mothers or mothers with AIDS.

Esta dissertação teve como objetivo examinar especificidades no processo de iniciação sexual de jovens mulheres vivendo com HIV. Utilizaram-se dados do estudo transversal GENIH: gênero e infecção pelo HIV, com amostra probabilística, que entrevistou mulheres de 18 a 49 anos, usuárias dos serviços públicos de saúde no município de São Paulo. Analisaram-se variáveis referentes às características sociodemográficas, à primeira relação sexual e às trajetórias reprodutivas das jovens de 18 a 24 anos: 130 mulheres vivendo com HIV/Aids (MVHA) e 257 mulheres não vivendo com HIV/Aids (MNVHA). As MVHA foram estratificadas em infectadas por transmissão vertical (TV) e infectadas por outras vias (OV). Observou-se associação (p<0,05) entre iniciação sexual tardia e ser infectada por TV, possuir religião, ter cursado ensino médio completo ou mais e não ter feito uso de drogas na vida. As jovens infectadas por outras vias iniciaram-se mais cedo do que as demais, com parceiros bem mais velhos e relataram menor uso de preservativo na primeira relação sexual. Há diferenças significativas entre os grupos com relação ao tempo de vida sexual ativa, conjugalidade, número de gestações e aborto. Apesar de mais tardias, jovens infectadas por transmissão vertical (TV) apresentaram menor intervalo entre a primeira relação sexual e a primeira gravidez do que as demais, logo o adiamento do início da vida sexual não implica na postergação da trajetória reprodutiva. A multiplicidade de trajetórias sexuais e reprodutivas evidencia a diversidade de intercâmbios entre as experiências de socialização que se dão no âmbito da escola, família, trabalho e demais instituições a que as jovens pertencem. O processo de iniciação sexual das jovens vivendo com HIV carrega marcas das hierarquias de gênero que modulam a socialização juvenil / The present dissertation aimed at examining the specificities of the sexual initiation process of young women living with HIV. Data from the cross-sectional study called GENIH: Gender and HIV infection were used. A probabilistic sample included interviewing women aged 18-49, who were users of the public health services in the city of São Paulo. Variables relating to sociodemographic characteristics, first sexual intercourse, and reproductive trajectories of young women aged 18-24 130 women living with HIV (WLHIV) and 257 not living with HIV (WNLHIV) were analysed. The WLHIV were stratified either by vertical transmission infection (VT) or by other routes infection (OR). Association (p<0,05) between late sexual initiation and getting infected by (VT), having a religion, having attended high school or college, not having used drugs was noticed. Young women who got infected by other routes had an earlier initiation than the others, with significantly older partners, and reported less frequent use of condoms in the first sexual intercourse. There are significant differences between the groups concerning active sexual life length, conjugality, number of pregnancies and abortions. Though having a later initiation, young women infected by VT reported shorter time span between the first sexual intercourse and the first pregnancy than the others. Therefore the postponement of the sexual initiation does not imply in postponing the reproductive trajectory. The multiplicity of sexual and reproductive trajectories shows the diversity of interchanges among socializing experiences that take place in the context of school, family, work place and other institutions to which the young women belong. The process of sexual initiation of young women living with HIV is marked by the gender hierarchy that shapes the youth socialization

Esta pesquisa teve como objetivo avaliar a evolução de crianças nascidas de mães positivas para o HIV ou com AIDS no Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto, durante o período compreendido entre 1986 e 2001. Foram levantadas informações relativas a profilaxia pré-natal e da criança ao nascer, assim como à reversão sorológica, soropositividade e sobrevida. Dos 680 participantes, 67 (9,8%) se infectaram, 520 (76,5%) não se infectaram e 93 (13,7%) ficaram sem informação devido ao abandono de seguimento. Profilaxia durante a gestação ocorreu em 144 mulheres com o uso de uma droga (21,2%) e em 77 com a utilização de duas ou mais drogas (11,3%), não tendo se verificado em 459 gestantes (67,5%). Entre os recém nascidos, 205 (30,1%) receberam apenas AZT, 134 (19,7%) foram medicados com AZT+SMX/TMP e 341 (50,1%) não foram tratados. Ocorreu óbito de 39 crianças (5,7%), com 559 (82,2%) tendo permanecido vivas e 82 (12,0%) cuja informação foi perdida. O percentual de óbito foi consideravelmente mais elevado entre os que não receberam profilaxia (9,7%), em relação aos que receberam apenas AZT (2,9%). Não se verificou nenhuma morte entre as 134 crianças em uso AZT+SMX/TMP. As proporções de óbitos variaram de acordo com o tempo, atingindo 9,5% no período pré-profilaxia (1986/1995) e caindo para 2,7% entre os anos de 1996 e 2001. Entre os 67 indivíduos infectados pelo HIV foram verificadas 22 mortes (33,8%), valor muito superior ao encontrado entre os 520 não infectados, nos quais ocorreram apenas 4 óbitos (0,8%). Os tempos medianos de reversão sorológica foram iguais a 589 dias para os nascidos de 1986 a 1995, e 451 dias, para os que nasceram no período 1996 a 2001. As curvas de sobrevivência demonstraram o evidente favorecimento dos indivíduos que foram submetidos a algum tipo de profilaxia, indicando que a intervenção terapêutica trouxe ganhos inquestionáveis para os recém nascidos de gestantes positivas para o HIV ou com AIDS. / The objective of the present study was to evaluate the evolution of children born to HIV-positive mothers or mothers with AIDS at the University Hospital, Faculty of Medicine of Ribeirão Preto, during the period from 1986 to 2001. Information was obtained about prenatal prophylaxis and infant prophylaxis at birth, and about serologic reversal, seropositivity and survival. Of the 680 participants, 67 (9.8%) were infected, 520 (76.5%) were not infected, and no information was available for 93 (13.7%) infants who were lost to follow-up. Prophylaxis during pregnancy occurred in 144 women with the use of mono prophylaxis (21.2%) and in 77 with the use of two or more drugs (11.3%), and 459 (67.5%) received no prophylaxis. Among the newborns, 205 (30.1%) received only AZT, 134 (19.7%) were medicated with AZT+SMX/TMP, and 341 (50.1%) had not carried trough prophylaxis. Thirty-nine children died (5.7%), 559 (82.2%) continued to live, and for 82 (120%) the information was lost. The death rate was considerably more elevated among the children who did not receive prophylaxis (9.7%) compared to those who received only AZT (2.9%). No death occurred among the 134 children had prophylaxis with AZT+SMX/TMP. Death rates varied according to time, reaching 9.5% during the preprophylaxis period (1986/1995) and falling to 2.7% between 1996 and 2001 Twenty-two deaths occurred among the 67 HIV-infected individuals (33.8%), a much higher value than detected among the 520 non-infected individuals (4 deaths, 0.8%). The median times for serological reversal were 589 days for the infants born between 1986 and 1995 and 451 days for those born from 1996 to 2001. The survival curves demonstrated an evident favoring of individuals submitted to some type of prophylaxis, indicating that therapeutic intervention has brought unquestionable gains for infants born to HIV-positive mothers or mothers with AIDS.

No description available.

Esta dissertação teve como objetivo examinar especificidades no processo de iniciação sexual de jovens mulheres vivendo com HIV. Utilizaram-se dados do estudo transversal GENIH: gênero e infecção pelo HIV, com amostra probabilística, que entrevistou mulheres de 18 a 49 anos, usuárias dos serviços públicos de saúde no município de São Paulo. Analisaram-se variáveis referentes às características sociodemográficas, à primeira relação sexual e às trajetórias reprodutivas das jovens de 18 a 24 anos: 130 mulheres vivendo com HIV/Aids (MVHA) e 257 mulheres não vivendo com HIV/Aids (MNVHA). As MVHA foram estratificadas em infectadas por transmissão vertical (TV) e infectadas por outras vias (OV). Observou-se associação (p<0,05) entre iniciação sexual tardia e ser infectada por TV, possuir religião, ter cursado ensino médio completo ou mais e não ter feito uso de drogas na vida. As jovens infectadas por outras vias iniciaram-se mais cedo do que as demais, com parceiros bem mais velhos e relataram menor uso de preservativo na primeira relação sexual. Há diferenças significativas entre os grupos com relação ao tempo de vida sexual ativa, conjugalidade, número de gestações e aborto. Apesar de mais tardias, jovens infectadas por transmissão vertical (TV) apresentaram menor intervalo entre a primeira relação sexual e a primeira gravidez do que as demais, logo o adiamento do início da vida sexual não implica na postergação da trajetória reprodutiva. A multiplicidade de trajetórias sexuais e reprodutivas evidencia a diversidade de intercâmbios entre as experiências de socialização que se dão no âmbito da escola, família, trabalho e demais instituições a que as jovens pertencem. O processo de iniciação sexual das jovens vivendo com HIV carrega marcas das hierarquias de gênero que modulam a socialização juvenil / The present dissertation aimed at examining the specificities of the sexual initiation process of young women living with HIV. Data from the cross-sectional study called GENIH: Gender and HIV infection were used. A probabilistic sample included interviewing women aged 18-49, who were users of the public health services in the city of São Paulo. Variables relating to sociodemographic characteristics, first sexual intercourse, and reproductive trajectories of young women aged 18-24 130 women living with HIV (WLHIV) and 257 not living with HIV (WNLHIV) were analysed. The WLHIV were stratified either by vertical transmission infection (VT) or by other routes infection (OR). Association (p<0,05) between late sexual initiation and getting infected by (VT), having a religion, having attended high school or college, not having used drugs was noticed. Young women who got infected by other routes had an earlier initiation than the others, with significantly older partners, and reported less frequent use of condoms in the first sexual intercourse. There are significant differences between the groups concerning active sexual life length, conjugality, number of pregnancies and abortions. Though having a later initiation, young women infected by VT reported shorter time span between the first sexual intercourse and the first pregnancy than the others. Therefore the postponement of the sexual initiation does not imply in postponing the reproductive trajectory. The multiplicity of sexual and reproductive trajectories shows the diversity of interchanges among socializing experiences that take place in the context of school, family, work place and other institutions to which the young women belong. The process of sexual initiation of young women living with HIV is marked by the gender hierarchy that shapes the youth socialization

The role that amniotic fluid (AF) may play in HIV vertical infection is unresolved. We used the FIV-infected cat model to study this question. We hypothesized that AF may be a source of fetal infection if the virus is present in the fluids. However, virus neutralizing (VN) antibodies in AF may limit vertical transfer. Fetuses were delivered from FIV-infected queens by cesarean section at early and late gestation. AFs were aspirated from intact fetal membranes and tested for viral antigen and RNA and for FIV-specific antibody. Randomlyselected samples were tested for VN activity using a syncytium reduction assay. Neither FIV antigen nor RNA was detected in any AFs. AFs and parallel serum samples from early and late pregnancy were positive for FIV-specific antibody. VN activity was detected in three early-term AFs and a parallel serum, but not late-term AFs. AF appears to play no appreciable role in FIV vertical transmission.

Purpose: The purpose of this study was to examine the maternal influences on the development of infant oral biofilm and early childhood dental caries. Methods: The study utilized a cross-sectional design to evaluate factors influencing biofilm colonization and the identification of bacterial strains present in mother and child by utilizing oral health literacy surveys, clinical examinations, and plaque samples. Participants were enrolled in the Children’s Health Involving Parents of Greater Richmond (CHIP). Plaque samples and dental disease levels were collected from mother and children ages six months to thirty-six months. Oral Health Literacy was compared to both mother and child’s dental disease levels. Results: Sixty-two CHIP families were involved in the pilot study yielding caries in 88% of mothers and 26% of children. The DMFTs for adults was 32.60 and the dmft for children was 7.69.

O impacto que a epidemia da aids vem produzindo sobre a população infantil é particularmente importante, pois, do total de casos notificados no mundo todo, entre adultos e crianças, aproximadamente 10% têm menos de 15 anos de idade, sendo a maioria proveniente dos países em desenvolvimento. A aids confirma a associação, historicamente determinada, entre as condições concretas de vida e a produção da doença. Tomando a expressão da epidemia como objeto do estudo, teve por finalidade oferecer subsídios para a intervenção em saúde coletiva no fenômeno da aids infantil, de transmissão vertical, especialmente, para o aprimoramento do Sistema de Informação em Vigilância Epidemiológica da aids. Adotou-se a como refererencial teórico-filosófico a determinação social do processo saúde-doença e as categorias analíticas exclusão/inclusão social e processo de adoecimento e morte por aids. A fonte empírica de dados foi obtida do Sistema de Informação de Vigilância Epidemiológica da Secretaria de Estado da Saúde do Estado de São Paulo e do Programa de Aprimoramento das Informações de Mortalidade da Prefeitura Municipal de São Paulo. A análise dos dados demonstra a gravidade da situação: as crianças já nascem duplamente em desvantagem, têm suas mães e/ou pais acometidos pela doença e encontram pela frente um penoso processo de aprendizagem com a própria soropositividade. Evidenciaram-se situações que denotam exclusão social, na constatação do número de crianças órfãs de mães, na ocorrência de crianças institucionalizadas, na vulnerabilidade programática e no uso de drogas injetáveis pelas mães. No entanto, não ficou explícita a exclusão social como produto das formas diferenciadas de reprodução social dos grupos sociais. Apontou-se a necessidade de transformar a forma de captação da realidade pela vigilância epidemiológica, para superar os modelos multicausais que tornam invisíveis as dimensões sociais da doença. A ausência de visibilidade pública da exclusão social, especialmente no caso das crianças vulneráveis ao HIV/aids, está diretamente vinculada à sua ausência de autonomia, ou seja, à incapacidade do Sistema de Informação em Vigilância Epidemiológica em considerar a criança como sujeito com pleno direito de cidadania. Reconhece-se a necessária e urgente revisão da ficha de notificação, importante instrumento que informa sobre a epidemia, de modo a ser possível a caracterização da exclusão social das pessoas afetadas pelo HIV/aids no caso de crianças. Ao final apontam-se recomendações para a intervenção em saúde coletiva na Cidade de São Paulo frente à epidemia de aids infantil. / The impact that aids epidemic has been producing on the infantile population is particularly important, out of the total number of notified cases in the whole world, among adults and children, approximately 10% is composed of individuals who are younger than 15 years old and the majority comes from countries in development. Aids cases confirm the association, historically determined, between the concrete conditions of living and the disease production. Taking the expression of epidemic as the object of study, our study had as its objective to offer subsidy for the intervention of collective health at infantile aids phenomena, of vertical transmission, especially, to the improvement of Information System in Aids Epidemiological Surveillance. The social determination and the analytical categories social inclusion/exclusion and the process of becoming sick and dying due to aids were adopted as a theoretical-philosophic reference. Data is from the Sistema de Informação of the Vigilância Epidemiológica da Secretaria de Estado da Saúde do Estado de São Paulo (Health State Department of Epidemiological Surveillance Information System from the State of São Paulo) and from the Programa de Aprimoramento das Informações de Mortalidade da Prefeitura Municipal de São Paulo (Mortality Information Improvement Program from the Municipality of the City of São Paulo). The data analysis shows the seriousness of the situation: many children are born with double disadvantage, their fathers or mothers already have the disease and they will face a painful learning process with their own HIV positive status. We found some evident situations in which we could notice social exclusion, verifying the number of children without mothers, in institucionalized children, at programmatic vulnerability and the usage of injectable drugs by mothers. However, social exclusion was not explicit as a product of the different ways of social reproduction from the social groups. A need to transform the methodology of data recording by the epidemiological vigilance, to surpass the multicause models that make the social dimensions of the disease invisible. The lack of public ability to be aware and record data about social exclusion, especially in the case of children vulnerable to HIV/aids, is directly linked to the lack of autonomy, or due to the incompetence of the Epidemiological Surveillance Information System in considering the child as a person with rights to citizenship. We consider it urgent to review the notification record, important instrument that informs about the epidemic, in a way that enables health professionals to distinguish social exclusion of the affected people, mainly in case of HIV/aids positive children. At the end, proposals are made for intervention in collective health in the City of São Paulo, in order to better enable health professionals to have other resources to face infantile aids epidemic.