O estudo dos padrões espaciais de transmissão de doença diarréica permite a elaboração de propostas que permitam o controle da dispersão dessas doenças. O presente estudo teve por objetivo identificar padrões espaciais de internação por doença diarréica nos municípios do Vale do Paraíba Paulista, utilizando-se de geoprocessamento. Foram obtidos dados de internação de diarréia no DATASUS, analisados sob a forma de taxas, IDH, percentuais de cobertura de esgotamento sanitário e de água tratada; os dados foram analisados pelo programa TerraView. Utilizou-se o coeficiente de Moran global para identificar aglomerados espaciais. Foi possível identificar um aglomerado espacial na região central do Vale do Paraíba e na região da Serra da Mantiqueira. Não foi possível identificar correlação entre internação por diarréia e as demais variáveis. A doença diarréica é multifatorial, mas o geoprocessamento oferece subsídios para os gestores de saúde para implantação de políticas para minimizar este problema. / The study of the spatial patterns of transmission of intestinal infectious diseases allows the elaboration of methodologies to control the dispersion of these diseases. The aim of this study was to identify spatial patterns of interment by diarrheal disease in Vale do Paraíba, Brazil, through geoprocessing techniques. The interments records were obtained in DATASUS and analysed by rates, HDI, percentage of sanitation and water coverage; the data were analyzed by the software TerraView. The global Moran coefficient was used to identify spatial clusters. It was possible to identify a spatial cluster in the central region of the Vale do Paraiba and the region of Serra da Mantiqueira. This was unable to identify correlation between hospitalization for diarrhea and other variables. The diarrhea is a multifactorial disease, but geoprocessing approach may provide subsidies to implement policies to minimize this problem by public health service.

Norovirus and rotavirus are the most common viral causes of acute gastroenteritis among all age groups and in children under 5 years of age, respectively. Understanding the pathogenesis of the virus and correlates of protective immunity is fundamental to developing effective prevention and treatment strategies. Gnotobiotic (Gn) pigs are an attractive animal model for studying enteric viruses due to their similarities to humans, particularly in regards to the immune system and gastrointestinal anatomy and physiology. Here, to establish a reliable Gn pig model of human norovirus (HuNoV) infection and disease, we determined the median infectious dose (ID50) of a GII.4 2006b variant in pigs. We also evaluated the effects of age and administration of the cholesterol-lowering drug simvastatin on susceptibility to NoV infection. In neonatal pigs (4-5 days of age, the ID50 was determined to be 2.74 x 103 viral RNA copies. The ID50 was increased in 33-34 day old pigs (6.43 x 104), but decreased to <2.74 x 103 following simvastatin treatment in the same age group. Overall, the development of diarrhea, fecal virus shedding and small intestinal cytopathological changes confirmed the usefulness of the Gn pig as an appropriate animal model for studying HuNoVs. We also utilized the well-established Gn pig model of human rotavirus (HRV) infection and disease to evaluate adjunctive treatment options for HRV-induced diarrhea. We demonstrated that the anti-secretory drug racecadotril was capable of diminishing clinical signs of HRV infection and shortening duration of illness. Reduced dehydration in the racecadotril-treated pigs was evident by the significant gain in body weight compared to controls during the course of the study. We also determined that a high dose of the probiotic Lactobacillus acidophilus NCFM (LA) was able to reduce RV diarrhea severity and duration compared to a low dose. The difference in therapeutic potential was attributed to divergent effects in innate immunity pre- and post-challenge. High dose of LA (HiLA) induced an anti-inflammatory dendritic cell (DC) profile, characterized primarily by upregulation of TLR2 expression and production of cytokine IL-10. Conversely, low dose of LA (LoLA) upregulated TLR3 and TLR9 and increased secretion of cytokine IL-6. Additionally, HiLA induced both IFN-alpha and TNF-alpha responses in DCs, but LoLA was only able to increase the frequency of TNF-alpha-producing DCs. These results provide further support of Gn pigs as a highly applicable animal model for studying pathogenesis, innate immunity and therapeutics of human enteric viruses. / Ph. D.

<p>The study proposed to conduct a descriptive study related to the correlation of infant feeding (EFF or EBF) and occurrence of morbidity diarrhoea and/or respiratory infections, in infants by 14 weeks of age. The study adopted a quantitative epistemological approach in seeking to describe the correlation of infant feeding and the occurrence of diarrhoea or respiratory infections by 14 weeks of age. The researcher embarked on a descriptive survey design and employed the questionnaire method during the data collection process. The Amathole District of the Eastern Cape Province was selected due to the accessibility of the targeted population. The unique demographic profile and rural-urban setting allows for a potentially rich data source whilst simultaneously reducing the potential incidence of bias in the data collection. The study sample was drawn from routine immunization and growth monitoring clinics in the Amathole district.</p>

<p>The study proposed to conduct a descriptive study related to the correlation of infant feeding (EFF or EBF) and occurrence of morbidity diarrhoea and/or respiratory infections, in infants by 14 weeks of age. The study adopted a quantitative epistemological approach in seeking to describe the correlation of infant feeding and the occurrence of diarrhoea or respiratory infections by 14 weeks of age. The researcher embarked on a descriptive survey design and employed the questionnaire method during the data collection process. The Amathole District of the Eastern Cape Province was selected due to the accessibility of the targeted population. The unique demographic profile and rural-urban setting allows for a potentially rich data source whilst simultaneously reducing the potential incidence of bias in the data collection. The study sample was drawn from routine immunization and growth monitoring clinics in the Amathole district.</p>

Magister Curationis - MCur / The study proposed to conduct a descriptive study related to the correlation of infant feeding (EFF or EBF) and occurrence of morbidity diarrhoea and/or respiratory infections, in infants by 14 weeks of age. The study adopted a quantitative epistemological approach in seeking to describe the correlation of infant feeding and the occurrence of diarrhoea or respiratory infections by 14 weeks of age. The researcher embarked on a descriptive survey design and employed the questionnaire method during the data collection process. The Amathole District of the Eastern Cape Province was selected due to the accessibility of the targeted population. The unique demographic profile and rural-urban setting allows for a potentially rich data source whilst simultaneously reducing the potential incidence of bias in the data collection. The study sample was drawn from routine immunization and growth monitoring clinics in the Amathole district. / South Africa

Water is a primary shared resource that connects all species across the landscape and can facilitate shared exposure to a community of waterborne pathogens. Despite remarkable global progress in sanitation and hygiene development in the past two decades, infectious diarrhea remains a prominent public health threat in sub-Saharan Africa. This thesis identifies and discusses persistent challenges limiting the success of current waterborne disease management strategies and several existing research hurdles that continue to impede characterization of microbial transmission and transport. In this work, the Chobe River watershed in Northern Botswana serves as a target study site for the application of hydrological modeling tools to quantify emergent water quality and health challenges in Southern Africa. A watershed model with extensive data requirements, the Hydrological Simulation Program – Fortran (HSPF), is used to identify primary data gaps and model assumptions that limit the progress of model development, and guide opportunities for data collection, tool development, and research direction. Environmental pathogen exposure risk and epidemiological outbreak dynamics are best described by interactions between the coupled human and environmental processes within a system. The challenge of reducing diarrheal disease incidence strengthens a call for research studies and management plans that join multiple disciplines and consider a range of spatiotemporal scales. / Master of Science

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