The incidence of paracoccidioidomycosis (PCM) varies in Latin America, and it is influenced by environmental factors. This study evaluated the distribution of PCM acute/subacute form (AF) cases and their correlation with geoclimatic factors in the Mato Grosso do Sul (MS) state. The study included 81 patients diagnosed with the PCM/AF at the University Hospital of the Federal University of Mato Grosso do Sul between January 1980 and February 2022. Geographic coordinates, health microregion of patient’s residence, compensated average temperature, relative air humidity (RH), El Niño Southern Oscillation (ENSO), and average global temperature were analyzed. The highest incidence was observed in the Aquidauana (7/100,000 inhabitants), while Campo Grande, the state’s capital, had the highest number (n = 34; 42.4%) and density (4.4 cases/km²) of cases. The number of cases increased during extended periods of the El Niño phenomenon. A positive correlation was found between higher RH and PCM/AF cases. Most PCM/AF cases were found in areas with loamy soils and RH ranging from 60.8 to 73.6%. In MS, the health microregions of PCM/AF patients are characterized by deforestation for agricultural and pasture use, coupled with loamy soils and specific climatic phenomena leading to higher soil humidity.

Introduction: Leprosy is a chronic infection caused by Mycobacterium leprae, primarily affecting the peripheral nerves. It is known that despite the reduction in the number of new cases, transmission remains active due to the incidence of cases in children under 15 years of age. Thus, the search for more sensitive and specific diagnostic methods for the detection of subclinical infection becomes relevant. Objective: to verify, through qPCR, the presence of M. leprae in intradermal scrapings (IS) of individuals treated at CREDEN-PES/GV/MG. Method: Intradermal scraping (IS) samples were collected from 411 participants to determine the bacilloscopic index (BI), extraction, and amplification of M. leprae DNA. Participants were divided into two groups: GROUP 1, “Notified cases,” registered at SINAN; GROUP 2, “Individuals not notified,” who had a suspected diagnosis of leprosy. Of the total of 411 samples collected, 158 were obtained from notified cases and 253 from not notified individuals. Results: It was found that of the total number of cases, 58.86% (male) and 41.14% (female). Among the not notified individuals, 53.36% (male) and 46.64% (female). Considering the age range, both groups were aged (40 to 69 years). As for the IS, 34.18% (cases) and 0% (not notified) had a positive IS. In qPCR, 82.28% of cases and 47.43% of not notified individuals tested positive, with an illness odds ratio of 5.14. Conclusion: It is possible to infer those individuals with suspected leprosy, with positive qPCR, may be carriers of subclinical infection and potential transmitters of M. leprae to more susceptible individuals.

Brazil has the second largest number of leprosy cases worldwide, and the state of São Paulo has been considered non-endemic since 2006. We analyzed 16 variable number tandem repeats loci and three single nucleotide polymorphisms loci of Mycobacterium leprae (M. leprae) in 125 clinical isolates from patients in different municipalities in the state. The clustering pattern of M. leprae indicated that the transmission of leprosy persisted in the state and included scenarios of intra-extra-familial transmission in areas with low endemicity. A significantly active circulation of M. leprae was observed. Therefore, surveillance and control measures must be implemented.

Various techniques have been used for the molecular identification of Mycobacterium leprae (M. leprae). The aim of this review was to identify the relationship between the molecular presence of M. leprae and the process of infection and/or illness of contact of leprosy cases. A systematic review was carried out by searching the Medical Literature Analysis and Retrieval System Online (MEDLINE), Cochrane Library, Embase, Scopus, Web of Science and the Latin American and Caribbean Health Sciences Literature (LILACS) databases in January 2024. The studies were selected by two pairs of reviewers. Observational cross-sectional, case–control and cohort studies were included. A descriptive synthesis of the results by category was carried out. A total of 443 studies were identified, and 36 were included in the review. Twelve molecular targets were tested to identify the presence of the bacillus. A relationship was established between the identification of M. leprae DNA and factors related to the index case, housing characteristics, living conditions, epidemiology and anti-PGL-1 serology. None of the studies identified evaluated the molecular viability of M. leprae among contacts. The detection of M. leprae DNA alone does not necessarily predict the development of infection or clinical illness among contacts.

Although Brazil has shown a considerable reduction in the number of new cases of leprosy, some studies have shown active transmission even in non-endemic areas, such as São Paulo state. Considering this, we investigated the sociodemographic, clinical, and geospatial profile of new cases of leprosy diagnosed between 2015 and 2019 at the Lauro de Souza Lima Institute (ILSL) a reference center localized in Bauru, a municipality in the interior of São Paulo state. A total of 177 new cases of leprosy were diagnosed in this period, with 61.6% of the patients born inthe state. Most of the individuals were male (59.9%), the most prevalent age group was 60 to 69 years old, 79.1% declared themselves white color/race and 65.6% had little or no schooling. The borderline form of leprosy was the most frequent (42.4%), slit skin smear was positive in 38.4% of patients (49.0% among men and 22.5% among women) and 49.0% had disabilities at diagnosis. Georeferencing,performed for cases from the municipality of Bauru (n = 31), revealed that most patients lived in regions with a high level of social vulnerability. The profile of leprosy new cases found at ILSL pointed to a predominance of adult or elderly men with low education, multibacillary, presenting physical disabilities and a long time of symptoms. Altogether, our data suggests a delay in diagnosis that may contribute to the maintenance of leprosy transmission even in a non-endemic region.

Dermatophytes are keratinophilic fungi that cause fungal infections in humans. This study aimed to characterize dermatophyte species' epidemiology and geospatial distribution and their relation with climatic, geoenvironmental and social aspects in municipalities monitored by the Epidemiological Surveillance Group XV (GVE XV) of São Paulo State from January 2016 to December 2020. Six species of dermatophytes were identified, namely Trichophyton rubrum (69.2%), Trichophyton mentagrophytes (17.9%), Trichophyton tonsurans (3.6%), Microsporum canis (5.4%), Microsporum gypseum (0.9%) and Epidermophyton floccosum (0.9%). The occurrence of these species was predominant in the Cerrado phytogeographic domain (60.7%), in soils with a temperature >18°C (97.3%), clayey soils (92.4%), and in humid climates. A particularized analysis in the municipality of extended occurrence of dermatophytes demonstrated the predominance of M. canis and M. tonsurans in areas of higher social vulnerability. The occurrence of dermatophytes in different contexts provided information about these fungi's epidemiology and dissemination patterns. However, more extensive studies may contribute to a better understanding of the factors that influence the movement of dermatophyte hosts and species over time, which is fundamental for developing more effective prevention and control approaches.