Objective: To explore the scientific evidence regarding the leprosy patients quality of life. Method: Scoping review according to the Joanna Briggs Institute methodology, with articles indexed in PubMed, Cochrane, LILACS, Embase, CINAHL, Scopus, Web of Science, PsyINFO, INFOLEP, and Google Scholar databases, published in full in Portuguese, English, or Spanish. Results: Seventy-four studies were identified, with 71 of quantitative approach and 3 with a mixed method. There was a predominance of studies published in Brazil (58.1%), with an adult population, (97.3%) and recruited in reference centers for the treatment of leprosy (52.7%). There was greater use of the WHOQOL-bref (50%) and SF-36 (18.9%) instruments to assess quality of life. The study showed that the greatest impairment in quality of life was related to the delay in the diagnosis of the disease, to leprosy reactions, physical disabilities, neuropathic pain, and stigma. Conclusion: Most studies were developed in endemic countries, with adults, and based on observational studies, and the worst scores obtained were associated with physical domain impairment.

Background: Blastocystis sp. affects a wide variety of animals and is the most common protozoan in human fecal samples with potential pandemic distribution. In the present study, a systematic review and meta-analysis were conducted to determine the prevalence and distribution of Blastocystis sp. in different classes of hosts in Brazil. Methods: Studies that analyzed hosts of various classes, including humans, domestic animals, wild animals or captive animals, were considered. The pooled prevalence of Blastocystis sp. infection was estimated by random effects models. Results: For humans, similar prevalence rates were found for males (31.0%, 95% CI: 17.0–45.0%; weight 10%) and females (28.0%, 95% CI: 16.0–41.0%; weight 10%); the state of Mato Grosso do Sul showed the highest prevalence, with 41.0% positivity (95% CI: 36.0–46.0%; weight 2.9%). The prevalence among immunocompromised patients was 5.0% (95% CI: 3.0–7.0%; weight 10%), and the most common cause of immunosuppression was hemodialysis, with 23.0% (95% CI: 17.0–29.0%; weight 12.4%). Among classifications according to interaction with humans, wild and domestic animals presented values of 19.0% (95% CI: 7.0–31.0%; weight 42.6%) and 17.0% (95% CI: 13.0–21.0%; weight 29.6%), respectively. Among these animals, mammals (39.0%, 95% CI: 21.0–56.0%; weight 47.3%) and birds (18.0%, 95% CI: 10.0–27.0%; weight 39.3%) exhibited the highest prevalence. Phylogenetic analysis of Blastocystis sp. revealed greater genetic diversity for clades of subtypes (STs) ST1, ST2 and ST3. Conclusions: The overall prevalence of Blastocystis sp. in the Brazilian human population was 24%, which reflects the reality in the South, Southeast and Midwest regions, where prevalence rates of up to 40% were found. Among animals, mammals and birds exhibited the highest prevalence.

Objectives: To analyze the factors associated with leprosy in children who were intradomiciliary contacts of notified adults with the disease in an endemic municipality in Mato Grosso, Brazil. Method: Case-control study with 204 children under 15 years of age, living in an endemic municipality. Cases (n =40) were considered as the children with leprosy registered at the National Information System of Notifiable Diseases in 2014 and 2015, who were intradomiciliary contacts of at least one adult diagnosed with the disease in the family, and as a control group (n = 164) of children living within a radius of up to 100 m of the notified cases. Data were obtained through medical file analysis, interviews, and blood samples for anti-PGL-I serological test by the ELISA method. The binary logistic regression technique was used, with p <= 0.05. Results: After adjustments, the following were associated with leprosy: age (95% CI: 1.24-9.39, p= 0.018), area of residence (95% CI: 1.11-6.09, p = 0.027), waste disposal (95% 0: 1.91-27.98, p = 0.004), family history of the disease (95% CI: 3.41-22.50, p = 0.000), and time of residence (95% CI: 1.45-7.78, p= 0.005). Conclusion: Factors associated with the disease indicate greater vulnerability of children aged 8-14 years, associated with living conditions and time of residence, as well as the family history of the disease. (C) 2019 Published by Elsevier Editora Ltda. on behalf of Sociedade Brasileira de Pediatria.

Previous studies have shown that high levels of air pollutants may increase activity of systemic lupus erythematosus (SLE). The aim of this study is to analyze the association between pollutants originating from the Brazilian Legal Amazon and SLE activity. This is a retrospective longitudinal cohort study with patients with SLE in the General Hospital in Cuiabá, Brazil. The association with SLE activity was measured using the SLE disease activity index (SLEDAI) and data on air quality—PM_2.5 and CO, published on the websites of the State Department of Environment and the Center for Weather Forecasting and Climate Studies. To assess the effect of daily concentrations of pollutants on SLEDAI scores, the generalized estimation equation (GEE) model was used. A total of 32 female patients were assessed, in 96 doctor’s appointments. The average SLEDAI score was 6 points (±5.05). GEE showed an association of disease activity with both higher rates of wildfires (p = 0.021) and average CO rate (p = 0.013), but there was no statistical association between particulate levels and SLE activity. The results suggest that variations in air pollution are associated with the activity of autoimmune rheumatic diseases.

Este estudo objetivou analisar o impacto da pandemia de Covid-19 no atendimento em hanseníase sob a ótica do profissional de saúde. Trata-se de um estudo de avaliação de serviços, transversal, descritivo, através de questionário impresso, destinado a profissionais de saúde médicos, enfermeiros e fisioterapeutas. O estudo foi realizado com 17 profissionais de saúde, sendo 7 enfermeiros, 7 médicos e 3 fisioterapeutas pertencentes a 7 unidades de saúde da atenção primária em um município paraense. Observou-se que apenas 24% dos profissionais entrevistados passaram por remanejamento de setor, 82% dos profissionais afirmaram que houve mudanças no perfil de atendimento das unidades de saúde, houve necessidade de reagendamentos de atendimentos para os pacientes, 88% dos profissionais passaram por rodízio de atividades, 47% afirmaram que houve falta de medicamentos para o tratamento da hanseníase nas unidades em que eles atuam, 53% afirmaram que não houve falta de materiais para o cuidado do paciente com hanseníase, houve dificuldades no agendamento de exames laboratoriais, na avaliação de contatos domiciliares e sociais e na referência e contrarreferência dos pacientes. A partir destes dados conclui-se que a pandemia de Covid-19 criou dificuldades para o atendimento e tratamento do paciente com hanseníase nas unidades de saúde da atenção primária em saúde participantes, gerando atrasos em agendamentos, remarcações de consultas, prorrogações de tratamento devido à falta de medicação, dificuldades na avaliação de contatos e busca ativa de novos casos, contribuindo para gerar um impacto negativo no programa e consequentemente no sistema de saúde.

Keywords: Adolescent; Child; Leprosy; Risk factors; Serologic tests