Poverty, malnutrition and neglected tropical diseases such as soil-transmitted helminthiases (STHs) interact in a multi-causal feedback network. This study aimed to assess the relationships between STHs, income and nutritional status of children in impoverished communities in the city of Caxias, Maranhao State, Northeastern Brazil. A cross-sectional survey (n=259 children) was carried out with the collection of fecal samples and assessment of sociodemographic, anthropometric, dietary and sanitation data. Hookworm infection and ascariasis presented prevalence rates of 14.3% and 9.3%, respectively. The logistic regression analysis showed that hookworm infection was more frequent in males (odds ratio [OR]=3.43; 95% confidence interval [CI]=1.45-8.08), children aged 11-15 years old (OR=3.72; 95% CI=1.19-11.62), children living in poor families (OR=2.44; 95% CI=1.04-5.68) and those living in rented houses (OR=5.74; 95%CI=1.91-17.25). Concerning ascariasis, living in the Caldeiroes community (OR=0.01; 95%CI=0-0.17) and belonging to the 11-15 years age group (OR=0.21; 95%CI=0.04-1.02) were protection factors. Poor children have a significantly lower frequency of consumption of meat, milk, vegetables, tubers and fruits than not poor children. The frequent consumption of meat, milk and tubers was associated with significant higher values in the parameter height-for-age, whereas the consumption of meat and milk positively influenced the weight-for-age. The frequencies of stunting, underweight and wasting were 8.1%, 4.9% and 2.9%, respectively. The multivariate model demonstrated that stunting was significantly associated with economic poverty (OR=2.82; 95%CI=1.03-7.70) and low weight was associated with male sex (OR=6.43; 95% CI=1.35-30.68). In conclusion, the study describes the interactions between the dimensions of development represented by income, STHs and nutritional status revealing the importance of raising income levels to improve the living conditions of families in impoverished communities in Northeastern Brazil.

Human infections with gut protozoan parasites are neglected and not targeted by specific control initiatives, leading to a knowledge gap concerning their regional diversity and epidemiology. The present study aims to explore Giardia duodenalis genetic diversity and assess the epidemiologic scenario of subclinical infections in different Brazilian biogeographic regions. Cross-sectional surveys (n = 1334 subjects) were conducted in four municipalities in order to obtain fecal samples and socioenvironmental data. Microscopy of non-diarrheal feces and nucleotide sequencing of a β-giardin gene fragment were performed. From a total of 51 samples that could be sequenced, 27 (52.9%) β-giardin sequences were characterized as assemblage A and 24 (47.1%) as assemblage B. In the Amazon, assemblage B was the most frequently detected, predominantly BIII, and with two novel sub-assemblages. Assemblage A predominated in the extra-Amazon region, with five novel sub-assemblages. Prevalence reached 17.8% (64/360) in the Amazon, 8.8% (48/544) in the Atlantic Forest, 7.4% (22/299) in Cerrado and 2.3% (3/131) in the Semiarid. People living in poverty and extreme poverty presented significantly higher positivity rates. In conclusion, subclinical giardiasis is endemic in Brazilian communities in different biogeographic regions, presenting high genetic diversity and a heterogeneous genotypic distribution.

Objetivo: Avaliar os cuidados realizados por enfermeiros as pessoas vivendo com Anemia Falciforme. Métodos: Estudo exploratório e descritivo realizado com 28 enfermeiros na cidade de Caxias (MA). A análise dos dados ocorreu por meio do software Iramuteq. O estudo foi aprovado pelo Instituto Superior de Educação e Saúde Sinop Eireli com CAAE: 47406315.9.0000.5685. Resultados e Discussão: Houve predominância do sexo feminino e idade variando entre 31 à 40 anos. A maioria dos enfermeiros do estudo demostraram ter conhecimento acerca da temática anemia falciforme, porém afirmaram que não prestam a assistência as pessoas portadores da doença, seja pela falta de pacientes na área de abrangência da UBS, seja pela falta de preparo dos profissionais em prestar uma assistência de qualidade as mesmos. Conclusão: O estudo mostrou que os enfermeiros não prestam uma assistência adequada às pessoas portadores de anemia falciforme. Descritores: Anemia Falciforme, Cuidados de Enfermagem, Estratégia Saúde da Família, Centros de Saúde.

Intestinal Parasitic Infections (IPIs) are prevalent in vulnerable populations, yet zoonotic transmission is underreported. This study analyzed, under the One Health approach, the prevalence of and risk factors for IPIs among humans and dogs in a rural region of Teresina, Piauí, Brazil. A total of 361 human fecal samples, 23 household dog fecal samples and 81 dog fecal samples collected from public roads were analyzed using the Lutz, Baermann and Kato-Katz methods. Anthropometric measurements, haemoglobin levels in children aged 5 to 14 and a survey of cases of cutaneous larva migrans (CLM) were also analyzed. The height and weight of these individuals were used to calculate Z-scores for height-for-age (HAZ), weight-for-age (WAZ) and weight-for-height (WHZ). Associations between parasites and risk factors were assessed using Pearson's chi-square test, Student's t-test and logistic regression. The results showed that 47,9% (173/361) of the residents were parasitized, being 42,9% (155/361) by protozoa and 9,4% (34/361) by helminths. The most common pathogenic protozoa were Giardia duodenalis (8.3%; 30/361) and Entamoeba histolytica/dispar (5.3%, 19/361), while the most pathogenic helminths were Ascaris lumbricoides (6.6%, 24/361) and hookworms (4.7%, 17/361). Analysis of nutritional status revealed that 3.1% of children and adolescents had short stature (HAZ<-2), 7.3% had low weight (WAZ<-2) and 21.9% had anemia (hemoglobin <11.5g/dL). Mean HAZ was significantly lower in children with ascariasis (-1.16±0.24 vs. -0.34±0.10; p=0.008) and hookworm (-1.28±0.33 vs. -0.39±0.09; p=0.041). Hookworms were the most frequent parasites in dog feces (62.5%, 65/104). Infections by Toxocara spp. and Trichuris spp. were observed in dogs, with 3.8% of the samples presenting mixed infections. Cases of CLM were identified (n=45/361), with 62.2% of the cases in children (2 to 9 years) and a predominance for males (68.8%). These data highlight the intersections between IPIs in humans and dogs and reinforce the need for intersectoral and integrated health promotion measures. The adoption of the One Health approach could strengthen surveillance and prevention of zoonoses and contribute to public policies aimed at improving the quality of life in vulnerable areas.

Objetivo: avaliar os cuidados de enfermagem a nível de Estratégia de Saúde da Família realizados por enfermeiros apessoas vivendo com Anemia Falciforme. Método: estudo descritivo de abordagem qualitativa. A pesquisa foi realizadaatravés de entrevista semiestruturada com enfermeiros das unidades básicas de saúde da zona urbana de Caxias-MA, noperíodo de agosto a novembro de 2015. Os dados foram processados pelo software IRAMUTEQ, e analisados por meio dasimilitude e nuvem de palavras. Resultados: a partir de um corpus, gerou-se o gráfico de similitude e nuvem depalavras, os quais permitiram inferir que os enfermeiros não realizam cuidados a pessoas com anemia falciforme.Conclusão: o estudo trouxe subsídios para a compreensão do cuidado com qualidade ao pessoa vivendo com AnemiaFalciforme além de fazer uma abordagem sobre o conhecimento da patologia com o intuito de que outros profissionaisda área da saúde possam entender a importância da realização de cuidados às estas pessoas.

Some helminth species belonging to the order Strongylida are parasites of the digestive tract of vertebrates, including man and domestic animals. In humans, infections with Oesophagostomum spp. and Trichostrongylus spp. may be misdiagnosed as hookworm disease on parasitological stool examination, mainly in regions where these infections are coendemic, since eggs released in hosts feces are morphologically similar. This study presents the morphologic characterization of Strongylida larvae recovered from humans and pigs living in close proximity, exploring putative zoonotic cycles. One hundred three humans and 27 pigs were included in low-resource rural communities in the state of Piauí, northeastern Brazil. Strongylida eggs were present in 12 (11.7) humans and 23 (85.2) pigs through conventional parasitological examination. Strongylida-positive fecal samples were submitted to coprocultures using the HaradaMori technique. All 22 larvae obtained from human feces were classified as hookworms (Ancylostomatidae). From a total of 37 larvae obtained from swine, 23 (62.3) were classified as Oesophagostomum, 6 (16.2) were Hyostrongylus, and 4 (10.8) were Trichostrongylus. Four larvae (10.8) obtained from pigs were classified as Strongyloides. The morphological study of filariform larvae obtained in coprocultures is a useful and inexpensive tool in the screening of intestinal helminthiasis in a One Health approach.