RESUMEN
In January 2019, the state of Minas Gerais experienced another environmental disaster with the collapse of a mining dam near the city of Brumadinho. This disaster has resulted in 256 deaths and 14 people still missing. Toxic mud has contaminated the Paraopeba River resulting in significant fish and wildlife deaths in the river and surrounding areas. The effect of environmental disasters such as this is felt across multiple sectors damaging ecosystems in agriculture, wildlife and human communities. Environmental disasters cause significant disruption of ecosystems, flooding, contamination of water supplies, and displacement of human populations, which can result in increases in transmission and outbreaks of mosquito-borne and zoonotic diseases that can become a serious and long-term public health problem for the region.
Asunto(s)
Enfermedades Transmisibles/epidemiología , Desastres , Minería , Ríos , Brasil , Ciudades , Control de Enfermedades Transmisibles , Ecosistema , Monitoreo del Ambiente , Humanos , Contaminantes Químicos del AguaRESUMEN
Microscopic examination of placental tissue can provide an accurate assessment of malaria infection during pregnancy. In this cross-sectional study of 193 women in Iquitos, Peru, 1.0% and 6.6% had parasites in the peripheral blood as detected by microscopy and polymerase chain reaction, respectively. However, 22% had placental malaria pigment indicating past, subclinical infections. Placental tissues with pigment from 24 cases were matched by gravidity and month of delivery to 24 controls and histopathologically examined. Cases had significantly higher number of monocytes in the intervillous space (44.7 versus 25.5; P = 0.012). Pigmented monocytes in fetal vessels were present in 33.3% of cases. This study demonstrated that subclinical malarial infection occurred frequently in pregnant women and is associated with increased presence of monocytes in the placenta. Pigmented monocytes in fetal vessels suggest parasites can breach the placental barrier and enter the fetal circulation.
Asunto(s)
Malaria Falciparum/patología , Malaria Vivax/patología , Placenta/patología , Complicaciones Parasitarias del Embarazo/patología , Adolescente , Adulto , Estudios de Casos y Controles , Estudios Transversales , Femenino , Hemoproteínas/análisis , Humanos , Malaria Falciparum/sangre , Malaria Falciparum/epidemiología , Malaria Vivax/sangre , Malaria Vivax/epidemiología , Monocitos/patología , Parasitemia/sangre , Perú/epidemiología , Pigmentos Biológicos/análisis , Placenta/química , Placenta/parasitología , Embarazo , Complicaciones Parasitarias del Embarazo/sangre , Complicaciones Parasitarias del Embarazo/epidemiología , Adulto JovenRESUMEN
The Amazon region of Iquitos, Peru is hypoendemic for Plasmodium vivax and P. falciparum. There is limited information regarding the epidemiology of malaria during pregnancy in this region. Passive surveillance for clinical malaria among pregnant women was conducted in eight health posts in 2004 and 2005. Community-based active surveillance was conducted to determine the incidence of malarial infection among pregnant women in the community of Zungarococha in 2004 and 2005. Passive surveillance demonstrated that pregnant women had a prevalence of clinical malaria of 7.5% in 2004 and 6.6% in 2005 compared with 20.6% and 22.4% of the total population. Active surveillance showed that pregnant women were 2.3 (95% confidence interval = 1.32-3.95, P = 0.004) times more likely to have a P. falciparum infection compared with non-pregnant women. This study demonstrated that because of detection bias, passive surveillance underestimates the burden of malarial infection during pregnancy, and that subclinical malarial infections may occur frequently among pregnant women in this region. Furthermore, pregnant women in this low-transmission and P. vivax-dominant setting, experience an increased risk for P. falciparum infection, but not P. vivax infection.