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BACKGROUND: The food environment can influence opportunities and barriers to food access. This study aimed to investigate whether access to healthy foods varies according to store types and the socioeconomic status of the users of the public health promotion program in Brazil, known as the Health Academy Program. METHODS: A total of 18 Health Academy Program centers were selected via simple conglomerate sampling. Health Academy Program users living up to 1 km from the food stores were evaluated (n = 2831). Their socioeconomic status was investigated via face-to-face interviews. The food stores were audited through direct observation. Variables included the community nutrition environment (type and location) and consumer nutrition environment (healthy food store index, involving variables such as availability, variety, and advertising of healthy and unhealthy products). Multiple linear regression analysis was performed to examine the association between access to healthy foods, socioeconomic status, and food store type. RESULTS: A total of 336 stores were investigated. The majority were specialty fruit and vegetable markets/stores or open-air food markets. Access to healthy food was only associated with the food store type. An increase of 1% in the availability of specialized fruits and vegetable markets or open-air food markets and supermarket raised healthy food store index values by 0.12 and 0.07, respectively. CONCLUSIONS: Public food supply policies aimed at improving the diet quality of the population and reducing inequality in access should prioritize the implementation of stores of better quality, such as specialty fruit and vegetable markets and open-air food markets.

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This study aimed to investigate the distribution of congenital toxoplasmosis in the state of Minas Gerais, Southeastern Brazil and describe the demographic and socioeconomic profile of the municipalities associated with the disease. An ecological study was conducted using socioeconomic indicators of a database (MGSSRI) created by Fundação João Pinheiro (a government technical support agency of Minas Gerais), in order to show the development of the municipalities in the state. The prevalence of toxoplasmosis was the outcome and the items of the MGSSRI were the explanatory variables. Of 146,307 newborns screened (November 2006 to May 2007), 190 had congenital toxoplasmosis, yielding a prevalence of 1·3/1000, ranging from 0 to 76·9/1000 in the municipalities. The multivariate model indicated a higher occurrence of toxoplasmosis in municipalities with smaller populations and worse indexes of tax performance. Congenital toxoplasmosis appears to be a neglected disease in the state of Minas Gerais, given the high prevalence found and its concentration in municipalities with worse socioeconomic indexes.

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BACKGROUND: The present study aimed to calibrate a food frequency questionnaire (FFQ) using one 24-h recall (R24) associated with foodstuff replicas. METHODS: Calibration was performed by linear regression. Of a probability sample of 150 individuals (>18 years) of the town of Bambui, 98 completed the study. RESULTS: The mean age of the participants was 43.8 years and 63.3% were women. The calibration of the FFQ included sex for the estimation of iron, protein and zinc; and an interaction between sex and R24 was significant for vitamin A and cholesterol models. Age contributed to the vitamin C, polyunsaturated fatty acids, proteins and zinc models, and an interaction between age and R24 was significant for protein and zinc. CONCLUSIONS: Calibration coefficients and many interactions in linear regression models revealed important differences between dietary methods, indicating the complexity encountered when combining two methodologies for estimating food intake.

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INTRODUCTION: A telecardiology remote cardiology medical care system was implemented in 82 municipalities of Minas Gerais State, Brazil to support basic network services in the early diagnosis and management of cardiovascular diseases. OBJECTIVE: To investigate the factors associated with the implementation of this program in the municipalities. METHOD: This 2006 ecological study involved 393 candidate municipalities to implement the system. The municipalities were divided into two groups: non-random intervention (n = 82) and comparative (n = 311). The social, structure, healthcare needs, and governability indexes of the two groups of municipalities were compared by descriptive and multiple regression analysis using the generalized estimation equation model. RESULTS: After fitting for other characteristics, participation of the municipalities in the intervention was associated with a higher social responsibility index (OR: 2.44, CI: 1.50-3.96) and lower healthcare needs (OR: 2.29, CI: 1.24-4.22). CONCLUSION: Greater efforts by municipality management was the key to attracting and implementing the remote cardiology intervention, even when fitted for lower healthcare needs, which suggests greater municipal political and social engagement. This translated to improved access to cardiovascular health care for Brazilian rural and remote populations in the intervention municipalities.

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UNLABELLED: Patients with chronic renal failure(CRF) in hemodialysis(HD) programs comprise a risk group for acquisition of hepatitis C virus(HCV) infection. The objectives were to evaluate the seroprevalence of HCV in patients submitted to HD in State of Minas Gerais(MG), southwest of Brazil; to correlate this seroprevalence with the time of treatment on HD; to investigate the anti-HCV seropositivity in health professionals, to investigate the existence of a correlation between mean HCV seroprevalence and the human development index (HDI). Patients from 66 healthcare units(HU) were studied using a validated questionnaire and considering the positive values of anti-HCV(Elisa III) tests performed in these units between january and december 2003. RESULTS: the majority of patients were male (56.2%), between 41 and 60 years old. The mean seroprevalence of HCV in the 66 healthcare units was 13+/-9.5%; the three-monthly seroprevalence was below 20%, 15% and 10% in 75%, 50% and 40% of healthcare units, respectively. When the HU were grouped according to HCV seroprevalence into low(<5%), medium(5-15%) and high seroprevalence(>15%), 20% of the units have low, 42% medium and 37.5% were found to have high seroprevalence. No correlation was found between HDI and HCV seroprevalence (r=0.42; p=0.174) but in the regions in which the HDI was higher, HCV seroprevalence was also higher. There was a positive correlation between HCV seroprevalence and time on HD in 884 patients in the 4 HU (p<0.001). The seroprevalence of HCV was investigated in 387 healthcare professionals(29%) working in 14 HU. They were divided into two groups according to their time of professional activity: <10 y (G1) and >10 y (G2). In G1, there were no cases of anti-HCV seropositivity. In G2, 3 members of the staff were anti-HCV seropositive. The mean time of work of the seropositive staff in the HU was 15.6 years. The seroprevalence of HCV was 0.8% when all the healthcare professionals were taken into consideration. There was no statistically significant difference with respect to HCV seroprevalence between G1 and G2 with respect to the time of occupational exposure (p=0.27). CONCLUSION: the seroprevalence of HCV in patients on HD in MG is 13+/-9.5% and was <10% in 40% of the HU; there was no statistically significant correlation between HDI and seroprevalence of HCV in the healthcare units evaluated; there was a statistically significant correlation between HCV seroprevalence and time of treatment on HD; HCV seroprevalence in the health professionals studied was 0.8% and similar to the literature.

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Accurate measurements of food intake in surveys are difficult to be obtained especially in the older adults. Calibration, using two instruments, has been adopted in order to improve the information. This study was carried out in a random sample of older adults (> or =60) living in a Brazilian town. Food intake was obtained by the semi-quantitative food frequency questionnaire associated with photos (SFFQ-P) and the 24 hours recall (R24) with or without food models. Statistical analysis included tests to compare averages, Pearson's correlation coefficient and multiple linear regression. For all nutrients, the average intake obtained through SFFQ-P was significantly higher compared to the obtained by the R24 (p < or =0.05). SFFQ-P correlated better with R24 with food models, which was chosen as the reference method. In the multiple linear regression, vitamin C, fatty acid, protein and zinc intakes were influenced by age, especially when such nutrients were more concentrated in food not frequently reported. For protein and zinc, the significantly interaction between age with the 24 hours recall may have happened because of a differential selection of food sources as a function of age. This fact is probable related to chewing difficulties, reduction in the income and, a diet simplification associated with less complicated preparations, such as meat. This study reinforces the need for calibration of SFFQ in nutritional surveys among older adults, especially in etiological studies where the exposure assessment has to be accurate. In this case, R24 with food models should be used as a reference method to best estimate the true intake.

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Este estudo objetiva determinar a prevalência do consumo de álcool e outras drogas entre estudantes universitários através de três estudos transversais (1998,1999,2000).Foi utilizado um questionário anônimo e auto-aplicado contendo dez questões do Alcohol Use Disorders Identification Test - AUDIT, questões referentes ao uso de drogas na vida e nos últimos 12 meses. Um total de 374 estudantes participaram dos três in-quéritos(1998,1999 e 2000).A adesão ao estudo variou de 67 a 83 por cento.A idade média foi de 21,9 anos, variando de 20 a 32 anos.Um total de 166 alunos eram do sexo feminino(44 por cento) e 208 do sexo masculi-no(56 por cento).O uso na vida de tabaco foi relatadopor 44 por cento;maconha por 29 por cento e cocaína por 6 por cento de todos os alunos.no último ano,o uso de maconha e cocaína foram de 9,1 por cento e 0,5 por cento,respectivamente.30,2 por cento dos entrevistados foram classificados como fazendo uso nocivo de álcool(AUDIT maior que 8 pontos):35,7 por cento no 1º estudo(1998);26,4 por cento no 2º (1999)e 28,3 por cento no 3º(2000). Estudantes do sexo masculino tinham duas vezes mais chance de usar o álcool de forma nociva do que estudantes do sexo feminino(OR=2.3,C195 por cento:1.7-4.9). Este estudo sugere que o AUDIT pode ser um instrumento útil para estudos de prevalência relacionados ao consumo de álcool entre universitários. Além disto, monitorar a prevalência destes problemas em estudos transversais sucessivos pode ajudar estimar o impacto de esforços direcionados àprevenção

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OBJECTIVE: We assessed nutrition status and prevalence of malnutrition in hospital patients as determined by the Subjective Global Assessment Form, awareness of patients' nutrition status by health teams, and the use of nutrition therapy. METHODS: We enrolled 4000 hospital patients at least 18 y old who were covered by the Brazilian public health care system in a cross-sectional, multicenter epidemiologic study. We used Student's t and chi-square tests for univariate and multiple logistic regression analyses. RESULTS: Malnutrition was present in 48.1% of patients and severe malnutrition was present in 12.5% of patients. The prevalence of malnutrition was higher in the northern and northeastern regions of Brazil, where per-capita income is lower. Malnutrition correlated with primary diagnosis at admission, age (60 y), presence of cancer or infection, and longer hospital stay (P < 0.05). Fewer than 18.8% of patients' records contained information on nutrition-related issues. Nutrition therapy was used in 7.3% of patients (6.1% enteral nutrition and 1.2% parenteral nutrition). CONCLUSIONS: The prevalence of malnutrition in hospitalized patients in Brazil is high, physician awareness of malnutrition is low, and nutrition therapy is underprescribed.

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OBJECTIVE: The aim of this study was to assess the nutritional status of 374 surgical patients with gastrointestinal disease and hernias of the abdominal wall; to identify risk factors associated with a poorer nutritional status in this group of patients and to assess awareness of the patient's nutritional status by medical teams. SUMMARY BACKGROUND DATA: Malnutrition is prevalent among surgical patients and is associated with higher surgical complication rates and mortality. The major causes of poor nutritional status are related to the underlying disease, socio-economic factors, age, and length of hospitalization. Despite its high prevalence, medical teams often overlook malnutrition, and screening of these patients is not routine. It is of utmost importance to identify patients at risk for malnutrition in order to prevent related complications. METHODS: The 374 patients evaluated in this study were a subgroup of a larger multicenter, cross-sectional, randomized study that was carried out in 1996. Nutritional status was assessed by using Subjective Global Assessment. RESULTS: Malnutrition was present in 55% of the patients, with 19% of the patients severely malnourished. The presence of cancer, infection, age over 60 years, upper gastrointestinal disease, and longer length of hospital stay all negatively influenced nutritional status. Despite the high prevalence of malnutrition, the medical teams only assessed the nutritional status of a few patients. CONCLUSION: Malnutrition was highly prevalent in this setting of patients. Therefore, patients with the risk factors above presented should routinely undergo nutritional screening and/or assessment in order to be able to early diagnose or prevent malnutrition and its correlated morbidity and mortality.

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BACKGROUND: American cutaneous leishmaniasis (ACL) is endemic in many rural areas of Brazil where different transmission patterns of the disease have been described. This ecological study was carried out in a municipality located in Southeast Brazil and aimed to investigate the space-temporal patterns of the disease and environmental risk factors from 1966 to 1996. METHODS: Incident ACL cases were defined by clinical diagnosis, confirmed by a positive skin test and/or parasitological examination. Age-adjusted morbidity rate of ACL was calculated by year for this municipality and their different census enumeration districts. The homogeneity chi2 test, Moran and empirical Bayes index and Knox procedure were employed for testing the significance of clusters in time, space and in time-space, respectively. A Poisson regression model was used to identify environmental factors related to rate variability. RESULTS: A total of 1712 new ACL cases were reported with a yearly incidence rate of 48/100000 inhabitants. Higher incidence rates were detected in 1968, 1974, and 1988 (100, 160, and 190 cases/100000, respectively) with evidence of spatial clustering from 1986 to 1993. Significant space-time clustering with epidemic peaks followed by low incidence in subsequent periods was observed. The incidence rates of ACL were independently associated with rural areas; areas lacking sanitary installations and with higher proportion of exposed garbage (P < 0.01). CONCLUSIONS: This study suggests that ACL rates vary across space and time. Rural areas and some environmental factors could explain part of this variation. Environmental modifications in the vicinity of households over time and accumulation of susceptible individuals are discussed as possible factors responsible for variability.

PIP: This paper presents the results of an ecological study on American cutaneous leishmaniasis (ACL) cases carried out in Caratinga municipality, Southeast Brazil. The study aimed to estimate the incidence rates of ACL from 1966 to 1996, to test for space and temporal patterns in the rates and to correlate them to sociogeographic factors. Findings of the study showed an increase in the incidence rates of reported ACL cases. A total of 1712 ACL cases were reported in Caratinga during 1966-96, with a yearly incidence rate of 48/100,000 inhabitants. Evidence of spatial clustering was noted during 1986-93. Higher incidence rates were detected in 1968 (100 cases/100,000 inhabitants), 1974 (160/100,000), and 1988 (190/100,000). In addition, an observation noted that explosive outbreaks of ACL are followed with very low incident rate cases in the subsequent period. This observation indicates a lifelong resistance for treated individuals following clinically apparent infection. Moreover, prevalence of ACL infection was associated with rural areas, lack of sanitary disposal, and exposed garbage.

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Foram submetidas à pesquisa de coliformes fecais, utilizando-se a técnica do número mais provável (NMP/g), 168 amostras de variedades de queijo Minas (20 frescal, 48 canastra e 100 padronizado) coletadas em Belo Horizonte. Para a comparaçäo de diferentes ensaios em temperatura elevada, utilizou-se o caldo EC isoladamente, e caldos EC e triptofano em paralelo. Visando à pesquisa de indol foi realizado ensaio para confirmaçäo de produçäo de Beta-D-glucuronidase e indol em caldo fluorocult lauril sulfato. Os resultados demonstraram näo haver diferença estatística significativa entre as três metodologias utilizadas para a pesquisa de coliformes fecais, considerando os índices de aceitaçäo definidos pelos padröes legais de inspeçäo de queijo Minas. A facilidade de execuçäo do ensaio da Beta-D-glucuronidase em caldo fluorocult lauril sulfato, associada à confiabilidade dos resultados e demanda de tempo (reduçäo de 96 para até 48h), permitem sugeri-lo como método de escolha para enumeraçäo de coliformes em queijo Minas

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Foram submetidas à contagem de coliformes fecais e pesquisa de Salmonella sp. 168 amostras de variedades de queijo Minas (20 frescal, 48 canastra e 100 padronizado) coletadas em Belo Horizonte no período de 1995 a 1996. Foram adquiridos queijos com e sem registro no Serviço de Inspeçäo Federal (SIF) para avaliar a diferença de qualidade microbiológica. Os resultados evidenciaram ausência de Salmonella sp. em todas as amostras de queijo. Entretanto, verificou-se que 90 por cento das amostras de queijo Minas frescal, 81,2 por cento de Minas canastra e 52 por cento de Minas padronizado apresentavam elevada contagem de coliformes fecais, sendo essas superiores aos valores permitidos para inspeçäo.Näo houve diferença estatística significativa entre os queijos com e sem SIF com relaçäo aos resultados das análises microbiológicas de queijo Minas frescal padronizado

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There were submitted to the fecal coliforms enumeration and Samonella sp. search 168 samples of "Minas" cheese varieties (20 white, 48 "canastra" and 100 standardized), collected in Belo Horizonte, Brazil, from 1995 to 1996. There were purchased cheeses with and without Federal Inspection Service (FIS) register, in order to evaluate microbiological quality difference. However, it was verified that 90.0% of the "Minas" white cheese, 81.2% of the "canastra Minas" and 52.0% of the standardized "Minas" presented high fecal coliforms counts, which were superior to the inspection allowed values. There was no significant statistical difference among FIS registered and not registered cheeses concerning "Minas" white and standardized cheeses microbiological analysis.

Foram submetidas à contagem de coliformes fecais e pesquisa de Salmonella sp. 168 amostras de variedades de queijo Minas (20 frescal, 48 canastra e 100 padronizado) coletadas em Belo Horizonte no período de 1995 a 1996. Foram adquiridos queijos com e sem registro no Serviço de Inspeção Federal (SIF) para avaliar a diferença de qualidade microbiológica. Os resultados evidenciaram ausência de Salmonella sp. em todas as amostras de queijo. Entretanto, verificou-se que 90% das amostras de queijo Minas frescal, 81,2% de Minas canastra e 52% de Minas padronizado apresentavam elevada contagem de coliformes fecais, sendo essas superiores aos valores permitidos para inspeção. Não houve diferença estatística significativa entre os queijos com e sem SIF com relação aos resultados das análises microbiológicas de queijo Minas frescal padronizado.

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There were submitted to fecal coliforms enumeration, according to the most probable number (MPN/g) method, 168 samples of "Minas" cheese varieties (20 white, 48 "canastra" and 199 standardized), collected in Belo Horizonte, Brazil. In order to comparing different assays under high temperature, there was used EC broth isolated, and EC broth and tryptophane broth in parallel. With the aim of indol search, it was carried out an assay for beta-D-glucuronidase in indol production in fluorocult lauryl sulphate broth. The results did not show significant statistical difference among the three approaches used for fecal coliforms research, considering the acceptance indexes established by legal standards for "Minas" cheese inspection. The feasibility for beta-D-glucuronidase assay in fluorocult lauryl sulphate broth, coupled with results confidence and time required (reduction from 96 to up to 48h), suggest it as a preference method for fecal coliforms enumeration in "Minas" cheese.

Foram submetidas à pesquisa de coliformes fecais, utilizando-se a técnica do número mais provável (NMP/g), 168 amostras de variedades de queijo Minas (20 frescal, 48 canastra e 100 padronizado) coletadas em Belo Horizonte. Para a comparação de diferentes ensaios em temperatura elevada, utilizou-se o caldo EC isoladamente, e caldos EC e triptofano em paralelo. Visando à pesquisa de indol foi realizado ensaio para confirmação de produção de beta-D-glucuronidase e indol em caldo fluorocult lauril sulfato. Os resultados demonstraram não haver diferença estatística significativa entre as três metodologias utilizadas para a pesquisa de coliformes fecais, considerando os índices de aceitação definidos pelos padrões legais de inspeção de queijo Minas. A facilidade de execução do ensaio da beta-D-glucuronidase em caldo fluorocult lauril sulfato, associada à confiabilidade dos resultados e demanda de tempo (redução de 96 para até 48h), permitem sugeri-lo como método de escolha para enumeração de coliformes em queijo Minas.

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This study aims to describe the measles vaccination campaigns that have been carried out in the state of Minas Gerais, Brazil, since 1988; to highlight their importance in the control of the disease, and to pinpoint the age groups at risk during the recent epidemic, which began in 1996, spread all over the country, and declined in 1998. However, the analysis includes only data up to September 1997. The methodology used was based on the birth cohort analysis design. Data compared by cohorts included target population and vaccination coverage for each campaign, and measles incidence rates during the present epidemic. Results show that the more opportunities for exposure to vaccination campaigns, the lesser the risk for having measles in any birth cohort. In 1997, the relative risk for getting measles was 15.38 (IC 95%: 9.89 to 23.93) for the cohort under 2 years of age, which had not had the opportunity to be exposed to any vaccination campaigns, as compared to cohorts between 3 and 19 years of age with two or more opportunities of exposure to vaccination campaigns. On the basis of the experiences analyzed, catch-up measles vaccination campaigns as well as follow-up campaigns--particularly when routine vaccination did not achieve sufficient coverage--have had an outstanding role in controlling the measles epidemic in the state of Minas Gerais. We therefore suggest making the measles vaccine immediately available to all birth cohorts that did not have the opportunity for exposure to past vaccination campaigns and intensifying epidemiological surveillance. Moreover, it is necessary to find ways to improve routine vaccination coverage in order to achieve the 95% goal set by the National Plan to Eliminate Measles by the Year 2000.

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Epidemiologic and clinical aspects of 310 hospitalized snakebite patients and 310 matched controls were described, over a seven years period, from an emergency hospital in Belo Horizontal, Southeast Brazil. The diagnosis was based upon clinical picture or actual snake identification. Fifty six percent of victims were bitten by the snakes of genus Bothrops, 32.0% by Crotalus, 1.0% by Lachesis and 10.0% undetermined. During the study period, stable number of cases and marked seasonal variation were noted. In comparing cases of snakebite and controls, those from a rural area or who were involved in agricultural labor activity were identified as a high risk group, with an odds ratio (OR) of 14.7 and 6.7, respectively, in favor of being bitten. Upon treatment, snakebite patients were 13.5 times more likely to have had early anaphylactic reactions than their controls, with a higher association in the age group > or = 20 years (OR = 30.3). Increased risks were also detected for pyrexia (OR = 11.7), with a marked association in the group under 19 years old (OR = 16.6). Severe cases of snakebite are an important treatable cause of morbidity in Brazil but therapy may be potentially life threatening. The higher case-fatality ratio encountered, compared to national statistics may be due the representativeness of the more severe cases who sought hospitalization. Preventing snakebite and early referral of those who are bitten is proposed.

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Factors associated with clinical complications of snake bite and antivenom therapy were studied in 310 hospital patients admitted with snake bite over 6 years to a tertiary referral hospital in Belo Horizonte, southeast Brazil. Overall, 17.4% had early clinical complications including tissue loss associated with abscess and necrosis, acute renal failure, shock, acute lung oedema and intracranial haemorrhage. 3% had permanent sequelae, caused by muscle contractures and amputations, chronic renal failure, or death. Early complications were associated with the following: age under 9 years (P = 0.04), residence in a rural area (P = 0.04), and a delay of more than 8 h in seeking clinical care (P < 0.01). Antivenom was administered to 98.1% of patients; 13.8% presented with anaphylaxis and 11.8% with pyrexia. Individuals from a rural area had a higher occurrence of anaphylactic reactions (P = 0.03). Neither anaphylaxis nor pyrexia was linked with antivenom type and dosage. This study suggested that antivenom might be associated with a reduced risk of serious injuries related to snake bite, especially when administered within the first 8 h. Complications appeared to be a far greater risk than adverse reactions to the antivenom.

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A case-control study evaluating the association between mental retardation and toxoplasmosis was conducted among 845 school children in Belo Horizonte, MG, Brazil. Cases (450) were mentally retarded children attending a public school for special education. Controls (395) were children from the regular public school system. Clinical and anthropometric examinations and interviews were carried out to determine risk factors for toxoplasmosis and mental retardation. Diagnosis of Toxoplasma gondii infection was based upon an indirect immunofluorescent test (IFA); 55% of cases and 29% of controls were positive. The Relative Odds of mental retardation in children with positive serology was 3.0 (95% CI 2.2-4.0). Maternal exposure to cats and contact with soil were associated with an increased risk of mental retardation. Retinochoroiditis was fourfold more prevalent among cases than controls and was only diagnosed in T. gondii IFA positive participants. Congenital toxoplasmosis, in its subclinical form, appears to be an important component in the etiology of mental retardation, especially in high risk (lower socio-economic) groups. The population attributable risk was estimated as 6.0-9.0%, suggesting the amount of mental retardation associated with this infection.

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O autor realizou investigaçäo oftalmológica em 403 crianças, sendo 230 portadoras de deficiência mental em graus variados (Casos) e 173 com desenvolvimento intelectual considerado como normal (Controles), todas integrantes do Sistema Operacional de Ensino da Secretaria de Estado da Educaçäo de Minas Gerais, com o objetivo principal de detectar alteraçöes oftalmoscópicas e correlacioná-las com a presença de infecçäo por Toxoplasma gondii e com a condiçäo de deficiência mental, através de análises de associaçäo ("Odds Ratio"). O estudo teve caráter simples-cego; o autor näo conhecia os resultados da sorología (RIF) quando da realizaçäo do exame oftalmológico. Além da lesäo clássica da toxoplasmose ocular, foram consideradas como sugestivas de toxoplasmose as pequenas lesöes de retinocoroidite cicatrizada, detectadas pelo examinador, que se caracterizavam por centro pigmentado, halo hipocrômico, tamanho variando entre meio a um diâmetro papilar, localizadas a distância variáveis do pólo posterior, sem extrapolar os limites equatoriais. A associaçäo destas lesöes com a infecçäo toxoplásmica foi bastante alta ("Odds Ratio" = 34,4). Foi verificado que estas lesöes estavam associadas a condiçäo de deficiência mental, com "Odds Ratio" igual a 4,4, levando o autor a concluir que, as crianças que apresentavam esta lesäo têm uma chance quatro vezes maior de serem portadoras de deficiência mental por toxoplasmose do que as crianças sem a lesäo. As lesöes de degeneraçäo da periferia da retina e a palidez da cabeça do Nervo Optico também mostraram-se associadas a deficiência mental, mas associaçäo possivelmente foi determinada pela presença de outros fatores causais que näo a toxoplasmose

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