Revista da Sociedade Brasileira de Medicina Tropical最新文献

{"title":"Renal Alterations Secondary to Visceral Leishmaniasis: A Scoping Review.","authors":"João Victor Corrêa E Silva, Lethícia de Oliveira Carvalho, Luiz Henrique da Silva, Marcos Antonio da Silva Barbosa Junior, Pedro Vinicius Leite de Sousa, Laurisson Albuquerque da Costa","doi":"10.1590/0037-8682-0190-2025","DOIUrl":"10.1590/0037-8682-0190-2025","url":null,"abstract":"<p><strong>Background: </strong>Visceral leishmaniasis (VL) is an endemic and neglected disease in several countries. In addition to affecting the visceral tissues, kidney alterations are recurrent and result from the pathophysiological implications of infection or drug action during treatment. This review mapped and described renal changes, renal biomarkers, and treatment-related nephrotoxicity in humans with confirmed VL.</p><p><strong>Methods: </strong>This scoping review was conducted in accordance with the Joanna Briggs Institute Manual for Evidence Synthesis and the PRISMA-ScR guidelines. PubMed, SciELO, ScienceDirect, Scopus, and Web of Science. were searched with no temporal or geographical restrictions. We included studies involving humans with confirmed VL that reported renal alterations, kidney injury biomarkers, or treatment-related nephrotoxicity. Two reviewers independently screened the records and extracted data. Study selection was documented using the PRISMA-ScR flowchart.</p><p><strong>Results: </strong>In total, 1,444 studies were identified, of which 15 met the eligibility criteria. The included studies reported a wide spectrum of renal alterations in VL, including urinary abnormalities, kidney injury biomarkers, and acute kidney injury. Glomerular and tubulointerstitial changes, such as mesangial alterations, membranoproliferative patterns, cryoglobulinemia, interstitial nephritis, and impaired urinary concentrating ability, have also been described. Reports have also addressed the potential treatment-related nephrotoxicity.</p><p><strong>Conclusion: </strong>This scoping review identified diverse renal alterations in patients with VL, ranging from functional changes and urinary abnormalities to glomerular and tubulointerstitial involvement. Evidence has also described biomarkers of kidney injury and potential treatment-related nephrotoxicity. The heterogeneity and limited data highlight the need for robust research to clarify the underlying mechanisms, diagnostic markers, and optimal management.</p>","PeriodicalId":21199,"journal":{"name":"Revista da Sociedade Brasileira de Medicina Tropical","volume":"59 ","pages":"e01902025"},"PeriodicalIF":2.3,"publicationDate":"2026-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13037720/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147691667","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prolonged Evaluation of COVID-19 Vaccine Effectiveness in Healthcare Workers at a Public Tertiary Hospital: A Retrospective Cohort Study.","authors":"Guilherme Silveira Castro, Yasmim Colins Silva de Oliveira, Michel Morais Marques Sawan, Marcela Padovan Prado Budoia, Janaína Soares, Mateus Rennó de Campos, Felipe Santos de Carvalho, Gilberto Gambero Gaspar, Benedito Antônio Lopes da Fonseca, Leandro Machado Colli, Antonio Pazin-Filho, Fernando Bellissimo-Rodrigues","doi":"10.1590/0037-8682-0219-2025","DOIUrl":"10.1590/0037-8682-0219-2025","url":null,"abstract":"<p><strong>Background: </strong>Most studies evaluating COVID-19 vaccine efficacy and effectiveness were conducted over short follow-up periods due to the urgency of vaccine approval and rollout during the pandemic. This study aimed to assess the long-term effectiveness of COVID-19 vaccines among healthcare workers at a tertiary hospital.</p><p><strong>Methods: </strong>We conducted an open retrospective cohort study at Hospital das Clínicas de Ribeirão Preto, including healthcare workers employed between July 3, 2020, and February 8, 2022. A total of 7,385 workers were followed for 3,185,239 person-days. Three monovalent vaccines were administered during the study period: Coronavac™ (Sinovac), Covishield™ (AstraZeneca), and Comirnaty™ (Pfizer-BioNTech). Participants were categorized as unvaccinated, partially vaccinated, or fully vaccinated. The unadjusted relative risk (RR) of COVID-19 was calculated for vaccinated groups compared with the unvaccinated group.</p><p><strong>Results: </strong>For COVID-19 of any severity, the RR was 0.72 (95%CI: 0.59-0.89) among partially vaccinated and 1.30 (95%CI: 1.19-1.44) among fully vaccinated workers. For severe or critical cases, the RR was 0.75 (95%CI: 0.26-2.16) with partial vaccination and 0.14 (95%CI: 0.05-0.41) with full vaccination. For COVID-19-related deaths, the RR with full vaccination was 0.32 (95%CI: 0.03-3.09).</p><p><strong>Conclusions: </strong>The vaccines provided limited long-term protection against SARS-CoV-2 infection and mild COVID-19. However, protection against severe disease and death remained substantial despite the circulation of multiple variants.</p>","PeriodicalId":21199,"journal":{"name":"Revista da Sociedade Brasileira de Medicina Tropical","volume":"59 ","pages":"e02192025"},"PeriodicalIF":2.3,"publicationDate":"2026-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13035244/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147594467","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence of Latent Tuberculosis Infection in Vulnerable Groups in the State of Santa Catarina, Brazil.","authors":"Emanuela da Rocha Carvalho, Emil Kupek","doi":"10.1590/0037-8682-0329-2025","DOIUrl":"10.1590/0037-8682-0329-2025","url":null,"abstract":"<p><strong>Background: </strong>Tuberculosis remains a major public health challenge that exerts substantial pressure on healthcare systems worldwide. Despite advances in diagnosis and treatment, the proper management of latent tuberculosis infection (LTBI) remains inefficient, especially among vulnerable populations. In the State of Santa Catarina, Brazil, the absence of comprehensive and specific records on LTBI prevalence in these at-risk groups limits effective public health planning and interventions.</p><p><strong>Methods: </strong>Interferon-gamma release assay (IGRA) test records in the State of Santa Catarina, Brazil, contained partial information on risk factors for LTBI. Multiple imputations were used to estimate the likely risk groups among individuals without such information. The study was approved by the Human Research Ethics Committee under protocol number CAAE 79499224.4.0000.5361.</p><p><strong>Results: </strong>The estimated LTBI prevalence among individuals with available IGRA results was 6.89%, with higher rates among people living with human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (18.25%) and immigrants (3.65%). Underreporting was notable among individuals deprived of liberty, those experiencing homelessness, those who use illicit drugs, and those with diabetes mellitus. Missing data were frequent among individuals living with HIV; people of African, Indigenous, or Asian descent; and those exposed to drug-resistant TB. More than 10% of LTBI cases occurred in children and adolescents aged <15 years.</p><p><strong>Conclusion: </strong>HIV was the most prevalent risk factor among IGRA-positive individuals and was substantially underestimated. An urgent expansion of LTBI identification efforts is needed for all vulnerable populations, with special attention paid to children and adolescents who present a high risk of progressing to active TB.</p>","PeriodicalId":21199,"journal":{"name":"Revista da Sociedade Brasileira de Medicina Tropical","volume":"59 ","pages":"e03292025"},"PeriodicalIF":2.3,"publicationDate":"2026-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13037719/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147691450","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Establishing tropical medicine as a recognized medical specialty or strengthening its training within infectious diseases residency programs in Colombia: an urgent need.","authors":"Carlos Ramiro Silva-Ramos, Carlos Arturo Álvarez-Moreno, Alfonso J Rodriguez-Morales, Álvaro A Faccini-Martínez","doi":"10.1590/0037-8682-0527-2025","DOIUrl":"10.1590/0037-8682-0527-2025","url":null,"abstract":"<p><p>Colombia is entirely located within the tropical latitudinal zone and is characterized by extensive biodiversity, complex ecosystems, and socio-environmental inequities that contribute to the sustained persistence of a wide range of tropical diseases. Despite the high prevalence and public health impact of these conditions, tropical medicine is not currently recognized as a clinical specialty in Colombia, and its inclusion within infectious diseases residency programs remains limited, fragmented, and primarily hospital-centered. As a result, future specialists may complete their training with insufficient clinical experience in endemic tropical diseases, particularly those affecting rural and marginalized populations. Although research-oriented postgraduate programs in tropical medicine exist, clinical training and direct patient management are largely absent. In contrast, several countries in Europe, North America, and Latin America have adopted specialized educational models that integrate fieldwork, interdisciplinary curricula, and strong clinical components to strengthen expertise in tropical medicine. To reduce persistent health inequities and enhance national preparedness for emerging tropical threats, Colombia urgently needs to strengthen tropical medicine training, either by expanding and standardizing content within existing infectious diseases residency programs or by establishing a dedicated clinical postgraduate specialty. Strengthening academic and clinical capacity in this field would improve patient care, promote applied research, and support evidence-based strategies for managing tropical diseases nationwide.</p>","PeriodicalId":21199,"journal":{"name":"Revista da Sociedade Brasileira de Medicina Tropical","volume":"59 ","pages":"e05272025"},"PeriodicalIF":2.3,"publicationDate":"2026-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13035242/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147594483","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Atypical manifestations of leishmaniasis in the state of Mato Grosso: a clinical-epidemiological study at the Júlio Müller University Hospital (2013-2023).","authors":"Bianca Coelho Damin Ribeiro, Tatiana Fortes de Oliveira, Tiago Rodrigues Viana, Giovana Volpato Pazin Feuser, Fernanda Ferreira Fernandes, Marcia Hueb","doi":"10.1590/0037-8682-0440-2025","DOIUrl":"10.1590/0037-8682-0440-2025","url":null,"abstract":"<p><strong>Background: </strong>Leishmaniasis is a neglected tropical infectious disease caused by protozoa of the Leishmania genus and transmitted by the bite of female sand flies. It may present with various clinical manifestations depending on species, parasite load, and host immunity. Recently, a geographic expansion of the disease has been observed, along with variations in clinical manifestations.</p><p><strong>Methods: </strong>We aimed to better define this clinical entity in the Brazilian context by describing leishmaniasis cases with atypical clinical manifestations treated at the Júlio Müller University Hospital in Cuiabá, Mato Grosso, between 2013 and 2023.</p><p><strong>Results: </strong>During the study period, 1,041 cases of cutaneous and mucosal leishmaniasis and 51 suspected cases of visceral leishmaniasis were recorded, of which 47 were classified as atypical (4.5%). Atypical presentations included localized cutaneous forms with unusual morphology (91.5%), mucocutaneous forms (4.2%), one case resembling post-kala-azar dermal leishmaniasis (2.1%), and one case of mucocutaneous lesions occurring after visceral leishmaniasis (2.1%), both of which are considered atypical in Brazil, where there is no endemic description of post-kala-azar dermal leishm aniasis. Most cases involved men aged 50-59 years, who were predominantly rural workers. These cases primarily originated from the Cerrado biome. The lesions had a median evolution of 120 d and mainly affected the lower limbs and face. Uncommon symptoms included fever, weight loss, and hepatosplenomegaly. Molecular identification of the etiological agent contributed to the diagnosis of selected cases.</p><p><strong>Conclusions: </strong>This study highlights the importance of recognizing atypical clinical manifestations of leishmaniasis to improve disease diagnosis and management.</p>","PeriodicalId":21199,"journal":{"name":"Revista da Sociedade Brasileira de Medicina Tropical","volume":"59 ","pages":"e04402025"},"PeriodicalIF":2.3,"publicationDate":"2026-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13037722/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147692014","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Epidemiology of Acute Chagas Disease in the Amazon: Association between the açaí production chain and case reports in Pará state, Brazil.","authors":"Mateus Gomes Oliveira, André Walsh-Monteiro, John Fontenele Araújo, Marco Aurélio Oliveira","doi":"10.1590/0037-8682-0360-2025","DOIUrl":"10.1590/0037-8682-0360-2025","url":null,"abstract":"<p><strong>Background: </strong>Acute Chagas Disease (ACD) in the Brazilian Amazon exhibits a unique epidemiological profile characterized primarily by oral transmission. The state of Pará, recognized as the world's largest producer of açaí, represents an epicenter of the disease. This study aimed to analyze the epidemiological patterns of ACD cases in Pará and investigate the relationship between its seasonality and the açaí production chain.</p><p><strong>Methods: </strong>This epidemiological study used data on 2,762 ACD cases reported to the Notifiable Diseases Information System (SINAN) between 2013 and 2023. Sociodemographic and epidemiological variables were evaluated. Time series analysis was performed to determine seasonality and assess its correlation with variations in açaí prices.</p><p><strong>Results: </strong>Oral transmission accounted for 87.44% of cases. The predominant demographic profiles were males (54.16%) and individuals with parda (mixed-race) skin color (85.41%). Temporal analysis revealed a significant seasonal trend (p < 0.001), with a peak incidence projected at the end of September, coinciding with the açaí harvest season. A moderate negative Spearman correlation was observed between ACD case numbers and açaí prices (r = -0.413; p < 0.001), suggesting that increased supply and consumption are associated with a heightened risk of infection.</p><p><strong>Conclusions: </strong>The epidemiology of ACD in Pará is closely linked to the açaí production cycle, confirming its role as the principal mode of oral transmission in the region. These results underscore the importance of public health policies focused on food safety and effective management practices throughout the entire açaí production chain to prevent new cases.</p>","PeriodicalId":21199,"journal":{"name":"Revista da Sociedade Brasileira de Medicina Tropical","volume":"59 ","pages":"e03602025"},"PeriodicalIF":2.3,"publicationDate":"2026-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13035243/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147594362","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Kaposi sarcoma with extensive thoracic involvement.","authors":"Antônio Carlos Portugal Gomes, Bruno Hochhegger, Alexandre Dias Mançano, Gláucia Zanetti, Edson Marchiori","doi":"10.1590/0037-8682-0598-2025","DOIUrl":"10.1590/0037-8682-0598-2025","url":null,"abstract":"","PeriodicalId":21199,"journal":{"name":"Revista da Sociedade Brasileira de Medicina Tropical","volume":"59 ","pages":"e05982025"},"PeriodicalIF":2.3,"publicationDate":"2026-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13035240/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147594431","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Erratum.","authors":"","doi":"10.1590/0037-8682-0276B-2025","DOIUrl":"10.1590/0037-8682-0276B-2025","url":null,"abstract":"<p><p>[This corrects the article doi: 10.1590/0037-8682-0276-2025].</p>","PeriodicalId":21199,"journal":{"name":"Revista da Sociedade Brasileira de Medicina Tropical","volume":"59 ","pages":"e0276B2025"},"PeriodicalIF":2.3,"publicationDate":"2026-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13037721/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147692025","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"New technologies for identification and surveillance of Chagas disease vectors.","authors":"Rodrigo Gurgel-Gonçalves, Genimar Rebouças Julião, Raquel Aparecida Ferreira, Rita de Cássia Moreira de Souza, Mirko Rojas-Cortez, Thallyta Maria Vieira, Vinícius Lima de Miranda, Jonas Lotufo Brant, Marcos Takashi Obara, Rafaella Albuquerque E Silva, Ana Karina Ibarrola-Vannucci, Gerardo Marti, Soledad Ceccarelli","doi":"10.1590/0037-8682-0597-2025","DOIUrl":"10.1590/0037-8682-0597-2025","url":null,"abstract":"<p><p>Technologies are essential for surveillance of vector-borne diseases. The increasing frequency of triatomine house invasion in the Americas highlights the need to strengthen surveillance strategies. This narrative review examines how emerging technologies can improve identification and reporting of Chagas disease vectors. We analyzed studies published between 2015 and 2025 on digital tools for triatomine surveillance. Technologies were grouped by purpose: (1) identification apps (TriatoKey, TriatoDex, automated identification); (2) community engagement platforms (WhatsBarb, TriatoChat); and (3) institutional surveillance systems (SISVetor-Chagas, GeoVin, Triatomine Information Posts). We summarize their characteristics, applications, knowledge gaps, and potential integration with national surveillance systems, and discuss implications for public health policy. Digital innovation and citizen-based surveillance may support improved prevention and control of vector-borne Chagas disease.</p>","PeriodicalId":21199,"journal":{"name":"Revista da Sociedade Brasileira de Medicina Tropical","volume":"59 ","pages":"e05972025"},"PeriodicalIF":2.3,"publicationDate":"2026-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13035241/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147594479","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk factors associated with dengue lethality: case-control study, Joinville, Brazil.","authors":"Romana Pedott Apel, Saulo Vicente Rocha, Dorceli Alves Lemes da Cruz, Juliana Antunes Safanelli, Helbert do Nascimento Lima","doi":"10.1590/0037-8682-0165-2025","DOIUrl":"10.1590/0037-8682-0165-2025","url":null,"abstract":"<p><strong>Background: </strong>Dengue remains a major public health concern in Brazil, with approximately 6 million cases and over 6,000 deaths reported in 2024. Joinville, in southern Brazil, recorded one of the highest incidence rates in the country. Understanding the clinical and demographic factors associated with dengue-related mortality in this region is essential for developing effective interventions.</p><p><strong>Methods: </strong>We conducted a retrospective matched case-control study using data from the Sistema de Informação de Agravos de Notificação database, involving adult patients with dengue who presented with warning signs or severe disease and were treated within Joinville's public health system (Sistema Único de Saúde) between January 2021 and December 2024. Cases were defined as fatal outcomes, while controls were matched survivors. Univariate and multivariate logistic regression models were used to estimate mortality risk.</p><p><strong>Results: </strong>Among 454 patients, 116 (26%) were cases and 336 (74%) were controls. Lower mortality was associated with having ≥ 2 medical consultations (odds ratio [OR] = 0.20; 95% confidence interval [CI]: 0.10-0.51) and receiving intravenous hydration of ≥ 1 L (OR = 0.32; 95% CI: 0.14-0.72). Hypotension (OR = 3.06; 95% CI: 1.33-7.03), thrombocytopenia (OR = 2.47; 95% CI: 1.21-5.02), and lethargy or irritability (OR = 15.59; 95% CI: 6.50-37.38) were significantly associated with mortality.</p><p><strong>Conclusions: </strong>Early intravenous rehydration and repeated clinical evaluations were associated with reduced mortality. Close monitoring of patients with warning signs is crucial for improving outcomes in high-incidence settings.</p>","PeriodicalId":21199,"journal":{"name":"Revista da Sociedade Brasileira de Medicina Tropical","volume":"59 ","pages":"e01652025"},"PeriodicalIF":2.3,"publicationDate":"2026-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13037723/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147691758","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}