Luciano Medeiros de Toledo

Bio: Luciano Medeiros de Toledo is an academic researcher from Oswaldo Cruz Foundation. The author has contributed to research in topics: Population & Leishmaniasis. The author has an hindex of 11, co-authored 21 publications receiving 422 citations.

Canine Visceral Leishmaniasis in Rio de Janeiro, Brazil: clinical, parasitological, therapeutical and epidemiological findings (1977-1983)

Abstract: Forty dogs from the periphery of the city of Rio de Janeiro were studied. All dogs where diagnosed as positive for leishmaniasis either parasitologically and/or serologically. Among them, 19 came from areas where only Visceral Leishmaniasis (VL) occurs (Realengo, Bangu, Senador Camara). Clinical signs of the disease were seen in 36.8% of the cases, including emaciation - 100%, lymphadenopathy and depilation - 85.7%. The other 21 dogs came from an area (Campo Grande) where both diseases (VL, and American Cutaneous Leishmaniasis - ACL) occur. Clinical signs of the disease, mainly cutaneous or mucocutaneous ulcers were seen in 76.2% of the cases. Leishmania parasites were found in 39 cases: 22% in viscera, 42.5% in viscera and normal skin and 35% in cutaneous or mucocutaneous ulcers. All the Leishmania stocks isolated from dogs which came from Realengo, Bangu, Senador Camara (VL area), and from Campo Grande (VL + ACL area) were characterized as L. donovani (except in one case) according to their schizodeme, zymodeme and serodeme. The only stock characterized as L. b. braziliensis, was isolated from the lymph node of a dog from Campo Grande with visceral disease and without skin lesions. Antimony therapy attempted in eight Leishmania donovani positive dogs was unsuccessful.

Distribution of dengue vectors in neighborhoods with different urbanization types of Manaus, state of Amazonas, Brazil.

Abstract: Aedes aegypti and Ae. albopictus are vectors of dengue viruses, which cause endemic disease in the city of Manaus, capital of the state of Amazonas, Brazil. More than 53 thousand cases have been registered in this city since the first epidemic in 1998. We evaluated the hypothesis that different ecological conditions result in different patterns of vector infestation in Manaus, by measuring the infestation level in four neighborhoods with different urbanization patterns, during the rainy (April), dry (August), and transitional (November) seasons. Ae. aegypti predominated throughout the study areas and sampling periods, representing 86% of all specimens collected in oviposition traps. High frequencies of houses positive for both species were observed in all studied sites, with Ae. aegypti present in more than 84% of the houses in all seasons. Ae. albopictus, on the other hand, showed more spatial and temporal variation in abundance. We found no association between infestation level and house traits. This study highlights the homogeneity of dengue vector distribution in Manaus.

Leishmaniose visceral na cidade do Rio de Janeiro - Brasil

Abstract: A recente ocorrencia de casos humanos e caninos de leishmaniose visceral, autoctones de areas peri-urbanas da cidade do Rio de Janeiro, a partir de 1977, motivou pesquisadores da Escola Nacional de Saude Publica e do Instituto Oswaldo Cruz da Fundacao Oswaldo Cruz (FIOCRUZ), da Universidade Federal do Rio de Janeiro, da Universidade Federal Rural do Rio de Janeiro, da Secretaria Municipal da Saude do Rio de Janeiro e da Superintendencia das Campanhas do Ministerio da Saude (SUCAM-RJ), a participarem de um programa de estudo dessa zooantroponose, visando a uma abordagem ecologica, epidemiologica, parasitologica, imunologica, clinico-terapeutica e de avaliacao das medidas de controle adotadas. Resultados gerais dessas pesquisas sao apresentados na presente comunicacao.

Mortalidade infantil em remanescentes de quilombos do Munícipio de Santarém - Pará, Brasil

Abstract: Este trabalho e uma analise preliminar da mortalidade infantil em areas quilombolas do municipio de Santarem-Para. Trata-se de uma Pesquisa Domiciliar Censitaria realizada no periodo de marco/abril de 2006, por meio de procedimentos de busca ativa de obitos em menores de um ano de idade, com identificacao de sub-registro na populacao das comunidades de terra firme e de varzea. Os niveis de mortalidade foram obtidos pela tecnica indireta de estimacao. Encontrou-se diferencial na mortalidade de menores de um ano de idade para os quilombos da area de terra firme e varzea, de 30,4 obitos/por mil nascidos vivos e de 50,2 obitos/por mil nascidos vivos, respectivamente. Os resultados evidenciam profundas desigualdades, na medida em que as taxas de mortalidade das comunidades quilombolas sao maiores quando comparadas com as do pais (27,0 obitos/por mil nascidos vivos), da regiao Norte (26,2 obitos/por mil nascidos vivos), e da populacao negra rural do estado do Para (32,9 obitos/por mil nascidos vivos). Observa-se que nenhuma das taxas de mortalidade dos quilombos alcancou niveis considerados satisfatorios quando comparadas com os parâmetros preconizados pelo Ministerio da Saude em 2005 (menos de 20 obitos/por mil nascidos vivos). Constata-se que, enquanto a mortalidade infantil vem diminuindo no pais como um todo, nos quilombos de Santarem, principalmente os da area de varzea, a probabilidade de uma crianca quilombola morrer antes de completar o primeiro ano de vida e bastante elevada, superando a media nacional, regional e estadual e classificando-se como alta, conforme os criterios definidos pelo Ministerio da Saude.

A rede de causalidade da insegurança alimentar e nutricional de comunidades quilombolas com a construção da rodovia BR-163, Pará, Brasil

Abstract: Objective This work describes results based on the participative and encompassing development of a model of causal determination done in six quilombola communities of Santarem, Para State, regarding the causality of food and nutrition insecurity with the construction of the BR-163 highway. Methods The research process used socio-anthropological approach methods based on the development of a causality model constructed by forming focal groups with community representatives. Result The results of the study show that the use of participative approaches stimulates the community’s self-esteem and takes control of the factors that determine its problems. The causal model reveals that, for the communities, nutrition and food insecurity establish that historical factors associated with land ownership and current use based on predatory practices are essential to understand the causal determination of food and nutrition insecurity. Conclusion Racism and its social nuances have contributed for the social invisibility of these communities in public Brazilian policies. The quilombola communities consider themselves in a state of nutritional and food insecurity and indicate that the construction of the BR-163 highway can be a threat to the sustainable ethnic development in the region. They also state that the economic development expected with the construction of this highway can increase hunger, poverty and racism if the communities do not participate.

Hepatitis B Virus Infection: Epidemiology and Vaccination

Abstract: Worldwide, two billion people have been infected with hepatitis B virus (HBV), 360 million have chronic infection, and 600,000 die each year from HBV-related liver disease or hepatocellular carcinoma. This comprehensive review of hepatitis B epidemiology and vaccines focuses on definitive and influential studies and highlights current trends, policies, and directions. HBV can be transmitted vertically, through sexual or household contact, or by unsafe injections, but chronic infections acquired during infancy or childhood account for a disproportionately large share of worldwide morbidity and mortality. Vaccination against HBV infection can be started at birth and provides long-term protection against infection in more than 90% of healthy people. In the 1990s, many industrialized countries and a few less-developed countries implemented universal hepatitis B immunization and experienced measurable reductions in HBV-related disease. For example, in Taiwan, the prevalence of chronic infection in children declined by more than 90%. Many resource-poor nations have recently initiated universal hepatitis B immunization programs with assistance from the Global Alliance for Vaccines and Immunization. Further progress towards the elimination of HBV transmission will require sustainable vaccination programs with improved vaccination coverage, practical methods of measuring the impact of vaccination programs, and targeted vaccination efforts for communities at high risk of infection.

Logistic Regression A Self Learning Text

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Leishmaniases of the New World: current concepts and implications for future research.

Abstract: Recent epidemiologic studies indicate that leishmaniasis in the Americas is far more abundant and of greater public health importance than was previously recognized. The disease in the New World is caused by a number of different parasite species that are capable of producing a wide variety of clinical manifestations. The outcome of leishmanial infection in humans is largely dependent on the immune responsiveness of the host and the virulence of the infecting parasite strain. This article reviews current concepts of the clinical forms, immunology, pathology, laboratory diagnosis, and treatment of the disease as well as aspects of its epidemiology and control. Recommendations for future research on the disease and its control are made.

Assessing the global threat from Zika virus

Abstract: First discovered in 1947, Zika virus (ZIKV) infection remained a little-known tropical disease until 2015, when its apparent association with a considerable increase in the incidence of microcephaly in Brazil raised alarms worldwide. There is limited information on the key factors that determine the extent of the global threat from ZIKV infection and resulting complications. Here, we review what is known about the epidemiology, natural history, and public health effects of ZIKV infection, the empirical basis for this knowledge, and the critical knowledge gaps that need to be filled.