Papers by Rosa Maria Salani Mota
Diagnostic Microbiology and Infectious Disease, Jul 1, 2010
Journal of Medical Microbiology, May 1, 2013
Enteroaggregative Escherichia coli (EAEC) is an important agent that causes endemic and epidemic ... more Enteroaggregative Escherichia coli (EAEC) is an important agent that causes endemic and epidemic diarrhoeal diseases worldwide. Several EAEC virulence-related genes (VRGs) have been described but their role in the clinical outcome of infection is not completely defined. This study investigated the prevalence of EAEC and potential associations of its VRGs with risk of or protection from diarrhoeal diseases in children from urban communities in north-eastern Brazil. The case-control study included 166 children, who had their stools evaluated for the EAEC diagnostic genes (aaiC and aatA) using PCR. Positive samples were further analysed by multiplex PCR and identified 18 VRGs. EAEC was found in the same proportion in both groups (41 %). The plasmid-borne gene encoding a hexosyltransferase homologue (capU) was the most frequently detected (89.6 %), followed by dispersin protein (aap, 58.2 %) and EAEC HilA homologue (eilA, 57.8 %). The AAF/III fimbrial subunit (agg3A) gene was observed at lower frequency (1.5 %). Plasmid-encoded toxin (pet) or AAF/II fimbrial subunit (aafA) was associated significantly with disease. AAF/IV fimbrial subunit (agg4A) or hypothetical plasmid-encoded haemolysin (orf61) was detected significantly more in controls than in children with diarrhoea. In addition, one set of genes in combination, aaiC and agg3/4C but lacking agg4A and orf61, was associated with diarrhoea cases; and another one, orf61 in the absence of pet and aafA, was correlated with control children. These data confirm a high prevalence, endemicity and heterogeneity of EAEC strains in the developing urban areas of north-eastern Brazil. Statistical correlation between cases and controls was seen with either isolated or combined sets of genes, suggesting that the pathophysiology of EAEC infection involves a complex and dynamic modulation of several VRGs. Abbreviations: AAF, aggregative adherence fimbria; aai, aggR-activated island; aap, anti-aggregation protein gene; aatA, EAEC ABC transporter A gene; aggR, activator aggregative adherence regulator gene; CART, classification and regression tree; CI, confidence interval; EAEC, enteroaggregative Escherichia coli; OR, odds ratio; pet, plasmid-encoded toxin gene; sat, secreted autotransporter toxin gene; SPATE, serine protease autotransporter of Enterobacteriaceae; sigA, Shigella IgA-like protease homologue gene; VRG, virulence-related gene.
Revista da Sociedade Brasileira de Medicina Tropical, 2019
The aim of this study was to characterize the clinical-epidemiological profile of Chikungunya vir... more The aim of this study was to characterize the clinical-epidemiological profile of Chikungunya virus infection and the factors associated with hospitalization during the peak of the most recent epidemic period in Brazil (2016-2017). Methods: Two official databases of the State Health Secretariat of Ceará were used, and a total of 182,731 notifications were analyzed. Results: Independent factors associated with hospital admission were chronic kidney disease (OR 4.56, 95% CI 3.36-6.17), hypertension (OR 1.90, 95% CI 1.69-2.14), leukopenia (OR 1.89, 95% CI 1.56-2.30) and diabetes mellitus (OR 1.70, 95% CI 1.44-1.99). Conclusions: The pre-existing comorbidities have shown the potential to destabilize the patients' clinical status.
Journal of Pediatric Gastroenterology & Nutrition, 2017
Objective: We evaluated the impact of subclinical enteroaggregative Escherichia coli (EAEC) infec... more Objective: We evaluated the impact of subclinical enteroaggregative Escherichia coli (EAEC) infection alone and in combination with other pathogens in the first 6 months of life on child growth. Methods: Nondiarrheal samples from 1684 children across 8 Multisite Birth Cohort Study, Malnutrition and Enteric Diseases (MAL-ED) sites in Asia, Africa, and Latin America were tested monthly; more than 90% of children were followed-up twice weekly for the first 6 months of life. Results: Children with subclinical EAEC infection did not show altered growth between enrollment and 6 months. Conversely, EAEC coinfection with any other pathogen was negatively associated with delta weight-for-length (P < 0.05) and weight-for-age (P > 0.05) z scores between 0 and 6 months. The presence of 2 or more pathogens without EAEC was not significantly associated with delta weight-for-length and weight-for-age. The most frequent EAEC coinfections included Campylobacter spp, heat-labile toxin-producing...
Nephrology Dialysis Transplantation, 2016
The Lancet, 2016
Abbreviations used in this issue ANA = antinuclear antibody CIN3+ = cervical intraepithelial neop... more Abbreviations used in this issue ANA = antinuclear antibody CIN3+ = cervical intraepithelial neoplasia grade 3 or worse Comment: You may know that C. trachomatis is one of my very favourite bugs…It comes in a number of different colours and flavours and despite being supposedly genetically static, continues to enthral us with new and unexpected manifestations. One of these is anorectal LGV in men who have sex with men, which has been found sporadically in New Zealand. However, this paper describes an inguinal presentation of LGV in a heterosexual man with painful erythema nodosum on his lower legs as the primary complaint. It is clinically interesting because 1) it shows spread of LGV to the heterosexual community, and 2) by the secondary stage of the disease, the C. trachomatis DNA is no longer detectable in the urine, only in the fluid from the abscess. Borsje et al. therefore get the award for understatement of the year for their final discussion: "This case illustrates the fact that the diagnosis of LGV should also be entertained outside the usual context". Scary Maclary!
Nephrology Dialysis Transplantation, 2013
Introduction and Aims: Almost one-third of critically ill patients in intensive care units have a... more Introduction and Aims: Almost one-third of critically ill patients in intensive care units have acute kidney injury (AKI), predominantly due to acute tubular necrosis and as part of multiple organ failure. The optimal dialysis in these patients is still unclear. The purpose of the study is to compare clinical outcomes between intermittent hemofiltration and standard hemodialysis in this spesific population. Methods: The purpose of this prospective randomized controlled single centre clinical study was to compare mortality and recovery of kidney function between intermittent hemofiltration (HF) and hemodialysis (HD) in critically ill patients with AKI. From 2010 to 2012 we randomly assigned 86 patients with AKI to intermittent HF or HD. Death from any cause within 30 and 60 days were primary study outcomes. In subgroup of patients with in hospital recovery of kidney function time to kidney function recovery and the number of required dialysis procedures were analyzed. Results: Forty-four patients were given intermittent HF and 42 were given HD. The mean age (±SD) was 62.1±8.8 years. 72.5% of patients were male, 52.1% were oligouric and 60.2% required mechanical ventilation. The most attributed conditions in AKI were sepsis and ischaemia. The two groups had similar baseline characteristics and received treatment for an average of 10.2 days (HF) and 9.8 days (HD). Total all cause mortality by day 60 was 74.8% and was similar between the HF and the HD study groups. There were no significant differences between the groups in number of deaths at 30 and 60 days. Kidney function has recovered during hospitalization in 86 (39.8%) patients. In survivors at day 60 the two groups were similar for renal outcome. Conclusions: In this randomized, controlled clinical study,intermittant HF in critically ill patients with AKI does not improve survival or recovery of kidney function compared to standard intermittent HD. The optimal treatment modality in AKI in critically ill patients remains unclear and needs further studies.
The International Journal of Tuberculosis and Lung Disease, 2011
To evaluate the distribution of the Mycobacterium tuberculosis Beijing genotype and the associati... more To evaluate the distribution of the Mycobacterium tuberculosis Beijing genotype and the association of the genotype with drug-resistant M. tuberculosis strains in fi ve provinces in China. D E S I G N : M. tuberculosis strains (n = 158) isolated from fi ve provinces of China were subjected to insertion sequence 6110 restriction fragment length polymorphism (RFLP), spoligotyping and mycobacterial interspersed repetitive units (MIRU) analyses. The prevalence of the Beijing genotype strains in each province was determined and compared. The proportion method was used to test the drug susceptibility of all strains. R E S U LT: Of the 158 strains, 123 (77.8%) were identi-fi ed as the Beijing genotype by RFLP and spoligotyping. Nearly all the strains (n = 152, 96.2%) were grouped into 14 shared spoligotypes. Six other spoligotypes were unique to China. The prevalence of the Beijing genotype was signifi cantly higher in the interior than in coastal areas (P < 0.001, OR 5.4, 95%CI 2.3-12.7). Resistance to rifampicin (RMP) was associated with the Beijing strain (P < 0.05, OR 3.7, 95%CI 1.2-11.1). C O N C L U S I O N : The M. tuberculosis Beijing genotype varies in prevalence in different regions of China and is solely associated with RMP resistance.
Ciência & Saúde Coletiva
To estimate the prevalence of leprosy among Brazilian female prisoners and identify factors assoc... more To estimate the prevalence of leprosy among Brazilian female prisoners and identify factors associated with the disease. Cross-sectional study conducted between 2014 and 2015 in 15 Brazilian female prisons. The data of 1,327 women were collected using Audio Computer-Assisted Self-Interviewing and dermatological and neurological examination to identify suspicious lesions of leprosy. The average age was 33.4 years. Suspicion of leprosy was identified in 5.1% of women in prison, and lifetime self-reported prevalence was 7.5%. The variables that were associated with lifetime self-reported leprosy were: women in prison once being twice as likely to have leprosy; white women were 1.4 time more likely to have leprosy than non-white women; women who knew someone with leprosy was 1.9 time more likely to have leprosy; and women who shared a cell with 11 or more women were 2.5 times more likely to have leprosy than women who shared a cell with two or fewer people. The leprosy prevalence among ...
DOAJ (DOAJ: Directory of Open Access Journals), Aug 1, 2014
Background: This study was conducted to investigate factors associated with thrombocytopenia in a... more Background: This study was conducted to investigate factors associated with thrombocytopenia in a large cohort of patients with leptospirosis in an endemic area. Patients and Methods: This is a retrospective study including 374 consecutive patients with leptospirosis admitted to tertiary hospitals in Fortaleza, Brazil. All patients had diagnosis of leptospirosis, and acute kidney injury (AKI) was defined according to the RIFLE criteria. Thrombocytopenia was defined as platelets count lower than 100,000/mm3. Results: A total of 374 patients were included, with a mean age of 36.1±15.5 years, and 83.4% were male. Thrombocytopenia was present at hospital admission in 200 cases (53.5%) and developed during hospital stay in 150 cases (40.3%). Patients with thrombocytopenia had a higher frequency of dehydration (53% vs. 35.3%, p=0.001), epistaxis (5.7% vs. 0.8%, p=0.033), hematemesis (13% vs. 4.6%, p=0.006), myalgia (91.5% vs. 84.5%, p=0.038), hematuria (54.8% vs. 37.6%, p=0.011), metabolic acidosis (18% vs. 9.2%, p=0.016) and hypoalbuminemia (17.8% vs. 7.5%, p=0.005). Independent risk factors associated with thrombocytopenia during hospital stay were length of disease (OR: 1.2, p=0.001) and AKI (OR: 6.6, p=0.004). Mortality was not associated with thrombocytopenia at admission (12.5% vs. 12.6%, p=1.000) or during hospital stay (12.6% vs. 11.3%, p=0.748). Conclusions: Thrombocytopenia is a frequent complication in leptospirosis, which was present in more than half of patients at hospital admission. The length of disease and AKI are risk factors for thrombocytopenia. There was no significant association between thrombocytopenia and mortality. Advanced age and oliguria were independent risk factors for death.
Journal of Occupational Health, 2020
To estimate hypertension prevalence and associated factors among female correctional officers (FC... more To estimate hypertension prevalence and associated factors among female correctional officers (FCO) in female Brazilian prisons.
Ciência & Saúde Coletiva
Resumo Objetivou-se estimar a prevalência de hipertensão arterial (HA) e os fatores de risco asso... more Resumo Objetivou-se estimar a prevalência de hipertensão arterial (HA) e os fatores de risco associados em mulheres presas. Utilizou-se dados do Inquérito Nacional de Saúde na População Penitenciária Feminina e em Servidoras Prisionais, investigando-se características sociodemográficas, fatores das prisões, comportamentos e condições de saúde. As informações foram coletadas por meio de questionário autoaplicado, sendo a magnitude da associação estimada por odds ratio e intervalo de confiança de 95%. Das 1.327 participantes, 24,4% eram hipertensas, a maioria tinha 31 anos ou mais (54,6%), 51,5% autorreferiram etnia/cor parda. Após mutual ajustamento pelos fatores de risco associados na análise bivariada, observou-se relação direta e com gradiente entre idade e HA, em que idade igual/maior a 41 anos foi associada independentemente com uma chance sete vezes maior de ter HA, se comparado a quem tem menos de 25 anos. Aquelas que autorreferiram etnia/cor negra apresentaram colesterol alto...
Tropical Medicine and Infectious Disease, Apr 6, 2023
This article is an open access article distributed under the terms and conditions of the Creative... more This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY
Ciência & Saúde Coletiva
The majority of the women in prisons comes from the poorest strata of society with limited access... more The majority of the women in prisons comes from the poorest strata of society with limited access to education, income and health services. This contributes to the fact that female prisoners have a higher burden of adverse health events than both male prisoners and women in general population We objectived to estimate the prevalence of different morbidities and risk factors among female prisoners in Brazil. A total of 1,327 women were recruited in this cross-sectional study. Data were collected using a using audio computer-assisted self-interviewing questionnaire, rapid antibody tests and physical examination. The higher prevalences was of syphilis, infection sexually disease, arterial hypertense, asthma, common mental disorders and severe physical violence. Regarding risk factors, 36.3% have good knowledge about HIV, 55.8% were smokers, 72.3% had ever used any illicit drug, 92.1% are sedentary and 92.1% maintained an unhealthy diet. Female prisoners are disproportionately affected ...
Journal of the Association of Nurses in AIDS Care, 2020
Brazil has the third largest prison population in the world and is also experiencing a high and r... more Brazil has the third largest prison population in the world and is also experiencing a high and rising rate of syphilis infection. To establish the gaps in syphilis testing, we examined data from a nationally representative sample of incarcerated women in Brazil. Data originated from a cross-sectional survey designed to represent all regions of Brazil (N = 1,327). Data were collected by Audio Computer-Assisted Self-Interview, including variables in several blocks or domains. 49.2% had a lifetime history of being tested for syphilis. Increased likelihood of syphilis testing was significantly associated with completed elementary education (odds ratio ajustado [AOR] 1.75, 95% confidence interval [CI] 1.28–2.40), completed high school or more (AOR 2.04, 95% CI 1.36–3.06), income below minimum wage (AOR 1.46, 95% CI 1.10–1.94), homelessness (AOR 1.83, 95% CI 1.21–2.76), having heard of the female condom (AOR 1.92, 95% CI 1.25–2.95), received a condom in prison (AOR 1.56, 95% CI 1.11–2.21...
Transactions of The Royal Society of Tropical Medicine and Hygiene, 2021
Background Mycobacterium leprae was the first microorganism directly associated with a disease, h... more Background Mycobacterium leprae was the first microorganism directly associated with a disease, however, there are still important gaps in our understanding of transmission. Although household contacts are prioritized, there is evidence of the importance of extrahousehold contacts. The goal of this article is to contribute to our understanding of the transmission of leprosy ex-household. Methods We compare co-location data of 397 leprosy cases and 211 controls drawn from the Centro de Dermatologia Sanitária D. Libânia in Fortaleza, Brazil. We collected lifetime geolocation data related to residence, school attendance and workplace and developed novel methods to establish a critical distance (Rc) for exposure and evaluated the potential for transmission for residence, school and workplace. Results Our methods provide different threshold values of distance for residence, school and workplace. Residence networks demonstrate an Rc of about 500 m. Cases cluster in workplaces as well. Sch...
Revista Brasileira de Epidemiologia, 2019
Introduction: Discrimination based on sexual orientation can influence vulnerability to HIV, incr... more Introduction: Discrimination based on sexual orientation can influence vulnerability to HIV, increasing exposure to risky sexual behavior among men who have sex with men (MSM). Objectives: To analyze data using latent class analysis (LCA) to identify groups of individuals with specific patterns of discrimination based on sexual orientation (DSO). Methods: Cross-sectional study using respondent-driven sampling in 12 Brazilian cities in 2016. LCA was used to characterize discrimination among MSM based on 13 variables in the survey questionnaire. The proportions of men reporting DSO and other variables of interest were estimated using Gile’s Successive Sampling estimator. Results: Most MSM were young, single, had a religion, had a high school or college degree, black or brown skin color, and socioeconomic status classified as average. More than half of the participants reported that they had been discriminated against during the last 12 months due to their sexual orientation (65%), mor...
The Pediatric infectious disease journal, Jan 22, 2017
Malnutrition results in serious consequences for growth and cognitive development in children. We... more Malnutrition results in serious consequences for growth and cognitive development in children. We studied select child and maternal biological factors, socio-economic factors, enteric pathogenic burden, and gut function biomarkers in 402 children 6-24 months of age in North-eastern Brazil. In this prospective case-control study, not being fed colostrum (odds ratio [OR] = 3.29, 95% confidence interval [CI] 1.73-6.26), maternal age ≥18 years (OR = 1.88, 95% CI 1.10-3.22), and no electrical fan (OR = 2.46, 95% CI 1.22-4.96) or bicycle (OR = 1.80, 95% CI 1.10-2.95) in the household were positively associated, and higher birth weight (OR = 0.27, 95% CI 0.19-0.38), larger head circumference (OR = 0.74, 95% CI 0.66-0.82), and shortness of breath in the last two weeks (OR = 0.49, 95% CI 0.27-0.90) were negatively associated with malnutrition. Subclinical enteric pathogen infections were common, and enteroaggregative Escherichia coli infections were more prevalent in malnourished children (p...
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Papers by Rosa Maria Salani Mota