https://repositorio.ufms.br/handle/123456789/1840 2026-04-15T23:58:05Z https://repositorio.ufms.br/handle/123456789/14272 Título: PREVALÊNCIA DE ANTICORPOS CONTRA SARS-CoV-2 EM COMUNIDADES QUILOMBOLAS DE MATO GROSSO DO SUL, BRASIL Abstract: The COVID-19 pandemic exposed and exacerbated social inequalities in Brazil, particularly among traditional populations such as quilombolas. This study aimed to investigate the prevalence of antibodies against SARS-CoV-2 in two quilombola communities in the state of Mato Grosso do Sul, Brazil, as well as to analyze factors associated with viral exposure, vaccination status, and sociocultural health practices. This is an observational, cross-sectional, and analytical study with a quantitative approach, conducted between July and December 2023 in the communities of Furnas do Dionísio (Jaraguari/MS) and Tia Eva (Campo Grande/MS). Structured questionnaires were administered to collect sociodemographic and clinical data, as well as information on knowledge, attitudes, and practices related to COVID-19, in addition to performing rapid serological tests for antibody detection. A total of 84 volunteers participated, of whom 96.4% tested positive for anti-SARS-CoV-2 antibodies, indicating high viral circulation within these communities. Most participants (98.8%) had been vaccinated and no severe adverse events were reported. A notable use of traditional health practices was observed, such as phytotherapy, reported by 32% of participants, demonstrating the integration of traditional and biomedical knowledge. Data analysis indicates that the high seroprevalence is directly related to structural vulnerabilities, such as household crowding, limited access to healthcare services, and historical inequalities. These findings underscore the importance of implementing specific public policies that encompass not only vaccination, but also improvements in living conditions, access to information, and the promotion of integrative and culturally sensitive healthcare practices. It is concluded that, despite the effectiveness of the vaccination campaign in reducing severe cases and deaths, quilombola communities remain highly exposed to risks, requiring continuous epidemiological surveillance, strengthening of primary healthcare, and recognition of traditional knowledge as an ally in promoting collective health. Tipo: Dissertação 2025-01-01T00:00:00Z https://repositorio.ufms.br/handle/123456789/14205 Título: Diversidade genética e mecanismos de resistência antifúngica em isolados clínicos e ambientais de Aspergillusfumigatus Abstract: Aspergillosis is a group of opportunistic diseases resulting from the inhalation of conidia from fungi of the genus Aspergillus. Therapeutic management is challenging due to both diagnostic limitations and the emergence of isolates resistant to triazole antifungals, which is frequently associated with prolonged use in hospitalized patients. Furthermore, there are reports of resistant isolates infecting patients with no prior history of treatment, suggesting that resistance is acquired in the environment as a result of excessive fungal exposure to triazole pesticides used in agriculture. Compounding this scenario, there are few studies on the epidemiology of resistance in South America, particularly in Brazil, a country with significant agricultural activity and specifically in the state of Mato Grosso do Sul (MS).This study aimed to analyze the frequency of resistant clinical and environmental isolates of Aspergillus spp. in Mato Grosso do Sul, investigate mutations, understand the influence of specific mutations on resistance phenotypes, and determine the genetic similarity of resistant A. fumigatus isolates. Between 2022 and 2024, 86 clinical isolates and 67 atmospheric air isolates of Aspergillus spp. were recovered. Molecular species identification was performed by sequencing the β-tubulin and calmodulin genes. Species delimitation was based on the monophyly of clades obtained through phylogenetic analyses. Antifungal susceptibility testing was conducted via broth microdilution, following the EUCAST E.DEF 9.3.2 method, to determine the minimum inhibitory concentration (MIC). Sequencing of the cyp51A gene was performed on resistant A. fumigatus isolates, and microsatellite genotyping was used to assess the genetic relationship between them. CRISPR-Cas9 experiments were conducted to investigate the contribution of mutations to the resistance phenotype. Of the 84 A. fumigatus isolates, seven showed MIC values above the cutoff points, indicating resistance. Among these, one clinical isolate (CMMS 154) harboring the G138S mutation was resistant to voriconazole (4 mg/L) and itraconazole (>16 mg/L), and one environmental isolate (CMMS 321) with the G54A mutation was resistant to posaconazole (8 mg/L) and itraconazole (> 16 mg/L). Five other environmental isolates (CMMS 340 to 344), resistant only to the agrochemical tebuconazole, presented the non-silent M172V mutation in addition to four silent mutations and microsatellite analysis indicated they belong to the same genetic group. Isolates CMMS 154 and CMMS 321 clustered distinctly but near wild-type isolates. Validation of the M172V and silent mutations demonstrated that they contribute, in part, to reduced susceptibility to tebuconazole, but are not the sole resistance mechanism involved. The results suggest the possible circulation and expansion of environmental isolates under selective pressure from agricultural azoles in an important agro-industrial region of the Brazilian Midwest. Furthermore, the silent dissemination of different resistant environmental genotypes in urban and rural areas was evidenced, reinforcing the need for genomic monitoring of aspergillosis agents in South America. Tipo: Tese 2025-01-01T00:00:00Z https://repositorio.ufms.br/handle/123456789/14176 Título: PREVALÊNCIA E EVOLUÇÃO DE MICOSES PULMONARES E SISTÊMICAS EM PACIENTES COM AIDS E IMUNOSSUPRESSÃO GRAVE EM MATO GROSSO DO SUL Abstract: Pulmonary and systemic fungal diseases constitute a significant public health problem, especially in people living with HIV/AIDS (PLWHA) in advanced stages of immunosuppression. These infections present high morbidity and mortality, since they are frequently diagnosed and treated late or inadequately. This is due to nonspecific clinical manifestations, the unavailability of accurate diagnostic methods, and limited access to first-line antifungals. This study investigated the frequency and clinical evolution of cryptococcosis, histoplasmosis, pneumocystosis (PCP), chronic pulmonary aspergillosis (CPA), and paracoccidioidomycosis (PCM) in a cohort of 232 AIDS patients with CD4⁺ counts ≤ 200 cells/mm³ treated at a reference hospital in Mato Grosso do Sul. The sample was predominantly composed of men (68.5%) and people who self-identified as mixed-race or black (74.6%). Almost half had low levels of education (42.6%) and a monthly income equal to or less than one minimum wage (48.8%), highlighting significant social vulnerability. The median CD4⁺ cell count was 59.5 cells/mm³ and the median viral load was 4.56 log/mL, reflecting late diagnosis and/or immunological and virological failure. The overall mortality rate at six months was 15.9%, concentrated in the first weeks after admission, and a low rate of immunological recovery was observed among survivors. Cryptococcosis was diagnosed in 35 patients (15.1%), with a mortality rate of 20%. Headache (p=0.001), disorientation (p=0.003), and diplopia (p=0.002) were manifestations associated with its occurrence. PCP had a prevalence of 9.5% and a mortality rate of 22.7%, being diagnosed exclusively by clinical-radiological criteria and in patients with a recent HIV diagnosis. The predominant clinical manifestations were cough and dyspnea (p Tipo: Tese 2025-01-01T00:00:00Z https://repositorio.ufms.br/handle/123456789/14158 Título: PREVALÊNCIA DE INFECÇÃO POR HPV DE ALTO RISCO ONCOGÊNICO E LESÕES CERVICAIS EM MULHERES PRIVADAS DE LIBERDADE Abstract: Human papillomavirus (HPV) is a globally prevalent sexually transmitted infectious agent. Although sexual contact represents the primary route of transmission, HPV may also be transmitted through direct skin-to-skin, skin-to-mucosa, or mucosa-to-mucosa contact. More than 400 HPV types have been identified, of which only a subset are capable of infecting the anogenital tract. Based on oncogenic potential, HPV is classified as either low-risk (LR-HPV) or high-risk (HR-HPV). Persistent infection with HR-HPV types constitutes the principal etiological factor in the development of precursor lesions that may progress to cervical cancer, particularly when persistence coexists with biological, social, and behavioral risk factors. Cervical cancer is characterized by a slow progression, which facilitates early screening and diagnosis. Women deprived of liberty represent a population at heightened risk of HPV infection and, consequently, cervical neoplasia. The present study aimed to assess the prevalence of high-risk HPV infection and cervical lesions among incarcerated women. This cross-sectional, quantitative study was conducted between October and November 2023 in the women’s penitentiaries of Campo Grande and Três Lagoas, located in the state of Mato Grosso do Sul, Brazil. A total of 141 incarcerated women were interviewed, and cervical cell samples were subsequently collected. Liquid-based cytology samples were processed using TPK-Fênix (Kolplast®) equipment, and HPV DNA detection and genotyping were performed using the Cobas HPV Test® (Roche Molecular Systems, Inc., Branchburg, NJ, USA). Data were stored on the REDCap (Research Electronic Data Capture) platform and later exported for statistical analysis in R software (version 4.4.0). Descriptive analyses of categorical and continuous variables were conducted, with results presented as absolute and relative frequencies. Associations between variables were examined using the chi-square test or Fisher’s exact test, as appropriate, with statistical significance defined as p < 0.05. Results were expressed as odds ratios (OR) and 95% confidence intervals (95% CI). The prevalence of cytological abnormalities was 44.7% (95% CI: 36.5%–52.9%), while the prevalence of HR-HPV infection was 23.4% (95% CI: 16.4%–30.4%). The presence of other microorganisms (OR = 3.16; 95% CI: 1.22–8.11) and HR-HPV positivity (OR = 5.03; 95% CI: 3.68–8.82) were independently associated with cytological alterations. These findings indicate that incarcerated women exhibit a substantially higher prevalence of HR-HPV infection and pre-neoplastic cervical lesions compared with women in the general population. Given the distinct epidemiological profile of this population, they are more susceptible to HR-HPV infection and its related outcomes. The results underscore the urgent need to strengthen and implement comprehensive measures for screening, prevention, treatment, and follow-up, with the objective of reducing HPV-related disease burden in this vulnerable group. Tipo: Tese 2025-01-01T00:00:00Z