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PCR screening of tick-borne agents in sensitive conservation areas, Southeast Portugal

Publication . Santos-Silva, M.M.; Melo, P.; Santos, N.; Antunes, S.; Duarte, L.R.; Ferrolho, J.; Milhano, N.; Santos, P.T.; Domingos, A.; Santos, A.S.

The Southeast region of Portugal, particularly the Guadiana valley, is currently the reintroduction territory of Lynx pardinus (Iberian lynx), one of the most endangered felids in the world that is only found in the Iberian Peninsula. Over the last century, populations have declined, placing L. pardinus at extremely high risk of extinction in the wild and relying on reintroduction projects. Among the aspects taken into account in the establishment of new populations is the sanitary status of the selected habitats, especially concerning infectious diseases, including tick-borne pathogens (TBPs). This study presents the results of TBPs survey on ticks collected at sensitive conservation areas of Southeast Portugal. From 2012 to 2014, 231 ticks obtained from vegetation, sympatric domestic and wild animals were submitted for analysis. The presence of Babesia spp., Cytauxzoon spp., Theileria spp., Hepatozoon spp., Anaplasma spp., Ehrlichia spp., Candidatus Neoehrlichia mikurensis, among other Anaplasmataceae, and Coxiella burnetii were investigated by PCR. Six tick species were recorded, Dermacentor marginatus (n = 13/5.6%), Hyalomma lusitanicum (n = 175/75.8%), Ixodes ricinus (n = 4/1.7%), Rhipicephalus bursa (n = 7/3.0%), R. pusillus (n = 21/9.1%) and R. sanguineus sensu lato (n = 11/4.8%). The molecular screening confirmed the presence of two tick-borne pathogens, C. burnetii (N = 34) and Anaplasma platys (N = 1), and one tick-endosymbiont, Candidatus Midichloria mitochondrii (N = 45). The results obtained provide new information on the circulation of ticks and TBPs with potential veterinary importance in Iberian lynx habitat.

2016-11Journal article

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Insights on the Mycobacterium tuberculosis population structure associated with migrants from Portuguese-speaking countries over a three-year period in greater Lisbon, Portugal: Implications at the public health level

Publication . Pereira, Catarina; Gomes, Pedro; Taveira, Ricardo; Silva, Carla; Maltez, Fernando; Macedo, Rita; Costa, Catarina; Couvin, David; Rastogi, Nalin; Viveiros, Miguel; Perdigão, João; Portugal, Isabel

Tuberculosis among foreign-born patients is a key indicator of country-level epidemiological profiles and, of an increasing concern in Europe given the more intensified migratory waves of refugees. Since Portugal presents a lower immigrant-associated TB incidence rate when compared to other European countries, we sought to characterize the epidemiology and transmission dynamics among the foreign-born population coming from Portuguese-speaking countries that are associated with higher TB incidences. In the present study we analyzed 133 Mycobacterium tuberculosis isolates obtained from foreign-born individuals over a three-year period in Lisbon, Portugal, using molecular epidemiological methods such as spoligotyping and 24-loci MIRU-VNTR. Moreover, all strains were subjected to drug susceptibility testing. The genetic profiles obtained suggest that strain importation from Portuguese speaking countries plays a less important role in TB epidemiology but instead argue in favor of a high degree of penetrance of Portuguese endemic strains to the migrant population, including multidrug resistant strains, which is particularly relevant to active screening programs.

2019-03-27Journal article

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Tuberculosis care for migrant patients in Portugal: a mixed methods study with primary healthcare providers

Publication . Tavares, Ana Maria; Garcia, Ana Cristina; Gama, Ana; Abecassis, Ana B.; Viveiros, Miguel; Dias, Sónia

Background: Tuberculosis (TB) is still a major global health problem. The increasing number of cases observed among foreign-born populations contrasts with the decreasing trends observed in later years in some high-income countries. Healthcare providers are key interveners in the control of TB and HIV-TB infections. In this study, we aimed to explore the perspectives of healthcare providers working in primary care in Portugal about the provision of TB care for migrant patients with TB or HIV-TB co-infection. Methods: We applied a mixed-methods approach using an online survey and semi-structured interviews with primary healthcare providers. A total of 120 Portuguese healthcare providers participated in the survey, and 17 were interviewed. Survey and interview data were analysed applying descriptive statistics and thematic analysis, respectively. Results: Migrants' lack of knowledge on TB disease and its symptoms was the main reason for advanced-stage presentation of cases. Their high mobility and social isolation affect adherence to treatment. The providers also listed several barriers to migrants' access and use of TB care. The most frequently referred were limited socioeconomic resources, complex bureaucracy at the point of access and registration for healthcare services, especially for undocumented migrants, and obstacles for social protection. Providers also advocated more training initiatives on migrants' health, social and cultural contexts, on HIV and TB integrated care, and on TB scientific update for general practitioners and nurses working at primary healthcare centres. Conclusions: Future efforts should provide measures to overcome social, economic and administrative obstacles to care for TB-infected migrants, and promote regular training initiatives for national healthcare providers in order to raise awareness and facilitate better care to culturally diverse populations with TB.

2019-04-18Journal article

Open access

Molecular heterogeneity of Rhipicephalus sanguineus sensu lato and screening for Ehrlichia canis in mainland Portugal

Publication . Santos, G.S.; Couto, J.; Silva-Perdosa, R.; Ferrolho, J.; Santos, A.S.; Santos-Silva, M.M.; Antunes, S.; Domingos, A.

The present study aimed to expand knowledge regarding the molecular characterization of R. sanguineus s.l. in Portugal and to screen for ticks naturally infected with E. canis. A total of 113 R. sanguineus s.l. were collected questing or attached to domestic and wild animals from the 18 administrative regions of mainland Portugal. All the ticks were analyzed for the 16S rRNA and the partial sequences obtained showed high genetic similarities with specimens belonging to the temperate lineage. These sequences revealed eight haplotypes (H1‒H8), with a genetic distance ranging from 0.3% to 1.4%. A convenience sample representing approximately 75% of all the R. sanguineus s.l. ticks collected was tested for the presence of E. canis by qPCR for the dsb gene. No ticks were found to be infected with this pathogen. Accordingly, further studies are required to determine the role of the R. sanguineus s.l. temperate lineage in E. canis maintenance and transmission, as well as to elucidate if a different R. sanguineus s.l. lineage or other tick species act as E. canis vectors for dogs in Portugal.

2018-09Journal article

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