RESUMO
Current diagnosis of malaria is based on the combined and sequential use of rapid antigen detection tests (RDT) of Plasmodium and subsequent visualization of the parasite stained with Giemsa solution in a thin and thick blood smears. If an expert microscopist is not available, should always be a sensitive RDT to rule out infection by Plasmodium falciparum, output the result immediately and prepare thick smears (air dried) and thin extensions (fixed with methanol) for subsequent staining and review by an expert microscopist. The RDT should be used as an initial screening test, but should not replace microscopy techniques, which should be done in parallel. The diagnosis of malaria should be performed immediately after clinical suspicion. The delay in laboratory diagnosis (greater than 3 hours) should not prevent the initiation of empirical antimalarial treatment if the probability of malaria is high. If the first microscopic examination and RDT are negative, they must be repeated daily in patients with high suspicion. If suspicion remains after three negative results must be sought the opinion of an tropical diseases expert. Genomic amplification methods (PCR) are useful as confirmation of microscopic diagnosis, to characterize mixed infections undetectable by other methods, and to diagnose asymptomatic infections with submicroscopic parasitaemia.
Assuntos
Malária/diagnóstico , Antígenos de Protozoários/análise , Diagnóstico Precoce , Ensaio de Imunoadsorção Enzimática , Reações Falso-Negativas , Humanos , Malária/parasitologia , Parasitemia/diagnóstico , Parasitemia/parasitologia , Plasmodium/imunologia , Plasmodium/isolamento & purificação , Reação em Cadeia da Polimerase/métodos , Testes Sorológicos/métodos , Coloração e Rotulagem/métodos , ViagemRESUMO
Microscopy and rapid diagnostic tests (RDTs) are the techniques commonly used for malaria diagnosis but they are usually insensitive at very low levels of parasitemia. Nested PCR is commonly used as a reference technique in the diagnosis of malaria due to its high sensitivity and specificity. However, it is a cumbersome assay only available in reference centers. We evaluated a new nested PCR-based assay, BIOMALAR kit (Biotools B&M Labs, Madrid, Spain) which employs ready-to-use gelled reagents and allows the identification of the main four species of Plasmodium. Blood samples were obtained from patients with clinical suspicion of malaria. A total of 94 subjects were studied. Fifty-two (55.3%) of them were malaria-infected subjects corresponding to 48 cases of Plasmodium falciparum, 1 Plasmodium malariae, 2 Plasmodium vivax, and 1 Plasmodium ovale. The performance of the BIOMALAR test was compared with microscopy, rapid diagnostic test (RDT) (BinaxNOW® Malaria) and real-time quantitative PCR (qPCR). The BIOMALAR test showed a sensitivity of 98.1% (95% confidence interval [CI], 89.7-100), superior to microscopy (82.7% [95% CI, 69.7-91.8]) and RDT (94.2% [95% CI, 84.1-98.8]) and similar to qPCR (100% [95% CI, 93.2-100]). In terms of specificity, the BIOMALAR assay showed the same value as microscopy and qPCR (100% [95% CI, 93.2-100]). Nine subjects were submicroscopic carriers of malaria. The BIOMALAR test identified almost all of them (8/9) in comparison with RDT (6/9) and microscopy (0/9). In conclusion, the BIOMALAR is a PCR-based assay easy to use with an excellent performance and especially useful for diagnosis submicroscopic malaria.
Assuntos
Malária/diagnóstico , Plasmodium falciparum/genética , Plasmodium malariae/genética , Plasmodium ovale/genética , Plasmodium vivax/genética , Reação em Cadeia da Polimerase/métodos , Adulto , Estudos de Casos e Controles , Testes Diagnósticos de Rotina , Feminino , Genes de RNAr , Humanos , Malária/parasitologia , Masculino , Microscopia , Pessoa de Meia-Idade , Plasmodium falciparum/isolamento & purificação , Plasmodium malariae/isolamento & purificação , Plasmodium ovale/isolamento & purificação , Plasmodium vivax/isolamento & purificação , RNA Ribossômico 18S/genética , Sensibilidade e Especificidade , ViagemRESUMO
BACKGROUND: Submicroscopic malaria (SMM) can be defined as low-density infections of Plasmodium that are unlikely to be detected by conventional microscopy. Such submicroscopic infections only occasionally cause acute disease, but they are capable of infecting mosquitoes and contributing to transmission. This entity is frequent in endemic countries; however, little is known about imported SMM.The goals of this study were two-fold: a) to know the frequency of imported SMM, and b) to describe epidemiological, laboratorial and clinical features of imported SMM. METHODS: A retrospective study based on review of medical records was performed. The study population consisted of patients older than 15 years attended at the Tropical Medicine Unit of Hospital Carlos III, between January 1, 2002 and December 31, 2007. Routinely detection techniques for Plasmodium included Field staining and microscopic examination through thick and thin blood smear. A semi-nested multiplex malaria PCR was used to diagnose or to confirm cases with low parasitaemia. RESULTS: SMM was diagnosed in 104 cases, representing 35.5% of all malaria cases. Mean age (IC95%) was 40.38 years (37.41-43.34), and sex distribution was similar. Most cases were in immigrants, but some cases were found in travellers. Equatorial Guinea was the main country where infection was acquired (81.7%). Symptoms were present only in 28.8% of all SMM cases, mainly asthenia (73.3% of symptomatic patients), fever (60%) and arthromialgias (53.3%). The associated laboratory abnormalities were anaemia (27.9%), leukopaenia (15.4%) and thrombopaenia (15.4%). Co-morbidity was described in 75 cases (72.1%). CONCLUSIONS: Results from this study suggest that imported SMM should be considered in some patients attended at Tropical Medicine Units. Although it is usually asymptomatic, it may be responsible of fever, or laboratory abnormalities in patients coming from endemic areas. The possibility of transmission in SMM has been previously described in endemic zones, and presence of vector in Europe has also been reported. Implementation of molecular tests in all asymptomatic individuals coming from endemic area is not economically feasible. So re-emergence of malaria (Plasmodium vivax) in Europe may be speculated.
Assuntos
Doenças Assintomáticas/epidemiologia , Malária/diagnóstico , Malária/epidemiologia , Plasmodium/isolamento & purificação , Adulto , Idoso , Técnicas de Laboratório Clínico/métodos , Emigração e Imigração , Feminino , Humanos , Malária/parasitologia , Malária/patologia , Masculino , Microscopia/métodos , Pessoa de Meia-Idade , Reação em Cadeia da Polimerase Multiplex/métodos , Parasitologia/métodos , Reação em Cadeia da Polimerase/métodos , Estudos Retrospectivos , Espanha , ViagemRESUMO
BACKGROUND: The diagnostic approach to eosinophilia is complex, given the numerous reported etiologies. Intestinal parasites (especially helminths) are a concern in children from high-burden settings. We describe the diagnostic approach and clinical management of eosinophilia in a cohort of migrant children. METHODS: We conducted a retrospective observational study that included children diagnosed with eosinophilia at a reference center for pediatric tropical diseases from 2014 to 2018. All patients were screened according to a unified protocol, including direct microbiologic and serologic tests. RESULTS: A total of 163 children presented with eosinophilia during the study period [median age, 7.7 years (4.1-12.2); 57.1% boys], mostly from Asia (27.6%) and South America (22.1%). Most were internationally adopted children (43.6%) or migrants (26.4%). Only 34.4% of the children were symptomatic, and the main etiology for eosinophilia was helminths (56.4%). After a sequential diagnostic approach, no etiology was found for 40.5% of the patients. The independent risk factors for an unexplained etiology were younger age (≤2 years: odds ratio, 3.6; 95% CI, 1.3-10.2; P = 0.015), absence of symptoms (odds ratio, 4.8; 95% CI, 1.8-12.5; P = 0.001) and mild eosinophilia (<1000/µL: odds ratio, 4.2; 95% CI, 4.5-11.7; P = 0.005). Only 6 children were treated empirically. In those children with an identified cause and in those treated empirically, the eosinophilia resolved in 52% in a median of 7 months (5-9). CONCLUSIONS: Helminths are the main cause of eosinophilia in migrant children and need to be hunted, especially in older children with eosinophil counts >1000 eosinophils/µL.
Assuntos
Eosinofilia , Helmintíase , Migrantes/estatística & dados numéricos , Adolescente , Criança , Pré-Escolar , Eosinofilia/epidemiologia , Eosinofilia/parasitologia , Feminino , Helmintíase/complicações , Helmintíase/epidemiologia , Humanos , Lactente , Masculino , Estudos RetrospectivosRESUMO
BACKGROUND: Globalization has pushed population movements in the last decades, turning imported diseases into the focus. Due to behavioral habits, children are at higher risk of acquiring parasitosis. This study aims to investigate the prevalence of parasites in migrant children and factors associated with parasitic diseases. METHOD: Retrospective cross-sectional study (2014-2018) including children diagnosed with parasitosis. The diagnosis was based on serology and/or microscopic stool-sample evaluation. Epidemiological and clinical data were recorded. RESULTS: Out of 813 migrant children screened, 241 (29.6%) presented at least one parasite, and 89 (10.9%) more than one. The median age was 6.6 years (IQR: 3.1-11.9) and 58.9% were males. Most cases were referred for a health exam; only 52.3% of children were symptomatic, but 43.6% had eosinophilia. The most common diagnosis were giardiasis (35.3%), schistosomiasis (19.1%), toxocariasis (15.4%), and strongyloidiasis (9.1%). After the multivariate analysis, African origin and presenting with eosinophilia were the main risk factors for parasitism. CONCLUSIONS: parasitosis are frequent among migrant children. Children are often asymptomatic, and thus active screening for parasitosis should be considered among high-risk populations. Eosinophilia can be useful to guide complimentary tests, as well as geographical origin, but normal eosinophil count does not exclude parasitosis.
Assuntos
Eosinofilia , Parasitos , Doenças Parasitárias , Migrantes , Animais , Criança , Estudos Transversais , Eosinofilia/parasitologia , Feminino , Humanos , Masculino , Doenças Parasitárias/epidemiologia , Prevalência , Estudos RetrospectivosRESUMO
INTRODUCTION: To assess and compare the performance of two immunochromatographic tests for the simultaneous detection of Giardia duodenalis and Cryptosporidium spp. in faeces. MATERIALS AND METHODS: In this study 254 faeces samples were tested using the two immunochromatography strips Cryto-Giardia (CerTest Biotec) and Stick Crypto-Giardia (Operon). RESULTS: In the diagnosis of G. duodenalis, the sensitivity and specificity of the kits were 97% and 100%, respectively for the CerTest; and 97% and 95% for Operon. In the diagnosis of Cryptosporidium spp. Certest strip rendering a sensitivity of 100%, compared to with a sensitivity of 92% using Operon. There were no false positives using either technique. CONCLUSIONS: Both methods yielded good sensitivity and specificity values and are thus useful tools for a rapid diagnosis of G. duodenalis and Cryptosporidium spp. The benefits of immunochromatography methods are that there is no requirement for expert microscopists or special equipment.
Assuntos
Cromatografia/métodos , Criptosporidiose/diagnóstico , Cryptosporidium/isolamento & purificação , Giardia lamblia/isolamento & purificação , Giardíase/diagnóstico , Testes Imunológicos/métodos , Fitas Reagentes , Adolescente , Adulto , Idoso , Criança , Pré-Escolar , Comorbidade , Criptosporidiose/epidemiologia , Criptosporidiose/parasitologia , Cryptosporidium/imunologia , DNA de Protozoário/análise , Feminino , Giardia lamblia/imunologia , Giardíase/epidemiologia , Giardíase/parasitologia , Infecções por HIV/epidemiologia , Humanos , Lactente , Masculino , Pessoa de Meia-Idade , Oocistos/ultraestrutura , Reação em Cadeia da Polimerase , Sensibilidade e Especificidade , Coloração e Rotulagem , Adulto JovemRESUMO
BACKGROUND: Mansonella perstans infection can be considered one of the most neglected tropical infectious diseases. Very few studies have reported on the clinical picture caused by infection with this nematode. Therefore, our study was aimed to describe the clinical patterns and treatment of imported M. perstans infection by migrants from Africa. METHODS: The present study evaluated a large cohort of migrants who have been diagnosed, examined and treated for imported M. perstans infection at a Spanish reference center (Hospital Carlos III Tropical Medicine Unit, Madrid, Spain) over a 19-year period. Most patients voluntarily attend the emergency unit or are referred from primary care or general hospitals in Madrid. Chi-square test was used to compare the association between categorical variables. The continuous variables were compared by Student's t-test or the Mann-Whitney test. The corresponding regression models were used for multivariate analysis. RESULTS: Five hundred three cases of migrants from tropical and subtropical areas with M. perstans infection were identified. Two hundred sixty-four patients were female (52.5%). The mean age (± SD) was 44.6 ± 18.2 years (range: 16-93 years). The mean time (± SD) between the arrival in Spain and the first consultation was 8.6 ± 18.0 months. The major origin of the patients was Equatorial Guinea (97.6%). Regarding the clinical picture, 257 patients were asymptomatic (54.7%) and 228 were symptomatic (45.3%); 190 patients had pruritus (37.8%), 50 (9.9%) had arthralgia, 18 patients had Calabar-like swelling (3.6%), and 15 (3%) had abdominal pain. Four hundred forty-two (87.9%) migrants had hyper-IgE, and 340 (67.6%) had eosinophilia. One hundred ninety-five patients had coinfections with other filarial nematodes (38.8%), and 308 migrants had only M. perstans infection (61.2%). Four hundred thirty-seven cases (86.9%) had been treated with anti-filarial drugs; 292 cases were treated with one anti-filarial drug, and 145 cases were treated with combined anti-filarial therapy. Additionally, 20 (4%) cases received steroids and 38 (7.6%) cases received antihistamines. CONCLUSIONS: A long series of M. perstans infections is presented in sub-Saharan immigrants whose data indicate that it should be included in the differential diagnosis in patients with pruritus or analytical alterations such as eosinophilia or hyper-IgE presentation, and they also have a high number of coinfections with other microorganisms whose treatment needs to be protocolized.
Assuntos
Doenças Transmissíveis Importadas/epidemiologia , Doenças Transmissíveis Importadas/parasitologia , Mansonelose/epidemiologia , Adolescente , Adulto , África , Idoso , Idoso de 80 Anos ou mais , Animais , Antiparasitários/uso terapêutico , Feminino , Humanos , Masculino , Mansonella/isolamento & purificação , Mansonelose/tratamento farmacológico , Pessoa de Meia-Idade , Espanha/epidemiologia , Migrantes , Resultado do Tratamento , Adulto JovemRESUMO
BACKGROUND: Loiasis is an uncommon and poorly understood parasitic disease outside endemic areas of Africa. The aim of this study was to describe the clinical and biological patterns and treatment of imported loiasis by sub-Saharan migrants diagnosed in Madrid, Spain. METHODS: A retrospective study was conducted with sub-Saharan immigrants seen at the Tropical Medicine Unit of the Carlos III Hospital in Madrid, Spain, a reference center, over 19 years. Categorical variables were expressed as frequency counts and percentages. Continuous variables were expressed as the mean and standard deviation (SD) or median and interquartile range (IQR: Q3-Q1). Chi-square tests were used to assess the association between categorical variables. The measured outcomes were expressed as the odds ratio (OR) with a 95% confidential interval. Continuous variables were compared by Student's t-tests or Mann-Whitney U tests. Binary logistic regression models were used. P < 0.05 was considered a statistically significant difference. RESULTS: One hundred thirty-one migrants from tropical and subtropical areas with loiasis were identified. Forty-nine patients were male (37.4%). The migrants' mean age (±SD) was 42.3 ± 17.3 years, and 124 (94.7%) were from Equatorial Guinea. The median time (IQR) between arrival in Spain and the first consultation was 2 (1-7) months. One hundred fifteen migrants had eosinophilia, and one hundred thirteen had hyper-IgE syndrome. Fifty-seven patients had pruritus (43.5%), and thirty patients had Calabar swelling (22.9%). Seventy-three patients had coinfections with other filarial nematodes (54.2%), and 58 migrants had only Loa loa infections (45.8%). One hundred two patients (77.9%) were treated; 45.1% (46/102) patients were treated with one drug, and 54.9% (56/102) patients were treated with combined therapy. Adverse reactions were described in 14 (10.7%) migrants. CONCLUSIONS: Our patients presented early clinical manifestations and few atypical features. Thus, physicians should systematically consider loiasis in migrants with a typical presentation. However, considering that 72.5% of the patients had only positive microfilaremia without any symptoms, we suggest searching for microfilaremia in every migrant from endemic countries for loiasis presenting with eosinophilia.
Assuntos
Loíase/epidemiologia , Adulto , Idoso , Anti-Helmínticos/uso terapêutico , Eosinofilia/diagnóstico , Eosinofilia/epidemiologia , Eosinofilia/etiologia , Guiné Equatorial/etnologia , Feminino , Humanos , Loíase/diagnóstico , Loíase/tratamento farmacológico , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Espanha/epidemiologia , Migrantes , Adulto JovemRESUMO
INTRODUCTION: Onchocerciasis is caused by Onchocerca volvulus and mainly leads to pruritus and skin and visual disorders, including blindness. Seventeen million people are infected in 38 countries; 31 of these are in sub-Saharan Africa, six in Latin America and one on the Arabian Peninsula. More than 99% of cases occur in sub-Saharan Africa where 120 million people are at risk of infection. Eye disorders have been well-documented; however, skin disorders have not been described accurately. The objective of our study was to describe the epidemiology, main skin manifestations and treatment of imported onchocerciasis. MATERIAL AND METHODS: A retrospective study was thus conducted by analysing the main demographic, clinical and treatment data regarding a cohort of 400 patients attending a reference clinical unit over a 17-year period. RESULTS: Most patients were female (55%) with mean age 37.5±16.7 years. All the migrants came from sub-Saharan countries. The most frequently occurring dermatological symptom was pruritus. Ivermectin had been used as first-line therapy and adverse reactions had been described in 11 patients (3.2%). CONCLUSIONS: The results indicate the fact that there should be a clinical suspicion of onchocerciasis regarding immigrants from endemic areas having skin lesions compatible with the disease's profile or asymptomatic patients having eosinophilia or unexplained high IgE. Moreover, skin snips from the buttocks region were very fruitful and treatment with ivermectin was seen to be safe. This is the largest case series regarding imported onchocerciasis described up to the present time.
Assuntos
Doenças Transmissíveis Importadas , Oncocercose , Dermatopatias Parasitárias , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Doenças Transmissíveis Importadas/diagnóstico , Doenças Transmissíveis Importadas/tratamento farmacológico , Doenças Transmissíveis Importadas/epidemiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Oncocercose/diagnóstico , Oncocercose/tratamento farmacológico , Oncocercose/epidemiologia , Estudos Retrospectivos , Dermatopatias Parasitárias/diagnóstico , Dermatopatias Parasitárias/tratamento farmacológico , Dermatopatias Parasitárias/epidemiologia , Adulto JovemRESUMO
Epidemiological data on dengue in Africa are still scarce. We investigated imported dengue infection among travelers with a high proportion of subjects from Africa over a 9-year period. From January 2005 to December 2013, blood samples from travelers with clinical suspicion of dengue were analyzed. Dengue was diagnosed using serological, antigen detection, and molecular methods. Subjects were classified according to birthplace (Europeans versus non-Europeans) and last country visited. Overall, 10,307 serum samples corresponding to 8,295 patients were studied; 62% were European travelers, most of them from Spain, and 35.9% were non-Europeans, the majority of whom were born in Africa (mainly Equatorial Guinea) and Latin America (mainly Bolivia, Ecuador, and Colombia). A total of 492 cases of dengue were identified, the highest number of cases corresponding to subjects who had traveled from Africa (N = 189), followed by Latin America (N = 174) and Asia (N = 113). The rate of cases for Africa (4.5%) was inferior to Asia (9%) and Latin America (6.1%). Three peaks of dengue were found (2007, 2010, and 2013) which correlated with African cases. A total of 2,157 of past dengue infections were diagnosed. Non-Europeans who had traveled from Africa had the highest rate of past infection (67.8%), compared with non-Europeans traveling from Latin America (38.7%) or Asia (35%). Dengue infection in certain regions of Africa is underreported and the burden of the disease may have a magnitude similar to endemic countries in Latin America. It is necessary to consider dengue in the differential diagnosis of other febrile diseases in Africa.
Assuntos
Dengue/etnologia , Viagem , Adolescente , Adulto , África/etnologia , Idoso , Idoso de 80 Anos ou mais , Anticorpos Antivirais/sangue , Antígenos Virais/sangue , Criança , Pré-Escolar , Dengue/diagnóstico , Vírus da Dengue/isolamento & purificação , Humanos , Imunoglobulina M/sangue , Lactente , América Latina/etnologia , Pessoa de Meia-Idade , Estudos Retrospectivos , Espanha/epidemiologia , Adulto JovemRESUMO
BACKGROUND: Cyclosporiasis is a disease due to Cyclospora cayetanensis, an emerging coccidian parasite first described in 1979. It is an orally transmitted disease that is more frequent in tropical and subtropical areas. Cyclospora cayetanensis has been mainly described as a cause of travelers' diarrhea. This pathogen has given rise to a number of epidemic outbreaks attributable to ingestion of imported foods, particularly from tropical areas. METHODS: Descriptive study of clinical and epidemiological data of a small epidemic outbreak of C cayetanensis-induced gastroenteritis. RESULTS: Seven confirmed cases of C cayetanensis among Spanish nationals who had traveled to Antigua Guatemala are described. The incubation period was 6 days. Diarrhea, asthenia, anorexia, borborygmi, flatulence, and abdominal distension were present in all cases. Fever and heart burn in 85.7%. Weight loss in 71.4%. Abdominal pain, rectal tenesmus, and nausea in 42.8%. Vomiting and eructation in 14.2%. Heart burn was a frequent symptom, a finding not often previously described. The infection was probably acquired from raspberry juice. All cases improved with trimethoprim/sulphametoxazol. CONCLUSIONS: Cyclosporiasis is a cause of travelers' diarrhea. Parasitology laboratories must be advised of clinical suspicion of cyclosporiasis so that they can conduct a suitable targeted study; otherwise, false negative results may arise.
Assuntos
Ciclosporíase/epidemiologia , Surtos de Doenças , Gastroenterite/epidemiologia , Viagem , Adulto , Animais , Cyclospora/isolamento & purificação , Ciclosporíase/etiologia , Fezes/parasitologia , Feminino , Gastroenterite/etiologia , Guatemala/epidemiologia , Humanos , MasculinoAssuntos
COVID-19/parasitologia , Coinfecção/diagnóstico , Strongyloides stercoralis/isolamento & purificação , Estrongiloidíase/diagnóstico , Corticosteroides/uso terapêutico , Animais , COVID-19/diagnóstico , COVID-19/terapia , Coinfecção/parasitologia , Coinfecção/virologia , Fezes/parasitologia , Humanos , Larva , Masculino , Pessoa de Meia-Idade , Testes Sorológicos , Estrongiloidíase/tratamento farmacológico , Estrongiloidíase/virologiaRESUMO
Automated light depolarization analysis could be a useful tool for diagnosing malarial infections. This work discusses the results of a diagnostic efficacy study on 411 samples from patients with suspected malaria infection performed with a Cell-Dyn 4000 analyser. Light dispersed at 90 degrees and depolarized can be used for identifying and counting eosinophils. However, other cell populations with depolarizing capacity occur in malarial samples; these result from leukocytes ingesting haemozoin that is derived from the degradation of the haem group of haemoglobin performed by the parasite. A sensitivity of 72 % and specificity of 98 % were recorded, with positive and negative predictive values of 78 % and 97 %, respectively. Although the sensitivity level of the automated light depolarization analysis is not adequate to replace the existing methods for the diagnosis of parasitic diseases, it could alert clinicians to unsuspected infections by parasites, particularly those from the genus Plasmodium.
Assuntos
Malária/diagnóstico , Parasitemia/diagnóstico , Plasmodium/isolamento & purificação , Adulto , Animais , Contagem de Células Sanguíneas , Pré-Escolar , Hemeproteínas , Humanos , Lasers , Luz , Malária/sangue , Microscopia de Polarização/métodos , Pigmentos Biológicos , Sensibilidade e EspecificidadeRESUMO
BACKGROUND: Infestation by intestinal parasites could be a cause of a false-negative tuberculin skin test (TST) result. OBJECTIVE: To evaluate TST results in a population of immigrants and internationally adopted children and to analyze whether intestinal parasitic infestation may modify or not TST results. METHODS: A cross-sectional observational study which includes adopted children or immigrants evaluated in our hospital between January 2003 and December 2008. The TST was considered as the dependent variable and independent variables were gender, age, geographical origin, bacille Calmette-Guérin scar, nutritional status, immune status, and intestinal parasitism. RESULTS: One thousand and seventy-four children were included, of whom 69·6% were female. There was a bacillus Calmette-Guérin scar in 79% of the children and in 20·3% intestinal parasites were found. There were no differences in TST results among infested and non-infested children. CONCLUSIONS: Intestinal parasitic infestation did not change TST results in our study and these results coincide with recent articles regarding questionable interference that intestinal parasitic infestations may produce on TST results.
Assuntos
Reações Falso-Negativas , Helmintíase/imunologia , Enteropatias/imunologia , Teste Tuberculínico , Tuberculose/diagnóstico , Tuberculose/prevenção & controle , Adolescente , Criança , Pré-Escolar , Estudos Transversais , Feminino , Humanos , Lactente , Enteropatias Parasitárias , Masculino , Testes Cutâneos , Tuberculose/imunologiaRESUMO
Initially described in travelers, outbreaks of cyclosporiasis were soon linked to imported food products. An outbreak of cyclosporiasis in Spanish travelers is described. After identification of Cyclospora cayetanensis in stool analyses, a specific questionnaire was completed. Pyrosis was described in 57% of cases (4/7). Peptic symptoms can be a useful clue to indicate the diagnosis of cyclosporiasis in patients with travelers' diarrhea.