Characterization of Leishmania spp. causing cutaneous leishmaniasis in Manaus, Amazonas, Brazil.

In the State of Amazonas, American tegumentary leishmaniasis is endemic and presents a wide spectrum of clinical variability due to the large diversity of circulating species in the region. Isolates from patients in Manaus and its metropolitan region were characterized using monoclonal antibodies and isoenzymes belonging to four species of the parasite: Leishmania (Viannia) guyanensis, 73% (153/209); Leishmania (Viannia) braziliensis, 14% (30/209); Leishmania (Leishmania) amazonensis, 8% (17/209); and Leishmania (Viannia) naiffii, 4% (9/209). The most prevalent species was L. (V.) guyanensis. The principal finding of this study was the important quantity of infections involving more than one parasite species, representing 14% (29/209) of the total. The findings obtained in this work regarding the parasite are further highlighted by the fact that these isolates were obtained from clinical samples collected from single lesions.

Failure of both azithromycin and antimony to treat cutaneous leishmaniasis in Manaus, AM, Brazil.

A non-randomized controlled clinical trial was carried out in order to evaluate both azithromycin and antimony efficacy in cutaneous leishmaniasis in Manaus, AM, Brazil. Forty nine patients from both genders, aged 14 to 70, with cutaneous ulcers for less than three months and a positive imprint for Leishmania spp. amastigotes were recruited into two groups. Group I (26 patients) received a daily-single oral dose of 500 mg of azithromycin for 20 days and Group II (23 patients) received a daily-single intramuscular dose of 20 mg/kg of meglumine antimony, also for 20 days. Azithromycin cured three of 24 (12.5%) patients on days 60, 90 and 120 respectively whereas therapeutic failure was considered in 21 of 24 (87.5%) cases. In group II, antimony cured eight of 19 (42.1%) cases as follows: three on day 30, one each on day 60 and day 90, and three on day 120. Therapeutic failure occurred in 11 of 19 (57.9%) individuals. The efficacy of antimony for leishmaniasis was better than azithromycin but analysis for the intention-to-treat response rate did not show statistical difference between them. Although azithromycin was better tolerated, it showed a very low efficacy to treat cutaneous leishmaniasis in Manaus.

Failure of both azithromycin and antimony to treat cutaneous leishmaniasis in Manaus, AM, Brazil / Falha da azitromicina e do antimonial no tratamento da leishmaniose cutânea em Manaus, AM, Brasil

A non-randomized controlled clinical trial was carried outin order to evaluate both azithromycin and antimony efficacy in cutaneous leishmaniasis in Manaus, AM, Brazil. Forty nine patients from both genders, aged 14 to 70, with cutaneous ulcers for less than three months and a positive imprint for Leishmania spp. amastigotes were recruited into two groups. Group I (26 patients) received a daily-single oral dose of 500 mg of azithromycin for 20 days and Group II (23 patients) received a daily-single intramuscular dose of 20 mg/kg of meglumine antimony, also for 20 days. Azithromycin cured three of 24 (12.5 percent) patients on days 60, 90 and 120 respectively whereas therapeutic failure was considered in 21 of 24 (87.5 percent) cases. In group II, antimony cured eight of 19 (42.1 percent) cases as follows: three on day 30, one each on day 60 and day 90, and three on day 120. Therapeutic failure occurred in 11 of 19 (57.9 percent) individuals. The efficacy of antimony for leishmaniasis was better than azithromycin but analysis for the intention-to-treat response rate did not show statistical difference between them. Although azithromycin was better tolerated, it showed a very low efficacy to treat cutaneous leishmaniasis in Manaus.

Com o objetivo de avaliar a eficácia da azitromicina no tratamento da leishmaniose cutânea, foi realizado ensaio comparativo, em Manaus. Foram recrutados 49 pacientes de ambos os sexos, com idades entre 14 e 70 anos que apresentassem úlceras cutâneas com menos de três meses de evolução e que tivessem exame direto positivo para amastigotas de leishmânia. Estes pacientes foram alocados em dois grupos assim: Grupo I (26) recebeu uma dose diária de 500 mg de azitromicina pela via oral durante 20 dias e o Grupo II, recebeu uma dose diária de 20 mg/kg de antimoniato de meglumina por via intramuscular, durante 20 dias. Do grupo da azitromicina, três (12,5 por cento) de 24 pacientes curaram 60, 90 e 120 dias, respectivamente, enquanto, em 21 (87,5 por cento) de 24 houve falha terapêutica. No grupo do antimonial, oito (42,5 por cento) de 19 pacientes curaram como segue: três no dia 30, um no dia 60, um no dia 90 e três no dia 120. Contudo, em 11 (57,9 por cento) de 19 casos, houve falha terapêutica. A azitromicina foi menos eficaz do que o antimonial, embora, a análise da taxa de resposta por intenção de tratamento não mostrou diferença significativa, entre eles. A azitromicina foi melhor tolerada; porém, mostrou-se pouco eficaz no tratamento da leishmaniose cutânea, em Manaus.

Low efficacy of azithromycin to treat cutaneous leishmaniasis in Manaus, AM, Brazil.

An open trial to evaluate the azithromycin efficacy in cutaneous leishmaniasis patients was carried out in Manaus (AM), where Leishmania (Viannia) guyanensis is the main etiologic agent. Forty-one patients with skin lesions of less than 12 weeks duration, without specific treatment for the last three months and a positive imprint to Leishmania sp. were included. From these, 31 (75.6%) were male with median age of 30.2. All of them received a daily-single oral dose of 500 mg of azithromycin for ten days. At 25th day, 16 (39%) presented therapeutic failure and received intramuscular pentavalent antimonial, four were considered lost, 21, that had improved or were inaltered received another ten-day series of azithromycin and were monthly followed, but nine (21.9%) of them presented a poor clinical response and switched to intramuscular pentavalent antimonial on day 55. Of the 12 remaining cases evaluated on day 55, despite of clinical improvement, three asked for antimony therapy and 9 (21.9%) continued the follow-up but, only three were cured on 55th, 85th and 115 th days, and six did not come back for final evaluation. The intention-treatment overall response rate was 22% and whole cure was seen in three (7.3%) of cases. Thus, azithromycin showed a low efficacy to treat cutaneous leishmaniasis in Manaus.

Low efficacy of azithromycin to treat cutaneous leishmaniasis in Manaus, AM, Brazil

An open trial to evaluate the azithromycin efficacy in cutaneous leishmaniasis patients was carried out in Manaus (AM), where Leishmania (Viannia) guyanensis is the main etiologic agent. Forty-one patients with skin lesions of less than 12 weeks duration, without specific treatment for the last three months and a positive imprint to Leishmania sp. were included. From these, 31 (75.6 percent) were male with median age of 30.2. All of them received a daily-single oral dose of 500 mg of azithromycin for ten days. At 25th day, 16 (39 percent) presented therapeutic failure and received intramuscular pentavalent antimonial, four were considered lost, 21, that had improved or were inaltered received another ten-day series of azithromycin and were monthly followed, but nine (21.9 percent) of them presented a poor clinical response and switched to intramuscular pentavalent antimonial on day 55. Of the 12 remaining cases evaluated on day 55, despite of clinical improvement, three asked for antimony therapy and 9 (21.9 percent) continued the follow-up but, only three were cured on 55th, 85th and 115th days, and six did not come back for final evaluation. The intention-treatment overall response rate was 22 percent and whole cure was seen in three (7.3 percent) of cases. Thus, azithromycin showed a low efficacy to treat cutaneous leishmaniasis in Manaus.

Para avaliar a eficácia da azitromicina na leishmaniose cutânea, foi realizado ensaio clínico em Manaus, Amazonas, onde o agente etiológico predominante é a Leishmania (Viannia) guyanensis. Incluídos 41 pacientes com lesões de menos de 12 semanas, sem história de tratamento específico nos últimos três meses e com esfregaço positivo para Leishmania sp. Destes, 31 (75,6 por cento) eram masculinos, idade média 30,2 anos. Todos receberam azitromicina 500 mg em dose única oral, diária, por 10 dias. No dia 25°, 16 (39 por cento) pioraram e receberam antimonial pentavalente via intramuscular por 20 dias e, 21 (61 por cento) que apresentaram melhora da lesão ou esta permanecia inalterada no 25° dia, receberam outro ciclo de 10 dias de azitromicina e foram acompanhados mensalmente. Destes, nove (21,9 por cento) apresentaram piora das lesões na avaliação do dia 55 e iniciaram tratamento com antimonial neste dia. Dos 12 que permaneceram no estudo, porque tinham melhorado clinicamente, três optaram por tratamento com antimonial pentavalente no 55° dia e três apresentaram reepitelização completa das lesões nos dias 55°, 65° e 115°. Seis pacientes não retornaram para avaliação final. Análise por tentativa de tratamento foi 22 por cento e cura confirmada em três (7,3 por cento) casos. Estes resultados mostraram que azitromicina tem baixa eficácia para tratar leishmaniose em área onde a Leishmania (Viannia) guyanensis é o agente etiológico predominante.

Estudo de dois anos com animais reservatórios em área de ocorrência de leishmaniose tegumentar americana humana em bairro de urbanização antiga na cidade de Manaus-AM, Brasil / Two year study of reservoir animals in an old urban area with cutaneous Leishmaniasis occurrence in the city of Manaus-AM, Brazil

Os autores descrevem o resultado de dois anos de investigação de um foco de Leishmaniose Tegumentar Americana (LTA), ocorrida em área urbanizada em um conjunto habitacional na cidade da Manaus-AM. Chama atenção o fato de que este não é o padrão de ocorrência de surtos da doença na região, e sim interrupção da transmissão após urbanização. Foram investigados os animais considerados reservatórios em potencial para a leishmaniose em domicílios humanos e em áreas de floresta adjacentes. Foram testados anticorpos contra Leishmania spp em amostras de sangue de cães e detectada reatividade pela reação de imunofluorescencia indireta em oito (20,51 por cento) dos examinados. Entre os animais silvestres examinados a espécie Didelphis marsupialis foi predominante, com 20 exemplares capturados, sendo encontrados homoflagelados em três destes e lesões suspeitas de leishmaniose cutanea em dois. Acredita-se que um assentamento populacional desordenado ocorrido nas adjacências tenha causado o deslocamento das populações de vetores e reservatórios naturais em direção às casas do conjunto Hiléia propiciando o surto.

This is the result of a two year follow-up of a Cutaneous Leishmaniasis (CL) foci in the Hileia urban neighborhood in Manaus. It is important to point out that this is not the usual pattern of Leishmaniasis occurrence in this area. The authors investigated the animal potential reservoir in households and in the surrounding forest area. Samples were tested for leishmaniasis antibodies by RIFI. Eight (20.51 percent) of the examined domestic dogs showed reactivity. In captured wild animals, the Didelphis marsupialis was predominant in twenty specimens, three with homoflagelated in the blood and two with suspicious cutaneous lesions. We believe that the disordered population growth in the nearby area pushed the population of vectors and natural reservoir toward the homes in the Heleia neighborhood creating conditions for this outbreak.

[Epidemiology of tegumentary leishmaniasis in São João, Manaus, Amazonas, Brazil]. / Epidemiologia da leishmaniose tegumentar na Comunidade São João, Manaus, Amazonas, Brasil.

In Manaus, Amazonas State, Brazil, the degree of individual exposure to leishmaniasis is related to disorganized land occupation. In order to evaluate predisposing factors for an outbreak, confirm the parasitological diagnosis, treat patients, and assess etiological agents, reservoirs, and vectors, a 12-month study was conducted in Manaus in a community located along the BR-174 federal highway. Some 451 individuals were studied, among whom 17 cases of American tegumentary leishmaniasis (ATL) were diagnosed (six women and 11 men). Age varied from one to 64 years. Eleven patients had from one to three lesions. As for reservoirs, three opossums were captured. No hemoflagellates were found in the blood tests. Lutzomyia umbratilis was the predominant vector species captured. Many ATL patients were engaged in activities that exposed them to Leishmania vectors. Some patients may have been infected in the household and peridomiciliary environments. The epidemiological profile of ATL in this community is similar that of other foci in the region. This case series characterizes ATL as an endemic local public health problem.

Epidemiologia da leishmaniose tegumentar na Comunidade São João, Manaus, Amazonas, Brasil / Epidemiology of tegumentary leishmaniasis in São João, Manaus, Amazonas, Brazil

Em Manaus, Amazonas, Brasil, o grau de exposição dos indivíduos à leishmaniose está relacionado aos processos de ocupação desordenada. Para avaliar fatores predisponentes à gênese do surto, confirmar o diagnóstico parasitológico, tratar os doentes, avaliar agentes etiológicos, reservatórios e transmissores, realizou-se um estudo em Manaus, numa comunidade localizada no Km 4 da BR-174, durante 12 meses. Atendeu-se 451 indivíduos, dos quais foram diagnosticados 17 casos de leishmaniose tegumentar americana. Seis pacientes eram mulheres e 11 homens. A idade variou de um a 64 anos. Onze pacientes tinham entre uma e três lesões. Em relação aos reservatórios, três marsupiais foram capturados. Não foram encontrados hemoflagelados nos exames realizados. Dentre os insetos capturados, Lutzomyia umbratilis foi a espécie predominante. Grande parte dos pacientes de leishmaniose tegumentar americana tem atividades que os expõem aos vetores da Leishmania. Um grupo de pacientes foi infectado possivelmente no intra/peridomicílio. O perfil epidemiológico da leishmaniose tegumentar americana nessa comunidade é semelhante àquele observado em outros focos na região. Com essa casuística, a leishmaniose tegumentar americana é caracterizada como endêmica e como um problema de saúde pública local.

In Manaus, Amazonas State, Brazil, the degree of individual exposure to leishmaniasis is related to disorganized land occupation. In order to evaluate predisposing factors for an outbreak, confirm the parasitological diagnosis, treat patients, and assess etiological agents, reservoirs, and vectors, a 12-month study was conducted in Manaus in a community located along the BR-174 federal highway. Some 451 individuals were studied, among whom 17 cases of American tegumentary leishmaniasis (ATL) were diagnosed (six women and 11 men). Age varied from one to 64 years. Eleven patients had from one to three lesions. As for reservoirs, three opossums were captured. No hemoflagellates were found in the blood tests. Lutzomyia umbratilis was the predominant vector species captured. Many ATL patients were engaged in activities that exposed them to Leishmania vectors. Some patients may have been infected in the household and peridomiciliary environments. The epidemiological profile of ATL in this community is similar that of other foci in the region. This case series characterizes ATL as an endemic local public health problem.

Antibody response in patients with cutaneous leishmaniasis infected by Leishmania (Viannia) braziliensis or Leishmania (Viannia) guyanensis in Brazil.

The antibody response against Leishmania (Leishmania) amazonensis crude antigen was measured through the indirect immunofluorescent assay (IFA) and the immunoenzymatic assay (ELISA) in 114 patients with cutaneous leishmaniasis (CL) in Brazil. Fifty-four patients were infected by Leishmania (Viannia) braziliensis, and 60 patients had L. (V.) guyanensis infection. Patients were comparable by age, sex, disease duration and the Montenegro skin test diameter. L. (V.) braziliensis-infected patients showed significant lower number of ulcerated lesions, greater ulcerated area and higher proportion of lymph node enlargement. Sensitivity of IFA was 79.6% (95% CI 66.1-88.9) and 71.7% (95% CI 58.4-82.2) for L. (V.) braziliensis and L. (V.) guyanensis-infected patients, respectively (P=0.324). Sensitivity of ELISA was 98.2% (95% CI 88.8-99.9) and 85.0% (95% CI 72.9-92.5) for L. (V.) braziliensis and L. (V.) guyanensis-infected patients, respectively (P=0.018). Significant differences were observed in the magnitude of the antibody response before treatment with higher levels detected in L. (V.) braziliensis-infected patients by both serologic techniques. Eighty-four patients had serologic evaluations before and 12 weeks after treatment with meglumine antimoniate, 20 mg/kg/day for 20 days. Significant lower optic density values were observed after treatment with both species independent of cure or failure. Our data showed that L. (V.) braziliensis induces a higher antibody response against L. (L.) amazonensis antigens than L. (V.) guyanensis and that down-modulation of the antibody response occurs shortly during disease evolution after treatment. Moreover the data support the use of ELISA as a better tool for detection of antibodies in CL.

[Visceral leishmaniasis among Indians of the State of Roraima, Brazil: clinical and epidemiologic aspects of the cases observed from 1989 to 1993]. / Leishmaniose visceral entre índios no Estado de Roraima, Brasil: aspectos clínicoepidemiológicos de casos observados no período de 1989 a 1993.

A description of the epidemiological profile of visceral leishmaniasis among Indians in the State of Roraima, Brazil, was based on the clinical characteristics of human and dog disease, ecological aspects of the area where the cases occurred and entomologic investigations performed from 1989 to 1993. The 82 human cases were reported in six out of eight Counties that existed then in the state; there was a 69.5% predominance of male cases among those registered and a greater (52.4%) occurrence of the disease in children from zero to ten years old. The rate of natural infection was 10.3% out of 3,773 dogs examined in 74 different locations. Lutzomyia longipalpis was found in 31 areas with greater prevalence of the disease. The human and animal cases as well as the vectors were concentrated in areas where mountains and arable soil predominate, typical locations for the occurrence of American visceral leishmaniasis.

Leishmaniose visceral entre índios no Estado de Roraima, Brasil: aspectos clínicoepidemiológicos de casos observados no período de 1989 a 1993 / Visceral leishmaniasis among Indians of the State of Roraima, Brazil: clinical and epidemiologic aspects of the cases observed from 1989 to 1993

Descreve-se o perfil epidemiológico da leishmaniose visceral entre índios no estado de Roraima, Brasil, baseado na ocorrência de casos humanos observados e nos inquéritos caninos e entomológicos realizados no período de 1989 a 1993. Foram registrados 82 casos humanos de leishmaniose visceral em seis dos oito municípios então existentes no estado; houve predomínio de 69,5 por cento para o sexo masculino entre os casos observados. A maioria (52,4 por cento) dos casos foi entre crianças de zero a dez anos de idade. Registrou-se o índice de 10,3 por cento de infecção canina natural, entre 3.773 cães examinados em 74 localidades pesquisadas. A Lutzomyia longipalpis foi encontrada nas áreas de maior prevalência da doença, em 31 localidades diferentes. Os casos humanos, caninos e vetores estão concentrados em regiões onde predominam serras e lavrados, áreas características de ocorrência da leishmaniose visceral americana. A introdução e intensificação das atividades garimpeiras na região podem ter contribuído para a introdução da doença.

[Clinical and diagnostic aspects of American tegumentary leishmaniosis in soldiers simultaneously exposed to the infection in the Amazon Region]. / Aspectos clínicos e diagnósticos da leishmaniose tegumentar americana em militares simultaneamente expostos à infecção na Amazônia.

Military exercises in the forest of the Amazon region constitute an important factor in the incidence of American cutaneous leishmaniasis in this region. This report describes 48 cases of American tegumentary leishmaniosis. All these patients acquired the disease after military exercises in the Amazon. The mean incubation time was 27.6 days. The lesions were predominantly in the upper extremities, face and neck. The majority of patients presented two lesions. Ulcers were the most common clinical manifestation. The diagnosis was obtained through skin smears of the lesions. A total of 43 cases (89.6 %) were found to be positive.

Aspectos clínicos e diagnósticos da leishmaniose tegumentar americana em militares simultaneamente expostos à infecçäo na Amazônia / Clinical and diagnostic aspects of American tegumentary leishmaniosis in soldiers simultaneously exposed to the infection in the Amazon Region

Os treinamentos militares na selva amazônica constituem importantes fatores na incidência de leishmaniose tegumentar americana na regiäo. Este trabalho descreve 48 casos de leishmaniose tegumentar americana em pacientes militares nos quais a doença se manifestou após operaçäo de treinamento na Amazônia. O período de incubaçäo médio foi de 27,6 dias. Houve predomínio de lesöes nos membros superiores, face e pescoço. A maioria dos indivíduos apresentou duas lesöes, sendo as úlceras as manifestaçöes mais freqüentes. O diagnóstico foi realizado pelo exame de escarificaçäo das lesöes, sendo confirmado pela demonstraçäo do parasito em 43 (89,6 por cento) casos

Identification of antigenically distinct populations of Leishmania (Viannia) guyanensis from Manaus, Brazil, using monoclonal antibodies.

Eighty Leishmania isolates from patients who contracted cutaneous leishmaniasis in the Manaus region, Amazonas State, Brazil, were identified as Leishmania (Viannia) guyanensis by the electrophoretic profiles of six enzymes. None reacted with the species-specific monoclonal antibody B19. Two L. (V.) guyanensis subpopulations were detected with the monoclonals B2 and B12. The lack of B19 expression by the L. (V.) guyanensis strains in the present study contrasts with that of the vast majority of the strains of the same parasite from eastern Amazonia and French Guyana that express the epitope.

Consideraçöes sobre a produçäo da Leishmaniose Tegumentar Americana no Estado do Amazonas / Notes on the production of the American leishmaniosis in the State of Amazonas

Após apresentaçäo de um histórico sobre a Leishmaniose Tegumentar Americana no Amazonas, mostra a situaçäo atual da transmissäo da leishmaniose no Estado, e em Manaus em particular, enfatizando os aspectos da epidemiologia da doença que contribuam para a identificaçäo dos espaços críticos de sua produçäo.(AU)

Consideraçöes sobre a produçäo da Leishmaniose Tegumentar Americana no Estado do Amazonas / Notes on the production of the American leishmaniosis in the State of Amazonas

Após apresentaçäo de um histórico sobre a Leishmaniose Tegumentar Americana no Amazonas, mostra a situaçäo atual da transmissäo da leishmaniose no Estado, e em Manaus em particular, enfatizando os aspectos da epidemiologia da doença que contribuam para a identificaçäo dos espaços críticos de sua produçäo.

Aspectos clínicos comparativos da leishmaniose tegumentar na Regiåo Amazônica e Regiåo Centro-Oeste / A comparative study of cutaneous leishmaniasis from the Amazon and Central West regions of Brazil

Foram estudados 245 casos de Leishmaniose Tegumentar, sendo 149 da Regiåo Amazônica e 96 da Regiåo Centro-Oeste. De cada caso foram analisadas 30 variáveis clínicas. Na Regiåo Amazônica há incidência significativamente maior da LT no grupo etário de 15 a 25 anos. Na Regiåo Centro-Oeste, a incidência maior é em casados. Quanto à profissåo, na Regiåo Centro-Oeste há incidência maior em agricultores e dométicas, em relaçåo a idênticas profissÆes da Regiåo Amazônica; nessa regiåo, as profissÆes de estudante, de militar e de trabalhador braçal, comparativamente com as mesmas profissÆes da Regiåo Centro-Oeste, têm maior significaçåo. Há incidência signifivamente maior de lesÆes sistematizadas (múltiplas) no caso da Regiåo Amazônica que da Regiåo Centro-Oeste, e o único caso de forma foi observado naquela regiåo. Há predominância significativamente maior do tempo de evoluçåo das lesÆes, inferior a 60 dias na Regiåo Amazônica, quando comparado com igual período da Regiåo Centro-Oeste. Nesta regiåo, o período de maior predominância é aquele superior a 240 dias. Há incidência significativamente maior de lesÆes ulceradas e em atividade na Regiåo Amazônica, quando comparadas com as lesÆes observadas na Regiåo Centro-Oeste. O inverso sucede com o comprometimento das mucosas e a presença de lesÆes cutâneas verrucosas que incidem mais na Regiåo Centro-Oeste. As leishmânides såo mais freqüentes na Regiåo Amazônica. É provável que essas diferenças observadas, entre as duas regiÆes, sejam devidas a diferentes espécies ou subespécies de parasitos envolvidos

Prevalência de parasitas intestinais em habitantes do rio Negro, Estado do Amazonas, Brasil

Summary The authors evaluated the prevalence of intestinal parasites among inhabitants at four localities along the Rio Negro. Results for the Lutz method performed on fecal samples of 213 persons and Kato-Katz method, in 154, gave prevalences of, respectively, 40.4% and 50.0% for hookworms, 54.5% and 65.6% for A. lumbricoides, 52.1% and 87.0% for T. trichiura and 0.0% and 0.6% for E. vermicularis. Results from iron-hematoxylin staining carried out with 190 samples gave prevalences of 17.9% for E. histolytica, 11.0% for E. coli, 2.1% for I. bütschlii, 4.7% for E. nana and 17.9 for G. lamblia. Infection by S. stercoralis, in 147 persons, was 1.4%, using the Baermann-Moraes method. The Harada-Mori method used in 161 patients revealed 50.3% of those with larvae, of which 97.5% were N. americanus. The intensity of parasitism by hookworms, as evaluated by the Kato-Katz method in 71 patients, was mild ( 2,599 eggs/g of stool) in 95.8%. In 103 samples with A. lumricoides the median was 14,160 eggs/g and the median for T. trichiura in 103 stools was 1,320 eggs/g. The authors concluded that the prevalence of intestinal parasites did not diffed greatly from earlier data from the the Amazonian region, and the intensity of parasitism by worms was mild.

Resumo Os autores avaliaram a prevalência de enteroparasitas em habitantes de 4 localidades, às margens do rio Negro, no Estado do Amazonas. Utilizando-se os métodos de Lutz nas fezes de 213 indivíduos e de Kato-Katz. em 154, as prevalências foram respectivamente, para ancilostomídeo 40,4% e 50,0%. para A. lumbricoides 54,5% e 65,6%, para T. trichiura 52,1% e 87,0% e para E. vermicularis 0.0% e 0,6%. Em 190 amostras de fezes examinadas pela técnica de hematoxilina férrica, houve prevalências de 17,9% de E. histolytica, de 11,0% de E. coli, de 2,1% de I. bütschlii, de 4,7% de E. nana e de 17,9% de G. lamblia. A prevalência de S. stecoralis, em 147 indivíduos, foi de 1,4%, pelo método de Baermann-Moraes. Em 161 amostras examinadas pelo método de Harada-Mori, constatou-se em 81 (50,3%) presença de larvas, sendo 97,5% de N. americanus. Pelo método de Kato-Katz. a intensidade de infecção por ancilostomídeos, em 71 indivíduos, foi leve ( 2 599 ovos/g de fezes) em 95,8%; a carga parasitária por A. lumbricoides teve a mediana de 14 160 ovos/g. em 103 amostras; a mediana foi de 1 320 ovos/g de fezes em 108 indivíduos portadores de T. trichiura. Os autores concluíram que a prevalência das parasitoses intestinais não diferem, grandemente, dos valores assinalados para região Amazônica e que foi leve a intensidade de parasitismo por vermes.