RESUMO
Helicobacter pylori (Hp) infection affects almost half of the world population, it is almost a pandemia, and has been associated to poverty in underdeveloped countries. The Club Argentino del Estómago y Duodeno decided to fulfill the lack of information upon this subject in Argentina designing a seroprevalence, multicentric, prospective study performed in voluntary adults donors in blood banks and in children seen during normal growth controls. Seven hundred and nineteen individuals were evaluated, 645 of them were included: 178 children (age 0-18 years) and 467 adults. In all cases a serological IgG Hp test (Flex-Pack Abbott) was performed and an epidemiological questionnaire was completed by a physician. General prevalence of Hp infection was 44.8% of individuals. In the paediatric population prevalence was 15.7% and in adults 55.9%. The highest prevalence was observed in the fifth decade: 64%. In concordance with other similar studies carried out in different countries, we may conclude that the risk of acquisition of Hp infection is directly related to age, area of residence, social-economical status, sanitary facilities, and educational level reached. Even though the prevalence of Hp infection in Argentina is intermediate between highly developed and underdeveloped countries, the number of people infected is very high and the incidence of Hp-associated pathologies in the future represents a formidable task for gastroenterologists and sanitary authorities.
Assuntos
Infecções por Helicobacter/epidemiologia , Helicobacter pylori , Adolescente , Adulto , Fatores Etários , Argentina/epidemiologia , Criança , Pré-Escolar , Escolaridade , Feminino , Humanos , Lactente , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Análise Multivariada , Estudos Prospectivos , Estudos Soroepidemiológicos , Fatores Sexuais , Fatores SocioeconômicosRESUMO
La infección por Helicobacter pylori (Hp) afecta a casi la mitad de la población mundial, está considerada como una pondemia y se asocia fundamentalmente a la carencia de infraestructura sanitaria, el subdesarrollo y la pobreza. El Club argentino de Estómago y Duodeno decidió llenar una carencia en las estadísticas nacionales coordinando un estudio de seroprevalencia del Hp en la República Argentina, multicéntrico, prospectivo, en adultos dadores de sangre voluntarios en bancos de sangre con patologías no digestivas y en pacientes pediátricos que concurrían a consultorio del niño sano. Se evaluaron 719 sujetos, de los que fueron incluídos 645, de los cuales 178 eran niños y 467 adultos. A todos se les praticó el test serológico para detección de anticuerpos IgG anti=HP Flexpack (Abbott) consignadose los datos epidemiológicos en una planilla en el momento. La prevalencia general fue del 44.8 por ciento. La prevalencia en el grupo pediátrico fue del 15,7 por ciento. La prevalencia del grupo de adultos fue del 55.9 por ciento. La prevalencia mayor se observó en la 5a década de la vida: 64 por ciento. Al igual que lo encontrado en estudios de prevalencia en otros países, de acuerdo a nuestros resultados podemos inferir que los riesgos de adquirir la infección están en relación directa con la edad, la zona de residencia, la vivenda, la infraestructura sanitaria y el nivel de enseñanza alcanzado. Si bien la tasa de prevalencia de infección por Hp en nuestro país es intermedia entre la de los países desarrollados y la de los en vía de desarrollo, la cantidad de infectados es muy alta por lo que la incidencia esperada de enfermedades asociadas al Hp en los próximos años será un verdadero desafío para los gastroenterólogos y sanitaristas.
Assuntos
Humanos , Masculino , Feminino , Lactente , Pré-Escolar , Criança , Adolescente , Adulto , Pessoa de Meia-Idade , Infecções por Helicobacter/epidemiologia , Helicobacter pylori , Fatores Etários , Argentina , Aparelho Sanitário , Doadores de Sangue , Escolaridade , Pisos e Cobertura de Pisos , Higiene , Modelos Logísticos , Análise Multivariada , Estudos Prospectivos , Estudos Soroepidemiológicos , Fatores Sexuais , Fatores SocioeconômicosRESUMO
BACKGROUND: The pre-treatment detection of H.p. in the stomach of patients is easily achieved with routine methods. Conversely, with conventional methods, it is difficult to detect the presence of H.p. after treatment. OBJECTIVE: To estimate the actual percentage of successfully treated patients by using a more sensitive and specific technique (PCR) in the same biopsies where standard methods were negative for H.p. MATERIALS AND METHODS: We selected 97 treated patients (31 Gastric Ulcers/66 Duodenal Ulcers, 62 male/35 female, age: 49 +/- 14 years), in whom success of treatment was defined by histological means and CLO Test. In the same gastric biopsies H.p-DNA PCR was performed. Different therapeutic schemes were utilized, but all included Proton Pump Inhibitors + ATB. Eight weeks after the end of the treatment, without medication, the patients were controlled as follows: 5 biopsies per patient, 2 of antrum, 2 of corpus (in different zones) and 1 for CLO Test. H.p. eradication was defined on histological grounds (gastric biopsy histology: 10% formaldehide buffer fixation, paraffin inclusion, Giemsa, HE staining and inmunohistochemistry), CLO Test (Delta West Pty. Ltd. Bentley, Australia) and by the absence of H.p.-DNA by PCR (amplification of a 296 bp of the species-specific antigen of H.p. and visualization of the amplified product in agarose gel with Ethidium Bromide and UV light). RESULTS: [table: see text] CONCLUSIONS: The higher sensitivity of PCR (10(3) fold more than conventional methods) allowed us in this group of patients to detect 13% of false eradication. It would be necessary to follow up this group of patients in order to know whether they develop or not clinical symptoms and/or histological evidence of disease. If such a case PCR could become an important tool for treatment evaluation.