Pediatric hydatidosis in the south-east of the Buenos Aires province, Argentina.

Hydatidosis is a zoonosis produced by the metacestode Echinococcus spp. The aims of this research are: to contribute to the knowledge of pediatric hydatidosis in the south-east of Buenos Aires province, to study its evolution from 1993 to 2002 at the Regional Maternity and Pediatric Hospital "Dr. Victorio Tetamanti", to determine the strains involved and to discuss the importance of the disease. The clinical records of diagnosed and/or operated patients were reviewed with regard to the hydatid disease. The strain was determined by using PCRs with Eg1 121a/122a primers. Forty-four cases were analyzed. Fifty nine point one per cent of the patients were boys. The mean age was 8 SD=3.8 years. Sixty one point four per cent had urban residence. Ultrasonography was used in 61% of the cases. The hepatic location was most frequently seen and the liver/lung ratio was 1.25. Ninety point nine per cent of patients received surgical treatment. Albendazole was used in 52% of cases. The average hospitalization time was 11 days. The G1/G2 strain group was determined. This report is the first one of its kind in the studied region. The permanence of hydatidosis in the region depends on the natural transmission of the parasite in the absence of control and prevention measures. The health authorities should implement strategies of prevention and control in the study area.

Pediatric hydatidosis in the south-east of the Buenos Aires province, Argentina / Hidatidosis pediátrica en el sudeste de la provincia de Buenos Aires, Argentina

Hydatidosis is a zoonosis produced by the metacestode Echinococcus spp. The aims of this research are: to contribute to the knowledge of pediatric hydatidosis in the south-east of Buenos Aires province, to study its evolution from 1993 to 2002 at the Regional Maternity and Pediatric Hospital "Dr. Victorio Tetamanti", to determine the strains involved and to discuss the importance of the disease. The clinical records of diagnosed and/or operated patients were reviewed with regard to the hydatid disease. The strain was determined by using PCRs with Eg1 121a/122a primers. Forty-four cases were analyzed. Fifty nine point one per cent of the patients were boys. The mean age was 8 SD=3.8 years. Sixty one point four per cent had urban residence. Ultrasonography was used in 61% of the cases. The hepatic location was most frequently seen and the liver/lung ratio was 1.25. Ninety point nine per cent of patients received surgical treatment. Albendazole was used in 52% of cases. The average hospitalization time was 11 days. The Gl/G2 strain group was determined. This report is the first one of its kind in the studied region. The permanence of hydatidosis in the region depends on the natural transmission of the parasite in the absence of control and prevention measures. The health authorities should implement strategies of prevention and control in the study area.

Los objetivos de este trabajo fueron: contribuir al conocimiento de la hidatidosis pediátrica en el sudeste de la provincia de Buenos Aires, estudiar su evolución desde 1993 hasta 2002, establecer la o las cepas involucradas y discutir la importancia de la enfermedad. Para ello se revisaron las historias clínicas de los pacientes pediátricos con diagnóstico de hidatidosis asistidos en el Hospital Interzonal Especializado Materno Infantil "Dr. Victorio Tetamanti" durante ese período. Se analizaron 44 casos, el 59,1% de ellos correspondió a varones. La media de edad fue de 8 años (SD=3,8 años) y el 61,4% de los niños afectados eran de residencia urbana. Se empleó ultrasonografía como método diagnóstico en el 61% de los casos. La localización hepática fue la más frecuente y la relación hígado/pulmón fue 1,25. El 90,9% recibió tratamiento quirúrgico. Se utilizó albendazol en el 52% de los pacientes. El tiempo de hospitalización tuvo una mediana de 11 días. Las cepas se determinaron mediante PCR con los cebadores Eg1 121a/122a. Se determinó la presencia de cepas del grupo G1/G2, dato informado por primera vez en humanos para la región de estudio. Se concluyó que la permanencia de la enfermedad en la región depende de la transmisión natural del parásito en ausencia de medidas de control y prevención. Por consiguiente, las autoridades de salud deberían implementar estrategias de prevención y control en dicha zona.

High polymorphism in genes encoding antigen B from human infecting strains of Echinococcus granulosus.

Echinococcus granulosus antigen B (AgB) is encoded by a gene family and is involved in the evasion of the host immune response. E. granulosus exists as a number of strains (G1-G10) that differ in biological characteristics. We used PCR-SSCP followed by DNA sequencing to evaluate sequence variation and transcription profile of AgB in 5 E. granulosus strains. Twenty-four genomic sequences were isolated and clustered in 3 groups related to 2 of the 5 reported AgB genes. AgB4 genes were present in almost all strains, whereas AgB2 were present as functional genes exclusively in G1/G2 cluster, and as non-functional genes in G5 and the G6/G7 cluster, suggesting inter-strain variation. The AgB transcription patterns, analysed by RT-PCR, showed that AgB2 and AgB4 genes were transcribed in G1, while only the AgB4 gene was transcribed in G7 strain. Cysts from the same strain or cluster shared more genomic and cDNA variants than cysts from different strain or cluster. The level of nucleotide and deduced amino acid sequence variation observed is higher than that reported so far for coding genes of other helminths. Neutrality was rejected for AgB2 genes. These data show the genetic polymorphism of antigen-coding genes among genetically characterized strains of E. granulosus.