RESUMEN
The enzyme-linked immunosorbent assay (ELISA) is the most widely used tool to detect anti-Toxocara IgG antibodies for both serodiagnostic and seroepidemiological surveys on human toxocariasis. In the last eight years a high prevalence of toxocariasis (32.2-56.0%) has been reported in children attending public health units from municipalities in the state of Paraná, Brazil. Therefore, the aim of this work was to compare the frequency found among the general child population with that of children attending a public pneumology service in Maringá, Paraná, Brazil and describe the laboratorial, clinical and epidemiological findings. The research was conducted at the Consórcio Público Intermunicipal de Saúde do Setentrião Paranaense (CISAMUSEP) from July 2009 to July 2010 among children aged between one and 15 years. From a total of 167 children studied, only 4.2% (7/167) tested positive for anti-Toxocara spp. IgG antibodies and presented mild eosinophilia (2/7), increased serum IgE levels (6/7) and a positive allergy test for mites (5/7). The presence of pets (dogs or cats) at home did not correlate with the seroprevalence. In conclusion, cases of toxocariasis involving the respiratory tract are rare in children attending a public health pneumology unit in the northwestern region of Paraná State, despite the high prevalence of this type of toxocariasis among the infantile population attending Basic Health Units in the same geographical area.
Asunto(s)
Anticuerpos Antihelmínticos/sangre , Inmunoglobulina G/sangre , Toxocara/inmunología , Toxocariasis/epidemiología , Adolescente , Animales , Brasil/epidemiología , Niño , Preescolar , Ensayo de Inmunoadsorción Enzimática , Humanos , Lactante , Prevalencia , Sector Público , Toxocariasis/diagnósticoRESUMEN
The enzyme-linked immunosorbent assay (ELISA) is the most widely used tool to detect anti-Toxocara IgG antibodies for both serodiagnostic and seroepidemiological surveys on human toxocariasis. In the last eight years a high prevalence of toxocariasis (32.2-56.0%) has been reported in children attending public health units from municipalities in the state of Paraná, Brazil. Therefore, the aim of this work was to compare the frequency found among the general child population with that of children attending a public pneumology service in Maringá, Paraná, Brazil and describe the laboratorial, clinical and epidemiological findings. The research was conducted at the Consórcio Público Intermunicipal de Saúde do Setentrião Paranaense (CISAMUSEP) from July 2009 to July 2010 among children aged between one and 15 years. From a total of 167 children studied, only 4.2% (7/167) tested positive for anti-Toxocara spp. IgG antibodies and presented mild eosinophilia (2/7), increased serum IgE levels (6/7) and a positive allergy test for mites (5/7). The presence of pets (dogs or cats) at home did not correlate with the seroprevalence. In conclusion, cases of toxocariasis involving the respiratory tract are rare in children attending a public health pneumology unit in the northwestern region of Paraná State, despite the high prevalence of this type of toxocariasis among the infantile population attending Basic Health Units in the same geographical area.
O teste imunoenzimático (ELISA) constitui a ferramenta mais utilizada no diagnóstico individual da toxocaríase humana e/ou em inquéritos soroepidemiológicos para pesquisa de anticorpos IgG anti-Toxocara spp. Tendo em vista a elevada freqüência da toxocaríase (32,2% e 56,0%) observada em crianças atendidas em Unidades Básicas de Saúde de municípios do noroeste do Paraná, durante pesquisas realizadas ao longo dos últimos oito anos, o objetivo deste trabalho foi comparar estas frequências em crianças encaminhadas a uma unidade de Pneumologia do serviço de saúde pública da cidade de Maringá, noroeste do Estado do Paraná, Brasil e descrever os achados laboratoriais, clínicos e epidemiológicos das crianças soropositivas. A pesquisa foi realizada no Centro de Especialidades Regional - CISAMUSEP - entre julho de 2009 a julho de 2010, em crianças com idade entre um e 15 anos. De 167 crianças investigadas, sete (4,2%) apresentaram anticorpos IgG anti-Toxocara spp. Entre elas, duas (1,2%) crianças soropositivas apresentaram eosinofilia (baixos níveis), seis mostraram níveis elevados de IgE e cinco, teste alérgico positivo, principalmente para ácaros. Concluindo, no noroeste do estado do Paraná foram observados raros casos de crianças com toxocaríase envolvendo o trato respiratório e que foram atendidas por serviços públicos de Pneumologia ainda que na região estudada tenha sido observada elevada prevalência de toxocaríase em crianças assistidas pelas Unidades Básicas de Saúde (BHU).
Asunto(s)
Adolescente , Animales , Niño , Preescolar , Humanos , Lactante , Anticuerpos Antihelmínticos/sangre , Inmunoglobulina G/sangre , Toxocara/inmunología , Toxocariasis/epidemiología , Brasil/epidemiología , Ensayo de Inmunoadsorción Enzimática , Prevalencia , Sector Público , Toxocariasis/diagnósticoRESUMEN
Aiming to verify gaps in the conduct and knowledge of health professionals concerning Chagas disease in Maringá and Paiçandu, Paraná State, Brazil, from September/2004 to July/2005. The participants were chosen by systematic sampling. A total of 487 professionals, consisting of 75 physicians, 75 nurses, 150 nursing assistants and 187 community health agents (CHA), were interviewed using two semi-structured questionnaires, one created for the physicians and another for the nurses, nursing assistants and health agents. A considerable percentage of professionals from all categories demonstrated doubts about treatment, mechanisms of transmission, recognition of the triatomines and the sending of official notification of the presence of insects, tests for diagnosis confirmation, etiologic treatment, and the prognosis of the disease. Doubts arose more frequently among the CHA, who are the main link between patients and basic health units. In order to maintain the current state of disease control and provide appropriate treatment for those already infected by Trypanosoma cruzi, it is necessary to invest in epidemiological surveillance, education and to have duly capable and qualified health professionals.
Objetivando verificar diferenças no comportamento e conhecimento dos profissionais de saúde sobre a doença de Chagas em Maringá e Paiçandu, Paraná, Brasil, de setembro/2004 à julho/2005, participantes foram escolhidos por amostragem sistemática. Um total de 487 profissionais, sendo 75 médicos, 75 enfermeiros, 150 auxiliares de enfermagem e 187 agentes comunitários de saúde (ACS), foram entrevistados por meio de dois questionários semi-estruturados, que foi criado para os médicos e outro para os enfermeiros, auxiliares de enfermagem e agentes de saúde. Uma porcentagem considerável de profissionais de todas as categorias demonstrou dúvidas sobre tratamento, reconhecimento de mecanismos de transmissão, triatomíneos e envio da notificação oficial da presença de insetos, testes para confirmação do diagnóstico, tratamento etiológico, e prognóstico da doença. Além disso, surgiram dúvidas mais frequentes entre os ACS, que são o principal elo entre pacientes e unidades básicas de saúde. A fim de manter o estado atual de controle da doença, e oferecer tratamento adequado para aqueles já infectados pelo Trypanosoma cruzi, é necessário investir na vigilância epidemiológica, educação e ter profissionais de saúde devidamente capacitados e qualificados.
Asunto(s)
Humanos , Masculino , Femenino , Enfermedad de Chagas , Enfermedad de Chagas/prevención & control , Educación en Salud , Práctica ProfesionalRESUMEN
Este estudo indica a presença de enteroparasitos em material fecal e subungueal de 343 manipuladores de alimentos de Cascavel, Estado do Paraná, Brasil, de ambos os gêneros e com idade entre 14 e 75 anos. O material fecal foi analisado pelos métodos de Lutz, Ritchie modificado e Ziehl-Neelsen modificado e o subungueal, pelo Ritchie. O material fecal foi positivo para 131 (38,2%) manipuladores. As espécies mais prevalentes foram Endolimax nana (67,9%), Entamoeba coli (35,9%), Blastocystis sp. (28,2%), Entamoebahistolytica/dispar (10,1%) e Giardia duodenalis (8,4%), e E. nana foi diferente (p = 0,00) em relação às demais. A infecção por protozoários foi maior do que por helmintos (p = 0,00). Foi verificada associação entre a positividade para algum parasito e o gênero masculino e a categoria ocupacional (p ≤ 0,05). O material subungueal foi positivo em 17 indivíduos(5,0%), com encontro de E. nana (2,9%), E. coli (1,2%), G. duodenalis (0,3%) e a associação de E. nana e E. coli (0,6%), não havendo convergência com o material fecal (p = 0,00). A ocorrência de enteroparasitos nos manipuladores de alimentos de Cascavel, Estado doParaná é alta, indicando condições higiênicas inadequadas e a necessidade de medidas educativas rígidas, para se evitar que agentes patogênicos para o homem sejam propagados para os alimentos pela manipulação.
This study shows the presence de enteroparasites in fecal and subungual material of 343 food handlers in the city of Cascavel, Paraná State, Brazil, fromboth genders and ages between 14 and 75 years. Fecal samples were analyzed using Lutz, modified Ritchie and Ziehl-Neelsen techniques, and subungual material was analyzed using the Ritchie method. Fecal samples were positive in 131 (38.2%) handlers. Species with highest prevalence were Endolimax nana (67.9%), Entamoeba coli (35.9%), Blastocystis sp.(28.2%), Entamoeba histolytica/dispar (10.1%) and Giardia duodenalis (8.4%), with E. nana being significantly different (p = 0.00) from the others. The infection by protozoa was greater than by helminths (p = 0.00). Association was observed between the positive results for some parasites and the male gender and professional category (p ≤ 0.05). The subungual material was positive in 17 individuals (5.0%), who had E. nana (2.9%), E. coli (1.2%), G. duodenalis (0.3%) and the association of E. nana and E. coli (0.6%), with no convergence observed between it and fecal material. The occurrence of enteroparasites in food handlers in Cascavel is high, indicating improper hygienic-sanitary conditions and the need for effective educational measures, to avoid the propagation of pathogenic organisms to food by manipulation.
Asunto(s)
Humanos , Masculino , Femenino , Adulto , Enfermedades Parasitarias/epidemiología , Contaminación de Alimentos , Manipulación de Alimentos , Higiene Alimentaria , Parasitología de Alimentos , Servicios de AlimentaciónRESUMEN
This study reports on the occurrence of enteroparasites based on data from an ethnographic study of food handlers in the city of Cascavel, Paraná, Brazil. Fecal material from 343 food handlers of both sexes, between 14 and 75 years of age, was analyzed using Lutz, modified Ritchie and Ziehl-Neelsen techniques. Ethnographic relationships were investigated by means of specific questionnaires. Positive fecal samples were found for 131 (38.2%) handlers. Endolimax nana (67.9%) was the predominant species, followed by Entamoeba coli (35.9%), Blastocystis hominis (28.2%), Entamoeba histolytica/dispar (10.1%) and Giardia duodenalis (8.4%). Protozoan infections were more common than helminth infections (p = 0.00). The positive results for some parasites were associated with the male sex, professional category, and the performance of other activities (p < 0.05). The high overall occurrence of enteroparasites found indicates improper hygiene and sanitation conditions. Effective educational measures should be implemented to prevent the transfer of pathogenic organisms to food via handling.
Asunto(s)
Manipulación de Alimentos/estadística & datos numéricos , Helmintiasis/epidemiología , Parasitosis Intestinales/epidemiología , Infecciones por Protozoos/epidemiología , Adolescente , Adulto , Anciano , Animales , Brasil/epidemiología , Estudios Transversales , Heces/parasitología , Femenino , Helmintiasis/diagnóstico , Helmintiasis/parasitología , Humanos , Parasitosis Intestinales/diagnóstico , Parasitosis Intestinales/parasitología , Masculino , Persona de Mediana Edad , Infecciones por Protozoos/diagnóstico , Infecciones por Protozoos/parasitología , Encuestas y Cuestionarios , Adulto JovenRESUMEN
This study reports on the occurrence of enteroparasites based on data from an ethnographic study of food handlers in the city of Cascavel, Paraná, Brazil. Fecal material from 343 food handlers of both sexes, between 14 and 75 years of age, was analyzed using Lutz, modified Ritchie and Ziehl-Neelsen techniques. Ethnographic relationships were investigated by means of specific questionnaires. Positive fecal samples were found for 131 (38.2 percent) handlers. Endolimax nana (67.9 percent) was the predominant species, followed by Entamoeba coli (35.9 percent), Blastocystis hominis (28.2 percent), Entamoeba histolytica/dispar (10.1 percent) and Giardia duodenalis (8.4 percent). Protozoan infections were more common than helminth infections (p = 0.00). The positive results for some parasites were associated with the male sex, professional category, and the performance of other activities (p < 0.05). The high overall occurrence of enteroparasites found indicates improper hygiene and sanitation conditions. Effective educational measures should be implemented to prevent the transfer of pathogenic organisms to food via handling.
Este estudo mostra a ocorrência de enteroparasitos e realiza um estudo etnográfico de manipuladores de alimentos do município de Cascavel/Paraná, Brasil. O material fecal de 343 manipuladores de alimentos de ambos os gêneros e idade entre 14 e 75 anos foi analisado pelos métodos de Lutz, Ritchie modificado e Ziehl-Neelsen modificado. A relação etnográfica foi investigada utilizando questionários específicos. O material fecal foi positivo para 131 (38,2 por cento) manipuladores. Endolimax nana (67,9 por cento) foi a espécie predominante seguida por Entamoeba coli (35,9 por cento), Blastocystis hominis (28,2 por cento), Entamoeba histolytica/dispar (10,1 por cento) e Giardia duodenalis (8,4 por cento). A infecção por protozoários foi maior do que por helmintos (p = 0,00). Foi verificada associação entre a positividade para algum parasito e o gênero masculino, a categoria ocupacional e a realização de outras atividades (p < 0,05). Estes resultados permitem concluir que a ocorrência de enteroparasitos em manipuladores de alimentos é alta, indicando condições higiênicas inadequadas e que medidas educativas rígidas devem ser aplicadas, para evitar a propagação de agentes patogênicos para os alimentos pela manipulação.
Asunto(s)
Adolescente , Adulto , Anciano , Animales , Femenino , Humanos , Masculino , Persona de Mediana Edad , Adulto Joven , Manipulación de Alimentos/estadística & datos numéricos , Helmintiasis/epidemiología , Parasitosis Intestinales/epidemiología , Infecciones por Protozoos/epidemiología , Brasil/epidemiología , Estudios Transversales , Heces/parasitología , Helmintiasis/diagnóstico , Helmintiasis/parasitología , Parasitosis Intestinales/diagnóstico , Parasitosis Intestinales/parasitología , Infecciones por Protozoos/diagnóstico , Infecciones por Protozoos/parasitología , Encuestas y Cuestionarios , Adulto JovenRESUMEN
The objective of this study was to investigate the occurrence of cysts of Giardia spp. and oocysts of Cryptosporidium spp. in waters of the Ivaí Indigenous Land, Brazil. Samples of river and spring water and of treated water were filtered and analyzed by direct immunofluorescence (Merifluor kit, Meridian Bioscience, Cincinnati, Ohio). Of 21 samples, 7 from each locality, 3 (3/7, 42.8%) from a river were positive for Giardia (mean concentration 2.57 cysts/L), and 1 (1/7, 14.3%) was positive for Cryptosporidium (6 oocysts/L). From springs, 1 sample (1/7, 14.3%) was positive for Cryptosporidium (6 oocysts/L). One sample (1/7, 14.3%) from treated water was positive for both, with 4 oocysts/L and 2 cysts/L. Giardia was the more frequent protozoan present.
Asunto(s)
Cryptosporidium/aislamiento & purificación , Agua Dulce/parasitología , Giardia/aislamiento & purificación , Abastecimiento de Agua/normas , Animales , Brasil , Concentración de Iones de Hidrógeno , Purificación del Agua , Tiempo (Meteorología)RESUMEN
Chronic renal insufficiency disease (CRI) leads to uremia in hemodialysis patients and induces a state of immunodepression that results in higher frequencies of infections and diarrhea. Hemodialysis patients resident in the city of Campo Mourão, Paraná, Brazil were analyzed from April 2006 through September 2007 for Blastocystis sp. and other intestinal parasites and for associated diarrhea. Fecal samples from 86 hemodialysis patients and 146 healthy (reference) persons were examined by standard methods for detecting ova, larvae and cysts, which included preservation in 10% formalin and the Kinyoun method. Thirty-three hemodialysis patients (45.1%) and 36 reference individuals (25.7%) were found to be parasitized. The differences in the percentages of parasitism and polyparasitism between the reference group and the chronic renal patients was significant (p= 0.0318 and 0.0019, respectively). Blastocystis sp. (18%-20.1%), Endolimax nana (14%-16.3%), Cryptosporidium sp. (4%-4.7%) and Entamoeba coli (4%-4.7%) were the most frequent protozoa found in the hemodialysis patients. Parasitism was not significantly associated with diarrhea (p=0.9947) or with decreased white blood cell counts (p=0.7046) in these individuals. Because parasitic infections may be an important comorbidity factor in hemodialysis patients, we suggest that parasitological stool examinations, especially for Blastocystis sp. and Cryptosporidium sp., be included in routine medical follow-up examinations of these patients.
Asunto(s)
Infecciones por Blastocystis/epidemiología , Diarrea/parasitología , Heces/parasitología , Parasitosis Intestinales/parasitología , Diálisis Renal , Adulto , Anciano , Anciano de 80 o más Años , Animales , Infecciones por Blastocystis/diagnóstico , Brasil/epidemiología , Femenino , Humanos , Parasitosis Intestinales/diagnóstico , Parasitosis Intestinales/epidemiología , Masculino , Persona de Mediana Edad , PrevalenciaRESUMEN
To determine the indices of prevalence of intestinal parasites and commensals in the residents of ecotourism region of Paraná State, a retrospective study was conducte, from January/2003 to December/2004 on 3,764 fecal parasitological examinations performed by a private laboratory of Ubiratã using the Baermann-Moraes, water-sedimentation and Willis methods. Among the individuals aged eight months to 89 years, 522 (13.9%) cases were positive. Giardia lamblia (175/522; 24.2%) was the most prevalent parasite (p<0.000). Entamoeba coli was the most common commensal, with 238/552 (32.9%) cases (p<0.000), being frequently associated with other species, either parasitic or commensal. The children of preschool age (2-6 years old) and school age (7-14 years) were mainly parasitized (66.0% of positivity; p<0.0000). More individuals harbored a single species of parasite (233; 44.6%) than had multiple species (169; 32.4%). These results indicated a significant degree of the environmental contamination in the cities of Paraná, mainly the medium-and small-sized ones, which was a cause for concern in view of the increase in ecotourism in the region.
A prevalência de enteroparasitas e comensais, de janeiro/2003 a dezembro/2004, foi determinada em residentes de região de ecoturismo do Paraná por meio de estudo retrospectivo. Foram examinados os resultados de 3.764 exames coproparasitológicos efetuados em laboratório privado de Ubiratã Entre indivíduos de 8 meses a 89 anos, 522 (13,9%) exames foram positivos. Giardia intestinalis (175/522; 24,2%) foi o parasita prevalente (p<0,000). Entamoeba coli mostrou-se o commensal mais comum, com 238/552 (32,9%) casos (p<0,000), encontrando-se frequentemente associado com outras espécies, parasitas ou comensais. Crianças em idade pré-escolar (2-6 anos) e escolar (7-14 anos) apresentaram-se mais parasitados (66,0% de positividade; p<0,0000). A maioria dos indivíduos encontrava-se parasitado por uma única espécie (233; 44.6%) do que por várias espécies (169; 32.4%). Estes resultados indicam um grau significativo de contaminação ambiental em cidades do Paraná, principalmente aquelas de médio e pequeno porte, representando fonte de preocupação em vista do crescimento do ecoturismo na região.
RESUMEN
Chronic renal insufficiency disease (CRI) leads to uremia in hemodialysis patients and induces a state of immunodepression that results in higher frequencies of infections and diarrhea. Hemodialysis patients resident in the city of Campo Mourão, Paraná, Brazil were analyzed from April 2006 through September 2007 for Blastocystis sp. and other intestinal parasites and for associated diarrhea. Fecal samples from 86 hemodialysis patients and 146 healthy (reference) persons were examined by standard methods for detecting ova, larvae and cysts, which included preservation in 10 percent formalin and the Kinyoun method. Thirty-three hemodialysis patients (45.1 percent) and 36 reference individuals (25.7 percent) were found to be parasitized. The differences in the percentages of parasitism and polyparasitism between the reference group and the chronic renal patients was significant (p= 0.0318 and 0.0019, respectively). Blastocystis sp. (18 percent-20.1 percent), Endolimax nana (14 percent-16.3 percent), Cryptosporidium sp. (4 percent-4.7 percent) and Entamoeba coli (4 percent-4.7 percent) were the most frequent protozoa found in the hemodialysis patients. Parasitism was not significantly associated with diarrhea (p=0.9947) or with decreased white blood cell counts (p=0.7046) in these individuals. Because parasitic infections may be an important comorbidity factor in hemodialysis patients, we suggest that parasitological stool examinations, especially for Blastocystis sp. and Cryptosporidium sp., be included in routine medical follow-up examinations of these patients.
Asunto(s)
Adulto , Anciano , Anciano de 80 o más Años , Animales , Femenino , Humanos , Masculino , Persona de Mediana Edad , Infecciones por Blastocystis/epidemiología , Diarrea/parasitología , Heces/parasitología , Parasitosis Intestinales/parasitología , Diálisis Renal , Infecciones por Blastocystis/diagnóstico , Brasil/epidemiología , Parasitosis Intestinales/diagnóstico , Parasitosis Intestinales/epidemiología , PrevalenciaRESUMEN
O objetivo deste estudo foi avaliar e comparar os resultados das análises microbiológicas e físico-químicas da água in natura e da água tratada pela Companhia de Saneamento do Paraná (SANEPAR), de Maringá, Paraná, com dados da literatura que se referem à relação entre esses parâmetros e a presença de Cryptosporidium sp. e Giardia sp. Foram coletadas 186 amostras de água, sendo 93 in natura e 93 de águatratada. As análises microbiológicas (coliformes totais e termotolerantes) e físico-químicas (turbidez, pH, ferro, fluoretos, cor e cloro) foram realizadas de acordo com a metodologia descrita pelo Standart Methods for the Examination of Water and Wastewater. Os resultados destas análises encontravam-se em conformidade com os requerimentos regulatórios, entretanto, comparando estes resultados com aqueles encontrados na literatura, mesmo a água tratada obedecendo às normas da Portaria estabelecida pelo Ministério da Saúde, não elimina a possibilidade de ocorrência desses protozoários. O presente estudo suporta a recomendação de que a pesquisade indicadores para Cryptosporidium sp e Giardia sp e de metodologias que sejam simples, sensíveis, eficientese de baixo custo para a pesquisa destes protozoários em águas de abastecimento precisam ser continuadas.
The objective of this study was to evaluate and compare the results of microbiological and physical-chemical analyses of untreated and treated water from the Sanitation Company of Paraná (SANEPAR) of Maringá,Paraná, with literature data relating to the relation between these parameters and the presence of Cryptosporidium sp. and Giardia sp. We collected 186 water samples, 93 of treated water and 93 of untreatedwater. The microbiological analyses (total and thermotolerant coliforms) and physical-chemical analyses(turbidity, pH, iron, fluorides, color and chlorine) were carried out in accordance with the methodology describedin the Standard Methods for the Examination of Water and Wastewater. The results of these analyses met incompliance with legislation; however, comparing these results with those found in literature does not eliminate the possibility of the occurrence of these protozoans. The present study supports the recommendation for the continuation of research of indicators for Cryptosporidium sp and Giardia sp, as well as methodologies that aresimple, sensible, efficient and affordable for the research of these protozoans in water supplies.
El objetivo de este estudio fue evaluar y comparar los resultados de los análisis físico-químicas y microbiológicos del agua in natura y del agua tratada por la Compañía de Saneamiento del Paraná (SANEPAR),de Maringá, Paraná, con los datos de la literatura que se refieren a la relación entre esos parámetros y lapresencia de Cryptosporidium sp. y Giardia sp. Fueron recogidas 186 muestras de agua, siendo 93 de aguatratada y 93 de agua in natura. Los análisis microbiológicos (coliformes totales y termotolerantes) y los físicoquímicas(turbidez, pH, hierro, fluoruro, color y cloro) fueron realizadas de acuerdo con la metodología descritapor Standart Methods for the Examination of Water and Wastewater. Los resultados de estos análisis se encontraban en conformidad con la legislación, no obstante, comparando estos resultados con aquellos encontrados en la literatura, mismo el agua tratada obedeciendo a las normas establecidas por el Ministerio dela Salud, no elimina la posibilidad de ocurrencia de estos protozoarios. El actual estudio soporta la recomendación de que la investigación de los indicadores para el Cryptosporidium sp. y Giardia sp. y de las metodologías que sean simples, sensibles, eficientes y de bajo costo para la investigación de estos protozoariosen aguas de abastecimiento necesitan ser continuadas.
Asunto(s)
Abastecimiento de Agua/análisis , Cryptosporidium , Giardia , Técnicas In Vitro , Microbiología del AguaRESUMEN
This is the first report of congenital toxoplasmosis in dizygotic twins in Brazil. We emphasize the need for early diagnosis of the mother and follow-up of children with suspected or confirmed infection from birth to adolescence, in order to avoid the hazard and damage from congenital toxoplasmosis.
Asunto(s)
Enfermedades en Gemelos/parasitología , Toxoplasmosis Congénita/diagnóstico , Gemelos Dicigóticos , Enfermedades en Gemelos/diagnóstico , Femenino , Estudios de Seguimiento , Humanos , Recién Nacido , Masculino , EmbarazoRESUMEN
The aim of this study was to drawn an epidemiological and clinical profile of the neurocysticercosis (NCC) patients assisted by Hospital Universitário Regional de Maringá. A transversal, retrospective and descriptive study based on 6,100 records of the Neurology, Neuropediatry, Neurosurgery and Psychiatry clinics was done from January/1998 to December/2004. Of these, 48 were selected with diagnosis of NCC. The prevalence was greater in female (p<0.001), 31-60 years (43.7%), and urban zone (93.8%). The number of NCC cases overcame those notified to the Epidemic Surveillance in 1998, 1999, 2001, 2002 and 2004. The epilepsy due to NCC (CI=1.77;16.07; p=0.0024) was generalized and of late onset in 91.7% patients, being associated to headache in 37.5% ones. There was need of hospitalization in 22.9% of the patients (medium time of 3.91+/-3.35 days). It was concluded that the epidemiological and clinical profile observed is peculiar, displaying some common points with other Brazilian studies.
Asunto(s)
Neurocisticercosis/epidemiología , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Brasil/epidemiología , Niño , Preescolar , Estudios Transversales , Femenino , Humanos , Lactante , Recién Nacido , Masculino , Persona de Mediana Edad , Neurocisticercosis/diagnóstico , Neurocisticercosis/terapia , Estudios RetrospectivosRESUMEN
This is the first report of congenital toxoplasmosis in dizygotic twins in Brazil. We emphasize the need for early diagnosis of the mother and follow-up of children with suspected or confirmed infection from birth to adolescence, in order to avoid the hazard and damage from congenital toxoplasmosis.
Este é o primeiro relato de caso de toxoplasmose congênita em gêmeos dizigóticos no Brasil. Os autores enfatizam a necessidade de diagnóstico precoce das gestantes e do acompanhamento de crianças do nascimento à adolescência, a fim de evitar riscos e danos decorrentes da infecção congênita.
Asunto(s)
Humanos , Masculino , Femenino , Embarazo , Recién Nacido , Enfermedades en Gemelos/parasitología , Gemelos Dicigóticos , Toxoplasmosis Congénita/diagnóstico , Enfermedades en Gemelos/diagnóstico , Estudios de SeguimientoRESUMEN
Neste trabalho, estabeleceu-se a ocorrência de parasitoses intestinais em crianças e funcionários da creche municipal de Itambé-PR, e os fatores de risco relacionados a ela. Foram investigados 145 indivíduos (127crianças e 18 adultos). O exame parasitológico foi realizado pelos métodos de Faust et al. e Lutz. Foi aplicadoum questionário semi-estruturado, padronizado com questões relativas às condições epidemiológicas nas quais vive a população estudada. Foram utilizados os testes do Qui-quadrado e de Regressão Logística, empregando o método stepwise para análise dos dados. Verificou-se um parasitismo de 34,5%, sendo Giardia duodenalis(54,7%) a espécie predominante, principalmente em crianças menores de dois anos (23- 65,7%). As variáveis que permaneceram estatisticamente associadas à presença da parasitose foram gênero, idade e tipo de água consumida. Crianças com até dois anos de idade tiveram 4,8 vezes mais chances de adquirir parasitose, o gênero feminino foi considerado fator de proteção e quem consumiu água não-filtrada teve 15,9 vezes mais chance de ter parasitoses. Este trabalho permitiu concluir que as infecções intestinais, em crianças e adultos da creche municipal, constituem um problema de saúde pública para o município de Itambé-PR e são indicativos de condições socioeconômicas, higiênicas e culturais inadequadas.
This work established the occurrence of intestinal parasitism in children and adults at a municipal day-carecenter in Itambé/PR, as well as related risk factors. One hundred forty-five individuals were investigated (127children and 18 adults). Parasitological examinations were carried out by the Faust et al. and Lutz methods. Asemi-structured questionnaire regarding the epidemiological conditions of the population was applied. Chisquareand Stepwise Logistic Regression tests were applied for analysis of the data. A parasitism rate of 34.5%was verified, with Giardia duodenalis (54.7%) as the predominant species, mainly in children < 2 years (23 -65.7%). Gender, age and type of consumed water were the variables statistically associated with the occurence of parasitism. Children up to two years of age had 4.8 times greater probabilities of acquiring parasitism. The female gender was considered a protection factor. Children who consumed non-filtered water have 15.9 times greater possibilities to have parasitism. This paper concluded that intestinal parasite infections in children andadults of the day-care center constitute a problem of public health for the city of Itambé/PR, and are indicative of inadequate socio-economic, hygienic and cultural conditions.
En este trabajo fue establecida la ocurrencia del parasitismo intestinal en niños y adultos en un centro de guardería municipal de Itambé/PR y los factores de riesgo relacionados a ella. Fueron investigados cientos cuarenta y cinco individuos (127 niños y 18 adultos). El examen parasitológico fue realizado por los métodos de Faust et al. y Lutz. Fue aplicado un cuestionario semiestructurado, estandarizado con cuestiones relativas a las condiciones epidemiológicas en las cuales vive la población estudiada. Fueron utilizados testes del Chicuadradoy de la Regresión Logística, empleando el método stepwise para análisis de los datos. Unparasitismo de 34.5% fue verificado, siendo Giardia duodenalis (54.7%) la especie predominante, principalmente en niños con menos de 2 años (23 - 65.7%). El género, la edad y el tipo de agua consumida fueron las variables que permanecieron estadísticamente asociadas a la presencia de parasitosis. Los niñoscon hasta dos años de edad tuvieron 4,8 veces más posibilidades de adquirir el parasitosis, el género femeninofue considerado factor de protección, y los que consumieron el agua no-filtrada tuvieron 15,9 veces más posibilidad de tener parasitosis. Este estudio concluyó que las infecciones intestinales del parásito en niños y adultos del centro de guardería municipal constituyen un problema de salud pública para el municipio de Itambé/PR y son indicativas de condiciones social-económicas, higiénicas y culturales inadecuadas.
Asunto(s)
Humanos , Masculino , Femenino , Niño , Adulto , Guarderías Infantiles , Enfermedades Parasitarias , Factores de Riesgo , Educación en SaludRESUMEN
Este estudo propõe-se verificar o perfil clínico-epidemiológico da neurocisticercose (NCC) em pacientes atendidos no Hospital Universitário Regional de Maringá. Foram analisados 6100 prontuários dos setores de Neurologia, Neuropediatria, Neurocirurgia e Psiquiatria, de janeiro/1998 a dezembro/2004. Destes, foram selecionados 48 com diagnóstico de NCC. O número de casos de NCC observados superou aqueles notificados à Vigilância Epidemiológica nos anos de 1998, 1999, 2001, 2002 e 2004. Houve predomínio do gênero feminino (p<0,001), com idade entre 31-60 anos (43,7 por cento) e residentes na zona urbana (93,8 por cento). A epilepsia por NCC (IC=1,77;16,07; p=0,0024) foi de início tardio e generalizada em 91,7 por cento dos pacientes, estando associada a cefaléia em 37,5 por cento dos pacientes. Houve necessidade de internação em 22,9 por cento dos pacientes, com tempo médio de internação de 3,91±3,35dias. Concluiu-se que o perfil clínico-epidemiológico observado é peculiar, apresentando alguns pontos em comum com estudos conduzidos em outras regiões endêmicas brasileiras.
The aim of this study was to drawn an epidemiological and clinical profile of the neurocysticercosis (NCC) patients assisted by Hospital Universitário Regional de Maringá. A transversal, retrospective and descriptive study based on 6,100 records of the Neurology, Neuropediatry, Neurosurgery and Psychiatry clinics was done from January/1998 to December/2004. Of these, 48 were selected with diagnosis of NCC. The prevalence was greater in female (p<0.001), 31-60 years (43.7 percent), and urban zone (93.8 percent). The number of NCC cases overcame those notified to the Epidemic Surveillance in 1998, 1999, 2001, 2002 and 2004. The epilepsy due to NCC (CI=1.77;16.07; p=0.0024) was generalized and of late onset in 91.7 percent patients, being associated to headache in 37.5 percent ones. There was need of hospitalization in 22.9 percent of the patients (medium time of 3.91±3.35 days). It was concluded that the epidemiological and clinical profile observed is peculiar, displaying some common points with other Brazilian studies.
Asunto(s)
Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Niño , Preescolar , Femenino , Humanos , Lactante , Recién Nacido , Masculino , Persona de Mediana Edad , Neurocisticercosis/epidemiología , Brasil/epidemiología , Estudios Transversales , Neurocisticercosis/diagnóstico , Neurocisticercosis/terapia , Estudios RetrospectivosRESUMEN
OBJECTIVE: To determine the prevalence of reagent serology for suspected acute toxoplasmosis in pregnant women and to describe clinical, laboratory and therapeutic profiles of mothers and their children. METHODS: A retrospective study was conducted with IgM-anti-Toxoplasma gondii-reagent pregnant women and their children who attended the public health system in the state of Paraná, Southern Brazil, from January 2001 to December 2003. Information were obtained from clinical, laboratory (ELISA IgM/IgG) and ultrasonographic data and from interviews with the mothers. To test the homogeneity of the IgM indices in relation to the treatment used, the Pearson's Chi-square test was applied. Comparisons were considered significant at a 5% level. RESULTS: Two hundred and ninety (1.0%) cases of suspected IgM-reagent infection were documented, with a prevalence of 10.7 IgM-reagent women per 1,000 births. Prenatal care started within the first 12 weeks for 214/290; 146/204 were asymptomatic. Frequent complaints included headaches, visual disturbance and myalgia. Ultrasonography revealed abnormalities in 13 of 204 pregnancies. Chemoprophylaxis was administered to 112/227; a single ELISA test supported most decisions to begin treatment. Pregnant women with IgM indices =2.000 tended to be treated more often. Among exposed children, 44/208 were serologically followed up and all were IgG-reagent, and three IgM-reagent cases showed clinical symptoms. CONCLUSIONS: The existence of pregnant women with laboratorially suspected acute toxoplasmosis who were not properly followed up, and of fetuses that were not adequately monitored, shows that basic aspects of the prenatal care are not being systematically observed. There is need of implementing a surveillance system of pregnant women and their children exposed to T. gondii.
Asunto(s)
Anticuerpos Antiprotozoarios/sangre , Complicaciones Parasitarias del Embarazo/epidemiología , Toxoplasma/inmunología , Toxoplasmosis/epidemiología , Enfermedad Aguda , Animales , Antiprotozoarios/uso terapéutico , Brasil/epidemiología , Ensayo de Inmunoadsorción Enzimática , Femenino , Humanos , Inmunoglobulina G/sangre , Inmunoglobulina M/sangre , Recién Nacido , Estudios Longitudinales , Embarazo , Complicaciones Parasitarias del Embarazo/diagnóstico , Complicaciones Parasitarias del Embarazo/tratamiento farmacológico , Diagnóstico Prenatal , Prevalencia , Estudios Retrospectivos , Toxoplasmosis/diagnóstico , Toxoplasmosis/tratamiento farmacológico , Toxoplasmosis Congénita/diagnóstico , Toxoplasmosis Congénita/tratamiento farmacológico , Toxoplasmosis Congénita/epidemiologíaRESUMEN
OBJECTIVE: To determine the prevalence of reagent serology for suspected acute toxoplasmosis in pregnant women and to describe clinical, laboratory and therapeutic profiles of mothers and their children. METHODS: A retrospective study was conducted with IgM-anti-Toxoplasma gondii-reagent pregnant women and their children who attended the public health system in the state of Paraná, Southern Brazil, from January 2001 to December 2003. Information were obtained from clinical, laboratory (ELISA IgM/IgG) and ultrasonographic data and from interviews with the mothers. To test the homogeneity of the IgM indices in relation to the treatment used, the Pearson's Chi-square test was applied. Comparisons were considered significant at a 5 percent level. RESULTS: Two hundred and ninety (1.0 percent) cases of suspected IgM-reagent infection were documented, with a prevalence of 10.7 IgM-reagent women per 1,000 births. Prenatal care started within the first 12 weeks for 214/290; 146/204 were asymptomatic. Frequent complaints included headaches, visual disturbance and myalgia. Ultrasonography revealed abnormalities in 13 of 204 pregnancies. Chemoprophylaxis was administered to 112/227; a single ELISA test supported most decisions to begin treatment. Pregnant women with IgM indices =2.000 tended to be treated more often. Among exposed children, 44/208 were serologically followed up and all were IgG-reagent, and three IgM-reagent cases showed clinical symptoms. CONCLUSIONS: The existence of pregnant women with laboratorially suspected acute toxoplasmosis who were not properly followed up, and of fetuses that were not adequately monitored, shows that basic aspects of the prenatal care are not being systematically observed. There is need of implementing a surveillance system of pregnant women and their children exposed to T. gondii.
OBJETIVO: Determinar a prevalência de gestantes com sorologia reagente suspeita de toxoplasmose aguda e descrever as variáveis maternas e do concepto relacionadas ao perfil clínico, laboratorial e terapêutico. MÉTODOS: Estudo retrospectivo com gestantes IgM anti-Toxoplasma gondii reagentes e conceptos atendidos em serviço público de saúde do Paraná, de janeiro/2001-dezembro/2003. Foram obtidas informações a partir de dados dos registros clínicos, laboratoriais (ELISA IgM/IgG), ultrassonográficos e de entrevista materna. Para testar a homogeneidade dos indices de IgM em relação ao tratamento usado, aplicou-se o qui-quadrado de Pearson. O nível de significância adotado foi de 5 por cento. RESULTADOS: Ocorreram 290 casos (1,0 por cento) IgM reagentes, evidenciando prevalência de 10,7 gestantes com sorologia reagente a cada 1.000 nascimentos. Duzentos e quatorze de 290 gestantes iniciaram o pré-natal até a 12ª semana de gestação; 146/204 foram assintomáticas; cefaléia, distúrbios visuais e mialgia foram queixas freqüentes; 13/204 gestantes apresentaram anormalidades ao ultrassom; 112/227 gestantes receberam quimioprofilaxia; um único teste ELISA apoiou a maioria das tomadas de decisão para a quimioprofilaxia. Houve tendência em tratar gestantes com índices de IgM=2.000. Dentre as crianças expostas, 44/208 tiveram algum acompanhamento sorológico, das quais todas foram IgG reagentes e três casos IgM reagentes apresentaram manifestações clínicas. CONCLUSÕES: A existência de gestantes com suspeita laboratorial de toxoplasmose aguda não devidamente investigada e de conceptos sem monitoração adequada evidenciam que aspectos fundamentais da assistência pré-natal não estão sendo sistematicamente observados. Aponta-se a necessidade de implementar o sistema de vigilância para gestantes e crianças expostas ao T. gondii.
Asunto(s)
Femenino , Embarazo , Humanos , Atención Prenatal , Embarazo , Toxoplasmosis Congénita/diagnóstico , Toxoplasmosis Congénita/prevención & control , Toxoplasmosis/epidemiología , Monitoreo Epidemiológico , Estudios SeroepidemiológicosRESUMEN
Este estudo avaliou a contaminação parasitológica de hortaliças consumidas cruas que são comercializadas no CEASA do município de Maringá, Paraná; as condições higiênico-sanitárias do local e dos comerciantes. Foram analisadas 30 amostras de alface crespa; 30 de rúcula; 27 de espinafre e 24 de agrião pela técnica descrita por Oliveira e Germano, em duplicata, e pelo método de Ziehl-Neelsen, modificado por Henriksen-Polenz. A avaliação das condições higiênico-sanitárias do local e dos hábitos dos comerciantes foi efetuada por meio de questionário estruturado, pré-codificado. As hortaliças mais contaminadas foram o agrião e a rúcula, com índices de parasitismo maiores que 80 por cento. Foram encontrados oocistos de coccídeos, ovos e larvas das superfamílias Rhabdiasoidea e Ancylostomatoidea. Não foram encontradas amostras parasitadas por Cryptosporidium sp. A avaliação das condições higiênico-sanitárias do local e dos hábitos dos comerciantes demonstrou que as hortaliças ficavam expostas à poeira e ao trânsito de veículos pesados; a falta de paramentação dos distribuidores e ao manuseio concomitantemente de verduras e dinheiro em 40 por cento dos comerciantes. Conclui-se que as condições de horticultura, transporte, distribuição e manipulação de hortaliças precisam ser constantemente avaliadas e a população, diretamente envolvida.
The aim of this work was to evaluate parasitologicaly the vegeta¬bles that are consumed raw and are marketed in the Food Supply Center of Maringá City (Paraná State-Brazil), the hygienic-sanitary conditions of the place and of the merchants. Thirty samples of curly lettuce, 30 of rocket-salad, 27 of spinach and 24 of watercress were analyzed by Oliveira & Germano technique, in duplicate, and by Ziehl-Neelsen method modified by Henriksen-Polenz. The evaluation of the hygienic-sanitary conditions of the place and of the merchants' habits was made by an epidemiological data collection instrument. Watercress and rocket salad, which contamination index was upper than 80 percent, show the major number of contaminants. Coccidian oocysts, Superfamily Rhabdiasoidea and Ancylostomatoidea eggs and larvae were the mainly parasites found. There were no green vegetables parasited by Cryptosporidium sp. The hygienic-sanitary conditions of the place and of the merchants' habits showed irregularities. The vegetables were exposed to dust and to trucks traffic, the distributors were not appropriately dressed and 40 percente of the merchants handled green veg¬etables and money at the same time. The horticulture conditions, transport, distribution and manipulation of vegetables need to be constantly appraised and the population directly involved enlighten in order to improve the quality of green vegetables.
Asunto(s)
Humanos , Parasitología/análisis , Helmintos/parasitología , Verduras , Eucariontes , Higiene Alimentaria , VerdurasRESUMEN
É discutido o monitoramento de 290 gestantes com suspeita de toxoplasmose aguda atendidas em servicos públicos. Em 69 por cento um único teste (Elisa-IgM) conduziu ao tratamento. De 112 tratadas, o sistema não disponibilizou medicamento para 24 por cento. Em 12,1 por cento houve aumento progressivo de IgM e IgG. Em 48,2 por cento, o tratamento foi iniciado trinta dias após o diagnóstico laboratorial.