RESUMEN
Pediatric gastroenterologists, family members, and caregivers of patients with inflammatory bowel disease (IBD) are on alert; they are all focused on implementing prophylactic measures to prevent infection by severe acute respiratory syndrome coronavirus 2, evaluating the risks in each patient, guiding them in their treatment, and keeping IBD in remission. To face the current issues of the coronavirus disease pandemic, we have developed a synthesis of the main recommendations of the literature directed at pediatric gastroenterologists in control of patients with pediatric IBD and adapted to the national reality.
Asunto(s)
Betacoronavirus , Infecciones por Coronavirus/prevención & control , Enfermedades Inflamatorias del Intestino/terapia , Pandemias/prevención & control , Neumonía Viral/prevención & control , COVID-19 , Niño , Infecciones por Coronavirus/diagnóstico , Infecciones por Coronavirus/transmisión , Humanos , Neumonía Viral/diagnóstico , Neumonía Viral/transmisión , Pautas de la Práctica en Medicina , Prevención Primaria , SARS-CoV-2 , TelemedicinaRESUMEN
Pediatric gastroenterologists, family members, and caregivers of patients with inflammatory bowel disease (IBD) are on alert; they are all focused on implementing prophylactic measures to prevent infection by severe acute respiratory syndrome coronavirus 2, evaluating the risks in each patient, guiding them in their treatment, and keeping IBD in remission. To face the current issues of the coronavirus disease pandemic, we have developed a synthesis of the main recommendations of the literature directed at pediatric gastroenterologists in control of patients with pediatric IBD and adapted to the national reality.
Asunto(s)
Humanos , Niño , Neumonía Viral/prevención & control , Enfermedades Inflamatorias del Intestino/terapia , Infecciones por Coronavirus/prevención & control , Pandemias/prevención & control , Betacoronavirus , Neumonía Viral/diagnóstico , Neumonía Viral/transmisión , Prevención Primaria , Pautas de la Práctica en Medicina , Telemedicina , Infecciones por Coronavirus/diagnóstico , Infecciones por Coronavirus/transmisión , SARS-CoV-2 , COVID-19RESUMEN
INTRODUCTION: The aim of this study was to evaluate the frequency of anti-Toxocara antibodies in serum from 7-year-old children attending elementary school in Vitória-ES, Brazil and to correlate these antibodies with socio-demographic factors, the presence of intestinal helminths, blood eosinophil numbers, past history of allergy or asthma, and clinical manifestations of helminth infections. METHODS: The detection of anti-Toxocara antibodies was performed using an ELISA (Cellabs Pty Ltd)on serum from 391 children who had already been examined by fecal examination and blood cell counts. Data from clinical and physical examinations were obtained for all children. RESULTS: The prevalence of anti-Toxocara antibodies was 51.6%, with no gender differences. No significant differences were observed between positive serology and the presence or absence of intestinal worms (60.3 and 51.7%, respectively; p = 0.286). The only variables significantly related to positive serology were onycophagy and the use of unfiltered water. Although eosinophilia (blood eosinophil count higher than 600/mm³) was significantly related to the presence of a positive ELISA result, this significance disappeared when we considered only children without worms or without a past history of allergy or asthma. No clinical symptoms related to Toxocara infection were observed. CONCLUSIONS: There is a high prevalence of anti-Toxocara antibodies in children attending elementary schools in Vitória, which may be partially related to cross-reactivity with intestinal helminths or to a high frequency of infection with a small number of Toxocara eggs.
Asunto(s)
Anticuerpos Antihelmínticos/sangre , Heces/parasitología , Parasitosis Intestinales/epidemiología , Toxocara/inmunología , Toxocariasis/epidemiología , Animales , Brasil/epidemiología , Niño , Ensayo de Inmunoadsorción Enzimática , Femenino , Humanos , Parasitosis Intestinales/diagnóstico , Parasitosis Intestinales/parasitología , Masculino , Prevalencia , Factores de Riesgo , Instituciones Académicas/estadística & datos numéricos , Factores Socioeconómicos , Toxocariasis/diagnósticoRESUMEN
INTRODUCTION: The aim of this study was to evaluate the frequency of anti-Toxocara antibodies in serum from 7-year-old children attending elementary school in Vitória-ES, Brazil and to correlate these antibodies with socio-demographic factors, the presence of intestinal helminths, blood eosinophil numbers, past history of allergy or asthma, and clinical manifestations of helminth infections. METHODS: The detection of anti-Toxocara antibodies was performed using an ELISA (Cellabs Pty Ltd)on serum from 391 children who had already been examined by fecal examination and blood cell counts. Data from clinical and physical examinations were obtained for all children. RESULTS: The prevalence of anti-Toxocara antibodies was 51.6%, with no gender differences. No significant differences were observed between positive serology and the presence or absence of intestinal worms (60.3 and 51.7%, respectively; p = 0.286). The only variables significantly related to positive serology were onycophagy and the use of unfiltered water. Although eosinophilia (blood eosinophil count higher than 600/mm³) was significantly related to the presence of a positive ELISA result, this significance disappeared when we considered only children without worms or without a past history of allergy or asthma. No clinical symptoms related to Toxocara infection were observed. CONCLUSIONS: There is a high prevalence of anti-Toxocara antibodies in children attending elementary schools in Vitória, which may be partially related to cross-reactivity with intestinal helminths or to a high frequency of infection with a small number of Toxocara eggs.
INTRODUÇÃO: O objetivo desse estudo foi avaliar a prevalência de anticorpos anti-Toxocara em crianças admitidas no primeiro ano de escola fundamental em Vitória e correlacionar com variáveis sociodemográficas, helmintos intestinais, eosinófilos no sangue, geofagia, onicofagia, história de asma e alergia cutânea e manifestações clínicas. MÉTODOS: A pesquisa de anticorpos anti-Toxocara, utilizando um teste de ELISA (Cellabs), foi realizada em 391 crianças nas quais foram realizados exames parasitológicos de fezes e hemograma completo. Todas as crianças foram submetidas a exame clínico e físico. RESULTADOS: A prevalência de reação positiva foi de 51,6%, sem diferença entre os sexos. Não foram observadas diferenças significativas na prevalência de reação positiva em crianças com ou sem helmintos intestinais (60,3 e 51,7%, respectivamente; p = 0.286). Ainda que a frequência de eosinófilos acima de 600/mm³ tenha sido significativamente maior em crianças com sorologia positiva, a significância desapareceu quando se considerou as crianças sem helmintos intestinais ou história pregressa de asma ou alergia cutânea. As únicas variáveis significativamente correlacionadas, de modo independente, com a presença de sorologia positiva foram onicofagia e hábito de beber água não filtrada. Nenhuma criança apresentou manifestação clínica relacionada com a presença de anticorpos anti-Toxocara. CONCLUSÕES: A prevalência de anticorpos anti-Toxocara em crianças admitidas nas escolas elementares em Vitória é alta, a qual pode estar, em parte, relacionada à reação cruzada com antígenos de helmintos intestinais ou devida a frequente exposição a baixas quantidades de ovos do Toxocara.
Asunto(s)
Animales , Niño , Femenino , Humanos , Masculino , Anticuerpos Antihelmínticos/sangre , Heces/parasitología , Parasitosis Intestinales/epidemiología , Toxocara/inmunología , Toxocariasis/epidemiología , Brasil/epidemiología , Ensayo de Inmunoadsorción Enzimática , Parasitosis Intestinales/diagnóstico , Parasitosis Intestinales/parasitología , Prevalencia , Factores de Riesgo , Factores Socioeconómicos , Instituciones Académicas/estadística & datos numéricos , Toxocariasis/diagnósticoRESUMEN
The aim of this investigation was to evaluate the possible effect of nematode infection on anti-HBs antibody levels in the serum of seven-year-old schoolchildren vaccinated at birth with the recombinant hepatitis B vaccine. Anti-HBs and anti HBc antibodies were evaluated in the sera of 100 schoolchildren with at least one intestinal nematode and/or a positive serological reaction for anti-Toxocara antibodies and in 95 schoolchildren without intestinal helminthiasis or serum anti-Toxocara antibodies. Both groups were from public elementary schools located on the urban periphery of Vitória, ES, Brazil. Among these 195 children, the median anti-HBs antibody titer was 31.3 IU/ml and the frequency of titers less than 10 IU/ml was 33.8% (95% CI: 27.1-40.4%). There were no significant differences between the medians of anti-HBs titers or the frequency of titers less than 10 IU/ml between the groups with or without helminthes (29.5 and 32.9 IU/ml and 33 and 34.7%, respectively; p>0.05). Even when the children with intestinal nematodes and/or anti-Toxocara antibodies and with blood eosinophil counts over 600/mm(3) were compared with children without infection from intestinal nematodes and without anti-Toxocara antibodies, with blood eosinophil counts less than 400 eosinophils/mm(3), these differences were not significant. None of the children presented anti-HBc antibodies. In conclusion, infections with intestinal nematodes and/or the presence of anti-Toxocara antibodies did not interfere with the anti-HBs antibody titers in seven-year-old children vaccinated at birth with the recombinant hepatitis B vaccine.
Asunto(s)
Anticuerpos contra la Hepatitis B/sangre , Antígenos de Superficie de la Hepatitis B/sangre , Vacunas contra Hepatitis B/inmunología , Parasitosis Intestinales/inmunología , Infecciones por Nematodos/inmunología , Animales , Anticuerpos Antihelmínticos/sangre , Ascaris lumbricoides/inmunología , Estudios de Casos y Controles , Niño , Ensayo de Inmunoadsorción Enzimática , Femenino , Anticuerpos contra la Hepatitis B/inmunología , Antígenos de Superficie de la Hepatitis B/inmunología , Humanos , Parasitosis Intestinales/parasitología , Masculino , Infecciones por Nematodos/parasitología , Toxocara/inmunología , Trichuris/inmunologíaRESUMEN
The aim of this investigation was to evaluate the possible effect of nematode infection on anti-HBs antibody levels in the serum of seven-year-old schoolchildren vaccinated at birth with the recombinant hepatitis B vaccine. Anti-HBs and anti HBc antibodies were evaluated in the sera of 100 schoolchildren with at least one intestinal nematode and/or a positive serological reaction for anti-Toxocara antibodies and in 95 schoolchildren without intestinal helminthiasis or serum anti-Toxocara antibodies. Both groups were from public elementary schools located on the urban periphery of Vitória, ES, Brazil. Among these 195 children, the median anti-HBs antibody titer was 31.3IU/ml and the frequency of titers less than 10IU/ml was 33.8 percent (95 percent CI: 27.1-40.4 percent). There were no significant differences between the medians of anti-HBs titers or the frequency of titers less than 10IU/ml between the groups with or without helminthes (29.5 and 32.9IU/ml and 33 and 34.7 percent, respectively; p>0.05). Even when the children with intestinal nematodes and/or anti-Toxocara antibodies and with blood eosinophil counts over 600/mm³ were compared with children without infection from intestinal nematodes and without anti-Toxocara antibodies, with blood eosinophil counts less than 400 eosinophils/mm³, these differences were not significant. None of the children presented anti-HBc antibodies. In conclusion, infections with intestinal nematodes and/or the presence of anti-Toxocara antibodies did not interfere with the anti-HBs antibody titers in seven-year-old children vaccinated at birth with the recombinant hepatitis B vaccine.
O objetivo dessa investigação foi avaliar um possível efeito de infecções por nematóides sobre os níveis de anticorpos anti-HBs no soro de escolares de sete anos de idade, vacinados ao nascer com a vacina recombinante para hepatite B. Anticorpos anti-HBs e anti-HBc foram avaliados no soro de 100 escolares portadores de pelo menos um nematóide intestinal e/ou uma reação sorológica positiva para anticorpos anti-Toxocara e em 95 escolares sem helmintíases intestinais e sem anticorpos séricos anti-Toxocara, todos matriculados em escolas primárias públicas situadas na periferia urbana de Vitória, ES, Brasil. Nas 195 crianças, a mediana dos títulos dos anticorpos anti-HBs foi 31,3UI/ml, e a freqüência de títulos inferiores a 10UI/ml foi de 33,8 por cento (IC a 95 por cento:27,1- 40,4 por cento). Não houve diferença significativa entre as medianas dos títulos de anti-HBs ou da freqüência de títulos inferiores a 10 UI/ml entre as crianças com ou sem helmintos (29,5 e 32,9 UI/ml e 33 e 34,7 por cento, respectivamente; p >0.05). Mesmo quando comparadas crianças com nematóides intestinais e/ou anticorpos anti-Toxocara com eosinófilos circulantes acima de 600/mm³, com crianças sem infecção com nematóides intestinais e sem anticorpos anti-Toxocara, com menos de 400 eosinófilos/mm³, aquelas diferenças não foram significativas. Nenhuma das crianças apresentou anticorpos anti-HBc. Em conclusão, infecções com nematóides intestinais e/ou presença de anticorpos anti-Toxocara não interferem nos títulos de anticorpos anti-HBs em crianças de sete anos de idade, vacinadas ao nascer com a vacina recombinante para hepatite B.