Asociación de fascioliasis con el estado nutricional y coinfección enteroparasitaria en niños / Association of fascioliasis to nutritional status and enteroparasite coinfection in children

Introducción: La fascioliasis es causada por el trematodo Fasciola hepatica que afecta a animales herbívoros, omnívoros y al humano. Los niños de edad escolar son los más afectados y el órgano más dañado es el hígado. Este parásito requiere de reservorio y huésped intermediario para completar su ciclo biológico. Objetivo: Determinar la asociación de la fascioliasis con el estado nutricional y coinfección enteroparasitaria en niños. Métodos: La investigación se realizó entre septiembre de 2016 y abril de 2017 en el distrito de Santa María de Chicmo, región Apurímac. El estudio fue analítico de corte transversal. La población de niños de 6 a 16 años estuvo constituida por 2 172 individuos. El tamaño de muestra fue de 435 niños y se determinó mediante un muestreo simple al azar. Además, para que el muestreo fuera más eficiente se distribuyó el tamaño total de la muestra entre los estratos I.E. Primaria e I.E. Secundaria, para un resultado de 209 y 226 muestras, respectivamente. Sin embargo, se logró tomar 493 muestras coprológicas y serológicas repartidas proporcionalmente entre la totalidad de 23 instituciones educativas. Resultados: La prevalencia de fascioliasis fue de 5,3 por ciento (26/493; IC95 por ciento =3,2-7,4). Las instituciones educativas con mayor prevalencia fueron: Taramba con 17,2 por ciento (5/29; IC95 por ciento = 5,9-35,8), Libertadores de América con 16,1 por ciento (5/31; IC95 por ciento = 5,5-33,7), Mariano Melgar con 15 por ciento (3/20; IC95 por ciento = 3,2-37,9) y Nuestra Señora de Guadalupe con 10,8 por ciento (4/37; IC95 por ciento = 3-25,4). No se encontró asociación de fascioliasis con la valoración nutricional antropométrica ni con la coinfección enteroparasitaria en niños (p˃ 0,05). Conclusiones: La fascioliasis no estaría afectando el estado nutricional de los niños; asimismo, los signos clínicos, atribuidos a fascioliasis, corresponderían también a la alta presentación de parásitos entéricos(AU)

Introduction: Fascioliasis is caused by the trematode Fasciola hepatica and affects herbivorous and omnivorous animals as well as humans. Schoolchildren are the most affected group, and the organ most commonly targeted is the liver. This parasite requires an intermediate reservoir and host to complete its biological cycle. Objective: Determine the association of fascioliasis to nutritional status and enteroparasite coinfection in children. Methods: An analytical cross-sectional study was conducted from September 2016 to April 2017 in the district of Santa María de Chicmo, Apurímac Region. The child population aged 6-16 years was composed of 2 172 individuals. The sample size was 435 children, and it was determined by simple random sampling. Additionally, in order for the sampling to be more efficient, the total sample size was distributed between the strata Primary E.I. and Secondary E.I., for 209 and 226 samples, respectively. However, 493 coprological and serological samples were proportionally taken from the total 23 educational institutions. Results: Prevalence of fascioliasis was 5.3 percent (26/493; CI95 percent=3.2-7.4). The educational institutions with the highest prevalence were Taramba with 17.2 percent (5/29; CI95 percent= 5.9-35.8), Libertadores de América with 16.1 percent (5/31; CI95 percent= 5.5-33.7), Mariano Melgar with 15 percent (3/20; CI95 percent= 3.2-37.9) and Nuestra Señora de Guadalupe with 10.8 percent (4/37; CI95 percent= 3-25.4). No association was found between fascioliasis and nutritional anthropometric assessment or enteroparasite coinfection in children (p˃ 0.05). Conclusions: Fascioliasis was not found to affect the nutritional status of children. On the other hand, the clinical signs attributed to fascioliasis also correspond to the high presentation of enteric parasites(AU)

Prevalence of geophagy and knowledge about its health effects among native Sub-Saharan Africa, Caribbean and South America healthy adults living in France.

Geophagy is widespread among women from Sub-Saharan Africa, South America and the Caribbean and may persist in western countries. This practice may be associated with adverse effects such as anaemia, constipation or intestinal occlusion. We aimed to determine the prevalence of geophagy and the level of knowledge about its health effects among healthy adults originating from these countries and attending a travel medicine and international vaccination consultation in France. Among 101 travellers enrolled in the study, 83 (82.1%) were born in Sub-Saharan Africa and 13 (12.8%) in South America or the Caribbean. The mean duration of residence in France was 15.6 ± 10.4 years. Previous or current geophagy was present in 42 travellers [previous geophagy in 31 (30.7%) and current consumption in 11 (10.9%)]; 38 (90.5%) were women. The rate of awareness of harmful effects of geophagy as the risk of iron-deficient anaemia (18.8%) and soil-transmitted intestinal parasitic infections (11.9%) was low overall. Women with previous or current geophagy more often had history of iron therapy compared to those who never consumed, both during pregnancy (50.0 versus 14.3%; p = 0.0009) and outside pregnancy (47.4 versus 2.8%; p < 0.0001). Despite a long period of residence in France, geophagy was still a current practice among 10.9% of Sub-Saharan, South American and Caribbean travellers, who are poorly informed of its harmful effects. Therefore, specific information tailored to Sub-Saharan, South American and Caribbean about the risks of geophagy should be implemented in western countries.Level of evidence Level V, descriptive cross-sectional survey.

[Access to drinking water, environmental protection and intestinal parasites in pediatric patients from the neighborhood El Codito in Bogotá, Colombia]. / Acceso a agua potable, protección ambiental y parasitismo intestinal infantil en El Codito. Bogotá, Colombia.

OBJECTIVE: To establish the correlation between intestinal parasitism in children younger than 6 years old and their dwelling in environmental protected areas without aqueduct service, in the neighborhood El Codito, in Bogotá, Colombia. MATERIALS AND METHODS: A cross-sectional study was done with 144 children between the ages of 4 and 70 months. Socio-demographic data were collected by surveying parents, and fecal samples were taken from the children to identify parasites. Descriptive measures were calculated for the variables by population type (parasitized and non-parasitized), establishing significant differences. Using a binary multivariate logistic regression, the correlation between intestinal parasitism and aqueduct was determined, adjusting the other studied variables. RESULTS: The prevalence of intestinal parasitism was 38.9%. The lack of aqueduct service was associated with intestinal parasitism (OR=31.25) after adjusting for other studied variables, which included affiliation to the subsidized health insurance regime compared with the contributory regime (OR= 1.49), home pets (OR= 2.58), mothers with professional jobs compared to mothers with non-professional jobs (OR=0.05), and dwelling in a rented room when compared with own dwelling (OR= 6.62). CONCLUSIONS: Children under the age of 6 living in protected areas without water service were more likely to suffer from intestinal parasitism. It is known that preserving protected areas to protect the environment is of great importance, but if the settlement of populations in these territories is not prevented in time, the population living there is subject to adverse conditions which violate human dignity.

OBJETIVOS: Establecer la relación entre parasitismo intestinal en niños menores de 6 años y vivienda en áreas de protección ambiental, sin servicio de acueducto, en El Codito -Bogotá, Colombia. MÉTODOS: Estudio de corte transversal que incluyó 144 niños entre los 4 y 70 meses de edad. Se recolectaron datos sociodemográficos encuestando a los padres y se tomaron muestras fecales de los niños. Se calcularon medidas descriptivas de las variables por tipo de población (parasitada y no parasitada) estableciendo diferencias estadísticamente significativas. Utilizando una regresión logística binomial multivariada se determinó la relación entre parasitismo intestinal y servicio de acueducto, controlando por las demás variables estudiadas. RESULTADOS: Se encontró una prevalencia de parasitismo intestinal de 38,9%. La falta de servicio de acueducto estuvo asociada a parasitismo (OR=31,25) ajustando por las demás variables estudiadas. Otras variables asociadas a parasitismo fueron: afiliación al régimen de salud subsidiado al compararla con el contributivo (OR=1,49), presencia de animales en la vivienda (OR=2,58), madres con oficio técnico-profesional al compararlas con madres con oficios no calificados (OR=0,05) y vivienda en habitación rentada al compararla con vivienda propia (OR=6,62). CONCLUSIONES: Los niños menores de 6 años viviendo en áreas protegidas sin servicio de acueducto presentaron con mayor frecuencia parasitismo intestinal. Si bien es claro que el establecimiento de áreas protegidas para preservar el medio ambiente es esencial, si no se previene el asentamiento de poblaciones en estos territorios a tiempo, la población que habita en los mismos está sujeta a condiciones adversas que atentan contra la dignidad humana.

Conocimientos y hábitos higiénicos sobre parasitosis intestinal en niños. Comunidad "Pepita de Oro". Ecuador. 2015-2016 / Hygienic knowledge and habits on intestinal parasitism in children. Community “Pepita de Oro”. Ecuador. 2015-2016

Introducción: las infecciones por parasitismo intestinal, se consideran un problema de salud por sus altas tasas de prevalencia. La población infantil resulta la más afectada. A esta realidad no escapa la comunidad "Pepita de Oro", de Ecuador. Objetivo: evaluar conocimientos y hábitos higiénicos sobre parasitosis intestinal en niños de 1 a 9 años en dicha comunidad. Materiales y métodos: se realizó un estudio observacional, transversal, correlacional, en el período comprendido de agosto 2015 a septiembre 2016, en la comunidad urbana marginal "Pepita de Oro", de la ciudad del Tena, en la amazonia del Ecuador. Se aplicó encuestas a 50 padres de familia y se les realizó coproparasitario a sus 50 niños, previo consentimiento. Se trabajó con las siguientes variables: sexo, edad, tipo de parasitosis, abasto de agua, tratamiento de la misma, condiciones higiénicas, conocimientos sobre parasitismo intestinal y normas higiénicas. Resultados: se detectó que en los hábitos como el lavado de las manos antes de comer fue alto, para el 94 %; el lavado de las manos después de ir al baño, fue de 88 %. Según coproparasitario el porcentaje mayor se encontró poliparasitado, con el 77 % y 23 % monoparasitado. El grupo atareo más afectado con monoparasitismo fue de 5 a 9 años, con el 18 %; mientras que por el poliparasitismo fue de 1 a 4 años con el 67 %. El 60 % fue evaluado con parasitosis y con desconocimiento de las diferentes normas higiénicas. Conclusiones: los conocimientos y práctica de los hábitos higiénicos fueron insatisfactorios y existe la prevalencia de parasitosis (AU).

Introduction: the infections caused by intestinal parasitism are considered a health problem because of their high prevalence rates. Child population is the most affected one. The community "Pepita de Oro" does not scape this reality. Objective: to evaluate hygienic habits and knowledge on intestinal parasitism in 1-9 years-old in that community. Materials and methods: An observational, correlational and cross-sectional study was carried out in the urban marginal community "Pepita de Oro" from the city Tena, in the Ecuadorian Amazonia, in the period from August 2015 to September 2016. 50 family fathers applied a survey and coproparasitical tests were made to their 50 children, after obtaining the previous consent. The following variables were worked out: sex, age, kind of parasitism, water supply, water treatment, hygienic conditions, knowledge on intestinal parasitism and hygienic norms. Results: it was found that the habit of washing hands before eating was high, 94 %; washing hands after going to the toilet was 88 %. According to the results of the coproparasitical tests, the highest percent of children was found poliparasitized, with 77 % and 23 % were monoparasitized. The age group that was most affected by mono-parasitism was the 5-9 years-old group, with 18 %, while the 1-4 years-old group was the most affected with poliparasitism. 60 % was evaluated with parasitism and lack of knowledge on the different hygienic norms. Conclusions: hygienic habits knowledge and practice were poor and there is a prevalence of parasitism (AU).

Conocimientos y hábitos higiénicos sobre parasitosis intestinal en niños. Comunidad "Pepita de Oro". Ecuador. 2015-2016 / Hygienic knowledge and habits on intestinal parasitism in children. Community "Pepita de Oro". Ecuador. 2015-2016

Introducción: las infecciones por parasitismo intestinal, se consideran un problema de salud por sus altas tasas de prevalencia. La población infantil resulta la más afectada. A esta realidad no escapa la comunidad "Pepita de Oro", de Ecuador. Objetivo: evaluar conocimientos y hábitos higiénicos sobre parasitosis intestinal en niños de 1 a 9 años en dicha comunidad. Materiales y métodos: se realizó un estudio observacional, transversal, correlacional, en el período comprendido de agosto 2015 a septiembre 2016, en la comunidad urbana marginal "Pepita de Oro", de la ciudad del Tena, en la amazonia del Ecuador. Se aplicó encuestas a 50 padres de familia y se les realizó coproparasitario a sus 50 niños, previo consentimiento. Se trabajó con las siguientes variables: sexo, edad, tipo de parasitosis, abasto de agua, tratamiento de la misma, condiciones higiénicas, conocimientos sobre parasitismo intestinal y normas higiénicas. Resultados: se detectó que en los hábitos como el lavado de las manos antes de comer fue alto, para el 94 %; el lavado de las manos después de ir al baño, fue de 88 %. Según coproparasitario el porcentaje mayor se encontró poliparasitado, con el 77 % y 23 % monoparasitado. El grupo atareo más afectado con monoparasitismo fue de 5 a 9 años, con el 18 %; mientras que por el poliparasitismo fue de 1 a 4 años con el 67 %. El 60 % fue evaluado con parasitosis y con desconocimiento de las diferentes normas higiénicas. Conclusiones: los conocimientos y práctica de los hábitos higiénicos fueron insatisfactorios y existe la prevalencia de parasitosis (AU).

Introduction: the infections caused by intestinal parasitism are considered a health problem because of their high prevalence rates. Child population is the most affected one. The community "Pepita de Oro" does not scape this reality. Objective: to evaluate hygienic habits and knowledge on intestinal parasitism in 1-9 years-old in that community. Materials and methods: An observational, correlational and cross-sectional study was carried out in the urban marginal community "Pepita de Oro" from the city Tena, in the Ecuadorian Amazonia, in the period from August 2015 to September 2016. 50 family fathers applied a survey and coproparasitical tests were made to their 50 children, after obtaining the previous consent. The following variables were worked out: sex, age, kind of parasitism, water supply, water treatment, hygienic conditions, knowledge on intestinal parasitism and hygienic norms. Results: it was found that the habit of washing hands before eating was high, 94 %; washing hands after going to the toilet was 88 %. According to the results of the coproparasitical tests, the highest percent of children was found poliparasitized, with 77 % and 23 % were monoparasitized. The age group that was most affected by mono-parasitism was the 5-9 years-old group, with 18 %, while the 1-4 years-old group was the most affected with poliparasitism. 60 % was evaluated with parasitism and lack of knowledge on the different hygienic norms. Conclusions: hygienic habits knowledge and practice were poor and there is a prevalence of parasitism (AU).

Multiple Simultaneous Gastrointestinal Parasitic Infections in a Patient with Human Immunodeficiency Virus.

Patients with the human immunodeficiency virus (HIV) infection are at high risk for gastrointestinal infections causing diarrhea, particularly when those infections are parasitic in nature. This propensity is more pronounced in AIDS, where opportunistic parasitic infections may cause severe diarrhea, marked absorptive dysfunction, and significant risk of mortality. There are scant data regarding parasitic infections among HIV patients in the developed world; most studies and research come from povertystricken areas of South Africa, India, Iran, and the South Pacific. Although multiple infections with the same or different parasites have been reported, simultaneous infections are rare. We present the case of a 35-year-old man who developed a co-infection with Giardia, Cryptosporidium, and Strongyloides, simultaneously, the diagnosis being made after the judicious evaluation of a stool sample. Given the associated morbidity, prompt diagnosis and treatment are needed to avoid further complications in patients with HIV. To our knowledge this is the first reported case of triple parasitic infection in a patient with HIV.

Resultados de una intervención educativa sobre parasitismo intestinal en personal médico / Results of an educational intervention on intestinal parasitism in medical staffs

Introducción: las infecciones por parásitos intestinales son frecuentes en áreas geográficas donde el clima y las condiciones higiénico sanitarias deficientes favorecen su supervivencia, reproducción y transmisión. Objetivos: evaluar los resultados de una intervención educativa sobre parasitismo intestinal en médicos que prestan servicios en la Atención Primaria de Salud (APS). Métodos: se realizó un estudio descriptivo, transversal con médicos de la APS en quienes se evidenció previamente, con la aplicación de una encuesta, la existencia de insuficientes conocimientos en relación con el parasitismo intestinal. Con este propósito se impartió el curso Actualización en parasitismo intestinal acreditado en la Facultad de Ciencias Médicas Dr. Miguel Enríquez, dictamen 3/2013. Una vez finalizado el curso, se aplicó una nueva encuesta para evaluar los conocimientos adquiridos. Se confeccionó una base de datos utilizando el programa Microsoft Excel 2013. Se compararon las medias de las puntuaciones obtenidas en las dos evaluaciones utilizando una distribución t de Student a través del programa Epidat versión 3.1. Resultados: el 100 por ciento de los médicos aprobaron el segundo cuestionario con más de 70 puntos. Se observaron diferencias estadísticamente significativas al comparar la media de las puntuaciones en las dos evaluaciones (p< 0,05). Conclusiones: se demostró la eficacia de esta intervención educativa pues se produjo una mejoría estadísticamente significativa de las evaluaciones(AU)

Introduction: Intestinal parasite infections are common in geographic areas where poor hygiene and sanitary conditions favor survival, reproduction and transmission of intestinal parasitism. Objectives: Evaluate the results of an educational intervention on intestinal parasitism in physicians who provide services in Primary Health Care (PHC). Methods: A descriptive, cross-sectional study was carried out with PHC physicians who previously had a survey. It was evidenced the existence of insufficient knowledge regarding intestinal parasitism. For this purpose the course Intestinal parasitism update was given at Dr. Miguel Enríquez Faculty of Medical Sciences, dictum 3/2013. After completing the course, a new survey was applied to evaluate the knowledge acquired. A database was made using the Microsoft Excel 2013 program. the means of the scores obtained were compared in the two evaluations using a t Student distribution through the program Epidat version 3.1. Results: 100 percent of the doctors passed the second questionnaire with more than 70 points. Statistically significant differences were observed when comparing the mean scores obtained in the two evaluations (p< 0.05). Conclusions: This educational intervention was proven to be effective, as there was a statistically significant improvement of the evaluations(AU)

Population Density, Poor Sanitation, and Enteric Infections in Nueva Santa Rosa, Guatemala.

Poor sanitation could pose greater risk for enteric pathogen transmission at higher human population densities because of greater potential for pathogens to infect new hosts through environmentally mediated and person-to-person transmission. We hypothesized that incidence and prevalence of diarrhea, enteric protozoans, and soil-transmitted helminth infections would be higher in high-population-density areas compared with low-population-density areas, and that poor sanitation would pose greater risk for these enteric infections at high density compared with low density. We tested our hypotheses using 6 years of clinic-based diarrhea surveillance (2007-2013) including 4,360 geolocated diarrhea cases tested for 13 pathogens and a 2010 cross-sectional survey that measured environmental exposures from 204 households (920 people) and tested 701 stool specimens for enteric parasites. We found that population density was not a key determinant of enteric infection nor a strong effect modifier of risk posed by poor household sanitation in this setting.

Recomendações da Sociedade Brasileira de Reumatologia sobre diagnóstico e tratamento das parasitoses intestinais em pacientes com doenças reumáticas autoimunes / Recommendations from the Brazilian Society of Rheumatology on the diagnosis and treatment of intestinal parasitic infections in patients with autoimmune rheumatic disorders

RESUMOAs parasitoses intestinais – helmintíases e protozooses – são doenças cosmopolitas com maior prevalência em regiões tropicais. Pacientes com diagnóstico de doenças reumáticas autoimunes apresentam, em função da própria doença de base ou de seu tratamento, um maior risco de ocorrência de manifestações graves das parasitoses intestinais. Embora a prevalência dessas parasitoses seja bastante elevada em nosso meio, nem sempre o reumatologista está atento à necessidade de investigação e tratamento das helmintíases e protozooses antes do uso de terapias imunomoduladoras, imunossupressoras e dos medicamentos biológicos modificadores do curso da doença. Neste documento, a Sociedade Brasileira de Reumatologia estabelece recomendações gerais sobre o diagnóstico e tratamento das parasitoses intestinais no Brasil em pacientes com doenças reumáticas autoimunes, com destaque para a artrite reumatoide, o lúpus eritematoso sistêmico e as espondiloartrites.

ABSTRACTIntestinal parasites – helminths and protozoa – are cosmopolitan diseases which are most prevalent in tropical regions. Patients with diagnoses of autoimmune rheumatic diseases have, due to the underlying disease or its treatment, an increased risk of occurrence of severe manifestations of intestinal parasites. Although the prevalence of these parasitic infections is very high in our environment, not always is the rheumatologist attentive to the need for investigation and treatment of helminthiasis and protozooses before the use of immunomodulatory, immunosuppressive therapies, and of biological drugs that are modifiers of the course of the disease. In this document, the Brazilian Society of Rheumatology establishes general recommendations on the diagnosis and treatment of intestinal parasitic infections in Brazil in patients with autoimmune rheumatic diseases, highlighting rheumatoid arthritis, systemic lupus erythematosus and spondyloarthritis.

Enteropathogens detected in a daycare center, Southeastern Brazil: bacteria, virus, and parasite research.

INTRODUCTION: The objective of this study was to determine the prevalence and etiological profile of enteropathogens in children from a daycare center. METHODS: From October 2010 to February 2011 stool samples from 100 children enrolled in a government daycare center in the municipality of São José do Rio Preto, in the state of São Paulo, were collected and analyzed. RESULTS: A total of 246 bacteria were isolated in 99% of the fecal samples; 129 were in the diarrheal group and 117 in the non-diarrheal group. Seventy-three strains of Escherichia coli were isolated, 19 of Enterobacter, one of Alcaligenes and one of Proteus. There were 14 cases of mixed colonization with Enterobacter and E. coli. Norovirus and Astrovirus were detected in children with clinical signs suggestive of diarrhea. These viruses were detected exclusively among children residing in urban areas. All fecal samples were negative for the presence of the rotavirus species A and C. The presence of Giardia lamblia, Entamoeba coli, Endolimax nana and hookworm was observed. A significant association was found between food consumption outside home and daycare center and the presence of intestinal parasites. CONCLUSIONS: For children of this daycare center, intestinal infection due to pathogens does not seem to have contributed to the occurrence of diarrhea or other intestinal symptoms. The observed differences may be due to the wide diversity of geographical, social and economic characteristics and the climate of Brazil, all of which have been reported as critical factors in the modulation of the frequency of different enteropathogens.

Enteropathogensddetected in a daycare center, sutheastern Brazil: bacteria, viirus, and parasite research / Enteropatógenos detectados em crianças de creche no Sudeste do Brasil: pesquisa de bactérias, vírus e parasitos

Introduction: The objective of this study was to determine the prevalence and etiological profile of enteropathogens in children from a daycare center. Methods: From October 2010 to February 2011 stool samples from 100 children enrolled in a government daycare center in the municipality of São José do Rio Preto, in the state of São Paulo, were collected and analyzed. Results: A total of 246 bacteria were isolated in 99% of the fecal samples; 129 were in the diarrheal group and 117 in the non-diarrheal group. Seventy-three strains of Escherichia coli were isolated, 19 of Enterobacter, one of Alcaligenes and one of Proteus. There were 14 cases of mixed colonization with Enterobacter and E. coli. Norovirus and Astrovirus were detected in children with clinical signs suggestive of diarrhea. These viruses were detected exclusively among children residing in urban areas. All fecal samples were negative for the presence of the rotavirus species A and C. The presence of Giardia lamblia, Entamoeba coli, Endolimax nana and hookworm was observed. A significant association was found between food consumption outside home and daycare center and the presence of intestinal parasites. Conclusions: For children of this daycare center, intestinal infection due to pathogens does not seem to have contributed to the occurrence of diarrhea or other intestinal symptoms. The observed differences may be due to the wide diversity of geographical, social and economic characteristics and the climate of Brazil, all of which have been reported as critical factors in the modulation of the frequency of different enteropathogens.

Introdução: O objetivo deste estudo foi determinar a prevalência e o perfil etiológico de enteropatógenos em crianças de uma creche. Métodos: No período de outubro de 2010 a fevereiro de 2011 foram coletadas e analisadas amostras de fezes de 100 crianças matriculadas em creche do governo no município de São José do Rio Preto, Estado de São Paulo. Resultados: Um total de 246 bactérias foram isoladas em 99% das amostras de fezes; 129 eram diarreicas e 117 não-diarreicas. Foram isoladas setenta e três cepas de Escherichia coli, 19 de Enterobacter, uma de Alcaligenes e uma de Proteus. Foram detectados 14 casos de colonização mista com Enterobacter e de E. coli. Norovírus e Astrovirus foram detectados em crianças com sinais clínicos sugestivos de diarréia. Estes vírus foram detectados exclusivamente entre as crianças residentes em áreas urbanas. Todas as amostras fecais foram negativas para a presença das espécies de rotavírus A e C. Foi observada a presença de Giardia lamblia, Entamoeba coli, Endolimax nana e ancilostomídeos. Foi encontrada associação significativa entre o consumo de alimentos fora do centro da casa e creche e a presença de parasitos intestinais. Conclusões: Para as crianças desta creche, a infecção intestinal por patógenos não parece ter contribuido para a ocorrência de diarreia ou outros sintomas intestinais. As diferenças observadas podem ser atribuídas à grande diversidade de características geográficas, sociais e econômicas e o clima do Brasil, as quais tem sido relatadas como fatores críticos para a modulação da frequência de diferentes enteropatógenos.

[Recommendations from the Brazilian Society of Rheumatology on the diagnosis and treatment of intestinal parasitic infections in patients with autoimmune rheumatic disorders]. / Recomendações da Sociedade Brasileira de Reumatologia sobre diagnóstico e tratamento das parasitoses intestinais em pacientes com doenças reumáticas autoimunes.

Intestinal parasites - helminths and protozoa - are cosmopolitan diseases which are most prevalent in tropical regions. Patients with diagnoses of autoimmune rheumatic diseases have, due to the underlying disease or its treatment, an increased risk of occurrence of severe manifestations of intestinal parasites. Although the prevalence of these parasitic infections is very high in our environment, not always is the rheumatologist attentive to the need for investigation and treatment of helminthiasis and protozooses before the use of immunomodulatory, immunosuppressive therapies, and of biological drugs that are modifiers of the course of the disease. In this document, the Brazilian Society of Rheumatology establishes general recommendations on the diagnosis and treatment of intestinal parasitic infections in Brazil in patients with autoimmune rheumatic diseases, highlighting rheumatoid arthritis, systemic lupus erythematosus and spondyloarthritis.

Ascaris lumbricoides infection and parasite load are associated with asthma in children.

INTRODUCTION: Association between Ascaris lumbricoides infection and asthma is a controversial subject that has been studied by several authors based on the hygiene theory. This work contributes to better understanding this issue. METHODOLOGY: This was a cross-sectional study involving 1,004 children from a neighborhood of low socioeconomic status in Campina Grande, Paraíba, northeastern Brazil. Asthma was diagnosed using the International Study of Asthma and Allergy in Childhood (ISAAC) questionnaire. Intestinal parasitosis was diagnosed by parasitological examination (the Ritchie technique), and parasite load determined by the Kato-Katz technique. The statistical analysis was descriptive, and hypotheses were tested according to odds ratios. RESULTS: A total of 260 children were infected with A. lumbricoides, and 233 had asthma. Light parasite loads were significantly associated with asthma (wheezing more than three times per year); p = 0.003, OR = 0.41(IC 0.22 - 0.75), while the heavy parasite loads were not; p = 0.002, OR = 2.37(IC 1.35 - 4.18). Similar results were observed in almost all the symptoms of asthma. No association was found with maternal educational level. CONCLUSION: In children living in urban areas of low socioeconomic status, a light parasite load of A. lumbricoides is a protective factor against asthma and its symptoms. Meanwhile, heavy parasite load is a risk factor and contributes to the high prevalence of asthma and its symptoms among these children.

Nutritional status in parasitized and nonparasitized children from two districts of Buenos Aires, Argentina.

UNLABELLED: The Program for the Control of Intestinal Parasites and Nutrition was designed to intervene in small communities to prevent and control the effects of parasitic infections on children's health. OBJECTIVES: To analyze the association between nutritional status and parasitic infection in suburban and rural children from Buenos Aires, Argentina. METHODS: Nutritional status was assessed by anthropometric (weight, height, BMI, skinfolds, upper arm circumference, muscle, and fat upper arm areas) and biochemical (Hb, Ca, Mg, Zn, and Cu) indicators. Parasitological analysis were made on both serial stool and perianal swab samples. A total of 708 children aged 3-11 were measured. The biochemical analysis included 217 blood samples and the parasitological study included 284 samples. RESULTS: Anthropometric status was similar in both settings with low rates of underweight and stunting (<6%), and high rates of overweight (~17%) and obesity (~12%). Ca deficiency was significantly higher in suburban children where 80% of them were hypocalcemic. Around 70% of fecal samples contained parasites. Among infected children, the most prevalent species were Blastocystis hominis and Enterobius vermicularis (~43%) followed by Giardia lamblia (~17%). Differences in parasitological status between districts were not significant. In the suburban district parasitized children were lighter, shorter, and had a lower upper arm circumference than their non-infected peers. No differences in anthropometric status were seen among infected and uninfected rural children. CONCLUSIONS: The results suggest an association between intestinal parasites and physical growth in suburban children. Rural children seem to be protected against the effects of parasitic infection.

Factores asociados al parasitismo intestinal en círculos infantiles del municipio Matanzas: segundo semestre, 2008 / Factors associated to intestinal parasitism in day care centres of the municipality of Matanzas: second semester, 2008

Se realizó un estudio observacional analítico de corte transversal a niños que asisten a círculos infantiles, del municipio Matanzas, en el segundo semestre de 2008, para identificar factores asociados al parasitismo intestinal. La muestra quedó constituida por 203 niños que asistían a dos círculos infantiles del mencionado municipio. A los padres de cada niño, previo consentimiento, se les realizó una encuesta que recogía datos de interés epidemiológico y se les solicitó la recogida de una muestra de heces fecales de sus hijos, las que fueron estudiadas por el examen directo de heces y el método de concentración de Willis-Malloy modificado. Para el cálculo de la prevalencia de los niños parasitados, se dividió el total de parasitados entre el total de niños en el estudio multiplicado por 100. Se realizó un análisis bivariado, donde se cruzaron en tablas de contingencias cada una de las variables independientes con la dependiente. Se calcularon frecuencias absolutas y relativas, el odds ratio (OR) con sus intervalos de confianza del 95 por ciento y el Chi cuadrado. Se consideraron resultados estadísticamente significativos cuando el intervalo de confianza no incluyó el valor 1 y el valor de p del Chi cuadrado fue inferior al 0,05. Posteriormente, se controlaron los posibles factores de confusión utilizando la regresión logística mediante el programa SPSS. Fueron hallados como factores verdaderamente asociados al parasitismo intestinal de estos niños el no lavado de las verduras, caminar descalzo, comerse las uñas y succión digital...(AU)

We carried out an analytic, observational, transversal study of children assisting day care centres in the municipality of Matanzas, in the second semester of 2008, to identify the factors associated to intestinal parasitism. The sample was formed by 203 children who assisted two day care centres of the municipality. The parents of each child, with their previous accord, answered a survey with some data of epidemiologic interest, and were asked to collect samples of their children's feces that were studied by direct examination of the feces and the modified Willis-Malloy concentration method. To calculate the prevalence of the parasited children, the total of the parasited children was divided among the total of children in the study multiplied by 100. We carried out a bivariate analysis, where, in contingency charts, we crossed each one of the independent variables with the dependent ones. We calculated absolute and relative frequencies, the odd ratio with its 95 percent confidence intervals and the Chi squared. Statistically significant results were considered when the confidence interval did not included the value 1 and p value of Chi squared was less than 0,05. Then, the possible confusion facts were controlled using the logistic regression through the SPSS program. As facts truly associated to these children's intestinal parasitism we found not washing the vegetables, barefoot walking and digital suction...(AU)

Enteroparásitos en niños y adolescentes de una comuna periurbana de la provincia de Córdoba / Enteroparasites in children and adolescents of a periurban community in the province of Cordoba / Enteroparasitas em crianças e adolescentes de uma comuna periurbana do Província de Córdoba

El objetivo del presente trabajo fue detectar y caracterizar enteroparásitos en niños y adolescentes de la Comuna Los Cedros de la provincia de Córdoba. La detección de parásitos se realizó en 111 individuos (con edades comprendidas entre 6 meses y 21 años) mediante examen macroscópico y microscópico (directo y métodos de concentración de Ritchie y de Willis) y escobillado anal (método de Graham). La prevalencia de parasitados fue de 74% sin asociación significativa entre mujeres y varones (51% vs. 49%). Los niños de 5 a 11 años evidenciaron el mayor porcentaje de parásitos intestinales (61%). Las especies identificadas fueron: Enterobius vermicularis (54%), Blastocystis hominis (52%), Giardia lamblia (28%), Entamoeba coli (17%), Endolimax nana (10%), Chilomastix mesnilii (2%), Iodamoeba bütschlii (2%) e Hymenolepis nana (5%). La prevalencia de monoparasitados y poliparasitados fue de 44% y 56%, respectivamente, sin asociación significativa con la edad o el sexo. En niños y adolescentes poliparasitados las combinaciones más frecuentes fueron: Enterobius vermicularis/Blastocystis hominis y Enterobius vermicularis/Giardia lamblia. En conclusión, este estudio determinó una elevada prevalencia de enteroparásitos en niños y adolescentes de esta comuna periurbana de la provincia de Córdoba, lo que puede ayudar a establecer y consolidar programas de control y vigilancia epidemiológica.

The objective of the present investigation was to detect and characterize enteroparasites in children and adolescents of the community Los Cedros in the province of Cordoba. Parasites were detected in 111 individuals (6 months to 21 years old) by: macroscopic and microscopic examination (direct and Willis and Ritchie concentration methods) and anal swabs (Graham method). The prevalence of parasites was 74% without significant association between women and men (51 % vs. 49%). Chíldren from 5 to 11 years of age evídenced the greatest percentages of parasitosis (61%). The species identified were: Enterobius vermicularis (54%), Blastocystis hominis (52%), Giardia lamblia (28%), Entamoeba coli (17%), Endolimax nana (10%), Chilomastix mesnilii (2%), lodamoeba bütschlii (2%) and Hymenolepis nana (5%). The prevalence of monoparasitosis and poliparasitosis was 44% and 56%, respectively, without any significant association with age and sex. In chíldren and adoiescents wíth poliparasitosis, the mosi frequent combinations were: Enterobius vermicularis/Blastocystis hominis and Enterobius vermicularis/Giardia lamblia. In conclusión, this study determined a high prevalence of enteropararasites in chíldren and adoiescents of thís perturban communíty in the provínce of Córdoba thai could help to establish and to consolídate control programs and epidemiológica! surveillance.

GIS applications for mapping and spatial modeling of urban-use water quality: a case study in District of Cuiabá, Mato Grosso, Brazil.

A cross-sectional study utilizing spatial analysis techniques was conducted to study water quality problems and risk of waterborne enteric diseases in a lower-middle-class urban district of Cuiabá, the capital of Mato Grosso State, Brazil. Field surveys indicate high rates of supply water contamination in domiciles and, conspicuously, in public and private schools. Logistic regression models developed for the variables turbidity, Escherichia coli, total coliforms, and intestinal parasite infection did not identify singular explanatory factors for the supply water conditions and elevated incidences of enteric diseases among children. The contamination problems were found to be the result of precarious conditions involving both public infrastructure and in-building sanitary installations and their maintenance. GIS methods were successfully applied to create spatial datasets for logistic regression model building and to construct risk maps using regression coefficients.

Prevalence and risk factors of intestinal parasites in Cuban children.

OBJECTIVES: To determine the prevalence of intestinal parasite infections and their risk factors in children in urban and rural settings in two Cuban municipalities. METHODS: A total of 1320 Cuban schoolchildren aged 4-14 were tested by stool examination for intestinal parasite infections and evaluated by parental questionnaire for a number of common environmental, sanitary, socioeconomic and behavioural risk factors. Multivariate regression was applied to examine the relationship between the respective parasite infections and the risk factors. RESULTS: Prevalences of intestinal parasite infections were 58% in Fomento and 45% in San Juan y Martínez; for helminth infections, these were 18% and 24% and for protozoa infections, 50% and 29%, respectively. Helminth infections were associated with high parental education (maternal: OR 0.68, CI 0.50-0.93; paternal: OR 0.71, CI 0.52-0.96), absence of toilet (OR 1.57, CI 1.12-2.19), consumption of water from a well or river (OR 0.56, CI 0.41-0.77) and eating unpeeled/unwashed fruit (OR 1.37, CI 1.01-1.87); protozoa infections were only associated with high maternal education (OR 0.72, CI 0.57-0.91). CONCLUSIONS: Paediatric intestinal parasite infections are still prevalent in certain areas in Cuba and associated with a number of common environmental, socioeconomic and sanitary risk factors.