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1.
Artigo em Inglês | MEDLINE | ID: mdl-33187301

RESUMO

Homeless adults are at increased risk of latent tuberculosis infection (LTBI), which can lead to active tuberculosis (TB) disease. The purpose of this study was to assess acceptability and feasibility of a six-month, nurse-led, community health worker-partnered short-course treatment (3HP) LTBI adherence model for a high risk, LTBI positive, homeless population. Informed by our community advisory board (CAB) and community-based participatory research principles (CBPR), a qualitative study was undertaken and used focus group discussions to identify perspectives of homeless men and women who had undergone LTBI treatment (N = 11, Mage = 51.2, SD 8.60, range 35-60). Three themes formed, which were engaging and recruiting LTBI intervention participants, delivering an LTBI intervention, and retaining LTBI intervention participants. Within those themes, barriers (e.g., lack of LTBI treatment readiness, substance use, etc.), and facilitators (e.g., LTBI and TB health education, familiarity with homeless population, etc.) were discussed to facilitate program recruitment, program delivery and program retention. These findings provide a greater understanding of how to effectively utilize a nurse-led, Community Health Worker (CHW) intervention delivery method to not only improve 3HP LTBI medication adherence, but also decrease substance use, improve mental health, and decrease unstable housing among this vulnerable population at high risk for active tuberculosis.

2.
BMC Public Health ; 20(1): 1434, 2020 Sep 21.
Artigo em Inglês | MEDLINE | ID: mdl-32957943

RESUMO

BACKGROUND: In Los Angeles County, the tuberculosis (TB) disease incidence rate is seven times higher among non-U.S.-born persons than U.S.-born persons and varies by country of birth. But translating these findings into public health action requires more granular information, especially considering that Los Angeles County is more than 4000 mile2. Local public health authorities may benefit from data on which areas of the county are most affected, yet these data remain largely unreported in part because of limitations of sparse data. We aimed to describe the spatial distribution of TB disease incidence in Los Angeles County while addressing challenges arising from sparse data and accounting for known cofactors. METHODS: Data on 5447 TB cases from Los Angeles County were combined with stratified population estimates available from the 2005-2011 Public Use Microdata Survey. TB disease incidence rates stratified by country of birth and Public Use Microdata Area were calculated and spatial smoothing was applied using a conditional autoregressive model. We used Bayesian Poisson models to investigate spatial patterns adjusting for age, sex, country of birth and years since initial arrival in the U.S. RESULTS: There were notable differences in the crude and spatially-smoothed maps of TB disease rates for high-risk subgroups, namely persons born in Mexico, Vietnam or the Philippines. Spatially-smoothed maps showed areas of high incidence in downtown Los Angeles and surrounding areas for persons born in the Philippines or Vietnam. Areas of high incidence were more dispersed for persons born in Mexico. Adjusted models suggested that the spatial distribution of TB disease could not be fully explained using age, sex, country of birth and years since initial arrival. CONCLUSIONS: This study highlights areas of high TB incidence within Los Angeles County both for U.S.-born cases and for cases born in Mexico, Vietnam or the Philippines. It also highlights areas that had high incidence rates even when accounting for non-spatial error and country of birth, age, sex, and years since initial arrival in the U.S. Information on spatial distribution provided here complements other descriptions of local disease burden and may help focus ongoing efforts to scale up testing for TB infection and treatment among high-risk subgroups.

3.
J Health Psychol ; : 1359105320956693, 2020 Sep 19.
Artigo em Inglês | MEDLINE | ID: mdl-32951464

RESUMO

Homeless persons have disproportionate rates of latent tuberculosis infection (LTBI). LTBI treatment can prevent and reduce active tuberculosis spread. We examined associations between mental health, social support, and perceptions of general health in 50 LTBI-positive, homeless adults enrolled in LTBI treatment. Depression and anxiety prevalence were 40% and 48%, respectively. Depression was negatively associated with general health, positive social interaction, and tangible, emotional/informational, and total social support, and positively associated with severe substance use (ps < 0.05). Anxiety was negatively associated with emotional/informational, tangible and total social support, and positively associated with severe substance use (ps < 0.05). Mental health services may help improve LTBI interventions.

4.
Am J Infect Control ; 2020 Aug 20.
Artigo em Inglês | MEDLINE | ID: mdl-32828799

RESUMO

BACKGROUND: Routine manual cleaning and disinfection of the health care environment is often suboptimal. Residual contamination poses an infection risk, particularly for immunocompromised patients. This study evaluates the efficacy of dry hydrogen peroxide (DHP) on microbial surface contamination in a pediatric oncology intensive care unit. METHODS: Surface samples from 5 high-touch and 2 low-touch surfaces were obtained for culture and adenosine triphosphate readings after manual cleaning on multiple days in 4 intensive care unit rooms, before and after DHP was deployed. Air samples were collected as well at the study site. Data outcomes were measured in terms of total colony-forming units for the cultures and relative light units for adenosine triphosphate. RESULTS: The overall mean surface microbial burden was significantly reduced in the intervention group compared to the control group (mean 5.50 vs 11.77, P<.001). These reductions in colony-forming units were seen across all sampling sites in the intervention group. A reduction in the mean relative light units levels was also noted in the intervention group when compared to the control group (172.08 vs 225.83, P <.006). Reductions with the air samples were also noted (P = .139). CONCLUSIONS: Study demonstrates that DHP was effective in reducing microbial surface contamination and improves quality of environmental cleaning.

5.
JCO Glob Oncol ; 6: 508-517, 2020 03.
Artigo em Inglês | MEDLINE | ID: mdl-32216650

RESUMO

PURPOSE: Our objective was to provide regionally appropriate, resource-conscious recommendations for the diagnosis and treatment of pediatric patients with febrile neutropenia. METHODS: A multinational panel of Central American and Caribbean clinicians who deliver pediatric oncology care prioritized clinically important questions and then used the Grading of Recommendations Assessment, Development and Evaluation methodology to provide recommendations on the selected topics. RESULTS: Twenty-two questions and 2 definitions were included in the guideline, which was intended to establish minimum care standards for pediatric patients treated in regional centers. Of all the included studies, 6.9% were conducted in low- and middle-income countries, and no studies were performed in countries represented on the panel. CONCLUSION: The panel made recommendations on the basis of existing evidence but identified important gaps in knowledge from the region and from resource-limited settings that may affect the clinical applicability of these recommendations. These deficiencies suggest a research agenda that will enable future guidelines to be more responsive to the local context.

6.
Nucleic Acids Res ; 47(15): 7955-7972, 2019 09 05.
Artigo em Inglês | MEDLINE | ID: mdl-31147717

RESUMO

Sickle cell disease (SCD) is a monogenic disorder that affects millions worldwide. Allogeneic hematopoietic stem cell transplantation is the only available cure. Here, we demonstrate the use of CRISPR/Cas9 and a short single-stranded oligonucleotide template to correct the sickle mutation in the ß-globin gene in hematopoietic stem and progenitor cells (HSPCs) from peripheral blood or bone marrow of patients with SCD, with 24.5 ± 7.6% efficiency without selection. Erythrocytes derived from gene-edited cells showed a marked reduction of sickle cells, with the level of normal hemoglobin (HbA) increased to 25.3 ± 13.9%. Gene-corrected SCD HSPCs retained the ability to engraft when transplanted into non-obese diabetic (NOD)-SCID-gamma (NSG) mice with detectable levels of gene correction 16-19 weeks post-transplantation. We show that, by using a high-fidelity SpyCas9 that maintained the same level of on-target gene modification, the off-target effects including chromosomal rearrangements were significantly reduced. Taken together, our results demonstrate efficient gene correction of the sickle mutation in both peripheral blood and bone marrow-derived SCD HSPCs, a significant reduction in sickling of red blood cells, engraftment of gene-edited SCD HSPCs in vivo and the importance of reducing off-target effects; all are essential for moving genome editing based SCD treatment into clinical practice.


Assuntos
Anemia Falciforme/terapia , Edição de Genes/métodos , Transplante de Células-Tronco Hematopoéticas/métodos , Células-Tronco Hematopoéticas/metabolismo , Globinas beta/genética , Anemia Falciforme/genética , Animais , Sistemas CRISPR-Cas , Linhagem Celular Tumoral , Células Cultivadas , Eritrócitos/metabolismo , Terapia Genética/métodos , Humanos , Células K562 , Camundongos , Camundongos Endogâmicos NOD , Camundongos Knockout , Camundongos SCID , Resultado do Tratamento
7.
Front Psychol ; 10: 1090, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31139124

RESUMO

Number-related language input has been shown to influence children's number word acquisition and mathematical ability. Significant differences exist between how Mandarin Chinese speaking parents and monolingual English-speaking parents use numeric language in speech to children. In particular, Mandarin Chinese speaking parents use cardinal number much more frequently in speech to children than do English speaking parents. However, because previous studies have been conducted cross-nationally, research has been unable to disentangle the influences of language from parental influence. The current study examined numeric language input to preschool children with bilingual Mandarin-English American parents. Results show that when parents speak to their children in Mandarin Chinese, children hear more instances and examples of the cardinal number principle than when parents speak to their children in English. This suggests that differences between how the Mandarin Chinese and English languages are structured leads to disparities in how frequently children hear cardinal number in everyday speech.

8.
PLoS One ; 14(3): e0213524, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30865724

RESUMO

OBJECTIVES: To investigate treatment outcomes and associated characteristics of persons experiencing homelessness who received 12-weekly doses of directly observed isoniazid and rifapentine (3HP/DOT) treatment for latent TB infection (LTBI). METHODS: Among homeless persons treated with 3HP/DOT during July 2011 -June 2015 in 11 U.S. TB programs, we conducted descriptive analyses of observational data, and identified associations between sociodemographic factors and treatment outcomes. Qualitative interviews were conducted to understand programmatic experiences. RESULTS: Of 393 persons experiencing homelessness (median age: 50 years; range: 13-74 years), 301 (76.6%) completed treatment, 55 (14.0%) were lost to follow-up, 18 (4.6%) stopped because of an adverse event (AE), and 19 (4.8%) stopped after relocations or refusing treatment. Eighty-one (20.6%) had at least one AE. Persons aged ≥65 were more likely to discontinue treatment than persons aged 31-44 years. Programs reported difficulty in following up with persons experiencing homelessness because of relocations, mistrust, and alcohol or drug use. CONCLUSIONS: This study demonstrates the feasibility of administering the 3HP/DOT LTBI regimen to persons experiencing homelessness, a high-risk population.


Assuntos
Antituberculosos/administração & dosagem , Pessoas em Situação de Rua , Isoniazida/administração & dosagem , Tuberculose Latente , Mycobacterium tuberculosis , Rifampina/análogos & derivados , Adolescente , Adulto , Idoso , Quimioterapia Combinada , Feminino , Seguimentos , Humanos , Tuberculose Latente/tratamento farmacológico , Tuberculose Latente/epidemiologia , Masculino , Pessoa de Meia-Idade , Rifampina/administração & dosagem , Estados Unidos/epidemiologia
9.
PLoS One ; 13(12): e0209051, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30562366

RESUMO

BACKGROUND: Among U.S. residents, tuberculosis (TB) disease disproportionally affects non-U.S.-born persons and varies substantially by country of birth. Yet TB disease incidence rates by country of birth are not routinely reported despite these large, known health disparities. This is in part due to the technical challenges of using standard regression analysis with a communicable disease. Here, we estimate tuberculosis disease incidence rates by country of birth and demonstrate methods for overcoming these challenges using TB surveillance data from Los Angeles County which has more than 3.5 million non-U.S.-born residents. METHODS: Cross-sectional data on 5,447 cases of TB disease from Los Angeles County were combined with population estimates from the American Community Survey to calculate TB disease incidence rates for 2005 through 2011. Adjusted incidence rates were modelled using Poisson and negative binomial regressions. Bayesian models were used to account for the uncertainty in population estimates. RESULTS: The unadjusted incidence rate among non-U.S.-born persons was 15 per 100,000 person-years in contrast to the rate among U.S-born persons, 2 per 100,000. The unadjusted incidence rates were 44 and 12 per 100,000 person-years among persons born in the Philippines and Mexico, respectively. In adjusted analysis, persons born in the Philippines were 2.6 (95% CI: 2.3-3.1) times as likely to be reported as a TB case than persons born in Mexico. Bayesian models showed similar results. CONCLUSION: This study confirms substantial disparities in TB disease by country of birth in Los Angeles County. Accounting for age, gender, years in residence and year of diagnosis, persons from the Philippines, Vietnam and several other countries had much higher rates of reported TB disease than other foreign countries. We demonstrated that incidence rates by country of birth can be estimated using available data despite technical challenges.


Assuntos
Modelos Biológicos , Tuberculose/epidemiologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Teorema de Bayes , Criança , Pré-Escolar , Estudos Transversais , Emigração e Imigração , Feminino , Humanos , Incidência , Lactente , Recém-Nascido , Los Angeles/epidemiologia , Masculino , Pessoa de Meia-Idade , Adulto Jovem
10.
Pediatr Blood Cancer ; 65(8): e27222, 2018 08.
Artigo em Inglês | MEDLINE | ID: mdl-29741223

RESUMO

Hepatic hemangiomas are the most common benign liver tumor of infancy and are divided into two main types: rapidly involuting congenital hemangiomas (RICH) and non-involuting congenital hemangiomas. RICH typically involute by 12 months and are often asymptomatic. Surgical resection is rare. Indications for surgical resection include rupture, rapid growth, consumptive coagulopathy, and abdominal pain. We present two patients from different institutions who both developed clinically significant ascites as the RICH involuted, prompting surgical resection. This is a new indication for resection.


Assuntos
Ascite/cirurgia , Hemangioma/cirurgia , Neoplasias Hepáticas/cirurgia , Hemangioma/congênito , Humanos , Recém-Nascido , Neoplasias Hepáticas/congênito , Masculino
11.
Clin Hemorheol Microcirc ; 68(2-3): 147-164, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-29614629

RESUMO

Sickle cell disease (SCD) is one of the most common single disease disorders world-wide. It is remarkable for its clinical heterogeneity, even among individuals with identical genotypes. Some individuals experience morbidity and mortality in early childhood, while others have a relatively mild course, and normal or near normal life expectancy. Many clinical complications are associated with SCD; most notably frequent pain episodes, stroke, acute chest syndrome, avascular necrosis, nephropathy, retinopathy and pulmonary hypertension. While the effects of higher fetal hemoglobin (HbF) levels, UGTA1A polymorphisms, alpha-thalassemia and G6PD deficiency on SCD has been extensively studied, these variables do not explain all of the clinical heterogeneity of SCD. It is not known why some patients develop certain complications, and it is difficult to predict which complications a particular patient will experience. Much work has been done to identify genetic variants associated with these disease complications; many associations remain unvalidated. As the field continues to move beyond small sample collections and candidate gene approaches into whole genome sequencing and merging of samples from all over the world, we will identify more genetic variants associated with development of specific SCD related complications, and hopefully leverage this knowledge into targeted therapies.


Assuntos
Anemia Falciforme/genética , Talassemia alfa/complicações , Anemia Falciforme/complicações , Anemia Falciforme/patologia , Feminino , Humanos , Masculino , Talassemia alfa/patologia
12.
Rev. Fac. Med. (Guatemala) ; 1(22 Segunda Época): 24-29, Ene - Jun.- 2017.
Artigo em Espanhol | LILACS-Express | LILACS | ID: biblio-1140591

RESUMO

Introducción: Las infecciones por organismos multidroga resistentes (MDR) en pacientes oncológicos pediátricos se han convertido en una causa frecuente de morbilidad y mortalidad. Objetivos: El objetivo principal de este estudio fue determinar la incidencia y los factores de riesgo para estas infecciones en una muestra de pacientes de la UNOP. Métodos: Se realizó un estudio de tipo retrospectivo. Se incluyeron pacientes de la unidad de nosocomiales con infección por organismos MDR con cultivo positivo (hemocultivo, uro cultivo, aspirado oro traqueal cultivo de secreción). Se revisaron los registros comprendidos entre 1 de enero del 2015 al 31 de diciembre del 2015; obteniendo los registros médicos de 30 pacientes que cumplían con los criterios de inclusión. Resultados: Se observó que el 60% de los pacientes con infecciones por organismo MDR son del sexo femenino, el 70% poseen el diagnóstico de un tumor hematológico y el 37% tuvieron como diagnóstico bacteriemia/sepsis, siendo la incidencia de ésta de 3.49%. Palabras Claves: factores de riesgo, Infecciones por organismos multidroga resistentes, pacientes oncológicos pediátricos. A. baumannii, K. pneumonie; cancer pediátrico.


Introduction: Multidrug resistant (MDR) organism infections in pediatric oncology patients have become a frequent cause of morbidity and mortality. The main objective of the following study was to determine the incidence and risk factors associated to MDR organisms infections in a sample of patients from UNOP. Methods: Retrospective study. The inclusion criteria were documented MDR infection with positive culture (blood, urinary, tissue or endotracheal aspirate). We reviewed medical records between January 1st, 2015 to December 31st, 2015; obtaining the medical records of 30 patients who fulfilled the inclusion criteria. Results: Sixty percent (60%) of patients female; 70% had the diagnosis of hematologic malignancy; 37% of patients were diagnosed with clinical sepsis and the incidence of sepsis was 3.49%. Key words: risk factors, infections by multidrug-resistant organisms, pediatric cancer patients. A. baumannii, K. pneumonie; pediatric cancer

13.
Guatem. pediátr. ; 1(1): 18-19, 2017.
Artigo em Espanhol | LILACS | ID: biblio-981381

RESUMO

Artículo que presenta un caso clínico relacionado con un paciente masculino de 3 años de edad, nacido a término de un embarazo gemelar del cual sólo él nació vivo. Consulta en la clínica con una historia de infecciones recurrentes del tracto respiratorio desde que nació, ha sido diagnosticado varias veces con bronquitis y ha tenido múltiples tratamientos con antibióticos.


Assuntos
Pré-Escolar , Infecções Respiratórias , Deficiência de IgA , Tosse
14.
Am J Infect Control ; 44(12): 1650-1655, 2016 12 01.
Artigo em Inglês | MEDLINE | ID: mdl-27378008

RESUMO

INTRODUCTION: There are only few reports describing the influence of central line-associated bloodstream infection (CLABSI) prevention strategies on the incidence of bacterial bloodstream infections (BBSIs). METHODS: We performed a retrospective cohort study among pediatric recipients of allogeneic hematopoietic stem cell transplantation (allo-HCT) to assess potential changes in BBSI rates during 3 time periods: pre-CLABSI prevention era (era 1, 2004-2005), CLABSI prevention implementation era (era 2, 2006-2009), and maintenance of CLABSI prevention era (era 3, 2010-2012). BBSI from day 0-365 following allo-HCT were studied. The comparison of person-years incidence rates among different periods was carried out by Poisson regression analysis. RESULTS: The mean age of patients was 10.0 years. During the study period, 126 (65%) of 190 patients had at least a single BBSI. From day 0-30, day 31-100, day 101-180, and day 181-365, 20%, 28%, 30%, and 17% of patients, respectively, experienced BBSIs. The rate of Staphylococcus epidermidis and gram-negative pathogens significantly declined from 3.16-0.93 and 6.32-2.21 per 100 person-months during era 1 and era 3, respectively (P = .001). CONCLUSIONS: Patients undergoing allo-HCT during era 3 were associated with decreased risk of BBSI (P = .012). Maintenance of CLABSI protocols by nursing staff and appropriate education of other care providers is essential to lower incidence of BBSI in this high-risk population, and further strategies to decrease infection burden should be studied.


Assuntos
Bacteriemia/epidemiologia , Bacteriemia/prevenção & controle , Infecções Relacionadas a Cateter/epidemiologia , Infecções Relacionadas a Cateter/prevenção & controle , Cateterismo Venoso Central/efeitos adversos , Controle de Infecções/métodos , Transplantados , Adolescente , Bactérias/classificação , Bactérias/isolamento & purificação , Criança , Pré-Escolar , Feminino , Transplante de Células-Tronco Hematopoéticas , Hospitais Pediátricos , Humanos , Incidência , Lactente , Masculino , Estudos Retrospectivos , Medição de Risco , Transplante Homólogo
15.
Guatem. pediátr. ; 2(2): 28-31, 2016.
Artigo em Espanhol | LILACS | ID: biblio-981323

RESUMO

Aspergillus spp se encuentra ampliamente en el medio ambiente y puede ser aislado tanto de ambientes externos como internos, incluyendo hospitales. la enfermedad pulmonar es causada principalmente por Aspergyllus fumigatus y tiene un gran espectro de síndromes clínicos. La Aspergillosis pulmonar invasiva es una enfermedad severa que se encuentra en pacientes inmunodeprimidos, la Aspergillosis crónica necrotizante es localmente invasiva y se encuentra en pacientes con discreta disminución de la inmunidad o enfermedad pulmonar crónica, el aspergilloma y la enfermedad pulmonar alérgica por aspergillus son formas no invasivas, la última es una manifestación de hipersensibilidad que muy comúnmente afecta a pacientes con asma y fibrosis quística.


Assuntos
Adulto , Aspergilose Broncopulmonar Alérgica , Terapêutica
17.
Child Dev ; 85(3): 1062-1076, 2014.
Artigo em Inglês | MEDLINE | ID: mdl-24112041

RESUMO

This study focuses on three main goals: First, 3-year-olds' spatial assembly skills are probed using interlocking block constructions (N = 102). A detailed scoring scheme provides insight into early spatial processing and offers information beyond a basic accuracy score. Second, the relation of spatial assembly to early mathematical skills was evaluated. Spatial skill independently predicted a significant amount of the variability in concurrent mathematical performance. Finally, the relation between spatial assembly skill and socioeconomic status (SES), gender, and parent-reported spatial language was examined. While children's performance did not differ by gender, lower SES children were already lagging behind higher SES children in block assembly. Furthermore, lower SES parents reported using significantly fewer spatial words with their children.


Assuntos
Aptidão/fisiologia , Conceitos Matemáticos , Destreza Motora/fisiologia , Classe Social , Percepção Espacial/fisiologia , Pré-Escolar , Feminino , Humanos , Masculino , Vocabulário
18.
BMC Public Health ; 13: 894, 2013 Sep 28.
Artigo em Inglês | MEDLINE | ID: mdl-24073620

RESUMO

BACKGROUND: Patient adherence to isoniazid (INH) monotherapy for latent tuberculosis infection (LTBI) has been suboptimal despite its proven efficacy. Various strategies have been studied to improve adherence, but all have been based at a clinic or treatment program. At the Santa Clara Valley Tuberculosis Clinic, it was our practice to refer a subset of high-risk LTBI patients to the Public Health Department for monthly follow-up at home instead of at the clinic. Our goal was to assess whether house calls by community health workers and public health nurses affected INH adherence or frequency of adverse effects. METHODS: We retrospectively studied 3918 LTBI patients who received INH. At the discretion of the treating physician, 986 (25.2%) received house calls instead of clinic follow-up. Home-based follow-up included language translation, medication delivery, assessment of compliance with pill counts, monitoring for adverse effects, and active tracking of noncompliant patients. We assessed differences in patient characteristics, treatment completion, and reasons for treatment discontinuation between patients followed at home versus in the clinic. Multivariate analyses to address possible referral bias or confounding were performed using logistic regression. RESULTS: More patients followed with house calls completed INH treatment (90% home versus 73.2% clinic). This was the case across all subgroups of patients, including those with historically the lowest adherence: patients from correctional and rehabilitation facilities (77.8% home versus 46.9% clinic), postpartum women (86.4% home versus 55.6% clinic), and patients aged between 18 and 35 years (87% home versus 63.1% clinic). After adjusting for age, place of birth, referral category (TB contacts/skin test converters, correctional/rehabilitation patients, postpartum women, tuberculin positive patients from other screening), and prescribed INH regimen duration (9 versus 6 months), home-based follow-up of LTBI patients was a significant predictor of treatment completion (AOR 2.94, 95% CI: 2.33, 3.71). Patients followed at home were 21% more likely to complete therapy (ARR 1.21, p<0.001). Risk of adverse effects was similar between the two types of follow-up. CONCLUSION: Home-based follow-up of LTBI patients taking isoniazid was associated with improved treatment completion and no increase in adverse effects regardless of patient characteristics or prescribed duration of INH therapy.


Assuntos
Antituberculosos/administração & dosagem , Isoniazida/administração & dosagem , Tuberculose Latente/tratamento farmacológico , Cooperação do Paciente , Adolescente , Adulto , California , Criança , Agentes Comunitários de Saúde , Esquema de Medicação , Feminino , Visita Domiciliar , Humanos , Tuberculose Latente/patologia , Masculino , Enfermeiras de Saúde Pública , Avaliação de Resultados em Cuidados de Saúde , Estudos Retrospectivos
19.
Am J Trop Med Hyg ; 88(1): 191-7, 2013 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-23149583

RESUMO

Beginning in 2005, the Centers for Disease Control and Prevention (CDC) expanded the overseas presumptive treatment of intestinal parasites with albendazole to include refugees from the Middle East. We surveyed the prevalence of helminths and protozoa in recent Middle Eastern refugees (2008-2010) in comparison with refugees from other geographical regions and from a previous survey (2001-2004) in Santa Clara County, California. Based on stool microscopy, helminth infections decreased, particularly in Middle Eastern refugees (0.1% versus 2.3% 2001-2004, P = 0.01). Among all refugees, Giardia intestinalis was the most common protozoan found. Protozoa infections also decreased somewhat in Middle Eastern refugees (7.2%, 2008-2010 versus 12.9%, 2001-2004, P = 0.08). Serology for Strongyloides stercoralis and Schistosoma spp. identified more infected individuals than stool exams. Helminth infections are increasingly rare in refugees to Northern California. Routine screening stool microscopy may be unnecessary in all refugees.


Assuntos
Intestinos/parasitologia , Doenças Parasitárias/epidemiologia , Refugiados , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , California/epidemiologia , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Pessoa de Meia-Idade , Oriente Médio/etnologia , Doenças Parasitárias/parasitologia , Adulto Jovem
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