RESUMO
To improve the serodiagnosis of human toxocariasis, a sensitive and specific enzyme-linked immunoelectrotransfer blot (EITB-IgG) test was developed and evaluated using Toxocara canislarvae excretory-secretory antigens for detecting anti-Toxocara IgG antibodies. The EITB-IgG profile of toxocariasis was characterized by comparing 27 sera from patients with toxocariasis, 110 sera from healthy subjects and 186 sera from patients with other helminth diseases (ascariasis, ancylostomiasis, trichuriasis, enterobiasis, strongyloidiasis, hymenolepiasis, diphyllobothriasis, taeniasis, cysticercosis, hydatidosis and fascioliasis). Antigenic bands of 24, 28, 30, 35, 56, 117, 136 and 152 kDa were predominantly recognized in sera from all patients with toxocariasis. However, only bands of 24-35 kDa were highly specific for Toxocara infection (98.3%), whereas other antigenic bands observed displayed cross-reactivity. Additionally, when the results of the EITB-IgG test were compared to those of the ELISA-IgG test, a 100% concordance was observed for positive results in human toxocariasis cases. The concordance for negative results between the two tests for healthy subjects and patients with other helminth diseases were 96.3% and 53.7%, respectively, showing that the EITB-IgG test has a higher specificity than ELISA. In conclusion, the EITB-IgG test is a very useful tool to confirm the serological diagnosis of human toxocariasis.
Assuntos
Anticorpos Anti-Helmínticos/sangue , Ensaio de Imunoadsorção Enzimática/métodos , Immunoblotting/métodos , Imunoglobulina G/sangue , Toxocara/imunologia , Toxocaríase/diagnóstico , Animais , Estudos de Casos e Controles , Criança , Humanos , Valor Preditivo dos Testes , Sensibilidade e EspecificidadeRESUMO
The aim of this study was to estimate the frequency of human toxocariosis in a child population from Morrope district, Lambayeque, Peru. From October to December 2005, 182 school children (96 male and 86 female) were studied. Blood samples were collected for Toxocara ELISA-IgG test and hematological examination. Additionally, stool samples were collected for coproparasitological examination to check cross reactions. We found frequency of positives in 32.4% (59/182) with a significant higher proportion of positivity in male children (p < 0.00001). 71.2% of the children with positive serology (52 male and seven female), were between five and 10 years old, 77.96% had respiratory symptoms, 61.02% had ocular manifestations, 38.98% had hepatic symptoms, 38.98% had mild or moderate eosinophilia, signs statistically associated with seropositivity. 83.5% of studied population had some intestinal parasite, such as: Blastocystis hominis (53.3%), Giardia lamblia (31.3%), Entamoeba coli (29.1%), Entamoeba histolytica/E. dispar (1.1%), Hymenolepis nana (5.49%), and Ascaris lumbricoides (3.3%), but they had not any association with serology results. The ownership of dogs or/and cats were significantly associated with seropositivity to anti-Toxocara antibodies although the presence of such pets within the house was not. In conclusion, clinical and serological evidence of Toxocara infection exists in the studied population.
Assuntos
Enteropatias Parasitárias/epidemiologia , Toxocara/isolamento & purificação , Toxocaríase/epidemiologia , Animais , Anticorpos Anti-Helmínticos/sangue , Gatos , Criança , Pré-Escolar , Cães , Ensaio de Imunoadsorção Enzimática , Fezes/parasitologia , Feminino , Humanos , Imunoglobulina G/sangue , Lactente , Enteropatias Parasitárias/diagnóstico , Enteropatias Parasitárias/parasitologia , Masculino , Peru/epidemiologia , Prevalência , Fatores de Risco , Índice de Gravidade de Doença , Toxocara/imunologia , Toxocaríase/diagnósticoRESUMO
Human toxocarosis is an important parasitic zoonosis caused by larval stages of Toxocara species, the roundworms from dogs and cats. Larval migration through different soft tissues in the human generates several clinical entities in the patient, such as visceral larva migrans, ocular toxocarosis, and neurotoxocarosis. Definitive diagnosis by histopathological methods is very difficult or almost impossible and, nowadays, the diagnosis is usually made by clinical signs/symptoms, epidemiological background of the patient and the use of hematological and immunological tests which finally help to confirm the clinical suspicion of the illness. The purpose of this paper was to update the available knowledge on the use of different tools for both the diagnosis and following up of human toxocarosis.
Assuntos
Toxocaríase/diagnóstico , HumanosRESUMO
The aim of this study was to determine the seroprevalence of the infection by Toxocara in the general population of the Amazonian city of Yurimaguas, Peru. From March to August 2008, a total of 300 subjects were sampled and tested by means of a Toxocara ELISA-IgG test. A clinical and epidemiological questionnaire was used to assess the symptomatology and risk factors associated with human toxocariasis. The overall rate of seropositivity was 35.66%, with a significant high proportion in children (p < 0.001). The clinical evaluation revealed that 95.33% of the seropositive group had some type of symptomatology: headache (66.36%), respiratory compromise (63.55%), abdominal pain (54.21%), cutaneous signs (40.19%) and ocular manifestations (36.45%), and almost all of them were statistically significant (p < 0.001). Furthermore, 56.07% of the seropositive subjects presented at least one intestinal pathogen parasite with predominance of helminthes, but without significant association (p = 0.334). The analysis of risk factors showed only that the use of public places and geophagia exhibited a significant association with the seropositivity (p < 0.001). Clinical, serological and epidemiological findings associated to infection with Toxocara were observed in the present study and future studies should be done to assess this serious health problem.
Assuntos
Anticorpos Anti-Helmínticos/sangue , Imunoglobulina G/sangue , Toxocara/imunologia , Toxocaríase/epidemiologia , Distribuição por Idade , Animais , Ensaio de Imunoadsorção Enzimática , Feminino , Humanos , Masculino , Peru/epidemiologia , Prevalência , Fatores de Risco , Estudos Soroepidemiológicos , Distribuição por Sexo , Toxocara/isolamento & purificação , Toxocaríase/diagnósticoRESUMO
The aim of this study was to assess the seroprevalence of human toxocariasis in three Andean communities from the Northeast of Lima, Peru. A total of 303 subjects including children and adults were studied and blood samples were collected to detect anti-Toxocara antibodies by ELISA-IgG test and by hematological examination; stool samples were collected also for parasitological examination. The overall seroprevalence of toxocariasis observed in the total population was 20.46%, with a significant high proportion in children from one to 10 years old (p = 0.034). Among the subjects with positive serology, 32.26% of them had respiratory disturbances, 22.58% hepatomegaly, 17.74% ocular signs or symptoms, 14.51% abdominal pain, 9.68% neurological involvement, and 4.84% cutaneous signs, but none of these clinical features were associated to a positive serology by multivariate analysis. Furthermore, 79.03% of seropositive subjects also harbored at least one intestinal parasite, which was associated to a positive serology (p < 0.05). The presence of pets within the houses, a previous history of pica or geophagia and the use of public places were also present in this population, but only the latter was associated to the serology (p < 0.05). In conclusion, clinical, serological, and epidemiological evidences for larval Toxocara infection were found in the studied population.
Assuntos
Anticorpos Anti-Helmínticos/sangue , Imunoglobulina G/sangue , Toxocara/imunologia , Toxocaríase/epidemiologia , Adulto , Animais , Criança , Cães , Ensaio de Imunoadsorção Enzimática , Fezes/parasitologia , Feminino , Humanos , Masculino , Peru/epidemiologia , Prevalência , Fatores de Risco , Estudos Soroepidemiológicos , Toxocara/isolamento & purificação , Toxocaríase/diagnósticoRESUMO
The aim of this study was to estimate the frequency of human toxocariasis in Cauday district, Cajamarca, Peru, using a dot-ELISA test. From June to October 2005, a total of 256 adult subjects were studied. Blood samples were collected for serology by a dot-ELISA test and for hematological examination. Parasitological examination was also carried out in stool samples to check cross-reactions in the dot-ELISA. The frequency observed was 44.92%, with a significant higher proportion of positivity in male subjects. From subjects with positive serology, 45.6% had respiratory symptoms, 40.44% abdominal pain, 32.35% hepatic symptoms, 14.7% cutaneous signs, 13.23% ocular manifestations, 43.38% eosinophilia, and all of these were statistically associated to serology. Among the population evaluated, 90.23% (231/256) were parasitized. From subjects with positive serology, 92.17% had at least one intestinal parasite and the most frequent were: Blastocystis hominis (68.38%), Giardia lamblia (28.68%), Hymenolepis nana (20.0%), Ascaris lumbricoides (15.65%), Entamoeba histolytica/E. dispar (13.24%), Cyclospora cayetanensis (4.41%), Cryptosporidium sp. (1.47%), Enterobius vermicularis (0.87%), Strongyloides stercoralis (0.87%), Taenia sp. (0.87%), and Trichuris trichiura (0.87%). The rate of false positives in the dot-ELISA test was improved by serum absorption each with A. suum antigens, with a decrease of cross-reactions. In conclusion, human toxocariasis is highly frequent in this population and some risk factors like dog/cat ownership, presence of pets within house, and previous history of geophagia were observed in the present study.
Assuntos
Anticorpos Anti-Helmínticos/sangue , Imunoglobulina G/sangue , Enteropatias Parasitárias/epidemiologia , Toxocara/imunologia , Toxocaríase/epidemiologia , Adolescente , Adulto , Animais , Gatos , Cães , Ensaio de Imunoadsorção Enzimática/métodos , Feminino , Humanos , Enteropatias Parasitárias/diagnóstico , Enteropatias Parasitárias/parasitologia , Masculino , Pessoa de Meia-Idade , Peru/epidemiologia , Prevalência , Fatores de Risco , Toxocara/isolamento & purificação , Toxocaríase/diagnóstico , Adulto JovemRESUMO
During a health survey in a primary school from the district of Carabayllo (North of Lima, Peru), 200 schoolchildren (96 male and 104 female between five to 12 years old) were randomly selected and divided in two groups (as positive or negative group), according to the serologic result of the Toxocara ELISA test from a total population of 646 schoolchildren. All children were analyzed by hematologic tests to determinate the frequency of eosinophilia and leukocytosis. Additionally, all clinical and epidemiological data were also analyzed to determine their association with toxocariasis. From group of children with positive serology, 40% had some type of eosinophilia in contrast to 19% of children with negative serology, and their association was statistically significant (OR = 2.84, p < 0.001). From all signs and symptoms evaluated, only 'dry cough' was more frequent and statistically significant in the positive serology group (OR = 2.79, p < 0.001). Almost all risk factors evaluated were highly frequent and statistically associated to the positive serology. In conclusion, the presence of eosinophilia and the risk factors evaluated in this population were frequently associated to human toxocariasis.
Assuntos
Eosinofilia/epidemiologia , Enteropatias Parasitárias/epidemiologia , Toxocaríase/epidemiologia , Animais , Anticorpos Anti-Helmínticos/sangue , Gatos , Criança , Pré-Escolar , Cães , Ensaio de Imunoadsorção Enzimática , Eosinofilia/diagnóstico , Eosinofilia/parasitologia , Fezes/parasitologia , Feminino , Inquéritos Epidemiológicos , Humanos , Imunoglobulina G/sangue , Enteropatias Parasitárias/diagnóstico , Enteropatias Parasitárias/parasitologia , Masculino , Peru/epidemiologia , Prevalência , Fatores de Risco , Toxocara/imunologia , Toxocaríase/diagnósticoRESUMO
Objetivos: Determinar las diluciones y concentraciones optimas de una prueba de ELISA para detectar anticuerpos IgE, así como su sensibilidad, espécificidad y valor predictivo en pacientes con equinococosis quistica. Analizar si los niveles de anticuerpos IgE especificos se correlacionan con la respuesta al tratamiento médico con albendazol en un periodo mayor a un año de finalizado el tratamiento. Diseño: Estudio cuasiexperimental con grupo control. Institución: Instituto de Medicina Tropical Daniel A. Carrión, Facultad de Medicina, UNMSM, Lima, Perú. Material de estudio: Prueba de ELISA para anticuerpo IgE. Intervenciones: Estandarizacion de la prueba de ELISA para anticuerpo IgE y diseño preexperimento con preprueba y posprueba en un solo grupo, para evaluar su valor en el diagnóstico y seguimiento postratamiento de pacientes con quiste hidatidico hepatico tratados con albendazol. Para la estandarizacion de la prueba de ELISA, se utilizó suero de cinco pacientes con diagnóstico clínico de equinococosis quistica, y la sensibilidad y especificidad de la prueba se usó suero de 30 pacientes aparentemente sanos. Para determinar las reacciones cruzadas, se utilizó 16 muestras de suero de pacientes con otras helmintiasis (ascariasis, strongiloidiasis, toxocariosis, trichuriasis, himenolepiasis, cisticercosis y teniasis). Para el diagnóstico y seguimiento postratamiento de equinocococosis quística, se utilizó el suero de 17 pacientes. Principales medidas de resultados: Sensibilidad y especificidad de prueba estandarizada de ELISA para detectar anticuerpos IgE. Resultados: La prueba estandarizada de ELISA para detectar anticuerpos IgE tuvo una sensibilidad de 95,6 por ciento y una especificidad de 100 por ciento. En los pacientes con quiste hidatídico hepático considerados curados, uniformemente disminuyeron los niveles de anticuerpo tipo IgE hasta la negativización. Se obtuvo elevación de los niveles de IgE en los pacientes que presentaron recurrencia de la enfermedad quística hepática. Conclusiones: En el presente estudio se encontró un excelente nivel de sensibilidad y especificidad de la prueba de ELISA para anticuerpos IgE de equinococosis quística. La curación de los quistes coincidió con una dismuinución progresiva de los niveles de IgE, que pudo llegar a la negativización después de un año postratamiento y fue de gran utilidad para detectar la recurrencia. La persistencia de niveles elevados de IgE en pacientes tratados médicamente fue indicativo de no haber respuesta al tratamiento. Siendo no muy grande el tamaño de la muestra de nuestro estudio, es necesario continuar con la investigación para confirmar estos resultados.
Objectives: To determine best dilutions and concentrations of ELISA test to detect IgE antibody, its sensitivity and specificity and predictive value in patients with cistyc echinococcosis. To analyze the relationship between IgE specific antibody level and albendazole medical treatment response in a period over one year after completion of albendazole therapy. Design: Quasiexperimental study with control group. Setting: Instituto de Medicina Tropical Daniel A. Carrion, Faculty of Medicine, UNMSM, Lima, Peru. Study material: IgE antibody ELISA test. Interventions: IgE antibody ELISA test standardization with preexperimental pretest and post test in one group to assess its value in diagnosis and post-treatment of patients with hepatic hydatid cysts treated with albendazole. For ELISA test standardization we used serum from five patients with clinical and immunological diagnosis of cystic echinococcosis; to test sensitivity and specificity sera of 30 apparently healthy subjects were studied; to determine crossreactions 16 serum samples from patients with other helminth infections (ascariasis, strongiloidiasis, toxocariasis, trichuriasis, hymenolepiasis cysticercosis and taeniasis) were used. For diagnosis and post-treatment evaluation of cystic echinocococosis serum from 17 patients was studied. Main outcome measures: Standarized ELISA test sensitivity and specificity to detect IgE antibodies. Results: Sensitivity and specificity of standardized ELISA test to detect IgE antibody were respectively 95.6 per cent and 100 per cent. Patients with hepatic hydatid cyst considered cured uniformly showed lower levels of IgE antibody even to negativization. There was increase of IgE levels in patients who had recurrence of hepatic cystic disease. Conclusions: This study found excellent sensitivity and specificity of ELISA test for cystic echinococcosis IgE antibodies. Healing of cysts coincided with progressive decrease in IgE levels that could reach negativization after one year post-treatment and was useful to detect recurrence. Persistence of IgE high levels in patients treated medically was indicative of no response to treatment. As sample size was not large, it seems necessary to continue investigation to confirm these results.
Assuntos
Humanos , Albendazol , Ensaio de Imunoadsorção Enzimática , Equinococose , Imunoglobulina ERESUMO
The aim of this study was to determine the seroprevalence of the infection by Toxocara in the general population of the Amazonian city of Yurimaguas, Peru. From March to August 2008, a total of 300 subjects were sampled and tested by means of a Toxocara ELISA-IgG test. A clinical and epidemiological questionnaire was used to assess the symptomatology and risk factors associated with human toxocariasis. The overall rate of seropositivity was 35.66 percent, with a significant high proportion in children (p < 0.001). The clinical evaluation revealed that 95.33 percent of the seropositive group had some type of symptomatology: headache (66.36 percent), respiratory compromise (63.55 percent), abdominal pain (54.21 percent), cutaneous signs (40.19 percent) and ocular manifestations (36.45 percent), and almost all of them were statistically significant (p < 0.001). Furthermore, 56.07 percent of the seropositive subjects presented at least one intestinal pathogen parasite with predominance of helminthes, but without significant association (p = 0.334). The analysis of risk factors showed only that the use of public places and geophagia exhibited a significant association with the seropositivity (p < 0.001). Clinical, serological and epidemiological findings associated to infection with Toxocara were observed in the present study and future studies should be done to assess this serious health problem.
O objetivo do presente estudo foi estimar a soroprevalência da infecção por Toxocara em população geral da cidade de Yurimaguas, Peru. Entre os meses de Março e Agosto de 2008, foi estudado um total de 300 pessoas por exame imunológico mediante Toxocara ELISA-IgG teste. Uma ficha clínico-epidemiológica foi utilizada para avaliar a sintomatologia e os fatores de risco associados à toxocaríase. A freqüência geral de anticorpos na população foi de 35,66 por cento com proporção significativamente maior de positividade em meninos de um a 10 anos (p < 0.001). A avaliação clínica revelou que 95.33 por cento do grupo de soropositivos apresentava algum tipo de sintomatologia associada à toxocaríase: 66,36 por cento cefaléia, 63,55 por cento sintomas respiratórios, 54,21 por cento dor abdominal, 40,19 por cento sinais cutâneos e 36,45 por cento manifestações oculares e quase todos estes sinais foram estatisticamente associados ao resultado da sorologia (p < 0.001). Além disso, 56,07 por cento das pessoas com sorologia positiva tinham pelo menos algum parasito intestinal patogênico e com predominância de helmintos, mas sem nenhuma associação significativa (p = 0.334). A análise dos fatores de risco mostrou que o uso de lugares públicos e história de geofagia tiveram significativa associação com a sorologia positiva (p < 0,001). Conclui-se que existem evidências clínicas, sorológicas e epidemiológicas de infecção por Toxocara na população estudada e futuros estudos são necessários para avaliar este sério problema de saúde pública.
Assuntos
Animais , Feminino , Humanos , Masculino , Anticorpos Anti-Helmínticos/sangue , Imunoglobulina G/sangue , Toxocara/imunologia , Toxocaríase/epidemiologia , Distribuição por Idade , Ensaio de Imunoadsorção Enzimática , Prevalência , Peru/epidemiologia , Fatores de Risco , Estudos Soroepidemiológicos , Distribuição por Sexo , Toxocara/isolamento & purificação , Toxocaríase/diagnósticoRESUMO
La toxocarosis humana es una importante zoonosis parasitaria causada por formas larvarias de especies del género Toxocara, un parásito nematodo de los perros y los gatos. La migración de la larva por los diferentes tejidos blandos en el ser humano genera una serie de entidades clínicas en el paciente, tales como el síndrome de larva migrans visceral, la toxocarosis ocular y la neurotoxocarosis. El diagnóstico definitivo es mediante la histopatología en biopsias, pero resulta ser casi imposible de realizar y actualmente su diagnóstico se establece mediante el análisis de la sintomatología clínica, los antecedentes epidemiológicos del paciente y el uso de pruebas hematológicas e inmunológicas de laboratorio que son las que finalmente ayudan a confirmar la sospecha clínica de la enfermedad. El propósito del presente artículo es actualizar los conocimientos que se tienen sobre el uso de las diferentes herramientas para establecer el diagnóstico y el monitoreo de la toxocarosis humana.
Human toxocarosis is an important parasitic zoonosis caused by larval stages of Toxocara species, the roundworms from dogs and cats. Larval migration through different soft tissues in the human generates several clinical entities in the patient, such as visceral larva migrans, ocular toxocarosis, and neurotoxocarosis. Definitive diagnosis by histopathological methods is very difficult or almost impossible and, nowadays, the diagnosis is usually made by clinical signs/symptoms, epidemiological background of the patient and the use of hematological and immunological tests which finally help to confirm the clinical suspicion of the illness. The purpose of this paper was to update the available knowledge on the use of different tools for both the diagnosis and following up of human toxocarosis.
Assuntos
Humanos , Toxocaríase/diagnósticoRESUMO
The aim of this study was to assess the seroprevalence of human toxocariasis in three Andean communities from the Northeast of Lima, Peru. A total of 303 subjects including children and adults were studied and blood samples were collected to detect anti-Toxocara antibodies by ELISA-IgG test and by hematological examination; stool samples were collected also for parasitological examination. The overall seroprevalence of toxocariasis observed in the total population was 20.46 percent, with a significant high proportion in children from one to 10 years old (p = 0.034). Among the subjects with positive serology, 32.26 percent of them had respiratory disturbances, 22.58 percent hepatomegaly, 17.74 percent ocular signs or symptoms, 14.51 percent abdominal pain, 9.68 percent neurological involvement, and 4.84 percent cutaneous signs, but none of these clinical features were associated to a positive serology by multivariate analysis. Furthermore, 79.03 percent of seropositive subjects also harbored at least one intestinal parasite, which was associated to a positive serology (p < 0.05). The presence of pets within the houses, a previous history of pica or geophagia and the use of public places were also present in this population, but only the latter was associated to the serology (p < 0.05). In conclusion, clinical, serological, and epidemiological evidences for larval Toxocara infection were found in the studied population.
O propósito do presente trabalho foi estimar a soroprevalência da toxocaríase humana em três comunidades andinas do Nordeste de Lima, Peru. Foi estudado um total de 303 pessoas, entre crianças e adultos. Foram coletadas amostras de sangue para a detecção de anticorpos anti-Toxocara e para a análise hematológica, além de amostras fecais para o exame parasitológico. A soroprevalência geral da população foi de 20,46 por cento com proporção significativamente maior de positividade em crianças de um a 10 anos (p = 0,034). Das pessoas com sorologia positiva, 32,26 por cento apresentavam sintomas respiratórios, 22,58 por cento moléstias hepáticas, 17,74 por cento manifestações oculares, 14,51 por cento dor abdominal, e 4,84 por cento sinais cutâneos. Além disso, 79,03 por cento das pessoas com sorologia positiva tinham pelo menos algum parasito intestinal com associação significativa (p < 0.05). A presença de cachorros dentro das casas, história de pica ou geofagia e o uso dos lugares públicos também estiveram presentes nesta população, mas o ultimo deles só esteve associado com a sorologia positiva (p < 0.05). Conclui-se que existem evidências clínicas, sorológicas e epidemiológicas de infecção por larvas de Toxocara na população estudada.
Assuntos
Adulto , Animais , Criança , Cães , Feminino , Humanos , Masculino , Anticorpos Anti-Helmínticos/sangue , Imunoglobulina G/sangue , Toxocara/imunologia , Toxocaríase/epidemiologia , Ensaio de Imunoadsorção Enzimática , Fezes/parasitologia , Prevalência , Peru/epidemiologia , Fatores de Risco , Estudos Soroepidemiológicos , Toxocara/isolamento & purificação , Toxocaríase/diagnósticoRESUMO
To improve the serodiagnosis of human toxocariasis, a sensitive and specific enzyme-linked immunoelectrotransfer blot (EITB-IgG) test was developed and evaluated using Toxocara canislarvae excretory-secretory antigens for detecting anti-Toxocara IgG antibodies. The EITB-IgG profile of toxocariasis was characterized by comparing 27 sera from patients with toxocariasis, 110 sera from healthy subjects and 186 sera from patients with other helminth diseases (ascariasis, ancylostomiasis, trichuriasis, enterobiasis, strongyloidiasis, hymenolepiasis, diphyllobothriasis, taeniasis, cysticercosis, hydatidosis and fascioliasis). Antigenic bands of 24, 28, 30, 35, 56, 117, 136 and 152 kDa were predominantly recognized in sera from all patients with toxocariasis. However, only bands of 24-35 kDa were highly specific for Toxocara infection (98.3 percent), whereas other antigenic bands observed displayed cross-reactivity. Additionally, when the results of the EITB-IgG test were compared to those of the ELISA-IgG test, a 100 percent concordance was observed for positive results in human toxocariasis cases. The concordance for negative results between the two tests for healthy subjects and patients with other helminth diseases were 96.3 percent and 53.7 percent, respectively, showing that the EITB-IgG test has a higher specificity than ELISA. In conclusion, the EITB-IgG test is a very useful tool to confirm the serological diagnosis of human toxocariasis.
Assuntos
Animais , Criança , Humanos , Anticorpos Anti-Helmínticos/sangue , Ensaio de Imunoadsorção Enzimática/métodos , Immunoblotting/métodos , Imunoglobulina G/sangue , Toxocara/imunologia , Toxocaríase/diagnóstico , Estudos de Casos e Controles , Valor Preditivo dos Testes , Sensibilidade e EspecificidadeRESUMO
The aim of this study was to estimate the frequency of human toxocariasis in Cauday district, Cajamarca, Peru, using a dot-ELISA test. From June to October 2005, a total of 256 adult subjects were studied. Blood samples were collected for serology by a dot-ELISA test and for hematological examination. Parasitological examination was also carried out in stool samples to check cross-reactions in the dot-ELISA. The frequency observed was 44.92%, with a significant higher proportion of positivity in male subjects. From subjects with positive serology, 45.6% had respiratory symptoms, 40.44% abdominal pain, 32.35% hepatic symptoms, 14.7% cutaneous signs, 13.23% ocular manifestations, 43.38% eosinophilia, and all of these were statistically associated to serology. Among the population evaluated, 90.23% (231/256) were parasitized. From subjects with positive serology, 92.17% had at least one intestinal parasite and the most frequent were: Blastocystis hominis (68.38%), Giardia lamblia (28.68%), Hymenolepis nana (20.0%), Ascaris lumbricoides (15.65%), Entamoeba histolytica/E. dispar (13.24%), Cyclospora cayetanensis (4.41%), Cryptosporidium sp. (1.47%), Enterobius vermicularis (0.87%), Strongyloides stercoralis (0.87%), Taenia sp. (0.87%), and Trichuris trichiura (0.87%). The rate of false positives in the dot-ELISA test was improved by serum absorption each with A. suum antigens, with a decrease of cross-reactions. In conclusion, human toxocariasis is highly frequent in this population and some risk factors like dog/cat ownership, presence of pets within house, and previous history of geophagia were observed in the present study.
O propósito do presente estudo foi estimar a freqüência da toxocaríase no distrito de Cauday, Cajamarca, Peru, usando o dot-ELISA teste. Entre junho e outubro de 2005, um total de 256 pessoas foram avaliadas. Coletaram-se amostras de sangue para o teste de dot-ELISA e para o exame hematológico e amostras de fezes para exame parasitológico. A freqüência geral de anticorpos anti-Toxocara observada foi de 44,92%, com maior proporção significativa de positividade em pessoas do sexo masculino. Das pessoas com sorologia positiva, 45,6% apresentavam sintomas respiratórios, 40,44% dores abdominais, 32,35% moléstias hepáticas, 14,7% sinais cutâneos, 13,23% manifestações oculares, 43,38% eosinofilia e todos estes fatores foram estatisticamente associados à sorologia. Entre as pessoas avaliadas 90,23% estavam parasitadas e 92,17% das pessoas com sorologia positiva tinham algum parasito intestinal, sendo os mais freqüentes: Blastocystis hominis (68,38%), Giardia lamblia (28,68%), Hymenolepis nana (20,0%), Ascaris lumbricoides (15,65%), Entamoeba histolytica/E. dispar (13,24%), Cyclospora cayetanensis (4,41%), Cryptosporidium sp. (1,47%), Enterobius vermicularis (0,87%), Strongyloides stercoralis (0,87%), Taenia sp. (0,87%) e Trichuris trichiura (0,87%). A taxa de falsos positivos no teste dot-ELISA foi melhorada pela absorção dos soros com antígenos de A. suum, com diminuição das reações cruzadas. Em conclusão, a toxocaríase humana é altamente freqüente nesta população e fatores de risco como ter um cão/gato, presença dos animais dentro de casa e estória prévia de geofagia foram observados durante o presente estudo.
Assuntos
Adolescente , Adulto , Animais , Gatos , Cães , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Adulto Jovem , Anticorpos Anti-Helmínticos/sangue , Imunoglobulina G/sangue , Enteropatias Parasitárias/epidemiologia , Toxocara/imunologia , Toxocaríase/epidemiologia , Ensaio de Imunoadsorção Enzimática/métodos , Enteropatias Parasitárias/diagnóstico , Enteropatias Parasitárias/parasitologia , Prevalência , Peru/epidemiologia , Fatores de Risco , Toxocara/isolamento & purificação , Toxocaríase/diagnóstico , Adulto JovemRESUMO
During a health survey in a primary school from the district of Carabayllo (North of Lima, Peru), 200 schoolchildren (96 male and 104 female between five to 12 years old) were randomly selected and divided in two groups (as positive or negative group), according to the serologic result of the Toxocara ELISA test from a total population of 646 schoolchildren. All children were analyzed by hematologic tests to determinate the frequency of eosinophilia and leukocytosis. Additionally, all clinical and epidemiological data were also analyzed to determine their association with toxocariasis. From group of children with positive serology, 40 percent had some type of eosinophilia in contrast to 19 percent of children with negative serology, and their association was statistically significant (OR = 2.84, p < 0.001). From all signs and symptoms evaluated, only 'dry cough' was more frequent and statistically significant in the positive serology group (OR = 2.79, p < 0.001). Almost all risk factors evaluated were highly frequent and statistically associated to the positive serology. In conclusion, the presence of eosinophilia and the risk factors evaluated in this population were frequently associated to human toxocariasis.
Durante estudo epidemiológico em escola primária do Distrito de Carabayllo (norte de Lima, Peru), 200 crianças (96 do sexo masculino e 104 do feminino, entre cinco e 12 anos de idade) foram selecionadas ao acaso e divididas em dois grupos (grupo positivo e grupo negativo) de acordo com os resultados de teste de ELISA para Toxocara em população total de 646 escolares. Todas as crianças foram analisadas por testes hematológicos para determinar a freqüência de eosinofilia e leucocitose. Adicionalmente, os dados clínicos e epidemiológicos foram analisados para determinar associação com toxocaríase. No grupo de crianças com sorologia positiva 40 por cento tinham eosinofilia em contraste com 19 por cento de crianças com sorologia negativa e esta associação foi estatisticamente.significante (OR = 2,84, p < 0,001). De todos os sinais e sintomas avaliados, somente tosse seca foi mais freqüente e estatisticamente significante no grupo de sorologia positiva (OR = 2,79, p < 0,001). Quase todos os fatores de risco avaliados foram de alta freqüência e estatisticamente associados à sorologia positiva. Em conclusão, a presença de eosinofilia e dos fatores de risco avaliados nesta população foram frequentemente associados à toxocaríase humana.
Assuntos
Animais , Gatos , Criança , Pré-Escolar , Cães , Feminino , Humanos , Masculino , Eosinofilia/epidemiologia , Enteropatias Parasitárias/epidemiologia , Toxocaríase/epidemiologia , Anticorpos Anti-Helmínticos/sangue , Ensaio de Imunoadsorção Enzimática , Eosinofilia/diagnóstico , Eosinofilia/parasitologia , Fezes/parasitologia , Inquéritos Epidemiológicos , Imunoglobulina G/sangue , Enteropatias Parasitárias/diagnóstico , Enteropatias Parasitárias/parasitologia , Prevalência , Peru/epidemiologia , Fatores de Risco , Toxocara/imunologia , Toxocaríase/diagnósticoRESUMO
The aim of this study was to estimate the frequency of human toxocariosis in a child population from Morrope district, Lambayeque, Peru. From October to December 2005, 182 school children (96 male and 86 female) were studied. Blood samples were collected for Toxocara ELISA-IgG test and hematological examination. Additionally, stool samples were collected for coproparasitological examination to check cross reactions. We found frequency of positives in 32.4 percent (59/182) with a significant higher proportion of positivity in male children (p < 0.00001). 71.2 percent of the children with positive serology (52 male and seven female), were between five and 10 years old, 77.96 percent had respiratory symptoms, 61.02 percent had ocular manifestations, 38.98 percent had hepatic symptoms, 38.98 percent had mild or moderate eosinophilia, signs statistically associated with seropositivity. 83.5 percent of studied population had some intestinal parasite, such as: Blastocystis hominis (53.3 percent), Giardia lamblia (31.3 percent), Entamoeba coli (29.1 percent), Entamoeba histolytica/E. dispar (1.1 percent), Hymenolepis nana (5.49 percent), and Ascaris lumbricoides (3.3 percent), but they had not any association with serology results. The ownership of dogs or/and cats were significantly associated with seropositivity to anti-Toxocara antibodies although the presence of such pets within the house was not. In conclusion, clinical and serological evidence of Toxocara infection exists in the studied population.
O propósito do presente trabalho foi estimar a freqüência da toxocaríase humana em crianças do distrito de Morrope, Lamabayeque, Perú. Nos meses de outubro a dezembro de 2005, 182 escolares (96 meninos e 86 meninas) foram estudados. Coletaram-se amostras de sangue para a análise hematológica e imunológica pelo teste de ELISA-IgG-Toxocara e amostras fecais para o exame parasitológico. A freqüência geral da população foi de 32,4 por cento (59/182) com proporção significativamente maior de positividade nos meninos. Das crianças com resultado positivo ao teste sorológico (52 meninos e sete meninas), 71,2 por cento tinham entre cinco e 10 anos, 77,96 por cento apresentavam sintomas respiratórios, 61,02 por cento apresentavam manifestações oculares, 38,98 por cento apresentavam moléstias hepáticas, 38,98 por cento apresentavam suave ou moderada eosinofília e todos estes sinais foram estatisticamente associados ao resultado da sorologia. A presença de algum parasito intestinal foi observada em 83,5 por cento da população estudada: Blastocystis hominis (53,3 por cento), Giardia lamblia (31,3 por cento), Entamoeba coli (29,1 por cento), Entamoeba histolytica/E. dispar (1,1 por cento), Hymenolepis nana (5,49 por cento), e Ascaris lumbricoides (3,3 por cento), mas estes não tiveram nenhuma associação com a sorologia. A posse de cães e gatos revelou associação estatisticamente significante com a positividade para toxocaríase embora a presença destes animais no domicílio não tenha revelado tal associação. Conclui-se que existem evidências clínicas e sorológicas de infecção por Toxocara na população estudada.