RESUMO
BACKGROUND: The National Program for Chagas disease was implemented in Bolivia in 2006, and it greatly decreased the number of infections through vector control. Subsequently, a treatment regimen of benznidazole (BNZ) was started in seropositive school-age children living in certified vector control areas. METHODS AND FINDINGS: We conducted a 12-month follow-up study and seven blood samples were taken during and after the treatment. Serology, conventional diagnostic PCR (cPCR) and quantitative Real-time PCR (qPCR) were performed. Plasma Th1/Th2/Th17 cytokines levels were also determined. Approximately 73 of 103 seropositive children complied with BNZ, with three interruptions due to side effects. To evaluate each individual's treatment efficacy, the cPCR and qPCR values during the final 6 months of the follow-up period were observed. Among 57 children who completed follow-up, 6 individuals (11%) showed both cPCR(+) and qPCR(+) (non reactive), 24 (42%) cPCR(-) but qPCR(+) (ambiguous) and 27 (47%) cPCR(-) and qPCR(-) (reactive). Within 14 Th1/Th2/Th17 cytokines, IL-17A showed significantly higher levels in seropositive children before the treatment compared to age-matched seronegative children and significantly decreased to the normal level one-year after. Moreover, throughout the follow-up study, IL-17A levels were positively co-related to parasite counts detected by qPCR. At the 12 months' time point, IL-17A levels of non-reactive subjects were significantly higher than either those of reactive or ambiguous subjects suggesting that IL-17A might be useful to determine the reactivity to BNZ treatment. CONCLUSIONS: Plasma levels of IL-17A might be a bio-marker for detecting persistent infection of T. cruzi and its chronic inflammation.
Assuntos
Doença de Chagas/tratamento farmacológico , Interleucina-17/sangue , Nitroimidazóis/uso terapêutico , Resultado do Tratamento , Adolescente , Biomarcadores/sangue , Bolívia , Doença de Chagas/sangue , Criança , Pré-Escolar , Citocinas , Feminino , Seguimentos , Humanos , Masculino , Nitroimidazóis/sangue , Reação em Cadeia da Polimerase/métodos , Tripanossomicidas/sangue , Tripanossomicidas/uso terapêutico , Trypanosoma cruzi/efeitos dos fármacos , Trypanosoma cruzi/isolamento & purificaçãoRESUMO
Tenemos como objetivo demostrar la utilidad de la herramienta BABIES en la determinación de las principales causalidades de la mortalidad neonatal hospitalaria. Hospital Municipal "Alfonso Gumucio Reyes". Montero Santa Cruz. Gestión 2003. Se trata de un estudio descriptivo, retrospectivo y transversal. Se aplica la matriz BABIES, haciendo uso de los Carnest de la Mujer No Gestante y Gestante, formularios de encuestas, y las Historias Clinicas de los casos sometidos a estudio. Entonces, las principales causas para la ocurrrencia de los casos de óbitos hospitalarios son. las deficiencias del periodo concepcional, seguida del periodo no gestacional, luego la atención en las primeras 24 horas, la atención del parto y la atención entre 1 a 6 días de vida.
Assuntos
Mortalidade InfantilRESUMO
Tenemos como objetivo demostrar la utilidad de la herramienta BABIES en la determinación de las principales causalidades de la mortalidad neonatal hospitalaria. Hospital Municipal "Alfonso Gumucio Reyes". Montero Santa Cruz. Gestión 2003. Se trata de un estudio descriptivo, retrospectivo y transversal. Se aplica la matriz BABIES, haciendo uso de los Carnest de la Mujer No Gestante y Gestante, formularios de encuestas, y las Historias Clinicas de los casos sometidos a estudio. Entonces, las principales causas para la ocurrrencia de los casos de óbitos hospitalarios son. las deficiencias del periodo concepcional, seguida del periodo no gestacional, luego la atención en las primeras 24 horas, la atención del parto y la atención entre 1 a 6 días de vida.