Does targeting children with hygiene promotion messages work? The effect of handwashing promotion targeted at children, on diarrhoea, soil-transmitted helminth infections and behaviour change, in low- and middle-income countries.

OBJECTIVES: To synthesise evidence on the effect of handwashing promotion interventions targeting children, on diarrhoea, soil-transmitted helminth infection and handwashing behaviour, in low- and middle-income country settings. METHODS: A systematic review of the literature was performed by searching eight databases, and reference lists were hand-searched for additional articles. Studies were reviewed for inclusion according to pre-defined inclusion criteria and the quality of all studies was assessed. RESULTS: Eight studies were included in this review: seven cluster-randomised controlled trials and one cluster non-randomised controlled trial. All eight studies targeted children aged 5-12 attending primary school but were heterogeneous for both the type of intervention and the reported outcomes so results were synthesised qualitatively. None of the studies were of high quality and the large majority were at high risk of bias. The reported effect of child-targeted handwashing interventions on our outcomes of interest varied between studies. Of the different interventions reported, no one approach to promoting handwashing among children appeared most effective. CONCLUSION: Our review found very few studies that evaluated handwashing interventions targeting children and all had various methodological limitations. It is plausible that interventions which succeed in changing children's handwashing practices will lead to significant health impacts given that much of the attributable disease burden is concentrated in that age group. The current paucity of evidence in this area, however, does not permit any recommendations to be made as to the most effective route to increasing handwashing with soap practice among children in LMIC.

Screening for parasite infections in immigrant children from low-income countries.

INTRODUCTION: In Spain, minors represent approximately 20% of the immigration flow. Many of these immigrants come from countries in the tropics and sub-tropics where intestinal parasitic infections caused by helminths and protozoa are one of the major causes of human disease. The main objective of the present work was to describe parasite infections in a group of immigrant children. METHODS: A prospective evaluation was performed in 373 minors from Sub-Saharan Africa, North Africa, and Latin America. Details were collected from the medical records and physical examination. Urine, stool and peripheral blood samples were obtained for serological and routine laboratory tests. Direct and indirect parasitological tests were also performed. RESULTS: At least 1 parasitic disease was diagnosed in 176 (47.1%) immigrant children, while 77 (20.6%) minors were infected with two or more parasites. The number of parasites was highest in children from Sub-Saharan Africa compared with the rest of the areas of origin (p<.001), and in children from urban areas compared with those from rural areas (OR 1.27 [1.059-1.552], p=.011). The most frequent causes of multiple parasite infection were filariasis plus strongyloidiasis and filariasis plus schistosomiasis. Intestinal parasite infection was diagnosed in 38 cases (13.8%). Logistic regression analysis revealed that for each month of stay, the probability of a positive finding in the stool sample decreased by 0.02% [ß=-0.020, (p=.07)]. CONCLUSIONS: The high infection rates of parasite diseases in immigrant children point to the need for screening protocols for certain infectious diseases in these children according to their country of origin and their length of residence in Spain.

Clinical aspects of paediatric visceral leishmaniasis in North-west Ethiopia.

OBJECTIVE: Visceral leishmaniasis (VL) in north-west Ethiopia is causing an overwhelming case load among adult migrant workers that masked the disease burden in children. This study describes the clinical profile and explores comorbidities in paediatric VL patients. METHODS: A prospective study at two hospitals in this region (Gondar and Humera) was conducted in a year period, 2011-2012. The clinical manifestations and comorbidities such as malnutrition, intestinal parasitosis and vitamin D deficiency and HIV infection were assessed, and treatment outcomes noted. RESULTS: A total of 122 children with VL were detected during the study period with median age of 8.5 years (IQR 5-12 years); 23% were under 5 years. Eighty-five (69.7%) cases were male. The clinical manifestations were similar to the adult patients. High rates of malnutrition, intestinal parasitosis (47.5%) and hypovitaminosis D (56.4%) were detected. The proportion of stunting and wasting was 63% and 22.2% in children aged under five years, and 50.5% and 75.9% in 5-year and older children, respectively, using WHO standard growth curves. Only one child had HIV infection. In 95% of the cases, sodium stibogluconate (20 mg/kg/day for 30 days) was used for treatment. The treatment success rate at end of therapy was 98.3%, but the definitive outcome at 6 months could not be determined because of a high loss to follow-up (80.2%). CONCLUSION: While HIV co-infection was rare, malnutrition, intestinal parasitosis and vitamin D deficiency were frequent indicating the need for further research on their role in the pathophysiology. Meanwhile, systematic assessment and management of malnutrition and intestinal parasitosis in VL programmes is recommended.

Impact of periodic selective mebendazole treatment on soil-transmitted helminth infections in Cuban schoolchildren.

OBJECTIVE: To evaluate the impact of periodic selective treatment with 500 mg mebendazole on soil-transmitted helminth (STH) infections in Cuban schoolchildren. METHODS: We followed up a cohort of 268 STH-positive schoolchildren, aged 5-14 years at baseline, at six-month intervals for two years and a final follow-up after three years. Kato-Katz stool examination was used to detect infections with Ascaris lumbricoides, Trichuris trichiura and hookworm. Common risk factors related to STHs were assessed by parental questionnaire. RESULTS: A significant reduction in the number of STH infections was obtained after three years with the highest reduction for T. trichiura (87.8%) and the lowest for hookworm (57.9%). After six months, cure rates (CRs) were 76.9% for A. lumbricoides, 67.4% for T. trichiura and 44.4% for hookworm. After two treatment rounds, more than 75% of all STH-positive children at baseline were cured, but with important differences between STH species (95.2% for A. lumbricoides, 80.5% for T. trichiura and 76.5% for hookworm). At the end of the study, these cumulative CRs were almost 100% for all three STHs. Risk factors for STHs were sex, sanitary disposal and habit of playing in the soil. CONCLUSIONS: Our results indicate that periodic selective treatment with 500 mg mebendazole is effective in reducing the number of STH infections in Cuban schoolchildren. Although important differences were found between helminth species, two rounds of treatment appeared sufficient to obtain substantial reductions.

Knowledge, attitudes and practices concerning self-medication with antibiotics among university students in western China.

OBJECTIVES: To evaluate the knowledge, attitude and behaviours of university students on the use of antibiotics. METHODS: A knowledge-attitude-practice questionnaire was developed and distributed to undergraduate students of Xi'an Jiaotong University, comprising 18 schools/colleges in Shaanxi Province, western China. Chi-square test and logistic regression analysis were applied to identify risk factors associated with self-medication with antibiotics. RESULTS: Of the 731 respondents (response rate = 73.1%), 294 (40.2%) had self-medicated with antibiotics in the past 6 months. Most of the antibiotics (59.2%) for self-medication were purchased without prescription in retail pharmacies. The median score of students' knowledge about antibiotics was 4 (IQR: 3-6) of a maximum possible score of 10. Students had moderately accurate beliefs towards antibiotics. More than half of the students (56.5%) were storing antibiotics frequently. During self-medication, 16.7% of students claimed to have experienced adverse reactions, and 30.6% had used antibiotics to prevent common colds. The majority preferred to use broad-spectrum antibiotics, and nearly half preferred intravenous antibiotics. Over 44% of students had changed antibiotic dosage, and 36.5% had switched to another antibiotic during the treatment course. Logistic regression analysis identified college and home town as independent risk factors for self-medication with antibiotics (P < 0.01). CONCLUSIONS: Undergraduate students had inadequate knowledge, moderately accurate beliefs and inappropriate practices concerning antibiotics, and a high rate of self-medication. This highlights the need for focused educational intervention and stricter governmental regulation concerning antibiotic use and sale in retail pharmacies.

[Imported hookworm infection in Almeria]. / Uncinariasis importada en Almería.

OBJECTIVES: To study the clinical and epidemiological characteristics of immigrant patients diagnosed with a hookworm infection in the Tropical Medicine Unit of the Hospital de Poniente in El Ejido (Almería, Spain). MATERIAL AND METHODS: A retrospective observational study of all immigrant patients diagnosed with hookworm, by direct visualization of eggs in stool samples, from October 2004 until December 2012. RESULTS: Of the 1872patients studied, 253 (13.5%) were diagnosed with a hookworm infection. In patients where hookworm was the only helminthiasis diagnosed, 8.3% had iron deficiency anaemia, 65.7% did not have eosinophilia, and of these, 25.9% had no abdominal pain. CONCLUSIONS: Hookworm is a frequent parasite infestation in the Sub-Saharan immigrant population. Many patients are asymptomatic; thus the implementation of a study protocol for immigrants from endemic areas could diagnose and treat more patients with this disease.

Diagnóstico molecular de parasitosis intestinales.

Infections causes by parasites of the gastrointestinal tract are a global public health problem. In industrialised countries, their particular epidemiological (low general prevalence of enteroparasites), economic (high labour costs) and clinical characteristics (constant increase in the number of samples and diagnostic determinations to be performed) have led molecular techniques to progressively replace conventional microscopy as the first-line diagnostic method of these pathogens in modern clinical laboratories. PCR-based techniques, particularly those developed for the simultaneous detection of the various agents that can cause the same infectious disease (syndromic diagnosis), already represent a cost-effective option that allow process automisation, workflow optimisation, and comparison of results among different laboratories, and facilitate accreditation of diagnostic procedures. This review clearly and concisely discusses the current situation of the molecular diagnosis of the main species of intestinal parasites in humans, particularly the enteric protozoans causing diarrhoea (Cryptosporidium spp., Giardia duodenalis, Entamoeba histolytica), the most important members the Microsporidia phyla (Enterocytozoon bieneusi) and Stramenopiles phyla (Blastocystis sp.), as well as the helminths transmitted by soil (Ancylostoma spp., Ascaris lumbricoides, Necator americanus, Strongyloides stercoralis and Trichuris trichiura) and food (Anisakis spp., Clonorchis sinensis, Fasciola spp., Taenia solium, and Trichinella spiralis). Special attention is paid to the description of available techniques and formats, to their diagnostic benefits and the most widely used genetic markers for their detection, both in clinical laboratories and genotyping in referral and research centres.

Comparative analysis of the incidence of enteroparasitosis andthe COVID-19 pandemic profile in the city of Bananeiras - PB / Análise comparativa da incidência de enteroparasitoses e doperfil pandêmico da COVID-19 na cidade de Bananeiras - PB

Enteroparasitosis are diseases caused by parasitic agents present in the environment and in the gastrointestinal tract of living beings. In addition, they are still considered neglected diseases, but of great importance for public health, especially when they are related to secondary infections and currently their co-infection profile with COVID-19. The interaction of protozoa and/or helminths with the SARS-CoV-2 virus is timely and its signs and symptoms are confused with other pathogen relationships. In this way, this study aims to correlate the incidence of enteroparasitosis and COVID-19, in the pandemic period from 2020 to April 2022. This is a documentary and exploratory study of secondary data from laboratory tests of patients who were treated and diagnosed with COVID-19 and enteroparasitosis at Hospital Doutor Cloves Bezerra Cavalcante, Municipal Hospital of Bananeiras, Paraíba, Brazil. In the analysis of the database, a significant increase of approximately 48.85% in the incidence of COVID-19 cases from 2020 to 2021 stands out, remaining high until 2022. In contrast, cases of enteroparasites peaked at 48.74% in 2021, followed by an average reduction of 23.12%, with a deviation of 1.49%, in relation to the years 2020 and 2022. It was concluded that COVID-19 is predominantly associated with an increase in secondary infections, highlighting the crucial need to promote health education, improve basic sanitation and guarantee access to health services as essential components in combating the increase in parasitic infections, especially those related to viral pathologies.

As enteroparasitoses são enfermidades originadas por agentes parasitários presentes no meio ambiente e no trato gastrointestinal dos seres vivos. Ademais, ainda são consideradas doenças negligenciadas, porém de grande importância para a saúde pública, em especial, quando estão relacionadas com infecções secundárias e atualmente seu perfil de coinfecção com a COVID-19. A interação de protozoários e/ou helmintos com o vírus SARS-CoV-2 é oportuna e seus sinais e sintomas são confundidos com outras relações de patógenos. Desta maneira, este estudo visa correlacionar a incidência de enteroparasitoses e COVID-19, no período pandêmico de 2020 a abril de 2022. Trata--se de uma pesquisa documental e exploratória, de dados secundários dos exames laboratoriais de pacientes que foram atendidos e diagnosticados com COVID-19 e enteroparasitoses no Hospital Doutor Cloves Bezerra Cavalcante, Hospital Municipal de Bananeiras, Paraíba, Brasil. Na análise da base de dados, destaca-se um aumento significativo de aproximadamente 48,85% na incidência de casos de COVID-19 de 2020 a 2021, mantendo-se elevado até 2022. Em contraste, os casos de enteroparasitas atingiram um pico de 48,74% em 2021, seguido por uma redução média de 23,12%, com um desvio de 1,49%, em relação aos anos de 2020 e 2022. Conclui-se que a COVID-19 está predominantemente associada ao aumento de infecções secundárias, destacando a necessidade crucial de promover a educação em saúde, melhorar o saneamento básico e garantir o acesso aos serviços de saúde como componentes essenciais no combate ao aumento de infecções parasitárias, especialmente aquelas relacionadas a patologias virais.

Caracterização morfológica e morfométrica de estágios larvares de Strongyloides spp, ancilostomídeos e Angiostrongylus spp: subsídios para identificação em amostras ambientais / Morphological and morphometric characterization of larval stages of Strongyloides spp, hookworms and Angiostrongylus spp: subsidies for identification in environmental samples

A identificação precisa de nematódeos de interesse médico-veterinário em amostras de solo ou alimentos é uma ação complexa, devido à grande diversidade de nematódeos no ambiente. O objetivo do estudo foi realizar a caracterização morfológica e morfométrica de diferentes estágios larvários de ancilostomídeos, Strongyloides stercoralis, Strongyloides venezuelensis, Angiostrongylus cantonensis e Angiostrongylus costaricensis, e desenvolver um estudo de similaridade entre espécies do mesmo gênero, a fim de orientar o diagnóstico diferencial com os nematódeos ambientais. As larvas foram fixadas e diversos parâmetros corporais foram mensurados, para os quais foi realizada estatística descritiva e estudo de similaridade. Os resultados médios das larvas padrões foram compatíveis com os descritos para as espécies, com variabilidade em alguns parâmetros. S. stercoralis e S. venezuelensis demonstraram similaridade de 59% para L1 e 79% para L3, com maior diferenciação entre os grupos em relação à extremidade anterior e ao primórdio genital. No pool de larvas de ancilostomídeos, verificou-se uma grande variação nos parâmetros avaliados, especialmente quanto ao comprimento total do corpo. A. cantonensis e A. costaricensis apresentaram 48% de similaridade entre L1 e 76% para L3. Por meio da análise morfométrica e de similaridade verificou-se a possibilidade do aprimoramento do diagnóstico diferencial de nematódeos de origem ambiental. (AU)

Due to the enormous diversity of nematodes in the environment, identifying nematodes of medical and veterinary significance within soil or food samples can be challenging. To facilitate the differential diagnosis with environmental nematodes, this study aimed morphologically and morphometrically characterize various larval stages of hookworms, Strongyloides stercoralis, Strongyloides venezuelensis, Angiostrongylus cantonensi and Angiostrongylus costaricensis. Additionally, a similarity study was conducted among species within the same genus. The larvae were fixated and several body parameters were measured for the analysis, which included a comparison using descriptive statistics. Despite some parameter fluctuation, the average results for standard larvae were consistent with those of the respective species as a whole. The similarity between S. stercoralis and S. venezuelensis was 59% for L1 and 79% for L3, with more pronounced differences observed in the anterior extremity and the genital primordium. The examined parameters exhibited significant variation among the pool of hookworm larvae, particularly concerning the total length of the body. The similarities between A. cantonensis and A. costaricensis larvae ranged from 48% for L1 to 76% for L3. Analyses of morphometric and similarity data provided support for the potential improvement of differentiation between nematodes with environmental origins. This research contributes to enhancing the accuracy of identifying medically and veterinary relevant nematodes present in soil. (AU)

Coinfección por helmintos y Mycobacteriumtuberculosis

Introducción: Las infecciones por helmintos y Mycobacterium tuberculosis se superponen geográficamente, en particular en los países de ingresos económicos bajos y medianos, donde son altamente endémicas. En estos, la mayoría de las personas se infectan crónicamente por uno o ambos tipos de patógenos en etapas tempranas de sus vidas. Objetivo: Incursionar en los principales aspectos inmunológicos de la coinfección helmintos-M. tuberculosis y sus consecuencias para la progresión de la infección por M. tuberculosis y la vacunación contra la tuberculosis. Métodos: Revisión de artículos sobre inmunología, diagnóstico, tratamiento y control de las infecciones por helmintos y M. tuberculosis publicados entre 2010-2022 en las bases de datos PubMed, Medline y Google Scholar. Se consultaron, además, algunas monografías y artículos originales fechados con anterioridad. Análisis y síntesis de la información: Durante la infección crónica por helmintos, la modulación de las respuestas inmunitarias Th2 y Tregs por parte de esos parásitos podría inhibir las respuestas inmunitarias Th1 y Th17 contra la infección por M. tuberculosis y conducir a su progresión desde la fase latente, de escasa expresión clínica, hasta la fase activa de la tuberculosis. La modulación inmune de los helmintos podría dar lugar a una respuesta deficiente a la vacunación con BCG. Resultados epidemiológicos demuestran que la inmunomodulación podría revertirse mediante tratamientos antihelmínticos. Conclusiones: En la infección crónica por helmintos, es importante considerar que la modulación de sus respuestas inmunitarias activa circuitos inmunorreguladores complejos que pueden conducir a formas graves de la tuberculosis en el hospedero y a respuesta deficiente a la vacunación con BCG.

Introduction: Helminth and Mycobacterium tuberculosis infections overlap geographically, particularly in low- and middle-income countries, where they are highly endemic. There, most people are chronically infected by one or both types of pathogens early in their lives. Objective: To explore the main immunological aspects of helminth-M tuberculosis coinfection and its consequences for the progression of M. tuberculosis infection and vaccination against tuberculosis. Methods: A review of articles on immunology, diagnosis, treatment, and control of helminth and M. tuberculosis infections was conducted on those published between 2010-2022 in PubMed, Medline, and Google Scholar databases. In addition, some previously dated original monographs and articles were consulted. Analysis and synthesis of information: During chronic helminth infection, modulation of Th2 and Treg immune responses by these parasites could inhibit Th1 and Th17 immune responses against M. tuberculosis infection and lead to its progression from the latent phase, with little clinical expression, to the active phase of tuberculosis. Immune modulation of helminths could lead to poor response to BCG vaccination. Epidemiological results show that immunomodulation could be reversed by anthelmintic treatments. Conclusions: In chronic helminth infection, it is important to consider that the modulation of their immune responses activates complex immunoregulatory circuits that can lead to severe forms of tuberculosis in the host and poor response to BCG vaccination.

Helminthosis and eosinophilia in Spain (1990-2015). / Helmintosis y eosinofilia en España (1990-2015).

The finding of blood eosinophilia in a patient is a relatively frequent reason to refer him/her to a Clinical Department of Infectious Diseases. The doctor usually intends to rule out a parasitic disease in the autochthonous population, travelers or immigrants. It is uncommon for an eosinophilia to be produced by protozoa infection, whereas helminth parasites are more frequently associated with an increase of eosinophil counts in the infected patient. Eosinophilia can be the only abnormal finding, or it could be part of more complex clinical manifestations suffered by the patient. Furthermore, many, but not all, helminth infections are associated with eosinophilia, and the eosinophil level (low, high) differs according to parasite stages, helminth species, and worm co-infections. The purpose of the present article is to carry out a systematic review of cases and case series on helminth infections and eosinophilia reported in Spain from 1990 to 2015, making a distinction between autochthonous and imported (immigrants and travelers) cases, and studying their relationship with immunodepression situations.

Endoparasites of marsupials in fragments of the Atlantic rainforest, western Paraná State, Brazil / Endoparasitas de marsupiais em fragmentos de Mata Atlântica no oeste do Estado do Paraná, Brasil

Abstract Knowledge of taxonomy and biodiversity of parasites is fundamental to better understand ecosystem dynamics. The objective of this study was to describe the helminth fauna of two species of marsupials in five fragments of the Atlantic rainforest in the western region of Paraná State, Brazil. In a total of 4050 trap-nights, the animals were captured using Sherman, Tomahawk, and Pitfall traps, euthanized, necropsied, and their organs inspected for helminths. After identification of the parasites, descriptors of infection, such as prevalence, mean abundance, mean intensity, and range of intensity, were calculated. Collectively, six helminth species were observed in 18 animals. The following five species were observed in Marmosa paraguayana: Viannaia hamata (58.8%), Gracilioxyuris agilisis (52.9%), Travassostrongylus sextus (17.6%), Oncicola luehei (5.9%), and Pritchardia boliviensis (5.9%). Whereas the following two species were observed in Monodelphis dimidiata: Trichohelix tuberculata (100%) and Travassostrongylus sextus (100%). This study represents a new locality record for all helminths described herein, and a new host for four helminth species. This is the first report on the helminth fauna of Monodelphis dimidiata, expanding knowledge about marsupials in the Brazilian Atlantic Forest.

Resumo Conhecimentos taxonômicos e da biodiversidade parasitária são fundamentais para uma melhor compreensão da dinâmica do ecossistema. O objetivo do estudo foi descrever a helmintofauna de marsupiais em cinco fragmentos de Mata Atlântica, na região Oeste do Estado do Paraná, Brasil. Em um total de 4.050 armadilhas/noite, os animais foram capturados com as do tipo Sherman, Tomahawk e Pitfall, eutanasiados, necropsiados e seus órgãos inspecionados em busca de helmintos. Após a identificação do parasita, foram calculados os indicadores de infecção (prevalência, abundância média, intensidade média e variação de intensidade). Seis espécies de helmintos foram observadas em dezoito animais; cinco em Marmosa paraguayana: Viannaia hamata (58,8%), Gracilioxyuris agilisis (52,9%), Travassostrongylus sextus (17,6%), Oncicola luehei (5,9%) e Pritchardia boliviensis (5,9%), e duas em Monodelphis dimidiata: Trichohelix tuberculata (100%) e Travassostrongylus sextus (100%). Este estudo representa um novo registro de localidade para todos os helmintos descritos e um novo hospedeiro para quatro deles. Trata-se do primeiro relato da helmintofauna de Monodelphis dimidiata, expandindo-se os conhecimentos sobre marsupiais na mata Atlântica brasileira.

Occurrence of gastrointestinal parasites in dogs in a rural area of Santa Catarina, Brazil / Ocorrência de parasitas gastrintestinais em cães de área rural de Santa Catarina, Brasil

Abstract We investigated the occurrence of gastrointestinal parasites in dogs in rural areas of the municipality of Painel, Santa Catarina, Brazil. For this, 91 canine feces samples were collected from 82 farms between August, 2017 and January, 2018. These fecal materials were processed using the techniques of spontaneous sedimentation, centrifugation-floatation in zinc sulfate and Ziehl-Neelsen staining. A questionnaire in the form of an interview was administered to the dogs' owner and information about the farm and the main care provided for the dogs was obtained. Among 91 sampled dogs, 27 (29.7%) were positive for at least one parasite species. Ancylostoma was the most prevalent genus (16.5%), followed by Giardia duodenalis (14.3%), Trichuris vulpis (6.6%), Toxocara canis (5.5%), Entamoeba spp. (4.8%), Cryptosporidium spp. (3.3%) and Taeniidae (1.1%). Most dogs do not receive veterinarian care and rarely received antiparasitic treatment. They were free to roam and had free access to animal remains and garbage, which was reflected in the significant associations with the occurrence of parasites that were found. We conclude that rural dogs harbor gastrointestinal parasites, but that their owners are unaware of the risks that these parasites can bring to human health.

Resumo Foi investigada a ocorrência de parasitos gastrintestinais com potencial zoonótico, em cães de área rural do munícipio de Painel, Santa Catarina, Brasil. Para isso, foram colhidas amostras de fezes de 91 cães de 82 propriedades rurais, no período de agosto de 2017 a janeiro de 2018. Este material fecal foi processado pelas técnicas de sedimentação espontânea, centrífugo-flutuação em sulfato de zinco e coloração pelo Ziehl-Neelsen. Um questionário em forma de entrevista foi aplicado aos tutores dos cães e foram obtidas informações sobre a propriedade rural e principais cuidados com os cães. Entre as 91 amostras de fezes, em 27 (29,7%) foi detectada a presença de parasitos gastrintestinais, sendo Ancylostoma o gênero mais prevalente (15 / 16,5%), seguido por Giardia duodenalis (13 / 14,3%), Trichuris vulpis (6 / 6,6%), Toxocara canis (5 / 5,5%), Entamoeba spp. (4 / 4,8%), Cryptosporidium spp. (3 / 3,3%) e Taeniidae (1 / 1,1%). A maioria dos cães não recebia cuidados veterinários ou antiparasitários. Concluiu-se que os cães de área rural albergam parasitos gastrintestinais, porém seus tutores desconhecem os riscos que esses parasitos podem trazer para a saúde humana.

Comparación de técnicas coproparasitológicas para el diagnóstico de geohelmintos intestinales en niños Lambayecanos

Los helmintos transmitidos a través del suelo pueden afectar el desempeño educativo y desenvolvimiento normal de los niños. Objetivo: comparar cinco técnicas coproparasitológicas para el diagnóstico de geohelmintos intestinales en niños lambayecanos. Métodos: estudio descriptivo de corte transversal. Se recolectaron 150 muestras de materia fecal de niños que residían en los distritos de Túcume y Lambayeque en el departamento de Lambayeque (Perú), durante el año 2021. Los niños y niñas tenían entre 4 y 12 años de edad. Previo a la recolección, se les explicó a los padres de familia y apoderados de los menores las condiciones preclínicas adecuadas. Se calculó la sensibilidad, especificidad, concordancia, valor predictivo positivo y negativo de las técnicas de Baerman, sedimentación rápida, Willis Molloy, Sheathers Sugar y examen directo de heces. Los padres y apoderados autorizaron la participación de los menores en el estudio. El estudio contó con la aprobación del comité de ética de la Universidad Nacional de Jaén. Resultados: la prevalencia geohelmintos intestinales fue del 20,7%, 19,3% y 18,0% con las técnicas de Baerman, sedimentación rápida y examen directo, respectivamente. Además, las técnicas de Baerman y de sedimentación rápida reportaron mayor sensibilidad, especificidad, valor predictivo positivo y negativo. Se obtuvo alto índice de concordancia para las técnicas de Baerman (0,894) y sedimentación rápida (0,891). Conclusiones: las técnicas de Baerman y de sedimentación rápida permitieron mayor recuperación de parásitos, respecto al examen directo. Además, las especies de geohelmintos intestinales más identificadas en niños lambayecanos fueron Ascaris lumbricoides, Hymenolepis nana y Ancilostomideos.

Helminths transmitted through the soil can affect the educational performance and normal development of children. Objective: to compare five coproparasitological techniques for the diagnosis of intestinal geohelminths in Lambayecan children. Methods: Descriptive cross-sectional study. 150 stool samples were collected from children residing in the districts of Túcume and Lambayeque in the department of Lambayeque (Peru), during the year 2021. The boys and girls included were between 4 and 12 years of age. Prior to the collection, the appropriate preclinical conditions are explained to the parents and guardians of the minors. The sensitivity, specificity, concordance, positive and negative predictive value of the Baerman, rapid sedimentation, Willis Molloy, Sheathers Sugar and direct stool examination techniques were calculated. Parents and guardians authorized the participation of minors in the study. The study was approved by the ethics committee of the National University of Jaén. Results: the prevalence of intestinal geohelminths was 20,7%, 19,3% and 18,0% with the Baerman, rapid sedimentation and direct examination techniques, respectively. In addition, the Baerman and rapid sedimentation techniques reported higher sensitivity, specificity, positive and negative predictive value. A high concordance index was obtained for the Baerman (0,894) and rapid sedimentation (0,891) techniques. Conclusions: the Baerman and rapid sedimentation techniques allowed greater recovery of parasites compared to direct stool examination. In addition, the species of intestinal geohelminths most identified in children from Lambaye were Ascaris lumbricoides, Hymenolepis nana and Ancilostomideos.

Neurocisticercosis y epilepsia en un hospital universitario de Popayán, Colombia: una serie de casos / Neurocysticercosis and epilepsy in a university hospital in Popayán, Colombia: A case series

RESUMEN INTRODUCCIÓN: La neurocisticercosis es una infección del sistema nervioso central causada por el estadio larvario del cestodo Taenia solium, y se estima que puede ocasionar hasta 30% de los casos de epilepsia en los países donde esta parasitosis es endémica. El objetivo de este estudio fue determinar la frecuencia de pacientes que presentaron epilepsia como secuela de neurocisticercosis en un hospital universitario en Popayán. MATERIALES Y MÉTODOS: Se realizó un estudio retrospectivo con todos los pacientes con diagnóstico de neurocisticercosis que ingresaron al Hospital Universitario San José entre enero 2014 y diciembre 2018 que cumplieron los criterios de inclusión. RESULTADOS: Se encontraron 50 pacientes, de estos, 40 (80%) reingresaron, encontrándose que 37 (74%) presentaron epilepsia como secuela. Las edades más afectadas fueron la de 41 a 60 años; 48 (96%) provenían del departamento del Cauca en especial de Mercaderes, y 33 (66%) de área rural. El síndrome convulsivo fue la manifestación clínica de ingreso más frecuente. La TAC fue la técnica de imagen de elección. CONCLUSIÓN: El departamento del Cauca se considera como una de las áreas endémicas para neurocisticercosis en Colombia, y la epilepsia secundaria es un secuela común.

ABSTRACT INTRODUCTION: Neurocysticercosis is an infection of the central nervous system caused by the larval stage of the cestode Taenia solium, it has been estimated to produce up to 30% of the cases in countries where this parasitosis is endemic. The objective of this study was to determine the frequency of patients who presented epilepsy as a sequel of neurocysticercosis in a university hospital in Popayán. MATERIALS AND METHODS: A retrospective study was conducted with all patients with a diagnosis of neurocysticercosis who were admitted to the Hospital Universitario San José between January 2014 and December 2018 who met the inclusion criteria. RESULTS: We found 50 patients, 40 (80%) of which were readmitted and 37 (74%) presented epilepsy as sequela. The most affected age-group was 41 to 60 years; 48 (96%) were from the department of Cauca, especially Mercaderes, and 33 (66%) from rural areas. Convulsive syndrome was the most frequent clinical manifestation on admission. CT was the imaging technique of choice. CONCLUSION: The department of Cauca is considered as an endemic area for neurocysticercosis, and secondary epilepsy was a common consequence.

Anemia por uncinarias, una infección subestimada por el clínico / Hookworm anemia, an infection underestimated by clinician

La uncinariasis fue descrita por primera vez por Dubini en 1838. Es una helmintiasis intestinal causada por el Necator americanus y/o Ancylostoma duodenale. Frecuentemente son endémicas de áreas tropicales y subtropicales; afecta tanto a niños como a adultos. La transmisión asciende cuando existen entornos socioculturales y demográficos que favorecen la contaminación fecal, por lo que es considerado un problema de salud pública en el mundo. Se presenta el caso de un paciente masculino de 20 años que acudió a urgencias por astenia, adinamia, taquicardia y palidez mucocutánea generalizada; el hemograma reportó anemia severa y eosinofilia. Se requirió transfusión de 4 UI de glóbulos rojos y sulfato ferroso. El examen coprológico mostró infección por Necator americanus, que fue tratada con albendazol y, posteriormente, fue egresado de la institución sanitaria. La infección por uncinarias constituye una causa olvidada para el clínico de hemorragia de las vías digestivas y desarrollo de anemia. Por tanto, el presente estudio destaca que esta parasitosis es una causa importante en el diagnóstico diferencial. Además, se ofrece mayor importancia a las estrategias preventivas como la capacitación a profesionales de salud, el refuerzo de técnicas de aseo, la disminución de la contaminación y el aumento de la higiene personal(AU)

Hookworm infection was first described by Dubini in 1838. It is an intestinal helminth infection caused by Necator americanus and/or Ancylostoma duodenale. They are frequently endemic to tropical and subtropical areas and affect both children and adults. Transmission increases when there are socio-cultural and demographic environments that favor fecal contamination; therefore, it is a public health problem worldwide. We describe the case of a 20-year-old male patient who presented to the emergency department with asthenia, adynamia, tachycardia, and generalized mucocutaneous pallor. The blood test showed severe anemia and eosinophilia. Transfusion of 4 IU of red blood cells and ferrous sulphate was required. The coprological test showed infection by Necator americanus, which was treated with albendazole. Afterwards, the patient was discharged from the health institution. Hookworm infection is a neglected cause of gastrointestinal bleeding and anemia by the clinician. Therefore, the present study highlights this parasitosis as an important cause in the differential diagnosis. In addition, greater importance is given to preventive strategies such as training the health professionals, reinforcement of hygiene techniques, decrease of contamination and increase of proper personal hygiene(AU)

Nematódeos de interesse médico veterinário em represa urbana no município de Catalão, no sudeste do estado de Goiás, Brasil / Nematodes of veterinary medical interest in an urban reservoir in the municipality of Catalão, southeastern Goiás State, Brazil

Objetivo: realizar análises parasitológicas em amostras de solo provenientes da represa da Bica situada no município de Catalão-GO. Métodos: a área do entorno da represa foi dividida em cinco parcelas, sendo realizadas coletas em dois pontos de cada parcela, superior e inferior. Foram realizadas quatro coletas em dias alternados, totalizando 40 amostras de, aproximadamente, 50g da camada superficial do solo, com profundidade máxima de cinco centímetros. As amostras foram processadas no Setor de Diagnóstico Parasitológico do Laboratório de Biologia Molecular da Universidade Federal de Catalão (UFCAT). Para as análises parasitológicas, foram utilizados cinco métodos encontrados na literatura, Rugai, Willis, Sedimentação espontânea, Ritchie e Ritchie modificado. Resultados: pelo método de Rugai, foi possível detectar larvas rabditoides do gênero Ancylostoma e Strongyloides. Utilizando o método de Ritchie modificado, foram encontrados ovos de Ascaris lumbricoidese Ancylostoma sp. Conclusão: a presença de formas evolutivas no solo da represa indica contaminação por dejetos animais e humanos, favorecendo o estabelecimento de ciclos biológicos das espécies encontradas e de outras diferentes zoonoses. Os dados obtidos demonstram a importância de sensibilizar a população de medidas de promoção da saúde, além de ações preventivas e programas de educação em saúde.

Objective: to conduct parasitological analyses in soil samples from the Bica reservoir located in the municipality of Catalão-GO. Methods: the area around the dam was divided into five plots, and samples were collected from two points in each plot, upper and lower. Four samples were collected on alternate days, totaling 40 samples of approximately 50g of topsoil, with a maximum depth of five centimeters. The samples were processed in the Parasitological Diagnostic Sector of the Molecular Biology Laboratory of the Federal University of Catalão (UFCAT). For the parasitological analyses, we used five methods found in the literature, Rugai, Willis, spontaneous sedimentation, Ritchie, and modified Ritchie. Results: by the Rugai method, it was possible to detect rhabditoid larvae of the genus Ancylostoma and Strongyloides. Using the modified Ritchie method, eggs of Ascaris lumbricoidesand Ancylostoma sp were found. Conclusion: the presence of evolutive forms in the soil of the reservoir indicates contamination by animal and human waste, favoring the establishment of biological cycles of the species found and of other different zoonoses. The data obtained demonstrated the importance of raising the population's awareness of health promotion measures besides preventive actions and health education programs.

Detection of enteroparasites in foliar vegetables commercialized in street- and supermarkets in Aparecida de Goiânia, Goiás, Brazil / Detecção de enteroparasitas em hortaliças comercializadas em feiras e supermercados em Aparecida de Goiânia, Goiás, Brasil

Foliar vegetables contaminated with fecal residues are an important route of transmission of intestinal parasites to humans. The aim of this study was to evaluate the presence of parasitic forms of protozoa and helminths on lettuces (Lactuca sativa) and collard greens (Brassica oleracea) sold in street- and supermarkets in the city of Aparecida de Goiânia, Goiás, Brazil. A total of 30 samples of each vegetable (15 samples from each supermarkets and street markets) was analyzed. All samples were processed by spontaneous sedimentation method and centrifugal flotation. In 45% of the samples, immature forms of intestinal parasites were identified with 66.7% helminths eggs and 33.3% protozoan cysts or oocysts. Significantly more lettuce samples were contaminated with eggs, cysts or oocyst of at least one parasite than collard green samples (U=216; Z=-3.45; P <0.001). The parasitic forms were identified morphologically up to the family level with eggs of Ancylostomatidae, Strongyloididae, Ascarididae and Taeniidae, or oocysts of Eimeriidae, to the genus with Cystoisospora sp. and Toxocara sp., and to the species level with Cystoisospora canis, Dipylidium caninum and Hymenolepis nana. The presence of these infective agents in lettuce and collard green from both street- and supermarkets highlights the high risk of spreading parasites by eating raw vegetables sold in Aparecida de Goiânia.

Hortaliças contaminadas com resíduos fecais são importantes vias de transmissão de parasitas intestinais ao homem. O objetivo deste estudo foi avaliar a presença de formas parasitárias de protozoários e helmintos em alface (Lactuca sativa) e couve (Brassica oleracea) vendidas em feiras e supermercados na cidade de Aparecida de Goiânia, Goiás, Brasil. Um total de 30 amostras de cada vegetal (15 amostras de supermercados e 15 de feiras livres) foi analisado. Todas as amostras foram processadas pelos métodos de sedimentação espontânea e centrífugo-flutuação. Em 45% das amostras foram identificadas formas imaturas de parasitas intestinais sendo 66,7% ovos de helmintos e 33,3% de cistos ou oocistos de protozoários. Significativamente, mais amostras de alface estavam contaminadas com ovos, cistos ou oocistos de pelo menos um parasita do que as amostras de couve (U = 216; Z = -3,45; P <0,001). As formas parasitárias foram identificadas morfologicamente ao nível de família com ovos de Ancylostomatidae, Strongyloididae, Ascarididae e Taeniidae ou oocistos de Eimeriidae, dos gêneros Cystoisospora sp. e Toxocara sp., e ao nível de espécies com Cystoisospora canis, Dipylidium caninum e Hymenolepis nana. A presença desses agentes infecciosos em alface e couve, provenientes tanto de feiras quanto de supermercados, ressalta o alto risco de veiculação de parasitas pela ingestão de hortaliças cruas comercializadas em Aparecida de Goiânia.

Detection of enteroparasites in foliar vegetables commercialized in street- and supermarkets in Aparecida de Goiânia, Goiás, Brazil

Abstract Foliar vegetables contaminated with fecal residues are an important route of transmission of intestinal parasites to humans. The aim of this study was to evaluate the presence of parasitic forms of protozoa and helminths on lettuces (Lactuca sativa) and collard greens (Brassica oleracea) sold in street- and supermarkets in the city of Aparecida de Goiânia, Goiás, Brazil. A total of 30 samples of each vegetable (15 samples from each supermarkets and street markets) was analyzed. All samples were processed by spontaneous sedimentation method and centrifugal flotation. In 45% of the samples, immature forms of intestinal parasites were identified with 66.7% helminths eggs and 33.3% protozoan cysts or oocysts. Significantly more lettuce samples were contaminated with eggs, cysts or oocyst of at least one parasite than collard green samples (U=216; Z=-3.45; P 0.001). The parasitic forms were identified morphologically up to the family level with eggs of Ancylostomatidae, Strongyloididae, Ascarididae and Taeniidae, or oocysts of Eimeriidae, to the genus with Cystoisospora sp. and Toxocara sp., and to the species level with Cystoisospora canis, Dipylidium caninum and Hymenolepis nana. The presence of these infective agents in lettuce and collard green from both street- and supermarkets highlights the high risk of spreading parasites by eating raw vegetables sold in Aparecida de Goiânia.

Resumo Hortaliças contaminadas com resíduos fecais são importantes vias de transmissão de parasitas intestinais ao homem. O objetivo deste estudo foi avaliar a presença de formas parasitárias de protozoários e helmintos em alface (Lactuca sativa) e couve (Brassica oleracea) vendidas em feiras e supermercados na cidade de Aparecida de Goiânia, Goiás, Brasil. Um total de 30 amostras de cada vegetal (15 amostras de supermercados e 15 de feiras livres) foi analisado. Todas as amostras foram processadas pelos métodos de sedimentação espontânea e centrífugo-flutuação. Em 45% das amostras foram identificadas formas imaturas de parasitas intestinais sendo 66,7% ovos de helmintos e 33,3% de cistos ou oocistos de protozoários. Significativamente, mais amostras de alface estavam contaminadas com ovos, cistos ou oocistos de pelo menos um parasita do que as amostras de couve (U = 216; Z = -3,45; P 0,001). As formas parasitárias foram identificadas morfologicamente ao nível de família com ovos de Ancylostomatidae, Strongyloididae, Ascarididae e Taeniidae ou oocistos de Eimeriidae, dos gêneros Cystoisospora sp. e Toxocara sp., e ao nível de espécies com Cystoisospora canis, Dipylidium caninum e Hymenolepis nana. A presença desses agentes infecciosos em alface e couve, provenientes tanto de feiras quanto de supermercados, ressalta o alto risco de veiculação de parasitas pela ingestão de hortaliças cruas comercializadas em Aparecida de Goiânia.

Detection of enteroparasites in foliar vegetables commercialized in street- and supermarkets in Aparecida de Goiânia, Goiás, Brazil / Detecção de enteroparasitas em hortaliças comercializadas em feiras e supermercados em Aparecida de Goiânia, Goiás, Brasil

Foliar vegetables contaminated with fecal residues are an important route of transmission of intestinal parasites to humans. The aim of this study was to evaluate the presence of parasitic forms of protozoa and helminths on lettuces (Lactuca sativa) and collard greens (Brassica oleracea) sold in street- and supermarkets in the city of Aparecida de Goiânia, Goiás, Brazil. A total of 30 samples of each vegetable (15 samples from each supermarkets and street markets) was analyzed. All samples were processed by spontaneous sedimentation method and centrifugal flotation. In 45% of the samples, immature forms of intestinal parasites were identified with 66.7% helminths eggs and 33.3% protozoan cysts or oocysts. Significantly more lettuce samples were contaminated with eggs, cysts or oocyst of at least one parasite than collard green samples (U=216; Z=-3.45; P <0.001). The parasitic forms were identified morphologically up to the family level with eggs of Ancylostomatidae, Strongyloididae, Ascarididae and Taeniidae, or oocysts of Eimeriidae, to the genus with Cystoisospora sp. and Toxocara sp., and to the species level with Cystoisospora canis, Dipylidium caninum and Hymenolepis nana. The presence of these infective agents in lettuce and collard green from both street- and supermarkets highlights the high risk of spreading parasites by eating raw vegetables sold in Aparecida de Goiânia.

Hortaliças contaminadas com resíduos fecais são importantes vias de transmissão de parasitas intestinais ao homem. O objetivo deste estudo foi avaliar a presença de formas parasitárias de protozoários e helmintos em alface (Lactuca sativa) e couve (Brassica oleracea) vendidas em feiras e supermercados na cidade de Aparecida de Goiânia, Goiás, Brasil. Um total de 30 amostras de cada vegetal (15 amostras de supermercados e 15 de feiras livres) foi analisado. Todas as amostras foram processadas pelos métodos de sedimentação espontânea e centrífugo-flutuação. Em 45% das amostras foram identificadas formas imaturas de parasitas intestinais sendo 66,7% ovos de helmintos e 33,3% de cistos ou oocistos de protozoários. Significativamente, mais amostras de alface estavam contaminadas com ovos, cistos ou oocistos de pelo menos um parasita do que as amostras de couve (U = 216; Z = -3,45; P <0,001). As formas parasitárias foram identificadas morfologicamente ao nível de família com ovos de Ancylostomatidae, Strongyloididae, Ascarididae e Taeniidae ou oocistos de Eimeriidae, dos gêneros Cystoisospora sp. e Toxocara sp., e ao nível de espécies com Cystoisospora canis, Dipylidium caninum e Hymenolepis nana. A presença desses agentes infecciosos em alface e couve, provenientes tanto de feiras quanto de supermercados, ressalta o alto risco de veiculação de parasitas pela ingestão de hortaliças cruas comercializadas em Aparecida de Goiânia.