RESUMO
Abstract Chagas disease is a neglected parasitic disease caused by Trypanosoma cruzi, whose treatment has remained unsatisfactory for over 50 years, given that it is limited to two drugs. Benznidazole (BZN) is an efficient antichagasic drug used as the first choice, although its poor water-solubility, irregular oral absorption, low efficacy in the chronic phase, and various associated adverse effects are limiting factors for treatment. Incorporating drugs with such characteristics into nanostructured lipid carriers (NLC) is a promising alternative to overcome these limiting obstacles, enhancing drug efficacy and bioavailability while reducing toxicity. Therefore, this study proposed NLC-BZN formulations in different compositions prepared by hot-melt homogenization followed by ultrasound, and the optimized formulation was characterized by FTIR, DRX, DSC, and thermogravimetry. Biological activities included in vitro membrane toxicity (red blood cells), fibroblast cell cytotoxicity, and trypanocidal activity against epimastigotes of the Colombian strain of T. cruzi. The optimized NLC-BZN had a small size (110 nm), negative zeta potential (-18.0 mV), and high encapsulation (1.64% of drug loading), as shown by infrared spectroscopy, X-ray diffraction, and thermal analysis. The NLC-BZN also promoted lower in vitro membrane toxicity (<3% hemolysis), and 50% cytotoxic concentration (CC50) for NLC-BZN in L929 fibroblast cells (110.7 µg/mL) was twice the value as the free BZN (51.3 µg/mL). Our findings showed that the NLC-BZN had higher trypanocidal activity than free BZN against the epimastigotes of the resistant Colombian strain, and this novel NLC-BZN formulation proved to be a promising tool in treating Chagas disease and considered suitable for oral and parenteral administration
Assuntos
Trypanosoma cruzi/isolamento & purificação , Difração de Raios X/instrumentação , Doença de Chagas/patologia , Doenças Negligenciadas/classificação , Doenças Parasitárias/patologia , Análise Espectral/instrumentação , Entorses e Distensões/classificação , Termogravimetria/métodos , Técnicas In Vitro/métodos , Preparações Farmacêuticas/análise , Espectroscopia de Infravermelho com Transformada de Fourier/métodosRESUMO
In vertebrates, connexins (Cxs) and pannexins (Panxs) are proteins that form gap junction channels and/or hemichannels located at cell-cell interfaces and cell surface, respectively. Similar channel types are formed by innexins in invertebrate cells. These channels serve as pathways for cellular communication that coordinate diverse physiologic processes. However, it is known that many acquired and inherited diseases deregulate Cx and/or Panx channels, condition that frequently worsens the pathological state of vertebrates. Recent evidences suggest that Cx and/or Panx hemichannels play a relevant role in bacterial and viral infections. Nonetheless, little is known about the role of Cx- and Panx-based channels in parasitic infections of vertebrates. In this review, available data on changes in Cx and gap junction channel changes induced by parasitic infections are summarized. Additionally, we describe recent findings that suggest possible roles of hemichannels in parasitic infections. Finally, the possibility of new therapeutic designs based on hemichannel blokers is presented.
Assuntos
Conexinas/metabolismo , Junções Comunicantes/metabolismo , Junções Comunicantes/parasitologia , Doenças Parasitárias/metabolismo , Animais , Infecções Bacterianas/metabolismo , Infecções Bacterianas/patologia , Junções Comunicantes/microbiologia , Junções Comunicantes/patologia , Junções Comunicantes/virologia , Humanos , Doenças Parasitárias/patologia , Viroses/metabolismo , Viroses/patologiaRESUMO
Foram realizados exames coproparasitológicos de sedimentação e flutuação em sete tamanduás-bandeira (Myrmecophaga tridactyla) cativos, mantidos no Laboratório de Pesquisa em Animais Silvestres (Lapas/UFU). Dos sete tamanduás-bandeira examinados, quatro apresentaram ovos de Strongyloides spp, quatro apresentaram oocistos de Entamoeba spp, um apresentou ovos de Ancylostoma spp e um apresentou ovos de acantocéfalo. Os indivíduos que apresentaram ovos ou oocistos nos exames foram medicados com metronidazol por via oral na dose de 40mg/kg, durante três dias, além de 5mg/kg de praziquantel e 14,4mg/kg de pirantel por via oral em dose única. Nos animais submetidos a tratamento antiparasitário, os exames foram repetidos após trinta dias, revelando que os quatro animais previamente infectados por Strongyloides spp continuavam infectados. Os ovos e oocistos dos outros parasitas encontrados antes da medicação estavam ausentes.
Flotation and sedimentation parasitological exams were carried out in seven captive giant anteaters (Myrmecophaga tridactyla) kept at the Laboratory for Wild Animal Research (LAPAS/UFU). Four animals presented eggs of Strongyloides spp, four presented cysts of Entamoeba spp, one presented eggs of Ancylostoma spp and one presented eggs of acanthocephala. Individuals who were positive for either eggs or cysts were treated orally for three days with 40mg/kg metronidazole, plus a single oral dose of 5mg/kg prazyquantel and 14.4mg/kg pyrantel. Exams were repeated thirty days post treatment, revealing that the four animals infected by Strongyloides spp were still infected. The eggs and cysts of other parasites found prior to medication were absent.
Resumen: Fueron realizados exámenes coproparasitológicos de sedimentación y flotación en siete osos hormigueros gigantes (Myrmecophaga tridactyla) mantenidos en cautiverio en el Laboratorio de Pesquisa de Animales Silvestres (Lapas/UFU). De los siete animales examinados, cuatro presentaron huevos de Strongyloides spp, cuatro evidenciaron ooquistes de Entamoeba spp, uno presentó huevos de Ancylostoma spp y otro huevos de acantocéfalo. Los animales que presentaron huevos u ooquistes en los exámenes, fueron tratados con metronidazol por vía oral (40mg/kg) durante tres días, además de praziquantel (5mg/kg) y pirantel vía oral a dosis única. En los animales que fueron sometidos al tratamiento antiparasitario, se repitieron los exámenes después de 30 días. En ese momento pudo comprobarse que los cuatro osos que previamente estaban infectados con Strongyloides, continuaban en la misma condición. Los animales que habían presentado huevos y ooquistes en el primer examen, resultaron negativos en esta última evaluación.
Assuntos
Animais , Doenças Parasitárias/patologia , Fármacos Gastrointestinais , Xenarthra/classificaçãoRESUMO
INFLUENCE OF COLOR CARDS, HOSTS AND FIRST TROPHIC LEVEL ON TRICHOGRAMMA PRETIOSUM RILEY, 1879 (HYMENOPTERA: TRICHOGRAMMATIDAE) PARASITISM. Species of the Trichogramma genus are the most studied and used natural enemies worldwide. The quality and performance of the mass-produced control agents can be influenced by some factors such as the choice of the appropriate host for multiplication of the parasitoid and the use of different colors of cards, given that these parasitoids may use physical stimuli such as color to help in locating the host. The aim of the present study was to evaluate the influence of color cards on the parasitism of Trichogramma pretiosum in eggs of Anagasta kuehniella and in eggs of two populations of Plutella xylostella, one reared on broccoli, the other on collard greens. Hosts eggs were stuck to the different color cards. The selected colors were blue, yellow, green, pink, red and black. For every treatment, 20 replications were observed, and each was composed by 30 eggs of those hosts. Later the cards were exposed to parasitoid females individually in Eppendorf® tubes of 2.0 mL containing one honey droplet for feeding for 24 hours. The number of parasitized eggs and the emergence percentage were evaluated. The strain Tp-8 of T. pretiosum presented better greater parasitism in A. kuehniella eggs. The feeding substratum of P. xylostella (collard greens and broccoli) did not influence the parasitism of T. pretiosum. Thus for mass rearing of T. pretiosum, blue, green and white color cards are most suitable. (AU)
Espécies do gênero Trichogramma são dos inimigos naturais os mais estudados e utilizados atualmente no mundo. A qualidade e o desempenho desses agentes de controleproduzidos massalmente podem ser influenciados por alguns fatores, tais como a escolha do hospedeiro adequado para multiplicação do parasitoide e a utilização de diferentes cores de cartelas, haja vista que estes parasitoides podem utilizar estímulos físicos como cor para facilitar a localização do hospedeiro. O objetivo desse trabalho foi avaliar à influência de cores de cartelas no parasitismo de Trichogrammapretiosum que foi submetido a ovos do hospedeiro alternativo Anagasta kuehniella e duas populações de Plutella xylostella, sendo uma delas criada no substrato brócolis e a outra em couve. Ovos dos hospedeiros foram aderidos às cartelas de papel cartão, sendo que as cores selecionadas foram: azul, amarela, verde, rosa, vermelha e preta. Para cada tratamento foram observadas 20 repetições, cada uma composta por 30 ovos dos hospedeiros. Posteriormente, as cartelas foram expostas às fêmeas do parasitoide individualizadas em tubos tipo Eppendorf® de 2,0 mL que continha uma gotícula de mel para alimentação delas por 24 horas, em teste de confinamento. Foram avaliados o número de ovos parasitados e a porcentagem de emergência. A linhagem Tp-8 de T. pretiosumapresentou maior parasitismo em ovos de A. kuehniella. Os substratos de alimentação de P. xylostella (couve e brócolis) não influenciam o parasitismo de T. pretiosum. As cores de cartelas indicadas para a condução da criação massal de T. pretiosum são azul, verde e branco.(AU)
Assuntos
Animais , Interações Hospedeiro-Parasita , Ovos , Controle Biológico de Vetores , Doenças Parasitárias/patologia , Vespas/classificaçãoRESUMO
Foram realizados exames coproparasitológicos de sedimentação e flutuação em sete tamanduás-bandeira (Myrmecophaga tridactyla) cativos, mantidos no Laboratório de Pesquisa em Animais Silvestres (Lapas/UFU). Dos sete tamanduás-bandeira examinados, quatro apresentaram ovos de Strongyloides spp, quatro apresentaram oocistos de Entamoeba spp, um apresentou ovos de Ancylostoma spp e um apresentou ovos de acantocéfalo. Os indivíduos que apresentaram ovos ou oocistos nos exames foram medicados com metronidazol por via oral na dose de 40mg/kg, durante três dias, além de 5mg/kg de praziquantel e 14,4mg/kg de pirantel por via oral em dose única. Nos animais submetidos a tratamento antiparasitário, os exames foram repetidos após trinta dias, revelando que os quatro animais previamente infectados por Strongyloides spp continuavam infectados. Os ovos e oocistos dos outros parasitas encontrados antes da medicação estavam ausentes.(AU)
Flotation and sedimentation parasitological exams were carried out in seven captive giant anteaters (Myrmecophaga tridactyla) kept at the Laboratory for Wild Animal Research (LAPAS/UFU). Four animals presented eggs of Strongyloides spp, four presented cysts of Entamoeba spp, one presented eggs of Ancylostoma spp and one presented eggs of acanthocephala. Individuals who were positive for either eggs or cysts were treated orally for three days with 40mg/kg metronidazole, plus a single oral dose of 5mg/kg prazyquantel and 14.4mg/kg pyrantel. Exams were repeated thirty days post treatment, revealing that the four animals infected by Strongyloides spp were still infected. The eggs and cysts of other parasites found prior to medication were absent.(AU)
Resumen: Fueron realizados exámenes coproparasitológicos de sedimentación y flotación en siete osos hormigueros gigantes (Myrmecophaga tridactyla) mantenidos en cautiverio en el Laboratorio de Pesquisa de Animales Silvestres (Lapas/UFU). De los siete animales examinados, cuatro presentaron huevos de Strongyloides spp, cuatro evidenciaron ooquistes de Entamoeba spp, uno presentó huevos de Ancylostoma spp y otro huevos de acantocéfalo. Los animales que presentaron huevos u ooquistes en los exámenes, fueron tratados con metronidazol por vía oral (40mg/kg) durante tres días, además de praziquantel (5mg/kg) y pirantel vía oral a dosis única. En los animales que fueron sometidos al tratamiento antiparasitario, se repitieron los exámenes después de 30 días. En ese momento pudo comprobarse que los cuatro osos que previamente estaban infectados con Strongyloides, continuaban en la misma condición. Los animales que habían presentado huevos y ooquistes en el primer examen, resultaron negativos en esta última evaluación.(AU)
Assuntos
Animais , Fármacos Gastrointestinais , Doenças Parasitárias/patologia , Xenarthra/classificaçãoRESUMO
INFLUENCE OF COLOR CARDS, HOSTS AND FIRST TROPHIC LEVEL ON TRICHOGRAMMA PRETIOSUM RILEY, 1879 (HYMENOPTERA: TRICHOGRAMMATIDAE) PARASITISM. Species of the Trichogramma genus are the most studied and used natural enemies worldwide. The quality and performance of the mass-produced control agents can be influenced by some factors such as the choice of the appropriate host for multiplication of the parasitoid and the use of different colors of cards, given that these parasitoids may use physical stimuli such as color to help in locating the host. The aim of the present study was to evaluate the influence of color cards on the parasitism of Trichogramma pretiosum in eggs of Anagasta kuehniella and in eggs of two populations of Plutella xylostella, one reared on broccoli, the other on collard greens. Hosts eggs were stuck to the different color cards. The selected colors were blue, yellow, green, pink, red and black. For every treatment, 20 replications were observed, and each was composed by 30 eggs of those hosts. Later the cards were exposed to parasitoid females individually in Eppendorf® tubes of 2.0 mL containing one honey droplet for feeding for 24 hours. The number of parasitized eggs and the emergence percentage were evaluated. The strain Tp-8 of T. pretiosum presented better greater parasitism in A. kuehniella eggs. The feeding substratum of P. xylostella (collard greens and broccoli) did not influence the parasitism of T. pretiosum. Thus for mass rearing of T. pretiosum, blue, green and white color cards are most suitable.
Espécies do gênero Trichogramma são dos inimigos naturais os mais estudados e utilizados atualmente no mundo. A qualidade e o desempenho desses agentes de controleproduzidos massalmente podem ser influenciados por alguns fatores, tais como a escolha do hospedeiro adequado para multiplicação do parasitoide e a utilização de diferentes cores de cartelas, haja vista que estes parasitoides podem utilizar estímulos físicos como cor para facilitar a localização do hospedeiro. O objetivo desse trabalho foi avaliar à influência de cores de cartelas no parasitismo de Trichogrammapretiosum que foi submetido a ovos do hospedeiro alternativo Anagasta kuehniella e duas populações de Plutella xylostella, sendo uma delas criada no substrato brócolis e a outra em couve. Ovos dos hospedeiros foram aderidos às cartelas de papel cartão, sendo que as cores selecionadas foram: azul, amarela, verde, rosa, vermelha e preta. Para cada tratamento foram observadas 20 repetições, cada uma composta por 30 ovos dos hospedeiros. Posteriormente, as cartelas foram expostas às fêmeas do parasitoide individualizadas em tubos tipo Eppendorf® de 2,0 mL que continha uma gotícula de mel para alimentação delas por 24 horas, em teste de confinamento. Foram avaliados o número de ovos parasitados e a porcentagem de emergência. A linhagem Tp-8 de T. pretiosumapresentou maior parasitismo em ovos de A. kuehniella. Os substratos de alimentação de P. xylostella (couve e brócolis) não influenciam o parasitismo de T. pretiosum. As cores de cartelas indicadas para a condução da criação massal de T. pretiosum são azul, verde e branco.
Assuntos
Animais , Controle Biológico de Vetores , Interações Hospedeiro-Parasita , Ovos , Doenças Parasitárias/patologia , Vespas/classificaçãoRESUMO
La cátedra de Medicina Tropical de la Universidad Central de Venezuela viene empleando el antimoniato de meglumina en series terapéuticas de 10 días en el tratamiento de leishmaniosis tegumentaria americana, la cual continúa como problema de salud del medio rural venezolano. Se evalúa una experiencia con una dosis de 70 mg/kg/día de meglumina en niños con la enfermendad. A los pacientes con presunción diagnóstica de leishmaniosis tegumentaria americana (clínica y antecedentes epidemiológicos) se les efectuó la prueba de leishmania, la demostración de anticuerpos flurescentes antileishmania y la visualización de amastigotes en frotis teñidos con Giemsa. Los casos identificados ingresaron al Hospital Universitario (Pediatría médica infecciosa), recibieron 70 mg/kg/día de antimoniato de meglumina en series terapéuticas de 10 días con reposo intercalados por el mismo número de días. Se incluyeron 33 niños con la enfermedad, 21 de género femenino (64%) con promedio de edad 7,12 años y predominio de escolar (70%). Del Estado Miranda procedía el 85%, una sola úlcera la tenía el 88%, localizada en miembros inferiores (49%). La Leishmanina y los anticuerpos fluorescentes antileishmania fueron positivos en todos los pacientes y el frotis para amastigotes en 45%. Dos series de antimoniato de meglumina las recibió 91% de los pacientes; una de 10 días 6%. Egresaron con cicatrizaciones de sus procesos ulcerosos y fueron evaluados durante seis meses en la consulta de endemias rurales y no se evidenciaron recaídas. La variedad cutánea localizada de la enfermedad fue la única identificada, el Estado Miranda continúa aportando la mayoría de los pacientes atendidos en medicina tropical. El antimoniato de meglumina en leishmaniosis tegumentaria americana a la dosis de 70 mg/kg/día en series terapéuticas fue tan eficaz como la anterior de 100 mg/kg/día que dejó de administrarse hace ocho años.
The Tropical Medicine Department of the Universidad Central de Venezuela employs the meglumine pentavalent antimonial in series of 10 days of treatment for American Tegumentary Leishmaniosis, which continues being a health problem in the Venezuelan rural areas. We are reporting a clinical experience of treatment in children at a dose of 70 mg/kg/day. Patients with diagnostic suspición of American Tegumentary Leishmaniosis (clinical and epidemiologic antecedents) who attended the Rural Endemics Clinic at the Instituto de Medicina Tropical of the Universidad Central de Venezuela and to the Medical Infectious Pediatrics Service at the Hospital Universitario de Caracas (HUC), were tested for leishmanine, fluorescent antileishmania antibodies and for the presence of amastigotes of the parasite in smear for apposition from the ulcer that were treated by the Giemsa method. Patients hospitalized at the Medical Infectious Pediatric Service (Hospital Universitario de Caracas) received 70 mg/kg/day of meglumine pentavalent antimonial during 10 days, a rest period of 10 days without treatment and, if 20 days after ulcers were unhealed, was administred a new 10 days meglumine pentavalent antimonial series. We included 33 children with the disease with a mean age of 7,12 years, 70% in school age and 30% preschool children, and 21 (64%) were girls. The 85% of patients came from Miranda`s state, 88% had only ulcer and in 49% of them the lesions where localized in the legs. The apposition smear showed Leishmania amastigotes in 45% od cases. One series of treatment was given to 91% of cases, two children received two series and one three. At discharge from the hospital all ulcers were healed and follow-up control for a 6 months period showed no relapses. The cutaneous localized from was the clinical form of presentation in the children studied. The great majority of patients that assits to the Tropical Medicine Institute come from the Miranda`s state area...
Assuntos
Humanos , Masculino , Feminino , Pré-Escolar , Criança , Doenças Parasitárias/patologia , Leishmaniose Cutânea/diagnóstico , Leishmaniose Cutânea/tratamento farmacológico , Leishmaniose Cutânea/terapia , Meglumina , Meglumina/uso terapêutico , Anticorpos Antinucleares/uso terapêutico , População Rural/tendências , Medicina TropicalRESUMO
Entre los meses de enero y junio de 2004 fue realizado un estudio epidemiológico de corte transversal, cuyo objetivo fue determinar la prevalencia de parásitos intestinales en la población infantil entre 2 y 6 años de edad en Hogares Comunitarios del Instituto Colombiano del Bienestar Familiar de los municipios de Santo Tomás y Galapa en el departamento del Atlántico (norte de Colombia). El diagnóstico se realizó a través de montaje húmedo de muestras fecales en solución salina y solución de lugol. También se empleó la técnica de concentración éter-formalina y coloración de Ziehl Neelsen. Se realizó un análisis exploratorio de los datos y la prueba Chi-cuadrada (χ²) para determinar diferencias significativas entre las prevalencias de parásitos intestinales de cada municipio y Odds Ratio para evaluar factores de riesgo. La prevalencia para Santo Tomás fue de 82% y el parásito intestinal de mayor frecuencia fue Trichiuris trichiura (39,8%), para Galapa la prevalencia fue de 72% y el parásito de mayor frecuencia fue Giardia duodenalis con 37,3%. La prueba de independencia χ² con α = 0,05 mostró diferencias significativas para la prevalencia general entre municipios y para los parásitos Ascaris lumbricoides, T. trichiura, Blastocystis hominis y Entamoeba coli. La presencia de madres con infecciones causadas por parásitos intestinales se presentó como el factor de mayor riesgo en la epidemiología de las parasitosis intestinales en las comunidades evaluadas.
In order to determine the intestinal parasite population of children from 2 and 6 years old, an epidemiological cross section study was done during January to June 2004, at the community homes in the Colombian Wellbeing Family Institute (Instituto Colombiano del Bienestar Familiar), at the Santo Tomas and Galapa municipalities, Atlántico, Colombia. The procedure was achieved by wet mounting in saline and iodine solutions, also an ether-formalin concentration technique was employed and then the coloration was done with the Ziehl Neelsen technique. A tentative data analysis and a Chi square (χ²) test determined a significant difference of intestinal parasite prevalence in each municipality and the risk factor with an odds ratio test. The results were as follows: the prevalence in Santo Tomas 82% and the most frequent intestinal parasite in the zone was Trichiuris trichiura with 39.8%. In Galapa, the prevalence was 72% and the most common parasite was Giardia duodenalis (37.3%). The Chi square (χ²) test (α = 0.05) showed significant difference between the municipalities and among the following parasites Ascaris lumbricoides, T. trichiura, Blastocystis hominis and Entamoeba coli. The principal risk factor was found to be the presence of intestinal parasite infections at the mother´s population level.
Assuntos
Humanos , Animais , Criança , Doenças Parasitárias/patologia , Doenças Parasitárias/prevenção & controle , Doenças Parasitárias/transmissão , Enteropatias Parasitárias/epidemiologia , Epidemiologia , Saúde Pública , Medicina SocialRESUMO
La estrongiloidosis constituye una enfermedad endémica de países en regiones tropicales y subtropicales y es menos ocurrente en países desarrollados donde se informa de casos esporádicos procedentes de países endémicos. Este trabajo persiguió investigar los factores de riesgo que permitieran predecir esta infección en pacientes urbanos en un país endémico para estrongiloidosis, así como también determinar la ocurrencia de las coinfecciones parasitarias para la enfermedad. Se estudiaron prospectivamente 2815 pacientes de la Sección de Geohelmintiasis del Instituto de Medicina Tropical, Universidad Central de Venezuela, desde enero 2006 hasta julio de 2009, a los que se les realizó estudio coproparasitológico directo (Lugolsalina), formol tritón éter (FTE) y Baermann, evidenciando 44 pacientes positivos para Strongyloides stercoralis (ocurrencia de 1,56%) y 37 pacientes controles negativos. La moyoría de los participantes (92%) procedían de zonas urbanas de los estados norte-costeros de Venezuela. El FTE determinó 100% de los casos positivos para Strongyloides stercoralis, el examen directo 70% (31/44) y el Baermann solo 45% (20/44). Al comparar el grupo infectado con el grupo control, se evidenciaron diferencias en relación a la presencia de diarrea (P = 0,001), dolor abdominal (P = 0,022), eosinofilia (P < 0,0001) y cristales de Charcot-Leyden (P = 0,023). El análisis de los factores predictivos de riesgo para estrongiloidosis demostró que el contacto con tierra (OR = 4,7; P = 0,027), dolor abdominal (OR = 3,6; P = 0,017), diarrea (OR = 6,4; P = 0,001), eosinofilia (OR = 22,5; P = 0,000) y presencia de cristales de Charcot-Leyden (OR = 3,6; P = 0,017) son importantes como indicadores de infección por Strongyloides stercoralis.
Strongyloidiasis is endemic in tropical and subtropical countries, where sporadic cases are reported from endemic countries. This study pursued investigate the risk factors that allowed predicting Strongyloides sterocoralis infection in urban patients in an endemic country for strongyloidiasis, as well as to determine the ocurrence of parasitic coinfections for the disease. This is a prospective study of 2815 patients from the soil transmittedm helminthes section of the Tropical Medicine Institute, Univesidad Central de Venezuela, from January 2006 until July 2009. Stool examination was performed by different methods: direct (Lugol-saline), formaldehyde triton ether (FTE) and Baermann, identifying 44 positive patients for Strongyloides stercoralis (ocurrence of 1.56%) and 37 negative controls. Most participants (92%) were from urban areas of the north-coastal states of Venezuela. FTE identified 100% of cases positive for Strongyloides stercoralis, direct 70% (31/44) and Baermann only 45% (20/44). There were difference when comparing infected group with control group in terms of presence of diarrhea (P = 0.001), abdominal pain (P = 0.022), eosinophilia (P < 0.0001) and Charcot-Leyden crystals (P = 0.023). The analysis of risk factors for strongyloidiasis showed that contact with soil (OR = 4.7, P = 0.027), abdominal pain (OR = 3.6, P = 0.017), diarrhea (OR = 6.4; P = 0.001), eosinophilia (OR = 22.5, P = 0.000) and presence of Charcot-Leyden crystals (OR = 3.6, P = 0.017), are important as indicators of Strongyloides stercoralis infection.
Assuntos
Humanos , Masculino , Feminino , Doenças Parasitárias/epidemiologia , Doenças Parasitárias/patologia , Estrongiloidíase/diagnóstico , Estrongiloidíase/patologia , Fatores de RiscoRESUMO
Este estudio de corte transversal, estimó la ocurrencia de infecciones por coccidias intestinales (CI) en pacientes urbanos procedentes de Caracas-Venezuela. Se analizaron, 1 831 referencias de pacientes externos de ambos sexos y con edad promedio ± desviación estándar de 28,8 ± 22,93 años. En la Sección de Geohelmintiasis del Instituto de Medicina Tropical (SGH-IMT), se evaluaron 4 650 muestras de heces seriadas, por examen directo, formol tritón éter y Baermann, pertenecientes a 1 550 pacientes. Adicionalmente, la prueba de Ziehl-Neelsen modificada, se aplicó a las muestras fecales de 150 pacientes, por solicitud del médico tratante o sugerencia de SGH-IMT. La eosinofilia (40,54 por ciento; 225/555) constituyó el principal motivo de referencia y consulta. El promedio ± DS de contaje absoluto de eosinófilo (3 151 ± 5 161) demostró eosinofilias leves (63/204) y moderadas (25/204). Otros motivos de consulta fueron: dolor abdominal (27,72 por ciento; 122/440), náuseas/vómitos (19,03 por ciento; 83/436), pujo/tenesmo (16,05 por ciento; 70/436) y por último, la consistencia líquida de las heces (4,87 por ciento; 74/1 477). Los parasitados (43,7 por ciento; 677/1 550) presentaron evacuaciones pastosa (81,25 por ciento; 494/608) y blandas (37 por ciento; 57/608). Sólo, 5,92. por ciento (36/608) presentaron consistencia líquida. La prueba de Ziehl-Neelsen modificada demostró 12 casos positivos (8 por ciento) para CI: Isospora belli (5,33 por ciento; 8/150), Cryptosporidium spp (2 por ciento; 3/150) y Cyclospora cayetanensis (0,66 por ciento; 1/150). El único caso de ciclosporiosis estaba co-infectado con Blastocystis hominis y no presentó cambios en la consistencia de las heces. Estos resultados apoya la idea de que los médicos interconsultantes soliciten la aplicación de exámenes coproparasitológicos adicionales, en forma seriada, de bajo costo, para evaluar pacientes inmunocompetentes urbanos, con síntomas gastrointestinales/ eosinofilia, ...
These two years follow up; cross-sectional study estimates the occurrence of intestinal coccidias in urban patients from the metropolitan area of Caracas-Venezuela. One thousand eight hundred thirty one outpatient case reports were analyzed, both sex and 28.8 ± 22.93 years. Soil-transmitted helminthes laboratory of the Tropical Medicine Institute (SGH-IMT) evaluated 4 650 feces samples from 1 550 outpatients by direct, formol triton ether and Baermann techniques, Additionally, modified Ziehl-Neelsen, were done because of clinicians or SGH-IMT suggestion for 150 outpatients. Eosinophilia (40.54 percent; 225/555) was the major cause of referral and consultation. The mean of the absolute count of eosinophils (3 151+ 5 161) showed low (63/204) and moderate (25/204) eosinophila. Other causes of consultation were: abdominal pain (27.72 percent; 122/440), nausea/ vomiting (19.03 percent; 83/436), tenesmus/constipation (16.05 percent; 70/436) and finally, liquid fecal consistency (4.87 percent; 74/1477). Parasite infected patients (43.7 percent; 677/1550) had normal (81.25 percent; 494/608) and semi liquid feces (37 percent; 57/608). Only, 5.92 percent (36/608) had liquid consistency. Modified Ziehl-Neelsen demonstrates 12 positive IC (8 percent) for: Isospora belli (5.33. percent; 8/150), Cryptosporidium spp (2 percent; 3/150) and Cyclospora cayetanensis (0.66 percent; 1/150). The only case of cyclosporidiosis was co-infected with Blastocystis hominis and had normal feces. These results agrees with the idea for clinicians to ask for additional, low cost, serial parasitological test in feces, to evaluate urban inmunocompetent outpatients, with gastrointestinal symptoms/eosinophilia, even without diarrhea, because the basic feces techniques, used routinely, fails to make the precise parasite diagnostic, underestimating coccidiosis