Estudio en niños con diagnóstico presuntivo de toxocariasis en Santa Fe, Argentina / Analysis of children with a presumptive diagnosis of toxocariasis in Santa Fe, Argentina

La toxocariasis humana es una parasitosis de amplia distribución en el mundo, cuyo agente etiológico más importante es el Toxocara canis, parásito del perro. El hombre adquiere esta zoonosis mediante la ingesta de huevos infectivos; en el intestino delgado desarticulan sus envolturas y las larvas se liberan atravesando la mucosa, ubicándose en diversos tejidos. Los niños son la población de mayor riesgo. El diagnostico clínico es dificultoso. El test de ELISA usando antígenos de excreción-secreción de la larva, es la técnica de elección. Se estudiaron por esta técnica inmunoserológica 100 niños con diagnóstico presuntivo de toxocariasis y se revisaron posteriormente sus historias clínicas de Hospital. La técnica de diagnóstico fue estandarizada y validada en el laboratorio. Su aplicación permitió identificar dos poblaciones de niños: infectados (59) y no infectados (41). La eosinofilia fue más frecuente en la población infectada (100% vs. 85.2%, p = 0.017); no así la leucocitosis (p = 0.950). La fuerza de asociación de ambos parámetros fue mayor en la población positiva (R = 0.918). La dificultad respiratoria se presentó más frecuentemente en pacientes con ELISA positiva, considerados como infectados (p = 0.05). La edad promedio de los positivos fue significativamente mayor que la de los negativos (p = 0.009). Se halló eosinofilia en el 100% de los infectados y en el 85.2% de los no infectados. La tenencia de canes en los domicilios no fue significativamente mayor entre los casos positivos que entre los negativos (p = 0.53). Sería necesario investigar esta enfermedad en niños consultantes con sospecha clínica, y promover las medidas de prevención, diagnóstico temprano y su correcto tratamiento.

Human toxocariasis is a parasitic disease found worldwide. The most important etiological agent is Toxocara canis, a dog parasite. Humans are infected by the ingestion of their eggs; the eggs hatch in the small intestine and the larvae migrate through the capillaries, taking up residence in different tissues. Clinical manifestations are associated with mechanical and/or reaction damage caused by these parasites larvae. Clinical diagnosis is difficult. The method applied in this work is the demonstration of antibodies against the helminth in the blood of children, target host population of this parasitic disease. An ELISA test was performed using T. canis larval excretory-secretory products as antigen. A total of 100 children presumptively diagnosed of toxocariasis that had been derived from different services of the Regional Children’s Hospital for complementary studies, were included in the analysis. The test detected two different populations: infected (59) and non-infected (41). The statistical analysis showed a non significant association between infection and sex (p = 0.279). Infected subjects tended to be older than the non infected (p = 0.009). Eosinophilia was detected in 100% of seropositive children and in 85.2% of the seronegative. There was no significant association between infection and leucocytosis ( = 0.950). The association of these two parameters was significantly higher among infected patients (R = 0.918). Respiratory symptoms and signs were more frequently detected in the positive population (p = 0.05). Dogs tenancy was as frequent among infected as in the non infected homes (p = 0.53). According to these results, prevention, early diagnosis and opportune treatment for toxocariasis should be considered as prioritary health activities in this region.

Urban contamination with zoonotic parasites in the central region of Argentina / Contaminación urbana con parásitos zoonóticos en la región central de la Argentina

Adult worms develop in dogs and their eggs are shed in the feces. Non-embryonated eggs of Toxocara canis become infectious after about 2-6 weeks in the soil and the likelihood of their transmission to humans is through ingestion. In 2004 studies were carried out in the areas of urban recreation in the central region of Argentina. A total of 393 dog excrement samples were collected in eight different cities: 59.3 per cent were positive for parasites. These areas of urban recreation are contaminated with zoonotic parasites in the cities of Paraná (19 of 24 areas), Santa Fe (20 of 26), and Santo Tomé (14 of 18). Eggs of T. canis were present in 101 of 393 (25.7%) of the excrement samples, and eggs could be found in 53 of the 68 (77.9%) areas of urban recreation studied in these cities. This contamination is greater in areas of lower socio-economic conditions. The object of this paper is to discuss markers of parasitic contamination with the aim of triggering the necessary control measures.

Uno de los parásitos de cánidos de riesgo para la salud de los niños es el Toxocara canis. Las formas adultas y sus huevos no embrionados son liberados con las heces al medio ambiente. Después de aproximadamente dos semanas en el suelo, los huevos se transforman en infectivos y su ingestión por el ser humano puede provocar una infección parasitaria. En primavera y otoño de 2004, se llevaron a cabo estudios en áreas urbanas de recreación en una amplia zona geográfica de la Región Centro de la Argentina. Un total de 393 muestras de heces de canes fueron colectadas y analizadas en ocho ciudades; 59.3% de esas muestras fueron positivas para otros parásitos, además del T. canis. Las áreas de recreación pública de las ciudades demográficamente más importantes mostraron resultados positivos para parásitos zoonóticos en 19 de 24 áreas en Paraná, 20 de 26 en Santa Fe y 14 de 18 en Santo Tomé, es decir 53 de 68 (77.9%). Se encontraron huevos de T. canis en 101 de las 393 (25.7%) muestras fecales, y en el 60% de los parques públicos investigados en todas las ciudades. Esta contaminación fue mayor en barrios con condiciones socioeconómicas más bajas. En este trabajo se proponen medidas sanitarias de control y prevención.

Leptospirosis en la Provincia de Santa Fe. Descripción epidemiológica, clínica y socioeconómica / [Leptospirosis in the Province of Santa Fé, Argentina. Epidemiologic, clinical and socioeconomic description]

Leptospirosis is produced by a bacteria belonging to the Leptospira genus. Water contaminated with this germ which comes from the urine of infected animals is an excellent source of infection for mammals. It gets into the human body through the skin or mucus. The aims of this work were to describe the cases that occurred during the first five months of 2001, and to determine the causes of this phenomenon. There was a total of 49 patients confirmed by the laboratory, 39 of whom completed the epidemiologic form; 24 of whom were over 15 years of age, 19 were male cases, 13 of whom involved in semiurban jobs; 82

mialgias and 48.7

presented the conjunctivitis shot; 61.5

a meningeal, and 18.5

respiratory and renal syndrome. These patients had a low level of education, with unstable jobs and lots of rodents in or near their houses. The structure of these houses was precarious, with a deficient system of water drainage. Fifty percent of the patients had primary instruction, 11.1

secondary instruction, one was illiterate, and none had gone to university. Patients coming from rural areas (an outbreak), belonged to a higher social and economic condition and had got infected through exposure in relation with their jobs. Sources of infection in the rural patients were different from those of the urban patients: in the former they were related to the presence of rodents, which related to the type of work, while in the urban cases they had to do with the poverty of their living conditions.