Prevalência de parasitoses intestinais em crianças do Parque Indígena do Xingu / Prevalence of intestinal parasitoses in children at the Xingu Indian Reservation

OBJETIVO: Avaliar a prevalência da parasitose intestinal em crianças indígenas de 2 a 9 anos. MÉTODOS: Para a realização do exame protoparasitológico, foram convidadas todas as crianças de 2 a 9 anos, de seis aldeias localizadas no Médio e Baixo Xingu: Pavuru, Moygu, Tuiararé, Diauarum, Capivara e Ngojwere. Para a conservação das amostras de fezes, foi utilizado o kit coletor Paratest® (Diagnostek, Brasil). As amostras foram transportadas para São Paulo. A pesquisa de helmintos e protozoários foi feita através do método de Hoffman, com posterior pesquisa de ovos e cistos por microscopia óptica. Foram feitas duas coletas com intervalo de 1 ano. RESULTADOS: Não houve diferença significativa entre as idades médias das crianças provenientes das seis aldeias. Resultaram positivas para a presença de parasitas, 97,5 por cento (198/202) e 96,1 por cento (98/102) na primeira e segunda coletas, respectivamente, sem associação estatística entre a idade. Realizaram o exame parasitológico de fezes nos 2 anos, 89/102 (87,3 por cento). Após 1 ano, não houve diferença na proporção de pacientes infestados por protozoários (93,3 por cento em 2007 contra 93,3 por cento em 2008, McNemar = 0,01, p = 0, 1) ou por helmintos (37,1 por cento em 2007 contra 38,2 por cento em 2008, McNemar = 0,03, p = 0,85). Houve diferença significativa quanto à prevalência de Entamoeba coli em 2007 (43,8 por cento) e 2008 (61,8 por cento) (McNemar's Chi 6,1; p = 0,0135). Não houve diferenças significativas quanto aos outros parasitas após comparação dos dois resultados. CONCLUSÃO: A alta prevalência de parasitose intestinal foi compatível com o alto índice de contaminação ambiental dessa comunidade.

OBJECTIVE: To evaluate the prevalence of intestinal parasitoses in Native Brazilian children from 2 to 9 years old. METHODS: A search for ova and parasites was conducted in the stools of children between 2 to 9 years old living in six indigenous villages located in the Middle and Lower Xingu River, to wit: Pavuru, Moygu, Tuiararé, Diauarum, Capivara, and Ngojwere. The study utilized the Paratest kit® (Diagnostek, Brazil) to preserve collected stools. Fecal samples were shipped to the Laboratory of the Pediatric Gastroenterology Division of the UNIFESP/EPM, in São Paulo, for analysis. The search for ova and parasites was performed utilizing the Hoffman method, and later through optical microscopic evaluation. Fecal samples were collected one year apart from each other. RESULTS: There were no significant statistical differences between the mean ages of the children from the six indigenous villages studied. The search for ova and parasites found positive results for the stools of 97.5 percent (198/202) and 96.1 percent (98/102) of children in the first and second collections, respectively. There was no statistical association with the children's age. The search performed one year later found no differences in the proportion of parasites identified in the first collection for protozoa (93.3 percent in 2007 versus 93.3 percent in 2008, McNemar = 0.01, p = 0.1) or for helminths (37.1 percent in 2007 versus 38.2 percent in 2008, McNemar = 0.03, p = 0.85). There were significant differences in prevalence of Entamoeba coli between 2007 (43.8 percent) and 2008 (61.8 percent) (McNemar Chi 6.1; p = 0.0135). There were no significant differences for other parasites when comparing the results of the two studies. CONCLUSION: The high prevalence of intestinal parasitosis matched the elevated rates of environmental contamination in this indigenous community.

Diffuse and enteroaggregative patterns of adherence of escherichia coli isolated from stools of children in northeastern Brazil

Childhood diarrheal diseases remain highly endemic in northeastern Brazil. The attributable fraction of all diarrheal diseases among children less than 2 years of age due to Escherichia coli was examined in a 2 year prospective study in two large urban centers of Brazil. Between May 1997 and June 1999, fecal E.coli isolates from 237 children with diarrhea (217 acute and 20 persistent cases) and 231 children without diarrhea (controls) attending two hospitals in Northeast Brazil were tested for their pattern of adherence to HEp-2 cells and for colony hybridization with DNA probes specific for the six pathotypes of diarrheagenic E.coli. Enteroinvasive E.coli, enterotoxigenic E.coli and enterohemorrhagic E.coli were not isolated from any children. Diffusely adherent E.coli (DAEC) and enteroaggregative E.coli (EAEC) were the most frequent isolates with similar frequencies from children with or without diarrhea. Atypical EPEC (EAF-negative) strains were isolated with similar frequency from both cases 5.5 per cente and controls 5.6 per cente. Enteropathogenic E.coli (typical EPEC) strains, characterized by localized adherence pattern of adherence, hybridization with the EAF probe, and belonging to the classical O serogroups, were significantly associated with diarrhea (P=0.03). These E.coli strains associated with diarrhea accounted for 9 per cente of all children with diarrhea. Collectively, in Northeast Brazil, E.coli strains comprise a small proportion of severe diarrhea prevalence in children.