Eficacia del tinidazol en la profilaxis terapéutica de la colitis amebiana en pacientes con leucemia aguda de novo que reciben quimioterapia intensiva / Efficacy of tinidazole in the therapeutic prophylaxis of amoebic colitis in patients with de novo acute leukemia receiving intensive chemotherapy

Resumen Introducción: En México la seroprevalencia de la Entamoeba histolytica es del 8.4%. La amebiasis intestinal en pacientes con leucemia aguda de novo posterior al inicio de quimioterapia (QT), en el Servicio de Hematología del CMN 20 de Noviembre, es del 12%, aún si muestran test coprológico negativo basal. Objetivo: Averiguar si la administración de tinidazol, en pacientes con leucemia aguda y coprológico negativo, al principio de la QT, disminuye la incidencia de colitis amebiana durante la inducción a la remisión. Método: Prospectivo y no comparativo. Enfermos con diagnóstico de leucemia aguda de novo que inician QT de inducción y coprológico inicial. Se indicó tinidazol, 2 g/día durante 5 días en la primera semana de comenzada QT. Se vigilaron hasta que la inducción concluyó y se inició la recuperación hematopoyética. Resultados: 38 pacientes, 15 mujeres y 23 hombres con edad media de 44 años (16-72). Con leucemia aguda linfoblástica 19, con mieloblástica 16 y con promielocítica 3. Casos sin y con amebiasis intestinal, 35 y 3, respectivamente. Los pacientes con amebiasis solo recibieron tinidazol durante 3 días y se dio después de 2 días de empezada la QT. Conclusión: El tinidazol, en pacientes con leucemia aguda de novo que inician QT de inducción, es efectivo en la prevención de la amebiasis intestinal, durante la etapa de inducción, si se administra a 2 g/día, durante cinco días, a partir del día 1 de la QT.

Abstract Introduction: In Mexico, seroprevalence of Entamoeba histolytica is 8.4%. The intestinal amebiasis in patients with acute leukemia of novo, after the start of chemotherapy (CT) in the Hematology Service of the CMN 20 de Noviembre is 12%, even if patients show a negative baseline coprological test. Objective: To find out if the administration of tinidazole, in patients with acute leukemia and negative coprological test, at the beginning of the CT, decreases the incidence of amoebic colitis during the induction to remission. Method: Prospective and not comparative study. Patients with de novo diagnosis of acute leukemia who initiate induction and initial coprological CT. Tinidazole was indicated, 2 g/day for 5 days in the first week of CT started. They were monitored until the induction was concluded and hematopoietic recovery started. Results: 38 patients, 15 women and 23 men with a mean age of 44 years (16-72), with acute lymphoblastic leukemia 19, myeloblastic 16 and promyelocytic 3. Cases without and with intestinal amebiasis were 35 and 3, respectively. Patients with amebiasis only received tinidazole for 3 days and it was given 2 days after the CT started. Conclusion: Tinidazole, in patients with acute de novo leukemia who initiate induction CT, is effective in the prevention of intestinal amebiasis, during the induction stage, if administered at 2 g/day, for five days, starting on day 1 of the CT.

Parasitological Evaluation of Domestic Water Sources in a Rural Community in Nigeria.

Aim: To evaluate the level of safety of water sources in a rural settlement in Nigeria with reference to parasitic infections and to make appropriate recommendations to the government and the community dwellers. Study Design: Investigative study. Place and Duration of Study: Samples were collected in Heipang, Barkin Ladi Local Government Area of Plateau State, Nigeria between October-December, 2012. They were processed at the General Laboratory of National Veterinary Research Institute, Vom, Nigeria. Methodology: 100 water samples were collected from domestic water sources. 10 of the samples were from streams, 60 from ponds, 20 from wells and 10 were from bore holes. Samples were investigated for presence of parasites using standard World Health Organisation approved laboratory techniques. Each sample was subjected to macroscopy, filtration, centrifugation and microscopy. Results: It revealed that 59 out of 100 water sources investigated had parasitic infestation. Ponds had the highest degree of parasitic contamination (78.3%), streams followed closely with 50%, while wells and bore holes had 35% and 0% in that order. Helminths were the leading parasitic genera encountered with Ascaris species accounting for 33.9% of the parasites. Hookworm was the second most common helminth with the prevalence of 20.3%. Strongyloides species accounted for a paltry prevalence of 3.4%. Protozoan cysts of Balanditium coli and Entamoeba histolytica accounted for 18.6% of parasites each. Conclusion: These findings clearly show that most water sources in the study area constitute grave epidemiological threat to public health. Inhabitants of such communities should boil or treat their water before consumption while government authorities should provide safe drinking water to the rural dwellers.