Impact on prevalence of intestinal helminth infection in school children administered with seven annual rounds of diethyl carbamazine (DEC) with albendazole.

Background & objectives: One third of the world’s population is infected with one or more of the most common soil-transmitted helminths (STH). Albendazole (ALB) is being administered with diethyl carbamazine (DEC) in filariasis endemic areas to eliminate lymphatic filariasis (LF) and helminth infections. In this study, the cumulative impact of seven annual rounds of mass drug administrations (MDA) of DEC and ALB on STH infection in school children in selected villages in southern India was determined. Methods: During 2001-2010, seven MDAs were implemented by the Tamil Nadu state health department, India. LF and STH infections were monitored in school children from 18 villages of the two treatment arms (viz, DEC alone and DEC+ALB). Kato-Katz cellophane quantitative thick smear technique was employed to estimate STH infections at three weeks, six months and one year post MDA. Results: Prior to treatment, an overall STH prevalence was 60 per cent. After each MDA, infection markedly reduced at three weeks post-treatment in both the arms. The prevalence increased at six months period, which was maintained up to one year. After seven rounds of MDA, the infection reduced from 60.44 to 12.48 per cent in DEC+ALB arm; while the reduction was negligible in DEC alone arm (58.77 to 52.70%). Interpretation & conclusions: Seven rounds of MDA with DEC+ALB reduced the infection load significantly, and further sustained low level of infection for 10 years. However, complete parasite elimination could not be achieved. To curtail STH infection in the community, MDA should be regularized and environmental sanitation measures need to be improved by effective community-based campaigns.

Prevalence of Schistosomes and Soil-Transmitted Helminths among Schoolchildren in Lake Victoria Basin, Tanzania

The objectives of this study was to conduct a survey on schistosomiasis and soil-transmitted helminth (STH) infections in order to come up with feasible control strategies in Lake Victoria basin, Tanzania. Depending on the size of the school, 150-200 schoolchildren were recruited for the study. Duplicate Kato-Katz stool smears were prepared from each child and microscopically examined for Schistosoma mansoni and STHs. Urine specimens were examined for Schistosoma haematobium eggs using the filtration technique. After the survey, mass drug administration was done using praziquantel and albendazole for schistosomiasis and STHs infections, respectively. A total of 5,952 schoolchildren from 36 schools were recruited for the study and had their stool and urine specimens examined. Out of 5,952 schoolchildren, 898 (15.1%) were positive for S. mansoni, 754 (12.6%) for hookworms, 188 (3.2%) for Ascaris lumblicoides, and 5 (0.008%) for Trichuris trichiura. Out of 5,826 schoolchildren who provided urine samples, 519 (8.9%) were positive for S. haematobium eggs. The results revealed that intestinal schistosomiasis, urogenital schistosomiasis, and STH infections are highly prevalent throughought the lake basin. The high prevalence of intestinal and urogenital schistosomisiasis in the study area was a function of the distance from Lake Victoria, the former being more prevalent at localities close to the lake, whilst the latter is more so away from it. Control of schistosomiasis and STHs in the study area requires an integrated strategy that involves provision of health education to communities, regular treatments, and provision of adequate safe water supply and sanitation facilities.

Prevalence of Schistosomes and Soil-Transmitted Helminths and Morbidity Associated with Schistosomiasis among Adult Population in Lake Victoria Basin, Tanzania

The objective of this study was to carry out a community survey on schistosomiais and soil-transmitted helminth (STH) infections in order to suggest feasible and effective intervention strategies in Lake Victoria basin, Tanzania. A total of 37 communities selected from 23 districts of the 4 regions in the Lake Victoria basin of Tanzania were involved in the study. From each of the selected locality, 50 adult community members, 25 males and 25 females, were recruited for the study. Each study participant was requested to submit stool and urine specimens. From each stool specimen, duplicate Kato-Katz thick smears were prepared and microscopically examined for Schistosoma mansoni and STH eggs. Urine specimens were processed by the filtration technique and microscopically examined for Schistosoma haematobium eggs. Ultrasound examination for morbidity due to schistosomiasis was performed. Mass treatment was done using praziquantel and albendazole for schistosome and STHs infections, respectively. Out of 1,606 adults who provided stool specimens, 199 (12.4%) were positive for S. mansoni, 349 (21.7%) for hookworms, 133 (8.3%) for Ascaris lumbricoides, and 33 (2.0%) for Trichuris trichiura. Out of 1,400 participants who provided urine specimens, 25 (1.8%) were positive for S. haematobium eggs. Because of the co-endemicity of these afflictions and their impact on vulnerable population groups, the helminthiasis could be simultaneously treated with 2 drugs, praziquantel for schistosomiasis and albendazole for STHs.

Improved Socio-Economic Status of a Community Population Following Schistosomiasis and Intestinal Worm Control Interventions on Kome Island, North-Western Tanzania

Research on micro-level assessment of the changes of socio-economic status following health interventions is very scarce. The use of household asset data to determine wealth indices is a common procedure for estimating socio-economic position in resource poor settings. In such settings information about income is usually lacking, and the collection of individual consumption or expenditure data would require in-depth interviews, posing a considerable risk of bias. In this study, we determined the socio-economic status of 213 households in a community population in an island in the north-western Tanzania before and 3 year after implementation of a participatory hygiene and sanitation transformation (PHAST) intervention to control schistosomiasis and intestinal worm infections. We constructed a household 'wealth index' based housing construction features (e.g., type of roof, walls, and floor) and durable assets ownership (e.g., bicycle, radio, etc.). We employed principal components analysis and classified households into wealth quintiles. The study revealed that asset variables with positive factor scores were associated with higher socio-economic status, whereas asset variables with negative factor scores were associated with lower socio-economic status. Overall, households which were rated as the poorest and very poor were on the decrease, whereas those rated as poor, less poor, and the least poor were on the increase after PHAST intervention. This decrease/increase was significant. The median shifted from -0.4376677 to 0.5001073, and the mean from -0.2605787 (SD; 2.005688) to 0.2605787 (SD; 1.831199). The difference in socio-economic status of the people between the 2 phases was highly statistically significant (P<0.001). We argue that finding of this study should be treated with caution as there were other interventions to control schistosomiasis and intestinal worm infections which were running concurrently on Kome Island apart from PHAST intervention.

Eficacia del Albendazol en dosis única sobre las infecciones por helmintos transmitidos por el suelo en escolares de una comunidad de Iquitos, Perú / Efficacy of a single dose of Albendazole for soil-transmitted helminth infections in school children of a village in Iquitos, Perú

Objetivos. Determinar la eficacia en dosis única del albendazol sobre las infecciones por helmintos transmitidos por el suelo (HTS) en escolares de una comunidad de la ciudad de Iquitos en Perú. Materiales y métodos. Dentro del contexto de un ensayo controlado aleatorizado realizado en una comunidad periurbana de escasos recursos, situada en Iquitos, en la Amazonía de Perú, se obtuvieron muestras de heces de escolares del quinto grado de primaria en 18 escuelas y se analizó la prevalencia y la intensidad de HTS. Un total de 1193 escolares fueron desparasitados con albendazol en dosis única (400 mg). De los 909 escolares que fueron encontrados positivos con al menos una infección por HTS, una muestra aleatoria de 385 fue seguida dos semanas más tarde, cuando se recolectó y analizó una segunda muestra de heces. Resultados. La eficacia del albendazol fue satisfactoria para las infecciones por Ascaris lumbricoides con una tasa de reducción de huevos (TRH) de 99,8%; IC 95: 99,3-100 y por anquilostomideos con una TRH de 93,6%, IC 95%: 88,2-96,6 y por Trichuris trichiura con una TRH de 72,7%, IC 95: 58,5-79,1. Conclusiones. Estos resultados son indicativos de niveles satisfactorios de eficacia y son congruentes con datos publicados sobre la eficacia del albendazol y directivas de la Organización Mundial de la Salud. Futuras investigaciones deben centrarse en mejorar la eficacia de las estrategias de tratamiento para la infección por Trichuris trichiura.

Objectives. To determine the efficacy of single-dose albendazole (400 mg) for soil-transmitted helminth infections (STH) in schoolchildren living in one community of the city of Iquitos, Perú. Materials and methods. Within the context of a randomized controlled trial performed in a peri-urban community of limited resources located in Iquitos in the Peruvian Amazon, stool specimens were collected from Grade 5 schoolchildren in 18 schools and analysed for STH prevalence and intensity. A total of 1,193 school-age children were then dewormed with single-dose albendazole (400 mg). Of the 909 children who were found positive with at least one STH infection, a random sample of 385 was followed two weeks later when a second stool specimen was collected and analyzed. Results. The efficacy of albendazole was satisfactory: for Ascaris lumbricoides , with an egg reduction rate (ERR) of 99.8%; (95% CI: 99.3-100); for hookworm, with an ERR of 93.6 %; (95% CI: 88.2-96.6) and, for Trichuris trichiura, with an ERR of 72.7 %; (95% CI: 58.5-79.1). Conclusions. These results are consistent with previous data published on the efficacy of albendazole and the directives of the World Health Organization. Future research should focus on improving the efficacy of the treatment strategies for Trichuris trichiura infection.

Development of cognitive abilities of children infected with helminths through health education / Desenvolvimento de habilidades cognitivas de crianças infectadas por helmintos através da Educação em Saúde

INTRODUCTION: The aim of this study was to evaluate the effect of health education in learning and cognitive development of children infected, previously treated in an endemic area for helminthiasis. METHODS: It is a longitudinal, experimental, with random allocation of participants. The study included 87 children of both sexes enrolled in the school hall of Maranhão, State of Minas Gerais, Brazil, and divided into two groups: intervention and control. Initially the children were submitted to the parasitological fecal examination for infection diagnosis and, when positive, they were treated. For the data collection, a structured questionnaire and the psychological tests Raven, Wisc-III and DAP III were applied, before and after the educational intervention. For the group comparison, the Mann Whitney test was used, and established significance level of 5%. RESULTS: It was found that previously infected children who received the educational intervention, children showed higher performance than the control group in strutured questionnaire (p<0.05). CONCLUSIONS: It is acceptable to suppose the positive influence and the importance in the use of educational interventions in the cognitive recovery and learning of children previously treated with anthelmintics.

INTRODUÇÃO: O objetivo do estudo foi avaliar o efeito da educação em saúde na aprendizagem e desenvolvimento cognitivo de crianças infectadas, previamente tratadas, em área endêmica para helmintoses. MÉTODOS: Trata-se de um estudo longitudinal, experimental e com distribuição aleatória dos participantes. Participaram do estudo 87 crianças, de ambos os sexos, matriculadas na escola municipal de Maranhão, Minas Gerais, Brasil, e distribuídas em dois grupos: intervenção e controle. Inicialmente, as crianças foram submetidas ao exame parasitológico de fezes para diagnóstico de infecção e, em caso positivo, foram tratadas. Para a coleta de dados, foi aplicado um questionário estruturado e os testes psicológicos Raven, Wisc-III e DFH III, antes e após intervenção educativa. Para a comparação entre os grupos foi utilizado o teste Mann Whitney e estabelecido nível de significância de 5%. RESULTADOS: Verificou-se que as crianças previamente infectadas, que receberam a intervenção educativa, apresentaram desempenho superior as crianças do grupo controle no questionário estruturado (p<0,05). CONCLUSÕES: É aceitável supor a influencia positiva e a importância da utilização de intervenções educativas na recuperação cognitiva e aprendizagem das crianças previamente tratadas com antihelmínticos.

Human intestinal capillariasis: A rare case report from non-endemic area (Andhra Pradesh, India).

Human intestinal capillariasis is caused by Capillaria philippinensis. This disease is endemic in Philippines and Thailand. To the best of our knowledge, we report the third case of human intestinal capillariasis from India and the first case from Andhra Pradesh, which is a non-endemic area. A 40-year-old female presented with diarrhoea, vomiting, decreased urinary output, ascitis, pedal oedema, hypoalbuminemia, and electrolyte imbalance. Microscopic examination of stool sample revealed the presence of ova, larvae, and adult worms of C. philippinensis. Patient recovered from the disease after taking albendazole 400 mg daily for 1 month along with supportive treatment.

An Indigenous Case of Intestinal Capillariasis with Protein-Losing Enteropathy in Korea

We encountered an indigenous case of intestinal capillariasis with protein-losing enteropathy in the Republic of Korea. A 37-year-old man, residing in Sacheon-si, Gyeongsangnam-do, admitted to the Gyeongsang National University Hospital (GNUH) due to long-lasting diarrhea, abdominal pain, anasarca, and weight loss. He recalled that he frequently ate raw fish, especially the common blackish goby (Acanthogobius flavimanus) and has never been abroad. Under the suspicion of protein-losing enteropathy, he received various kinds of medical examinations, and was diagnosed as intestinal capillariasis based on characteristic sectional findings of nematode worms in the biopsied small intestine. Adults, juvenile worms, and eggs were also detected in the diarrheic stools collected before and after medication. The clinical symptoms became much better after treatment with albendazole 400 mg daily for 3 days, and all findings were in normal range in laboratory examinations performed after 1 month. The present study is the 6th Korean case of intestinal capillariasis and the 3rd indigenous one in the Republic of Korea.

Parasitological monitoring of helminth control program in Northern Thailand.

Nan Province, located in northern Thailand, is hyperendemic for parasite infections; the helminthic infection rate in 1,010 schoolchildren was 60.0% in 2001. Mass anthelmintic chemotherapy has been conducted with schoolchildren, and selective treatment has been given to people in the community, from 2002. The modified cellophane thick smear method was used to examine the prevalence and intensity of helminth infections in schoolchildren and community people once a year during the period 2002-2004. The prevalence of helminth infections decreased slowly from 60.0 to 40.3% in schoolchildren and from 70.8 to 60.0% in the older age population. Three parasite species were common: hookworm, Ascaris and Haplorchis, an intestinal trematode. Hookworm presented throughout the whole district. Ascaris infection occurred at high rates in some villages, while in some villages none was found. The villages where Ascaris infection was nil had high rates of Haplorchis infection, and vice versa. Most hookworm and Trichuris infections were of light intensity. Heavy intensity infection was found in 12.8-18.1% of Ascaris cases examined. Parasite infection rates in Chaloem Phra Kiat District can be classified as low prevalence.

Enteric parasitic infections in HIV/AIDS patients before and after the highly active antiretroviral therapy

Enteroparasites are related to gastrointestinal alterations among patients with HIV/AIDS, some causing severe manifestations in the period before the institution of the highly active antiretroviral therapy (HAART). The prevalence of enteroparasitoses in patients with HIV/AIDS seen at two hospitals in Ceará , Brazil, was compared in the pre-HAART (Group 1; n = 482) and HAART (Group 2; n = 100) eras. Fecal parasitologic examinations (FPE) were performed using the direct, Lutz, Baermann-Moraes and modified Ziehl-Neelsen methods. The following parasites were detected in Groups 1 and 2, respectively: Strongyloides stercoralis - 30.1 percent and 11 percent (p<0.0001), Ascaris lumbricoides - 15.6 percent and 2 percent (p<0.0001), hookworms - 13.7 percent and 2 percent (p<0.0001), Trichuris trichiura - 13.1 percent and 1 percent (p<0.0001), Hymenolepis nana - 0 and 1 percent (p = 0.1718), Giardia duodenalis - 7.9 percent and 1 percent (p = 0.0076), Entamoeba histolytica/dispar - 3.3 percent and 1 percent (p = 0.3301), Isospora belli - 4.8 percent and 1 percent (p = 0.0993), Cryptosporidium sp. - 8.1 percent and 0 (p = 0.0007), and non-pathogenic protozoans as well. There was a significant reduction in the prevalence of enteroparasites between the eras (63.9 percent to 24 percent; p<0.0001). In the HAART era, the following observations were made: greater frequency of enteroparasites in patients without antiretroviral therapy (p = 0.0575), as in those with AIDS (p = 0.08), and diarrhea (36 percent of the patients); lack of association with positive FPE (p = 0.626); and non-detection of Cryptosporidium sp. Strongyloides stercoralis showed an elevated prevalence in the two eras and was more frequent in men (32.41 percent) than women (19.04 percent) of Group 1 (p = 0.018), a finding suggesting the transmission of the helminth through sodomy. The advent of the HAART modified the profile of opportunistic infections, including parasites, probably due...

A case of Moniliformis moniliformis (Acanthocephala) infection in Iran

Only a few cases of Acanthocephala infections have been reported in humans, and Moniliformis moniliformis is the most common species around the world. We report here a case of infection with M. moniliformis, which passed in the stool of a 2-year-old girl in Iran. The patient had abdominal pain, diarrhea, vomiting, and facial edema. According to her mother, the patient had habit of eating dirt and once a cockroach was discovered in her mouth. In stool examination, eggs of M. moniliformis were not found. She was treated with levamisole and the clinical symptoms reduced within 2 weeks. The specimen contained 2 pieces of a female worm with a total length of 148 mm lacking the posterior end. The spiral musculature of the proboscis receptacle and the shape of the trunk allowed its generic determination. Previously 2 cases of M. moniliformis infection were reported in Iran. This is the 3rd case of M. moniliformis infection in Iran.

Mass treatment for intestinal helminthisis control in an Amazonian endemic area in Brazil / Tratamento em massa para controle das helmintíases intestinais em área endêmica na Amazônia Brasileira

The objective of the present study was to estimate the prevalence of soil-transmitted helminthiasis and evaluate the sanitary conditions and the role of a mass treatment campaign for control of these infections in Santa Isabel do Rio Negro. A cross-sectional survey was carried out in 2002, to obtain data related to the sanitary conditions of the population and fecal samples for parasitological examination in 308 individuals, followed by a mass treatment with albendazole or mebendazole with coverage of 83 percent of the city population in 2003. A new survey was carried out in 2004, involving 214 individuals, for comparison of the prevalences of intestinal parasitosis before and after the mass treatment. The prevalences of ascariasis, trichuriasis and hookworm infection were 48 percent; 27 percent and 21 percent respectively in 2002. There was a significant decrease for the frequency of infections by Ascaris lumbricoides (p < 0.05; OR / 95 percent CI = 0.44 / 0.30 - 0.65), Trichuris trichiura (p < 0.05; OR / 95 percent CI = 0.37 / 0.22 - 0.62), hookworm (p < 0.05; OR / 95 percent CI = 0.03 / 0.01 - 0.15) and helminth poliparasitism (p < 0.05; OR / 95 percent CI = 0.16 / 0.08 - 0.32). It was also noticed a decrease of prevalence of infection by Entamoeba histolytica / dispar (p < 0.05; OR / 95 percent CI = 0.30 / 0.19 - 0.49) and non-pathogenic amoebas. It was inferred that a mass treatment can contribute to the control of soil-transmitted helminthiasis as a practicable short-dated measure. However, governmental plans for public health, education and urban infrastructure are essential for the sustained reduction of prevalences of those infections.

O presente trabalho objetivou avaliar a prevalência e o papel de um tratamento em massa das helmintíases intestinais em Santa Isabel do Rio Negro, Estado do Amazonas, Brasil. Foi realizado em 2002 um estudo seccional, incluindo inquérito copro-parasitológico, objetivando a obtenção das prevalências das parasitoses intestinais e dados sobre as condições sanitárias do local, estudando-se uma amostra de 308 indivíduos. Em 2003 foi realizada intervenção para tratamento em massa das helmintíases intestinais com administração de albendazol (ou mebendazol para crianças entre 12 e 24 meses) na sede do município, alcançando-se 83 por cento de cobertura. Novo inquérito copro-parasitológico foi realizado em 2004, para comparação das prevalências antes a após o tratamento. As prevalências das infecções por Ascaris lumbricoides, Trichuris trichiura e ancilostomídeos foram 48 por cento, 27 por cento e 21 por cento, respectivamente em 2002. Em 2004 observou-se redução significativa das infecções por Ascaris lumbricoides (p < 0,05; OR / 95 por cento IC = 0,44 / 0,30 - 0,65), Trichuris trichiura (p < 0,05; OR / 95 por cento IC = 0,37 / 0,22 - 0,62), ancilostomídeos (p < 0,05; OR / 95 por cento IC = 0,03 / 0,01 - 0,15) e poliparasitismo por helmintos intestinais (p < 0,05; OR / 95 por cento IC = 0,16 / 0,08 - 0,32). Foi também observada redução da prevalência de infecção por Entamoeba histolytica/dispar (p < 0,05; OR / 95 por cento CI = 0,30 / 0,19 - 0,49). Concluiu-se que o tratamento em massa pode auxiliar o controle das helmintíases intestinais, porém ações governamentais em infraestrutura urbana e educação são essenciais para uma redução sustentada das prevalências destas infecções.

Status of soil transmitted helminthiasis in UT of Lakshadweep.

Soil Transmitted Helminthes (STH) survey in UT of Lakshadweep was conducted during February-March 2004. The survey was undertaken using WHO sampling methodology and Kato-Katz technique for stool sample examination. A total of 387 stool samples were examined of whom 322 samples (83.2%) were found positive for one or more STH. Maximum prevalence (100%) was found in Kavaratti Junior Basic School. Thirty children (7.8%) had high intensity of infection. In Kadmat Junior Basic School high intensity TT infection was 8.9%, For AL highest intensity of infection was found among Kavaratti Senior Basic School (7.0%). Mass anthelminthic chemotherapy of all school children was advocated.

Intestinal helminth infection in an ethnic minority commune in southern Vietnam.

A program to control intestinal helminth infections, based on stool surveys, mass treatment of children below 17 years, improvement of sanitation and health education was performed between 1997 and 1999 in Phan Tien, an ethnic minority community in mountainous southern Vietnam. Before intervention, 28.6% of children excreted eggs of at least one parasite, hookworm being the most common (23%), followed by Trichuris trichiura (1.9%), Hymenolepis nana (1.9%), Enterobius vermicularis (0.9%), Ascaris lumbricoides (0.5%), and multiple kinds of helminthes (0.5%). Strongyloides stercoralis was never detected. Poor sanitation and personal hygiene, and walking barefoot were considered the main risk factors for intestinal helminth infections. The success of 400 mg albendazole single dose mass treatment was initially frustrated by the poor quality of the drug formulation used, only containing half of the indicated amount of albendazole. Using another formulation quickly reduced the hookworm infection rate. Praziquantel was used to treat H. nana infections. After three years of intervention, intestinal helminth infections were reduced to 3.3% (p<0.0001). We conclude that interventions combining health education, improvement of sanitation and mass treatment effectively control intestinal helminth infections, but the quality of the drugs used is an important factor.

Efficacy of benzimidazole carbamate on an intestinal fluke co-infected with nematodes.

The efficacy of a single dose of benzimidazole, drugs commonly used for the treatment of Ascaris and hookworm, was evaluated against one of the tiny-sized intestinal flukes, Haplorchis sp in the endemic area where mixed infections of roundworms and flatworms existed. At day 7 after treatment, albendazole (400 mg) induced 42.5% cure rate, mebendazole (500 mg) a cure rate of 32.4%, on the other hand, praziquantel (40 mg/kg) gave 94.6% cure rate and the placebo at 15.9%. At the single dose, benzimidazole could not completely expelled the haplorchid; but could reduce one third to two fifth of the infection, similar to the drugs efficacy against Trichuris infection.

Cure and reinfection patterns of geohelminthic infections after treatment in communities inhabiting the tropical rainforest of Assam, India.

Mass de-worming targeted at socio-economically poor communities can be considered as an option for communities living in the tropical forests of Assam who do not have access to safe drinking water and proper sanitation, and consequently have a higher risk of suffering from geohelminthic infection and associated morbidity. A random sample of 265 subjects was included in this study (134 males and 131 females). The chemotherapeutic regimen followed was a single dose of albendazole 400 mg. Stools samples were collected in 10% formol-saline for detection of infection before treatment. Post-treatment stool samples were collected 10 to 14 days after treatment to determine the cure rate. Stool samples were again collected 3 to 6 months post-treatment to study the rate of reinfection. Multiple logistic regression was used to find possible associations between age, sex and treatment failure. The chi-square test was used wherever appropriate. The cure rates for Ascaris lumbricoides, Trichuris trichiura and hookworms were 70.8%, 68.7% and 93.0%, respectively. Logistic regression revealed that age was associated with treatment failure in A. lumbricoides infection. Re-infection rates after 3 months of successful treatment were 19.6% for A. lumbricoides, 30.9% for T. trichiura and 11.3% for hookworms. Six months post-treatment, the prevalence of re-infection was highest with T. trichiura (43.6%); followed by A. lumbricoides (35.3%). The rate of reinfection with hookworms was lower (11.3%) six months post-treatment. The rates of re-infection with A. lumbricoides and T. trichiura was higher in children below 15 years of age, compared with adults. Hookworm reinfection was higher in the adult age group (15 to 39 years). The rates of new infection in previously uninfected subjects were lower compared with the rates for re-infection.

Enteroparasitoses e utilização de drogas antiparasitárias no período gestacional / Enteroparasitoses and the use of antiparasitic drugs during pregnancy

As Enteroparasitoses representam doenças endêmicas no contexto de vida da população de países menos desenvolvidos socioeconomicamente por deficiência de educação sanitária e estrutura básica de saneamento. Desse modo, compreendem intercorrências clínicas freqüentes no período gravídico-puerperal. Não raro o obstetra encontra-se diante de gestantes portadoras de enteroparasitoses durante o pré-natal, o que muitas vezes suscita dúvidas a respeito do tratamento dessas helmintíases durante a gravidez. Objetivou-se com esta revisão. a abordagem das principais parasitoses intestinais, abordando o quadro clínico e possíveis complicações, o tratamento indicado em gestantes, a farmacologia das drogas mais utilizadas, bem como as evidências científicas de embriotoxicidade e teratogenicidade desses fármacos durante a gravidez

Avaliação anti-helmíntica de extratos das espécies Andira, em camundogos naturalmente infectados por Vampirolepis nana (Sielbold, 1852;) Spasskii, 1954 (Eucestoda; Hymenolepididae) e Aspiculuris teraptera (Nitzsch, 1821) Schulz, 1924 (Nematoda; Heteroxynematidae) / Anthelmintic avaliation of two andira species extrects, in mice naturally infected by Vampirolepis nana (Sielbold, 1852;) Spasskii, 1954 (Eucestoda; Hymenolepididae) e Aspiculuris teraptera (Nitzsch, 1821) Schulz, 1924 (Nematoda; Heteroxynematidae)

A atividade anti-helmíntica de extratos vegetais obtidos das espécies Andira anthelmia (Velloso, 1829) MacBride (1934) e Andira fraxinifolia Benthan, 1838 foi avaliada em camundongos naturalmente infectados por Vampirolepis nana (Sielbold, 1852) Spasskii, 1954 e Aspiculuris tetraptera (Nitzsch, 1821) Schulz, 1924. Os extratos obtidos através de infusão (folhas), decocção (casca da raiz e do caule), maceração e fervura sob refluxo da casca da raiz e do caule, foram aplicados por via intra-gástrica, correspondendo às doses que variaram de 0,2 a 16 g/kg/dia. O efeito anti-helmíntico exercido pelas plantas foi avaliado pelo método crítico e os resultados expressos em termos de percentuais médios de eliminação de V. nana e A. tetraptera. As doses de 2 e 4 g/kg/dia da casca da raiz de A.anthelmia, 49,4 por cento e 42,7 por cento, respectivamente, foram significativamente mais ativas para V. nana, em comparação com as demais partes da planta usadas e o grupo controle, não apresentando diferença em relação ao quimioterápico mebendazol e sendo menos ativa do que o nitroscanato. A dose de 2 g/kg/dia da casca da raiz de A. anthelmia foi significativamente mais ativa para A. tetraptera (63,2 por cento), em comparação com as folhas, a casca da raiz utilizadas nas doses de 1, 4 e 8 g/kg/dia, e o grupo controle; não apresentando diferença significativa em relação ao quimioterápico nitroscanato e sendo menos ativa do que o mebendazol. Não houve diferença significativa no percentual de eliminação de V. nana e A. tetraptera, quando avaliado os extratos obtidos da espécie A. fraxinifolia. A extração da casca da raiz de A. anthelmia e da casca do caule de A. fraxinifolia, através dos processos de maceração e fervura sob refluxo, demonstrou que somente os extratos metanólico (26,7 por cento) e aquoso (maceração) (18,9 por cento) de A. anthelmia foram significativamente mais ativos para A. tetraptera, não o sendo para V. nana, quando comparados ao grupo controle. Após o fraciofraxinifolia, através do processo de partição, a fração clorofórmica apresentou um percentual significativamente maior de eliminação de A. tetraptera (24,6 por cento), quando comparada ao grupo controle. De acordo com os resultados obtidos as espécies A. anthelmia e A. fraxinifolia são promissoras como anti-helmínticas.