Evaluation of the level of knowledge and prevalence of Toxoplasma gondii infection in pregnant women in Santa Catarina, Brazil

This study aimed to determine the prevalence of Toxoplasma gondii (T. gondii) infection in pregnant women in Santa Catarina, as well as to analyze the knowledge about zoonosis in the study population. Methods: Therefore, 109 volunteers evaluated in Basic Health Units in the city of Blumenau and Brusque were evaluated. The data were collected through questionnaires and analysis of the pregnant woman's handbooks with medical records. Results: In this study, the prevalence of IgG anti-T. gondii was 53.7%, with positivity for IgM anti-T. gondii was 1.0%. Seronegativity for toxoplasmosis was verified in 45.3% of the participants. In addition, the data demonstrated that the majority of pregnant women have not any knowledge of the disease. Conclusion: The results of obtained demonstrated that health actions promotion is crucial to clarify about T. gondii infection, in order to prevent this disease during pregnancy.

O presente trabalho teve por objetivo determinar a prevalência de infecção pelo Toxoplasma gondii (T. gondii) entre gestantes de Santa Catarina, bem como analisar o conhecimento sobre a zoonose na população em estudo. Métodos: Para tanto, foram avaliadas 109 voluntárias atendidas em Unidades Básicas de Saúde dos municípios de Blumenau e Brusque. Os dados foram coletados por meio de questionários e análise de cadernetas da gestante. Resultados: Neste estudo, a prevalência global de anti-T. gondii IgG foi de 53,7%, sendo que a positividade para anti-T. gondii IgM foi de 1,0%. A soronegatividade para toxoplasmose foi verificada em 45,3% das participantes. Além disso, os dados revelaram que a maioria das gestantes não tem conhecimento acerca da doença. Conclusão: Os resultados deste estudo demostraram a necessidade da promoção de ações de saúde voltadas ao esclarecimento sobre o T. gondii visando prevenir a infecção durante a gestação.

Strongyloides stercoralis hyperinfection in a renal transplant recipient

Strongyloidiasis is a worldwide intestinal infection produced by the nematode Strongyloides stercoralis. In this study, we report the case of a 47-year-old female patient who was submitted to renal transplant and an immunosuppression regimen. She was admitted to the emergency service with intense abdominal pain, evolving to an acute respiratory insufficiency, gram-negative bacteremia, refractory shock and death. S. stercoralis larvae were identified in the parasitological exam and bronchoalveolar lavage. This provides evidence for the importance of the early diagnosis of this neglected helminthiasis in transplanted patients undergoing immunosuppresive therapy

High prevalence of HBV carriers among waste collectors in the largest landfill in Latin America

Hepatitis B virus (HBV) is a serious public health problem. Some professions are at an increased risk for HBV infection, such as recyclable waste collectors. In this study, the aim was to evaluate the prevalence of HBV carriers and vaccination coverage among waste collectors in the largest landfill in the Rio de Janeiro metropolitan area, as well as to determine the association between risk factors and HBV infection in the studied population. In this study 73 participants answered a questionnaire on their socio-demographic variables and occupational exposure to waste. All of the subjects in the study were tested for HBsAg and their vaccination cards were evaluated in order to assess their HBV vaccination status. The vaccination coverage among the individuals who had a vaccination card was 57.4%. The overall prevalence of HBsAg was 12.3%. The prevalence of HBsAg was significantly higher among men (p = 0.002). However, no statistical differences were found in the prevalence of HBsAg between individuals with a history of occupational accidents involving sharp edges and non-injured individuals (p = 0.267). The results of this study demonstrate the need to strengthen prevention measures and increase HBV vaccination among waste collectors.

Comprometimento hemostático em pacientes com icterícia obstrutiva / Haemostatic impairment in patients with obstructive jaundice

A doença hepática é associada à alterações hemostáticas devido à diminuição na síntese dos fatores de coagulação. Neste sentido, objetivou-se avaliar o comprometimento da hemostasia em pacientes com icterícia obstrutiva. Os pacientes foram analisados por gênero, idade, etiologia da doença, tempo de protrombina (TP) e tempo de tromboplastina parcial (TTP) antes e após a cirurgia. A icterícia obstrutiva ocorreu com maior frequência entre as mulheres (60,0%), sendo a coledocolitíase a causa mais comum da doença (80,0%). Os valores pré-cirúrgicos do TTP estavam dentro da faixa normal. No entanto, todos os pacientes apresentaram um TP prolongado na avaliação pré-operatória. Uma redução significativa (p<0,001) foi verificada na análise pós-operatória do TP, atingindo a faixa normal em 66,7% dos pacientes estudados. Verificou-se uma correlação positiva (r = 0,813 p<0,001) entre os valores pré-operatórios do TP e a idade dos pacientes. Além disso, os valores pré-operatórios e pós-operatórios do TP foram significativamente mais elevados (p<0,05) entre pacientes com icterícia obstrutiva de etiologia tumoral. Os resultados deste estudo demonstraram uma forte correlação entre a idade dos pacientes e a atividade dos fatores de coagulação vitamina K dependentes, além de uma diminuição significativa na atividade destes fatores em pacientes com icterícia obstrutiva de etiologia tumoral.

Liver disease is associated with haemostatic abnormalities due to the decreased synthesis of the clotting factors. Therefore, this study aimed to evaluate the impairment of haemostasis in patients with obstructive jaundice. Patients were analyzed by gender, age, cause of jaundice, prothrombin time (PT) and partial thromboplastin time (PTT) before and after surgery. Obstructive jaundice occurred more commonly amongst the females (60.0%), and choledocholithiasis was the most frequent cause of the disease (80.0%). Presurgical PTT values were within the normal range, whereas all the patients showed increased PT in the preoperative evaluation. A significant decrease (p<0.001) was found in the postoperative PT measurement, reaching the normal range in 66.7% of the studied patients. A positive correlation was found between the preoperative PT values and the age of the patients (r = 0.813 p<0.001). In addition, preoperative and postoperative PT values were significantly higher (p<0.05) among the patients with obstructive jaundice of tumoral etiology. Results from this study have shown that activity of vitamin K-dependent clotting factors in obstructive jaundice was strongly correlated with subject's age and was significantly decreased in patients with tumoral etiology.

Vaccination coverage and immunity against hepatitis B among HIV-infected patients in South Brazil

Evidence-based strategies to improve the hepatitis B virus (HBV) vaccination coverage rates might help to reduce the burden caused by co-infection with HBV and human immuno-deficiency virus (HIV). In this study, the aim was to evaluate the vaccination coverage and immunity against HBV among HIV-infected individuals in South Brazil, and identify factors that are associated with compliance patterns and antibody reactivity. Three hundred HIV-infected men and women were included in this survey. The patients answered a standardized questionnaire, and vaccination cards were checked in order to assess hepatitis B vaccine status. A blood sample was collected for quantitative determination of antibody to hepatitis B virus surface antigen (anti-HBs). Participants were also evaluated for their CD4 cell count and HIV viral load. The overall vaccination coverage of HBV vaccination found in this study (57.4%) was lower than that was previously reported in South Brazil. Anti-HBs levels >10 IU/L were observed in 47.0% of the studied population. A significant inequality in the coverage rates and antibody reactivity was found in favor of patients with better economic status. In conclusion, the results indicate the need for improvement in the HBV vaccination coverage among HIV carriers, in particular focusing on low-income individuals.

The prevalence of hepatitis B virus infection markers and socio-demographic risk factors in HIV-infected patients in Southern Brazil

Introduction Hepatitis B virus (HBV) and human immunodeficiency virus (HIV) infections are two of the world's most important infectious diseases. Our objective was to determine the hepatitis B surface antigen (HBsAg) and hepatitis B core antibody (anti-HBc) prevalences among adult HIV-infected patients and identify the associations between socio-demographic variables and these HBV infection markers. Methods This study was performed from October 2012 to March 2013. Three hundred HIV-seropositive patients were monitored by the Clinical Analysis Laboratory of Professor Polydoro Ernani de São Thiago University Hospital, Santa Catarina, Brazil. The blood tests included HBsAg, anti-HBc immunoglobulin M (IgM) and total anti-HBc. Patients reported their HIV viral loads and CD4+ T-cell counts using a questionnaire designed to collect sociodemographic data. Results The mean patient age was 44.6 years, the mean CD4 T-cell count was 525/mm3, the mean time since beginning antiretroviral therapy was 7.6 years, and the mean time since HIV diagnosis was 9.6 years. The overall prevalences of HBsAg and total anti-HBc were 2.3% and 29.3%, respectively. Among the individuals analyzed, 0.3% were positive for HBsAg, 27.3% were positive for total anti-HBc, and 2.0% were positive either for HBsAg or total anti-HBc and were classified as chronically HBV-infected. Furthermore, 70.3% of the patients were classified as never having been infected. Male gender, age >40 years and Caucasian ethnicity were associated with an anti-HBc positive test. Conclusions The results showed an intermediate prevalence of HBsAg among the studied patients. Moreover, the associations between the anti-HBc marker and socio-demographic factors suggest a need for HBV immunization among these HIV-positive individuals, who are likely to have HIV/HBV coinfection. .

Anti-HBs levels among children and adolescents with complete immunization schedule against hepatitis B virus. A cross-sectional study in Blumenau, State of Santa Catarina, Brazil, 2007-2008 / Níveis de anti-HBs entre crianças e adolescentes com o esquema completo de imunização contra o vírus da hepatite B. Um estudo transversal em Blumenau, Estado de Santa Catarina, 2007-2008

INTRODUCTION: Vaccination is the main tool for preventing hepatitis B virus (HBV) infection; however, following the completion of the vaccination series, the concentrations of anti-HBs can decline over the years and reach levels less than 10mIU/mL. The persistence of protection in these individuals is still unknown. The present study aimed to determine the anti-HBs antibody levels among children and adolescents who had received a complete vaccination course for hepatitis B. METHODS: Antibodies against HBV surface antigen (anti-HBs) were tested in 371 individuals aged 10 to 15 years-old. RESULTS: Volunteers who showed undetectable quantities of anti-HBs accounted for 10.2% of the population studied and 39.9% presented antibody titers of less than 10mIU/mL. Anti-HBs ≥ 10mIU/mL were verified in 49.9%. CONCLUSIONS: These results corroborate other studies indicating levels of anti-HBs below 10mIU/mL in vaccinated individuals. Additional studies are required to assess whether this indicates susceptibility to HBV infection and the need and age for booster doses.

INTRODUÇÃO: A vacinação é o principal instrumento para prevenir a infecção pelo vírus da hepatite B. Todavia, após a conclusão da série de vacinação, as concentrações de anti-HBs podem diminuir ao longo dos anos e atingir níveis inferiores a 10mUI/mL. A persistência da proteção nestes indivíduos ainda é desconhecida. O presente estudo objetivou determinar os níveis do anticorpo anti-HBs em crianças e adolescentes que receberam o esquema completo de vacinação para a hepatite B. MÉTODOS: O anticorpo para o antígeno de superfície do vírus da hepatite B (anti-HBs) foi testado em 371 indivíduos com idade entre 10-15 anos. RESULTADOS: Os voluntários que apresentaram quantidades indetectáveis de anti-HBs corresponderam a 10,2% da população estudada, e 39,9% apresentaram títulos do anticorpo inferiores a 10mUI/mL. Anti-HBs ≥ 10mUI/mL foi verificado em 49,9%. CONCLUSÕES: Nossos resultados corroboram com outros estudos que indicam níveis de anti-HBs inferiores a 10mUI/mL em indivíduos vacinados. Estudos adicionais são necessários para avaliar se isso indica suscetibilidade à infecção pelo HBV e necessidade e idade para a dose reforço.

Hepatitis B marker seroprevalence and vaccination coverage in adolescents in the City of Itajaí, State of Santa Catarina, Southern Brazil, in 2008 / Soroprevalência de marcadores da hepatite B e cobertura de vacinação em adolescentes no município de Itajaí, Estado de Santa Catarina Sul do Brasil, em 2008

INTRODUCTION: Hepatitis B infection constitutes an important cause of morbidity and mortality worldwide. In Brazil, however, the current epidemiological situation is not clear. Considering the importance of establishing this prevalence, the aim of this study was to determine the prevalence of HBV markers in voluntary adolescents, junior high (secondary school) students, in the City of Itajaí, State of Santa Catarina, Brazil. METHODS: A seroepidemiological, transverse study was conducted with 353 randomly chosen adolescents from elementary school in 2008. Blood samples were analyzed for HBsAg, anti-HBc and anti-HBs. All analyses were conducted by automated microparticle enzyme immunosorbent assay (Abbott®, AxSYM system, Deerfield, IL, USA), according to the manufacturer's instructions. RESULTS: The prevalence of HBsAg was 0.6% (CI 95% 0.1 - 2.0), that of anti-HBc was 1.1% (CI 95% 0.3 - 2.9) and that of detectable anti-HBs was 83.6% (CI 95% 79.3 - 87.3). Hepatitis B vaccination coverage was 97.5% (CI 95% 95.2 - 98.8). CONCLUSIONS: These results demonstrate the success of the vaccination program against hepatitis B in the region studied and indicate that prevention strategies must be maintained and, if possible, expanded to contribute to the establishment of positive prevalence rates in all age groups.

INTRODUÇÃO: A hepatite B constitui uma causa relevante de morbidade e mortalidade em todo o mundo. No Brasil, entretanto, a situação epidemiológica atual não é claramente conhecida. Considerando-se a importância do estabelecimento de tal prevalência, o objetivo deste estudo foi determinar a prevalência dos marcadores de HBV em adolescentes voluntários, estudantes do ensino fundamental na Cidade de Itajaí, Santa Catarina, Brasil. MÉTODOS: Trata-se de um estudo soroepidemiológico, transversal, conduzido com 353 adolescentes do ensino fundamental, randomicamente selecionados, em 2008. As amostras de sangue foram analisadas quanto à presença dos marcadores HBsAg, anti-HBc e anti-HBs. Todas as análises foram conduzidas em ensaio imunoenzimático de micropartículas automatizado (Abbott®, AxSYM system, Deerfield, IL, EUA), de acordo com as instruções do fabricante. RESULTADOS: A prevalência do HBsAg foi de 0,6% (CI 95% 0,1 - 2,0), do anti-HBc foi de 1,1% (CI 95% 0,3 - 2,9) e de títulos detectáveis de anti-HBs foi de 83,6% (CI 95% 79,3 - 87,3). A cobertura vacinal nos adolescentes estudados foi de 97,5% (CI 95% 95,2 - 98,8). CONCLUSÕES: Estes resultados demonstram o sucesso do programa de vacinação contra a hepatite B na região estudada e indicam que as estratégias de prevenção devem ser mantidas e, se possível, expandidas para que contribuam no estabelecimento de taxas de prevalência positivas em todas as faixas etárias.

Seroprevalence of hepatitis B and hepatitis C markers in adolescents in Southern Brazil / Soroprevalência de marcadores de hepatite B e hepatite C em adolescentes no Sul do Brasil

Este estudo teve como objetivo determinar a prevalência de marcadores do vírus da hepatite B (HBV) e do vírus da hepatite C (HCV) entre adolescentes com idade entre 10 e 16 anos, alunos do Ensino Fundamental da cidade de Chapecó, Santa Catarina, Brasil. Trata-se de um estudo transversal incluindo 418 voluntários, realizado entre março e julho de 2008. As análises sorológicas incluíram: HBsAg, anti-HBc, anti-HBs e anti-HCV. Os testes foram realizados em Ensaio Enzimático de Micropartículas (Abbott, AxSYM System, Wiesbaden, Alemanha). A prevalência de HBsAg foi de 0,2 por cento (IC95 por cento: 0,0-1,3), e a prevalência de anti-HBc foi de 1,4 por cento (IC95 por cento: 0,5-3,1). Quanto ao anti-HBs, 48,6 por cento dos voluntários apresentaram títulos maiores que 10UI/L. Nenhum dos voluntários apresentou resultados reativos para anti-HCV. Este estudo demonstrou uma baixa prevalência de marcadores de infecção HBV e HCV e um grande número de voluntários imunizados contra o HBV. Finalmente, demonstrou-se a importância de campanhas e políticas adequadas de saúde na redução dessas prevalências.

This study was carried out to determine the prevalence of hepatitis B virus (HBV) and hepatitis C virus (HCV) markers among adolescents aged between 10 and 16 years old, who are elementary school students in the city of Chapecó, Santa Catarina State, Brazil. The study involved a cross-sectional survey that included 418 volunteers, from March to July, 2008. Serology comprised HBsAg, anti-HBc, anti-HBs and anti-HCV. Tests were performed using automated Microparticle Enzyme Immunosorbant Assay (Abbott, AxSYM System, Wiesbaden, Germany). The prevalence of HBsAg was found to be 0.2 percent (95 percentCI: 0.0-1.3), and the prevalence of anti-HBc was found to be 1.4 percent (95 percentCI: 0.5-3.1). Regarding anti-HBs, 48.6 percent had titers greater than 10UI/L. None of the volunteers presented reactive results for anti-HCV. This study showed a low prevalence of HBV and HCV markers of infection and a great number of volunteers immunized against HBV. Finally this study shows the importance of proper health campaigns and policies in reducing those prevalences.

Seroprevalence of hepatitis B and C infection markers among children and adolescents in the southern Brazilian region / Soroprevalência dos marcadores de infecção das hepatites B e C em crianças e adolescentes da região sul do Brasil

Hepatitis B virus (HBV) and hepatitis C virus (HCV) infections account for a substantial proportion of liver diseases worldwide. The aim of this study was to determine the prevalence of HBV and HCV serological markers among children and adolescents and verify the epidemiology of the HBV infection over than a decade of the introduction of vaccination program. Serologic markers to HBsAg, total anti-HBc and anti-HCV had been tested in 393 samples. The seropositivity for HBsAg was 0.76 percent and for total anti-HBc was 1.02 percent. Copositivity between HBsAg and total anti-HBc was verified in 0.76 percent of the analyzed samples. There was no seropositivity for anti-HCV marker. The seroprevalence of HBV infection markers among children and adolescents in the southern Brazilian region is high compared to that reported in other countries. Preventive measures, such as educational activities in addition to the universal childhood HBV vaccination, should be initiated in order to reduce the morbimortality and the economic burden associated with the disease.

As infecções pelo vírus da hepatite B (HBV) e pelo vírus da hepatite C (HCV) representam a causa de uma substancial proporção das doenças hepáticas em todo o mundo. O objetivo deste estudo foi determinar a prevalência dos marcadores sorológicos do HBV e do HCV em crianças e adolescentes, e verificar a epidemiologia da infecção pelo HBV passada uma década desde a introdução do programa de vacinação. Os marcadores sorológicos HBsAg, anti-HBc total e anti-HCV foram avaliados em 393 amostras. A soropositividade para o HBsAg foi de 0,76 por cento e para o anti-HBc total foi de 1,02 por cento. Co-positividade entre HBsAg e anti-HBc total foi verificada em 0,76 por cento das amostras analisadas. Não houve soropositividade para o marcador anti-HCV. A soroprevalência dos marcadores de infecção pelo HBV em crianças e adolescentes da região sul do Brasil é elevada em relação à reportada em outros países. Medidas preventivas, tais como atividades educativas além da vacinação infantil universal contra o HBV, devem ser iniciadas a fim de reduzir a morbimortalidade e o impacto econômico associados a doença.

Avaliação do nível de conhecimento de adolescentes a respeito da transmissão e prevenção das hepatites B e C / Evaluation of the knowledge of adolescents on transmission and prevention of hepatitis B and C

O objetivo deste estudo foi avaliar o conhecimento de adolescentes do município de Blumenau, Santa Catarina, sobre os meios de transmissão e prevenção das hepatites B e C. Foi realizado um estudo transversal com 393 adolescentes entre 10 e 15 anos atendidos em postos de saúde do município, que responderam a um questionário relativo às hepatites B e C. Dos 393 participantes, 210 (53,4 por cento) eram do sexo feminino. A maioria dos adolescentes (83,2 por cento) demonstrou ter conhecimento da vacina preventiva contra a hepatite B. Pouco mais da metade dos participantes (55,5 por cento) acreditam que a contaminação pelo HBV e HCV ocorra pelo contato com sangue ou secreções de uma pessoa infectada e 23,5 por cento desconhecem as formas de transmissão. Dentre os participantes, 29,0 por cento relataram conhecimento de um ou mais casos de hepatite na família. Quase 40 por cento dos adolescentes informaram antecedente de internação hospitalar, dos quais 5 (1,3 por cento do total de participantes) já haviam recebido sangue por transfusão e 13 (3,3 por cento do total) possuem body piercing e/ou tatuagem. O nível de conhecimento na população estudada mostra a necessidade de intensificação das atividades educativas e a importância de uma política de educação em saúde voltada para os adolescentes.