Seroprevalence of human cysticercosis in Jataí, Goiás state, Brazil

ABSTRACT The Taenia solium cysticercosis affects millions of people worldwide and is considered a public health problem, especially in developing countries. The diagnosis of neurocysticercosis is complex and involves the analysis of epidemiological, clinical, neuroimaging, and immunological host data. Neurocysticercosis is endemic in Brazil, and is related to the cause of death mainly in the Southeast, South, and Central-West regions. The objective of this study was to determine the seroprevalence of cysticercosis in inhabitants of the city of Jataí, Goiás, in the Central-West region of Brazil from April to August 2012. A total of 529 serum samples were analyzed by enzyme-linked immunosorbent assay for detecting IgG antibodies against T. solium larvae, and Western blotting was used for confirming the diagnosis through the recognition of at least two specific peptides from their serum antibodies. The 351/529 (66.3%) reactive samples were analyzed by enzyme-linked immunosorbent assay and Western blotting confirmed the diagnosis in 73 samples that recognized at least two of the following peptides specific IgG antibodies for cysticercosis: 18, 24, 28-32, 39-42, 47-52, 64-68, and 70 kDa. The seroprevalence of cysticercosis was 13.8% (95% CI 5.9-21.7), demonstrating that the studied area is endemic to this disease.

Estudo descritivo sobre o gerenciamento de resíduos de serviços de saúde no município de Jataí, Goiás, 2010 / Descriptive study of health service waste management in the municipality of Jataí, Goiás, 2010

Objetivo: descrever o gerenciamento de resíduos de serviços de saúde (RSS) no município de Jataí, Estado de Goiás, Brasil. Métodos: estudo descritivo com dados de 15 instituições de saúde, coletados mediante questionário semiestruturado, em 2010. Resultados: os responsáveis pelo gerenciamento de RSS eram, principalmente, do sexo feminino (13/15), com idade média de 32,9 anos, com 3,2 anos de experiência no cargo e graduados em enfermagem (13/15); verificou-se que as etapas de segregação, identificação e acondicionamento dos resíduos potencialmente infectantes, comuns e perfurocortantes foram priorizadas em todas as instituições; as etapas de tratamento, transporte e armazenamento apresentaram execução diferenciada nas instituições; o destino final foi o aterro municipal; o uso de equipamentos de proteção individual pelos funcionários que transportaram os RSS foi considerado insuficiente. Conclusão: o gerenciamento de RSS na área do estudo foi considerado inadequado segundo as normas regulamentadoras vigentes.

Objective: to describe health service waste (HSW) management in the municipality of Jataí-GO, Brazil. Methods: this descriptive study was conducted in 15 health institutes using data collected through a semi-structured questionnaire over ten months in 2010. Results: the professionals responsible for HSW management in the institutions analyzed were mainly female (13/15) (p=0.002). Their average age was 32.9, on average they had 3.3 years of experience in their position and 13/15 had Nursing degrees. The identification, segregation and packaging of potentially infectious waste, household waste and sharps were found to be prioritized in all the institutions. Differences were noted between institutions regarding treatment, transportation and storage. Final disposal occurred at the municipal landfill site. Individual protection equipment use by employees transporting HSW waste was considered insufficient. Conclusion: HSW management compliance with current regulatory rules was considered to be lacking.

Avaliação parasitológica de alfaces (Lactuca sativa) comercializadas no município de Tangará da Serra, Mato Grosso< Brasil / Parasitological evaluation of lettuce (Lactuca sativa) commercialized in the municipality of Tangará da Serra, Mato Grosso State, Brazil

A contaminação de hortaliças por parasitos pode ser um fator de risco à saúde. Este estudo teve como objetivos verificar a ocorrência de parasitos e avaliar as condições higiênico-sanitárias de alfaces (Lactuca sativa) comercializadas no município de Tangará da Serra, estado de Mato Grosso, no período de dezembro de 2006 a abril de 2007. Cem exemplares de alface comercializadas na feira municipal foram submetidos ao método de sedimentação espontânea. Constataram-se 11por cento de positividade para espécies de importância médica (Strongyloides spp., Toxocara sp., Fasciola hepatica e Entamoeba coli) e 71por cento para espécies de vida livre. A água predominante na irrigação era de poço artesiano (59,1por cento) e as hortaliças eram transportadas predominantemente em veículosabertos (77,2or cento). A eliminação de dejetos em fossas sanitárias foi verificada em 86,4por cento daspropriedades e o uso de fezes de animais na adubação foi relatado por 100por cento dos produtores, portantoas amostras de alface foram consideradas inadequadas para o consumo.

Genetic polymorphism in Taenia solium metacestodes from different Brazilian geographic areas

The aim of the present study is to investigate genetic polymorphisms in Taenia solium metacestodes from different Brazilian geographical areas and to relate them to antibody recognition in serum samples of neurocysticercosis (NC) patients. Metacestodes were obtained from the Distrito Federal (DF), Bahia, Minas Gerais (MG) and São Paulo (SP) regions of Brazil. Samples of human sera from 49 individuals with NC, 68 individuals with other helminthiasis and 40 healthy volunteers were analysed (157 individuals in total). Antigens were prepared and used in enzyme-linked immunosorbent assay and western blotting assays to detect specific immunoglobulin G antibodies. Genetic distances between metacestode populations were analysed using random amplified polymorphic DNA (RAPD) analysis. Our results show that there was a higher frequency of reactivity in the DF region in the sera from NC patients (p < 0.05), while discrimination between active and inactive NC was seen only in extracts from the MG and SP regions (p < 0.05). Using RAPD, the sample from the DF region presented a greater increase compared to the other regions. A relationship between genetic polymorphisms among T. solium metacestodes from different areas in Brazil and the differences in antibody detection in patients with NC were established.

Taenia solium metacestode immunodominant peptides recognized by IgG antibodies in cerebrospinal fluid and serum paired samples from patients with active and inactive neurocysticercosis

The aim of this study was to test if serological distinction between patients with active and inactive neurocysticercosis (NCC), could be accomplished by the recognition of immunodominant peptides in total saline antigenic extract of Taenia solium metacestodes by IgG antibody in cerebrospinal fluid (CSF) and serum paired samples. CSF and serum samples of 10 each, active NCC patients, inactive NCC, and individuals with other neurological disorders, were used to recognize the antigenic peptides by western blot (WB). In the active NCC the 28-32 and 39-42 kDa peptides were more frequently detected in CSF than in sera (p < 0.05). The 47-52, 64-68, and 70 kDa antigens showed high frequencies in both samples from patients with active NCC. All the CSF samples of inactive NCC and other neurological disorder (control) patients tested negative, while serum samples from these last two groups recognized mainly the 80, 86, 95, and 98 kDa bands. This finding eliminates the use of the high molecular weigh bands (> 80 kDa) for diagnosis of NCC. The final conclusions were that the difference between active and inactive NCC may be done with the detection of peptides only in the CSF samples and that the 47-52, 64-68, and 70 kDa bands may be included as specific markers for active NCC when detected in CSF samples by WB using total saline extract of T. solium metacestode.

Use of the paired samples (cerebrospinal fluid and serum) in immunodiagnostic of active and inactive human neurocysticercosis

Paired samples of cerebrospinal fluid (CSF) and serum of 30 patients - 10 with active, 10 with inactive neurocysticercosis (NCC), and 10 control subjects - were evaluated by enzyme-linked immunosorbent assay (ELISA) using two Taenia crassiceps metacestode extracts as antigen in order to detect IgG antibodies. In active NCC, high levels of IgG were detected (p < 0.05). The CSF samples showed 80 percent (CI 72-88) of reactivity in the saline extract (S) and 90 percent (CI 84-95) in sodium dodecyl sulphate (SDS) and the serum samples were reactive in 90 percent (CI 84-95) and 100 percent (CI 98-100) in the S and SDS antigenic extracts, respectively. The use of the paired samples of CSF and serum in active NCC showed equivalent results suggesting that the serum samples could be used as a screening in those patients whose CSF puncture is counter-indicated.

Western blotting using Strongyloides ratti antigen for the detection of IgG antibodies as confirmatory test in human strongyloidiasis

The present study was conducted to evaluate the frequency of antigenic components recognized by serum IgG antibodies in Western blotting (WB) using a Strongyloides ratti larval extract for the diagnosis of human strongyloidiasis. In addition, the WB results were compared to the enzyme-linked immunosorbent assay (ELISA) and the indirect immunofluorescence antibody test (IFAT) results. Serum samples of 180 individuals were analyzed (80 with strongyloidiasis, 60 with other intestinal parasitoses, and 40 healthy individuals). S. ratti was obtained from fecal culture of experimentally infected Rattus rattus. For IFAT, S. ratti larvae were used as antigen and S. ratti larval antigenic extracts were employed in WB and ELISA. Eleven S. ratti antigenic components were predominantly recognized by IgG antibodies in sera of patients with strongyloidiasis. There was a positive concordance for the three tests in 87.5 percent of the cases of strongyloidiasis. The negative concordance in the three tests was 94 percent and 97.5 percent, in patients with other intestinal parasitoses and healthy individuals, respectively. In cases of positive ELISA and negative IFAT results, diagnosis could be confirmed by WB. ELISA, IFAT, and WB using S. ratti antigens showed a high rate of sensitivity and specificity. In conclusion, WB using S. ratti larval extract was able to recognize 11 immunodominant antigenic components, showing to be a useful tool to define the diagnosis in cases of equivocal serology