Eficacia y tolerabilidad de Nitazoxanida para parasitismo intestinal en escolares atendidos en el Centro de Salud de la Universidad del Quindío / Efficacy and tolerability of Nitazoxanide for intestinal parasitism in schoolchildren treated at the Health Center of the University of Quindío

Resumen Objetivo: Describir la efectividad del tratamiento antiparasitario intestinal brindado a niños de cuatro a nueve años atendidos en el centro de Salud de la Universidad del Quindío entre Julio de 2017 a marzo de 2018. Materiales y métodos: Estudio observacional prospectivo. Se extrajeron datos de historias clínicas de pacientes con rango de edad de 4 a 9 años, quienes consultaron en el Centro de Salud de la Universidad del Quindío y se diagnosticaron mediante coprológico con blastocistosis o giardiasis. Se seleccionaron las historias cuyo tratamiento fuese Nitazoxanida y tuviesen un coprológico control postratamiento. Se presentan estadísticas descriptivas; porcentaje de eficacia y tolerabilidad. Resultados: De 15 niños tratados con Nitazoxanida, respondieron al tratamiento 10, en quienes no se hallaron parásitos en el coprológico control. Con una eficacia del 83,3% (IC95% 60 - 100) en blastocistosis, 57,1% (IC95% 32 - 82%) en giardiasis. Conclusión: Se evidenciaron resultados porcentuales similares a los reportados en la literatura, siendo más eficaz en blastocisotisis que en giardiasis.

Abstract Objective: To describe the effectiveness of the intestinal antiparasitic treatment given to children ranging between 4 and 9 years old that were attended in the Health Center of the University of Quindío in the period of July 2017 and March 2018. Materials and methods: Prospective observational study. Data were extracted from medical records of patients with an age range of 4 to 9 years, who consulted at the Health Center of the University of Quindío and were diagnosed through coprological tests with Blastocystis and Giardiasis. The clinical records were selected by whose treatment was done with Nitazoxanide or Albendazole with coprological results of post-treatment check-up. Descriptive statistics are presented along with percentage of efficacy and tolerability. Results: From 15 children treated with Nitazoxanide, 10 responded to the treatment, who presented no parasites in the coprological check-up. The remaining population presented some type of parasitic infection (n = 5). With an efficiency of 83,3% (IC95% 32 - 82%) in blastocystis, and 57,1% (IC95% 32 - 82%) in giardiasis. Conclusion: Percentage results similar to those reported in the literature were evidenced, being more effective in blastocystis than in giardiasis.

Antibacterial and anti-parasitic activities of Terfezia claveryi methanolic extract against some common pathogenic agents of infectious diarrhea

Objective: To assess the antidiarrheal effects of Terfezia claveryi methanolic extract against Escherichia coli, Salmonella typhimurium, Shigella flexneri, and Giardia lamblia. Methods: Antibacterial effects of the Terfezia claveryi methanolic extract were carried out by determining the minimum inhibitory concentration (MIC) and minimum bactericidal concentration through micro broth dilution technique. Furthermore, reactive oxygen species production and protein leakage were evaluated. To evaluate the in vitro anti-giardial effects of Terfezia claveryi methanolic extract, Giardia lamblia WB (ATCC® 30957) trophozoites were treated with various concentrations of Terfezia claveryi methanolic extract for 10-360 min. In addition, the plasma membrane permeability of trophozoites treated with Terfezia claveryi methanolic extract was determined. The cytotoxicity effects of Terfezia claveryi methanolic extract against normal (HEK293T) and cancer (MCF-7) cells were also assessed using the MTT assay. Results: The MIC and minimum bactericidal concentration of Terfezia claveryi methanolic extract against bacterial strains were in the range of 0.52-1.04 and 1.04-2.08 mg/mL, respectively. The results revealed that reactive oxygen species production and protein leakage were significantly increased after the bacteria were treated with the Terfezia claveryi methanolic extract, especially at 1/3 and 1/2 MICs (P<0.001). Furthermore, Terfezia claveryi methanolic extract decreased the viability of Giardia lamblia trophozoites in a dose-dependent manner. Terfezia claveryi methanolic extract at 1, 2, and 4 mg/mL resulted in 100% mortality in Giardia lamblia trophozoites after 360, 240, and 120 min, respectively. Moreover, Terfezia claveryi methanolic extract altered the permeability of plasma membrane of Giardia lamblia trophozoites by increasing the concentration. MTT assay revealed that the 50% cytotoxic concentrations values for HEK293T and MCF-7 cells were 4.32 mg/mL and 6.40 mg/mL, respectively, indicating that Terfezia claveryi methanolic extract had greater cytotoxicity against cancer cells than normal cells. Conclusions: Terfezia claveryi methanolic extract had potent in vitro antibacterial and anti-parasitic effects on Escherichia coli, Salmonella typhimurium, Shigella flexneri, and Giardia lamblia by affecting cell membrane permeability and reactive oxygen species generation with no significant cytotoxicity on normal cells.

Prevalence of intestinal parasites in children from public preschool in the Triple Border Brazil, Argentina, and Paraguay / Prevalência de parasitos intestinais em crianças de pré-escolas públicas na Tríplice Fronteira Brasil, Argentina e Paraguai

INTRODUCTION: The prevalence of parasitosis in children from Brazilian border cities is unknown. OBJECTIVE: To identify the prevalence of intestinal parasites in children from public pre-school on the Brazilian border and their socioeconomic and health profile. METHODS:: Fecal samples were obtained from 178 children from public early childhood educational center (CMEI) in Brazilian border municipalities in Foz do Iguaçu, Brazil. Samples were processed by Hoffman sedimentation and zinc sulfate centrifugation and flotation methods. A questionnaire was administered to children´s parents or guardians regarding parasitic diseases, socioeconomic status, and sanitary habits. RESULTS: The prevalence of intestinal parasites was 26.9% (n=48). A high prevalence of Giardia duodenalis was found (16.3%), followed by Endolimax nana (8.4%), Enterobius vermiculares (1.7%), Ascaris lumbricoides, and Entamoeba coli (0.5%). Forty-seven children (26.4%) presented monoparasitism. The percentage of parasitosis was significantly higher among male children (33.7% - p<0.036) who exhibited weight loss (50.0%), were from low-income families (35.4% - p=0.05), and had mothers with a low education (54.0% - p=0.0001). The highest percentage of Giardia was in children who exhibited weight loss (42.9% - p<0.05) and had mothers with low education (35.0% - p=0.0001). Multivariate analysis indicated that in the variable gender (male gender), weight loss and low maternal education contributed to the variability of parasitosis in children from the surveyed MCEC. CONCLUSION: The higher prevalence of Giardia was due to child and family variables. The detection of Enterobius vermiculares and Ascaris lumbricoides, despite the low frequency, indicates the need for better basic sanitation policies.

INTRODUÇÃO: A prevalência de parasitoses em crianças de municípios brasileiros de fronteira é desconhecida. OBJETIVO: Identificar a prevalência de parasitos intestinais em crianças de pré-escola pública de fronteira brasileira e seu perfil socioeconômico e sanitário. MÉTODOS: Foram obtidas amostras fecais de 178 crianças de Centro Municipal de Educação Infantil (CMEI) de Foz do Iguaçu, Brasil. As amostras foram processadas pelos métodos de sedimentação de Hoffman e centrifugação e flutuação no sulfato de zinco. Foi aplicado questionário aos pais ou responsáveis, referente a doenças parasitárias, nível socioeconômico e hábitos sanitários. RESULTADOS: A prevalência de parasitos intestinais foi de 26,9% (n=48). Houve maior prevalência de Giardia duodenalis (16,3%), seguido por Endolimax nana (8,4%), Enterobius vermiculares (1,7%), Ascaris lumbricoides e Entamoeba coli (0,5%). 47 (26,4%) crianças apresentaram monoparasitismo. O percentual de parasitose foi significantemente maior nas crianças do sexo masculino (33,7% - p<0,036), perda de peso (50,0%), famílias de baixa renda (35,4% - p=0,05) e mães com baixa escolaridade (54,0% - p=0,0001), enquanto, o maior percentual de Giardia foi em crianças com perda de peso (42,9% - p<0,05) e mães com baixa escolaridade (35,0% - p=0,0001). Análise multivariada indicou que na variável gênero (sexo masculino), perda de peso e baixa escolaridade das mães refletem parte da variabilidade da condição de parasitado das crianças dos CMEI pesquisados. CONCLUSÃO: Presença de maior prevalência de Giardia foi decorrente de variáveis da criança e da família e a detecção de Enterobius vermiculares e Ascaris lumbricoides, apesar da baixa frequência, indica necessidade de melhores políticas de saneamento básico.

Occurrence and molecular characterization of Giardia duodenalis from naturally infected dogs in the municipality of Santa Maria, Rio Grande do Sul, Brazil

ABSTRACT: Giardiasis is an important and prevalent zoonosis in dogs and humans caused by Giardia spp. The close relationship between pets and humans has physical, emotional and social benefits. The dogs have an important role in Giardia duodenalis cycle and transmission. This study aimed to verify the occurrence of the parasite in dogs from Central Region, in Santa Maria, Rio Grande do Sul State, Brazil, from April to October 2018. Dog feces (230) were submitted to Faust coproparasitological and molecular analyses. The positive samples in the nested-PCR (-giardin gene) were sent for DNA sequencing and phylogenetic analyses (Neighbor-Joining). The occurrence of G. duodenalis, was 5.6% (13/230) and 4.3% (10/230) detected by coproparasitological technique and nested-PCR, respectively. There was no difference in the sensitivity of the tests used. From the faecal samples analyzed, there were no differences among the variables: diagnostic techniques, local, sex, and age of the animals (p>0.05). Only in the stool examination methodology a difference was observed between the ages (p 0.05). G. duodenalis assemblages were C and D, frequently reported in dogs. The close relationship between dogs and people may allow co-infections of circulating parasites in the population, including Giardia spp. and increasing the risk of transmission of zoonotic agents.

RESUMO: A giardíase é uma zoonose importante e prevalente em cães e humanos, sendo causada por Giardia spp. A estreita relação entre animais de estimação e seres humanos traz benefícios físicos, emocionais e sociais. Os cães têm um papel importante no ciclo e transmissão de Giardia duodenalis. Este estudo teve como objetivo verificar a ocorrência do parasita em cães da Região Central, em Santa Maria, RS, Brasil, de abril a outubro de 2018. As fezes de cães (230) foram submetidas a técnica coproparasitológica de Faust e análises moleculares. As amostras positivas no nested-PCR (gene -giardin) foram enviadas para sequenciamento de DNA e posterior análise filogenética (Neighbor-Joining). A ocorrência de G. duodenalis foi de 5,6% (13/230) e 4,3% (10/230) detectados pela técnica coproparasitológica e nested-PCR, respectivamente. Não houve diferença na sensibilidade dos testes utilizados. Das amostras fecais analisadas, não houve diferenças entre as variáveis: técnicas de diagnóstico, local, sexo e idade dos animais (p>0,05). Somente na metodologia de exame de fezes observou-se diferença entre as idades (p 0,05). As assemblages de G. duodenalis encontradas foram C e D, frequentemente relatadas em cães. A estreita relação entre cães e pessoas pode permitir co-infecções de parasitas circulantes na população, incluindo Giardia spp. e aumentando o risco de transmissão de agentes zoonóticos.

Occurrence and molecular characterization of Giardia duodenalis from naturally infected dogs in the municipality of Santa Maria, Rio Grande do Sul, Brazil / Ocorrência e caracterização molecular de Giardia duodenalis em cães naturalmente infectados no município de Santa Maria, Rio Grande do Sul, Brasil

Giardiasis is an important and prevalent zoonosis in dogs and humans caused by Giardia spp. The close relationship between pets and humans has physical, emotional and social benefits. The dogs have an important role in Giardia duodenalis cycle and transmission. This study aimed to verify the occurrence of the parasite in dogs from Central Region, in Santa Maria, Rio Grande do Sul State, Brazil, from April to October 2018. Dog feces (230) were submitted to Faust coproparasitological and molecular analyses. The positive samples in the nested-PCR (β-giardin gene) were sent for DNA sequencing and phylogenetic analyses (Neighbor-Joining). The occurrence of G. duodenalis, was 5.6% (13/230) and 4.3% (10/230) detected by coproparasitological technique and nested-PCR, respectively. There was no difference in the sensitivity of the tests used. From the faecal samples analyzed, there were no differences among the variables: diagnostic techniques, local, sex, and age of the animals (p>0.05). Only in the stool examination methodology a difference was observed between the ages (p<0.05). G. duodenalis assemblages were C and D, frequently reported in dogs. The close relationship between dogs and people may allow co-infections of circulating parasites in the population, including Giardia spp. and increasing the risk of transmission of zoonotic agents.(AU)

A giardíase é uma zoonose importante e prevalente em cães e humanos, sendo causada por Giardia spp. A estreita relação entre animais de estimação e seres humanos traz benefícios físicos, emocionais e sociais. Os cães têm um papel importante no ciclo e transmissão de Giardia duodenalis. Este estudo teve como objetivo verificar a ocorrência do parasita em cães da Região Central, em Santa Maria, RS, Brasil, de abril a outubro de 2018. As fezes de cães (230) foram submetidas a técnica coproparasitológica de Faust e análises moleculares. As amostras positivas no nested-PCR (gene β-giardin) foram enviadas para sequenciamento de DNA e posterior análise filogenética (Neighbor-Joining). A ocorrência de G. duodenalis foi de 5,6% (13/230) e 4,3% (10/230) detectados pela técnica coproparasitológica e nested-PCR, respectivamente. Não houve diferença na sensibilidade dos testes utilizados. Das amostras fecais analisadas, não houve diferenças entre as variáveis: técnicas de diagnóstico, local, sexo e idade dos animais (p>0,05). Somente na metodologia de exame de fezes observou-se diferença entre as idades (p<0,05). As assemblages de G. duodenalis encontradas foram C e D, frequentemente relatadas em cães. A estreita relação entre cães e pessoas pode permitir co-infecções de parasitas circulantes na população, incluindo Giardia spp. e aumentando o risco de transmissão de agentes zoonóticos.(AU)

Prevalencia de la Giardia duodenalis en el centro de bienestar animal "CEIBA", Rionegro, Colombia (2017) / Prevalence of Giardia duodenalis in the "CEIBA" animal welfare center, Rionegro, Colombia (2017) / Prevalência de Giardia duodenalis no centro de apicultura animal de "CEIBA", Rionegro, Colômbia (2017)

Resumen Determinar la prevalencia de parasitismo de Giardia duodenalis, en el centro de bienestar "CEIBA", del municipio de Rionegro, Colombia durante junio 2017. Se realizó un estudio descriptivo transversal, no experimental, aleatorio, fueron evaluados 112 coprológicos de caninos del centro de bienestar "CEIBA", de ambos sexos, todas las edades y alimentación comercial. Fueron sometidos a evaluación coprológica, por extracción directa de ampolla rectal y evaluada en el Laboratorio Clínico de la Corporación Universitaria Lasallista "Hermano Marco Antonio Serna f.s.c", fueron realizados dos métodos diagnósticos, flotación con solución salina saturada (Willys Molloy) y frotis directo. La presencia de Giardia duodenalis fue categorizado en escala de cruces de 0-3. Se encontraron 60 (55%) muestras con presencia de parásitos, de los cuales 10 (8,92%) estaban infestados por Giardia duodenalis, representando 16,66% de la parasitosis total, para una cruz 2 (20%), con dos cruces 5 (50%) y con tres 3 (30%). La prevalencia de Giardia duodenalis en el centro de bienestar CEIBA, es baja con respecto a datos de prevalencia en otros albergues o centros caninos, lo cual puede estar influenciado por las medidas de prevención y control de la enfermedad.

Abstract To determine the prevalence of Giardia duodenalis parasitism at the CEIBA wellness center in the municipality of Rionegro, Colombia, during June 2017. A descriptive cross-sectional, non-experimental, randomized study was carried out. 112 coprological evaluations of canines of the "CEIBA" wellness center of both sexes, all ages and commercial feeding were evaluated. They were submitted to a cochrological evaluation, by direct extraction of rectal ampulla and evaluated in the Clinical Laboratory of the University of Lasallian Hospital "Hno Marco Antonio Serna, fsc", two diagnostic methods were carried out, flotation with saturated saline solution (Willys Molloy) and direct smears. The presence of Giardia duodenalis was categorized as 0-3 crosses. A total of 60 (55%) samples were present, with 10 (8.92%) infested by Giardia duodenalis, accounting for 16.66% of the total parasite, for a cross 2 (20%), with two crosses 5 (50%) and three 3 (30%). The prevalence of Giardia duodenalis in the CEIBA well-being center is low with respect to prevalence data in other canines or hostels, which may be influenced by disease prevention and control measures.

Resumo Determinar a prevalência do parasitismo de Giardia duodenalis no centro de bem-estar CEIBA no município de Rionegro, Colômbia, em junho de 2017. Foi realizado um estudo descritivo transversal, não experimental, randomizado. Foram avaliadas as avaliações coprológicas dos caninos do centro de bem estar "CEIBA" de ambos os sexos, todasas idades e alimentação comercial. Eles foram submetidos a avaliação cochrológica, por extração direta de ampola retal e avaliada no Laboratório Clínico do Hospital Universitário das Ilhas "Hno Marco Antonio Serna, fsc", foram realizados dois métodos de diagnóstico, flotação com solução salina saturada (Willys Molloy) e esfregaços diretos. A presença de Giardia duodenalis foi categorizada como 0-3 cruzamentos. Um total de 60 (55%) amostras estavam presentes, com 10 (8,92%) infestadas por Giardia duodenalis, representando 16,66% do parasita total, para uma cruz 2 (20%), com duas cruza 5 (50%) e três 3 (30%). A prevalência de Giardia duodenalis no centro de bem-estar da CEIBA é baixa em relação aos dados de prevalência em outros caninos ou albergues, o que pode ser influenciado por medidas de prevenção e controle de doenças.

Predominance of Giardia duodenalis AII sub-assemblage in young children from Salvador, Bahia, Brazil / Predominio del subconjunto AII de Giardia duodenalis en niños pequeños de Salvador, Bahía, Brasil

Introduction. Giardia duodenalis is an intestinal protozoan with a high prevalence in children of developing countries. Molecular studies revealed a great genetic diversity of G. duodenalis, with assemblages A and B found mainly in humans. Despite its importance, the information on the molecular epidemiology of human giardiasis is still limited in Brazil. Objective. To characterize G. duodenalis molecular isolates in children from Salvador, Bahia, Brazil. Materials and methods. Giardia duodenalis positive fecal samples were obtained from 71 children from two day care centers and 39 users of a clinical analysis laboratory. Samples were analyzed by PCR-RFLP of the glutamate dehydrogenase (gdh) and beta-giardin genes and by the sequencing of beta-giardin. Results. Of the 110 G. duodenalis samples, 80 (72.7%) amplified one or both target genes. Of these, 62 (77.5 %) were identified as assemblage A and 18 (22.5%) as assemblage B. The subassemblage AII was identified in 58.8% (n=47) of isolates followed by the sub-assemblage AI (18.8%, n=15), BIV (11.2%, n=9), and BIII (5.0%, n=4). The AII sub-assemblage was the most frequent in children of both day care centers whereas AI was found only in the group attended at the clinical laboratory. Sub-assemblage AII predominated in children under two years. Conclusions. The higher frequency of AII sub-assemblage suggests that anthroponotic transmission is more common in Salvador, but that zoonotic transmission pathways are also present and a change in susceptibility to different molecular patterns of Giardia may occur during child growth.

Introducción. Giardia duodenalis es un protozoo intestinal de gran prevalencia en los niños de los países en desarrollo. En estudios moleculares se ha evidenciado la gran diversidad genética de G. duodenalis y se han identificado los conjuntos A y B, principalmente en humanos. A pesar de su importancia, el conocimiento de la epidemiología molecular de la giardiasis humana aún es limitado en Brasil. Objetivo. Caracterizar los aislamientos moleculares de G. duodenalis de muestras tomadas a niños de Salvador, Bahía, Brasil. Materiales y métodos. Las muestras fecales positivas para G. duodenalis se obtuvieron de 71 niños de dos guarderías y de 39 usuarios de un laboratorio de análisis clínicos. Las muestras se analizaron mediante PCR-RFLP de los genes gdh y beta-giardin, y secuenciación de beta-giardin. Resultados. De las 110 muestras de G. duodenalis, en 80 (72,7 %) se amplificaron uno o ambos genes. De estos, 62 (77,5 %) se identificaron como pertenecientes al conjunto A y 18 (22,5 %) al B. El subconjunto AII se identificó en el 58,8 % (n=47) de los aislamientos, seguido del AI en el 18,8% (n=15), el BIV en el 11,2% (n=9) y el BIII en el 5,0% (n=4). El subconjunto AII fue el más frecuente en los niños de ambas guarderías, en tanto que el AI solo se encontró en el grupo atendido en el laboratorio clínico. El subconjunto AII predominó en los niños menores de dos años. Conclusiones. La mayor frecuencia del subconjunto AII sugiere que la transmisión antroponótica es más común en Salvador, pero también existen vías de transmisión zoonóticas, y que pueden ocurrir cambios en la sensibilidad frente a diferentes patrones moleculares de Giardia durante el crecimiento infantil.

Perfil de desempenho de técnicas coproscópicas Coproplus® e Hoffman, Pons e Janner no diagnóstico de giardíase / Performance profile of coproscopic techniques Coproplus® and Hoffman, Pons and Janner in the diagnosis of giardiasis / Perfil de rendimiento de las técnicas coproscópicas Coproplus® y Hoffman, Pons y Janner en el diagnóstico de giardiasis

Justificativa e Objetivos: Os parasitas intestinais representam um problema de saúde pública no Brasil, e sua identificação é feita rotineiramente, por meio de várias técnicas diagnósticas. Muitas dessas técnicas são criticadas por suas limitações, como a de Hoffman, Pons e Janner. Considerou-se avaliar o grau de sensibilidade diagnóstica dessa técnica em comparação ao método coproscópico de coleta e filtragem Coproplus®, uma vez que esta metodologia também é baseada na concentração de estruturas parasíticas e é uma adaptação prática aos métodos usuais, pois não há documentos diagnósticos de protozoários. Métodos: A análise gráfica pelo método de Bland-Altman mostrou que há concordância entre os dois métodos de identificação dos cistos avaliados, ao traçar as diferenças entre o número de cistos contra as médias de ambos os valores. Resultados: Verificou-se que, para os protozoários, o uso de apenas um método parasitológico de Hoffman, Pons e Janner não é suficiente para identificar todas as amostras. Conclusão: Os métodos têm se mostrado eficazes na identificação de parasitas intestinais, mas nem todos os agentes foram identificados simultaneamente em ambas as técnicas e números de cistos, o que leva à conclusão de que uma técnica pode complementar a outra.(AU)

Background and Objectives: Intestinal parasites are a public health problem in Brazil. The identification of parasites in feces is routinely performed by several diagnostic techniques; many of these methods are still criticized for their limitations such as the Hoffman, Pons, and Janner one. We thus considered valid to evaluate the degree of diagnostic sensitivity of this technique in Coproplus® coproscopic collecting and filtering method, since this methodology is also based on the concentration of parasitic structures, and this is a practical adaptation to the usual methods, since there are diagnosis documents of protozoa. Methods: The graphic analysis by the Bland-Altman method showed that there is agreement between the two methods of identification of cysts evaluated when plotting the differences between the number of cysts against the means of both values. Results: For protozoa, the use of a single parasitological method ­ Hoffman, Pons and Janner ­ is not sufficient to identify all samples. Conclusion: The analyzed methods were effective in identifying intestinal parasites, but not all agents were identified simultaneously in both techniques and numbers of cysts, which leads to the conclusion that the two techniques are complementary.(AU)

Justificación y Objetivos: Los parásitos intestinales son un problema de salud pública en Brasil, y la identificación de parásitos se realiza de forma rutinaria mediante diversas técnicas de diagnóstico. Incluso con la existencia de numerosos métodos de diagnóstico, muchos aún son criticados por sus limitaciones, como el de Hoffman, Pons y Janner. Se consideró oportuno evaluar el grado de sensibilidad diagnóstica de esta técnica en el método de coprofia de recolección y filtro Coproplus®, ya que esta metodología también se basa en la concentración de estructuras parásitas y es una adaptación práctica a los métodos habituales, y no hay documentos de diagnóstico de protozoos. Métodos: El análisis gráfico por el método de Bland-Altman mostró que existe una concordancia entre los dos métodos de identificación de los quistes evaluados al rastrear las diferencias entre el número de quistes y los promedios de ambos valores. Resultados: Se ha encontrado que, para los protozoos, el uso de un solo método parasitológico (Hoffman, Pons y Janner) no es suficiente para identificar todas las muestras. Conclusión: Se ha demostrado que los métodos son eficaces para identificar parásitos intestinales, pero no todos los agentes se han identificado simultáneamente en las técnicas y en el número de quistes, lo que lleva a la conclusión de que una técnica puede complementar a la otra.(AU)

Human leukocyte antigen class-II DRB1 alleles and Giardia lamblia infection in children: A case-control study

Objective: To compare the genotype frequencies of HLA class- II DRB1 alleles in Giardia (G.) lamblia-infected children. Methods: A total of 490 Egyptian children aged 2-16 years were subjected to microscopic stool examination to detect G. lamblia infection, and to exclude other intestinal pathogens. On the basis of their microscopic findings, a group of 80 children were chosen as giardiasis cases, another 80 children were confirmed as Giardia free control group by immunochromatographic test, and the remaining children were excluded. Both giardiasis and control groups were then subjected to blood examination to identify their genetic type of HLA-DRB1 alleles. Results: HLA class-II DRB1∗03:01 and DRB1∗13:01 alleles were significantly associated with G. lamblia infection (P<0.001 for each variable). On the other hand, HLA class-II DRB1∗04:02, DRB1∗10:01, DRB1∗14:01 and DRB1∗15:01 alleles were significantly demonstrated in Giardia free children. However, other HLA-DRB1 alleles did not show any significant association with giardiasis. Conclusions: HLA class-II DRB1∗03, DRB1∗13, DRB1∗04, DRB1∗10, DRB1∗14 and DRB1∗15 alleles may be involved in the establishment of host immune response to G. lamblia infection.

Human leukocyte antigen class-II DRB1 alleles and Giardia lamblia infection in children: A case-control study

Objective: To compare the genotype frequencies of HLA class- II DRB1 alleles in Giardia (G.) lamblia-infected children. Methods: A total of 490 Egyptian children aged 2-16 years were subjected to microscopic stool examination to detect G. lamblia infection, and to exclude other intestinal pathogens. On the basis of their microscopic findings, a group of 80 children were chosen as giardiasis cases, another 80 children were confirmed as Giardia free control group by immunochromatographic test, and the remaining children were excluded. Both giardiasis and control groups were then subjected to blood examination to identify their genetic type of HLA-DRB1 alleles. Results: HLA class-II DRB1∗03:01 and DRB1∗13:01 alleles were significantly associated with G. lamblia infection (P<0.001 for each variable). On the other hand, HLA class-II DRB1∗04:02, DRB1∗10:01, DRB1∗14:01 and DRB1∗15:01 alleles were significantly demonstrated in Giardia free children. However, other HLA-DRB1 alleles did not show any significant association with giardiasis. Conclusions: HLA class-II DRB1∗03, DRB1∗13, DRB1∗04, DRB1∗10, DRB1∗14 and DRB1∗15 alleles may be involved in the establishment of host immune response to G. lamblia infection.

Isolation of Giardia Cyst in Paediatric Patient Under FivComparisons of Results of Type 1 Tympanoplasty Using Temporalis Fascia and Tragal Perichondrium: A Prospective Study

Introduction: Giardia lamblia is an important cause of diarrheal disease followed by malabsorption in children throughout the world and is the most frequent pathogenic intestinal protozoan infection. Children having diarrhoea with duration of more than seven days with abdominal pain comprises of Giardia infection . Around 80% of children were affected with Giardia infection as they belong from lower socioeconomical class. Giardia intestinalis causes Giardiasis which is one of the major causes of diarrheal diseases throughout the world. Infection occurred by Giardia may be either asymptomatic or may cause diarrheal illness that can be acute or chronic. In areas of poor sanitation it affects 33% of the people in the developing world. Study aimed to isolate Giardia cyst in paediatric patient under five in Kanpur Region. Material and Methods: The study was carried in the Department of Microbiology, GSVM Medical College, Kanpur, Uttar Pradesh. A total of 197 stool sample were collected and screened for Giardia through microscopy (Iodine and saline mount. Result: Among 197 samples screened. The 18 samples were positive through direct microscopy for Giardia cyst. Maximum amount of parasitic infection was found in age group 3.5-5 years. Conclusion: Stool microscopy is (gold standard); however, its sensitivity is low due to intermittent faecal shedding for Giardiasis which is a common gastrointestinal parasitic infection in tropics. Parasitic infection caused by Giardia lamblia is a major worldwide public health problem. Infection is also associated with complications in early childhood if not treated. For better management of the patients early diagnosis and treatment is required. Drinking water standards, hand hygiene, health education, safe sanitation are factors and should be given priority to minimize such infections.

Intervenção educativa com agentes comunitários de saúde sobre giardíase em região de fronteira - Foz do Iguaçu / Educational intervention with health community agents regarding giardiasis in border region - Foz do Iguaçu

O objetivo deste estudo foi comparar o conhecimento prévio e a assimilação das informações sobre giardíase pelos Agentes Comunitários de Saúde (ACS) de Foz do Iguaçu após intervenção educativa. Trata-se de um estudo comparativo de abordagem quantitativa com 55 ACS, do distrito sanitário Norte de Foz do Iguaçu. Foi utilizado um questionário contendo 10 questões fechadas sobre a giardíase que foi aplicado em dois momentos sequenciais da pesquisa. Inicialmente, foi aplicado um questionário para a avaliação do conhecimento prévio dos ACS sobre a giardíase. Em seguida, foi ministrada uma palestra sobre a doença para esse público e, aplicado novamente o questionário para a avaliação da assimilação das informações sobre a giardíase. Os dados coletados foram analisados pelo programa BioEstat 5.0® e utilizado o teste de Poisson, com significância de 5%. Foram identificadas fragilidades no conhecimento dos ACS na avaliação prévia para as variáveis investigadas (p<0,05). Após a intervenção educativa, observou-se aumento na média de acertos em todas as variáveis estudadas (p<0,05). A intervenção educativa favorece conhecimento aos ACS, possibilitando mudança no panorama da giardíase e, consequentemente melhora na qualidade de saúde da população.

The objective of this study was to compare the prior knowledge and assimilation of information regarding giardiasis by the Health Community Agents (HCA) from Foz do Iguaçu after educational intervention. This is a comparative study of the quantitative approach using 55 HCA from the northern health district in Foz do Iguaçu. A questionnaire containing 10 yes-or-no questions about giardiasis that was applied in two sequential moments of the research. Initially, a questionnaire was applied for assessing the HCA's prior knowledge regarding giardiasis. Then, the subjects attended a lecture on the disease and then, the questionnaire was applied again for assessing the assimilation of information on giardiasis. The data collected were analyzed using BioEstat 5.0® and the Poisson test with 5% significance. Weak points in the knowledge of the HCA were identified in the previous assessment for the investigated variables (p<0.05). After the educational intervention, there was an increase in the average number of correct answers in all variables studied (p<0.05). The educational intervention favors the retention of knowledge by the HCA, allowing a change in the panorama of giardiasis and, consequently, an improvement in the health quality of the population.

Infecção por Giardia duodenalis entre crianças em idade escolar no sul do Mato Grosso / Infection by Giardia duodenalis among school-age children in the south of Mato Grosso / Infección por Giardia duodenalis entre niños en edad escolar en el sur del Mato Grosso

Justificativa e Objetivos: A giardíase representa um problema de saúde pública com possibilidade de ocasionar agravos no desenvolvimento físico e mental, particularmente em crianças. Assim, destaca-se a relevância em efetuar a avaliação parasitológica desse público e seus determinantes. Desse modo, essa pesquisa teve como objetivo avaliar a prevalência e fatores associados à infecção por Giardia duodenalis em crianças matriculadas entre o 1º e 3º ano do ensino fundamental em duas unidades de ensino de um município no sul de Mato Grosso. Métodos: Após o consentimento dos pais e crianças, foram entregues o questionário socioepidemiológico e o coletor universal, contendo solução conservante para a coleta única de amostra fecal, que foi analisada pela técnica de sedimentação espontânea. Resultados: Foram incluídos 60 participantes com média de idade de 7,05 anos e predominância do sexo masculino (53,3%). A prevalência global de enteroparasitas foi de 36,7%, dos quais 54,5% estavam infectados por G. duodenalis. Foi encontrada associação significativa entre a ocorrência dessa infecção e o fato de a criança pertencer à família que declarou não possuir renda financeira (p=0,04). Conclusão: A infecção por G. duodenalis em crianças em idade escolar persiste e está associada à ausência de renda financeira familiar. Tais achados evidenciam a necessidade de melhoria das condições de vida, ações de educação em saúde e tratamento medicamentoso dessa população.(AU)

Background and Objectives: Giardiasis represents a health public problem that may damage the physical and mental development, particularly of children. Therefore, the importance of performing the parasitological evaluation of this population and its determinants is highlighted. Thus, this study aimed to evaluate the prevalence and factors associated with Giardia duodenalis infection in children enrolled between the 1st and 3rd grades of primary education in two educational units in the south of Mato Grosso. Methods: After the consent of parents and children, the socioepidemiological questionnaire and the universal collector containing a preservative solution for the single fecal sample collection were handed out, which were analyzed by the spontaneous sedimentation technique. Results: Sixty participants with mean age of 7.05 years and male predominance (53.3%) were included. The overall prevalence of enteroparasites was 36.7%, of which 54.5% was infected by G. duodenalis. A significant association was found between the occurrence of this infection and the fact that the child belonged to the family that declared not having financial income (p = 0.04). Conclusion: G. duodenalis infection in school-age children persists and is associated with the absence of family financial income. These findings highlight the need to improve this population's living conditions, health education practices, and drug treatment access.(AU)

Justificación y Objetivos: La giardiasis representa un problema de salud pública con posibilidad de ocasionar agravios en el desarrollo físico y mental, particularmente en niños. Así se pone en relieve la importancia en efectuar la evaluación parasitológica de ese público y sus determinantes. De este modo, esta investigación tuvo como objetivo evaluar la prevalencia y los factores asociados a la infección por Giardia duodenalis en niños matriculados entre el 1º y el 3º año de la enseñanza básica en dos unidades de enseñanza en un distrito en el sur de Mato Grosso (Brasil). Métodos: Después del consentimiento de los padres y de los niños, se les entregó el cuestionario socioepidemiológico y el colector universal conteniendo solución conservante para extraer una única muestra fecal, que fue analizada por el técnica de sedimentación espontánea. Resultados: Se incluyeron 60 participantes con media de edad de 7,05 años y predominancia del sexo masculino (53,3%). La prevalencia global de enteroparasitas fue del 36,7%, de los cuales el 54,5% estaban infectados por G. duodenalis. Se encontró una asociación significativa entre la ocurrencia de esta infección y el hecho del niño pertenecer a la familia que declaró no tener ingresos financieros (p = 0,04). Conclusión: La infección por G. duodenalis en niños en edad escolar persiste y estuvo esencialmente asociada a la ausencia de renta financiera familiar. Estos resultados evidencian la necesidad de mejorar las condiciones de vida, de contar con acciones de educación en salud y tratamiento medicamentoso para esa población.(AU)

Recent etiologies of Malabsorption syndrome among adults and features differentiating celiac disease and tropical malabsorption

Introduction: There is a constant change in the order of etiologies causing Malabsorption syndromes in India. Establishing the etiology of this challenging clinical disorder requires judicious use of a wide array of tests. Implementation of preventive health measures and improved sanitation may have changed the etiology of mal absorption syndrome. Aim: This study was aimed to document the recent etiologies of malabsorption syndromes and also to compare the features that differentiate tropical sprue from celiac disease, the recent two most common etiologies of mal absorption seen at our centre. Materials and methods: Patients seen at our centre with malabsorption syndromes from February 2016 to November 2018 were included in this study. The etiological, clinical and investigation details were recorded on uniform structured data forms. The data obtained was statistically analyzed. Results: Out of the 300 patients screened, 200 patients were included in the study; the other 100 patients were not included as they did not fit in to the inclusion criteria for malabsorption syndrome. Of these 200, 22 (11%) patients were in the age group between 13-19 years. Tropical malabsorption (n=82) was the common cause of MAS followed by celiac disease (n=42). 35 of 42 patients (83.3%) with celiac disease, who underwent test for anti-endomysial antibody, had positive result followed by giardiasis and other diseases. Of the remaining seven patients, four had low level of serum IgA, one had anti-tTG antibody and others had anti-gliadin antibody in serum. Two patients with strongyloidosis, Two patients with Chron’s and one patient with IPSID died. Frequency of recurrence Akula Sanjeevaiah, Akula Sushmitha, Thota Srikanth. Recent etiologies of Malabsorption syndrome among adults and features differentiating celiac disease and tropical malabsorption. IAIM, 2019; 6(3): 325-331. Page 326 after successful treatment was comparable among patients with celiac disease and tropical malaabsorption (two patients each) during a follow up period of 13.7 ± 16.1 and 14.7 ± 10.5 months, respectively. Conclusion: In the present study, tropical malabsorption and celiac disease were the most common causes of mal-absorption syndrome followed by giardiasis, AIDS and tuberculosis.

Manifestaciones clínicas bucales detectadas en pacientes con diagnóstico de amebiasis, giardiasis en el Centro de Salud de Yauri. Cusco / Clinical manifestations detectedin patients with diagnosis of amebiasis, giardiasis in the Center of Health of Yauri. Espinar, Cusco

Objetivos: Determinar el tipo de manifestaciones bucales en los pacientes con diagnóstico de Amebiasis y giardiasis. Material y métodos: La presente investigación es de campo de tipo descriptivo, observacional, la técnica utilizada fue observación clínica, y documental. El instrumento utilizado fue una ficha de observación estructurada; para realizar esta investigación se examinaron 90 pacientes de ambos sexos mayores de 16 años que presenten como diagnóstico Amebiasis, Giardiasis el cual fue confirmado utilizando como método de diagnóstico el examen parasitológico. Los pacientes fueron ordenados en dos grupos de trabajo: Grupo A: Constituido por 45 pacientes con diagnóstico de Amebiasis, Grupo B: Constituido por 45 pacientes con diagnóstico de Giardiasis. Resultados: En el Grupo A: 28 pacientes presentaron manifestaciones bucales de esto, el 38% de pacientes presentaron solamente una manifestación bucal siendo estas las Úlceras aftosas 18%; Glositis 11% y Queilitis 9%; el 24% de pacientes presentaron más de una manifestación bucal asociada. En el Grupo B: 24 pacientes presentaron solamente una manifestación bucal, siendo estas las úlceras aftosas 31,1%, queilitis 15,6% y glositis 6,6%,el 13,3% de pacientes presentaron más de una manifestación bucal asociada. La prueba estadística de Chi2 = 0,000, nos dice que hay una diferencia significativa entre la presencia de amebiasis y giardiasis con la presencia de lesiones bucales. (AU)

Objectives: To determine the type of oral manifestations in patients diagnosed with Amebiasis and giardiasis. Material and methods: The present investigation is of field of descriptive, observational type, the used technique was clinical observation, and documentary. The instrument used was a structured observation card; In order to carry out this investigation, 90 patients of both sexes older than 16 years were examined who presented as diagnosis Amebiasis, Giardiasis, which was confirmed using parasitological examination as diagnostic method. The patients were ordered into two working groups: Group A: Consisting of 45 patients diagnosed with Amebiasis, Group B: Consisting of 45 patients diagnosed with Giardiasis. Results: In group A: 28 patients presented oral manifestations of this, 38% of patients presented only one oral manifestation, these being aphthous ulcers 18%; Glositis 11% and Cheilitis 9%; 24% of patients presented more than one associated oral manifestation. In Group B: 24 patients presented only one oral manifestation, these being aphthous Ulcers 31.1%, Queilitis 15.6% and Glositis 6.6%. 13.3% of patients presented more than one associated oral manifestation. The Chi2 statistical test = 0.000, tells us that there is a significant difference between the presence of amebiasis and giardiasis with the presence of oral lesions. (AU)

Hiperplasia linfoide ileo-colónica en pacientes pediátricos / Ileo-colonic lymphoid hyperplasia in pediatric patients

Introducción: La Hiperplasia nodular linfoide gastrointestinal constituye una entidad infrecuente con manifestaciones clínicas diversas y con mayor frecuencia en la edad pediátrica. Objetivo: Caracterizar clínica, endoscópica e histológicamente a los pacientes pediátricos con hiperplasia linfoide de colon e íleon terminal diagnosticados en el Instituto de Gastroenterología. Material y Métodos: Se realizó un estudio descriptivo, transversal, en el periodo comprendido entre 2014 y 2016 en el Instituto de Gastroenterología. La muestra estuvo constituida por 50 pacientes, quienes cumplieron los criterios de inclusión y exclusión. Se evaluaron variables demográficas, clínicas, endoscópicas e histológicas, así como el comportamiento de la comorbilidad con enfermedades malignas, enfermedades inflamatorias intestinales, giardiosis, trastornos de la respuesta inmunohumoral y alergias alimentarias. Resultados: El sexo masculino, entre 7-10 años y el color de la piel blanca fueron los más frecuentes. El sangrado rectal fue el síntoma principal (62 por ciento) y la localización a nivel del íleon terminal en 69 por ciento, no se relacionó con enfermedad maligna, hubo tres pacientes con diagnóstico de hiperplasia linfoide de íleon terminal y colitis ulcerosa. El 74 por ciento presentó aspecto nodular por histología y 60 por ciento se le diagnosticó Giardia lamblia, en la evaluación inmunohumoral predominó los pacientes sin inmunocompromiso (78 por ciento), el Prick Test fue positivo en 60 por ciento, sobre todo, a la leche de vaca. Conclusiones: La manifestación clínica que predominó fue el sangrado rectal, endoscópicamente la localización en íleon y la forma nodular por histología. No encontramos comorbilidades con enfermedades malignas y fueron más frecuentes los trastornos alérgicos y parasitarios que las alteraciones inmunológicas(AU)

Introduction: Lymphoid nodular hyperplasia of the gastrointestinal tract is an uncommon entity with diverse clinical manifestations, which is more frequent in the pediatric age. Objective: To characterize clinically, endoscopically, and histologically, those pediatric patients with lymphoid hyperplasia of the colon and terminal ileum diagnosed in the Institute of Gastroenterology. Material and Methods: A descriptive, cross-sectional study was carried out during the period between 2014 and 2016 in the Institute of Gastroenterology. The sample consisted of 50 patients who met the inclusion and exclusion criteria. Demographic, clinical, endoscopic and histological variables were evaluated, as well as the behavior of comorbidity with malignant diseases, inflammatory bowel diseases, giardiasis, disorders of the humoral immune response and food allergies. Results: The male sex, the age group between 7-10 years, and the white skin color were the most frequent. Rectal bleeding was the main symptom (62 percent), and the location of the lesions in the terminal ileum was observed in 69 percent of the patients. There was no relationship between lymphoid hyperplasia and malignant disease, but three patients were diagnosed with lymphoid hyperplasia of the terminal ileum, and ulcerative colitis. 74 percent of the biopsies presented a nodular variety, and 60 percent of the patients were diagnosed with Giardia lamblia; the cases that were not immunocompromised prevailed in the evaluation of humoral immune response (78 percent); the Prick Test was positive in 60 percent of children, especially to cow's milk. Conclusions: The predominant clinical manifestation was rectal bleeding; the localization was in the ileum, which was seen by endoscopic procedure; and the nodular form was demonstrated by histology. We did not find comorbidities with malignant diseases, and allergic and parasitic disorders were more frequently diagnosed than immunological alterations(AU)

D-dimer levels as a procoagulative marker in association with disease progress during giardiasis in dogs / D dímero como marcador procoagulante en asociación con el progreso de la enfermedad durante la giardiasis en perros

Abstract Objective. The present study was conducted to measure D-dimer concentrations and assess their value in disease activity in dogs with giardiasis. Furthermore another purpose was to analyze correlation between cyst excretion and D-dimer levels to those of dogs naturally infected with Giardia sp. Materials and methods. D-dimer analysis were performed in three groups of dogs; (i) 15 dogs with giardiasis to those of treated with secnidazol, (ii) 10 dogs with giardiasis, left untreated as control group, then were compared to those of (iii) 17dogs without giardiasis, used to detect reference ranges for D-dimer values as control group. was a correlation between D-dimer levels and logarythmic cyst counts. Results. The D-dimer range in healthy dogs was <0.1 mg/L. In dogs with giardiasis, the D-dimer concentrations were greater than those of healthy dogs (p<0.05) and (p<0.01), respectively. The mean initial plasma D-dimer level was 2.84±0.50 and 2.99±0.61 ng/L in treated and untreated control groups. At the final follow-up evaluation on day 10 was 0.27±0.50 and 2.14±0.61 ng/L, in treated and untreated control groups, respectively, which was significantly lower in treated group (p<0.001). The area under curve (AUC) of the receiver operating characteristics for d-dimer was 0.922 (z-value = 12.977, p<0.0001). (95%CI: 0.780-0.885). At a cut-off value of 0.1 ng/L, the D-dimer measurement had a sensitivity of 87.2%, a specificity of 90.9%. Conclusions. As a result D-dimer concentrations measured in giardiasis support the probable link between probable pro-thrombotic and inflammatory condition.

Resumen Objetivo. El presente estudio se realizó para medir las concentraciones del dímero D y detectar su valor en la actividad de la enfermedad en perros con giardiasis. Además, otro objetivo fue analizar la correlación entre la excreción de quistes y los niveles de D-dímero a los de perros naturalmente infectados con Giardia sp. Materiales y métodos. El análisis del dímero D se realizó en tres grupos de perros; (I) 11 perros con giardiasis tratados con secnidazol, (ii) 10 perros con giardiasis, no tratados como grupo control, luego se compararon con los de (iii) 17 perros sin giardiasis, utilizados para detectar rangos de referencia para el dímero D Valores como grupo de control. Resultados. El rango del D-dímero en perros sanos fue <0.1 mg/L. En perros con giardiasis, las concentraciones de dímero D fueron mayores que las de perros sanos (p<0.05) y (p<0.01), respectivamente. El nivel medio inicial de dímero D plasmático fue 2.84±0.50 y 2.99±0.61 ng/L en los grupos de control tratados y no tratados. En la evaluación final de seguimiento al día 10 se obtuvieron 0.27±0.50 y 2.14±0.61 ng/L, tratados y no tratados, respectivamente, que fue significativamente menor en el grupo tratado (p<0.001). El área bajo curva (AUC) de las características de funcionamiento del receptor para el dímero d fue 0.922 (valor z = 12.977, p<0.0001). (IC del 95%: 0.780-0.885). Con un valor de corte de 0.1 ng/l, la medida del dímero-D tenía una sensibilidad de 87.2%, una especificidad de 90,9%. Hubo una correlación entre los niveles de D-dímero y los recuentos de quistes logarítmicos. Conclusiones. Como resultado, las concentraciones del dímero D medidos en la giardiasis apoyan el probable vínculo entre la probable condición pro-trombótica e inflamatoria.

Efectividad del Oleozón® en el tratamiento de niños y adolescentes con giardiasis / Effectiveness of Oleozón® in the treatment of children and adolescents with giardiasis

Se realizó un ensayo clínico en fase IV para evaluar la efectividad del Oleozón® aplicado por vía oral en niños y adolescentes con giardiasis, atendidos en la interconsulta de Pediatría del Policlínico Universitario Julián Grimau García de Santiago de Cuba, desde enero hasta diciembre del 2015. El universo estuvo constituido por 116 pacientes (con igual número de casos y controles) en las edades de 1 a 18 años, infectados por Giardia lamblia, quienes presentaban dolor abdominal, vómito y anorexia como síntomas fundamentales. En la serie se obtuvo que el mayor número de los pacientes del grupo experimental, cuyo esquema terapéutico incluía el Oleozón®, resolvió el dolor abdominal y mejoró su estado general al disminuir el resto de los síntomas. Pudo concluirse que el Oleozón® resultó efectivo en el tratamiento contra la giardiasis, pues las muestras de heces fecales dieron negativo en todos los casos; además, no se produjeron reacciones adversas y su costo es bajo, lo que conlleva un impacto económico, social y medioambiental

A clinical assay in phase IV was carried out to evaluate the effectiveness of oral Oleozón® used in children and adolescents with giardiasis, assisted in the Pediatrics specialty consultation from Julián Grimau García University Polyclinic in Santiago de Cuba, from January to December, 2015. The universe was constituted by 116 patients (with the same number of cases and controls) and aged 1 to 18 years, infected by Giardia lamblia who presented abdominal pain, vomit and anorexy as fundamental symptoms. In the series it was obtained that the highest number in the patients of the experimental group whose therapeutic schedule included Oleozón® , solved the abdominal pain and it improved their general state when decreasing the rest of the symptoms. It could be concluded that the Oleozón® was effective in the treatment against giardiasis, because the samples of faeces were negative in all cases; besides, it produced no adverse reactions and its cost is low, what bears an economic, social and environmental impact

Saúde itinerante nos centros municipais de educação infantil do município de Guarapuava - PR; os desafios da promoção da saúde em crianças expostas a doenças parasitárias / Travelling health in the municipal kindergartens in the city of Guarapuava - PR; the challenges of health promotion in children exposed to parasitic diseases

A presença de enteroparasitoses em crianças em idade pré-escolar tem sido motivo de preocupação pelos órgãos de saúde principalmente devido ao impacto negativo sobre o crescimento e desenvolvimento intelectual dessas crianças. As infecções por parasitas intestinais podem levar a quadros de desnutrição e formas de gastroenterite crônica. O presente trabalho analisou crianças em idade pré-escolar frequentadoras de 11 unidades CMEIs (Centros Municipais de Educação Infantil) na cidade de Guarapuava-PR em 11 unidades. Foram estudadas 287 crianças e o índice de positividade para enteroparasitoses foi de 13,9%. A idade média das 287 crianças foi de 2,7 anos e a maioria das crianças analisadas foram domicialiadas em zona urbana 84,3% e somente 15,7% em zona rural, com média de filhos por família de 2,08 membros. A prevalência das parasitoses mostrou que G. duodenalis foi o protozoário mais isolado com 70,4%, seguido de Ascaris lumbricoides 6,8% o único helminto encontrado. Com relação à terapêutica empregada 20% das crianças tratadas com o fármaco albendazol continuaram apresentando exames positivos para os mesmos parasitas. Já com o fármaco benzoilmetronidazol todas as crianças apresentaram resultados negativos para presença de parasitas nas fezes. Os fatores de risco para enteroparasitoses indicaram que a presença da variável água tratada foi menor nos casos positivos. Nossos resultados mostraram que G. duodenalis foi o parasita mais isolado em crianças em idade pré-escolar.

The presence of enteroparasitoses in pre-school children has been a concern of health agencies mainly due to the negative impact on the growth and intellectual development of those children. Intestinal parasite infections can lead to malnutrition and chronic forms of gastroenteritis. The present study analyzed pre-school children attending 11 CMEIs (Municipal Kindergarten Schools) in the city of Guarapuava ­ PR. A total of 287 children were studied, resulting in a positive index for enteroparasitoses of 13.9%. The mean age of the 287 children was 2.7 years and most of the children analyzed were domiciled in urban areas (84.3%), with only 15.7% living in rural areas, with a mean number of children per family of 2.08. The parasite prevalence showed that G. duodenalis was the most frequently isolated protozoan, with 70.4%; followed by Ascaris lumbricoides with 6.8%, the only helminth found. Regarding therapy, 20% of the children treated with albendazole continued to present positive tests for the same parasites. When treated with benzoylmetronidazole, all children presented negative results for the presence of parasites in the faeces. The risk factors for enteroparasitoses showed that the variable treated water was lower in the positive cases. The results of this study showed that G. duodenalis was the most frequently parasite isolated in pre-school children.

Vigilancia tecnológica e inteligencia competitiva de un desarrollo tecnológico para la detección de Giardia, una innovación en salud / Technological surveillance and competitive intelligence for a new technique to detect Giardia: an innovation in health / Vigilância tecnológica e inteligência competitiva de um avanço tecnológico para detecção de Giardia, uma inovação em saúde

RESUMEN La giardiasis es una enfermedad causada por Giardia duodenalis, protozoario enteropatógeno que también es responsable de la enfermedad diarreica aguda y la gastroenteritis en humanos. Dadas las características de excreción intermitente propias de este parásito, la probabilidad de obtener resultados falsos negativos durante el proceso de diagnóstico es alta. En el Grupo de Parasitología del Instituto Nacional de Salud de Colombia se identificaron proteínas inmunogénicas presentes en quistes y trofozoítos del parásito en aislamientos colombianos de Giardia con potencial comercial y posibilidad de ser patentadas. Se realizó un estudio exploratorio descriptivo a partir de las características de la técnica en estudio, su estado de desarrollo y la viabilidad comercial de la invención. Se encontraron 390 patentes y se seleccionaron cinco invenciones similares que no representaban ningún riesgo frente a una eventual solicitud de patente. De los 36 estuches para el diagnóstico de Giardia disponibles en el mercado y las 21 licencias sanitarias otorgadas hasta diciembre del 2017, sólo cuatro y tres, respectivamente, proponen técnicas similares a la de la estudiada, pero ninguna de ellas cuenta con un registro de patente relacionado. La técnica en desarrollo es innovadora y puede aplicarse en el campo de la salud pública en la Región de las Américas con beneficios previsibles.

ABSTRACT Giardiasis is a disease caused by Giardia duodenalis, an intestinal protozoan that causes acute diarrhea and gastroenteritis in humans. Given the characteristic intermittent excretion of this parasite, there is a high probability of false negative results during diagnosis. The Parasitology Group of Colombia's National Institute of Health identified immunizing proteins present in the parasite's cysts and trophozoites in Colombian Giardia isolates with commercial and patentability potential. A descriptive exploratory study was conducted that focused on characteristics of the technique under study, its state of development, and the commercial viability of the invention. A total of 390 patents were found and five similar inventions were selected that did not pose any risk regarding an eventual patent application. Of the 36 Giardia diagnostic kits available on the market and the 21 health licenses granted as of December 2017, only four and three, respectively, offer techniques similar to the technique studied, but none of them has a related patent on record. The technique under development is innovative and can be applied in the field of public health in the Region of the Americas with foreseeable benefits.

RESUMO A giardíase é uma doença causada pela Giardia duodenais, protozoário enteropatogênico causador de doença diarreica aguda e gastroenterite em seres humanos. Como uma das características deste parasita é a excreção intermitente, a probabilidade de se obter resultados falso-negativos no processo diagnóstico é alta. O Grupo de Parasitologia do Instituto Nacional de Saúde da Colômbia identificou proteínas imunogênicas presentes em cistos e trofozoítos do parasita em isolados colombianos de Giardia com potencial comercial e possibilidade de patenteamento. Foi realizado um estudo exploratório descritivo das características da técnica em estudo, situação de desenvolvimento e viabilidade comercial da invenção. Foram encontradas 390 patentes e selecionadas cinco invenções similares sem risco de eventual pedido de patente. Dos 36 kits de diagnóstico de Giardia comercializados e 21 licenças sanitárias concedidas até dezembro de 2017, apenas quatro kits e três licenças de produtos empregam técnicas semelhantes à estudada, mas nenhum deles tem um registro de patente relacionado. A técnica em desenvolvimento é inovadora e pode ser empregada em saúde pública na Região das Américas com benefícios esperados.