RESUMO
Water samples were collected from five sources related to five residential areas where human populations use them in their daily life and for drinking in El-Ekhewa village. The first and the second were slow running surface water, the third was underground water at shallow depth [5.6 +/- 18 meters], the fourth was chlorinated piped water and the fifth was underground water at depth> [21 +/- 1] meters. The samples were filtered, diluted then concentrated. The thick walled oocysts of Cryptosporidium were identified and counted after specific monoclonal immunofluorescent staining. The density of water contamination by thick walled oocysts per litre was high in surface water of the first [465] and the second [398] sources: Both are frequently in contact with domestic and wild animals. Lesser degrees, although still infective were encountered in underground water at shallow depth [132] and in the piped chlorinated water [85]. Meanwhile, no oocysts were detected in the underground water at depth>20 meters. These findings may indicate that the oocyts are chlorine resistant and the main method for their elimination is effective filteration. Stool from 120 patients with diarrhea and 100 without diarrhea [1-20 ys] from these 5 areas were examined by acid fast trichrome stain of saline Hemo De concentrate to detect intestinal parasites including coccidia and microsporida Bacterial pathogens were sought by standard bacteriologic techniques. Only those with Cryptosporidium as single pathogen were considered. 10.4% of the symptomatic were shedding oocysts in their stools.The correlation between the density of water contamination and the prevalence of cryptosporidiosis among individuals of each area was so significant that it can be concluded that the disease in the present community is water borne. Most of symptomatic cases were encountered at mean age [10.6/-4.2] while the asymptomatic cases were mostly detected at mean age [15 7 +/- 4.4] indicating age related tolerance towards this organism
Assuntos
Poluição da Água , Microbiologia da Água , Diarreia , FezesRESUMO
With the fact that oxyuriasis is frequent in early childhood and that renal scarring due to urinary tract infection almost always occurs before puberty, this study investigated 451 female children [4-9 years] with urinary tract infection to assess the role of oxyuriasis in inducing and maintaining UTI among them. Oxyuris infection was detected among 242 girls by perianal adhesive tape technique. Specific antioxyuris and antimicrobial therapy was applied empirically as a first line treatment, however 42 girls [9.3%] showed recurrence of UTI, 21 of them were oxyuris re-infected. The recurrence of UTI was represented by 18 relapses detected within 7 days and 24 reinfections detected after two weeks post treatment. After culture isolation and sensitivity testing, second line specific antimicrobial therapy was applied togehter with antioxyuris therapy. After second line therapy, oxyuris infection was detected in 15 cases out of 19 reinfections [78.9%] and in 4 out of 13 relapses [30.7%], these 32 girls were subjected to intravenous urography [IVU] to detect renal scarring or anatomical abnormalities of the urinary tract, voiding cystourethrogram [VCUG] to detect vesicoureteral reflux [VUR] and to serum IgA assay. The study emphasized the significant role of vesicoureteral reflux in developing renal scarring. However the striking finding was that persistent oxyuriasis among IgA deficient girls in the absence of reflux was as significant as the reflux in developing UTI attributed renal scarring. So the study considered these young girls with combined persistent oxyuriasis and IgA deficiency being under high risk of developing UTI, renal scarring and later in life end stage renal failure. The oxyuris induced perianal pruritis should alert the parents for early detection and treatment of UTI and oxyuriasis especially in view of the high prevalence of asymptomatic IgA deficiency [1:500] together with the nonspecificity of the symptoms of UTI in childhood