Conocimientos y prácticas asociadas a transmisión de triquinelosis, hanta y equinococosis quística / Knowledge and practices associated with transmission of trichinellosis, hanta and cystic equinococcosis

RESUMEN Objetivo: Asociar el nivel de conocimiento y prácticas (hábitos y costumbres) responsables de la transmisión de Triquinelosis, Síndrome Cardiopulmonar por Hantavirus y Equinococosis quística (Hidatidosis), en habitantes de los sectores rurales. Material y método: Estudio descriptivo correlacional de corte transversal en el que se aplicó una encuesta a 149 habitantes residentes en el área rural de las localidades de Curacautín, Lonquimay y Melipeuco, a través de muestreo no probabilístico por conveniencia, durante los meses de diciembre 2013 a enero 2014. Resultados: La población posee mejores conocimientos de Triquinelosis y Hanta que Hidatidosis, 64,9, 72,8 y 39,3%, respectivamente; los hábitos y costumbres para Hanta e Hidatidosis alcanzan mejores prácticas (84% cada una) que para Triquinelosis (69,5%); la población reconoce correctamente reservorio, fuente de infección y mecanismos de transmisión en Triquinelosis y Hanta, pero en menor grado Hidatidosis; respecto de los hábitos y costumbres, aun desconociendo los fundamentos teóricos, reportan buenas prácticas, aunque mantienen algunas que favorecen la transmisión de infecciones predominantemente en Triquinelosis. Conclusión: El nivel de conocimiento no asegura buenas prácticas, además los conocimientos y prácticas siguen un patrón empírico más que cognitivo, respaldados por aspectos culturales y del entorno. Esto sugiere mayor participación de los equipos interdisciplinarios en comunidades aisladas para fortalecer la promoción, educación y refuerzo de las buenas prácticas de acuerdo con sus condiciones sociales e incentivar la adherencia a conductas que reduzcan el riesgo de la transmisión de zoonosis.

ABSTRACT Objective: To associate the level of knowledge and practices (habits and customs) responsible for the transmission of trichinellosis, Hanta and cystic echinococcosis (hydatidosis), among rural population. Material and method: Cross-sectional correlational descriptive study in which 149 residents of the rural areas of Curacautín, Lonquimay and Melipeuco were surveyed, using non-probability convenience sampling from December 2013 to January 2014. Results: The population has better knowledge of trichinellosis and Hanta than hydatidosis, 64.9%, 72.8 and 39.3% respectively; they also have better practices regarding Hanta and hydatidosis (84% each) than regarding trichinellosis (69.5%). The population recognizes correctly the reservoir, source of infection and transmission mechanisms of trichinellosis and Hanta, and to a lesser degree hydatidosis; they report good practices regarding habits and customs, even ignoring theoretical foundations, but maintain some practices that favor the transmission of infections related to trichinellosis. Conclusion: The level of knowledge does not ensure good practices. Additionally, knowledge and practices follow an empirical rather than cognitive pattern, rooted on cultural and environmental aspects. This suggests greater participation of interdisciplinary teams in isolated communities to strengthen the promotion, education and reinforcement of good practices in accordance with their social conditions and to encourage adherence to behaviors that reduce the risk of the transmission of zoonoses.

Conocimientos y prácticas sobre hidatidosis y triquinosis en usuarios y acompañantes del Hospital Comunitario de Salud Familiar El Carmen, Región del Biobío, Chile / Knowledge and practices regarding cystic echinococcosis and trichinellosis in users and companions of users of the Hospital Comunitario de Salud Familiar El Carmen, Biobio Region, Chile

We surveyed users of the Hospital Comunitario de Salud Familiar El Carmen and their companions to analyze knowledge and practices regarding cystic echinococcosis and trichinellosis. Most people recognized risky practices. Previous attendance at talks and working in agricultural-livestock enhanced the knowledge. Age, sex and formal education were not associated with the knowledge. Knowledge was not associated with practices.

Introducción: La comuna de El Carmen, Región del Biobío, presenta factores de riesgo para la hidatidosis y la triquinosis, como un alto índice de pobreza, actividad principalmente agropecuaria y carencia de plantas faenadoras de animales. Método: Se analizó, a través de una encuesta a los usuarios y acompañantes del hospital de El Carmen, el conocimiento y las prácticas relacionadas con esas enfermedades. Resultados: La mayoría de los encuestados reconoció conductas de riesgo. La asistencia previa a charlas y el trabajo en actividades agropecuarias se asoció a mayor conocimiento de la hidatidosis y triquinosis, respectivamente. No hubo asociación entre edad, género o nivel educacional con el conocimiento de las enfermedades. Tampoco hubo asociación entre el conocimiento y las prácticas. Conclusiones: Los resultados sugieren la necesidad de mejoras educacionales, así como también intervenciones públicas, especialmente en sectores más lejanos.

Critical analysis of cystic echinococcosis control programs and praziquantel use in South America, 1974-2010 / Análisis crítico de los programas de control de la equinococosis quística y uso del prazicuantel en América del Sur, 1974-2010

Cystic echinococcosis (CE) is one of the most prevalent zoonoses in Argentina, Brazil, Chile, Peru, and Uruguay. Control programs in South America were originally modeled after programs developed in insular territories, such as Tasmania and New Zealand. The advent and proven effectiveness of praziquantel, plus the experience of insular models, produced high expectations for rapid advances; however, after 30 years of praziquantel use, no endemic area in South America has obtained eradication. In fact, only modest gains in CE control have been made and impact on prevalence among humans has been slight. A major impediment has been the infrastructure needed to administer praziquantel to dogs in rural areas 8 times per year over numerous years, a requirement for rapid attack stage 1. Such an infrastructure has not been financially or politically sustainable in endemic areas, which tend to be the poorest. On the other hand, certain areas in Argentina have had success with simple and economically viable alternatives. Based primarily on continuous field work supported by the local community, these strategies have significantly decreased transmission to humans, the health sector's main objective. In addition, new possibilities and tools, such as the EG95 vaccine, are being evaluated; as are early detection and treatment of asymptomatic carriers.

La equinococosis quística (EQ) es una de las zoonosis más prevalentes en Argentina, Brasil, Chile, Perú y Uruguay. Los programas de control en América del Sur fueron originalmente hechos a imitación de los programas desarrollados en territorios insulares, como Tasmania y Nueva Zelandia. El advenimiento y la eficacia comprobada del prazicuantel, sumados a la experiencia de los modelos insulares, dieron lugar a altas expectativas de adelantos rápidos; sin embargo, después de 30 años de uso del prazicuantel, ninguna zona endémica en América del Sur ha logrado la erradicación de la enfermedad. De hecho, solo se han obtenido avances moderados en el control de la EQ, y su repercusión sobre la prevalencia en seres humanos ha sido leve. Un impedimento mayor ha sido la infraestructura necesaria para administrar el prazicuantel a los perros en zonas rurales 8 veces por año durante varios años, un requisito para el estadio 1 de ataque rápido. Tal infraestructura no ha sido sostenible desde el punto de vista económico o político en las zonas endémicas, que tienden a ser las más pobres. Por otro lado, ciertas áreas de la Argentina han tenido éxito con opciones sencillas y económicamente viables. Basadas principalmente en el trabajo continuo en el terreno apoyado por la comunidad local, estas estrategias han reducido significativamente la transmisión a los seres humanos, que es el objetivo principal del sector de la salud. Además, se están evaluando nuevas posibilidades y herramientas, como la vacuna EG95, al igual que la detección temprana y el tratamiento de los portadores asintomáticos.

Hidatidosis poliquística autóctona en dos pacientes Yanomami en el Alto Orinoco, Amazonas, Venezuela / Polycystic hydatid disease in two patients indigenous Yanomami in the Upper Orinoco, Amazonas, Venezuela

La infección por Echinococcus sp. es hipoendémica en Venezuela. Sólo cuatro casos de hidatidosis autóctona por E. vogeli han sido reportados, tres de ellos en la región de la Guayana venezolana. En Febrero del año 2009 se realizó el diagnóstico clínico-sero-epidemiológico de hidatidosis poliquística en una paciente femenina de la etnia Yanomami, procedente de Parima B, Alto Orinoco, en la Amazonía venezolana. Se resolvió con tratamiento médico y quirúrgico por laparoscopia y se evidenció en el quiste la presencia de ganchos rostelares compatibles con E. vogeli. En Abril del 2009 en una segunda paciente Yanomami de igual procedencia, se le diagnosticó hidatidosis por E. vogeli siendo operada exitosamente por cirugía laparoscópica asistida por robot. Dos casos humanos en una misma población y la presencia de factores de riesgo como la tenencia de perros domésticos y la comunicación por informantes indígenas del hallazgo de quistes en hígados de animales de cacería (Cuniculus paca o lapa y Dasyprocta sp. o picure), hacen pensar en transmisión activa en la cuenca del Alto Orinoco y en zonas selváticas de la Guayana venezolana. El presente, es el primer registro de casos de hidatidosis poliquística en indígenas de la etnia Yanomami.

Infection by Echinococcus sp. is hypoendemic in Venezuela. Only four cases of autochthonous E. vogeli hydatidosis have been reported, including three in the Venezuelan region of Guayana. In February 2009, based on epidemiological data, signs and symptoms and serological tests, a female patient of the Yanomami ethnic group, was diagnosed with a polycystic hydatid disease in Parima B, Alto Orinoco, in the Venezuelan Amazon. Rostellar hooks compatible with E. vogeli were found in the cyst. It was resolved with medical and surgical treatment by laparoscopy. A second Yanomami patient from the same location was diagnosed with E. vogeli hydatidosis in April 2009, being successfully operated with robot-assisted laparoscopy. Two human cases in the same population and the presence of risk factors such as domestic dog ownership and findings of cysts in livers of hunted animals (such as Cuniculus and Dasyprocta sp.) reported by indigenous informants, suggest active transmission in the Upper Orinoco basin and forested areas of the Venezuelan Guayana. These are the first reported cases of polycystic hydatid disease of the Yanomami ethnic group.

[Fauna of zoontic parasites of stray dogs in Yasouj suburbs in 2008]

Dogs are among the closest animals to human residents and can by useful for human. A few of zoontic diseases are prevalent in Iran. Dogs are the reservoirs of many of these zoonosis and a major role in transmission of infection. The aim of this study was to determine the zoonotic parasitic fauna of stray dogs in Yasuj. In this descriptive study which was conducted at Yasuj suburbs in 2008, 25 dogs' corpses were necropsied and their tissues were studied for parasitic infections. Collected parasites were placed in special containers and stained for genus and species diagnosis based on their morphological features. The collected data were analyzed with the SPSS software, using descriptive analysis. Of the 25 studied corpses, 23 dogs were infected with at least one parasite. Helminthic infections of dogs were consisted of: Taenia hydatigena, Mesocestoides sp., Echinococcus granulosus, Dipylidium caninum, Macracanthorhynchus hirudinaceus and Spirocerca lupi. Four of six detected helminthes in in dogs in this study are zoonotic parasites which are important in human diseases. Among them larval stage of Echinococcus granulosus which causes hydatid cyst disease in human is very important. Control programs should be implemented in this region to prevent these zoonotic diseases

Hydatid disease in Yemeni patients attending public and private hospitals in Sana'a City, Yemen

Hydatid disease is endemic and represents a major health problem in Yemen. The aim of this study is to determine the magnitude of the problem of hydatidosis in patients attending Public and Private Hospitals at Sana'a city, Yemen. 66 patients with hydatid disease were identified during the period from August 2006 to February 2007. Complete medical history for all CE patients were collected and analyzed. Among the 66 CE patients, 67% were females and 33% males. Liver was the most common involved organ. Single cyst was more frequently detected than multiple cysts and approximately 94% of the cysts were >/= 5 cm. Moreover, Public hospitals were the main source of patients with CE disease. Hydatidosis is still an endemic disease and an important health problem in Yemen which needs to be studied further. Therefore, accurate information on the distribution of the disease is the first step for the control and prevention of the disease. Moreover, it is crucial to investigate the role of different intermediate hosts and genotypes of E. granulosus in humans and animals

Hydatid cyst of the left thigh

A 25-year old female patient from Gurage zone rural area; a shepherd by occupation presented with a with a cystic swelling of the left thigh which had been gradually increasing in size and became painful. She reported having been taking unboiled pond water from the pond the sheep and other domestic animals used to drink from. She was apparently in a good state of health until 2 years previously when she started to notice swelling of the left upper thigh which gradually increased in size and became painful. For which presented to our center

Cystic echinococcosis in southern Brazil / Equinococose cística no sul do Brasil

Cystic echinococcosis (CE) is very common in the southern part of Rio Grande do Sul State where sheep and cattle raising is the most important economical activity. Prevalence in intermediate hosts is well known due to reports in slaughterhouses while human reports are of discussed value. This is due to underreporting of cases and few epidemiological studies make it difficult to assess the situation of echinococcosis in the population. Whereas cattle infection rate is more or less stable around 12 percent of the slaughter animals, in sheep there has been an increasing number in the last five years. Some efforts have been done to control the zoonosis but no effective results were obtained so far. Probably educational efforts to change human practices (feeding dogs with raw viscera), periodic treatment of dogs with praziquantel and joined actions with slaughterhouses could bring more attention to improve some control measures.

A equinococose cística (CE) é muito comum na região sul do estado do Rio Grande do Sul, onde a criação de bovinos e ovinos representa a maior atividade econômica. A prevalência nos hospedeiros intermediários é bem conhecida devido aos registros em frigoríficos enquanto que os casos humanos apresentam dados discutíveis e de difícil interpretação. Isto é devido a subnotificação e os poucos estudos epidemiológicos tornam difícil a avaliação da equinococose na população. Enquanto que a prevalência em bovinos estabilizou ao redor de 12 por cento de animais abatidos na última década, em ovelhas está ocorrendo um aumento nos últimos cinco anos. Algumas tentativas estão sendo feitas para controlar esta zoonose mas não tem sido obtidos resultados práticos até agora. Provavelmente ações educativas que alterem comportamentos humanos (alimentação de cães com vísceras cruas), tratamento periódico dos cães com praziquantel e ações junto a frigoríficos poderiam resultar em incremento nas medidas de controle devido às perdas econômicas mensuráveis.

Human hydatidosis granulosus in greater Cairo, Egypt: with general review

In this study, human cases [41] of proved hydatidosis granulosus were obtained from Al Kasr Al Aini University Hospitals from 2000-2006. They were 22 females with ages from 8 to 70 years and 19 males with ages from 5 to 75 years. The highly infected organ was the liver. Infection in other organs as lung, spleen, brain, eye, pelvic and bones of upper and lower limbs were reported. Most of the hydatidosis patients were from governorates of Giza [24 cases], Qalyobia [7 cases], Cairo [5 cases], Bani-Swef [3 cases], Sharkia [1 case] and Demiatta [1 case]. Biopsies of infected liver and lung were processed for the histopathological studies and photographed. The results were discussed on the light of work done before Egypt

Control program of hydatid disease in the province of Río Negro Argentina 1980-1997

La hidatidosis constituye un serio problema de Salud Pública en la Provincia de Río Negro, Argentina. Los factores que han motivado esta situación incluyen una economía rural basada en la ganadería ovina extensiva, bajas condiciones socioculturales en una porción importante de la población rural, hábitos de faenamiento domiciliario de ovinos adultos para consumo humano con entrega de las vísceras resultantes del acto para consumo de los perros e infraestructura de faena en pequeñas comunidades rurales altamente deficiente. Esta situación ha promovido la instrumentación de un programa de control basado en la desparasitación canina sistemática con praziquantel, la vigilancia con arecolina, la educación sanitaria, el control de faena, la legislación y la atención de las personas. El programa, puesto en marcha en 1980, cubrió inicialmente con acciones sistemáticas 51.479 km², alcanzándose en 1992 120.013 Km² bajo control

Hidatidosis del omóplato con localización extraósea / Scapular hydatidosis with extraosseous involvement

A forty three-year-old female, born in a rural area of southern Chile, at the age of 30 presented pain and limitation of motility of the righ shoulder. Later on, she presented an increasing of volume at the right scapular region. A radiography showed an osteolytic lesion of the scapula. In a biopsy an osseous hydatidosis was found and a hydatid cyst was extirpated from the soft tissues. Four years later, as she presented again pain and volume increasing in the same anatomical area, albendazole was given to her, and a CAT practiced revealed osteolytic lesions of the bone, several periosteal ruptures and multiple cyst in the muscles. She was submitted so surgery again in order to extirpate cyst. After two years the patient presented the same clinical manifestations and radiological and CAT images previously observed. In considering all these facts a radical surgery was decided

Hidatidosis/equinococosis en el área de General Acha, provincia de La Pampa de Argentina / Hydatidosis/echinococosis in General Acha area, La Pampa province, Argentina

Hydatidosis situation in the General Acha area (La Pampa province) is described herein. The work comprises a retrospective compilacion of new hydatidosis in human population, and investigation on dog echinococosis granulosus infection prevalence carried out on the basis of arecoline bromhydrate application. Sicteen human cases were detected during 1994 (incidence rate: 26,7/100,000) founding a serological prevalence of 1,3 percent. Studies on dog echinococosis have shown a prevalence rate of 2,3 percent. The epidemiological situation of hydatidosis is analyzed by comparison with values from other endemic areas. These results suggest the necessity of completing surveys in the whole provincial territory, and the implementation of educational and sanitary measures aimed to controlling this zoonosis.

Prevalence of Human Hydatid Disease in Southern Sudan

A total of 3443 people were screened by ultrasound to determine the prevalence of hydatid disease in southern Sudan. Hydatid cysts were found in 16 (0.5) of the people screened. Thirteen of the 16 hydatid cases were from among the Bouya people who showed an overall hydatid prevalence of 2by ultrasound. All ultra-sound positive cases were further confirmed by dot-blot ELISA. At the time of the survey; Chukudum Hospital had five cases with histories and clinical manifestations consistent with hydatidosis. However; on scan examination only three of them were confirmed to be cases of hydatid disease. The proportion of hydatid infected women in south-western Sudan was almost twice that of men (M:F ratio of 1:1.7); with most of those infected being women in the child-bearing age bracket. Dogs are common in this area and they could be the main reservoirs of Echinococcus granulosus in the Sudan. Due to the low prevalence of hydatid in humans in the study area; and the dispersed nature of the population; it is recommended that hydatid control measures for south-western Sudan include an educational component coupled with treatment of the infected people

Participacion comunitaria y tecnologia apropiada en el diagnostico precoz de la hidatidosis humana / Community participation and appropiate technology in the precocious diagnostic of human hydatidosis

La estrategia basica para el desarrollo de programas de lucha contra la hidatidosis es en la actualidad la de atencion primaria de la salud. En el presente trabajo, y en ese marco, se instrumenta un sistema de deteccion precoz de la hidatidosis basado en el diagnostico inmunologico mediante la tecnica de Elisa, a partir de muestras de sangre capilar tomadas en papel de filtro por maestras y agentes sanitarios de los servicios oficiales de la provincia de Rio Negro. Fueron entrenadas 177 maestras y 45 agentes sanitarios correspondientes a 25 escuelas, 3 albergues y 9 hospitales, todos del medio rural....

Vigilancia epidemiológica de la hidatidosis en la región patagónica, Argentina 1983-1988 / Epidemiological surveillance of hydatidosis in the Patagonian region, Argentina 1983-1988

Se presentan los resultados de los programas de control de la hidatidosis efectuados en las cinco jurisdicciones de la Región Patagónica Argentina. Se desglosan las tasas de infección humana (95 x 100.000 en 1983 y 15 x 100.000 en 1988) y ovina (16,6% en 1983 y 2,6% en 1988). Se analizan los factores condicionantes de la endemia en la región