[Epidemiology of hemolytic uremic syndrome in two regions of Buenos Aires Province]. / Epidemiología del síndrome urémico hemolítico en dos regiones de la Provincia de Buenos Aires.

The objectives of this study were (a) to describe and estimate the frequency of hemolytic uremic syndrome (HUS) in rural and urban populations in two regions of Buenos Aires Province, and (b) to compare the presentation and distribution of factors hypothetically associated with HUS. A total of 82 HUS cases, recorded during the years 2005-2010 in rural and urban areas of the south-central region of Buenos Aires Province, were clinically and epidemiologically characterized. Statistical data analysis included Chi square or Fisher test and median test. The incidence rate of HUS was significantly higher in the rural population, being 12.7 cases per 100 000 (CI 0-23.5) in rural inhabitants vs. 7.1 cases per 100 000 (CI 0-9.5) in urban inhabitants. The median age of the patients was 27 months (5-139 months), significantly lower in children from the rural area. This could be explained by a more frequent contact with bovine feces, the consumption of raw milk and a higher proportion of relatives who work in risk labors found in the rural population. Although HUS is often associated with the consumption of undercooked minced meat, most of the children cases here included did not present this antecedent. Clinical manifestations were similar in both subpopulations. One-third of urban patients had received antibiotics prior to HUS development.

Epidemiología del síndrome urémico hemolítico en dos regiones de la Provincia de Buenos Aires / Epidemiology of hemolytic uremic syndrome in two regions of Buenos Aires Province

Los objetivos de este estudio fueron describir y comparar la frecuencia del síndrome urémico hemolítico (SUH), registrada durante el periodo 2005-2010 en pobladores rurales y urbanos de la región centro-sur de la provincia de Buenos Aires y caracterizar la distribución de factores hipotéticos asociados al SUH en ambas poblaciones. Se caracterizaron 82 casos de SUH clínica y epidemiológicamente. Para el análisis estadístico de los datos se utilizó el test de Chi² o test exacto de Fisher cuando fue necesario, y el test de la mediana. La incidencia específica fue 12.7 casos cada 100 000 habitantes rurales (IC 0-23.5) y 7.1 casos cada 100 000 habitantes urbanos (IC 0-9.5). La mediana de la edad en el total de los pacientes estudiados fue de 27 meses (5-139 meses), siendo significativamente más baja en los niños del área rural. Estos resultados podrían explicarse por el contacto más frecuente con materia fecal de bovinos, el mayor consumo de leche sin pasteurizar y la mayor proporción de familiares que realizan actividades de riesgo, encontrados en la subpoblación rural. Aunque el SUH es una enfermedad que se asocia frecuentemente con el consumo de carne picada, la mayor parte de los niños que enfermaron no presentaron este antecedente. Las manifestaciones clínicas fueron semejantes en ambas subpoblaciones. Un tercio de los pacientes urbanos había recibido tratamiento con antibióticos previo al desarrollo del SUH.

The objectives of this study were (a) to describe and estimate the frequency of hemolytic uremic syndrome (HUS) in rural and urban populations in two regions of Buenos Aires Province, and (b) to compare the presentation and distribution of factors hypothetically associated with HUS. A total of 82 HUS cases, recorded during the years 2005-2010 in rural and urban areas of the south-central region of Buenos Aires Province, were clinically and epidemiologically characterized. Statistical data analysis included Chi square or Fisher test and median test. The incidence rate of HUS was significantly higher in the rural population, being 12.7 cases per 100 000 (CI 0-23.5) in rural inhabitants vs. 7.1 cases per 100 000 (CI 0-9.5) in urban inhabitants. The median age of the patients was 27 months (5-139 months), significantly lower in children from the rural area. This could be explained by a more frequent contact with bovine feces, the consumption of raw milk and a higher proportion of relatives who work in risk labors found in the rural population. Although HUS is often associated with the consumption of undercooked minced meat, most of the children cases here included did not present this antecedent. Clinical manifestations were similar in both subpopulations. One-third of urban patients had received antibiotics prior to HUS development.

Epidemiología del síndrome urémico hemolítico en dos regiones de la Provincia de Buenos Aires / Epidemiology of hemolytic uremic syndrome in two regions of Buenos Aires Province

Los objetivos de este estudio fueron describir y comparar la frecuencia del síndrome urémico hemolítico (SUH), registrada durante el periodo 2005-2010 en pobladores rurales y urbanos de la región centro-sur de la provincia de Buenos Aires y caracterizar la distribución de factores hipotéticos asociados al SUH en ambas poblaciones. Se caracterizaron 82 casos de SUH clínica y epidemiológicamente. Para el análisis estadístico de los datos se utilizó el test de Chi² o test exacto de Fisher cuando fue necesario, y el test de la mediana. La incidencia específica fue 12.7 casos cada 100 000 habitantes rurales (IC 0-23.5) y 7.1 casos cada 100 000 habitantes urbanos (IC 0-9.5). La mediana de la edad en el total de los pacientes estudiados fue de 27 meses (5-139 meses), siendo significativamente más baja en los niños del área rural. Estos resultados podrían explicarse por el contacto más frecuente con materia fecal de bovinos, el mayor consumo de leche sin pasteurizar y la mayor proporción de familiares que realizan actividades de riesgo, encontrados en la subpoblación rural. Aunque el SUH es una enfermedad que se asocia frecuentemente con el consumo de carne picada, la mayor parte de los niños que enfermaron no presentaron este antecedente. Las manifestaciones clínicas fueron semejantes en ambas subpoblaciones. Un tercio de los pacientes urbanos había recibido tratamiento con antibióticos previo al desarrollo del SUH.(AU)

The objectives of this study were (a) to describe and estimate the frequency of hemolytic uremic syndrome (HUS) in rural and urban populations in two regions of Buenos Aires Province, and (b) to compare the presentation and distribution of factors hypothetically associated with HUS. A total of 82 HUS cases, recorded during the years 2005-2010 in rural and urban areas of the south-central region of Buenos Aires Province, were clinically and epidemiologically characterized. Statistical data analysis included Chi square or Fisher test and median test. The incidence rate of HUS was significantly higher in the rural population, being 12.7 cases per 100 000 (CI 0-23.5) in rural inhabitants vs. 7.1 cases per 100 000 (CI 0-9.5) in urban inhabitants. The median age of the patients was 27 months (5-139 months), significantly lower in children from the rural area. This could be explained by a more frequent contact with bovine feces, the consumption of raw milk and a higher proportion of relatives who work in risk labors found in the rural population. Although HUS is often associated with the consumption of undercooked minced meat, most of the children cases here included did not present this antecedent. Clinical manifestations were similar in both subpopulations. One-third of urban patients had received antibiotics prior to HUS development.(AU)

Epidemiología del síndrome urémico hemolítico en dos regiones de la Provincia de Buenos Aires. / [Epidemiology of hemolytic uremic syndrome in two regions of Buenos Aires Province].

The objectives of this study were (a) to describe and estimate the frequency of hemolytic uremic syndrome (HUS) in rural and urban populations in two regions of Buenos Aires Province, and (b) to compare the presentation and distribution of factors hypothetically associated with HUS. A total of 82 HUS cases, recorded during the years 2005-2010 in rural and urban areas of the south-central region of Buenos Aires Province, were clinically and epidemiologically characterized. Statistical data analysis included Chi square or Fisher test and median test. The incidence rate of HUS was significantly higher in the rural population, being 12.7 cases per 100 000 (CI 0-23.5) in rural inhabitants vs. 7.1 cases per 100 000 (CI 0-9.5) in urban inhabitants. The median age of the patients was 27 months (5-139 months), significantly lower in children from the rural area. This could be explained by a more frequent contact with bovine feces, the consumption of raw milk and a higher proportion of relatives who work in risk labors found in the rural population. Although HUS is often associated with the consumption of undercooked minced meat, most of the children cases here included did not present this antecedent. Clinical manifestations were similar in both subpopulations. One-third of urban patients had received antibiotics prior to HUS development.

Caracterización epidemiológica de casos de síndrome urémico hemolítico en la región sur de la provincia de Buenos Aires / Epidemiological characterization of hemolytic-uremic syndrome cases in the south region of Buenos Aires province

INTRODUCCION: El síndrome urémico hemolítico (SUH) es la causa más frecuente de insuficiencia renal aguda en niños menores de 5 años en Argentina y se asocia principalmente a la infección por Escherichia coli shigatoxigénica (STEC). El bovino es el principal reservorio de STEC, las infecciones al hombre pueden producirse directa o indirectamente a partir de él. Es probable que las personas que presentan un mayor contacto con estos animales tengan una mayor exposición a la bacteria.OBJETIVO: Caracterizar epidemiológicamente la presentación de casos de SUH registrados durante 2005-2010 en poblaciones rurales y urbanas de la región centro-sur de la provincia de Buenos Aires.METODOS: El análisis de los datos incluyó estadísticas descriptivas y de comparación.RESULTADOS: La mediana de las edades del total de los pacientes estudiados fue de 27 meses (5-139 meses). El 54,3% de los casos respondió al género femenino y el 17,5%, al medio rural. Aunque la mayoría de los casos de SUH fueron pobladores urbanos, la tasa de incidencia específica fue significativamente mayor en poblaciones rurales y, en este grupo, las edades de los niños fueron más bajas.CONCLUSIONES: Los resultados obtenidos en el presente estudio concuerdan con otros realizados en la Argentina en lo que respecta a edad y género. No obstante, se encontró una mayor incidencia de SUH en pobladores rurales y a edades más bajas, lo que constituye una novedad. Esto podría deberse al contacto más frecuente con bovinos, ya sea directa o indirectamente, lo que aumentaría el riesgo de enfermar, sobre todo a edades más tempranas.

INTRODUCTION: In Argentina, the hemolytic-uremic syndomre (HUS) is the most frequent cause of acute renal failure in children under 5 years old and is associated with shigatoxigenic Escherichia coli (STEC) infection. Cattle are the major reservior for STEC, and the infection in human may be acquired directly or indirectly from cattle. People with increased contact with cattle are more likely to acquire STEC infections.OBJECTIVE: To characterize epidemiologically the HUS cases recorded during 2005-2010 in rural and urban populations in the central-southern region of Buenos Aires province.METHODS: Data analysis included descriptive and comparative statistics.RESULTS: The median age of the patients was 27 months (5-139 months). 54.3% of the cases were female and 17.5% belonged to rural areas. Although most cases of HUS were urban, the specific incidence rate was significantly higher in rural populations and the children were younger.CONCLUSIONS: The results obtaines in ths study are consistent with other studies conducted in Argentina in terms of age and gender. However, it detected a higher HUS incidence in rural populations and at younger ages, which is new in Argentina. This may be due to more frequent contact with cattle, directly or indirectly increasing the risk of developing the disease especially in younger children.

Caracterización epidemiológica de casos de síndrome urémico hemolítico en la región sur de la provincia de Buenos Aires / Epidemiological characterization of hemolytic-uremic syndrome cases in the south region of Buenos Aires province

INTRODUCCION: El síndrome urémico hemolítico (SUH) es la causa más frecuente de insuficiencia renal aguda en niños menores de 5 años en Argentina y se asocia principalmente a la infección por Escherichia coli shigatoxigénica (STEC). El bovino es el principal reservorio de STEC, las infecciones al hombre pueden producirse directa o indirectamente a partir de él. Es probable que las personas que presentan un mayor contacto con estos animales tengan una mayor exposición a la bacteria.OBJETIVO: Caracterizar epidemiológicamente la presentación de casos de SUH registrados durante 2005-2010 en poblaciones rurales y urbanas de la región centro-sur de la provincia de Buenos Aires.METODOS: El análisis de los datos incluyó estadísticas descriptivas y de comparación.RESULTADOS: La mediana de las edades del total de los pacientes estudiados fue de 27 meses (5-139 meses). El 54,3% de los casos respondió al género femenino y el 17,5%, al medio rural. Aunque la mayoría de los casos de SUH fueron pobladores urbanos, la tasa de incidencia específica fue significativamente mayor en poblaciones rurales y, en este grupo, las edades de los niños fueron más bajas.CONCLUSIONES: Los resultados obtenidos en el presente estudio concuerdan con otros realizados en la Argentina en lo que respecta a edad y género. No obstante, se encontró una mayor incidencia de SUH en pobladores rurales y a edades más bajas, lo que constituye una novedad. Esto podría deberse al contacto más frecuente con bovinos, ya sea directa o indirectamente, lo que aumentaría el riesgo de enfermar, sobre todo a edades más tempranas.

INTRODUCTION: In Argentina, the hemolytic-uremic syndomre (HUS) is the most frequent cause of acute renal failure in children under 5 years old and is associated with shigatoxigenic Escherichia coli (STEC) infection. Cattle are the major reservior for STEC, and the infection in human may be acquired directly or indirectly from cattle. People with increased contact with cattle are more likely to acquire STEC infections.OBJECTIVE: To characterize epidemiologically the HUS cases recorded during 2005-2010 in rural and urban populations in the central-southern region of Buenos Aires province.METHODS: Data analysis included descriptive and comparative statistics.RESULTS: The median age of the patients was 27 months (5-139 months). 54.3% of the cases were female and 17.5% belonged to rural areas. Although most cases of HUS were urban, the specific incidence rate was significantly higher in rural populations and the children were younger.CONCLUSIONS: The results obtaines in ths study are consistent with other studies conducted in Argentina in terms of age and gender. However, it detected a higher HUS incidence in rural populations and at younger ages, which is new in Argentina. This may be due to more frequent contact with cattle, directly or indirectly increasing the risk of developing the disease especially in younger children.