Risk factors associated with taeniasis-cysticercosis in Lagamar, Minas Gerais State, Brazil.

An epidemiological survey was carried out in 3,344 people of an urban town in Lagamar, Minas Gerais, Brazil--during 1992-1993, to evaluate the main risk factors related to taeniasis and cysticercosis. A total number of 875 (78.9%) houses were visited and 1080 (32.3%) subjects were clinically examined. Poor sanitary conditions were positively associated with former history of taeniasis or seizures in households (p < 0.05). It was remarkable the positive relationship between taeniasis and seizures when households were questioned and subjects were clinically evaluated (p < 0.05). The relative risk of seizures was 2.3 between households and 1.7 for individuals clinically examined respectively. The breeding of swine nearby and the chronic carriers of taeniasis are determinant factors in the maintenance of the epidemiological link between taeniasis and cysticercosis in endemic areas.

Risk factors associated with taeniasis-cysticercosis in Lagamar, Minas Gerais State, Brazil

An epidemiological survey was carried out in 3,344 people of an urban town in Lagamar, Minas Gerais, Brazil--during 1992-1993, to evaluate the main risk factors related to taeniasis and cysticercosis. A total number of 875 (78.9%) houses were visited and 1080 (32.3%) subjects were clinically examined. Poor sanitary conditions were positively associated with former history of taeniasis or seizures in households (p < 0.05). It was remarkable the positive relationship between taeniasis and seizures when households were questioned and subjects were clinically evaluated (p < 0.05). The relative risk of seizures was 2.3 between households and 1.7 for individuals clinically examined respectively. The breeding of swine nearby and the chronic carriers of taeniasis are determinant factors in the maintenance of the epidemiological link between taeniasis and cysticercosis in endemic areas.

Foi realizado inquérito epidemiológico em 3344 indivíduos da área urbana de Lagamar, Minas Gerais, Brasil, durante 1992-1993 para avaliar os principais fatores de risco relacionados com teníase e cisticercose. Foram visitadas 875 (78,9%) casas e examinados clinicamente 1080 (32,3%) indivíduos. As condições sanitárias deficientes estiveram associadas estatisticamente com história anterior ou atual de teníase ou de convulsões entre os membros de cada família (p < 0,05). A correlação entre teniase e convulsões foi evidenciada tanto no inquérito domiciliar como durante a avaliação clínica dos indivíduos (p < 0,0001). O risco relativo de convulsões foi de 2,3 entre os moradores entrevistados no domicílio e 1,7 entre os indivíduos que compareceram para exame clínico, respectivamente. A criação de suínos no peridomicílio e os portadores crônicos de teníase são fatores determinantes na perpetuação do elo epidemiológico teníase-cisticercose nas áreas endêmicas.

[The epidemiological aspects of taeniasis-cysticercosis in an endemic area of Lagamar, Minas Gerais]. / Aspectos epidemiológicos da teníase-cisticercose na área endêmica de Lagamar, MG.

An epidemiological inquiry of humancysticercosis due to Taenia solium was carried out in Lagamar, Minas Gerais State, Brazil, in 1992. A survey of 1109 houses with 3344 inhabitants was made. The inquiry included 875 (86%) families and the questionnaire was answered by an informer, who was the father in 80% of the cases. One hundred pigsties, sheltering 406 swines in extremely precarious conditions, were found in 100 (11.4%) houses. A history on taeniasis in some member of the family was verified in 300 (34.2%) houses. A history of seizures was referred to by 125 (14.2%) of families. The outset of convulsion in adult age was characterized in 39 (37.8%) families. A history of mental disorder was reported in 53 (6.0%) of houses. Stool examinations were positive for Taenia spp in 24 (1.3%) of samples examined.

[Neurologic and laboratory findings in a population of an endemic area for taeniasis-cysticercosis, Lagamar, MG, Brazil (1992-1993)]. / Achados neurológicos e laboratoriais em população de área endêmica para teníase-cisticercose, Lagamar, MG, Brasil (1992-1993).

A clinic-epidemiological enquiry was conducted on in an endemic area for teniasis-cysticercosis. From the whole population 1080 (32.2%) individuals were examined. We found 198 (18.3%) individuals referring teniasis-bearing in the past, and 103 (9.5%) affirming to have had convulsions, either in the past or present. From the last group, 39 (37.8%) indicated that the crisis had begun in adulthood. From the group of patients presenting convulsions, 62 (62%) had laboratory tests performed. Computed tomography showed intracranial calcifications in 21 (33.8%) patients, variable in number and location, suggesting neurocysticercosis and no evidence of disease activity. Electroencephalograms showed abnormal waves in 21 (33.8%) patients and cerebrospinal fluid analyses were altered in 27 (43.5%) cases, having detected eosinophils only in 3 (4.8%) patients. Spinal fluid tests for cysticercosis through enzyme linked immunosorbent assay (ELISA) or indirect immunofluorescence were taken in only 26 (41.9%) patients, obtaining positive results in 6 (23%) samples. Varying upward shifts of protein levels were found in spinal fluid analysis. Assuming that all epidemiologic risk factors for teniasis-cysticercosis in the studied region and its correlation with the laboratory alterations described in convulsing crisis, a prevalence of 1.9% for neurocysticercosis was found.

[Tests of inflammatory activity in endemic pemphigus foliaceus]. / Provas de atividade inflamatória no pênfigo foliáceo endêmico.

Endemic pemphigus foliaceus (EPF) has its pathogenesis frequently associated to autoimmune phenomena. In this paper, a few routine laboratory tests, usually disturbed in some autoimmune diseases, were taken in 20 patients with EPF, which were screened for antinuclear antibodies (ANA), rheumatoid factor (RF), C-reactive protein (CRP) and changes of erythrocyte sedimentation rate (ESR), serologic proteins electrophoresis and total leucocyte count. The CRP was found in 60% of cases, leukocytosis in 85%, high ESR in all of them and mild alterations in serologic proteins analysis. No ANA or RF was found. Although widely accepted as nonspecific tests, we believe that an association of the laboratory routine tests with clinical findings, can prove to be helpful in the follow up care of these patients.

Possible role of an adrenal parasite reservoir in the pathogenesis of chronic Trypanosoma cruzi myocarditis.

The possible contribution of parasitism of the central vein of the adrenal gland (CVAG) to chronic Trypanosoma cruzi myocarditis was assayed by comparing the occurrence of nests of amastigotes in the left ventricular myocardium (LVM) and determining the number and extent of areas of focal leucocyte exudate (FLE) in Chagas disease patients with and without CVAG parasitism. The frequency of occurrence of T. cruzi nests in the LVM, as well as the FLE number and area, were greater among patients with CVAG parasitism. We therefore suggest that CVAG parasitism plays a role in the onset and intensity of chronic T. cruzi myocarditis.