RESUMO
INTRODUCTION: The study aimed to show the situation of paracoccidioidomycosis in the state of Maranhão, Brazil. METHODS: This study is a descriptive case series developed in two stages. First, a survey of cases originating from the state of Maranhão at the Instituto de Doenças Tropicais Natan Portela, Piauí (IDTNP) from 1997 to 2007, and second, the clinical description of 29 cases diagnosed in the Centro de Referências em Doenças Infecciosas e Parasitárias, Maranhão (CREDIP) from 2004 to 2010. RESULTS: Two hundred and sixteen cases have been cataloged at the IDTNP. West, east, and central regions of the state of Maranhão recorded 90.3% of cases proving to be important areas for study. The western region, with a prevalence of 10.8/100,000 inhabitants, has a significantly higher proportion of cases than the northern, southern, and eastern regions (p < 0.05). The occurrence was higher in men with 89.3% of cases, and the male-to-female ratio was 8.4:1. The majority of patients were older than 20 years, lived in rural areas, and had farming or soil management as main occupation (73.8%). At CREDIP, 29 cases were diagnosed, of which 26 (89.6%) had multifocal manifestations. Mucous tissues were involved more (75.8%) frequently, followed by lymph nodes, skin, and lungs with 65.5%, 39% and 37.9 %, respectively. The diagnosis was made by combining direct examination, culture, and histopathology. CONCLUSIONS: The study shows the geographical distribution and the epidemiological and clinical aspects of paracoccidioidomycosis, revealing the significance of the disease to the state of Maranhão.
Assuntos
Paracoccidioidomicose/epidemiologia , Adolescente , Adulto , Idoso , Brasil/epidemiologia , Criança , Pré-Escolar , Feminino , Geografia Médica , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Fatores de Risco , População Rural , Adulto JovemRESUMO
INTRODUCTION: The study aimed to show the situation of paracoccidioidomycosis in the state of Maranhão, Brazil. METHODS: This study is a descriptive case series developed in two stages. First, a survey of cases originating from the state of Maranhão at the Instituto de Doenças Tropicais Natan Portela, Piauí (IDTNP) from 1997 to 2007, and second, the clinical description of 29 cases diagnosed in the Centro de Referências em Doenças Infecciosas e Parasitárias, Maranhão (CREDIP) from 2004 to 2010. RESULTS: Two hundred and sixteen cases have been cataloged at the IDTNP. West, east, and central regions of the state of Maranhão recorded 90.3% of cases proving to be important areas for study. The western region, with a prevalence of 10.8/100,000 inhabitants, has a significantly higher proportion of cases than the northern, southern, and eastern regions (p < 0.05). The occurrence was higher in men with 89.3% of cases, and the male-to-female ratio was 8.4:1. The majority of patients were older than 20 years, lived in rural areas, and had farming or soil management as main occupation (73.8%). At CREDIP, 29 cases were diagnosed, of which 26 (89.6%) had multifocal manifestations. Mucous tissues were involved more (75.8%) frequently, followed by lymph nodes, skin, and lungs with 65.5%, 39% and 37.9 %, respectively. The diagnosis was made by combining direct examination, culture, and histopathology. CONCLUSIONS: The study shows the geographical distribution and the epidemiological and clinical aspects of paracoccidioidomycosis, revealing the significance of the disease to the state of Maranhão.
INTRODUÇÃO: O estudo teve o objetivo de mostrar a situação da paracoccidioidomicose no Estado do Maranhão, Brasil. MÉTODOS: Trata-se de um estudo descritivo do tipo série de casos, desenvolvido em duas etapas: na primeira, levantamento de casos originários do Maranhão, atendidos no Instituto de Doenças Tropicais Natan Portela, Piauí (IDTNP), de 1997 a 2007; na segunda, descrição clínica de 29 casos diagnosticados no Centro de Referência em Doenças Infecciosas e Parasitárias, Maranhão (CREDIP), no período de 2004 a 2010. RESULTADOS: Foram catalogados 216 casos no IDTNP. As regiões Oeste, Leste e Centro do Maranhão registraram 90,3% destes casos, demonstrando serem áreas importantes para estudo. A região oeste, com prevalência de 10,8/100.000 habitantes, apresenta proporção de casos significativamente maior que as regiões Norte, Sul e Leste (p<0,05). A ocorrência foi maior em indivíduos do sexo masculino (89,3% dos casos), sendo a proporção entre homens e mulheres de 8,4:1. A maioria dos acometidos possuía mais de 20 anos, residia na zona rural e tinha como principal ocupação a lavoura ou o manejo do solo (73,8%). Foram diagnosticados 29 casos no CREDIP, dos quais 26 (89,6) tinham manifestações multifocais. O acometimento mais comum foi de mucosas (75,8%), seguindo-se gânglios, pele e pulmões com 62%, 39% e 34,7%, respectivamente. A confirmação do diagnóstico foi feita pela combinação de exame micológico direto, cultura e histopatológico. CONCLUSÕES: O estudo mostra a distribuição geográfica, os aspectos epidemiológicos e clínicos da paracoccidioidomicose, revelando a importância da doença no Estado do Maranhão.
