Domingas M. A. G. Vieira Torres

Estudo das condições de saúde das crianças do Município de São Paulo (Brasil), 1984/1985: VII - Parasitoses intestinais

Como parte de estudo populacional sobre condicoes de saude na infância, uma amostra representativa das criancas menores de cinco anos residentes no Municipio de Sao Paulo, SP (Brasil) (n=695) foi submetida a exames parasitologicos de fezes. Os exames foram realizados atraves da tecnica de sedimentacao e, quando as fezes tinham consistencia amolecida ou liquefeita, tambem pela tecnica do exame direto. A prevalencia de enteroparasitoses em geral foi de 30,9%, sendo de 16,4%, 14,5% e 12,5% as prevalencias especificas da ascaridiase, giardiase e tricuriase. Prevalencias inferiores foram assinaladas para os enteroparasitas E. histolytica, H. nana e S. stercoralis, respectivamente 2,0%, 0,9% e 0,3%. Em apenas uma crianca foram encontrados ovos de ancilostomideos e em nenhuma delas ovos de Schistosoma mansoni. Das criancas examinadas, 13,1% apresentaram duas ou mais especies de enteroparasitas e 4,8% tres ou mais. As prevalencias atuais, comparadas as prevalencias encontradas em 1973/74 por outro inquerito populacional realizado no municipio, indicam queda expressiva da ascaridiase e tricuriase, mas nao da giardiase. A estratificacao das prevalencias segundo faixa etaria revelou aumento significativo com a idade da crianca, chamando atencao o aumento que ocorre do primeiro para o segundo ano de vida. As enteroparasitoses aumentam tambem significativamente sua frequencia a medida que piora o nivel socioeconomico, chegando a ser de nove vezes a diferenca de prevalencia existente entre os estratos socioeconomicos extremos da populacao. No caso especifico da giardiase o gradiente socioeconomico foi consideravelmente menor do que o encontrado para as demais enteroparasitoses, o que confirma a maior complexidade epidemiologica do problema.Como parte de estudo populacional sobre condicoes de saude na infância, uma amostra representativa das criancas menores de cinco anos residentes no Municipio de Sao Paulo, SP (Brasil) (n=695) foi submetida a exames parasitologicos de fezes. Os exames foram realizados atraves da tecnica de sedimentacao e, quando as fezes tinham consistencia amolecida ou liquefeita, tambem pela tecnica do exame direto. A prevalencia de enteroparasitoses em geral foi de 30,9%, sendo de 16,4%, 14,5% e 12,5% as prevalencias especificas da ascaridiase, giardiase e tricuriase. Prevalencias inferiores foram assinaladas para os enteroparasitas E. histolytica, H. nana e S. stercoralis, respectivamente 2,0%, 0,9% e 0,3%. Em apenas uma crianca foram encontrados ovos de ancilostomideos e em nenhuma delas ovos de Schistosoma mansoni. Das criancas examinadas, 13,1% apresentaram duas ou mais especies de enteroparasitas e 4,8% tres ou mais. As prevalencias atuais, comparadas as prevalencias encontradas em 1973/74 por outro inquerito populacional realizado no municipio, indicam queda expressiva da ascaridiase e tricuriase, mas nao da giardiase. A estratificacao das prevalencias segundo faixa etaria revelou aumento significativo com a idade da crianca, chamando atencao o aumento que ocorre do primeiro para o segundo ano de vida. As enteroparasitoses aumentam tambem significativamente sua frequencia a medida que piora o nivel socioeconomico, chegando a ser de nove vezes a diferenca de prevalencia existente entre os estratos socioeconomicos extremos da populacao. No caso especifico da giardiase o gradiente socioeconomico foi consideravelmente menor do que o encontrado para as demais enteroparasitoses, o que confirma a maior complexidade epidemiologica do problema.

Detection of Cryptosporidium sp. in non diarrheal faeces from children, in a day care center in the city of São Paulo, Brazil

The protozoan Cryptosporidium sp. has been frequently detected in faeces from children with persistent diarrhoea. This work achieved to investigate an outbreak of cryptosporidiosis, in a day care center, attending children of high socio-economic level, between 0 and six years old. The outbreak was detected through the network of public health, when stool samples, not diarrhoeic, were examined at the Parasitology Service of the Adolfo Lutz Institute. Among the 64 examined children, 13 (20.3%) showed oocysts of Cryptosporidium sp. in the faeces examined by Kinyoun technique: seven children one year old, three, two years old and three, three years old. Among the 23 examined adults, only a 22 years old woman, possibly having an immunocomprometiment, was positive. Clinical and epidemiological aspects were investigated by questionnaires, highlighting the occurrence of the outbreak in a very dry period.

Giardíase em creches mantidas pela prefeitura do município de São Paulo, 1982/1983

Parasitological analysis was carried out during 1982 and 1983 in 3,076 children aged under 7 years, who were enrolled in 52 day nurseries supported by Municipal Prefecture of Sao Paulo and 50 food handlers (cooking employees) working at 18 day nurseries. The prevalence of Giardia lamblia infection was studied according to sex, age group and seasonal variations, and attained 32.80% among children and 4.0% among adult population. The occurrence of giardiasis was most frequent in age group corresponding to 1-4 years old. The study of seasonal variations showed that, in 1982, the prevalence of G. lamblia was high in the autumn and in the spring and, in 1983, giardiasis was more prevalent in the autumn and in the summer. Statistical analysis indicated non association between sex and prevalence for Giardia infection, and there was also no significative difference on the distribution of G. lamblia prevalence in the four regions analysed in the present study (p > 0.05). The most probable mode of acquisition of Giardia infection, in the nurseries analysed in the present study was person-to-person, as factors, like environmental contamination and others, associated with the spreading of giardiasis through water, reported in other countries, are unlike from those verified in our Municipality. On the other hand, there is evidence of no significant role of food handlers in Giardia transmission, because the rate of infection in this group was very low.

Cryptosporidiosis among patients with acquired immunodeficiency syndrome (AIDS) in the county of São Paulo, Brazil

Stool samples of 157 patients with AIDS, living in the county of Sao Paulo, were submitted to several techniques in the search for Cryptosporidium sp.. Among the various techniques tested for slide preparation (direct smear, spontaneous sedimentation method, and formol-ether concentration), the latter, formol-ether concentration, offered the best results, clearly outdoing all the others. Nineteen samples out of 157 prepared by this technique, after dyeing by the Kinyoun method or by carbol fuchsin dimethyl sulfoxide, were found to be positive for Cryptosporidium sp..

Parasitismo por Cryptosporidium sp. em crianças com diarréia aguda

During the period from August 1987 to July 1990, 241 fecal samples collected from 1 to 48 months old children with acute diarrhea and examined in the Childs Institute of Hospital das Clinicas of Faculdade de Medicina da Universidade de Sao Paulo, were submitted to parasitological tests in the Enteroparasitosis Section of the Instituto Adolfo Lutz. Fourty two (17.43%) fecal samples showed Cryptosporidium sp. oocysts by carbol-fucsin stain. Parasitism by Cryptosporidium sp. was more frequent during the period comprised from March to May, in the studied three years. The authors discussed the Cryptosporidium sp. in association with other agents.

Human parasitism by Phagicola sp (Trematoda, Heterophyidae) in Cananéia, São Paulo State, Brazil

We report one case of parasitism by Phagicola sp. (Trematoda, Heterophyidae) in a 31 year-old woman who, in 1987, travelled and stayed several months in the municipality of Cananéia (SP), where she ingested, in various occasions, raw mullet (Mugil sp.). The patient referred mild intestinal pain and laboratory examinations showed eggs of Phagicola sp. in the stools and a slight increase in eosinophil blood levels (8%). After treatment with praziquantel (75 mg/kg per day for three days) all the symptoms and signs disappeared. This is, certainly, the first record of human infection by Phagicola sp. in Brazil and, perhaps, in countries other than the U.S.A. where unclear references to a few human cases were reported in the South-eastern region.

Ocorrência de Taenia sp. na população atendida no laboratório central do Instituto Adolfo Lutz, São Paulo, SP, Brasil (1960/1989)

Foram examinados retrospectivamente os relatorios mensais e anuais da Secao de Enteroparasitoses do Laboratorio Central do Instituto Adolfo Lutz, Sao Paulo, SP, do periodo de 1960 a 1989, perfazendo uma serie historica de 30 anos, com 1.519.730 exames protoparasitologicos e 355 identificacoes de proglotes de Taenia. Pelo metodo da sedimentacao espontânea foram diagnosticados 7.663 (0,5%) casos de presenca de ovos de Taenia sp. nas fezes. Das 355 proglotes enviadas para identificacao, 311 (87,60%) estavam em condicoes de serem especificadas, e dessas, 273 (87,80%) eram proglotes de Taenia saginata e 38 (12,22%) de T. solium.Monthly and yearly reports of the Seção de Enteroparasitoses of the Instituto Adolfo Lutz (São Paulo, SP, Brazil) from 1960 to 1989 with 1,519,730 parasitological stool examinations were studied. There were also 355 identifications of Taenia sp. proglottids. Using Hoffman, Pons & Janers method, 7,663 (0.5%) cases of taeniasis were diagnosed, and 311 (87.60%) of the 355 proglottids were on easy terms to be specified, 273 (87.80%) of them were from Taenia saginata.