Gerson Bragagnoli

Ascaris lumbricoides infection and parasite load are associated with asthma in children

INTRODUCTION Association between Ascaris lumbricoides infection and asthma is a controversial subject that has been studied by several authors based on the hygiene theory. This work contributes to better understanding this issue. METHODOLOGY This was a cross-sectional study involving 1,004 children from a neighborhood of low socioeconomic status in Campina Grande, Paraíba, northeastern Brazil. Asthma was diagnosed using the International Study of Asthma and Allergy in Childhood (ISAAC) questionnaire. Intestinal parasitosis was diagnosed by parasitological examination (the Ritchie technique), and parasite load determined by the Kato-Katz technique. The statistical analysis was descriptive, and hypotheses were tested according to odds ratios. RESULTS A total of 260 children were infected with A. lumbricoides, and 233 had asthma. Light parasite loads were significantly associated with asthma (wheezing more than three times per year); p = 0.003, OR = 0.41(IC 0.22 - 0.75), while the heavy parasite loads were not; p = 0.002, OR = 2.37(IC 1.35 - 4.18). Similar results were observed in almost all the symptoms of asthma. No association was found with maternal educational level. CONCLUSION In children living in urban areas of low socioeconomic status, a light parasite load of A. lumbricoides is a protective factor against asthma and its symptoms. Meanwhile, heavy parasite load is a risk factor and contributes to the high prevalence of asthma and its symptoms among these children.

NONALCOHOLIC FATTY LIVER DISEASE IN PATIENTS WITH CORONARY DISEASE FROM A BRAZIL NORTHEAST AREA

Background Nonalcoholic fatty liver disease (NAFLD) is the most frequent chronic liver injury around the world. It is associated with metabolic syndrome and cardiovascular diseases. Objective To evaluate the frequency and relevance of NAFLD in patients with coronary artery disease (CAD). Methods Patients from a Brazil Northeast area, who underwent elective coronary angiography (CAG) from 2009 to 2010 were included. All of them had suspicion of CAD. Criteria to CAD: presence of obstructive lesions in the epicardial coronary arteries, or in their major branches. NAFLD criteria: presence of hepatic steatosis on ultrasound; exclusion of other liver diseases; ethanol intake ≤ 20g/day. Statistics analysis included Independent t-test, Mann-Whitney and Pearsons chi-squared test. Multivariate regression analysis measured the relationship between the risk factors and the concomitant presence of CAD and NAFLD. Results A total of 244 patients were evaluated: 63.5% had CAD and 42.2% had NAFLD. NAFLD was observed in 43.9% of the CAD patients. The regression analysis showed that the relationship between CAD and NAFLD was positively correlated with HOMA-IR ≥3.0 or insulin resistance and overweight/obesity. Conclusion NAFLD was frequent among CAD patients; insulin resistance and overweight/obesity were the most relevant risk factors related to the association NAFLD and CAD. The results suggest that patients with CAD should be evaluated for NAFLD.

PREVALENCE OF Entamoeba histolytica/Entamoeba dispar IN THE CITY OF CAMPINA GRANDE, IN NORTHEASTERN BRAZIL

There is a clear need to perform epidemiological studies to find the true prevalence of Entamoeba histolytica around the world. The evaluation of this prevalence has been hindered by the existence of two different species which are morphologically identical, but genetically different, namely E. histolytica, which causes amebiasis, and E. dispar, which is non-pathogenic. In Brazil, the E. dispar has been detected in communities in the Southeastern (SE) and Northeastern (NE) regions with poor sanitation. However, individuals infected with E. histolytica have been identified in other regions. There is an absence of reports on the prevalence of these parasites in the state of Paraíba, which also has areas with poor sanitary conditions where a high prevalence of the E. histolytica/E. dispar complex has been detected in children from urban slums. The present study evaluated the prevalence of E. histolytica and E. dispar in 1,195 asymptomatic children between two and 10 years of age, living in a sprawling urban slum in Campina Grande, in the state of Paraíba, in Northeastern Brazil. These children were examined and their feces samples were analyzed microscopically. A total of 553 children tested positive for the E. histolytica/E. dispar complex, and 456 of the positive samples were tested with the E. histolytica II® ELISA kit. All 456 samples were negative for the presence of the adhesin E. histolytica specific antigen. The evidence suggests that in this community E. histolytica is absent and E. dispar is the dominant species.

Dermatite atópica e ascaridíase em crianças de 2 a 10 anos

OBJECTIVE To assess the association between atopic dermatitis (AD) and ascariasis in 2 to 10-aged children from the neighborhood Pedregal, in the city of Campina Grande, Brazil, an area of low socioeconomic index. METHODS Cross-sectional study conducted with the use of the standard questionnaire from the International Study of Asthma and Allergies in Childhood (ISAAC) and stool parasitological exam for Ascaris lumbricoides. The dependent variable was AD diagnosis: absent, mild, and severe. Multivariate logistic regression and descriptive analysis of the variable were used. Associations were estimated using relative risk (RR) and odds ratio (OR). The statistical inference was based on 95% confidence intervals (95%CI). RESULTS We assessed 1,195 children, 612 (51.2%) female. The AD prevalence was 24.6%, and ascariasis prevalence was 26.1%. In the mild AD group of children, 44 (36.7%) were infected by A. lumbricoides while in the severe AD group, 40 (22.9%) had the same geohelminthosis (p = 0.01). Comparing negative cases of AD between mild and severe forms, the infection with A. lumbricoides increased the frequency of mild AD (RR = 1.7; p = 0.009), but not the severe form (RR = 0.86; p = 0.46). Evaluating only the positive cases of dermatitis, 120 mild AD (40.8%) and 176 with severe AD (58.2%), it can be said that the exposure to the parasite decreased the frequency of the severe form of dermatitis (RR = 1.46; p = 0.016). CONCLUSION There is a high prevalence of AD and of ascariasis in the population studied. The severe AD is related to lower parasitemia of A. lumbricoides.

Poisoning with household cleaning products in a city in Northeast Brazil

This study analyzes toxic exposures to household cleaning products based on data from the Center for Notification and Treatment of Poisoning (CEATOX) in Campina Grande, Paraíba State, Brazil, from 2007 to 2010. The data were collected from the reporting forms from the Information System on Notifiable Diseases (SINAN), analyzed with SPSS (Version 17). Chemical identification was performed in urine samples using high-resolution chromatography techniques (GC-MS and HPLC-UV). Six hundred and sixty cases of poisoning were reported, with pesticides as the principal causal agents (42.2%). Poisoning with household cleaning products occurred mainly in children (30.1%) and/or females (55.21%) who were exposed to the product accidentally (55.4%) by the oral route (82%). These data indicate that poisoning with household cleaning products in Campina Grande should be treated with specific prevention and control measures, including evaluation of ease of access to pesticides, in order to reach the goals set by the Brazilian National Health Plan for 2012-2015.

Avaliação das intoxicações por domissanitários em uma cidade do Nordeste do Brasil

Este trabalho analisa as exposicoes toxicas a domissanitarios registradas pelo Centro de Informacao e Assistencia Toxicologica de Campina Grande, Paraiba, Brasil, no periodo de 2007 a 2010. Os dados foram coletados das fichas de notificacao do Sistema de Informacao de Agravos de Notificacao (SINAN), analisados pelo software SPSS (Versao 17), e a identificacao quimica em amostras de urina foi feita por tecnicas cromatograficas de alta resolucao (CG-MS e HPLC-UV). Foram registradas 660 intoxicacoes e, considerando as variaveis de estudo, observados como principais agentes causais os agrotoxicos (42,2%).Os intoxicados por saneantes domesticos na regiao sao predominantemente criancas (30,1%), e/ou do genero feminino (55,21%), que se expoem ao produto acidentalmente (55,4%) pela via oral (82%). Diante desses dados, conclui-se que a intoxicacao por domissanitarios em Campina Grande e regiao deve ser tratada com acoes especificas de prevencao e controle junto a populacao, como a avaliacao da facilidade de acesso aos venenos agricolas, para que se consiga atingir as metas estabelecidas pelo Plano Nacional de Saude, para o quadrienio 2012-2015.