Katia Jaira Galisteu

Enteric parasites in HIV-1/AIDS-infected patients from a Northwestern São Paulo reference unit in the highly active antiretroviral therapy era

INTRODUCTION We describe the epidemiology of intestinal parasites in patients from an AIDS reference service in Northeastern São Paulo, Brazil. METHODS Retrospective evaluation was done for all HIV-1/AIDS-positive patients whose Hospital de Base/São José do Rio Preto laboratorial analysis was positive for enteroparasites after diagnosis of HIV-1 infection, from January 1998 to December 2008. Statistical analysis was performed using the R statistical software version 2.4.1. The level of significance adopted was 5%. RESULTS The most frequent protozoan was Isospora belli (4.2%), followed by Giardia lamblia (3.5%), Entamoeba coli (2.8%), and Cryptosporidium parvum (0.3%). Ancylostoma duodenale (1.4%) was the most frequently detected helminth, while Taenia saginata and Strongiloides stercoralis were found in 0.7% of the samples. The results showed that diarrhea was significantly associated with giardiasis and isosporiasis. However, no association was observed between CD4+ cell counts, viral load, and the characteristics of any particular parasite. CONCLUSIONS Our data may be useful for further comparisons with other Brazilian regions and other developing countries. The data may also provide important clues toward improving the understanding, prevention, and control of enteric parasites around the world.

Enteroparasitoses numa população de escolares da rede pública de ensino do Município de Mirassol, São Paulo, Brasil

Diseases that originate from enteric parasites are major public health problems worldwide and contribute to high rates of morbidity and mortality, especially in 1,2 developing countries . In these countries, it is estimated that approximately one-third of the population lives under environmental conditions that are favorable for the 3 spread of parasitic infections . Worldwide, infections by protozoa and helminths affect 3.5 billion people, and these organisms cause disease in approximately 450 4 million people . In most cases, enteric parasites are transmitted orally by ingesting food or water that is contaminated with parasites. In Brazil, the wide diversity of socioeconomic characteristics, climate and geography are critical for the etiologic agent profile in diarrhea, thus modeling the frequency of these different enteric 5,6 pathogens . ABSTRACTThis study observed the prevalence of intestinal parasites in 310 students (2 to 15 years old) enrolled in a public school in the Municipality of Mirassol, Sao Paulo State, Brazil. A stool sample was collected from each child and analyzed by the methods of Faust and Hoffmann, Pons and Janer, normally used for detection of protozoa and human helminths. A total of 30.3% of the children analyzed were parasitized, with at least one pathogenic intestinal parasite. Giardia Lamblia was the most common protozoan (15.16%), followed by Entamoeba histolytica (0.64%). The helminths found were Ascaris lumbricoides (3.55%), Strongiloides stercoralis and Taenia sp, which were diagnosed in 0.32% of the samples. There was a significant association between the occurrence of enteroparasitoses and the use of tap water. The comparison between the age groups, gender and the presence of parasites showed no statistical relevance. Although there was no association between gastrointestinal disorders and the occurrence of intestinal parasitic diseases, these agents may cause new infections because the children can act as carriers and therefore a source of contamination. This article suggests that a continuing education program focused on the prevention and treatment of parasitic infections is a key measure for their eradication.

Opportunistic infections among individuals with HIV-1/AIDS in the highly active antiretroviral therapy era at a Quaternary Level Care Teaching Hospital

INTRODUCTION In this study, clinical-laboratory and epidemiological characteristics are described for a group of 700 individuals with HIV (human immunodeficiency virus)/AIDS (acquired immunodeficiency syndrome) in the ART (antiretroviral therapy) era at a teaching hospital that provides a quaternary level of care, with an emphasis on opportunistic infections (OIs), co-infections and immune profile. METHODS A retrospective cross-sectional study of AIDS cases was conducted from 1998 to 2008 by reviewing medical records from the Base Hospital/FUNFARME (Fundação Faculdade Regional de Medicina), São José do Rio Preto, São Paulo, Brazil. RESULTS The individuals were 14 to 75 years of age, and 458 were males. Heterosexuals accounted for 31.1% of all patients. Eighty-three percent were on ART, and 33.8% of those presented difficulties with treatment adherence. OIs were analyzed from medical records, and Pneumocystis jiroveci pneumonia was the most prevalent, regardless of the LTCD4+ (TCD4+ Lymphocytes) levels. Individuals whose viral loads were ≥10,000 showed a 90% greater chance of neurotoxoplasmosis. For P. jiroveci pneumonia, neurotoxoplasmosis, esophageal candidiasis, pulmonary tuberculosis and neurocryptococcosis, the chances of infection were higher among patients with LTCD4+ levels below 200 cells/mm3. HIV/hepatitis C virus (HCV) and HIV/hepatitis B virus (HBV) co-infections were significantly associated with death. CONCLUSIONS OIs remain frequent in the ART era even in populations where the access to medical care is considered satisfactory.

Enteroparasitoses in a population of students from a public school in the Municipality of Mirassol, São Paulo State, Brazil

Diseases that originate from enteric parasites are major public health problems worldwide and contribute to high rates of morbidity and mortality, especially in 1,2 developing countries . In these countries, it is estimated that approximately one-third of the population lives under environmental conditions that are favorable for the 3 spread of parasitic infections . Worldwide, infections by protozoa and helminths affect 3.5 billion people, and these organisms cause disease in approximately 450 4 million people . In most cases, enteric parasites are transmitted orally by ingesting food or water that is contaminated with parasites. In Brazil, the wide diversity of socioeconomic characteristics, climate and geography are critical for the etiologic agent profile in diarrhea, thus modeling the frequency of these different enteric 5,6 pathogens . ABSTRACTThis study observed the prevalence of intestinal parasites in 310 students (2 to 15 years old) enrolled in a public school in the Municipality of Mirassol, Sao Paulo State, Brazil. A stool sample was collected from each child and analyzed by the methods of Faust and Hoffmann, Pons and Janer, normally used for detection of protozoa and human helminths. A total of 30.3% of the children analyzed were parasitized, with at least one pathogenic intestinal parasite. Giardia Lamblia was the most common protozoan (15.16%), followed by Entamoeba histolytica (0.64%). The helminths found were Ascaris lumbricoides (3.55%), Strongiloides stercoralis and Taenia sp, which were diagnosed in 0.32% of the samples. There was a significant association between the occurrence of enteroparasitoses and the use of tap water. The comparison between the age groups, gender and the presence of parasites showed no statistical relevance. Although there was no association between gastrointestinal disorders and the occurrence of intestinal parasitic diseases, these agents may cause new infections because the children can act as carriers and therefore a source of contamination. This article suggests that a continuing education program focused on the prevention and treatment of parasitic infections is a key measure for their eradication.

CLINICAL AND SOCIODEMOGRAPHIC ASPECTS OF PEOPLE WITH A TEMPORARY INTESTINAL STOMA

This study aimed to characterize sociodemographic and clinical aspects of people with a temporary intestinal stoma seen by care service targeted at ostomates. This is a quantitative, cross-sectional descriptive study, including 117 people with a temporary intestinal stoma. Data were collected through medical chart review and a structured interview. Sixty-four patients (5.7%) were male, with a mean age of 62.9 years, 59.8% were married, 74.4% were Catholic and 70.9% had up to eight years of study. Most (52.9%) had a paid labor activity, 60 of which (51.3%) had discontinued their work activities, and 44.4% had not returned, receiving a social security leave. Of the 57 (48.7%) that had not interrupted their work activities, 33.3% were retired, 13.6% performed unpaid activities and 1.7% were self-employed without the possibility of having a leave. Most had a family income of up to two minimum wages (67.5%). Neoplasias were the major cause of indication of stoma (47.9%), followed by acute abdomen (31.6%). Colostomies were the most frequent stomas (75.2%), the mean duration of stoma implantation was 5.3 years (median 3 years, minimum 6 months and maximum 25 years). Knowledge of the characteristics of the attended population contribute for care planning according to the real needs of people with a stoma, thereby enabling greater effectiveness of the service and consequently greater user satisfaction.

Enteroparasitosis en una población de escolares de la red de enseñanza pública del Municipio de Mirassol, São Paulo, Brasil

Diseases that originate from enteric parasites are major public health problems worldwide and contribute to high rates of morbidity and mortality, especially in 1,2 developing countries . In these countries, it is estimated that approximately one-third of the population lives under environmental conditions that are favorable for the 3 spread of parasitic infections . Worldwide, infections by protozoa and helminths affect 3.5 billion people, and these organisms cause disease in approximately 450 4 million people . In most cases, enteric parasites are transmitted orally by ingesting food or water that is contaminated with parasites. In Brazil, the wide diversity of socioeconomic characteristics, climate and geography are critical for the etiologic agent profile in diarrhea, thus modeling the frequency of these different enteric 5,6 pathogens . ABSTRACTThis study observed the prevalence of intestinal parasites in 310 students (2 to 15 years old) enrolled in a public school in the Municipality of Mirassol, Sao Paulo State, Brazil. A stool sample was collected from each child and analyzed by the methods of Faust and Hoffmann, Pons and Janer, normally used for detection of protozoa and human helminths. A total of 30.3% of the children analyzed were parasitized, with at least one pathogenic intestinal parasite. Giardia Lamblia was the most common protozoan (15.16%), followed by Entamoeba histolytica (0.64%). The helminths found were Ascaris lumbricoides (3.55%), Strongiloides stercoralis and Taenia sp, which were diagnosed in 0.32% of the samples. There was a significant association between the occurrence of enteroparasitoses and the use of tap water. The comparison between the age groups, gender and the presence of parasites showed no statistical relevance. Although there was no association between gastrointestinal disorders and the occurrence of intestinal parasitic diseases, these agents may cause new infections because the children can act as carriers and therefore a source of contamination. This article suggests that a continuing education program focused on the prevention and treatment of parasitic infections is a key measure for their eradication.