Mirthes Ueda

Visceral larva migrans: a seroepidemiological survey in five municipalities of São Paulo State, Brazil

An enzyme-linked immunosorbent assay (ELISA), employing antigens from Toxocara canis larvae and the absortion of suspected sera with Ascaris lumbricoides extracts was used in a seroepidemiological study performed in five municipalities of São Paulo State, Brazil (São Paulo, Campinas, Santos, Marília and Presidente Prudente) in order to determine the frequency of antibodies to Toxocara. In 2,025 blood samples collected, 806 proceeded from male subjects and 1,219 from females; 483 samples were collected from subjects under 15 years of age and the remaining 1,542 from subjects aged 15 years or over. Among the 2,025 sera investigated, 3.60% had antibodies to Toxocara at significant levels. A moderate predominance of infection with Toxocara among male subjects (3.72%) was observed, although the difference was not statistically significant when this rate was compared with that for female (3.28%). Related to age, a higher frequency of positive results was detected among subjects under 15 years (6.41%) against the older group (2.53%). A trend of more elevated rates of infection was observed in municipalities with high demographic densities (São Paulo, Campinas and Santos). Nevertheless, such findings only appeared to be statistically significant in subjects younger than 15 years.

Incidence and clinical characteristics of the infection by the Respiratory Syncytial Virus in children admitted in Santa Casa de São Paulo Hospital

The purpose of this study was to identify the rate of infections due to RSV and other viruses in children. In addition we have analyzed demographic data and clinical characteristics of the RSV-positive patients comparing with patients infected by other respiratory viruses. We also described the seasonality of the RSV occurrence in a hospital in São Paulo. Children below 5 years old admitted in Santa Casa de São Paulo Hospital between February 2005 and September 2006 due to acute respiratory infections (ARI) were included. A nasopharyngeal specimens were obtained with sterile No. 5 French feeding catheters as soon as possible (usually within 24 h). Specimens were kept refrigerated at 4 degrees C and transported to Adolfo Lutz Institute, where the indirect immunofluorescent assay was performed. Virus identified by these assay included RSV, Adenovirus, Influenza A and B virus and Parainfluenza 1, 2, and 3. Clinical data from each group was compared. Four hundred and fifty five cases were included in the study, with 30% positive for some type of virus. Viruses that were identified included Respiratory Syncytial Virus (73.03%), Influenza (8.42%), Parainfluenza (8.42%) and Adenovirus (3.37%). We divided the subjects in 3 groups: Group 1 RSV-Positive, Group 2 Other Positive Viruses and Group 3 Negative for Respiratory Virus. Mean age (months) was of 7.5 for RSV-positive children, 7.6 for other viruses, and 8 for negative for respiratory virus. The RSV-Positive Group was significantly younger than the Group Negative for Respiratory Virus (p<0.05). Signs of UAI were more present in the Positive RSV Group (p<0.05). General mortality was of 2.41%. There was a higher incidence of RSV between the months of March and August in the two years of the study. Our study indicates RSV as the most prevalent viral agent in children admitted due to (ARI), especially in infants below 3 months old. We have also found that infections due to RSV can occur in months others than the classic seasonal period.

Prevalência de deficiência de vitamina A e fatores associados em pré-escolares de Teresina, Piauí, Brasil

A deficiencia de vitamina A constitui um problema de saude publica no Nordeste brasileiro. O objetivo deste estudo foi determinar a prevalencia da deficiencia de vitamina A e os fatores associados em pre-escolares de Teresina, Piaui, Brasil. Os niveis de retinol serico foram determinados por HPLC, e foram investigadas as caracteristicas socio-economicas e demograficas de 631 criancas com idade de 36 a 83 meses. Investigou-se a associacao entre os niveis de retinol e as variaveis de interesse por analise de regressao linear uni e multivariada. O nivel medio de retinol foi de 1,21mmol/L (IC95%: 1,17-1,25µmol/L), independente do sexo (p = 0,259). A hipovitaminose A (retinol < 0,69µmol/L) foi observada em 15,4% das criancas (IC95%: 12,7-18,4), com tendencia a diminuicao com o avanco da idade; 29% das criancas (IC95%: 25,2-32,4) tinham valores aceitaveis de retinol, mas nao adequados (0,70 a 1,04µmol/L). Encontrou-se associacao positiva entre niveis de retinol e idade, renda per capita, suplementacao previa com vitamina A e escolaridade materna. A prevalencia de hipovitaminose A representa um problema moderado de saude publica, ressaltando a importância das estrategias de combate a essa carencia na regiao.

Assessment of the rapid test based on an immunochromatography technique for detecting anti-Treponema pallidum antibodies

A rapid test based on an immunochromatography assay - Determine Syphilis TP (Abbott Lab.) for detecting specific antibodies to Treponema pallidum was evaluated against serum samples from patients with clinical, epidemiological and serological diagnosis of syphilis, patients with sexually transmitted disease other than syphilis, and individuals with negative serology for syphilis. The Determine test presented the sensitivity of 93.6%, specificity of 92.5%, and positive predictive value and negative predictive value of 95.2% and 93.7%, respectively. One serum sample from patient with recent latent syphilis showed a prozone reaction. Determine is a rapid assay, highly specific and easy to perform. This technique obviates the need of equipment and its diagnostic features demonstrate that it may be applicable as an alternative assay for syphilis screening under some emergency conditions or for patients living in remote localities.

Contacto domiciliar e profissional com cães como fatores de risco para infecção humana por larvas de Toxocara

The contact with dogs at home or place of work has been investigated as factors of risk in the occurrence of the visceral larva migrans syndrome caused by Toxocara, in man. Through the E.L.I.S.A. (enzyme-linked immunosorbent assay) technique, the presence of antibodies to Toxocara was searched in the sera of 79 women who have been raising or had raised dogs at home in the last two years and 123 men, who were municipal public employees in charge of the capture and keeping of stray dogs. The control groups were constituted by 205 sera from women who denied domiciliary contact with dogs, at least in the last two years, and 139 sera from men whose occupation did not urge them to contact with dogs. A significant more elevated frequency of antibodies to Toxocara was observed among women with domiciliary contact with dogs; nevertheless, there was not a significant difference in the positive rates in the case of men with occupational contact with dogs.Investigou-se o papel do contacto com caes no domicilio e na atividade profissional como fatores de risco para transmissao de larvas de Toxocara sp. a seres humanos, acarretando a sindrome de larva migrans visceral. Atraves de tecnica imunoenzimatica (E.L.I.S.A.) pesquisou-se a presenca de anticorpos anti-Toxocara no soro de 79 mulheres adultas, residentes no municipio de Sao Paulo, que possuiam, ou possuiram nos dois ultimos anos, caes em seus domicilios e de 123 homens adultos, funcionarios da Prefeitura Municipal de Sao Paulo, encarregados da captura de caes vadios e de sua manutencao em canis. Como controles utilizaram-se os soros de 205 mulheres adultas que nao possuiram, nos dois ultimos anos, caes em suas casas e de 139 homens adultos, cuja atividade profissional nao os obrigava a manter contacto com caes. Os resultados indicaram que, nas condicoes do presente trabalho, a posse de caes no domicilio constitui fator de risco para transmissao de larvas de Toxocara a seres humanos, ao contrario do verificado para o contacto profissional com caes.

Rate and incidence estimates of recent human immunodeficiency virus type 1 infections among pregnant women in São Paulo, Brazil, from 1991 to 2002

ABSTRACT The serological testing algorithm for recent human immunodeficiency virus (HIV) seroconversion (STARHS) was employed to estimate HIV incidence among pregnant women from São Paulo, Brazil. A cross-sectional study (1999 to 2002) showed an incidence of infection of 0.2 per 100 pregnant women per year (95% confidence interval, 0.041 to 0.608). Western blot profiles suggested an association between results of the STARHS analysis and gp41/gp31 bands.

Estudo comparativo de testes sorológicos no diagnóstico imunológico da neurocisticercose

Estudamos comparativamente quatro tecnicas imunologicas para o diagnostico da neurocisticercose (NC) utilizando liquido cefalorraquiano (LCR) como especime clinico: as reacoes de fixacao de complemento (RFC), hemaglutinacao passiva (RHA), imunofluorescencia indireta (RIF) e teste imunoenzimatico ELISA Foram ensaiadas 125 amostras de LCR de pacientes com NC comprovada e 94 amostras de LCR do grupo controle (60 de pacientes com quadros clinicos neurologicos diversos e 34 de pacientes supostamente normais). Os indices de sensibilidade e especificidade obtidos para os testes foram, respectivamente, de 48,0% e 90,4% para a RFC; 88,8% e 96,8% para a RHA; 87,2 e 98,9% para a RIF e 97,6% e 98,9% para o teste ELISA. A diferenca significativa (p < 0,05) observada entre os testes permite concluir que o melhor teste para o diagnostico de NC foi o teste ELISA seguido das reacoes de HA e IF.

The impact of vitamin A supplementation on the immune system of vitamin A-deficient children.

BACKGROUND & AIMS To investigate the effect of vitamin A supplementation on parameters of the immune system of vitamin A-deficient children. METHODS The study was carried out in four phases: 1) determination of serum retinol in 631 children from 36 to 83 months of age; 2) assessment of immunological markers [immunoglobulins and complement fractions, immunophenotyping of T and B lymphocytes, and natural killer (NK) cells], blood count, and serum ferritin of 52 vitamin A-deficient children (serum retinol < 0.70 micromol/L); 3) supplementation of the 52 deficient children with 200,000 IU of vitamin A; 4) determination of serum retinol and the immunological parameters 2 months after vitamin A supplementation. RESULTS before vitamin A supplementation, 24.0 % of the children were anemic and 4.3 %had reduced ferritin concentrations. There was no significant difference between mean values of retinol according to the presence/absence of anemia. The mean values of the humoral and cellular immunological parameters did not show a statistically significant difference before and after supplementation with vitamin A. Children with concomitant hypovitaminosis A and anemia presented a significant increase in absolute CD4 and CD8 T-cell counts after vitamin A supplementation (p < 0.05). CONCLUSION vitamin A had an effect on the recruitment of T and B lymphocytes to the circulation of children with hypovitaminosis A and anemia.

Analysis of Treponema pallidum recombinant antigens for diagnosis of syphilis by western blotting technique.

Three GST fusion recombinant antigen of Treponema pallidum, described as GST-rTp47, GST-rTp17 and GST-rTp15 were analyzed by Western blotting techniques. We have tested 53 serum samples: 25 from patients at different clinical stages of syphilis, all of them presenting anti-treponemal antibody, 25 from healthy blood donors and three from patients with sexually transmitted disease (STD) other than syphilis. Almost all samples from patients with syphilis presented a strong reactivity with GST-rTp17 antigen. Some samples were non-reactive or showed a weak reaction with GST-rTp47 and/or GST-rTp15, and apparently there was no correlation with the stage of disease. There was no seropositivity among blood donors. No sample reacted with purified GST. We concluded that due to their specificity these recombinant antigens can be used as GST fusion protein for development of syphilis diagnostic assays.

Teste imunoenzimático (ELISA) para detecção de anticorpos circulantes da classe IgM na leptospirose humana

An Enzyme-linked immunosorbent assay ELISA was evaluated for the detection of IgA antibodies in the human leptospirosis. The assay proved to be sensitive and specific when compared with the ELISA-IgM, in the examinated serum samples. The results found suggest that IgA antibodies became positive later in leptospirosis, and will can be an evolutive indicator in the development of the diseaseFoi avaliado o teste imunoenzimatico (ELISA), para deteccao de anticorpos da classe IgM na leptospirose humana. Nas amostras de soros analisadas, o teste ELISA demonstrou ser mais sensivel, especifico e precoce, quando comparado ao teste de soroaglutinacao microscopica. A analise dos resultados obtidos nesta avaliacao demonstra que o teste ELISA permite detectar niveis baixos de anticorpos circulantes, e tambem anticorpos nao aglutinantes. nao detectaveis atraves do teste de soroaglutinacao microscopica.