Raúl Tello

Treatment failure in intestinal strongyloidiasis: an indicator of HTLV-I infection

BACKGROUND The association of severe strongyloides with HTLV-I is well known; however, the seroprevalence of HTLV-I in other groups with strongyloidiasis is still unknown. We conducted a prospective study in patients with intestinal strongyloidiasis without known immunodepression who failed to respond to standard therapy with ivermectin or thiabendazole (failure was defined as one positive stool examination at the post-therapy follow up). All these patients were tested for HTLV-I by ELISA and Western Blot. RESULTS Forty seven patients were evaluated: 74.5% (35 out of 47) were HTLV-I positive, without significant difference between males (76%) and females (72.7%). CONCLUSIONS We recommend that all patients with uncomplicated intestinal strongyloidiasis, who fail standard therapy, be studied for HTLV-I infection.

Sintomatología y factores epidemiologicos asociados al parasitismo por Blastocystis hominis

To contribute to the knowledge of symptoms and factors associated with the infection by Blastocystis hominis of patients attending the outpatient clinic of the Department of Enfermedades Transmisibles y Dermatologicas (DETD) of the Hospital Nacional Cayetano Heredia. A prospective case-control study was carried out from January to March 1999, in patients between the ages of 5 to 80 years. The case-patients had a positive stool examination for B. hominis (in the absence of other pathogens such helminths) done at the laboratory of Tropical Medicine. The controls had at least 2 of 3 negative fecal samples of B. hominis, in absence of other pathogens. The presence of B. hominis was examined under direct microscopy (high-power field x 400) and it was rated from 1 plus to 4 plus according to the quantity of parasites present. Epidemiological data, symptomatology and the factors associated with infection in each patient were registered A total of 144 persons (74 cases and 70 controls) matched by age and sex were included in the study. A significant statistical correlation (p < 0.05) was found between the presence of B. hominis and the presence of symptoms (91.9%). The predominant symptoms in order of significance (p < 0.05), associated to the infection by B. hominis were: abdominal pain (OR = 3) 1.47 < OR < 6.60, abdominal distention (OR = 2.36) 1.06 < OR < 5.29, urticaria (OR = 3.19) 0.81 < OR < 12.48. The only risk factor found associated with the infection with B. hominis, was the consumption of raw unboiled water (OR = 2.52) 1.01 < OR < 5.83

Highly effective and inexpensive parasitological technique for diagnosis of intestinal parasites in developing countries: spontaneous sedimentation technique in tube

Millions of low-income people in the world are affected by intestinal parasites. Inexpensive, simple, and effective techniques for diagnosis are necessary. The spontaneous sedimentation technique in tube (SSTT), for application in poor healthcare settings and under field-work conditions, was described 25 years ago in Peru by Tello. The advantages of the SSTT are its ability to detect the majority of intestinal parasites, including eggs, larvae, cysts, and trophozoites, and its low cost.