Roberto Ruhman Daher

Intestinal protozoa and helminths among Terena Indians in the State of Mato Grosso do Sul: high prevalence of Blastocystis hominis

A parasitological survey was carried out among Terena Indians living in the Tereré settlement in the municipality of Sidrolândia, State of Mato Grosso do Sul, Brazil. Single samples of feces from 313 Indians were processed by means of the spontaneous sedimentation method. In the population studied, 73.5% were infected with at least one intestinal parasite or commensal. Protozoa predominated. Blastocystis hominis (40.9%), Entamoeba coli (33.2%) and Entamoeba histolytica/Entamoeba dispar (31.6%) were the most common. Bivariate analysis showed that females were generally more infected and presented higher rates of infection by Entamoeba histolytica/Entamoeba dispar and Entamoeba coli. Males were more infected by hookworms and Strongyloides stercoralis than females. The precarious sanitary conditions of the Tereré settlement are probably a contributory factor towards the high prevalence of intestinal protozoa.

Seroprevalence of hepatitis B virus infection and seroconvertion to anti-HBsAg in laboratory staff in Goiânia, Goiás

Were analyzed 648 serum samples from laboratory staff in Goiânia, Goiás aiming detection of three serological markers of HBV: HBsAg, anti-HBsAg and anti-HBcAg. The HBsAg and anti-HBcAg positive samples were also analyzed for HBeAg, anti-HBeAg and anti-HBcAgIgM markers. HBV infection rate of 24.1% was observed and, from them, 0.7% were positive for HBsAg. Viral DNA was detected by PCR in two HBsAg positive samples. A vaccination index of 74.5% and a global index of 89.9% of serological response to vaccination were observed. The direct work with biological fluids as well as cleaning workers represented significant risks for acquisition of HBV infection. The data from the present study showed an increase of the vaccination index among laboratory staff but the rates of HBV infection did not change through the years in the region.

Seroprevalence of hepatitis B virus infection in patients with mental problems

OBJECTIVES Hepatitis B virus (HBV) infection is an important worldwide public health problem and it has been cause of elevated morbidity and mortality rates. The objectives of this study were determine the HBV infection seroprevalence in psychiatric institutions and in individuals with Downs syndrome, detect viral DNA in HBsAg and anti-HBc total positive serum samples and determine the HBsAg subtypes circulating these groups. METHODS The study assessed 433 subjects, with 408 being mentally disordered inpatients (71 had also chemical dependence), and 25 were Downs syndrome outpatientes. Blood samples were collected and tested for HBV markers: HBsAg, anti-HBs and anti-HBc total by enzyme-linked immunosorbent assay (ELISA). HBsAg positive samples were also tested for anti-HBc IgM, HBeAg, anti-HBe, and subtyped by radial immunodifusion. HBV-DNA was investigated in HBsAg and/or anti-HBc total positive samples by PCR methodology. RESULTS A global HBV positivity of 22.4% was detected. HBsAg was found in 1.6% of the samples. Among them, five were subtyped as adw2, adw4 and ayw3. DNA viral was found in 3 HBsAg samples and 11 HBsAg and anti-HBc total/anti-HBs positive samples, respectively. The risk factors analysis showed that multiple hospital admission were significantly associated with HBV markers. CONCLUSION These results show high HBV seroprevalence in groups investigated and reinforce the importance of HBV specifics preventive measures to reduce the risk of hepatitis B in individuals with mental disturbs and retard.

Prevalence of antibodies to hepatitis B core antigen in blood donors in the middle west region of Brazil

The prevalence of antibodies to hepatitis B core antigen in 552 prime blood donors was of 9.4%. The majority (71.2%) has antibodies to hepatitis B surface antigen. The hepatitis B surface antigen was present in 0.7%, all of them antibodies to hepatitis B core antigen positive.

Risk factors and prevalence of antibodies against hepatitis A virus (HAV) in children from day-care centers, in Goiania, Brazil

A seroepidemiologic survey about hepatitis A virus (HAV) infection was carried out in a group comprising 310 children, ranging in age from 3 months to 9 years, from day-care centers, in Goiania, a middle sized city in the central region of Brazil. The biomarkers employed in the investigation of previous infection include total IgG and IgM anti-HAV antibodies, and for the detection of more recent infection, IgM anti-HAV antibodies were analyzed. The study was performed in 1991 and 1992. According to the results, 69.7% of the children presented total IgG/IgM anti-HAV antibodies, with 60% of the group in the age range of 1 to 3 years. Among 10 day-care centers analyzed, the prevalence of the biomarker IgM anti-HAV was 3.2%, with an uniform distribution of the cases in the group of children ranging in age from 1 to 4 years. Multivariate analysis was performed to investigate the sociodemographic factors that could influence the results. It was verified that the risk for the infection increased with the length of the attendance in the day-care centers, i.e., the risk for children with attendance of one year or more was 4.7 times higher, when compared with children with one month attendance (CI 95% 2.3-9.9). According to the results, hepatitis A is an endemic infection in day-care centers in the study area. The length of attendance in the day-care settings was demonstrated to be a risk factor for the HAV infection. Such findings suggest that if hepatitis A vaccination becomes available as a routine policy in our region, the target group should be children under one year. Moreover, those children should receive the vaccine before they start to attend the day-care centers.

Soroepidemiologia para o virus da hepatite B (VHB) em gestantes/parturientes e sua transmissão para recém-nascidos em Goiânia, GO

In order to detect hepatitis B virus (HBV), 1459 serum samples from pregnant/parturient women were collected at two public hospitals in Goiânia, GO. These samples were tested by enzyme linked immunosorbent assay forHBsAg and anti-HBs. 109 (7.5%) serum samples were positive. Eight (0.5%) sera were positive for HBsAg and 101 (7.0%) for anti-HBs. Viral positivity for both HBsAg and anti- HBs were observed in women which age ranged from 15 to 30 years. Four newborns from HBsAg positive mothers were submitted to the treatment with HBV vaccine (Engerix B) and with hyperimmune gammaglobulin (HBIG - Abbott Laboratories - Brazil). Cord blood from one of the newborns was positive for HBsAg. A positive association was found between hepatitis B and sexually transmited infections and blood transfusion. These results emphasize the need for prenatal sereening for HBV in pregnant women and treatment of the newborns from AgHBs positive mothers.

Soroepidemiologia da infecção pelo vírus da hepatite A em "meninos de/na rua" de Goiânia-Goiás

A cross-sectional study was performed to determine the age-prevalence of hepatitis A virus (HAV) among street youth from Goiania city--Central Brazil, and to determine if any risk factors could be identified. The surveys were conducted between 1991/1992. The street youth were 397 individuals aged 7 to 21 years old living in institutions and teenagers working at streets. Then, 313 adolescents working at streets and with family links, and 84 institutionalized ones without family were screened for antibodies against HAV. Prevalences ranged from 80.0% to 92.2% to total anti-HAV and there was not a statistically significant trend of positivity with age in this group. Univariate analysis for risk factors associated with HAV infection was performed with no statistically significant difference for adolescents working at streets and living with parents, and street youth with family links. Economic variables were not statistically associated with seropositivity, probable due to homogeneous characteristics of the group. This study disclosed that street youth have a high rate of HAV infection. These findings do not suggest differences between subgroups of populations in acquiring immunity to HVA. The public health implication and the need of screening other subgroups of population of the same city were suggested in order to discuss vaccine strategy in underdeveloped countries.

Rastreamento sorológico para hepatite B em profissionais de saúde na cidade de Goiânia - Goiás

Markers for hepatitis B virus in health care workers were analysed in 625 employees of three institutions in Goiânia city. The virus prevalence was 23.4 % related to different markers (AgHBs, anit-HBs and anti-HBc). Among the positive individuals, 1.3% presented acute infection, 1.0% were virus carriers and21.1% presented only anti-HBs and 32.6% only anti-HBc as markers. There were 19 reports of virus vaccination. Eight of them seroconvertedfor anti-HBs and 6 were positive for both anti-HBc and anti-HBs. Higher prevalence rates were found above 30 year of age (p< 0.05). The male and female prevalence rates were 29.5 % and 21.1% (p< 0.05) respectively. The virus prevalence rates among blood and patient contacts were 25.9% (p< 0.05) and the highest prevalence was found in persons followed up for at least tenyears fp < 0.05). The greatest risk section has shown to be hemodialysis unitpersonnelwith a percentual of 77% (p< 0.05).Markers for hepatitis B virus in health care workers were analysed in 625 employees of three institutions in Goiânia city. The virus prevalence was 23.4% related to different markers (AgHBs, anit-HBs and anti-HBc). Among the positive individuals, 1.3% presented acute infection, 1.0% were virus carriers and 21.1% presented only anti-HBs and 32.6% only anti-HBc as markers. There were 19 reports of virus vaccination. Eight of them seroconverted for anti-HBs and 6 were positive for both anti-HBc and anti-HBs. Higher prevalence rates were found above 30 year of age (p < 0.05). The male and female prevalence rates were 29.5% and 21.1% (p < 0.05) respectively. The virus prevalence rates among blood and patient contacts were 25.9% (p < 0.05) and the highest prevalence was found in persons followed up for at least ten years (p < 0.05). The greatest risk section has shown to be hemodialysis unit personnel with a percentual of 77% (p < 0.05).

Seroprevalence of hepatitis B virus infection in individuals with clinical evidence of hepatitis in Goiânia, Goiás. Detection of viral DNA and determination of subtypes.

The presence of serological markers for hepatitis B virus (HBsAg, anti-HBc IgM and Anti-HBc total) was investigated in the serum of 1,396 individuals who had clinical suspect of hepatitis. It was observed that 50.7% of the individuals were positive and, from the total of the studied individuals, 14.5% were positive for HBsAg. From these, 8.5% were also positive for anti-HBc IgM. The analysis in relation to gender showed a higher seroprevalence index among male individuals (p < 0.0001). It was observed the occurrence of subtypes adw2 (62.7%), ayw3 (23.5%), ayw2 (9.8%) and adw4 (3.9%). The viral DNA was detected in 61 (33.9%) HBsAg positive samples and in one sample positive only for anti-HBc total. These results indicate an important incidence of the HBV infection in this population, and reinforce previous studies regarding this virus in the central west region of Brazil.

Soroprevalência do vírus da hepatite C na população em diálise de Goiânia, GO

The patients were 173, aged 10 to 70 years old. An Elisa II test was undertaken and 61 to 173 (35.3%) had positive test; when INNO-LIA test was made, soropositivity was 26% (44/173). Patients with anti-VHC antibodies have been kept on hemodialysis treatment for periods longer than negatives (p < 0.05). Neither drugs users, blood transfusions, sexual and aminotransferase activity were significantly correlated with the infection. There is an elevated prevalence of anti-VHC antibodies among chronic hemodialysis patients which seems to be related to the time that patients are on dialysis treatment.