Focal persistence of soil-transmitted helminthiases in impoverished areas in the State of Piaui, Northeastern Brazil

This study aims to describe the prevalence, distribution, and factors associated with soil-transmitted helminthiases (STHs) in rural localities in Piaui, Brazil. Two cross-sectional surveys (n=605 subjects; 172 families) were carried out in order to obtain socio-demographic, anthropometric, spatial and parasitological data. Parasites were evaluated using Kato-Katz and centrifugal sedimentation techniques. Eggs were measured to assess infection with zoonotic Strongylida parasites. Kernel maps were constructed with Q-GIS. The prevalence of hookworm infection was 12.4% (75/605). Other helminthes found were Trichuris trichiura (n=1; 0.2%) and Hymenolepis nana (n=1; 0.2%). The hookworm positivity rate was significantly lower among subjects who had used albendazole when compared with individuals who had not used anthelmintics or had used antiprotozoal drugs in the last 6 months (8/134 [6.0%] vs. 59/415 [14.2%]; p=0.009). A total of 39/172 (22.7%) families had at least one infected member. The association between the number of dwellers and hookworm positivity in the family was present in a logistic regression multivariate model. Assessment of worm burdens showed 92.2% light, 6.2% moderate, and 1.6% heavy infections. Hookworm eggs (n=34) measured 57.2 - 75.4 µm in length and 36.4 - 44.2 µm in width (mean ± SD = 65.86 ± 4.66 µm L and 40.05 ± 1.99 µm W), commensurate with human hookworms. Hotspots suggest that transmission has a focal pattern. STHs persist in impoverished rural areas in Northeastern Brazil where currently available control strategies (mass drug administration) apparently do not allow the elimination of the infection

Giardia duodenalis em três municípios das regiões norte e nordeste do Brasilestudo epidemiológico, molecular e ações de educação em saúde

Submitted by Gilvan Almeida ([email protected]) on 2017-05-17T14:39:51Z No. of bitstreams: 2 license.txt: 1748 bytes, checksum: 8a4605be74aa9ea9d79846c1fba20a33 (MD5) 72954.pdf: 17590387 bytes, checksum: 26291419cc638fbedc0df62ac4a427e2 (MD5)Approved for entry into archive by Anderson Silva ([email protected]) on 2017-06-14T18:57:57Z (GMT) No. of bitstreams: 2 72954.pdf: 17590387 bytes, checksum: 26291419cc638fbedc0df62ac4a427e2 (MD5) license.txt: 1748 bytes, checksum: 8a4605be74aa9ea9d79846c1fba20a33 (MD5)Made available in DSpace on 2017-06-14T18:57:57Z (GMT). No. of bitstreams: 2 72954.pdf: 17590387 bytes, checksum: 26291419cc638fbedc0df62ac4a427e2 (MD5) license.txt: 1748 bytes, checksum: 8a4605be74aa9ea9d79846c1fba20a33 (MD5) Previous issue date: 2016Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Rio de Janeiro, RJ, BrasilObjetivos. Estimar a prevalência, a distribuição e fatores de risco associados à infecção em três municípios brasileiros, avaliar o impacto da infecção sobre o estado nutricional das crianças, caracterizar genotipicamente Giardia duodenalis, estabelecer relações filogenéticas entre G. duodenalis identificadas nos municípios estudados, analisar a relação entre giardíase e pobreza nas áreas estudadas e envolver os participantes em ações de esclarecimento sobre os parasitos intestinais. Metodologia. Foram realizados estudos transversais, entre 2011 e 2014, nos municípios de Russas (RSS) (n=213), no Ceará, Nossa Senhora de Nazaré (NSN) (n=298), no Piauí e Santa Isabel do Rio Negro (SIRN) (n=433), no Amazonas para obtenção de dados parasitológicos, sociodemográficos e nutricionais. As amostras positivas para G. duodenalis tiveram os ácidos nucleicos extraídos para amplificação e sequenciamento dos genes codificantes das proteínas \03B2- giardina, glutamato-desidrogenase (gdh) e triose-fosfato-isomerase (tpi). A reconstrução filogenética foi feita segundo os modelos bayesiano e de máxima verossimilhança. Foram inferidas genealogias (ou redes haplotípicas) das sequências no programa NETWORK 4.6. Variáveis antropométricas foram obtidas de crianças até 14 anos de RSS e NSN para análise dos escores-Z dos indicadores estatura por idade (HAZ), peso por idade (WAZ) e peso por estatura (WHZ). O geoprocessamento foi realizado com Sistema de Posicionamento Global no datum geodésico SAD-69. Os dados espaciais foram analisados com ArcGis 9.3. Atividades de educação em saúde foram realizadas nas localidades estudadas dos municípios de Russas e Nossa Senhora de Nazaré Resultados. A prevalência da infecção por G. duodenalis foi 14,1% em RSS, 8,4% em NSN e 16,9% em SIRN. A giardíase esteve associada à fonte de água para consumo e à pobreza em RSS. Em NSN, a positividade para G. duodenalis esteve associada à defecação a céu aberto e ao maior número de moradores da casa. Nos municípios estudados, alguns hotspots de positividade foram identificados pela análise espacial. Em RSS e NSN a desnutrição crônica definida por HAZ < -2 e o baixo peso (WAZ < -2) estiveram associados a uma maior chance de infecção por G. duodenalis (odds ratio=5,66, intervalo de confiança de 95%=1,57 a 20,33, p=0,008 e OR=3,62, IC 95%=1,09 a 11,94, p=0,035, respectivamente) após ajuste para renda, faixa etária, sexo e município em um modelo multivariado por regressão logística. A análise do gene \03B2-giardina resultou em 22 (31%) isolados classificados em assemblage A e 49 (69%) em assemblage B; pelo gene gdh 13 (31%) foram assemblage A e 29 (69%) assemblage B; e pelo tpi 13 (48,1%) amostras do assemblage A e 14 (51,9%) do assemblage B. Em SIRN, os assemblages A e B estavam distribuídos em toda a região estudada. Enquanto assemblage A exibiu baixa diversidade de haplótipos, o assemblage B exibiu uma alta diversidade genética. Conclusões. A giardíase teve elevadas prevalências nas áreas, com relação com repercussão sobre o desenvolvimento pondero-estatural das crianças, presente em biomas distintos, submetidos a diferentes graus de estresse hídrico. A infecção nem sempre esteve associada à renda, havendo importantes determinantes socioambientais em áreas com infraestrutura sanitária inadequadaObjectives. In this study, we intended to: i) estimate the prevalence, distribution and factors associated with Giardia duodenalis infection in three municipalities, ii) assess the impact of infection on the nutritional status of children, iii) characterize genotypically G. duodenale, establishing phylogenetic relationships between parasites identified in the cities studied, iv) analyzing the relationship between giardiasis and poverty in the studied areas and v) engage participants in educational activities on intestinal parasites. Methods. We carried out cross-sectional surveys from 2011-2014 in the municipalities Russas (RSS) (n=213), in Ceará State, Nossa Senhora de Nazaré (NSN) (n=298), in Piauí and Santa Isabel do Rio Negro (SIRN) (n=433), in Amazonas, in order to obtain parasitological, socio-demographic and anthropometric data. G. duodenalis-positive samples were submitted to DNA extraction in order to amplify and sequence genes coding \03B2-giardin, glutamate dehydrogenase (gdh) e triosephosphate-isomerase (tpi). Phylogenetic reconstructions were performed according to the Bayesian and maximum likelihood models. We inferred genealogies (or haplotype networks) of the sequences with NETWORK 4.6. Anthropometric variables were assessed from children up to 14 years in NSN and RSS for analysis of the height-for-age (HAZ), weight-for-age (WAZ) and weight-for-height (WHZ) Z-scores. The geographic information system was conducted on the geodetic datum SAD-69. Spatial data were analyzed with ArcGIS 9.3. Health education activities were performed in RSS and NSN Results. The prevalence of infection with G. duodenalis was 14.1% in RSS, 8.4% in NSN, and 16.9% in SIRN. Giardiasis was associated with the source of water for consumption and with poverty in RSS. In NSN, positivity for G. duodenalis was associated with open defecation and the largest number of residents living in the house. In the municipalities studied, some hotspots were identified by spatial analysis. In RSS and NSN chronic malnutrition defined by HAZ <-2 and low weight (WAZ <-2) were associated with a greater chance of infection with G. duodenalis (odds ratio=5,66, 95% confidence interval=1,57-20,33, p=0,008 e OR=3,62, 95% CI 95%=1,09-11,94, p=0,035, respectively) after adjusting for income, age, sex and municipality in a multivariate logistic regression model. The analysis of \03B2-giardin gene resulted in 22 (31%) isolates classified in the assemblage A and 49 (69%) in assemblage B; with the gdh gene 13 (31%) were assemblage A and 29 (69%) assemblage B; and by the tpi 13 (48.1%) were assemblage A and 14 (51.9%) were the assemblage B. In SIRN, the assemblages A and B were distributed throughout the study area. While assemblage A exhibited low diversity of haplotypes, assemblage B exhibited a high genetic diversity. Conclusions. In the areas studied, giardiasis is a highly prevalent parasitic disease, affecting the physical growth of children, present in different biomes, subjected to different degrees of water stress. The infection is not always associated with income, presenting socio-environmental determinants in areas with inadequate health infrastructur

Parasitoses intestinais na Ilha da Marambaia, Mangaratiba-RJ e intervenção educativa

O presente estudo objetivou avaliar a freqüência de infecções e identificar as espécies parasitárias circulantes em estudantes e funcionários da Escola Municipal Levy Miranda, Ilha da Marambaia, Mangaratiba-RJ, bem como em amostras fecais coletadas no ambiente, para fomentar ações em educação em saúde, e aplicado questionário para identificação dos saberes e obtenção de dados epidemiológicos. Dos 72 estudantes que aderiram ao estudo, 45 entregaram amostras de material fecal, sendo que na 1ª coleta, 22/34 estavam positivas, e na 2ª, 12/21 apresentaram positividade, com predominância para formas evolutivas de protozoários. Já quanto aos profissionais da escola, 16/25 aderiram à pesquisas, e seis entregaram amostras fecais, sendo duas positivas. Nas amostras de material subungueal, uma apresentou positividade para Enterobius vermiculares. Das 105 amostras coletadas do ambiente, 86 apresentaram positividade para ao menos uma forma evolutiva de parasito. Ovos de ancilostomídeos foram as formas evolutivas mais frequentes, sendo observados em 79 amostras. Observou-se elevada prevalência de parasitos intestinais nos escolares na Ilha da Marambaia, o que representa um grave problema de saúde pública. Não houve associação significativa entre as variáveis do questionário epidemiológico e a positividade nos resultados dos exames de fezes dos estudantes para nenhuma das variáveis estudadas. Foram realizadas oito atividades de educação em saúde pública devido a elevada freqüência de ovos de ancilostomídeos. Foram evidenciados conhecimentos corretos sobre parasitoses intestinais dentre os escolares e funcionários, observando-se a ampliação e sedimentação, após a intervenção educativa. As ações educativas em saúde desenvolvidas propiciaram a mediação da informação cientifica e a interação coletiva de uma cartilha educativa sobre parasitoses intestinais. as ações desenvolvidas possibilitaram a sensibilização da comunidade escolar, tornando-os mais aptos a intervir no meio em que vivem, em relação a parasitoses intestinais

Spatial and Molecular Epidemiology of Giardia intestinalis Deep in the Amazon, Brazil

Submitted by Sandra Infurna ([email protected]) on 2017-02-09T15:39:53Z No. of bitstreams: 1 beatriz_nunes_etal_IOC_2016.pdf: 1599651 bytes, checksum: c6fe43adb7c313b98638c98b7590e84e (MD5)Approved for entry into archive by Sandra Infurna ([email protected]) on 2017-02-09T15:46:52Z (GMT) No. of bitstreams: 1 beatriz_nunes_etal_IOC_2016.pdf: 1599651 bytes, checksum: c6fe43adb7c313b98638c98b7590e84e (MD5)Made available in DSpace on 2017-02-09T15:46:52Z (GMT). No. of bitstreams: 1 beatriz_nunes_etal_IOC_2016.pdf: 1599651 bytes, checksum: c6fe43adb7c313b98638c98b7590e84e (MD5) Previous issue date: 2016Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Rio de Janeiro, RJ. Brasil.Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Rio de Janeiro, RJ. Brasil.Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Rio de Janeiro, RJ. Brasil.Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Rio de Janeiro, RJ. Brasil.Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Rio de Janeiro, RJ. Brasil.Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Rio de Janeiro, RJ. Brasil.Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Rio de Janeiro, RJ. Brasil.Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Rio de Janeiro, RJ. Brasil / Fundação Oswaldo Cruz. Terezina, PI, Brasil.Current control policies for intestinal parasitosis focuses on soil-transmitted helminths, being ineffective against Giardia intestinalis, a highly prevalent protozoon that impacts children's nutritional status in developing countries. The objective of this study was to explore spatial and molecular epidemiology of Giardia intestinalis in children of Amerindian descent in the Brazilian Amazon

A community-based, cross-sectional study to assess interactions between income, nutritional status and enteric parasitism in two Brazilian cities: are we moving positively towards 2030?

Abstract Background This study assessed the interactions between income, nutritional status and intestinal parasitism in children in Brazil. Methods A cross-sectional study (n = 421 children aged 1 to 14 years living in the states of Piauí (rural communities in the city of Teresina) and Rio de Janeiro (rural and periurban communities in the city of Cachoeiras de Macacu) was performed in order to obtain income and anthropometric data, as well as fecal samples for parasitological analyses through the Ritchie technique. Results Children infected with Ascaris lumbricoides had significantly lower means of height-for-age z scores (− 1.36 ± 0.75 vs. − 0.11 ± 1.02; p < 0.001), weight-for-age z scores (− 1.23 ± 0.74 vs. 0.09 ± 1.15; p = 0.001), and weight-for-height z scores (− 0.68 ± 0.44 vs. 0.23 ± 1.25; p = 0.006) when compared with uninfected children. Infection with hookworm was also associated with lower means of height-for-age z scores (− 1.08 ± 1.17 vs. − 0.12 ± 1.02; p = 0.015) and weight-for-age z scores (− 1.03 ± 1.13 vs. 0.08 ± 1.15; p = 0.012). Children infected with Entamoeba coli presented significantly lower means of height-for-age z scores (− 0.54 ± 1.02 vs. − 0.09 ± 1.02; p = 0.005) and weight-for-age z scores (− 0.44 ± 1.15 vs. 0.12 ± 1.15; p = 0.002). The multivariate multiple linear regression analysis showed that height-for-age z scores are independently influenced by monthly per capita family income (β = 0.145; p = 0.003), female gender (β = 0.117; p = 0.015), and infections with A. lumbricoides (β = − 0.141; p = 0.006) and Entamoeba coli (β = − 0.100; p = 0.043). Weight-for-age z scores are influenced by monthly per capita family income (β = 0.175; p < 0.001), female gender (β = 0.123; p = 0.010), and infections with A. lumbricoides (β = − 0.127; p = 0.012), and Entamoeba coli (β = − 0.101; p = 0.039). Monthly per capita family income (β = 0.102; p = 0.039) and female gender (β = 0.134; p = 0.007) positively influences mid upper arm circumpherence. Conclusions Intestinal parasitism and low family income negatively influence the physical development of children in low-income communities in different Brazilian regions

Frequency and molecular characterisation of Entamoeba histolytica, Entamoeba dispar, Entamoeba moshkovskii, and Entamoeba hartmanni in the context of water scarcity in northeastern Brazil

This study aimed to estimate the frequency, associated factors, and molecular characterisation of Entamoeba histolytica, Entamoeba dispar, Entamoeba moshkovskii, andEntamoeba hartmanni infections. We performed a survey (n = 213 subjects) to obtain parasitological, sanitation, and sociodemographic data. Faecal samples were processed through flotation and centrifugation methods.E. histolytica, E. dispar, E. moshkovskii, and E. hartmanni were identified by nested-polymerase chain reaction (PCR). The overall prevalence of infection was 22/213 (10.3%). The infection rate among subjects who drink rainwater collected from roofs in tanks was higher than the rate in subjects who drink desalinated water pumped from wells; similarly, the infection rate among subjects who practice open defecation was significantly higher than that of subjects with latrines. Out of the 22 samples positive for morphologically indistinguishableEntamoeba species, the differentiation by PCR was successful for 21. The species distribution was as follows: 57.1% to E. dispar, 23.8% to E. histolytica, 14.3% toE. histolytica and E. dispar, and 4.8% E. dispar and E. hartmanni. These data suggest a high prevalence of asymptomatic infection by the group of morphologically indistinguishable Entamoeba histolytica/dispar/moshkovskiicomplex and E. hartmanni species. In this context of water scarcity, the sanitary and socioenvironmental characteristics of the region appear to favour transmission

Genetic diversity of Ascaris spp. infecting humans and pigs in distinct Brazilian regions, as revealed by mitochondrial DNA.

In this study, we assessed the genetic diversity of Ascaris lumbricoides / Ascaris suum circulating in humans and pigs, exploring potential zoonotic cycles in endemic areas in Brazil. We carried out cross-sectional surveys in four municipalities: Santa Isabel do Rio Negro (SIRN-AM) (n = 328); Nossa Senhora de Nazaré (NSN-PI) and Teresina (TER-PI) (n = 605 and n = 297, respectively); and Cachoeiras de Macacu (CAM-RJ) (n = 543). We also studied 61 fecal samples/adult worms obtained from pigs (n = 53 in NSN-PI and n = 8 in TER-PI). A ~450 bp fragment of the Ascaris cytochrome c oxidase subunit 1 (cox1) and ~400 bp of the NADH dehydrogenase subunit 1 (nad1) were amplified and sequenced. Maximum-likelihood (ML) tree and Median-joining (MJ) haplotype network analyses were performed. We also performed scanning electron micrographs of adult specimens. Positivity rates were 93/328 (28.4%) in SIRN-AM, 6/297 (2.0%) in TER-PI, 0/605 (0%) in NSN-PI, and 6/543 (1.1%) in CAM-RJ. In NSN-PI it reached 11/53 (20.7%) in pigs. The MJ network based on cox1 locus (383 bp) revealed three main clusters, one centered around haplotypes H01/H28/H32 and the other around H07/H11. The cox1 haplotypes had a heterogeneous distribution, showing no pattern by geographic region, and high haplotype diversity. The ML trees based on cox1 and nad1 loci showed a similar topology with each other, and with the haplotype networks. Three distinct clusters were observed. Sequences of cox1 and nad1 from humans and animals were distributed throughout the tree and it was not possible to differentiate specimens of human and swine origin. Ascaris populations obtained from humans and swine in different Brazilian regions are not discriminable through the genetic markers used, which indicates the potential for zoonotic transmission and the need for better control of these infections in swine herds, mainly when created in a peridomestic environment

Giardia intestinalis infection associated with malnutrition in children living in northeastern Brazil

Submitted by Sandra Infurna ([email protected]) on 2017-11-14T16:55:10Z No. of bitstreams: 1 beatriz_nunes_etal_IOC_2017.pdf: 1288946 bytes, checksum: 3feb9602f461a112f57676a2f0f90632 (MD5)Approved for entry into archive by Sandra Infurna ([email protected]) on 2017-11-16T09:48:35Z (GMT) No. of bitstreams: 1 beatriz_nunes_etal_IOC_2017.pdf: 1288946 bytes, checksum: 3feb9602f461a112f57676a2f0f90632 (MD5)Made available in DSpace on 2017-11-16T09:48:35Z (GMT). No. of bitstreams: 1 beatriz_nunes_etal_IOC_2017.pdf: 1288946 bytes, checksum: 3feb9602f461a112f57676a2f0f90632 (MD5) Previous issue date: 2017Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Laboratório de Epidemiologia e Sistemática Molecular. Rio de Janeiro, RJ. Brasil.Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Laboratório de Epidemiologia e Sistemática Molecular. Rio de Janeiro, RJ. Brasil.Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Laboratório de Epidemiologia e Sistemática Molecular. Rio de Janeiro, RJ. Brasil.Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Laboratório de Epidemiologia e Sistemática Molecular. Rio de Janeiro, RJ. Brasil.Escritório Municipal de Saúde Nossa Senhora de Nazaré. Coordenação de Cuidados de Saúde Primária. Nossa Senhora de Nazaré, Brasil.Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Laboratório de Biologia dos Tripanossomatídeos. Rio de Janeiro, RJ. Brasil.Fred Hutchinson Cancer Research Center. Seattle, WA, USA.Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Laboratório de Eco-Epidemiologia da Doença de Chagas. Rio de Janeiro, RJ. Brasil.Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Laboratório de Biologia e Parasitologia de Mamíferos Silvestres Reservatórios. Rio de Janeiro, RJ. Brasil.Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Laboratório de Epidemiologia e Sistemática Molecular. Rio de Janeiro, RJ. Brasil / Fundação Oswaldo Cruz. Escritório Regional no Piauí. Teresina, PI, Brasil.Introduction: The present study aimed to determine the prevalence and factors associated with Giardia intestinalisinfection, verifying its impact on the nutritional status of children in northeastern Brazil. Methodology:A cross-sectional study was conducted to obtain parasitological, sociodemographic, and anthropometric data in two municipalities in the states of Piauí and Ceará, northeastern Brazil. Results: Prevalence of giardiasis was 55/511 (10.8%). G. intestinaliswas more frequent in people living in poverty (30/209 [14.4%], p = 0.041), performing open evacuation (26/173 [15%], p = 0.034), and drinking rainwater stored in cisterns (9/56 [16.1%], p = 0.005). The proportion of stunting and being underweight in children infected with G. intestinaliswas significantly higher than that in uninfected children (5/23 [21.7%] vs. 10/179 [5.6%], p = 0.017, OR = 4.69, 95% confidence interval [CI] = 1.44–15.25 and 5/23 [21.7%] vs. 13/179 [7.3%], p = 0.038, OR = 3.54, 95% CI = 1.13–11.09, respectively). Infection with G. intestinalisremained significantly associated with stunting and being underweight after adjustment for poverty, municipality, sex, and age in a logistic regression multivariate model. Conclusions: In rural areas in northeastern Brazil, giardiasis has acquired great public health importance in the soil-transmitted helminths control era, impacting the nutritional status of children and requiring new approaches to diagnosis and treatment and translational research that could generate applicable solutions at the community level