Estudos nutricionais das populações rurais da Amazônia. I - Várzea do rio Solimões

In the absense of any previous published data on the nutritional status of people living in the rural areas of the Amaon a nutrition survey was performed on a riverside population inhabiting the fertile varzea of the River Solimões. The study area included the banks of two hundred kilometers of river between the town of Coari and the mouth of the River Purus, in the State of Amazonas, Brasil. Every one in ten houses was visited and fifty nine mothers and their one hundred and thirty nine children under six years of age were interviewed and examined. Results are presented concerning the literacy, hygienic and sanitary conditions, child mortality and morbidity, infant feeding, twenty four hour dietary history and food tabus of the mothers and clinical, anthropometric and biochemical findings in the children of the population studied. Infant mortality was 76.4 per thousand a low figure, considering the high rate of maternal illiteracy, lack of hygiene and sanitary concepts, probably related to the protective effects of breast feeding which the majority of children benefited from in the first six months of life. Whilst infant foods were introduced for the majority of children in this period, breast milk was not substituted but was supplemented or complemented and was nearly always offered on demand without any schedule. On average breast feeding lasted thirteen months. Diarrhoea was found in 27.3% of the children in their first year of life, affecting only 14% in the first semester against 50% in the second semester. In the subsequent age groups diarrhoea was found in approximally 25% of the children at the time of the examination. Wasting was most prominent in the first year of life affecting 25% in the second semester. Stunting increased gradually from 15% in the first semester until 80% in the fourth year. Clinical signs possibly associated with vitamin A deficiency were noted in 20% and riboflavin deficiency in 25% of the children. Biochemical evidence of iron deficiency anemia was found in 70% and dental caries in 47% of the children examined. The adult diet appears to be based on fish and cassava flour with little cereal, legume or vegetable consumption. Fifteen percent of the women reported having eaten game in the last twenty four hours whilst the consumption of wild fruits was a little more frequent. Food tabus were reported more commonly in lactation than pregnancy and related mostly to the avoidance of fish and preference for meat during this period.Um Inquérito nutricional foi realizado em 59 famílias da área rural ribeirinha do rio Solimões. As mães foram entrevistadas e cento e quarenta crianças de 0-5 anos dessas mães foram examinadas clinicamente e medidas quanto ao peso e estatura. As principais conclusões são de que as condições higiênico-educacionais locais são precárias. A mortalidade infantil média atinge 76,4/1000 nascidos vivos. A amamentação é prolongada, porém a suplementação alimentar é bastante precoce, com 81,3% das mães introduzindo alimentos infantis no 1.º trimestre. A introdução de alimentos adultos na dieta infantil é tardia, ocorrendo após o 1.º ano de vida. A alimentação aduita básica é a farinha de mandioca, peixe e alguma carne de caça, sendo o consumo de vegetais, legumes e frutas escasso. O estudo nutricional dessas crianças revelou que a anemia atinge 70% delas, predominando a ferropriva. Cárie dentária foi constatada em 47% das crianças. Sinais clínicos de deficiência de vitamina A e riboflavina, foram concentrados em 20% e 25% das crianças respectivamente. O estudo antropométrico revelou que a desnutrição aguda atinge 10,8% e a desnutrição crônica 59,0% das crianças. A doença diarréica predomina no quadro mórbido local, atingindo, no momento do exame, 27,3% das crianças no 1.° ano de vida. Houve correlação nas crianças da amostra entre a freqüência de antecedentes diarréicos e a desnutrição crônica (P < 0,1)

Diffusely adherent Escherichia coli strains isolated from children and adults constitute two different populations

Background: Diffusely adherent Escherichia coli (DAEC) have been considered a diarrheagenic category of E. coli for which several potential virulence factors have been described in the last few years. Despite this, epidemiological studies involving DAEC have shown inconsistent results. In this work, two different collections of DAEC possessing Afa/Dr genes, from children and adults, were studied regarding characteristics potentially associated to virulence. Results: DAEC strains were recovered in similar frequencies from diarrheic and asymptomatic children, and more frequently from adults with diarrhea (P < 0.01) than from asymptomatic adults. Association with diarrhea (P < 0.05) was found for SAT-positive strains recovered from children and for curli-positive strains recovered from adults. Mixed biofilms involving DAEC and a Citrobacter freundii strain have shown an improved ability to form biofilms in relation to the monocultures. Control strains have shown a greater diversity of Afa/Dr adhesins and higher frequencies of cellulose, TTSS, biofilm formation and induction of IL-8 secretion than strains from cases of diarrhea in children. Conclusions: DAEC strains possessing Afa/Dr genes isolated from children and adults represent two different bacterial populations. DAEC strains carrying genes associated to virulence can be found as part of the normal microbiota present in asymptomatic children

In vitro adhesion and invasion inhibition of Shigella dysenteriae, Shigella flexneri and Shigella sonnei clinical strains by human milk proteins

BACKGROUND: Shigella is the etiological agent of shigellosis, a disease responsible for more than 500,000 deaths of children per year, in developing countries. These pathogens colonize the intestinal colon, invade, spreading to the other enterocytes. Breastfeeding plays a very important role in protecting infants from intestinal infections. Amongst milk compounds, glycosylated proteins prevent the adhesion of many enteropathogens in vitro. The aim of this work was to determine the effect of human milk proteins on the colonization potential of Shigella dysenteriae, S. flexneri and S. sonnei. To fulfill this purpose, pooled milk samples from five donors, were fractionated by gel filtration and affinity chromatography. Using tissue culture, the milk fractions obtained were tested in Shigella adhesion and invasion assays. RESULTS: Our revealed showed that both adhesion and invasion of Shigella species were inhibited by low concentration of secretory immunoglobulin A, lactoferrin and free secretory component. This work also showed that, these proteins bind to superficial and whole-cell Shigella proteins. CONCLUSIONS: Our findings suggest that human milk may act inhibiting adhesion and, consequently, invasion of Shigella, thereafter preventing shigellosis in infants

Levantamento da freqüência de baixo peso de nascimento em Manaus, 1976

The Amazon Basin has bean called a zone of endemic hunger, however few representative scientific studies of human nutritional status have been carried out. Birth weight is influenced amongts other things by nutritional status. As data on the frequency of low birth weights in the Amazon was not available, 4168 birth records for the year 1976 were studied in two maternity clinics of Manaus. One clinic with 2552 births, attended principally the poor of the city, whilst the second attended 1614 births of a higher socio-economic level. The study represent some 25% of the estimated total number of births in the city for 1976. The frequency of low birth weight in the poor maternity clinic (11.7%) was higher than in the richer one (8.1%) (P<0,001). Attention is brought to the fact that most probably half of the poorest people in the city had their children at home. In comparison with other parts of the world these frequencies are intermediate between the north east of Brazil and developed countries, being only half of the frequencies found in Asia. The possible local factors responsible for these results are discussend and recommendations made that could improve the situation.Foi levantado o peso de nascimento de 4.166 crianças nascidas em Manaus, no ano de 1976, em 2 maternidades que atendem a populações de níveis socioeconômicos diferentes. Na maternidade I (classe pobre), foram levantados 2.552 nascimentos e encontrou-se uma freqüência de baixo peso de nascimento (<2,500g) de 11,7% enquanto que, na maternidade II (classe média/alta) apurou-se 1.614 nascimentos, com uma freqüência de baixo peso de 8,1%. A diferença foi significativa (p<0,001). Quando analisada a freqüência de peso abaixo de 2.000g. nas duas maternidades, verificou-se que é 4 vezes maior na maternidade I em relação à maternidade II. São discutidas também comparações desses dados com outros disponíveis na literatura, suas implicações sobre as taxas de mortalidade infantil e o posterior desenvolvimento saudável da criança e as possíveis causas e sugestões para sua melhori

Bactérias enteropatogênicas em lactentes de um bairro de Manaus-Amazonas ()

Bacteriological studies were carried out on approximately 10% of the infants of a poor urban population in Manaus - Amazonas. One third of the infants had diarrhoea at the time of faeces collection. One strain of Shigella sonnei and five different serogroups of enteropathogenic E. coli were isolated from the faeces of the infants with diarrhoea. Three strains of Salmonella sp. and five different serogroups of pathogenic E. coli were isolated in the faeces of infants without diarrhoea. The strains of Shigella sonnei and pathogenic E. coli showed multiple resistance to antimicrobial drugs.Foram realizadas culturas de fezes de aproximadamente 10% dos lactentes de uma população urbana de Manaus-Amazonas. No momento da coleta 32,50% das crianças se encontravam com diarréia e 69,44% apresentavam história anterior da enfermidade. Das crianças diarréicas foram isolados uma cepa de Shigella sonnei e 5 diferentes sorogrupos de Escherichia coli enteropatogênica. Das crianças sem diarréia isolaram-se 3 amostras de Salmonella sp e 5 diferentes sorogrupos de E. coli enteropatogênica. As cepas de Shigella sonnei e E. coli enteropatogênicas apresentaram resistência múltipla quando submetidas ao teste de susceptibilidade à antimicrobianos

Diagnóstico da realidade alimentar e nutricional do Estado do Amazonas, 1978

An analysis of the food and nutrition situation in the state of Amazonas is made based on health statistics, types of malnutrition, dietary patterns, food consumption and production in the region. It is concluded that the sanitary situation of the population is precarious. The frequency of gastro-intestinal deseases is high, associated with pem and anemia. The diet is deficient in Vitamins A and B, principaly due to low vegetable consumption. Food production is stagnant with imports rising. These conclusions are discussed and recomendations made.O diagnóstico da situação alimentar e nutricional do Estado do Amazonas foi analisado baseado em dados do área de saúde, padrões alimentares, consumo e produção de alimentos e a ocorrência e tipos de mal nutrição. Concluiu-se que o situação sanitária no Estado é precária, com alta freqüência de doenças gastro-intestinais associadas com desnutrição proteico-calóríca e anemia, A dieta parece deficiente em vitamina A e B devido principalmente ao baixo consumo de verduras e legumes. A produção de aumentos está estagnada com aumento das importações. Essas conclusões são discutidas e recomendações são feitos

Enteroparasitoses em uma comunidade fechada. I - Estudo do solo como elo de transmissão em um orfanato de Manaus, Amazonas, Brasil

Helminths During the months of September through November a parasitological investigation was made from fecal samples of 49 children and 20 soil samples of an orphanage in Manaus, Amazonas, Brazil. The specimens were concentrated by Faust's method, and the authors prepared the following index of intestinal parasites in these individuals. These results were obtained. : Trichocephalus trlchiurus 89,0%, Ascaris lumbricoides 73,5%; Ancylostomidae 71,4%; Strongyloides stercoralis 12,2% and Enterobius vermiculares 8,2%. The highest incidence of protozoan parasites was of Entamoeba coli 38,8%, Giardia lamblia 34,7%, Iodamoeba butschlii 8,2% and Entamoeba histolytica 6,1%. 90% of the soil samples were contaminated.", 'enPor meio de métodos parasitológicos, baseados na centrífugo-flutuação em sulfato de zinco, os AA estudaram a prevalência das enteroparasitoses em 49 crianças de um orfanato da cidade de Manaus e, paralelamente, a contaminação fecal de seu solo nas principais áreas de recreação. Os resultados mostraram que 100% das crianças examinadas apresentaram uma ou mais espécies de parasitas e que 90% das amostras do solo estavam contaminadas tanto por cistos de protozoários como por ovos de helmintos parasitas

Inhibition of enterotoxigenic Escherichia Coli (ETEC) adhesion to caco-2 cells by human milk and its immunoglobulin and non-immunoglobulin fractions.

Enterotoxigenic Escherichia coli (ETEC) is the most common cause of diarrhea in children in developing countries and among travelers to ETEC endemic areas. ETEC diarrhea is caused by colonization of the small intestine mediated by colonization factor (CF) antigens, and subsequent elaboration of enterotoxins. Breast feeding has been related to protection against enteric infections. The protective effect of human milk can be ascribed to its immunoglobulin content, specially secretory immunoglobulin A (sIgA), and to nonimmunoglobulin components such as free oligosaccharides, glycoproteins and glycolipids. In this study we investigated the effect of whole human milk and its fractions immunoglobulin and non-immunoglobulin on the adherence of ETEC strains possessing different CFs to Caco-2 cells, as well as the ability of sIgA and free secretory component (fSC) to bind to bacterial superficial proteins. Pooled human milk from three donors were fractionated by gel filtration and analyzed by SDS-PAGE. Our results revealed that whole human milk and its proteins fractions, containing sIgA and fSC, inhibited adhesion ETEC strains harboring different colonization factors antigens. We also verified that sIgA and fSC, using immunoblotting and immunogold labeling assays, bound to some fimbrial proteins and other material present in bacterial surface. Our findings suggest that whole human milk and its fractions may contribute to protection against ETEC infections by blocking bacterial adhesion mediated by different colonization antigens

Binding of lactoferrin and free secretory component to enterotoxigenic Escherichia coli

The ability of two glycoproteins of human milk, lactoferrin and free secretory component, to bind to Escherichia coli colonization factors (CFAs) was investigated using immunocytochemistry assays of enriched fimbrial extracts. The results revealed that lactoferrin binds to fimbrial CFA I adhesin but not to CFA II adhesin (CS1 and CS3), while free secretory component interacts with both CFA I and CFA II adhesins. Our data indicate that lactoferrin and free secretory component, which are very abundant proteins of human milk, could play an important role against infant enteric disease by blocking bacterial adhesion

The circulation of human astrovirus genotypes in the Central West Region of Brazil

Out of 1,588 faecal samples of children taken from three locations of the Central West Region of Brazil, 57 were positive for astroviruses (HAstVs) using reverse transcription-polymerase chain reaction (RT-PCR). They were genotyped by nested RT-PCR and/or genomic sequencing. HAstV-1 (42.8%), HAstV-2 (23.2%), HAstV-3 (3.6%), HAstV-4 (14.3%) and HAstVs -5, -6, -7 and -8 (1.8% each) were detected. In Goiânia and Campo Grande, HAstV-1 was the most frequently detected genotype while in Brasília (DF) it was HAstV-2. Shifts in the circulation of astrovirus genotypes were observed in DF and Campo Grande. All samples collected by rectal swabs were viral negative. The astrovirus genotypes were detected in all age groups and there was no correlation between genotype and age group