Fatores associados à infecção por Toxoplasma gondii em gestantes atendidas nas Unidades Básicas de Saúde do município de Rolândia, Paraná, Brasil

The aim of the present work was to determine the prevalence of IgG and IgM anti-Toxoplasma gondii antibodies and the factors associated to the infection in pregnant women attended in Basic Health Units in Rolândia, Paraná, Brazil. The sample was divided in two groups: group I (320 pregnant women who were analyzed from July 2007 to February 2008) and group II (287 pregnant women who were analyzed from March to October 2008). In group I, it was found 53.1% of pregnant women with IgG reactive and IgM non-reactive, 1.9% with IgG and IgM reactive, 0.3% with IgG non-reactive and IgM reactive and 44.7% with IgG and IgM non-reactive. In group II, it was found 55.1% with IgG reactive and IgM non-reactive and 44.9% with IgG and IgM non-reactive. The variables associated to the presence of IgG antibodies were: residence in rural areas, pregnant women between 35-40 years old, low educational level, low family income, more than one pregnancy, drinking water which does not originate from the public water supply system and the habit of handling soil or sand. Guidance on primary prevention measures and the quarterly serological monitoring of the pregnant women in the risk group are important measures to prevent congenital toxoplasmosis.O objetivo deste trabalho foi determinar a prevalência de anticorpos IgG e IgM anti-Toxoplasma gondii e os fatores associados à infecção em gestantes atendidas nas Unidades Básicas de Saúde de Rolândia, Paraná, Brasil. A amostra foi dividida em dois grupos: grupo I (320 gestantes, analisadas entre julho de 2007 e fevereiro de 2008) e grupo II (287 gestantes, analisadas de março a outubro de 2008). No grupo I, foram encontrados 53,1% de gestantes IgG reagente e IgM não reagente, 1,9% de IgG e IgM reagentes, 0,3% de IgG não reagente e IgM reagente e 44,7% de IgG e IgM não reagentes. No grupo II foram 55,1% de IgG reagente e IgM não reagente e 44,9% de IgG e IgM não reagentes. As variáveis associadas à infecção foram: residência em área rural, gestantes entre 35-40 anos de idade, baixa escolaridade, baixa renda familiar, mais de uma gravidez, consumo de água não proveniente do sistema de abastecimento público de água e hábito de manipular terra ou areia. As orientações sobre medidas de prevenção primária e o acompanhamento sorológico trimestral das gestantes no grupo de risco são medidas importantes para prevenir a toxoplasmose congênita

Descriptive molecular epidemiology study of Giardia duodenalis in children of Parana State, Brazil

Background and aims: We investigated the children of Parana State, Brazil the prevalence of intestinal parasitosis and the associated factors involved in the transmission of intestinal parasites, and we genotyped the Giardia duodenalis isolates obtained. Methods: Fecal samples were analyzed by established microscopic methods. G. duodenalis positive samples were subjected to genotypic characterization by PCR amplification of sequences of the glutamate dehydrogenase gene (gdh) and by enzymatic digestion with the restriction enzyme NlaIV for classification of genotypes. Results: Of the 877 samples tested, 41% were positive for some intestinal parasitosis, the most common being the presence of protozoa (87.8%). Lack of basic sanitation and poor health education were associated for the intestinal parasite cases found, and the only associated factor for giardiasis was low family income. The G. duodenalis assemblages of gdh amplified samples were 68.6% B and 31.4% AII. Conclusion: These data demonstrate the importance of epidemiological studies for the development of effective strategies with the aim of decreasing the incidence of intestinal parasites in children. Moreover, these results contribute to our knowledge of G. duodenalis assemblages circulating in the world and also offer support for future work on the molecular and clinical aspects of giardiasis

Toxoplasmose adquirida na gestação e congênita: vigilância em saúde, diagnóstico, tratamento e condutas

Este manual foi concebido com o objetivo de introduzir alguns conceitos, sistematizar os conhecimentos existentes e nortear o Programa de Vigilância em Saúde da Toxoplasmose Congênita no município de Londrina. [...] [trecho retirado da Apresentação do livro

Factors associated with intestinal parasites in schoolchildren of municipal schools in Cambé

Abstract: The aim of this work was to determine factors associated with the prevalence of intestinal parasites in schoolchildren in the municipality of Cambé, Paraná. A total of 1996 stool samples were collected between 2006 and 2009, using the methods of Hoffman, Pons and Janer, Faust and collaborators and the Kato-Katz. The prevalence was 23.2%. The parasites found were Entamoeba coli (10.4%); Endolimax nana (9.6%), Giardia lamblia (6.4%), Enterobius vermicularis (1.5%), Entamoeba histolytica/dispar (0.3%), Trichuris trichiura (0.4%), Iodamoeba butschlii, Hymenolepis nana and hookworm infection (0.2%) and Ascaris lumbricoides and Schistosoma mansoni (0.1%). We found no statistically significant gender differences. The age, family income, mother's education level, consumption of untreated water, absence of sewage collection and contact with freshwater streams were associated with the presence of intestinal parasites. Although the highest prevalence of protozoa is commensal this is worrying as it indicates that the fecal-oral transmission is present in this population and may increase the transmission of pathogenic forms, since they share the same transmission routes. The identified cases of schistosomiasis were not autochthonous, but early diagnosis of this infection was important to avoid contamination of the environment

Congenital toxoplasmosis in a reference center of Paraná, Southern Brazil

This study describes the characteristics of 31 children with congenital toxoplasmosis children admitted to the University Hospital of Londrina, Southern Brazil, from 2000 to 2010. In total, 23 (85.2%) of the mothers received prenatal care but only four (13.0%) were treated for toxoplasmosis. Birth weight was <2500 g in 37.9% of the infants. During the first month of life, physical examination was normal in 34.5%, and for those with clinical signs and symptoms, the main manifestations were hepatomegaly and/or splenomegaly (62.1%), jaundice (13.8%), and microcephaly (6.9%). During ophthalmic examination, 74.2% of the children exhibited injuries, 58.1% chorioretinitis, 32.3% strabismus, 19.4% microphthalmia, and 16.2% vitreitis. Anti-Toxoplasma gondii IgM antibodies were detected in 48.3% of the children. Imaging brain evaluation was normal in 44.8%; brain calcifications, hydrocephaly, or both conditions were observed in 27.6%, 10.3%, and 17.2%, respectively, of the patients. Patients with cerebrospinal fluid protein > 200 mg/dL presented more brain calcifications (p = 0.0325). Other sequelae were visual impairment (55.2% of the cases), developmental delay (31.0%), motor deficit (13.8%), convulsion (27.5%), and attention deficit (10.3%). All patients were treated with sulfadiazine, pyrimethamine, and folinic acid, and 55.2% of them exhibited adverse effects. The results demonstrate the significance of the early diagnosis and treatment of toxoplasmosis during pregnancy to reduce congenital toxoplasmosis and its consequences

Zoonoses in humans from small rural properties in Jataizinho, Parana, Brazil

The aim of this study was to conduct a serological survey for Lyme diseases, brucellosis, leptospirosis and toxoplasmosis and identify the risk variables related to these zoonoses in humans living in the rural area of Jataizinho, state of Parana, Brazil. A total of 63 rural properties were surveyed. Additionally, 207 serum samples collected from these rural area inhabitants were tested for indirect immunofluorescence (IFI) and western blots (WB) were performed to detect Borrelia burgdorferi (sensu lato); a tamponated acidified antigen test (AAT) and 2-mercaptoethanol (2-ME) were used to detect antibodies of Brucella abortus; the microscopic agglutination test (MAT) was carried out to detect antibodies anti-Leptospira spp. and IFI was used to find antibodies of Toxoplasma gondii. Two of the samples (0.96%) were reactive for Lyme borreliosis, three (1.4%) for brucellosis, 25 (12.1%) for leptospirosis and 143 (69.1%) for toxoplasmosis. Although the town of Jataizinho has a human development index (IDH) that was considered to be average (0.733) in the state of Parana, the low social, economic and cultural conditions of the population from small rural properties have resulted in lack of basic information on animal health and direct or indirect contact with the various species of domestic animals, wildlife and ticks have probably contributed to the prevalence levels found. These results show the need for additional regional studies in order to determine the epidemiological characteristics of these diseases as well as their respective vectors and reservoirs so that effective prophylaxis can be administered in the human population