High prevalence of blastocystis Spp. infection in children and staff members attending public urban schools in São Paulo stare, Brazil

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)After a gastroenteritis outbreak of unknown etiology in the municipality of Sebastiao da Grama, Sao Paulo, Brazil, we conducted a parasitological survey to establish the epidemiological profile of enteroparasitosis in children and staff members attending the public urban schools in operation in town. The cross-sectional study evaluated 172 children aged 11 months to 6 years old and 33 staff members aged 19 to 58 years old. Overall, 96 (55.81%) children and 20 (60.61%) staff members were mono-parasitized, while 58 (33.72%) children and 4 (12.12%) workers were poly-parasitized. Protozoa (88.37%; 72.73%) was more prevalent than helminthes (3.48%; 0%) in children and staff members respectively. Blastocystis spp. was the most prevalent parasite in children (86.63%) and staff members (66.67%). The age of 1 year old or less was found to be associated with increased prevalence of giardiasis [OR = 13.04; 95% CI 2.89-58.91; p = 0.00] and public garbage collection was identified as a protective factor against intestinal helminth infections [OR = 0.06; 95% CI 0.00-0.79; p = 0.03]. Although most of the children tested positive for Blastocystis spp. and also presented clinical signs/symptoms (62.2%), this association was not statistically significant [OR = 1.35; 95% CI 0.53-3.44; p = 0.51]. Intestinal parasites still represent a public health concern and this study underscores the importance of further investigations to better understand the pathogenic role of Blastocystis spp.After a gastroenteritis outbreak of unknown etiology in the municipality of Sebastiao da Grama, Sao Paulo, Brazil, we conducted a parasitological survey to establish the epidemiological profile of enteroparasitosis in children and staff members attending58CNPQ - CONSELHO NACIONAL DE DESENVOLVIMENTO CIENTÍFICO E TECNOLÓGICOConselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)sem informaçã

HIGH PREVALENCE OF Blastocystis spp. INFECTION IN CHILDREN AND STAFF MEMBERS ATTENDING PUBLIC URBAN SCHOOLS IN SÃO PAULO STATE, BRAZIL

After a gastroenteritis outbreak of unknown etiology in the municipality ofSebastião da Grama, SãoPaulo, Brazil, we conducted a parasitological survey to establish the epidemiological profile of enteroparasitosis in children and staff members attending the public urban schools in operation in town. The cross-sectional study evaluated 172 children aged 11 months to 6 years old and 33 staff members aged 19 to 58 years old. Overall, 96 (55.81%) children and 20 (60.61%) staff members were mono-parasitized, while 58 (33.72%) children and 4 (12.12%) workers were poly-parasitized. Protozoa (88.37%; 72.73%) was more prevalent than helminthes (3.48%; 0%) in children and staff members respectively.Blastocystis spp. was the most prevalent parasite in children (86.63%) and staff members (66.67%). The age of 1 year old or less was found to be associated with increased prevalence of giardiasis [OR = 13.04; 95%CI 2.89-58.91; p = 0.00] and public garbage collection was identified as a protective factor against intestinal helminth infections [OR = 0.06; 95%CI 0.00-0.79; p = 0.03]. Although most of the children tested positive for Blastocystis spp. and also presented clinical signs/symptoms (62.2%), this association was not statistically significant [OR = 1.35; 95%CI 0.53-3.44; p = 0.51]. Intestinal parasites still represent a public health concern and this study underscores the importance of further investigations to better understand the pathogenic role ofBlastocystis spp

Parasitological survey, comparison of fecal diagnostic techniques, control and prevention of Giardia in daycare centers and preschools, São Sebastião da Grama, São Paulo

Orientadores: Regina Maura Bueno Franco, Eliete Maria Silva, Jancarlo Ferreira GomesDissertação (mestrado) - Universidade Estadual de Campinas, Instituto de BiologiaResumo: Parasitoses intestinais são frequentes na população usuária do Sistema Único de Saúde de São Sebastião da Grama, município do interior do estado de São Paulo. Durante a ocorrência de um surto de gastroenterite em uma das creches do município, objetivou-se investigar a ocorrência de enteroparasitos nos trabalhadores e crianças das instituições municipais urbanas de educação infantil, avaliar o desempenho de técnicas diagnósticas na detecção de Giardia duodenalis em amostras fecais provenientes de creche, local de surto de gastroenterite, e implantar um programa de controle desta parasitose, o "Programa de Controle da Giardiose em Creches e Pré-escolas" (PCGCP) a fim de avaliar a adesão de gestores, trabalhadores e famílias das crianças às medidas higiênicas no ambiente escolar infantil. Para tanto se utilizou amostras fecais de 172 crianças e 33 trabalhadores, processadas pelos métodos Three Fecal Test Conventional® e Modified®, diagnosticando-se 89,53 % das crianças e 71,87 % dos trabalhadores positivos para parasitos e comensais. Blastocystis hominis foi o parasito intestinal de maior prevalência entre as crianças (86,62 %) e trabalhadores (65,62 %). Os casos de monoparasitismo foram mais frequentes que os de poliparasitismo entre as crianças e os trabalhadores estudados, bem como a prevalência de protozoários foi maior que a de helmintos. O modelo de regressão logística evidenciou associação significativa entre criança atendida na creche e a frequência de infecção por enteroparasitos (p = 0,01), por G. duodenalis (p = 0,00), por B. hominis (p = 0,02), e pelos protozoários intestinais (p = 0,01). Entre criança menor de um ano e a frequência de infecção por G. duodenalis (p = 0,00), e entre crianças cujos domicílios não possuíam coleta de lixo e a frequência de infecção por helmintos (p = 0,03). Os resultados obtidos utilizando-se os métodos de Faust et al. e ELISA foram concordantes substancialmente, contudo, a presença de resultados falsos positivos verificados no imunoensaio limitam sua aplicabilidade como teste diagnóstico em uma situação de surto. Como ferramenta de controle e prevenção da giardiose, foi implantado e avaliado o PCGCP nestes ambientes do estudo. A adesão e ativo engajamento dos gestores, trabalhadores e famílias das crianças ao PCGCP foi considerada satisfatória, e os resultados sugerem que o treinamento das práticas para se evitar a giardiose deva ser mantido de forma permanente a fim de se alcançar uma efetiva prevenção nos ambientes escolares infantisAbstract: Intestinal parasites are common in the population using the Unified Health System of São Sebastião da Grama, a municipality in the state of São Paulo. The aims of this study to investigate the occurrence of intestinal parasites in children and workers of urban municipal institutions of early childhood education, to evaluate the performance of diagnostic techniques for detection of Giardia duodenalis in stool samples from daycare centers, where outbreaks of gastroenteritis occur. To implement a program to control this parasite, the "Program of Control of Giardiasis in Day Care Centers and Preschools" (PCGCP), in order to assess the commitment of managers, workers and children?s families to hygienic measures within these school environments. For this purpose we used fecal samples from 172 children and 33 workers, processed using the Conventional and Modified Three Fecal Test® method. As a result, 89,53 % of the children and 71,87 % of workers were diagnosed positive for pathogenic parasites and commensals. Blastocystis hominis was the most prevalent intestinal parasite among children (86,62 %) and employees (65,62 %). Monoparasitism cases were more frequent than those of multiple parasitic infections among children and workers. The prevalence of protozoa was greater than that of helminths. The logistic regression model revealed a significant association between child attended in the day care center and the frequency of infection with intestinal parasites (p = 0,01), by G. duodenalis (p = 0,00), by B. hominis (p = 0,02), and the intestinal protozoa (p = 0,01). Higher indices were found among children under one year of age (frequency of infection with G. duodenalis (p = 0,00)) and among children whose homes had no waste collection (frequency of helminth infection (p = 0,03)).The results obtained using the methods of Faust et al. and ELISA were substantially consistent. However, the presence of false positive results observed in the immunoassay limits its applicability as a diagnostic test in an outbreak situation. As a tool for control and prevention of giardiasis, the program PCGCP was implemented and its adherence was evaluated in the sites investigated, places considered at the scope of this study. The commitment and active engagement of managers, workers and families with children to PCGCP was considered satisfactory, and the results suggest that training practices to avoid giardiasis should be made permanent for an effective prevention in day care centers and preschools environments to be achievedMestradoParasitologiaMestre em Parasitologi