Prevalence of intestinal parasites among inmates in Midwest Brazil

<div><p>Background</p><p>Intestinal parasitic infections constitute a public health issue in developing countries, with prevalence rates as high as 90%, a figure set to escalate as the socioeconomic status of affected populations deteriorates. Investigating the occurrence of these infections among inmates is critical, since this group is more vulnerable to the spread of a number of infectious illnesses.</p><p>Methods</p><p>This cross-sectional, analytical, quantitative study was conducted in July 2015 at prison facilities located in Midwest Brazil to estimate the prevalence of parasitic infection among inmates. For detection of parasites, 510 stool samples were examined by ether centrifugation and spontaneous sedimentation.</p><p>Results</p><p>Eight parasitic species were detected, with an overall prevalence of 20.2% (103/510). <i>Giardia lamblia</i> and <i>Entamoeba histolytica</i>/<i>dispar</i> were the most frequent pathogenic parasites. <i>Endolimax nana</i> was the predominant non-pathogenic species. Nearly half of the subjects (53/103; 51.4%) were positive for mixed infection. Logistic regression revealed that inmates held in closed conditions were more likely to contract parasitic infections than those held in a semi-open regime (OR = 1.97; 95% CI = 1.19–3.25; <i>p</i> = 0.0085). A higher prevalence of parasitic infections was observed among individuals who had received no prophylactic antiparasitic treatment in previous years (OR = 10.2; 95% CI = 5.86–17.66; <i>p</i> < 0.001). The other factors investigated had no direct association with the presence of intestinal parasites.</p><p>Conclusion</p><p>Infections caused by directly transmissible parasites were detected. Without adequate treatment and prophylactic guidance, inmates tend to remain indefinitely infected with intestinal parasites, whether while serving time in prison or after release.</p></div

Symptoms reported by inmates with positive parasitological stool tests.

<p>Mato Grosso do Sul, Midwest Brazil (<i>n</i> = 103).</p

Logistic regression analysis of structural, social, and behavioral factors associated with prevalence of intestinal parasitic infection among inmates.

<p>Mato Grosso do Sul, Midwest Brazil.</p

Cases of single- and mixed-species intestinal infection among positively diagnosed inmates, by prison facility.

<p>Mato Grosso do Sul, Midwest Brazil (<i>n</i> = 103).</p

Brazilian guidelines for the clinical management of paracoccidioidomycosis

<div><p>Abstract Paracoccidioidomycosis is a systemic fungal disease occurring in Latin America that is associated with rural environments and agricultural activities. However, the incidence and prevalence of paracoccidiodomycosis is underestimated because of the lack of compulsory notification. If paracoccidiodomycosis is not diagnosed and treated early and adequately, the endemic fungal infection could result in serious sequelae. While the Paracoccidioides brasiliensis ( P. brasiliensis ) complex has been known to be the causal agent of paracoccidiodomycosis, a new species, Paracoccidioides lutzii ( P. lutzii ), has been reported in Rondônia, where the disease has reached epidemic levels, and in the Central West and Pará. Accurate diagnoses and availability of antigens that are reactive with the patients’ sera remain significant challenges. Therefore, the present guidelines aims to update the first Brazilian consensus on paracoccidioidomycosis by providing evidence-based recommendations for bedside patient management. This consensus summarizes etiological, ecoepidemiological, molecular epidemiological, and immunopathological data, with emphasis on clinical, microbiological, and serological diagnosis and management of clinical forms and sequelae, as well as in patients with comorbidities and immunosuppression. The consensus also includes discussion of outpatient treatments, severe disease forms, disease prevalence among special populations and resource-poor settings, a brief review of prevention and control measures, current challenges and recommendations.</p></div